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      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Fidelity Investments</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 770001</AddressLine1Txt>
            <CityNm>Cincinnati</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45277</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Investment Advisory Services</ServicesDesc>
        <CompensationAmt>191515</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>85775</FundraisingAmt>
      <AllOtherContributionsAmt>95268</AllOtherContributionsAmt>
      <NoncashContributionsAmt>8975</NoncashContributionsAmt>
      <TotalContributionsAmt>181043</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Affiliate admin fees</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>4341270</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4341270</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>4341270</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>289475</TotalRevenueColumnAmt>
        <ExclusionAmt>289475</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>9467749</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>9534064</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-66315</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-66315</TotalRevenueColumnAmt>
        <ExclusionAmt>-66315</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>32332</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>85775</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>85485</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-53153</TotalRevenueColumnAmt>
        <ExclusionAmt>-53153</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GrossSalesOfInventoryAmt>136392</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>183107</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-46715</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-46715</RelatedOrExemptFuncIncomeAmt>
      </NetIncomeOrLossGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>4645605</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4294555</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>170007</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>26965</TotalAmt>
        <ProgramServicesAmt>26965</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1413520</TotalAmt>
        <ProgramServicesAmt>1250771</ProgramServicesAmt>
        <ManagementAndGeneralAmt>162749</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>2780514</TotalAmt>
        <ProgramServicesAmt>2382674</ProgramServicesAmt>
        <ManagementAndGeneralAmt>310031</ManagementAndGeneralAmt>
        <FundraisingAmt>87809</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>20725</TotalAmt>
        <ProgramServicesAmt>17821</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2319</ManagementAndGeneralAmt>
        <FundraisingAmt>585</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>110783</TotalAmt>
        <ProgramServicesAmt>95135</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12379</ManagementAndGeneralAmt>
        <FundraisingAmt>3269</FundraisingAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>221687</TotalAmt>
        <ProgramServicesAmt>189968</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24718</ManagementAndGeneralAmt>
        <FundraisingAmt>7001</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>39694</TotalAmt>
        <ManagementAndGeneralAmt>39694</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>5458</TotalAmt>
        <ManagementAndGeneralAmt>5458</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>191515</TotalAmt>
        <ManagementAndGeneralAmt>191515</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>27175</TotalAmt>
        <ProgramServicesAmt>27175</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>254573</TotalAmt>
        <ManagementAndGeneralAmt>251337</ManagementAndGeneralAmt>
        <FundraisingAmt>3236</FundraisingAmt>
      </OfficeExpensesGrp>
      <TravelGrp>
        <TotalAmt>758</TotalAmt>
        <ProgramServicesAmt>758</ProgramServicesAmt>
      </TravelGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>5126</TotalAmt>
        <ManagementAndGeneralAmt>5126</ManagementAndGeneralAmt>
      </PaymentsToAffiliatesGrp>
      <OtherExpensesGrp>
        <Desc>Provision for bad debts</Desc>
        <TotalAmt>1468696</TotalAmt>
        <ProgramServicesAmt>1468696</ProgramServicesAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>6567189</TotalAmt>
        <ProgramServicesAmt>5459963</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1005326</ManagementAndGeneralAmt>
        <FundraisingAmt>101900</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>44849</BOYAmt>
        <EOYAmt>161921</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>450210</BOYAmt>
        <EOYAmt>401374</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>40000</BOYAmt>
        <EOYAmt>20000</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>11240</BOYAmt>
        <EOYAmt>21552</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>2123</BOYAmt>
        <EOYAmt>3096</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>65000</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>48691</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>21435</BOYAmt>
        <EOYAmt>16309</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>7147884</BOYAmt>
        <EOYAmt>3460739</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>2352982</BOYAmt>
        <EOYAmt>2512969</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>1066693</BOYAmt>
        <EOYAmt>1066693</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1684453</BOYAmt>
        <EOYAmt>270666</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>12821869</BOYAmt>
        <EOYAmt>7935319</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>755409</BOYAmt>
        <EOYAmt>556774</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>102513</BOYAmt>
        <EOYAmt>1071711</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>857922</BOYAmt>
        <EOYAmt>1628485</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>6376166</BOYAmt>
        <EOYAmt>284676</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>5587781</BOYAmt>
        <EOYAmt>6022158</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>11963947</BOYAmt>
        <EOYAmt>6306834</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>12821869</BOYAmt>
        <EOYAmt>7935319</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1921584</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>254033</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-3989562</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <CommunityTrustInd>X</CommunityTrustInd>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>228893</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>90768</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>63435</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>201158</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>181043</CurrentTaxYearAmt>
        <TotalAmt>765297</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>228893</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>90768</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>63435</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>201158</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>181043</CurrentTaxYearAmt>
        <TotalAmt>765297</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>136284</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>629013</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>291281</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>324779</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>388179</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>581084</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>289475</CurrentTaxYearAmt>
        <TotalAmt>1874798</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <CurrentTaxYearMinus4YearsAmt>2469</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3096</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2483</CurrentTaxYearMinus2YearsAmt>
        <TotalAmt>8048</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>55385</CurrentTaxYearMinus4YearsAmt>
        <TotalAmt>55385</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>2703528</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>21019719</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.23270</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.24180</PublicSupportPY170Pct>
      <TenPctFactsCrcmstncsTestCYInd>X</TenPctFactsCrcmstncsTestCYInd>
      <FactsAndCircumstancesTestTxt>The Organization meets the 10% facts-and-circumstances test, for the following reasons: 1. The Organization is a 501(c)(3) tax-exempt public charity that functions as the parent organization of Holyoke Medical Center and its other affiliated 501(c)(3) healthcare organizations. As a result, the Organization is highly invested in, reactive to, and reliant upon the community which it serves. 2. The Organization regularly solicits donations from the general public on behalf of itself and its related organizations, including through annual fundraising events. 3. The Organization also receives revenues from administration and management fees charged to its affiliated entities. A portion of those management fees are funded through donations from the general public or from government grants and subsidies, which first may go to the affiliated entities before being paid to Valley Health Systems. Accordingly, while the Organization itself may not directly receive public support greater than 33 1/3 percent in a given tax year, the vast majority of its funding and revenue is sourced either directly from gifts and donations due to its own direct fundraising efforts, or indirectly through the management and administrative fees assessed to its related organizations within the broader Valley Health System network of affiliated entities. Therefore, the Organization has reported that it continues to meet the public support test as a Section 170(b)(1)(A)(vi) public support charity.</FactsAndCircumstancesTestTxt>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <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="RetDoc1040000001">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>3888925</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>500767</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>170773</OtherExpendituresAmt>
        <EndYearBalanceAmt>4218919</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>2829124</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>1196015</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>136214</OtherExpendituresAmt>
        <EndYearBalanceAmt>3888925</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>2688295</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>202390</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>61561</OtherExpendituresAmt>
        <EndYearBalanceAmt>2829124</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>2891090</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>-83789</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>119006</OtherExpendituresAmt>
        <EndYearBalanceAmt>2688295</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>2671370</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>417132</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>197412</OtherExpendituresAmt>
        <EndYearBalanceAmt>2891090</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.00000</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.40950</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.59050</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>1</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>1</RelatedOrgListSchRInd>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>55036</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>39225</DepreciationAmt>
        <BookValueAmt>15811</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>9964</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>9466</DepreciationAmt>
        <BookValueAmt>498</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>16309</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>Investments in perpetual trusts</Desc>
        <BookValueAmt>2512969</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>2512969</TotalBookValueSecuritiesAmt>
      <InvstProgramRelatedOrgGrp>
        <Desc>Investments in affiliated companies</Desc>
        <BookValueAmt>1066693</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </InvstProgramRelatedOrgGrp>
      <TotalBookValueProgramRltdAmt>1066693</TotalBookValueProgramRltdAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to affiliates</Desc>
        <Amt>821711</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>General reserve</Desc>
        <Amt>250000</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>1071711</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>5070662</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>254033</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>419604</OtherRevenueAmt>
      <RevenueNotReportedAmt>673637</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>4397025</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>191515</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>57065</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>248580</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>4645605</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>6635291</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>259617</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>259617</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>6375674</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>191515</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>191515</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>6567189</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The intended use of the endowment funds at Valley Health Systems, Inc. is to provide a predictable, stable, and consistent stream of earnings for the Organization. The Organization's endowment funds consist of both perpetually and temporarily restricted funds. Permanently restricted funds are to be used to generate investment returns, which can be released for advancing charity care and general support of the Organization and its affiliated entities. A portion of the permanently restricted Endowment Funds are held by related organizations of Valley Health Systems. Due to the inter-related nature of the affiliated entities, revenue generated from one endowment for general support may ultimately fund another organization within the related group. Accordingly, all such endowment funds have been reported in aggregate on this Form 990, Schedule D, Part V.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization and the member organizations are exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board (FASB), assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Organization has evaluated the position taken on its filed tax returns. The Organization has concluded no uncertain income tax positions exist at September 30, 2025. The Organization's tax years from 2023 through 2025 are open and subject to examination.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Coffee and gift shop expenses 183,107. Fundraising expenses 76,510. Change in beneficial interest in perpetual trusts 159,987.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 4b - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Adjustment for assets transferred and used in operations 57,065.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>Coffee and gift shop expenses 183,107. Fundraising expenses 76,510.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041300001">
      <FundraisingEventInformationGrp>
        <Event1Nm>Gala</Event1Nm>
        <GrossReceiptsEvent1Amt>116179</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>85775</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>30404</GrossRevenueEvent1Amt>
        <NonCashPrizesEvent1Amt>11124</NonCashPrizesEvent1Amt>
        <RentFacilityCostsEvent1Amt>21262</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>38910</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>3800</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>10220</OtherDirectExpensesEvent1Amt>
        <GrossReceiptsTotalAmt>116179</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>85775</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>30404</GrossRevenueTotalEventsAmt>
        <NonCashPrizesTotalEventsAmt>11124</NonCashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>21262</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>38910</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>3800</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>10220</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>85316</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-54912</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleI documentId="RetDoc1041900001">
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          <BusinessNameLine1Txt>Holyoke Medical Center</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>575 Beech Street</AddressLine1Txt>
          <CityNm>Holyoke</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>010402223</ZIPCd>
        </USAddress>
        <RecipientEIN>222520073</RecipientEIN>
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        <CashGrantAmt>26965</CashGrantAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization may from time to time award sponsorships and grants to various 501(c)(3) public charities or municipalities. In particular, the Organization regularly provides grants to Holyoke Medical Center, Inc., a related organization of which the Organization is the sole member and shares similar board members and officers.</ExplanationTxt>
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        <PersonNm>Spiridon E Hatiras</PersonNm>
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        <PersonNm>Carl Cameron</PersonNm>
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        <PersonNm>Dean Vitarisi</PersonNm>
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        <PersonNm>Avadhoot S Gokhale</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Richard T O'Connor</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Certain officers and directors of Valley Health Systems, Inc. are employed by a related tax-exempt organization which has common officers and/or directors. By virtue of this arrangement, certain individuals listed in Form 990, Part VII have a business relationship with one another.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A copy of Valley Health Systems, Inc.'s Form 990 was provided to each voting member of the governing body prior to its filing with the Internal Revenue Service. The Form 990 was prepared with the assistance of an independent public accounting firm and thoroughly reviewed by the Senior Vice President of Finance and CFO and key financial staff of the Hospital prior to distibuting it to the governing body for review.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The conflict of interest policy is monitored and enforced as part of the Valley Health Systems, Inc. System and is reviewed annually by the System's conflict of interest committee. Valley Health Systems, Inc. board members, officers, and key employees complete and sign a conflict of interest questionnaire annually. All signed questionnaires are then submitted to the committeed for review and monitoring.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation committee of the Valley Health Systems, Inc. utilizes a market compensation survey to recommend to the Board the approval of its determination of the appropriate compensation of the Chief Executive Officer. During that process, the Committee also reviews the compensation levels of other senior management and key employees of the System. These individuals are not members of the compensation committee and do not participate in this process. The CEO, as a member of the Board of VHS, does not participate in the approval process of that officer's compensation.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents, conflict of interest policy, and financial statements of Valley Health Systems and Affiliates, which includes supplemental information of the filing entity, are available to the public upon request at the Organization's administrative office at 575 Beech Street, Holyoke, MA.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Equity contributions from affiliates 920,983. Change in beneficial interest of perpetual trusts 159,987. Net adjustment for assets transferred and used in operations -57,065. Equity contributions to affiliates -5,013,467.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2c:</FormAndLineReferenceDesc>
        <ExplanationTxt>The audit process has not changed from the prior year.</ExplanationTxt>
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          <BusinessNameLine1Txt>Holyoke Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>E</TransactionTypeTxt>
        <InvolvedAmt>821712</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Holyoke Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>3343569</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Western Mass Physician Associates Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>307908</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>River Valley Counseling Center Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>375262</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Holyoke Visiting Nurse Association Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>297720</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Holyoke Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>211704</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Western Mass Physician Associates Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>250000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Holyoke Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>4763467</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>River Valley Counseling Center Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>920983</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Actual Per Books</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Schedule R, Part II:</FormAndLineReferenceDesc>
        <ExplanationTxt>On June 30, 2025, Valley Health Services ("VHS") entered into an agreement with Servicenet, an unrelated entity, whereby VHS agreed to transfer its sole member interest in River Valley Counseling Center ("RVCC") to Servicenet for no consideration. VHS was concurrently released from all guarantees and other obligations related to RVCC, and effective July 1, 2025, RVCC ceased to be considered a related organization of VHS or its other affiliated entities.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>