﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2023v6.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-05-14T09:40:04-04:00</ReturnTs>
    <TaxPeriodEndDt>2024-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>383133790</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>ANDREWS HOOPER PAVLIK PLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>4295 OKEMOS RD STE 200</AddressLine1Txt>
        <CityNm>OKEMOS</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>488646201</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>381358172</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>SPARROW CLINTON HOSPITAL</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>SPAR</BusinessNameControlTxt>
      <PhoneNum>9892273400</PhoneNum>
      <USAddress>
        <AddressLine1Txt>805 S OAKLAND STREET</AddressLine1Txt>
        <CityNm>ST JOHNS</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48879</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MARGARET DIMOND PHD</PersonNm>
      <PersonTitleTxt>REGIONAL PRESIDENT</PersonTitleTxt>
      <PhoneNum>9892246881</PhoneNum>
      <SignatureDt>2025-05-09</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>true</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>JULIE M PFEIFLE</PreparerPersonNm>
      <PTIN>P00751307</PTIN>
      <PhoneNum>5177060800</PhoneNum>
      <PreparationDt>2025-05-09</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc4" referenceDocumentId="RetDoc7 RetDoc3">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>UNIV OF MI HEALTH - SPARROW CLINTON</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>MARGARET DIMOND PHD</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
        <CityNm>LANSING</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48912</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>79272596</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.UOFMHEALTHSPARROW.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1926</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>IMPROVING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES BY PROVIDING QUALITY, COMPASSIONATE CARE TO EVERYONE, EVERY TIME.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>12</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>5</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>336</TotalEmployeeCnt>
      <TotalVolunteersCnt>24</TotalVolunteersCnt>
      <TotalGrossUBIAmt>8021771</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>522221</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>54321</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>32208747</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>71971021</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>3740279</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>6686377</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>235643</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>541605</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>36706890</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>79253324</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>13198832</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>28176465</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>13134480</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>30288059</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>26333312</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>58464524</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>10373578</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>20788800</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>193163954</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>222569231</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>10773173</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>11707280</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>182390781</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>210861951</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>IMPROVING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES BY PROVIDING QUALITY, COMPASSIONATE CARE TO EVERYONE, EVERY TIME.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>35064810</ExpenseAmt>
      <RevenueAmt>49417926</RevenueAmt>
      <Desc>SPARROW CLINTON HOSPITAL'S OUTPATIENT SERVICES ARE TYPICAL OF A SMALL RURAL FACILITY. THE EMERGENCY DEPARTMENT PROVIDES NURSING AND PHYSICIAN SERVICES 24 HOURS A DAY, 7 DAYS A WEEK, WITH PHYSICIANS ON SITE 100% OF THE TIME. SCREENING EXAMS ARE PROVIDED TO EVERYONE WHO PRESENTS FOR SERVICES PRIOR TO ANY FINANCIAL INFORMATION BEING OBTAINED OR CHARGES DISCUSSED WITH PATIENTS IN ACCORDANCE WITH EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA). LABORATORY, RADIOLOGY, RESPIRATORY SERVICES, SURGERY, WOUND CARE, AS WELL AS INFUSION/ONCOLOGY ARE TYPICAL OF OTHER OUTPATIENT SERVICES PROVIDED. SPARROW CLINTON HOSPITAL ACCEPTS ALL GOVERNMENTAL PAYERS INCLUDING MEDICARE, MEDICAID, AND TRICARE WITH REIMBURSEMENT AT OR BELOW COSTS. ADDITIONALLY, SPARROW CLINTON HOSPITAL'S CHARITY CARE POLICY COVERS SERVICES IN THE OUTPATIENT SETTING, IN TURN PROVIDING FREE CARE TO THOSE IN THE COMMUNITY WHO QUALITY. FOR THE YEAR ENDED JUNE 30, 2024, SPARROW CLINTON HOSPITAL RECORDED 13,460 EMERGENCY ROOM VISITS; 234,376 LAB TESTS; 37,265 RADIOLOGY PROCEDURES; 19,540 CARDIO/RESPIRATORY PROCEDURES; 1,035 SURGERIES/723 SCOPES; AND 1,108 INFUSION/ONCOLOGY VISITS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>7009413</ExpenseAmt>
        <RevenueAmt>4678317</RevenueAmt>
        <Desc>SPARROW CLINTON HOSPITAL OPERATES TWO PHYSICIAN PRACTICE OFFICES WITHIN CLINTON COUNTY, OFFERING PRIMARY CARE AS WELL AS SOME SPECIALTY CARE WITHIN AREAS SUCH AS INTERNAL MEDICINE, GENERAL SURGERY, ORTHOPEDICS, PLASTIC SURGERY, AND NEUROLOGY. THE PRIMARY CARE PRACTICES ARE LOCATED IN THE COMMUNITIES OF ST JOHNS AND OWOSSO, AND ARE DESIGNATED AS PATIENT-CENTERED MEDICAL HOMES. SPARROW CLINTON HOSPITAL ACCEPTS ALL GOVERNMENTAL PAYERS INCLUDING MEDICARE, MEDICAID, AND TRICARE, WITH REIMBURSEMENT RATES AT OR BELOW COSTS. ADDITIONALLY, SPARROW CLINTON HOSPITAL'S CHARITY CARE POLICY COVERS SERVICES IN THE OUTPATIENT SETTING, IN TURN PROVIDING FREE CARE TO THOSE IN THE COMMUNITY WHO QUALIFY. FOR THE YEAR ENDED JUNE 30, 2024, THERE WERE 26,687 VISITS IN OUR PHYSICIAN OFFICES.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>5011038</ExpenseAmt>
        <RevenueAmt>10093459</RevenueAmt>
        <Desc>SPARROW CLINTON HOSPITAL'S INPATIENT SERVICES ARE TYPICAL OF A SMALL RURAL FACILITY. OPERATING 25 BEDS, SPARROW CLINTON HOSPITAL PROVIDES NURSING AND PHYSICIAN SERVICES 24 HOURS A DAY, 7 DAYS A WEEK. SPARROW CLINTON HOSPITAL ALSO PARTICIPATES IN THE SWING BED PROGRAM TO PROVIDE SKILLED NURSING CARE AND REHABILITATION TO PATIENTS TRANSITIONING FROM ACUTE CARE TO HOME OR LONG-TERM CARE. FOR THE YEAR ENDED JUNE 30, 2024, THERE WERE 728 ADMISSIONS WITH 2,449 INPATIENT DAYS OF CARE; AS WELL AS 44 SWING BED ADMISSIONS WITH 469 SWING BED DAYS OF CARE. NURSING STAFF ARE ON SITE 100% OF THE TIME, AND HOSPITALIST COVERAGE IS AVAILABLE ON AN ON-CALL BASIS 100% OF THE TIME WHEN NOT IN THE HOSPITAL. SPARROW CLINTON HOSPITAL ACCEPTS ALL GOVERNMENTAL PAYERS INCLUDING MEDICARE, MEDICAID, AND TRICARE WITH REIMBURSEMENT AT OR BELOW COSTS. ADDITIONALLY, THE HOSPITAL'S CHARITY CARE POLICY COVERS ALL INPATIENT SERVICES, IN TURN PROVIDING FREE CARE TO THOSE IN THE COMMUNITY WHO QUALIFY.</Desc>
      </ProgSrvcAccomActy3Grp>
      <TotalProgramServiceExpensesAmt>47085261</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc10">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc5">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc5">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc5">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc5">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc5">true</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc5">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc5">true</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc5">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc5">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc5">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc5">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc5">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc5">true</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd referenceDocumentId="RetDoc9">true</OperateHospitalInd>
      <AuditedFinancialStmtAttInd referenceDocumentId="RetDoc3">true</AuditedFinancialStmtAttInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc6">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc8">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc8">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>true</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc8">true</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc8">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc8">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>32</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>336</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>true</Form990TFiledInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>12</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>5</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>true</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MI</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>CHRISTOPHER SHEMES</PersonNm>
        <PhoneNum>9892273372</PhoneNum>
        <USAddress>
          <AddressLine1Txt>805 S OAKLAND STREET</AddressLine1Txt>
          <CityNm>ST JOHNS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48879</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAULA REICHLE</PersonNm>
        <TitleTxt>FRMR SR VP-C</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>721275</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>115729</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOEL COHN</PersonNm>
        <TitleTxt>FORMER BOARD</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>749010</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>65337</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW WILCOX</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>665827</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>77146</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIRA CARTER-ROBERTSON</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>591593</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>109916</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK WEISMILLER MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>501099</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>68348</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARGARET DIMOND PHD</PersonNm>
        <TitleTxt>REGIONAL PRE</TitleTxt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>511056</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>55501</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRADLEY GARRETT</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>434024</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>59094</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY HOLZHEI DO</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>443860</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>48214</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERICH HORNBACH</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>424792</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>64662</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL DEGRAND</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>385576</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>56005</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM HOWE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>325176</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>57560</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HELEN JOHNSON</PersonNm>
        <TitleTxt>FORMER REGIO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>335711</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43570</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATIE RYAN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>316563</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>59466</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CONSTANCE O'MALLEY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>313284</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>39605</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK BRISBOE</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>20.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>294579</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>47040</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW NOBIS</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>284432</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>55351</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAY MCLAUGHLIN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>308903</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30146</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRUCE SHIVELY</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>10.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>245009</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>50381</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KRISTINA MCCARTY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>244859</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>25908</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTOPHER BEAL DO</PersonNm>
        <TitleTxt>FORMER BOARD</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>17450</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TOM FRENCH</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1440</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CRAIG BISHOP</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY BRZOZOWSKI</PersonNm>
        <TitleTxt>BOARD MBR/VI</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL COSS</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VIRGINIA HAMILTON CROWE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIM HANNA</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CURTIS KECK</PersonNm>
        <TitleTxt>BOARD MMBR/S</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AMY PALUS</PersonNm>
        <TitleTxt>BOARD MMBR/C</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>3077126</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>5038392</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>1128979</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>48</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>true</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AYA HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5930 CORNERSTONE CT W 300</AddressLine1Txt>
            <CityNm>SAN DIEGO</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>92121</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>AGENCY STAFFING</ServicesDesc>
        <CompensationAmt>1830645</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GUNTHORPE PLUMBING &amp; HEATING</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4055 HUNSAKER DR</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>488236100</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONTRACTOR</ServicesDesc>
        <CompensationAmt>1355313</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GRANGER CONSTRUCTION CO</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6267 AURELIUS RD</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>489114230</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
        <CompensationAmt>1229844</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ALLIANCE-HNI LEASING CO LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>18201 VON KARMAN SUITE 600</AddressLine1Txt>
            <CityNm>IRVINE</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>926121176</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MRI SERVICES</ServicesDesc>
        <CompensationAmt>648175</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RESTORIX HEALTH INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3445 N CAUSEWAY BLVD SUITE 600</AddressLine1Txt>
            <CityNm>METAIRIE</CityNm>
            <StateAbbreviationCd>LA</StateAbbreviationCd>
            <ZIPCd>70002</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CLINICAL STAFF</ServicesDesc>
        <CompensationAmt>273175</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>10</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>54321</RelatedOrganizationsAmt>
      <TotalContributionsAmt>54321</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>63786128</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>63786128</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RETAIL PHARMACY/LAB</Desc>
        <BusinessCd>446110</BusinessCd>
        <TotalRevenueColumnAmt>8021771</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>8021771</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>340B CONTRACTED PHARMACY NI</Desc>
        <BusinessCd>446110</BusinessCd>
        <TotalRevenueColumnAmt>163122</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>163122</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>71971021</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>4989950</TotalRevenueColumnAmt>
        <ExclusionAmt>4989950</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>62425</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>19272</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>43153</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>43153</TotalRevenueColumnAmt>
        <ExclusionAmt>43153</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1696427</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1696427</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1696427</TotalRevenueColumnAmt>
        <ExclusionAmt>1696427</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>ALL OTHER REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>272551</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>272551</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAFETERIA REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>167734</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>167734</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>WELLNESS REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>58167</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>58167</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>498452</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>79253324</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>64447702</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>8021771</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>6729530</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>270767</TotalAmt>
        <ManagementAndGeneralAmt>270767</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>23283578</TotalAmt>
        <ProgramServicesAmt>22218477</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1065101</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1035527</TotalAmt>
        <ProgramServicesAmt>976798</ProgramServicesAmt>
        <ManagementAndGeneralAmt>58729</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2159785</TotalAmt>
        <ProgramServicesAmt>2037294</ProgramServicesAmt>
        <ManagementAndGeneralAmt>122491</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1426808</TotalAmt>
        <ProgramServicesAmt>1332675</ProgramServicesAmt>
        <ManagementAndGeneralAmt>94133</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1126360</TotalAmt>
        <ProgramServicesAmt>1126045</ProgramServicesAmt>
        <ManagementAndGeneralAmt>315</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>23286</TotalAmt>
        <ManagementAndGeneralAmt>23286</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>50483</TotalAmt>
        <ProgramServicesAmt>43949</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6534</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>1533219</TotalAmt>
        <ProgramServicesAmt>1446845</ProgramServicesAmt>
        <ManagementAndGeneralAmt>86374</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>121704</TotalAmt>
        <ProgramServicesAmt>78763</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42941</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>15464</TotalAmt>
        <ProgramServicesAmt>15464</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1696780</TotalAmt>
        <ManagementAndGeneralAmt>1696780</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>304845</TotalAmt>
        <ManagementAndGeneralAmt>304845</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PURCHASED SERVICES</Desc>
        <TotalAmt>8745549</TotalAmt>
        <ProgramServicesAmt>3303206</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5442343</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>8610981</TotalAmt>
        <ProgramServicesAmt>8561675</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49306</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>COGS</Desc>
        <TotalAmt>4891547</TotalAmt>
        <ProgramServicesAmt>4891547</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER</Desc>
        <TotalAmt>2335207</TotalAmt>
        <ProgramServicesAmt>477889</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1857318</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>832634</TotalAmt>
        <ProgramServicesAmt>574634</ProgramServicesAmt>
        <ManagementAndGeneralAmt>258000</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>58464524</TotalAmt>
        <ProgramServicesAmt>47085261</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11379263</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3091034</BOYAmt>
        <EOYAmt>8725008</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>2566</BOYAmt>
        <EOYAmt>2566</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>34349372</BOYAmt>
        <EOYAmt>40707411</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1128786</BOYAmt>
        <EOYAmt>1015059</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>112101</BOYAmt>
        <EOYAmt>56091</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>50920984</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>33910148</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>15172834</BOYAmt>
        <EOYAmt>17010836</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>138294908</BOYAmt>
        <EOYAmt>152658503</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1012353</BOYAmt>
        <EOYAmt>2393757</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>193163954</BOYAmt>
        <EOYAmt>222569231</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>6616195</BOYAmt>
        <EOYAmt>7495241</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>4156978</BOYAmt>
        <EOYAmt>4212039</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>10773173</BOYAmt>
        <EOYAmt>11707280</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>182390781</BOYAmt>
        <EOYAmt>210861951</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>182390781</BOYAmt>
        <EOYAmt>210861951</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>193163954</BOYAmt>
        <EOYAmt>222569231</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>20788800</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>7682370</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc10">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc5">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>9785856</BeginningYearBalanceAmt>
        <ContributionsAmt>321482</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>130539</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>10237877</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>9199222</BeginningYearBalanceAmt>
        <ContributionsAmt>273470</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>313164</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>9785856</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>6297032</BeginningYearBalanceAmt>
        <ContributionsAmt>5192208</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-280050</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>11209190</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>5606321</BeginningYearBalanceAmt>
        <ContributionsAmt>561053</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>129658</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>6297032</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>4912247</BeginningYearBalanceAmt>
        <ContributionsAmt>237860</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>456214</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>5606321</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <PrmnntEndowmentBalanceEOYPct>1.00000</PrmnntEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>true</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>true</RelatedOrgListSchRInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>812616</OtherCostOrOtherBasisAmt>
        <BookValueAmt>812616</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>30921048</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>19258604</DepreciationAmt>
        <BookValueAmt>11662444</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>394216</OtherCostOrOtherBasisAmt>
        <BookValueAmt>394216</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>18754175</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>14651544</DepreciationAmt>
        <BookValueAmt>4102631</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>38929</OtherCostOrOtherBasisAmt>
        <BookValueAmt>38929</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>17010836</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>INVESTMENTS</Desc>
        <BookValueAmt>152658503</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>152658503</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>POST RETIREMENT BENEFITS PAYABLE</Desc>
        <Amt>3886870</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LONG TERM LEASE PAYABLE</Desc>
        <Amt>171299</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>SHORT TERM LEASE LIABILITY</Desc>
        <Amt>102965</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>UNFUNDED PENSION LIABILITY</Desc>
        <Amt>45474</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED INFLOW</Desc>
        <Amt>5431</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>4212039</TotalLiabilityAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 2, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY SPARROW FOUNDATION. SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF SPARROW CLINTON HOSPITAL AND SPARROW FOUNDATION. THE ENDOWMENTS ARE MAINTAINED TO PROVIDE A PERMANENT SOURCE OF INCOME, WITH THE STIPULATION THE PRINCIPAL IS KEPT INTACT IN PERPETUITY AND THE INCOME GENERATED FROM INVESTMENTS OF THE ENDOWMENT FUNDS CAN BE USED FOR THE PURPOSE ESTABLISHED BY THE ENDOWMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc9">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent200DInd>X</Percent200DInd>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>true</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>false</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>553611</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>553611</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00950</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>7737423</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>8285355</DirectOffsettingRevenueAmt>
      </UnreimbursedMedicaidGrp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>8291034</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>8285355</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>553611</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00950</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>14030</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>14030</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00020</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <TotalCommunityBenefitExpnsAmt>11193</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>11193</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00020</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>25223</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>25223</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00040</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>8316257</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>8285355</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>578834</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00990</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <EconomicDevelopmentGrp>
        <TotalCommunityBenefitExpnsAmt>7500</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>7500</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </EconomicDevelopmentGrp>
      <CommunitySupportGrp>
        <TotalCommunityBenefitExpnsAmt>26584</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>26584</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00050</TotalExpensePct>
      </CommunitySupportGrp>
      <HealthImprovementAdvocacyGrp>
        <TotalCommunityBenefitExpnsAmt>5455</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>5455</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </HealthImprovementAdvocacyGrp>
      <OtherCommuntityBuildingActyGrp>
        <TotalCommunityBenefitExpnsAmt>14706</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>14706</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00030</TotalExpensePct>
      </OtherCommuntityBuildingActyGrp>
      <TotalCommuntityBuildingActyGrp>
        <TotalCommunityBenefitExpnsAmt>54245</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>54245</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00090</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>669743</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>100461</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>26491885</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>26141100</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>350785</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>SPARROW CLINTON HOSPITAL</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>805 S OAKLAND STREET</AddressLine1Txt>
          <CityNm>ST JOHNS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48879</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>WWW.UOFMHEALTHSPARROW.ORG</WebsiteAddressTxt>
        <StateLicenseNum>0000190011</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>MAIN CAMPUS</OtherDesc>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>SPARROW CLINTON HOSPITAL</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>false</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <CHNAConductedYr>22</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>true</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>true</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>WWW.UOFMHEALTHSPARROW.ORG</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>22</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>false</StrategyPostedWebsiteInd>
        <StrategyAttachedInd referenceDocumentId="RetDoc3">true</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>200.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>WWW.UOFMHEALTHSPARROW.ORG</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>WWW.UOFMHEALTHSPARROW.ORG</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>WWW.UOFMHEALTHSPARROW.ORG</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <NoneMadeInd>X</NoneMadeInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicaidMedcrPrvtInd>X</LookBackMedicaidMedcrPrvtInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>true</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, SPARROW CLINTON HOSPITAL - PART V, LINE 3E</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SIGNIFICANT HEALTH NEEDS WERE PRIORITIZED AND DOCUMENTED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, SPARROW CLINTON HOSPITAL - PART V, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>HEALTHY CAPITAL COUNTIES FOCUS GROUPS: IN ORDER TO GATHER INFORMATION FROM TRADITIONALLY HARD TO SURVEY POPULATIONS AND TO DOCUMENT THE EXPERIENCE, THOUGHTS, BELIEFS, AND STORIES OF THE COMMUNITY, A SERIES OF FOCUS GROUPS WERE CONDUCTED FOR THE PROJECT. SIX FOCUS GROUPS WERE HELD BETWEEN JUNE AND JULY 2021 AND WERE CONDUCTED VIRTUALLY AS WELL AS IN VARIOUS LOCATIONS THROUGHOUT THE THREE COUNTIES. GROUPS THAT WERE ACTIVELY SOLICITED FOR INPUT WERE: - PERSONS WITH DISABILITIES - PERSONS IN RECOVERY FROM SUBSTANCE ADDICTION - PERSONS WHO DID NOT HAVE HEALTH INSURANCE - PERSONS WHO HAD LOW INCOMES OR WERE UNEMPLOYED - PERSONS WHO IDENTIFIED AS SPANISH-SPEAKING HISPANIC OR LATINO/A - PERSONS WHO IDENTIFIED AS A PERSON OF COLOR CAPITAL AREA BEHAVIORAL RISK FACTOR &amp; SOCIAL CAPITAL SURVEY (BRFS): SINCE 2000, THE CAPITAL AREA UNITED WAY, BARRY-EATON DISTRICT HEALTH DEPARTMENT, INGHAM COUNTY HEALTH DEPARTMENT, AND MID-MICHIGAN DISTRICT HEALTH DEPARTMENT HAVE CONDUCTED A TELEPHONE HEALTH SURVEY OF THE ADULT POPULATION IN THEIR JURISDICTIONS (BARRY, EATON, INGHAM, CLINTON, GRATIOT, AND MONTCALM COUNTIES) ON VARIOUS BEHAVIORS, MEDICAL CONDITIONS, AND PREVENTATIVE HEALTH CARE PRACTICES. THE SURVEY WAS CONDUCTED USING THE CAPITAL AREA BEHAVIORAL RISK FACTOR &amp; SOCIAL CAPITAL SURVEY INSTRUMENT, WHICH INCLUDES QUESTIONS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM QUESTIONNAIRE AS WELL AS QUESTION DEVELOPED BY THE HEALTH DEPARTMENTS TO COLLECT INFORMATION OF INTEREST TO THE LOCAL COMMUNITY. DURING THE 2017-2019 SAMPLING PERIOD, A TOTAL OF 2,634 ADULTS IN CLINTON, EATON, AND INGHAM COUNTIES RESPONDED TO THE LANDLINE/MOBILE PHONE SURVEY. COMMUNITY AND HEALTH CARE PROVIDER SURVEYS: IN ORDER TO GATHER INPUT ABOUT THE COMMUNITY'S HEALTH NEEDS FROM STAKEHOLDERS AND THE GENERAL PUBLIC, TWO ONLINE SURVEYS WERE ADMINISTERED DURING FEBRUARY-MAY 2021. ONE SURVEY WAS FOR ANY COMMUNITY RESIDENT WHO LIVED AND/OR WORKED IN THE TRI-COUNTY AREA, AND THE SECOND SURVEY WAS FOR HEALTH CARE PROVIDERS WITH THE PROJECT'S HOSPITAL SYSTEM PARTNERS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, SPARROW CLINTON HOSPITAL - PART V, LINE 6A</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HOSPITAL, CONSISTING OF SIX COMMUNITY HOSPITALS, THREE OF WHICH ARE LOCATED IN THE THREE-COUNTY GREATER LANSING REGION: - EDWARD W SPARROW HOSPITAL, LANSING, MI - SPARROW SPECIALTY HOSPITAL, LANSING, MI - SPARROW CLINTON HOSPITAL, ST. JOHNS, MI - SPARROW IONIA HOSPITAL, IONIA, MI - SPARROW CARSON HOSPITAL, CARSON CITY, MI - SPARROW EATON HOSPITAL, CHARLOTTE, MI - MCLAREN GREATER LANSING - EATON RAPIDS MEDICAL CENTER</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, SPARROW CLINTON HOSPITAL - PART V, LINE 6B</FormAndLineReferenceDesc>
        <ExplanationTxt>- MICHIGAN PUBLIC HEALTH INSTITUTE - BARRY-EATON DISTRICT HEALTH DEPARTMENT - INGHAM COUNTY HEALTH DEPARTMENT - MID MICHIGAN DISTRICT HEALTH DEPARTMENT</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, SPARROW CLINTON HOSPITAL - PART V, LINE 11</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL HAS DEVELOPED AN IMPLEMENTATION STRATEGY FOR THE TOP PRIORITIES THAT WERE IDENTIFIED IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. THE TOP NEEDS IDENTIFIED WERE HEALTH CARE ACCESS AND QUALITY AND BEHAVIORAL HEALTH. FOR EACH OF THE NEEDS IDENTIFIED MULTIPLE KEY OBJECTIVES WERE IDENTIFIED TO CREATE A STRATEGY ON HOW TO MEET THE NEEDS. FOR EACH KEY OBJECTIVE AN IMPLEMENTATION STRATEGY WAS CREATED, INCLUDING TIMING FOR THE IMPLEMENTATION AND GOALS TO MONITOR THE SUCCESS. OTHER NEEDS IDENTIFIED IN THE CHNA BUT NOT ADDRESSED IN THIS STRATEGY INCLUDED FINANCIAL STABILITY AND BEHAVIORAL HEALTH. THIS HEALTH NEED IS IMPORTANT BUT IT IS NOT WITHIN THE SCOPE OF THE HOSPITAL'S CORE COMPETENCIES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, SPARROW CLINTON HOSPITAL - PART V, LINE 24</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL PATIENTS AND INSURANCES ARE CHARGED THE SAME GROSS CHARGE FROM OUR FEE SCHEDULE. DISCOUNTS ARE THEN PROVIDED TO UNINSURED PATIENTS BASED ON OUR FINANCIAL ASSISTANCE POLICY AND/OR INDIVIDUAL CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>3</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPARROW CLINTON REHAB &amp; WELLNESS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1079 S BUSINESS 127</AddressLine1Txt>
            <CityNm>ST JOHNS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48879</ZIPCd>
          </USAddress>
          <FacilityTxt>SPEECH, PHYSICAL &amp; OCCUPATIONAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPARROW CLINTON ST JOHNS MED BLDG</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>901 S OAKLAND</AddressLine1Txt>
            <CityNm>ST JOHNS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48879</ZIPCd>
          </USAddress>
          <FacilityTxt>MED PRACTICE, SPECIALTY CLINIC, PHARMACY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SMG OWOSSO INTERNAL MEDICINE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1457 M-52 UNIT 1</AddressLine1Txt>
            <CityNm>OWOSSO</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48867</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICIAN PRACTICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>A COST TO CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART II</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL PROVIDES THE FOLLOWING COMMUNITY ACTIVITIES TO PROMOTE HEALTHY LIFESTYLES: ANNUAL HEALTH FAIR; VACCINATION CLINICS; CLINTON COUNTY FOOD DISTRIBUTION; SAFE KIDS BICYCLE HELMET AND CAR SEAT FITTINGS; AMERICAN CANCER SOCIETY LOOK GOOD, FEEL BETTER PROGRAM; DIABETES EDUCATIONAL PROGRAMS; HEALTHCARE CAREER SCHOLARSHIPS; EXPIRED MEDICATION COLLECTIONS; AREA AGENCY AND ORGANIZATION EVENTS AND PROGRAMS THAT SUPPORT HEALTHY LIFESTYLES. PROGRAMS AND EVENTS OFFERED BY SPARROW CLINTON HOSPITAL ARE PROVIDED TO THE PUBLIC FREE OR AT COST, WITH ASSISTANCE FROM VOLUNTEERS, INCLUDING MEDICAL STAFF, HOSPITAL LEADERSHIP, ASSOCIATES, HOSPITAL BOARD AND COMMITTEE MEMBERS, COMMUNITY VOLUNTEERS AND HOSPITAL AUXILIANS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGH THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>IN REVIEWING ACCOUNTS CLASSIFIED AS BAD DEBT, THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3, REFLECTS PATIENTS WHO HAD PREVIOUSLY QUALIFIED FOR MEDICAID OR OTHER MEANS-TESTED SUPPORT, BUT WHO AT THE TIME OF SERVICES, WERE NO LONGER ELIGIBLE FOR MEDICAID OR OTHER MEANS-TESTED SUPPORT OR THE SERVICES PROVIDED WERE NOT COVERED BENEFITS. THE HOSPITAL FURTHER REVIEWED THESE PATIENTS TO MAKE A DETERMINATION OF THE PATIENTS' ELIGIBILITY FOR ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT FOOTNOTE - SEE THE ATTACHED AUDITED FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS, REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT, IS A RATIO OF COSTS TO CHARGES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 9B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHARGES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE ARE WRITTEN OFF THE SYSTEM TO CHARITY CARE AT THE TIME THE PATIENT'S CHARITY STATUS IS DETERMINED. AS SUCH, NO FURTHER COLLECTION EFFORTS TAKE PLACE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL DETERMINES THE HEALTH CARE NEEDS OF THE COMMUNITY BY USING THE FOLLOWING: ACCUMULATING AND REVIEWING THE RESULTS AND FEEDBACK FROM EXTERNALLY PREPARED PATIENT SATISFACTION SURVEYS AND BY CONDUCTING SMALL FOCUS GROUPS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL EMPLOYS SEVERAL METHODS TO COMMUNICATE ELIGIBILITY FOR ASSISTANCE TO PATIENTS. ALL UNINSURED INPATIENTS ARE DIRECTLY SCREENED FOR POTENTIAL MEDICAID ELIGIBILITY AND ANY OTHER GOVERNMENT PROGRAMS (COBRA BENEFITS, ETC). SIGNAGE IS POSTED IN OUR PATIENT REGISTRATION AREAS REGARDING AVAILABILITY OF SPARROW COMMUNITY FINANCIAL AID (CFA) PROGRAM (CHARITY CARE). ALL PATIENT BILLING STATEMENTS HAVE A NOTE REGARDING THE CFA PROGRAM AND OUR WEBSITE CONTAINS LINKS TO OUR CFA POLICY AND APPLICATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL SERVES THE PEOPLE OF CLINTON COUNTY AND SURROUNDING AREAS. CLINTON COUNTY IS 566 SQUARE MILES, WITH A POPULATION OF 75,382 AS OF THE 2010 CENSUS. IT IS ESTIMATED THAT 33% OF COUNTY RESIDENTS HAD EITHER PUBLIC COVERAGE OR NO HEALTH COVERAGE IN 2010.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAMS AND EVENTS OFFERED BY SPARROW CLINTON HOSPITAL ARE PROVIDED TO THE PUBLIC FREE OR AT COST WITH ASSISTANCE FROM VOLUNTEERS, INCLUDING THE MEDICAL STAFF, HOSPITAL LEADERSHIP, ASSOCIATES, HOSPITAL BOARD AND COMMITTEE MEMBERS, COMMUNITY VOLUNTEERS, AND HOSPITAL AUXILIARIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL IS A WHOLLY-OWNED SUBSIDIARY OF SPARROW HEALTH SYSTEM. SPARROW HEALTH SYSTEM IS A NON-PROFIT, COMMUNITY-GOVERNED, INTEGRATED HEALTH DELIVERY SYSTEM SERVING MID-MICHIGAN. SPARROW HEALTH SYSTEM PROVIDES SERVICES TO THE COMMUNITIES IT SERVES THROUGH ITS WHOLLY OWNED SUBSIDIARIES: EDWARD W. SPARROW HOSPITAL, SPARROW CLINTON HOSPITAL, SPARROW IONIA HOSPITAL. SPARROW EATON HOSPITAL, SPARROW SPECIALTY HOSPITAL, SPARROW DEVELOPMENT, INC, SPARROW COMMUNITY CARE, SPARROW FOUNDATION, SPARROW CARSON HOSPITAL, AND SPARROW CLINICAL RESEARCH INSTITUTE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>MICHIGAN</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE H, PART V, LINE 16 FULL WEBSITE FOR LINES A, B, AND C HTTPS://WWW.UOFMHEALTHSPARROW.ORG/OUR-HOSPITALS-SERVICES/UM-HEALTH- SPARROW-HOSPITALS/CLINTON</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc6">
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>true</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAULA REICHLE</PersonNm>
        <TitleTxt>FRMR SR VP-CFO-SHS</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>590250</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>49613</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>81412</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>61554</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>54175</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>837004</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOEL COHN</PersonNm>
        <TitleTxt>FORMER BOARD MEMBER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>731486</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>10000</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>7524</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>19050</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>46287</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>814347</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW WILCOX</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>636721</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>10000</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>19106</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>9150</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>67996</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>742973</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KIRA CARTER-ROBERTSON</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>415934</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>32583</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>143076</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>39667</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>70249</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>701509</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK WEISMILLER MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <BaseCompensationFilingOrgAmt>462930</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>37351</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>818</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19050</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>49298</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>569447</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARGARET DIMOND PHD</PersonNm>
        <TitleTxt>REGIONAL PRESIDENT</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>429938</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>62038</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>19080</OtherCompensationRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>55501</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>566557</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRADLEY GARRETT</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>420624</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>12535</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>865</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>10893</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>48201</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>493118</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GREGORY HOLZHEI DO</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <BaseCompensationFilingOrgAmt>318211</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>119647</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>6002</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9150</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>39064</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>492074</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERICH HORNBACH</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>399339</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>23381</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2072</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9900</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>54762</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>489454</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL DEGRAND</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>370999</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>13755</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>822</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19050</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>36955</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>441581</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM HOWE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>302163</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>20074</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>2939</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>18907</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>38653</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>382736</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HELEN JOHNSON</PersonNm>
        <TitleTxt>FORMER REGIONAL COO</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>317021</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>16900</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>1790</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>7848</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>35722</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>379281</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATIE RYAN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>218952</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>94771</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2840</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>18893</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>40573</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>376029</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CONSTANCE O'MALLEY</PersonNm>
        <TitleTxt>BOARD MEMBER/COO</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>259931</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>53353</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>27938</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>11667</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>352889</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK BRISBOE</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>265903</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>27558</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>1118</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>7667</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>39373</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>341619</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW NOBIS</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>249265</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>34812</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>355</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>6840</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>48511</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>339783</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KAY MCLAUGHLIN</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>207116</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>74771</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>27016</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>30146</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>339049</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRUCE SHIVELY</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>231730</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>12312</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>967</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>6840</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>43541</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>295390</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KRISTINA MCCARTY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <BaseCompensationFilingOrgAmt>244444</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>415</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>2965</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22943</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>270767</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTOPHER BEAL DO</PersonNm>
        <TitleTxt>FORMER BOARD MEMBER</TitleTxt>
        <OtherCompensationFilingOrgAmt>17450</OtherCompensationFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>17450</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>PAULA REICHLE 157,503 52,404 0 KIRA CARTER-ROBERTSON 0 30,517 0 KRISTINA MCCARTY 36,925 0 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NON-FIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>WILLIAM HOWE AND CHRISTOPHER BEAL ARE FORMER BOARD MEMBERS AND OFFICERS OF SPARROW CLINTON HOSPITAL. THE FORMER BOARD MEMBERS/OFFICERS ARE BEING COMPENSATED BY SPARROW HEALTH SYSTEM AND AFFILIATES FOR SERVICES PROVIDED TO SPARROW HEALTH SYSTEM AND AFFILIATES IN POSITIONS OTHER THAN BOARD MEMBERS/OFFICERS. THE FORMER BOARD MEMBERS/OFFICERS ARE NOT BEING COMPENSATED FOR ANY PAST SERVICES PROVIDED TO SPARROW CLINTON HOSPITAL AS FORMER BOARD MEMBERS/OFFICERS. PART I, LINE 4B - NONQUALIFIED CERTAIN EXECUTIVES PARTICIPATE IN THE 457(F) SUPPLEMENTAL RETIREMENT PLAN AND ARE MAKING CURRENT YEAR CONTRIBUTIONS AS WELL AS RECEIVING CURRENT YEAR DISTRIBUTIONS. CONTRIBUTIONS TO THE PLAN ARE DISCLOSED IN PART I LINE 4B AND REQUIRED DISTRIBUTIONS FROM THE PLAN ARE REPORTED BELOW AS A NEGATIVE AS WELL AS BEING DISCLOSED ON SCHEDULE J, PART II COLUMN B (III) KIRA CARTER-ROBINSON: -141,657 PAULA REICHLE: -52,404</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc7">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990</FormAndLineReferenceDesc>
        <ExplanationTxt>FULL WEBSITE - HTTPS://WWW.UOFMHEALTHSPARROW.ORG/OUR-HOSPITALS-SERVICES/UM-HEALTH- SPARROW-HOSPITALS/CLINTON ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. ON APRIL 1, 2023, SPARROW HEALTH SYSTEM, THE REGENTS OF THE UNIVERSITY OF MICHIGAN, AND UM HEALTH CONSUMMATED THEIR AFFILIATION. AS A RESULT OF THE TRANSACTION UM HEALTH CORP BECAME THE SOLE CORPORATE MEMBER OF SPARROW HEALTH SYSTEM. DUE TO AFFILIATION, THE ORGANIZATION CHANGED ITS YEAR END TO A FISCAL YEAR ENDING 6/30. THE PRIOR YEAR FINANCIAL INFORMATION REPORTED THROUGHOUT THE FORM 990 AND SUPPORTING SCHEDULES IS BASED ON A 6-MONTH SHORT PERIOD RETURN FOR 6/30/2023. PART IV, QUESTION 4 - THE ORGANIZATION DOES NOT ENGAGE IN DIRECT LOBBYING ACTIVITIES. THE ORGANIZATION DOES HAVE MEMBERSHIPS IN VARIOUS TRADE ASSOCIATIONS THAT USE A PORTION OF THE DUES PAID TO THE TRADE ASSOCIATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THE APPLICABLE TRADE ASSOCIATION INDUSTRIES, THUS INDIRECTLY BENEFITING THE ORGANIZATION. THE PERCENTAGE OF DUES ALLOCATED TO THIS INDUSTRY-WIDE LOBBYING ACTIVITY IS MINOR AND IS NOT CONSIDERED BY THE ORGANIZATION AS LOBBYING ACTIVITIES REQUIRED FOR DISCLOSURE ON SCHEDULE C, PART II.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL'S OUTPATIENT SERVICES ARE TYPICAL OF A SMALL RURAL FACILITY. THE EMERGENCY DEPARTMENT PROVIDES NURSING AND PHYSICIAN SERVICES 24 HOURS A DAY, 7 DAYS A WEEK, WITH PHYSICIANS ON SITE 100% OF THE TIME. SCREENING EXAMS ARE PROVIDED TO EVERYONE WHO PRESENTS FOR SERVICES PRIOR TO ANY FINANCIAL INFORMATION BEING OBTAINED OR CHARGES DISCUSSED WITH PATIENTS IN ACCORDANCE WITH EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA). LABORATORY, RADIOLOGY, RESPIRATORY SERVICES, SURGERY, WOUND CARE, AS WELL AS INFUSION/ONCOLOGY ARE TYPICAL OF OTHER OUTPATIENT SERVICES PROVIDED. SPARROW CLINTON HOSPITAL ACCEPTS ALL GOVERNMENTAL PAYERS INCLUDING MEDICARE, MEDICAID, AND TRICARE WITH REIMBURSEMENT AT OR BELOW COSTS. ADDITIONALLY, SPARROW CLINTON HOSPITAL'S CHARITY CARE POLICY COVERS SERVICES IN THE OUTPATIENT SETTING, IN TURN PROVIDING FREE CARE TO THOSE IN THE COMMUNITY WHO QUALITY. FOR THE YEAR ENDED JUNE 30, 2024, SPARROW CLINTON HOSPITAL RECORDED 13,460 EMERGENCY ROOM VISITS; 234,376 LAB TESTS; 37,265 RADIOLOGY PROCEDURES; 19,540 CARDIO/RESPIRATORY PROCEDURES; 1,035 SURGERIES/723 SCOPES; AND 1,108 INFUSION/ONCOLOGY VISITS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4C</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW CLINTON HOSPITAL'S INPATIENT SERVICES ARE TYPICAL OF A SMALL RURAL FACILITY. OPERATING 25 BEDS, SPARROW CLINTON HOSPITAL PROVIDES NURSING AND PHYSICIAN SERVICES 24 HOURS A DAY, 7 DAYS A WEEK. SPARROW CLINTON HOSPITAL ALSO PARTICIPATES IN THE SWING BED PROGRAM TO PROVIDE SKILLED NURSING CARE AND REHABILITATION TO PATIENTS TRANSITIONING FROM ACUTE CARE TO HOME OR LONG-TERM CARE. FOR THE YEAR ENDED JUNE 30, 2024, THERE WERE 728 ADMISSIONS WITH 2,449 INPATIENT DAYS OF CARE; AS WELL AS 44 SWING BED ADMISSIONS WITH 469 SWING BED DAYS OF CARE. NURSING STAFF ARE ON SITE 100% OF THE TIME, AND HOSPITALIST COVERAGE IS AVAILABLE ON AN ON-CALL BASIS 100% OF THE TIME WHEN NOT IN THE HOSPITAL. SPARROW CLINTON HOSPITAL ACCEPTS ALL GOVERNMENTAL PAYERS INCLUDING MEDICARE, MEDICAID, AND TRICARE WITH REIMBURSEMENT AT OR BELOW COSTS. ADDITIONALLY, THE HOSPITAL'S CHARITY CARE POLICY COVERS ALL INPATIENT SERVICES, IN TURN PROVIDING FREE CARE TO THOSE IN THE COMMUNITY WHO QUALIFY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF SPARROW CLINTON HOSPITAL AND HAS 100% OWNERSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HEALTH SYSTEM HAS THE RIGHT TO ELECT, REPLACE, OR REMOVE DIRECTORS OF THE SPARROW CLINTON HOSPITAL BOARD. THE PRESIDENT OF THE MEDICAL STAFF, WHICH IS A MEMBER OF THE GOVERNING BODY, IS ELECTED BY THE MEDICAL STAFF OF SPARROW CLINTON HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HEALTH SYSTEM HAS THE RIGHT TO ELECT, REPLACE, AND REMOVE DIRECTORS OF SPARROW CLINTON HOSPITAL. SPARROW HEALTH SYSTEM ALSO HAS THE AUTHORITY TO APPROVE DECISIONS OF THE SPARROW CLINTON HOSPITAL BOARD WHEN IT IS DEEMED NECESSARY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>COPIES OF THE FORM 990 ARE REVIEWED BY MANAGEMENT. THE FORM 990 COPIES WERE PROVIDED AT THE BOARD MEETING FOR ALL BOARD MEMBERS TO REVIEW AND COMMENT ON PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>1) CORPORATE COMPLIANCE SENDS OUT THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRES TO ALL VOTING BOARD MEMBERS AND THE EXECUTIVE TEAM ANNUALLY. 2) ALL DISCLOSURES ARE RECEIVED AND REVIEWED BY CORPORATE COMPLIANCE. 3) ALL DISCLOSURES ARE GIVEN A RESOLUTION CODE AND PRESENTED TO THE CEO AND GOVERNANCE COMMITTEE OF THE BOARD. 4) ALL BOARD/COMMITTEE LEVEL DISCLOSURES ARE PROVIDED TO THE RESPECTIVE BOARD CHAIR AND EXECUTIVE LIAISON TO ENSURE ISSUES CAN BE ADDRESSED ON A TRANSACTIONAL LEVEL (I.E. IF A VOTE IS REQUIRED ON A TRANSACTION INVOLVING AN INTERESTED PERSON).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, USING COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE SHS BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, USING INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, USING COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE SHS BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON SEVERAL INTERNET WEBSITES, INCLUDING NMSIR AND MSHFA WEBSITES, AS WELL AS AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc8">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>REGENTS OF THE UNIV OF MICHIGAN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5082 WOLVERINE TWR 3003 S STATE</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>481091287</ZIPCd>
        </USAddress>
        <EIN>386006309</EIN>
        <PrimaryActivitiesTxt>SCHOOL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>2</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WEST MICHIGAN RADIATION ONCOLOGY</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5950 METRO WAY</AddressLine1Txt>
          <CityNm>WYOMING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49519</ZIPCd>
        </USAddress>
        <EIN>300501592</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>METROPOLITAN HOSPITAL (UMH WEST)</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5900 BYRON CENTER AVENUE SW</AddressLine1Txt>
          <CityNm>WYOMING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49519</ZIPCd>
        </USAddress>
        <EIN>380593405</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UM HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UM HEALTH</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5082 WOLVERINE TWR 3003 S STATE</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48109</ZIPCd>
        </USAddress>
        <EIN>814913150</EIN>
        <PrimaryActivitiesTxt>SUP ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UM</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>METROPOLITAN FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5900 BYRON CENTER AVENUE SW</AddressLine1Txt>
          <CityNm>WYOMING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49519</ZIPCd>
        </USAddress>
        <EIN>383033329</EIN>
        <PrimaryActivitiesTxt>SUP HOSP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>METRO HOSP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW HEALTH SYSTEM</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382542859</EIN>
        <PrimaryActivitiesTxt>PARENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UM HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW COMMUNITY CARE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3315 E MICHIGAN AVENUE STE 4</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382543305</EIN>
        <PrimaryActivitiesTxt>HOME HLTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UNIVERSITY OF MICHIGAN HEALTH PLAN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382356288</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C4</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHP HO LLC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UNIV OF MICHIGAN HEALTH MEDICARE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>832766121</EIN>
        <PrimaryActivitiesTxt>HMO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C4</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UNIV OF MICHIGAN HEALTH NETWORK</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382594856</EIN>
        <PrimaryActivitiesTxt>HMO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C4</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHP HO LLC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>386100687</EIN>
        <PrimaryActivitiesTxt>FUNDRAISE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>EDWARD W SPARROW HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>381360584</EIN>
        <PrimaryActivitiesTxt>HLTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW SPECIALTY HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1215 E MICH AVE 8W SPARROW TOWER</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>141885340</EIN>
        <PrimaryActivitiesTxt>LT ACUTE C</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW IONIA HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3565 S STATE RD</AddressLine1Txt>
          <CityNm>IONIA</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48846</ZIPCd>
        </USAddress>
        <EIN>383218134</EIN>
        <PrimaryActivitiesTxt>HLTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW CLINICAL RESEARCH INSTITUTE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1200 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>383075242</EIN>
        <PrimaryActivitiesTxt>RESEARCH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>4</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW CARSON HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>406 E ELM ST PO BOX 879</AddressLine1Txt>
          <CityNm>CARSON CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48811</ZIPCd>
        </USAddress>
        <EIN>381490180</EIN>
        <PrimaryActivitiesTxt>HLTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW EATON HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>321 E HARRIS ST</AddressLine1Txt>
          <CityNm>CHARLOTTE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48813</ZIPCd>
        </USAddress>
        <EIN>382007629</EIN>
        <PrimaryActivitiesTxt>HLTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HAYES GREEN BEACH HOSPITAL AUXILIAR</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>321 E HARRIS ST</AddressLine1Txt>
          <CityNm>CHARLOTTE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48813</ZIPCd>
        </USAddress>
        <EIN>382377160</EIN>
        <PrimaryActivitiesTxt>FUNDRAISE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>UNIV OF MICHIGAN HLTH HOLDINGS LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>833965697</EIN>
        <PrimaryActivitiesTxt>HOLDING CO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MICHIGAN DIALYSIS SERVICES LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>5082 WOLVERINE TWR 3003 S STATE ST</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>481091287</ZIPCd>
        </USAddress>
        <EIN>383472138</EIN>
        <PrimaryActivitiesTxt>DIALYSIS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PHYSICIAN ORGANIZATION OF MI ACO</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>5082 WOLVERINE TWR 3003 S STATE ST</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>481091287</ZIPCd>
        </USAddress>
        <EIN>454542046</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>KENT HEALTH CARE PHYSICIAN ORG</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2225 MAIN STREET SW STE 110</AddressLine1Txt>
          <CityNm>WYOMING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49519</ZIPCd>
        </USAddress>
        <EIN>383404658</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SPARROW DEVELOPMENT INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382595963</EIN>
        <PrimaryActivitiesTxt>RENTAL PRO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>UNIV OF MICHIGAN HLTH INSURANCE CO</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>205565219</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>UNIV OF MICH HLTH SERVICE COMPANY</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>383344741</EIN>
        <PrimaryActivitiesTxt>MED SERV</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EAST LANSING ATHLETIC CLUB</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2900 HANNAH BLVD</AddressLine1Txt>
          <CityNm>EAST LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48823</ZIPCd>
        </USAddress>
        <EIN>382886420</EIN>
        <PrimaryActivitiesTxt>HLTH CLUB</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MAC RESTAURANT LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2900 HANNAH BLVD</AddressLine1Txt>
          <CityNm>EAST LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48823</ZIPCd>
        </USAddress>
        <EIN>205120690</EIN>
        <PrimaryActivitiesTxt>RESTAURANT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>CLINTON SERVICES CORPORATION</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>805 S OAKLAND STREET</AddressLine1Txt>
          <CityNm>ST JOHNS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48879</ZIPCd>
        </USAddress>
        <EIN>382494110</EIN>
        <PrimaryActivitiesTxt>SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EAST LANSING HTH ATH CLUB &amp; HSP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1200 E MICHIGAN AVENUE STE 600</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>813131851</EIN>
        <PrimaryActivitiesTxt>CONDO ASSO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>EDWARD W SPARROW HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>2006344</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>EDWARD W SPARROW HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>627770</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>54321</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>