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      <GrantsToDomesticOrgs>
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      <GrantsToDomesticIndividuals>
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      <BenefitsToMembers>
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      <FeesForServicesLegal>
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      <FeesForServicesLobbying>
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      <Advertising>
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      <Royalties>
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      </Royalties>
      <Occupancy>
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      <Travel>
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        <ProgramServices>489075</ProgramServices>
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      </Travel>
      <TravelEntrtnmntPublicOfficials>
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      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
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      <Interest>
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        <ProgramServices>2147402</ProgramServices>
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      <PaymentsToAffiliates>
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        <ProgramServices>16300685</ProgramServices>
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      <OtherExpenses>
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      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
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        <Explanation>Indiana Hospital Association IHA Annual Dues x 5.45 IHA determined to be attributable to lobbying as defined by federal law. IHA deemed as lobbying and not Elkhart General Hospital directly.</Explanation>
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        <BookValue>31942342</BookValue>
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      <OtherLandBuildings>
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        <BookValue>4466731</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>139234691</TotalOfBookValueLandBuildings>
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        <Description>Accrued Pension Liabilities</Description>
        <Amount>24000972</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Other Liabilities</Description>
        <Amount>5716511</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Accrued interest</Description>
        <Amount>878077</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Capital lease obligations</Description>
      </OtherLiabilities>
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      <TotalExpenses>258292729</TotalExpenses>
      <ExcessOrDeficitForYear>7866189</ExcessOrDeficitForYear>
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      <TotalAdjustments>21481332</TotalAdjustments>
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      <RevenueNotRptdOnFinStmt>3296260</RevenueNotRptdOnFinStmt>
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        <ReturnReference>4b</ReturnReference>
        <Explanation>Loan writeoffs, other, miscellaneous costs of 260,496</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>XIII</Identifier>
        <ReturnReference>4b</ReturnReference>
        <Explanation>Interest Expense of 2,147,402.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>XIII</Identifier>
        <ReturnReference>4b</ReturnReference>
        <Explanation>Loan writeoffs, other, miscellaneous expense 260,496</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>XIII</Identifier>
        <ReturnReference>2d</ReturnReference>
        <Explanation>Rental expenses of 732,060</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>X</Identifier>
        <ReturnReference>2</ReturnReference>
        <Explanation>US GAAP requires that a tax position is recognized as a benefit only if it is more likely than not that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50 likely of being realized on examination . For tax positions not meeting the more likely than not test, no tax benefit is recorded. Due to its tax-exempt status, the Hospital is not subject to US</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="990H" softwareId="10000149" softwareVersion="2010.2.15">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>false</FPGReferenceFreeCare>
      <FPGReferenceDiscountedCare>false</FPGReferenceDiscountedCare>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>false</ExpensesExceededBudget>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <PersonsServed>4878</PersonsServed>
        <TotalCommunityBenefitExpense>4402089</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>4402089</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01700</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>33371927</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>13999226</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>19372701</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.07500</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <PersonsServed>4878</PersonsServed>
        <TotalCommunityBenefitExpense>37774016</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>13999226</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>23774790</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.09200</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>1002950</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>1002950</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00390</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <NumberOfActivitiesOrPrograms>34</NumberOfActivitiesOrPrograms>
        <PersonsServed>101</PersonsServed>
        <TotalCommunityBenefitExpense>193992</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>193992</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00080</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>5204989</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>285932</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>4919057</NetCommunityBenefitExpense>
      </SubsidizedHealthServices>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>203726</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>203726</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00080</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <NumberOfActivitiesOrPrograms>34</NumberOfActivitiesOrPrograms>
        <PersonsServed>101</PersonsServed>
        <TotalCommunityBenefitExpense>6605657</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>285932</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>6319725</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00550</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <NumberOfActivitiesOrPrograms>34</NumberOfActivitiesOrPrograms>
        <PersonsServed>4979</PersonsServed>
        <TotalCommunityBenefitExpense>44379673</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>14285158</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>30094515</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.09750</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>6550154</BadDebtExpenseAmount>
      <AmountAttributableTo>3275077</AmountAttributableTo>
      <AmountReimbursedByMedicare>86390183</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>108674525</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-22284342</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>false</ProvisionForCharityCare>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>RiverPointe Surgery Center LLC</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>Surgeries</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.40000</OrganizationProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.60000</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>Wakarusa Medical Clinic LLC</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>Medical Clinic Building</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.41780</OrganizationProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.58220</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>Community Occupational Medicine LLC</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>Occupational Medicine</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.26390</OrganizationProfitOrOwnership>
        <OfficersEtcProfitOrOwnership>0.10190</OfficersEtcProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.63420</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>RiverPointe Cardiovascular Laboratory LLC</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>Cardiovascular Procedures</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.50000</OrganizationProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.50000</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <Form990ScheduleHPartIV>
        <NameOfEntity>
          <BusinessNameLine1>WaNee Walk In Clinic LLC</BusinessNameLine1>
        </NameOfEntity>
        <DescriptionEntPrimaryActivity>Medical Clinic</DescriptionEntPrimaryActivity>
        <OrganizationProfitOrOwnership>0.50000</OrganizationProfitOrOwnership>
        <PhysicansProfitOrOwnership>0.50000</PhysicansProfitOrOwnership>
      </Form990ScheduleHPartIV>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>Elkhart General Hospital Inc</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>600 East Blvd</AddressLine1>
          <City>Elkhart</City>
          <State>IN</State>
          <ZIPCode>46514</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Elkhart General Home Care</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Elkhart General Home Medical Equipment</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>2</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Family Practice Associates</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>3</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>For Women Only</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>4</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Center for Behavioral Management</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>5</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Wakarusa Medical Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>6</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Family Medicine Center</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>7</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Bristol Family Practice</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>8</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Osceola Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>9</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Nappanee Family Medical Clinic</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>10</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Center for Family Practice</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>11</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Bittersweet Medical Associates</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>12</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Edwardsburg Family Medicine</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>13</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>EGH Health Education Center</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>14</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>RiverPointe Ambulatory Surgery Center</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>15</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>RiverPoint Cardiovascular Laboratory LLC</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>16</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Community Occupational Medicine</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>17</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>WaNee Walk In Clinic LLC</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>18</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>18</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Elkhart General Home Care</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2020 Industrial Parkway</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46516</ZIPCode>
          </Address>
          <FacilityType>0</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Elkhart General Home Medical Equipment</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>225 East Jackson Blvd</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46516</ZIPCode>
          </Address>
          <FacilityType>Home Health Care Provider</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Family Practice Associates</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>3301 County Road 6 East</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46514</ZIPCode>
          </Address>
          <FacilityType>Durable Medical Equipment Store</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>For Women Only</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1215 Lawn Avenue Suite 100</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46514</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Center for Behavioral Management</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1506 Osolo Road Suite A</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46514</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Wakarusa Medical Clinic</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>207 North Elkhart Street</AddressLine1>
            <City>Wakarusa</City>
            <State>IN</State>
            <ZIPCode>46573</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Family Medicine Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2120 Reith Blvd</AddressLine1>
            <City>Goshen</City>
            <State>IN</State>
            <ZIPCode>46526</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Bristol Family Practice</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>306 East Vistula</AddressLine1>
            <City>Bristol</City>
            <State>IN</State>
            <ZIPCode>46507</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Osceola Clinic</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>5314 Lincolnway East</AddressLine1>
            <City>Mishawaka</City>
            <State>IN</State>
            <ZIPCode>46544</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Nappanee Family Medical Clinic</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>357 Nappanee Street</AddressLine1>
            <City>Nappanee</City>
            <State>IN</State>
            <ZIPCode>46550</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Center for Family Practice</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1753 Fulton Street</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46514</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Bittersweet Medical Associates</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>12340 Bittersweet Commons Blvd</AddressLine1>
            <City>Granger</City>
            <State>IN</State>
            <ZIPCode>46530</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Edwardsburg Family Medicine</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>27082 West Main Street</AddressLine1>
            <City>Edwardsburg</City>
            <State>MI</State>
            <ZIPCode>49112</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>EGH Health Education Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2220 Reith Blvd</AddressLine1>
            <City>Goshen</City>
            <State>IN</State>
            <ZIPCode>46526</ZIPCode>
          </Address>
          <FacilityType>Owned Physician Practice</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>RiverPointe Ambulatory Surgery Center</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>500 Arcade Ave</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46514</ZIPCode>
          </Address>
          <FacilityType>Health Education Center</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>RiverPoint Cardiovascular Laboratory LLC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>500 Arcade Ave</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46514</ZIPCode>
          </Address>
          <FacilityType>Surgery Center Joint Venture</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Community Occupational Medicine</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>22818 Old US 20</AddressLine1>
            <City>Elkhart</City>
            <State>IN</State>
            <ZIPCode>46516</ZIPCode>
          </Address>
          <FacilityType>Cardiovascular Lab Joint Venture</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>WaNee Walk In Clinic LLC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1208 A East Waterford Street</AddressLine1>
            <City>Wakarusa</City>
            <State>IN</State>
            <ZIPCode>46573</ZIPCode>
          </Address>
          <FacilityType>Occupational Health Clinic Joint Venture</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 3c</Identifier>
        <Explanation>The hospital does not specifically use FPG to determine eligibility for financial assistance. The hospital uses both an asset test and an income/expense test to determine eligibility for financial assistance, either in whole or in part. The asset test consists of the patient or responsible party reporting assets that might be used to make payment to reduce or eliminate the financial obligation to the hospital. Typical household assets are never requested to be liquidated.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 3c</Identifier>
        <Explanation>Assets of a significant, extraordinary nature such as stocks, bonds, retirement savings, other savings, second homes, etc, which are not needed or required to provide normal, ongoing living expenses for the household are excess. These assets may be requested to be liquidated and used toward payment of the financial obligation of the hospital.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 3c</Identifier>
        <Explanation>An income/expense test is also used to determine a patients or a responsible partys ability to pay based upon current monthly net income. The responsible party is requested to provide information about household income and household expenses. Only expenses in excess of a reasonable norm would not be considered when compared with monthly net or spendable income. In order to deny financial assistance, ones net income must significantly exceed ones reasonable expenses.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 3c</Identifier>
        <Explanation>Additionally, while the actual charity care did not exceed budget, charity care will not be denied should charity care exceed budgetary levels.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 6a</Identifier>
        <Explanation>Elkhart General Hospital, Inc. prepares a Community Benefit Report annually, both for the State of Indiana and for the Annual Report, which is posted at www.egh.org.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 7g</Identifier>
        <Explanation>Physician Clinics are a vital piece of the inpatient mission of the hospital, and correspondingly contribute to charity care and community benefit just as the hospital itself does.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 7 column f</Identifier>
        <Explanation>No portion of bad debt expense is being included in line 7.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 7</Identifier>
        <Explanation>Hospital-wide cost to charge ratio is used when the activity is not isolated within a single department.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 4</Identifier>
        <Explanation>Bad debt expense is not footnoted within the audited financial statement. Also, bad debt expense is not classified as community benefit. Provision for bad debt expense of 16,300,686 is recorded as an expense at gross, within the expense classification of the Statement of Operations. After applying the cost to charge ratio, bad debt expense at cost would be 6,550,154. It is estimated that half of the bad debt expense cases would actually qualify for charity care, had the patient gone</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 4</Identifier>
        <Explanation>through the process, but it is not currently classified at all as charity care.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 8</Identifier>
        <Explanation>The hospital consistently uses the Hospital-wide cost to charge ratio to determine cost overall. Simply stated, the calculation divides the operating costs less the bad debt expense by the gross revenue. While we believe the Medicare shortfall is a benefit to the community and reduces the government burden, none of the Medicare shortfall is being recorded as community benefit.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 9b</Identifier>
        <Explanation>Patients who are known to qualify for charity care or financial assistance are immediately eliminated from the hospitals collection protocols. Thus, they are no longer subject to hospital collection practices.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 2</Identifier>
        <Explanation>In 2010, Elkhart General Hospital embarked on a new community health needs assessment CHNA. Hospital representatives worked with other public health representatives to secure participation of a broad base of partners in implementing the assessment. More than 40 representatives were involved in the CHNA. One of the initial tasks was to conduct a healthcare provider survey, which netted 283 responses. From the survey, the healthcare CHNA partners worked on ranking priorities and deciding</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 2</Identifier>
        <Explanation>on next steps to address the communitys health needs. Elkhart General will use plans developed by the partners to guide the 2011 community outreach activities and help improve healthcare access and affordability. Additionally, Elkhart General conducts annual market projections by diseases for our primary and secondary service areas. Indiana hospital use rates are applied to the local population to achieve these projections. Unemployment and uninsured statistics are obtained from the</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 2</Identifier>
        <Explanation>Elkhart County Department of Economic Development. To ensure there are enough providers to care for the population and the projected disease rates, a medical staff development plan is conducted every two years. The Medical Staff Development Plan is used to determine the number of physicians by specialty needed to serve the community. New physician recruits and retirements are taken into account.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 3</Identifier>
        <Explanation>The hospital provides four 4 full time equivalents FTEs to counsel patients without insurance regarding their ability to qualify for the State of Indiana Medicaid programs. In addition, billing statements sent to all patients address the concern of financial hardship and what a patient can do to make the hospital aware of any financial hardship that they may be incurring. Our billing statements also provide patient information about their first steps to obtain financial assistance.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 3</Identifier>
        <Explanation>Additionally, a patient financial services brochure, available during the intake process, describes our financial assistance policy and what steps can be taken if the patient experiences a financial hardship. Patients are also made aware of financial assistance program via telephone conversation with our Patient Accounts staff. Staff is particularly sensitive to address this program with anyone who indicates that there might be a financial need.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>Elkhart County is considered to be Elkhart General Hospitals primary service area. According to the US Census Bureau, currently Elkhart County has a population of 197,559 with a median household income of 43,531. 11.5 are age 65 and over. 77.2 of the population is white, non-Hispanic 14.1 is Hispanic 5.7 is black. 21.3 of the adults over the age of 25 have less than a high school education. 14.4 of the community is below poverty level. In December 2010, Elkhart Countys</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>unemployment rate was 12.3.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>Elkhart General Hospitals goal is to create a healthier community by seeking out and partnering with organizations that share our mission. We strive to promote the health and well being of individuals and families by providing education that may aid in detection and prevention of disease, while also assisting these families in finding the non health-related services needed to keep their families and our community strong. In 2010, Elkhart General Hosptial partnered with many organizations</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>including the low-income Elkhart Community School System to offer support for the Elkhart County Childhood Obesity Initiative ECCOI to identify preventative measures and ways to reduce obesity among the countys children, over 40 of whom are currently obese or at risk for obesity, the Peers Educating and Encouraging Relationship Skills PEERS Project, and the K-6th grade Mentoring Program Heart City Health Center to provide free pap tests to uninsured women the Minority and Latino Health</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>Coalitions to educate the community about diversity, working together to create healthier families, and creating common goals to build stronger neighborhoods the Back2School Elkhart Program to provide groceries, shoes, school supplies, back packs, and free health screenings and education to Title 1 School Systems over 6,000 people attended this event in 2010 the Elkhart County Health Department to analyze Perinatal Periods of Risk PPOR data to eventually reduce perinatal death rates in</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>Elkhart County and the Elkhart Chamber of Commerce Leadership Programs to offer education to the underserved Hispanic population served as a patient advocate through the Medications Assistance Program MAP to assist over 600 community members in acquiring free or discounted medications partnered with YMCA to help educate more than 1,000 children and their families about nutrition offered support to local clinics who serve the under-insured and uninsured populations provided a large number</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>of free health screenings to community members including pap, prostate, cancer, cholesterol, bone density, blood glucose, and PAD screenings and sponsored multiple health fairs at local schools, churches, and other public organizations. Elkhart General Hospitals governing body is comprised of persons who reside in Elkhart County. The 17 member Board of Directors, who serve without pay, guides the system in its mission to provide high quality, affordable health care to the communities it</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>serves. The Boards roles include guaranteeing fair and equal access, approving new medical staff members and approving long-term strategies for the continued success of the hospital. Additionally, Elkhart General extends medical staff privileges to all qualified physicians in our community.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 6</Identifier>
        <Explanation>n/a</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 7</Identifier>
        <Explanation>IN</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="990J" softwareId="10000149" softwareVersion="2010.2.15">
      <ClubDuesOrFees>X</ClubDuesOrFees>
      <WrittenPolicyReTAndEExpenses>true</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>true</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <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>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>Gregory Lintjer</NamePerson>
        <BaseCompensationFilingOrg>528063</BaseCompensationFilingOrg>
        <BonusFilingOrg>210992</BonusFilingOrg>
        <OtherCompensationFilingOrg>25367</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>986418</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15199</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>1766039</TotalCompensationFilingOrg>
        <CompReportPrior990FilingOrg>135745</CompReportPrior990FilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Kevin Higdon</NamePerson>
        <BaseCompensationFilingOrg>251836</BaseCompensationFilingOrg>
        <BonusFilingOrg>43747</BonusFilingOrg>
        <OtherCompensationFilingOrg>2212</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>115377</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>19442</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>432614</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Gregory Losasso</NamePerson>
        <BaseCompensationFilingOrg>227615</BaseCompensationFilingOrg>
        <BonusFilingOrg>55934</BonusFilingOrg>
        <OtherCompensationFilingOrg>469</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>92456</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15892</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>392366</TotalCompensationFilingOrg>
        <CompReportPrior990FilingOrg>23583</CompReportPrior990FilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Kurt Meyer</NamePerson>
        <BaseCompensationFilingOrg>198667</BaseCompensationFilingOrg>
        <BonusFilingOrg>20935</BonusFilingOrg>
        <OtherCompensationFilingOrg>7822</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>94828</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15106</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>337358</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Danielle Dyer</NamePerson>
        <BaseCompensationFilingOrg>158237</BaseCompensationFilingOrg>
        <BonusFilingOrg>44449</BonusFilingOrg>
        <OtherCompensationFilingOrg>195</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>65835</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>13484</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>282200</TotalCompensationFilingOrg>
        <CompReportPrior990FilingOrg>22581</CompReportPrior990FilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Burton Boron</NamePerson>
        <BaseCompensationFilingOrg>397197</BaseCompensationFilingOrg>
        <BonusFilingOrg>239037</BonusFilingOrg>
        <DeferredCompFilingOrg>60705</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>12868</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>709807</TotalCompensationFilingOrg>
        <CompReportPrior990FilingOrg>171065</CompReportPrior990FilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Jeff Howe</NamePerson>
        <BaseCompensationFilingOrg>446767</BaseCompensationFilingOrg>
        <BonusFilingOrg>78858</BonusFilingOrg>
        <DeferredCompFilingOrg>35212</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>16797</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>577634</TotalCompensationFilingOrg>
        <CompReportPrior990FilingOrg>35300</CompReportPrior990FilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Douglas Jarvis</NamePerson>
        <BaseCompensationFilingOrg>234330</BaseCompensationFilingOrg>
        <BonusFilingOrg>45796</BonusFilingOrg>
        <OtherCompensationFilingOrg>19430</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>26831</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>14332</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>340719</TotalCompensationFilingOrg>
        <CompReportPrior990FilingOrg>8458</CompReportPrior990FilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Majid Malik</NamePerson>
        <BaseCompensationFilingOrg>261318</BaseCompensationFilingOrg>
        <BonusFilingOrg>22778</BonusFilingOrg>
        <OtherCompensationFilingOrg>9588</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>16848</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>16916</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>327448</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Laura Munkel</NamePerson>
        <BaseCompensationFilingOrg>250835</BaseCompensationFilingOrg>
        <BonusFilingOrg>25898</BonusFilingOrg>
        <OtherCompensationFilingOrg>839</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>40852</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15416</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>333840</TotalCompensationFilingOrg>
        <CompReportPrior990FilingOrg>16358</CompReportPrior990FilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>I</Identifier>
        <ReturnReference>1a</ReturnReference>
        <Explanation>Health or social dues are taxable and added to the appropriate W-2. For Gregory Lintjer, President, dues were paid to YMCA and Rotary. These are correctly shown in Column Biii for Mr. Lintjer.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>I</Identifier>
        <ReturnReference>4b</ReturnReference>
        <Explanation>Deferred benefits under defined benefit Supplemental Employee Retirement Plan SERP expense at 501,532 for Gregory Lintjer, President. The SERP benefits are included in Schedule J, Column C and will not be paid out until after Mr. Lintjer retires. SERP is part of the overall retirement plan. Deferred benefits under the defined benefit Restoration Plan Expense, which is included in Schedule J, Column C for the following employees Gregory Lintjer, 170,998 Kurt Meyer, 4,738 and Kevin Higdon, 6,293. Consistent with the above SERP, the Restoration Plan payouts would be part of the retirement plan package received after the retirement of the employee.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>II</Identifier>
        <Explanation>TAXABLE WAGES reported to the Federal and State governments on the employee W-2 is broken down into segments in columns Bi, Bii, Biii. The summation of these three columns agrees to the respective employees W-2 for 2010. Column Bi BASE COMPENSATION represents payment for a typical work week, and includes regular pay, vacation pay, holiday pay, and the employees contribution into EGHs 403b retirement plan.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>II</Identifier>
        <Explanation>Column Bii BONUS AND INCENTIVE COMPENSATION includes payments received in the current year upon being vested in the capital accumulation plan. The capital accumulation plan had funds put aside in a previous year and recorded as deferred. When each management employee becomes vested in their respective amount, those funds shift from being deferred to being received. The bonus column also includes bonuses paid out in the current year based upon achieved goals.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>II</Identifier>
        <Explanation>COLUMN Biii OTHER COMPENSATION includes premiums on supplemental life insurance for benefits exceeding 50,000. For Mr. Lintjer, Biii also includes a car allowance and club dues.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>II</Identifier>
        <Explanation>Column C RETIREMENT AND OTHER DEFERRED COMPENSATION represents compensation deferred until a defined future date or until retirement. Included in column C are retirement benefits such as actuarially calculated increases in the SERP, Restoration, and hospital pension retirement plans. Examples of compensation deferred to a future date are capital accumulation funds set aside, or the current year earned bonuses that will be paid out in the following year.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>II</Identifier>
        <Explanation>Column C DEFERRED COMPENSATION funds often appear to overstate the overall benefit package, as they appear in the deferred compensation column one year, and in the W-2 Compensation in a future year.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>II</Identifier>
        <Explanation>Column D NON-TAXABLE BENEFITS column includes both employee and employer payments for standard benefits such as medical, dental and life insurance, etc.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>II</Identifier>
        <Explanation>Column E TOTAL OF ALL COLUMNS is simply an addition of the taxable wages, deferred compensation, future retirement benefits accrued in current year and nontaxable benefits. This does not represent the total compensation the employee actually received during the year.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>II</Identifier>
        <Explanation>Column F COMPENSATION REPORTED ON PRIOR FORM 990 reflects taxable current year earnings which were reported in a previous year as deferred. This includes such programs as annual bonus accruals accrued in one year and paid in the following year and capital accumulation funds put aside in one year and received by the employee, if vested, in a future year.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="990K:1" softwareId="10000149" softwareVersion="2010.2.15">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Hospital Authority of Elkhart County</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>351657690</IssuerEIN>
        <CUSIPNumber>287468EM0</CUSIPNumber>
        <DateIssued>2008-12-09</DateIssued>
        <IssuePrice>47800000</IssuePrice>
        <DescriptionOfPurpose>Refund 2003 Series Bonds, which were used for capital expenditures.</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>1485000</AmountRetired>
        <TotalProceeds>47800000</TotalProceeds>
        <IssuanceCostsFromProceeds>478471</IssuanceCostsFromProceeds>
        <CreditEnhancement>33988</CreditEnhancement>
        <WorkingCapitalExpenditures>87541</WorkingCapitalExpenditures>
        <CapitalExpenditures>47200000</CapitalExpenditures>
        <YearOfSubstCompletion>2004</YearOfSubstCompletion>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>true</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>true</BondCounselRoutinelyEngaged>
        <PrcntgePrvtBusinessUseByOthers>0.01900</PrcntgePrvtBusinessUseByOthers>
        <TotalPrivateBusinessUse>0.01900</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>true</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>true</ExceptionToRebate>
      </Form990ScheduleKPartIV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="990L" softwareId="10000149" softwareVersion="2010.2.15">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Patricia Killoren</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Wife of G. Killoren, Volunteer Board Member</Relationship>
        <AmountOfTransaction>22503</AmountOfTransaction>
        <DescriptionOfTransaction>Compensation as nurse</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="990O" softwareId="10000149" softwareVersion="2010.2.15">
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>2</ReturnReference>
        <Explanation>Scott Troeger Glenn Killoren Business Relationship</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>2</ReturnReference>
        <Explanation>John Martin Todd Martin Family Relationship</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>2</ReturnReference>
        <Explanation>Dan Morrison Craig Fulmer Family Relationship</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>11b</ReturnReference>
        <Explanation>Elkhart General Hospital accounting staff prepared Form 990 and an independent CPA firm reviewed the return. Accounting staff then presented the return to the Vice President of Finance and the President of the Hospital for their review. Prior to filing, the President made the entire Form 990 available for review by all board members. The form will be presented to the full board at a regularly scheduled meeting.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part XI</Identifier>
        <ReturnReference>5</ReturnReference>
        <Explanation>Unrealized gain of 18,008,924 plus joint venture book to tax adjustment of 100,171 plus Minimum Pension Liability Adjustment of 3,372,238</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>12c</ReturnReference>
        <Explanation>The Hospital has a conflict of interest policy to protect the Hospitals interest when it is contemplating entering into a transaction or arrangement in which an Officer, Director, or Key Employee of the Hospital is financially interested. Annually, board members and key employees complete and sign a conflict of interest questionnaire. In connection with any actual or possible conflilcts of interest, an interested person must disclose the existence and nature of his or her financial interest to the directors and the members of board committees considering the proposed transaction or arrangement. After disclosure, the interested person shall leave the Board or Committee meeting while the financial interest is being voted upon. The remaining Board or Committee members shall decide if a conflict of interest exists. If the Board or Committee has</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>12c</ReturnReference>
        <Explanation>continued.... reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an explanation.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>15ab</ReturnReference>
        <Explanation>The full Board has delegated responsibility for the review and determination of executive compensation to the Executive Committee of the Board. Prior to making any salary or benefit changes for the Chief Executive Officer CEO, the Committee obtains and relies upon comparative hospital compensation and benefits data provided by an independent compensation firm. The Committee, excluding the CEO, considers the independent data in conjunction with the job performance of the CEO. Compensation and/or benefit changes are approved by the Committee and duly documented in the Committee meeting minutes. Changes to Vice Presidents salaries are also reviewed and approved by the Executive Committee of the Board. Every other year, the Committee authorizes Human Resources to engage an independent compensation firm to conduct a complete review of the compensation and benefits structure for senior</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>15ab</ReturnReference>
        <Explanation>continued... leadership. The CEO considers the independent data in conjunction with job performance to evaluate and then recommend salary changes to the Committee.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part III</Identifier>
        <ReturnReference>1</ReturnReference>
        <Explanation>MIssion To create a healthier community by being a premier provider of healthcare Promoting the health and well being of individuals and families by providing education that may aid in detection and prevention of disease conducting our activities with compassion and respect acting with recognition that health is wholistic and embraces the body, mind, and spirit seeking and partnering with those who share our mission continuously improving the quality and cost-effectiveness of our services maintaining the financial viability of the Hospital while continuing our charitable role in the community.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="990R" softwareId="10000149" softwareVersion="2010.2.15">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Elkhart General Hospital Foundation</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>600 East Blvd</AddressLine1>
          <City>Elkhart</City>
          <State>IN</State>
          <ZIPCode>46514</ZIPCode>
        </AddressUS>
        <EIN>356061200</EIN>
        <PrimaryActivities>Charitable support</PrimaryActivities>
        <LegalDomicileState>IN</LegalDomicileState>
        <ExemptCodeSection>501c 3</ExemptCodeSection>
        <PublicCharityStatus>Type II</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Elkhart General Hospital Auxiliary</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>600 East Blvd</AddressLine1>
          <City>Elkhart</City>
          <State>IN</State>
          <ZIPCode>46514</ZIPCode>
        </AddressUS>
        <EIN>350938148</EIN>
        <PrimaryActivities>Volunteer support</PrimaryActivities>
        <LegalDomicileState>IN</LegalDomicileState>
        <ExemptCodeSection>501c 3</ExemptCodeSection>
        <PublicCharityStatus>Type I</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>RiverPointe Cardiovascular Laboratory LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>500 Arcade Avenue Suite 410</AddressLine1>
          <City>Elkhart</City>
          <State>IN</State>
          <ZIPCode>46514</ZIPCode>
        </AddressUS>
        <EIN>352042178</EIN>
        <PrimaryActivity>Cardiovascular lab</PrimaryActivity>
        <LegalDomicileState>IN</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>Not applicable</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>Related</PredominantIncomeType>
        <ShareOfTotalIncome>-17880</ShareOfTotalIncome>
        <ShareOfEOYAssets>40783</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
        <PercentageOwnership>0.50000</PercentageOwnership>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Wakarusa Medical Clinic LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>PO Box 501</AddressLine1>
          <City>Nappanee</City>
          <State>IN</State>
          <ZIPCode>46550</ZIPCode>
        </AddressUS>
        <EIN>200273243</EIN>
        <PrimaryActivity>Building Lessor</PrimaryActivity>
        <LegalDomicileState>IN</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>Not applicable</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>Related</PredominantIncomeType>
        <ShareOfTotalIncome>48107</ShareOfTotalIncome>
        <ShareOfEOYAssets>406961</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
        <PercentageOwnership>0.41780</PercentageOwnership>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>WaNee Walk In Clinic LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1028-A East Waterford Street</AddressLine1>
          <City>Wakarusa</City>
          <State>IN</State>
          <ZIPCode>46573</ZIPCode>
        </AddressUS>
        <EIN>272192375</EIN>
        <PrimaryActivity>Medical Clinic</PrimaryActivity>
        <LegalDomicileState>IN</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>Not applicable</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>Related</PredominantIncomeType>
        <ShareOfTotalIncome>-68323</ShareOfTotalIncome>
        <ShareOfEOYAssets>24951</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>true</GeneralOrManagingPartner>
        <PercentageOwnership>0.50000</PercentageOwnership>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Michiana Linen Service LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>600 East Blvd</AddressLine1>
          <City>Elkhart</City>
          <State>IN</State>
          <ZIPCode>46514</ZIPCode>
        </AddressUS>
        <EIN>272182953</EIN>
        <PrimaryActivity>Linen Washing</PrimaryActivity>
        <LegalDomicileState>IN</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>Not applicable</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>Related</PredominantIncomeType>
        <ShareOfTotalIncome>27631</ShareOfTotalIncome>
        <ShareOfEOYAssets>1022174</ShareOfEOYAssets>
        <DisproportionateAllocations>true</DisproportionateAllocations>
        <GeneralOrManagingPartner>true</GeneralOrManagingPartner>
        <PercentageOwnership>0.50000</PercentageOwnership>
      </Form990ScheduleRPartIII>
      <ReceiptOfIntAnnRentsRoyalties>true</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>true</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>true</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>true</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>RiverPointe Cardiovascular LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>a</TransactionType>
        <AmountInvolved>79772</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Michiana Linen Services LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>b</TransactionType>
        <AmountInvolved>786210</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>WaNee Walk In Clinic LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>b</TransactionType>
        <AmountInvolved>93274</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Michiana Linen Services LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>f</TransactionType>
        <AmountInvolved>429653</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Wakarusa Medical Clinic LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>j</TransactionType>
        <AmountInvolved>141600</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Michiana Linen Services LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>k</TransactionType>
        <AmountInvolved>1009279</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Michiana Linen Services LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>l</TransactionType>
        <AmountInvolved>705169</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Michiana Linen Services LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>241487</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>