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        <ExplanationTxt>The CEO and other officers receive all compensation from Southwest General Health Center. Southwest has a CEO Oversight Board Committee that annually reviews the CEOs salary. The committee uses an outside consultant to perform a salary survey using data about similarly situated executives in other organizations. Documentation for these decisions are currently kept by Southwest General Health Centers Human Resources department.</ExplanationTxt>
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        <ExplanationTxt>Southwest General Health Center receives support from six communities. The tax levy communities are Berea, Brook Park, Columbia Township, Middleburg Heights, Olmsted Falls, and Strongsville. Each of the six communities has the right to elect or appoint four trustees to the Board.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>The 990 is reviewed internally by the CEO and CFO. It is presented and reviewed at the Audit Committee of the Board of Trustees Governing Board at their October meeting. The Audit Committee of the Board of Trustees is a joint committee of the Boards of Southwest Community Health System and Southwest General Health Center. The return is distributed electronically to the entire board before filing. Also prior to filing, the entire Board is presented with a review of the highlights and key points of the 990 at their October meeting.</ExplanationTxt>
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        <ExplanationTxt>Southwest Community Health System SCHS has a written conflict of interest policy that requires our officers, directors, and key employees to annually disclose potential conflicts of themselves and their family members on a questionnaire distributed by the Compliance Officer. If a designated person discloses in writing a circumstance that falls within the terms and conditions of the SCHSs policy, such disclosure shall be reviewed by the Compliance Officer and, as applicable, SCHSs Legal Counsel, senior leadership, and the Governance and Ethics Committee to determine the appropriate course of action. SCHS requires all new physicians to disclose in writing any potential conflicts as part of the onboarding process. SCHS also requires requests for proposals from vendors, suppliers, or contractors to disclose whether the bidder or any of the bidding companys officers or key personnel or their family members have a conflict with SCHS. The Compliance Officer monitors potential conflicts disclosed from year to year and addresses changes in disclosures appropriately such as evaluating whether a disclosed conflicted interest still exists when a designated persons disclosure is inconsistent from their previous conflicts reported on the annual questionnaire. SCHS enforces the conflict of interest policy in various ways on a case by case basis such as requiring a person to abstain from voting, advocating, or participating in decisions involving the conflicted interest or by requiring severing the relationship. The Compliance Officer is responsible for administering the conflict of interest program and documenting all actions required by the policy.</ExplanationTxt>
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        <ExplanationTxt>The CEO and other officers receive all compensation from Southwest General Health Center. Southwest has a CEO Oversight Board Committee that annually reviews the CEOs salary. The committee uses an outside consultant to perform a salary survey using data about similarly situated executives in other organizations. Documentation for these decisions are currently kept by Southwest General Health Centers Human Resources department.</ExplanationTxt>
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        <ExplanationTxt>Executive salary actions are reviewed with the CEO Oversight Board Committee. Documentation for these decisions are currently kept by Southwest General Health Centers Human Resources department.</ExplanationTxt>
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        <ExplanationTxt>Board of Trustee lists, Mission and Vision statement, and a consolidated financial summary are available on our website at www.swgeneral.com. The 990 is available upon request. Quarterly and annual financial statement disclosure is available to the public at www.dacbond.com and https//emma.msrb.org/. Conflict of interest policy is available upon request.</ExplanationTxt>
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        <ExplanationTxt>The compensation information for the following individual will also be found on related tax exempt organizations 990 returns. The compensation amounts on those other 990 returns is not additive to the amounts on this 990 return for tax ID 34-1455141. William A. Young, Jr. 34-0753531 34-1455135.</ExplanationTxt>
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        <ExplanationTxt>The compensation information for the following individual will also be found on related tax exempt organizations 990 returns. The compensation amounts on those other 990 returns is not additive to the amounts on this 990 return for tax ID 34-1455141. Kelly Linson 34-0753531 34-1652755.</ExplanationTxt>
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        <ExplanationTxt>Southwest General Health Center receives support from six communities. The tax levy communities are Berea, Brook Park, Columbia Township, Middleburg Heights, Olmsted Falls, and Strongsville.</ExplanationTxt>
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        <ExplanationTxt>This statement is pursuant to Regulation Section 1.351-3a by the following entity, a significant transferor, Southwest Community Health System EIN 34-1455141 SCHS. During the year ended December 31, 2022, SCHS, a U.S. tax exempt corporation, made cash transfers that represented non-taxable deposits in the amount of 8,902,713 to Western Reserve Assurance Co., Ltd SPC-Southwest Community Health System Segregated Portfolio EIN 98-1504997, SCHS-SP, its subsidiary formed in the Cayman Islands. To the extent that such transfers are not treated as deposits, but rather as constructive capital contributions from SCHS only to SCHS-SP for U.S. Federal tax purposes, SCHS is reporting such amounts on this statement as a protective measure in compliance with Regulation Section 1.351-3a. The cost basis in the cash equals the fair market value. No private letter rulings were received in connection with the Section 351 exchanges.</ExplanationTxt>
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        <ExplanationTxt>In the course of preparing their audit report, the independent auditors reviewed the organizations financial statements.There were no changes in the audit procedures from the prior year.</ExplanationTxt>
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        <ExplanationTxt>Form 5471 is included for informational purposes. The balance sheet within form 5471 is not included in the balance sheet of the 990 because it is a separate entity.</ExplanationTxt>
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          <CityNm>Middleburg Hts</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44130</ZIPCd>
        </USAddress>
        <EIN>340753531</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 c 3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SW Com Hlth System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Southwest Comm Hlth Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>18697 Bagley Road</AddressLine1Txt>
          <CityNm>Middleburg Hts</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44130</ZIPCd>
        </USAddress>
        <EIN>341455135</EIN>
        <PrimaryActivitiesTxt>Foundation</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 c 3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12a</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SW Com Hlth System</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Southwest Gen Medical Group</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>18697 Bagley Road</AddressLine1Txt>
          <CityNm>Middleburg Hts</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44130</ZIPCd>
        </USAddress>
        <EIN>341652755</EIN>
        <PrimaryActivitiesTxt>Physicians</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 c 3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12b</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SW Gen Hlth Cntr</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Southwest Protection Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>18697 Bagley Road</AddressLine1Txt>
          <CityNm>Middleburg Hts</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44130</ZIPCd>
        </USAddress>
        <EIN>841661280</EIN>
        <PrimaryActivitiesTxt>Security</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 c 3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12a</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SW Gen Hlth Cntr</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Southwest Holdings Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>18697 Bagley Road</AddressLine1Txt>
          <CityNm>Middleburg Hts</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44130</ZIPCd>
        </USAddress>
        <EIN>341461753</EIN>
        <PrimaryActivitiesTxt>Retail Pharmacy</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SW Gen Hlth</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>19054</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>2301222</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Western Reserve Assurance Co LTD SP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>PO Box 1051</AddressLine1Txt>
          <CityNm>Grand Cayman</CityNm>
          <CountryCd>CJ</CountryCd>
        </ForeignAddress>
        <EIN>981504997</EIN>
        <PrimaryActivitiesTxt>Self Insurance</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SW Com Hlth Sys</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ShareOfEOYAssetsAmt>23484339</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</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>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Western Reserve Assurance Co Ltd SPC - Southwest Community Health System</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>r</TransactionTypeTxt>
        <InvolvedAmt>6648276</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Cash Transferred</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>