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        <FormAndLineReferenceDesc>SUPPLEMENTAL INFORMATION</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CORPORATION IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>BASED ON THE BY-LAWS, THE BOARD MEMBERS CONSIST OF TEN INDIVIDUALS: 6 OF WHICH CONSIST OF THE PRESIDENT AND CEO OF COVENANT, A PHYSICIAN APPOINTED BY COVENANT, PRESIDENT AND CEO OF ASCENSION ST. MARY'S, A PHYSICIAN APPOINTED BY ASCENSION ST. MARY'S, DEAN OF COLLEGE OF MEDICINE OF CENTRAL MICHIGAN UNIVERSITY AND A CMU EMPLOYEE APPOINTED BY THE DEAN OF THE COLLEGE OF MEDICINE. THE 4 REMAINING BOARD MEMBERS ARE SELECTED FROM MEMBERS OF THE COMMUNITY THAT ARE NOT FROM ANY SPECIFIC ORGANIZATION. IN ADDITION, THE PRESIDENT AND CEO, CFO, COO, AND CAO ARE INVITED TO ATTEND THE MEETINGS AS NON-VOTING MEMBERS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE MEMBERS: A. TO APPROVE THE STATEMENT OF PHILOSOPHY AND MISSION OF THE CORPORATION, B. TO APPROVE THE ADOPTION OF ANY STRATEGIC PLAN OF THE CORPORATION OR ANY MAJOR CHANGE IN THE PROGRAMS OR SERVICES OF THE CORPORATION, C. TO SELECT A QUALIFIED AUDIT FIRM FOR THE CORPORATION, D. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS AND EXPENDITURES OF THE CORPORATION, E. TO APPROVE ANY INDEBTEDNESS OF THE CORPORATION, F. TO APPROVE THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION, G. TO APPROVE ANY AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION, H. TO APPROVE ANY AMENDMENT OF THE BYLAWS OF THE CORPORATION, I. TO APPROVE THE MERGER, CONSOLIDATION, DISSOLUTION, SALE OR OTHER TRANSFER OF SUBSTANTIALLY ALL ASSETS OF THE CORPORATION, AND J. TO APPROVE THE PURCHASE, SALE, TRANSFER OR OTHER ENCUMBRANCE OF ASSETS OF THE CORPORATION.</ExplanationTxt>
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        <ExplanationTxt>ALL MEMBERS OF THE BOARD ARE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. THE FORM IS THEN REVIEWED FOR ANY POSSIBLE CONFLICTS OF INTEREST.</ExplanationTxt>
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        <ExplanationTxt>COMPENSATION FOR THE PRESIDENT AND CEO IS DETERMINED BY A COMPENSATION COMMITTEE COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS. DATA FROM THE MGMA AND VARIOUS OTHER NATIONAL SALARY SURVEYS ARE USED TO DETERMINE THE SALARY OF THE PRESIDENT AND CEO, WHICH IS THEN TAKEN TO THE ENTIRE MEMBERSHIP OF THE BOARD OF DIRECTORS FOR APPROVAL.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>DOCUMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII</FormAndLineReferenceDesc>
        <ExplanationTxt>NO TRUSTEES OR OFFICERS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD. THEY ARE CONSIDERED TO WORK 1 HOUR PER WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 40 HOURS PER WEEK RELATED TO THEIR FULL-TIME POSITION. WE WERE UNABLE TO PRESENT THE COMPENSATION PAID BY ALL RELATED ORGANIZATIONS DUE TO THE FACT THE COMPENSATION INFORMATION WAS NOT PROVIDED. REASONABLE EFFORTS WERE TAKEN TO OBTAIN THE COMPENSATION INFORMATION FROM ASCENSION ST. MARY'S, COVENANT HEALTHCARE, AND CENTRAL MICHIGAN UNIVERSITY BUT THESE EFFORTS WERE UNSUCCESSFUL. AS PREVIOUSLY DISCLOSED, THE COMPENSATION PAID BY THESE RELATED ORGANIZATIONS ARE BEING PAID TO THE INDIVIDUALS FOR SERVICES PROVIDED TO THE RELATED ORGANIZATIONS AS EMPLOYEES OF THESE ORGANIZATIONS. NO COMPENSATION IS BEING PAID TO THESE INDIVIDUALS FOR SERVICES PROVIDED TO THE ORGANIZATION AS BOARD MEMBERS. THE FOLLOWING BOARD MEMBERS ARE PAID BY A RELATED ORGANIZATION: GEORGE KIKANO, MD ROBERT DAVIES BETH CHARLTON MICHAEL SULLIVAN, MD STEPHANIE DUGGAN, MD DOUGLAS APPLE, MD MARY HILL</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc6">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COVENANT HEALTHCARE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1447 NORTH HARRISON</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48602</ZIPCd>
        </USAddress>
        <EIN>383369443</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ASCENSION ST MARY'S</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>800 S WASHINGTON AVE</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48601</ZIPCd>
        </USAddress>
        <EIN>380997730</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CMU</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>WARRINER HALL</AddressLine1Txt>
          <CityNm>MT PLEASANT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48859</ZIPCd>
        </USAddress>
        <EIN>386004447</EIN>
        <PrimaryActivitiesTxt>EDUCATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>2</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CENTRAL HEALTH ADVANCEMENT SOLUTION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>WARRINER HALL</AddressLine1Txt>
          <CityNm>MT PLEASANT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48859</ZIPCd>
        </USAddress>
        <EIN>453862232</EIN>
        <PrimaryActivitiesTxt>EDUCATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>5</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CMU</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
