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            <AddressLine1Txt>PO BOX 936451</AddressLine1Txt>
            <CityNm>ALANTA</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>31193</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EMERGENCY MED</ServicesDesc>
        <CompensationAmt>898971</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WOUND CARE SPECIALISTS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 71849</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60694</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>WOUND CARE SERVICES</ServicesDesc>
        <CompensationAmt>611725</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MENTO HEALTH LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>10440 N CENTRAL EXPRESSWAY</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75231</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTHCARE</ServicesDesc>
        <CompensationAmt>588250</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>INTUITIVE SURGICAL INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 883629</AddressLine1Txt>
            <CityNm>LOS ANGELES</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>90088</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SURGICAL</ServicesDesc>
        <CompensationAmt>800853</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>INERGY HEALTH LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6010 TRINITY HTS</AddressLine1Txt>
            <CityNm>TEXARKANA</CityNm>
            <StateAbbreviationCd>AR</StateAbbreviationCd>
            <ZIPCd>71854</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTHCARE</ServicesDesc>
        <CompensationAmt>440000</CompensationAmt>
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        <BusinessCd>722210</BusinessCd>
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        <ExclusionAmt>311472</ExclusionAmt>
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        <ExclusionAmt>455328</ExclusionAmt>
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        <ExclusionAmt>890038</ExclusionAmt>
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        <ExclusionAmt>65200</ExclusionAmt>
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        <RelatedOrExemptFuncIncomeAmt>29653508</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>2309730</ExclusionAmt>
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      <GrantsToDomesticIndividualsGrp>
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      <ForeignGrantsGrp>
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      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
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        <ManagementAndGeneralAmt>324444</ManagementAndGeneralAmt>
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      <CompDisqualPersonsGrp>
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        <ManagementAndGeneralAmt>2849315</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>68406</ProgramServicesAmt>
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        <ProgramServicesAmt>816951</ProgramServicesAmt>
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      <PayrollTaxesGrp>
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      <FeesForServicesLegalGrp>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>732664</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>85605</ProgramServicesAmt>
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        <ProgramServicesAmt>6227042</ProgramServicesAmt>
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      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X : FIN48 Footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital has adopted Accounting Standards Codification Topic 740, Accounting for Uncertainty in Income Taxes. The System will recognize a tax benefit only if it is more likely than not the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized will be the largest amount of tax benefit that has a greater than 50% likelihood of being realized on examination for tax positions not meeting the more likely than not test, no tax benefit will be recorded.</ExplanationTxt>
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        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
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      <HospitalFcltyPoliciesPrctcGrp>
        <FirstLicensedCYOrPYInd>false</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <OtherInd>X</OtherInd>
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        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>false</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>WWW.HOWARDMEMORIAL.COM</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <RptAvailableThruOtherMethodInd>X</RptAvailableThruOtherMethodInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>24</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>WWW.HOWARDMEMORIAL.COM</StrategyWebsiteURLTxt>
        <StrategyAttachedInd>false</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100.0000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>200.0000</FPGFamilyIncmLmtDscntCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
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        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
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        <FAPSummaryOnWebsiteURLTxt>WWW.HOWARDMEMORIAL.COM</FAPSummaryOnWebsiteURLTxt>
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        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
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        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <OtherPublicityInd>X</OtherPublicityInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 3j</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRACTED WITH OFFICE OF BEHAVIORAL RESEARCH &amp; EVALUATION AT ARKANSAS STATE UNIVERSITY TO CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENT</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>HMH CREATED FOUR DIFFERENT FOCUS GROUPS BASED ON THE DEMOGRAPHICS OF HOWARD COUNTY TO CAPTURE VARYING POPULATIONS</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 7d</FormAndLineReferenceDesc>
        <ExplanationTxt>COPY OF NEEDS ASSESSMENT READILY AVAILABLE IN ADMINISTRATION.NEEDS ASSESSMENT POSTED ON HOSPITAL'S WEBSITE AND FACEBOOK PAGE.NEEDS ASSESSMENT PRESENTED TO HOSPITAL BOARD OF DIRECTORS, HOSPITAL MEDICAL STAFF, PRESS RELEASE TO MEDIA (NEWSPAPER AND RADIO), INCLUDED AS A COMPONENT OF HOSPITAL'S STRATEGIC PLAN.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>PLAN OF ACTION TO ADDRESS NEEDS INDENTIFIED THROUGH THE CHNA ARE PRIORITIZED IN THE IMPLEMENTATION STRATEGY</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 16j</FormAndLineReferenceDesc>
        <ExplanationTxt>SPANISH</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCOUNTS CALCULATED BASED ON REIMBURSEMENT FROM PRIVATE PAY/ UNINSURED PATIENTS AVERAGES TO BE 10 CENTS PER DOLLAR CHARGE, BASED ON A 12 MONTH LOOK BACK ANALYSIS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4 - Bad Debt Expense</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCOUNTS RECEIVABLE IS REDUCED BY IMPLICIT PRICE CONCESSIONS RELATING TO ALLOWANCES FOR CREDIT LOESSES AND ALLOWANCES FOR EXCESS OF ESTABLISHED CHARGES OVER THE PAYMENTS TO BE RECEIVED. IN EVALUATING THE PRICE CONCESSIONS, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE AND IS ADJUSTED FOR CURRENT AND EXPECTED ECONOMIC CONDITIONS TO ESTIMATE NET REALIZABLE VALUE OF ACCOUNTS RECEIVABLE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF PRICE CONCESSIONS. THE HOSPITAL WRITES OFF AMOUNTS THAT ARE CONSIDERED TO BE UNCOLLECTIBLE BECAUSE OF CIRCUMSTANCES THAT EFFECT THE ABILITY OF PAYORS TO MAKE PAYMENTS AS THEY OCCUR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b - Provisions On Collection Practices For Qualified Patients</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENTS ARE INFORMED OF CHARITY CARE PROGRAM AND FINANCIAL ASSISTANCE PROGRAM FOR UNINSURED PATIENTS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3 - Patient Education of Eligibility for Assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>INFORMS PATIENTS UPON ADMISSION AND POSTS NOTICES IN CONSPICUOUS AREAS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4 - Community Information</FormAndLineReferenceDesc>
        <ExplanationTxt>RURAL SETTING, PREDOMINANTLY AGRICULTURAL BASE. AVERAGE INCOME AT OR BELOW POVERTY GUIDELINES. PREDOMINANTLY CAUCASIAN, HIGH SCHOOL EDUCATED AND GERIATRIC IN NATURE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5 - Promotion of Community Health</FormAndLineReferenceDesc>
        <ExplanationTxt>HOWARD MEMORIAL HOSPITAL IS CLASSIFIED AS A 20-BED CRITICAL ACCESS HOSPITAL AND PROVIDES ACUTE AND SWING BED SERVICES. THE HOSPITAL PROVIDES MEDICAL CARE TO RESIDENTS OF SOUTHWESTERN ARKANSAS. THIS CARE INCLUDED APPROXIMATELY 2,884 INPATIENT DAYS OF CARE, AS WELL AS 26,695 OUTPATIENT VISITS AND 8,083 EMERGENCY DEPARTMENT VISITS, TO BENEFIT THE POOR AND ELDERLY IN THE COMMUNITY, THE HOSPITAL PARTICIPATED IN MEDICARE AND MEDICAID PROGRAMS. 1,512 DAYS OF CARE WERE PROVIDED TO PARTICIPANTS IN THESE PROGRAMS INCLUDING SWING BED.</ExplanationTxt>
      </SupplementalInformationDetail>
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      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
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      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
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      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
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        <PersonNm>CHARLES CALDWELL</PersonNm>
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        <PersonNm>JIM LOGGINS</PersonNm>
        <TitleTxt>CRNA</TitleTxt>
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        <TotalCompensationFilingOrgAmt>263838</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOHN JOHNSON</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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        <TotalCompensationFilingOrgAmt>345111</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL COX</PersonNm>
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        <TotalCompensationFilingOrgAmt>163728</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM CRAIG</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>178616</BaseCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>178616</TotalCompensationFilingOrgAmt>
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        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>PUMPHREY MEDICAL PA</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>BOARDMEMBER OWNS</RelationshipDescriptionTxt>
        <TransactionAmt>384866</TransactionAmt>
        <TransactionDesc>HOSPITALIST SERVICES</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
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    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="24020490" softwareVersionNum="2024v5.2">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>CFO PRESENTS THE HOSPITAL'S 990 TO THE BOARD OF DIRECTORS AT THE MONTHLY BOARD MEETING; ACTION DOCUMENTED IN THE BOD MINUTES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD OF DIRECTORS, OFFICERS, EXECUTIVES ARE REQUIRED TO DISCLOSE ANNUALLY IN WRITING ANY POTENTIAL CONFLICT OF INTEREST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPARATIVE COMPENSATION DATA IS OBTAINED FROM THE AHA FOR ALL EXECUTIVE OFFICERS IN C SUITE LEVEL.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE UPON REQUEST FROM ADMINISTRATION</ExplanationTxt>
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          <BusinessNameLine1Txt>HOWARD MEMORIAL HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>130 MEDICAL CIRCLE</AddressLine1Txt>
          <CityNm>NASHVILLE</CityNm>
          <StateAbbreviationCd>AR</StateAbbreviationCd>
          <ZIPCd>71852</ZIPCd>
        </USAddress>
        <EIN>710644638</EIN>
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          <StateAbbreviationCd>AR</StateAbbreviationCd>
          <ZIPCd>71852</ZIPCd>
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          <AddressLine1Txt>420 WEST PINHOOK</AddressLine1Txt>
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          <StateAbbreviationCd>LA</StateAbbreviationCd>
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        <LegalDomicileStateCd>LA</LegalDomicileStateCd>
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        <PredominantIncomeTypeTxt>RELATED</PredominantIncomeTypeTxt>
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        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
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      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
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</Return>