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        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Roger Sessions MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>693384</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10609</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>R Scott Confer</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Norman Jennings MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Perry O'Brian Jr</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Peggy Lowry</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Patricia Smith</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Virginia Lewis</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Nghia Truong MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>603877</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10609</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Norman Hicks MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Ned Muse</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Thom Lambert</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Michelle Brookshire</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Michael Banks DDS</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Michael Austin MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>308188</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10609</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Lucia Williams MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Lisa Graves MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>364933</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>9934</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Linda K Dean</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Leesa N Hedge</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Mark Hamilton MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Larry King</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Larry Durrett</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>12.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Larry Cunningham DO</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>436527</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10609</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Kenneth McGee</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Kenneth Kemp MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>348803</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10609</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Ken Greer</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Karen Wies MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>408864</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10609</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Jon Johnston</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>John T Wilson</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>John Magouyrk</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>John H Keller Jr MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>49257</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>2483</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>John Payne</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Joe Angle</NamePerson>
        <Title>ViceChairmn&amp;Dir</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <Officer>X</Officer>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Jessica Parish</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Jerry Webster</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>James Wynne</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>12.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>James H Reynolds</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Richard R Tutt MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Heidi McKeller MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Harold Beaird</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Ray Morrison MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>George T Hall</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>George Robinson</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Gary Patterson</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Gary Gross MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Fred A Heirich</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Ennis Christenberry</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Doug Johnston DO</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>257014</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10609</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Donald E Arego MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>320340</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10609</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Laura Vanecek</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Judge David Anderson</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>David Jones MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>David Johnson MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>72000</ReportableCompFromOrganization>
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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>David E Holdredge</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>David Craig MD</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Charles Lowry</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Charles Halstead</NamePerson>
        <Title>Director</Title>
        <AverageHoursPerWeek>2.00</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>John Cain</NamePerson>
        <Title>Director</Title>
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        <NamePerson>Bryan Price</NamePerson>
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        <NamePerson>Bryan Hyland MD</NamePerson>
        <Title>Director</Title>
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        <NamePerson>Brian Holcomb</NamePerson>
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        <NamePerson>Brian Ballard</NamePerson>
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        <NamePerson>Jeff Taylor</NamePerson>
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        <NamePerson>Bill James</NamePerson>
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        <NamePerson>Bill Clawater</NamePerson>
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        <NamePerson>BG Hartley</NamePerson>
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        <NamePerson>Barry Hughes</NamePerson>
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        <NamePerson>Ilanko Upendran MD</NamePerson>
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        <NamePerson>Ann Lake</NamePerson>
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        <NamePerson>Andrew Roberts MD</NamePerson>
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        <NamePerson>Stephanie Redding MD</NamePerson>
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        <NamePerson>Allen Bell</NamePerson>
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        <NamePerson>Alan Hale</NamePerson>
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        <NamePerson>Billy Langford</NamePerson>
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        <NamePerson>Curt Smith</NamePerson>
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        <NamePerson>Brett Kirkham</NamePerson>
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        <NamePerson>Jorge Leal</NamePerson>
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        <NamePerson>Warren Robicheaux</NamePerson>
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        <NamePerson>Jack Endres</NamePerson>
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        <NamePerson>Mark Leitner</NamePerson>
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        <NamePerson>Perry Henderson</NamePerson>
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        <NamePerson>Ruth Raz Cook</NamePerson>
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        <NamePerson>Terry Cutler</NamePerson>
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        <NamePerson>John Hart</NamePerson>
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        <NamePerson>Gary M Hudson</NamePerson>
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        <NamePerson>Patrick L Wallace</NamePerson>
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        <NamePerson>Eddie Howard</NamePerson>
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        <NamePerson>Stephen Rydzak MD</NamePerson>
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        <NamePerson>Paula Anthony</NamePerson>
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        <NamePerson>Mike Thomas</NamePerson>
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        <NamePerson>Jerry Massey</NamePerson>
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        <NamePerson>Byron Hale</NamePerson>
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        <NamePerson>Elmer G Ellis</NamePerson>
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        <NamePerson>Phil Caron</NamePerson>
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        <NamePerson>Tommy O'Gorman</NamePerson>
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        <NamePerson>Gerry Dominguez</NamePerson>
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        <NamePerson>Jim Hines</NamePerson>
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        <NamePerson>David Travis</NamePerson>
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        <NamePerson>Becki Mangum</NamePerson>
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        <NamePerson>James Blanton</NamePerson>
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        <NamePerson>Todd Sigmon</NamePerson>
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        <NamePerson>Robert Evans</NamePerson>
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        <NamePerson>Kim Pearson-Wahl</NamePerson>
        <Title>Vice President</Title>
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        <NamePerson>Ron Schwartz</NamePerson>
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        <NamePerson>Mike Gray</NamePerson>
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        <NamePerson>Freddie Sanchez</NamePerson>
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        <NamePerson>Dennis S Devinney</NamePerson>
        <Title>Physician</Title>
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        <NamePerson>Joseph M Conflitti</NamePerson>
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        <NamePerson>Cody Anderson</NamePerson>
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        <NamePerson>Michael J Klouda</NamePerson>
        <Title>Physician</Title>
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        <NamePerson>Brandon A Tinkler</NamePerson>
        <Title>Physician</Title>
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        <NamePerson>William Roberson DO</NamePerson>
        <Title>Former Director (FY 11)</Title>
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        <NamePerson>Ravi Kumar Sreerama</NamePerson>
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        <OtherCompensation>9934</OtherCompensation>
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        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
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        <OtherCompensation>4967</OtherCompensation>
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        <Explanation>The organization pays membership dues to member organiations which may engage in lobbying activities. Therfore, a portion of the dues are attributable to lobbying activities. This amount represents a specified percentage of total dues paid.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="11000144" softwareVersion="2011v1.5">
      <CurrentYear>
        <BeginningOfYearBalance>6070504</BeginningOfYearBalance>
        <Contributions>394384</Contributions>
        <InvestmentEarningsOrLosses>272531</InvestmentEarningsOrLosses>
        <OtherExpenditures>1343269</OtherExpenditures>
        <EndOfYearBalance>5394150</EndOfYearBalance>
      </CurrentYear>
      <CurrentYearMinus1Year>
        <BeginningOfYearBalance>6308565</BeginningOfYearBalance>
        <Contributions>874950</Contributions>
        <InvestmentEarningsOrLosses>70190</InvestmentEarningsOrLosses>
        <OtherExpenditures>1183202</OtherExpenditures>
        <EndOfYearBalance>6070503</EndOfYearBalance>
      </CurrentYearMinus1Year>
      <CurrentYearMinus2Years>
        <BeginningOfYearBalance>5124574</BeginningOfYearBalance>
        <Contributions>3109511</Contributions>
        <InvestmentEarningsOrLosses>236481</InvestmentEarningsOrLosses>
        <OtherExpenditures>2162000</OtherExpenditures>
        <EndOfYearBalance>6308566</EndOfYearBalance>
      </CurrentYearMinus2Years>
      <PermanentEndowmentEOYBalance>0.37000</PermanentEndowmentEOYBalance>
      <TermEndowmentEOYBalance>0.29000</TermEndowmentEOYBalance>
      <EndowmentsHeldByUnrelatedOrgs>false</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>false</EndowmentsHeldByRelatedOrgs>
      <AreRelatedOrgsListedScheduleR>false</AreRelatedOrgsListedScheduleR>
      <Land>
        <OtherCostOrOtherBasis>520030</OtherCostOrOtherBasis>
        <BookValue>520030</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>144748365</OtherCostOrOtherBasis>
        <Depreciation>49100810</Depreciation>
        <BookValue>95647555</BookValue>
      </Buildings>
      <LeaseholdImprovements>
        <OtherCostOrOtherBasis>34459322</OtherCostOrOtherBasis>
        <Depreciation>6517502</Depreciation>
        <BookValue>27941820</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <OtherCostOrOtherBasis>323078719</OtherCostOrOtherBasis>
        <Depreciation>251740929</Depreciation>
        <BookValue>71337790</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>53863355</OtherCostOrOtherBasis>
        <Depreciation>30503813</Depreciation>
        <BookValue>23359542</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>218806737</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>Rounding</Description>
        <BookValue>1</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Restricted Funds</Description>
        <BookValue>31215059</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Goodwill-Athens Cancer Institute net</Description>
        <BookValue>1000555</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Estimated 3rd Party Settlement</Description>
        <BookValue>5104279</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Due From Outside Entities</Description>
        <BookValue>6162181</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Due From Affiliates</Description>
        <BookValue>395966829</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Deposits on Equip &amp; Various Items</Description>
        <BookValue>722470</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Bonds Receivables &amp; Unamortized Bond Exp</Description>
        <BookValue>4146780</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Accrued Interest Receivable</Description>
        <BookValue>2509</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>444320663</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>Other Noncurrent Liabilities</Description>
        <Amount>1116894</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Noncurrent Pension Liability</Description>
        <Amount>56582072</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Investment In Cyberknife</Description>
        <Amount>292629</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Estimated 3rd Party Settlement</Description>
        <Amount>1509125</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Due to Affiliates</Description>
        <Amount>208853202</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Deferred Direct &amp; Admin Expenses</Description>
        <Amount>71094781</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Capital Lease Obligations</Description>
        <Amount>30204028</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>369652731</TotalOfAmounts>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XI, Line 8</Identifier>
        <ReturnReference>Part XI, Line 8: Other Changes in Net Assets or Fund Balances</ReturnReference>
        <Explanation>Defined Benefit Plan Adjustment $ -10487585</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="IRS990ScheduleG" softwareId="11000144" softwareVersion="2011v1.5">
      <AgreementRefFundraising>false</AgreementRefFundraising>
      <EventsInformation>
        <NameOfEvent1>Bell Golf Tournament</NameOfEvent1>
        <GrossReceiptsEvent1>38508</GrossReceiptsEvent1>
        <CharitableContributionsEvent1>21550</CharitableContributionsEvent1>
        <GrossRevenueEvent1>16958</GrossRevenueEvent1>
        <OtherDirectExpensesEvent1>16867</OtherDirectExpensesEvent1>
        <GrossReceiptsTotal>38508</GrossReceiptsTotal>
        <CharitableContributionsTotal>21550</CharitableContributionsTotal>
        <GrossRevenueTotalEvents>16958</GrossRevenueTotalEvents>
        <OtherDirectExpensesTotalEvents>16867</OtherDirectExpensesTotalEvents>
        <DirectExpenseSummaryEvents>16867</DirectExpenseSummaryEvents>
        <NetIncomeSummary>91</NetIncomeSummary>
      </EventsInformation>
    </IRS990ScheduleG>
    <IRS990ScheduleH documentId="IRS990ScheduleH" softwareId="11000144" softwareVersion="2011v1.5">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent200D>X</Pcent200D>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>27567844</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>10625090</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>16942754</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02080</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>71326931</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>63700763</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>7626168</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00940</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>10480190</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>7742070</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2738120</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00340</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>109374965</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>82067923</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>27307042</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03360</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>519950</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>133541</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>386409</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00050</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>807947</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>113580</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>694367</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00090</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>81310107</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>67350134</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>13959973</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01720</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <Research>
        <TotalCommunityBenefitExpense>251361</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>127376</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>123985</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00020</PercentOfTotalExpense>
      </Research>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>1990114</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>1990114</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00240</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>84879479</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>67724631</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>17154848</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02120</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>194254444</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>149792554</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>44461890</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05480</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>13366836</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>224624473</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>308665413</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-84040940</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>false</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>14</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>14</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Specia</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1000 South Beckham Avenue</AddressLine1>
          <City>Tyler</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>13</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Tyler</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1000 South Beckham Avenue</AddressLine1>
          <City>Tyler</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>12</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Trinit</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>317 Prospect Drive</AddressLine1>
          <City>Trinity</City>
          <State>TX</State>
          <ZIPCode>75862</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>11</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Quitma</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>117 N Winnsboro Street</AddressLine1>
          <City>Quitman</City>
          <State>TX</State>
          <ZIPCode>75783</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>10</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Pittsb</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>414 Quitman Street</AddressLine1>
          <City>Pittsburg</City>
          <State>TX</State>
          <ZIPCode>75686</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>9</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-MtVern</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>500 S State Highway 37</AddressLine1>
          <City>Mount Vernon</City>
          <State>TX</State>
          <ZIPCode>75457</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>8</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Jackso</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>501 S Ragsdale Street</AddressLine1>
          <City>Jacksonville</City>
          <State>TX</State>
          <ZIPCode>75768</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>7</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Hender</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>300 Wilson Street</AddressLine1>
          <City>Henderson</City>
          <State>TX</State>
          <ZIPCode>75652</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>6</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Gilmer</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>712 North Wood</AddressLine1>
          <City>Gilmer</City>
          <State>TX</State>
          <ZIPCode>75644</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>5</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Fairfi</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>125 Newman Street</AddressLine1>
          <City>Fairfield</City>
          <State>TX</State>
          <ZIPCode>75840</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>4</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Crocke</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1100 Loop 304 East</AddressLine1>
          <City>Crockett</City>
          <State>TX</State>
          <ZIPCode>75835</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>3</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Clarks</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>3000 W Main Hwy 82 W</AddressLine1>
          <City>Clarksville</City>
          <State>TX</State>
          <ZIPCode>75426</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>2</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Cartha</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>409 W Cottage Road</AddressLine1>
          <City>Carthage</City>
          <State>TX</State>
          <ZIPCode>75633</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>East Texas Medical Cntr-Athens</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>2000 South Palestine</AddressLine1>
          <City>Athens</City>
          <State>TX</State>
          <ZIPCode>75751</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
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        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Specia</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>14</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
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        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
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        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
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        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
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        <CollectionActivities>true</CollectionActivities>
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        <NotifiedAllPatients>X</NotifiedAllPatients>
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        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
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        <GrossCharges>false</GrossCharges>
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      <Form990ScheduleHPartVSectionB>
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        </HospitalFacilityName>
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        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
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        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
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        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
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        <ExplainsBasis>true</ExplainsBasis>
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        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
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        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
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        <CollectionActivities>true</CollectionActivities>
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        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Trinit</BusinessNameLine1>
        </HospitalFacilityName>
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        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Quitma</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>11</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Pittsb</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>10</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-MtVern</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>9</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Jackso</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>8</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Hender</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>7</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Gilmer</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>6</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Fairfi</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>5</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Crocke</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>4</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Clarks</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>3</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Cartha</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>2</HospitalFacilityNumber>
        <CHNAConducted>true</CHNAConducted>
        <CommunityDefinition>X</CommunityDefinition>
        <CommunityDemographics>X</CommunityDemographics>
        <ExistingResources>X</ExistingResources>
        <HowDataObtained>X</HowDataObtained>
        <CommunityHealthNeeds>X</CommunityHealthNeeds>
        <OtherHealthIssues>X</OtherHealthIssues>
        <IdentifyingProcess>X</IdentifyingProcess>
        <ConsultingProcess>X</ConsultingProcess>
        <InformationGaps>X</InformationGaps>
        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>true</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <OtherMethod>X</OtherMethod>
        <AdoptImplementStrategy>X</AdoptImplementStrategy>
        <ExecuteImplementStrategy>X</ExecuteImplementStrategy>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <ParticipateCommunityPlan>X</ParticipateCommunityPlan>
        <IncludeOperationalPlans>X</IncludeOperationalPlans>
        <AdoptBudget>X</AdoptBudget>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>true</AllNeedsAddressed>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>East Texas Medical Cntr-Athens</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>200.0000</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>false</ActionsOnNonpayment>
        <CollectionActivities>true</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>7</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FirstNet Exchange</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1000 S Beckham Ave</AddressLine1>
            <City>Tyler</City>
            <State>TX</State>
            <ZIPCode>75701</ZIPCode>
          </Address>
          <FacilityType>Provide electronic medical records for the physicians to view.</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>East Texas Medical Center - Self Insurance Trust</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1000 S Beckham Ave</AddressLine1>
            <City>Tyler</City>
            <State>TX</State>
            <ZIPCode>75701</ZIPCode>
          </Address>
          <FacilityType>Insurance coverage for the East Texas Medical Center Regional Healthcare System.</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>East Texas Medical Center - Home Services</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1000 S Beckham Ave</AddressLine1>
            <City>Tyler</City>
            <State>TX</State>
            <ZIPCode>75701</ZIPCode>
          </Address>
          <FacilityType>Home Healthcare Services</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>East Texas Medical Center - Healthcare Associates</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1000 S Beckham Ave</AddressLine1>
            <City>Tyler</City>
            <State>TX</State>
            <ZIPCode>75701</ZIPCode>
          </Address>
          <FacilityType>Physicians</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>East Texas Medical Center - Foundation</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1000 S Beckham Ave</AddressLine1>
            <City>Tyler</City>
            <State>TX</State>
            <ZIPCode>75701</ZIPCode>
          </Address>
          <FacilityType>Support related hospitals within the system through raising, management and distribution of charitab</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>East Texas Meical Center - Cancer Institute</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1000 S Beckham Ave</AddressLine1>
            <City>Tyler</City>
            <State>TX</State>
            <ZIPCode>75701</ZIPCode>
          </Address>
          <FacilityType>Provide radiation therapy, healthcare and related services to cancer patients.</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>East Texas Medical Center - Rehab</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>701 Olympic Plaza Circle</AddressLine1>
            <City>Tyler</City>
            <State>TX</State>
            <ZIPCode>75701</ZIPCode>
          </Address>
          <FacilityType>Rehabilitation Center, Physical and Occupational, Inpatient and Outpatient</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Additional Information</ReturnReference>
        <Explanation>Uncompensated care program funds were evenly allocated to uninsured and Medicaid patient costs.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part V - Explanation of Number of Facility Type</ReturnReference>
        <Explanation>One Rehabilitation Center, one Cancer Institute, and three Home Healthcare services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Community Information</ReturnReference>
        <Explanation>The 20 county service area is composed of about 16 percent of the population over age 65, an increasing Hispanic population, 60 percent of households defined as 'working poor' or poverty level, with 40 percent uninsured or underinsured.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Patient Education of Eligibility for Assistance</ReturnReference>
        <Explanation>Notifications of financial assistance and the Charity Care program are posted in the patient admission areas and emergency departments, and also printed in local newspapers. The Charity Care policy and application for financial assistance are also available on the internet at www.etmc.org. Additionally, notification of availability of financial assistance is noted on all patient billing statements, along with the phone number of whom to contact for financial assistance. In addition, direct contact is made to those individuals that the organization beleves may qualify for Charity Care, based on lack of insurance or other indications, to explain the availability of financial assistance and to request the individual complete and returned an application.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Needs Assessment</ReturnReference>
        <Explanation>The community health needs assessment process adopted by ETMC was divided into three major components:- Internal and External Data Collection and Analysis- Community Assessment of Community Need- ETMC Provider InputThe community health needs assessment process is designed to measure positive and negative progress relative to selected health status indicators; target needs by population group, geographic market segment and health issue; consider community input and feedback; and identify opportunities for program and service development and enhancement.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 9</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 8</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 7</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 6</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 5</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 4</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 3</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 2</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 14</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 13</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 12</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 11</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 10</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 19d - Other Billing Determination of Individuals Without Insurance</ReturnReference>
        <Explanation>A 60% discount is applied to standard charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 9</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 8</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 7</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 6</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 5</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 4</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 3</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 2</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 14</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 13</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 12</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 11</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 10</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 5c - Description of Making Needs Assessment Widely Available</ReturnReference>
        <Explanation>Presented at community summary meeting.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 9</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 8</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 7</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 6</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 5</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 4</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 3</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 2</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 14</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 13</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 12</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 11</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 10</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC AthensETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment</ReturnReference>
        <Explanation>ETMC TylerETMC CarthageETMC ClarksvilleETMC CrockettETMC FairfieldETMC GilmerETMC Henderson ETMC JacksonvilleETMC Mt VernonETMC PittsburgETMC QuitmanETMC TrinityETMC Cancer InstituteETMC Home Health ServicesETMC Rehabilitation HospitalETMC RHF Self Insurance TrustEast Texas Medical Center FoundationFirstNet ExchangeETMC Healthcare AssociatesETMC Specialty Hospital</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 9</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Mount Vernon. Individuals interviewed included representatives of: * First National Bank of Mount Vernon * Mount Vernon ISD - School Nurse * Franklin County Chamber of Commerce * Franklin County - Treasurer, County Judge * First United Methodist ChurchThe interview task force included the administrator from ETMC Mount Vernon, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 8</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Jacksonville. Individuals interviewed included representatives of: * Jacksonville Economic Development Corporation * Crisis Center of Anderson and Cherokee Counties * Jacksonville Police Department * The Chaparral Center, Alto * Austin Bank * Our Lady of Sorrows * Cherokee County Health Department * HOPEThe interview task force included the administrator from ETMC Jacksonville, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 7</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Henderson. Individuals interviewed included representatives of: * Henderson Memorial Hospital Foundation * Rusk County Child Advocacy Center * Henderson ISD * Rusk County Health Clinic * Texas Dept. of State Health Services - Rusk County * Rusk County Judge * City of Henderson, City Manager * St. Matthew's Episcopal ChurchThe interview task force included the administrator from ETMC Henderson, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 6</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Gilmer. Individuals interviewed included representatives of: * Dodd Motor Company * First National Bank * Heart to Heart * Women's Center of East Texas * Gilmer Chamber of Commerce * Flight of the Phoenix Museum * Gilmer ISD * Area Minister * Upshur County JudgeThe interview task force included the administrator from ETMC Gilmer, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 5</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Fairfield. Individuals interviewed included representatives of: * First Baptist Church, Fairfield * Community National Bank * Freestone County, Justice of the Peace * Freestone ISD * Luminant * Medical Staff * Home for Vets * First Baptist Church, Teague * Fairfield Hospital District BoardThe interview task force included the administrator from ETMC Fairfield, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 4</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Crockett. Individuals interviewed included representatives of: * City of Crockett - Mayor, City Manager * Houston County Courier * Central Baptist Church * Chamber of Commerce * Allstate * Car dealership * CASA - Court Appointed Special AdvocatesThe interview task force included the administrator from ETMC Crockett, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 3</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Clarksville. Individuals interviewed included representatives of: * City of Annona - Mayor * First Federal Community Bank * Bogata Funeral Home * City of Clarksville - Mayor, City Secretary, City Manager * Big Brothers, Big Sisters * Zion Travelers Baptist ChurchThe interview task force included the administrator from ETMC Clarksville, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 2</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Carthage. Individuals interviewed included representatives of: * Mayor, City of Beckville * Clayton Church * Carthage Courtesy Club * Carthage ISD * Office of the County Judge, Panola County * Texas Dept. State Health Services * Panola College, Nursing &amp; Health Sciences * AgriLife (extension services) - Natural Resources &amp; FCS County HealthThe interview task force included the administrator from ETMC Carthage, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 14</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Specialty Hospital. Individuals interviewed included representatives of: * Bethesda Health Clinic * East Texas Food Bank * Literacy Council * PATH * Hispanic Business Alliance * AgriLife (extension service) * Texas Dept. of State Health Services * East Texas Crisis Center * East Texas Medical Center EMS * Tyler Area Chamber of Commerce * Tyler Police Department * ETCOG - Agency on Aging * NE Texas Public Health DistrictThe interview task force included the administrator from ETMC Specialty Hospital, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 13</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Tyler. Individuals interviewed included representatives of: * Bethesda Health Clinic * East Texas Food Bank * Literacy Council * PATH * Hispanic Business Alliance * AgriLife (extension service) * Texas Dept. of State Health Services * East Texas Crisis Center * East Texas Medical Center EMS * Tyler Area Chamber of Commerce * Tyler Police Department * ETCOG - Agency on Aging * NE Texas Public Health DistrictThe interview task force included the administrator from ETMC Tyler, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 12</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Trinity. Individuals interviewed included representatives of: * Trinity County Hospital District board of directors * State Farm Insurance * Boys and Girls Club * Small Business/Chamber of Commerce * Sheriff, Trinity County * Mayor, City of Trinity * City Manager, City of Trinity * Texas Dept. of State Health Services, area Emergency Operations CoordinatorThe interview task force included the administrator from ETMC Trinity, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 11</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Quitman. Individuals interviewed included representatives of: * ETMC Quitman board of directors * Watkins Insurance Agency * City of Quitman * Wood County Electric Coop * Bank Texas * Wood County Chief Appraiser * Mayor, City of Quitman * City Manager, City of MineolaThe interview task force included the administrator from ETMC Quitman, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 10</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Pittsburg. Individuals interviewed included representatives of: * Camp County Judge * Pittsburg ISD * Dept. of Housing and Urban Development (HUD) * First Baptist Church, Pittsburg * Mayor, City of PittsburgThe interview task force included the administrator from ETMC Pittsburg, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Number of Hospital Faciltiy - 1</Identifier>
        <ReturnReference>Part V, Line 3 - Account Input from Person Who Represent the Community</ReturnReference>
        <Explanation>Interviews with community leaders represented a critical component of the Community Health Needs Assessment conducted by ETMC Athens. Individuals interviewed included representatives of: * Aley United Methodist Church * St. Edwards Catholic Church * Disciples Clinic * Meals on Wheels * Joy Works - Eastern Hills Church of Christ * Department of Assistive and Rehabilitative Services * Henderson County - Indigent Care; Senior Citizen's Program * East Texas Crisis Center * Family Peace Project * Andrews Center * West Place Nursing HomeThe interview task force included the administrator from ETMC Athens, as well as members of the ETMC Regional Healthcare System's CHNA team.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part III, Line 9b - Provisions On Collection Practices For Qualified Patients</ReturnReference>
        <Explanation>The Organization does not pursue collection of amounts determined to qualify as charity care and therefore are not considered in the collection policy.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="IRS990ScheduleI" softwareId="11000144" softwareVersion="2011v1.5">
      <RecordsMaintained>true</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Sonet Service Organization</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>2950 50th Street</AddressLine1>
          <City>Lubbock</City>
          <State>TX</State>
          <ZIPCode>79413</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>922580</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Indigent Care Donation</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Partnership for Healthy Aging</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>110 Free Street</AddressLine1>
          <City>Portland</City>
          <State>ME</State>
          <ZIPCode>04101</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>21900</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Fall Provention Program</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>ETMCRH System</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1000 South Beckham Avenue</AddressLine1>
          <City>Tyler</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EINOfRecipient>751803327</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>1000000</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Pittsburg Building Fund</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Cherokee County Health Dept</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>593 North Main Street</AddressLine1>
          <City>Rusk</City>
          <State>TX</State>
          <ZIPCode>75785</ZIPCode>
        </AddressUS>
        <EINOfRecipient>756000854</EINOfRecipient>
        <AmountOfCashGrant>10000</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Donation</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>American Heart Assoc</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>10900-BstoneLakeBlvd Ste 320</AddressLine1>
          <City>Austin</City>
          <State>TX</State>
          <ZIPCode>78759</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>6000</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Donation</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>American Cancer Society Tyler</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1301 So Broadway</AddressLine1>
          <City>Tyler</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <AmountOfCashGrant>12500</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>Donations</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>1</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>5</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIV>
        <Identifier>Grantmaker's Description of How Grants are Used</Identifier>
        <Explanation>Senior management will review the needs and give approval to support a variety of agencies, service organziations and projects related to meeting health and human service needs for Tyler and East Texas, as well as those contributing to overall quality of life for the community. Contributions were made in terms of financial and in-kind donations, agencies and organizations supported are non-profit.The ETMC Helping Hands Fund was established to help our fellow employees who may encounter substantial emergency situations and needs. Through generous gifts on the part of ETMC personnel, we are able to help our own by offering immediate, short-term financial assistance to those in need. The Helping Hands Fund is managed through the East Texas Medical Center Foundation and ETMC Human Resources, and governed by an employee review committee.Due to the special nature of the Chaplains Fund, flexibility is essential in its operating procedures. The following guidelines are designed as general policies to be followed by the Chaplains office and the ETMC Foundation.Administration The ETMC Tyler Chaplains Fund is a restricted account under the East Texas Medical Center Foundation. The ETMC Tyler Chaplain supervises the Chaplains Fund on a day-to-day basis. In addition to the Chaplain, the President and Chief Financial Officer of the East Texas Medical Center Regional Healthcare System has signature authorization over the Chaplains Fund account. The Chaplains Fund is included in the financial statements presented at meetings of the ETMC Foundations Board of Directors. The Foundation staff, Board and Executive Committee may help address issues and govern the fund as needed.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
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      <ClubDuesOrFees>X</ClubDuesOrFees>
      <WrittenPolicyReTAndEExpenses>true</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>true</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>true</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
        <NamePerson>William Roberson DO</NamePerson>
        <BaseCompensationFilingOrg>96000</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>96000</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Warren Robicheaux</NamePerson>
        <BaseCompensationFilingOrg>144017</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>20308</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>17891</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>182216</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Tony Myers</NamePerson>
        <BaseCompensationFilingOrg>196548</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>100916</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>16639</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>314103</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Tommy O'Gorman</NamePerson>
        <BaseCompensationFilingOrg>167974</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>1062</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>21316</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>190352</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Todd Sigmon</NamePerson>
        <BaseCompensationFilingOrg>158950</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>18667</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>22698</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>200315</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Terry Cutler</NamePerson>
        <BaseCompensationFilingOrg>184312</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>54190</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>20719</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>259221</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ted Trimble MD</NamePerson>
        <BaseCompensationFilingOrg>181534</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>1983</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>7450</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>190967</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Stephen Rydzak MD</NamePerson>
        <BaseCompensationFilingOrg>483352</BaseCompensationFilingOrg>
        <BonusFilingOrg>177609</BonusFilingOrg>
        <OtherCompensationFilingOrg>2678</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>731</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>664370</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Sam Raborn MD</NamePerson>
        <BaseCompensationFilingOrg>121000</BaseCompensationFilingOrg>
        <BonusFilingOrg>132086</BonusFilingOrg>
        <OtherCompensationFilingOrg>1434</OtherCompensationFilingOrg>
        <TotalCompensationFilingOrg>254520</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ruth Raz Cook</NamePerson>
        <BaseCompensationFilingOrg>138489</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>35773</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>22117</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>196379</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ron Schwartz</NamePerson>
        <BaseCompensationFilingOrg>194343</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>14323</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>23593</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>232259</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Roger Sessions MD</NamePerson>
        <BaseCompensationFilingOrg>545788</BaseCompensationFilingOrg>
        <BonusFilingOrg>142437</BonusFilingOrg>
        <OtherCompensationFilingOrg>5159</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>10609</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>703993</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Robert Evans</NamePerson>
        <BaseCompensationFilingOrg>396088</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>281936</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>28482</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>706506</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Ravi Kumar Sreerama</NamePerson>
        <BaseCompensationFilingOrg>17150</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>17150</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Randy Randall MD</NamePerson>
        <BaseCompensationFilingOrg>364298</BaseCompensationFilingOrg>
        <BonusFilingOrg>45485</BonusFilingOrg>
        <OtherCompensationFilingOrg>6425</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>10598</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>426806</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Phil Caron</NamePerson>
        <BaseCompensationFilingOrg>172707</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>5326</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>21939</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>199972</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Perry Henderson</NamePerson>
        <BaseCompensationFilingOrg>211599</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>113174</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>24116</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>348889</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Paula Anthony</NamePerson>
        <CompBasedOnRelatedOrgs>342792</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>79129</OtherCompensationRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>26843</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>448764</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Patrick L Wallace</NamePerson>
        <BaseCompensationFilingOrg>288477</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>176019</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>30196</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>494692</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Nghia Truong MD</NamePerson>
        <BaseCompensationFilingOrg>429125</BaseCompensationFilingOrg>
        <BonusFilingOrg>173184</BonusFilingOrg>
        <OtherCompensationFilingOrg>1568</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>10609</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>614486</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Mike Thomas</NamePerson>
        <CompBasedOnRelatedOrgs>317355</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>135643</OtherCompensationRelatedOrgs>
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        <TotalCompensationRelatedOrgs>483142</TotalCompensationRelatedOrgs>
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        <IssuerName>
          <BusinessNameLine1>Camp County Texas</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>756000845</IssuerEIN>
        <DateIssued>2007-11-29</DateIssued>
        <IssuePrice>10000000</IssuePrice>
        <DescriptionOfPurpose>New hospital facility</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>250000</AmountRetired>
        <TotalProceeds>7000001</TotalProceeds>
        <CapitalizedInterest>863244</CapitalizedInterest>
        <IssuanceCostsFromProceeds>7000</IssuanceCostsFromProceeds>
        <WorkingCapitalExpenditures>863244</WorkingCapitalExpenditures>
        <CapitalExpenditures>6129757</CapitalExpenditures>
        <YearOfSubstCompletion>2009</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <AmountRetired>350000</AmountRetired>
        <TotalProceeds>10000067</TotalProceeds>
        <CapitalizedInterest>252733</CapitalizedInterest>
        <WorkingCapitalExpenditures>252733</WorkingCapitalExpenditures>
        <CapitalExpenditures>9747334</CapitalExpenditures>
        <YearOfSubstCompletion>2009</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <AmountRetired>545000</AmountRetired>
        <TotalProceeds>10068035</TotalProceeds>
        <CapitalizedInterest>725080</CapitalizedInterest>
        <WorkingCapitalExpenditures>725080</WorkingCapitalExpenditures>
        <CapitalExpenditures>9342955</CapitalExpenditures>
        <YearOfSubstCompletion>2009</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <AmountRetired>545000</AmountRetired>
        <TotalProceeds>10081131</TotalProceeds>
        <CapitalizedInterest>898543</CapitalizedInterest>
        <IssuanceCostsFromProceeds>74500</IssuanceCostsFromProceeds>
        <WorkingCapitalExpenditures>898543</WorkingCapitalExpenditures>
        <CapitalExpenditures>9108087</CapitalExpenditures>
        <YearOfSubstCompletion>2009</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <EngageBondCounselResearch>false</EngageBondCounselResearch>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <EngageBondCounselResearch>false</EngageBondCounselResearch>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <EngageBondCounselResearch>false</EngageBondCounselResearch>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <EngageBondCounselResearch>false</EngageBondCounselResearch>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <FedTaxRequirementsCompliance>X</FedTaxRequirementsCompliance>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="11000144" softwareVersion="2011v1.5">
      <GeneralExplanation>
        <ReturnReference>Fundraising Expenses</ReturnReference>
        <Explanation>Fundraising is conducted at the related organization, ETMC Foundation for all ETMC Regional Healthcare System organizations. The expenses are not charged back to the organization.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Audited Financial Statements</ReturnReference>
        <Explanation>The organization was included in consolidated, independent audited financial statements for the tax year.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Utilities: Column (A) - Total = $9271337; Column (B) - Program Services = $9136138; Column (C) - Management &amp; General = $135199; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Uniforms: Column (A) - Total = $230468; Column (B) - Program Services = $230368; Column (C) - Management &amp; General = $100; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Telephone/Cell phones/pagers: Column (A) - Total = $2925723; Column (B) - Program Services = $2687351; Column (C) - Management &amp; General = $238372; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Taxes: Column (A) - Total = $114657; Column (B) - Program Services = $108212; Column (C) - Management &amp; General = $6445; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Rounding: Column (A) - Total = $-4; Column (B) - Program Services = $-4; Column (C) - Management &amp; General = $-1; Column (D) - Fundraising = $1</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Repairs - Equipment: Column (A) - Total = $2262020; Column (B) - Program Services = $2256973; Column (C) - Management &amp; General = $5047; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Repairs - Building: Column (A) - Total = $718983; Column (B) - Program Services = $715864; Column (C) - Management &amp; General = $3119; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Recruiting/ Interview: Column (A) - Total = $232844; Column (B) - Program Services = $153354; Column (C) - Management &amp; General = $79490; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Recruiting Agency Fees: Column (A) - Total = $334288; Column (B) - Program Services = $193606; Column (C) - Management &amp; General = $140682; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Public Relations: Column (A) - Total = $147467; Column (B) - Program Services = $103451; Column (C) - Management &amp; General = $44016; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Professional Fees: Column (A) - Total = $1034051; Column (B) - Program Services = $969147; Column (C) - Management &amp; General = $64904; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Printing and Publications: Column (A) - Total = $329297; Column (B) - Program Services = $320549; Column (C) - Management &amp; General = $4956; Column (D) - Fundraising = $3792</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Postage and Shipping: Column (A) - Total = $939205; Column (B) - Program Services = $891495; Column (C) - Management &amp; General = $47710; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Personal Vehicle Mileage: Column (A) - Total = $778587; Column (B) - Program Services = $712036; Column (C) - Management &amp; General = $66551; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Patient Surveys: Column (A) - Total = $237162; Column (B) - Program Services = $185834; Column (C) - Management &amp; General = $51328; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Patient Outside Activity: Column (A) - Total = $2541; Column (B) - Program Services = $2541; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Nourishments: Column (A) - Total = $841722; Column (B) - Program Services = $742897; Column (C) - Management &amp; General = $98825; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Miscellaneous: Column (A) - Total = $37457; Column (B) - Program Services = $-41053; Column (C) - Management &amp; General = $78510; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Minor Equipment: Column (A) - Total = $2280567; Column (B) - Program Services = $2229556; Column (C) - Management &amp; General = $51011; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Micro Filming: Column (A) - Total = $703573; Column (B) - Program Services = $703573; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Medical Transcription: Column (A) - Total = $82812; Column (B) - Program Services = $82812; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Management Fees: Column (A) - Total = $1523482; Column (B) - Program Services = $1456616; Column (C) - Management &amp; General = $66866; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Maintenance General Hospital: Column (A) - Total = $899823; Column (B) - Program Services = $888877; Column (C) - Management &amp; General = $10946; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Lost Patient Items Replacement: Column (A) - Total = $12151; Column (B) - Program Services = $11881; Column (C) - Management &amp; General = $270; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Licenses: Column (A) - Total = $521148; Column (B) - Program Services = $469114; Column (C) - Management &amp; General = $52034; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Library Expense: Column (A) - Total = $58323; Column (B) - Program Services = $58323; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Laundry/Linen Service: Column (A) - Total = $1337371; Column (B) - Program Services = $1337371; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Laundry: Column (A) - Total = $48780; Column (B) - Program Services = $48737; Column (C) - Management &amp; General = $43; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Late Run Penalties: Column (A) - Total = $90157; Column (B) - Program Services = $89464; Column (C) - Management &amp; General = $693; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Landscaping: Column (A) - Total = $474098; Column (B) - Program Services = $467299; Column (C) - Management &amp; General = $6799; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Infectious/Hazardous Waste: Column (A) - Total = $197986; Column (B) - Program Services = $197986; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Housekeeping: Column (A) - Total = $1818005; Column (B) - Program Services = $1812491; Column (C) - Management &amp; General = $5514; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Helicopter Lease: Column (A) - Total = $3260364; Column (B) - Program Services = $3260364; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Hazmat Disposal: Column (A) - Total = $3209; Column (B) - Program Services = $3209; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Faciliity Rental: Column (A) - Total = $0; Column (B) - Program Services = $0; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Equipment Rental: Column (A) - Total = $6141617; Column (B) - Program Services = $6037333; Column (C) - Management &amp; General = $104284; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>EMS Ambulance Expense: Column (A) - Total = $3189224; Column (B) - Program Services = $3189224; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Employee Physicals/Injuries: Column (A) - Total = $6806; Column (B) - Program Services = $6806; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>EE Activities: Column (A) - Total = $24774; Column (B) - Program Services = $24774; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Educational Instructors: Column (A) - Total = $30087; Column (B) - Program Services = $30087; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Dues and Subscription: Column (A) - Total = $980754; Column (B) - Program Services = $450480; Column (C) - Management &amp; General = $530274; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Drug Testing Awareness: Column (A) - Total = $23757; Column (B) - Program Services = $23757; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Contract/Outside Maintenance: Column (A) - Total = $10344757; Column (B) - Program Services = $10235885; Column (C) - Management &amp; General = $108872; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Contract Labor: Column (A) - Total = $9638265; Column (B) - Program Services = $9636849; Column (C) - Management &amp; General = $1416; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Consulting Fees: Column (A) - Total = $2580805; Column (B) - Program Services = $1846559; Column (C) - Management &amp; General = $734246; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Collection Fees: Column (A) - Total = $3465580; Column (B) - Program Services = $3465580; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Classified Advertising: Column (A) - Total = $89959; Column (B) - Program Services = $80701; Column (C) - Management &amp; General = $9258; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Claims Expense: Column (A) - Total = $12512194; Column (B) - Program Services = $12512194; Column (C) - Management &amp; General = $0; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Biomed Service: Column (A) - Total = $2506464; Column (B) - Program Services = $2505945; Column (C) - Management &amp; General = $519; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Bank Charges: Column (A) - Total = $490109; Column (B) - Program Services = $489926; Column (C) - Management &amp; General = $183; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Auto Lease: Column (A) - Total = $447704; Column (B) - Program Services = $439814; Column (C) - Management &amp; General = $7890; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Auto Expense/Fuel/Oil/Diesel: Column (A) - Total = $717125; Column (B) - Program Services = $710720; Column (C) - Management &amp; General = $6405; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part IX, Line 24e</Identifier>
        <ReturnReference>Form 990, Part IX, Line 24e: Other Expenses</ReturnReference>
        <Explanation>Administrative Expenses: Column (A) - Total = $24277; Column (B) - Program Services = $0; Column (C) - Management &amp; General = $24277; Column (D) - Fundraising = $0</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>The organization's governing documents, conflict of interest policy and financial statements are provided upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>Compensation for other officers and key employees are reviewed and approved by independent directors, after considering the results of a compensation survey of comparable positions at comparable entities. The evaluation and determination process, as well as a description of the comparable information utilized, is documented in meeting minutes promptly following the conclusion of the meeting of the directors.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>The organization has a written conflict of interest policy for all employees, officers and trustees. Annually all officers, key employees and trustees are required to complete a conflict of interest form disclosing any actual or potential conflict of interest with the organization. Should any transaction arise that may create a conflict, the transaction is reviewed and appropriate measures are taken.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: Form 990 Review Process</ReturnReference>
        <Explanation>The return is prepared by our staff accountant and is reviewed by senior management. It is then presented to the board for their review and comments. The final return is provided to the board prior to filing.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 6</Identifier>
        <ReturnReference>Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder</ReturnReference>
        <Explanation>ETMC Regional Healthcare System is the parent and sole member of the ETMC System affiliates and appoints certain members to the board.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 2</Identifier>
        <ReturnReference>Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et</ReturnReference>
        <Explanation>The following members of ETMC Regional Healthcare System are also board members / key employees of entities affiliated with ETMC Regional Healthcare System: Elmer G. Ellis, Byron Hale, B.G. Hartley, Larry Durrett, Ron Donaldson, M.D., Stephen Rydzak, M.D., Wade Ridley, James Wynne, Freddie Sanchez, Mike Gray, Mike Thomas and Paula Anthony.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part III, Line 4d</Identifier>
        <ReturnReference>Form 990, Part III, Line 4d : Other Program Services Description</ReturnReference>
        <Explanation>OTHER PROGRAM SERVICES 4: ETMC Air One has 3 air ambulances. OTHER PROGRAM SERVICES 5: ETMC Tyler has a Behavioral Health Center that provides inpatient and outpatient mental health services. OTHER PROGRAM SERVICES 6: The ETMC Rehabilitation Hospital has 49 licensed beds. It provides inpatient and outpatient services including physical, occupational and speech therapies, cardiac and pulmonary rehabilitation. ETMC Rehabilitation also offers preventive and health enhancement services. OTHER PROGRAM SERVICES 7: The ETMC Specialty Hospital is a long-term, acute hospital licensed for 36 beds. The hospital is dedicated to acute care for the medically complex patient. Specialized programs include ventilator care, complex multi-system medical, CVA/stroke, trauma, oncology and wound care. OTHER PROGRAM SERVICES 8: ETMC Home Services provides non-hospital health care services. OTHER PROGRAM SERVICES 9: ETMC Cancer Institute operates a free standing radiation cancer center and provides comprehensive cancer care with programs encompassing diagnostics services, medical and radiation, oncology, surgery and support programs. ETMC Cancer Institute is accredited by the American College of Surgeons as a comprehensive community cancer program. OTHER PROGRAM SERVICES 10: East Texas Medical Center Regional Healthcare System Self Insurance Trust provides self insurance coverage for the East Texas Medical Center Regional Healthcare System entities. OTHER PROGRAM SERVICES 11: ETMC Foundation supports the System and affiliate hospitals as well as the charitable companies affiliated with the System. This includes providing financial assistance to the System, raising, managing and distributing of charitable funds and gifts, providing educational programs on medical and health matters and providing for the regional development of healthcare and medical treatment of illnesses, physical and mental disabilities. OTHER PROGRAM SERVICES 12: FirstNet Exchange provides physicians electronic access to medical records.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
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          <ZIPCode>75835</ZIPCode>
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        <LegalDomicileState>TX</LegalDomicileState>
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        <PublicCharityStatus>Exempt</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ETMCRHS</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>ETMC Regional Health Services Inc</BusinessNameLine1>
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          <City>Tyler</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
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        <PrimaryActivity>Health Services</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
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        <ShareOfTotalIncome>162356987</ShareOfTotalIncome>
        <ShareOfEOYAssets>64726439</ShareOfEOYAssets>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>ETMC Regional Healthcare SystemETMCRHS</BusinessNameLine1>
        </NameOfOtherOrganization>
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        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>ETMC Regional Healthcare SystemETMCRHS</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>45234590</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
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      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>ETMC Regional Healthcare SystemETMCRHS</BusinessNameLine1>
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        <AmountInvolved>16804306</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>