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        <ProgramServices>7790205</ProgramServices>
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        <ManagementAndGeneral>494181</ManagementAndGeneral>
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      <FeesForServicesAccounting>
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        <ManagementAndGeneral>173106</ManagementAndGeneral>
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      <FeesForServicesLobbying>
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        <ManagementAndGeneral>72425</ManagementAndGeneral>
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      <OfficeExpenses>
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      <InformationTechnology>
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        <ManagementAndGeneral>3962385</ManagementAndGeneral>
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        <ManagementAndGeneral>2983957</ManagementAndGeneral>
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        <ProgramServices>13960741</ProgramServices>
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        <ProgramServices>516015</ProgramServices>
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        <Description>LICENSES AND TAXES</Description>
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        <ManagementAndGeneral>7138890</ManagementAndGeneral>
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      <OtherExpenses>
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        <ProgramServices>286789</ProgramServices>
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        <ManagementAndGeneral>66000</ManagementAndGeneral>
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        <EOY>312685</EOY>
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        <ReturnReference>PART II-B, LINE 1I:</ReturnReference>
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      <OtherLiabilities>
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      <OtherLiabilities>
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      <OtherLiabilities>
        <Description>NOTE PAYABLE</Description>
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        <ReturnReference>PART X:</ReturnReference>
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        <NetCommunityBuildingExpense>13216</NetCommunityBuildingExpense>
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        <NetCommunityBuildingExpense>4472</NetCommunityBuildingExpense>
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        <NetCommunityBuildingExpense>65691</NetCommunityBuildingExpense>
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      </HealthImprovementAdvocacy>
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        <NetCommunityBuildingExpense>21374</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </WorkforceDevelopment>
      <Other>
        <TotalCommunityBuildingExpense>343409</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>343409</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00100</PercentOfTotalExpense>
      </Other>
      <Total>
        <TotalCommunityBuildingExpense>448162</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>448162</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00130</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>1</BadDebtExpenseReported>
      <BadDebtExpenseAmount>3979614</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>90828249</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>112932273</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-22104024</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>1</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>0</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>YAKIMA VALLEY MEMORIAL HOSPITAL</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>2811 TIETON DRIVE</AddressLine1>
          <City>YAKIMA</City>
          <State>WA</State>
          <ZIPCode>98902</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <TeachingHospital>X</TeachingHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>YAKIMA VALLEY MEMORIAL HOSPITAL</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <EligibilityCriteriaExplained>1</EligibilityCriteriaExplained>
        <UsesFPGFree>1</UsesFPGFree>
        <FPGFreePercent>300.000000000000</FPGFreePercent>
        <UsesFPGDiscounted>1</UsesFPGDiscounted>
        <FPGDiscountPercent>300.000000000000</FPGDiscountPercent>
        <ExplainsBasis>1</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <ExplainsApplicationMethod>1</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>1</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <ActionsOnNonpayment>1</ActionsOnNonpayment>
        <PermitReportToCreditAgency>X</PermitReportToCreditAgency>
        <PermitLawsuit>X</PermitLawsuit>
        <CollectionActivities>1</CollectionActivities>
        <ReportToCreditAgency>X</ReportToCreditAgency>
        <Lawsuit>X</Lawsuit>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifyBeforeDischarge>X</NotifyBeforeDischarge>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>1</NondiscrimEmergencyCarePolicy>
        <AverageNegotiatedRates>X</AverageNegotiatedRates>
        <AmountsGenerallyBilled>0</AmountsGenerallyBilled>
        <GrossCharges>0</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>17</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YAKIMA GASTROENTEROLOGY ASSOCIATES</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3909 CREEKSIDE LOOP</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>MEMORIAL CORNERSTONE MEDICINE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>402 S 12TH AVE</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>GARDEN VILLAGE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>206 S 10TH AVE</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>SKILLED NURSING FACILITY</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FAMILY MEDICINE OF YAKIMA</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>504 S 40TH AVE</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98908</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>PACIFIC CREST FAMILY MEDICINE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>31 S 72ND AVE</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98908</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>APPLE VALLEY FAMILY MEDICINE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1008 S 38TH AVE</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>CASCADE SURGICAL PARTNERS</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3003 TIETON DRIVE SUITE 300</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>SELAH FAMILY MEDICINE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>620 N PARK DRIVE</AddressLine1>
            <City>SELAH</City>
            <State>WA</State>
            <ZIPCode>98942</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>MEMORIAL HOSPITAL PHYSICIANS</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2811 TIETON DRIVE</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YAKIMA VASCULAR ASSOCIATES</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3999 ENGLEWOOD SUITE 202</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YAKIMA INTERNAL MEDICINE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3003 TIETON DRIVE SUITE 320</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YAKIMA NEUROSURGERY ASSOCIATES</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1470 N 16TH AVE</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YAKIMA PLASTIC SURGERY ASSOCIATES</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3003 TIETON DRIVE SUITE 330</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>MEMORIAL SLEEP SPECIALISTS</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>406 S 30TH AVE SUITE 206</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YAKIMA EAR NOSE AND THROAT</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1601 CREEKSIDE LOOP</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>VALLEY ORTHOPEDIC SURGEONS</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3003 TIETON DRIVE SUITE 350</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YAKIMA ENDOCRINOLOGY ASSOCIATES</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3909 CREEKSIDE LOOP</AddressLine1>
            <City>YAKIMA</City>
            <State>WA</State>
            <ZIPCode>98902</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT PHYSICIAN CLINIC</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, LINE 7: THE HOSPITAL USED RATIO OF PATIENT CARE COST TO CHARGES METHODOLOGY TO CALCULATE THE AMOUNT REPORTED IN THE TABLE DERIVED FROM WORKSHEETS 1 AND 2.LINE 7G: THE AMOUNTS LISTED ON THIS LINE ARE FOR OPERATING LOSSES OF VARIOUS PHYSICIAN CLINICS THAT OPERATE AT A LOSS.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART II: #3 COMMUNITY SUPPORT - STAFF MEMBERS ATTEND MEETINGS AND PARTICIPATE ON THE COMMITTEE FOR THE COMMUNITY/REGION/COUNTY TO PLAN AND PRACTICE REGIONAL EMERGENCY RESPONSE FOR DISASTERS.#5 LEADERSHIP DEVELOPEMENT/TRAINING OF COMMUNITY MEMBERS - ORGANIZATIONAL HEALTH &amp; WELLNESS DEPARTMENT SHARES THEIR TRAINING AND EXPERTISE WITH THE COMMUNITY THROUGH WORKSHOPS AND TRAININGS. TEMPERAMENT, INTERACTION STYLES, INTO THE BLUE, AND LEADERSHIP TOOLS ARE USED.#7 COMMUNITY HEALTH IMPROVEMENT ADVOCACY - YOUTHWORKS IS A YOUTH IMPROVEMENT AND COMMUNITY SERVICE INITIATIVE ENGAGING YOUTH DIRECTLY THROUGH MENTORING, VOLUNTEERING &amp; PHILANTHROPY.#8 WORKFORCE DEVELOPMENT - DEPARTMENTS AND STAFF PROVIDE CAREER DEVELOPMENT FOR STUDENTS WITH DISABILITIES.#9 OTHER - EDUCATION OF HIGH SCHOOL STUDENTS ON MENTORING AND VOLUNTEERING SKILLS, PROVISION OF TRAINING FOR STUDENTS WITH DISABILITIES BY PROVIDING OPPORTUNITIES ON THE WORK SITE, ASSISTANCE WITH COMMUNITY COALITIONS WORKING ON REDUCING EMERGENCY ROOM VISITS AND DEVELOPING EMERGENCY RESPONSE NETWORKS, PROVIDING ASSISTANCE TO NON-PROFIT ORGANIZATIONS IN COMMUNITY DEVELOPMENT AND EMPLOYEE POLICIES AND PROCEDURES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 4: THE HOSPITAL USED RATIO OF PATIENT CARE COST TO CHARGES METHODOLOGY TO CALCULATE THE AMOUNT ON LINE 2. OUR FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT AND REPORT BAD DEBT AS AN EXPENSE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 8: TO THE EXTENT THAT COSTS (USING THE MEDICARE COST REPORT) EXCEED CHARGES, THIS SHORTFALL SHOULD BE REGARDED AS COMMUNITY BENEFIT BECAUSE WE TREAT AND MAINTAIN THE HEALTH OF OUR LARGE LOCAL MEDICARE POPULATION DESPITE THE NECESSARY SUBSIDIZATION OF THESE HEALTH BENEFITS.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY DOESN'T ADDRESS COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY OR FINANCIAL ASSISTANCE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 2: UTILIZED DATA FROM COUNTY PUBLIC HEALTH ASSESSMENT.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 3: WE HAVE A CHARITY CARE POLICY WHICH HAS RECEIVED STATE APPROVAL. THERE ARE NUMEROUS MECHANISMS DOCUMENTED UNDER THE POLICY FOR INFORMING AND EDUCATING PATIENTS AND GUARANTORS.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 4: THE COMMUNITY SERVED IS PRIMARILY RESIDENTS OF YAKIMA COUNTY, WASHINGTON (POPULATION 240,000), WITH A SMALL PERCENTAGE (LESS THAN 15%) FROM OUTLYING AREAS.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommittee>X</CompensationCommittee>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>0</SeverancePayment>
      <SupplementalNonqualRetirePlan>1</SupplementalNonqualRetirePlan>
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      <Form990ScheduleJPartII>
        <NamePerson>RICHARD W LINNEWEH JR</NamePerson>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JOHN G VORNBROCK</NamePerson>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>DAVE ATTEBERRY</NamePerson>
        <BaseCompensationFilingOrg>659099</BaseCompensationFilingOrg>
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      <Form990ScheduleJPartII>
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      <Form990ScheduleJPartII>
        <NamePerson>GEORGE GADE</NamePerson>
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      <Form990ScheduleJPartIII>
        <ReturnReference>PART I, LINE 4B</ReturnReference>
        <Explanation>IN JULY 2002, THE HOSPITAL'S BOARD OF TRUSTEES ADOPTED A SALARY CONTINUATION PLAN (THE "PLAN"), IN THE FORM OF A NON-QUALIFIED RETIREMENT BENEFIT FOR SENIOR EXECUTIVES. THE RETIREMENT BENEFIT PROVIDED BY THE PLAN IS SUPPLEMENTARY TO THE HOSPITAL'S EMPLOYEE PENSION PLAN, TAX-DEFERRED ANNUITY RETIREMENT PLAN, 401(K) PLAN AND SOCIAL SECURITY RETIREMENT EARNINGS. BENEFITS ARE CALCULATED AS THE DIFFERENCE BETWEEN THE PROJECTED AGE-65 VALUE OF THE AFOREMENTIONED BENEFITS AND 75% OF THE LUMP SUM AT AGE 65. NO BENEFITS UNDER THE PLAN ARE GENERALLY AVAILABLE FOR A SENIOR EXECUTIVE WHO RETIRES PRIOR TO HIS/HER 65TH BIRTHDAY. FUNDING FOR THE PLAN BEGAN IN 2002, AND THE HOSPITAL FIRST BEGAN ACCRUING A LIABILITY FOR THE PLAN DURING THE FISCAL YEAR ENDING OCTOBER 31, 2005. THE HOSPITAL'S LIABILITY ACCRUAL IS BASED ON THE ASSUMPTION THAT ALL SEVEN EXECUTIVES WILL BE WORKING UNTIL AGE 65. MR. JOHN G. VORNBROCK IS THE SENIOR VICE PRESIDENT/CFO OF YAKIMA VALLEY MEMORIAL HOSPITAL. AS OF 10/31/11, MR. VORNBROCK IS 64 YEARS OLD AND HAS BEEN IN HIS CURRENT OTHER SENIOR ADMINISTRATIVE CAPACITIES AT THE HOSPITAL SINCE 1978. MR VORNBROCK ACCRUED BENEFITS UNDER THE PLAN IN THE AMOUNT OF $556,498 DURING THE 2010 CALENDAR YEAR. GAIL WEAVER WAS PAID $459,966 FROM THE PLAN DURING THE 2010 CALENDAR YEAR UPON REACHING AGE 65.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>WASHINGTON HEALTH CARE FACILITIES AUTHORITY</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>911108929</IssuerEIN>
        <CUSIPNumber>NONEAVAIL</CUSIPNumber>
        <DateIssued>2007-05-21</DateIssued>
        <IssuePrice>6000000</IssuePrice>
        <DescriptionOfPurpose>CAPITAL EQUIPMENT LEASE</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>WASHINGTON HEALTH CARE FACILITIES AUTHORITY</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>911108929</IssuerEIN>
        <CUSIPNumber>NONEAVAIL</CUSIPNumber>
        <DateIssued>2009-08-20</DateIssued>
        <IssuePrice>4977500</IssuePrice>
        <DescriptionOfPurpose>CAPITAL EQUIPMENT LEASE</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>5125952</AmountRetired>
        <TotalProceeds>6055252</TotalProceeds>
        <IssuanceCostsFromProceeds>40000</IssuanceCostsFromProceeds>
        <CapitalExpenditures>6015252</CapitalExpenditures>
        <YearOfSubstCompletion>2008</YearOfSubstCompletion>
        <CurrentRefunding>0</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <AmountRetired>2019514</AmountRetired>
        <TotalProceeds>4977729</TotalProceeds>
        <IssuanceCostsFromProceeds>20500</IssuanceCostsFromProceeds>
        <CapitalExpenditures>4957229</CapitalExpenditures>
        <YearOfSubstCompletion>2010</YearOfSubstCompletion>
        <CurrentRefunding>0</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>0</OwningBondFinancedProperty>
        <AnyLeaseArrangements>0</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>0</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>0</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>1</BondCounselRoutinelyEngaged>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>1</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>0</OwningBondFinancedProperty>
        <AnyLeaseArrangements>0</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>0</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>0</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>1</BondCounselRoutinelyEngaged>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>1</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>0</Form8038TFiled>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>0</GrossProceedsInvested>
        <ExceptionToRebate>1</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>0</Form8038TFiled>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>0</GrossProceedsInvested>
        <ExceptionToRebate>1</ExceptionToRebate>
      </Form990ScheduleKPartIV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>DIANE PATTERSON</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>DAUGHTER OF TRUSTEE</Relationship>
        <AmountOfTransaction>62442</AmountOfTransaction>
        <DescriptionOfTransaction>EMPLOYEE OF HOSPITAL</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>EMERGENCY ASSOCIATES OF YAKIMA PLLC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>A TRUSTEE IS A PHYS. SHAREHOLDER IN THE ENTITY.</Relationship>
        <AmountOfTransaction>6866668</AmountOfTransaction>
        <DescriptionOfTransaction>EMERGENCY PHYSICIANS SERVICES CONTRACT.</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>KATE ROSSMAN</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>DAUGHTER OF TRUSTEE</Relationship>
        <AmountOfTransaction>60735</AmountOfTransaction>
        <DescriptionOfTransaction>EMPLOYED IN A NURSING POSITION.</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>YAKIMA HEART CENTER INC PS</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>TWO TRUSTEES ARE PHYS. SHAREHOLDERS IN THE ENTITY.</Relationship>
        <AmountOfTransaction>1445354</AmountOfTransaction>
        <DescriptionOfTransaction>EIGHT SERVICE CONTRACTS RELATED TO CARDIOLOGY.</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>MICHAEL LINNEWEH</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SON OF KEY EMPLOYEE</Relationship>
        <AmountOfTransaction>28920</AmountOfTransaction>
        <DescriptionOfTransaction>EMPLOYEE OF HOSPITAL.</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>PHYSICIAN ANESTHIESIA ASSOCIATION</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>ROSS KATZ, SHAREHOLDER</Relationship>
        <AmountOfTransaction>2090000</AmountOfTransaction>
        <DescriptionOfTransaction>ANESTHESIA SERVICES PROVIDED TO HOSPITAL</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 2</Identifier>
        <Explanation>RICHARD SPIEGEL AND ROGER VEILBIG HAVE A BUSINESS RELATIONSHIP.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION B, LINE 11</Identifier>
        <Explanation>REVIEW IS CONDUCTED BY THE CHIEF ACCOUNTANT, CFO, CEO AND BOARD OF TRUSTEES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>CONFLICTS ARE DISCLOSED. PERSONS HAVING A CONFLICT MAY NOT BE DECISION-MAKERS IN AREAS WHERE CONFLICTS EXIST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15</ReturnReference>
        <Explanation>COMPENSATION IS SET BY A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES FOLLOWING REVIEW OF COMPARABILITY AND PERFORMANCE DATA.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>GOVERNING DOCUMENTS ARE FILED WITH THE WASHINGTON SECRETARY OF STATE. CONFLICT OF INTEREST POLICY IS CONTAINED IN A BUSINESS ETHICS BROCHURE. FINANCIAL STATEMENTS ARE FILED WITH THE WASHINGTON STATE DEPARTMENT OF HEALTH.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES:</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5:</ReturnReference>
        <Explanation>NET CHANGE IN BOOKED VALUE OF SUBSIDIARIES 7,807,941. TOTAL TO FORM 990, PART XI, LINE 5: 7,807,941.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART XII, LINE 2C:</ReturnReference>
        <Explanation>NO CHANGE FROM PRIOR YEAR.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MEMORIAL PHYSICIANS</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>PO BOX 2947</AddressLine1>
          <City>YAKIMA</City>
          <State>WA</State>
          <ZIPCode>98907</ZIPCode>
        </AddressUS>
        <EIN>911615998</EIN>
        <PrimaryActivities>MEDICAL SERVICES</PrimaryActivities>
        <LegalDomicileState>WA</LegalDomicileState>
        <TotalIncome>30080442</TotalIncome>
        <EOYAssets>11721321</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>YAKIMA VALLEY MEMORIAL HOSPITAL</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartI>
      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>CENTRAL WASHINGTON HEALTHCARE PARTNERS LLC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>PO BOX 2947</AddressLine1>
          <City>YAKIMA</City>
          <State>WA</State>
          <ZIPCode>98907</ZIPCode>
        </AddressUS>
        <EIN>453483343</EIN>
        <PrimaryActivities>ACCOUNTABLE CARE ORG</PrimaryActivities>
        <LegalDomicileState>WA</LegalDomicileState>
        <TotalIncome>0</TotalIncome>
        <EOYAssets>915011</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>YAKIMA VALLEY MEMORIAL HOSPITAL</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartI>
      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>YAKIMA VALLEY MEMORIAL PHYSICIANS</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>PO BOX 9787</AddressLine1>
          <City>YAKIMA</City>
          <State>WA</State>
          <ZIPCode>98909</ZIPCode>
        </AddressUS>
        <EIN>753186720</EIN>
        <PrimaryActivities>MEDICAL SERVICES</PrimaryActivities>
        <LegalDomicileState>WA</LegalDomicileState>
        <TotalIncome>33265930</TotalIncome>
        <EOYAssets>0</EOYAssets>
        <DirectControllingEntityName>
          <BusinessNameLine1>YAKIMA VALLEY MEMORIAL HOSPITAL</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartI>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>GARDEN VILLAGE</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>206 S 10TH AVE</AddressLine1>
          <City>YAKIMA</City>
          <State>WA</State>
          <ZIPCode>98902</ZIPCode>
        </AddressUS>
        <EIN>912090034</EIN>
        <PrimaryActivities>SKILLED NURSING</PrimaryActivities>
        <LegalDomicileState>WA</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>9</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>0</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>VALLEY IMAGING</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>314 S 11TH AVE SUITE B</AddressLine1>
          <City>YAKIMA</City>
          <State>WA</State>
          <ZIPCode>98902</ZIPCode>
        </AddressUS>
        <EIN>911926010</EIN>
        <PrimaryActivities>IMAGING SERVICES</PrimaryActivities>
        <LegalDomicileState>WA</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11A</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>0</ControlledOrg>
      </Form990ScheduleRPartII>
      <ReceiptOfIntAnnRentsRoyalties>0</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>1</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>1</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>0</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>0</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>0</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>0</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>0</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>0</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>0</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>0</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>1</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>1</SharingOfFacilities>
      <SharingOfPaidEmployees>1</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>1</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>1</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>0</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>0</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>