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        <ReportableCompFromOrganization>558793</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>35078</OtherCompensation>
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      <Form990PartVIISectionA>
        <NamePerson>LINDA L STRAND</NamePerson>
        <Title>PHYSICIAN</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>275406</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>39446</OtherCompensation>
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      <Form990PartVIISectionA>
        <NamePerson>MARK E TRUMP</NamePerson>
        <Title>PHYSICIAN</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>418763</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>4692</OtherCompensation>
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      <TotalReportableCompFromOrg>3712616</TotalReportableCompFromOrg>
      <TotalReportableCompFrmRltdOrgs>0</TotalReportableCompFrmRltdOrgs>
      <TotalOtherCompensation>409254</TotalOtherCompensation>
      <NumberIndividualsGT100K>98</NumberIndividualsGT100K>
      <FormersListed>0</FormersListed>
      <TotalCompGT150K>1</TotalCompGT150K>
      <CompensationFromOtherSources>0</CompensationFromOtherSources>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>WENATCHEE EMERGENCY PHYSICIANS</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>1201 S MILLER ST</AddressLine1>
            <City>WENATCHEE</City>
            <State>WA</State>
            <ZIPCode>98001</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>EMERGENCY PHYSICIAN SERVICES</DescriptionOfServices>
        <Compensation>2974585</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>WENATCHEE VALLEY MEDICAL CT</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
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            <City>WENATCHEE</City>
            <State>WA</State>
            <ZIPCode>98801</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>PHYSICIAN SERVICES</DescriptionOfServices>
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      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
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          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
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            <City>SPOKANE</City>
            <State>WA</State>
            <ZIPCode>99202</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>CONSULTING &amp; DESIGN</DescriptionOfServices>
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      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>PEER CONSULTING</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>2856 80TH AVE SE STE 200</AddressLine1>
            <City>MERCER ISLAND</City>
            <State>WA</State>
            <ZIPCode>98040</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>CONSULTING</DescriptionOfServices>
        <Compensation>962639</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>EBMS</BusinessNameLine1>
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        <AddressOfContractor>
          <AddressUS>
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            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59102</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>ADMINISTRATIVE FEES</DescriptionOfServices>
        <Compensation>702489</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>27</NumberOfContractorsGT100K>
      <GovernmentGrants>75572</GovernmentGrants>
      <AllOtherContributions>1124902</AllOtherContributions>
      <TotalContributions>1200474</TotalContributions>
      <ProgramServiceRevenue>
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        <BusinessCode>624100</BusinessCode>
        <TotalRevenueColumn>89100657</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>89100657</RelatedOrExemptFunctionIncome>
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      <ProgramServiceRevenue>
        <Description>OTHER NURSING SERVICES</Description>
        <BusinessCode>624100</BusinessCode>
        <TotalRevenueColumn>42274867</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>42274867</RelatedOrExemptFunctionIncome>
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      <ProgramServiceRevenue>
        <Description>DAILY PATIENT SERVICES</Description>
        <BusinessCode>624100</BusinessCode>
        <TotalRevenueColumn>32195375</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>32195375</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>PHYSICIAN SERVICES</Description>
        <BusinessCode>624100</BusinessCode>
        <TotalRevenueColumn>10369257</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>10369257</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>HOME HEALTH, HOSPICE,</Description>
        <BusinessCode>624100</BusinessCode>
        <TotalRevenueColumn>5977626</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>5977626</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalOthProgramServiceRevenue>
        <TotalRevenueColumn>1695965</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>10603</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>291826</UnrelatedBusinessRevenue>
        <ExclusionAmount>1393536</ExclusionAmount>
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      <TotalProgramServiceRevenue>181613747</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>64634</TotalRevenueColumn>
        <ExclusionAmount>64634</ExclusionAmount>
      </InvestmentIncome>
      <GrossRents>
        <Real>1321536</Real>
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      <LessRentalExpenses>
        <Real>1358231</Real>
      </LessRentalExpenses>
      <RentalIncomeOrLoss>
        <Real>-36695</Real>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>-36695</TotalRevenueColumn>
        <ExclusionAmount>-36695</ExclusionAmount>
      </NetRentalIncomeOrLoss>
      <GrossAmountSalesAssets>
        <Securities>51105307</Securities>
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      <LessCostOthBasisSalesExpenses>
        <Securities>48176862</Securities>
      </LessCostOthBasisSalesExpenses>
      <GainOrLoss>
        <Securities>2928445</Securities>
      </GainOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>2928445</TotalRevenueColumn>
        <ExclusionAmount>2928445</ExclusionAmount>
      </NetGainOrLossInvestments>
      <OtherRevenueMisc>
        <Description>MISCELLANEOUS</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>1202348</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>1202348</RelatedOrExemptFunctionIncome>
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      <OtherRevenueMisc>
        <Description>PURCHASE DISCOUNTS</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>63349</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>21826</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>41523</ExclusionAmount>
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      <OtherRevenueMisc>
        <Description>AUTOPSY MORGUE CHARGES</Description>
        <BusinessCode>900099</BusinessCode>
        <TotalRevenueColumn>5372</TotalRevenueColumn>
        <ExclusionAmount>5372</ExclusionAmount>
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      <MiscellaneousRevenue>
        <TotalRevenueColumn>-103955</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>-103955</RelatedOrExemptFunctionIncome>
      </MiscellaneousRevenue>
      <TotalOtherRevenue>1167114</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>186937719</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>181048604</RelatedOrExemptFunctionIncome>
        <UnrelatedBusinessRevenue>291826</UnrelatedBusinessRevenue>
        <ExclusionAmount>4396815</ExclusionAmount>
      </TotalRevenue>
      <CompCurrentOfficersDirectors>
        <Total>1645942</Total>
        <ManagementAndGeneral>1645942</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <OtherSalariesAndWages>
        <Total>79338478</Total>
        <ProgramServices>60116466</ProgramServices>
        <ManagementAndGeneral>19222012</ManagementAndGeneral>
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      <PensionPlanContributions>
        <Total>4425695</Total>
        <ProgramServices>3199043</ProgramServices>
        <ManagementAndGeneral>1226652</ManagementAndGeneral>
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      <OtherEmployeeBenefits>
        <Total>7990226</Total>
        <ProgramServices>5789003</ProgramServices>
        <ManagementAndGeneral>2201223</ManagementAndGeneral>
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      <PayrollTaxes>
        <Total>7807813</Total>
        <ProgramServices>4489161</ProgramServices>
        <ManagementAndGeneral>3318652</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesLegal>
        <Total>513868</Total>
        <ManagementAndGeneral>513868</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>208263</Total>
        <ProgramServices>511</ProgramServices>
        <ManagementAndGeneral>207752</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>34902</Total>
        <ManagementAndGeneral>34902</ManagementAndGeneral>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>1600</Total>
        <Fundraising>1600</Fundraising>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>86993</Total>
        <ManagementAndGeneral>86993</ManagementAndGeneral>
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      <FeesForServicesOther>
        <Total>9250215</Total>
        <ProgramServices>5776336</ProgramServices>
        <ManagementAndGeneral>3473879</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>220700</Total>
        <ProgramServices>94418</ProgramServices>
        <ManagementAndGeneral>126282</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>8331309</Total>
        <ProgramServices>4065430</ProgramServices>
        <ManagementAndGeneral>4265879</ManagementAndGeneral>
      </OfficeExpenses>
      <Occupancy>
        <Total>2070034</Total>
        <ProgramServices>103103</ProgramServices>
        <ManagementAndGeneral>1966931</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>653276</Total>
        <ProgramServices>205741</ProgramServices>
        <ManagementAndGeneral>447535</ManagementAndGeneral>
      </Travel>
      <ConferencesMeetings>
        <Total>137817</Total>
        <ProgramServices>35896</ProgramServices>
        <ManagementAndGeneral>101921</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>476825</Total>
        <ManagementAndGeneral>476825</ManagementAndGeneral>
      </Interest>
      <DepreciationDepletion>
        <Total>9165468</Total>
        <ProgramServices>4106306</ProgramServices>
        <ManagementAndGeneral>5059162</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>787493</Total>
        <ProgramServices>342776</ProgramServices>
        <ManagementAndGeneral>444717</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>SUPPLIES</Description>
        <Total>35713262</Total>
        <ProgramServices>34085580</ProgramServices>
        <ManagementAndGeneral>1627682</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>BAD DEBTS</Description>
        <Total>6464286</Total>
        <ProgramServices>6464286</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>OTHER PURCHASED SERVICE</Description>
        <Total>3084532</Total>
        <ProgramServices>1321029</ProgramServices>
        <ManagementAndGeneral>1763503</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>LICENSES/TAXES</Description>
        <Total>2958729</Total>
        <ProgramServices>13120</ProgramServices>
        <ManagementAndGeneral>2945609</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>OTHER DIRECT EXPENSES</Description>
        <Total>426781</Total>
        <ProgramServices>71297</ProgramServices>
        <ManagementAndGeneral>355484</ManagementAndGeneral>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>401190</Total>
        <ProgramServices>121849</ProgramServices>
        <ManagementAndGeneral>279341</ManagementAndGeneral>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>182195697</Total>
        <ProgramServices>130401351</ProgramServices>
        <ManagementAndGeneral>51792746</ManagementAndGeneral>
        <Fundraising>1600</Fundraising>
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        <EOY>2825028</EOY>
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      <SavingsAndTempCashInvestments>
        <BOY>6592649</BOY>
        <EOY>14220890</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
        <BOY>5505300</BOY>
        <EOY>6430202</EOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
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        <EOY>30996239</EOY>
      </AccountsReceivable>
      <InventoriesForSaleOrUse>
        <BOY>5933468</BOY>
        <EOY>5741113</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>3769837</BOY>
        <EOY>3680858</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>268948114</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>103794004</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>90464101</BOY>
        <EOY>165154110</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
        <BOY>153060300</BOY>
        <EOY>77835081</EOY>
      </InvestmentsPubTradedSecurities>
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        <BOY>12001147</BOY>
      </InvestmentsOtherSecurities>
      <OtherAssetsTotal>
        <BOY>6145898</BOY>
        <EOY>5614422</EOY>
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      <TotalAssets>
        <BOY>305515972</BOY>
        <EOY>312497943</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>25890192</BOY>
        <EOY>30315449</EOY>
      </AccountsPayableAccruedExpenses>
      <TaxExemptBondLiabilities>
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        <EOY>114825000</EOY>
      </TaxExemptBondLiabilities>
      <OtherLiabilities>
        <BOY>6867190</BOY>
        <EOY>2215293</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>148452382</BOY>
        <EOY>147355742</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>151558290</BOY>
        <EOY>158711999</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>5505300</BOY>
        <EOY>6430202</EOY>
      </TemporarilyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>157063590</BOY>
        <EOY>165142201</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>305515972</BOY>
        <EOY>312497943</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>4742022</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>3336589</ReconcilationOtherChanges>
      <InfoInScheduleOPartXII>X</InfoInScheduleOPartXII>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>0</AccountantCompileOrReview>
      <FSAudited>1</FSAudited>
      <AuditCommittee>1</AuditCommittee>
      <FinancialStatementSeparate>X</FinancialStatementSeparate>
      <FederalGrantAuditRequired>0</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
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      <PaidStaffOrManagement>0</PaidStaffOrManagement>
      <MediaAdvertisements>0</MediaAdvertisements>
      <MailingsMembers>0</MailingsMembers>
      <PublicationsOrBroadcast>0</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>0</GrantsOtherOrganizations>
      <DirectContactLegislators>1</DirectContactLegislators>
      <DirectContactLegislatorsAmount>34902</DirectContactLegislatorsAmount>
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      <OtherActivities>0</OtherActivities>
      <TotalLobbyingExpendituresIIB>34902</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>0</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>EXPLANATION OF OTHER LOBBYING ACTIVITIES:</Identifier>
        <ReturnReference>PART II-B, LINE 1I:</ReturnReference>
        <Explanation>WA STATE HOSPITAL ASSOCIATION DUES - 23% OF $118,519 = $27,259 AMERICAN HOSPITAL ASSOCIATION DUES - 24.42% OF $31,296 =$7,643 TOTAL $34,902</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
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        <BookValue>8981311</BookValue>
      </Land>
      <Buildings>
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        <Depreciation>15588230</Depreciation>
        <BookValue>11398238</BookValue>
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      <LeaseholdImprovements>
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        <BookValue>10940663</BookValue>
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      <Equipment>
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        <BookValue>101147532</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>165154110</TotalOfBookValueLandBuildings>
      <OtherLiabilities>
        <Description>RESERVE FOR MALPRACTICE INSURANCE CLAIMS</Description>
        <Amount>1954000</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DOUGLAS COUNTY WATER ASSESSMENT DEBT</Description>
        <Amount>261293</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>2215293</TotalOfAmounts>
      <TotalRevenue>186937719</TotalRevenue>
      <TotalExpenses>182195697</TotalExpenses>
      <ExcessOrDeficitForYear>4742022</ExcessOrDeficitForYear>
      <NetUnrealizedGLOnInvestments>3232633</NetUnrealizedGLOnInvestments>
      <OtherAmount>103956</OtherAmount>
      <TotalAdjustments>3336589</TotalAdjustments>
      <ExcessOrDeficitPerFS>8078611</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>190068643</TotRevenueEtcAuditedFinclStmt>
      <NetUnrealizedGainsInvestments>3232633</NetUnrealizedGainsInvestments>
      <RevenueNotRptdF990>3232633</RevenueNotRptdF990>
      <RevenueSubtotal>186836010</RevenueSubtotal>
      <InvestmentExpensesNotIncluded>86993</InvestmentExpensesNotIncluded>
      <OtherRevenuesNotIncluded>14716</OtherRevenuesNotIncluded>
      <RevenueNotRptdOnFinStmt>101709</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>186937719</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>181990031</TotExpensesEtcAuditedFinclStmt>
      <ExpensesNotRptdF990>0</ExpensesNotRptdF990>
      <ExpensesSubtotal>181990031</ExpensesSubtotal>
      <InvestmentExpensesNotIncluded2>86993</InvestmentExpensesNotIncluded2>
      <OtherExpensesNotIncluded>118673</OtherExpensesNotIncluded>
      <ExpensesNotRptdOnFinStmt>205666</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>182195697</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIV>
        <Identifier>DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:</Identifier>
        <ReturnReference>PART X:</ReturnReference>
        <Explanation>EFFECTIVE JANUARY 1, 2009, THE ASSOCIATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF DECEMBER 31, 2010 AND 2009, THE ASSOCIATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>PART XI, LINE 8 - OTHER ADJUSTMENTS:</Identifier>
        <Explanation>ROUNDING 1. LOSS ON K-1 NOT INCLUDED IN REVENUE ON FINANCIAL STATEMENT 103,955.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>PART XII, LINE 4B - OTHER ADJUSTMENTS:</Identifier>
        <Explanation>SALARY, BENEFITS AND OTHER OPERATING EXP. INCLUDED IN REVENUE ON FORM 990 3,241. LOSS ON K-1 NOT INCLUDED IN REVENUE ON FINANCIAL STATEMENT -103,955. SALARY, BENEFITS AND OTHER NON-OPER. EXP. INCLUDED IN REVENUE ON FORM 990 115,429. ROUNDING 1.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>PART XIII, LINE 4B - OTHER ADJUSTMENTS:</Identifier>
        <Explanation>SALARY, BENEFITS AND OTHER OPERATING EXP. INCLUDED IN REVENUE ON FORM 990 3,241. ROUNDING 3. SALARY, BENEFITS AND OTHER NON-OPER. EXP. INCLUDED IN REVENUE ON FORM 990 115,429.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc1041500001">
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      <WrittenPolicy>1</WrittenPolicy>
      <FPGReferenceFreeCare>1</FPGReferenceFreeCare>
      <OtherPercentage>
        <Other>X</Other>
        <FreeOtherPercentage>175.000000000000</FreeOtherPercentage>
      </OtherPercentage>
      <FPGReferenceDiscountedCare>1</FPGReferenceDiscountedCare>
      <Pcent300>X</Pcent300>
      <FreeDiscCareMedicallyIndigent>1</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>1</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>0</ExpensesExceededBudget>
      <AnnualCommunityBenefitReport>1</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>1</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>3443987</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>3443987</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01890</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>27744013</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>21151470</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>6592543</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03620</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>31188000</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>21151470</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>10036530</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05510</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <NumberOfActivitiesOrPrograms>27</NumberOfActivitiesOrPrograms>
        <PersonsServed>1113</PersonsServed>
        <TotalCommunityBenefitExpense>26369</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>26369</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <NumberOfActivitiesOrPrograms>1</NumberOfActivitiesOrPrograms>
        <PersonsServed>524</PersonsServed>
        <TotalCommunityBenefitExpense>1383402</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>1383402</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00760</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <CashAndInKindContributions>
        <NumberOfActivitiesOrPrograms>14</NumberOfActivitiesOrPrograms>
        <PersonsServed>750</PersonsServed>
        <TotalCommunityBenefitExpense>46481</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>46481</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00030</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <NumberOfActivitiesOrPrograms>42</NumberOfActivitiesOrPrograms>
        <PersonsServed>2387</PersonsServed>
        <TotalCommunityBenefitExpense>1456252</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>1456252</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00800</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <NumberOfActivitiesOrPrograms>42</NumberOfActivitiesOrPrograms>
        <PersonsServed>2387</PersonsServed>
        <TotalCommunityBenefitExpense>32644252</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>21151470</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>11492782</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.06310</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>0</BadDebtExpenseReported>
      <AmountReimbursedByMedicare>71248032</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>71093315</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>154717</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>1</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>1</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>CENTRAL WASHINGTON HOSPITAL</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>PO BOX 1887</AddressLine1>
          <City>WENATCHEE</City>
          <State>WA</State>
          <ZIPCode>98807</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>NOT REQUIRED IRS ANNOUNCEMENT 2011-37</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 8: DIRECTLY FROM THE MEDICARE COST REPORT.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART III, LINE 9B: COLLECTION IS SUSPENDED WHEN THE COMPLETED UNCOMPENSATED CARE APPLICATION AND SUPPORTING FINANCIAL DOCUMENTATION IS RECEIVED. COLLECTION REMAINS SUSPENDED UNTIL FINAL DETERMINATION OF QUALIFICATION FOR ASSISTANCE IS COMPLETED.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART I, LINE 6A: THE ANNUAL COMMUNITY BENEFIT REPORT IS SUBMITTED TO THE WASHINGTON STATE HOSPITAL ASSOCIATION. THE ASSOCIATION MAKES THE REPORT AVAILABLE TO THE PUBLIC.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 2: CURRENTLY CENTRAL WASHINGTON HOSPITAL DOES NOT HAVE AN ASSESSMENT PROGRAM TO EVALUATE THE HEALTH CARE NEEDS OF THE COMMUNITY. CENTRAL WASHINGTON HOSPITAL'S PROGRAM IS BASED ON HISTORICAL ACTIVITIES AND RESPONDING TO SPECIFIC REQUESTS.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 3: THE HOSPITAL'S CHARITY CARE POLICY IS MADE PUBLICLY AVAILABLE THROUGH THE FOLLOWING ELEMENTS:A. A NOTICE ADVISING PATIENTS THAT THE HOSPITAL PROVIDES CHARITY CARE WILL BE POSTED IN KEY AREAS OF THE HOSPITAL, INCLUDING ADMISSIONS, THE EMERGENCY DEPARTMENT, AND CASHIER OFFICE.B. THE HOSPITAL WILL INCLUDE A WRITTEN NOTICE EXPLAINING THE POLICY TO PATIENTS AT THE TIME THAT THE HOSPITAL SUBMITS BILLING TO THE PATIENT OR RESPONSIBLE PARTY (HEREAFTER REFERRED TO AS 'GUARANTOR').C. THE WRITTEN INFORMATION WILL BE AVAILABLE IN ANY LANGUAGE SPOKEN BY MORE THAN TEN PERCENT OF THE POPULATION IN THE HOSPITAL'S SERVICE AREA. INTERPRETIVE SERVICES WILL BE PROVIDED FOR OTHER NON-ENGLISH SPEAKING OR LIMITED-ENGLISH SPEAKING PATIENTS. INTERPRETIVE SERVICES WILL ALSO BE PROVIDED FOR PATIENTS WHO CANNOT UNDERSTAND THE WRITING AND/OR EXPLANATION.D. THE HOSPITAL WILL TRAIN ADMITTING AND PATIENT ACCOUNTS STAFF TO ANSWER CHARITY CARE QUESTIONS EFFECTIVELY.E. WRITTEN INFORMATION ABOUT THE HOSPITAL'S CHARITY CARE POLICY WILL BE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION IN PERSON, VIA PHONE, OR BY LETTER. THE HOSPITAL'S CHARITY DISCOUNT TABLE WILL ALSO BE MADE AVAILABLE UPON REQUEST.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 4: CENTRAL WASHINGTON HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS AND OPERATES A LICENSED 206-BED ACUTE CARE HOSPITAL DELIVERING A FULL RANGE OF HEALTH CARE SERVICES IN WENATCHEE, WASHINGTON AND THE NORTH CENTRAL WASHINGTON AREA. THE MAJORITY OF PATIENTS COME FROM CHELAN, DOUGLAS, GRANT AND OKANOGAN COUNTIES. 67% OF THE HOSPITAL'S PATIENTS ARE MEDICARE/MEDICAID ELIGIBLE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>PART VI, LINE 6: CENTRAL WA HOSPITAL'S GOVERNING BOARD IS COMPRISED OF LOCAL AREA RESIDENTS. THE HOSPITAL EXTENDS ITS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. CWH USES ITS INCOME TO UPDATE EQUIPMENT, TECHNOLOGY AND FACILITIES TO IMPROVE PATIENT CARE. THE HOSPITAL OFFERS EDUCATION FOR AREA PHYSICIANS AND COMMUNITY MEMBERS. ALSO AVAILABLE TO PHYSICIANS AND THE COMMUNITY IS THE HEMINGER HEALTH LIBRARY. WE COLLABORATE WITH MANY LOCAL AND STATE COLLEGES, UNIVERSITIES, AND OUR LOCAL HIGH SCHOOL IN SUPPORT OF STUDENT LEARNING OPPORTUNITIES. IN 2010 AN ELECTRONIC MEDICAL RECORD WAS IMPLEMENTED. THE SYSTEM GIVES OUR PROVIDERS ALL THE MEDICAL INFORMATION NEEDED TO MAKE THE BEST DECISIONS IN THE CARE OF OUR PATIENTS. THE HOSPITAL IS A FEDERAL REGIONAL REFERRAL CENTER AND A LEVEL III GENERAL AND PEDIATRIC TRAUMA CENTER. CENTRAL WASHINGTON HOSPITAL HAS BEEN NAMED TO THE COMMUNITY VALUE INDEX TOP 100 HOSPITALS LIST, IDENTIFYING CENTRAL AS A LEADER IN LOW-COST, LOW-CHARGE HOSPITAL CARE.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <TravelForCompanions>X</TravelForCompanions>
      <WrittenPolicyReTAndEExpenses>1</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>1</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>1</SeverancePayment>
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        <NamePerson>JOHN T EVANS JR</NamePerson>
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        <NamePerson>STEVEN R JACOBS</NamePerson>
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        <NamePerson>JOHN B HAMILTON</NamePerson>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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        <NontaxableBenefitsFilingOrg>2648</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>TRACEY A KASNIC</NamePerson>
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        <BonusFilingOrg>30447</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>14709</DeferredCompFilingOrg>
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        <NontaxableBenefitsFilingOrg>22413</NontaxableBenefitsFilingOrg>
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        <TotalCompensationFilingOrg>224856</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MARK A BROBERG</NamePerson>
        <BaseCompensationFilingOrg>698987</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
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        <DeferredCompFilingOrg>18137</DeferredCompFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>CRAIG R BROWNLEE</NamePerson>
        <BaseCompensationFilingOrg>379727</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>HANK J VEJVODA</NamePerson>
        <BaseCompensationFilingOrg>558793</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
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        <NontaxableBenefitsFilingOrg>17526</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>LINDA L STRAND</NamePerson>
        <BaseCompensationFilingOrg>275406</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
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        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>MARK E TRUMP</NamePerson>
        <BaseCompensationFilingOrg>418763</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <ReturnReference>PART I, LINES 4A-B</ReturnReference>
        <Explanation>FORM 990, SCHEDULE J, PART I, LINE 4A: DEBORAH HASSLER: $165,569 FORM 990, SCHEDULE J, PART I, LINE 4B: JOHN T. EVANS, JR: $79,364 JOHN HAMILTON: $49,470 THE VALUE IS BASED ON A PERCENTAGE OF THEIR INDIVIDUAL ANNUAL SALARY.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>WASHINGTON HEALTH CARE FACILITIES AUTHORITY</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>911108929</IssuerEIN>
        <CUSIPNumber>93978E4M1</CUSIPNumber>
        <DateIssued>2009-08-12</DateIssued>
        <IssuePrice>114560771</IssuePrice>
        <DescriptionOfPurpose>CONSTRUCTION OF HEALTHCARE FACILITY</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>WASHINGTON HEALTH CARE FACILITIES AUTHORITY</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>911108929</IssuerEIN>
        <CUSIPNumber>93978EQL9</CUSIPNumber>
        <DateIssued>2001-04-10</DateIssued>
        <IssuePrice>19755081</IssuePrice>
        <DescriptionOfPurpose>CONSTRUCTION OF HEALTHCARE FACILITY</DescriptionOfPurpose>
        <Defeased>1</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
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        <TotalProceeds>116535000</TotalProceeds>
        <AmountInReserveFund>9357737</AmountInReserveFund>
        <RefundingEscrow>17249000</RefundingEscrow>
        <WorkingCapitalExpenditures>2145873</WorkingCapitalExpenditures>
        <CapitalExpenditures>82709004</CapitalExpenditures>
        <AmountUnspent>3099158</AmountUnspent>
        <YearOfSubstCompletion>2011</YearOfSubstCompletion>
        <CurrentRefunding>0</CurrentRefunding>
        <AdvanceRefunding>1</AdvanceRefunding>
        <FinalAllocationMade>0</FinalAllocationMade>
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        <WorkingCapitalExpenditures>239919</WorkingCapitalExpenditures>
        <CapitalExpenditures>18157886</CapitalExpenditures>
        <YearOfSubstCompletion>2002</YearOfSubstCompletion>
        <CurrentRefunding>0</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
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        <AnyResearchAgreements>0</AnyResearchAgreements>
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        <PostIssuanceComplianceProcdrs>1</PostIssuanceComplianceProcdrs>
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        <Form8038TFiled>1</Form8038TFiled>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>1</GrossProceedsInvestedInGIC>
        <TermOfGIC>20.000000000000</TermOfGIC>
        <RegulatorySafeHarborSatisfied>1</RegulatorySafeHarborSatisfied>
        <GrossProceedsInvested>0</GrossProceedsInvested>
        <ExceptionToRebate>0</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartV>
        <Identifier>FORM 990, SCHEDULE K, PART IV, LINE 4B AND 4C, COLUMN A:</Identifier>
        <ReturnReference>NAME OF PROVIDER OF GIC:</ReturnReference>
        <Explanation>LINE 4B: 1. TRINITY FUNDING 2. RBC CAPITAL(2 GICS) LINE 4C: 1. 1.2 YEARS 2. 5 YEARS AND 10 YEARS</Explanation>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <Identifier>FORM 990, SCHEDULE K, PART IV, LINE 4B, COLUMN B:</Identifier>
        <ReturnReference>NAME OF PROVIDER OF GIC:</ReturnReference>
        <Explanation>1. MBIA</Explanation>
      </Form990ScheduleKPartV>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 4</Identifier>
        <Explanation>ON SEPTEMBER 13TH 2011, THE MEMBERSHIP OF THE ASSOCIATION (MADE UP OF REGIONAL CLERGY AND LAITY OF SPECIFIC DENOMINATIONS AND THE BOARD OF DIRECTORS) AMENDED THEIR ARTICLES OF INCORPORATION TO DISCONTINUE MEMBERSHIP. ALONG WITH THAT CHANGE, A FAVORABLE VOTE OF 3/4 OF THE BOARD OF DIRECTORS WILL BE REQUIRED TO RATIFY BY-LAWS AND AMEND ARTICLES OF INCORPORATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 6</Identifier>
        <Explanation>THE MEMBERSHIP OF THE ASSOCIATION SHALL BE OF A SINGLE CLASS CONSISTING OF PASTORS AND LAY PERSONS OF SPECIFIED CHURCHES, DISTRICT AND DIOCESAN REPRESENTATION, AND ALL ELECTED MEMBERS OF THE BOARD OF DIRECTORS. EACH CLERGY OR LAYPERSON SHALL BE A RESIDENT OF CHELAN, OKANOGAN OR DOUGLAS COUNTY, WASHINGTON.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 7A</Identifier>
        <Explanation>THE MANAGEMENT OF THIS ASSOCIATION SHALL BE VESTED IN THE BOARD OF DIRECTORS. AUTHORITY TO MAKE THE BYLAWS FOR THE ASSOCIATION IS HEREBY EXPRESSLY VESTED IN THE BOARD OF DIRECTORS OF THE ASSOCIATION. HOWEVER, THE MEMBERSHIP MAY CHANGE OR REPEAL ANY SUCH BYLAW, PROVIDED THAT ANY SUCH CHANGE OR REPEAL SHALL REQUIRE A FAVORABLE VOTE OF THREE-FOURTHS OF THE TOTAL MEMBERSHIP OF THE ASSOCIATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION B, LINE 11</Identifier>
        <Explanation>A COPY OF FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED. THE 990 IS REVIEWED BY THE DIRECTOR OF ACCOUNTING, AND THE CFO. A SUMMARY OF THE 990 IS PROVIDED TO THE FINANCE COMMITEE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>ALL BOARD MEMBERS, EMPLOYED PHYSICIANS, AND MEMBERS OF THE ADMINISTRATIVE TEAM ARE REQUIRED TO REVIEW THE CURRENT CONFLICT OF INTEREST POLICY AND COMPLETE AN ANNUAL QUESTIONNAIRE. THE NOMINATING COMMITTEE OF THE BOARD REVIEWS QUESTIONNAIRES SUBMITTED BY BOARD MEMBERS FOR POTENTIAL CONFLICTS OF INTEREST. POTENTIAL QUESTIONS OF CONFLICT FOR BOARD MEMBERS ARE RESOLVED BY THE NOMINATING COMMITTEE OF THE BOARD. THE HOSPITAL'S EXECUTIVE TEAM REVIEWS QUESTIONNAIRES SUBMITTED BY EMPLOYED PHYSICIANS AND THE ADMINISTRATIVE TEAM FOR POTENTIAL CONFLICTS OF INTEREST. POTENTIAL QUESTIONS OF CONFLICT FOR MEMBERS OF THE ADMINISTRATIVE TEAM ARE RESOLVED BY THE EXECUTIVE TEAM IN COLLABORATION WITH THE CORPORATE COMPLIANCE OFFICER. BOARD MINUTES REFLECT WHEN THE REVIEW IS COMPLETE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15</ReturnReference>
        <Explanation>THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS INDEPENDENT SALARY SURVEY INFORMATION AND RECOMMENDS A SALARY INCREASE FOR THE CEO TO THE FULL BOARD. THE OTHER OFFICERS RECEIVE THE ANNUAL PERCENT INCREASE WHICH OTHER NON-CONTRACTUAL EMPLOYEES RECEIVE UNLESS THE CEO AWARDS A DIFFERENT PERCENTAGE. THE AMOUNT IS BASED ON CURRENT CPI, MARKET, AND SALARY SURVEY INFORMATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>CENTRAL WASHINGTON HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES:</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5:</ReturnReference>
        <Explanation>NET UNREALIZED GAINS ON INVESTMENTS: 3,232,633. ROUNDING 1. LOSS ON K-1 NOT INCLUDED IN REVENUE ON FINANCIAL STATEMENT 103,955. TOTAL TO FORM 990, PART XI, LINE 5: 3,336,589.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART XII, LINE 2C:</ReturnReference>
        <Explanation>NO CHANGE FROM PRIOR YEAR.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, SCHEDULE D, PART VI, LINE 1E:</ReturnReference>
        <Explanation>CONSTRUCTION IN PROGRESS: $101,147,532.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>