COREWELL HEALTH: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: COREWELL HEALTH (EIN 38-3382353)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2021-10-25
IRS object ID: 202102989349300435
Schema version: 2020v4.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-10-25T10:00:59-05:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	135381590	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BDO USA LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	200 OTTAWA AVE NW SUITE 300	AddressLine1Txt
City	GRAND RAPIDS	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49503	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	383382353	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Spectrum Health System	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SPEC	BusinessNameControlTxt
Phone	6167745083	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	221 Michigan St NE MC498	AddressLine1Txt
City	GRAND RAPIDS	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49503	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Matthew E Cox	PersonNm
Person Title	SVP, Chief Financial Officer	PersonTitleTxt
Signature	2021-10-25	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	Matthew E	PersonFirstNm
Person Last	Cox	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JACOB COOK	PreparerPersonNm
PTIN	P01240455	PTIN
Phone	6167747000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Christina Freese Decker	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	221 Michigan St NE MC498	AddressLine1Txt
City	GRAND RAPIDS	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49503	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,641,804,812	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	5981	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.spectrumhealth.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1997	FormationYr
Legal Domicile State	MI	LegalDomicileStateCd
Activity Or Mission	To improve health, inspire hope and save lives in the communities we serve by providing administrative and supporting services to the healthcare system affiliated entities.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	6980	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$241,911	PYContributionsGrantsAmt
CY Contributions Grants	$9,822,678	CYContributionsGrantsAmt
PY Program Service Revenue	$412,424,120	PYProgramServiceRevenueAmt
CY Program Service Revenue	$926,812,240	CYProgramServiceRevenueAmt
PY Investment Income	$69,517,643	PYInvestmentIncomeAmt
CY Investment Income	$113,680,370	CYInvestmentIncomeAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$482,183,674	PYTotalRevenueAmt
CY Total Revenue	$1,050,315,288	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$307,275,625	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$528,623,255	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$170,454,998	PYOtherExpensesAmt
CY Other Expenses	$367,787,965	CYOtherExpensesAmt
PY Total Expenses	$477,730,623	PYTotalExpensesAmt
CY Total Expenses	$896,411,220	CYTotalExpensesAmt
PY Revenues Less Expenses	$4,453,051	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$153,904,068	CYRevenuesLessExpensesAmt
Total Assets BOY	$2,480,780,187	TotalAssetsBOYAmt
Total Assets EOY	$2,915,356,282	TotalAssetsEOYAmt
Total Liabilities BOY	$984,353,860	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,147,187,948	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,496,426,327	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,768,168,334	NetAssetsOrFundBalancesEOYAmt
Mission	To improve health, inspire hope and save lives	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$892,094,420	ExpenseAmt
Revenue	$926,811,669	RevenueAmt
Desc	SPECTRUM HEALTH SYSTEM PROVIDES COMMON MANAGEMENT OF THE NOT-FOR-PROFIT HEALTH CARE SYSTEM ACTIVITIES CARRIED ON BY SUPPORTED ORGANIZATIONS. THE SUPPORTED ORGANIZATIONS INCLUDE 14 SEPARATELY LICENSED HOSPITAL FACILITIES, MORE THAN 150 AMBULATORY AND SERVICE SITES, AND OVER 2,500 LICENSED BEDS SYSTEM-WIDE WITH FACILITIES THAT INCLUDE A MEDICAL CENTER, REGIONAL COMMUNITY HOSPITALS, A DEDICATED CHILDREN'S HOSPITAL, A MULTISPECIALTY MEDICAL GROUP, AFFILIATED PHYSICIANS AND A NATIONALLY RECOGNIZED HEALTH PLAN WITH OVER 920,000 MEMBERS.	Desc
Total Program Service Expenses	$892,094,420	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	Yes (true)	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (true)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	413	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	6980	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	Yes (true)	ForeignFinancialAccountInd
Foreign Country	CJ	ForeignCountryCd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (true)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Celeste M Mcintyre	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6167745083	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	221 Michigan St NE MC498	AddressLine1Txt
City	Grand Rapids	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49503	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
CHRISTINA FREESE DECKER
President / CEO	40.0	10.0	Yes (X)	Yes (X)	$2,487,249	$0	$1,034,330
ROBERT ROTH
Chair	2.0	0	Yes (X)	Yes (X)	$36,500	$0	$0
Sean Welsh
Treasurer	1.0	0	Yes (X)	Yes (X)	$24,500	$0	$0
DANIEL HOPP
DIRECTOR	1.0	4.0	Yes (X)		$22,500	$0	$0
Gloria Lara
Director	1.0	1.0	Yes (X)		$34,000	$0	$0
M Ashraf Mansour MD
Director	1.0	49.0	Yes (X)		$0	$803,283	$46,321
Mark Murray
DIRECTOR - PART YEAR	1.0	0	Yes (X)		$0	$0	$0
Mehmood Khan
Director	1.0	0	Yes (X)		$14,500	$0	$0
Melonie Ice MD
Director	1.0	0	Yes (X)		$25,000	$0	$0
Michael Jandernoa
Director	1.0	0	Yes (X)		$22,000	$0	$0
MICHAEL TODMAN
Director	1.0	2.0	Yes (X)		$22,500	$0	$0
Michelle Van Dyke
Director	1.0	0	Yes (X)		$22,000	$0	$0
Richard DeVos Jr
Director	1.0	0	Yes (X)		$0	$0	$0
Stephen Boshoven
Director	1.0	0	Yes (X)		$22,000	$0	$0
Steve Ender
Director	1.0	0	Yes (X)		$23,000	$0	$0
WILLIAM PAYNE
DIRECTOR	1.0	2.0	Yes (X)		$27,750	$0	$0
David Leonard
Secretary, SVP, Chief Legal Officer / SVP, Strategic Partnerships	49.0	1.0		Yes (X)	$976,800	$0	$291,448
MATTHEW COX
SVP, Chief Financial Officer	48.5	1.5		Yes (X)	$1,361,160	$0	$461,670
Celeste McIntyre
SVP, Corporate Controller	50.0	0			$365,796	$0	$142,502	Yes (X)
JASON JOSEPH
SVP, Chief Information Officer	49.0	1.0			$816,339	$0	$299,585	Yes (X)
LOREN HAMEL MD
SVP, CHIEF STRATEGY OFFICER, PRESIDENT, LAKELAND REGIONAL HEALTH SYSTEM	25.0	25.0			$1,106,091	$0	$355,648	Yes (X)
Lori Smith
SVP, Treasury	50.0	0			$413,191	$0	$133,450	Yes (X)
PAMELA RIES
SVP, Chief Human Resources Officer	49.0	1.0			$859,029	$0	$256,482	Yes (X)
James Schweigert
VP, CMIO	50.0	0			$510,990	$0	$90,502		Yes (X)
Karen Hollingsworth
SVP, IS SH Delivery System - Part Year	50.0	0			$524,236	$0	$63,245		Yes (X)
Michael Rosencrance
Interim VP, Information Services	50.0	0			$1,120,098	$0	$42,679		Yes (X)
Scott Lancaster
VP, Business Dev & Strategic Planning - Part Year	50.0	0			$537,419	$0	$62,048		Yes (X)
Scott McLean
VP, Managing Dir, SH Ventures	50.0	0			$476,187	$0	$80,496		Yes (X)
Patrick O'Hare
FORMER KEY EMPLOYEE	0.0	0			$2,636,674	$0	$0			Yes (X)
Roger Jansen
Former Highest Compensated	0.0	0			$663,226	$0	$0			Yes (X)
Ronald Knaus
Former SVP, Chief Financial Officer	0.0	0.0			$346,522	$0	$0			Yes (X)
SETH WOLK MD
Former Highest Compensated	0.0	0.0			$1,148,766	$0	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$16,646,023	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$803,283	TotReportableCompRltdOrgAmt
Total Other Compensation	$3,360,406	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	864	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
KPMG LLP
355 S Grand Ave	Los Angeles	CA	90071	IT CONSULTING	$20,299,306
CHANGE HEALTHCARE SOLUTIONS
3055 LEBANON PIKE	NASHVILLE	TN	37214	IT CONSULTING	$20,194,424
BIRDSALL VOSS & ASSOCIATES INC
250 W COVENTRY COURT	MILWAUKEE	WI	53217	MARKETING & ADVERTISING	$11,129,469
BOSTON CONSULTING GROUP INC
200 Pier 4 Boulevard	BOSTON	MA	02210	CONSULTING	$10,698,750
COGNIZANT TECHNOLOGY SOLUTIONS
500 FRANK W BURR BOULEVARD	TEANECK	NJ	07666	IT CONSULTING	$7,800,062

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	207	CntrctRcvdGreaterThan100KCnt
Related Organizations	$770,872	RelatedOrganizationsAmt
Government Grants	$9,051,806	GovernmentGrantsAmt
Total Contributions	$9,822,678	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Management Fee Revenue	561000	$921,878,573	$921,878,573
Shared Services Revenue	561000	$2,381,306	$2,381,306
Contractual Incentives	900099	$1,336,292	$1,336,292
Medical Record Fees	900099	$475,455	$475,455
Affiliate Physician Program	900099	$337,217	$337,217

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$403,397	TotalRevenueColumnAmt
Related Or Exempt Func Income	$402,826	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$571	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$926,812,240	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$19,309,759	TotalRevenueColumnAmt
Exclusion	$19,309,759	ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$685,860,135	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$591,489,524	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$94,370,611	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$94,370,611	TotalRevenueColumnAmt
Exclusion	$94,370,611	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,050,315,288	TotalRevenueColumnAmt
Related Or Exempt Func Income	$926,811,669	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$113,680,941	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$11,657,019	TotalAmt
Program Services	$11,657,019	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$418,157,742	TotalAmt
Program Services	$417,979,650	ProgramServicesAmt
Management And General	$178,092	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$21,668,937	TotalAmt
Program Services	$21,668,937	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$45,703,818	TotalAmt
Program Services	$45,644,207	ProgramServicesAmt
Management And General	$59,611	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$31,435,739	TotalAmt
Program Services	$31,435,739	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,659,845	TotalAmt
Management And General	$2,659,845	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,164,945	TotalAmt
Management And General	$1,164,945	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$371,168	TotalAmt
Program Services	$371,168	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$89,315,601	TotalAmt
Program Services	$89,123,652	ProgramServicesAmt
Management And General	$191,949	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$44,273,445	TotalAmt
Program Services	$44,271,958	ProgramServicesAmt
Management And General	$1,487	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$28,993,310	TotalAmt
Program Services	$28,948,281	ProgramServicesAmt
Management And General	$45,029	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$102,311,818	TotalAmt
Program Services	$102,311,818	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$27,472,215	TotalAmt
Program Services	$27,470,447	ProgramServicesAmt
Management And General	$1,768	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$872,470	TotalAmt
Program Services	$870,251	ProgramServicesAmt
Management And General	$2,219	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,567,863	TotalAmt
Program Services	$1,567,012	ProgramServicesAmt
Management And General	$851	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$9,304,726	TotalAmt
Program Services	$9,304,726	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$28,259,941	TotalAmt
Program Services	$28,249,968	ProgramServicesAmt
Management And General	$9,973	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$618,043	TotalAmt
Program Services	$617,012	ProgramServicesAmt
Management And General	$1,031	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
est. contractual allowance	$5,000,000	$5,000,000
Dues and Subscriptions	$3,616,999	$3,616,999
Credit Card Processing Fees	$3,236,723	$3,236,723
Sponsorship/Community Benefit	$2,898,501	$2,898,501

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$15,850,352	TotalAmt
Program Services	$15,850,352	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$896,411,220	TotalAmt
Program Services	$892,094,420	ProgramServicesAmt
Management And General	$4,316,800	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,500	BOYAmt
EOY	$1,500	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,805,086	BOYAmt
EOY	$120,418,813	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$13,367	BOYAmt
EOY	$3,422	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$185,672,873	BOYAmt
EOY	$283,540,108	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$44,203,853	BOYAmt
EOY	$48,754,609	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$324,105,188	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$213,113,356	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$101,059,573	BOYAmt
EOY	$110,991,832	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,856,224,304	BOYAmt
EOY	$1,968,237,808	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$3,068,486	BOYAmt
EOY	$500,001	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$53,231,625	BOYAmt
EOY	$52,904,706	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,329,353	BOYAmt
EOY	$6,514,980	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$222,170,167	BOYAmt
EOY	$323,488,503	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,480,780,187	BOYAmt
EOY	$2,915,356,282	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$131,273,605	BOYAmt
EOY	$162,194,417	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$15,277,242	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$450,998,366	BOYAmt
EOY	$449,941,980	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$402,081,889	BOYAmt
EOY	$519,774,309	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$984,353,860	BOYAmt
EOY	$1,147,187,948	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,496,426,327	BOYAmt
EOY	$1,768,168,334	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,496,426,327	BOYAmt
EOY	$1,768,168,334	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,480,780,187	BOYAmt
EOY	$2,915,356,282	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$153,904,068	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$62,730,368	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$55,107,571	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	Yes (X)	SupportingOrganization509a3Ind
Supporting Org Type3 Func Int	Yes (X)	SupportingOrgType3FuncIntInd
IRS Written Determination	Yes (X)	IRSWrittenDeterminationInd
Supported Organizations	17	SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (17 entries)

EINEIN	Organization TypeOrganizationTypeCd	Governing Document ListedGoverningDocumentListedInd	SupportSupportAmt	Other SupportOtherSupportAmt
SPECTRUM HEALTH HOSPITALS
381360529	3	Yes (true)	$340,836,690	$0
SPECTRUM HEALTH PRIMARY CARE PARTNERS
381358164	3	Yes (true)	$94,300,154	$0
SPECTRUM HEALTH UNITED
381358412	3	Yes (true)	$15,449,391	$0
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
381359517	3	Yes (true)	$11,286,267	$0
LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC
382156872	3	Yes (true)	$10,168,016	$0
MECOSTA COUNTY MEDICAL CENTER
381368744	3	Yes (true)	$9,618,460	$0
ZEELAND COMMUNITY HOSPITAL
381411184	3	Yes (true)	$8,584,405	$0
REED CITY HOSPITAL CORPORATION
382770076	3	Yes (true)	$8,357,177	$0
MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
381359266	3	Yes (true)	$7,947,934	$0
PENNOCK HOSPITAL
381360562	3	Yes (true)	$7,880,944	$0
SPECTRUM HEALTH CONTINUING CARE
383242232	9	Yes (true)	$6,068,829	$0
SPECTRUM HEALTH FOUNDATION
382752328	7	Yes (true)	$12,000	$0
LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER
383452303	3	Yes (true)	$0	$0
LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH
382539929	7	Yes (true)	$0	$0
MERCY MEMORIAL HEALTH SERVICES INC
382748035	9	Yes (true)	$0	$0
LAKELAND COMMUNITY HOSPITAL - WATERVLIET
381368745	3	Yes (true)	$0	$0
HOSPICE AT HOME INC dba CARING CIRCLE
382416086	7	Yes (true)	$0	$0

Field	Value	IRS element (for citing)
Supported Organizations Total	17	SupportedOrganizationsTotalCnt
Support Sum	$520,510,267	SupportSumAmt
Other Support Sum	$0	OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

Field	Value	IRS element (for citing)
Listed By Name Governing Doc	Yes (true)	ListedByNameGoverningDocInd
Suprt Org No IRS Determination	false	SuprtOrgNoIRSDeterminationInd
Supported Org Section C456	false	SupportedOrgSectionC456Ind
Supported Org Not Organized US	false	SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org	false	OrganizationChangeSuprtOrgInd
Support Non Supported Org	Yes (true)	SupportNonSupportedOrgInd
Payment Substantial Contribtr	false	PaymentSubstantialContribtrInd
Loan Disqualified Person	false	LoanDisqualifiedPersonInd
Controlled Disqualified Prsn	false	ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int	false	DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int	false	DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules	false	ExcessBusinessHoldingsRulesInd
Contribution Controller	false	ContributionControllerInd
Contribution Family	false	ContributionFamilyInd
Contribution35 Controlled	false	Contribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

Field	Value	IRS element (for citing)
Timely Provided Documents	Yes (true)	TimelyProvidedDocumentsInd
Officers Close Relationship	Yes (true)	OfficersCloseRelationshipInd
Supported Org Voice Investment	Yes (true)	SupportedOrgVoiceInvestmentInd

Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp

Field	Value	IRS element (for citing)
Parent Supported Org	Yes (X)	ParentSupportedOrgInd
Appoint Elect Majority Officer	Yes (true)	AppointElectMajorityOfficerInd
Exercise Direction Policies	Yes (true)	ExerciseDirectionPoliciesInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule A, Part IV, Section A, Line 1 SUPPLEMENTAL INFORMATION.	SPECTRUM HEALTH SYSTEM IS THE PARENT ORGANIZATION AND SUPPORTING ORGANIZATION TO THE HEALTH SYSTEM. THE PURPOSES OF THIS ORGANIZATION, AS DEFINED IN THE ARTICLES OF INCORPORATION, ARE AS FOLLOWS: PURPOSES 2.1. THE PURPOSES FOR WHICH THE CORPORATION IS ORGANIZED ARE TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT ALL OF THE PURPOSES OF MECOSTA COUNTY MEDICAL CENTER, MEMORIAL MEDICAL CENTER OF WEST MICHIGAN, NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION, PENNOCK HOSPITAL, LAKELAND HOSPITALS AT NILES & ST. JOSEPH, INC., LAKELAND HOSPITAL, WATERVLIET, LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER, LAKELAND HEALTH FOUNDATION, BENTON HARBOR/ST. JOSEPH, LAKELAND HEALTH FOUNDATION, NILES, CARING CIRCLE, MERCY MEMORIAL HEALTH SERVICES, INCORPORATED, REED CITY HOSPITAL CORPORATION, SPECTRUM HEALTH CONTINUING CARE, SPECTRUM HEALTH FOUNDATION, SPECTRUM HEALTH HOSPITALS, SPECTRUM HEALTH PRIMARY CARE PARTNERS, SPECTRUM HEALTH UNITED AND ZEELAND COMMUNITY HOSPITAL (THE "SUPPORTED ORGANIZATIONS") ALL OF WHICH ARE DESCRIBED IN SECTION 501(C)(3) AND EITHER SECTION 509(A)(1) OR SECTION 509(A)(2) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED OR COMPARABLE PROVISIONS OF SUBSEQUENT LEGISLATION (THE "CODE"). SUBJECT TO AND IN FURTHERANCE OF THE FOREGOING, THE PURPOSES OF THE CORPORATION SHALL BE: 2.1.1. TO FORMULATE AND IMPLEMENT POLICIES AND PROGRAMS DESIGNED TO ENABLE AND/OR CAUSE THE SUPPORTED ORGANIZATIONS TO FUNCTION AS A COORDINATED HEALTH CARE DELIVERY SYSTEM, TO PROVIDE DIRECTION AND MANAGEMENT TO THE SUPPORTED ORGANIZATIONS, AND TO ACT AND/OR MAKE DECISIONS FOR THE BENEFIT OF SUCH SUPPORTED ORGANIZATIONS. 2.1.2. TO ESTABLISH AND MAINTAIN, EITHER DIRECTLY, THROUGH RELATED ORGANIZATIONS OR IN COOPERATION WITH OTHER ORGANIZATIONS, SUCH FACILITIES AND SERVICES FOR THE CARE OF PERSONS SUFFERING FROM ILLNESS, INJURY OR DISABILITY, THE ELDERLY AND THE INDIGENT AND FOR THE PRESERVATION AND IMPROVEMENT OF HEALTH AS THE BOARD OF DIRECTORS MAY DETERMINE, INCLUDING, WITHOUT LIMITATION: 2.1.2.1. HOSPITALS FOR THE INPATIENT OR OUTPATIENT CARE OF PERSONS SUFFERING FROM ILLNESS, INJURY AND DISABILITY, FOR THE PREVENTION OF ILLNESS, INJURY AND DISABILITY AND FOR THE MAINTENANCE OF HEALTH. 2.1.2.2. FACILITIES PROVIDING AMBULATORY CARE, NURSING CARE, REHABILITATION AND OTHER SERVICES. 2.1.2.3. CLINICS THROUGH WHICH PHYSICIANS AND OTHER PROVIDERS RENDER PROFESSIONAL MEDICAL SERVICES. 2.1.2.4. OTHER ACTIVITIES AND PROGRAMS DESIGNED AND CARRIED ON PROMOTING THE GENERAL HEALTH OF THE COMMUNITY. 2.1.3. TO PROMOTE AND CARRY ON SUCH SCIENTIFIC RESEARCH AS THE BOARD OF DIRECTORS MAY DETERMINE WITH RESPECT TO THE CAUSE, TREATMENT AND PREVENTION OF ILLNESS AND INJURY, THE IMPROVEMENT OF PUBLIC HEALTH AND OTHER MATTERS. 2.1.4. TO PARTICIPATE IN AND TO CARRY ON SUCH ACTIVITIES AS THE BOARD OF DIRECTORS MAY DETERMINE FOR THE EDUCATION OF PHYSICIANS, NURSES, OTHER PROFESSIONAL AND PARAPROFESSIONAL PERSONNEL AND THE PUBLIC ABOUT RENDERING CARE TO THE SICK, INJURED AND DISABLED, ABOUT PREVENTION OF ILLNESS AND INJURY AND ABOUT THE PROMOTION OF HEALTH. 2.1.5. TO CONDUCT ACTIVITIES, EITHER DIRECTLY, THROUGH RELATED ORGANIZATIONS OR IN COOPERATION WITH ORGANIZATIONS EXEMPT FROM TAX UNDER SECTION 501(C)(3) OF THE CODE OR COMPARABLE PROVISIONS OF SUBSEQUENT LEGISLATION IN ORDER TO RAISE FUNDS TO FURTHER THE PURPOSES OF THE CORPORATION, SUBJECT, HOWEVER, TO ALL LIMITATIONS ON THE NATURE OR EXTENT OF SUCH ACTIVITIES APPLICABLE, FROM TIME TO TIME, TO ORGANIZATIONS DESCRIBED IN SECTIONS 501(C)(3) AND 509(A)(3) OF THE CODE. 2.1.6. TO ACQUIRE, TO OWN, TO DISPOSE OF AND TO DEAL WITH REAL AND PERSONAL PROPERTY AND INTERESTS THEREIN AND TO APPLY GIFTS, GRANTS, BEQUESTS AND DEVISES AND THE PROCEEDS THEREOF IN FURTHERANCE OF THE PURPOSES OF THE CORPORATION. 2.1.7. TO DEAL WITH AND DISTRIBUTE THE CORPORATION'S INCOME AND ASSETS IN SUCH MANNER AS IN THE JUDGMENT OF THE BOARD OF DIRECTORS WILL BEST PROMOTE ITS OBJECTIVES AND PURPOSES, WITHOUT LIMITATION EXCEPT SUCH, IF ANY, AS MAY BE CONTAINED IN INSTRUMENTS UNDER WHICH SUCH PROPERTY IS CONVEYED TO THE CORPORATION. 2.1.8. TO DO SUCH THINGS AND TO PERFORM SUCH ACTS TO ACCOMPLISH ITS PURPOSES AS ARE PERMITTED BY SECTIONS 501(C)(3) AND 509(A)(3) OF THE CODE, WITH ALL THE POWERS CONFERRED ON NONPROFIT CORPORATIONS BY THE LAWS OF THE STATE OF MICHIGAN. THE AMOUNTS REPORTED IN SCHEDULE A, PART I, LINE 11H, COLUMN (VII) RELATE TO EXPENSES INCURRED BY THE ORGANIZATION ON BEHALF OF THE SUPPORTED ENTITIES (REIMBURSED IN WHOLE OR IN PART THROUGH MANAGEMENT FEES).
Schedule A, Part IV, Section D, Line 2 OFFICERS APPOINTED OR SERVING SUPPORTED ORG.	Spectrum Health System maintains a close and continuous working relationship with its supported organizations through integrated policies and procedures and unified leadership. As described in Schedule A, Part IV, Section E, line 3a, Spectrum Health System is the parent to all supported organizations and as such has the power to appoint/elect a majority of the directors/trustees of each of the supported organizations.
Schedule A, Part IV, Section A, Line 6 Support to other supported orgs	Spectrum Health System provides services and support to organizations within the integrated health care system that are outside of Spectrum Health System's supported organizations. The other organizations Spectrum Health System provides services and support to are related organizations reported on Schedule R.
Schedule A, Part IV, Section D, Line 3 Supp. Org. Have Significant Voice In Investment Policies	As noted below, investments of cash and/or reserves, whether on an individual basis or as part of a pooled investment strategy, is a reserved power maintained by the supporting organization. The consolidated treasury function is considered a shared service function provided by the supporting organization to each supported organization. As part of that shared service function, the supporting organization controls all investment policies, and directs all investment strategies. This provides many benefits including reduced costs and subject matter expertise to yield greater results. The supported organizations have the ability to provide direction specifically related to their respective assets as it relates to grant making and directing the use of the organization's income or assets.
Schedule A, Part IV, Section E, Line 3a Power To Appoint/Elect Majority of Officer/Director/Trustee	The actions listed below may be unilaterally caused and/or taken by the supporting organization, within its sole and exclusive power and discretion, and shall not be deemed authorized unless and until approved by the supporting organization: -Election and/or removal of the members of the supported organization's Board of Directors pursuant to the nomination, election and removal processes ; -Election and/or removal of the supported organization's Chairperson of the Board of Directors; and -Hiring, discharge, and evaluation of the supported organization's President as delegated by the supporting organization's Board of Directors to the supporting organization's Chief Executive Officer (or designee).
Schedule A, Part IV, Section E, Line 3b Substantial Direction Over Policies/Programs/Activities	The actions listed below may be unilaterally caused and/or taken by the supporting organization, within its sole and exclusive power and discretion, and shall not be deemed authorized unless and until approved by the supporting organization: -Amendment of the Articles of Incorporation or Bylaws of the supported organization; -Election and/or removal of the members of the supported organization's Board of Directors; -Election and/or removal of the supported organization's Chairperson of the Board of Directors; -Hiring, discharge, and evaluation of the supported organization's President; -Adoption of the supported organization's strategic plan; -Adoption of the supported organization's annual operating and capital budgets and any amendments to such budgets in excess of the Authority Matrix Amount; -All capital expenditures by the supported organization in excess of the amount which would require approval by the supporting organization (the "Authority Matrix Amount"); -All borrowings or guarantees of indebtedness by the supported organization (or any entity controlled by the supported organization through ownership or membership interest); -All lending by the supported organization (or any subsidiary) to persons other than the supporting organization or a subsidiary in excess of the Authority Matrix Amount; -The supported organization's or any subsidiary's investments of cash and/or reserves, whether on an individual basis or as part of a pooled investment strategy; -Any merger or consolidation of the supported organization (or any subsidiary), or any other change in ownership percentages, control, or capital structure; -The creation of any entity controlled, directly or indirectly, by the supported organization; -The sale or transfer of more than ten percent (10%) of the assets of the supported organization (or any subsidiary) to any person or entity not controlled by the supporting organization; -Dissolution of the supported organization or any subsidiary; -The selection, retention, and oversight of the outside auditors for the supported organization (or any subsidiary); and -Any other approval for which supporting organization approval is required by law. In addition to these reserved powers of the supporting organization listed above, the supporting organization has the authority to adopt system-wide policies and procedures.

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	Yes (true)	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Direct Contact Legislators	$203,855	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$167,313	OtherActivitiesAmt
Total Lobbying Expenditures	$371,168	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule C, Part II-B, Line 1 Description of the activities reported on lines 1A through 1I

Spectrum Health System employs government affairs staff who are chiefly responsible for Government Affairs activities. Additionally the organization employs a Vice President, Government Relations/Public Policy to oversee this role. Other executive staff are engaged on a very limited basis for lobbying purposes. Spectrum Health System retains federal and state level multi-client lobby firms. The function of their respective duties involves direct contact with legislators, their staff, government officials, or a legislative body on numerous legislative and regulatory issues of interest to the organization. The amount is reported in lines 1g "Direct contact with legislators, their staffs, government officials, or a legislative body" and 1i, "Other activities." Direct contact with qualifying individuals includes sending letters, publications, making phone calls or meeting with government officials, their staff or legislators.

Schedule C, Part II-B, Line 1i Other activities

Spectrum Health System is a member of the American Hospital Association, the Children's Hospital Association, and Michigan Health & Hospital Association. Lobbying expenditures reported on Line 1i reflect activities performed by trade organizations on the filing organization's behalf.

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$17,849,074	OtherCostOrOtherBasisAmt
Depreciation	$4,804,769	DepreciationAmt
Book Value	$13,044,305	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,751,005	OtherCostOrOtherBasisAmt
Depreciation	$6,756,808	DepreciationAmt
Book Value	$1,994,197	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$44,081,611	OtherCostOrOtherBasisAmt
Depreciation	$26,530,952	DepreciationAmt
Book Value	$17,550,659	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$253,423,498	OtherCostOrOtherBasisAmt
Depreciation	$175,020,827	DepreciationAmt
Book Value	$78,402,671	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$110,991,832	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
Post Retirement Benefits	$182,402,797
Other Assets	$76,834,624
Due From Affiliates	$64,251,082

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$323,488,503	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
Post Retirement Benefits	$157,111,730
SWAP Market Value	$135,106,199
Insurance	$123,872,061
Due to Affiliates	$93,463,578
Other Liabilities	$6,852,746
Operating Lease Liability	$3,367,995

Field	Value	IRS element (for citing)
Total Liability	$519,774,309	TotalLiabilityAmt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Offices	0	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	Investments	TypeOfActivitiesConductedTxt
Region Total Expenditures	$307,000,000	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$307,000,000	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$307,000,000	TotalSpentAmt
Transfer To Foreign Corp	Yes (true)	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CHRISTINA FREESE DECKER
President / CEO	$1,347,427	$0	$1,109,422	$0	$30,400	$0	$798,238	$0	$236,092	$0	$3,521,579	$0	$616,186	$0
M Ashraf Mansour MD
Director	$0	$674,918	$0	$115,016	$0	$13,349	$0	$31,350	$0	$14,971	$0	$849,604	$0	$0
Ronald Knaus
Former SVP, Chief Financial Officer	$1	$0	$342,528	$0	$3,993	$0	$0	$0	$0	$0	$346,522	$0	$342,528	$0
MATTHEW COX
SVP, Chief Financial Officer	$771,262	$0	$567,640	$0	$22,258	$0	$330,204	$0	$131,466	$0	$1,822,830	$0	$332,341	$0
David Leonard
Secretary, SVP, Chief Legal Officer / SVP, Strategic Partnerships	$549,054	$0	$418,475	$0	$9,271	$0	$190,992	$0	$100,456	$0	$1,268,248	$0	$232,381	$0
Patrick O'Hare
FORMER KEY EMPLOYEE	$0	$0	$2,635,467	$0	$1,207	$0	$0	$0	$0	$0	$2,636,674	$0	$2,635,467	$0
LOREN HAMEL MD
SVP, CHIEF STRATEGY OFFICER, PRESIDENT, LAKELAND REGIONAL HEALTH SYSTEM	$679,931	$0	$401,088	$0	$25,072	$0	$247,848	$0	$107,800	$0	$1,461,739	$0	$196,357	$0
JASON JOSEPH
SVP, Chief Information Officer	$486,511	$0	$326,489	$0	$3,339	$0	$216,864	$0	$82,721	$0	$1,115,924	$0	$183,392	$0
PAMELA RIES
SVP, Chief Human Resources Officer	$494,360	$0	$353,239	$0	$11,430	$0	$187,220	$0	$69,262	$0	$1,115,511	$0	$203,544	$0
Lori Smith
SVP, Treasury	$312,916	$0	$87,991	$0	$12,284	$0	$70,396	$0	$63,054	$0	$546,641	$0	$31,108	$0
Celeste McIntyre
SVP, Corporate Controller	$273,373	$0	$83,238	$0	$9,185	$0	$79,319	$0	$63,183	$0	$508,298	$0	$33,801	$0
SETH WOLK MD
Former Highest Compensated	$0	$0	$1,148,766	$0	$0	$0	$0	$0	$0	$0	$1,148,766	$0	$1,148,766	$0
Roger Jansen
Former Highest Compensated	$0	$0	$0	$0	$663,226	$0	$0	$0	$0	$0	$663,226	$0	$0	$0
Michael Rosencrance
Interim VP, Information Services	$272,109	$0	$846,299	$0	$1,690	$0	$22,800	$0	$19,879	$0	$1,162,777	$0	$816,299	$0
James Schweigert
VP, CMIO	$392,672	$0	$113,829	$0	$4,489	$0	$15,675	$0	$74,827	$0	$601,492	$0	$44,735	$0
Scott Lancaster
VP, Business Dev & Strategic Planning - Part Year	$191,765	$0	$179,206	$0	$166,448	$0	$9,832	$0	$52,216	$0	$599,467	$0	$105,167	$0
Karen Hollingsworth
SVP, IS SH Delivery System - Part Year	$157,836	$0	$172,188	$0	$194,212	$0	$5,625	$0	$57,620	$0	$587,481	$0	$115,647	$0
Scott McLean
VP, Managing Dir, SH Ventures	$355,904	$0	$116,163	$0	$4,120	$0	$15,675	$0	$64,821	$0	$556,683	$0	$40,127	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a First-class or charter travel	The organization has provided first class travel and/or charter travel for certain executive employees and/or board members in limited situations. First class and/or charter travel is utilized when commercial air travel was not available for a destination, or not efficient due to schedules and/or connections, and also for bi-annual board retreat travel. In limited situations where first class travel was utilized, it was paid for as part of a corporate award airline mileage program at no additional cost to the organization. To the extent the benefit is deemed reportable, it is treated as taxable compensation in a 1099 or W-2 to the recipient.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	The organization provided health club dues for three executive employees. These amounts were treated as taxable compensation and included in Form W-2.
Schedule J, Part I, Line 4a Severance or change-of-control payment	$187,269 KAREN HOLLINGSWORTH $659,922 ROGER JANSEN $164,870 SCOTT LANCASTER
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	$332,341 MATTHEW COX $616,186 CHRISTINA FREESE DECKER $196,357 LOREN HAMEL $115,647 KAREN HOLLINGSWORTH $183,392 JASON JOSEPH $342,528 RONALD KNAUS $105,167 SCOTT LANCASTER $232,381 DAVID LEONARD $33,801 CELESTE MCINTYRE $40,127 SCOTT MCLEAN $2,635,467 PATRICK OHARE $203,544 PAMELA RIES $816,299 MICHAEL ROSENCRANCE $44,735 JAMES SCHWEIGERT $31,108 LORI SMITH $1,148,766 SETH WOLK SCHEDULE J, PART I, LINE 4B IS ANSWERED "YES" BECAUSE CERTAIN INDIVIDUALS, DO "PARTICIPATE IN" SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN(S). SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN(S) BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN SCHEDULE J, PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR WHILE ALSO BEING REPORTED IN THE CURRENT 990 AS TOTAL COMPENSATION. The nonqualified retirement plans are an industry standard and are subject to the funding requirements of nonqualified deferred compensation plans under ERISA and federal tax regulations.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Celeste McIntyre	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship With Org	Key Employee	RelationshipWithOrgTxt
Loan Purpose	Tuition Assistance	LoanPurposeTxt
Loan From Organization	Yes (X)	LoanFromOrganizationInd
Original Principal	$27,000	OriginalPrincipalAmt
Balance Due	$3,422	BalanceDueAmt
Default	false	DefaultInd
Board Or Committee Approval	false	BoardOrCommitteeApprovalInd
Written Agreement	Yes (true)	WrittenAgreementInd

Field	Value	IRS element (for citing)
Total Balance Due	$3,422	TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 6 CLASSES OF MEMBERS OR STOCKHOLDERS	THE ORGANIZATION IS ORGANIZED ON A NON-STOCK DIRECTORSHIP BASIS WITH NO MEMBERS.
Form 990, Part VI, Line 7b DECISIONS SUBJECT TO APPROVAL OF MEMBERS	THE ORGANIZATION IS ORGANIZED ON A NON-STOCK DIRECTORSHIP BASIS WITH NO MEMBERS.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	MS. MICHELLE VAN DYKE AND MS. CHRISTINA FREESE DECKER - Business relationship, MR. RICHARD DEVOS, JR. AND MR. WILLIAM PAYNE - Business relationship
Form 990, Part VI, Line 11b Review of form 990 by governing body	A copy of the Form 990 is provided to the Board of Directors prior to filing. The review process for this Form 990 is as follows: 1. Preparation of the return is supervised and reviewed by the Organization's Corporate Tax Manager. 2. A second review is performed by an external CPA firm with expertise in tax-exempt return preparation. 3. The return is reviewed by the Organization's finance and legal departments (including the Chief Financial Officer, Chief Legal Officer and Corporate Controller) and shared with the members of the Finance and Audit Committee and Board of Directors. 4. The Organization's Chief Financial Officer reviews comments or questions received from members of the Board of Directors, if any, to address or to incorporate, as appropriate, into the return prior to filing.
Form 990, Part VI, Line 12c Conflict of interest policy	BOARD OF DIRECTORS 1. Conflicts of interest must be disclosed, BOTH VIA AN ANNUAL ELECTRONIC DISCLOSURE PROCESS as well as verbally at a board meeting prior to discussion of any agenda item with regard to which a board member has a conflict. 2. A person having a financial interest in a proposed transaction or arrangement may make a presentation at a meeting of the Board of Directors or committee considering that transaction or arrangement, but after that presentation he or she shall leave the meeting during discussion and voting on that proposed transaction or arrangement. The person having the financial interest shall not be counted in determining whether a quorum is present. 3. The chairperson of the Board of Directors or committee shall, if appropriate, appoint a disinterested person or committee (including outside advisors) to investigate alternatives to the proposed transaction or arrangement, and to advise whether the proposed transaction or arrangement is in the organization's best interest. 4. The Board of Directors or committee shall exercise due diligence to determine whether the organization can, with reasonable efforts, obtain a more advantageous transaction or arrangement that would not give rise to a conflict of interest. 5. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board of Directors or committee shall determine by a majority vote of the disinterested directors and members whether the proposed transaction or arrangement is in the organization's best interest and for its own benefit and whether the transaction is fair and reasonable to the organization, and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. 6. The minutes of the meetings of the Board of Directors and all of the organization's committees shall set forth: a)The names of the persons who disclosed a financial interest in a proposed transaction or arrangement involving the organization or any of its subsidiaries and the nature of the financial interest; and b)The names of the persons who were present for discussions and votes relating to such transaction or arrangement, including any discussion of alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection with that matter. The votes of individual members need not be recorded unless otherwise directed by the Board of Directors or committee. 7. There is an ongoing requirement that members of the board of directors complete another disclosure questionnaire at any point during his/her tenure on the board of directors when a new potential conflict of interest arises. If a member of the board of directors completes a disclosure questionnaire as a result of a new potential conflict of interest, that disclosure questionnaire is submitted to the conflicts of interest committee, which is comprised of individuals from legal, organizational integrity, internal audit, human resources, and members of leadership for review. MANAGEMENT 1. Upon acceptance of an employment offer, each member of management completes a conflict of interest disclosure questionnaire. A copy of the member of management's disclosure questionnaire is sent to the organization's organizational integrity department. A copy of the member of management's disclosure is reviewed by the organization's COI coordinator and escalated to the Conflicts of Interest Committee if necessary. 2. Annually, each member of management completes an annual conflict of interest disclosure questionnaire electronically. The disclosure questionnaire is reviewed by the conflicts of interest committee, which is comprised of individuals from legal, organizational integrity, internal audit, human resources, and members of leadership. 3. There is an ongoing requirement that members of management complete another disclosure questionnaire at any point during his/her employment when a new potential conflict of interest arises. If a member of management completes a disclosure questionnaire as a result of a new potential conflict of interest, that disclosure questionnaire is submitted to the conflicts of interest committee. 4. The conflicts of interest committee, in consultation with executive management, determines how any reported conflicts should be managed. Management of a conflict may take a variety of different forms from implementation of a management plan to requiring that the member of management cease the activity creating the conflict or, in extreme cases, leave the organization's employment. Management is determined on an individual basis based upon the facts and circumstances surrounding the disclosure. The purpose of conflict management is to provide transparency within the organization and to ensure that the organization's employees are always acting in the best interest of the organization.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	The Spectrum Health System Board of Directors (through its Executive Committee) uses the following process for determining compensation of the top management official, other officers, and key employees at Spectrum Health System. Labor market data reflecting comparable organizations and jobs (prepared by independent firms) are relied upon. Competitive assessment reports are provided to the Executive Committee in advance of meetings. The competitive assessment report is prepared by a nationally known independent executive compensation firm. For Calendar Year 2020 (1/1/20-12/31/20), three health care executive compensation surveys, two medical group surveys, on pediatric hospital survey, and one health plan survey prepared by independent firms, were the primary sources referenced to obtain market data for the review: * Sullivan, Cotter and Associates: 2018 Survey of Manager and Executive Compensation in Hospitals and Health Systems * Integrated Healthcare Strategies: 2018 HealthCare Executive Compensation Survey * Mercer: 2018 Integrated Health Networks Compensation Survey, also provides data for health plans * Medical Group Management Association: 2018 Management Compensation Survey * Sullivan, Cotter and Associates: 2018 Physician Compensation and Productivity Survey Report * Sullivan, Cotter and Associates: 2018 Custom Survey of Manager and Executive Compensation in Children's Hospitals * Warren: Fall 2018 HMO Salary Survey In addition, four general industry surveys were referenced: * Mercer: 2018 Executive Compensation Survey * Mercer: 2018 Information Technology Survey * Mercer: 2018 Human Resources Survey * Towers Watson: 2018 Top Management Compensation Report In addition to the above data sources, the Executive Committee approved the creation of a custom peer group of high performing integrated health systems to ensure robust data and a relevant comparator universe. The peer group organizations are approved by the Executive Committee and consist of double A bond rated and / or Truven top quintile organizations. Data for the peer group organizations is compiled by the independent executive compensation firm. Compensation adjustments are approved by Executive Committee members, consistent with the Spectrum Health compensation philosophy described below. Minutes of Committee discussions and decisions are prepared to memorialize Executive Committee decisions based upon the above data. Cash compensation data relied upon by the Executive Committee is national and reflects the compensation paid to executives in comparable jobs in comparably-sized health care and / or health insurance organizations. Spectrum Health recruits nationally for its executives. Benefits data reflect national health care / health insurance market practices. Geographic pay differential and cost of living data indicates consistency with national data. This process is intended to assist Spectrum Health in qualifying for the rebuttable presumption of reasonableness (Intermediate Sanctions Regulations) and complying with the potential Spectrum Health Excess Benefit Transaction Policy for those individuals in the group who are disqualified persons. The opinion submitted from the third party independent consulting firm is in accordance with the provisions of Treasury Regulations Section 53.4958-6(c)(2) and is also intended to satisfy the professional advice requirement of Treasury Regulations Section 53.4958-1(d)(4)(iii).
Form 990, Part VI, Line 15b Process to establish compensation of other employees	See explanation provided for Form 990, Part VI, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the public	The organization's Articles of Incorporation have been provided to the State of Michigan and are available to the public on the State's website. The organization's Bylaws and internal policies are generally not made available to the public. The overall system consolidated financial statements are provided at www.spectrumhealth.org/about-us within subsection "Value and Transparency".
Form 990, Part VII, Section A Reported Compensation and Hours	THE COMPENSATION REPORTED FOR EMPLOYEES OF THE ORGANIZATION IS NOT FOR SERVICES IN THEIR CAPACITY AS MEMBERS OF THE BOARD OF DIRECTORS BUT FOR SERVICES AS EMPLOYEES OF THE Health System. CERTAIN DIRECTORS WERE PAID REASONABLE COMPENSATION FOR THEIR SERVICES AS MEMBERS OF THE BOARD. EMPLOYEES WITH COMPENSATION REPORTED IN PART VII WORK A COMBINED AVERAGE OF 50 HOURS PER WEEK FOR THE Health System.
Form 990, Part VII, Section A Compensation of Directors	Based on external opinion by Sullivan Cotter and Associates, Inc., Spectrum Health System compensates board members in a manner that is reasonable in relation to market data. Board of directors compensation is continually reviewed to confirm compensation falls within reasonable limits. Any compensation amount is treated as taxable to the board member and is reported and provided to them on Form 1099.
Form 990, Part VIII, Line 2f Other Program Service Revenue	Other Operating Income - Total Revenue: 403397, Related or Exempt Function Revenue: 402826, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 571;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	VALUATION ALLOWANCE - -1308690; MINIMUM PENSION LIABILITY - 31107282; FUNDS TRANSFER FROM SUPPORTED ORGANIZATIONS - 25308979;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
SPECTRUM HEALTH VENTURES LLC
100 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	815424150	INVESTMENT IN HEALTHCARE INNOVATION	MI	$3,879,613	$8,305,869	SPECTRUM HEALTH SYSTEM
SPECTRUM HEALTH INNOVATIONS LLC
100 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	272868213	IP DEVELOP	MI	$571	$249,864	SPECTRUM HEALTH VENTURES
HEALTH DATA COLLABORATIVE LLC
221 MICHIGAN STREET NE SUITE 501	GRAND RAPIDS	MI	49503		HEALTH DATA COLLABORATION	MI	$0	$0	SPECTRUM HEALTH SYSTEM

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
SPECTRUM HEALTH HOSPITALS
100 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	381360529	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
SPECTRUM HEALTH PRIMARY CARE PARTNERS
1840 WEALTHY ST SE	GRAND RAPIDS	MI	49506	381358164	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
SPECTRUM HEALTH FOUNDATION
100 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	382752328	PHILANTHROPY	MI	501(c)(3)	7	SPECTRUM HEALTH SYSTEM	Yes (true)
SPECTRUM HEALTH CONTINUING CARE
750 FULLER AVE NE	GRAND RAPIDS	MI	49503	383242232	REHAB/CARE	MI	501(c)(3)	10	SPECTRUM HEALTH SYSTEM	Yes (true)
SPECTRUM HEALTH CONTINUING CARE CENTER
750 FULLER AVE NE	GRAND RAPIDS	MI	49503	382415333	REHAB/NRS	MI	501(c)(3)	10	SPECTRUM HEALTH CONTINUING CARE	false
SPECTRUM HEALTH WORTH SERVICES
750 FULLER AVE NE	GRAND RAPIDS	MI	49503	382786617	HEALTHCARE	MI	501(c)(3)	10	SPECTRUM HEALTH CONTINUING CARE	false
VISITING NURSE SERVICES OF WESTERN MICHIGAN
750 FULLER AVE NE	GRAND RAPIDS	MI	49503	381359195	HEALTHCARE	MI	501(c)(3)	10	SPECTRUM HEALTH CONTINUING CARE	false
SPECTRUM HEALTH - LEFFINGWELL AVENUE
100 MICHIGAN STREET NE	GRAND RAPIDS	MI	49503	854390483	REHAB/CARE	MI	501(c)(3)	10	SPECTRUM HEALTH CONTINUING CARE	false
PRIORITY HEALTH
1231 EAST BELTLINE NE	GRAND RAPIDS	MI	49525	382715520	HMO	MI	501(c)(4)		SPECTRUM HEALTH SYSTEM	Yes (true)
TRINITY HEALTH PLANS
1231 EAST BELTLINE NE	GRAND RAPIDS	MI	49525	382663747	HMO MGMT	MI	501(c)(4)		PRIORITY HEALTH	false
PRIORITY HEALTH CHOICE INC
1231 EAST BELTLINE NE	GRAND RAPIDS	MI	49525	320016523	HMO (MEDICAID)	MI	501(c)(3)	10	PRIORITY HEALTH	false
SPECTRUM HEALTH KELSEY
615 S BOWER	GREENVILLE	MI	48838	381297435	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH UNITED	false
REED CITY HOSPITAL CORPORATION
300 N PATTERSON RD	REED CITY	MI	49677	382770076	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
212 S SULLIVAN AVENUE	FREMONT	MI	49412	381359517	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
KENT COMMUNITY HEALTH FOUNDATION
750 FULLER AVE NE	GRAND RAPIDS	MI	49503	383607110	PHILANTHROPY	MI	501(c)(3)	Type III-O	SPECTRUM HEALTH HOSPITALS	false
ZEELAND COMMUNITY HOSPITAL
8333 FELCH STREET	ZEELAND	MI	49464	381411184	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
SPECTRUM HEALTH UNITED
615 S BOWER	GREENVILLE	MI	48838	381358412	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
ONE ATKINSON DRIVE	LUDINGTON	MI	49431	381359266	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
MECOSTA COUNTY MEDICAL CENTER
605 OAK STREET	BIG RAPIDS	MI	49307	381368744	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
PENNOCK HOSPITAL
1009 WEST GREEN STREET	HASTINGS	MI	49058	381360562	HEALTHCARE	MI	501(c)(3)	3	SPECTRUM HEALTH SYSTEM	Yes (true)
LAKESHORE AREA RADIATION ONCOLOGY CENTER
12642 Riley Street	Holland	MI	494249202	383067954	Radiation services	MI	501(c)(3)	3	Spectrum Health Hospitals	false
LAKELAND REGIONAL HEALTH SYSTEM INC
1234 NAPIER AVENUE	ST JOSEPH	MI	49085	382609624	PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY	MI	501(c)(3)	Type III-FI	SPECTRUM HEALTH SYSTEM	Yes (true)
LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER
1234 NAPIER AVENUE	STJOSEPH	MI	49085	383452303	LONGTERM HEALTHCARE/HEALING SERVICES	MI	501(c)(3)	3	LAKELAND REGIONAL HEALTH SYSTEM INC	false
LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH
1234 NAPIER AVENUE	ST JOSEPH	MI	49085	382539929	PROMOTE AND ASSIST IN PROVIDING HEALTH CARE	MI	501(c)(3)	7	LAKELAND REGIONAL HEALTH SYSTEM INC	false
MERCY MEMORIAL HEALTH SERVICES INC
4368 CLEVELAND AVENUE	STEVENSVILLE	MI	49127	382748035	PROVIDE HOMECARE AND LONG-TERM HEALTHCARE TO PATIENTS IN SOUTHWEST MICHIGAN	MI	501(c)(3)	10	LAKELAND REGIONAL HEALTH SYSTEM INC	false
LAKELAND COMMUNITY HOSPITAL - WATERVLIET
400 MEDICAL PARK DRIVE	WATERVLIET	MI	49098	381368745	TO PROVIDE GENERAL HEALTH OF THE COMMUNITY THROUGH EDUCATION AND HEALTHCARE	MI	501(c)(3)	3	LAKELAND REGIONAL HEALTH SYSTEM INC	false
HOSPICE AT HOME INC
4025 HEALTH PARK LANE	ST JOSEPH	MI	49085	382416086	TO PROVIDE HOSPICE AND PALLIATIVE CARE TO THE TERMINALLY ILL	MI	501(c)(3)	7	LAKELAND REGIONAL HEALTH SYSTEM INC	false
LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC
1234 NAPIER AVENUE	GRAND RAPIDS	MI	49085	382156872	PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY	MI	501(c)(3)	3	LAKELAND REGIONAL HEALTH SYSTEM INC	false
HEALTH POINTE
15100 WHITTAKER WAY	GRAND HAVEN	MI	49417	474398187	AMBULATORY HEALTH CARE	MI	501(c)(3)	3	SPECTRUM HEALTH HOSPITALS	false
TOTAL HEALTH CARE INC
3011 W GRAND BLVD SUITE 1600	DETROIT	MI	48202	382018957	HMO MGMT	MI	501(c)(4)		PRIORITY HEALTH	false
TOTAL HEALTH CARE USA INC
3011 W GRAND BLVD SUITE 1600	DETROIT	MI	48202	383240485	HMO MGMT	MI	501(c)(4)		TOTAL HEALTH CARE INC	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	WEST MICHIGAN ACCOUNTABLE CARE ORGANIZATION LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	221 MICHIGAN ST NE STE 501	AddressLine1Txt
City	GRAND RAPIDS	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49503	ZIPCd

Field	Value	IRS element (for citing)
EIN	833153113	EIN
Primary Activities	ACCOUNTABLE CARE ORGANIZATION	PrimaryActivitiesTxt
Legal Domicile State	MI	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	SPECTRUM HEALTH SYSTEM	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	Related	PredominantIncomeTypeTxt
Share Of Total Income	$0	ShareOfTotalIncomeAmt
Share Of EOY Assets	$490	ShareOfEOYAssetsAmt
Disproportionate Allocations	false	DisproportionateAllocationsInd
General Or Managing Partner	false	GeneralOrManagingPartnerInd
Ownership	0.9804	OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (22 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
PRIORITY HEALTH MANAGED BENEFITS
1231 EAST BELTLINE NE	GRAND RAPIDS	MI	49525	383085182	THIRD PARTY ADMINISTRATOR	MI	SPECTRUM HEALTH SYSTEM	C Corporation	$401,505,275	$20,858,098	1	Yes (true)
SPECTRUM HEALTH PHYSICIAN ALLIANCE
100 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	371655728	PHYSICIANS	MI	SPECTRUM HEALTH SYSTEM	C Corporation	$0	$264,656	1	Yes (true)
WEST MICHIGAN HEART
2900 BRADFORD STREET NE	GRAND RAPIDS	MI	49525	382125186	PHYSICIANS	MI	SPECTRUM HEALTH SYSTEM	C Corporation	$484,812	$6,819,093	1	Yes (true)
CAMPUS TOWN CENTRE CONDO ASSOCIATION
4868 LAKE MICHIGAN DRIVE	ALLENDALE	MI	49401	382910067	MGMT	MI	NA	C Corporation				false
HELEN DEVOS WOMEN'S AND CHILDREN'S HEALTH PAVILION ASSOCIATION
330 BARCLAY NE	GRAND RAPIDS	MI	49503	383264184	MGMT	MI	NA	C Corporation				false
LEMMEN-HOLTON CANCER PAVILION CONDOMINIUM ASSOCIATION
145 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	161734150	MGMT	MI	NA	C Corporation				false
MUSCULOSKELETAL CENTER CONDOMINIUM ASSOCIATION
230 MICHIGAN NE	GRAND RAPIDS	MI	49503	383180086	MGMT	MI	NA	C Corporation				false
PRIORITY HEALTH INSURANCE COMPANY
1231 EAST BELTLINE NE	GRAND RAPIDS	MI	49525	201529553	INSURANCE	MI	NA	C Corporation				false
THE FRED AND LENA MEIJER HEART CENTER CONDOMINIUM ASSOCIATION
100 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	830464302	MGMT	MI	NA	C Corporation				false
THE MICHIGAN STREET PARKING CONDOMINIUM ASSOCATION
100 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	161734145	MGMT	MI	NA	C Corporation				false
25 MICHIGAN STREET CONDOMINIUM ASSOCIATION
100 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	161734157	MGMT	MI	NA	C Corporation				false
35 MICHIGAN STREET CONDOMINIUM ASSOCIATION
35 MICHIGAN ST NE	GRAND RAPIDS	MI	49503	272193084	MGMT	MI	NA	C Corporation				false
PENNOCK VENTURES INC
1009 WEST GREEN STREET	HASTINGS	MI	49058	382712819	Healthcare	MI	NA	C Corporation				false
LAKELAND HEALTH ENTERPRISES INC
31 NORTH ST JOSEPH AVENUE	NILES	MI	49120	382669798	ACCOUNTING AND BILLING	MI	LAKELAND REGIONAL HEALTH SYSTEM INC	C Corporation				false
PHARMACY SHOPPE INC DBA LAKELAND PHARMACY SHOPPE INC
1234 NAPIER AVENUE	ST JOSEPH	MI	49085	382929090	PHARMACEUTICALS	MI	LAKELAND HEALTH ENTERPRISES INC	C Corporation				false
LAKELAND MEDICAL PRACTICES
1234 NAPIER AVENUE	STJOSEPH	MI	49085	270381199	MEDICAL ADMINISTRATIVE SERVICES	MI	LAKELAND HEALTH ENTERPRISES INC	C Corporation				false
SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC
1234 NAPIER AVENUE	ST JOSEPH	MI	49085	272589359	PHYSICIAN OFFICE	MI	LAKELAND HEALTH ENTERPRISES INC	C Corporation				false
FOUR FLAGS PROPERTIES INC
122 GRANT STREET	NILES	MI	49120	364501639	PROPERTY MANAGEMENT/RENTAL	MI	LAKELAND HEALTH ENTERPRISES INC	C Corporation				false
LAKELAND HEALTH VENTURES INC
1234 NAPIER AVENUE	ST JOSEPH	MI	49085	272313790	HOLDING COMPANY	MI	LAKELAND HEALTH ENTERPRISES INC	C Corporation				false
LAKELAND PHYSICIAN CARE NETWORK
1234 NAPIER AVENUE	ST JOSEPH	MI	49085	208513031	MEDICAL SERVICES	MI	LAKELAND HEALTH ENTERPRISES INC	C Corporation				false
LAKELAND PERSONAL CARE SERVICES INC
1234 NAPIER AVENUE	ST JOSEPH	MI	49085	272990797	HEALTHCARE SERVICES	MI	LAKELAND HEALTH ENTERPRISES INC	C Corporation				false
1697 MICHIGAN STREET PROPERTY
100 MICHIGAN STREET NE	GRAND RAPIDS	MI	49503	831721239	MGMT	MI	SPECTRUM HEALTH HOSPITALS	C Corporation				false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (20 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Spectrum Health Foundation
C	$570,038	GAAP, CASH, OR FMV
Spectrum Health Hospitals
C	$200,834	GAAP, CASH, OR FMV
Priority Health
L	$408,600,028	GAAP, CASH, OR FMV
Spectrum Health Hospitals
L	$340,836,690	GAAP, CASH, OR FMV
Spectrum Health Primary Care Partners
L	$94,300,154	GAAP, CASH, OR FMV
Spectrum Health United
L	$15,449,391	GAAP, CASH, OR FMV
Newaygo County General Hospital Association
L	$11,286,267	GAAP, CASH, OR FMV
Lakeland Hospitals at Niles & St Joseph Inc
L	$10,168,016	GAAP, CASH, OR FMV
Mecosta County Medical Center
L	$9,618,460	GAAP, CASH, OR FMV
Zeeland Community Hospital
L	$8,584,405	GAAP, CASH, OR FMV
Reed City Hospital Corporation
L	$8,357,177	GAAP, CASH, OR FMV
Memorial Medical Center of West Michigan
L	$7,947,934	GAAP, CASH, OR FMV
Pennock Hospital
L	$7,880,944	GAAP, CASH, OR FMV
Spectrum Health Continuing Care
L	$6,068,829	GAAP, CASH, OR FMV
Spectrum Health Physician Alliance
L	$109,404	GAAP, CASH, OR FMV
Priority Health
M	$40,716,569	GAAP, CASH, OR FMV
Lakeland Hospitals at Niles & St Joseph Inc
Q	$32,521,700	GAAP, CASH, OR FMV
Spectrum Health Hospitals
Q	$11,539,825	GAAP, CASH, OR FMV
Spectrum Health Primary Care Partners
Q	$441,034	GAAP, CASH, OR FMV
Mecosta County Medical Center
Q	$63,856	GAAP, CASH, OR FMV

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule R, Part II, Column (g) SECTION 512(B)(13) CONTROLLED ENTITY

THE ORGANIZATION IS THE COMMON PARENT ORGANIZATION OF A CONSOLIDATED HEALTH SYSTEM, SPECTRUM HEALTH SYSTEM.

Schedule R, Part IV IDENTIFICATION OF RELATED ORGANIZATIONS

35 MICHIGAN STREET CONDOMINIUM ASSOCIATION AND LEMMEN-HOLTON CANCER PAVILION CONDOMINIUM ASSOCIATION ARE INCLUDED ON SCHEDULE R, PART IV AS THE VOTING POWER IS CONTROLLING UNDER THE CONSTRUCTIVE OWNERSHIP RULES UNDER SECTION 318 OF THE INTERNAL REVENUE CODE. SCHEDULE R, PART IV, COLUMNS (F) SHARE OF TOTAL INCOME AND (G) SHARE OF END-OF-YEAR ASSETS, AND (H) PERCENTAGE OWNERSHIP ARE REPORTED BASED ON THE GREATER OF OWNERSHIP OR VOTING POWER.