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      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Advanced Imaging Inc</BusinessNameLine1>
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        </NameOfContractor>
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          <AddressUS>
            <AddressLine1>90 Chamber Place</AddressLine1>
            <City>Charleroi</City>
            <State>PA</State>
            <ZIPCode>15022</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Imaging Services</DescriptionOfServices>
        <Compensation>2513335</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Metz Associates Ltd</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>Two Woodland Drive</AddressLine1>
            <City>Dallas</City>
            <State>PA</State>
            <ZIPCode>18612</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Environmental/Dietar</DescriptionOfServices>
        <Compensation>2205996</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Independence Excavating Inc</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>5720 Schaaf Road</AddressLine1>
            <City>Independence</City>
            <State>OH</State>
            <ZIPCode>44131</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Construction</DescriptionOfServices>
        <Compensation>2195276</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>29</NumberOfContractorsGT100K>
      <FederatedCampaigns>7080</FederatedCampaigns>
      <RelatedOrganizations>91894</RelatedOrganizations>
      <GovernmentGrants>1203748</GovernmentGrants>
      <AllOtherContributions>1339</AllOtherContributions>
      <TotalContributions>1304061</TotalContributions>
      <ProgramServiceRevenue>
        <Description>Net Patient Services</Description>
        <BusinessCode>621500</BusinessCode>
        <TotalRevenueColumn>196712595</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>193391449</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>3321146</UnrelatedBusinessRevenue>
      </ProgramServiceRevenue>
      <TotalProgramServiceRevenue>196712595</TotalProgramServiceRevenue>
      <InvestmentIncome>
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        <ExclusionAmount>1723717</ExclusionAmount>
      </InvestmentIncome>
      <OtherRevenueMisc>
        <Description>Other Income</Description>
        <BusinessCode>900099</BusinessCode>
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        <RelatedOrExemptFunctionIncome>3059945</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>241008</UnrelatedBusinessRevenue>
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      <OtherRevenueMisc>
        <Description>Dietary/Cafeteria Sales</Description>
        <BusinessCode>722210</BusinessCode>
        <TotalRevenueColumn>1238313</TotalRevenueColumn>
        <ExclusionAmount>1238313</ExclusionAmount>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>Physician Billing Services</Description>
        <BusinessCode>541900</BusinessCode>
        <TotalRevenueColumn>935565</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>577122</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>358443</UnrelatedBusinessRevenue>
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      <TotalOtherRevenue>5474831</TotalOtherRevenue>
      <TotalRevenue>
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        <RelatedOrExemptFunctionIncome>197028516</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>3920597</UnrelatedBusinessRevenue>
        <ExclusionAmount>2962030</ExclusionAmount>
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      <GrantsToDomesticOrgs>
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        <ProgramServices>54167</ProgramServices>
      </GrantsToDomesticOrgs>
      <CompCurrentOfficersDirectors>
        <Total>1944977</Total>
        <ManagementAndGeneral>1944977</ManagementAndGeneral>
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      <OtherSalariesAndWages>
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      <PensionPlanContributions>
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        <ProgramServices>5232900</ProgramServices>
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      <OtherEmployeeBenefits>
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        <ProgramServices>12650063</ProgramServices>
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      <PayrollTaxes>
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        <ProgramServices>4392119</ProgramServices>
        <ManagementAndGeneral>568524</ManagementAndGeneral>
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      <FeesForServicesLegal>
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        <ProgramServices>138118</ProgramServices>
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      <FeesForServicesAccounting>
        <Total>90000</Total>
        <ManagementAndGeneral>90000</ManagementAndGeneral>
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      <FeesForServicesOther>
        <Total>12934243</Total>
        <ProgramServices>10250912</ProgramServices>
        <ManagementAndGeneral>2683331</ManagementAndGeneral>
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      <Advertising>
        <Total>603755</Total>
        <ProgramServices>390556</ProgramServices>
        <ManagementAndGeneral>213199</ManagementAndGeneral>
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      <OfficeExpenses>
        <Total>46643605</Total>
        <ProgramServices>45439423</ProgramServices>
        <ManagementAndGeneral>1204182</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>1471890</Total>
        <ProgramServices>1187512</ProgramServices>
        <ManagementAndGeneral>284378</ManagementAndGeneral>
      </InformationTechnology>
      <Occupancy>
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        <ProgramServices>3294579</ProgramServices>
        <ManagementAndGeneral>438270</ManagementAndGeneral>
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      <Travel>
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        <ProgramServices>167967</ProgramServices>
        <ManagementAndGeneral>276597</ManagementAndGeneral>
      </Travel>
      <ConferencesMeetings>
        <Total>140917</Total>
        <ProgramServices>84233</ProgramServices>
        <ManagementAndGeneral>56684</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
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        <ManagementAndGeneral>1314193</ManagementAndGeneral>
      </Interest>
      <DepreciationDepletion>
        <Total>7617081</Total>
        <ManagementAndGeneral>7617081</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
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        <ProgramServices>1029922</ProgramServices>
        <ManagementAndGeneral>760448</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>Bad Debt Expense</Description>
        <Total>8008251</Total>
        <ManagementAndGeneral>8008251</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Miscellaneous</Description>
        <Total>1926428</Total>
        <ProgramServices>893167</ProgramServices>
        <ManagementAndGeneral>1033261</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Recruitment</Description>
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        <ProgramServices>104449</ProgramServices>
        <ManagementAndGeneral>598946</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>Organizational Dues</Description>
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        <ProgramServices>81542</ProgramServices>
        <ManagementAndGeneral>276266</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Collection Agency Fees</Description>
        <Total>177215</Total>
        <ManagementAndGeneral>177215</ManagementAndGeneral>
      </OtherExpenses>
      <TotalFunctionalExpenses>
        <Total>187087260</Total>
        <ProgramServices>151575853</ProgramServices>
        <ManagementAndGeneral>35541407</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
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      <CashNonInterestBearing>
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        <EOY>2715</EOY>
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      <SavingsAndTempCashInvestments>
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      <PrepaidExpensesDeferredCharges>
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      <LandBuildingsEquipmentBasis>285471435</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>129747013</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
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        <BOY>4654712</BOY>
        <EOY>5909921</EOY>
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      <TotalAssets>
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        <EOY>323981857</EOY>
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      <AccountsPayableAccruedExpenses>
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      <TaxExemptBondLiabilities>
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        <EOY>136953820</EOY>
      </TaxExemptBondLiabilities>
      <OtherLiabilities>
        <BOY>20449193</BOY>
        <EOY>29045549</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>183840822</BOY>
        <EOY>196627380</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>118818066</BOY>
        <EOY>125887342</EOY>
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      <TemporarilyRestrictedNetAssets>
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        <EOY>1467135</EOY>
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      <TotalNetAssetsFundBalances>
        <BOY>119192665</BOY>
        <EOY>127354477</EOY>
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      <TotalLiabNetAssetsFundBalances>
        <BOY>303033487</BOY>
        <EOY>323981857</EOY>
      </TotalLiabNetAssetsFundBalances>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
      <FederalGrantAuditPerformed>false</FederalGrantAuditPerformed>
    </IRS990>
    <IRS990ScheduleA documentId="2">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
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    <IRS990ScheduleB documentId="3">
      <ContributorInfo>
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          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
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        <ContributorAddressUS>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="9">
      <DisclosedOrgsLegalControl>false</DisclosedOrgsLegalControl>
      <DisclosedForCharitablePurposes>false</DisclosedForCharitablePurposes>
      <WrittenPolicyMonitoring>false</WrittenPolicyMonitoring>
      <Sect170hRequirementsSatisfied>false</Sect170hRequirementsSatisfied>
      <SolicitedAssetsForSale>false</SolicitedAssetsForSale>
      <AgentTrusteeEtc>false</AgentTrusteeEtc>
      <IncludedOnFS>false</IncludedOnFS>
      <EndowmentsHeldByUnrelatedOrgs>false</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>false</EndowmentsHeldByRelatedOrgs>
      <AreRelatedOrgsListedScheduleR>false</AreRelatedOrgsListedScheduleR>
      <Land>
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        <BookValue>2550603</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>30797492</OtherCostOrOtherBasis>
        <Depreciation>23962931</Depreciation>
        <BookValue>6834561</BookValue>
      </Buildings>
      <LeaseholdImprovements>
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        <Depreciation>1627311</Depreciation>
        <BookValue>2935065</BookValue>
      </LeaseholdImprovements>
      <Equipment>
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        <BookValue>25555309</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>120880588</OtherCostOrOtherBasis>
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        <BookValue>117848884</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>155724422</TotalOfBookValueLandBuildings>
      <InvestmentsProgramRelated>
        <Description>Benbrook Medical Holdings</Description>
        <BookValue>118633</BookValue>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Chart - Insurance Captive</Description>
        <BookValue>1729359</BookValue>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Benbrook II</Description>
        <BookValue>214450</BookValue>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Butler Physicians Realty</Description>
        <BookValue>121354</BookValue>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Vie Care Butler LLC</Description>
        <BookValue>128110</BookValue>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>South Butler Medical</Description>
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      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Medcare - DME</Description>
        <BookValue>906544</BookValue>
      </InvestmentsProgramRelated>
      <TotalOfBookValueProgramRelated>3364450</TotalOfBookValueProgramRelated>
      <OtherAssets>
        <Description>Splt $ Life Insurance</Description>
        <BookValue>1351050</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Delta Development Grp Fees</Description>
        <BookValue>316608</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Asset Value Life Insurance</Description>
        <BookValue>43666</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>VHA of PA</Description>
        <BookValue>200000</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Debt Issuance Costs</Description>
        <BookValue>2562773</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Net Assets of Butler Health System Foundation</Description>
        <BookValue>1435824</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>5909921</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>Pension liability</Description>
        <Amount>24201276</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Third party settlements</Description>
        <Amount>4844273</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>29045549</TotalOfAmounts>
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      <ExcessOrDeficitForYear>18127944</ExcessOrDeficitForYear>
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      <Form990ScheduleDPartXIV>
        <Explanation>Part X (2) Fin 48 Footnote: The Hospital accounts for uncertainty in income taxes using a recognition threshold of more-likely-than-not to be substained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. Management determined there were no tax uncertainties that met the recognition threshold in 2009. The Hospital's federal tax returns for 2010, 2009, 2008, and 2007 remain subject to examination by the IRS. BMH'S policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses. Part XI Change in Net Assets: Net transfers to related entities (2,199,935) Pension liability adjustment (8,918,759) Non controlling interest in Net Loss of Consolidated Subsidiary 60,026</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="4">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent300>X</Pcent300>
      <FreeDiscCareMedicallyIndigent>false</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
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        <PercentOfTotalExpense>0.00500</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
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        <DirectOffsettingRevenue>13993460</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>7351947</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.04110</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>212888</TotalCommunityBenefitExpense>
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        <PercentOfTotalExpense>0.00020</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>22963175</TotalCommunityBenefitExpense>
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        <PercentOfTotalExpense>0.04630</PercentOfTotalExpense>
      </TotalCharityCare>
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        <PercentOfTotalExpense>0.00130</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
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      </HealthProfessionsEducation>
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      </CashAndInKindContributions>
      <TotalOtherBenefits>
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        <NetCommunityBenefitExpense>6405997</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03580</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
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        <PercentOfTotalExpense>0.08210</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
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      <MedicareSurplusOrShortfall>2669824</MedicareSurplusOrShortfall>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Butler Healthcare Providers</BusinessNameLine1>
          <BusinessNameLine2>DBA Butler Memorial Hospital</BusinessNameLine2>
        </Name>
        <Address>
          <AddressLine1>One Hospital Way</AddressLine1>
          <City>Butler</City>
          <State>PA</State>
          <ZIPCode>16001</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartV>
    </IRS990ScheduleH>
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        <RecipientNameBusiness>
          <BusinessNameLine1>Community Health Clinic of Butler County</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>103 Bonnie Drive</AddressLine1>
          <City>Butler</City>
          <State>PA</State>
          <ZIPCode>16002</ZIPCode>
        </AddressUS>
        <EINOfRecipient>204852135</EINOfRecipient>
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        <AmountOfCashGrant>54167</AmountOfCashGrant>
        <PurposeOfGrant>General support to provide medical care for indigent patients</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>1</TotalNbrOf501C3AndGovtGrants>
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      <SubstantiationRequired>true</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>true</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>Kenneth P DeFurio</NamePerson>
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        <DeferredCompFilingOrg>134775</DeferredCompFilingOrg>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Anne B Krebs</NamePerson>
        <BaseCompensationFilingOrg>236765</BaseCompensationFilingOrg>
        <BonusFilingOrg>48231</BonusFilingOrg>
        <OtherCompensationFilingOrg>15428</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>42289</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>36023</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>378736</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Maureen A Gray</NamePerson>
        <BaseCompensationFilingOrg>182437</BaseCompensationFilingOrg>
        <BonusFilingOrg>36888</BonusFilingOrg>
        <OtherCompensationFilingOrg>15459</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>26873</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>20893</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>282550</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Stephanie Roskovski</NamePerson>
        <BaseCompensationFilingOrg>146848</BaseCompensationFilingOrg>
        <BonusFilingOrg>29370</BonusFilingOrg>
        <OtherCompensationFilingOrg>20312</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>26433</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15644</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>238607</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>A Thomas McGill MD</NamePerson>
        <BaseCompensationFilingOrg>264569</BaseCompensationFilingOrg>
        <BonusFilingOrg>53100</BonusFilingOrg>
        <OtherCompensationFilingOrg>49863</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>40849</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>26867</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>435248</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Charles E Oleson</NamePerson>
        <BaseCompensationFilingOrg>192592</BaseCompensationFilingOrg>
        <BonusFilingOrg>29520</BonusFilingOrg>
        <OtherCompensationFilingOrg>28582</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>25586</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>34325</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>310605</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Michael D Busch</NamePerson>
        <BaseCompensationFilingOrg>199991</BaseCompensationFilingOrg>
        <BonusFilingOrg>30450</BonusFilingOrg>
        <OtherCompensationFilingOrg>14539</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>16214</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>34576</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>295770</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Paula L Hooper</NamePerson>
        <BaseCompensationFilingOrg>194719</BaseCompensationFilingOrg>
        <BonusFilingOrg>29948</BonusFilingOrg>
        <OtherCompensationFilingOrg>12160</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>14695</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>34272</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>285794</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Richard L Allen</NamePerson>
        <BaseCompensationFilingOrg>188764</BaseCompensationFilingOrg>
        <BonusFilingOrg>19300</BonusFilingOrg>
        <OtherCompensationFilingOrg>13155</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>23313</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>32813</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>277345</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>John C Reefer MD</NamePerson>
        <BaseCompensationFilingOrg>236119</BaseCompensationFilingOrg>
        <BonusFilingOrg>44556</BonusFilingOrg>
        <OtherCompensationFilingOrg>27516</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>40102</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>35689</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>383982</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Explanation>(1) (a) The CEO is provided with a membership to the local country club within Butler County, which is primarily utilized for work-related functions and meetings. Approximate annual membership cost is $2,700. The amount is not included in taxable income. (4)(b) The following individuals received payment noted below as part of a Senior Executive Benefit Plan for a tax-deferred Capital Accumulation Account. The amounts represent the amount paid out after a two year vesting period. The program was discontinued January, 2009. However, in some cases payments have been deferred into future years. DeFurio 50,462 Gray 3,696 Roskovski 11,321 McGill 32,532 Oleson 13,959 Allen 1,130 Reefer 12,121 (4) (b) As part of the Senior Executive Benefit Plan, the Hospital contributed to A SERP plan for the following individuals: DeFurio 120,981 Krebs 28,932 Gray 22,132 Roskovski 17,622 McGill 31,859 Oleson 13,777 Busch 14,211 Hooper 13,976 Allen 13,511 Reefer 26,735 (4) (b) The Senior Executive Benefit Plan permits participation in a 457(b) plan. The following individuals had the wages listed below deferred to the plan in calendar 2009: DeFurio 13,794 Krebs 13,357 Gray 4,741 Roskovski 8,811 McGill 8,990 Oleson 11,809 Busch 2,003 Hooper 719 Allen 9,802 Reefer 13,367 (7) Officers and employees are eligible for and received bonus compensation. Bonuses are not guaranteed and are awarded based on Board approved metrics which include quality, services and finanacial performances.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="6">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Butler County Hospital Authority</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>251458912</IssuerEIN>
        <CUSIPNumber>1235926Q8</CUSIPNumber>
        <DateIssued>2009-04-29</DateIssued>
        <IssuePrice>50000000</IssuePrice>
        <DescriptionOfPurpose>Construction of addition to Hosp</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>true</OnBehalfOfIssuer>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Butler County Hospital Authority</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>251458912</IssuerEIN>
        <CUSIPNumber>123592CPO</CUSIPNumber>
        <DateIssued>2009-04-29</DateIssued>
        <IssuePrice>74728451</IssuePrice>
        <DescriptionOfPurpose>Construction of addition to Hosp</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>true</OnBehalfOfIssuer>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Butler County Hospital Authority</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>251458912</IssuerEIN>
        <DateIssued>2010-06-29</DateIssued>
        <IssuePrice>12165000</IssuePrice>
        <DescriptionOfPurpose>Construction of addition to Hosp</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>true</OnBehalfOfIssuer>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <TotalProceeds>50000000</TotalProceeds>
        <AmountUnspent>12347559</AmountUnspent>
        <IssuanceCostsFromProceeds>833495</IssuanceCostsFromProceeds>
        <CapitalExpenditures>36818946</CapitalExpenditures>
        <YearOfSubstCompletion>2010</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>false</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <TotalProceeds>74728451</TotalProceeds>
        <AmountInReserveFund>6853300</AmountInReserveFund>
        <AmountUnspent>6029029</AmountUnspent>
        <IssuanceCostsFromProceeds>1419179</IssuanceCostsFromProceeds>
        <CapitalExpenditures>60426143</CapitalExpenditures>
        <YearOfSubstCompletion>2010</YearOfSubstCompletion>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>false</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartII>
        <TotalProceeds>12165000</TotalProceeds>
        <IssuanceCostsFromProceeds>217226</IssuanceCostsFromProceeds>
        <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>
        <BondCounselRoutinelyEngaged>false</BondCounselRoutinelyEngaged>
        <PostIssuanceComplianceProcdrs>false</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>false</BondCounselRoutinelyEngaged>
        <PostIssuanceComplianceProcdrs>false</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>false</BondCounselRoutinelyEngaged>
        <PostIssuanceComplianceProcdrs>false</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <RegulatorySafeHarborSatisfied>false</RegulatorySafeHarborSatisfied>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <RegulatorySafeHarborSatisfied>false</RegulatorySafeHarborSatisfied>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <RegulatorySafeHarborSatisfied>false</RegulatorySafeHarborSatisfied>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="1">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Anne B Krebs</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Officer of Org; On Board of Dir of YMCA</Relationship>
        <AmountOfTransaction>198196</AmountOfTransaction>
        <DescriptionOfTransaction>Hosp leases from YMCA</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Richard F Latuska MD</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Trustee of Org; Part owner in Benbrook</Relationship>
        <AmountOfTransaction>276589</AmountOfTransaction>
        <DescriptionOfTransaction>Hosp leases from Benbrook</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="7">
      <GeneralExplanation>
        <Explanation>Part VI 2 Dr. Thomas Muzzonigro served for one year as an ex-officio trustee due to his position as President of the Medical Staff of Butler Memorial Hospital. Dr. Kelly Agnew is a trustee on this corporation's Board as well. Both of these physicians are directors, officers and greater than 10% owners in a private medical group, as well as that group's affiliated entities. 11 (a) The Finance Committee of the Board conducts a detailed review of the 990 filing, which is then provided to the full board for final review and approval. 12 (c) The reponses to the conflict of interest disclosure form are collected and reviewed annually by General Counsel, who then reviews the same with the Audit and Compliance Committee of the Board of Trustees. Conflict of Interest disclosure forms are completed by all trustees, officers, committee members as well as the executive team. In the event a relationship results in a potential conflict for an issue being discussed by the Board, the trustee recuses himself/herself from the discussion and vote. This recusal is documented in the minutes. The Vice President and General Counsel attends all board meetings and ensures that any needed recusals occur. 15 The organization engages a compensation consultant and outside legal councel to review current market for all of its executive positions. This consultant then meets with the fully independent Board Compensation Committee to review market for the various positions,including obtaining reasonableness opinions and engaging outside counsel regarding compensation relating to each executive position. The recommendations of the Compensation Committee are then presented to full board for final approval. The most recent review occurred in September, 2010. 19. Historically finanacials are provided to the public at the annual public board meeting and through mailing. Bylaws, Articles of Incorporation and the Conflict of Interest Policy are posted on the website. Part VII: Section A includes John C Reefer, MD as a former trustee and a VP of Professional Affairs &amp; Medical Director with compensation. His term as trustee ended in February, 2005 prior to taking the VP position. This compensation relates to his role as VP of Professional Affairs. Schedule I Part II: Grants and Other Assistance: The organization's bylaws control the contributions that can be made and the process relating to such.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="8">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Butler Health System</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>One Hospital Way</AddressLine1>
          <City>Butler</City>
          <State>PA</State>
          <ZIPCode>16001</ZIPCode>
        </AddressUS>
        <EIN>251441855</EIN>
        <PrimaryActivities>Healthcare delivery system</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501 (c) (3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Butler Medical Providers</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>One Hospital Way</AddressLine1>
          <City>Butler</City>
          <State>PA</State>
          <ZIPCode>16001</ZIPCode>
        </AddressUS>
        <EIN>251441961</EIN>
        <PrimaryActivities>Physician practices</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501 (c) (3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Butler Health System Foundation</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>One Hospital Way</AddressLine1>
          <City>Butler</City>
          <State>PA</State>
          <ZIPCode>16001</ZIPCode>
        </AddressUS>
        <EIN>261543883</EIN>
        <PrimaryActivities>Fundraising on behalf of Butler Health System</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501 (c) (3)</ExemptCodeSection>
        <PublicCharityStatus>11-Type 1</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Nixsar Corporation</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>One Hospital Way</AddressLine1>
          <City>Butler</City>
          <State>PA</State>
          <ZIPCode>16001</ZIPCode>
        </AddressUS>
        <EIN>251441960</EIN>
        <PrimaryActivities>Own and operate real estate assets on behalf of Butler Health System</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501 (c) (3)</ExemptCodeSection>
        <PublicCharityStatus>11- Type 1</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Butler Ambulatory Surgery Center LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>102 Technology Drive</AddressLine1>
          <City>Butler</City>
          <State>PA</State>
          <ZIPCode>16001</ZIPCode>
        </AddressUS>
        <EIN>061728190</EIN>
        <PrimaryActivity>Ambulatory surgery center</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <PredominantIncomeType>not applicable</PredominantIncomeType>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>PCA of Butler PC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>480 East Jefferson St</AddressLine1>
          <City>Butler</City>
          <State>PA</State>
          <ZIPCode>16001</ZIPCode>
        </AddressUS>
        <EIN>251351445</EIN>
        <PrimaryActivity>Physician Office Practice</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C Corp</TypeOfEntity>
      </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>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>