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      <TotalContributionsAmt>879213</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>33074652</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>33074652</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Hospital Support</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>2145</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2145</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Medical Office Rent</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>54336</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>54336</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>33131133</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>247255</TotalRevenueColumnAmt>
        <ExclusionAmt>247255</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>1000</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>1000</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>1000</TotalRevenueColumnAmt>
        <ExclusionAmt>1000</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>9910</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <OtherAmt>9910</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>9910</TotalRevenueColumnAmt>
        <ExclusionAmt>9910</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>Cafeteria Income</Desc>
        <BusinessCd>624200</BusinessCd>
        <TotalRevenueColumnAmt>80611</TotalRevenueColumnAmt>
        <ExclusionAmt>80611</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Gift Shop Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>73564</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>73564</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Intercompany Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>269384</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>269384</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>27153</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>27153</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>450712</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>34719223</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>33501234</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>338776</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>14521</TotalAmt>
        <ProgramServicesAmt>14521</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>562423</TotalAmt>
        <ProgramServicesAmt>232558</ProgramServicesAmt>
        <ManagementAndGeneralAmt>329865</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>12351094</TotalAmt>
        <ProgramServicesAmt>10371417</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1979677</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>0</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2202725</TotalAmt>
        <ProgramServicesAmt>1895285</ProgramServicesAmt>
        <ManagementAndGeneralAmt>307440</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1212666</TotalAmt>
        <ProgramServicesAmt>1018296</ProgramServicesAmt>
        <ManagementAndGeneralAmt>194370</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
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      <FeesForServicesLegalGrp>
        <TotalAmt>76466</TotalAmt>
        <ProgramServicesAmt>76466</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>110551</TotalAmt>
        <ProgramServicesAmt>110551</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>35608</TotalAmt>
        <ProgramServicesAmt>35608</ProgramServicesAmt>
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      <FeesForServicesProfFundraising></FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1944709</TotalAmt>
        <ProgramServicesAmt>857265</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1087444</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>38940</TotalAmt>
        <ProgramServicesAmt>38940</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>3511504</TotalAmt>
        <ProgramServicesAmt>2858923</ProgramServicesAmt>
        <ManagementAndGeneralAmt>652581</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>0</TotalAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>387726</TotalAmt>
        <ProgramServicesAmt>365306</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22420</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>24555</TotalAmt>
        <ProgramServicesAmt>24555</ProgramServicesAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>220398</TotalAmt>
        <ProgramServicesAmt>207656</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12742</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>344065</TotalAmt>
        <ProgramServicesAmt>344065</ProgramServicesAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1760509</TotalAmt>
        <ProgramServicesAmt>1658728</ProgramServicesAmt>
        <ManagementAndGeneralAmt>101781</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>138933</TotalAmt>
        <ProgramServicesAmt>138933</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Provision for Doubtful Accounts</Desc>
        <TotalAmt>462392</TotalAmt>
        <ProgramServicesAmt>462392</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>5210973</TotalAmt>
        <ProgramServicesAmt>5210973</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Taxes, Licenses, Fees</Desc>
        <TotalAmt>58547</TotalAmt>
        <ProgramServicesAmt>58547</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Other Business Related Expenses</Desc>
        <TotalAmt>8893</TotalAmt>
        <ProgramServicesAmt>8893</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>25989878</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4688320</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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      <AccountsReceivableGrp>
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      <InventoriesForSaleOrUseGrp>
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      <PrepaidExpensesDefrdChargesGrp>
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      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>21506245</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1920538</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
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      <InvestmentsOtherSecuritiesGrp>
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      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
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      <TotalAssetsGrp>
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        <EOYAmt>61003853</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
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      <MortgNotesPyblScrdInvstPropGrp>
        <EOYAmt>12500000</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <EOYAmt>13809896</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>30494117</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <EOYAmt>29689815</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <EOYAmt>819921</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>30509736</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>61003853</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>4041025</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>3778012</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>22690699</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleA documentId="990A" softwareId="22015461" softwareVersionNum="22.0.1.0">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="990B" softwareId="22015461" softwareVersionNum="22.0.1.0">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>true</DirectContactLegislatorsInd>
      <DirectContactLegislatorsAmt>32500</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>4201</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>36701</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>II-B 1g</FormAndLineReferenceDesc>
        <ExplanationTxt>During 2022, GRMC, Inc. dba Garrett Regional Medical Center, paid fees to Keller Partners Company for services that included lobbying on behalf of GRMC, Inc.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>II-B 1i</FormAndLineReferenceDesc>
        <ExplanationTxt>This amount is calculated based on information provided by the American Hospital Association. The American Hospital Association estimates that 27.29 of the 2022 dues were allocated to lobbying expense.</ExplanationTxt>
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    </IRS990ScheduleC>
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        <BookValueAmt>3890000</BookValueAmt>
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      <BuildingsGrp>
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        <DepreciationAmt>150453</DepreciationAmt>
        <BookValueAmt>7342021</BookValueAmt>
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      <LeaseholdImprovementsGrp>
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        <DepreciationAmt>19455</DepreciationAmt>
        <BookValueAmt>482673</BookValueAmt>
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      <EquipmentGrp>
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        <DepreciationAmt>1559747</DepreciationAmt>
        <BookValueAmt>7209435</BookValueAmt>
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      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>852461</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>190883</DepreciationAmt>
        <BookValueAmt>661578</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>19585707</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>Financial derivatives and other financial products</Desc>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Closely-held equity interests</Desc>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Cash and Cash Equivalents</Desc>
        <BookValueAmt>3930</BookValueAmt>
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      <OtherSecuritiesGrp>
        <Desc>U.S. Government and Agency Obligations</Desc>
        <BookValueAmt>9012184</BookValueAmt>
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      <OtherSecuritiesGrp>
        <Desc>Marketable Equity Securities</Desc>
        <BookValueAmt>1465588</BookValueAmt>
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      <OtherSecuritiesGrp>
        <Desc>Marketable Debt Securities</Desc>
        <BookValueAmt>1382636</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Domestic Equity Mutual Funds</Desc>
        <BookValueAmt>919199</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>International Equity Mutual Funds</Desc>
        <BookValueAmt>88855</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Domestic Fixed Income Mutual Funds</Desc>
        <BookValueAmt>882688</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Domestic Equity Exchange Traded Funds</Desc>
        <BookValueAmt>1546072</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Domestic Fixed Income Exchance Traded Funds</Desc>
        <BookValueAmt>125021</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Alternative Investments</Desc>
        <BookValueAmt>1049174</BookValueAmt>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>16475347</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Federal income taxes</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to Third Party Payors</Desc>
        <Amt>543972</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Other Non Current Liabilities</Desc>
        <Amt>609905</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Other Current Liabilities</Desc>
        <Amt>3012117</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Long Term Lease Liability</Desc>
        <Amt>105695</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Self Insurance Liability</Desc>
        <Amt>446901</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DB Pension Obligation</Desc>
        <Amt>9091306</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>13809896</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>20727346</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>3778012</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>-17769888</OtherRevenueAmt>
      <RevenueNotReportedAmt>-13991876</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>34719222</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>34719222</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>30201286</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>-14521</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>-14521</ExpensesNotReportedAmt>
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      <OtherExpensesNotIncludedAmt>462392</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>462392</ExpensesNotRptFinclStmtAmt>
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        <ExplanationTxt>This amount consists of the following items that were recorded as revenue on the Audited Financial Statements but not reported as such on the Form 990. Defined benefit cost 105,039, Non-Controlling Interest Expense 51,708, Inherent Contributions 17,346,306, Contribution expense 14,521, and Provisions for doubtful accounts - patients of 462,392.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>This amount consists of contribution expense of 14,521 that was netted against Contribuion Revenue on the audited financial statements but reported as expense on the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount shown on line 4b consists of 462,392 provision for doubtful accounts - patients reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Most of the entities that comprise the System are tax-exempt organizations and not subject to federal or state income taxes in accordance with Section 501c3 of the Internal Revenue Code. On such basis, they will not incur any liability for income taxes, except for possible unrelated business income. AHS, WVUIS and GHC are organizations subject to federal and/or state income taxes. The System does not have any material uncertain tax positions as of December 31, 2022 and 2021.</ExplanationTxt>
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    </IRS990ScheduleD>
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      <WrittenPolicyInd>true</WrittenPolicyInd>
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      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent300Ind>X</Percent300Ind>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>false</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>false</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
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        <NetCommunityBenefitExpnsAmt>1487775</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04940</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>5987769</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>5987769</DirectOffsettingRevenueAmt>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
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        <NetCommunityBenefitExpnsAmt>7586</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00030</TotalExpensePct>
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        <DirectOffsettingRevenueAmt>5987769</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>1495361</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.04970</TotalExpensePct>
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        <FormAndLineReferenceDesc>Group Garrett Regional Medical Center Line Part V, Section B, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Effective July 1, 2022, GRMC, Inc, assumed operations of Garrett Regional Medical Center in Oakland, MD. GRMC, Inc. is recognized by the IRS as a 501c3 non-profit hosptial organization and is a member of the West Virginia United Health System. prior to becoming a part of the West Virginia United Health System, Garrett Regional Medical Center was operated under the local county government.</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Garrett Regional Medical Center Line Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Local data collection began on March 18th and continued through June 17th, 2022. We conducted five focus groups and analyzed responses from 1,212 web-based and paper surveys completed by community members and agency stakeholders. We also evaluated secondary sources of information about our region and county specific data. The assessment includes several social determinants of health that help to provide a complete picture of our population by looking at factors like employment, housing, and transportation.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Garrett Regional Medical Center Line Part V, Section B, Line 6b</FormAndLineReferenceDesc>
        <ExplanationTxt>Prior to joining the West Virginia United Health System, Garrett Regional Medical Center was operated under the county government. The CHNA prepared in 2022 was prepared in conjunction with the Garrett County Health Departments Population Health, Innovation, and Informatics Unit. In addition to the Health Planning Council meetings, local agencies and key stakeholder groups consisted of staff from the Garrett County Health Department, Garrett County Local Management Board, Garrett County Behavioral Health Authority, Mountain Laurel Medical Center, and Garrett Regional Medical Center.</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Group Garrett Regional Medical Center Line Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>In addition to the health services provided, GRMC also addresses some determinants of health, such as transportation and housing, GRMC through its ongoing collaboration with a variety of social service agencies. The hospitals social work staff and its cadre of Community Health Workers work directly with Garrett County Social Services and the Garrett County Community Action Committee aging services, housing, child care, transportation, among other agencies, to meet the disparate needs identified in the Health Needs Assessment. In addition, the Garrett County Health Planning Council, of which GRMC is an active member, is a community organization that has representatives from a variety of community agencies active in addressing the social determinants of health. This organization plays an important role in helping conduct the Community Health Needs Assessment every three years.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part I Line 3c</FormAndLineReferenceDesc>
        <ExplanationTxt>If ineligibility results from the financial guidelines stated above or the applicant is eligible for partial assistance only and the applicant indicates an inability to pay the outstanding balance, the applicant will be asked to complete a financial statement to determine if his/her available monthly income is consumed by the daily necessities of life. Individual consideration of eligibility for applicants in this situation will apply to assure members of our community who cannot pay for their hospital care are included in our financial assistance program.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Garrett Regional Medical Center Inc., community benefit numbers are reported in total with other hospitals within the West Virginia United Health System. The most recent amounts can be found on WVU Medicines website here https//wvumedicine.org/about/leadership-and-more/community-benefit/</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Column f - Total community benefit expense for 2022 is 10,280,468 and is 34.10 of total net expenses. To calculate net expense, provision for doubtful accounts - paients of 533,019 was deducted from total expenses of 30,678,199 as shown in Part IX line 25 of the core Form 990.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Community Building activities for the 6 months July 1 - December 31, 2022 included Community Group Presentations reported as Communty Health Improvement/Saftey and Recruitment efforts reported under Workforce Development.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debt Expense at Cost on Line 2 was calculated by multiplying provision for doubtful accounts - patients of 533,019 by our cost-to-charge ratio of 73.03 for a total of 389,247.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Estimated bad debt attributable to patients eligible for charity care on Line 3 was calculated by pulling all outstanding patient balances of 15,000 or greater from our patient accounting system. That report totaled 254,161, which was then multiplied by the cost-to-charge ratio of 73.03 for a total of 185,606.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>We feel that at a minimum, the estimated bad debt attributable to patients eligible for charity care of 185,606 should be considered community benefit due to the fact that anyone with outstanding balances of 15,000 or greater in our demographic usually qualifies as catastrophic if the patient completes the application process. In our Charity Care Policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year and would have qualified for charity care if paperwork was completed.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Garrett Regional Medical Centers financial statements are prepared on a consolidated basis as a member of the WV United Health System. The footnote for Accounts Receivable is as follows Patient accounts receivable are reported at net realizable value. For accounts receivable associated with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The System grants credit without collateral to its patients, most of whom are local residents, and are insured under third-party payor agreements, primarily with Medicare, Medicaid and various commercial insurance companies. The System records accounts receivable net of estimated prince concessions and such amounts have historically been within managements expectations.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The mix of accounts receivable at December 31, 2022 and 2021, from patients and third-party payors is as follows For the year-end December 31, 2022 Medicare - 27, Medicaid - 16, Blue Cross - 19, Commercial, managed care and other - 35, Patients - 3, totaling 100. For the year-end December 31, 2021, Medicare - 31, Medicaid - 16, Blue Cross - 21, Commercial, managed care and other - 28, Patients - 4, totaling 100.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount reported in Part III Line 6 9,398,353 was calculated using the total Medicare allowable cost from the Medicare cost report less amounts of 3,502,433 mulitplied by the calculated cost to charge ratio of 73.03 to arrive at a cost of 2,557,723 reported on subsidized health services in Part I Line 7g. The reported surplus as reported on line 7 is utilized to provide services to the patient population.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Garrett Regiona Medical Center is reimbursed 100 by Medicare reimbursement includes DSH and IME for services provided to Medicare patients.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part III Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>Garrett Regional Medical Center does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity care, the patient will not be sent to a bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy. GRMC employs two financial counselors to help patients through the policies and applications.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>In addition to the CHNA identified needs GRMC aligns with the Maryland Statewide Integrated Health Improvement Strategy to address targeted goals of Diabetes and Opiod Use Disorder.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Diabetes - reduce the mean BMI for Maryland residents - GRMC has an active CDC approved Diabaetes Prevention Program that provides classes for community members and pateints referred by area providers. Opiod User Disorder - Improve overdose mortality - GRMC has an MAT program using Suboxone for people with opiod use disorder. The program requires ongoing counseling and works to support the patient by addressing social determinants of health that may be impacting them.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>GRMC offers The Caring Program Financial Assistance, established in 2006, it is a financial assistance program for members of our community who may need support in paying for medical care. The program offers assistance to patients who demonstrate financial need based upon individual circumstances. Each application for The Caring Program is individually and thoughtfully evaluated for eligibility. GRMC takes into consideration special or unusual financial circumstances in our final eligibility determination. The Caring Program continues our legacy of providing financial care for patients who demonstrate need. Information is made avaialbe to patients in person and online https//wvumedicine.org/garrett-regional-medical-center/patients-visitors/billing/</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>GRMC is a non-profit critical access hospital located in Garrett County, MD in the city of Oakland. Per the US Census Bureau, in 2022, Garrett County had a total population of 28,955, a median household income of 58,011, an employment rate of 58.6 and 7.4 of residents reported they were without healthcare coverage. Approximately 11 of residents were living in poverty.</ExplanationTxt>
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        <ExplanationTxt>The GRMC board of directors is a community board, with nine of the ten members living in or around Garrett County.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>GRMC extends privileges to all qualified medical staff in Garrett County and surrounding communities to meet its healthcare needs. GRMC allocates available funding to capital purchases, expanded services to improve patient care, and support medical education in Garrett County and surrounding counties in Maryland and bordering states.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Garrett Regional Medical Center is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional health care delivery system in its service areas, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves.</ExplanationTxt>
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        <ExplanationTxt>System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include West Virginia University Hospitals, Inc. in Morgantown, WV, United Hospital Center in Bridgeport, WV, Camden-Clark Memorial Hospital in Parkersburg, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, Reynolds Memorial Hospital, in Glen Dale, WV, West Virginia Healthcare Cooperative, doing business as, Summersville Regional Medical Center, in Summersville, WV, Braxton County Memorial Hospital in Gassaway, WV, Community Health Association, doing business as, Jackson General Hospital in Ripley, WV, Wetzel County Hospital, Inc. in New Martinsville, WV, Harrison Community Hospital in Cadiz, OH, Wheeling Hospital, Inc. in Wheeling, WV, Uniontown Hospital in Uniontown, PA, and Barnesville Hospital Assocation in Barnesville, OH.</ExplanationTxt>
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        <ExplanationTxt>In addition to the above mentioned hospitals, the System includes physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, Inc. a behavioral health center located in Clarksburg, WV. The System also includes, WVUH-East, Inc. and Camden-Clark Health Services, Inc. which operate as management companies for their respective hospitals. University Healthcare Foundation, Inc. in Martinsburg, WV, United Health Foundation, Inc. in Bridgeport, WV, Camden-Clark Foundation, Inc. in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, Inc. in Glen Dale, WV, which perform various fundraising activities for their respective hospitals. In 2020, the System formed WVUHS Home Care, LLC to provide Home Health and Hospice services to our service areas, supporting System hospitals by providing continuous care to our patients. Wheeling Hospital Ambulatory Surgical Center, LLC a surgical center located in Bridgeport, OH was acquired in 2021.</ExplanationTxt>
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        <NontaxableBenefitsFilingOrgAmt>14529</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>14528</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>260693</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>260692</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kendra Thayer</PersonNm>
        <TitleTxt>Chief Nursing Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>110024</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>23911</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>16802</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>194</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>77</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>2612</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>928</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9906</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>3377</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>139538</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>28293</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation for CEOs are determined by the WV United Health System compensation committee. The System engages an independent group to perform an executive compensation review and compensation survey every two years. This information is provided to the committee, which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package offered does not exceed fair market value.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Mark Boucot received deferred compensation contributions of 56,172 and James Venturella received deferred contributions of 78,163 in 2022. These amounts were properly recorded in deferred compensation on the Form 990 Schedule J.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Per the WVUHS Incentive Plan incentives are contingent on meeting a net earning target.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="990O" softwareId="22015461" softwareVersionNum="22.0.1.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization is a membership not a stock corporation under West Virginia State law. The Organizations sole coporate member is West Virginia United Health System, inc. a related not-for-profit organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7ab</FormAndLineReferenceDesc>
        <ExplanationTxt>West Virginia United Health System, Inc., as the sole corporate member, also has the right to remove any member or members of the Corporations governing board, approve amendments to the articles of incorporation or bylaws of the Corporation, Approve the dissolution, merger of or with, or consolidation by the Corporation, Approve the sale, lease, exchange, mortgage, pledge or other disposition of all or substantially all of the Corporations assets, and Appoint and remove the President and Chief Executive Office President/CEO of the Corporation and consultation with the Corporations Board of Trustees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is prepared by the West Virginia United Health System, Inc. Tax Team and then reviewed by the Director of Finance and VP of Finance and Operations at Garrett Regional Medical Center. After gaining approval from the Director of Finance, it is then presented to the board members for a final review. Upon board review, it is signed and submitted to the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Upon employment and annually thereafter, each key employee and officer of the organization is required to complete a conflict of interest and disclosure form, providing sufficient information about his/her personal interests and relationships so the organization can 1 determine whether any potential or actual conflicts of interest may exist, and 2 monitor work or service assignments to avoid placing the key employee, officer, or director in a position where there may be an appearance potential or actual of a conflict of interest or a question of objectivity. The completed conflict of interest and disclosure forms for directors are returned to the organization. These members are monitored and not assigned any projects that would create any potential conflict of interest. Any board member with a potential conflict recuses himself or herself from all discussions regarding the conflict.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the CEO is determined by the WV United Health System Compensation Committee based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This information is provided to the compensation committee which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compensation package does not exceed fair market value based on the data from the consultant group. The minutes of the compensation committee are contemporaneously documented and retained. A full compensation survey was completed in 2021 for 2022 compensation amounts.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of all officers at the Vice President level and below is determined based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This data is then interpreted and provided to an independent compensation committee. The independent compensation committee then uses this data to determine a fair and reasonable compensation package. All relevant data as well as minutes from each meeting are retained.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All financial and governing documents, including the conflict of interest policy are maintained onsite and made available to the public upon written request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Other changes in Net Assets include Change in Restricted Net Assets 857,932, Defined benefit cost 105,039, Non Controlling Interest Expense 51,708, Donated Capital of 43,672,223, Related organization capitalization of 4,546,481, and Inherent Contributions of 17,346,306.</ExplanationTxt>
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    </IRS990ScheduleO>
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        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Joseph's Foundation of Buckhannon Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Amalia Drive</AddressLine1Txt>
          <CityNm>Buckhannon</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26201</ZIPCd>
        </USAddress>
        <EIN>550727650</EIN>
        <PrimaryActivitiesTxt>Hospital Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>St Joseph's Hospital of Buckhannon Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Reynolds Memorial Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 Wheeling Ave</AddressLine1Txt>
          <CityNm>Glen Dale</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26038</ZIPCd>
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        <EIN>550357045</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Reynolds Memorial Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 Wheeling Ave</AddressLine1Txt>
          <CityNm>Glen Dale</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26038</ZIPCd>
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        <EIN>550710402</EIN>
        <PrimaryActivitiesTxt>Hospital Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Reynolds Memorial Hospital Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Braxton County Memorial Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 Hoylman Drive</AddressLine1Txt>
          <CityNm>Gassaway</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26624</ZIPCd>
        </USAddress>
        <EIN>550611919</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Community Health Association</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>122 Pinnell Street</AddressLine1Txt>
          <CityNm>Ripley</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25271</ZIPCd>
        </USAddress>
        <EIN>550462730</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Wetzel County Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3 East Benjamin Drive</AddressLine1Txt>
          <CityNm>New Martinsville</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26155</ZIPCd>
        </USAddress>
        <EIN>843480493</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WVUHS Home Care LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 8059</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26506</ZIPCd>
        </USAddress>
        <EIN>852915642</EIN>
        <PrimaryActivitiesTxt>Home Health and Hospice Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>509a2</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Uniontown Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>500 West Berkeley Street</AddressLine1Txt>
          <CityNm>Uniontown</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15401</ZIPCd>
        </USAddress>
        <EIN>250965588</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Fayette Physician Network</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>500 West Berkeley Street</AddressLine1Txt>
          <CityNm>Uniontown</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>15401</ZIPCd>
        </USAddress>
        <EIN>455440305</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Wheeling Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
          <CityNm>Wheeling</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
        </USAddress>
        <EIN>550357057</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Harrison Community Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>951 E Market Street</AddressLine1Txt>
          <CityNm>Cadiz</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43907</ZIPCd>
        </USAddress>
        <EIN>341571750</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Harrison Community Hospital Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>951 E Market Street</AddressLine1Txt>
          <CityNm>Cadiz</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43907</ZIPCd>
        </USAddress>
        <EIN>341571749</EIN>
        <PrimaryActivitiesTxt>Hospital Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>509a2</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Harrison Community Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Barnesville Hospital Association</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>639 W Main Street</AddressLine1Txt>
          <CityNm>Barnesville</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43713</ZIPCd>
        </USAddress>
        <EIN>340719172</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Belmont Community Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4697 Harrison Street</AddressLine1Txt>
          <CityNm>Bellaire</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43906</ZIPCd>
        </USAddress>
        <EIN>340714643</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Wheeling Hospital Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Medical Park Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
          <CityNm>Wheeling</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
        </USAddress>
        <EIN>550744690</EIN>
        <PrimaryActivitiesTxt>Church</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Wheeling Hospital Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Self Insurance Trust Agreement of Wheeling Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
          <CityNm>Wheeling</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
        </USAddress>
        <EIN>550676674</EIN>
        <PrimaryActivitiesTxt>Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type 1</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Grant Memorial Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 8034</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26506</ZIPCd>
        </USAddress>
        <EIN>881740605</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WVU Innovation Corporation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1085 Van Voorhis Dr Ste 500</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26505</ZIPCd>
        </USAddress>
        <EIN>611764272</EIN>
        <PrimaryActivitiesTxt>Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Allied Health Sourcing Solutions</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 8034</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26506</ZIPCd>
        </USAddress>
        <EIN>842403526</EIN>
        <PrimaryActivitiesTxt>Supply Chain Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Allied Health Services Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>PO Box 782</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26507</ZIPCd>
        </USAddress>
        <EIN>550652017</EIN>
        <PrimaryActivitiesTxt>Medical Lab</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>West Virginia United Insurance Services</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>3040 University Avenue Suite 3200</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26505</ZIPCd>
        </USAddress>
        <EIN>550756055</EIN>
        <PrimaryActivitiesTxt>Provider Network</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
