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        <NetCommunityBenefitExpense>19315377</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.07140</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>0</BadDebtExpenseReported>
      <BadDebtExpenseAmount>6245283</BadDebtExpenseAmount>
      <AmountAttributableTo>117114</AmountAttributableTo>
      <AmountReimbursedByMedicare>41318618</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>55876654</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-14558036</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>1</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>1</ProvisionForCharityCare>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>1 Wheeling Renal Care LLC</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>Specialty O/P facility</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.50000</OrganizationProfitOrOwnership>
        <OfficersEtcProfitOrOwnership>0.00000</OfficersEtcProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.50000</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>Wheeling Hospital Inc</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1 Medical Park</AddressLine1>
          <City>Wheeling</City>
          <State>WV</State>
          <ZIPCode>26003</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <TeachingHospital>X</TeachingHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Wheeling Hospital Inc</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <EligibilityCriteriaExplained>1</EligibilityCriteriaExplained>
        <UsesFPGFree>1</UsesFPGFree>
        <FPGFreePercent>200.000000000000</FPGFreePercent>
        <UsesFPGDiscounted>1</UsesFPGDiscounted>
        <FPGDiscountPercent>400.000000000000</FPGDiscountPercent>
        <ExplainsBasis>1</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <InsuranceStatus>X</InsuranceStatus>
        <MedicaidMedicare>X</MedicaidMedicare>
        <StateRegulation>X</StateRegulation>
        <ExplainsApplicationMethod>1</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>1</IncludesPublicityMeasures>
        <AvailableOnRequest>X</AvailableOnRequest>
        <OtherPublicity>X</OtherPublicity>
        <ActionsOnNonpayment>1</ActionsOnNonpayment>
        <PermitReportToCreditAgency>X</PermitReportToCreditAgency>
        <PermitLawsuit>X</PermitLawsuit>
        <CollectionActivities>1</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <Lawsuit>X</Lawsuit>
        <NondiscrimEmergencyCarePolicy>1</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>0</AmountsGenerallyBilled>
        <GrossCharges>0</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>2</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Continuous Care Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>PO Box 6316</AddressLine1>
            <City>Wheeling</City>
            <State>WV</State>
            <ZIPCode>26003</ZIPCode>
          </Address>
          <FacilityType>Skilled Nursing Facility</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Wheeling Renal Care LLC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>500 Medical Park Suite 100</AddressLine1>
            <City>Wheeling</City>
            <State>WV</State>
            <ZIPCode>26003</ZIPCode>
          </Address>
          <FacilityType>Specialty O/P Facility</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 6a: The hospital files a separate community benefit report with the West Virginia Healthcare Authority.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, L7 Col(f): $14,602,018 of bad debt expense was included on Form 990, Part IX, Line 25, column (A), but was subtracted for purposes of calculating the percentage in column f.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 2: Wheeling Hospital will accept applications for financial assistance and charity care from any person at any time. All hospital accounts for inpatient, outpatient, emergency room services, professional services of employed physicians and prescription drugs on an acute/emergent basis are eligible for financial assistance and charity care. Patients must submit a denial of coverage letter from Medicaid or Veteran's Outreach Center in order to be eligible for charity care. Those applicants who fail to submit a Medicaid or Veteran's Outreach Center denial, and are at or below 200% of the Federal Poverty Guidelines, will be eligible for a 65% discount based on their financial situation. Once a patient has provided sufficient documentation to prove financial status, eligibility is determined by referencing the Financial Assistance/Charity Care Matrix, which is based on the Federal Poverty Guidelines for the most current year available as issued by the Department of Health and Human Services. A patient shall be notified in writing of approval or denial of financial assistance/charity care. Those approved applicants who are at or below 200% of the Federal Poverty Guidelines and have provided the required documentation are eligible to receive Charity Care. Those approved applicants who are between 201% and 400% of the Federal Poverty Guidelines are eligible to receive a percentage discount up to 65% after complete analysis and approval of the CFO or his designee. Applicants at or below 200% of the Federal Poverty Guidelines, who fail to provide all required documentation, will be considered for financial assistance based on their financial situation.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part II: Community Building Activities is not applicable to this organization.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 4: Wheeling Hospital does not have separate audited financial statements. The bad debt reflected on the financial statements is the gross amount of the accounts deemed uncollectible. This would be for accounts that have had no payment for 60 days and have had a minimum of five statements produced. Therefore, the bad debt amounts would be after any discounts or patient payments have been applied.The ratio from Worksheet 2 of the Schedule H instructions was used. This ratio was applied to the total bad debt expense included on Form 990, Part IX, Line 25, column (A). The estimated amount of bad debt expense that could reasonably be attributable to patients who likely would qualify for financial assistance under the Hospital's Charity Care Policy was calculated by applying the percentage of charity care to gross patient revenue to the total bad debt expense at cost.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 8: The costs reflected in line 6 are the allowable costs from Worksheet D-1 of the 9/30/12 CMS cost report. None of the shortfall on line 7 is treated as community benefit. Despite the fact that the program serves all elderly and disabled beneficiaries and could represent community benefit, it is not treated as community benefit to be consistent with the presentation of the consolidated audited financial statements.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 9b: Wheeling Hospital's collection policy has been established to defray the costs of medically necessary services for those patients who meet certain guidelines and have no other medical funding sources. Inpatient, outpatient, emergency room services, professional services of employed physicians and prescription drugs on an acute/emergent basis are eligible for financial assistance/charity care. The Financial Assistance/Charity Care application must be signed by the applicant attesting to the truthfulness and accuracy of the information provided. Certain denial letters are required in order to be eligible for charity care. Eligibility is determined by referencing the Financial Assistance/Charity Care Matrix, which is based on the Federal Poverty Guidelines for the most current year available. Those approved applicants who are at or below 200% of the Federal Poverty Guidelines and have provided the required documentation are eligible to receive charity care, and those who are from 201% to 400% of those limits are eligible for discounts.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Wheeling Hospital, Inc.</Identifier>
        <Explanation>Part V, Section B, Line 13g: In addition to providing the full FAP upon request, a summary is posted in the hospital facility's emergency rooms and waiting rooms.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Wheeling Hospital, Inc.</Identifier>
        <Explanation>Part V, Section B, Line 19d: The Hospital charges the same amount to all patients, irrespective of their financial status.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 2: Wheeling Hospital engaged Arnett &amp; Foster to perform a formal needs assessment to assess the health care needs for the community that it serves. This assessment was completed and dated December 2012 and will be included for fiscal year ending September 30, 2013.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 3: If the patient has a scheduled procedure and has been pre-registered as self pay, they are directed to the financial counselor, where payment arrangements and discounts/charity are discussed if applicable. Self pay patients are seen by Medical Advocacy Services for Healthcare (MASH), screened for Medicare and Medicaid, and if not eligible for any programs, they supply them with the Charity Form and explain it to them. Self pay accounts over $500 are screened by the MASH service offsite for government program eligibility. Once an account drops to billing, the credit/collection staff gets that account and research for other accounts, noting insurance or charity. If nothing prior, the patient is called to discuss payment/charity as applicable.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 4: Wheeling Hospital predominantly services the Wheeling Metropolitan Statistical Area. The primary services area includes one county in the Northern Panhandle of West Virginia (Ohio County) and one county in Ohio (Belmont County), with a total population of approximately 114,000.The racial makeup of the MSA as of the 2011 census was 93.3% white, 3.8% African American, 0.8% Asian, 0.2% Native American, with the remainder from other races or a combination of two or more races. The median household income for 2011 was approximately $41,000, while the median household income for the United States was approximately $52,762. The below poverty level percentage for 2011 was approximately 15.4%, while the below poverty level percentage was approximately 14.3% for the United States.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 5: A majority of the hospital's board members are residents of the primary service area and are neither employees nor contractors of the hospital.In addition, the hospital extends medical staff privileges to any qualified physician in the community.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 6: Wheeling Hospital, Inc. (the "Hospital") was created by an Act of the Virginia Assembly in 1850. Currently, the Hospital operates and exists under the laws of West Virginia as a not-for-profit corporation. Under its corporate charter, the Hospital is operated, supervised, and controlled by the Roman Catholic Church of the United States of America through the Diocese of Wheeling/Charleston. The Hospital consists of the Wheeling Hospital Division, a full-service regional teaching hospital offering a wide range of medical and surgical services on an inpatient and outpatient basis, and the Bishop Joseph H. Hodges Continuous Care Center (CCC) Division, housing a 120-bed skilled and intermediate care center. The Hospital also operates a group of primary care and multispecialty physicians practicing at the Hospital (the "Physician Practice Division") as a department of the Hospital.The Hospital is also the sole member of Belmont Community Hospital, Inc., ("Belmont Hospital") located in Bellaire, Ohio.In addition, in October 2006, the Hospital and various West Virginia physicians formed a captive insurance company called Mountaineer Freedom Risk Retention Group Inc. ("MFRRG"). The Hospital is a 97% owner in this entity while the Physicians have a 3% noncontrolling interest. The terms of the by-laws provide that distributions, whether on a regular basis or upon dissolution, will be allocated based on the capital contributions the respective owners have made to MFRRG.The Medical Park Foundation (the "Foundation") raises contributions solely for the use of the Hospital controlled entities. The purpose of the Foundation is to cultivate philanthropic support for patient-care services, improve hospital facilities, support the uncompensated care program, and support community outreach programs. The Hospital is the sole member of the Foundation.In August 2010, Wheeling Hospital formed two holding companies, WH Holdings I, LLC and WH Holdings II, Inc. WH Holdings I, LLC is a taxable limited liability company, while WH Holdings II, Inc. is a non-profit corporation. These companies may be used for any future endeavors that might be undertaken by the Hospital separate from the United States Department of Housing and Urban Development (HUD) - insured mortgage. Capitalization for these holding companies will be derived, as necessary, from assets excluded from the HUD-insurance mortgage. At September 30, 2012, WH Holdings II, Inc. had both assets and activity related to the purchase of the Mt. DeChantal property. At September 30, 2012, there were neither assets nor activity for WH Holdings I, LLC.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Reports Filed With States</Identifier>
        <ReturnReference>Part VI, Line 7</ReturnReference>
        <Explanation>WV</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <RecordsMaintained>1</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Wheeling Jesuit University</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>216 Washington Avenue</AddressLine1>
          <City>Wheeling</City>
          <State>WV</State>
          <ZIPCode>26003</ZIPCode>
        </AddressUS>
        <EINOfRecipient>550394213</EINOfRecipient>
        <IRCSection>Section 501(c)(3)</IRCSection>
        <AmountOfCashGrant>600000</AmountOfCashGrant>
        <PurposeOfGrant>Enhancement of the Nursing Education program at Wheeling Jesuit University</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>1</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>0</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIV>
        <Identifier>Procedure for Monitoring Grants in the U.S.:</Identifier>
        <ReturnReference>Part I, Line 2:</ReturnReference>
        <Explanation>Schedule I, Part I, Line 2: As is the case with most hospitals in the United States, Wheeling Hospital struggles to maintain a steady flow of well-educated nurses from the local area to replace outgoing nurses who are retiring or relocating. To that end, senior management from Wheeling Hospital conducted several meetings with Wheeling Jesuit University administration to discuss various benchmarks and goals aimed at strengthening and adding depth to the nursing education program at Wheeling Jesuit University. In order to help foster this goal, Wheeling Hospital agreed to donate $600,000 to Wheeling Jesuit University. Specific stipulations were not made by Wheeling Hospital, however, the mutual agreement between the parties was that Wheeling Jesuit would use the funds to make improvements to their nursing education program in order to better serve Wheeling Hospital's ongoing needs for well-trained nurses. An excerpt from the Wheeling Hospital Board Minutes dated July 26, 2011 is attached as evidence that this decision brought to the Board of Directors. Wheeling Hospital administration continues to meet with Wheeling Jesuit University administration regarding various aspects of the nursing education program. Note: Although the minutes state that the funds would be disbursed over 5 quarters, in fact the initial payment was delayed for several months and the full $600,000 was paid during Wheeling Hospital's 2012 fiscal year.</Explanation>
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    </IRS990ScheduleI>
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        <NamePerson>Ronald L Violi Sch J L</NamePerson>
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        <NamePerson>Robert Coram</NamePerson>
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        <NamePerson>Susan Falbo</NamePerson>
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      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Line 1a</ReturnReference>
        <Explanation>Rent paid for Ron Violi, "Chief Executive Officer" in the amount of $11,370. Rent is paid because he lives over 60 miles from the Wheeling Hospital, Inc. Campus and his duties often require late hours. Rent also paid on behalf of Patricia Liebman in the amount of $14,135. This is for the convenience of Wheeling Hospital, Inc.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Line 5</ReturnReference>
        <Explanation>Dr. Swamy and Dr. Rahbar's incentives are based on a percentage of net revenue. Dr. Morano's incentive is based on the greater of net revenue or cash receipts.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Line 6</ReturnReference>
        <Explanation>Dr. Rahbar and Dr. Morano's incentives are based on a percentage of net income.</Explanation>
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      <Form990ScheduleJPartIII>
        <Identifier>Supplemental Information</Identifier>
        <ReturnReference>Part III</ReturnReference>
        <Explanation>Form 990, Part VII, Section A, Line 5: R &amp; V Associates, a business consulting firm, provides services to Wheeling Hospital, Inc. which include a management contract to manage the facility. Of the total amount paid to R &amp; V Associates reported on Form 990, Part VII, Section B, $1,155,000 is allocated to the agreement to provide Mr. Violi's services as "Chief Executive Officer", reported on this Form 990 in Part VII, Section A and on Schedule J, Part II. The amounts are paid to R &amp; V Associates and not to Mr. Violi. Mr. Violi is a principal and one of the managing directors of that firm.</Explanation>
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    <IRS990ScheduleL documentId="RetDoc1042800001">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Valerie Satkoske</BusinessNameLine1>
          </NameBusiness>
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        <Relationship>Daughter of "CEO"</Relationship>
        <AmountOfTransaction>99556</AmountOfTransaction>
        <DescriptionOfTransaction>Payments - Employee Compensation</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
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        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Scott Satkoske</BusinessNameLine1>
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        <Relationship>Son-in-law of "CEO"</Relationship>
        <AmountOfTransaction>136823</AmountOfTransaction>
        <DescriptionOfTransaction>Payments - Employee Compensation</DescriptionOfTransaction>
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        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>R &amp; V Associates</BusinessNameLine1>
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        <Relationship>"CEO" is principal</Relationship>
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        <DescriptionOfTransaction>Payments - R &amp; V Associates include compensation payments for "CEO" services of Ronald Violi, for other consulting services including services of Mr. Violi other than in his capacity as "CEO", and for expense reimbursements.</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
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        <Identifier>Part IV, Line 3:</Identifier>
        <ReturnReference>Explanation of Relationship/Transaction with R &amp; V Associates:</ReturnReference>
        <Explanation>R &amp; V Associates is an independent business consulting firm that provides services to Wheeling Hospital (the "Hospital"). Mr. Violi is a principal and one of the managing directors of that consulting firm. Mr. Violi receives all compensation for his services at the Hospital in the amount of $1,155,000 directly from R &amp; V Associates, and not from the Hospital. Although Mr. Violi currently serves as acting "CEO" of the Hospital, he does so through his affiliation with R &amp; V Associates and not through any direct employment relationship with the Hospital. The compensation paid to R &amp; V Associates by the Hospital is established by an independent Ad Hoc Committee of the Board of Directors of the Hospital. It is the practice of this Ad Hoc Committee to conduct its deliberations in full compliance with the established procedures under Section 4958 of the Internal Revenue Code of 1986, as amended, and with the settled purpose of establishing a rebuttable presumption of reasonableness with respect to the compensation paid to R &amp; V Associates. Additionally, the Ad Hoc Committee has sole authority over the retention and discharge of R &amp; V Associates, and Mr. Violi, as acting "CEO" has no authority over such retention or any other aspect of that engagement. The payments to R &amp; V Associates include compensation payments for Mr. Violi, expense reimbursement, and other consulting services.</Explanation>
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    <IRS990ScheduleM documentId="RetDoc1042900001">
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        <NonCashCheckbox>X</NonCashCheckbox>
        <Description>Equipment</Description>
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        <NoncashContribsRptdF990>10709</NoncashContribsRptdF990>
        <MethodOfDeterminingRevenues>Other - Donated Use</MethodOfDeterminingRevenues>
      </OtherNonCashContributionsTable>
      <OtherNonCashContributionsTable>
        <NonCashCheckbox>X</NonCashCheckbox>
        <Description>Other Equip.</Description>
        <NumberOfContributions>12</NumberOfContributions>
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        <MethodOfDeterminingRevenues>Other - Donated Use</MethodOfDeterminingRevenues>
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      <NumberOf8283Received>0</NumberOf8283Received>
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        <Identifier>Method for Determining Number of Contributors:</Identifier>
        <ReturnReference>Part I, Column (b):</ReturnReference>
        <Explanation>The numbers that appear in column b represent the number of items contributed.</Explanation>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section A, line 2</ReturnReference>
        <Explanation>The Very Reverend Kevin M. Quirk is the assistant to the Most Reverend Michael J. Bransfield, Bishop of the Diocese of Wheeling-Charleston.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section A, line 3</ReturnReference>
        <Explanation>Ronald L. Violi, "CEO" of Wheeling Hospital, Inc., is not an employee of Wheeling Hosptial, Inc. Ronald L. Violi is a 50% partner in R &amp; V Associates, a consulting firm which Wheeling Hospital, Inc. contracts with for consulting and management services.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section A, line 6</ReturnReference>
        <Explanation>Wheeling Hospital has a single member, The Most Reverend Michael J. Bransfield, Bishop of the Diocese of Wheeling-Charleston.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section A, line 7a</ReturnReference>
        <Explanation>Wheeling Hospital has a single member, The Most Reverend Michael J. Bransfield, Bishop of the Diocese of Wheeling-Charleston, who has the ability to elect members of the governing body of Wheeling Hospital.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 11</ReturnReference>
        <Explanation>Following completion of the Form 990 by the Wheeling Hospital tax preparer, the Form 990 is reviewed by internal personnel and the executive team prior to filing.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 12c</ReturnReference>
        <Explanation>All members of the board of directors and officers receive a copy of the Conflict of Interest Policy annually. Recipients are annually asked to acknowledge they have read the policy, identify any areas of conflict and return the signed disclosure form to Wheeling Hospital, Inc. Responses are reviewed and identified. Conflicts are referred to the Board of Directors for discussion and approval. Key employees and other employees are required to complete a Conflict of Interest questionnaire at hiring and when a change occurs that may be a conflict of interest.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 15</ReturnReference>
        <Explanation>Ronald L. Violi, "CEO" of Wheeling Hospital, Inc., is not an employee of Wheeling Hospital, Inc. Ronald L. Violi receives his compensation from R &amp; V Associates, which receives payments from Wheeling Hospital, Inc. for consulting and management services it provides, including for Ronald L. Violi's services as "CEO". Wheeling Hospital, Inc. has determined by means of committee review that the payments to R &amp; V Associates are reasonable and at fair market value. Therefore all compensation payments to Ronald L. Violi are reasonable. Other officers and key employees' compensation is reviewed by a Wheeling Hospital committee. The committee reviews national, regional and local compensation surveys. Additionally, years of service are also taken into account.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section C, line 19</ReturnReference>
        <Explanation>Governing documents, conflict of interest policy, and financial statements are available upon request. Wheeling Hospital, Inc. also files the financial statements with the WVHCA annually.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VII, Section B:</ReturnReference>
        <Explanation>Amounts paid to Graziano/PJ Dick represent amounts paid for services and materials. These amounts cannot be separated.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Changes in Net Assets or Fund Balances:</Identifier>
        <ReturnReference>Form 990, Part XI, line 5:</ReturnReference>
        <Explanation>Net unrealized gains on investments: 8,201,206. Grant Activity 66,158. Contributed Capital -256,992. Transfers 2,535. Total to Form 990, Part XI, Line 5: 8,012,907.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part XII, Line 3a</ReturnReference>
        <Explanation>Wheeling Hospital, Inc. entered into a HUD/FHA Section 242 mortgage insurance arrangement and was required by this arrangement to undergo an A-133 audit.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
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        </NameOfDisregardedEntity>
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          <AddressLine1>222 N 5th St</AddressLine1>
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          <BusinessNameLine1>Belmont Community Hospital Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>H</TransactionType>
        <AmountInvolved>119057</AmountInvolved>
        <MethodOfAmtDetermination>Actual amount paid</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Belmont Community Hospital Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>A</TransactionType>
        <AmountInvolved>31502</AmountInvolved>
        <MethodOfAmtDetermination>Actual amount paid</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Belmont Community Hospital Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>J</TransactionType>
        <AmountInvolved>58603</AmountInvolved>
        <MethodOfAmtDetermination>Actual amount paid</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Mountaineer Freedom Risk Retention Group Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>B</TransactionType>
        <AmountInvolved>256992</AmountInvolved>
        <MethodOfAmtDetermination>Actual amount paid</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Mountaineer Freedom Risk Retention Group Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>6193192</AmountInvolved>
        <MethodOfAmtDetermination>Actual amount paid</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>