2020-08-06T12:06:04-05:00 2019-09-30 381357951 PLANTE & MORAN PLLC 27400 NORTHWESTERN HIGHWAY SOUTHFIELD MI 48034 990 2018-10-01 208458840 NORTHERN MICHIGAN MEDICAL MANAGEMENT NORT 2314874094 416 CONNABLE AVENUE PETOSKEY MI 49770 TODD C BURCH CEO 2314874094 2020-07-31 1 DAVID LOWENTHAL P00378651 2483522500 2020-07-31 24.127.213.245 2020-07-31 10:44:32 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D1A42FCEE5CBCA1835161BC59C75369F1B7E9248 2018 2021-01-29 14:40:06Z TODD C BURCH 416 CONNABLE AVENUE PETOSKEY MI 49770 16285029 0 X WWW.MCLAREN.ORG/NORTHERNMICHIGAN/ X 2007 MI PROVIDE PROFESSIONAL SERVICES FOR THE DIAGNOSIS AND TREATMENT OF NEUROSURGERY ALONG WITH HOSPITAL SUPPORTED DEPARTMENTS IN CHEBOYGAN EMERGENCY ROOM, ADULT HOSPITALISTS, ACUTE REHAB, AND PEDIATRIC HOSPITALISTS. 3 0 101 0 0 0 0 0 16119629 16285029 0 0 0 0 16119629 16285029 0 0 0 0 1528882 956935 0 0 0 25867806 17425821 27396688 18382756 -11277059 -2097727 1239951 2582648 2308010 5748435 -1068059 -3165787 X PROVIDE PROFESSIONAL SERVICES FOR THE DIAGNOSIS AND TREATMENT OF CARDIOLOGY, CARDIOTHORACIC SURGERY, NEUROSURGERY AND RELATED CONDITIONS. 0 0 7602970 7602970 PROVIDE PROFESSIONAL SERVICES FOR AN ADULT HOSPITALIST PROGRAM IN THE HOSPITAL AS PART OF AN INTEGRATED HEALTH SYSTEM (81,759 RVU'S - RELATIVE VALUE UNITS). 6039904 6039904 PROVIDE PROFESSIONAL SERVICES TO SUPPORT THE PETOSKEY AND CHEBOYGAN CAMPUS EMERGENCY DEPARTMENTS AS PART OF AN INTEGRATED HEALTH SYSTEM. 2692370 1091698 PROVIDE PROFESSIONAL SERVICES FOR THE DIAGNOSIS AND TREATMENT OF NEUROSURGERY PATIENTS AS PART OF AN INTEGRATED HEALTH SYSTEM. (12,594 PHYSICIAN WORK RVU'S - RELATIVE VALUE UNITS). 1692329 1550457 OTHER PROGRAM SERVICES ARE, INCLUDING BUT NOT LIMITED TO, PEDIATRIC HOSPITALISTS AND ACUTE REHAB. 1692329 1550457 18027573 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 23 0 1 101 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 MI X STEVEN THOMPSON 2314874094 416 CONNABLE AVENUE PETOSKEY MI 49770 DAVID ZECHMAN CHAIRMAN & PRESIDENT/CEO-PART YEAR 5.00 45.00 X X 0 890745 29783 DAVID BELLAMY TREASURER/VP FINANCE/CFO-PART YEAR 5.00 40.60 X X 0 412910 34596 JENNIFER WOODS SECRETARY & VP PATIENT CARE 2.50 47.50 X X 0 224369 22645 TODD BURCH CHAIRMAN & PRESIDENT/CEO 2.00 46.50 X X 0 0 0 STEVEN THOMPSON TREASURER/VP OF FINANCE/CFO 5.00 15.60 X X 0 0 0 EUGENE KAMINSKI VP OF HUMAN RESOURCES-PART YEAR 5.00 40.60 X 0 177769 9607 ANDREW M MCDONAGH VP - CMO 15.00 25.50 X 0 253359 10100 SHARI A SCHULT VP OF OPERATIONS 10.00 30.00 X 0 197210 9719 DEREK M PETERS VP OF HUMAN RESOURCES 5.00 35.00 X 0 108379 12992 PATRICK SCHULTE VP - CHIEF DEV OFF/EX DIR FDN 2.00 48.00 X 0 196323 15191 GUY GOLEMBIEWSKI MD CHIEF MED INFO OFFICER 10.00 35.00 X 0 276809 19102 HEIDI HUCK PHYSICIAN 40.00 0.00 X 313775 0 7548 ANDREA H NAYLOR PHYSICIAN 40.00 0.10 X 256160 0 12308 CHANDRA L DELORENZO DO PHYSICIAN 40.00 0.00 X 244928 0 21970 NANCY J FRANTZ PHYSICIAN 40.00 0.00 X 210129 0 19358 AMOD TOOTLA PHYSICIAN 40.00 0.00 X 159420 0 10887 1184412 2737873 235806 6 0 1 0 APOGEE MEDICAL MANAGEMENT INC 15059 N SCOTTSDALE STE 600 SCOTTSDALE AZ 85254 PHYSICIAN AND MGMT SERVICES 7625413 ECS NORTHERN MICHIGAN PC 4100 EMBASSY DR SE STE 400 GRAND RAPIDS MI 49546 PHYSICIAN SERVICES 5889805 CENTER FOR NEUROLOGICAL SURGERY PC 515 W JEFFERSON STREET PETOSKEY MI 49770 PHYSICIAN SERVICES 1561450 AMERICAN HEALTHCARE STAFFING LLC PO BOX 1928 EDMUND OK 73083 PHYSICIAN SERVICES 735602 HAYES LOCUMS LLC 6700 N ANDREWS AVE STE 600 FORT LAUDERDALE FL 33309 PHYSICIAN SERVICES 446859 14 REVENUE FOR OPERATIONS 541900 6327865 6327865 OTHER RELATED REVENUE 541900 5409271 5409271 ADULT HOSPITALIST REV. 541900 3801214 3801214 PHYSICIAN PRACTICE 621110 746679 746679 16285029 16285029 16285029 0 0 X 844780 844780 73969 73969 38186 38186 16834482 16780716 53766 9398 9398 2975 2975 224898 224898 14633 14633 16675 16675 35369 5474 29895 CORPORATE ALLOCATION 182902 182902 HOME OFFICE EXPENSES 69250 69250 LICENSE FEES/DUES 20069 750 19319 MEDICAL SUPPLIES 15119 15119 0 51 51 18382756 18027573 355183 0 500 500 254012 1093717 133656 494387 84130 219223 962720 678530 341357 284190 426296 490631 1239951 2582648 1865521 4376435 75706 110791 366783 1261209 2308010 5748435 X -1068059 -3165787 -1068059 -3165787 1239951 2582648 -2097727 0 X X 0 1 X 1 0 X 54934 15014 39920 907786 663516 244270 284190 DUE FROM AFFILIATE 490631 490631 DUE TO AFFILIATES 1261209 1261209 0 1 0 0 0 0 0 0 0 DAVID ZECHMAN CHAIRMAN & PRESIDENT/CEO-PART YEAR 0 496308 0 154255 0 240182 0 13750 0 16033 0 920528 0 0 DAVID BELLAMY TREASURER/VP FINANCE/CFO-PART YEAR 0 325646 0 71692 0 15572 0 13750 0 20846 0 447506 0 0 JENNIFER WOODS SECRETARY & VP PATIENT CARE 0 189886 0 33673 0 810 0 11387 0 11258 0 247014 0 0 EUGENE KAMINSKI VP OF HUMAN RESOURCES-PART YEAR 0 49121 0 37688 0 90960 0 5844 0 3763 0 187376 0 13218 ANDREW M MCDONAGH VP - CMO 0 251573 0 0 0 1786 0 0 0 10100 0 263459 0 0 SHARI A SCHULT VP OF OPERATIONS 0 165346 0 29578 0 2286 0 9705 0 14 0 206929 0 0 PATRICK SCHULTE VP - CHIEF DEV OFF/EX DIR FDN 0 195081 0 0 0 1242 0 1724 0 13467 0 211514 0 0 GUY GOLEMBIEWSKI MD CHIEF MED INFO OFFICER 0 209982 0 30315 0 36512 0 10669 0 8433 0 295911 0 0 HEIDI HUCK PHYSICIAN 311871 0 0 0 1904 0 0 0 7548 0 321323 0 0 0 ANDREA H NAYLOR PHYSICIAN 237210 0 0 0 18950 0 9951 0 2357 0 268468 0 0 0 CHANDRA L DELORENZO DO PHYSICIAN 237022 0 0 0 7906 0 12521 0 9449 0 266898 0 0 0 NANCY J FRANTZ PHYSICIAN 188291 0 0 0 21838 0 8069 0 11289 0 229487 0 0 0 AMOD TOOTLA PHYSICIAN 153953 0 0 0 5467 0 3256 0 7631 0 170307 0 0 0 PART I, LINE 1A THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 1 BOXES HAVE BEEN CHECKED. THE CORPORATE CEO, SUBSIDIARY CEOS AND CORPORATE EXECUTIVE & SENIOR VICE-PRESIDENTS IN SOME INSTANCES HAVE RECEIVED TAX INDEMNIFICATION FOR THE FOLLOWING BENEFITS: VEHICLE COSTS, GROUP TERM LIFE INSURANCE, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS, AND HEALTH CLUB OR SOCIAL DUES. THESE BENEFITS HAVE BEEN INCLUDED IN TAXABLE COMPENSATION. PART I, LINE 3 THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 3 BOXES HAVE BEEN CHECKED. THE RELATED ORGANIZATION USED THE FOLLOWING METHODOLOGIES TO ESTABLISH THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B MCLAREN MAINTAINS TWO SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES (THE "SERPS"). THE OLD SERP WAS CLOSED TO NEW PARTICIPANTS ON OCTOBER 1, 2006, AND THE NEW SERP BECAME EFFECTIVE AS OF JANUARY 1, 2007. NO EMPLOYEE MAY PARTICIPATE IN BOTH OF THE SERPS. THE OLD SERP IS STRUCTURED AS A DEFINED BENEFIT PLAN THAT ESSENTIALLY REPLACES THE BENEFITS THE PARTICIPANT IS NOT PERMITTED TO RECEIVE UNDER MCLAREN'S QUALIFIED RETIREMENT PLAN DUE TO IRS LIMITATIONS APPLICABLE TO QUALIFIED PLANS. THE BENEFIT UNDER THE OLD SERP IS PAYABLE IN EITHER THE FORM OF A LUMP SUM DISTRIBUTION OR IN MONTHLY PAYMENTS EQUAL TO THE ACTUARIAL EQUIVALENT OF THE PARTICIPANT'S ACCRUED BENEFIT. THE BENEFIT IS PAID AT AGE 55, AND IF THE PARTICIPANT REMAINS EMPLOYED, THE BENEFIT IS PAID UPON TERMINATION OF EMPLOYMENT, REDUCED TO TAKE INTO ACCOUNT THE BENEFIT PREVIOUSLY PAID. THE NEW SERP IS STRUCTURED AS A DEFINED CONTRIBUTION PLAN, AND MCLAREN CONTRIBUTES 15 PERCENT OF EACH PARTICIPANT'S COMPENSATION TO THE PLAN EACH YEAR FOR ALLOCATION TO THE PARTICIPANT'S ACCOUNT. PARTICIPANTS IN THE NEW SERP BECOME VESTED IN THEIR ACCOUNTS UPON THE EARLIER OF FIVE YEARS OF PARTICIPATION IN THE PLAN OR ATTAINMENT OF AGE 60. PARTICIPANTS IN THE NEW SERP SELF-DIRECT THE INVESTMENT OF THEIR ACCOUNTS AND HAVE THE ACTUAL INVESTMENT RETURN CREDITED OR DEBITED TO THEIR ACCOUNTS. THE BENEFIT UNDER THE NEW SERP IS EQUAL TO THE PARTICIPANT'S ACCOUNT BALANCE, AND THE BENEFIT IS PAID IN A SINGLE SUM WITHIN 60 DAYS OF THE PARTICIPANT'S TERMINATION DATE. BENEFITS UNDER BOTH SERPS ARE PROVIDED ON A TAX-NEUTRAL BASIS. BOTH SERPS ARE DESIGNED TO COMPLY WITH INTERNAL REVENUE CODE SECTIONS 457(F) AND 409A. PART I, LINE 7 MCLAREN HEALTH CARE (MHC) HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION, SUBSIDIARY EXECUTIVES AND DIRECTORS, MANAGERS AND SUPERVISORS. THE PURPOSE OF THE PLAN IS TO ENHANCE THE ORGANIZATION'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING TOP OFFICIALS AND THE BOARD OF DIRECTORS WITH A TOOL FOR (A) CLEARLY COMMUNICATING PERFORMANCE ON THE PART OF KEY LEADERS, (B) STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE ON THE PART OF KEY LEADERS WHICH WILL ULTIMATELY BENEFIT THE COMMUNITIES MHC SERVES, AND (C) PROTECTING MHC'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH-TALENT LEADERS. FORM 990, PART VI, SECTION A, LINE 6 MCLAREN NORTHERN MICHIGAN SHALL BE THE SOLE MEMBER OF THE ENTITY. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER SHALL HAVE THE EXCLUSIVE RIGHT TO ELECT OR APPOINT THE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B ACTIONS REQUIRING MEMBER APPROVAL INCLUDE: [A] AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; [B] DISSOLUTION, MERGER, CONSOLIDATION, REORGANIZATION OR OTHER CHANGE IN THE CORPORATE STRUCTURE OF THE CORPORATION; [C] SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; [D] ACQUISITION OF ANY OTHER ENTITY OR ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE; [E] ADOPTION OF THE ANNUAL OPERATING BUDGET OF THE CORPORATION; AND [F] ANY LENDING OR BORROWING OF MONEY BY THE CORPORATION, THE GRANTING OF ANY MORTGAGE, SECURITY INTEREST OR LIEN IN ANY PROPERTY OF THE CORPORATION AND THE GUARANTEE BY THE CORPORATION OF ANY DEBT OR OBLIGATION OF ANY ENTITY OTHER THAN THE MEMBER. IN ADDITION, THE MNM BOARD OF TRUSTEES AND EACH MNM SUBSIDIARY OR AFFILIATE WILL NOT DO THE FOLLOWING WITHOUT MCLAREN (ACTING THROUGH ITS BOARD) APPROVAL: [G] ISSUE NOTES, BONDS OR OTHER EVIDENCE OF INDEBTEDNESS [H] SELL, COVEY, ASSIGN, TRANSFER, ALIENATE, PLEDGE OR ENCUMBER REAL PROPERTY WITH AN ANNUAL AGGREGATE VALUE IN EXCESS OF $250,000 [I] PURCHASE OR ACQUIRE ADDITIONAL REAL PROPERTY WITH AN ANNUAL AGGREGATE VALUE IN EXCESS OF $250,000 [J] APPROVE UNBUDGETED CAPITAL EXPENDITURES IN EXCESS OF $250,000 IN THE ANNUAL AGGREGATE FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 DATA IS PREPARED INTERNALLY AND SUBMITTED TO OUR AUDITING FIRM FOR RETURN PREPARATION. ONCE THE RETURNS HAVE BEEN COMPLETED, THE FORMS ARE REVIEWED BY ENTITY CFO AND THE FINANCE LEADERSHIP OF MCLAREN HEALTH CARE (MHC). COPIES OF DRAFT RETURNS ARE MADE AVAILABLE TO THE MHC BOARD MEMBERS, WHO SERVE AS THE OVERALL GOVERNING BOARD. RETURNS ARE AVAILABLE FOR ALL CORPORATIONS OF WHICH MHC IS THE SOLE MEMBER AS WELL AS OTHER RELATED ENTITIES OF THOSE CORPORATIONS FOR REVIEW RATHER THAN HAVING THE LOCAL BOARDS REVIEW THE RETURNS. THE BOARD OF MHC IS THE ULTIMATE ACCOUNTABLE ORGANIZATION FOR THE SYSTEM; AS SUCH IT IS THE OVERALL GOVERNING BOARD OF THE SYSTEM, WHOSE RESPONSIBILITIES INCLUDE BUT ARE NOT LIMITED TO: APPROVING ALL SUBSIDIARY BOARD MEMBERS, FINANCIAL BUDGETS, AND ISSUANCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE MCLAREN HEALTH CARE (MHC) BOARD CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL MHC CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE MHC GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. CONFLICTS ARE DISCLOSED TO THE FULL BOARD AND BOARD COMMITTEES SO APPROPRIATE ACTIONS CAN BE TAKEN. ACTIONS MAY INCLUDE PROHIBITING A BOARD MEMBER FROM PARTICIPATING IN DELIBERATIONS INVOLVING TRANSACTIONS WITH A COMPANY WITH WHICH THEY CONDUCT FINANCIAL TRANSACTIONS; BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE RELIEVED OF THEIR SERVICE TO MHC. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS TO REVIEW THE PERFORMANCE AND RECOMMEND THE TOTAL COMPENSATION PACKAGE OF THE MCLAREN HEALTHCARE CORPORATION'S CEO TO THE BOARD. FURTHER THE COMMITTEE ESTABLISHES THE SALARY RANGES AND PERQUISITES OF THE OTHER MOST HIGHLY COMPENSATED OFFICERS (MHC EXECUTIVE & SENIOR VICE-PRESIDENTS AND CEOS OF MHC SUBSIDIARY ORGANIZATIONS) TO THE BOARD. THE MEMBERS OF THE COMMITTEE MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE APPLICABLE PROVISIONS OF SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND FINAL TREASURY REGULATIONS SECTION 53.4958-6(C)(1)(III). THE COMMITTEE RETAINS THE SERVICES ANNUALLY OF AN INDEPENDENT FIRM WITH SIGNIFICANT QUALIFICATIONS AND EXPERIENCE TO CONDUCT A REVIEW OF THE CORPORATION'S EXECUTIVE COMPENSATION PROGRAM. THE RETAINED FIRM UTILIZES APPROPRIATE COMPENSATION COMPARABILITY DATA. THE RETAINED FIRM CONDUCTS ANALYSIS OF THE COMPETITIVENESS OF THESE PROGRAMS AND EXPRESSES AN OPINION TO THE REASONABLENESS OF THESE COMPENSATION PROGRAMS. ALL DATA UTILIZED BY THE COMMITTEE, DELIBERATIONS OF THE COMMITTEE, AND FINAL COMPENSATION DECISIONS BY THE COMMITTEE ARE DOCUMENTED IN FORMAL REPORTS AND MINUTES. THE CORPORATE COMPENSATION COMMITTEE WORKS UNDER AND PERIODICALLY RENEWS THE MCLAREN HEALTH CARE CORPORATION COMPENSATION COMMITTEE CHARTER. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2019. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 435,778. MANAGEMENT AND GENERAL EXPENSES 53,766. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 489,544. PURCHASED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 16,344,938. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,344,938. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MCLAREN BAY MEDICAL FOUNDATION 1900 COLUMBUS AVE BAY CITY MI 48708 382156534 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN BAY REGION 1 MCLAREN BAY REGION 1900 COLUMBUS AVE BAY CITY MI 48708 381976271 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 BAY REGIONAL MEDICAL CENTER AUXILIARY 1908 COLUMBUS AVENUE BAY CITY MI 48708 386081235 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I MCLAREN BAY REGION 1 MCLAREN BAY SPECIAL CARE 3250 E MIDLAND ROAD STE 1 BAY CITY MI 48706 383161753 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN BAY REGION 1 MCLAREN CENTRAL MICHIGAN 1221 SOUTH DRIVE MT PLEASANT MI 48858 381420304 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 CHARLEVOIX NURSING HOME CORPORATION DBA BOULDER PARK TERRACE 14676 WEST UPRIGHT CHARLEVOIX MI 49720 383038683 SKILLED NURSING FACILITY MI 501(C)(3) LINE 10 MCLAREN NORTHERN MICHIGAN 1 KARMANOS CANCER FOUNDATION 4100 JOHN R ST DETROIT MI 48201 383584572 CANCER CARE CENTER MI 501(C)(3) LINE 7 BARBARA ANN KARMANOS CANCER INSTITUTE 1 MCLAREN GREATER LANSING FOUNDATION 401 W GREENLAWN AVE LANSING MI 48910 382463637 FOUNDATION MI 501(C)(3) LINE 7 MCLAREN GREATER LANSING 1 MCLAREN GREATER LANSING 401 W GREENLAWN AVE LANSING MI 48910 381434090 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 BARBARA ANN KARMANOS CANCER HOSPITAL 4100 JOHN R ST DETROIT MI 48201 201649466 HOSPITAL MI 501(C)(3) LINE 3 BARBARA ANN KARMANOS CANCER INSTITUTE 1 BARBARA ANN KARMANOS CANCER INSTITUTE 4100 JOHN R ST DETROIT MI 48201 381613280 CANCER RESEARCH & CARE CENTER MI 501(C)(3) LINE 7 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN LAPEER REGION 1375 N MAIN ST LAPEER MI 48446 382689033 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN LAPEER REGION FOUNDATION 1375 N MAIN ST LAPEER MI 48446 382689603 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN LAPEER REGION 1 MARWOOD MANOR NURSING HOME PO BOX 5011 PORT HURON MI 48060 382683251 NURSING HOME MI 501(C)(3) LINE 10 MCLAREN PORT HURON 1 MCLAREN HEALTH CARE CORPORATION ONE MCLAREN PARKWAY GRAND BLANC MI 48439 382397643 SUPPORTING ORG MI 501(C)(3) LINE 12A, I N/A 0 MCLAREN HEALTH CARE VILLAGE FOUNDATION 401 S BALLENGER HIGHWAY FLINT MI 48532 262693350 SUPPORTING ORG MI 501(C)(3) LINE 12A, I MCLAREN HEALTH CARE CORPORATION 1 MCLAREN HEALTH PLAN COMMUNITY G-3245 BEECHER ROAD FLINT MI 48532 272204037 INSURANCE MI 501(C)(4) MCLAREN HEALTH PLAN 1 MCLAREN HEALTH PLAN INC G-3245 BEECHER ROAD FLINT MI 48532 383252216 HEALTH CARE SERVICES MI 501(C)(4) MCLAREN INTEGRTAED HMO GROUP 1 MCLAREN HOSPICE & HOME CARE FOUNDATION 1515 CAL DR DAVISON MI 48423 463643089 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN HEALTH MANAGEMENT GROUP 1 MCLAREN MEDICAL GROUP 401 S BALLENGER HWY FLINT MI 48532 382988086 MANAGEMENT COMPANY MI 501(C)(3) LINE 12A, I MCLAREN HEALTH CARE CORPORATION 1 MCLAREN NORTHERN MICHIGAN 416 CONNABLE AVENUE PETOSKEY MI 49770 382146751 ACUTE CARE HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN NORTHERN MICHIGAN FOUNDATION 360 CONNABLE AVENUE PETOSKEY MI 49770 382445611 FOUNDATION MI 501(C)(3) LINE 7 MCLAREN NORTHERN MICHIGAN 1 MCLAREN PORT HURON 1221 PINE GROVE AVENUE PORT HURON MI 48060 381369611 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN FLINT 401 S BALLENGER HWY FLINT MI 48532 382383119 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MICHIGAN CANCER SOCIETY 4100 JOHN R ST DETROIT MI 48201 382823451 CANCER RESEARCH MI 501(C)(3) LINE 7 BARBARA ANN KARMANOS CANCER INSTITUTE 1 MOUNT CLEMENS REGIONAL HEALTHCARE FOUNDATION PO BOX 326 MOUNT CLEMENS MI 48046 382578873 FOUNDATION MI 501(C)(3) LINE 10 MCLAREN MACOMB 1 MCLAREN MACOMB 1000 HARRINGTON MOUNT CLEMENS MI 48043 381218516 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 NORTH OAKLAND NORTH MACOMB IMAGING INC 50 NORTH PERRY STREET PONTIAC MI 48342 382807040 MRI IMAGING MI 501(C)(3) LINE 3 MCLAREN OAKLAND 1 NORTHERN MICHIGAN HEMATOLOGY AND ONCOLOGY 416 CONNABLE AVENUE PETOSKEY MI 49770 320020293 PHYSICIAN PRACTICE MI 501(C)(3) LINE 3 MCLAREN NORTHERN MICHIGAN 1 MCLAREN OAKLAND FOUNDATION 50 NORTH PERRY STREET PONTIAC MI 48342 200442217 FOUNDATION MI 501(C)(3) LINE 12C, III-FI MCLAREN OAKLAND 1 MCLAREN OAKLAND 50 NORTH PERRY STREET PONTIAC MI 48342 381428164 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 PORT HURON HOSPITAL FOUNDATION PO BOX 5011 PORT HURON MI 48060 382777750 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN PORT HURON 1 REGIONAL EMERGENCY MEDICAL SERVICE INC 25400 W 8 MILE ROAD SOUTHFIELD MI 48034 383255499 AMBULANCE SERVICE MI 501(C)(3) LINE 10 MCLAREN MEDICAL MANAGEMENT INC 1 THE CARDIAC INSTITUTE DBA MICHIGAN HEART & VASCULAR SPECIALISTS 416 CONNABLE AVENUE PETOSKEY MI 49770 262774689 PHYSICIAN PRACTICE MI 501(C)(3) LINE 3 MCLAREN NORTHERN MICHIGAN 1 MCLAREN HEALTH MANAGEMENT GROUP 1515 CAL DRIVE DAVISON MI 48423 383491714 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 MCLAREN HEALTH CARE CORPORATION 1 VITALCARE INC 761 LAFAYETTE AVENUE CHEBOYGAN MI 49721 382527255 HOSPICE CARE/HOME HEALTH SERVICES MI 501(C)(3) LINE 10 MCLAREN NORTHERN MICHIGAN 1 MCLAREN FLINT FOUNDATION 401 S BALLENGER HIGHWAY FLINT MI 48532 381358053 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I MCLAREN FLINT 1 CARO COMMUNITY HOSPITAL 410 N HOOPER ST CARO MI 48723 383426063 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 CARO COMMUNITY HOSPITAL ENDOWMENT FOUNDATION 410 N HOOPER ST CARO MI 48724 382422995 FOUNDATION MI 501(C)(3) LINE 12C, III-FI CARO COMMUNITY HOSPITAL 1 MDWISE INC 2955 N MERIDIAN STREET SUITE 201 INDIANAPOLIS IN 46208 351931354 HEALTH MAINTENANCE ORGANIZATION IN 501(C)(4) MCLAREN INTEGRTAED HMO GROUP 1 MDWISE MEDICAID NETWORK INC 2955 N MERIDIAN STREET SUITE 201 INDIANAPOLIS IN 46208 473192307 INSURANCE IN 501(C)(4) MCLAREN INTEGRTAED HMO GROUP 1 HURON MEMORIAL HOSPITAL 1100 S VAN DYKE ROAD BAD AXE MI 48413 381474929 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 HURON MEMORIAL FOUNDATION 1100 S VAN DYKE ROAD BAD AXE MI 48413 382717147 FOUNDATION MI 501(C)(3) LINE 7 HURON MEMORIAL HOSPITAL 1 MCLAREN INTEGRATED HMO GROUP G-3245 BEECHER ROAD FLINT MI 48532 824449304 HEALTH CARE SERVICES MI 501(C)(4) MCLAREN HEALTH CARE CORPORATION 1 MCLAREN - NORTHERN EQUITIES CANCER CENTER PROJECT LLC 39000 COUNTRY CLUB DRIVE FARMINGTON HILLS MI 48331 263112935 RENTAL REAL ESTATE MI N/A MOUNT CLEMENS REGIONAL HEALTH BUILDING HEALTH PARTNERS 1000 HARRINGTON ST MOUNT CLEMENS MI 48043 262524717 BUILDING MANAGEMENT MI N/A SOUTH VAN DYKE MEDICAL COMPLEX-A 125 N HANSELMAN ST BAD AXE MI 48413 383372174 VARIOUS HEALTHCARE ACTIVITIES MI N/A CLARKSTON PROPERTY ASSOCIATES 50 NORTH PERRY STREET PONTIAC MI 48342 432006072 REAL ESTATE MI N/A C 0 DELPHINUS INVESTMENT INC 4100 JOHN R ST DETROIT MI 48075 454758176 HOLD PASSIVE INVESTMENT MI N/A C 1 HEALTH ADVANTAGE INC G3245 BEECHER ROAD FLINT MI 48532 912141720 INSURANCE MI N/A C 1 MCLAREN INSURANCE COMPANY LTD 10 MAIN ST GRAND CAYMAN CJ INSURANCE CJ N/A C 1 MID-MICHIGAN PHYSICIANS PC 2510 KERRY STREET SUITE 200 LANSING MI 48912 383267121 PHYSICIAN PRACTICE MI N/A C 1 MCLAREN PHYSICIAN PARTNERS ONE MCLAREN PARKWAY GRAND BLANC MI 48439 383136458 MANAGED CARE MI N/A C 0 RAPIN & RAPIN INC DBA PRESCRIPTION SERVICES PHARMACY 416 CONNABLE AVENUE PETOSKEY MI 49770 383465261 RETAIL PHARMACY MI N/A C 1 VITALCARE HOME MEDICAL EQUIPMENT INC 761 LAFAYETTE AVENUE CHEBOYGAN MI 49721 382662954 SALE AND RENTAL OF DURABLE MEDICAL EQUIPMENT MI N/A C 1 HURON CLINIC CONDOMINIUMS OWNERS 125 N HANSELMAN ST BAD AXE MI 48413 412144341 VARIOUS HEALTHCARE ACTIVITIES MI N/A C 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 MCLAREN NORTHERN MICHIGAN P 5353889 ALLOCATION OF ACTUAL COST MCLAREN NORTHERN MICHIGAN Q 7935239 ALLOCATION OF ACTUAL COST MCLAREN NORTHERN MICHIGAN S 132155 CASH