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        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>HUGH SHERMAN PHD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>LARRY UNROE</PersonNm>
        <TitleTxt>DIRECTOR EMERITUS</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>4.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>J SCOTT CANTLEY</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>1579095</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT SILVESTRI</PersonNm>
        <TitleTxt>CFO (THRU 12/31/24)</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>45.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>731961</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>DOUG FULL</PersonNm>
        <TitleTxt>CFO (FROM 01/01/25)</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JODY BULLMAN</PersonNm>
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        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>404991</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH ZACHARIAS MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ALLAN FIGUEROA</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KAYLA MICHAELIS</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KENDAL NEILL</PersonNm>
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        <PersonNm>ROSEMARIE SEESE</PersonNm>
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        <ReportableCompFromRltdOrgAmt>150413</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>HEIDI MCGOWAN</PersonNm>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PROLINK STAFFING</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>10700 MONTGOMERY RD STE 226</AddressLine1Txt>
            <CityNm>CINCINNATI</CityNm>
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            <ZIPCd>45242</ZIPCd>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BELMONT HEALTHCARE CENTER</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>506 RIVERVIEW DR</AddressLine1Txt>
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            <StateAbbreviationCd>WV</StateAbbreviationCd>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        <ContractorAddress>
          <USAddress>
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          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HEALOGICS WOUND CARE</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5220 BELFORT RD 130</AddressLine1Txt>
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            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>32256</ZIPCd>
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        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>COMPREHENSIVE REIMBURSEMENT INC</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>947 EAST JOHNSTOWN ROAD STE 234</AddressLine1Txt>
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            <ZIPCd>43230</ZIPCd>
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        </ContractorAddress>
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      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>4440587</GovernmentGrantsAmt>
      <TotalContributionsAmt>4440587</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>36797646</TotalRevenueColumnAmt>
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      <ProgramServiceRevenueGrp>
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        <BusinessCd>456110</BusinessCd>
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        <TotalRevenueColumnAmt>12452</TotalRevenueColumnAmt>
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        <ExclusionAmt>1897</ExclusionAmt>
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      <OtherRevenueMiscGrp>
        <Desc>TIVITY HEALTH STIPEND</Desc>
        <BusinessCd>900099</BusinessCd>
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      <OtherRevenueMiscGrp>
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      <MiscellaneousRevenueGrp>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>5967</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>11890</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>31644</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>25459</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>188887</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>296295</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>1870157</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>PROVIDER TAX</Desc>
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      <OtherExpensesGrp>
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        <EOYAmt>59424</EOYAmt>
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      <TotalAssetsGrp>
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      <TotalLiabilitiesGrp>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
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        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL PAYS DUES TO THE WEST VIRGINIA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THE AMOUNT REPORTED REPRESENTS THE PORTION OF THOSE DUES USED BY THE NAMED ORGANIZATIONS FOR LOBBYING.</ExplanationTxt>
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        <BookValueAmt>514941</BookValueAmt>
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      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1976025</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1672528</DepreciationAmt>
        <BookValueAmt>303497</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>7788457</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>6349649</DepreciationAmt>
        <BookValueAmt>1438808</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>3915793</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>100463</DepreciationAmt>
        <BookValueAmt>3815330</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>6072576</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>PRACTICE BUYOUT</Desc>
        <BookValueAmt>320100</BookValueAmt>
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      <OtherAssetsOrgGrp>
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        <BookValueAmt>10785119</BookValueAmt>
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      <OtherAssetsOrgGrp>
        <Desc>ESTIMATED THIRD PARTY SETTLEMENTS</Desc>
        <BookValueAmt>3547115</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>14652334</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>ESTIMATED THIRD PARTY SETTLEMENTS</Desc>
        <Amt>3752813</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>3752813</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SYSTEM, EXCLUDING MSC, MOHP, AND THE INNOVATION CENTER, IS ORGANIZED AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE. MSC, MOHP AND THE INNOVATION CENTER ARE ORGANIZED AS LIMITED LIABILITY COMPANIES, WHEREBY, NET TAXABLE INCOME IS TAXED DIRECTLY TO THE MEMBERS AND NOT MSC, MOHP, OR THE INNOVATION CENTER. U.S. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM, AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2025 AND 2024, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. AS SUCH, THE SYSTEM IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, THE SYSTEM, EXCLUDING MSC, MOHP AND THE INNOVATION CENTER, IS REQUIRED TO FILE FEDERAL FORM 990 - RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WHICH IS AN INFORMATIONAL RETURN ONLY. THE SYSTEM, MSC, MOHP, AND INNOVATION CENTER HAVE FILED THEIR TAX RETURNS FOR PERIODS THROUGH 2024. THE RETURNS FOR MSC, MOHP, AND INNOVATION CENTER ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). THE SYSTEM, MSC, MOHP, AND INNOVATION CENTER ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE CONSOLIDATED FINANCIAL STATEMENTS WERE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.</ExplanationTxt>
      </SupplementalInformationDetail>
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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>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>25</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
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        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>SEE PART V, PAGE 8</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>25</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>HTTPS://WWW.MHSYSTEM.ORG/WP-CONTENT/UPLOADS/2023/09/2025-CHNA-SISTERSVILLE-</StrategyWebsiteURLTxt>
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        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
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        <FPGFamilyIncmLmtFreeCarePct>100.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>400.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
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        <FAPAvailableOnWebsiteURLTxt>HTTPS://WWW.MHSYSTEM.ORG/PATIENT-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/</FAPAvailableOnWebsiteURLTxt>
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        <FAPAppAvailableOnWebsiteURLTxt>HTTPS://WWW.MHSYSTEM.ORG/PATIENT-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/</FAPAppAvailableOnWebsiteURLTxt>
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        <FAPSummaryOnWebsiteURLTxt>HTTPS://WWW.MHSYSTEM.ORG/PATIENT-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/</FAPSummaryOnWebsiteURLTxt>
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        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <OtherActionsTakenInd>X</OtherActionsTakenInd>
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        <GrossChargesInd>0</GrossChargesInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SISTERSVILLE GENERAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: THIS ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWS FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY SISTERSVILLE GENERAL HOSPITAL AND PRC. THE STUDY AREA FOR THE SURVEY EFFORT (REFERRED TO AS THE "TOTAL SERVICE AREA" IN THIS REPORT) IS DEFINED AS EACH OF THE RESIDENTIAL ZIP CODES COMPRISING WETZEL, TYLER, AND PLEASANTS COUNTIES IN WEST VIRGINIA.THE SURVEY WAS ADMINISTERED AS AN ONLINE SURVEY. PRC HOSTED THE ONLINE SURVEY INSTRUMENT, AND SISTERSVILLE GENERAL HOSPITAL AND LOCAL PARTNERS USED A VARIETY OF COMMUNICATION TOOLS TO DRIVE RESIDENTS TO TAKE THE SURVEY ONLINE. EXAMPLES INCLUDE PRESS RELEASES, SOCIAL MEDIA ADVERTISING, POSTING ON ORGANIZATIONAL WEBSITES, AND EMAIL CAMPAIGNS TO COMMUNITY MEMBERS AND COMMUNITY PARTNERS. IN ALL, A TOTAL OF 201 SURVEYS IN THE TOTAL SERVICE AREA WERE ACHIEVED.TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY ALSO WAS IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY SISTERSVILLE GENERAL HOSPITAL; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 10 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.FINAL PARTICIPATION INCLUDED REPRESENTATIVES OF THE ORGANIZATIONS OUTLINED BELOW. MID-OHIO VALLEY HEALTH DEPARTMENT MOMENTIVE PERFORMANCE MATERIALS NEW MARTINSVILLE SCHOOL SISTERSVILLE ELEMENTARY SCHOOL SISTERSVILLE GENERAL HOSPITAL SISTERSVILLE POLICE DEPARTMENT TYLER COUNTY EMERGENCY MANAGEMENT WETZEL TYLER HEALTH DEPARTMENT WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SISTERSVILLE GENERAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: THE FOLLOWING "AREAS OF OPPORTUNITY" REPRESENT THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY, BASED ON THE INFORMATION GATHERED THROUGH THIS COMMUNITY HEALTH NEEDS ASSESSMENT. FROM THESE DATA, OPPORTUNITIES FOR HEALTH IMPROVEMENT EXIST IN THE AREA WITH REGARD TO THE FOLLOWING HEALTH ISSUES.THE AREAS OF OPPORTUNITY WERE DETERMINED AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING: STANDING IN COMPARISON WITH BENCHMARK DATA (PARTICULARLY NATIONAL DATA); IDENTIFIED TRENDS; THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; THE MAGNITUDE OF THE ISSUE IN TERMS OF THE NUMBER OF PERSONS AFFECTED; AND THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. THESE ALSO TAKE INTO ACCOUNT THOSE ISSUES OF GREATEST CONCERN TO THE COMMUNITY STAKEHOLDERS (KEY INFORMANTS) GIVING INPUT TO THIS PROCESS.AREAS OF OPPORTUNITY IDENTIFIED THROUGH THIS ASSESSMENT: 1. TOBACCO USE 2. MENTAL HEALTH 3. NUTRITION, PHYSICAL ACTIVITY &amp; WEIGHT 4. SUBSTANCE ABUSE 5. DIABETES 6. HEART DISEASE &amp; STROKE 7. ACCESS TO HEALTHCARE SERVICES 8. CANCER 9. POTENTIALLY DISABLING CONDITIONS 10. ORAL HEALTH 11. RESPIRATORY DISEASE 12. INFANT HEALTH &amp; FAMILY PLANNING 13. INJURY &amp; VIOLENCE SISTERSVILLE GENERAL HOSPITAL USED THE INFORMATION FROM THIS COMMUNITY HEALTH NEEDS ASSESSMENT TO DEVELOP AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY; THE HOSPITAL WILL TAKE THE FOLLOWING ACTIONS:THE HOSPITAL WILL IMPROVE ACCESS TO HEALTHCARE SERVICES BY INCREASING OPPORTUNITIES FOR HEALTH SCREENING. WE WILL DO THIS BY EXPANDING REDUCED-COST LAB SCREENINGS INTO PLEASANTS COUNTY.TO ADDRESS THE TWO IDENTIFIED NEEDS OF DIABETES AND HEART DISEASE &amp; STROKE, WE WILL IMPROVE NUTRITIONAL CHOICES OF THE COMMUNITY, INCREASE PHYSICAL ACTIVITY OF THE COMMUNITY AND INCREASE OPPORTUNITIES FOR HEALTH SCREENING. WE WILL DO THIS BY: O EXPANDING THE FARMACY PRODUCE PRESCRIPTION LIFESTYLE CHANGE PROGRAM IN SISTERSVILLE. O DECREASING COST OF MEMBERSHIP FOR SISTERSVILLE FITNESS CENTER FOR SENIORS. O EXPANDING REDUCED-COST LAB SCREENINGS INTO PLEASANTS COUNTY.IN ORDER TO ADDRESS INFANT HEALTH &amp; FAMILY PLANNING, THERE ARE MULTIPLE PRIORITY AREAS WE WILL IMPROVE. O FOR INJURY &amp; VIOLENCE, IN ORDER TO REDUCE FALLS AMONG OLDER INDIVIDUALS IN THE COMMUNITY, WE PLAN TO IMPLEMENT TRAINED FACILITATORS TO TEACH THE MATTER OF BALANCE FALLS PREVENTION PROGRAM, WHICH BEGAN IN OCTOBER 2024. O FOR MENTAL HEALTH, WE WILL BE EXPANDING THE FARMACY PRODUCE PRESCRIPTION LIFESTYLE CHANGE PROGRAM IN SISTERSVILLE. O FOR NUTRITION, PHYSICAL ACTIVITY &amp; WEIGHT, WE WILL IMPROVE NUTRITIONAL CHOICES AND PHYSICAL ACTIVITY OF COMMUNITY. WE WILL DO THIS BY:- EXPANDING FARMACY PRODUCE PRESCRIPTION LIFESTYLE CHANGE PROGRAM IN SISTERSVILLE- DECREASING COST OF MEMBERSHIP FOR SISTERSVILLE FITNESS CENTER FOR SENIORS.- DEVELOPING AN IMPLEMENTATION PLAN FOR EXPANSION OF WALKING TRACK AND ADULT OUTDOOR EXERCISE PARK IN SISTERSVILLE. THE HOSPITAL IS CURRENTLY SEEKING GRANT FUNDING.NOTE: THE FOOD FARMACY PRODUCE PRESCRIPTION PROGRAM IS A YEAR-LONG LIFESTYLE CHANGE PROGRAM THAT INCORPORATES HEALTH COACHING, PHYSICAL ACTIVITY (EDUCATION AS WELL AS ACTIVE EXERCISE LESSONS), LIFESTYLE MEDICINE* INSTRUCTION, HEALTHY COOKING CLASSES, BIOMETRIC SCREENINGS, ACCESS TO HEALTHY FOOD SAMPLES, AS WELL AS 15 WEEKS OF FRESH LOCAL PRODUCE DELIVERY DURING THE SUMMER. PARTICIPANTS ARE ALSO GIVEN NUTRITION EDUCATION AND HEALTHY RECIPES FOR THE PRODUCE THEY RECEIVE SO THAT THEY CAN CREATE INEXPENSIVE HEALTHY MEALS AT HOME. THE COMPONENTS OF THIS PROGRAM HAVE BEEN SHOWN TO ADDRESS THE FOLLOWING CHRONIC CONDITIONS: O OVERWEIGHT/OBESITY/HIGH BMI O DIABETES/UNCONTROLLED BLOOD SUGAR O HYPERTENSION, HEART DISEASE, HIGH CHOLESTEROL O ANXIETY &amp; DEPRESSION O CHRONIC PAIN/ARTHRITIS/JOINT PAIN O FOOD INSECURITY/LACK OF ACCESS TO HEALTHY, FRESH FOOD*LIFESTYLE MEDICINE IS A MEDICAL SPECIALTY THAT FOCUSES ON THE OPTIMIZATION OF MODIFIABLE RISK FACTORS TO PREVENT AND TREAT CHRONIC LIFESTYLE RELATED DISEASES, TO INCLUDE CARDIOVASCULAR DISEASE, METABOLIC SYNDROME AND ITS COMPONENTS, MANY COMMON CANCERS, AUTOIMMUNE DISEASES, MOOD DISORDERS, CHRONIC KIDNEY DISEASE, AND MANY OTHERS. THE 6 PILLARS OF LIFESTYLE MEDICINE AS DESCRIBED BY THE AMERICAN COLLEGE OF LIFESTYLE MEDICINE ARE NUTRITION (PLANT PREDOMINANT EATING PATTERN), PHYSICAL ACTIVITY, STRESS MANAGEMENT, RESTORATIVE SLEEP, MEANINGFUL RELATIONSHIPS, AND AVOIDANCE OF RISKY SUBSTANCES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SISTERSVILLE GENERAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 16J: APPLICATION IS ON THE BACK OF THE ACCOUNT STATEMENT MAILER. THE POPULATION SERVED BY THE HOSPITAL DOES NOT INCLUDE NON-ENGLISH SPEAKING POPULATIONS EXCEEDING 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY SERVED, SO TRANSLATIONS OF FINANCIAL ASSISTANCE DOCUMENTS HAVE NOT BEEN POSTED TO THE SYSTEM WEBSITE. HOWEVER, THE APPLICATION PLATFORM IS BROWSER-BASED, WHICH ALLOWS APPLICATIONS TO EASILY BE TRANSLATED INTO THE USER'S DESIRED LANGUAGE USING THE BROWSER'S INBUILT TRANSLATION FUNCTIONALITY.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SISTERSVILLE GENERAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 20E: NO EXTRAORDINARY COLLECTION ACTIONS WERE AUTHORIZED OR INITIATED.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, LINE 7A, CHNA REPORT WEBSITE:</FormAndLineReferenceDesc>
        <ExplanationTxt>HTTPS://WWW.MHSYSTEM.ORG/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE SYSTEM'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED 9/30/25 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENTS ARE ENCOURAGED BY THE FINANCIAL ADVOCATES TO COMPLETE A CHARITY APPLICATION AND THUS AVOID THE COLLECTION PROCEDURE. THIS IS WRITTEN ON THE PATIENT BILLING STATEMENT.FOR PATIENTS WHO QUALIFY FOR FULLY DISCOUNTED CARE, ANY QUALIFYING OUT-OF-POCKET COST IS ADJUSTED. PATIENTS WILL RECEIVE AN APPROVAL LETTER INDICATING THEIR QUALIFYING PERIOD AND BALANCE HAVE BEEN ADJUSTED.PATIENTS WHO QUALIFY FOR LESS THAN FULLY DISCOUNTED CARE (75% OR 80%) RECEIVE A BALANCE BILL, WITH THE OPTION TO PAY IN FULL OR ESTABLISH A PAYMENT PLAN FOR THE REMAINING BALANCE. PATIENTS RECEIVE AN APPROVAL LETTER INDICATING THEIR QUALIFYING PERIOD AND PROVIDING INFORMATION TO ADDRESS THEIR REMAINING BALANCE. COLLECTION PRACTICES FOR THIS POPULATION OF PATIENTS IS THE SAME AS FOR PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHNA IS THE METHOD BY WHICH THE HOSPITAL ASSESSES COMMUNITY HEALTH NEEDS.THIS ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWS FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY SISTERSVILLE GENERAL HOSPITAL AND PRC. THE STUDY AREA FOR THE SURVEY EFFORT (REFERRED TO AS THE "TOTAL SERVICE AREA" IN THIS REPORT) IS DEFINED AS EACH OF THE RESIDENTIAL ZIP CODES COMPRISING WETZEL, TYLER, AND PLEASANTS COUNTIES IN WEST VIRGINIA. THE SURVEY WAS ADMINISTERED AS AN ONLINE SURVEY. PRC HOSTED THE ONLINE SURVEY INSTRUMENT, AND SISTERSVILLE GENERAL HOSPITAL AND LOCAL PARTNERS USED A VARIETY OF COMMUNICATION TOOLS TO DRIVE RESIDENTS TO TAKE THE SURVEY ONLINE. EXAMPLES INCLUDE PRESS RELEASES, SOCIAL MEDIA ADVERTISING, POSTING ON ORGANIZATIONAL WEBSITES, AND EMAIL CAMPAIGNS TO COMMUNITY MEMBERS AND COMMUNITY PARTNERS. IN ALL, A TOTAL OF 201 SURVEYS IN THE TOTAL SERVICE AREA WERE ACHIEVED.TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY ALSO WAS IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY SISTERSVILLE GENERAL HOSPITAL; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 10 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>IN ORDER TO INFORM PATIENTS ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE, THE HOSPITAL HAS TAKEN THE FOLLOWING ACTIONS:- SIGNS ARE POSTED WITHIN THE HOSPITAL- A QUESTIONNAIRE REGARDING FINANCIAL ASSISTANCE IS ADMINISTERED DURING PRE-REGISTRATION- INDIVIDUALS ARE OFFERED A COPY OF THE FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTS- THE FINANCIAL ASSISTANCE PROGRAM IS PRINTED ON THE BACK OF BILLING STATEMENTS- A THIRD PARTY CONSULTS WITH PATIENTS PRIOR TO PATIENTS' EXIT FROM THE HOSPITAL REGARDING THEIR ELIGIBILITY</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>TYLER COUNTY HAS A SIGNIFICANT SENIOR POPULATION AND HIGH POVERTY LEVEL. THE PER CAPITA INCOME IN TYLER COUNTY IS LOWER THAN THE STATE MEDIAN, AND 18.4% OF THE OVERALL COUNTY POPULATION IS BELOW THE POVERTY LINE. OF THE CHILDREN IN TYLER COUNTY, 25.8% LIVE IN POVERTY. IN THE COUNTY, 4.9% OF THE RESIDENTS LACK HEALTH INSURANCE. TYLER COUNTY HAS A HIGHER RATE OF OBESITY THAN THE STATE OR NATION. THERE IS A 28.9% OF THE POPULATION THAT SELF-REPORTS A FAIR/POOR HEALTH STATUS COMPARED TO INDIVIDUALS ACROSS THE STATE/NATION. THE COUNTY HAS A HIGH RATE FOR CANCER, INCLUDING FEMALE BREAST CANCER AND PROSTATE CANCER THAN FOR THE STATE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>WE ENHANCE THE QUALITY OF LIFE IN THE AREA. WE NURTURE AND CARE FOR OUR COMMUNITY BY CARING FOR YOU, YOUR FRIENDS, NEIGHBORS AND RELATIVES 24 HOURS A DAY, SEVEN DAYS A WEEK, 365 DAYS A YEAR. WE ARE QUALITY - WITH ACCREDITATIONS, CERTIFICATIONS AND DESIGNATIONS TO EXPRESS, UTILIZE AND DEMONSTRATE OUR EXPERTISE. WE ARE PART OF A SYSTEM THAT EXTENDS ACCESS TO SPECIALISTS AND NATIONALLY RECOGNIZED CARE. WE ARE A PILLAR IN THIS COMMUNITY WITH ROOTS FIRMLY PLANTED IN THE REGIONS WE SERVE. WE ARE AT YOUR DOORSTEP, WITH PROGRAMS AND EDUCATIONAL INFORMATION THAT PROMOTE GOOD HEALTH AND DISEASE PREVENTION. WE ARE VOLUNTEERS AT LOCAL COMMUNITY EVENTS. WE ARE ADVOCATES FOR SUPERIOR HEALTH CARE SYSTEMS. WE ARE TEACHERS, TRAINING FUTURE HEALTH CARE PROFESSIONALS. WE ARE COMPASSIONATE, CARING AND DEDICATED TO CREATING A HEALTH CARE SETTING IN WHICH QUALITY OF LIFE AND SERVICE EXCELLENCE ARE EXPERIENCED BY OUR PATIENTS THEIR FAMILIES, THE MEDICAL STAFF AND THE COMMUNITY. WE ARE SISTERSVILLE GENERAL HOSPITAL.DURING THE TWELEVE MONTH ENDING SEPTEMBER 30, 2025, THE HOSPITAL PROVIDED 1,057 INPATIENT CARE DAYS, 74 DAYS OF OBSERVATION CARE, 7,760 DAYS OF HOSPICE CARE, 9,926 PHYSICAL THERAPY PROCEDURES, 4,952 EMERGENCY VISITS AND 8,427 IMAGING PROCEDURES. SISTERSVILLE BELIEVES IN MORE THAN PROVIDING THE BEST LOCAL HEALTHCARE. WE BELIVE IN INVESTING IN OUR COMMUNITY, SUPPORTING OUR NEIGHBORS, OUR FAMILIES, AND FRIENDS. OUR COMMITMENT IS TRULY TO OUR COMMUNITY - AS AN EMPLOYER, AS A CORPORATE CITIZEN AND AS A COMMUNITY RESOURCES AND AS A HEALTHCARE PROVIDER. TO THAT END, THE HOSPITAL, ITS PHYSICIANS, STAFF, AND VOLUNTEERS EXTEND THEMSELVES WELL BEYOND PATIENT CARE. WE PROVIDE COMMUNITY CLINICAL SUPPORT SERVICES, WELLNESS EDUCATION, PROGRAMS, SUPPORT GROUPS, FINANCIAL SUPPORT TO LOCAL ORGANIZATIONS, AND OUR OWN PERSONAL TIME TO OUR COMMUNITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>MARIETTA MEMORIAL HOSPITAL OF TYLER COUNTY, DBA SISTERSVILLE GENERAL HOSPITAL, IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. AFFILIATED ORGANIZATIONS, AND THEIR ROLES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED, ARE AS FOLLOWS:MARIETTA AREA HEALTH CARE, INC. - PARENT ORGANIZATION.MARIETTA MEMORIAL HOSPITAL - MMH IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL WHERE SERVICE EXCELLENCE AND CLINICAL QUALITY CREATE THE REGION'S BEST EXPERIENCE FOR PATIENTS AND THEIR FAMILIES, PHYSICIANS, THE COMMUNITY, AND MMH EMPLOYEES.MARIETTA HEALTHCARE PHYSICIANS, INC. - FORMED BY MARIETTA MEMORIAL HOSPITAL TO FURTHER ITS SECTION 501(C)(3) CHARITABLE PURPOSES. MHCPI PARTICIPATES IN MEDICARE AND MEDICAID, AND SERVICES ARE PROVIDED TO PATIENTS WITHOUT DISCRIMINATION AS TO ABILITY TO PAY.SELBY GENERAL HOSPITAL - SELBY GENERAL HOSPITAL IS A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL WHERE SERVICE EXCELLENCE AND CLINICAL QUALITY CREATE THE REGION'S BEST EXPERIENCE FOR PATIENTS AND THEIR FAMILIES, PHYSICIANS, THE COMMUNITY, AND SELBY GENERAL HOSPITAL'S EMPLOYEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>OH,WV</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7F</FormAndLineReferenceDesc>
        <ExplanationTxt>$1,870,157 OF BAD DEBT EXPENSE WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25; BUT WAS EXCLUDED IN CALCULATING COMMUNITY BENEFIT EXPENSE FOR SCHEDULE H, LINE 7. COMMUNITY BENEFIT EXPENSES WERE CALCULATED USING COST REPORTS FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025.</ExplanationTxt>
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        <NontaxableBenefitsRltdOrgsAmt>197</NontaxableBenefitsRltdOrgsAmt>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE COMMITTEE SHALL HAVE ALL THE POWERS AND DUTIES OF THE BOARD OF DIRECTORS IN THE INTERIM BETWEEN MEETINGS OF THE LATTER, EXCEPT AS LIMITED BY THIS CODE OF REGULATIONS OR BY SPECIFIC INSTRUCTION OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL NOT HAVE POWER TO ELECT DIRECTORS. A SUMMARY OF THE PROCEEDINGS OF THE EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE BOARD AT ITS NEXT MEETING. THE EXECUTIVE COMMITTEE SHALL MAINTAIN THE COMPENSATION COMMITTEE AND NOMINATING COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE CORPORATE INTEGRITY COMMITTEE. THE SCOPE OF THIS POLICY INCLUDES THE DIRECTORS, OFFICERS AND SENIOR EXECUTIVES. THE PURPOSE OF THE POLICY IS TO PROTECT THE HOSPITAL'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN INTERESTED OFFICER, DIRECTOR OR PERSON. ANY CONFLICT RESULTING IN INELIGIBILITY FOR OR REMOVAL FROM THE BOARD OR SPECIFIC COMMITTEES INCLUDE THE FOLLOWING: A. REPEATED, INTENTIONAL FAILURE TO DISCLOSE A CONFLICT OF INTEREST. B. HAVING A FAMILY MEMBER WHO IS A SENIOR EXECUTIVE FOR THE HOSPITAL. C. A MATERIAL INVESTMENT OR EMPLOYMENT RELATIONSHIP INVOLVING AN INTERESTED PERSON IN AN ASC, A PROPRIETARY HOSPITAL, OR NURSING FACILITY WITHIN THE HOSPITAL'S SERVICE AREA THAT IS NOT OWNED BY THE HOSPITAL. ANNUAL DISCLOSURES ARE REQUIRED SETTING FORTH ALL BUSINESS AND OTHER AFFILIATIONS, WHICH RELATE IN ANY WAY TO THE HOSPITAL. THE COMMITTEE RECOMMENDS THE DISQUALIFICATION OR REMOVAL OF INTERESTED PERSONS WHEN NECESSARY AND REPORTS TO THE BOARD THOSE DIRECTORS WHICH THE COMMITTEE HAS DETERMINED MEET THE DEFINITION OF INDEPENDENT DIRECTOR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION COMMITTEE REVIEWS FAIR MARKET WAGE DATA. SPECIFIC APPROVAL OF BOARD MUST BE SOUGHT IF PHYSICIAN COMPENSATION IS 75% OR GREATER OF MEDIAN IN THE ANNUAL MGMA STUDY. EXECUTIVE AND ALL OTHER HOSPITAL STAFF COMPENSATION IS SET AT MEDIAN. AN EXECUTIVE COMPENSATION FIRM IS UTILIZED (YAFFE &amp; COMPANY). A SEPARATE INDEPENDENT CONSULTANT (VMG) IS RETAINED FOR PHYSICIAN COMPENSATION STUDIES AS NEEDED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE DOCUMENTS CAN BE VIEWED IN THE ADMINISTRATION OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 460,993. MANAGEMENT AND GENERAL EXPENSES 499,409. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 960,402. MAINTENANCE CONTRACT FEES: PROGRAM SERVICE EXPENSES 71,843. MANAGEMENT AND GENERAL EXPENSES 77,830. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 149,673. CATERING AND FOOD SERVICE FEES: PROGRAM SERVICE EXPENSES 52,712. MANAGEMENT AND GENERAL EXPENSES 57,105. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 109,817. COLLECTION FEES: PROGRAM SERVICE EXPENSES 100,738. MANAGEMENT AND GENERAL EXPENSES 109,133. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 209,871. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,006,170. MANAGEMENT AND GENERAL EXPENSES 4,335,962. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,342,132.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS IS THE SAME AS AT MARIETTA MEMORIAL HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>MARIETTA AREA HEALTH CARE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 MATTHEW STREET</AddressLine1Txt>
          <CityNm>MARIETTA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
        </USAddress>
        <EIN>311126451</EIN>
        <PrimaryActivitiesTxt>MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MARIETTA HEALTHCARE PHYSICIANS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>401 MATTHEW STREET</AddressLine1Txt>
          <CityNm>MARIETTA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
        </USAddress>
        <EIN>311375125</EIN>
        <PrimaryActivitiesTxt>PHYSICIAN GROUP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MARIETTA AREA HEALTH CARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>MARIETTA MEMORIAL HEALTH FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>406 COLEGATE DR</AddressLine1Txt>
          <CityNm>MARIETTA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
        </USAddress>
        <EIN>311011321</EIN>
        <PrimaryActivitiesTxt>SUPPORTING ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MARIETTA AREA HEALTH CARE INC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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          <BusinessNameLine1Txt>MARIETTA MEMORIAL HOSPITAL</BusinessNameLine1Txt>
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          <AddressLine1Txt>401 MATTHEW STREET</AddressLine1Txt>
          <CityNm>MARIETTA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
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        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MARIETTA AREA HEALTH CARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SELBY GENERAL HOSPITAL</BusinessNameLine1Txt>
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          <AddressLine1Txt>1106 COLEGATE DR</AddressLine1Txt>
          <CityNm>MARIETTA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
        </USAddress>
        <EIN>314413259</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MARIETTA AREA HEALTH CARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MARIETTA OCCUPATIONAL HEALTH PARTNERS LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>401 MATTHEW ST</AddressLine1Txt>
          <CityNm>MARIETTA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
        </USAddress>
        <EIN>043587132</EIN>
        <PrimaryActivitiesTxt>OCCUPATIONAL HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MARIETTA SURGERY CENTER LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>611 2ND ST</AddressLine1Txt>
          <CityNm>MARIETTA</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45750</ZIPCd>
        </USAddress>
        <EIN>311684367</EIN>
        <PrimaryActivitiesTxt>SURGERY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
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      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
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      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
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</Return>