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        <DescriptionOfServices>PHYSICIAN SERVICES</DescriptionOfServices>
        <Compensation>1465878</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>ACADEMY FOR ADOLESCENT HEALTH</NamePerson>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>410 NORTH MAIN STREET</AddressLine1>
            <City>WASHINGTON</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>OUTREACH SERVICES</DescriptionOfServices>
        <Compensation>687255</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>ITXM CLINICAL SERVICES</NamePerson>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>PO BOX 3455</AddressLine1>
            <City>PITTSBURGH</City>
            <State>PA</State>
            <ZIPCode>15230</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>BLOOD PROCESSING</DescriptionOfServices>
        <Compensation>639136</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>FRESENIUS MANAGEMENT SERVICES</NamePerson>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>16343 COLLECTION CENTER DRIVE</AddressLine1>
            <City>CHICAGO</City>
            <State>IL</State>
            <ZIPCode>60693</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>HEMODIALYSIS</DescriptionOfServices>
        <Compensation>519105</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NamePerson>WASHINGTON CRITICAL CARE</NamePerson>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>997 N MAIN STREET</AddressLine1>
            <City>WASHINGTON</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>PHYSICIAN SERVICES</DescriptionOfServices>
        <Compensation>440000</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>24</NumberOfContractorsGT100K>
      <RelatedOrganizations>2105561</RelatedOrganizations>
      <TotalContributions>2105561</TotalContributions>
      <ProgramServiceRevenue>
        <Description>HOSPITAL IP AND OP SERVICES</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>231852555</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>228645277</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>3207278</UnrelatedBusinessRevenue>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>WELLNESS CENTER</Description>
        <BusinessCode>713940</BusinessCode>
        <TotalRevenueColumn>4227068</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>4227068</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>EDUCATION / TUITION</Description>
        <BusinessCode>611600</BusinessCode>
        <TotalRevenueColumn>1186800</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>1186800</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>DRUG SALES</Description>
        <BusinessCode>446110</BusinessCode>
        <TotalRevenueColumn>1827306</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>1813556</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>13750</UnrelatedBusinessRevenue>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>SERVICES TO AFFILIATES</Description>
        <BusinessCode>541900</BusinessCode>
        <TotalRevenueColumn>641362</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>641362</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalOthProgramServiceRevenue>
        <TotalRevenueColumn>599458</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>583375</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>16083</UnrelatedBusinessRevenue>
      </TotalOthProgramServiceRevenue>
      <TotalProgramServiceRevenue>240334549</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>3836733</TotalRevenueColumn>
        <ExclusionAmount>3836733</ExclusionAmount>
      </InvestmentIncome>
      <IncomeFromInvestBondProceeds>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </IncomeFromInvestBondProceeds>
      <RoyaltiesRevenue>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </RoyaltiesRevenue>
      <GrossRents>
        <Real>2709502</Real>
      </GrossRents>
      <LessRentalExpenses>
        <Real>2159978</Real>
      </LessRentalExpenses>
      <RentalIncomeOrLoss>
        <Real>549524</Real>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>549524</TotalRevenueColumn>
        <ExclusionAmount>549524</ExclusionAmount>
      </NetRentalIncomeOrLoss>
      <GrossAmountSalesAssets>
        <Other>20700</Other>
      </GrossAmountSalesAssets>
      <LessCostOthBasisSalesExpenses>
        <Other>0</Other>
      </LessCostOthBasisSalesExpenses>
      <GainOrLoss>
        <Other>20700</Other>
      </GainOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>20700</TotalRevenueColumn>
        <ExclusionAmount>20700</ExclusionAmount>
      </NetGainOrLossInvestments>
      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromGaming>
      <GrossSalesOfInventory>948008</GrossSalesOfInventory>
      <CostOfGoodsSold>936245</CostOfGoodsSold>
      <NetIncomeOrLoss>
        <TotalRevenueColumn>11763</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>11763</RelatedOrExemptFunctionIncome>
      </NetIncomeOrLoss>
      <OtherRevenueMisc>
        <Description>MANAGEMENT SERVICES</Description>
        <BusinessCode>541610</BusinessCode>
        <TotalRevenueColumn>1158750</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>1158750</UnrelatedBusinessRevenue>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>PARKING REVENUE</Description>
        <BusinessCode>812930</BusinessCode>
        <TotalRevenueColumn>904048</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>904048</RelatedOrExemptFunctionIncome>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>CAFETERIA SALES</Description>
        <BusinessCode>722210</BusinessCode>
        <TotalRevenueColumn>1036016</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>708665</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>327351</UnrelatedBusinessRevenue>
      </OtherRevenueMisc>
      <MiscellaneousRevenue>
        <TotalRevenueColumn>579834</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>522662</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>57172</UnrelatedBusinessRevenue>
      </MiscellaneousRevenue>
      <TotalOtherRevenue>3678648</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>250537478</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>239244576</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>4780384</UnrelatedBusinessRevenue>
        <ExclusionAmount>4406957</ExclusionAmount>
      </TotalRevenue>
      <GrantsToDomesticOrgs>
        <Total>0</Total>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>1521292</Total>
        <ProgramServices>1284101</ProgramServices>
        <ManagementAndGeneral>237191</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>97928767</Total>
        <ProgramServices>82660274</ProgramServices>
        <ManagementAndGeneral>15268493</ManagementAndGeneral>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>3502216</Total>
        <ProgramServices>2956171</ProgramServices>
        <ManagementAndGeneral>546045</ManagementAndGeneral>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>18294253</Total>
        <ProgramServices>15441918</ProgramServices>
        <ManagementAndGeneral>2852335</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>6741107</Total>
        <ProgramServices>5690072</ProgramServices>
        <ManagementAndGeneral>1051035</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>217386</Total>
        <ProgramServices>217386</ProgramServices>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>330504</Total>
        <ManagementAndGeneral>330504</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>367871</Total>
        <ManagementAndGeneral>367871</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>21185</Total>
        <ManagementAndGeneral>21185</ManagementAndGeneral>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>0</Total>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>17117238</Total>
        <ProgramServices>14448416</ProgramServices>
        <ManagementAndGeneral>2668822</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>866147</Total>
        <ProgramServices>731102</ProgramServices>
        <ManagementAndGeneral>135045</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>4258126</Total>
        <ProgramServices>3594223</ProgramServices>
        <ManagementAndGeneral>663903</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>1277358</Total>
        <ProgramServices>1078200</ProgramServices>
        <ManagementAndGeneral>199158</ManagementAndGeneral>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>3972553</Total>
        <ProgramServices>3353175</ProgramServices>
        <ManagementAndGeneral>619378</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>344864</Total>
        <ProgramServices>291095</ProgramServices>
        <ManagementAndGeneral>53769</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>0</Total>
      </ConferencesMeetings>
      <Interest>
        <Total>2180485</Total>
        <ProgramServices>2180485</ProgramServices>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>14863167</Total>
        <ProgramServices>12545787</ProgramServices>
        <ManagementAndGeneral>2317380</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>8271139</Total>
        <ProgramServices>7894404</ProgramServices>
        <ManagementAndGeneral>376735</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>MEDICAL SUPPLIES</Description>
        <Total>36520814</Total>
        <ProgramServices>36520814</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>BAD DEBT EXPENSE</Description>
        <Total>11698632</Total>
        <ProgramServices>11698632</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>MED. ASSISTANCE TAX ASSESS.</Description>
        <Total>3720000</Total>
        <ProgramServices>3720000</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>OTHER EXPENSES</Description>
        <Total>4541752</Total>
        <ProgramServices>3833628</ProgramServices>
        <ManagementAndGeneral>708124</ManagementAndGeneral>
      </OtherExpenses>
      <TotalFunctionalExpenses>
        <Total>238556856</Total>
        <ProgramServices>210139883</ProgramServices>
        <ManagementAndGeneral>28416973</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>19107950</BOY>
        <EOY>24227174</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>286337</BOY>
        <EOY>287465</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
        <BOY>31207166</BOY>
        <EOY>22758604</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>1267087</BOY>
        <EOY>1477421</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>2060766</BOY>
        <EOY>1548720</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>273194552</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>142578179</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>132336478</BOY>
        <EOY>130616373</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
        <BOY>98628879</BOY>
        <EOY>108417851</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsOtherSecurities>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </InvestmentsOtherSecurities>
      <InvestmentsProgramRelated>
        <BOY>12730632</BOY>
        <EOY>13673462</EOY>
      </InvestmentsProgramRelated>
      <IntangibleAssets>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </IntangibleAssets>
      <OtherAssetsTotal>
        <BOY>4532253</BOY>
        <EOY>1113971</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>302157548</BOY>
        <EOY>304121041</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>24245906</BOY>
        <EOY>30532233</EOY>
      </AccountsPayableAccruedExpenses>
      <GrantsPayable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </GrantsPayable>
      <DeferredRevenue>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </DeferredRevenue>
      <TaxExemptBondLiabilities>
        <BOY>96256070</BOY>
        <EOY>91876442</EOY>
      </TaxExemptBondLiabilities>
      <EscrowAccountLiability>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </EscrowAccountLiability>
      <LoansFromOfficersDirectors>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </LoansFromOfficersDirectors>
      <MortNotesPyblSecuredInvestProp>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </MortNotesPyblSecuredInvestProp>
      <UnsecuredNotesLoansPayable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </UnsecuredNotesLoansPayable>
      <OtherLiabilities>
        <BOY>44690078</BOY>
        <EOY>78817310</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>165192054</BOY>
        <EOY>201225985</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>125721046</BOY>
        <EOY>91669542</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>1899128</BOY>
        <EOY>1753338</EOY>
      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
        <BOY>9345320</BOY>
        <EOY>9472176</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>136965494</BOY>
        <EOY>102895056</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>302157548</BOY>
        <EOY>304121041</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>11980622</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>-46051060</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>21185</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>21185</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>false</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>Description of Lobbying Activities</Identifier>
        <ReturnReference>Schedule C, Part II-B, Line 1i</ReturnReference>
        <Explanation>Lobbying costs reported in Part II-B Line I consist of the portion of membership dues attributable to lobbying activities. The Hospital does not directly lobby or participate in political activities.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <CurrentYearMinus3Years />
      <Land>
        <OtherCostOrOtherBasis>7850809</OtherCostOrOtherBasis>
        <BookValue>7850809</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>150035210</OtherCostOrOtherBasis>
        <Depreciation>68046890</Depreciation>
        <BookValue>81988320</BookValue>
      </Buildings>
      <LeaseholdImprovements />
      <Equipment>
        <OtherCostOrOtherBasis>115199564</OtherCostOrOtherBasis>
        <Depreciation>74531289</Depreciation>
        <BookValue>40668275</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>108969</OtherCostOrOtherBasis>
        <BookValue>108969</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>130616373</TotalOfBookValueLandBuildings>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>ACCRUED PENSION COSTS</Description>
        <Amount>52143616</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO THIRD PARTY PAYORS</Description>
        <Amount>14662936</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>BOND SWAP LIABILITY</Description>
        <Amount>7698319</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>POST-RETIREMENT BENEFIT OBLIG.</Description>
        <Amount>2486511</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>SOFTWARE LICENSE OBLIGATION</Description>
        <Amount>75928</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>LEASE PAYABLE</Description>
        <Amount>1750000</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>78817310</TotalOfAmounts>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent400>X</Pcent400>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>false</AnnualCommunityBenefitReport>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>821666</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>821666</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00360</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>26576247</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>17797356</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>8778891</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03870</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>27397913</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>17797356</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>9600557</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.04230</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>3120990</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>707477</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2413513</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01060</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>15932986</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>9914444</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>6018542</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02650</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>67071606</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>59728801</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>7342805</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03240</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>86125582</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>70350722</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>15774860</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.06950</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>113523495</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>88148078</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>25375417</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.11180</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <CommunitySupport>
        <TotalCommunityBuildingExpense>156874</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>156874</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00070</PercentOfTotalExpense>
      </CommunitySupport>
      <WorkforceDevelopment>
        <TotalCommunityBuildingExpense>406558</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>406558</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00180</PercentOfTotalExpense>
      </WorkforceDevelopment>
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        <TotalCommunityBuildingExpense>563432</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>563432</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00250</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>false</BadDebtExpenseReported>
      <BadDebtExpenseAmount>6290771</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>33838268</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>37753130</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-3914862</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>WPHO</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>Local Healthcare Network</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.50000</OrganizationProfitOrOwnership>
        <OfficersEtcProfitOrOwnership>0.00790</OfficersEtcProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.49210</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>TRI-STATE SURGERY</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>Surgery Center</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.50000</OrganizationProfitOrOwnership>
        <OfficersEtcProfitOrOwnership>0.04740</OfficersEtcProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.45260</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>THE WASHINGTON HOSPITAL</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>155 WILSON AVENUE</AddressLine1>
          <City>WASHINGTON</City>
          <State>PA</State>
          <ZIPCode>15301</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <TeachingHospital>X</TeachingHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>THE WASHINGTON HOSPITAL</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>400.</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <InsuranceStatus>X</InsuranceStatus>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>15</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Tri-State Surgery Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>95 Leonard Avenue</AddressLine1>
            <City>Washington</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </Address>
          <FacilityType>Surgery Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Washington Hospital Family Medicine Ctr</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>95 Leonard Avenue</AddressLine1>
            <City>Washington</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </Address>
          <FacilityType>Family Medicine</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Washington Hospital Family Medicine Ctr</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>67 East Pike Street</AddressLine1>
            <City>Canonsburg</City>
            <State>PA</State>
            <ZIPCode>15317</ZIPCode>
          </Address>
          <FacilityType>Family Medicine</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Washington Hospital Family Medicine Ctr</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3415 Millers Run Road</AddressLine1>
            <City>Cecil</City>
            <State>PA</State>
            <ZIPCode>15321</ZIPCode>
          </Address>
          <FacilityType>Family Medicine</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Children's Therapy Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1000 Waterdam Plaza Drive</AddressLine1>
            <City>McMurray</City>
            <State>PA</State>
            <ZIPCode>15317</ZIPCode>
          </Address>
          <FacilityType>Children's Therapy</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Children's Therapy Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>289 North Avenue</AddressLine1>
            <City>Washington</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </Address>
          <FacilityType>Children's Therapy</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Wilfred R Cameron Wellness Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>240 Wellness Way</AddressLine1>
            <City>Washington</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </Address>
          <FacilityType>Fitness Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Wound &amp; Skin Healing Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>208 Wellness Way</AddressLine1>
            <City>Washington</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </Address>
          <FacilityType>Outpatient Office</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Diabetes Education &amp; Management Program</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>95 Leonard Avenue</AddressLine1>
            <City>Washington</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </Address>
          <FacilityType>Outpatient Office</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>TWH Lab &amp; Radiology Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1227 Smith Township State Road</AddressLine1>
            <City>Burgettstown</City>
            <State>PA</State>
            <ZIPCode>15201</ZIPCode>
          </Address>
          <FacilityType>Lab Stations &amp; Outpatient Radiology</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>TWH Lab &amp; Radiology Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>343 E Roy Furman Highway</AddressLine1>
            <City>Waynesburg</City>
            <State>PA</State>
            <ZIPCode>15370</ZIPCode>
          </Address>
          <FacilityType>Lab Stations &amp; Outpatient Radiology</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>TWH Lab &amp; Radiology Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>Neighbor Health Center 95 Leonard</AddressLine1>
            <City>Washington</City>
            <State>PA</State>
            <ZIPCode>15301</ZIPCode>
          </Address>
          <FacilityType>Lab Stations &amp; Outpatient Radiology</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>TWH Lab &amp; Radiology Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>67 East Pike Street</AddressLine1>
            <City>Canonsburg</City>
            <State>PA</State>
            <ZIPCode>15317</ZIPCode>
          </Address>
          <FacilityType>Lab Stations &amp; Outpatient Radiology</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>TWH Lab &amp; Radiology Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>CECIL OUTPATIENT CTR 3415 Millers</AddressLine1>
            <City>Cecil</City>
            <State>PA</State>
            <ZIPCode>15321</ZIPCode>
          </Address>
          <FacilityType>Lab Stations &amp; Outpatient Radiology</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>TWH Lab &amp; Radiology Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2001 Waterdam Plaza Drive</AddressLine1>
            <City>McMurray</City>
            <State>PA</State>
            <ZIPCode>15317</ZIPCode>
          </Address>
          <FacilityType>Lab Stations &amp; Outpatient Radiology</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Identifier>Part I, Line 3c</Identifier>
        <Explanation>N/A - the Hospital uses FPG to determine charity care.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I, Line 7g</Identifier>
        <Explanation>Programs reported as subsidized health services include hospital based programs whose purpose is to serve a medical need to the community, the largest being an inpatient psychiatric unit. Services provided to Medicare recipients which are not reportable on the Medicare cost report are also included in subsidized health services. There are no physician clinics reported as subsidized services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I, Line 7, Column (f)</Identifier>
        <Explanation>For purposes of calculating the percentages in line 7, column (F), Bad Debt Expense of $11,698,632 was subtracted from total expenses reported on form 990, part IX, line 25, column (A).</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I, Line 7</Identifier>
        <Explanation>The Hospital's cost-to-charge ratios were used to calculate all amounts reported on line 7.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III, Line 3</Identifier>
        <Explanation>Although we recognize the possibility that some of the bad debt costs could qualify under our charity care policy, we have no reasonable way to determine those amounts.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III, Lines 2 &amp; 4</Identifier>
        <Explanation>The Hospital follows AICPA guidance in reporting bad debt as an operating expense. Accounts are deemed to be bad debt after all reasonable collection efforts are applied. The Hospital has a generous interest-free payment plan policy and does not classify accounts on a payment plan as bad debt. Any accounts that are determined to be charity care are excluded from bad debt totals. Any discount or settlements provided to patients are also excluded from bad debt totals. The amount due from a patient is written off to bad debt once the account is deemed uncollectable. Those amounts can be a combination of gross charges (in the case of uninsured patients not seeking discounts or payment plans) and net amount due (in the case of insured patients with co-pays/deductibles/co-insurance obligations). The Hospital converts all bad debt account to gross charges and applies an overall cost-to-charge ratio to determine the cost of bad debt reported on part III, line 2. The audited financial statements of the Hospital discloses/describes bad debt as follows: Balance Sheet: The amount of the allowance for doubtful accounts is clearly disclosed with patient accounts receivable for all years presented. Statement of Operations: Bad debt is clearly reported as a separate operating expense for all years presented. Footnotes: The "Net Revenue from Patient Services &amp; Accounts Receivable" footnote states "Revenues from patient services are recognized in the period in which the services are provided. Management performs an evaluation of the collectability of revenues from patients based upon an assessment of historical and expected net collections and records an allowance for bad debts based on probability of collection."</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III, Line 8</Identifier>
        <Explanation>The Hospital's service area has a very high elderly population. Medicare makes up 62% of the inpatient patient care days and 37% of the outpatient services provided by the hospital. As the largest hospital in the county, we provide a wide array of services to our community. Our elderly population does not have to travel to the nearest large city hospital to seek care for most services. Medicare patients generally have multiple health conditions that can easily complicate the care provided to them. The current inpatient payment system provides payment for the health condition that precipitated an admission to the hospital - it does not necessarily take into account all of the other underlying illnesses that must be treated or attended to during a patient's stay. As such, tremendous resources can be used to treat a Medicare patient with multiple illnesses yet the hospital may only be paid for resources associated with the admitting illness. The hospital strives to provide all needed care to our patients without consideration of payment shortfalls. As such, we feel strongly that the Medicare shortfalls incurred by the hospital are a community benefit.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III, Line 9b</Identifier>
        <Explanation>The Hospital has a written bad debt policy by which it follows for all patients. If a patient is determined to qualify for charity care or financial assistance, the account is excluded from the normal collection process. Those accounts are handled under the separate charity care policy. If an account is set up on a payment plan, only the current monthly payment amount is pursued under the collection policy. Part V, Line 19d The maximum amount that can be charged to a financial assistance policy (FAP) eligible patient is 40% of the gross charge. This is a 60% discount from the gross charge and the intent is for the amount charged to approximate the net collection for all payers.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI, Line 2 - Needs Assessment</Identifier>
        <Explanation>The primary method that the Hospital uses to assess the health care needs of the communities it serves is through assessing the total number of physicians providing medical services to the areas served. The qualitative standard does not factor the economic or financial benefits to the hospital of any recruitment of physicians in addressing the continuum of need. The assessment focuses on community need as a determining factor in assessing the appropriateness of physician recruitment initiatives. The approach to evaluating physician need is based on the following factors: *Defining the demographic profile and payor mix of the Hospital's service area. *Researching unique service area factors that might influence the demand for healthcare services within the area. *Identifying the total number of physicians by specialty in the defined service area. *Developing a profile of the current medical staff. *Utilizing six established physician needs assessment models to identify potential physician surpluses or deficits in each medical specialty. *Examining results of the medical staff survey and physician focus interviews to determine the perceived recruitment needs of the Hospital's existing staff physicians and to identify medical community concerns. *Conduct a community survey to integrate perceived community shortages into recommendations. *Evaluating results of the above efforts in the context of our medical staffing and consulting experience. Other ways to assess the communities' health needs includes conducting various health screenings, seminars and education sessions held for the general public.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI, Line 3 - Patient Education of Eligibility for Assistance</Identifier>
        <Explanation>The Hospital attempts to inform all uninsured patients of available programs to assist them in obtaining health care services. Inpatient: Any patient admitted to the hospital without insurance is provided assistance in applying for the state medical assistance program. A hospital representative will explain the state programs to the patient and assist in the preparation of the application and gathering of information, if applicable. If the patient does not qualify for assistance, the representative informs him/her of the hospital's charity care program. Outpatient: Certain outpatient areas (emergency room, registration) have signs that let patients know the hospital has a charity care program. Some areas also have medical assistance applications on hand to give to patients. Consistent with the hospital mission, all patients requiring immediate care are treated without regard to their ability to pay. All Patients: The hospital does not have an up front financial counseling program, nor do we ask for payment prior to providing non-elective services. Once a patient receives a bill, a phone number is provided for them to call and discuss any payment issues. If the patient does not call or make payment, a hospital representative will call him/her to determine if they are eligible for any programs or insurances or to make payment arrangements that can help the patient. At any point in the conversation, if the patient says he/she cannot afford the bill, the patient is offered a charity care application. Once the charity care application is complete, if the patient does not qualify but continues to express concerns about being able to pay his/her bill, the account is reviewed for the possibility of a discount or an affordable payment plan. The hospital strives to accommodate every patient's financial situation if possible. The hospital's charity care program provides for free or discounted care based on federal poverty guidelines (FPG). Depending on income level, individuals without insurance can qualify for discounts ranging between 60-100%. Individuals with insurance can qualify for discounts ranging between 10-100%. All bills are sent out with gross charges whether it is billed to an insurance company or a self-pay individual. Patients who qualify will have their charge discounted based on our charity care policy. Bills for patients without insurance coverage are routinely discounted 30% - 50%.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI, Line 4 - Community Information</Identifier>
        <Explanation>The Washington Hospital (TWH) is a 260 bed acute care general hospital located in Washington, Pennsylvania. Founded in 1897, the hospital serves the surrounding communities with a total patient draw of over 320,000 residents living in 63 zip codes. The service area extends to the western and southern borders of Pennsylvania. There are three other general acute care hospitals that serve portions of TWH's geographic area, however, TWH is the largest hospital providing the broadest range of services to the community. TWH is the only hospital that offers obstetrical, cardiothoracic, electrophysiology, interventional cardiac procedures, acute rehabilitation, diabetes management, wound care and children's therapy services to the service area. The geographic area of service is quite large and has a substantial rural component. At least three areas within TWH's service area are designated as medically underserved and/or areas with a health care professional shortage. Approximately 16% of the patients served are medical assistance and another 3% are uninsured. To further support the large geographic area, TWH provides space for a medical helicopter to be stationed full time in the service area. Household income/economic factors can have a significant impact on the general health of a service area. Lower household income may reflect lower primary care utilization and higher critical care utilization. Various studies and articles also suggest greater reliance on hospital emergency rooms for non-emergency diagnosis and treatment in low-income areas. Median household income in the Hospital's primary service area in 2007 is $47,649, which is lower than the US as a whole ($49,280). The Hospital's service area may have some household income related factors that would drive an additional need for physician services within portions of the community. Approximately 7,400 households (13%) within the primary service area earn less than $15,000 per year. A lack of available resources to the indigent may increase volumes in the emergency room, as patients lacking primary care access often seek routine care through emergency services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI, Line 5 - Promotion of Community Health</Identifier>
        <Explanation>The Washington Hospital strives to promote the community health in many areas. The Hospital has an open medical staff. All applicants who meet the requirements are granted medical staff privileges. The Hospital actively recruits physicians in areas identified as having a need in the community. The Hospital's Board of Trustees is comprised of community leaders who reside in the communities we serve and whose insight and experience is invaluable in providing direction to the Hospital in promoting the community health. The Hospital provides many screening and educational programs in the community. The Hospital participates in regional emergency preparedness and is active in ensuring we can respond to a community emergency. The Hospital operates a Wellness Center to promote fitness and a healthy lifestyle. The Hospital funds a Teen Outreach program. This program promotes abstinence, pregnancy prevention and education to teenagers in the communities the Hospital serves.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI, Line 6 - Affiliated Health Care System</Identifier>
        <Explanation>N/A The Washington Hospital is not part of an affiliated health care system.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI, Line 7 - State Filing of Community Benefit Report</Identifier>
        <Explanation>N/A A community benefit report is not required to be filed.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
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        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>11955</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>247250</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Karen Bray</NamePerson>
        <BaseCompensationFilingOrg>158265</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>21996</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>6363</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>13084</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>199708</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Jeffrey Minteer MD</NamePerson>
        <BaseCompensationFilingOrg>302979</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>20500</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>11418</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>13492</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>348389</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Walter Slomiany MD</NamePerson>
        <BaseCompensationFilingOrg>227375</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>10400</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>8393</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>13470</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>259638</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Matthew Stantspainter MD</NamePerson>
        <BaseCompensationFilingOrg>207259</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>325</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>7327</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>13330</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>228241</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Paul Cullen MD</NamePerson>
        <BaseCompensationFilingOrg>308064</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>19787</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>11573</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>12344</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>351768</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>COLLEEN ALLISON</NamePerson>
        <BaseCompensationFilingOrg>158269</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>21996</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>6363</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>11630</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>198258</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>Schedule J, Part I, Line 1a - Tax Indemnification</Identifier>
        <Explanation>The CEO of the Hospital is provided a car. The personal use of the car is reported on his W-2. Tax indemnification for the personal use of his car is provided.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Schedule J, Part I, Line 6a - Compensation Contingent on Net Earnings</Identifier>
        <Explanation>Net operating results is a trigger for the executive incentive calculation. The incentive calculation is based on service, quality and financial indicators. The incentive paid is not a percentage of operating results.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>WASHINGTON HOSPITAL AUTHORITY 2007</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>256001043</IssuerEIN>
        <CUSIPNumber>938592HH8</CUSIPNumber>
        <DateIssued>2007-03-29</DateIssued>
        <IssuePrice>40000000</IssuePrice>
        <DescriptionOfPurpose>HOSPITAL EXPANSION AND RENOVATION</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>WASHINGTON HOSPITAL AUTHORITY 2008A</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>256001043</IssuerEIN>
        <CUSIPNumber>938592HJ4</CUSIPNumber>
        <DateIssued>2008-06-26</DateIssued>
        <IssuePrice>16800000</IssuePrice>
        <DescriptionOfPurpose>REFUND BONDS ISSUED 07/08/2004</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>855000</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>41436000</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>370220</IssuanceCostsFromProceeds>
        <CreditEnhancement>61003</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>41004777</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <YearOfSubstCompletion>2009</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <AmountRetired>900000</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>16800000</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>221939</IssuanceCostsFromProceeds>
        <CreditEnhancement>16950</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>0</CapitalExpenditures>
        <OtherSpentProceeds>16561111</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <YearOfSubstCompletion>2008</YearOfSubstCompletion>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>true</Form8038TFiled>
        <VariableRateIssue>true</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>true</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>PNC BANK</BusinessNameLine1>
        </NameOfHedgeProvider>
        <TermOfHedge>30.</TermOfHedge>
        <SuperintegratedHedge>true</SuperintegratedHedge>
        <HedgeTerminated>false</HedgeTerminated>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>true</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>true</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>PNC BANK</BusinessNameLine1>
        </NameOfHedgeProvider>
        <TermOfHedge>15.</TermOfHedge>
        <SuperintegratedHedge>true</SuperintegratedHedge>
        <HedgeTerminated>false</HedgeTerminated>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartVI>
        <Identifier>SCHEDULE K, PART II, LINE 3 - TOTAL PROCEEDS OF ISSUE</Identifier>
        <ReturnReference>0</ReturnReference>
        <Explanation>The difference between the total proceeds amount reported on Part II, Line 3 and the issue price reported on Part I, Column (e) is investment income.</Explanation>
      </Form990ScheduleKPartVI>
      <Form990ScheduleKPartVI>
        <Identifier>SCHEDULE K, PART IV, LINE 3A - QUALIFIED HEDGE</Identifier>
        <ReturnReference>0</ReturnReference>
        <Explanation>The 2007 bond issue consisted of two portions: 2007A (Issue price: $15,000,000) and 2007B (Issue price: $25,000,000). The qualified hedge identified relates only to the 2007B portion of the 2007 bond issue.</Explanation>
      </Form990ScheduleKPartVI>
      <Form990ScheduleKPartVI>
        <Identifier>SCHEDULE K, PART V - PROCEDURES TO UNDERTAKE CORRECTIVE ACTION</Identifier>
        <ReturnReference>0</ReturnReference>
        <Explanation>We do not have written procedures to undertake corrective action at this</Explanation>
      </Form990ScheduleKPartVI>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>JOHN CAMPBELL CAMPBELL INSURANCE</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>BOARD MEMBER</Relationship>
        <AmountOfTransaction>262390</AmountOfTransaction>
        <DescriptionOfTransaction>PURCHASE GENERAL INS COVERAGE</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>THOMAS NORTHROP OBSERVER REPORTER</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>BOARD MEMBER</Relationship>
        <AmountOfTransaction>93022</AmountOfTransaction>
        <DescriptionOfTransaction>ADVERTISING IN NEWSPAPER</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>Other Program Services</Identifier>
        <ReturnReference>Form 990, Part III, Line 4d</ReturnReference>
        <Explanation>Other program services include a multitude of activities performed by the Hospital to do business in the community and provide valuable community benefits. Activities in this category include, but are not limited to, a teenage abstinence education program, a Family Practice residency program, a School of Nursing, a School for X-ray Technicians, hospice services, certain Emergency department services, operation of a wellness center, rental activities, and operation of an employee cafeteria.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Business or Family Relationships</Identifier>
        <ReturnReference>Form 990, Part VI, Line 2</ReturnReference>
        <Explanation>The Hospital's Board of Trustees is made up of highly respected leaders in the community. Board members are selected and voted on by the entire Board. The Hospital does not compensate or select Board members. The Hospital has a Conflict of Interest policy and queries Board members, officers and key employees each year about any business or family relationships. There have been no family relationships reported. Although not classified as business relationships for this purpose, normal arms length business transactions do exist between some Board members. The business transactions are generally irrelevant and immaterial to the operations of the Hospital. The Hospital does not receive any benefits from the relationships that exist among Board members nor does it influence the relationships in any way.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Description of Classes of Members and the Nature of Their Rights</Identifier>
        <ReturnReference>Form 990, Part VI, Lines 6 &amp; 7</ReturnReference>
        <Explanation>The parent corporation of The Washington Hospital is Washington Health Care Services, Inc. The parent corporation has the following powers over the Board of Trustees of the Hospital: 1. The power to ratify the selection of members of the Board of Trustees of The Washington Hospital. 2. The power to approve any amendment, change, suspension or repeal of the Articles of Incorporation of The Washington Hospital, or of the Bylaws. 3. The power to nullify any action of the Board of Trustees of The Washington Hospital which the Board of Directors of the parent corporation determines to be an ultra vires act; that is, any act outside the scope of the legitimate powers or beyond the purpose of The Washington Hospital.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Describe the Process used by Management &amp;/or Governing Body to Review 990</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11b</ReturnReference>
        <Explanation>Prior to being filed, the Form 990 is reviewed by the members of the Finance Committee as designated by the entire Board of Trustees. The Finance Committee meets with Hospital management and reviews the content of the Form 990. After filing of the Form 990, the Finance Committee reports the review and any notable items from the review to the full Board of Trustees.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Description of Process to Monitor Transactions for Conflicts of Interest</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c</ReturnReference>
        <Explanation>The Hospital's conflict of interest policy is monitored primarily by Hospital management. Each year a conflict of interest statement must be completed by all Board of Trustee members as well as certain key management employees of the Hospital. The questionnaire is distributed by Hospital management and all responses must be received. If necessary, the assistance of the Board Chairperson is sought to obtain all responses. The responses are initially reviewed by Hospital management. Any exceptions or potential conflicts are reviewed by the CEO and Board Chairperson. Any necessary action is determined by the Chairperson and addressed at the Board level. Great care is taken by the Board Chairperson to ensure that an independent Board is in place. In the event that a conflict exists, that person is prohibited from participating in any related decision making on that issue.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Process for Determining Compensation for Top Mgmt Official &amp; Key Employees</Identifier>
        <ReturnReference>Form 990, Part VI, Lines 15a &amp; 15b</ReturnReference>
        <Explanation>The Board of Trustees elects a Personnel Committee to handle compensation, benefits and employee related issues related to the Hospital. The general compensation process for all employees starts with Hospital management compiling survey and comparison information and making recommendations for salary adjustments to the Personnel Committee. The Personnel Committee reviews that information annually, has discussions with Hospital Management and ultimately approves or denies the recommendations for salary adjustments. The Executive Compensation Committee determines the compensation of the executives. An independent consultant's review of executive salaries is the primary tool used to make their determination (the most recent consulting review was in 2012). The results of management's survey and comparison data will also be taken into consideration. All activities of the Executive Compensation Committee are reported to the Board of Trustees.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Avail of Gov Docs, Conflict of Interest Policy, &amp; Fin Stmts to Gen Public</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19</ReturnReference>
        <Explanation>The Hospital makes Form 990 and 990-T available to the public by request. The governing documents, conflict of interest policy and financial statements are not routinely available to the public.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Other Changes in Net Assets</Identifier>
        <ReturnReference>Form 990, Part XI, Line 5</ReturnReference>
        <Explanation>$-32,416,148 Change in Pension Liability -8,664,004 Transfers to Affiliates 38,310 Net Appreciation of Assets Held to Maturity 1,876,553 Net Restricted Contributions -1,739,292 Net Assets Released from Restriction -1,683,023 Unrealized Gains -3,451,693 Bond Swap Loss -11,763 Auxiliary Gain $-46,051,060 TOTAL</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Wendy Cameron TITLE:Board Chair THRu 12/31/11 HOURS:4</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Ralph B. Andy TITLE:Board Chairperson HOURS:4</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:John A. Campbell TITLE:Board Member HOURS:1</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Robert Griffin TITLE:Board Member HOURS:1</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Daniel Miller TITLE:BOARD SECRETARY-TREASURER HOURS:1</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Brian Smith TITLE:Board Member HOURS:1</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Gary B. Weinstein TITLE:President/CEO HOURS:10</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Michael J. Roney TITLE:CFO HOURS:10</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Brook T. Ward TITLE:COO HOURS:10</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:Jeffrey Minteer, MD TITLE:Director of Family Medicine HOURS:1</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>WASHINGTON HEALTHCARE SERVICES INC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>155 WILSON AVENUE</AddressLine1>
          <City>WASHINGTON</City>
          <State>PA</State>
          <ZIPCode>15301</ZIPCode>
        </AddressUS>
        <EIN>251509768</EIN>
        <PrimaryActivities>PARENT</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11a</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>THE WASHINGTON HOSPITAL FOUNDATION</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>155 WILSON AVENUE</AddressLine1>
          <City>WASHINGTON</City>
          <State>PA</State>
          <ZIPCode>15301</ZIPCode>
        </AddressUS>
        <EIN>251708215</EIN>
        <PrimaryActivities>SUPPORT TWH</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11a</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>WASHINGTON PHYSICIANS SERVICES ORG</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>155 WILSON AVENUE</AddressLine1>
          <City>WASHINGTON</City>
          <State>PA</State>
          <ZIPCode>15301</ZIPCode>
        </AddressUS>
        <EIN>251780139</EIN>
        <PrimaryActivity>PHYS OFFICES</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
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        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C CORP</TypeOfEntity>
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          <City>WASHINGTON</City>
          <State>PA</State>
          <ZIPCode>15301</ZIPCode>
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        <EIN>251533189</EIN>
        <PrimaryActivity>URGENT CARE</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C CORP</TypeOfEntity>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>true</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>true</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>true</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Phoenix-Washington</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>A</TransactionType>
        <AmountInvolved>931719</AmountInvolved>
        <MethodOfAmtDetermination>ACTUAL AMOUNT</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Phoenix-Washington</BusinessNameLine1>
        </NameOfOtherOrganization>
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        <MethodOfAmtDetermination>ACTUAL AMOUNT</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>THE WASHINGTON HOSPITAL FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
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        <AmountInvolved>2105561</AmountInvolved>
        <MethodOfAmtDetermination>ACTUAL AMOUNT</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>THE WASHINGTON HOSPITAL FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
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        <AmountInvolved>603634</AmountInvolved>
        <MethodOfAmtDetermination>ACTUAL AMOUNT</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>