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          <City>WINCHESTER</City>
          <State>VA</State>
          <ZIPCode>22601</ZIPCode>
        </AddressUS>
        <EINOfRecipient>541972659</EINOfRecipient>
        <IRCSection>501 (c)(3)</IRCSection>
        <AmountOfCashGrant>212772</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>COVER OUR HEALTH EXPENSES</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>GOOD SAMARITAN FREE CLINIC</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>121 QUEEN STREET</AddressLine1>
          <City>MARTINSBURG</City>
          <State>WV</State>
          <ZIPCode>25402</ZIPCode>
        </AddressUS>
        <EINOfRecipient>050602031</EINOfRecipient>
        <IRCSection>501 (c)(3)</IRCSection>
        <AmountOfCashGrant>26250</AmountOfCashGrant>
        <AmountOfNonCashAssistance>0</AmountOfNonCashAssistance>
        <PurposeOfGrant>CHARITY CARE</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>4</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>0</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIV>
        <Identifier>Grantmaker's Description of How Grants are Used</Identifier>
        <Explanation>VIRTUALLY ALL OF THE ORGANIZATIONS PROVIDED WITH GRANT FUNDS ARE LOCAL, AND CLOSELY MONITORED BY VALLEY HEALTH'S MANAGEMENT AND BOARD. PERIODIC REPORTS ARE OBTAINED AS WELL FROM THESE GRANTEES WHICH DISCUSS OPERATIONS AND BENEFITS RENDERED TO THE COMMUNITIES SERVED. BEFORE FUNDING IS GRANTED, CONSISTENCY OF MISSION IS EVALUATED IN ORDER TO ASSURE LIKE DIRECTION WITH VALLEY HEALTH INITIATIVES.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="11000144" softwareVersion="2011v1.2">
      <IdemnificationGrossUpPayments>X</IdemnificationGrossUpPayments>
      <DiscretionarySpendingAccount>X</DiscretionarySpendingAccount>
      <HousingAllowanceOrResidence>X</HousingAllowanceOrResidence>
      <WrittenPolicyReTAndEExpenses>true</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>true</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>true</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>true</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>true</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>true</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
        <NamePerson>WES WILLIAMS</NamePerson>
        <BaseCompensationFilingOrg>176330</BaseCompensationFilingOrg>
        <BonusFilingOrg>18329</BonusFilingOrg>
        <OtherCompensationFilingOrg>3011</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>16854</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>24326</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>238850</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>TONYA SMITH</NamePerson>
        <CompBasedOnRelatedOrgs>193928</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>26758</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>287</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>19113</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>28864</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>268950</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ROBERT AMOS</NamePerson>
        <BaseCompensationFilingOrg>193455</BaseCompensationFilingOrg>
        <BonusFilingOrg>26694</BonusFilingOrg>
        <OtherCompensationFilingOrg>263</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>28836</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>249248</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>RICHARD BRUCE CARLSON</NamePerson>
        <BaseCompensationFilingOrg>185269</BaseCompensationFilingOrg>
        <BonusFilingOrg>1000</BonusFilingOrg>
        <OtherCompensationFilingOrg>15191</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>25888</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>227348</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>PATRICK D IRELAND MD</NamePerson>
        <OtherCompensationRelatedOrgs>265598</OtherCompensationRelatedOrgs>
        <TotalCompensationRelatedOrgs>265598</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>PATRICK B NOLAN</NamePerson>
        <CompBasedOnRelatedOrgs>176335</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>25453</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>5121</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>17622</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>27852</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>252383</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>NELSON T CLARK</NamePerson>
        <CompBasedOnRelatedOrgs>150302</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>20704</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>10227</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>14529</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>13404</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>209166</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>NEIL MCLAUGHLIN</NamePerson>
        <CompBasedOnRelatedOrgs>142120</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>20177</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>5447</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>12651</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>20738</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>201133</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>NEAL MCKNIGHT</NamePerson>
        <BaseCompensationFilingOrg>192172</BaseCompensationFilingOrg>
        <BonusFilingOrg>1000</BonusFilingOrg>
        <OtherCompensationFilingOrg>255</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>17156</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>210583</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MARVIN T WAY</NamePerson>
        <BaseCompensationFilingOrg>322127</BaseCompensationFilingOrg>
        <BonusFilingOrg>55561</BonusFilingOrg>
        <OtherCompensationFilingOrg>4578</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>47624</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>29540</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>459430</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MARK H MERRILL</NamePerson>
        <BaseCompensationFilingOrg>594764</BaseCompensationFilingOrg>
        <BonusFilingOrg>105000</BonusFilingOrg>
        <OtherCompensationFilingOrg>23673</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>124961</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>44677</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>893075</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JOAN ROSCOE</NamePerson>
        <BaseCompensationFilingOrg>224309</BaseCompensationFilingOrg>
        <BonusFilingOrg>27302</BonusFilingOrg>
        <OtherCompensationFilingOrg>5356</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>25286</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>19113</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>301366</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>J CRAIG LEWIS</NamePerson>
        <BaseCompensationFilingOrg>347244</BaseCompensationFilingOrg>
        <BonusFilingOrg>59893</BonusFilingOrg>
        <OtherCompensationFilingOrg>4789</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>51336</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>35674</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>498936</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>FRANCIS X DENNEHY</NamePerson>
        <BaseCompensationFilingOrg>228224</BaseCompensationFilingOrg>
        <BonusFilingOrg>1000</BonusFilingOrg>
        <OtherCompensationFilingOrg>499</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>30664</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>260387</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>FLOYD R HEATER</NamePerson>
        <CompBasedOnRelatedOrgs>209444</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>30963</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>1244</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>20642</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>29642</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>291935</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ELIZABETH SAVAGE-TRACY</NamePerson>
        <BaseCompensationFilingOrg>211702</BaseCompensationFilingOrg>
        <BonusFilingOrg>25418</BonusFilingOrg>
        <OtherCompensationFilingOrg>763</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>20001</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>28948</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>286832</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DENA KENT</NamePerson>
        <CompBasedOnRelatedOrgs>194713</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>26866</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>4307</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>19189</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>28909</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>273984</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DAVID JAMES HUBER MD</NamePerson>
        <BaseCompensationFilingOrg>338945</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>39969</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>14636</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>393550</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>CHRISTOPHER GOODITIS</NamePerson>
        <BaseCompensationFilingOrg>181338</BaseCompensationFilingOrg>
        <BonusFilingOrg>2000</BonusFilingOrg>
        <OtherCompensationFilingOrg>157</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>28051</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>211546</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>BRET D RIPLEY</NamePerson>
        <BaseCompensationFilingOrg>200657</BaseCompensationFilingOrg>
        <BonusFilingOrg>500</BonusFilingOrg>
        <OtherCompensationFilingOrg>416</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>16824</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>218397</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ANDREW COHEN</NamePerson>
        <CompBasedOnRelatedOrgs>223224</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>22688</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>24635</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>22000</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>11024</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>303571</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ALFRED E PILONG JR</NamePerson>
        <CompBasedOnRelatedOrgs>365773</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>60360</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>7931</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>54054</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>36371</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>524489</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ADRIENNE MCKENNA</NamePerson>
        <BaseCompensationFilingOrg>78649</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>3641</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>14035</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>96325</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>Sch J, Part I, Line 6b</Identifier>
        <ReturnReference>Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or</ReturnReference>
        <Explanation>A portion of management's bonuses are based on the financial results of any given year with a residual on quality, patient satisfaction, patient safety, and project completion.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Sch J, Part I, Line 5b</Identifier>
        <ReturnReference>Part I, Line 5b: Explanation of organization compensation based on revenues of related organization</ReturnReference>
        <Explanation>A portion of management's bonuses are based on the financial results of any given year with a residual on quality, patient satisfaction, patient safety, and project completion.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>Sch J, Part I, Line 1a</Identifier>
        <ReturnReference>Part I, Line 1a: Relevant information in regards to selections on 1a.</ReturnReference>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK.1" softwareId="11000144" softwareVersion="2011v1.2">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>WEST VIRGINIA HOSPITAL FINANCE AUTHORITY</BusinessNameLine1>
        </IssuerName>
        <CUSIPNumber>956622c28</CUSIPNumber>
        <DateIssued>2009-12-17</DateIssued>
        <IssuePrice>24811955</IssuePrice>
        <DescriptionOfPurpose>SEE STATEMENT</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>IDA OF CITY OF WINCHESTER VA</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>521232253</IssuerEIN>
        <CUSIPNumber>973129EQ8</CUSIPNumber>
        <DateIssued>2009-12-17</DateIssued>
        <IssuePrice>74256930</IssuePrice>
        <DescriptionOfPurpose>SEE STATEMENT</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>IDA OF CITY OF WINCHESTERVA</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>521232253</IssuerEIN>
        <CUSIPNumber>973129DW6</CUSIPNumber>
        <DateIssued>2007-01-31</DateIssued>
        <IssuePrice>91415663</IssuePrice>
        <DescriptionOfPurpose>SEE STATEMENT</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <TotalProceeds>24811955</TotalProceeds>
        <IssuanceCostsFromProceeds>469612</IssuanceCostsFromProceeds>
        <CapitalExpenditures>24342343</CapitalExpenditures>
        <YearOfSubstCompletion>2011</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>false</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <TotalProceeds>74256930</TotalProceeds>
        <IssuanceCostsFromProceeds>1301587</IssuanceCostsFromProceeds>
        <CapitalExpenditures>48143389</CapitalExpenditures>
        <AmountUnspent>24811955</AmountUnspent>
        <YearOfSubstCompletion>2012</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>false</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <TotalProceeds>91415663</TotalProceeds>
        <RefundingEscrow>14508990</RefundingEscrow>
        <IssuanceCostsFromProceeds>3128218</IssuanceCostsFromProceeds>
        <CapitalExpenditures>73778455</CapitalExpenditures>
        <YearOfSubstCompletion>2008</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>true</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <EngageBondCounselResearch>true</EngageBondCounselResearch>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <EngageBondCounselResearch>true</EngageBondCounselResearch>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <EngageBondCounselResearch>true</EngageBondCounselResearch>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
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        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>true</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>WELLS FARGO</BusinessNameLine1>
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        <TermOfHedge>33.0000</TermOfHedge>
        <SuperintegratedHedge>false</SuperintegratedHedge>
        <HedgeTerminated>false</HedgeTerminated>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </NameOfGICProvider>
        <RegulatorySafeHarborSatisfied>true</RegulatorySafeHarborSatisfied>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>true</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>true</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>WELLS FARGO</BusinessNameLine1>
        </NameOfHedgeProvider>
        <TermOfHedge>33.0000</TermOfHedge>
        <SuperintegratedHedge>false</SuperintegratedHedge>
        <HedgeTerminated>false</HedgeTerminated>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </NameOfGICProvider>
        <RegulatorySafeHarborSatisfied>true</RegulatorySafeHarborSatisfied>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>true</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>true</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>MERRILL LYNCH</BusinessNameLine1>
        </NameOfHedgeProvider>
        <TermOfHedge>33.0000</TermOfHedge>
        <SuperintegratedHedge>false</SuperintegratedHedge>
        <HedgeTerminated>false</HedgeTerminated>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </NameOfGICProvider>
        <RegulatorySafeHarborSatisfied>true</RegulatorySafeHarborSatisfied>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <FedTaxRequirementsCompliance>X</FedTaxRequirementsCompliance>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="11000144" softwareVersion="2011v1.2">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Virginia Cancer Specialists PC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>See Below</Relationship>
        <AmountOfTransaction>269869</AmountOfTransaction>
        <DescriptionOfTransaction>Medical Office Lease</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>John Kent</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>See Below</Relationship>
        <AmountOfTransaction>11165</AmountOfTransaction>
        <DescriptionOfTransaction>Employment Arrangement</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Explanation>1.John Kent - Family member of Dena Kent, a current Officer$11,165 Employment arrangement2.Virginia Cancer Specialists, PC - Professional corporation with more than 5% ownership interests held by William Major, MD, a current Trustee$269,870 Medical Office Lease</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="11000144" softwareVersion="2011v1.2">
      <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 makes all records available as required by law.</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>The Board of Trustees is responsible for the compensation review. They use compensation literature and outside consultants to determine the appropriate compensation for the CEO,Officers,and Senior Management. As new individuals are hired into management positions, recruiting firms use FMV information to establish salary and general compensation levels.</Explanation>
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      <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>All employees that are managers, have purchasing rights with defined limits, or may enter into a contract on behalf of the organization are required to sign a conflict of interest attestation upon employment and annually. All employees can report breaches in VH policy. VH has an employee integrity hotline and a compliance officer. The audit committee is advised of compliance activity on a quarterly basis in addition to monthly follow up by the CEO on any immediate issues. Any infractions can result in disciplinary action or dismissal.</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 990 is prepared by internal staff and undergoes several levels of review including the CFO and CEO. Further, the board reviews the 990 during one of its recurring monthly meetings where any issues of concern or question are addressed by Senior Management.</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>The corporation shall have two classes of members: regular and honorary. The number of regular members shall not exceed 100. In addition, there may be an unlimited number of honorary members. Qualifications for both classes of membership shall be established in the Bylaws of the Corporation. Honorary members have no voting or any other rights whatsoever. Regular members shall have voting rights soley with respect to the election of regular members, honorary members and trustees, as established in the Bylaws of the Corporation.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Explanation>Client Note 1 - SCHEDULE K PART I LINE AFunds used to refinance 2003 of Warren Memorial Hospital and Shenandoah Memorial Hospital;purchase of equipment; construction of ambulatory care center at Warren; renovations and upgrades at Warren, Shenandoah, and Winchester Medical Center.PART I LINE BFunds used for WMC Campus Expansion, East Parking Garage and reimbursement for Diagnostic Center and CE Infrastructure.PART I LINE CFunds used to build new Hampshire Hospital.</Explanation>
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