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      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromGaming>
      <NetIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeOrLoss>
      <OtherRevenueMisc>
        <Description>CAFETERIA INCOME</Description>
        <BusinessCode>722210</BusinessCode>
        <TotalRevenueColumn>78842</TotalRevenueColumn>
        <ExclusionAmount>78842</ExclusionAmount>
      </OtherRevenueMisc>
      <TotalOtherRevenue>78842</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>22894728</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>22690658</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>145677</ExclusionAmount>
      </TotalRevenue>
      <InfoInScheduleOPartIX>X</InfoInScheduleOPartIX>
      <GrantsToDomesticOrgs>
        <Total>9152</Total>
        <ProgramServices>9152</ProgramServices>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>12574</Total>
        <ProgramServices>12574</ProgramServices>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>442670</Total>
        <ProgramServices>390826</ProgramServices>
        <ManagementAndGeneral>51844</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>9568618</Total>
        <ProgramServices>8305413</ProgramServices>
        <ManagementAndGeneral>1263205</ManagementAndGeneral>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>351153</Total>
        <ProgramServices>296600</ProgramServices>
        <ManagementAndGeneral>54553</ManagementAndGeneral>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>2060713</Total>
        <ProgramServices>1605458</ProgramServices>
        <ManagementAndGeneral>455255</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>680059</Total>
        <ProgramServices>598433</ProgramServices>
        <ManagementAndGeneral>81626</ManagementAndGeneral>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>0</Total>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>13306</Total>
        <ManagementAndGeneral>13306</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>154455</Total>
        <ManagementAndGeneral>154455</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>0</Total>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>2879949</Total>
        <ProgramServices>2493732</ProgramServices>
        <ManagementAndGeneral>380893</ManagementAndGeneral>
        <Fundraising>5324</Fundraising>
      </FeesForServicesOther>
      <Advertising>
        <Total>67511</Total>
        <ProgramServices>38831</ProgramServices>
        <ManagementAndGeneral>28680</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>755621</Total>
        <ProgramServices>646989</ProgramServices>
        <ManagementAndGeneral>108632</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>71432</Total>
        <ProgramServices>28836</ProgramServices>
        <ManagementAndGeneral>42596</ManagementAndGeneral>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>358341</Total>
        <ProgramServices>257329</ProgramServices>
        <ManagementAndGeneral>101012</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>47376</Total>
        <ProgramServices>36163</ProgramServices>
        <ManagementAndGeneral>11213</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>53579</Total>
        <ProgramServices>27423</ProgramServices>
        <ManagementAndGeneral>26156</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>310192</Total>
        <ProgramServices>244899</ProgramServices>
        <ManagementAndGeneral>65293</ManagementAndGeneral>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>1333728</Total>
        <ProgramServices>884906</ProgramServices>
        <ManagementAndGeneral>448822</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
        <Total>177765</Total>
        <ProgramServices>95978</ProgramServices>
        <ManagementAndGeneral>81787</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>BAD DEBT EXPENSE</Description>
        <Total>654087</Total>
        <ProgramServices>654087</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>REPAIRS &amp; MAINTENANCE</Description>
        <Total>377335</Total>
        <ProgramServices>297853</ProgramServices>
        <ManagementAndGeneral>79482</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>DUES &amp; SUBSCRIPTIONS</Description>
        <Total>112971</Total>
        <ProgramServices>60721</ProgramServices>
        <ManagementAndGeneral>52250</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Medical Supplies</Description>
        <Total>2428785</Total>
        <ProgramServices>2428704</ProgramServices>
        <ManagementAndGeneral>81</ManagementAndGeneral>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>547399</Total>
        <ProgramServices>456112</ProgramServices>
        <ManagementAndGeneral>91287</ManagementAndGeneral>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>23468771</Total>
        <ProgramServices>19871019</ProgramServices>
        <ManagementAndGeneral>3592428</ManagementAndGeneral>
        <Fundraising>5324</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>286</BOY>
        <EOY>286</EOY>
      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
        <BOY>5293805</BOY>
        <EOY>5154075</EOY>
      </SavingsAndTempCashInvestments>
      <PledgesAndGrantsReceivable>
        <BOY>50121</BOY>
        <EOY>50121</EOY>
      </PledgesAndGrantsReceivable>
      <AccountsReceivable>
        <BOY>3238196</BOY>
        <EOY>2924348</EOY>
      </AccountsReceivable>
      <ReceivablesFromOfficersEtc>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </ReceivablesFromOfficersEtc>
      <ReceivablesFromDisqualPersons>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </ReceivablesFromDisqualPersons>
      <OtherNotesLoansReceivableNet>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </OtherNotesLoansReceivableNet>
      <InventoriesForSaleOrUse>
        <BOY>673802</BOY>
        <EOY>506334</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>263635</BOY>
        <EOY>196833</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>29231006</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>13685802</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>14651059</BOY>
        <EOY>15545204</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsOtherSecurities>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </InvestmentsOtherSecurities>
      <InvestmentsProgramRelated>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </InvestmentsProgramRelated>
      <IntangibleAssets>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </IntangibleAssets>
      <OtherAssetsTotal>
        <BOY>207368</BOY>
        <EOY>1021172</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>24378272</BOY>
        <EOY>25398373</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>2138236</BOY>
        <EOY>2232855</EOY>
      </AccountsPayableAccruedExpenses>
      <GrantsPayable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </GrantsPayable>
      <DeferredRevenue>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </DeferredRevenue>
      <TaxExemptBondLiabilities>
        <BOY>4520000</BOY>
        <EOY>4335000</EOY>
      </TaxExemptBondLiabilities>
      <EscrowAccountLiability>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </EscrowAccountLiability>
      <LoansFromOfficersDirectors>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </LoansFromOfficersDirectors>
      <MortNotesPyblSecuredInvestProp>
        <BOY>2999432</BOY>
        <EOY>4662525</EOY>
      </MortNotesPyblSecuredInvestProp>
      <UnsecuredNotesLoansPayable>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </UnsecuredNotesLoansPayable>
      <OtherLiabilities>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>9657668</BOY>
        <EOY>11230380</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>14654349</BOY>
        <EOY>14102888</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>66255</BOY>
        <EOY>65105</EOY>
      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
        <BOY>0</BOY>
        <EOY>0</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>14720604</BOY>
        <EOY>14167993</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>24378272</BOY>
        <EOY>25398373</EOY>
      </TotalLiabNetAssetsFundBalances>
      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>-574043</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>21432</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <FSAuditedBasis>
        <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      </FSAuditedBasis>
      <AuditCommittee>true</AuditCommittee>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <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>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbying>
        <FilingOrganizationsTotals>4425</FilingOrganizationsTotals>
      </TotalGrassrootsLobbying>
      <TotalDirectLobbying />
      <TotalLobbyingExpenditures>
        <FilingOrganizationsTotals>4425</FilingOrganizationsTotals>
      </TotalLobbyingExpenditures>
      <OtherExemptPurposeExpenditures>
        <FilingOrganizationsTotals>19866594</FilingOrganizationsTotals>
      </OtherExemptPurposeExpenditures>
      <TotalExemptPurposeExpenditures>
        <FilingOrganizationsTotals>19871019</FilingOrganizationsTotals>
      </TotalExemptPurposeExpenditures>
      <LobbyingNontaxableAmount>
        <FilingOrganizationsTotals>1000000</FilingOrganizationsTotals>
      </LobbyingNontaxableAmount>
      <GrassrootsNontaxableAmount>
        <FilingOrganizationsTotals>250000</FilingOrganizationsTotals>
      </GrassrootsNontaxableAmount>
      <TotLobbyingGrassrootMinusNonTx />
      <TotLobbyExpendMnsLobbyingNontx />
      <Form4720Filed>false</Form4720Filed>
      <LobbyingNontaxableAmount2>
        <CurrentYearMinus3>971194</CurrentYearMinus3>
        <CurrentYearMinus2>967803</CurrentYearMinus2>
        <CurrentYearMinus1>1000000</CurrentYearMinus1>
        <CurrentYear>1000000</CurrentYear>
        <Total>3938997</Total>
      </LobbyingNontaxableAmount2>
      <LobbyingCeilingAmount>5908496</LobbyingCeilingAmount>
      <TotalLobbyingExpenditures2>
        <CurrentYearMinus3>3916</CurrentYearMinus3>
        <CurrentYearMinus2>4082</CurrentYearMinus2>
        <CurrentYearMinus1>4401</CurrentYearMinus1>
        <CurrentYear>4425</CurrentYear>
        <Total>16824</Total>
      </TotalLobbyingExpenditures2>
      <GrassrootsNontaxableAmount2>
        <CurrentYearMinus3>242799</CurrentYearMinus3>
        <CurrentYearMinus2>241951</CurrentYearMinus2>
        <CurrentYearMinus1>250000</CurrentYearMinus1>
        <CurrentYear>250000</CurrentYear>
        <Total>984750</Total>
      </GrassrootsNontaxableAmount2>
      <GrassrootsCeilingAmount>1477125</GrassrootsCeilingAmount>
      <GrassrootsLobbyingExpenditures>
        <CurrentYearMinus3>3916</CurrentYearMinus3>
        <CurrentYearMinus2>4082</CurrentYearMinus2>
        <CurrentYearMinus1>4401</CurrentYearMinus1>
        <CurrentYear>4425</CurrentYear>
        <Total>16824</Total>
      </GrassrootsLobbyingExpenditures>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <CurrentYearMinus3Years />
      <CurrentYearMinus4Years />
      <Land>
        <OtherCostOrOtherBasis>769309</OtherCostOrOtherBasis>
        <BookValue>769309</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>17172578</OtherCostOrOtherBasis>
        <Depreciation>6686608</Depreciation>
        <BookValue>10485970</BookValue>
      </Buildings>
      <LeaseholdImprovements />
      <Equipment>
        <OtherCostOrOtherBasis>8224627</OtherCostOrOtherBasis>
        <Depreciation>6544345</Depreciation>
        <BookValue>1680282</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>3064492</OtherCostOrOtherBasis>
        <Depreciation>454849</Depreciation>
        <BookValue>2609643</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>15545204</TotalOfBookValueLandBuildings>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <TotalOfAmounts>0</TotalOfAmounts>
      <Form990ScheduleDPartXIII>
        <Identifier>UNCERTAIN TAX POSITIONS DISCLOSURE</Identifier>
        <ReturnReference>SCHEDULE D, PART X, LINE 2</ReturnReference>
        <Explanation>MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent150>X</Pcent150>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent200D>X</Pcent200D>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>false</AmountsBudgetedForCharityCare>
      <AnnualCommunityBenefitReport>false</AnnualCommunityBenefitReport>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>479016</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>479016</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02040</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>2783058</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1316801</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1466257</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.06250</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>251298</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>186190</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>65108</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00280</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>3513372</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1502991</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2010381</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.08570</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>24640</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>10974</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>13666</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00060</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>937</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>937</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>10000</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>0</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>10000</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00040</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>35577</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>10974</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>24603</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00110</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>3548949</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1513965</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2034984</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.08680</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <EconomicDevelopment>
        <TotalCommunityBuildingExpense>2867</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>2867</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </EconomicDevelopment>
      <HealthImprovementAdvocacy>
        <TotalCommunityBuildingExpense>24640</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>10974</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>13666</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00060</PercentOfTotalExpense>
      </HealthImprovementAdvocacy>
      <Total>
        <TotalCommunityBuildingExpense>27507</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>10974</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>16533</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00070</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>false</BadDebtExpenseReported>
      <BadDebtExpenseAmount>654087</BadDebtExpenseAmount>
      <AmountAttributableTo>13082</AmountAttributableTo>
      <AmountReimbursedByMedicare>7235584</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>7869379</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-633795</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>HIAWATHA HOSPITAL ASSOCIATION</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>300 UTAH STREET</AddressLine1>
          <City>HIAWATHA</City>
          <State>KS</State>
          <ZIPCode>66434</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>HIAWATHA HOSPITAL ASSOCIATION</BusinessNameLine1>
        </HospitalFacilityName>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>150.</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <AssetLevel>X</AssetLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifyBeforeDischarge>X</NotifyBeforeDischarge>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>3</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>HIAWATHA COMMUNITY HOSPITAL HOME HEALTH</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>300 UTAH STREET</AddressLine1>
            <City>HIAWATHA</City>
            <State>KS</State>
            <ZIPCode>66434</ZIPCode>
          </Address>
          <FacilityType>HOME HEALTH AGENCY</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>HIAWATHA COMM HOSP FAM PRACTICE CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>300 OREGON STREET 2ND FLOOR</AddressLine1>
            <City>HIAWATHA</City>
            <State>KS</State>
            <ZIPCode>66434</ZIPCode>
          </Address>
          <FacilityType>RURAL HEALTH CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>HIAWATHA COMM HOSPITAL HIGHLAND CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>415 S MAIN STREET</AddressLine1>
            <City>HIAWATHA</City>
            <State>KS</State>
            <ZIPCode>66434</ZIPCode>
          </Address>
          <FacilityType>RURAL HEALTH CLINIC</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Identifier>SCHEDULE H, PART I, LINE 7, COLUMN F</Identifier>
        <Explanation>THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $654,087.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>SCHEDULE H, PART I, LINE 7</Identifier>
        <Explanation>THE HOSPITAL USES THE COST-TO-CHARGE RATIO. THIS METHOD WAS USED TO CALCULATE THE FIGURES IN THE TABLE AND WAS DETERMINED BY COMPARING PATIENT CARE COST TO PATIENT CARE CHARGES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY BUILDING ACTIVITIES</Identifier>
        <ReturnReference>SCHEDULE H, PART II, LINES 2 &amp; 7</ReturnReference>
        <Explanation>ECONOMIC DEVELOPMENT - HHA EMPLOYEE REPRESENTS THE HOSPITAL ON THE HIAWATHA ECONOMIC DEVELOPMENT COUNCIL TO DISCUSS THE HOSPITAL'S INVOLVEMENT IN IMPROVING THE COMMUNITY'S ECONOMIC HEALTH AND DEVELOPMENT. COMMUNITY HEALTH IMPROVEMENT ADVOCACY - OPERATION OF COMMUNITY DAY CARE AND A WEIGHT LOSS CLINIC TO BETTER SUPPORT THE HOSPITAL'S COMMUNITY &amp; HEALTHY LIVING.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>BAD DEBT EXPENSE</Identifier>
        <ReturnReference>SCHEDULE H, PART III, LINE 4</ReturnReference>
        <Explanation>The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Hospital provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions. As a service to the patient, the Hospital bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Line 2 is THE ORGANIZATION'S BAD DEBT FIGURE NET OF COLLECTIONS AND THEN MULTIPLIED BY THE ORGANIZATION'S COST TO CHARGE RATIO. THE ORGANIZATION FIGURED 2% OF THOSE BELONG IN CHARITY CARE BUT WERE INELIGIBLE BECAUSE THEY WOULDN'T COMPLETE PAPERWORK OR THE BUSINESS OFFICE DIDN'T HAVE ENOUGH INFORMATION TO BE ABLE TO SEND THEM TO PRESUMPTIVE CHARITY CARE.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COLLECTION PRACTICES</Identifier>
        <ReturnReference>SCHEDULE H, PART III, LINE 9B</ReturnReference>
        <Explanation>ON EACH STATEMENT WE STATE THAT WE HAVE A CHARITY CARE POLICY. FOR 3 MONTHS A STATEMENT IS SENT. AFTER 3RD STATEMENT, A COLLECTION LETTER GOES OUT WITH A CHARITY CARE APPLICATION. THE FOLLOWING MONTH IT IS LISTED ON THE BAD DEBT LIST. AT THE END OF THE FOLLOWING MONTH THE ACCOUNT IS WRITTEN OFF TO BAD DEBT AND SENT TO COLLECTIONS, OR LITIGATION. IF IT GOES TO LITIGATION, NOTIFICATION IS MADE THROUGH CERTIFIED MAIL. ANOTHER CHARITY CARE APPLICATION IS SENT ALONG WITH THE NOTIFICATION LETTER.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>UNINSURED PATIENT BILLING</Identifier>
        <ReturnReference>SCHEDULE H, PART V, LINE 19D</ReturnReference>
        <Explanation>Uninsured patients are offered a 10% discount on charges.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>NEEDS ASSESSMENT</Identifier>
        <ReturnReference>SCHEDULE H, PART VI, LINE 2</ReturnReference>
        <Explanation>THE ASSESSMENT OF COMMUNITY NEEDS IS A COMPILATION OF ISSUES IDENTIFIED BY THE ADMINISTRATOR, PHYSICIANS, NURSING STAFF, GOVERNING BOARD, AND INFORMAL COMMUNITY INPUT. THESE ISSUES ARE VALIDATED AND SUPPLEMENTED BY CONTRACTOR STUDIES AND GOVERNMENTAL AGENCY FEEDBACK.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</Identifier>
        <ReturnReference>SCHEDULE H, PART VI, LINE 3</ReturnReference>
        <Explanation>THE HOSPITAL'S SOCIAL SERVICES DEPARTMENT SPEAKS WITH PATIENTS REGARDING ELIGIBILITY FOR CHARITY CARE, MEDICAID, AND VARIOUS OTHER ASSISTANCE PROGRAMS THAT ARE AVAILABLE. OUR BUSINESS OFFICE MANAGER ALSO SPEAKS WITH PATIENTS REGARDING THE AVAILABILITY FOR DISABILITY DETERMINATION. PROVIDERS OFTEN BRING UP OUR CHARITY CARE PROGRAM WITH PATIENTS AT TIME OF TREATMENT. A CHARITY CARE PAMPHLET IS AVAILABLE AT ADMISSIONS AND APPLICATIONS ARE OFTEN HANDED OUT AT TIME OF ADMISSION FOR OUTPATIENT SERVICES. THE CHARITY CARE POLICY IS ALSO PUBLISHED ON OUR WEBSITE. THE FACT THAT WE HAVE A CHARITY CARE PROGRAM IS PRINTED ON THE BOTTOM OF EVERY STATEMENT THAT GOES OUT. THE CHARITY CARE APPLICATION IS PRINTED ON THE BACK OF ALL COLLECTION LETTERS AND PRE-LITIGATION CERTIFIED LETTERS.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY INFORMATION</Identifier>
        <ReturnReference>SCHEDULE H, PART VI, LINE 4</ReturnReference>
        <Explanation>OUR GEOGRAPHIC AREA INCLUDES ALL OF BROWN COUNTY AND PARTS OF DONIPHAN, ATCHISON, AND NEMAHA COUNTIES IN KANSAS AND PARTS OF RICHARDSON COUNTY NEBRASKA. 55% OF OUR COMMUNITY IS 45 YEARS OLD AND UNDER. 26% IS AGE 45 TO 64. 19% OF THE POPULATION IS OVER 65 YEARS OF AGE. 26% OF THE COMMUNITY HOUSEHOLDS ARE BELOW THE POVERTY LEVEL FOR A FAMILY OF FOUR.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PROMOTION OF COMMUNITY HEALTH</Identifier>
        <ReturnReference>SCHEDULE H, PART VI, LINE 5</ReturnReference>
        <Explanation>AS A TAX EXEMPT, NOT FOR PROFIT ENTITY, HIAWATHA COMMUNITY HOSPITAL'S PURPOSE IS TO PROVIDE THE BEST SERVICES POSSIBLE IN A MANNER THAT IS ACCESSIBLE TO ALL INDIVIDUALS. OFFERING OUR SERVICES AT NO, OR REDUCED COST TO THOSE WHO MEET OUR CHARITY REQUIREMENTS IS A CONERSTONE OF OUR MISSION. AS THE ECONOMIC CLIMATE IN THE COMMUNITY CHANGED, SO DID OUR CHARITY CARE SERVICES. IN 2010 WE BEGAN A PRESUMPTIVE CHARITY CARE PROGRAM THAT ALLOWS US TO GRANT CHARITY CARE TO THOSE INDIVIDUALS WHO QUALIFY BUT WON'T COMPLETE THE REQUIRED PAPERWORK WE NEED TO SUBSTANTIATE THE NEED FOR ASSISTANCE. ALSO SUPPPORTING OUR STATUS IS OUR COMMITMENT TO PROVIDE QUALITY SERVICE AND STAFF. TO THAT END, THE HIAWATHA COMMUNITY HOSPITAL PROVIDES SCHOLARSHIPS FOR EDUCATION IN HEALTH RELATED FIELDS. ANOTHER MANNER IN WHICH WE SUPPORT OUR NOT FOR PROFIT STATUS IS THROUGH PUBLIC HEALTH EDUCATIONAL PROGRAMS FOR THE COMMUNITY. WE PROVIDE DIABETES, HYPERTENSION AND SMOKING CESSATION EDUCATION. WE ALSO RUN A WEIGHT LOSS CLINIC.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="IRS990ScheduleI">
      <RecordsMaintained>true</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>LITTLE HANDS DAYCARE OF HIAWATHA</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>200 EAST LODGE ROAD</AddressLine1>
          <City>HIAWATHA</City>
          <State>KS</State>
          <ZIPCode>66434</ZIPCode>
        </AddressUS>
        <EINOfRecipient>264051457</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>10000</AmountOfCashGrant>
        <MethodOfValuation>CASH</MethodOfValuation>
        <PurposeOfGrant>OPERATIONAL SUPPORT</PurposeOfGrant>
      </RecipientTable>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>SCHOLARSHIPS</TypeOfGrant>
        <NumberOfRecipients>8</NumberOfRecipients>
        <AmountOfCashGrant>12574</AmountOfCashGrant>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIV>
        <Identifier>PROCESS FOR MONITORING SCHOLARSHIPS</Identifier>
        <ReturnReference>SCHEDULE I, PART III</ReturnReference>
        <Explanation>1) COMMUNITY SCHOLARSHIP - HCH HAS GIVEN SCHOLARSHIPS TO COMMUNITY MEMBERS PURSUING A DEGREE IN THE MEDICAL FIELD. AFTER THE SCHOLARSHIP IS APPROVED BY HOSPITAL CEO, THE TUITION IS PAID TO THE SCHOOL, THE STUDENT OR THE STUDENT LOAN HOLDER.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>true</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>DR BRYON BIGHAM</NamePerson>
        <Title>MD</Title>
        <BaseCompensationFilingOrg>198336</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>24808</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>8551</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>23705</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>255400</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JOHN MOORE</NamePerson>
        <Title>ADMINISTRATOR/CEO</Title>
        <BaseCompensationFilingOrg>147804</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>21570</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>169374</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR STEFFEN SHAMBURG</NamePerson>
        <Title>MD</Title>
        <BaseCompensationFilingOrg>277463</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>130433</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>11442</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>26595</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>445933</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR PETE ROSA</NamePerson>
        <Title>MD/TRUSTEE</Title>
        <BaseCompensationFilingOrg>189476</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>55642</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>8113</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>23267</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>276498</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR CROSBY GERNON</NamePerson>
        <Title>MD</Title>
        <BaseCompensationFilingOrg>399624</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>60122</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>18810</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>34521</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>513077</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>COMPENSATION CONTIGENT ON NET EARNINGS</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 6A</ReturnReference>
        <Explanation>The family physicians that are contracted with the hospital to provide services in our rural health care clinic and our radiologist are all eligible for additional compensation beyond their base pay rate. Each physician's expenses and revenues are tracked through their own department. Periodically throughout the year, if their respective departments are showing a positive net income, then they are eligible to receive additional compensation. The amount of net revenue to be distributed mid year is decided between the physicians and the Administrator. By the year end, 100% of the net revenue will be distributed as long as it doesn't exceed the annual maximum compensation amounts in the physician's respective contracts. To determine what each physician's portion of the distribution will be, income statements are run by physician that include allocations for building expenses and expenses and revenues from mid-levels.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <Form990ScheduleKPartI>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>CITY OF HIAWATHA</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>483025665</IssuerEIN>
        <CUSIPNumber>428545BD8</CUSIPNumber>
        <DateIssued>2007-03-29</DateIssued>
        <IssuePrice>5175000</IssuePrice>
        <DescriptionOfPurpose>SEE SCHEDULE K, PART V</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <BondReferenceCd>A</BondReferenceCd>
        <AmountRetired>840000</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>5175000</TotalProceeds>
        <AmountInReserveFund>0</AmountInReserveFund>
        <CapitalizedInterest>0</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>105804</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>5069196</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>0</AmountUnspent>
        <YearOfSubstCompletion>2007</YearOfSubstCompletion>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>true</AnyResearchAgreements>
        <EngageBondCounselResearch>true</EngageBondCounselResearch>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <BondIssMeetPrvtSecurityPayTest>true</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <RemedialActionTaken>false</RemedialActionTaken>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiled>false</Form8038TFiled>
        <RebateNotDueYet>false</RebateNotDueYet>
        <ExceptionToRebate>false</ExceptionToRebate>
        <NoRebateDue>false</NoRebateDue>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>false</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>A</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>false</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartVI>
        <Identifier>DESCRIPTION OF PURPOSE</Identifier>
        <ReturnReference>0</ReturnReference>
        <Explanation>REFINANCE EXISTING BOND TO BUILD</Explanation>
      </Form990ScheduleKPartVI>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>ORGANIZATION'S MISSION</Identifier>
        <ReturnReference>FORM 990, PART III, LINE 1</ReturnReference>
        <Explanation>HIAWATHA COMMUNITY HOSPITAL'S HIGHEST PRIORITY IS THE PROVISION OF QUALITY HEALTH CARE TO OUR PATIENTS THROUGHOUT NORTHEAST KANSAS. COMPREHENSIVE SERVICES INCLUDE PRIMARY, SECONDARY, AND LONG-TERM CARE. TO CARRY OUT THIS MISSION, HEALTH PROFESSIONALS WITHIN THE HOSPITAL CONTINUALLY WORK TOGETHER TO IMPROVE PATIENT CARE AND EDUCATION. THIS TEAM APPROACH ASSURES THAT OUR PATIENTS WILL BENEFIT FROM THE MOST UP-TO-DATE MEDICAL PRACTICES AVAILABLE. THE HOSPITAL CAN ONLY CONTINUE TO EXIST TO SERVE ITS MISSION THROUGH SOUND FINANCIAL MANAGEMENT AND STRATEGIC PLANNING. THEREFORE, THE PRINCIPLES OF COST EFFECTIVENESS AND EFFICIENCY GOVERN THE DEVELOPMENT OF HEALTH CARE POLICY FOR THE HOSPITAL. EXTERNAL AND INTERNAL ASSESSMENTS ARE DONE TO DETERMINE EVOLUTIONARY NEEDS AND TO RESPOND TO THE DEMANDS OF EVER-CHANGING TECHNOLOGY. HIAWATHA COMMUNITY HOSPITAL FEELS A STRONG COMMITMENT TO ITS EMPLOYEES AND STRIVES ALWAYS TO TREAT THEM FAIRLY, RESPONSIBLY, AND WITH A SENSE OF CONCERN FOR THEIR WELL-BEING. THE PROVISION OF COMPREHENSIVE CONTINUING EDUCATION IS ESSENTIAL TO MAINTAIN ADEQUATE SKILL LEVELS AND FOSTER A SENSE OF PRIDE AND PROFESSIONALISM. AS A COMMUNITY HOSPITAL, HIAWATHA COMMUNITY HOSPITAL RECOGNIZES ITS RESPONSIBILITY TO PROVIDE PUBLIC HEALTH EDUCATION AND, AS SUCH, STRIVES TO SERVE AS A REGIONAL HEALTH RESOURCE CENTER. MEDICAL AND PROFESSIONAL STAFF ARE ENCOURAGED TO PARTICIPATE IN COMMUNITY ACTIVITIES AND EDUCATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROGRAM SERVICE ACCOMPLISHMENT</Identifier>
        <ReturnReference>FORM 990, PART III, LINE 4A</ReturnReference>
        <Explanation>AS A TAX-EXEMPT, NOT-FOR-PROFIT ENTITY, HIAWATHA COMMUNITY HOSPITAL'S PURPOSE IS TO PROVIDE THE BEST SERVICES POSSIBLE IN A MANNER THAT IS ACCESSIBLE TO ALL INDIVIDUALS. OFFERING OUR SERVICES AT NO OR REDUCED COST TO THOSE WHO MEET OUR CHARITY REQUIREMENTS IS A CORNERSTONE OF OUR MISSION. TO ENSURE THAT AS MANY INDIVIDUALS AS POSSIBLE ARE DEEMED ELIGIBLE FOR CHARITY CARE, WE IMPLEMENTED A PRESUMPTIVE CHARITY CARE PROGRAM. THIS PROGRAM WILL VERIFY PATIENT FINANCIAL SITUATIONS ALLOWING US TO INCLUDE THEM IN THE CHARITY CARE PROGRAM EVEN IF THEY DON'T WANT TO COMPLETE THE PAPERWORK THEMSELVES. WE FEEL THAT THIS PROGRAM IS A GREAT WAY TO GET INDIVIUALS IN NEED THE CARE THEY DESERVE WITHOUT ADDED FINANCIAL STRESS. ALSO SUPPORTING OUR TAX-EXEMPT STATUS IS OUR COMMITMENT TO PROVIDE QUALITY SERVICE AND STAFF. TO THAT END, THE HIAWATHA COMMUNITY HOSPITAL DISTRIBUTED OVER $12,000 IN SCHOLARSHIPS IN 2012. ANOTHER MANNER IN WHICH WE SUPPORT OUR NOT-FOR-PROFIT STATUS IS THROUGH PUBLIC HEALTH EDUCATIONAL PROGRAMS FOR THE COMMUNITY. WE PROVIDE DIABETES, HYPERTENSION, AND SMOKING CESSATION EDUCATION. FINALLY, IN ADDRESSING COMMUNITY CONCERN FOR SAFE PLACES FOR CHILDREN, WE DONATED $10,000 TO THE NEW NOT-FOR-PROFIT COMMUNITY DAY CARE FACILITY IN TOWN.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990 REVIEW PROCESS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 11B</ReturnReference>
        <Explanation>AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS OR CONCERNS THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CONFLICT OF INTEREST POLICY</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>All employees and decision makers for the Hospital are covered under this policy. Conflicts are either reviewed by the Corporate Compliance Officer or the Board President. At Board meetings, the Board Chair is appraised of all conflicts of interest and then asks the member to abstain from discussing and voting on topics of conflict.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION REVIEW</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15A</ReturnReference>
        <Explanation>THE DIRECTOR OF HUMAN RESOURCES PERIODICALLY PROVIDES THE PRESIDENT OF THE BOARD OF DIRECTORS WITH A COMPENSATION SURVEY COMPILED BY THE KANSAS HOSPITAL ASSOCIATION. THE SURVEY DELINEATES COMPENSATION PACKAGES FOR ADMINISTRATORS AT HOSPITALS THAT ARE SIMILAR TO HIAWATHA. BASED ON THAT SURVEY, THE ADMINISTRATOR'S PERFORMANCE, AND THE PERFORMANCE OF THE HOSPITAL, THE BOARD SETS THE ADMINISTRATOR'S SALARY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>AVAILABILITY OF DOCUMENTS</Identifier>
        <ReturnReference>FORM 990, PART VI, LINE 19</ReturnReference>
        <Explanation>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>RECONCILIATION OF NET ASSETS</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5</ReturnReference>
        <Explanation>CHANGE IN FOUNDATION ASSETS $ 22,582 NET ASSETS RELEASED FROM RESTRICTION $ ( 1,150) ---------- TOTAL $ 21,432</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES FOR NON-EMPLOYEES</Identifier>
        <ReturnReference>FORM 990 PART IX LINE 11G</ReturnReference>
        <Explanation>DESCRIPTION:CONTRACTED MEDICAL SERVICES TOTAL FEES:2493732</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES FOR NON-EMPLOYEES</Identifier>
        <ReturnReference>FORM 990 PART IX LINE 11G</ReturnReference>
        <Explanation>DESCRIPTION:CONTRACTED BILLING/ADMIN SRVCS TOTAL FEES:380893</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES FOR NON-EMPLOYEES</Identifier>
        <ReturnReference>FORM 990 PART IX LINE 11G</ReturnReference>
        <Explanation>DESCRIPTION:PERSONNEL &amp; ADMIN FNDRSING SRV TOTAL FEES:5324</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>HIAWATHA HOSPITAL ASSOCIATION FOUNDATION</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>300 UTAH STREET</AddressLine1>
          <City>HIAWATHA</City>
          <State>KS</State>
          <ZIPCode>66434</ZIPCode>
        </AddressUS>
        <EIN>481223766</EIN>
        <PrimaryActivities>FUNDRAISING</PrimaryActivities>
        <LegalDomicileState>KS</LegalDomicileState>
        <ExemptCodeSection>503(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11A</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>HHA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>true</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>HIAWATHA HOSPITAL ASSOCIATION FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>S</TransactionType>
        <AmountInvolved>78606</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>