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        <ExcessBusinessHoldingsRulesInd>false</ExcessBusinessHoldingsRulesInd>
        <ContributionControllerInd>false</ContributionControllerInd>
        <ContributionFamilyInd>false</ContributionFamilyInd>
        <Contribution35ControlledInd>false</Contribution35ControlledInd>
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        <PowerAppointMajorityDirTrstInd>true</PowerAppointMajorityDirTrstInd>
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        <EndYearBalanceAmt>2030752</EndYearBalanceAmt>
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        <EndYearBalanceAmt>1437709</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
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      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
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        <Event1Nm>OKTOBERFEST</Event1Nm>
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        <GrossRevenueEvent1Amt>42071</GrossRevenueEvent1Amt>
        <FoodAndBeverageEvent1Amt>4024</FoodAndBeverageEvent1Amt>
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        <Event2Nm>GOLF TOURNAMENT</Event2Nm>
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        <GrossRevenueEvent2Amt>15605</GrossRevenueEvent2Amt>
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        <OtherEventsTotalCnt>1</OtherEventsTotalCnt>
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        <GrossRevenueTotalEventsAmt>69576</GrossRevenueTotalEventsAmt>
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        <FoodAndBeverageTotalEventsAmt>4504</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>600</EntertainmentTotalEventsAmt>
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    <IRS990ScheduleI documentId="RetDoc4">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PAWNEE VALLEY COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>923 CARROLL AVE</AddressLine1Txt>
          <CityNm>LARNED</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>67550</ZIPCd>
        </USAddress>
        <RecipientEIN>481253246</RecipientEIN>
        <IRCSectionDesc>509A1</IRCSectionDesc>
        <CashGrantAmt>30234</CashGrantAmt>
        <PurposeOfGrantTxt>EQUIPMENT PURCHASES</PurposeOfGrantTxt>
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    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="RetDoc5">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 - ORGANIZATION'S MISSION</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS FOUNDATION IS ESTABLISHED TO PROVIDE SUPPORT FOR THE ACTIVITIES AND MISSON OF PAWNEE VALLEY COMMUNITY HOSPITAL, INC ("PVCH) IN PVCH'S EFFORTS TO PROVIDE FOR THE HEALTHCARE AND WELLNESS NEEDS OF THE CITIZENS OF PAWNEE COUNTY, KS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4D</FormAndLineReferenceDesc>
        <ExplanationTxt>FOR OPERATION OF PROGRAM SERVICES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>COPY OF 990 WILL BE DISTRIBUTED TO BOARD MEMBERS FOR REVIEW BEFORE RETURN WILL BE TRANSMITTED TO IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD REVIEWS AND CONSISTENTLY MONITORS CONFLICT OF INTEREST POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS ARE AVAILABLE UPON REQEST FROM THE PAWNEE VALLEY COMMUNITY HOSPITAL FOUNDATION BY CONTACTING DAKOTA THACKER.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
