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            <AddressLine1Txt>1501 S Clinton Street 7th Floor</AddressLine1Txt>
            <CityNm>Baltimore</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>212245744</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Health Insurance Claims</ServicesDesc>
        <CompensationAmt>294972</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Wellspring Family Medicine</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>311 North Fourth Street Suite 1</AddressLine1Txt>
            <CityNm>Oakland</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21550</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Practice Assistance Payments</ServicesDesc>
        <CompensationAmt>134679</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Alvarez &amp; Orthopaedic Associates PA</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>311 North 4th Street Suite 3</AddressLine1Txt>
            <CityNm>Oakland</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21550</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Practice Assistance Payments</ServicesDesc>
        <CompensationAmt>105934</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>3</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>1180832</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>74840</AllOtherContributionsAmt>
      <TotalContributionsAmt>1255672</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>77745431</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>77745431</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Medical Office Rent</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>151539</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>151539</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>1426</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>77757567</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
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        <ExclusionAmt>913751</ExclusionAmt>
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      <GrossRentsGrp>
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      <NetRentalIncomeOrLossGrp>
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      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
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        <ExclusionAmt>-73784</ExclusionAmt>
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      <GrossSalesOfInventoryAmt>122806</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>74108</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
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        <ExclusionAmt>48698</ExclusionAmt>
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      <OtherRevenueMiscGrp>
        <Desc>Intercompany Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>547298</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Cafeteria Income</Desc>
        <BusinessCd>624200</BusinessCd>
        <TotalRevenueColumnAmt>206994</TotalRevenueColumnAmt>
        <ExclusionAmt>206994</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Healthworks Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>24584</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>24584</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>44287</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>44287</RelatedOrExemptFuncIncomeAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>823163</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>80729147</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>78373736</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>1099739</ExclusionAmt>
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      <GrantsToDomesticOrgsGrp>
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      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
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        <ProgramServicesAmt>500</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>670886</TotalAmt>
        <ProgramServicesAmt>264084</ProgramServicesAmt>
        <ManagementAndGeneralAmt>406802</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>23373505</TotalAmt>
        <ProgramServicesAmt>9719111</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13654394</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>230264</TotalAmt>
        <ProgramServicesAmt>97130</ProgramServicesAmt>
        <ManagementAndGeneralAmt>133134</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>3535780</TotalAmt>
        <ProgramServicesAmt>1478527</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2057253</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>2333796</TotalAmt>
        <ProgramServicesAmt>970433</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1363363</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>24034</TotalAmt>
        <ManagementAndGeneralAmt>24034</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>17535</TotalAmt>
        <ManagementAndGeneralAmt>17535</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>40131</TotalAmt>
        <ProgramServicesAmt>40131</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising></FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>4486556</TotalAmt>
        <ProgramServicesAmt>2462361</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2024195</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>99516</TotalAmt>
        <ManagementAndGeneralAmt>99516</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>4760056</TotalAmt>
        <ProgramServicesAmt>1210996</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3549060</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>55563</TotalAmt>
        <ProgramServicesAmt>9682</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45881</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>907208</TotalAmt>
        <ProgramServicesAmt>774786</ProgramServicesAmt>
        <ManagementAndGeneralAmt>132422</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>258045</TotalAmt>
        <ProgramServicesAmt>129127</ProgramServicesAmt>
        <ManagementAndGeneralAmt>128918</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>459986</TotalAmt>
        <ProgramServicesAmt>392843</ProgramServicesAmt>
        <ManagementAndGeneralAmt>67143</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>1026955</TotalAmt>
        <ProgramServicesAmt>8000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1018955</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>2527146</ProgramServicesAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>16000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>209273</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>11147696</TotalAmt>
        <ProgramServicesAmt>11147696</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Provision for Doubtful Accounts</Desc>
        <TotalAmt>1891980</TotalAmt>
        <ProgramServicesAmt>1891980</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Recruiting</Desc>
        <TotalAmt>341626</TotalAmt>
        <ProgramServicesAmt>329777</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11849</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Taxes, Licenses, Fees</Desc>
        <TotalAmt>162535</TotalAmt>
        <ProgramServicesAmt>10358</ProgramServicesAmt>
        <ManagementAndGeneralAmt>152177</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>704814</TotalAmt>
        <ProgramServicesAmt>27578</ProgramServicesAmt>
        <ManagementAndGeneralAmt>677236</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>59713312</TotalAmt>
        <ProgramServicesAmt>33508246</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26205066</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <InfoInScheduleOPartXInd>X</InfoInScheduleOPartXInd>
      <CashNonInterestBearingGrp>
        <BOYAmt>1750</BOYAmt>
        <EOYAmt>8553890</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>5207297</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>19849756</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>1990190</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>748265</BOYAmt>
        <EOYAmt>240973</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>25673354</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4616279</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>19585707</BOYAmt>
        <EOYAmt>21057075</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>18708304</EOYAmt>
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        <EOYAmt>864662</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>7846731</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>831969</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>11666666</EOYAmt>
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      <OtherLiabilitiesGrp>
        <BOYAmt>13809896</BOYAmt>
        <EOYAmt>10086402</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>30494117</BOYAmt>
        <EOYAmt>30431768</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>29689815</BOYAmt>
        <EOYAmt>45182680</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>819921</BOYAmt>
        <EOYAmt>857699</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>30509736</BOYAmt>
        <EOYAmt>46040379</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>61003853</BOYAmt>
        <EOYAmt>76472147</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>21015835</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>960172</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-6445364</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="990A" softwareId="23017659" softwareVersionNum="23.1.0.0">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="990B" softwareId="23017659" softwareVersionNum="23.1.0.0">
      <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>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
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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>35642</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>4489</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>40131</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>II-B 1g</FormAndLineReferenceDesc>
        <ExplanationTxt>During 2023, GRMC, Inc. dba Garrett Regional Medical Center, paid fees to Keller Partners Company for services that included lobbying on behalf of GRMC, Inc. This amount also includes a calculation of the hours the CEO participated in lobbying related activities in 2023 amount equals hours multiplied by hourly pay rate.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>II-B 1i</FormAndLineReferenceDesc>
        <ExplanationTxt>This amount is calculated based on information provided by the American Hospital Association and Maryland Hospital Association. The American Hospital Association estimates that 32 of the 2023 dues were allocated to lobbying expense. Maryland Hospital Association estimates that 2 of the 2023 dues were allocated to lobbying expense. GRMC, Inc. does not participate in or intervene in including publishing or distributing of statements any political campaign on behalf of or in opposition to any candidate for public office.</ExplanationTxt>
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        <BookValueAmt>3890000</BookValueAmt>
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      <BuildingsGrp>
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        <DepreciationAmt>460456</DepreciationAmt>
        <BookValueAmt>7005126</BookValueAmt>
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      <LeaseholdImprovementsGrp>
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        <DepreciationAmt>47690</DepreciationAmt>
        <BookValueAmt>503605</BookValueAmt>
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        <DepreciationAmt>4042545</DepreciationAmt>
        <BookValueAmt>7459488</BookValueAmt>
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      <OtherLandBuildingsGrp>
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        <DepreciationAmt>65588</DepreciationAmt>
        <BookValueAmt>2198856</BookValueAmt>
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      <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>744353</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>U.S. Government and Agency Obligations</Desc>
        <BookValueAmt>10272916</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Marketable Equity Securities</Desc>
        <BookValueAmt>1757548</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Marketable Debt Securities</Desc>
        <BookValueAmt>1483885</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Domestic Equity Mutual Funds</Desc>
        <BookValueAmt>803979</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>International Equity Mutual Funds</Desc>
        <BookValueAmt>294829</BookValueAmt>
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      <OtherSecuritiesGrp>
        <Desc>Domestic Fixed Income Mutual Funds</Desc>
        <BookValueAmt>984960</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Domestic Equity Exchange Traded Funds</Desc>
        <BookValueAmt>1565350</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Domestic Fixed Income Exchance Traded Funds</Desc>
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      <OtherSecuritiesGrp>
        <Desc>Alternative Investments</Desc>
        <BookValueAmt>598514</BookValueAmt>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>International Equity Exchange Traded Funds</Desc>
        <BookValueAmt>201970</BookValueAmt>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>18708304</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Federal income taxes</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to Third Party Payors</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Other Non Current Liabilities</Desc>
        <Amt>609905</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
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        <Amt>274424</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Long Term Lease Liability</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Self Insurance Liability</Desc>
        <Amt>446901</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DB Pension Obligation</Desc>
        <Amt>8755172</Amt>
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      <FootnoteTextInd>X</FootnoteTextInd>
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      <RevenueNotReportedAmt>-998108</RevenueNotReportedAmt>
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      <OtherRevenuesNotIncludedAmt>-85577</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-85577</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>80729147</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>57840609</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>85577</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>85577</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>57755032</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>1958280</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>1958280</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>59713312</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>X 2</FormAndLineReferenceDesc>
        <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, BCHS, PHIC, HPN, and TMHS are organizations subject to federal and/or state income taxes. The System does not have any material uncertain tax positions as of December 31, 2023 and 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XI 2d</FormAndLineReferenceDesc>
        <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 15,703, Non-Controlling Interest Expense 50,597, and Provisions for Doubtful Accounts of 1,891,980.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XI 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount on line 4b consists of 11,469 of rental expenses that are recorded as an offset to revenue on the Form 990 as well as 74,108 gift shop cost of goods sold that are recorded as an offset to revenue on the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount shown on line 2d consists of 11,469 of rental expenses that are recorded as an offset to revenue on the Form 990 as well as 74,108 gift shop cost of goods sold that are recorded as an offset to revenue on the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>XII 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount shown on line 4b consists of 1,891,980 provision for doubtful accounts, 15,703 defined benefit cost, and 50,597 non controlling interest expense that is reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
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      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
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      <EconomicDevelopmentGrp>
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      <CoalitionBuildingGrp>
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      <TotalCommuntityBuildingActyGrp>
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      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>847418</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>81010</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>51274666</ReimbursedByMedicareAmt>
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      <MedicareSurplusOrShortfallAmt>12198996</MedicareSurplusOrShortfallAmt>
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      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
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        <BusinessName>
          <BusinessNameLine1Txt>Garrett Regional Medical Center</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>215 N 4th St</AddressLine1Txt>
          <CityNm>Oakland</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21550</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>https//wvumedicine.org/garrett-regional-medical-center/</WebsiteAddressTxt>
        <StateLicenseNum>11005</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
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        <TaxExemptHospitalCYOrPYInd>true</TaxExemptHospitalCYOrPYInd>
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        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <CHNAConductedYr>22</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>true</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>https//wvumedicine.org/wp-content/uploads/2022/06/Garrett-Regional-Medical-Center-CHNA-2019.pdf</OwnWebsiteURLTxt>
        <OtherWebsiteInd>X</OtherWebsiteInd>
        <OtherWebsiteURLTxt>https//mygarrettcounty.com/cha2024/</OtherWebsiteURLTxt>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>23</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>https//mygarrettcounty.com/cha2024/</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>0000000200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>0000000300.000000000000</FPGFamilyIncmLmtDscntCarePct>
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        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
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        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
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        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>https//wvumedicine.org/garrett-regional-medical-center/wp-content/uploads/sites/66/2022/06/Caring-Pr</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>https//wvumedicine.org/garrett-regional-medical-center/wp-content/uploads/sites/66/2022/06/MARYLAND-</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>https//wvumedicine.org/garrett-regional-medical-center/patients-visitors/billing/</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
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        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <ProspectiveMedicareMedicaidInd>X</ProspectiveMedicareMedicaidInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>true</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <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>
      </SupplementalInformationGrp>
      <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>
      </SupplementalInformationGrp>
      <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>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <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>
      </SupplementalInformationDetail>
      <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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Column f - Net community benefit expense for 2023 is 13,145,817 and is 22.74 of total net expenses. To calculate net expense, provision for doubtful accounts - paients of 1,891,980 was deducted from total expenses of 59,713,312 as shown in Part IX line 25 of the core Form 990.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Community Building activities for 2023 included Community Group Presentations reported as Communty Health Improvement/Safety 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 1,891,980 by our cost-to-charge ratio of 44.79 for a total of 847,418.</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 180,865, which was then multiplied by the cost-to-charge ratio of 44.79 for a total of 81,009.</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 81,009 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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Patient accounts receivables are primarily paid by federal and state governmental authorities under the Medicare and Medicaid programs, managed health plans, commercial insurance companies, workers compensation programs, employers and patients. 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. The System does not believe there are any significant concentrations of revenues from any particular payor that would subject the System to any significant credit risks in the collection of patient accounts receivable. 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. Changes in general economic conditions, patient accounting service center operations, payor mix, payor claim processing could affect collections of accounts receivable, cash flows and results of operations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The System performs periodic assessments to determine if an allowance for expected credit losses is necessary. The System considers its incurred loss experience and adjusts for known and expected events and other circumstances. In estimating its expected credit losses, the System may consider changes in the length of time its receivables have been outstanding, changes in credit ratings for payors, requests from payors to alter payment terms due to financial difficulty, and notices of payor bankruptcies or payors entering receivership. Because the Systems accounts receivable is typically paid for by highly solvent, creditworthy payors, such as Medicare, Medicaid, other governmental programs, and highly regulated commercial insurers on behalf of the patient, the Systems credit losses are immaterial to the consolidated financial statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The mix of accounts receivable at December 31, 2023 and 2022, from patients and third-party payors is as follows For the year-end December 31, 2023 Medicare - 25, Medicaid - 13, Blue Cross - 21, Commercial, managed care and other - 39, Patients - 2, totaling 100. For the year-end December 31, 2022 Medicare - 27, Medicaid - 16, Blue Cross - 19, Commercial, managed care and other - 35, Patients - 3, totaling 100.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The amount reported in Part III Line 6 39,075,670 was calculated using the total Medicare allowable cost from the Medicare cost divided by total charges per the Medicare cost report. That percentage was 131. Total IP OP charges per the Medicare cost report were then mulitplied by the calculated cost to charge ratio of 131 to arrive at a cost of 39,075,670. The reported surplus as reported on line 7 is utilized to provide services to the patient population.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Garrett Regional Medical Center is reimbursed 100 by Medicare reimbursement includes DSH and IME for services provided to Medicare patients.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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 2023, Garrett County had a total population of 28,423, a median household income of 64,447, an employment rate of 58.2 and 8.4 of residents reported they were without healthcare coverage. Approximately 15.1 of residents were living in poverty.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The GRMC board of directors is a community board, with ten of the eleven members living in or around Garrett County.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <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>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <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, Potomac Valley Hospital in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, 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, Reynolds Memorial Hospital in Glen Dale, WV, Barnesville Hospital Association in Barnesville, OH, Uniontown Hospital in Uniontown, PA, Wheeling Hospital, Inc. in Wheeling, WV, Harrison Community Hospital, Inc. in Cadiz, OH, GRMC, Inc. in Oakland, MD, Princeton Community Hospital Association, Inc. in Princeton, WV, Thomas Health System, Inc. in South Charleston, WV, and Grant Memorial Hospital, Inc. in Petersburg, WV.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <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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        <PersonNm>Amy Boothe</PersonNm>
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        <PersonNm>Kendra Thayer</PersonNm>
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        <PersonNm>Mary Miller</PersonNm>
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        <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>
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        <FormAndLineReferenceDesc>Part I Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Mark Boucot received deferred compensation contributions of 29,208 from GRMC and 29,208 from a related party. Marjorie Fridkin received deferred compensation contributions of 8,744 from GRMC and 4,307 from a related party. James Venturella received deferred contributions of 86,760 from a related party in 2023. 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>
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      <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>
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      <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 2022 for 2023 compensation amounts.</ExplanationTxt>
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        <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>
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        <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 of 37,778, Donated Capital of 5,691,625, Related Organization Capitalization of 166,862, JOA Contribution to SOM of 34,787, Pension True Up of 386,892, and Intercompany Transfers of 976,760.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <FormAndLineReferenceDesc>Form 990, Part V, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>In 2023, West Virginia United Health System WVUHS, EIN 55-0754713, transitioned to a centralized accounts payable process in which WVUHS made the majority of vendor payments and then issued the required 1099s. WVUHS is reimbursed by the entities for their portion of payments made, vendor payments that meet the Top 5 Independent Contractor reporting requirements are reported in Part VII, Section B of the reporting entity.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part X, Section Sch. B, Line Part I</FormAndLineReferenceDesc>
        <ExplanationTxt>GRMC, Inc. reported contributions on Schedule B that were not recorded on page 9 as revenue. These contributions were not reported as revenue on the financial statements, but were reported as net assets.</ExplanationTxt>
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          <CityNm>Bridgeport</CityNm>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 Garfield Ave</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26101</ZIPCd>
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        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Physician Corp</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>604 Ann Street</AddressLine1Txt>
          <CityNm>Parkersburg</CityNm>
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          <ZIPCd>26101</ZIPCd>
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          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>West Virginia University Hospitals Inc</BusinessNameLine1Txt>
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          <ZIPCd>26506</ZIPCd>
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        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>West Virginia University Hospitals East</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>121 Administrative Drive</AddressLine1Txt>
          <CityNm>Martinsburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25401</ZIPCd>
        </USAddress>
        <EIN>202337985</EIN>
        <PrimaryActivitiesTxt>Healthcare Access</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>City Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2500 Hospital Drive</AddressLine1Txt>
          <CityNm>Martinsburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25401</ZIPCd>
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        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type I</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>West Virginia University Hospitals - East Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Jefferson Memorial Hospital</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>300 South Preston St</AddressLine1Txt>
          <CityNm>Ranson</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25438</ZIPCd>
        </USAddress>
        <EIN>550359755</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>West Virginia University Hospitals - East Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>United Hospital Center Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>327 Medical Park Drive</AddressLine1Txt>
          <CityNm>Bridgeport</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26330</ZIPCd>
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        <EIN>550525724</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>West Virginia Health Care Cooperative Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>400 Fairview Heights Rd</AddressLine1Txt>
          <CityNm>Summersville</CityNm>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Camden-Clark Memorial Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>800 Garfield Ave</AddressLine1Txt>
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          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Potomac Valley Hospital of W Va Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>100 Pin Oak Lane</AddressLine1Txt>
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        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>St Joseph's Hospital of Buckhannon Inc</BusinessNameLine1Txt>
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        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>St Joseph's Foundation of Buckhannon Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Amalia Drive</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Reynolds Memorial Hospital Inc</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Braxton County Memorial Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>100 Hoylman Drive</AddressLine1Txt>
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          <BusinessNameLine1Txt>Community Health Association</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>Fayette Physician Network Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>500 West Berkeley Street</AddressLine1Txt>
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          <BusinessNameLine1Txt>Wheeling Hospital Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
          <CityNm>Wheeling</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
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        <EIN>550357057</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>Harrison Community Hospital</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>951 E Market Street</AddressLine1Txt>
          <CityNm>Cadiz</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43907</ZIPCd>
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        <EIN>341571750</EIN>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>Barnesville Hospital Association</BusinessNameLine1Txt>
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          <AddressLine1Txt>639 W Main Street</AddressLine1Txt>
          <CityNm>Barnesville</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43713</ZIPCd>
        </USAddress>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Belmont Community Hospital</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>4697 Harrison Street</AddressLine1Txt>
          <CityNm>Bellaire</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43906</ZIPCd>
        </USAddress>
        <EIN>340714643</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Wheeling Hospital Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Medical Park Foundation</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
          <CityNm>Wheeling</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
        </USAddress>
        <EIN>550744690</EIN>
        <PrimaryActivitiesTxt>Church</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Wheeling Hospital Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>Self Insurance Trust Agreement of Wheeling Hospital Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1 Medical Park</AddressLine1Txt>
          <CityNm>Wheeling</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26003</ZIPCd>
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        <EIN>550676674</EIN>
        <PrimaryActivitiesTxt>Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        </DisregardedEntityName>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26847</ZIPCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>Herbert J Thomas Memorial Hospital Association</BusinessNameLine1Txt>
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          <CityNm>Charleston</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <EIN>611272692</EIN>
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          <BusinessNameLine1Txt>Thomas Health System Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Princeton Community Hospital Association</BusinessNameLine1Txt>
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          <AddressLine1Txt>122 Twelfth Street</AddressLine1Txt>
          <CityNm>Princeton</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>24740</ZIPCd>
        </USAddress>
        <EIN>550483245</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Princeton Community Hospital Foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>PO Box 1369</AddressLine1Txt>
          <CityNm>Princeton</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>24740</ZIPCd>
        </USAddress>
        <EIN>550694209</EIN>
        <PrimaryActivitiesTxt>Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 A Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Princeton Community Hospital Association</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Thomas Health System Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4605 MacCorkle Ave SW</AddressLine1Txt>
          <CityNm>South Charleston</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25309</ZIPCd>
        </USAddress>
        <EIN>260440674</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>THS Physician Partners Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4605 MacCorkle Ave SW</AddressLine1Txt>
          <CityNm>South Charleston</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25309</ZIPCd>
        </USAddress>
        <EIN>454395947</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Thomas Health System Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Welch Medical Center Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 8034</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26506</ZIPCd>
        </USAddress>
        <EIN>921990757</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>WV United Health System</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WVUHS Specialty Pharmacy Services Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>PO Box 8034</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        </USAddress>
        <EIN>872740836</EIN>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Ohio Valley Health Corporation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
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          <CityNm>Parkersburg</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26104</ZIPCd>
        </USAddress>
        <EIN>922553803</EIN>
        <PrimaryActivitiesTxt>Patient Care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Camden-Clark Health Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Oakland MRI Center</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>259 N 4th St</AddressLine1Txt>
          <CityNm>Oakland</CityNm>
          <StateAbbreviationCd>MD</StateAbbreviationCd>
          <ZIPCd>21550</ZIPCd>
        </USAddress>
        <EIN>201857646</EIN>
        <PrimaryActivitiesTxt>Patient Care - MRI</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MD</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>82877</ShareOfTotalIncomeAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.50000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Allied Health Services Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 782</AddressLine1Txt>
          <CityNm>Morgantown</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>26507</ZIPCd>
        </USAddress>
        <EIN>550652017</EIN>
        <PrimaryActivitiesTxt>Linen Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <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>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>