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        <Identifier>Part X</Identifier>
        <ReturnReference>Part X : FIN48 Footnote</ReturnReference>
        <Explanation>In June 2006, the Financial Accounting Standards Board (FASB) issued Interpretation NO. 48, Accounting for Uncertainty in Income Taxes-an interpretation of FASB Statement NO. 109, Accounting for Income Taxes (FIN 48), which creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Under the requirements of FIN 48, tax-exempt organizations could now be required to record an obligation as the result of a tax position they have historically taken or various tax exposure items. Prior to FIN 48, the determination of when to record a liability for tax exposure was based on whether a liability was considered probable and reasonably estimable in accordance with SFAS No.5, Accounting for Contingencies. On July 1, 2007, the parent company, WellSpan Health, adopted FIN 48. WellSpan Health determined that it does not have any uncertain tax positions through June 30, 2010.</Explanation>
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      <Form990ScheduleDPartXIV>
        <Identifier>Part V, Line 4</Identifier>
        <ReturnReference>Part V, Line 4: Intended uses of the endowment fund.</ReturnReference>
        <Explanation>The funds were used to improve the health and welfare of the residents of York and Adams counties of Pennsylvania.</Explanation>
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        <Explanation>All WellSpan non-research grant activities must be coordinated through the York Health Foundation and Gettysburg Hospital Foundation to insure that grant projects are implemented, evaluated, and monitored in accordance with applicable granting agency regulations, with WellSpan policies and procedures, and are consistent with the strategies and priorities of the organization. WellSpan has defined the processes by which grants are identified, developed, reviewed, approved, and monitored by the organization. This policy covers non-research grants applied for and received by an entity of WellSpan Health. It does not cover grants made by the organization. Research grants are defined as those that involve "a systematic investigation designed to develop or contribute to generalizable knowledge (45CFR 46.102(d)) and are overseen by Emig Research Center (Policy #619 Extramural Research Funding)</Explanation>
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      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Richard D Poole LLC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>Officer Dale Voorheis</Relationship>
        <AmountOfTransaction>2400000</AmountOfTransaction>
        <DescriptionOfTransaction>General Contracting Serv</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Talpier Inc</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>Officer Dale Voorheis</Relationship>
        <AmountOfTransaction>261000</AmountOfTransaction>
        <DescriptionOfTransaction>Rental of property</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>White Rose Surgical Associates Ltd</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>Pres.-Samuel S. Laucks,II</Relationship>
        <AmountOfTransaction>351000</AmountOfTransaction>
        <DescriptionOfTransaction>YH Resident Ed &amp; Coverage</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
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      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Adams County National Bank</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>Chairman Ronald Hankey</Relationship>
        <AmountOfTransaction>102899</AmountOfTransaction>
        <DescriptionOfTransaction>Checking &amp; Trust Mgmt</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Barley Snyder LLC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>Partner Jeffrey Lobach</Relationship>
        <AmountOfTransaction>455833</AmountOfTransaction>
        <DescriptionOfTransaction>Legal Service WSH &amp; Affil</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="09000047" softwareVersion="2009v1.7">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>Governing documents, policies, and financial statements are available 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>The Compensation Committee of WellSpan Health is responsible for rewarding and reinforcing key executives for the achievement of annual and long-term performance objectives. The Compensation Committee shall consist of not more than six (6) persons, of whom two (2) shall be the Chairman and Vice Chairman of the Board of the Corporation, and the remaining members shall be such other persons as may be appointed by the Chairman of the Board of the Corporation, with the approval of the Board of Directors; provided, however, that the Compensation Committee shall not include any persons who are employed by the System. The Chairman of the Board of Gettysburg Hospital shall participate. The role of the Compensation Committee is to set the Executive Compensation Philosophy for the system and ensure adherence, evaluate performance and establish compensation for the WellSpan President, evaluate team performance of the executive team and establish awards, review and approve senior executive base salary ranges, and oversee employed physician compensation programs. The Committee will approve salary ranges for each executive position and review incumbent salaries annually. The Committee will be responsible for reviewing the President's salary each year, and if warranted, authorizing an adjustment to maintain competitiveness. The President will have the authority to make salary adjustments for subordiate positions. The Committee is responsible for approving and authorizing payment of the performance awards. The Committee will approve and authorize payment of the President's performance awards. Integrated Healthcare Strategies, Inc., based in Minneapolis Minnesota is the external consultant to the committee. This consultant focuses exclusively on executive and physician compensation in the health care industry. In summary, the executive and physician compensation review process consists of the following: 1) Cash compensation reviewed annually 2) Cash compensation reviewed by external consultant biennially 3) external total compensation (cash, incentives, benefits, perquisites) reviewed by external consultant periodically 4) Process is integrated with compensation analysis for other WellSpan positions 5) Committee decisions are documented in minutes maintained in Human Resources.</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>Officers, directors, and key employees fill out a WellSpan Health Conflict of Interest Disclosure Statement questionaire annually. The questionaire is administered by the Internal Audit Department of WellSpan Health, the Parent Company.There shall be full disclosure by any Director having a business or personal interest or relationship which may be in conflict with the interests of the Corporation. After such disclosure the Director shall abide by the determination of the Board of Directors as to whether a conflict exists, the extent to which, if at all, the Director will be permitted to be present during the Board of Directors' discussion of the matter in which the Director may be interested, and whether the Director will be permitted to participate in such discussion and cast a vote in such matter.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: Form 990 Review Process</ReturnReference>
        <Explanation>Management provided an electronic copy of the form 990 to each voting member of the organization's governing body, prior to its filing with the IRS. The organization's finance management team provided a presentation to the Audit Committee on the organization's 990 return.</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>Jeffrey D. Lobach, Chairman of the Board of Directors, is married to Lucinda C. Lobach, who is a member of the Board of Directors of WellSpan Specialty Services, VNA Home Health Services, and VNA Community Services.Ronald Hankey, Board Director, is a brother-in-law of Paul Ketterman, who is a director on the Gettysburg Hospital Foundation Board.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Client Note1</ReturnReference>
        <Explanation>WellSpan Health - 2010 Community Benefit ReportPREPARED TO CAREWellSpan Health includes: Gettysburg Hospital o York Hospital o Apple Hill Surgical Center o VNA Home Health o WellSpan Medical Group o SOUTH CENTRAL Preferred o WellSpan Pharmacy o Gettysburg Hospital Foundation o York Health Foundation o York Provider NetworkOUR CHARITABLE COMMUNITY MISSIONWellSpan is an integrated health system serving the Adams-York county region. As a community-based, not-for-profit organization, WellSpan is dedicated to improving the health and well-being of the people it serves. WellSpan will assume a leadership role and develop partnerships with other organizations to:o improve access to coordinated, high-quality, cost-effective health care serviceso educate the health care providers of tomorrowo promote healthy lifestyles and lifelong wellnesso make its local communities healthier, more desirable places to live, work and playPREPAREDThe road of life may have its twists and turns, ups and downs. Rest assured, WellSpan Health is prepared. As a matter of practice, we seek to plan ahead for any crisis or concern that may impact our community. Our goal is to be ready to serve. Intelligently. Calmly. And with understanding and foresight.Over the last year, this proactive approach to life and the curves it may throw has impacted our community profoundly. WellSpan Health was ready and able to protect our children from H1N1, to help families receive the care they need when they couldn't afford to pay and to remove barriers that often impede access to quality health care.Even now, we are preparing for the future and whatever it may hold. WellSpan Health is constantly training tomorrow's health care professionals, studying and trialing advanced new treatments, and seeking innovative partnerships and ways to support, improve and protect our community.Because we never stop thinking ahead, WellSpan remains prepared to guide, protect and care. For the journey that is life.PREPARED TO PROTECTShielding our community from potential disaster.The worst thing to be in a disaster is unprepared. At WellSpan, we believe it is our responsibility to consider and plan for every scenario and possibility. Should there be a community-wide disaster or pandemic, we intend to be ready with solid partnerships, an action plan and a full understanding of our community's resources. This approach is best exemplified through our involvement with the York/Adams Metropolitan Medical Response System (YAMMRS) and, specifically, the recent H1N1 situation.Example: Carolyne Hack, RN, and Ethan and Kristia KannelIn late 2009, the H1N1 virus took center stage in the news media, our households and communities. There was a healthy amount of concern, especially for mothers like Amanda Kannel whose children were in the high-risk group.Amanda had taken all the necessary precautions to prevent an outbreak in her home, and she wanted to have her children vaccinated as soon as possible. Fortunately, the York/Adams Metropolitan Medical Response System (YAMMRS) had taken all the necessary precautions as well, and was prepared to meet her needs in addition to thousands of others. WellSpan played a key role in this preparedness, providing the key leaders responsible for planning, supply chain management, staff, communication, volunteer coordination and essential clinical expertise.At the end of the day, Amanda's children, Ethan and Kristia, received their immunizations through YAMMRS' school-based program. They made it through flu season, H1N1-free. Just as important, the Kannel family made it through the season with the peace of mind that comes from thinking ahead.OUR PROGRESS: H1N1 Flu VirusAfter nearly eight years of planning for a variety of disasters, the York/Adams Metropolitan Medical Response System (YAMMRS) mobilized in early 2009 with the emergence of the H1N1 flu virus.Since York and Adams counties do not have public health departments, YAMMRS made the decision to apply as a separate entity to receive the H1N1 vaccine, similar to what hospitals did. The group identified five priority groups for vaccination. Pregnant women and those of childbearing age were the first priority group. WellSpan Health, Memorial Hospital and other providers focused on the first priority group while YAMMRS decided to focus on young children.Beginning in November 2009 and running through February 2010, YAMMRS undertook the logistical challenge of administering the H1N1 vaccine to children and other residents of Adams and York counties. Consider some of the organization's accomplishments:"The administration of 65,000 doses of vaccine"The coordination of clinics at 124 different schools in both counties"The organization of nearly 1,200 people who volunteered to help with the effort - everyone from nursing students to retirees"The creation of a website and communication program to inform area residents about the H1N1 virus and the vaccinationsLooking back, we are fortunate that H1N1 did not turn out to be a crisis of monumental proportions. Nevertheless, residents of south central Pennsylvania should take comfort in the knowledge that our community was - and remains - prepared for the worst.Our partners in YAMMRS:Adams County Department of Emergency Services; American Red Cross, York-Adams and Greater Hanover chapters; The Brethren Home Community; Dallastown Area School District; Family First Health; Borough of Hanover; Hanover Hospital; HealthSouth Hospital of York; HEARS (Hospital Emergency Amateur Radio System); Lutheran Social Services of South Central Pennsylvania; Margaret E. Moul Home; Memorial Hospital of York; VNA of Hanover; City of York Fire/ Rescue Services; City of York Health Bureau; York College of Pennsylvania; York County Office of Emergency Management .We gratefully acknowledge the following school districts and institutions, which participated in the countywide H1N1 Immunization Program: Northern York County School District; Dallastown Area School District; Upper Adams School District; Littlestown Area School District; Dover Area School District; Bermudian Springs School District; South Eastern School District; York Country Day School; Fairfield School District; Hoffman Homes Inc.; Hanover Public School District; Red Lion Area School District; Christian School of York; Southern York County School District; South Western School District; Gettysburg Area School District; St. Joseph's School, Dallastown; Adams County Christian Academy; Central York School District; St. Joseph's School, Hanover; St. Joseph's Middle School; Shrewsbury Christian Academy; St. Joseph's School, York; Northeastern School District; St. Francis Xavier School; Conewago Valley School District; St. Rose of Lima School; Montessori Children's House of York; Spring Grove Area School District; York County School of Technology; Paradise School For Boys; York Catholic High School; Eastern York School District; Lincoln Intermediate Unit #12; York Suburban School District; West York Area School District; St. John's Lutheran School; Red Lion Christian School; Mission Home Education &amp; Counseling; Gettysburg College; and York College of Pennsylvania.PREPARED TO CAREEnsuring that every member of our community receives the health care they need.At WellSpan, it is our core belief that accessible health care is the key to a healthy community. Yet, in York and Adams counties, there are 34,000 uninsured individuals. This community health problem cannot be ignored and requires careful planning and forethought. Fortunately, WellSpan has done both.We take measures to care for those who have no insurance and are unable to pay. We offer discounted care to individuals whose income falls within 300 percent of federal poverty guidelines. Additionally, all uninsured patients, regardless of whether they qualify for charity care, receive discounts similar to those offered to private insurance companies.Together with our community partners, we support programs to take basic primary care and other services into urban and rural communities, improve access to oral health care and help people establish a "medical home" with a primary care physician.Example: Lisa Dewees, CRNP, and Crystal BowieWhen Crystal Bowie's husband was diagnosed with cancer, she didn't know where to turn. Not only did her husband need to travel to Philadelphia for treatment, he was the only driver in the family. In addition, the stress and emotional challenges of cancer were simply overwhelming. Luckily, Crystal didn't have to look very far for the help she needed. From transportation to emotional support, the team at the York Hospital Community Health Center was there to help. Sadly, Crystal's husband lost his battle with cancer last year and, today, she continues to struggle with her own complex health issues. But rest assured, she is not alone as she continues to receive help, guidance and support from the team at the York Hospital Community Health Center.OUR PROGRESS: Health care for</Explanation>
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        </AddressUS>
        <EIN>232400237</EIN>
        <PrimaryActivities>Health-related activities in the service area</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
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          <BusinessNameLine1>NA</BusinessNameLine1>
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          <BusinessNameLine1>VNA Home Health Services</BusinessNameLine1>
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          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
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        <PrimaryActivities>Home health and hospice care services</PrimaryActivities>
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          <BusinessNameLine1>VNA Community Services</BusinessNameLine1>
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          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
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        <EIN>232338591</EIN>
        <PrimaryActivities>Home personal care services for elderly and disabled</PrimaryActivities>
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          <BusinessNameLine1>Healthy Community Pharmacy Inc</BusinessNameLine1>
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          <AddressLine1>PO Box 2767</AddressLine1>
          <City>York</City>
          <State>PA</State>
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        <PrimaryActivities>Reduced rate prescription drugs to uninsured</PrimaryActivities>
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        <PrimaryActivities>Fundraising to support Gettysburg Hospital</PrimaryActivities>
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          <City>York</City>
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          <City>York</City>
          <State>PA</State>
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          <AddressLine1>PO Box 2767</AddressLine1>
          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
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        <EIN>232444154</EIN>
        <PrimaryActivity>MRI Center</PrimaryActivity>
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          <BusinessNameLine1>Cherry Tree Cancer Center LLP</BusinessNameLine1>
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          <City>York</City>
          <State>PA</State>
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        <EIN>232915628</EIN>
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          <BusinessNameLine1>Littlestown Health Care Partners</BusinessNameLine1>
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          <AddressLine1>300 West King Street</AddressLine1>
          <City>Littlestown</City>
          <State>PA</State>
          <ZIPCode>17340</ZIPCode>
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        <EIN>232880464</EIN>
        <PrimaryActivity>Lease facil</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
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          <BusinessNameLine1>WHCS</BusinessNameLine1>
        </DirectControllingEntityName>
        <ShareOfEOYAssets>1649091</ShareOfEOYAssets>
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          <BusinessNameLine1>Q-WH LLC</BusinessNameLine1>
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          <City>York</City>
          <State>PA</State>
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        <PrimaryActivity>GP of CHIP</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
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          <BusinessNameLine1>WHCS</BusinessNameLine1>
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          <AddressLine1>PO Box 2767</AddressLine1>
          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
        </AddressUS>
        <EIN>232910950</EIN>
        <PrimaryActivity>Ref. Lab</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>Related</PredominantIncomeType>
        <ShareOfTotalIncome>411269</ShareOfTotalIncome>
        <ShareOfEOYAssets>616071</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Apple Hill Surgical Center Partners</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>PO Box 2767</AddressLine1>
          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
        </AddressUS>
        <EIN>232489452</EIN>
        <PrimaryActivity>Surgical Cn</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>Related</PredominantIncomeType>
        <ShareOfTotalIncome>6793372</ShareOfTotalIncome>
        <ShareOfEOYAssets>5975360</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>York Provider Network</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>PO Box 2767</AddressLine1>
          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
        </AddressUS>
        <EIN>232907828</EIN>
        <PrimaryActivity>Coordinates managed care risk contracting</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PercentageOwnership>1.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>York Health Plan</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>PO Box 2767</AddressLine1>
          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
        </AddressUS>
        <EIN>232664989</EIN>
        <PrimaryActivity>Preferred Provider Organization</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C corp</TypeOfEntity>
        <ShareOfTotalIncome>7176098</ShareOfTotalIncome>
        <ShareOfEOYAssets>1345563</ShareOfEOYAssets>
        <PercentageOwnership>1.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Wellspan Reciprocal Risk Retention Group</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>PO Box 2767</AddressLine1>
          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
        </AddressUS>
        <EIN>200048457</EIN>
        <PrimaryActivity>Risk Retention Group</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C corp</TypeOfEntity>
        <ShareOfTotalIncome>155076</ShareOfTotalIncome>
        <ShareOfEOYAssets>308704</ShareOfEOYAssets>
        <PercentageOwnership>0.01490</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Wellspan Pharmacy Inc</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>PO Box 2767</AddressLine1>
          <City>York</City>
          <State>PA</State>
          <ZIPCode>174052767</ZIPCode>
        </AddressUS>
        <EIN>232374072</EIN>
        <PrimaryActivity>Dispenses Pharmaceuticals &amp; provides IV Therapy</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>WellSpan Health Care Services</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C corp</TypeOfEntity>
        <ShareOfTotalIncome>2755067</ShareOfTotalIncome>
        <ShareOfEOYAssets>6800114</ShareOfEOYAssets>
        <PercentageOwnership>1.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>true</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>York Health Plan</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>904600</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>York Health Plan</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>954086</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>York Health Plan</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>599759</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Wellspan Reciprocal Risk Retention Group</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>5775000</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Wellspan Pharmacy Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>833876</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Wellspan Pharmacy Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>275102</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Q-WH LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>85320</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Apple Hill Surgical Center Partners</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>86076</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Wellspan Properties</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>149799</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Wellspan Properties</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>j</TransactionType>
        <AmountInvolved>2007804</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>York Hospital</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>q</TransactionType>
        <AmountInvolved>747172</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>York Hospital</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>59210866</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>York Health Foundation</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>90857</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Wellspan Medical Group</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>18820466</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Wellspan Health Care Services</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>c</TransactionType>
        <AmountInvolved>462497</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>VNA Home Health Services</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>1413307</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>VNA Community Services</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>144036</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Healthy Community Pharmacy Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>101436</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Gettysburg Hospital Foundation</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>107880</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Gettysburg Hospital</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>8747195</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Gettysburg Hospital</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>11255026</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Apple Hill Surgical Center Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>273932</AmountInvolved>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>