5 August 1987, the Department of the Army directed a realignment of the 10th MASH with the 4th Infantry Division (Mechanized), with an effective date of 16 August 1988. The 10th MASH was under the 43rd Support Group as a battalion organization with the 517th Medical Company (Clearing), 571st Medical Detachment (Air Ambulance), 223rd Medical Detachment (Preventive Medicine) and 40th Dental Company as subordinate units. On 3 Jan. 1991, the 10th MASH deployed to Saudi Arabia with the 44th Medical Brigade, 1st Medical Group in support of Operation Desert Storm until July 1991. Second Reorganization as a Combat Support Hospital The Department of the Army redesignated the 10th MASH as the 10th Combat Support Hospital 16 Dec. 1992. The 10th CSH (FWD) deployed to Bosnia and Hungary in support of Operation Joint Forge from 12 March to 27 Sept. 1999. The 10th CSH was a modular-designed facility, which consisted of a HUB (Hospital Unit Base) and HUS (Hospital Unit Surgical). The unit had 8 wards providing intensive nursing care for up to 96 patients, 7 wards providing intermediate nursing care for up to 140 patients, one ward providing neuropsychiatric (NP) care for up to 20 patients. Surgical capacity was based on 8 operating room tables for a surgical capacity of 144 operating room (OR) table hours per day. The unit could be further augmented with specialty surgical/medical teams to increase its capabilities. The hospital was equipped with Deployable Medical System (DEPMEDS) equipment, which could be set up in various configurations. The major components of a combat support hospital were the expandable tactical shelters, TEMPER Tents, and the military vans. The expandable tactical shelter was a rigid paneled metal unit that could be unfolded to become an enclosed air conditioned shelter for use as an operating room, central material services, pharmacy, laboratory, blood bank, radiology, or biomedical maintenance. The TEMPER (Tent Extendible Modular Personnel) tent featured an aluminum frame and fabric outer skin, which could be quickly assembled and disassembled without, tools. The standard ward was 20 feet by 64 feet, consisting of 8 8-by-20-foot TEMPER sections. The MILVAN was a rigid paneled metal storage and transportation container, which was allocated to the functional sections of the hospital. When operational, the combat support hospital could provide climate and environmental control equivalent to that found in any fixed hospital. In January 2004, the 10th CSH became the first hospital to complete the