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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 2</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 2</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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        <PersonNm>DR PAUL STEINKE</PersonNm>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 11b</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Sec A, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>and also serve on the CGH Health Foundation Board. Amanda Blaine is</ExplanationTxt>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Sec A, Line 2</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>Organization maintains an independent Finance Committee responsible for</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>oversight of the audited financial statements. The Treasurer participates</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>in the process of the selection of the independent auditor, as they are</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>also members of the finance committee of CGH Medical Center.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR-198-Copy1">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CGH Medical Center</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 E LeFevre</AddressLine1Txt>
          <CityNm>Sterling</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61081</ZIPCd>
        </USAddress>
        <EIN>363479824</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>GovtUnitSec115</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>NA</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Rock River Health Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 E LeFevre Road</AddressLine1Txt>
          <CityNm>Sterling</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61081</ZIPCd>
        </USAddress>
        <EIN>363620761</EIN>
        <PrimaryActivitiesTxt>Healthcare Clinic</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>NFP501c3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Community General Hospital Employee Benefit Trust</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 E LeFevre Road</AddressLine1Txt>
          <CityNm>Sterling</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61081</ZIPCd>
        </USAddress>
        <EIN>363337699</EIN>
        <PrimaryActivitiesTxt>Medical Benefits to Employees</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>NFP501c9</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>NA</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <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>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>CGH Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>887896</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Cash</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
