﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2017v2.3">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2019-05-15T12:26:11-05:00</ReturnTs>
    <TaxPeriodEndDt>2018-06-30</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2017-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>382640544</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MUNSON HEALTHCARE</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>MUNS</BusinessNameControlTxt>
      <PhoneNum>2319355000</PhoneNum>
      <USAddress>
        <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
        <CityNm>TRAVERSE CITY</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49684</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MARK A HEPLER</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>2319357777</PhoneNum>
      <SignatureDt>2019-05-14</SignatureDt>
    </BusinessOfficerGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>204.63.207.116</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2019-05-15</IPDt>
      <IPTm>12:26:11</IPTm>
      <IPTimezoneCd>CD</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>3AD8FE5AAD7F1E7C8842AE1699DABE20D9503696</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>3AD8FE5AAD7F1E7C8842AE1699DABE20D9503696</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2017</TaxYr>
    <BuildTS>2019-02-21 02:37:17Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="10">
    <IRS990 documentId="RetDoc2" referenceDocumentId="RetDoc8">
      <PrincipalOfficerNm>EDWIN A NESS</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>1105 SIXTH STREET</AddressLine1Txt>
        <CityNm>TRAVERSE CITY</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49684</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>84757235</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.MUNSONHEALTHCARE.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1985</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>MUNSON HEALTHCARE AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>23</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>18</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>645</TotalEmployeeCnt>
      <TotalGrossUBIAmt>73156</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>16653</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>438794</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>353888</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>63185955</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>76307491</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>916014</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>1075516</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>204442</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>94914</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>64745205</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>77831809</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>8450</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>35807</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>37918010</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>39759430</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>91478</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>29406475</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>36636497</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>67332935</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>76431734</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-2587730</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>1400075</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>59743738</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>92950830</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>26923928</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>43124941</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>32819810</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>49825889</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>MUNSON HEALTHCARE AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>66292676</ExpenseAmt>
      <GrantAmt>35807</GrantAmt>
      <RevenueAmt>76232420</RevenueAmt>
      <Desc>PARENT HOLDING COMPANY FOR CORPORATIONS PROVIDING HEALTH CARE AND RELATED SERVICES.</Desc>
      <TotalProgramServiceExpensesAmt>66292676</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc10">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc4">false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc4">true</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc4">false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc5">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc5">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc5">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc5">false</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc5">true</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc5">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc5">true</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc5">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc5">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc5">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc5">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc5">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc5">true</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd referenceDocumentId="RetDoc11">true</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd referenceDocumentId="RetDoc11">false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd referenceDocumentId="RetDoc11">false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc6">true</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc6">false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc7">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd>false</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc9">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc9">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>true</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc9">true</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc9">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc9">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>98</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>645</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>true</Form990TFiledInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>23</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>18</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>true</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>true</InvestmentInJointVentureInd>
      <WrittenPolicyOrProcedureInd>true</WrittenPolicyOrProcedureInd>
      <StatesWhereCopyOfReturnIsFldCd>MI</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>NICOLE SULAK MUNSON HEALTHCARE</PersonNm>
        <PhoneNum>2319357777</PhoneNum>
        <USAddress>
          <AddressLine1Txt>4230 COPPER RIDGE DR</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>EDWIN A NESS</PersonNm>
        <TitleTxt>PRESIDENT &amp;</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>883822</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>176242</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALFRED E PILONG JR</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>592912</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>110020</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT SPRUNK MD</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>10.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>39200</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN KIESSLING MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>10.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>27500</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THEODORE N BATZER MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>10.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>10549</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CARL B ANDERS MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CASEY COWELL</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CONSTANCE DENEWETH</PersonNm>
        <TitleTxt>VICE CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEBORAH FELLOWS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATRICK HEINTZ</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>8125</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARLENE HULTEEN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EMORY D JOHNSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAUL LERG</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>3125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>5000</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID MCCURDY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DANIEL MCDAVID</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEBORAH J OCHS MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY SANDERS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELAINE WOOD</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>8125</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RUTH HOPPE MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>5000</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID HUNTER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>5000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROGER PERRY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>5000</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLIE PARKES</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>2500</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BARBARA BENSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN PELIZZARI</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROGER W SPOELMAN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK A HEPLER</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>470545</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>84671</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAUL SHIRILLA</PersonNm>
        <TitleTxt>VP LEGAL PAR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>551200</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>50120</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTOPHER J PODGES</PersonNm>
        <TitleTxt>VP &amp; CHIEF I</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>348626</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>62763</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUZANNE K PETERS</PersonNm>
        <TitleTxt>VP HUMAN RES</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>295083</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>46008</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RACHEL ROE</PersonNm>
        <TitleTxt>VP LEGAL PAR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>152479</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31545</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTINE NEFCY</PersonNm>
        <TitleTxt>CHIEF MEDICA</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>455016</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>65039</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK S DEPONIO</PersonNm>
        <TitleTxt>VP SYSTEM SE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>360351</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34420</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHANIE RIEMER</PersonNm>
        <TitleTxt>CEO GRAYLING</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>318157</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>49910</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TONYA SMITH</PersonNm>
        <TitleTxt>CEO CADILLAC</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>311667</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43175</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES BARKER</PersonNm>
        <TitleTxt>CEO MANISTEE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>299967</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>49399</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4560663</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>695786</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>803312</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>58</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>CERNER CORPORATION</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2800 ROCKCREEK PARKWAY</AddressLine1Txt>
            <CityNm>NORTH KANSAS CITY</CityNm>
            <StateAbbreviationCd>MO</StateAbbreviationCd>
            <ZIPCd>64117</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>AMB SUPPORT</ServicesDesc>
        <CompensationAmt>6857041</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>AHEAD LLC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>401 N MICHIGAN AVE SUITE 3400</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60611</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT SUPPORT</ServicesDesc>
        <CompensationAmt>1584671</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>ADVERTISING IMPRESSIONS INC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>626 S RUSCH ROAD</AddressLine1Txt>
            <CityNm>TRAVERSE CITY</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49696</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ADVERTISING</ServicesDesc>
        <CompensationAmt>1061740</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>CATALYSIS INC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>100 W LAWRENCE ST SUITE 422</AddressLine1Txt>
            <CityNm>APPLETON</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>54911</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EDUCATION</ServicesDesc>
        <CompensationAmt>955200</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>HURON CONSULTING</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>550 W VAN BUREN STREET</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60607</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSULTING</ServicesDesc>
        <CompensationAmt>770608</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>27</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>51460</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>302428</GovernmentGrantsAmt>
      <TotalContributionsAmt>353888</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACT REVENUES</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>74894312</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>74894312</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SERVICES TO OTHER ORGANIZATIO</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>1199157</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1199157</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>HEALTH SERVICE REVENUE</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>140983</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>140983</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONTRACT REVENUES</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>73039</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>73039</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>76307491</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>566407</TotalRevenueColumnAmt>
        <ExclusionAmt>566407</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>7431035</SecuritiesAmt>
        <OtherAmt>3500</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>6919894</SecuritiesAmt>
        <OtherAmt>5532</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>511141</SecuritiesAmt>
        <OtherAmt>-2032</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>509109</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-2032</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>511141</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <BusinessCd>900003</BusinessCd>
        <TotalRevenueColumnAmt>94797</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>94797</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>PASS THROUGH UBI FOR JV</Desc>
        <BusinessCd>900003</BusinessCd>
        <TotalRevenueColumnAmt>117</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>117</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>94914</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>77831809</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>76327217</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>73156</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1077548</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>35807</TotalAmt>
        <ProgramServicesAmt>35807</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>3545641</TotalAmt>
        <ProgramServicesAmt>1711613</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1742550</ManagementAndGeneralAmt>
        <FundraisingAmt>91478</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>31284510</TotalAmt>
        <ProgramServicesAmt>25852990</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5431520</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1073467</TotalAmt>
        <ProgramServicesAmt>1008369</ProgramServicesAmt>
        <ManagementAndGeneralAmt>65098</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1442543</TotalAmt>
        <ProgramServicesAmt>1258469</ProgramServicesAmt>
        <ManagementAndGeneralAmt>184074</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>2413269</TotalAmt>
        <ProgramServicesAmt>2026928</ProgramServicesAmt>
        <ManagementAndGeneralAmt>386341</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>439909</TotalAmt>
        <ManagementAndGeneralAmt>439909</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>483175</TotalAmt>
        <ManagementAndGeneralAmt>483175</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>122415</TotalAmt>
        <ManagementAndGeneralAmt>122415</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>67251</TotalAmt>
        <ManagementAndGeneralAmt>67251</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>5875504</TotalAmt>
        <ProgramServicesAmt>4855894</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1019610</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>178956</TotalAmt>
        <ProgramServicesAmt>163417</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15539</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1829444</TotalAmt>
        <ProgramServicesAmt>1806239</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23205</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>16910952</TotalAmt>
        <ProgramServicesAmt>16879029</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31923</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>199792</TotalAmt>
        <ProgramServicesAmt>187317</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12475</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>186013</TotalAmt>
        <ProgramServicesAmt>143761</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42252</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>252730</TotalAmt>
        <ProgramServicesAmt>187584</ProgramServicesAmt>
        <ManagementAndGeneralAmt>65146</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>9604620</TotalAmt>
        <ProgramServicesAmt>9504632</ProgramServicesAmt>
        <ManagementAndGeneralAmt>99988</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>-541306</TotalAmt>
        <ManagementAndGeneralAmt>-541306</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>383048</TotalAmt>
        <ProgramServicesAmt>246955</ProgramServicesAmt>
        <ManagementAndGeneralAmt>136093</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>261092</TotalAmt>
        <ProgramServicesAmt>224654</ProgramServicesAmt>
        <ManagementAndGeneralAmt>36438</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DIETARY</Desc>
        <TotalAmt>230496</TotalAmt>
        <ProgramServicesAmt>80113</ProgramServicesAmt>
        <ManagementAndGeneralAmt>150383</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>86328</TotalAmt>
        <ProgramServicesAmt>84231</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2097</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>66078</TotalAmt>
        <ProgramServicesAmt>34674</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31404</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>76431734</TotalAmt>
        <ProgramServicesAmt>66292676</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10047580</ManagementAndGeneralAmt>
        <FundraisingAmt>91478</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>24755</BOYAmt>
        <EOYAmt>1305518</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1026732</BOYAmt>
        <EOYAmt>4005229</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>5206126</BOYAmt>
        <EOYAmt>10000000</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>4726986</BOYAmt>
        <EOYAmt>5520700</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>106144161</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>72765912</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>23446163</BOYAmt>
        <EOYAmt>33378249</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>13663679</BOYAmt>
        <EOYAmt>14586918</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>9162861</BOYAmt>
        <EOYAmt>22583636</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>2486436</BOYAmt>
        <EOYAmt>1570580</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>59743738</BOYAmt>
        <EOYAmt>92950830</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>18565507</BOYAmt>
        <EOYAmt>28430455</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>5206126</BOYAmt>
        <EOYAmt>10000000</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>3152295</BOYAmt>
        <EOYAmt>4694486</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>26923928</BOYAmt>
        <EOYAmt>43124941</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>32819810</BOYAmt>
        <EOYAmt>49825889</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>32819810</BOYAmt>
        <EOYAmt>49825889</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>59743738</BOYAmt>
        <EOYAmt>92950830</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>1400075</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>126836</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>15479168</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc10">
      <SupportingOrganization509a3Ind>X</SupportingOrganization509a3Ind>
      <SupportingOrgType3FuncIntInd>X</SupportingOrgType3FuncIntInd>
      <SupportedOrganizationsCnt>7</SupportedOrganizationsCnt>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>381362830</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>45933281</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>PAUL OLIVER MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>381415623</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>1477913</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CADILLAC</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>471156297</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>8371148</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE GRAYLING</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>471161992</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>8218439</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CHARLEVOIX HOSPITAL</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>381459366</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>1697776</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE MANISTEE HOSPITAL</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>380350304</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>2564851</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>381303843</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>true</GoverningDocumentListedInd>
        <SupportAmt>0</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrganizationsTotalCnt>7</SupportedOrganizationsTotalCnt>
      <SupportSumAmt>68263408</SupportSumAmt>
      <OtherSupportSumAmt>0</OtherSupportSumAmt>
      <Form990SchASupportingOrgGrp>
        <ListedByNameGoverningDocInd>true</ListedByNameGoverningDocInd>
        <SuprtOrgNoIRSDeterminationInd>false</SuprtOrgNoIRSDeterminationInd>
        <SupportedOrgSectionC456Ind>false</SupportedOrgSectionC456Ind>
        <SupportedOrgNotOrganizedUSInd>false</SupportedOrgNotOrganizedUSInd>
        <OrganizationChangeSuprtOrgInd>false</OrganizationChangeSuprtOrgInd>
        <SupportNonSupportedOrgInd>false</SupportNonSupportedOrgInd>
        <PaymentSubstantialContribtrInd>false</PaymentSubstantialContribtrInd>
        <LoanDisqualifiedPersonInd>false</LoanDisqualifiedPersonInd>
        <ControlledDisqualifiedPrsnInd>false</ControlledDisqualifiedPrsnInd>
        <DisqualifiedPrsnControllIntInd>false</DisqualifiedPrsnControllIntInd>
        <DisqualifiedPrsnOwnrIntInd>false</DisqualifiedPrsnOwnrIntInd>
        <ExcessBusinessHoldingsRulesInd>false</ExcessBusinessHoldingsRulesInd>
        <ContributionControllerInd>false</ContributionControllerInd>
        <ContributionFamilyInd>false</ContributionFamilyInd>
        <Contribution35ControlledInd>false</Contribution35ControlledInd>
      </Form990SchASupportingOrgGrp>
      <Form990SchAType3SprtOrgAllGrp>
        <TimelyProvidedDocumentsInd>true</TimelyProvidedDocumentsInd>
        <OfficersCloseRelationshipInd>true</OfficersCloseRelationshipInd>
        <SupportedOrgVoiceInvestmentInd>false</SupportedOrgVoiceInvestmentInd>
      </Form990SchAType3SprtOrgAllGrp>
      <Form990SchAType3FuncIntGrp>
        <ParentSupportedOrgInd>X</ParentSupportedOrgInd>
        <AppointElectMajorityOfficerInd>true</AppointElectMajorityOfficerInd>
        <ExerciseDirectionPoliciesInd>true</ExerciseDirectionPoliciesInd>
      </Form990SchAType3FuncIntGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART I, LINE 11H</FormAndLineReferenceDesc>
        <ExplanationTxt>MUNSON HEALTHCARE MANISTEE HOSPITAL 38-0350304 3 X 2,564,851 0 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL 38-1303843 3 X 0 0</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART IV, SECTION E, LINE 3A</FormAndLineReferenceDesc>
        <ExplanationTxt>MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE DIRECTORS/TRUSTEES FOR SUBSIDIARY ENTITIES, INCLUDING SUPPORTED ORGANIZATIONS. NOMINATIONS TO MUNSON HEALTHCARE FOR SUBSIDIARY DIRECTORS/TRUSTEES ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART IV, SECTION E, LINE 3B</FormAndLineReferenceDesc>
        <ExplanationTxt>CERTAIN DECISIONS OF THE SUPPORTED ORGANIZATIONS' TRUSTEES/DIRECTORS ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF SUPPORTED ORGANIZATIONS; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE SUPPORTED ORGANIZATIONS; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF SUPPORTED ORGANIZATIONS; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR SUPPORTED ORGANIZATIONS INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY SUPPORTED ORGANIZATIONS WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF SUPPORTED ORGANIZATIONS WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF SUPPORTED ORGANIZATIONS; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY SUPPORTED ORGANIZATIONS; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1" />
    <IRS990ScheduleC documentId="RetDoc4">
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>122415</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>122415</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE C, PART II-B, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>GRASSROOTS LOBBYING EXPENSES GRANTED TO ORGANIZATIONS. PAID A CONSULTANT TO COORDINATE, MANAGE CONACTS AND COMMUNICATE WITH LOCAL, STATE AND FEDERAL LEGISLATORS ON HEALTHCARE LEGISLATION AND POLICY MATTERS OF IMPORTANCE TO MUNSON HEALTHCARE AND ITS FACILITIES AND SERVICES. OTHER ACTIVITIES INDICATE THE PORTION OF DUES ALLOCATED TO LOBBYING EXPENSES PAID TO REGIONAL OR NATIONAL ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc5">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>13663679</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>990490</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>67251</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>14586918</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12607987</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>1122251</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>66559</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>13663679</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>12418000</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>250388</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>60401</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>12607987</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>11914154</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>564742</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>60896</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>12418000</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>10419390</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>1557389</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>62625</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>11914154</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>1.00000</BoardDesignatedBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>105548</OtherCostOrOtherBasisAmt>
        <BookValueAmt>105548</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>2387738</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1165995</DepreciationAmt>
        <BookValueAmt>1221743</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>93048913</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>71599917</DepreciationAmt>
        <BookValueAmt>21448996</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>10601962</OtherCostOrOtherBasisAmt>
        <BookValueAmt>10601962</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>33378249</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>INVESTMENTS HELD IN TRUST</Desc>
        <BookValueAmt>12818007</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>INSURANCE INVESTMENTS</Desc>
        <BookValueAmt>8395599</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>INVESTMENT IN SUPPLY ALLIANCE</Desc>
        <BookValueAmt>811747</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>INVESTMENT IN PRIORITY HEALTH</Desc>
        <BookValueAmt>558283</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>22583636</TotalBookValueSecuritiesAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>INSURANCE CLAIMS RESERVE</Desc>
        <Amt>4224856</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED POST RETIREMENT BENEFIT</Desc>
        <Amt>431504</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>AFFILIATE PAYABLE</Desc>
        <Amt>38126</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>4694486</TotalLiabilityAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 2, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD-DESIGNATED FUNDS ARE MAINTAINED FOR THE FUTURE USE OF THE MUNSON HEALTHCARE SYSTEM. EARNINGS FROM THE INVESTMENTS ARE USED CURRENTLY, FOR THE OPERATIONS OF MUNSON HEALTHCARE AS A PARENT ORGANIZATION IN THE SYSTEM.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="RetDoc11">
      <GrantRecordsMaintainedInd>false</GrantRecordsMaintainedInd>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>CENTRAL AMERICA AND THE CARIBBEAN</RegionTxt>
        <TypeOfActivitiesConductedTxt>SELF INSURANCE</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>INSURANCE</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>1107760</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>CENTRAL AMERICA AND THE CARIBBEAN</RegionTxt>
        <TypeOfActivitiesConductedTxt>SELF INSURANCE</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>INCREASE INVESTMENT</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>495000</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>CENTRAL AMERICA AND THE CARIBBEAN</RegionTxt>
        <TypeOfActivitiesConductedTxt>INVESTMENT</TypeOfActivitiesConductedTxt>
        <SpecificServicesProvidedTxt>INSURANCE INVESTMENT</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>5261104</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalSpentAmt>6863864</SubtotalSpentAmt>
      <TotalSpentAmt>6863864</TotalSpentAmt>
      <TransferToForeignCorpInd>true</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>false</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>false</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>false</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>false</ForeignPartnershipInd>
      <BoycottCountriesInd>false</BoycottCountriesInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE F, PAGE 1, PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>CENTRAL AMERICA AND THE CARIBBEAN 1,107,760 0 CENTRAL AMERICA AND THE CARIBBEAN 0 495,000 CENTRAL AMERICA AND THE CARIBBEAN 0 5,261,104</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE F, PAGE 5, PART V</FormAndLineReferenceDesc>
        <ExplanationTxt>EXPENDITURES ARE REPORTED BASED ON THE ACCRUAL METHOD OF ACCOUNTING.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleI documentId="RetDoc6">
      <GrantRecordsMaintainedInd>true</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNITED WAY OF NORTHWEST MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>200 EAST GRANDVIEW PARKWAY</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <RecipientEIN>381679060</RecipientEIN>
        <IRCSectionDesc>501C3</IRCSectionDesc>
        <CashGrantAmt>16979</CashGrantAmt>
        <PurposeOfGrantTxt>COMMUNITY SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PAGE 1, PART I, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>MUNSON HEALTHCARE MAY AWARD A GRANT OR CONTRIBUTION TO ANOTHER TAX-EXEMPT ORGANIZATION BASED ON A REQUEST FOR REIMBURSEMENT FOR PRE-APPROVED SERVICES OR PURCHASES. THE AWARD IS BASED ON AN EVALUATION OF THE USE OF THE FUNDS FOR THE PROMOTION OF HEALTH IN THE COMMUNITY. THE ONGOING RELATIONSHIP OF MUNSON HEALTHCARE WITH ITS PARTNERS IN THE COMMUNITY FOR THE PROMOTION OF HEALTH ALLOWS FOR THE MONITORING OF THE GRANT AWARD.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc7">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EDWIN A NESS</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>682931</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>196867</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>4024</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>149728</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26514</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1060064</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALFRED E PILONG JR</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>472702</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>99947</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>20263</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>88153</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>21867</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>702932</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK A HEPLER</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>340821</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>68700</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>61024</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>57891</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26780</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>555216</TotalCompensationFilingOrgAmt>
        <CompReportPrior990FilingOrgAmt>11542</CompReportPrior990FilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL SHIRILLA</PersonNm>
        <TitleTxt>VP LEGAL PART-YEAR</TitleTxt>
        <BaseCompensationFilingOrgAmt>269303</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>42816</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>239081</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>34063</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16057</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>601320</TotalCompensationFilingOrgAmt>
        <CompReportPrior990FilingOrgAmt>74441</CompReportPrior990FilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTOPHER J PODGES</PersonNm>
        <TitleTxt>VP &amp; CHIEF INFO OFFI</TitleTxt>
        <BaseCompensationFilingOrgAmt>289105</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>55650</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3871</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>35582</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>27181</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>411389</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUZANNE K PETERS</PersonNm>
        <TitleTxt>VP HUMAN RESOURCES</TitleTxt>
        <BaseCompensationFilingOrgAmt>217603</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>44204</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>33276</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>27678</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>18330</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>341091</TotalCompensationFilingOrgAmt>
        <CompReportPrior990FilingOrgAmt>4508</CompReportPrior990FilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RACHEL ROE</PersonNm>
        <TitleTxt>VP LEGAL PART-YEAR</TitleTxt>
        <BaseCompensationFilingOrgAmt>144594</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>7159</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>726</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9594</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>21951</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>184024</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTINE NEFCY</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICE</TitleTxt>
        <BaseCompensationFilingOrgAmt>380010</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>74404</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>602</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>44377</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>20662</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>520055</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK S DEPONIO</PersonNm>
        <TitleTxt>VP SYSTEM SEVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>202074</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>27036</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>131241</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>25653</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8767</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>394771</TotalCompensationFilingOrgAmt>
        <CompReportPrior990FilingOrgAmt>35350</CompReportPrior990FilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEPHANIE RIEMER</PersonNm>
        <TitleTxt>CEO GRAYLING</TitleTxt>
        <BaseCompensationFilingOrgAmt>245479</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>48930</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>23748</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>22156</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>27754</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>368067</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TONYA SMITH</PersonNm>
        <TitleTxt>CEO CADILLAC</TitleTxt>
        <BaseCompensationFilingOrgAmt>261720</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>49175</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>772</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>21682</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>21493</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>354842</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES BARKER</PersonNm>
        <TitleTxt>CEO MANISTEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>227701</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>62021</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>10245</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>26368</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23031</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>349366</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>EDWIN A. NESS 0 136,951 0 ALFRED E. PILONG, JR. 0 75,376 0 MARK A. HEPLER 0 37,442 0 PAUL SHIRILLA 0 17,905 0 CHRISTOPHER J. PODGES 0 18,236 0 SUZANNE K. PETERS 0 14,622 0 RACHEL ROE 0 2,219 0 CHRISTINE NEFCY 0 38,950 0 MARK S. DEPONIO 0 13,530 0 STEPHANIE RIEMER 0 16,729 0 TONYA SMITH 0 16,310 0 JAMES BARKER 0 14,683 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>EXECUTIVE SUPPLEMENTAL RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. FOR THE PRESIDENT, THE PLAN PROVIDES A TARGETED BENEFIT AT AGE 62. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. VICE-PRESIDENTS ARE ELIGIBLE TO PARTICIPATE IN AN AMOUNT NOT TO EXCEED 6% OF BASE COMPENSATION, FUNDED ANNUALLY, AT THE SOLE DISCRETION OF MUNSON. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc8">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MUNSON HEALTHCARE IS A MEMBERSHIP ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE ARE TWO CLASSES OF MEMBERS OF MUNSON HEALTHCARE: (1) ELECTED MEMBERS; AND (2) EX-OFFICIO MEMBERS. THERE IS NO SEPARATE VOTING BY CLASS ON MATTERS BROUGHT TO VOTE BY THE MEMBERS. EACH ELECTED MEMBER AND EACH EX-OFFICIO MEMBER SHALL HAVE ONE (1) VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS. THE ELECTED MEMBERS OF THE CORPORATION SHALL CONSIST OF NOT MORE THAN TWO HUNDRED (200) PERSONS, AT LEAST TWO-THIRDS OF WHOM SHALL BE RESIDENTS OF GRAND TRAVERSE, LEELANAU, BENZIE, KALKASKA AND ANTRIM COUNTIES OF THE STATE OF MICHIGAN AT THE TIME OF THEIR ELECTION TO MEMBERSHIP. NO PERSON SHALL BE ELIGIBLE AS AN ELECTED MEMBER AFTER ATTAINING THE AGE OF EIGHTY-FIVE. EACH ELECTED MEMBER SHALL BE NOMINATED BY THE BOARD OF DIRECTORS PURSUANT TO RECOMMENDATION BY THE GOVERNANCE COMMITTEE AND ELECTED BY THE MEMBERS TO SERVE A FIVE (5) YEAR TERM. AN ELECTED MEMBER'S TERM SHALL AUTOMATICALLY CEASE IN THE EVENT THE INDIVIDUAL BECOMES AN EX-OFFICIO MEMBER. THE ELECTED MEMBERS SHALL BE DIVIDED INTO STAGGERED TERMS SO THAT NEARLY EQUAL NUMBERS SHALL BE ELECTED EACH YEAR. THE EX-OFFICIO MEMBERS OF THE CORPORATION SHALL CONSIST OF EACH DIRECTOR OR TRUSTEE SERVING ON THE BOARDS OF DIRECTORS OR BOARD OF TRUSTEES OF CERTAIN SUBSIDIARY AND AFFILIATE ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEMBERS VOTE TO ELECT THE ELECTED MEMBERS AND THE ELECTED DIRECTORS OF THE CORPORATION. ADDITIONALLY, ANY AMENDMENT, REPEAL OR ADOPTION OF NEW BYLAWS, TO THE EXTENT IT AFFECTS THE RIGHTS AND POWERS OF THE MEMBERS OF THE CORPORATION, SHALL BE EFFECTIVE ONLY UPON RATIFICATION BY THE MEMBERS. CERTAIN ACTIONS UNDER THE MICHIGAN NONPROFIT CORPORATIONS ACT ALSO REQUIRE THE APPROVAL OF THE MEMBERSHIP INCLUDING A MERGER, CONSOLIDATION, CORPORATE REORGANIZATION, SALE OF SUBSTANTIALLY ALL THE ASSETS, AMENDMENT OF THE ARTICLES OF INCORPORATION AND DISSOLUTION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MUNSON HEALTHCARE BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF EIGHT MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON EXECUTIVES IS DETERMINED IN PART BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES FOR MUNSON HEALTHCARE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MUNSON HEALTHCARE ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE DOES NOT MAKE THE BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE PREPARES AND DISTRIBUTES AN ANNUAL REPORT TO THE COMMUNITY, WHICH CONTAINS FINANCIAL AS WELL AS PROGRAM DATA.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSFER FROM MUNSON MOBILE IMAGING 700,000 TRANSFER FROM MUNSON MEDICAL CENTER 27,000,000 TRANSFER FROM MUNSON HOME CARE 2,000,000 TRANSFER FROM MUNSON HEALTHCARE GRAYLING HOSPITAL 2,000,000 TRANSFER FROM MUNSON SUPPORT SERVICES 750,000 TRANSFER TO MUNSON HOME SERVICES -500,000 TRANSFER TO MUNSUN HEALTHCARE CADILLAC -4,500,000 TRANSFER TO MUNSON MEDICAL GROUP -10,000,000 TRANSFER TO MUNSON MEDICAL CENTER -750,000 NET PERIODIC PENSION COST -1,220,832 TOTAL 15,479,168</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc9">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON DIALYSIS CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>383097861</EIN>
        <PrimaryActivitiesTxt>DIALYSIS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE FOUNDATIONS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>382642724</EIN>
        <PrimaryActivitiesTxt>RAISE FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HOME CARE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>382191390</EIN>
        <PrimaryActivitiesTxt>HOME HEALT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>MUNSON HOME HEATLH</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HOME HEALTH</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>383335362</EIN>
        <PrimaryActivitiesTxt>HOME HEALT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12B</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HOME SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>382543463</EIN>
        <PrimaryActivitiesTxt>HOME HEALT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>MUNSON HOME HEALTH</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>381362830</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NORTH FLIGHT INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>382657917</EIN>
        <PrimaryActivitiesTxt>MED TRANSP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12B</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PAUL OLIVER MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>381415623</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON MEDICAL GROUP</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>273600575</EIN>
        <PrimaryActivitiesTxt>PHYSICIAN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON MED</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>MUNSON MEDICAL CENTER</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CADILLAC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>471156297</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>MUNSON HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE GRAYLING</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>471161992</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>MUNSON HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CADILLAC FOUNDATI</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>472857600</EIN>
        <PrimaryActivitiesTxt>RAISE FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MHC CADILL</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>MUNSON HEALTHCARE CADILLAC</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CHARLEVOIX HOSPIT</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>381459366</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CHARLEVOIX</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HOSPITAL FOUNDATION</BusinessNameLine2Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <EIN>753078034</EIN>
        <PrimaryActivitiesTxt>RAISE FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MHC CHARLE</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HOSPITAL</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE MANISTEE HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1465 E PARKDALE AVE</AddressLine1Txt>
          <CityNm>MANISTEE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496609709</ZIPCd>
        </USAddress>
        <EIN>380350304</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE MANISTEE</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HOSPITAL FOUNDATION</BusinessNameLine2Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1465 E PARKDALE AVE</AddressLine1Txt>
          <CityNm>MANISTEE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496609709</ZIPCd>
        </USAddress>
        <EIN>383565083</EIN>
        <PrimaryActivitiesTxt>RAISE FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MHC MANIST</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HOSPITAL</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE OTSEGO MEMORIAL H</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HOSPITAL</BusinessNameLine2Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>825 N CENTER AVE</AddressLine1Txt>
          <CityNm>GAYLORD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>497351592</ZIPCd>
        </USAddress>
        <EIN>381303843</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HC</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>MUNSON HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE OTSEGO MEMORIAL</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HOSPITAL FOUNDATION</BusinessNameLine2Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>825 N CENTER AVE</AddressLine1Txt>
          <CityNm>GAYLORD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>497351592</ZIPCd>
        </USAddress>
        <EIN>382135473</EIN>
        <PrimaryActivitiesTxt>RAISE FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MHC OTSEGO</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>HOSPITAL</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL BUILDING PARTNERS</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1188</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496851188</ZIPCd>
        </USAddress>
        <EIN>382830005</EIN>
        <PrimaryActivitiesTxt>REAL ESTAT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>NORTHERN MICHIGAN SUPPLY ALLIANCE</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2651 AERO PARK DR</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49686</ZIPCd>
        </USAddress>
        <EIN>383453378</EIN>
        <PrimaryActivitiesTxt>SUPPLY PUR</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MUNSON HEA</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>MUNSON HEALTHCARE</BusinessNameLine2Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>RELATED</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>40762</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>2903547</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>true</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.67750</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MUNSON SUPPORT SERVICES</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1188</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496851188</ZIPCd>
        </USAddress>
        <EIN>382872821</EIN>
        <PrimaryActivitiesTxt>LAUNDRY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDICAL OFFICE BUILDING CONDOMINIUM</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>ASSOCIATION</BusinessNameLine2Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1188</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496851188</ZIPCd>
        </USAddress>
        <EIN>383567278</EIN>
        <PrimaryActivitiesTxt>REAL ESTAT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MUNSON SERVICES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1188</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496851188</ZIPCd>
        </USAddress>
        <EIN>383144382</EIN>
        <PrimaryActivitiesTxt>PHARMACY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SIXTH STREET DRUGS INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1188</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496851188</ZIPCd>
        </USAddress>
        <EIN>382298290</EIN>
        <PrimaryActivitiesTxt>PHARMACY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDICAL OFFICE CONDOMINIUM</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>ASSOCATION</BusinessNameLine2Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1188</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496851188</ZIPCd>
        </USAddress>
        <EIN>201902620</EIN>
        <PrimaryActivitiesTxt>REAL ESTAT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MUNSON MOBILE IMAGING</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO BOX 1188</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496851188</ZIPCd>
        </USAddress>
        <EIN>382704069</EIN>
        <PrimaryActivitiesTxt>IMAGING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>true</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>true</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON DIALYSIS CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>181109</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON DIALYSIS CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>273836</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON DIALYSIS CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>453996</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CADILLAC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>4500000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CADILLAC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>8371148</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CADILLAC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>5171634</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CADILLAC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>7607168</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CHARLEVOIX HOSPIT</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>1697776</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CHARLEVOIX HOSPIT</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>99886</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CHARLEVOIX HOSPIT</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>566919</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE FOUNDATIONS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>642636</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE FOUNDATIONS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>145103</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE FOUNDATIONS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>183877</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE GRAYLING</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>2000000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE GRAYLING</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>8218439</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE GRAYLING</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>175000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE GRAYLING</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>5486431</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE GRAYLING</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>7259410</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE MANISTEE HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>2564851</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE MANISTEE HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>192492</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE MANISTEE HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>228313</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HOME CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>2000000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HOME CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>968030</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HOME CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>2185813</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HOME CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>2833132</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HOME SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>500000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HOME SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>319303</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HOME SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>495661</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HOME SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>680194</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>750000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>27000000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>H</TransactionTypeTxt>
        <InvolvedAmt>4943396</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>45933281</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>102862</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>381867</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>55358241</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>89020873</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>872463</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>1246916</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL GROUP</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>10000000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL GROUP</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>1376485</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL GROUP</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>2584004</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MEDICAL GROUP</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>3122203</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON MOBILE IMAGING</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>700000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON SERVICES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>349582</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON SERVICES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>413023</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON SERVICES INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>325580</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON SUPPORT SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>750000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON SUPPORT SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>273609</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON SUPPORT SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>207236</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON SUPPORT SERVICES</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>306421</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NORTH FLIGHT INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>350920</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NORTH FLIGHT INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>614770</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NORTH FLIGHT INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>1022503</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NORTHERN MICHIGAN SUPPLY ALLIANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>400420</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NORTHERN MICHIGAN SUPPLY ALLIANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>1380272</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NORTHERN MICHIGAN SUPPLY ALLIANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>1342284</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PAUL OLIVER MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>1477913</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PAUL OLIVER MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>127537</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PAUL OLIVER MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>80954</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PAUL OLIVER MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>1810835</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PAUL OLIVER MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>1138255</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SIXTH STREET DRUGS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>112472</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SIXTH STREET DRUGS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>102304</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SIXTH STREET DRUGS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>118303</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE FOUNDATIONS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>51460</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL AMOUNT PAID</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE R</FormAndLineReferenceDesc>
        <ExplanationTxt>MUNSON HEALTHCARE USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>