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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2899</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>41565</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41565</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>11200</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11200</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <AdvertisingGrp>
        <TotalAmt>30719</TotalAmt>
        <ProgramServicesAmt>15360</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>15359</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>93814</TotalAmt>
        <ProgramServicesAmt>65670</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14072</ManagementAndGeneralAmt>
        <FundraisingAmt>14072</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>209611</TotalAmt>
        <ProgramServicesAmt>157208</ProgramServicesAmt>
        <ManagementAndGeneralAmt>52403</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>59283</TotalAmt>
        <ProgramServicesAmt>44463</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14820</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>99926</TotalAmt>
        <ProgramServicesAmt>97632</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2294</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>13772</TotalAmt>
        <ProgramServicesAmt>12395</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1377</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>37359</TotalAmt>
        <ProgramServicesAmt>35491</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1868</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>30645</TotalAmt>
        <ProgramServicesAmt>27580</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3065</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Contract services</Desc>
        <TotalAmt>495689</TotalAmt>
        <ProgramServicesAmt>495689</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Medical supplies</Desc>
        <TotalAmt>88918</TotalAmt>
        <ProgramServicesAmt>88918</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Meetings and training</Desc>
        <TotalAmt>27700</TotalAmt>
        <ProgramServicesAmt>20775</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6925</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Dues and subscriptions</Desc>
        <TotalAmt>7328</TotalAmt>
        <ProgramServicesAmt>7328</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>8134</TotalAmt>
        <ProgramServicesAmt>2707</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5427</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>4263009</TotalAmt>
        <ProgramServicesAmt>3624995</ProgramServicesAmt>
        <ManagementAndGeneralAmt>608583</ManagementAndGeneralAmt>
        <FundraisingAmt>29431</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>375342</BOYAmt>
        <EOYAmt>67001</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1319236</BOYAmt>
        <EOYAmt>1370268</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>389462</BOYAmt>
        <EOYAmt>478817</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>7213</BOYAmt>
        <EOYAmt>13737</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>13760</BOYAmt>
        <EOYAmt>15979</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>1781013</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>790056</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>1028316</BOYAmt>
        <EOYAmt>990957</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>414051</BOYAmt>
        <EOYAmt>470137</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>45186</BOYAmt>
        <EOYAmt>39791</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <TotalAssetsGrp>
        <BOYAmt>3592566</BOYAmt>
        <EOYAmt>3446687</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>257221</BOYAmt>
        <EOYAmt>325934</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>51701</BOYAmt>
        <EOYAmt>4000</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>293615</BOYAmt>
        <EOYAmt>241516</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>602537</BOYAmt>
        <EOYAmt>571450</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>2990029</BOYAmt>
        <EOYAmt>2875237</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>2990029</BOYAmt>
        <EOYAmt>2875237</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>3592566</BOYAmt>
        <EOYAmt>3446687</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-114792</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA-01" softwareId="23017509">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <OtherSupportSumAmt>0</OtherSupportSumAmt>
      <PublicSupportCY170Pct>0</PublicSupportCY170Pct>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>92286</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>321666</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>112091</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>89106</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>179070</CurrentTaxYearAmt>
        <TotalAmt>794219</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>4630032</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4021066</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5486424</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3941142</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3868513</CurrentTaxYearAmt>
        <TotalAmt>21947177</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <GrossReceiptsNonUnrltBusGrp>
        <TotalAmt>0</TotalAmt>
      </GrossReceiptsNonUnrltBusGrp>
      <TaxRevLeviedOrgnztnlBnft509Grp>
        <TotalAmt>0</TotalAmt>
      </TaxRevLeviedOrgnztnlBnft509Grp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>4722318</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4342732</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>5598515</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4030248</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>4047583</CurrentTaxYearAmt>
        <TotalAmt>22741396</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>22741396</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>6347</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>18411</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7670</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4919</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>65777</CurrentTaxYearAmt>
        <TotalAmt>103124</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>6347</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>18411</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7670</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4919</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>65777</CurrentTaxYearAmt>
        <TotalAmt>103124</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <TotalSupportCalendarYearGrp>
        <TotalAmt>22844520</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99550</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99830</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00450</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00170</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB-01">
      <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>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="IRS990ScheduleD-01" softwareId="23017509">
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>275408</OtherCostOrOtherBasisAmt>
        <BookValueAmt>275408</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1167086</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>454677</DepreciationAmt>
        <BookValueAmt>712409</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>141340</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>138200</DepreciationAmt>
        <BookValueAmt>3140</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>197179</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>197179</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>990957</TotalBookValueLandBuildingsAmt>
      <TotalRevEtcAuditedFinclStmtAmt>4148217</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueSubtotalAmt>4148217</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>4148217</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>4263009</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>4263009</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>4263009</TotalExpensesPerForm990Amt>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="IRS990ScheduleG-01">
      <FundraisingEventInformationGrp>
        <Event1Nm>Puttin for Panhandle</Event1Nm>
        <GrossReceiptsEvent1Amt>38597</GrossReceiptsEvent1Amt>
        <GrossRevenueEvent1Amt>38597</GrossRevenueEvent1Amt>
        <CashPrizesEvent1Amt>1000</CashPrizesEvent1Amt>
        <RentFacilityCostsEvent1Amt>0</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>2956</FoodAndBeverageEvent1Amt>
        <OtherDirectExpensesEvent1Amt>3066</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>38597</GrossReceiptsTotalAmt>
        <GrossRevenueTotalEventsAmt>38597</GrossRevenueTotalEventsAmt>
        <CashPrizesTotalEventsAmt>1000</CashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>0</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>2956</FoodAndBeverageTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>3066</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>7022</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>31575</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleO documentId="IRS990ScheduleO-01" softwareId="23017509">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is reviewed and discussed before filing at a regularly scheduled BOD meeting. The process is documented in the minutes of the meeting.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Conflict of Interest Statements for BOD members are reviewed and discussed annually at a regularly scheduled BOD meeting. The policy is monitored on a continual basis as matters are presented to the Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>A compensation committee is appointed annually to review compensation for all employees before the annual budget is approved.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>A compensation committee is appointed annually to review compensation for all employees before the annual budget is approved.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>An annual financial disclosure is published as a legal advertisement in the local newspaper. The Agency's annual financial statements, reports and documents are available for public inspection at the West Virginia Health Care Authority offices.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
