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      <Desc>THE MISSION OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. IS TO SERVE THE PEOPLE OF A MULTI-COUNTY SERVICE AREA IN REFERENCE TO THEIR CURRENT AND FUTURE NEEDS FOR HEALTH CARE SERVICES. IN FURTHERANCE OF THIS MISSION, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. PROVIDES QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. DURING 2023, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. ADMITTED APPROXIMATELY 11,829 PATIENTS FOR IN-PATIENT SERVICES REPRESENTING 48,362 PATIENT DAYS; 622 BIRTHS REPRESENTING 1,274 NEWBORN PATIENT DAYS AND PERFORMED APPROXIMATELY 1,755 IN-PATIENT SURGERIES. IN ADDITION, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. RECEIVED 325,561 OUT-PATIENT ENCOUNTERS FOR NON-EMERGENCY DIAGNOSTIC AND TREATMENT SERVICES INCLUDING 10,717 AMBULATORY SURGERIES AND 19,877 HOME HEALTH ENCOUNTERS. REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. OFFERS EMERGENCY SERVICES 24 HOURS PER DAY, 365 DAYS EACH YEAR. IN 2023, 58,803 PATIENTS WERE TREATED THROUGH EMERGENCY SERVICES. IN KEEPING WITH REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S COMMITMENT TO SERVE ALL MEMBERS OF OUR MULTI-COUNTY SERVICE AREA, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. PROVIDES HEALTHCARE TO THE ELDERLY AND DISABLED COVERED UNDER MEDICARE AND MEDICAID PROGRAMS AT OR BELOW COST. IN ADDITION, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. HAS ESTABLISHED A FINANCIAL ASSISTANCE POLICY FOR THE POOR WHO DO NOT HAVE THE MEANS TO PAY FOR SERVICES. FOR 2023, FINANCIAL ASSISTANCE FOR THE POOR WAS $6.1 MILLION. TO ENSURE MEMBERS OF OUR SERVICE COMMUNITY HAVE ADEQUATE ACCESS AND RESOURCES AVAILABLE TO MEET THEIR HEALTHCARE NEEDS, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. HAS UNDERTAKEN A DELIBERATE PHYSICIAN RECRUITMENT PROGRAM CONSISTENT WITH IRS GUIDANCE. THIS PROGRAM PROVIDES ASSURANCE THAT OUR SERVICE COMMUNITY HAS ADEQUATE AND QUALIFIED PHYSICIAN RESOURCES COVERING VARIETY OF SPECIALTY AREAS. THE COST OF FUNDING THIS RECRUITMENT EFFORT WAS $1,543,933 FOR 2023. IN ADDITION, REID HOSPITAL &amp; HEALTHCARE SERVICES, INC. IS COMMITTED TO INITIATING, PARTICIPATING IN, OR COOPERATIVELY SUPPORTING COMMUNITY EFFORTS THAT ENHANCE THE GENERAL HEALTH STATUS, WELL-BEING AND TOTAL QUALITY OF LIFE IN OUR SERVICE COMMUNITY.</Desc>
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      <OtherRevenueMiscGrp>
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        <TotalRevenueColumnAmt>3503993</TotalRevenueColumnAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>298922</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>6211005</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1413951</ManagementAndGeneralAmt>
        <FundraisingAmt>9152</FundraisingAmt>
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        <ManagementAndGeneralAmt>87690</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>4979103</ProgramServicesAmt>
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      <OtherEmployeeBenefitsGrp>
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        <FundraisingAmt>25935</FundraisingAmt>
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      <PayrollTaxesGrp>
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        <ProgramServicesAmt>9081604</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2067450</ManagementAndGeneralAmt>
        <FundraisingAmt>13382</FundraisingAmt>
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        <ProgramServicesAmt>500896</ProgramServicesAmt>
        <ManagementAndGeneralAmt>110267</ManagementAndGeneralAmt>
        <FundraisingAmt>1556</FundraisingAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>59618</ManagementAndGeneralAmt>
        <FundraisingAmt>841</FundraisingAmt>
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      <TravelGrp>
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        <ManagementAndGeneralAmt>41296</ManagementAndGeneralAmt>
        <FundraisingAmt>86</FundraisingAmt>
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      <ConferencesMeetingsGrp>
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        <ManagementAndGeneralAmt>276489</ManagementAndGeneralAmt>
        <FundraisingAmt>577</FundraisingAmt>
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        <ProgramServicesAmt>90856956</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6121482</ManagementAndGeneralAmt>
        <FundraisingAmt>12779</FundraisingAmt>
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      <OtherExpensesGrp>
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        <FundraisingAmt>0</FundraisingAmt>
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        <ManagementAndGeneralAmt>1000131</ManagementAndGeneralAmt>
        <FundraisingAmt>2088</FundraisingAmt>
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        <ProgramServicesAmt>25311853</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1705385</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>70221604</ManagementAndGeneralAmt>
        <FundraisingAmt>527843</FundraisingAmt>
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        <EOYAmt>554</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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      <LoansFromOfficersDirectorsGrp>
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        <EOYAmt>10185997</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>396809317</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
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        <EOYAmt>1194471887</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>20665270</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>1159600234</BOYAmt>
        <EOYAmt>1215137157</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>1549441015</BOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
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      <NetUnrlzdGainsLossesInvstAmt>42100846</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>3726454</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
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        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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      <HospitalInd>X</HospitalInd>
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      <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>
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        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>true</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>true</DirectContactLegislatorsInd>
      <DirectContactLegislatorsAmt>1000</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>20000</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>21000</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule C, Part II-B, Line 1g LOBBYING ACTIVITIES BY PAID STAFF</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING THE YEAR, SEVERAL LETTERS WERE WRITTEN TO STATE REPRESENTATIVES EXPLAINING THE IMPACT OF SPECIFIC LEGISLATION TO REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. THE ESTIMATED AMOUNT EXPENDED BY THE ORGANIZATION WAS $1,000. THIS AMOUNT REFLECTS AN ESTIMATE OF LABOR COST FOR THIS ACTIVITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY</FormAndLineReferenceDesc>
        <ExplanationTxt>REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. IS A MEMBER OF CERTAIN TRADE ORGANIZATIONS WHICH ENGAGE IN LOBBYING ACTIVITIES. THIS AMOUNT REFLECTS THE PORTION OF THE DUES USED FOR SUCH ACTIVITIES.</ExplanationTxt>
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        <EndYearBalanceAmt>165793</EndYearBalanceAmt>
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        <BeginningYearBalanceAmt>165793</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>165793</EndYearBalanceAmt>
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      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>165793</BeginningYearBalanceAmt>
        <EndYearBalanceAmt>165793</EndYearBalanceAmt>
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      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>true</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>true</RelatedOrgListSchRInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>20607391</OtherCostOrOtherBasisAmt>
        <BookValueAmt>20607391</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>239874721</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>127864637</DepreciationAmt>
        <BookValueAmt>112010084</BookValueAmt>
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      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>13645110</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>10063115</DepreciationAmt>
        <BookValueAmt>3581995</BookValueAmt>
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      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>359525110</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>280214457</DepreciationAmt>
        <BookValueAmt>79310653</BookValueAmt>
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      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>84820286</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>48209855</DepreciationAmt>
        <BookValueAmt>36610431</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>252120554</TotalBookValueLandBuildingsAmt>
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        <Desc>SAVILLE ROW</Desc>
        <BookValueAmt>208326</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>ENTRUST CAPITAL DIVERSIFIED FUND</Desc>
        <BookValueAmt>37991</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>PRIVATE ADVISORS</Desc>
        <BookValueAmt>9081529</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>WHITE OAK PINNACLE</Desc>
        <BookValueAmt>3402221</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>SCHRODER FOCUS</Desc>
        <BookValueAmt>3905616</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>VINTAGE</Desc>
        <BookValueAmt>4823665</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>NORTHERN TRUST CO OPP</Desc>
        <BookValueAmt>5604067</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>VANGUARD INST ADVISORY</Desc>
        <BookValueAmt>352658108</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>TIAA</Desc>
        <BookValueAmt>466722</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>US BANK SERIES 2022A PROJECT</Desc>
        <BookValueAmt>106732565</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>CORE PROPERTY INDEX FUND</Desc>
        <BookValueAmt>12922561</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>HARBOURVEST</Desc>
        <BookValueAmt>1719219</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>US BANK DISTRIBUTION ACCT</Desc>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>MORGAN STANLEY SMITH BARNEY</Desc>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>501562590</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>EST THIRD PARTY SETTLEMENTS</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITY</Desc>
        <Amt>7310553</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>10185997</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part V, Line 4 Intended uses of endowment funds</FormAndLineReferenceDesc>
        <ExplanationTxt>AT DECEMBER 31, 2023 AND 2022, THE REID HOSPITAL &amp; HEALTH CARE SERVICES FOUNDATION HAD PERMANENTLY RESTRICTED NET ASSETS OF $165,793 AND $165,793, RESPECTIVELY. THE INCOME FROM THIS FUND IS EXPENDABLE TO SUPPORT THE ACUTE REHABILITATION UNIT AND THE SPEECH, OUTPATIENT, AND PHYSICAL THERAPY SERVICES FOR REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. THESE NET ASSETS HAVE BEEN CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OF DONOR-IMPOSED RESTRICTIONS IN ACCORDANCE WITH ACCOUNTING STANDARDS AND THE PROVISIONS OF THE STATE OF INDIANA ENACTED VERSION OF THE UNIFORM PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <ExplanationTxt>REID HOSPITAL &amp; HEALTHCARE SERVICES (HOSPITAL), REID PHYSICIAN ASSOCIATES (RHPA), AND REID HEALTH AMBULANCE (RHA) HAVE BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THESE ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. REID OUTPATIENT SURGERY AND ENDOSCOPY, LLC, REID ANESTHESIA, LLC, CONNERSVILLE PHARMACY, LLC, REID HEALTH PROPERTIES, LLC AND SOUTH 37TH STREET PROPERTIES, LLC ARE NOT DIRECTLY SUBJECT TO INCOME TAXES UNDER THE PROVISIONS OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE LAWS. TAXABLE INCOME OR LOSS IS ALLOCATED TO ITS MEMBERS IN ACCORDANCE WITH THEIR RESPECTIVE PERCENTAGE OWNERSHIP FOR INCLUSION IN THEIR RESPECTIVE TAX RETURNS. THE HOSPITAL AND ITS CONTROLLED SUBSIDIARIES FILE TAX RETURNS IN THE U.S. FEDERAL JURISDICTION.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 5 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - REID HOSPITAL &amp; HEALTHCARE SERVICES. CHNA COMMUNITY INPUT To ensure the perspectives of community members were considered, input was collected from residents of the community served by Reid Health. Primary data used in this assessment consisted of key informant interviews, focus group discussions, and an online community survey. Community Survey Reid Health gathered community input from an online survey to inform its Community Health Needs Assessment. The survey was promoted across the eight primary counties served by Reid Health: Wayne, Randolph, Fayette, Union, Franklin, and Henry counties in Indiana, and Preble and Darke counties in Ohio. Responses were collected from April 11, 2022, to May 13, 2022. Both an English and Spanish version of the survey were made available. A paper survey was also developed and distributed. The survey consisted of 42 questions related to top health needs in the community, individuals' perception of their overall health, individuals' access to health care services, as well as social and economic determinants of health. Survey marketing and outreach efforts included distribution of flyers at community events and coalitions, email invitations, social media and other marketing efforts through Reid Health and its partner organizations. A total of 1,051 responses were collected for the entire survey target area, which included all eight counties: Wayne, Randolph, Fayette, Union, Franklin, and Henry counties in Indiana, and Preble and Darke counties in Ohio. Qualitative Data: Key Informant Interviews &amp; Focus Group Discussions Twenty- Five key informant interviews and five focus group discussions were conducted to gain a deeper understanding of health issues impacting the residents of the community served by Reid Health. Community members invited to participate were recognized as having expertise in public health, special knowledge of community health needs, representing the broad interests of the community served by the hospital, and/or being able to speak to the needs of medically underserved or vulnerable populations. A total of 17 different organizations participated in the process, including the local health department, social service organizations, local businesses, and representatives from the education sector. These discussions took place between April 2022 and May 2022. Each of 25 key informant interview discussions were conducted virtually by phone. There were 5 focus groups. 1 for Preble and Darke county held in Preble County, 1 for Fayette, Union, and Franklin counties held in Fayette County, 1 for Randolph County held in Randolph county, 1 for Wayne County held in Wayne county, and 1 for Henry county and additional Wayne county representation that was held in Wayne county, and 1 for Henry county and additional Wayne county representation that was held in Wayne county. A questionnaire was developed to guide each interview and focus group discussions. Discussions on topics included the (1) biggest perceived health needs in the community, (2) barriers of concern, and (3) the impact of health issues on vulnerable populations. Interviewees were also asked about their knowledge around health topics where there were data gaps in the secondary data. Additionally, questions were included to get feedback about the impact of COVID-19 on the community.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility , 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 1 - REID HOSPITAL &amp; HEALTHCARE SERVICES. COMMUNITY HEALTH NEEDS THE FOLLOWING COMMUNITY HEALTH NEEDS, IDENTIFIED IN REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, WERE ADDRESSED IN AN IMPLEMENTATION STRATEGY TO ADDRESS EACH COMMUNITY HEALTH NEED IDENTIFIED AND EXECUTING THE STRATEGY. A COMMUNITY BENEFIT SECTION IS INCLUDED WITHIN OPERATIONAL PLANS AND MONITORED BY THE CONTINUUM OF CARE COMMITTEE. PROVISIONS ARE BUDGETED EACH YEAR FOR SERVICES THAT ADDRESS THE IDENTIFIED NEEDS. THROUGH AN ANALYSIS OF THE PRIMARY AND SECONDARY DATA THE FOLLOWING prioritized HEALTH NEEDS WERE DETERMINED: 1. Mental Health &amp; Mental Disorders 2. Children's Health 3. Substance Misuse 4. Maternal, Fetal &amp; Infant Health 5. Weight Status/Physical Activity/Nutrition 6. Education 7. Health Care Access &amp; Quality, including Transportation 8. Support for Families with Children 9. Diabetes 10. Older Adults 11. Heart Disease &amp; Stroke An invitation to participate in the Reid Health CHNA data synthesis presentation and in-person prioritization activity was sent out in the weeks preceding the meeting held on July 21st, 2022. a total of 22 individuals representing local law enforcement, education, veteran services, health and fitness organizations, senior services, health clinics, and community mental health centers attended this in person presentation and of those fifteen completed the online prioritization activity. During the July 21st meeting, the group reviewed and discussed the results of HCI's primary and secondary data analyses leading to the significant health needs shown in Figure 1. A one-page handout called a "Prioritization Cheat Sheet" (see Appendix F) was provided to participants to support the prioritization activity. From there, participants were given time to access an online link and assign a score to each of the significant health needs based on how well they met the criteria set forth by the hospital. The group also agreed that root causes, disparities, and social determinants of health would be considered for all prioritized health topics resulting from the online prioritization activity. The criteria for prioritization included: 1. Magnitude of the Issue 2. Ability to Impact Participants assigned a score of 1-3 to each health topic and criterion, with a higher score indicating a greater need for that topic to be prioritized. For example, participants assigned a score of 1-3 to each topic based on whether the magnitude was (1) least concerning, (2) somewhat concerning or (3) most concerning. Along a similar line, participants assigned a score of 1-3 to each topic based on (1) least ability to impact (2) some ability to impact or (3) most ability to impact. In addition to considering the data presented by HCI in the presentation and on the prioritization cheat sheet, participants were encouraged to use their own judgment and knowledge of the community in considering how well a health topic met the criteria. Completion of the online exercise resulted in a numerical score for each health topic and criterion. Numerical scores for the two criteria were equally weighted and averaged to produce an aggregate score and overall ranking for each health topic. The ranked order of significant health needs that resulted from the prioritization process were presented to Reid Health Community Well-Being Committee. The committee reviewed the scoring results of the online prioritization activity for Reid Health. While Weight Status, Physical Activity &amp; Nutrition did not score as high as Alcohol &amp; Drug Use and Mental Health &amp; Mental Disorders in the online prioritization activity for Reid Health, the committee ultimately decided to prioritize the three health needs that were identified as significant: Mental Health &amp; Substance Misuse, Physical Activity, Nutrition &amp; Weight Status and Maternal-Fetal &amp; Children's Health. A decision was made to combine the prioritized health areas of Substance Misuse with Mental Health &amp; Mental Disorders and Children's Health with Maternal-Fetal &amp; Infant Health resulting in a final selection of three priority health areas that will be considered for subsequent implementation planning. 1. Mental Health &amp; Substance Misuse 2. Physical Activity, Nutrition &amp; Weight 3. Maternal, Fetal &amp; Children's Health Mental Health &amp; Substance Misuse GOAL Promote mental, emotional, and behavioral well-being within the communities we serve by improving mental health and reducing substance misuse. OBJECTIVES 1. IMPROVE OVERALL MENTAL HEALTH WITHIN THE COMMUNITY 2. REDUCE THE INCIDENCE AND COMPLICATIONS OF SUBSTANCE MISUSE INDICATORS 1. AVERAGE NUMBER OF POOR MENTAL HEALTH DAYS 2. AGE-ADJUSTED DEATH RATE DUE TO SUICIDE 3. Depression among members of the Medicare population 4. Death rate due to drug poisoning 5. Adults who smoke 6. Age adjusted drug &amp; opioid overdose rates STRATEGIES INITIATIVES 1. Reduce stigma associated with mental health and substance misuse 2. Increase access to mental health and addiction services 3. Increase prevention of overdose 4. Build stronger partnerships to improve mental health and substance misuse NEW TACTICS 1. Create campaign to highlight real stories of people living in recovery 2. Identify ways to attract providers and reduce burnout 3. Increase access to support groups 4. Increase collaboration between Reid Health, Centerstone, Meridian Services and the schools 5. Expand programs, such as Connection Cafe, into other counties and communities 6. Explore opportunities to increase mental health services at senior centers 5. Strengthen partnerships between schools, workplaces, community organizations, and community health centers CONTINUING TACTICS 1. Continue MindWise mental health and substance misuse screenings 2. Program funding for support groups 3. Promote current services available 4. Continue depression screenings 5. Provide adult psychiatric care 6. Continue medication assisted treatment support 7. Continue support for drug free coalitions and similar groups 8. Program funding for support groups 9. Continue Narcan program 10. Continue Dispose of Rx Program 11. Program funding for support groups and grief groups 12. Continue support for Systems of Care and programs that encourage collaboration 13. Continue to share best practices among counties served in the region Maternal, Infant &amp; Children's Health GOAL Improve the health of children in our community by expanding support for families and reducing disparities related to children's health. OBJECTIVES 1. Promote health and resiliency in children and families. 2. Improve access to care and reduce disparities related to children's health. Indicators 1. Child abuse rate 2. Number of single parent households 3. Percentage of families living below poverty level 4. Number of mothers who smoke during pregnancy 5. Number of mothers who receive early prenatal care 6. Teen pregnancy rate STRATEGIES INITIATIVES 1. Provide more education for families on available resources 2. Increase engagement among pregnant mothers through collaborative programs 3. Strengthen children's programming and family engagement 4. Expand existing programs that support family resiliency NEW TACTICS 1. Investigate a one stop website/app for local resources material 2. Explore options to offer childbirth classes, Baby Care Basics programming remotely or in rural communities 3. Increase access to smoking cessation efforts for pregnant mothers 4. Expand Parent Cafes to additional communities 5. Work collaboratively to provide support for parent education 6. Develop an MOU for schools to follow up after Challenge Day 7. Expand access to bilingual material that support families 8. Explore a community wide 529 program for families CONTINUING TACTICS 1. Continue support for community programs that support maternal, infant, and children's health 2. Continue support of Community Baby Shower program 3. Continue support and collaboration with Meridian Services to provide The Nest 4. Continue to provide childbirth classes, prenatal classes and Baby Care Basics 5. Continue support of JACY House, Child Advocacy Center of Randolph County and similar programs 6. Continue support of Prevent Child Abuse Coalition 7. Continue support programs and expand mentoring programs 8. Continue partnerships with area non-profits that support family resiliency</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility , 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility , 2 - REID HOSPITAL &amp; HEALTHCARE SERVICES (CONTINUED). Physical Activity, Nutrition Weight GOAL Improve the health of the community by encouraging healthy choices and reducing the disparities related to activity and nutrition. OBJECTIVES 1. Increase physical activity and reduce obesity 2. Increase the availability of healthy foods within the community INDICATORS 1. Access to exercise opportunities 2. Adults 20+ who are obese 3. Adults 20+ who are sedentary 4. Child food insecurity rate 5. Food insecurity rate 6. Number of adults who frequently cook meals at home STRATEGIES INITIATIVES 1. Promote resources and programs that support physical activity 2. Increase access to fresh and nutritious foods 3. Encourage healthy eating and cooking 4. Encourage organizational partners hips that support physical activity, nutrition &amp; weight NEW TACTICS 1. Increase membership in Reid Healthier Club 2. Investigate creating a Reid Healthier Junior Club 3. Explore online fitness activities with support groups 4. Create community gardens 5. Create mobile markets 6. Explore expanding the "Harvest Your Health" type program to include others 7. Create school education campaign about healthy eating 8. Partner with organizations to provide nutrition community education 9. Incentivize healthy options among businesses 10. Partner with Reid Wellness to provide physical activity opportunities in the community 11. Improved walk ability/bike ability CONTINUING TACTICS 1. Continue partnerships with area parks departments and non-profits 2. Continue Baby Boomers Fight Club 3. Support of Healthworks 4. Lactation/breastfeeding support 5. Support of farmer's market 6. Meals for Providing meals for Third Grade Academy, holiday meals, Rock Solid meals 7. Continue support of Wayne County Food Council 8. Continue online healthy cooking classes 9. Support of cooking classes 10. Continue partnerships with non-profits, schools and faith-based communities 11. Partner with Reid depts on community outreach 12. Continue Wayne County Food Council 13. Support of Reid Healthier Club 14. Participation in City Fit and other community events 15. Circle U Holiday Meal support SIGNIFICANT HEALTH NEEDS NOT ADDRESSED IN AN EFFORT TO MAKE IMPROVEMENTS IN THE PRIORITIZED AREAS OF COMMUNITY HEALTH NEEDS, THERE ARE OTHER SIGNIFICANT NEEDS WHICH REID HEALTH WILL NOT ADDRESS THROUGH THE IMPLEMENTATION PLAN DUE TO RESOURCE CONSTRAINTS OR SCOPE OF SERVICES. THOSE INCLUDE THE FOLLOWING: Education While education will be impacted through our efforts to improve mental health and physical activity, nutrition, and weight, it will not be considered as a prioritized need. Reid Health will continue its ongoing efforts to support our youth and educational providers through the following activities: - Ongoing internship and shadowing opportunities - Support of school-based programs and activities - Providing training to faculty and staff - Support of the athletic trainer program - Providing Challenge Day to the schools - Providing support to school partners such as Boys &amp; Girls Club, YMCA, etc. - Providing marketing and communications support to allow schools to more effectively engage parents and partners. - Providing overall health education through Thriving Thursdays and Medical Mondays Economy This implementation plan will not include a focused effort on the economy in the communities served. Reid Health, as a healthcare organization, lacks expertise or competency to effectively address the economy as a community health need. Reid Health will continue to support efforts to improve the economy by: 1. Supporting local economic development efforts 2. Providing sponsorships to community organizations 3. Providing local students with internship and shadowing opportunities 4. Supporting and actively participating in area chambers and economic development organizations Diabetes This health need is largely impacted by initiatives supporting Physical Activity, Nutrition &amp; Weight. Reid Health will continue to support ongoing initiatives related to diabetes which include the following: 1. Diabetes support group 2. Community screenings 3. Diabetes and nutrition education Access to Care Reid Health will continue to support ongoing initiatives related to access to care which include the following: Insurance enrollment services 1. Charity care 2. Financial assistance 3. Reid Nurse Call line 4. Transition Coaching program 5. Support of lab processing for free clinics 6. Athletic training services 7. The Residency Program 8. Health care site development in rural communities Transportation This implementation plan will not include a focused effort on transportation in the communities served. Reid Health, as a healthcare organization, lacks the expertise or competency to address the community's need of transportation. Reid Health will continue to support the on-going initiatives related to transportation, which include the following: 1. Transportation program with Lifestream 2. Increasing telehealth options 3. Patient assistance fund 4. Reid EMS Heart Disease and Stroke This health need is largely impacted by initiatives supporting Physical Activity, Nutrition &amp; Weight. Reid Health will continue to support ongoing initiatives related to heart disease and stroke which include the following: 1. Community blood pressure machines 2. Blood pressure screenings 3. Let's Cook Together cooking classes Cardiovascular care 4. Stroke care 5. Stroke certification 6. Stroke support group Cancer While this implementation plan will not include a focused effort on cancer in the communities served. Reid Health will continue to support the ongoing initiatives related to cancer as a community health need, which will include the following: 1. Community Blood Drives 2. Support groups 3. Mammograms 4. Community screenings (PSA, oral cancer, etc.) 5. Oncology care Low Income and Underserved While the low income and underserved population will be impacted by our efforts to improve the prioritized needs, it will not be considered independently as a prioritized need. Reid Health will continue to support ongoing efforts to support low income and underserved populations through the following activities: 1. Patient Assistance Program 2. Farmer's market support for SNAP 3. Financial assistance programs 4. Car seat assistance program 5. Meal assistance programs at various locations 6. Insurance enrollment assistance</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>1</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>REID HEALTH CONNSERSVILLE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1941 VIRGINIA AVE</AddressLine1Txt>
            <CityNm>CONNERSVILLE</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>47331</ZIPCd>
          </USAddress>
          <FacilityTxt>ER &amp; OP FACILITY</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation</FormAndLineReferenceDesc>
        <ExplanationTxt>17835770</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNT REPORTED ON PART III, LINE 2 IS CALCULATED BASED ON TOTAL BAD DEBT EXPENSE BASED ON CHARGES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 3 Bad Debt Expense Methodology</FormAndLineReferenceDesc>
        <ExplanationTxt>AN ALLOCATION PERCENTAGE WAS CALCULATED USING FY2023 BAD DEBT EXPENSE AND BAD DEBT ATTRIBUTED TO PATIENTS UNDER THE FINANCIAL ASSISTANCE POLICY. THIS PERCENTAGE WAS THEN APPLIED TO FY2023 BAD DEBT EXPENSE TO CALCULATE THE AMOUNT REPORTED ON LINE 3.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 8 Community benefit &amp; methodology for determining medicare costs</FormAndLineReferenceDesc>
        <ExplanationTxt>REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE OUR MISSION IS TO PROMOTE QUALITY HEALTHCARE AND HEALTH EDUCATION IN OUR SERVICE COMMUNITY REGARDLESS OF ONE'S ABILITY TO PAY. WE DO NOT LIMIT THE CARE AVAILABLE TO ANY PATIENTS, INCLUDING THOSE COVERED UNDER THE MEDICARE PROGRAM. WE ARE RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE TO MEDICARE PATIENTS BELOW COST. TAX-EXEMPT HOSPITALS ARE EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>ANY INDICATION OF A PATIENTS INABILITY TO PAY FOR SERVICES IS TREATED AS A REQUEST FOR CHARITY CARE. THIS REQUEST CAN BE MADE BY, OR ON BEHALF OF AN INDIVIDUAL SEEKING SERVICE. REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ANY COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, THE ACCOUNT IS REFERRED BACK TO A COUNSELOR FOR ASSISTANCE AND REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16a FAP website</FormAndLineReferenceDesc>
        <ExplanationTxt>- REID HOSPITAL &amp; HEALTHCARE SERVICES: Line 16a URL: www.reidhealth.org/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16b FAP Application website</FormAndLineReferenceDesc>
        <ExplanationTxt>- REID HOSPITAL &amp; HEALTHCARE SERVICES: Line 16b URL: www.reidhealth.org/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16c FAP plain language summary website</FormAndLineReferenceDesc>
        <ExplanationTxt>- REID HOSPITAL &amp; HEALTHCARE SERVICES: Line 16c URL: www.reidhealth.org/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2 Needs assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>A NEEDS ASSESSMENT IS CONDUCTED EVERY 3 YEARS IN ACCORDANCE WITH STATE AND FEDERAL REQUIREMENTS. THE LAST NEEDS ASSESSMENT OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S SERVICE AREA WAS CONDUCTED IN 2022. THE RESULTS OF THE NEEDS ASSESSMENT ARE POSTED ON REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S WEBSITE SO THAT COMMUNITY MEMBERS AND ORGANIZATIONS MAY USE THE INFORMATION AS NEEDED. FORMAL AND INFORMAL MEETINGS ARE WITH COMMUNITY STAKEHOLDERS TO SEEK THEIR INPUT ON THE RESULTS. HEALTHY COMMUNITIES INSTITUTE CONDUCTED THE NEEDS ASSESSMENT AND PROVIDED A COMPARISON TO THE 2019 NEEDS ASSESSMENT RESULTS. THE NEXT NEEDS ASSESSMENT WILL BE CONDUCTED IN 2025 AND WILL COMPLY WITH ALL REQUIREMENTS FOR COMMUNITY HEALTH NEEDS ASSESSMENTS UNDER THE AFFORDABLE CARE ACT AND CORRESPONDING REGULATIONS. IN ADDITION, ALL INDEPENDENT AND NON-INDEPENDENT VOTING MEMBERS OF THE BOARD ARE REQUIRED TO RESIDE WITHIN REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S SERVICE AREA. THE DISTINCTION IS IMPORTANT BECAUSE THEY ARE INVOLVED AND BETTER AWARE OF THE HEALTH NEEDS OF THE COMMUNITY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SERVES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3 Patient education of eligibility for assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. STAFF INFORMS ALL PATIENTS, AS THEY ARE ADMITTED, OF THE VARIOUS ASSISTANCE PROGRAMS AVAILABLE TO HELP THEM PAY THEIR BILL. WE HAVE COMMUNITY EDUCATION INITIATIVES (THAT INCLUDE THE DISTRIBUTION OF FLYERS AND CARDS IN PUBLIC PLACES, INSERTS IN BILLS, AND FLYERS FOR CHURCHES THAT PROMOTE THE PATIENT ADVOCATE PROGRAM) ASKING PEOPLE TO CONTACT A PATIENT ADVOCATE IF THEY, OR A LOVED ONE, DOES NOT HAVE HEALTH COVERAGE. REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. USES TARGETED ADVERTISEMENTS IN AN EFFORT TO REACH PEOPLE BEFORE THEY ARE IN NEED OF CARE AND TO CONNECT THEM WITH OUR PATIENT ADVOCATES TO HELP DETERMINE ELIGIBILITY FOR INSURANCE COVERAGE. WE HAVE CONTRACTED WITH A THIRD PARTY VENDOR THAT SPECIALIZES IN HELPING PEOPLE WITH THE APPLICATION PROCESS FOR VARIOUS PROGRAMS. IN ADDITION, WE PROVIDE INFORMATION ABOUT FINANCIAL ASSISTANCE IN OUR MONTHLY STATEMENTS. WE CURRENTLY PROMOTE FREE SCREENING SERVICES DIRECTED TO SELF PAY PATIENTS. THOSE WHO RESPOND MAKE AN APPOINTMENT WITH OUR PATIENT ADVOCATES THEN RECEIVE THEIR FREE WELLNESS LAB TEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4 Community information</FormAndLineReferenceDesc>
        <ExplanationTxt>REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SERVES FIVE (5) COUNTIES IN INDIANA (WAYNE, UNION, RANDOLPH, HENRY, FRANKLIN AND FAYETTE) AND TWO (2) COUNTIES IN OHIO (PREBLE AND DARKE)(SERVICE AREA). THE DEMOGRAPHICS OF A COMMUNITY SIGNIFICANTLY IMPACT ITS HEALTH PROFILE. DIFFERENT RACE/ETHNIC, AGE, AND SOCIOECONOMIC GROUPS MAY HAVE UNIQUE NEEDS AND REQUIRE VARIED APPROACHES TO HEALTH IMPROVEMENT EFFORTS. ALL DEMOGRAPHIC ESTIMATES ARE SOURCED FROM THE U.S. CENSUS BUREAU'S 2013-2017 AMERICAN COMMUNITY SURVEY UNLESS OTHERWISE INDICATED. Population According to the 2019 U.S. Census Bureau population estimates, the Reid Health service area has an estimated population of 283,430. This represents a slight decline from the 285,267 estimated in the 2013-2017 American Community Survey. Age Most of the population in Reid Health's service area falls between the ages of 25-64 years (3%). The area has fewer individuals within the age groups of birth to 19 years of age (24.7%) and 20 to 44 (28.6%) years of age than both the Indiana and Ohio averages. Reid's service area demonstrated a higher percentage of individuals older than 45 years (46.7%) than the state averages. Race AND Ethnicity The racial makeup of the Reid Health service area shows 94.4% of the population identify as White. Nearly a 1% decline since the last CHNA, this percentage remains significantly higher than overall averages in Indiana (84.8%) and Ohio (81.7%). Hispanic community members represent 2.3% of the Reid Health service area, which is lower than the percent of Hispanic community members in the states of Indiana (7.3%) and Ohio (4%). Income Within Reid Health's service area, only Franklin County ($68,180) maintains a median household income above the national value (67,521). Fayette ($47,465) and Wayne (4 counties of Indiana demonstrated the lowest values of median household income are well below the state median household income of $58,235. Preble County ($61,339) is slightly higher than the Ohio average of $58,116, while Darke County falls short at $54,799. Poverty Overall, 9.5% of families in the Reid Health Service Area live below the poverty level, which is higher than the Indiana state value of 8.9% and slightly lower than the Ohio state value of 9.6%. In several areas of Reid's service region, the poverty rate is well above the state average. For example, Richmond, Indiana's poverty level is 14.9% and Connersville, Indiana's level is 13.8%. West Manchester, Ohio's rate is 19.8%. The highest poverty level in the region is Bath, Indiana with 100%. Unemployment Of the counties in Reid's service area, Franklin County, Indiana has the highest workforce participation rate at 64.2%. It's the only county in Reid's service area that exceeds the national rate of 62.1%. The lowest labor participation rate in the service area belongs to Henry County, Indiana at 50.7% which followed by Fayette County (55%) and Wayne County (57.6%). The overall participation rate for Reid's service area is 57.8%. Education Three counties in Reid's service area reported an amount lower than the 88.5% national average for earning a high school degree or higher, for those age 25 years and older. Henry County, Indiana was the only County in Reid's service area to report a higher percentage than the county's respective state average.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5 Promotion of community health</FormAndLineReferenceDesc>
        <ExplanationTxt>REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SERVES AS A CORNERSTONE FOR THE COMMUNITY BY PROVIDING MANY AREAS OF OUTREACH AND COMMUNITY SERVICE. EXEMPT EMPLOYEES SERVE ON LOCAL BOARDS SUCH AS THE BOYS AND GIRLS CLUB, GIRLS, INC., UNITED WAY, ACHIEVA RESOURCES, THE CHAMBER OF COMMERCE, COMMUNITIES IN SCHOOLS, BIRTH TO FIVE, HEADSTART HEALTH AND EDUCATION ADVISORY COUNCIL AND MANY OTHER CIVIC ORGANIZATIONS. A COMMUNITY BENEFIT PAYROLL BUDGET IS ESTABLISHED EACH YEAR TO ALLOW HOURLY EMPLOYEES TO SERVE IN THE COMMUNITY (DURING WORKING HOURS) ON PROJECTS SUCH AS HABITAT FOR HUMANITY. AS OF 2023, A TOTAL OF 225 AED'S (AUTOMATED EXTERNAL DEFIBRILLATORS) WERE PLACED IN LOCAL SCHOOLS, NOT FOR PROFIT ORGANIZATIONS, FIRE AND POLICE, AND EMS SERVICES, TO SUPPORT THE HEALTH OF THE COMMUNITY. REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. ALSO PROVIDES ASSISTANCE TO THESE PUBLIC DEPARTMENTS WITH CERTIFICATION AND RENEWAL OF REQUIRED AMERICAN HEART ASSOCIATION COURSES SUCH AS BLS (BASIC LIFE SUPPORT), ACLS (ADVANCED CARDIAC LIFE SUPPORT), AND PALS (PEDIATRIC ADVANCED LIFE SUPPORT). SUSTAINING A WELL-EDUCATED HEALTH CARE WORK FORCE IS PART OF THE OUTREACH OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. MEDICAL GRAND ROUNDS ARE OFFERED WEEKLY AND ARE OPEN TO ALL PHYSICIANS IN THE COMMUNITY. EACH YEAR REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IVY TECH COMMUNITY COLLEGE AND INDIANA UNIVERSITY-EAST CAMPUS COLLABORATE ON A HEALTH CAREER CAMP WHICH PROVIDES HIGH SCHOOL STUDENTS AN OPPORTUNITY TO PARTICIPATE IN NURSING AND ALLIED HEALTH ACTIVITIES. STUDENTS FROM THE 7-COUNTY SERVICE AREA ARE INVITED TO ATTEND. THERE ARE SOCIAL DETERMINANTS OF HEALTH AND READING IS ONE OF THOSE ELEMENTS REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. HAS CHOSEN TO SUPPORT. EACH YEAR THE THIRD GRADE READING ACADEMY WORKS WITH CHILDREN WHO ARE NOT READING AT GRADE LEVEL AND SPEND THE SUMMER IMPROVING THEIR READING SKILLS. REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. HAS SUPPORTED THIS NOT FOR PROFIT ORGANIZATION SINCE IT BEGAN. THE GOVERNING BOARD OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. AND ESPECIALLY THE COMMUNITY BENEFIT COMMITTEE OF THE BOARD GUIDE THE OUTREACH TO THE COMMUNITY TO MAKE CERTAIN THAT REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SERVES THE PATIENTS AND THE COMMUNITY WITH EQUAL CARE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 7 State filing of community benefit report</FormAndLineReferenceDesc>
        <ExplanationTxt>IN</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
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      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
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          <BusinessNameLine1Txt>Boys &amp; Girls Clubs of Wayne Co IN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1717 South L Street</AddressLine1Txt>
          <CityNm>Richmond</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47374</ZIPCd>
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        <RecipientEIN>351065715</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>16000</CashGrantAmt>
        <PurposeOfGrantTxt>Support for relapse prevention class</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Whole Family Community Initiative</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>322 Summit Avenue</AddressLine1Txt>
          <CityNm>Connersville</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47331</ZIPCd>
        </USAddress>
        <RecipientEIN>204798593</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <PurposeOfGrantTxt>Funding for billboards to promote the 988 Suicide and Crisis hotline</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Wayne County Sheriffs Office</BusinessNameLine1Txt>
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          <AddressLine1Txt>200 East Main Street</AddressLine1Txt>
          <CityNm>Richmond</CityNm>
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          <ZIPCd>47374</ZIPCd>
        </USAddress>
        <RecipientEIN>356000212</RecipientEIN>
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        <PurposeOfGrantTxt>Support for the Prevention Plus programming at the clubs and in the schools</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Birth to Five</BusinessNameLine1Txt>
        </RecipientBusinessName>
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          <AddressLine1Txt>PO Box 1815</AddressLine1Txt>
          <CityNm>Richmond</CityNm>
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          <ZIPCd>47375</ZIPCd>
        </USAddress>
        <RecipientEIN>351843800</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>8000</CashGrantAmt>
        <PurposeOfGrantTxt>Funding for training of Certified Peer Recovery Coach for their "Recover Together" program</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Hope Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2004 Indiana Avenue</AddressLine1Txt>
          <CityNm>Connersville</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47331</ZIPCd>
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        <RecipientEIN>352029028</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>8000</CashGrantAmt>
        <PurposeOfGrantTxt>Scholarship support for their equine therapy program for children and adults</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Ind Living Cntr of Eastern IN</BusinessNameLine1Txt>
        </RecipientBusinessName>
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          <AddressLine1Txt>1818 West Main Street</AddressLine1Txt>
          <CityNm>Richmond</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47374</ZIPCd>
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        <RecipientEIN>352054653</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>7500</CashGrantAmt>
        <PurposeOfGrantTxt>Funding for staff training for Site Coordinators</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Richmond High School</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>380 Hub Etchison Pkwy</AddressLine1Txt>
          <CityNm>Richmond</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47374</ZIPCd>
        </USAddress>
        <RecipientEIN>351071211</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>7500</CashGrantAmt>
        <PurposeOfGrantTxt>Support for K-9 program</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Circle You Help Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>19 North 13th Street</AddressLine1Txt>
          <CityNm>Richmond</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47374</ZIPCd>
        </USAddress>
        <RecipientEIN>351611125</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>7500</CashGrantAmt>
        <PurposeOfGrantTxt>Funding for prefabricated, reusable ramps in Reid's service area</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Birth to Five</BusinessNameLine1Txt>
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          <AddressLine1Txt>PO Box 1815</AddressLine1Txt>
          <CityNm>Richmond</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47375</ZIPCd>
        </USAddress>
        <RecipientEIN>351843800</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>7000</CashGrantAmt>
        <PurposeOfGrantTxt>Funding for drug prevention programming through the schools</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Firefly Children &amp; Family Alliance</BusinessNameLine1Txt>
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          <AddressLine1Txt>1575 Dr MLK Jr St</AddressLine1Txt>
          <CityNm>Indianapolis</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>46202</ZIPCd>
        </USAddress>
        <RecipientEIN>351061264</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
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        <PurposeOfGrantTxt>Support for group meals for participants and families in the Maternal Treatment Program</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>Girls Inc of Wayne County</BusinessNameLine1Txt>
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        <USAddress>
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          <CityNm>Richmond</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47374</ZIPCd>
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        <RecipientEIN>237188644</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
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        <PurposeOfGrantTxt>Funding for purchase of vape detectors for the middle school and high school</PurposeOfGrantTxt>
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        <PurposeOfGrantTxt>Funding for staff to receive "train the trainer" Mental Health First Aid training for youth and adults</PurposeOfGrantTxt>
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          <CityNm>Hagerstown</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
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          <StateAbbreviationCd>IN</StateAbbreviationCd>
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          <StateAbbreviationCd>IN</StateAbbreviationCd>
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          <CityNm>Hagerstown</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
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          <CityNm>Richmond</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
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          <StateAbbreviationCd>IN</StateAbbreviationCd>
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        <TitleTxt>VICE PRESIDENT - GENERAL COUNSEL</TitleTxt>
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          <BusinessNameLine1Txt>CARRIE KOLENTUS</BusinessNameLine1Txt>
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        <TitleTxt>VICE PRESIDENT - CHIEF HUMAN RESOURCES OFFICER (TERM ENDED)</TitleTxt>
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          <BusinessNameLine1Txt>JASON TROUTWINE</BusinessNameLine1Txt>
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        <TitleTxt>VICE PRESIDENT - FOUNDATION PRESIDENT</TitleTxt>
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          <BusinessNameLine1Txt>DAVID DESANTIS</BusinessNameLine1Txt>
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        <TitleTxt>PHYSICIAN</TitleTxt>
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        <TitleTxt>CHIEF COMPLIANCE OFFICER AND DIRECTOR AUDIT SERVICES</TitleTxt>
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          <BusinessNameLine1Txt>TIMOTHY LOVE</BusinessNameLine1Txt>
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        <TitleTxt>DIRECTOR - INFORMATION TECHNOLOGY</TitleTxt>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a Travel for companions</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING CALENDAR YEAR 2023 REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. PROVIDED TRAVEL FOR COMPANIONS IN THE AMOUNT OF $1,333.53 TO CRAIG KINYON. THE BENEFIT WAS TREATED AS TAXABLE COMPENSATION.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a Tax indemnification and gross-up payments</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING CALENDAR YEAR 2023 REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. PROVIDED GROSS-UP PAYMENTS TO CRAIG KINYON FOR TRAVEL FOR COMPANIONS IN THE AMOUNT OF $716.48; FOR PERSONAL FINANCIAL SERVICES IN THE AMOUNT OF $13,487.09; FOR UNIVERSAL LIFE INSURANCE IN THE AMOUNT OF $12,120.97; AND FOR AICPA IN THE AMOUNT OF $1,355.75. THE BENEFITS WERE TREATED AS TAXABLE COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a Personal services</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING CALENDAR YEAR 2023 REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. PROVIDED PERSONAL FINANCIAL SERVICES IN THE AMOUNT OF $16,187.48 TO CRAIG KINYON. THE BENEFIT WAS TREATED AS TAXABLE COMPENSATION.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4a Severance or change-of-control payment</FormAndLineReferenceDesc>
        <ExplanationTxt>OFFICERS OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. RECEIVED SEVERANCE PAYMENTS. -CARRIE KOLENTUS $120,000 -JENNIFER EHLERS $193,744 -ANGELA DICKMAN $190,613</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>OFFICERS OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. PARTICIPATE IN A 457F NONQUALIFIED RETIREMENT PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN. AMOUNTS PROVIDED REPRESENT CURRENT YEAR CONTRIBUTIONS TO THE PLAN. - CRAIG KINYON $102,285 - ANGELA DICKMAN $16,520 - JENNIFER EHLERS $16,791 - MISTI FOUST-COFIELD $19,237 - BILLIE KESTER $19,031 - CHRISTOPHER KNIGHT $20,473 - MICHELLE MCCLURG $13,402 - JASON TROUTWINE $11,925 - PAMELA JONES $22,366 - MUHAMMAD SIDDIQUI $19,610 - VINAY BHOOMA, M.D. $27,825 - CARRIE KOLENTUS $12,000 OFFICERS OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. RECEIVED PAYMENT FROM A 457F NONQUALIFIED RETIREMENT PLAN. AMOUNTS PROVIDED REPRESENT CURRENT YEAR PAYMENTS FROM THE PLAN. - CARRIE KOLENTUS $12,945 - JENNIFER EHLERS $397,154 - ANGELA DICKMAN $332,955 - THOMAS HUTH M.D. $444,531</ExplanationTxt>
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    </IRS990ScheduleJ>
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      <TaxExemptBondsIssuesGrp>
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        <IssuerName>
          <BusinessNameLine1Txt>HOSPITAL AUTHORITY OF RICHMOND</BusinessNameLine1Txt>
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        <BondIssuedDt>2015-02-04</BondIssuedDt>
        <IssuePriceAmt>104156808</IssuePriceAmt>
        <PurposeDesc>REV. PROC. 2017-13. (REID HOSPITAL PROJECT) SERIES 2009A ISSUED ON MARCH 31, 2009.</PurposeDesc>
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        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>HOSPITAL AUTHORITY OF RICHMOND</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>351867077</BondIssuerEIN>
        <BondIssuedDt>2021-01-27</BondIssuedDt>
        <IssuePriceAmt>15000000</IssuePriceAmt>
        <PurposeDesc>TO PURCHASE CAPITAL EQUIPMENT</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>HOSPITAL AUTHORITY OF RICHMOND</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>351867077</BondIssuerEIN>
        <BondIssuedDt>2018-11-05</BondIssuedDt>
        <IssuePriceAmt>10000000</IssuePriceAmt>
        <PurposeDesc>TO PURCHASE CAPITAL EQUIPMENT</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>HOSPITAL AUTHORITY OF RICHMOND</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>351867077</BondIssuerEIN>
        <BondIssuedDt>2019-06-26</BondIssuedDt>
        <IssuePriceAmt>30000000</IssuePriceAmt>
        <PurposeDesc>TO PURCHASE CAPITAL EQUIPMENT</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>17595000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>108763515</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>952946</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>0</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>107810569</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>5735000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>15000533</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>98024</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>15000533</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>8041599</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>10128686</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>92450</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>10128686</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <RetiredAmt>10495659</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>30099947</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>154529</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>30099947</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>false</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.21</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.56</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.77</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part III, Line 3a</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT CONTRACTS ARE REGULARLY REVIEWED TO ENSURE COMPLIANCE WITH REV. PROC. 2017-13.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part III, Line 3b COLUMN C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNT LISTED EXCEEDS THE ISSUE PRICE BECAUSE SUCH AMOUNT INCLUDES INVESTMENT EARNINGS ON A DEFEASANCE ESCROW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part IV, Line 2c COLUMN A</FormAndLineReferenceDesc>
        <ExplanationTxt>A REBATE COMPUTATION WAS PERFORMED ON NOVEMBER 2, 2015.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column (f)</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 2016 BONDS WERE ISSUED TO CURRENTLY REFUND THE ISSUER'S REVENUE BONDS (REID HOSPITAL PROJECT) SERIES 2012 ISSUED ON DECEMBER 1, 2012.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part III, Line 3b COLUMN A &amp; PAGE 2 COLUMN B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNT LISTED EXCEEDS THE ISSUE PRICE BECAUSE SUCH AMOUNT INCLUDES INVESTMENT EARNINGS ON THE PROJECT FUND.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part V Different Procedures to Undertake Corrective Action</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer name: HOSPITAL AUTHORITY OF RICHMOND N/A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part V Different Procedures to Undertake Corrective Action</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer name: HOSPITAL AUTHORITY OF RICHMOND N/A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part V Different Procedures to Undertake Corrective Action</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer name: HOSPITAL AUTHORITY OF RICHMOND N/A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part V Different Procedures to Undertake Corrective Action</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer name: HOSPITAL AUTHORITY OF RICHMOND N/A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part V Different Procedures to Undertake Corrective Action</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer name: HOSPITAL AUTHORITY OF RICHMOND N/A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part V Different Procedures to Undertake Corrective Action</FormAndLineReferenceDesc>
        <ExplanationTxt>Issuer name: HOSPITAL AUTHORITY OF RICHMOND N/A</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleK documentId="IRS990ScheduleK2" softwareId="23017437" softwareVersionNum="2023v5.1">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>HOSPITAL AUTHORITY OF RICHMOND</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>351867077</BondIssuerEIN>
        <BondIssuedDt>2016-11-09</BondIssuedDt>
        <IssuePriceAmt>72071194</IssuePriceAmt>
        <PurposeDesc>SEE PART VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>HOSPITAL AUTHORITY OF RICHMOND</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>351867077</BondIssuerEIN>
        <BondIssuedDt>2022-07-27</BondIssuedDt>
        <IssuePriceAmt>100000000</IssuePriceAmt>
        <PurposeDesc>CONNERSVILLE HOSPITAL</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>14159000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>72071194</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>214662</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>0</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>71856572</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>103943693</TotalProceedsAmt>
        <InReserveFundAmt>106732565</InReserveFundAmt>
        <CapitalizedInterestAmt>1896846</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>1187223</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>2778068</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>false</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.18</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.64</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.82</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
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        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
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        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>GREGORY EHLERS</BusinessNameLine1Txt>
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        <RelationshipDescriptionTxt>EMPLOYED FAMILY MEMBER</RelationshipDescriptionTxt>
        <TransactionAmt>54746</TransactionAmt>
        <TransactionDesc>COMPENSATION</TransactionDesc>
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        <TransactionAmt>11964</TransactionAmt>
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      <BusTrInvolveInterestedPrsnGrp>
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            <BusinessNameLine1Txt>KELSEE TROUTWINE</BusinessNameLine1Txt>
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            <BusinessNameLine1Txt>MUHAMMAD SIDDIQUI</BusinessNameLine1Txt>
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            <BusinessNameLine1Txt>TERESA HALL</BusinessNameLine1Txt>
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            <BusinessNameLine1Txt>TYLER STEWART</BusinessNameLine1Txt>
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        <FormAndLineReferenceDesc>Schedule L, Part IV, Column (d) TRANSACTIONS WITH INTERESTED PERSONS</FormAndLineReferenceDesc>
        <ExplanationTxt>GREG EHLERS, FAMILY MEMBER OF JENNIFER EHLERS, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. HE EARNED $54,746 IN COMPENSATION DURING CALENDAR YEAR 2023. JACLYN SMITH, FAMILY MEMBER OF CRAIG KINYON, WHO IS A BOARD MEMBER AND OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SHE EARNED $11,964 IN COMPENSATION DURING CALENDAR YEAR 2023. MORGAN FOUST, FAMILY MEMBER OF MISTI FOUST-COFIELD, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SHE EARNED $82,998 IN COMPENSATION DURING CALENDAR YEAR 2023. RILEY WATKINS, FAMILY MEMBER OF BILLIE KESTER, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SHE EARNED $55,565 IN COMPENSATION DURING CALENDAR YEAR 2023. ASHLEY WERNER, FAMILY MEMBER OF MISTI FOUST-COFIELD, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SHE EARNED $72,457 IN COMPENSATION DURING CALENDAR YEAR 2023. JOSHUA WERNER, FAMILY MEMBER OF MISTI FOUST-COFIELD, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. HE EARNED $47,642 IN COMPENSATION DURING CALENDAR YEAR 2023. CARLA DRIVER, FAMILY MEMBER OF MISTI FOUST-COFIELD, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SHE EARNED $12,980 IN COMPENSATION DURING CALENDAR YEAR 2023. IAN DRIVER, FAMILY MEMBER OF MISTI FOUST-COFIELD, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. HE EARNED $24,814 IN COMPENSATION DURING CALENDAR YEAR 2023. KELSEE TROUTWINE, FAMILY MEMBER OF JASON TROUTWINE, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SHE EARNED $32,730 IN COMPENSATION DURING CALENDAR YEAR 2023. MUHAMMAD A SIDDIQUI, FAMILY MEMBER OF MUHAMMAD SIDDIQUI, WHO IS AN OFFICER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID PHYSICIAN ASSOCIATES, INC. HE EARNED $11,530 IN COMPENSATION DURING CALENDAR YEAR 2023. TERESA HALL, FAMILY MEMBER OF ALEASIA STEWART, WHO IS AN BOARD MEMBER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. SHE EARNED $20,106 IN COMPENSATION DURING CALENDAR YEAR 2023. TYLER STEWART, FAMILY MEMBER OF ALEASIA STEWART, WHO IS AN BOARD MEMBER OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC., IS EMPLOYED BY REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. HE EARNED $45,918 IN COMPENSATION DURING CALENDAR YEAR 2023.</ExplanationTxt>
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      <RealEstateOtherGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>10500</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Market value</MethodOfDeterminingRevenuesTxt>
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      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>false</ThirdPartiesUsedInd>
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        <FormAndLineReferenceDesc>Schedule M, Part I Explanations of reporting method for number of contributions</FormAndLineReferenceDesc>
        <ExplanationTxt>Real estate - Other - THE AMOUNT REPORTED IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS FORM 990 WAS PREPARED AND REVIEWED BY AN OUTSIDE ACCOUNTING FIRM AND LEGAL COUNSEL BEFORE BEING PRESENTED TO MANAGEMENT FOR REVIEW. FOLLOWING MANAGEMENT'S REVIEW, THE FORM 990 WAS PRESENTED TO THE BOARD FOR FINAL REVIEW AND APPROVAL.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>EVERY YEAR ALL KEY EMPLOYEES, OFFICERS, AND DIRECTORS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST RELATING TO REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. AND ITS SUBSIDIARIES. THIS INFORMATION IS REVIEWED BY THE ORGANIZATION'S ADMINSTRATIVE STAFF AND INTERNAL AUDITOR. DURING THE YEAR, EACH KEY EMPLOYEE AND OFFICER IS REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST ISSUE WHEN IT OCCURS. THE BOARD OF DIRECTORS IS ASKED IF THERE ARE ANY CONFLICT OF INTEREST ISSUES BEFORE EACH AND EVERY BOARD MEETING.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MISSION OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. IS TO SERVE THE PEOPLE OF A MULTI-COUNTY SERVICE AREA IN REFERENCE TO THEIR CURRENT AND FUTURE NEEDS FOR HEALTH CARE SERVICES. THE GOVERNING BOARD IS VESTED WITH THE ULTIMATE RESPONSIBILITY AND AUTHORITY FOR THE SUCCESSFUL FULFILLMENT OF THIS MISSION. THE GOVERNING BOARD OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. EXERCISES A FIDUCIARY RESPONSIBILITY ON BEHALF OF THE SERVICE AREA AND PEOPLE WE SERVE. WHILE REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. IS A PRIVATE, NON-PROFIT ORGANIZATION, THE BOARD IS COMMITTED TO A CONCEPT OF GOVERNANCE THAT SEES AS HAVING A PUBLIC MISSION AND OUTLOOK. REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S GOVERNING BOARD MAINTAINS AN ONGOING COMMITMENT TO QUALITY AND EXCELLENCE. IT IS THE BELIEF OF THE BOARD THAT THE PEOPLE WE SERVE DESERVE NOTHING LESS. TO COMMIT TO A LESSER STANDARD OR TO BE ACCEPTING OF LESSER PERFORMANCE WOULD BE AN ULTIMATE BREACH OF OUR REASON FOR EXISTENCE. THE COMMITMENT TO QUALITY AND EXCELLENCE STEMS FROM A REALIZATION OF THE STEWARDSHIP INVOLVED IN GOVERNING AND PRESERVING A VITAL HEALTH CARE RESOURCE FOR THE PEOPLE OF A SIX-COUNTY AREA IN EAST CENTRAL INDIANA AND WESTERN OHIO. THIS STEWARDSHIP AND SENSE OF RESPONSIBILITY EXTENDS TO A REALIZATION THAT REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. IS THE LARGEST EMPLOYER IN WAYNE COUNTY. THIS BOARD'S ULTIMATE AUTHORITY AND RESPONSIBILITY INCLUDES ALL ASPECTS OF THE OPERATION: QUALITY OF SERVICES RENDERED, QUALITY OF ITS MEDICAL STAFF, QUALITY OF ITS LEADERSHIP AND OTHER FINANCIAL, LEGAL, ETHICAL, AND OPERATIONAL CONSIDERATIONS. AS A SERVICE TEAM PROVIDING HUMAN SERVICES, REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S PEOPLE (GOVERNING AND FOUNDATION BOARDS, MEDICAL STAFF, EMPLOYEES AND VOLUNTEERS) REPRESENT THE SINGLE MOST IMPORTANT ASSET POSSESSED BY THE ORGANIZATION. MORE THAN ANY OTHER FACTOR (BUILDINGS, EQUIPMENT, TECHNOLOGY, ETC.), THE QUALITY OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S HUMAN RESOURCES DETERMINES THE QUALITY OF SERVICES ULTIMATELY PROVIDED TO ITS PATIENTS AND FAMILIES. THIS COMMITMENT TO QUALITY AND THE STEWARDSHIP OF HUMAN RESOURCES SERVICES ARE THE FOUNDATION FOR REID HOSPITAL &amp; HEALTH CARE SERVICES, INC.'S EMPLOYEE RELATIONS POSTURE. THIS APPLIES TO ALL ASPECTS OF EMPLOYEE RELATIONS AT ALL LEVELS. A COMPENSATION PHILOSOPHY THAT ATTRACTS AND RETAINS QUALIFIED, HIGH QUALITY COMMITTED EMPLOYEES AT ALL LEVELS IS IN THE BEST INTEREST OF REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. AND THOSE WE SERVE. THE CHIEF EXECUTIVE OFFICER (PRESIDENT AND CEO), SELECTED AND APPOINTED BY THE GOVERNING BOARD, IS CHARGED WITH THE RESPONSIBILITY OF DEVELOPING AND ADMINISTERING A COMPENSATION PLAN THAT REFLECTS THE PREVIOUSLY STATED PHILOSOPHY AND MISSION. THE CEO IS ACCOUNTABLE TO THE GOVERNING BOARD IN THIS REGARD, JUST AS HE/SHE IS ACCOUNTABLE IN ALL OTHER AREAS. THE FOLLOWING PHILOSOPHY AND GUIDELINES AFFIRM THE BOARD'S COMMITMENT IN REFERENCE TO DEVELOPING A REASONABLE AND APPROPRIATE COMPENSATION PACKAGE FOR THE CEO AND EXECUTIVE STAFF. EXECUTIVE COMPENSATION PHILOSOPHY, GUIDELINES, AND PRACTICES: AN EFFECTIVE EXECUTIVE COMPENSATION PROGRAM ADDRESSES A NUMBER OF GOALS. THESE GOALS INCLUDE: 1.) THE ABILITY TO ATTRACT AN INDIVIDUAL WHO IS HIGHLY QUALIFIED BY REASON OF PROFESSIONAL EDUCATION, PAST EXPERIENCE, AND PERSONAL CHARACTERISTICS; 2.) APPROPRIATE RECOGNITION OF PERFORMANCE (POSITIVE OR NEGATIVE); 3.) MAINTENANCE OF MOTIVATION FOR FURTHER PERFORMANCE AT A LEVEL OF EXCELLENCE; 4.) RETENTION (WHEN DESIRED) OF LEADERSHIP EXPERTISE; AND 5.) FAIRNESS. IT IS IMPORTANT TO NOTE THAT THE ISSUE OF FAIRNESS RELATES TO THE COMMUNITY, THE ORGANIZATION AND THE INDIVIDUAL. THAT IS, THE GOAL OF THE BOARD WILL NOT BE TO MINIMIZE COST PER SE. CONVERSELY, THE EXPECTATIONS OF THE CEO SHOULD NOT BE TO MAXIMIZE INCOME AS A SINGLE OBJECTIVE. THE GOAL OF BOTH PARTIES WILL BE TO ACHIEVE A COMPENSATION PACKAGE THAT IS FAIR TO THE COMMUNITY, FAIR TO THE ORGANIZATION, AND FAIR TO THE INDIVIDUAL. REID HOSPITAL &amp; HEALTH CARE SERVICES, INC. ENDEAVORS TO SATISFY THE STANDARDS ADVOCATED BY THE INTERNAL REVENUE SERVICE FOR APPROVING EXECUTIVE COMPENSATION.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b Process to establish compensation of other employees</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHIEF EXECUTIVE OFFICER (PRESIDENT AND CEO), SELECTED AND APPOINTED BY THE GOVERNING BOARD, IS CHARGED WITH THE RESPONSIBILITY OF DEVELOPING AND ADMINISTERING A COMPENSATION PLAN THAT REFLECTS THE PHILOSOPHY AND MISSION OF THE ORGANIZATION. THE CEO IS ACCOUNTABLE TO THE GOVERNING BOARD IN THIS REGARD JUST AS HE/SHE IS ACCOUNTABLE IN ALL OTHER AREAS. THE COMPENSATION IS SHARED WITH THE EXECUTIVE COMMITTEE FOR AWARENESS, CONSULTATION, AND DIALOGUE.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS AN ATTACHMENT TO FORM 990 AT WWW.GUIDESTAR.ORG OR UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER FEES FOR SERVICES - Total Expense: 95637838, Program Service Expense: 78183660, Management and General Expenses: 17211304, Fundraising Expenses: 242874;</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in valuation of Foundation - 3726454;</ExplanationTxt>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ROSE LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1100 REID PARKWAY</AddressLine1Txt>
          <CityNm>RICHMOND</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>47374</ZIPCd>
        </USAddress>
        <EIN>202844915</EIN>
        <PrimaryActivitiesTxt>SURGERY CENTER</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>IN</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>RHHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>5744688</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>7511424</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.55</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <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>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Reid Physician Associates</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>7014098</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Reid Health Ambulance</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>3630375</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>