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        <ExplanationTxt>MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE COMPANIES AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2023, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANIES' FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2020 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RELATED PARTIES REVENUES 213,668,170. INTERCOMPANY ELIMINATIONS -11,968,469.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RELATED PARTIES EXPENSES 190,833,727. INTERCOMPANY ELIMINATIONS -11,968,469.</ExplanationTxt>
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        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL COMPENSATION IS DETERMINED BY HUDSON HEADWATERS HEALTH NETWORK USING THE FOLLOWING: THE BOARD OF DIRECTORS SETS COMPENSATION FOR THE CEO. THE CEO SETS THE COMPENSATION FOR MEMBERS OF SENIOR MANAGEMENT. THE ORGANIZATION ALSO USES A SURVEY WHERE POSSIBLE, COMPARABLE POSITIONS WITHIN THE REGION, COMPENSATION CONSULTANTS AND BOARD REVIEW. COMPENSATION IS DETERMINED BY A COMBINATION OF SENIOR MANAGEMENT, FINANCE AND HUMAN RESOURCES TO ENSURE FAIRNESS AND CONSISTENCY IN SETTING PAY RATE AND BENEFIT LEVELS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS LISTED ON SCHEDULE J, PART II, PARTICIPATE IN A 457(F) SUPPLEMENTAL RETIREMENT PLAN: - DAVID T. SLINGERLAND, MD, CEO OF HHHN &amp; EX OFFICIO - CHRISTOPHER TOURNIER, EXECUTIVE VP OF FINANCE - JESSICA RUBIN, VP OF PHILANTHROPY &amp; COMMUNICATIONS IN 2023, CHRISTOPHER TOURNIER RECEIVED DISTRIBUTION OF $185,954, WHICH IS INCLUDED ON SCHEDULE J, PART II, COLUMN B(III).</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS ORGANIZATION'S SOLE MEMBER IS HUDSON HEADWATERS HEALTH NETWORK, A RELATED 501(C)(3) ORGANIZATION.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>AN INDEPENDENT ACCOUNTANT PREPARES THE 990. AFTER PREPARATION, A COPY OF THE DRAFT RETURN IS PROVIDED TO THE BOARD MEMBERS VIA EMAIL OR AT A BOARD MEETING PRIOR TO SUBMISSION WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION FOLLOWS THE CONFLICT OF INTREREST POLICY OF HUDSON HEADWATERS HEALTH NETWORK THE PARENT COMPANY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE DOCUMENTS ARE AVAILABLE UPON REQUEST AT 9 CAREY ROAD, QUEENSBURY, NY 12804.</ExplanationTxt>
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