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        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>WITH FEW EXCEPTIONS, NEITHER VALLEY HEALTH SYSTEMS, INC. NOR ANY OF ITS AFFILIATES ARE SUBJECT TO US FEDERAL OR STATE INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO THE FISCAL YEAR ENDED MAY 31, 2021. MANAGEMENT DETERMINED THAT THE SYSTEM HAD NO UNCERTAIN TAX POSITIONS IN 2024 AND 2023.</ExplanationTxt>
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        <ExplanationTxt>FORM 990 IS REVIEWED BY THE MANAGEMENT, THE FINANCE COMMITTEE, AND THE GOVERNING BOARD OF DIRECTORS OF VALLEY HEALTH SYSTEMS, INC., THE CONTROLLING ORGANIZATION, PRIOR TO FILING.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
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        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 18</FormAndLineReferenceDesc>
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        <ExplanationTxt>THE PROCESS BY WHICH OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS IS ASSUMED HAS NOT CHANGED FROM THE PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        </DisregardedEntityName>
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          <AddressLine1Txt>3377 US ROUTE 60</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <PrimaryActivitiesTxt>TO PROVIDE MEDICAL SERVICES TO MEDICALLY UNDERSERVED AREAS IN WEST VIRGINIA</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>170(B)(1) (A)(III)</PublicCharityStatusTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
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  </ReturnData>
</Return>