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      <Form990PartVIISectionAGrp>
        <PersonNm>BABEL MD JAMES BAILEY</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>12056</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BAYS MD RONALD</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>9325</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BOLES MD JAMES</PersonNm>
        <TitleTxt>SECRETARY/TREASURER (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MEYER STEVE</PersonNm>
        <TitleTxt>CHAIR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MURPHY LESLIE</PersonNm>
        <TitleTxt>CHAIR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BRANCH CANADY RENEE</PersonNm>
        <TitleTxt>VICE CHAIR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>CATHERINE HANNAH MARY</PersonNm>
        <TitleTxt>VICE CHAIR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BAUMAN HEATHER</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BETHUNE ANDREW</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FLEGENHEIMER MARK</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FREEL JOHN</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREENE JIMMY</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MAGANTI MD BAPINEEDU</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MASTRACCI DITMYER MARCIA</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MEADOWS PHYLLIS</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MOORE TERRY</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>O'BRIEN AVEC</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>POZO SUSAN</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>SAUNDERS DAVID</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>STREIBEL KENNETH</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ZAKS JEFFERY</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.50</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <TotalReportableCompFromOrgAmt>1094468</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>8769436</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>1859173</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>14</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
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      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>22266999</TotalRevenueColumnAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE/MEDICAID PAYMENTS</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>6358319</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6358319</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>SUBSIDIARY RELATED INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>11626</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>11626</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>CONTRACTED CLINICAL SERVICES</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>325</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>325</RelatedOrExemptFuncIncomeAmt>
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      <TotalProgramServiceRevenueAmt>28637269</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1748</TotalRevenueColumnAmt>
        <ExclusionAmt>1748</ExclusionAmt>
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      <GrossRentsGrp>
        <RealAmt>70259</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>70259</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>70259</TotalRevenueColumnAmt>
        <ExclusionAmt>70259</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>REFERENCE LAB INCOME</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>16734</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>16734</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>OUTSIDE INCOME</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>11788</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>11788</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CAFETERIA</Desc>
        <BusinessCd>722514</BusinessCd>
        <TotalRevenueColumnAmt>4515</TotalRevenueColumnAmt>
        <ExclusionAmt>4515</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>33037</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>28742313</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>28649057</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>16734</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>76522</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>413003</TotalAmt>
        <ProgramServicesAmt>413003</ProgramServicesAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>9333375</TotalAmt>
        <ProgramServicesAmt>9165713</ProgramServicesAmt>
        <ManagementAndGeneralAmt>167662</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>351963</TotalAmt>
        <ProgramServicesAmt>351963</ProgramServicesAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1519980</TotalAmt>
        <ProgramServicesAmt>1498101</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21879</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>710134</TotalAmt>
        <ProgramServicesAmt>698069</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12065</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>552</TotalAmt>
        <ManagementAndGeneralAmt>552</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>9080815</TotalAmt>
        <ProgramServicesAmt>5992735</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3088080</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>9252</TotalAmt>
        <ProgramServicesAmt>195</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9057</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
        <TotalAmt>754388</TotalAmt>
        <ProgramServicesAmt>725288</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29100</ManagementAndGeneralAmt>
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      <OccupancyGrp>
        <TotalAmt>363041</TotalAmt>
        <ProgramServicesAmt>363041</ProgramServicesAmt>
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      <TravelGrp>
        <TotalAmt>56827</TotalAmt>
        <ProgramServicesAmt>52736</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4091</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>13583</TotalAmt>
        <ProgramServicesAmt>13583</ProgramServicesAmt>
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      <DepreciationDepletionGrp>
        <TotalAmt>903385</TotalAmt>
        <ProgramServicesAmt>872928</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30457</ManagementAndGeneralAmt>
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      <InsuranceGrp>
        <TotalAmt>322746</TotalAmt>
        <ProgramServicesAmt>186427</ProgramServicesAmt>
        <ManagementAndGeneralAmt>136319</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>2740916</TotalAmt>
        <ProgramServicesAmt>2740916</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>1886527</TotalAmt>
        <ProgramServicesAmt>1884856</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1671</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>QAAP</Desc>
        <TotalAmt>817666</TotalAmt>
        <ProgramServicesAmt>817666</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>29278153</TotalAmt>
        <ProgramServicesAmt>25777220</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3500933</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>1845</BOYAmt>
        <EOYAmt>1845</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
        <BOYAmt>2673</BOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
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        <EOYAmt>4652832</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
        <BOYAmt>342600</BOYAmt>
        <EOYAmt>330160</EOYAmt>
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      <LandBldgEquipAccumDeprecAmt>809127</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>6476198</BOYAmt>
        <EOYAmt>6235142</EOYAmt>
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      <IntangibleAssetsGrp>
        <BOYAmt>5896</BOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1455715</BOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>12101150</BOYAmt>
        <EOYAmt>11337865</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1278897</BOYAmt>
        <EOYAmt>1910099</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>11155</BOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>7736508</BOYAmt>
        <EOYAmt>4091749</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>9026560</BOYAmt>
        <EOYAmt>6001848</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>3074590</BOYAmt>
        <EOYAmt>5336017</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>3074590</BOYAmt>
        <EOYAmt>5336017</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>12101150</BOYAmt>
        <EOYAmt>11337865</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-535840</ReconcilationRevenueExpnssAmt>
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        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>MYMICHIGAN MEDICAL CENTER STANDISH PAYS DUES TO MICHIGAN HEALTH AND HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. A PERCENTAGE OF THESE DUES ARE INDIRECT LOBBYING ACTIVITIES.</ExplanationTxt>
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          <CityNm>STANDISH</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
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        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
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      <HospitalFcltyPoliciesPrctcGrp>
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        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
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        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>SEE PART V, PAGE 8</OwnWebsiteURLTxt>
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        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>25</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>SEE PART V, PAGE 8</StrategyWebsiteURLTxt>
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        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
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        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
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        <FAPAppAvailableOnWebsiteURLTxt>WWW.MYMICHIGAN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE</FAPAppAvailableOnWebsiteURLTxt>
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        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
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        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
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        <GrossChargesInd>0</GrossChargesInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>MYMICHIGAN MEDICAL CENTER STANDISH</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: MYMICHIGAN MEDICAL CENTER STANDISH'S COMMUNITY HEALTH SUPERVISOR CREATED AN EXTERNAL ADVISORY COUNCIL FOR THEIR NEEDS ASSESSMENT. THIS COMMITTEE IS COMPRISED OF LOCAL STAKEHOLDERS IN HEALTH CARE, PUBLIC HEALTH, COMMUNITY SERVICES AND EDUCATION SECTORS. SOME ORGANIZATIONS THAT ARE REPRESENTED IN THIS COUNCIL INCLUDE: CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DEPARTMENT OF HEALTH AND HUMAN SERVICES, TEN16 RECOVERY NETWORK AND CENTRAL MICHIGAN COMMUNITY MENTAL HEALTH. THE COMMITTEE IS RESPONSIBLE FOR DEVELOPING AND EVALUATING ASSESSMENTS OF COMMUNITY NEED AND DEVELOPING PLANS TO MEET THOSE NEEDS. ADDITIONALLY, MYMICHIGAN MEDICAL CENTER STANDISH IS A PARTNER WITH MICHIGAN HEALTH INFORMATION ALLIANCE, INC., OR MIHIA, WHICH IS A FORMAL MULTI-STAKEHOLDER, COMMUNITY COLLABORATION WORKING TO ACHIEVE A COMMUNITY HEALTH EXCELLENCE FOR THE 14-COUNTY REGION IT SERVES. THIS INITIATIVE IS BASED ON A CORE BELIEF THAT SOLUTIONS TO OUR HEALTH AND HEALTH CARE PROBLEMS CAN BE FOUND AND DESIGNED AT A REGIONAL LEVEL, ACCELERATING REGIONAL COMPETITIVE ADVANTAGE AND SUSTAINABILITY.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>MYMICHIGAN MEDICAL CENTER STANDISH</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6B: MYMICHIGAN MEDICAL CENTER STANDISH COLLABORATED WITH THE FOLLOWING ORGANIZATIONS IN CONDUCTING ITS MOST RECENT CHNA:-ALPENA-MONTMORENCY-ALCONA EDUCATIONAL SERVICE DISTRICT-AREA AGENCY ON AGING OF NORTHWEST MICHIGAN-AUSABLE VALLEY COMMUNITY MENTAL HEALTH-BENZIE-LEELANAU DISTRICT HEALTH DEPARTMENT-CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT-COREWELL HEALTH-DISABILITY NETWORK WEST MICHIGAN-DISTRICT HEALTH DEPARTMENT #2-DISTRICT HEALTH DEPARTMENT #4-DISTRICT HEALTH DEPARTMENT #10-GRAND TRAVERSE COUNTY HEALTH DEPARTMENT-GREAT START COLLABORATIVE-GROUNDWORK CENTER FOR RESILIENT COMMUNITIES-HEALTH DEPARTMENT OF NORTHWEST MICHIGAN-ISABELLA CITIZENS FOR HEALTH, INC-MCLAREN NORTHERN MICHIGAN-MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES-MUNSON HEALTHCARE-NORTHEAST MICHIGAN COMMUNITY SERVICE AGENCY-PARTNERS IN PREVENTION-STRANGERS NO LONGER-TRAVERSE CITY HEALTH CLINIC-WEST MICHIGAN COMMUNITY MENTAL HEALTH</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>MYMICHIGAN MEDICAL CENTER STANDISH</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS WERE DETERMINED AND PRIORITIZED BY REVIEWING QUANTITATIVE AND QUALITATIVE DATA AND RANKING HEALTH ISSUES ACCORDING TO FOCUS. WE INVESTIGATED A VARIETY OF PRIMARY AND SECONDARY DATA SOURCES. A GRID OF OVER 150 INDICATORS FROM 20 DIFFERENT PRIMARY AND SECONDARY SOURCES WAS UTILIZED TO BUILD THE DATA PLATFORM. DATA THAT FELL OUTSIDE THE BENCHMARK RANGE WERE COMPARED WITH CURRENT STANDARDS, AND EVALUATED BY OUR COMMUNITY HEALTH TEAM, POPULATION HEALTH COLLABORATIVE TEAM, COLLABORATIVE PARTNERS AND COMMUNITY MEMBERS. IN ORDER TO DETERMINE CAUSES OF HEALTH PROBLEMS, DATA WAS CATEGORIZED INTO FOUR AREAS: 1. DETERMINANTS OF HEALTH, 2. ACCESS TO CARE, 3. HEALTH BEHAVIORS AND 4. HEALTH CONDITIONS. AREAS WHERE HEALTH ISSUES EXISTED WERE REVEALED IN TWO WAYS. FIRST, LOCAL QUANTITATIVE DATA INDICATORS WERE COMPARED TO MICHIGAN STATE BENCHMARKS, REVEALING AREAS OF POOR PERFORMANCE. SECOND, QUALITATIVE DATA ANALYSIS IDENTIFIED RECURRING THEMES OF UNACCEPTABLE HEALTH OUTCOMES. PRIORITIZATION OCCURRED IN STAGES; INPUT WAS SOLICITED FROM THE COMMUNITY HEALTH TEAM, MYMICHIGAN MEDICAL CENTER STANDISH LEADERSHIP TEAM, COMMUNITY HEALTH STAFF AND RESPECTIVE COMMUNITY GROUPS. IN ORDER TO RESPOND AND IMPACT THE IDENTIFIED HEALTH CARE NEEDS, THE TOP PRIORITY AREAS FOR MYMICHIGAN MEDICAL CENTER STANDISH CHOSEN BY THE COMMUNITY HEALTH TEAM AND REVIEWED BY THE MYMICHIGAN HEALTH POPULATION COLLABORATION TEAM AND MYMICHIGAN MEDICAL CENTER STANDISH BOARD OF DIRECTORS ON FEBRUARY 26, 2025 FOLLOW, ALONG WITH AN UPDATE OF STRATEGIES IMPLEMENTED: A. CHRONIC DISEASE PREVENTION. PROVIDE OPPORTUNITY FOR IMPROVED HEALTH BEHAVIORS AND PREVENT CHRONIC DISEASE. MYMICHIGAN MEDICAL CENTER STANDISH HAS IMPLEMENTED LIFESTYLE MEDICINE TO BOTH STAFF AND COMMUNITY MEMBERS AS A WAY TO PREVENT CHRONIC DISEASE. A TOBACCO CESSATION TIP SHEET HAS BEEN DEVELOPED TO SHARE WITH COMMUNITY MEMBERS AND MYMICHIGAN IS LOOKING FOR ADDITIONAL TOBACCO CESSATION PROGRAMS TO OFFER. MYMICHIGAN HAS ALSO IMPLEMENTED THE USE OF COMMUNITY HEALTH WORKERS TO HELP BRIDGE THE GAP FOR PATIENTS BETWEEN COMMUNITY, HEALTH CARE AND PUBLIC HEALTH. B. MENTAL WELLNESS. IMPROVE MENTAL HEALTH AND SUBSTANCE USE THROUGH PREVENTION AND BY INCREASING ACCESS TO APPROPRIATE SERVICES AND SUPPORTS. MYMICHIGAN MEDICAL CENTER STANDISH IS EXPLORING OPTIONS FOR SUICIDE PREVENTION TRAINING FOR STAFF AS WELL AS A YOUTH ASSET PROGRAM TO OFFER IN THE COMMUNITY.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINES 7A AND 10A</FormAndLineReferenceDesc>
        <ExplanationTxt>HTTPS://WWW.MYMICHIGAN.ORG/ABOUT/COMMUNITY-BENEFITS/CHNA/</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3C:</FormAndLineReferenceDesc>
        <ExplanationTxt>AS WELL AS USING THE FEDERAL POVERTY GUIDELINES, THE PATIENT'S AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT ARE TAKEN INTO CONSIDERATION WHEN DETERMINING FREE OR DISCOUNTED CARE. PATIENTS WHOSE FAMILY INCOME EXCEEDS 350% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7, COLUMN (F):</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,740,916.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>NOT ONLY DO THE INDIVIDUAL HOSPITALS PROVIDE COMMUNITY BENEFITS, BUT BASED ON THE NEEDS ASSESSMENTS PROVIDED BY THE HOSPITALS, THE PARENT ORGANIZATION ALSO PROVIDES EDUCATION AND OUTREACH TO COMMUNITY MEMBERS, WHICH IS NOT REFLECTED IN EACH HOSPITALS' COST OF COMMUNITY BENEFIT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II, COMMUNITY BUILDING ACTIVITIES:</FormAndLineReferenceDesc>
        <ExplanationTxt>MYMICHIGAN MEDICAL CENTER STANDISH EMPLOYEES CONTRIBUTED MANY HOURS ATTRIBUTED TO COALITION BUILDING AS MEMBERS FOR COMMUNITY BOARDS, CIVIC ORGANIZATIONS, ADVISORY COMMITTEES, COALITIONS AND WORK GROUPS. EXAMPLES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: ARENAC COUNTY PREVENTION COALITION, EDC ECONOMIC DEVELOPMENT CORPORATION, NECHIR STEERING COMMITTEE AND NMORC BOARD</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX.BAD DEBT EXPENSE METHODOLOGY: OTHER UNCOMPENSATED CARE REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH PAYMENT IS EXPECTED AT THE TIME SERVICE IS PROVIDED, BUT PAYMENT IS NOT RECEIVED OR IS LESS THAN THE COST INCURRED TO PROVIDE THE SERVICE. THE FOLLOWING IS INCLUDED AS PROGRAMS AND SERVICES RELATED TO OTHER UNCOMPENSATED CARE: UNCOMPENSATED SERVICES, AT COST REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH A FEE HAS BEEN ASSESSED BUT NOT COLLECTED OR ONLY A PORTION OF THE COST OF THE RENDERED SERVICE HAS BEEN RECOVERED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BAD DEBT COST WAS REVIEWED BY THE HOSPITAL'S REVENUE CYCLE TEAM AND THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE QUALIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY IS 5% OF TOTAL BAD DEBTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOCIAL SECURITY ACT AMENDMENT TO ESTABLISH MEDICARE STATES THAT MEDICARE WILL NOT PAY THE COST TO PROVIDE CARE TO NON-BENEFICIARIES AND NON-BENEFICIARIES WILL NOT PAY THE COST OF CARE FOR BENEFICIARIES. WHEN MEDICARE DOES NOT PAY RATES THAT COVER ALL THE COST OF CARE FOR BENEFICIARIES, IT BECOMES A COMMUNITY BURDEN. THEREFORE, THE FULL AMOUNT OF SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT.THIS ORGANIZATION BELIEVES THE AUDITED FINANCIAL STATEMENT CALCULATION IS A MORE ACCURATE DETERMINATION OF COST THAN THE MEDICARE ALLOWABLE COSTS USED FOR COST REPORTS THAT ARE REQUIRED TO BE UTILIZED ON THIS SCHEDULE IN PART III, SECTION B. THE AUDITED FINANCIAL STATEMENTS INCLUDE ALL MEDICARE REVENUES AND COSTS AND ALSO USE A COST-TO-CHARGE RATIO METHOD.COSTING METHODOLOGY: AN AVERAGE COST-TO-CHARGE RATIO IS APPLIED TO THE CHARGE WRITE-OFF. THE RATIO IS CALCULATED BY REMOVING FROM TOTAL EXPENSE THE OTHER OPERATING INCOME, UNCOMPENSATED CARE EXPENSE AND THE DIRECTLY ASSIGNED MEDICAID ASSESSMENT EXPENSE, THEN DIVIDING THIS NET EXPENSE BY TOTAL GROSS PATIENT REVENUES. THIS RATIO IS MULTIPLIED WITH THE CHARITY CARE CHARGES AND UNCOMPENSATED CARE CHARGES WRITTEN OFF FOR THE RELATED EXPENSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>MYMICHIGAN HEALTH DOES NOT TRY TO COLLECT FROM THOSE WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. MYMICHIGAN HEALTH'S POLICY STATES THAT THE PURPOSE OF THE POLICY "IS TO PROVIDE COST EFFECTIVE PAYMENT OPTIONS TO PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE (PER FINANCIAL AID/CHARITY CARE POLICY) AND EITHER HAVE NO INSURANCE OR HAVE A BALANCE AFTER INSURANCE WHICH IS THEIR RESPONSIBILITY TO PAY."</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>IN FISCAL YEAR 2025, MYMICHIGAN HEALTH'S FOCUS ON IMPROVING THE HEALTH OF OUR COMMUNITIES WAS REFLECTED IN OUR PURPOSE STATEMENT. WE PARTNERED WITH SCHOOLS, BUSINESSES AND HEALTH CARE AGENCIES TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITIES SERVED. OUR HOSPITAL BOARDS ARE COMPRISED OF COMMUNITY MEMBERS WHO PROVIDE INPUT INTO THE COMMUNITY ENDEAVORS WE INSTITUTE. ADDITIONALLY, WE PARTNER WITH THE MICHIGAN HEALTH INFORMATION ALLIANCE, INC., OR MIHIA, WHICH IS A DIVERSE GROUP OF STAKEHOLDERS COLLABORATING TOGETHER AS A NON-PROFIT ORGANIZATION TO IMPROVE HEALTH AND HEALTH DELIVERY IN CENTRAL MICHIGAN THROUGH PARTICIPATION IN A REGIONAL POPULATION HEALTH TEAM AND REGIONAL PERINATAL QUALITY COLLABORATIVE COMMITTEE. THESE COMMUNITY COLLABORATIONS HELP TO BUILD A HEALTH CARE SYSTEM WHERE CONSUMERS, PROVIDERS AND PAYORS MAKE DECISIONS FOR BEST PRACTICES IN THE AREA SERVED. ADDITIONALLY, WE PARTNER ON NEEDED HEALTH INITIATIVES, WORKING WITH LOCAL PUBLIC HEALTH DEPARTMENTS AND HEALTH AND HUMAN SERVICE AGENCIES TO UNDERSTAND THE UNIQUE HEALTH NEEDS OF EACH OF OUR COMMUNITIES. A 2024 WELL-BEING SURVEY WAS CONDUCTED TO UNDERSTAND THE HEALTH NEEDS AND THE VITALITY OF THE COMMUNITIES SERVED. THE COMMUNITY SERVED IS ARENAC COUNTY. THE SURVEY WAS PRESENTED TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY COLLABORATIVE TEAM FOR APPROVAL AND FOR FINAL SUGGESTIONS TO ENSURE THE SURVEY MET THE NEEDS OF THE HSCC AND OTHER COUNTY AGENCIES IN EACH OF THE COMMUNITIES SERVED. THE COLLABORATIVE TEAM THEN AIMED TO COLLECT DATA FROM ACROSS THE COUNTY. EFFORTS WERE MADE TO OBTAIN A SAMPLE OF DATA THAT WAS REPRESENTATIVE OF EACH COUNTY AND EACH ZIP CODE. DATA COLLECTION OCCURRED BOTH ONLINE AND VIA PAPER SURVEYS. MICROSOFT FORMS WAS USED TO ADMINISTER THE ONLINE SURVEY AND THE LINK WAS SENT VIA E-MAIL TO AGENCIES, ORGANIZATIONS AND E-MAIL CONTACT LISTS FROM EACH ORGANIZATION. THE SURVEY WAS ALSO ADVERTISED ON SOCIAL MEDIA PAGES AND LOCAL NEWSPAPERS. THE SURVEY WAS ALSO ADMINISTERED AT VARIOUS LOCATIONS THROUGHOUT EACH COUNTY AND MAILED TO ORGANIZATIONS WITH HARDER TO REACH POPULATIONS WITH LIMITED ACCESS TO INTERNET. PARTICIPANTS COMPLETED THE PAPER SURVEYS AT HOME AND RETURNED IT IN A POSTAGE PAID ENVELOPE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE IS COMMUNICATED TO THE PUBLIC THROUGH INFORMATIONAL BROCHURES AT REGISTRATION AREAS AND THROUGH PATIENT ACCOUNTING COUNSELORS. PATIENT ACCOUNTING COUNSELORS ARE TRAINED TO HELP PATIENTS OBTAIN FREE OR LOW-COST HEALTH INSURANCE OR TO WORK WITH PATIENTS TO PROVIDE CHARITY CARE OR FINANCIAL AID BASED ON THEIR FINANCIAL STATUS. MYMICHIGAN HEALTH PROVIDES FINANCIAL AID TO PATIENTS BASED ON THEIR INCOME, ASSETS, AND NEEDS. IN ADDITION, MYMICHIGAN HEALTH MAY BE ABLE TO HELP PATIENTS RECEIVE FREE OR LOW-COST HEALTH INSURANCE OR WORK WITH THE PATIENT TO ARRANGE A MANAGEABLE PAYMENT PLAN. ADDITIONALLY, SOCIAL WORKERS PROVIDE INFORMATION, BOTH WRITTEN AND VERBAL, ABOUT PROGRAMS FOR ASSISTANCE. THEY ALSO COORDINATE WITH THE MEDICAID ELIGIBILITY REPRESENTATIVE FROM DHS FOR FOLLOW-UP OR EXPEDITED APPLICATIONS. THEY PROVIDE MEDICAID APPLICATIONS, PERSONAL FINANCIAL STATEMENTS FOR HOSPITAL CHARITY CARE AND REFER TO THE PATIENT ACCOUNTING COUNSELORS. ADDITIONALLY, CONTACT INFORMATION ABOUT FINANCIAL ASSISTANCE IS AVAILABLE ON OUR WEBSITE AT HTTPS://WWW.MYMICHIGAN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/PATIENT-NOTICE-OF-FINANCIAL-AID.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMMUNITY SERVED FOCUSED ON ARENAC COUNTY, WHERE MYMICHIGAN MEDICAL CENTER STANDISH IS LOCATED. THE COMMUNITY SERVED IS COMPRISED OF ZIP CODES: 48610 (ALGER), 48658 (STANDISH), 48659 (STERLING), 48703 (AU GRES), 48749 (OMER), 48765 (TURNER) AND 48766 (TWINING). ACCORDING TO COUNTY HEALTH RANKINGS, THERE ARE 15,087 RESIDENTS IN ARENAC COUNTY. OF THOSE, 18.6% ARE UNDER 18 YEARS OF AGE AND 27.7% ARE 65 AND OLDER. FEMALES MAKE UP 48.7% OF THE POPULATION, WHILE MALES MAKE UP 51.3% OF THE POPULATION, 93.4% ARE WHITE (NON-HISPANIC) AND 6.6% ARE NON-WHITE. IN ARENAC COUNTY, THE PERCENTAGE OF PEOPLE WHO REPORTED THEIR HEALTH TO BE FAIR OR POOR WAS 18%.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH MYMICHIGAN HEALTH SUBSIDIARY ADDRESSES HEALTH AND WELL-BEING WITHIN THE COMMUNITIES SERVED. FOUR PORTFOLIOS OF POPULATION HEALTH ARE ADDRESSED: PHYSICAL HEALTH AND BEHAVIORAL HEALTH, SOCIAL AND SPIRITUAL WELL-BEING, COMMUNITY HEALTH AND WELL-BEING AND COMMUNITIES OF SOLUTIONS. PORTFOLIO ONE AIMS AT IMPROVING THE PHYSICAL AND OR MENTAL HEALTH OF INDIVIDUALS SERVED THROUGH QUALITY MEASUREMENT AND PERFORMANCE IMPROVEMENT INITIATIVES, AS WELL AS THE USE OF PATIENT CARE NAVIGATORS AND CARE MANAGERS IN PRIMARY CARE OFFICES AND INITIATIVES TO IMPROVE ACCESS TO CARE, LIKE INCREASED OPPORTUNITIES FOR TELEMEDICINE. PORTFOLIO TWO ADDRESSES SOCIAL AND SPIRITUAL DRIVERS OF HEALTH AND WELL-BEING, MANY OF WHICH ARE IDENTIFIED THROUGH SYSTEMATIC EVALUATION OF SOCIAL DETERMINANTS OF HEALTH COMPLETED AT SEVERAL POINTS OF CONTACT INCLUDING: NEW PATIENTS, EMERGENCY DEPARTMENT PATIENTS, ANNUAL PHYSICALS, POST HOSPITAL DISCHARGES, REFERRALS TO CARE MANAGERS AND PATIENTS WHO CONSISTENTLY DO NOT SHOW UP FOR APPOINTMENTS TO DETERMINE WHAT BARRIERS THEY MAY BE ENCOUNTERING. PORTFOLIO THREE ACTIVITIES AIM TO IMPROVE COMMUNITY HEALTH AND WELL-BEING BY COMMUNITY PARTNERS WORKING TOGETHER TO ASSESS DATA, DETERMINE FOCUS AREAS OF HEALTH AND POOL STAFF AND RESOURCES TO IMPLEMENT HEALTH IMPROVEMENT PROJECTS LIKE INCREASING PHYSICAL ACTIVITY, ACCESS TO HEALTHY FOODS AND REDUCING OPIOID USAGE. PORTFOLIO FOUR ADDRESSES OUR ROLE AS AN ANCHOR INSTITUTION. WE ARE THE MAJOR EMPLOYER IN EACH COMMUNITY WE SERVE AND AS SUCH, WE PROMOTE HEALTH AND WELL-BEING BY CAPITALIZING ON COMMUNITY ASSETS AND ACTIVE ENGAGEMENT WITH REGIONAL INITIATIVES. A TOTAL OF $47,402 IN COMMUNITY BENEFITS WAS PROVIDED BY MYMICHIGAN MEDICAL CENTER STANDISH IN FISCAL YEAR 2025 THROUGH COMMUNITY EDUCATION PROGRAMS, SCREENINGS, SPECIAL EVENTS AND HEALTH EXPERTISE. IN FISCAL YEAR 2025, 487 PERSONS WERE REACHED WITH GENERAL COMMUNITY EDUCATION TOPICS LIKE SENIOR EDUCATION AND OUTREACH AND SUBSTANCE ABUSE MEETINGS. MYMICHIGAN MEDICAL CENTER STANDISH PROVIDED EDUCATION TO OVER 300 INDIVIDUALS AT TWO EVENTS WITH SENIOR LIFE SOLUTIONS. THERE WAS ONE BLOOD DRIVE PROVIDED THAT SERVED 9 PEOPLE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMMUNITY BENEFITS PROVIDED BY MYMICHIGAN MEDICAL CENTER STANDISH IN FISCAL YEAR 2025 INCLUDE COMMUNITY EDUCATION PROGRAMS, SCREENINGS, SPECIAL EVENTS AND HEALTH EXPERTISE, INCLUDING INSURANCE UNDER-REIMBURSEMENTS AND SERVICES TO THOSE WHO COULD NOT PAY. OVER $242 MILLION IN COMMUNITY BENEFITS WAS PROVIDED BY MYMICHIGAN HEALTH TO THE COMMUNITIES IT SERVES. THE UNDERLYING PREMISE FOR EACH MYMICHIGAN HEALTH SUBSIDIARY IS SHARED OWNERSHIP FOR COMMUNITY HEALTH. THE PLAN REFLECTS INPUT FROM DESIGNATED INDIVIDUALS IN EACH COMMUNITY INCLUSIVE OF, BUT NOT LIMITED TO, PUBLIC HEALTH EXPERTS, REPRESENTATIVES OF LOW-INCOME AND MEDICALLY UNDERSERVED POPULATIONS AND THOSE SUFFERING FROM CHRONIC DISEASE. THE BROADENED SCOPE FROM WHICH WE FUNCTION IS INHERENT IN THE STRATEGIES WHICH INCLUDE INTERNAL HEALTH IMPROVEMENT INITIATIVES OF MYMICHIGAN MEDICAL CENTER STANDISH AND MYMICHIGAN HEALTH, AS WELL AS COLLABORATIVE EFFORTS OF THE HOSPITAL WITH PUBLIC HEALTH, THE UNIVERSITY OF MICHIGAN AND OUR COMMUNITY PARTNERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>MI</ExplanationTxt>
      </SupplementalInformationDetail>
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        <TotalCompensationRltdOrgsAmt>357212</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MAY MD JO STUDLEY</PersonNm>
        <TitleTxt>DIRECTOR (PART YEAR)</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>151651</CompensationBasedOnRltdOrgsAmt>
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        <BonusRelatedOrganizationsAmt>88152</BonusRelatedOrganizationsAmt>
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        <OtherCompensationRltdOrgsAmt>1907</OtherCompensationRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>259758</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>POCOBELLO REBEKAH</PersonNm>
        <TitleTxt>RN</TitleTxt>
        <BaseCompensationFilingOrgAmt>118488</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>20000</BonusFilingOrganizationAmount>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SLOCUM ANDREW</PersonNm>
        <TitleTxt>NP</TitleTxt>
        <BaseCompensationFilingOrgAmt>120448</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <NontaxableBenefitsFilingOrgAmt>25459</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>151852</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINES 4A-B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION DURING THE CALENDAR YEAR 2024: NANCY HAYWOOD: $43,702 DOUGLAS TODD MYERS: $375,000 JONATHAN SAMUEL NALLI: $933,000 WATSON-PINNEY, ROSE, AND ERICKSON ARE PARTICIPANTS IN A 457(F) PLAN. ROSE RECEIVED A PAYMENT IN 2024 WHICH IS REFLECTED ON SCHEDULE J, PART II, COLUMN F. THE CURRENT PARTICIPANTS OF THE PLAN ARE THE MEMBERS OF THE SENIOR LEADERSHIP OR EXECUTIVE TEAM. EACH PARTICIPANT'S ANNUAL AWARD IS BASED ON THEIR POSITION LEVEL AND IS A PERCENTAGE OF BASE SALARY ON DECEMBER 31 OF THE PLAN YEAR. THE PLAN PROVIDES ADDITIONAL RETIREMENT INCOME WHICH OTHERWISE WOULD BE PROVIDED UNDER THE PENSION PLAN AND 403(B) PLAN, BUT FOR LIMITATIONS ON SUCH BENEFITS REQUIRED BY FEDERAL LAW. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MYMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; TERMINATION OF EMPLOYMENT AFTER AT LEAST THREE CONSECUTIVE YEARS OF SERVICE; OR, A PLAN SPONSOR CHANGE IN CONTROL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>MYMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES. THE COMPENSATION COMMITTEE, WHO IS AUTHORIZED TO ACT ON BEHALF OF THE MYMICHIGAN HEALTH BOARD OF DIRECTORS, APPROVED COMPENSATION FOR THE MYMICHIGAN HEALTH CEO, SENIOR EXECUTIVES AND PHYSICIANS. SULLIVAN COTTER ANNUALLY CONDUCTS A COMPREHENSIVE ASSESSMENT OF EXECUTIVE COMPENSATION. PHYSICIAN COMPENSATION OFFERS EXCEEDING THE 90TH PERCENTILE MUST BE APPROVED BY THE COMPENSATION COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III:</FormAndLineReferenceDesc>
        <ExplanationTxt>MYMICHIGAN HEALTH'S COMPENSATION COMMITTEE CHARTER IS APPROVED ANNUALLY BY THE COMMITTEE AND BOARD AS WERE THE EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. MYMICHIGAN HEALTH ALSO CONTINUES TO UTILIZE AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES. HOSPITAL LEVEL EXECUTIVES AND SELECTED OTHER EXECUTIVES. MYMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MYMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED NATIONALLY FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NAME OF THE CORPORATION WAS CHANGED TO MYMICHIGAN MEDICAL CENTER STANDISH AND MYMICHIGAN HEALTH WAS NAMED AS THE SOLE MEMBER. THE ARTICLES OF INCORPORATION WERE AMENDED AND RESTATED INCLUDING THE PURPOSE TO FURTHER ANY AND ALL CHARITABLE AND SCIENTIFIC PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) IN THE DELIVERY OF HEALTH CARE THROUGH OPERATING A HOSPITAL AND ALSO REMOVING ANY REFERENCES TO CATHOLIC MINISTRY AND ETHICAL AND RELIGIOUS DIRECTIVES. BYLAWS WERE UPDATED TO DEFINE VOTING AND SPECIFIC RESERVED POWERS OF THE SOLE MEMBER AND TO DEFINE THE ORGANIZATION'S GOVERNANCE STRUCTURE, BOARD COMPOSITION, CONFLICT OF INTEREST, BOARD COMMITTEES, VOTING RIGHTS, MEETING PROCEDURES, AND RESPONSIBILITIES OF DIRECTORS AND OFFICERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER OF THE CORPORATION IS MYMICHIGAN HEALTH.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS OF MYMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE CORPORATION'S PURPOSES; B) APPROVE ANY CHANGE IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION, JOINT VENTURE, OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR OTHER ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE MYMICHIGAN HEALTH BOARD; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; AND G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE MYMICHIGAN HEALTH BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCE STAFF AT EACH SUBSIDIARY UPLOADS INFORMATION INTO THE SOFTWARE WHICH IS THEN REVIEWED BY THE CORPORATE CONTROLLER AT MYMICHIGAN HEALTH, THE SOLE MEMBER OF THIS CORPORATION. THE CORPORATE CONTROLLER REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. A FINAL REVIEW IS THEN DONE BY THE SVP AND TREASURER. IN ADDITION, ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MYMICHIGAN HEALTH CEO PRIOR TO FILING. THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION IS REVIEWED BY THE COMPENSATION COMMITTEE PRIOR TO FILING. FORM 990, INCLUDING ALL SCHEDULES, IS MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS IN A SECURE ELECTRONIC FORMAT WITH A SUMMARY OF ALL THE MAJOR CHANGES FROM THE PRIOR YEAR RETURN. QUESTIONS OR CONCERNS ARE ADDRESSED BY THE SVP AND TREASURER. THE QUESTIONS OR CONCERNS OF THESE REVIEWS ARE PRESENTED TO THE MYMICHIGAN HEALTH BOARD OF DIRECTORS AND THIS ORGANIZATION'S BOARD OF DIRECTORS, IF ANY ARE INDENTIFIED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; AND 3) TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MYMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. A LISTING OF ANY CONFLICTS ARE PROVIDED TO THE BOARD CHAIR, VICE CHAIR, AND PRESIDENT OF THE ORGANIZATION. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES MAY BE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND AT A MINIMUM IS REQUIRED TO ABSTAIN FROM VOTING ON ANY ISSUES IN WHICH THEY ARE NOT INDEPENDENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL CEOS AND OPERATING OFFICERS COMPENSATION IS ANNUALLY REVIEWED BY AN INDEPENDENT COMPENSATION CONSULTANT FOR REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE OF MYMICHIGAN HEALTH. THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). ALL OFFICERS AND KEY EMPLOYEE COMPENSATION (INCLUDING PHYSICIANS) IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE OF MYMICHIGAN HEALTH FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, SECTION B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>INDEPENDENT CONTRACTORS FOR ALL RELATED ORGANIZATIONS ARE COMPENSATED BY MYMICHIGAN HEALTH, 38-2459948, THE SOLE MEMBER OF THIS ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>NO DIRECTORS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD, BUT MAY BE COMPENSATED FOR OTHER SERVICES PROVIDED TO THE ORGANIZATION. THEY ARE CONSIDERED TO WORK AN AVERAGE OF 2 HOURS A WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK RELATED TO THEIR FULL-TIME POSITION. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MYMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MYMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES ARE NOT TRACKED BY SUBSIDIARY. THEREFORE THE FULL-TIME SERVICE TO ALL SUBSIDIARIES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>ASSOCIATION DUES AND OTHER FEES: PROGRAM SERVICE EXPENSES 17,281. MANAGEMENT AND GENERAL EXPENSES 7,434. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,715. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 249,723. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 249,723. PURCHASED AND CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 5,715,062. MANAGEMENT AND GENERAL EXPENSES 3,080,646. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,795,708. PHYSICAN FEES: PROGRAM SERVICE EXPENSES 10,669. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,669.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>INHERENT CONTRIBUTION FROM ACQUISITION 6,265,381. CHANGE IN OWNERSHIP ADJUSTMENT -3,468,114.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR.</ExplanationTxt>
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    </IRS990ScheduleO>
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      <IdRelatedTaxExemptOrgGrp>
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      <IdRelatedTaxExemptOrgGrp>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MYMICHIGAN MEDICAL CENTER TAWAS</BusinessNameLine1Txt>
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        <EIN>381443395</EIN>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MYMICHIGAN MEDICAL CENTER SAGINAW FOUNDATION</BusinessNameLine1Txt>
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          <AddressLine1Txt>4000 WELLNESS DR</AddressLine1Txt>
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          <ZIPCd>48670</ZIPCd>
        </USAddress>
        <EIN>382246366</EIN>
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        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MYMICHIGAN MEDICAL CENTER TAWAS FOUNDATION</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>4000 WELLNESS DR</AddressLine1Txt>
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          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48670</ZIPCd>
        </USAddress>
        <EIN>010790428</EIN>
        <PrimaryActivitiesTxt>FOUNDATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MYMICHIGAN HEALTH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FIELD NEUROSCIENCES INSTITUTE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4000 WELLNESS DR</AddressLine1Txt>
          <CityNm>MIDLAND</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48670</ZIPCd>
        </USAddress>
        <EIN>382790703</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MYMICHIGAN HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ASCENSION HEALTH ALLIANCE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO BOX 45998</AddressLine1Txt>
          <CityNm>ST LOUIS</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>631455998</ZIPCd>
        </USAddress>
        <EIN>453358926</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MO</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ASCENSION BORGESS HOSPITAL</BusinessNameLine1Txt>
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        <USAddress>
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          <ZIPCd>631455998</ZIPCd>
        </USAddress>
        <EIN>381360526</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ASCENSION MICHIGAN</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MYMICHIGAN HEALTH PAIN MANAGEMENT</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2463 SOUTH M-30</AddressLine1Txt>
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          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48661</ZIPCd>
        </USAddress>
        <EIN>834186622</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE PAIN MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ISOMM</BusinessNameLine1Txt>
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          <AddressLine1Txt>211 S CRAPO ST STE H</AddressLine1Txt>
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          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48858</ZIPCd>
        </USAddress>
        <EIN>270867311</EIN>
        <PrimaryActivitiesTxt>MRI SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MT PLEASANT SURGERY CENTER LLC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>4851 E PICKARD ST SUITE 1100</AddressLine1Txt>
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          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48858</ZIPCd>
        </USAddress>
        <EIN>300872082</EIN>
        <PrimaryActivitiesTxt>AMBULATORY SURGERY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>TOWNE CENTRE SURGERY CENTER LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>4599 TOWNE CENTRE</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48604</ZIPCd>
        </USAddress>
        <EIN>204943843</EIN>
        <PrimaryActivitiesTxt>AMBULATORY SURGERY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
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        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
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      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>