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      <IndivRcvdGreaterThan100KCnt>32</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
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      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
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        <RelatedOrExemptFuncIncomeAmt>21766008</RelatedOrExemptFuncIncomeAmt>
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        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>2251159</ExclusionAmt>
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      <GrantsToDomesticOrgsGrp>
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        <ManagementAndGeneralAmt>255739</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>54726</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>80610</ProgramServicesAmt>
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        <ProgramServicesAmt>98883</ProgramServicesAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>87</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48608</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>2692676</ProgramServicesAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>6121</ProgramServicesAmt>
        <ManagementAndGeneralAmt>224325</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <TotalAmt>6667292</TotalAmt>
        <ProgramServicesAmt>6667292</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>Repairs and Maintenance</Desc>
        <TotalAmt>1657820</TotalAmt>
        <ProgramServicesAmt>110919</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1546901</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>762052</ProgramServicesAmt>
        <ManagementAndGeneralAmt>391964</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ManagementAndGeneralAmt>460194</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
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        <ManagementAndGeneralAmt>439418</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>29817916</ProgramServicesAmt>
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        <EOYAmt>13538</EOYAmt>
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        <EOYAmt>229658</EOYAmt>
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      <AccountsReceivableGrp>
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      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>16891</EOYAmt>
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        <EOYAmt>1012046</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>25640</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>24501760</EOYAmt>
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        <EOYAmt>21037266</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>4982802</EOYAmt>
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        <EOYAmt>60823264</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>81860530</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>2099481</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>1931939</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-1948136</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
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      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleB documentId="RetDoc1234500001">
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        <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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      <OtherLiabilitiesOrgGrp>
        <Desc>OBLIGATIONS UNDER INTEREST RATE SWAP</Desc>
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      <TotalLiabilityAmt>6138567</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>With few exceptions, Valley Health Systems, Inc. or 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, 2018. Management determined that the System had no uncertain tax positions in 2021 and 2020.</ExplanationTxt>
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        </RecipientBusinessName>
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      <RecipientTable>
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        </RecipientBusinessName>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        </USAddress>
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      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>WHEELING HEALTH RIGHT INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>99 MAIN STREET</AddressLine1Txt>
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          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        </USAddress>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>SUBRECIPIENTS ARE REQUIRED TO OBTAIN AUDITED FINANCIAL STATEMENTS WHICH VALLEY HEALTH SYSTEMS, INC. REVIEWS FOR NONCOMPLIANCE ISSUES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
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      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
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      <CompBsdOnRevRelatedOrgsInd>1</CompBsdOnRevRelatedOrgsInd>
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      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Steven Shattls</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Richard Booth Jr</PersonNm>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Ashleigh Clickett</PersonNm>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12546</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>521637</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mathew Weimer</PersonNm>
        <TitleTxt>Medical Director/Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>452050</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15881</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>467931</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mary-Beth Brubeck</PersonNm>
        <TitleTxt>CFO</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>313613</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>It is common for the physicians' contracts to state that their incentive compensation is based on revenues posted related to that physician's services and performance. Most of the physicians listed have revenues attached to this organization only, but as some of them practice at related organizations, a review of their revenues in total (and not just specifically to this organization) is necessary.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <DrugsAndMedicalSuppliesGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>0</ContributionCnt>
        <NoncashContributionsRptF990Amt>0</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FAIR MARKET VALUE</MethodOfDeterminingRevenuesTxt>
      </DrugsAndMedicalSuppliesGrp>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>0</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 IS REVIEWED BY THE CEO, CFO, AND GOVERNING BOARD BEFORE FILING WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS AND EMPLOYEES ARE REQUIRED TO SIGN A STATEMENT ON AN ANNUAL BASIS CONFIRMING THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S EXECUTIVE COMMITTEE, A SUBGROUP OF BOARD MEMBERS, IS RESPONSIBLE FOR DETERMINING EXECUTIVE AND KEY EMPLOYEE COMPENSATION. THE EXEVUTIVE COMMITTEE USES COMPARABLE DATA TO DETERMINE COMPENSATION AMOUNTS. THE EXECUTIVE COMMITTEE ALSO REFERS CERTAIN MATTERS TO THE ORGANIZATION'S ATTORNEY WHEN NECESSARY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 18</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE UPON REQUEST AT THE CORPORATE OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE UPON REQUEST AT THE CORPORATE OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>NET OPERATIONAL SUBSIDY TO/FROM CLINICS -1,060,418. NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS -887,718.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <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>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FORT GAY PRIMARY HEALTH INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3329 BRIDGE STREET</AddressLine1Txt>
          <CityNm>FORT GAY</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>255140067</ZIPCd>
        </USAddress>
        <EIN>310962004</EIN>
        <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>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>GRANT MEDICAL CENTER INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>308 MAIN STREET EAST</AddressLine1Txt>
          <CityNm>MILTON</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25541</ZIPCd>
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        <EIN>510156065</EIN>
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        <DirectControllingEntityName>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HARTS HEALTH CLINIC INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>22 FLEMING DRIVE</AddressLine1Txt>
          <CityNm>HARTS</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25524</ZIPCd>
        </USAddress>
        <EIN>310961926</EIN>
        <PrimaryActivitiesTxt>TO PROVIDE MEDICAL SERVICES TO MEDICALLY UNDERSERVED AREAS IN WEST VIRGINIA</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>170(B)(1) (a)(III)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>VALLEY HEALTH SYSTEMS INC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>OUCH INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>3377 US ROUTE 60</AddressLine1Txt>
          <CityNm>HUNTINGTON</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
          <ZIPCd>25705</ZIPCd>
        </USAddress>
        <EIN>571142879</EIN>
        <PrimaryActivitiesTxt>TO PROVIDE MEDICAL SERVICES TO MEDICALLY UNDERSERVED AREAS IN WEST VIRGINIA</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WV</LegalDomicileStateCd>
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        <DirectControllingEntityName>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UPPER KANAWHA HEALTH ASSOCIATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO BOX F</AddressLine1Txt>
          <CityNm>CEDAR GROVE</CityNm>
          <StateAbbreviationCd>WV</StateAbbreviationCd>
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        </USAddress>
        <EIN>510146615</EIN>
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      <IdRelatedTaxExemptOrgGrp>
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          <CityNm>WAYNE</CityNm>
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      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
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        <InvolvedAmt>433115</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FAIR MARKET VALUE</MethodOfAmountDeterminationTxt>
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      <TransactionsRelatedOrgGrp>
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        <MethodOfAmountDeterminationTxt>FAIR MARKET VALUE</MethodOfAmountDeterminationTxt>
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      <TransactionsRelatedOrgGrp>
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        <InvolvedAmt>84675</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FAIR MARKET VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
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          <BusinessNameLine1Txt>WAYNE HEALTH SERVICES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
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        <MethodOfAmountDeterminationTxt>FAIR MARKET VALUE</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
