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      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES PF DOWLING</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>FRANK A COSIANO</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>CHERYL BUCKLAND</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL BROUGH</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DAN KENNARD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BETH KROETZ</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD STATES</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ADELE WEBB</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN REINEKE</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JEFF SHRADER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JAMIE STALL</PersonNm>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM HOPKINS MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
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      <IndivRcvdGreaterThan100KCnt>43</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
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      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>10700 MONTGOMERY ROAD SUITE 226</AddressLine1Txt>
            <CityNm>CINCINNATI</CityNm>
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      <ContractorCompensationGrp>
        <ContractorName>
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          <USAddress>
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          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>JDP VENTURES LLC</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>301 S MAIN STREET</AddressLine1Txt>
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          </USAddress>
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        <ServicesDesc>REAL ESTATE RENT</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>IRB MEDICAL EQUIPMENT LLC</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5445 ALU DR STE C</AddressLine1Txt>
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          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>TECHNICORE</PersonNm>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1900 SOUTH MAIN STREET</AddressLine1Txt>
            <CityNm>FINDLAY</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
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      <ProgramServiceRevenueGrp>
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        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>60222000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>60222000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT ALLOCATIONS TO RELATED ENTITIES</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>1512528</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>61734528</TotalProgramServiceRevenueAmt>
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        <TotalRevenueColumnAmt>1328725</TotalRevenueColumnAmt>
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        <ExclusionAmt>1065994</ExclusionAmt>
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      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
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      <GrossRentsGrp>
        <RealAmt>154000</RealAmt>
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      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
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      <RentalIncomeOrLossGrp>
        <RealAmt>154000</RealAmt>
        <PersonalAmt>0</PersonalAmt>
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      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>154000</TotalRevenueColumnAmt>
        <ExclusionAmt>154000</ExclusionAmt>
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        <SecuritiesAmt>2873891</SecuritiesAmt>
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      <NetIncomeFromGamingGrp>
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        <Desc>MISCELLANEOUS</Desc>
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        <RelatedOrExemptFuncIncomeAmt>3490000</RelatedOrExemptFuncIncomeAmt>
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      <OtherRevenueMiscGrp>
        <Desc>EQUITY INVESTMNETS</Desc>
        <BusinessCd>621400</BusinessCd>
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        <ExclusionAmt>-46000</ExclusionAmt>
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      <GrantsToDomesticIndividualsGrp>
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      <BenefitsToMembersGrp>
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        <ProgramServicesAmt>1108956</ProgramServicesAmt>
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        <ProgramServicesAmt>4358570</ProgramServicesAmt>
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      <FeesForServicesLegalGrp>
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      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ProgramServicesAmt>948507</ProgramServicesAmt>
        <ManagementAndGeneralAmt>948507</ManagementAndGeneralAmt>
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      </FeesForServicesLobbyingGrp>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <ProgramServicesAmt>61406</ProgramServicesAmt>
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        <ProgramServicesAmt>2464057</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>42500</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>2826772</ProgramServicesAmt>
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        <ProgramServicesAmt>4689584</ProgramServicesAmt>
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        <ProgramServicesAmt>439165</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48796</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>102700289</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30258589</ManagementAndGeneralAmt>
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        <EOYAmt>2447151</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>0</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>10740000</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>32000</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>3761000</EOYAmt>
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      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>40787000</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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      <DonorRestrictionNetAssetsGrp>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-66158855</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-10372000</NetUnrlzdGainsLossesInvstAmt>
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      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
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      <IRSWrittenDeterminationInd>X</IRSWrittenDeterminationInd>
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      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
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      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
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      <SupportedOrganizationsTotalCnt>3</SupportedOrganizationsTotalCnt>
      <SupportSumAmt>1244350</SupportSumAmt>
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      <Form990SchASupportingOrgGrp>
        <ListedByNameGoverningDocInd>true</ListedByNameGoverningDocInd>
        <SuprtOrgNoIRSDeterminationInd>false</SuprtOrgNoIRSDeterminationInd>
        <SupportedOrgSectionC456Ind>false</SupportedOrgSectionC456Ind>
        <SupportedOrgNotOrganizedUSInd>false</SupportedOrgNotOrganizedUSInd>
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        <ContributionControllerInd>false</ContributionControllerInd>
        <ContributionFamilyInd>false</ContributionFamilyInd>
        <Contribution35ControlledInd>false</Contribution35ControlledInd>
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      <Form990SchAType1SuprtOrgGrp>
        <PowerAppointMajorityDirTrstInd>true</PowerAppointMajorityDirTrstInd>
        <OperateBenefitNonSuprtOrgInd>false</OperateBenefitNonSuprtOrgInd>
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    </IRS990ScheduleA>
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      <HeldWorksArtGrp />
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        <InvestmentEarningsOrLossesAmt>-50657</InvestmentEarningsOrLossesAmt>
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        <EndYearBalanceAmt>554817</EndYearBalanceAmt>
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      <CYMinus1YrEndwmtFundGrp>
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        <EndYearBalanceAmt>609350</EndYearBalanceAmt>
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        <EndYearBalanceAmt>612151</EndYearBalanceAmt>
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        <EndYearBalanceAmt>574864</EndYearBalanceAmt>
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        <EndYearBalanceAmt>470566</EndYearBalanceAmt>
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      <RelatedOrgListSchRInd>true</RelatedOrgListSchRInd>
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      <OtherLiabilitiesOrgGrp>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>ENDOWMENT FUNDS ARE UTILIZED FOR DONOR DESIGNATED PURPOSES, INCLUDING CHARITY CARE, CAPITAL PROJECTS AND PURCHASES, AND CONTINUING EDUCATION FOR STAFF AND PHYSICIANS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSFERS FROM AFFILIATES $75,260,000</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT RECLASS $2,826,772 INVESTMENT INCOME TIMING DIFFERENCE $ 252,495 TOTAL $3,079,267</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT RECLASS $2,826,772</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>ASC 740</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
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      <CompensationSurveyInd>X</CompensationSurveyInd>
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      <InitialContractExceptionInd>false</InitialContractExceptionInd>
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        <PersonNm>MYRON LEWIS</PersonNm>
        <TitleTxt>CHIEF EXECUTIVE OFFICER</TitleTxt>
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        <PersonNm>DAVE CYTLAK</PersonNm>
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        <PersonNm>JAMES WELLMAN</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DR RICHARD POLDER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>358047</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>19084</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3978</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>12200</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>12291</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>405600</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4C</FormAndLineReferenceDesc>
        <ExplanationTxt>IN 2022, BLANCHARD VALLEY HEALTH SYSTEM CALCULATED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) PAYMENTS TO BE CONTRIBUTED IN 2022. $96,553 WILL BE CONTRIBUTED ON BEHALF OF MYRON LEWIS TO A SERP IN 2023. SERP CONTRIBUTIONS IN THE AMOUNT OF $90,461 WERE MADE FOR THE BENEFIT OF MYRON LEWIS IN 2022. THE SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT CONSISTING OF TWO PLANS: AN ELIGIBLE PLAN SUBJECT TO INTERNAL REVENUE CODE SECTION 457(B) AND AN INELIGIBLE PLAN SUBJECT TO SECTION 457(F). THE 457(B) PLAN WAS ORIGINALLY IMPLEMENTED EFFECTIVE JANUARY 1, 2002. THE 457(F) PLAN WAS ORIGINALLY EFFECTIVE SEPTEMBER 1, 2000 AND WAS RESTATED ON JANUARY 1, 2002 FOR COORDINATION WITH THE 457(B) PLAN. IN 2010 AND 2011, THE 457(F) PLAN WAS FURTHER AMENDED AND RESTATED TO COMPLY WITH THE LATEST REGULATORY GUIDANCE AND PROVIDE FOR A NEW CONTRIBUTION MODEL AND VESTING SCHEDULE. ADDITIONAL EXECUTIVES WERE ALSO ADDED AND DEEMED ELIGIBLE FOR PLAN BENEFITS IN 2010, INCLUDING DAVID CYTLAK. IN 2022, BLANCHARD VALLEY HEALTH SYSTEM CACLULATED SERP PAYMENTS TO BE CONTRIBUTED IN 2023. $27,474 WILL BE CONTRIBUTED ON BEHALF OF DAVID CYTLAK TO THE SERP IN 2023. SERP CONTRIBUTIONS IN THE AMOUNT OF $26,713 WERE MADE FOR THE BENEFIT OF DAVID CYTLAK IN 2022. KEY FEATURES OF THE SERP, AS AMENDED AND RESTATED IN 2010/2011, INCLUDE THE FOLLOWING: * ELIGIBILITY IS LIMITED TO CERTAIN MANAGEMENT OR HIGHLY-COMPENSATED EMPLOYEES OF BVHS (I.E., TOP HAT REFERENCE). FUTURE PARTICIPATION IS UPON NOMINATION BY THE CEO AND APPROVAL BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. **EMPLOYEE CONTRIBUTIONS TO THE SERP ACCOUNT ARE NOT ALLOWED. *EACH PARTICIPANT'S 457(B) ACCOUNT WILL BE CREDITED UP TO THE STATUTORY LIMIT ($20,500 IN 2022), WITH THE REMAINING AMOUNT BEING DEPOSITED INTO THE 457(F) ACCOUNT. *EMPLOYER CONTRIBUTIONS TO THE 457(F) PLAN ARE SUBJECT TO A CLASS YEAR VESTING SCHEDULE, WITH A WAITING PERIOD SET AT 0-5 YEARS, DEPENDING ON THE AGE OF THE PARTICIPANT AT THE TIME OF CONTRIBUTION. UPON VESTING, THE FULL VESTED BALANCE WILL BE DISTRIBUTED TO THE PARTICIPANT AND CONSIDERED TAXABLE INCOME. IN ADDITION TO THE VESTING SCHEDULE ABOVE, 100% AND IMMEDIATE VESTING OF THE BENEFIT ACCRUED UPON ATTAINMENT OF NORMAL RETIREMENT AGE, DEATH, DISABILITY, INVOLUNTARY TERMINATION WITHOUT CAUSE, PLAN TERMINATION, OR CHANGE OF CONTROL. *DISTRIBUTION OF THE VESTED PORTION OF THE 457(F) BENEFIT IS PAID AS A LUMP SUM AS SOON AS ADMINISTRATIVELY FEASIBLE. .</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1B</FormAndLineReferenceDesc>
        <ExplanationTxt>MYRON LEWIS AND DR. RICHARD POLDER ARE BOARD MEMBERS AND ARE PAID EMPLOYEES OF A RELATED ORGANIZATION. DUE TO THEIR EMPLOYMENT, THEY ARE CONSIDERED NON-INDEPENDENT VOTING MEMBERS OF THE BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>A DETAILED REVIEW OF THE FORM 990 IS PERFORMED BY THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE. THIS COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, MEMBERS OF THE COMMUNITY, AND MEMBERS OF UPPER MANAGEMENT. THE COMPLIANCE AND AUDIT COMMITTEE REPORTS TO THE BOARD OF TRUSTEES ANY AREAS OF CONCERN REGARDING THE FORM 990'S. ONCE THE FORM 990'S HAVE BEEN FINALIZED, REVIEWED AND APPROVED, THE MEMBERS OF BOARD OF TRUSTEES RECEIVE ELECTRONIC COMMUNICATION THAT THE FORM 990'S ARE COMPLETE AND AVAILABLE FOR REVIEW. ANY QUESTIONS ARISING FROM BOARD MEMBERS ARE ADDRESSED BY THE COMPLIANCE AND AUDIT COMMITTEE, UPPER MANAGEMENT, THE ACCOUNTING DEPARTMENT, AND/OR EXTERNAL ACCOUNTANTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUALLY, THE ORGANIZATION ASKS ITS BOARD MEMBERS, CORPORATE OFFICERS, UPPER MANAGEMENT, AND KEY EMPLOYEES TO COMPLETE CONFLICT OF INTEREST SURVEYS. THESE SURVEYS ALSO INCLUDE RELATIONSHIP &amp; ACTIVITY QUESTIONS THAT THESE INDIVIDUALS ARE ASKED TO COMPLETE FOR THE FORM 990 FILING YEAR. BOARD MEMBERS ARE REQUIRED TO BRING TO THE ATTENTION OF EXECUTIVE MANAGEMENT ANY CONFLICTS AS THEY ARISE. THESE CONFLICTS ARE DOCUMENTED IN THE BOARD MINUTES. BOARD MEMBERS THAT HAVE CONFLICTS ARE TO EXCUSE THEMSELVES FROM DISCUSSIONS AND/OR VOTING ON ISSUES WITH WHICH A CONFLICT EXISTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REVIEWS EXECUTIVE COMPENSATION, BENEFITS, AND PERQUISITES ON A PERIODIC BASIS TO ENSURE CONSISTENCY WITH COMPENSATION PHILOSOPHY AND MARKET PRACTICE. A SUBSET OF MEMBERS FROM THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION COMMITTEE, AND THIS COMMITTEE MEETS TO APPROVE WAGE INCREASES AS WELL AS REVIEWS THE ORGANIZATION'S POSITION IN THE MARKET WHEN IT COMES TO EXECUTIVE COMPENSATION. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEE ANNUALLY ENGAGES SULLIVAN COTTER AND ASSOCIATES, AN EXTERNAL COMPENSATION CONSULTING FIRM, TO ASSESS THE REASONABLENESS OF THE COMPENSATION PROGRAM USED FOR ITS EXECUTIVES. THE COMMITTEE ALSO PERIODICALLY PERFORMS A FULL BENEFIT ANALYSIS AND REVIEW WITH SULLIVAN COTTER AND ASSOCIATES AS PART OF THIS PROCESS. THE ORGANIZATION IS COMMITTED TO A DECISION-MAKING PROCESS FOR EXECUTIVE COMPENSATION THAT IS CONSISTENT WITH INTERNAL REVENUE CODE SECTION 4958 REQUIREMENTS FOR OBTAINING A REBUTTABLE PRESUMPTION OF REASONABLENESS. THE MEMBERS OF THE COMMITTEE APPROVING EXECUTIVE COMPENSATION DECISIONS ARE INDIVIDUALS WHO ARE DISINTERESTED (I.E., DO NOT HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE ARRANGEMENTS). THE COMMITTEE REVIEWS OBJECTIVE DATA, INCLUDING SURVEY DATA PREPARED BY INDEPENDENT FIRMS, AS PART OF THE DECISION-MAKING PROCESS. THE MARKET DATA PROVIDED IN THE COMPENSATION REPORT FROM THE CONSULTING FIRM ASSISTS THE ORGANIZATION IN ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE'S WORK IS ALSO SHARED/DISCUSSED WITH THE BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SAME PROCESS APPLIES FOR ALL OTHER EXECUTIVE STEERING COMMITTEE MEMBERS AS DETAILED FOR THE CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCIAL STATEMENTS, REQUIRED TAX FORMS (I.E., FORM 990), AS WELL AS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST THROUGH THE ADMINISTRATIVE AND FINANCE OFFICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>INVESTMENT INCOME TIMING DIFFERENCE $ -252,495 TRANSFERS FROM AFFILIATES $75,260,000 TOTAL $75,007,505</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
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      <IdDisregardedEntitiesGrp>
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          <BusinessNameLine1Txt>HANCO EMERGENCY MEDICAL SERVICES LLC</BusinessNameLine1Txt>
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        <EndOfYearAssetsAmt>414207</EndOfYearAssetsAmt>
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      <IdRelatedOrgTxblPartnershipGrp>
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      <IdRelatedOrgTxblPartnershipGrp>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>CITAS INC</BusinessNameLine1Txt>
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      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>true</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>BLANCHARD VALLEY REGIONAL HEALTH CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>75110000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
