2015-05-19T15:03:11-05:00 2013-06-30 382806590 MAKELA TOUTANT HILL & NARDI PC 201 W BLUFF STREET MARQUETTE MI 49855 990 2012-07-01 381358036 MGH WIND DOWN INC MGHW 9062253450 420 W MAGNETIC STREET MARQUETTE MI 49855 SCOTT HERIOUX 9062253450 2015-05-19 1 ROBIN RAUVALA CPA P00070626 9062283600 2015-05-19 2012 2016-02-25 16:41:14Z SCOTT HERIOUX 420 W MAGNETIC STREET MARQUETTE MI 49855 176981551 0 X N/A X 1897 MI TO WIND DOWN THE REMAINING ASSETS AND LIABILITIES OF MARQUETTE GENERAL HEALTH SYSTEM. 3 3 2778 510 785391 0 2957349 501060 327845066 39717517 -1180453 -4861895 -11946 -4122 329610016 35352560 0 0 0 0 164135024 32933547 0 0 0 162588849 43936231 326723873 76869778 2886143 -41517218 242532893 49226960 198400518 49226960 44132375 0 X THE ORGANIZATION OPERATED A HOSPITAL FOR THE FIRST TWO MONTHS. SUBSTANTIALLY ALL OF ITS ASSETS WERE SOLD EFFECTIVE SEPTEMBER 1, 2012. THE ORGANIZATION WILL CONTINUE ITS WIND DOWN ACTIVITIES UNTIL ALL OF ITS CURRENT AND POST-CLOSING OBLIGATIONS ARE MET. 0 1 36274526 24763969 HOSPITAL SERVICES 13140267 13583645 PHYSICIAN PRACTICES 757623 892842 HOME HEALTH SERVICES 14509018 477061 BLOOD PRODUCT SALES AND EMPLOYEE AND GUESTS MEALS 14509018 477061 64681434 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 0 1 219 0 1 2778 1 1 1 0 0 0 0 0 0 0 0 0 X 3 3 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 MI X STEPHEN EMBREE 9062253450 420 W MAGNETIC STREET MARQUETTE MI 49855 TIMOTHY J LARSON 3.00 X X 0 0 0 RICHARD R SCHAEFER 3.00 X X 0 0 0 JUDITH WATSON-OLSON 3.00 X X 0 0 0 SCOTT HERIOUX 3.00 X X 0 0 0 MICHAEL L VONCK 3.00 X X 0 0 0 LOIS A MICHELIN 3.00 X X 0 0 0 RICHARD BLOTTER 2.00 X 0 0 0 BRADLEY CORY 2.00 X 0 0 0 GARY LAPLANT 2.00 X 0 0 0 LARRY S LEWIS MD 50.00 X 282245 0 0 MARYANNE SHANNON 2.00 X 0 0 0 K MICHAEL SKYTTA 2.00 X 0 0 0 NANCY DWYER 2.00 X 0 0 0 DAN GREENLEE 2.00 X 0 0 0 A GARY MULLER 50.00 X X 1682803 0 17931 JERRY L WORDEN 50.00 X 816619 0 50756 DAVID S GRASER 50.00 X 748846 0 46754 THOMAS F NOREN MD 50.00 X 701922 0 17931 DAGMAR A RAICA 50.00 X 192161 0 14145 CRAIG COCCIA 50.00 X 1135671 0 22256 PAUL LAHAYE 50.00 X 593432 0 22114 DOUGLAS BALDWIN 50.00 X 575408 0 12114 ANDREW JAHODA 50.00 X 474105 0 13946 MICHAEL HARL 50.00 X 455370 0 22114 FREDERICK P HOENKE MD 50.00 X 255333 0 24310 7913915 0 264371 150 1 1 0 UPIMS LLC (CARDIOLOGY JOINT VENTURE) 1414 W FAIR AVE MARQUETTE MI 49855 IMAGING SERVICES 3122462 REHAB CARE GROUP INC 7733 FORSYTH BLVD ST LOUIS MO 63105 THERAPY SERVICES 2340889 UP REHAB SERVICES LLC 555 COUNTY ROAD HQ MARQUETTE MI 49855 THERAPY SERVICES 2156269 SOUND PHYSICIANS 1123 PACIFIC AVENUE TACOMA WA 98402 PHYSICIAN SERVICES 1518897 DMS IMAGING 2101 N UNIVERSITY DRIVE FARGO ND 58102 PET SCANNING 648208 34 490234 10826 501060 HOSPITAL SERVICES 622110 24763969 23978578 785391 PHYSICIAN PRACTICES 621111 13583645 13583645 HOME HEALTH SERVICES 621610 892842 892842 EMPLOYEE & GUEST MEALS 722212 242538 242538 BLOOD PRODUCTS 621511 234523 234523 39717517 244698 244698 159356 159356 10452 14574 -4122 -4122 -4122 136348468 141614417 -5265949 -5265949 -5265949 35352560 38689588 785391 -4623479 X 1149557 114956 1034601 23320360 22620749 699611 2920665 2833045 87620 4083459 3960955 122504 1459506 1415721 43785 1752219 1314164 438055 396745 396745 28488 7122 21366 257157 257157 9774595 4236767 5537828 53241 51644 1597 12376802 12005498 371304 776183 752898 23285 1485219 1440662 44557 262554 254677 7877 17236 16719 517 3240079 3142877 97202 2182317 2116847 65470 285478 276914 8564 EXTINGUISHMENT OF DEBT 2806862 2806862 UNCOMPENSATED CARE 2129651 2129651 QUALITY ASSURANCE ASSES 2050172 2050172 4061233 3939396 121837 76869778 64681434 12188344 0 33024052 7287154 789976 29675909 36208 8056032 3169284 0 89017879 57380554 20872251 14221522 7161477 21067555 242532893 49226960 38719695 11717242 61178740 427029 414718 98075054 37095000 198400518 49226960 X 41947903 0 1731710 0 452762 0 44132375 0 242532893 49226960 X -41517218 -51850 -2563307 X 1 X 0 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE FROM PURCHASER 18644184 DUE FROM FOUNDATION 728315 OTHER RECEIVABLES 1276379 OTHER NONCURRENT ASSETS 418677 21067555 CONTINGENT LIABILITY 18000000 LEGALLY DEFEASED BONDS 19095000 37095000 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE COMPANY AND RECOGNIZE A TAX LIABILITY IF THE COMPANY HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE COMPANY AND HAS CONCLUDED THAT AS OF JUNE 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2010. 1 1 1 X 1 X 1 1 0 0 146203 146203 0.00200 6881965 4036402 2845563 0.03810 97705 90961 6744 0.00010 7125873 4127363 2998510 0.04020 145137 32487 112650 0.00150 877619 482084 395535 0.00530 3816929 2830974 985955 0.01320 91164 250 90914 0.00120 16358 16358 0.00020 4947207 3345795 1601412 0.02140 12073080 7473158 4599922 0.06160 109 109 0.00000 12832 12832 0.00020 12941 12941 0.00020 1 2129651 1277791 12753312 9725535 3027777 X 1 0 1 UP IMAGING MANAGEMENT SERVICES LLC OUTPATIENT NON-INVASIVE DIAGNOSTIC CARDIOVASCULAR IMAGING SERVICES 0.60000 0.40000 1 1 MARQUETTE GENERAL HOSPITAL INC

420 W MAGNETIC ST MARQUETTE MI 49855

X X X X X MARQUETTE GENERAL HOSPITAL INC 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X 1 X X X 1 X X X X X X X 1 X 0 1 14 MARQUETTE MEDICAL CLINIC

1414 WEST FAIR AVENUE MARQUETTE MI 49855

OUTPATIENT CLINIC MARQUETTE GENERAL HEMOTOLOGYONCOLOGY

1711 SOUTH STEPHENSON AVE SUITE 315 IRON MOUNTAIN MI 49801

OUTPATIENT CLINIC CHIPPEWA MEDICAL ASSOCIATES

AVERY SQUARE 510 ASHUM SUITE 5 SAULT STE MARIE MI 49783

OUTPATIENT CLINIC MARQUETTE SPECIALTY CLINIC

800 EAST BOULEVARD KINGSFORD MI 49802

OUTPATIENT CLINIC LAKEWOOD MEDICAL ASSOCIATES

5087 US 41 SOUTH MARQUETTE MI 49855

OUTPATIENT CLINIC MARQUETTE MEDICAL CLINIC

2500 7TH AVE SOUTH ESCANABA MI 49829

OUTPATIENT CLINIC MARQUETTE MEDICAL CLINIC

405 US 41 EAST NEGAUNEE MI 49866

OUTPATIENT CLINIC MARQUETTE MEDICAL CLINIC

1500 W ICE LAKE RD IRON RIVER MI 49935

OUTPATIENT CLINIC MARQUETTE MEDICAL CLINIC

2002 MINNEAPOLIS AVE GLADSTONE MI 49837

OUTPATIENT CLINIC MARQUETTE MEDICAL CLINIC

500 CAMPUS DRIVE SUITE 5 HANCOCK MI 49930

OUTPATIENT CLINIC ONTONAGON COMMUNITY HEALTH CENTER

751 S 7TH ST ONTONAGON MI 49953

OUTPATIENT CLINIC MARQUETTE MEDICAL CLINIC

COMMUNITY BUILDING TRENARY MI 49891

OUTPATIENT CLINIC MARQUETTE MEDICAL CLINIC

BURT TOWNSHIP HALL GRAND MARAIS MI 49839

OUTPATIENT CLINIC MARQUETTE MEDICAL CLINIC

205 OSCEOLA ST LAURIUM MI 49913

OUTPATIENT CLINIC PART I, LINE 7: ROW A - CHARITY CARE: COST TO CHARGE RATIO.ROW B - MEDICAID: COST TO CHARGE RATIO USING MEDICARE COST REPORT RULES.ROW C - UNREIMBURSED COSTS: COST TO CHARGE RATIO USING MEDICARE COST REPORT RULES.ROW E TO J - OTHER BENEFITS: DIRECT CHARGE OF TIME AND COSTS. PART I, LINE 7G: THE SYSTEM PROVIDES SUBSIDIZED HEALTH SERVICES FOR BEHAVIORAL HEALTH, FAMILY PRACTICE CLINICS IN MEDICALLY UNDERSERVED AREAS, NICU, AND WOMEN'S SERVICES. COSTS OF SUBSIDIZED HEALTH SERVICES FOR PHYSICIAN CLINICS INCLUDED IN LINE 7G ARE $2,716,259. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2129651. PART II: COMMUNITY BUILDING ACTIVITIES INCLUDE PARTICIPATION IN COLLABORATIVE PARTNERSHIPS WITH COMMUNITY GROUPS, RECRUITMENT OF PROFESSIONALS FOR AREAS IDENTIFIED AS MEDICALLY UNDERSERVED, REGIONAL ECONOMIC DEVELOPMENT GROUPS AND PROGRAMS. PART III, LINE 4: ALL PATIENT ACCOUNTS RECEIVABLE WERE SOLD TO DLP MARQUETTE GENERAL HOSPITAL ON SEPTEMBER 1, 2012, AND THE ORGANIZATION IS IN THE PROCESS OF WINDING DOWN ITS FINANCIAL AFFAIRS. AS OF JUNE 30, 2013, THERE WERE NO BAD DEBT RESERVES AND THUS THERE WAS NO BAD DEBT FOOTNOTE.COSTING METHODOLOGY: BAD DEBT EXPENSE WAS $2,129,651 WHICH WAS CALCULATED USING THE ORGANIZATION'S RATIO OF PATIENT CARE COST TO CHARGES. AN ATTORNEY REVIEWED THE ACCOUNTS TO DETERMINE THE PERCENTAGE THAT WOULD HAVE QUALIFIED FOR CHARITY CARE. PART III, LINE 8: MEDICARE COSTS ARE FROM THE MEDICARE COST REPORT, WHICH UTILIZES MEDICARE ALLOWABLE COST AND THEN RATIO OF COST TO CHARGES BY HCFA LINE NUMBER. MEDICARE ALLOWABLE COST IS DETERMINED BY INCLUDING ALL DIRECT AND INDIRECT EXPENSES IN WORKSHEET A AND THEN OFFSETTING ANY NON-ALLOWABLE COSTS AND MISCELLANEOUS REVENUES. NON-ALLOWABLE COSTS INCLUDE ANY EXPENSE NOT NECESSARY FOR PATIENT CARE OR THOSE DEEMED A LUXURY OR EXCESSIVE. TYPICAL OFFSETS INCLUDE PATIENT TELEVISIONS AND TELEPHONES, PAYMENTS TO PROVIDER BASED PHYSICIANS IN EXCESS OF REASONABLE LIMITS, AND NON-PATIENT REVENUE, TO NAME A FEW. OVERHEAD IS STEPPED-DOWN TO THE REIMBURSABLE AND NON-REIMBURSABLE HCFA LINES. TOTAL COST IS THEN DETERMINED USING RATIO OF COST TO CHARGES. MARQUETTE GENERAL HOSPITAL INC PART V, SECTION B, LINE 12H: CREDIT REPORT, LIVING ARRANGEMENTS/HOME LIFE, CONVERSATIONS WITH PATIENT OR PATIENT'S FAMILY. MARQUETTE GENERAL HOSPITAL INC PART V, SECTION B, LINE 14G: REGISTRATION PERSONNEL REFER UNINSURED AND LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE POLICY. ALSO, A THIRD PARTY COLLECTOR WILL DISCUSS THE POLICY WITH PATIENTS HAVING PAST DUE ACCOUNTS. MARQUETTE GENERAL HOSPITAL INC PART V, SECTION B, LINE 18E: REGISTRATION PERSONNEL, FINANCIAL COUNSELORS, AND THE THIRD PARTY COLLECTOR REVIEW PATIENT AND/OR ACCOUNT INFORMATION TO DETERMINE IF PATIENTS MAY QUALIFY FOR STATE OR FEDERAL ASSISTANCE. MARQUETTE GENERAL HOSPITAL INC PART V, SECTION B, LINE 20D: ALL PATIENTS ARE CHARGED THE SAME FIXED GROSS RATES FOR SERVICES. DISCOUNTS ARE APPLIED IF QUALIFICATIONS ARE MET AND THE PATIENT FOLLOWS THE FINANCIAL ASSISTANCE POLICY PROCESS. MARQUETTE GENERAL HOSPITAL INC PART V, SECTION B, LINE 22: ALL PATIENTS ARE CHARGED THE SAME FIXED GROSS RATES FOR SERVICES. DISCOUNTS ARE APPLIED IF QUALIFICATIONS ARE MET AND THE PATIENT FOLLOWS THE FINANCIAL ASSISTANCE POLICY PROCESS. PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY UTILIZING NEEDS ASSESSMENTS CONDUCTED BY MULTIPLE AGENCIES PROVIDING HEALTH CARE TO THE SERVICE AREA POPULATION, AS WELL AS CONDUCTING AND DIRECTING QUALITATIVE (FOCUS GROUPS AND INDIVIDUAL, IN PERSON INTERVIEWS) AND QUANTITATIVE (PHONE SURVEYS) MARKET RESEARCH OF THE SERVICE AREA POPULATION. RESEARCH IS ALSO CONDUCTED VIA INTERVIEWS AND FOCUS GROUPS WITH PHYSICIANS AND MID-LEVELS TO DETERMINE HEALTH CARE NEEDS. PART VI, LINE 3: IN-HOUSE MEDICAL ASSISTANCE EXPERTS EXPLAIN PROGRAMS TO PATIENTS AND ASSIST WITH THE APPLICATION PROCESS. PATIENT ACCESS IDENTIFIES SELF-PAY AND UNDERINSURED PATIENTS AND REFERS THEM TO IN-HOUSE FINANCIAL COUNSELORS. FINANCIAL ASSISTANCE INFORMATION AND APPLICATIONS ARE AVAILABLE ON-LINE. PART VI, LINE 4: THE SYSTEM SERVES THE RESIDENTS OF THE UPPER PENINSULA OF MICHIGAN. PART VI, LINE 5: THE MAJORITY OF THE ORGANIZATION'S BOARD MEMBERS ARE INDEPENDENT AND RESIDE AND/OR WORK IN MARQUETTE COUNTY, THE ORGANIZATION'S PRIMARY SERVICE AREA. MANY LOCAL PHYSICIANS NOT EMPLOYED BY THE HOSPITAL HAVE PRIVILEGES AT THE HOSPITAL. X X X X X X 0 1 0 0 0 0 0 0 0 LARRY S LEWIS MD 282245 0 0 0 0 0 0 0 126 0 282371 0 0 0 A GARY MULLER 1583030 0 83081 0 16692 0 10000 0 21886 0 1714689 0 0 0 JERRY L WORDEN 696118 0 0 0 120501 0 41440 0 16866 0 874925 0 76880 0 DAVID S GRASER 644332 0 0 0 104514 0 38823 0 9773 0 797442 0 65829 0 THOMAS F NOREN MD 667670 0 30003 0 4249 0 10000 0 9688 0 721610 0 0 0 DAGMAR A RAICA 190868 0 0 0 1293 0 7686 0 7346 0 207193 0 0 0 CRAIG COCCIA 1135671 0 0 0 0 0 10000 0 13207 0 1158878 0 0 0 PAUL LAHAYE 593432 0 0 0 0 0 10000 0 13065 0 616497 0 0 0 DOUGLAS BALDWIN 508919 0 0 0 66489 0 0 0 14340 0 589748 0 0 0 ANDREW JAHODA 399105 0 75000 0 0 0 10000 0 5422 0 489527 0 0 0 MICHAEL HARL 435370 0 20000 0 0 0 10000 0 13320 0 478690 0 0 0 FREDERICK P HOENKE MD 255033 0 300 0 0 0 10000 0 15624 0 280957 0 0 0 PART I, LINE 4B PART I, LINE 4B: SUPPLEMENTAL RETIREMENT PAYMENTS MADE TO SECTION 457(F) PLAN FOR: JERRY L WORDEN $31,440 DAVID S GRASER $28,822 DISTRIBUTIONS FROM SECTION 457(F) PLAN MADE TO: JERRY L WORDEN $115,292 DAVID S GRASER $101,603 CINDY MASSIE FAMILY MEMBER OF CURRENT BOARD MEMBER, TIMOTHY J LARSON 38643 EMPLOYMENT 0 JESSICA BLEAU-WORDEN FAMILY MEMBER OF CURRENT OFFICER, JERRY WORDEN 41059 EMPLOYMENT 0 CASH AND CASH EQUIVALENTS 2012-09-01 27866 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC NET ACCOUNTS RECEIVABLE 2012-09-01 32255308 NET COLLECTABILITY ANALYSIS 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC INVENTORIES 2012-09-01 8691832 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC PREPAIDS 2012-09-01 2362203 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC OTHER CURRENT ASSETS 2012-09-01 4299196 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC LAND 2012-09-01 6566086 THIRD PARTY VALUATION 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC BUILDINGS AND IMPROVEMENTS 2012-09-01 80503814 THIRD PARTY VALUATION 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC EQUIPMENT 2012-09-01 26475630 THIRD PARTY VALUATION 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC CONSTRUCTION IN PROGRESS 2012-09-01 1195178 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC GOODWILL 2012-09-01 35632596 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC OTHER INTANGIBLE ASSETS 2012-09-01 11988788 NET PRESENT VALUE OF PROJECTED PROFIT/LOSS 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC ACCOUNTS PAYABLE 2012-09-01 -7754914 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC ACCRUED SALARIES 2012-09-01 -7390367 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC ACCRUED EXPENSES 2012-09-01 -17998261 ACTUAL COST 364733741 DLP MARQUETTE HOLDING COMPANY LLC 103 POWELL COURT BRENTWOOD TN 37027 LLC CASH 2012-09-01 23000000 ACTUAL COST 203615349 SUPERIOR HEALTH FOUNDATION 121 N FRONT STREET MARQUETTE MI 49855 501(C)(3) TRANSACTION EXP - CONSULTING 2012-09-01 5071500 COMMISSION BASIS 270150227 JUNIPER ADVISORY LLC 2727 ALLEN PARKWAY SUITE 1350 HOUSTON TX 77019 LLC TRANSACTION EXP - CONSULTING 2012-09-01 180000 FIXED FEE 540505857 MCGUIRE WOODS LLP 1750 TYSONS BLVDSUITE 1800 TYSONS CORNER VA 22102 LLP TRANSACTION EXP - LEGAL FEES 2012-09-01 310000 FIXED FEE 381446628 DYKEMA GOSSETT PLLC 400 RENAISSANCE CENTER DETROIT MI 48243 PLLC TRANSACTION EXP - FINANCIAL ADVISOR 2012-09-01 50417 FIXED FEE PLUS ACTUAL EXPENSES 223376133 FIRST RIVER ADVISORY LLC 2640 OVERRIDGE DRIVE ANN ARBOR MI 48104 LLC 0 1 0 1 PART II, LINE 2B: THE FOLLOWING OFFICERS AND KEY EMPLOYEES BECAME EMPLOYEES OF DLP MARQUETTE HOLDING COMPANY: A GARY MULLER, JERRY L WORDEN, DAVID S GRASER, THOMAS F NOREN AND DAGMAR A RAICA.PART II, LINE 2D: THE FOLLOWING OFFICERS AND KEY EMPLOYEES RECEIVED A SEVERANCE PAYMENT FOR THEIR CONTRACT TERMINATION: A GARY MULLER, JERRY L WORDEN, DAVID S GRASER AND THOMAS F NOREN. CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 THE ORGANIZATION SOLD SUBSTANTIALLY ALL OF ITS ASSETS EFFECTIVE SEPTEMBER 1, 2012, AT WHICH TIME IT DISCONTINUED ALL PROGRAM SERVICES. THE ORGANIZATION WILL CONTINUE ITS WIND DOWN ACTIVITIES UNTIL ALL OF ITS CURRENT AND POST-CLOSING OBLIGATIONS ARE MET. FORM 990, PART VI, SECTION A, LINE 4 THERE HAVE BEEN SIGNIFICANT CHANGES TO THE GOVERNING DOCUMENTS OF THE CORPORATION. AS OF SEPTEMBER 1, 2012, SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS WERE SOLD. THE CORPORATION NO LONGER OPERATES A HOSPITAL; HOWEVER, FOLLOW UP ACTIVITIES RELATED TO THE HOSPITAL OPERATION CONTINUE TO BE CARRIED OUT BY MGH WIND DOWN INC. NOTE THAT THE NAME OF THE CORPORATION HAS BEEN CHANGED FROM MARQUETTE GENERAL HOSPITAL INC TO MGH WIND DOWN INC. THE TRANSACTION VALUE WAS APPRAISED BY THE ATTORNEY GENERAL OF THE STATE OF MICHIGAN, AND ALTHOUGH THE APPRAISER DETERMINED THAT THE AMOUNT PAID WAS FAIR MARKET VALUE, THE ATTORNEY GENERAL REQUIRED THAT AN ADDITIONAL AMOUNT BE TRANSFERRED TO A FOUNDATION ESTABLISHED TO PROMOTE THE HEALTH OF THE COMMUNITY. SINCE THE NAME OF THE CONTINUING HOSPITAL IS MARQUETTE GENERAL HOSPITAL, THE NAME CHANGE WAS REQUIRED AND IS REFLECTED IN AN AMENDMENT TO THE ARTICLES OF INCORPORATION. FURTHERMORE, THE BYLAWS WERE AMENDED TO REFLECT OPERATIONAL CHANGES. YOU WILL NOTE THAT THE SIZE OF THE BOARD IS SUBSTANTIALLY SMALLER SINCE THE ACTIVITIES OF MGH WIND DOWN INC ARE LIMITED TO MONITORING DEFEASANCE OF TAX EXEMPT BONDS, ASSURING THE SATISFACTION OF DEFINED BENEFIT PLAN OBLIGATIONS, MONITORING COST REPORT ISSUES AND OTHER OBLIGATIONS OF THE CORPORATION, AND PROTECTION OF THE CORPORATE ASSETS - WHICH SHALL TRANSFER TO THE FOUNDATION UPON FINAL SETTLEMENT OF ALL ASSETS AND LIABILITIES. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE EMAILED TO ALL BOARD MEMBERS FOR THEIR REVIEW AND ANY QUESTIONS WILL BE RESPONDED TO PRIOR TO FILING. AT THE NEXT BOARD MEETING AFTER FILING, A SUMMARY PRESENTATION WILL BE GIVEN TO THE BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF TRUSTEES SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY. EMPLOYEES WHO ALSO SERVE ON THE BOARD OR WHO ARE OFFICERS ARE REMINDED AT THEIR ANNUAL EVALUATIONS TO ABIDE BY THE CODE OF CONDUCT AND ALSO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 TO DETERMINE EXECUTIVE COMPENSATION FOR THE CEO, VICE PRESIDENTS AND OFFICERS OF THE CORPORATION, THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO CONDUCT SALARY SURVEYS OF THE HEALTH CARE MARKET. THE INDEPENDENT CONSULTANT REVIEWS FINDINGS AND MAKES RECOMMENDATIONS TO THE COMPENSATION COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATION WEBSITE. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE WITHIN CONTINUING DISCLOSURES FOR BOND ISSUANCES AT WWW.FIRSTRIVER.COM. THE ORGANIZATION DOES NOT MAKE PUBLICLY AVAILABLE ITS CONFLICT OF INTEREST POLICY. OTHER FEES FORM 990, PART IX, LINE 11G ACQUISITION CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 5,314,167. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,314,167. OTHER: PROGRAM SERVICE EXPENSES 4,236,767. MANAGEMENT AND GENERAL EXPENSES 223,661. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,460,428. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS OF AFFILIATES -2,563,307. MATTSON MANAGEMENT GROUP LLC 420 W MAGNETIC ST MARQUETTE MI 49855 300136373 LANDHOLDING MI 0 0 N/A RAMPART EMERGENCY MEDICAL SERVICES INC 828 SHERIDAN ROAD ESCANABA MI 49829 382413139 EMERGENCY MEDICAL SERVICES MI 501(C)(3) 9 N/A 1 MARQUETTE GENERAL FOUNDATION 420 W MAGNETIC ST MARQUETTE MI 49855 203615349 FUNDRAISING FOR MARQUETTE GENERAL HOSPITAL MI 501(C)(3) 11A TYPE I N/A 1 UPPER PENINSULA HEALTH PLAN INC 228 W WASHINGTON ST MARQUETTE MI 49855 383379956 MEDICAID HMO MI 501(C)(4) N/A N/A 1 UPPER PENINSULA MANAGED CARE LLC 228 W WASHINGTON ST MARQUETTE MI 49855 383323620 MANAGEMENT COMPANY OF UP HEALTH PLAN MI N/A RELATED 282638 0 0 0.56270 ICE LAKE MEDICAL ARTS BUILDING 420 W MAGNETIC ST MARQUETTE MI 49855 382206384 LEASING OF BUILDING SPACE MI N/A C 14000 0.66670 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 MARQUETTE GENERAL FOUNDATION C 490234 CASH MARQUETTE GENERAL FOUNDATION L 58561 REVIEW OF G/L ACCOUNTS MARQUETTE GENERAL FOUNDATION N 6000 MANAGEMENT ESTIMATE MARQUETTE GENERAL FOUNDATION R 25455553 COST RAMPART EMERGENCY MEDICAL SERVICES INC S 2092660 FINANCIAL STATEMENTS MATTSON MANAGEMENT GROUP S 122433 FINANCIAL STATEMENTS