﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v6.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-05-12T08:58:07-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>331498605</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>PLANTE &amp; MORAN PLLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>10 S RIVERSIDE PLAZA 9TH FLOOR</AddressLine1Txt>
        <CityNm>CHICAGO</CityNm>
        <StateAbbreviationCd>IL</StateAbbreviationCd>
        <ZIPCd>60606</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>381458751</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MICHIGAN HEALTH &amp; HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>D/B/A MHA</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>MICH</BusinessNameControlTxt>
      <PhoneNum>5178868254</PhoneNum>
      <USAddress>
        <AddressLine1Txt>2112 UNIVERSITY PARK DRIVE</AddressLine1Txt>
        <CityNm>OKEMOS</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48864</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>SCOTT PILLION</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>5178868254</PhoneNum>
      <SignatureDt>2025-05-09</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>DAVID LOWENTHAL</PreparerPersonNm>
      <PTIN>P00378651</PTIN>
      <PhoneNum>3122071040</PhoneNum>
      <PreparationDt>2025-05-07</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>MHA</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>BRIAN PETERS</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>2112 UNIVERSITY PARK DRIVE</AddressLine1Txt>
        <CityNm>OKEMOS</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48864</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>61880527</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501cInd organization501cTypeTxt="6">X</Organization501cInd>
      <WebsiteAddressTxt>WWW.MHA.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationAssocInd>X</TypeOfOrganizationAssocInd>
      <FormationYr>1919</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROMOTE THE INTERESTS OF THE HEALTH CARE INDUSTRY.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>19</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>18</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>65</TotalEmployeeCnt>
      <TotalVolunteersCnt>18</TotalVolunteersCnt>
      <TotalGrossUBIAmt>357866</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>21243</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>192197454</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>27734993</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>20693941</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>33131470</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>814052</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>1014064</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>213705447</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>61880527</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>192912484</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>33957317</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>16978689</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>13301762</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>7130548</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>9870797</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>217021721</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>57129876</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-3316274</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>4750651</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>85656318</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>39525175</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>67823927</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>16838289</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>17832391</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>22686886</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>WE ADVANCE THE HEALTH OF INDIVIDUALS AND COMMUNITIES.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <Desc>THE ASSOCIATION PROMOTES THE INTERESTS OF THE HEALTHCARE INDUSTRY FOR ITS MEMBERS, WHICH CONSIST OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF MICHIGAN. IN ADDITION, THE ASSOCIATION HAS FOUR DESIGNATED FUNDS: THE MICHIGAN HOSPITAL ASSOCIATION PUBLIC POLICY INITIATIVE FUND, WHICH IS PRIMARILY FOCUSED ON HEALTHCARE REFORM AND RELATED POLICY ISSUES; MHA COLLABORATIVE HOSPITAL ASSISTANCE PROGRAM (CHAP), WHICH INVOLVES THE VOLUNTARY CONTRIBUTION BY HOSPITALS OF FUNDS WHICH ARE REDISTRIBUTED TO HOSPITALS AS A RESULT OF THE MEDICAID QUALITY ASSURANCE ASSESSMENT PROGRAM (QAAP).</Desc>
      <DescribedInSection501c3Ind>0</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039500001">1</PoliticalCampaignActyInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039500001">1</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">1</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>33</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>65</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>1</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>1</Form990TFiledInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>1</NondeductibleContributionsInd>
      <NondeductibleContriDisclInd>1</NondeductibleContriDisclInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>19</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>18</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>0</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>SCOTT PILLION CFO</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5173233443</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2112 UNIVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN PETERS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1233526</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>89489</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHANNON STRIEBICH</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JULIE YAROCH</PersonNm>
        <TitleTxt>CHAIR-ELECT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BILL MANNS</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANTHONY DENTON</PersonNm>
        <TitleTxt>PAST CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GAR ATCHISON</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAREN CHEESEMAN</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BETH CHARLTON</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK EASTBURG</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEREMIAH HODSHIRE</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY LANE</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRITTANY LAVIS</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DOUG APPLE</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTINA FREESE-DECKER</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EDWIN NESS</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT RINEY</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KENT RIDDLE</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LYDIA WATSON</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HUNTER NOSTRANT</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT PILLION</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>351737</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>76753</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NANCY MCKEAGUE</PersonNm>
        <TitleTxt>EXECUTIVE VP, CHIEF OF STAFF</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>670426</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>58895</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY ROTH</PersonNm>
        <TitleTxt>SENIOR VP, CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>372341</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>74277</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AMY BARKHOLZ</PersonNm>
        <TitleTxt>SENIOR VP, GENERAL COUNSEL</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>339149</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>54847</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SAM WATSON</PersonNm>
        <TitleTxt>SENIOR VP, FIELD ENGAGEMENT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>445563</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>78078</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURA APPEL</PersonNm>
        <TitleTxt>EXECUTIVE VP, CHIEF OF STAFF</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>619823</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>76147</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4032565</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>508486</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>33</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CAPITAL TOWER LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>110 W MICHIGAN AVE</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48933</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
        <CompensationAmt>505733</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GRAND HOTEL</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 286</AddressLine1Txt>
            <CityNm>MACKINAC ISLAND</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49757</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
        <CompensationAmt>478376</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CYBERFORCE Q LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>47911 HALYARD ROAD</AddressLine1Txt>
            <CityNm>PLYMOUTH</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48170</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
        <CompensationAmt>197638</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PLANTE &amp; MORAN PLLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1111 MICHIGAN AVE</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
        <CompensationAmt>180900</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>4</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>27514993</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>220000</AllOtherContributionsAmt>
      <TotalContributionsAmt>27734993</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>SERVICE FEES</Desc>
        <BusinessCd>561499</BusinessCd>
        <TotalRevenueColumnAmt>14046102</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>14046102</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RENTAL AND REGISTRATION REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>7903446</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7545580</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>357866</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEMBERSHIP DUES</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>7592922</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7592922</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT FEES</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>3070770</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3070770</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ADMINISTRATIVE FEES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>518230</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>518230</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>33131470</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1002064</TotalRevenueColumnAmt>
        <ExclusionAmt>1002064</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>12000</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>12000</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>12000</TotalRevenueColumnAmt>
        <ExclusionAmt>12000</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>61880527</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>32773604</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>357866</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1014064</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>33957317</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1751505</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>8869692</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1052164</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1126045</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>502356</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>233604</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>75260</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>897382</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>3613043</TotalAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>629224</TotalAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>1214617</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>1620872</TotalAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>398545</TotalAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>132637</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>TAXES</Desc>
        <TotalAmt>238024</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>215496</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BANK FEES</Desc>
        <TotalAmt>168942</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SPONSORSHIPS</Desc>
        <TotalAmt>166000</TotalAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>267151</TotalAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>57129876</TotalAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1045838</BOYAmt>
        <EOYAmt>579251</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>9392037</BOYAmt>
        <EOYAmt>14287119</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>54849334</BOYAmt>
        <EOYAmt>1961665</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>7079017</BOYAmt>
        <EOYAmt>7835779</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>549154</BOYAmt>
        <EOYAmt>566082</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>15068861</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>5612884</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>9474734</BOYAmt>
        <EOYAmt>9455977</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>1240054</BOYAmt>
        <EOYAmt>3340487</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>2026150</BOYAmt>
        <EOYAmt>1498815</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>85656318</BOYAmt>
        <EOYAmt>39525175</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>58204558</BOYAmt>
        <EOYAmt>6402555</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>684653</BOYAmt>
        <EOYAmt>59865</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>4117065</BOYAmt>
        <EOYAmt>3890637</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>4817651</BOYAmt>
        <EOYAmt>6485232</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>67823927</BOYAmt>
        <EOYAmt>16838289</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>17832391</BOYAmt>
        <EOYAmt>22686886</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>17832391</BOYAmt>
        <EOYAmt>22686886</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>85656318</BOYAmt>
        <EOYAmt>39525175</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>4750651</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>103844</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <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>
    <IRS990ScheduleC documentId="RetDoc1039500001">
      <PoliticalExpendituresAmt>205000</PoliticalExpendituresAmt>
      <InternalFundsContributedAmt>205000</InternalFundsContributedAmt>
      <TotalExemptFunctionExpendAmt>205000</TotalExemptFunctionExpendAmt>
      <Form1120POLFiledInd>1</Form1120POLFiledInd>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>MICHIGAN DEMOCRATIC STATE CENTRAL COMMITTEE</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>606 TOWNSEND</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <EIN>381323848</EIN>
        <PaidInternalFundsAmt>200000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>MICHIGAN LEGISLATIVE BLACK CAUCUS CIVIC TRUST</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>14567 ROSEMONT AVE</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48223</ZIPCd>
        </USAddress>
        <EIN>320028384</EIN>
        <PaidInternalFundsAmt>5000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <SubstantiallyAllDuesNondedInd>1</SubstantiallyAllDuesNondedInd>
      <OnlyInHouseLobbyingInd>0</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>0</AgreeCarryoverPriorYearInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I-A, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>MHA CONTRIBUTED TO A POLITICAL ACTION COMMITTEES WHICH SUPPORT CANDIDATES THAT ADVOCATE FOR HOSPITALS AND PATIENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>700706</OtherCostOrOtherBasisAmt>
        <BookValueAmt>700706</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>10184383</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2060717</DepreciationAmt>
        <BookValueAmt>8123666</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1097227</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>783959</DepreciationAmt>
        <BookValueAmt>313268</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3086545</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2768208</DepreciationAmt>
        <BookValueAmt>318337</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>9455977</TotalBookValueLandBuildingsAmt>
      <CloselyHeldEquityInterestsGrp>
        <BookValueAmt>210749</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </CloselyHeldEquityInterestsGrp>
      <OtherSecuritiesGrp>
        <Desc>VANGUARD INVESTMENTS</Desc>
        <BookValueAmt>3129738</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>3340487</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATES</Desc>
        <Amt>4986417</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITIES- OPERATING</Desc>
        <Amt>1498815</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>6485232</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MAUI STRONG</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>827 FORT STREET MALL</AddressLine1Txt>
          <CityNm>HONOLULU</CityNm>
          <StateAbbreviationCd>HI</StateAbbreviationCd>
          <ZIPCd>96813</ZIPCd>
        </USAddress>
        <RecipientEIN>990261283</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>5200</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>FOOD BANK COUNCIL OF MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>330 MARSHALL ST SUITE 103</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <RecipientEIN>382515765</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>30000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNIVERSITY OF MICHIGAN ATHLETICS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1000 SOUTH STATE STREEET</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48109</ZIPCd>
        </USAddress>
        <RecipientEIN>386006309</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>56500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MICHIGAN DEMOCRATIC STATE CENTRAL COMMITTEE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>606 TOWNSEND</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <RecipientEIN>381323848</RecipientEIN>
        <IRCSectionDesc>527</IRCSectionDesc>
        <CashGrantAmt>200000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MICHIGAN CITIZENS FOR BETTER HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 11075</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48901</ZIPCd>
        </USAddress>
        <RecipientEIN>932984944</RecipientEIN>
        <IRCSectionDesc>501C4</IRCSectionDesc>
        <CashGrantAmt>925000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ROAD TO MICHIGAN'S FUTURE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 12248</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48901</ZIPCd>
        </USAddress>
        <RecipientEIN>844298056</RecipientEIN>
        <IRCSectionDesc>501C4</IRCSectionDesc>
        <CashGrantAmt>205000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASCENSION ST JOHN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>22101 MOROSS RD</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>482362172</ZIPCd>
        </USAddress>
        <RecipientEIN>381359063</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>3793133</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS IRON RIVER HOSPITAL &amp; CLINICS INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1400 W ICE LAKE RD</AddressLine1Txt>
          <CityNm>IRON RIVER</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>499359526</ZIPCd>
        </USAddress>
        <RecipientEIN>383236977</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>350820</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS IRONWOOD HOSPITAL &amp; CLINICS INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>N10561 GRANDVIEW LN</AddressLine1Txt>
          <CityNm>IRONWOOD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>499389622</ZIPCd>
        </USAddress>
        <RecipientEIN>382908586</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>272273</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS KEWEENAW HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>205 OSCEOLA ST</AddressLine1Txt>
          <CityNm>LAURIUM</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>499132134</ZIPCd>
        </USAddress>
        <RecipientEIN>381443361</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>381858</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS ONTONAGON HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>601 S 7TH ST</AddressLine1Txt>
          <CityNm>ONTONAGON</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>499531448</ZIPCd>
        </USAddress>
        <RecipientEIN>260806477</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>24999</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BEHAVIORAL CENTER OF MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4050 TWELVE MILE RD 2534</AddressLine1Txt>
          <CityNm>WARREN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48092</ZIPCd>
        </USAddress>
        <RecipientEIN>383473188</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>150000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>COVENANT HEALTHCARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1447 N HARRISON ST</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>486024727</ZIPCd>
        </USAddress>
        <RecipientEIN>383369438</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>1400000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DMC DETROIT RECEIVING HOSPITAL &amp; UNIVERSITY HEALTH CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4201 SAINT ANTOINE ST</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>482012153</ZIPCd>
        </USAddress>
        <RecipientEIN>272844942</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>973962</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>EATON RAPIDS MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1500 S MAIN ST</AddressLine1Txt>
          <CityNm>EATON RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>488271952</ZIPCd>
        </USAddress>
        <RecipientEIN>381559180</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>351437</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>FOREST VIEW PSYCHIATRIC HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1055 MEDICAL PARK DR SE</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>495463607</ZIPCd>
        </USAddress>
        <RecipientEIN>232285657</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>150000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HARBOR BEACH COMMUNITY HOSPITAL INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>210 S 1ST ST</AddressLine1Txt>
          <CityNm>HARBOR BEACH</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>484411236</ZIPCd>
        </USAddress>
        <RecipientEIN>381565380</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>261578</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HEALTHSOURCE SAGINAW INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3340 HOSPITAL RD</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>486039622</ZIPCd>
        </USAddress>
        <RecipientEIN>386804889</RecipientEIN>
        <IRCSectionDesc>GOV</IRCSectionDesc>
        <CashGrantAmt>610290</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HELEN NEWBERRY JOY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>502 W HARRIE ST</AddressLine1Txt>
          <CityNm>NEWBERRY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>498681209</ZIPCd>
        </USAddress>
        <RecipientEIN>382873485</RecipientEIN>
        <IRCSectionDesc>GOV</IRCSectionDesc>
        <CashGrantAmt>168126</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HILLS &amp; DALES GENERAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4675 HILL ST</AddressLine1Txt>
          <CityNm>CASS CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>487261099</ZIPCd>
        </USAddress>
        <RecipientEIN>381619577</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>250000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>INSIGHT SURGICAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>28000 DEQUINDRE RD</AddressLine1Txt>
          <CityNm>WARREN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>480922468</ZIPCd>
        </USAddress>
        <RecipientEIN>134257646</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>430847</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>LAKE HURON MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2601 ELECTRIC AVE</AddressLine1Txt>
          <CityNm>PORT HURON</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>480606518</ZIPCd>
        </USAddress>
        <RecipientEIN>472361878</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>205927</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MARLETTE REGIONAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2770 MAIN ST</AddressLine1Txt>
          <CityNm>MARLETTE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>484531141</ZIPCd>
        </USAddress>
        <RecipientEIN>381507302</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>96676</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MARSHFIELD MEDICAL CENTER DICKINSON</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1721 S STEPHENSON AVE</AddressLine1Txt>
          <CityNm>IRON MOUNTAIN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>498013637</ZIPCd>
        </USAddress>
        <RecipientEIN>382780429</RecipientEIN>
        <IRCSectionDesc>GOV</IRCSectionDesc>
        <CashGrantAmt>62302</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MCKENZIE HEALTH SYSTEM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>120 N DELAWARE ST</AddressLine1Txt>
          <CityNm>SANDUSKY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>484711087</ZIPCd>
        </USAddress>
        <RecipientEIN>381738615</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>50355</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNISING MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1500 SANDPOINT RD</AddressLine1Txt>
          <CityNm>MUNISING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>498621406</ZIPCd>
        </USAddress>
        <RecipientEIN>381507046</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>117394</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1105 6TH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496842386</ZIPCd>
        </USAddress>
        <RecipientEIN>381362830</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>2800000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OSF ST FRANCIS HOSPITAL AND MEDICAL GROUP</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3401 LUDINGTON ST</AddressLine1Txt>
          <CityNm>ESCANABA</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>498291377</ZIPCd>
        </USAddress>
        <RecipientEIN>370813229</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>54588</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PIONEER SPECIALTY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>50 N PERRY ST</AddressLine1Txt>
          <CityNm>PONTIAC</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48342</ZIPCd>
        </USAddress>
        <RecipientEIN>462020627</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>75000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SAMARITAN BEHAVIORAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>5555 CONNER AVENUE SUITE 3N</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48213</ZIPCd>
        </USAddress>
        <RecipientEIN>381901104</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>150000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - ANN ARBOR</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>5301 E HURON RIVER DR 7 NORTH</AddressLine1Txt>
          <CityNm>YPSILANTI</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48197</ZIPCd>
        </USAddress>
        <RecipientEIN>383389548</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>18920</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - BATTLE CREEK</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>300 NORTH AVE 6TH FLOOR</AddressLine1Txt>
          <CityNm>BATTLE CREEK</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>490173307</ZIPCd>
        </USAddress>
        <RecipientEIN>752962822</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>73156</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - FLINT</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 SOUTH BALLENGER HIGHWAY 5TH</AddressLine1Txt>
          <AddressLine2Txt>FLOOR CENTRAL</AddressLine2Txt>
          <CityNm>FLINT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>485323638</ZIPCd>
        </USAddress>
        <RecipientEIN>383329100</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>38704</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - MACOMB COUNTY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>22101 MOROSS RD FL 6</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>482362148</ZIPCd>
        </USAddress>
        <RecipientEIN>383345654</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>15477</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - PONTIAC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>44405 WOODWARD AVE</AddressLine1Txt>
          <CityNm>PONTIAC</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>483415023</ZIPCd>
        </USAddress>
        <RecipientEIN>383389212</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>46216</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - SAGINAW</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1447 N HARRISON ST</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>486024785</ZIPCd>
        </USAddress>
        <RecipientEIN>251890958</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>37977</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - SPECTRUM HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1840 WEALTHY ST SE FL 5</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>495062921</ZIPCd>
        </USAddress>
        <RecipientEIN>384031103</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>38338</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SHERIDAN COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>301 N MAIN ST</AddressLine1Txt>
          <CityNm>SHERIDAN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>488849235</ZIPCd>
        </USAddress>
        <RecipientEIN>381369796</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>250000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TRINITY HEALTH ST JOSEPH MERCY ANN ARBOR</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>5301 E HURON RIVER DR PO BOX 995</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>481060995</ZIPCd>
        </USAddress>
        <RecipientEIN>382113393</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>3988024</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>STRAITH HOSPITAL FOR SPECIAL SURGERY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>23901 LAHSER RD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>480336035</ZIPCd>
        </USAddress>
        <RecipientEIN>381455020</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>810547</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HOLLAND HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>602 MICHIGAN AVE</AddressLine1Txt>
          <CityNm>HOLLAND</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>494234999</ZIPCd>
        </USAddress>
        <RecipientEIN>382800065</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>348384</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MEMORIAL HEALTHCARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>826 W KING ST</AddressLine1Txt>
          <CityNm>OWOSSO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>488672120</ZIPCd>
        </USAddress>
        <RecipientEIN>381358208</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>147754</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PINE REST CHRISTIAN MENTAL HEALTH SERVICES</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>300 68TH ST SE</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>495486927</ZIPCd>
        </USAddress>
        <RecipientEIN>381368360</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>888644</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>KALKASKA MEMORIAL HEALTH CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <RecipientEIN>940547327</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>750000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNIVERSITY OF MICHIGAN HOSPITALS &amp; HEALTH SYSTEMS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1500 EAST MEDICAL CENTER DRIVE</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48109</ZIPCd>
        </USAddress>
        <RecipientEIN>386006307</RecipientEIN>
        <IRCSectionDesc>GOV</IRCSectionDesc>
        <CashGrantAmt>4900000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <RecipientEIN>382640544</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>76519</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>43</Total501c3OrgCnt>
      <TotalOtherOrgCnt>3</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES A CONTRIBUTION TO ORGANIZATIONS WITH SIMILAR MISSIONS FOR THE GENERAL SUPPORT OF THE ORGANIZATION. SINCE THE FUNDS ARE TO BE USED FOR THE GENERAL SUPPORT OF THEIR MISSION, WE DO NOT REQUIRE THE ORGANIZATION TO SUBSTANTIATE THEIR EXPENDITURES RELATED TO THESE CONTRIBUTIONS. PASS THROUGH GRANTS SUBMIT EXPENDITURES FOR REIMBURSEMENT IN ACCORDANCE WITH GRANT AGREEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <FirstClassOrCharterTravelInd>X</FirstClassOrCharterTravelInd>
      <DiscretionarySpendingAcctInd>X</DiscretionarySpendingAcctInd>
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRIAN PETERS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>777138</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>270075</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>186313</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>36300</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>53189</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1323015</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>169425</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NANCY MCKEAGUE</PersonNm>
        <TitleTxt>EXECUTIVE VP, CHIEF OF STAFF</TitleTxt>
        <BaseCompensationFilingOrgAmt>414681</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>175000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>80745</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>36300</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22595</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>729321</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>30293</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LAURA APPEL</PersonNm>
        <TitleTxt>EXECUTIVE VP, CHIEF OF STAFF</TitleTxt>
        <BaseCompensationFilingOrgAmt>409375</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>175000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>35448</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>36300</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>39847</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>695970</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>23095</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SAM WATSON</PersonNm>
        <TitleTxt>SENIOR VP, FIELD ENGAGEMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>325901</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>90000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>29662</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>36300</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>41778</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>523641</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>19665</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GARY ROTH</PersonNm>
        <TitleTxt>SENIOR VP, CHIEF MEDICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>318780</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>45000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>8561</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>36300</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>37977</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>446618</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SCOTT PILLION</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>263051</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>80000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>8686</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>36300</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>40453</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>428490</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AMY BARKHOLZ</PersonNm>
        <TitleTxt>SENIOR VP, GENERAL COUNSEL</TitleTxt>
        <BaseCompensationFilingOrgAmt>250728</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>75000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>13421</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>36300</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18547</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>393996</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>CHARTER TRAVEL IS USED BY BOARD MEMBERS FOR BUSINESS ONLY AND IS NOT TAXED AS COMPENSATION. DISCRETIONARY SPENDING ACCOUNTS ARE USED FOR SELECT INDIVIDUALS AND IS TAXED AS COMPENSATION. BUSINESS CLUBS ARE FOR EXECUTIVE STAFF AND USED FOR BUSINESS PURPOSES, THEREFORE THEY ARE NOT TAXED AS COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: - LAURA APPEL - CHARLIE JOHNSON - NANCY MCKEAGUE - BRIAN PETERS - SAM WATSON - CHRISTOPHER MITCHELL THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE CURRENT YEAR: - CHARLIE JOHNSON - $15,391 - NANCY MCKEAGUE - $30,293 - BRIAN PETERS - $169,425 - SAM WATSON - $19,665 - LAURA APPEL - $23,095 - CHRISTOPHER MITCHELL - $172,890</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDES NON-FIXED PAYMENTS TO EMPLOYEES ON AN ANNUAL BASIS. THESE BONUSES ARE DISCRETIONARY IN NATURE. THE NON-FIXED PAYMENTS ARE REPORTED AS AMOUNT PROVIDED TO EACH INDIVIDUAL IS DETERMINED BY THE BOARD AND IS BONUS/INCENTIVE COMPENSATION IN PART II OF SCHEDULE J.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ASSOCIATION IS A MEMBER BASED ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>EXECUTIVE COMMITTEE CONSISTS OF MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>HOUSE OF DELEGATES APPROVES SOME DECISIONS OF GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 AND RELATED SCHEDULES ARE PREPARED BY INDEPENDENT ACCOUNTING/AUDIT FIRM AND ARE SUBSEQUENTLY REVIEWED BY THE ASSOCIATION'S CONTROLLER, CFO AND PRESIDENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>WE REQUIRE BOARD MEMBERS TO SIGN CONFLICT OF INTEREST STATEMENTS AND VERBALLY REMIND THEM OF THAT PERIODICALLY DURING THE YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR IS ESTABLISHED USING THE FOLLOWING METHODS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ADDITIONALLY, THE INDEPENDENT COMPENSATION COMMITTEE RECEIVES COMPARABILITY DATA ANNUALLY AND DOCUMENTS DECISION IN WRITTEN FORM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>PUBLIC DISCLOSURE DOCUMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MHA HEALTH FOUNDATION DBA MHA CENTER FOR HEALTH RESOURCES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2112 UNVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
        <EIN>386091188</EIN>
        <PrimaryActivitiesTxt>PERFORM CHARITABLE AND EDUCATIONAL FUNCTIONS OF THE MHA.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MICHIGAN HEALTH &amp; HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HEALTH POLITICAL ACTION COMMITTEE MICHIGAN HEALTH &amp; HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2112 UNVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
        <EIN>382769064</EIN>
        <PrimaryActivitiesTxt>PROMOTE GOOD HEALTH CARE FOR MICHIGAN CITIZENS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>527</ExemptCodeSectionTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MHA KEYSTONE CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2112 UNVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
        <EIN>462128815</EIN>
        <PrimaryActivitiesTxt>ASSIST AND EDUCATE HEALTH CARE PROVIDERS WITH PATIENT SAFETY AND CARE.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MHA HEALTH FOUNDATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2112 UNIVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
        <EIN>382259766</EIN>
        <PrimaryActivitiesTxt>SERVICES TO HOSPITALS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MICHIGAN HEALTH &amp; HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>6362071</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>5779295</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>1</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA KEYSTONE CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>143760</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>248532</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA HEALTH FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>185000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA KEYSTONE CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>384000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>236400</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA HEALTH FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>53116</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA KEYSTONE CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>717099</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>1305964</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>