2012-08-15T14:09:36-05:00 2011-09-30 PLANTE & MORAN PLLC 750 TRADE CENTRE WAY STE 300 PORTAGE MI 49002 990 2010-10-01 382383119 MCLAREN REGIONAL MEDICAL CENTER MCLA 8103422000 401 S BALLENGER HIGHWAY FLINT MI 48532 RICK WYLES 8103422000 2012-08-13 1 CAROL LALONDE CPA 2695674500 2010 2016-02-24 21:20:13Z RICK WYLES 401 S BALLENGER HIGHWAY FLINT MI 48532 400190839 0 X WWW.MCLARENREGIONAL.ORG X 1981 MI PROVIDE HEALTH CARE SERVICES TO THE COMMUNITY AND PROVIDE VARIOUS HEALTH PROMOTION EVENTS 13 11 2919 308 1105108 174022 1739842 1120445 363426731 395652112 1870740 1960261 317232 33558 367354545 398766376 1467999 2852363 0 0 172643408 189696994 0 0 0 179724579 191693123 353835986 384242480 13518559 14523896 358731109 440729432 287198765 386634471 71532344 54094961 MCLAREN HEALTH CARE, THROUGH ITS SUBSIDIARIES, WILL BE MICHIGAN'S BEST VALUE IN HEALTHCARE AS DEFINED BY QUALITY OUTCOMES AND COST. 0 0 337369648 2852363 394547004 PROVISION OF MEDICAL SERVICES FOR THE INPATIENT AND OUTPATIENT CARE OF PERSONS SUFFERING FROM ILLNESS, INJURY, AND DISABILITY; FOR THE PREVENTION OF ILLNESS INJURY AND DISABILITY AND FOR THE MAINTENANCE OF HEALTH.SELECTED ACTIVITY STATISTICS ARE PRESENTED:PATIENT DAYS: 97,025DISCHARGES: 21,576EMERGENCY ROOM VISITS: 64,986OUTPATIENT VISITS: 466,155BIRTHS: 555 337369648 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 242 4 1 2919 1 1 1 0 0 0 0 1 1 0 0 0 0 X 13 11 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X RICK WYLES 8103422000 401 S BALLENGER HWY FLINT MI 48532 X KRISTEN SKIVINGTON PHD 2.00 X X 0 0 0 LAWRENCE MOON 2.00 X 0 0 0 LYNN EVANS 2.00 X 0 0 0 PHILIP INCARNATI 2.00 X 0 5565975 619868 GHASSAN SAAB 2.00 X 0 0 0 OLIVIA PROCTOR MAYNARD 2.00 X 0 0 0 FRAZER WADENSTORER MD 2.00 X 70000 0 0 JAGDISH BHAGAT MD 2.00 X 120000 0 0 JIM CUMMINS 2.00 X 0 0 0 SHERRI STEPHENS 2.00 X 0 0 0 DAVID MAZURKIEWICZ 2.00 X 0 518327 88056 DON KOOY 40.00 X X 893828 0 254940 EDWARD ABBOTT 2.00 X X 0 0 0 DUANE MILLER 2.00 X X 0 0 0 RICK WYLES 40.00 X 247685 0 49800 SUSAN SMITH 40.00 X 297197 0 43807 CARLOS PETROZZI 40.00 X 285003 0 33012 MUSTAFA ALNOUNOU 40.00 X 449533 0 13242 JEFFREY MITCHELL 40.00 X 279389 0 11500 PRAJESH PATEL 40.00 X 277698 0 24750 DENNIS KRZEMINSKI 0.00 X 0 700599 1530 2920333 6784901 1140505 166 1 1 0 MORRISON MANAGEMENT SPECIALIST 5801 PEACH TREE DUNWOODY RD ATLANTA GA 30342 DIETARY MGMT & FOOD COSTS 3262691 ANTHELIOPROVIDER HEALTH NET SERVICE IN 5400 LBJ FREEWAY SUITE 200 DALLAS TX 75240 TRANSCRIPTION & CODING SERVICES 2731429 GENESEE HEALTH PLAN G-3169 BEECHER RD SUITE 104 FLINT MI 485323644 ARRANGE HEALTH CARE FOR ELIGIBLE PUBLIC 2341536 HEALTH ADVANTAGE INC G-3245 BEECHER RD FLINT MI 48532 ADMIN/STOP LOSS FEE 1447075 FLINT HEALTH SYSTEMS IMAGING ATTN DEPT CH 17861 PALATINE IL 60074 DIAGNOSTIC IMAGING SERVICES 1404450 41 610193 510252 1120445 PATIENT SERVICE REVENU 621400 391422309 391422309 CONTRACTED MEDICAL SER 621400 3124695 3124695 LABORATORY 621500 1105108 1105108 395652112 2518305 2518305 891477 857919 33558 33558 33558 8500 491538 75006 -491538 -66506 -558044 -558044 398766376 394547004 1105108 1993819 2852363 2852363 1608962 200923 1408039 143548007 133710486 9837521 14379897 13245957 1133940 19855174 18289476 1565698 10304954 9477794 827160 103521 5950 97571 93758 93758 50029955 30380061 19649894 1032195 140995 891200 71248518 67132441 4116077 361361 338613 22748 7366282 7085684 280598 167705 99307 68398 581576 251252 330324 6212000 5280200 931800 20022785 16454188 3568597 810338 810338 BAD DEBT EXPENSE 20906080 20906080 0 QUALITY ASSURANCE ASSES 6906965 6906965 REPAIRS AND MAINTENANCE 4487962 3352809 1135153 DUES, LICENSES, MEMBERS 572995 124254 448741 BOOKS 546311 80696 465615 242816 242816 384242480 337369648 46872832 0 44202 2813563 53794148 33361631 42750135 58601241 4351101 5507794 1634727 2109145 391948914 212576495 135453022 179372419 103961613 138905178 5156806 82700 11585355 19975761 358731109 440729432 42948460 50321365 119332662 117485475 7625000 79181132 117292643 139646499 287198765 386634471 X 69143892 51222843 2388452 2872118 71532344 54094961 358731109 440729432 X 14523896 -31961279 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 23702 23702 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: A PORTION OF OUR DUES TO MICHIGAN HEALTH AND HOSPITAL ASSOCIATION SUPPORT LOBBING ACTIVITIES. 5641114 5641114 126926464 72095376 54831088 3866627 1905306 1961321 203418376 134433999 68984377 52096333 4141814 47954519 179372419 PROFESSIONAL LIABILITY FUND-CASH, CORPORATE BONDS, AND MUTUAL FUNDS 1389783 F BOND PROCEEDS FOR CAPITAL PROJECTS 29941428 F FUND DESIGNATED FOR FUTURE CAPITAL IMPROVEMENTS 52716748 F FUNDS HELD WITH RESTRICTIONS 317228 F GENERAL INVESTMENTS 50888470 F BOND DEBT SERVICE RESERVE FUND 3619576 F BOND PAYMENT ACCOUNT 31945 F 138905178 COST REPORT SETTLEMENTS PAYABLE 11083052 ACCRUED PENSION COSTS 109390488 ACCRUED POST RETIREMENT BENEFIT 14238368 ACCRUED PROFESSIONAL LIABILITY CLAIMS 3800573 DEFERREC COMPENSATION ANNUITY CONTRACTS 1134018 139646499 398766376 384242480 14523896 -4925013 -27036266 -31961279 -17437383 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION AND SUBSTANTIALLY ALL ITS SUBSIDIARIES ARE NONPROFIT, TAX-EXEMPT ORGANIZATIONS; ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. SOME SUBSIDIARIES ARE FOR-PROFIT CORPORATIONS. INCOME TAX PROVISIONS ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION ADOPTED ACCOUNTING STANDARDS RELATED TO UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, REVIEWED ALL TAX POSITIONS. THE ACCOUNTING STANDARD THAT REFERS TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES IS EFFECTIVE FOR FISCAL YEARS BEGINNING AFTER DECEMBER 15, 2006 FOR NONPUBLIC ENTITIES THAT HOLD PUBLIC DEBT. THE STANDARD ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED ON THE CONSOLIDATED FINANCIAL STATEMENT. COMPANIES MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE STANDARD ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. THE EVALUATED POTENTIAL EXPOSURE RELATED TO UNCERTAIN TAX POSITIONS WAS FOUND TO BE IMMATERIAL. THE CORPORATION IS SUBJECT TO EXAMINATION BY TAXING AUTHORITIES; HOWEVER, NO EXAMINATIONS ARE IN PROGRESS. MANAGEMENT BELIEVES THE CORPORATION IS NOT SUBJECT TO TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2008. PART XI, LINE 8 - OTHER ADJUSTMENTS: MIMIMUM PENSION LIABILITY ADJUSTMENT -26,608,342. UNREALIZED GAIN/LOSS ON INVESTMENT IN SUB -427,924. 1 1 X 1 X 1 X 1 1 1 0 1 1 5681062 4820814 860248 0.00240 49047554 34785100 14262454 0.03930 8691226 1023608 7667618 0.02110 63419842 40629522 22790320 0.06280 110535 1644666 1644666 0.00450 14757331 8693931 6063400 0.01670 4634812 2068188 2566624 0.00710 1474652 1474652 0.00410 250125 348200 348200 0.00100 360660 22859661 10762119 12097542 0.03340 360660 86279503 51391641 34887862 0.09620 1 20983315 6075844 188602186 130521220 58080966 X 0 1 1 MCLAREN REGIONAL MEDICAL CENTER

401 S BALLENGER HIGHWAY FLINT MI 48532

X X X X X REHABILITATIVE & PSYCHIATRIC SERVICES AND DIAGNOSTIC CENTER NA 1 PART I, LINE 3C: INCOME CRITERIA IS BASED ON A 200% FEDERAL POVERTY GUIDELINES PER THE FEDERAL REGISTER. COLLECTIONS MAY BE CONSIDERED IF THE PATIENT HAS SUFFICIENT LIQUID ASSETS. PART I, LINE 6A: OUR PARENT, MCLAREN HEALTH CARE CORPORATION PREPARES AN ANNUAL REPORT OF ITS MEMBER HOSPITAL. THIS ANNUAL REPORT IS AVAILABLE ON OUR WEBSITE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 20906080. PART II: COMMUNITY-BUILDING ACTIVITIES ARE DESIGNED AND IMPLEMENTED BASED ON COMMUNITY NEEDS ASSESSMENTS AND INPUT FROM COMMUNITY-BASED ORGANIZATIONS AND OTHER COMMUNITY STAKEHOLDERS, INCLUDING BUSINESS VENDORS, RELIGIOUS ORGANIZATIONS AND POLITICAL LEADERS. EACH ORGANIZATION DEFINES ANNUAL COMMUNITY-BUILDING AND OUTREACH ACTIVITY PLANS. THESE PLANS ARE DESIGNED TO ADDRESS THE SPECIFIC HEALTH PREVENTION, EDUCATION, DIAGNOSIS, TREATMENT AND FOLLOW-UP CARE REQUIREMENTS OF UNIQUE DISEASE, DEMOGRAPHIC AND GEOGRAPHIC COMMUNITIES IDENTIFIED BY ONGOING NEEDS ASSESSMENTS DESCRIBED ABOVE. PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS FROM CERTAIN PAYORS.WE USED OUR BAD DEBT EXPENSE PER OUR FINANCIAL STATEMENTS AND CONVERTED TO ESTIMATED COST USING OUR OVERALL COST TO CHARGE RATIO. PART III, LINE 9B: AT THIS TIME WE DO NOT HAVE A FORMAL DEBT COLLECTION POLICY BUT WILL BE ATTEMPTING TO DEVELOP A FORMAL POLICY. CURRENTLY OUR PROCESS INCLUDES SELF AND PRIVATE PAY PATIENT ACTIVITY ARE SENT TO A VENDOR FOR ASSISTANCE. SELF PAY PATIENTS REQUESTING FINANCIAL ASSISTANCE AT REGISTRATION ARE GIVEN A FINANICAL ASSISTANCE APPLICATION WHICH IS EVALUATED TO DETERMINE IF CHARITY CARE IS APPLICABLE AND AN ATTEMPT IS ALSO MADE TO ASSIST PATIENTS FOR MEDICAL ELIGIBILITY. PART VI, LINE 2: PRIMARY AND SECONDARY MARKET RESEARCH IS CONDUCTED BY AND THROUGH COMMUNITY-BASED HEALTH COALITIONS, ACADEMIC INSTITUTIONS, THIRD PARTY DATA ANALYTICS ORGANIZATIONS, HEALTH NEEDS ASSESSMENTS AND SURVEYS, HISTORIC HEALTH SERVICES UTILIZATION PATTERNS, DEMOGRAPHIC ANALYSIS AND POPULATION-BASED HEALTH CARE SERVICES UTILIZATION FORECASTS. PART VI, LINE 3: AVAILABILITY OF FINANCIAL ASSISTANCE INFORMATION AND EDUCATION IS PROVIDED AT ALL INPATIENT AND OUTPATIENT REGISTRATION POINTS-OF-SERVICE. INFORMATION AND EDUCATION IS ALSO AVAILABLE THROUGH THE ORGANIZATIONS WEBSITE(S). FINANCIAL AND APPLICATION FORMS ARE AVAILABLE AT ALL INPATIENT AND OUTPATIENT POINTS-OF-SERVICE, INCLUDING PROVIDING ASSISTANCE IN COMPLETING THE APPLICATION. ORGANIZATION AND ITS SUBSIDIARIES/AFFILIATES ALSO PROVIDE SPECIALLY-TRAINED COUNSELORS TO ASSIST PATIENTS AND REVIEW ELIGIBILITY FOR FEDERAL, STATE AND OTHER GOVERNMENT PROGRAMS, INCLUDING, BUT NOT LIMITED TO, MEDICAID, DISABILITY, SOCIAL SECURITY, AND ANY OTHER FORMS OF THIRD PARTY PAYMENT. PART VI, LINE 4: THE SERVICE AREA OF MCLAREN REGIONAL MEDICAL CENTER IS COMPOSED OF 32 ZIP CODES AND IS CENTERED PRINCIPALLY ON THE CITY OF FLINT, MI IN THE COUNTY OF GENESEE. THE PRIMARY SERVICE AREA, ACCOUNTING FOR 93% OF ANNUAL INPATIENT DISCHARGES, IS COMPOSED OF 21 ZIP CODES AND CAN BE CHARACTERIZED AS LARGELY URBAN IN NATURE. THE SECONDARY SERVICE AREA, ACCOUNTING FOR 7% OF ANNUAL INPATIENT DISCHARGES, IS COMPOSED OF 11 ZIP CODES AND CAN BE CHARACTERIZED AS LARGELY URBAN IN NATURE. PRIMARY SERVICE AREA DEMOGRAPHIC DISTRIBUTIONSAGE DISTRIBUTION0 - 14 20.2%15 - 17 4.4%18 - 24 8.7%25 - 34 12.2%35 - 54 28.1%55 - 64 12.5%65+ 13.9%EDUCATION LEVELLESS THAN HIGH SCHOOL 3.2%SOME HIGH SCHOOL 9.0%HIGH SCHOOL DEGREE 33.9%SOME COLLEGE/ASSOC. DEGREE 34.7%BACHELORS DEGREE OR GREATER 19.1%HOUSEHOLD INCOME DISTRIBUTION<$15K 15.5%$15 - 25K 13.1%$25 - 50K 28.1%$50 - 75K 20.1%$75 - 100K 11.5%OVER $100K 11.8%RACE/ETHNICITYWHITE NON-HISPANIC 75.1%BLACK NON-HISPANIC 18.4%HISPANIC 2.6%ASIAN & PACIFIC IS. NON-HISPANIC 1.0%ALL OTHERS 2.8% PART VI, LINE 6: THE PARENT ORGANIZATION AND EACH OF ITS SUBSIDIARY/AFFILIATE MEMBERS MAINTAIN A LOCAL COMMUNITY-BASED BOARD WITH POWERS, RESPONSIBILITIES AND ACCOUNTABILITIES FOR THE OVERSIGHT OF THE OPERATION OF THEIR RESPECTIVE ORGANIZATIONS. EACH SUBSIDIARY/AFFILIATE ORGANIZATION MAINTAINS AN OPEN MEDICAL STAFF ALLOWING ANY PHYSICIAN OR OTHER CARE PROVIDER WITH PROPER CREDENTIALS TO JOIN THE STAFF AND PROVIDE APPROVED CARE. THE ORGANIZATION FUNDS AND MAINTAINS OVER 500 MEDICAL RESIDENCY AND FELLOWSHIP PROGRAMS TO TRAIN FUTURE GENERATIONS OF PHYSICIANS; ORGANIZATION FUNDS, OPERATES AND MAINTAINS NUMEROUS HEALTH CARE EDUCATION PROGRAMS AT THE HIGH SCHOOL, COMMUNITY COLLEGE, UNIVERSITY AND POST-GRADUATE LEVELS OF EDUCATION. ORGANIZATION PROVIDES SPONSORSHIP (FINANCIAL AND IN-KIND RESOURCES) SUPPORT TO COMMUNITY-LEVEL ACTIVITIES (HEALTH WALKS AND RACES, FITNESS TRAINING, DISEASE AWARENESS EVENTS, CULTURAL EVENTS AND OTHER HEALTH-RELATED NON-PROFIT ACTIVITIES, EVENTS AND ORGANIZATIONS). ORGANIZATION ALSO DIRECTS, FUNDS, SUPPORTS AND PARTICIPATES IN FUNDRAISING ACTIVITIES THAT SUPPORT HEALTH PREVENTION/EDUCATION, DIAGNOSIS AND TREATMENT PROVIDED BY OTHER NON-PROFIT COMMUNITY ORGANIZATIONS. PART VI, LINE 7: THE ROLE OF THE PARENT ORGANIZATION IS TO SET THE VISION AND STRATEGIC DIRECTION FOR THE ORGANIZATION AS A WHOLE. THIS INCLUDES THE DEVELOPMENT OF THE ANNUAL STRATEGIC PLAN WHICH DEFINES THE STRATEGIC PRIORITIES FOR THE ORGANIZATION AND ITS MEMBERS, THE METRICS TO BE MEASURED FOR EACH STRATEGIC PROGRAMS AND THE BENCHMARK OR TARGET/GOALS FOR EACH METRIC. STRATEGIC PRIORITIES DIRECTLY ADDRESS AND MEASURE (AT A SUBSIDIARY LEVEL) CLINICAL QUALITY AND CLINICAL OUTCOMES; PATIENT, PHYSICIAN, EMPLOYEE AND COMMUNITY SATISFACTION WITH THE ORGANIZATION AND ITS SUBSIDIARY/AFFILIATE MEMBERS; AND DEVELOPMENT OF NEW SERVICES TO IMPROVE ACCESS TO, QUALITY OF, AND COST OF HEALTH SERVICES.THE ROLE OF THE ORGANIZATION'S SUBSIDIARIES/AFFILIATES IS THE DEVELOPMENT AND IMPLEMENTATION OF ANNUAL STRATEGIC AND OPERATIONAL PLANS THAT SUPPORT AND ADVANCE THE STRATEGIC PLAN OF THE PARENT ORGANIZATION. ALL LOCAL PLANS ARE DEVELOPED AND DESIGNED TO REFLECT THE UNIQUE POPULATION-BASED HEALTH CARE NEEDS AND REQUIREMENTS OF THE COMMUNITIES SERVED BY THE SUBSIDIARY/AFFILIATE ORGANIZATION.ALL LOCAL SUBSIDIARIES/AFFILIATES HAVE FULL AUTHORITY AND DECISION-MAKING POWERS TO DEFINE AND EXECUTE THE STRATEGIC AND OPERATIONAL PLANS INTENDED TO IMPROVE THE HEALTH AND WELFARE OF THE COMMUNITIES THEY SERVE. REPORTS FILED WITH STATES PART VI, LINE 7 MI 1 MCLAREN HEALTH CARE CORPORATION 401 S BALLENGER HWY FLINT MI 48532 382397643 501(C)(3) 1614688 PROGRAM SUPPORT MCLAREN MEDICAL MANAGMENT INC 401 S BALLENGER HWY FLINT MI 48532 382988086 501(C)(3) 1237675 PROGRAM SUPPORT 2 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS ARE PROVIDED TO RELATED ORGANIZATIONS THAT SUPPORT THE MISSION OF MCLAREN REGIONAL MEDICAL CENTER. 0 1 0 0 0 0 0 0 0 PHILIP INCARNATI 0 1314422 0 1231316 0 3020237 0 612326 0 7542 0 6185843 0 0 DAVID MAZURKIEWICZ 0 472316 0 0 0 46011 0 72434 0 15622 0 606383 0 0 DON KOOY 511358 0 148750 0 233720 0 234561 0 20379 0 1148768 0 0 0 RICK WYLES 219432 0 28253 0 0 0 30000 0 19800 0 297485 0 0 0 SUSAN SMITH 297197 0 0 0 0 0 30000 0 13807 0 341004 0 0 0 CARLOS PETROZZI 285003 0 0 0 0 0 30000 0 3012 0 318015 0 0 0 MUSTAFA ALNOUNOU 449533 0 0 0 0 0 0 0 13242 0 462775 0 0 0 JEFFREY MITCHELL 279389 0 0 0 0 0 0 0 11500 0 290889 0 0 0 PRAJESH PATEL 277698 0 0 0 0 0 12250 0 12500 0 302448 0 0 0 DENNIS KRZEMINSKI 0 243000 0 0 0 457599 0 0 0 1530 0 702129 0 0 PART I, LINE 1A THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 1 BOXES HAVE BEEN CHECKED. THE CORPORATE CEO, SUBSIDIARY CEO'S AND CORPORATE VICE-PRESIDENTS IN SOME INSTANCES HAVE RECEIVED TAX INDEMNIFICATION FOR THE FOLLOWING BENEFITS: VEHICLE COSTS, GROUP TERM LIFE INSURANCE, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS, AND HEALTH CLUB OR SOCIAL DUES. THESE BENEFITS HAVE BEEN INCLUDED IN TAXABLE COMPENSATION. THE FOLLOWING INDIVIDUALS HAVE RECEIVED THESE BENEFITS: DON KOOY, PHIL INCARNATI, AND DAVE MAZURKIEWICZ. PART I, LINE 4B MCLAREN MAINTAINS TWO SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES (THE "SERPS"). THE OLD SERP WAS CLOSED TO NEW PARTICIPANTS ON OCTOBER 1, 2006, AND THE NEW SERP BECAME EFFECTIVE AS OF JANUARY 1, 2007. NO EMPLOYEE MAY PARTICIPATE IN BOTH OF THE SERPS. THE OLD SERP IS STRUCTURED AS A DEFINED BENEFIT PLAN THAT ESSENTIALLY REPLACES THE BENEFITS THE PARTICIPANT IS NOT PERMITTED TO RECEIVE UNDER MCLAREN'S QUALIFIED RETIREMENT PLAN DUE TO IRS LIMITATIONS APPLICABLE TO QUALIFIED PLANS. THE BENEFIT UNDER THE OLD SERP IS PAYABLE IN EITHER THE FORM OF A SINGLE SUM DISTRIBUTION OR IN MONTHLY PAYMENTS EQUAL TO THE ACTUARIAL EQUIVALENT OF THE PARTICIPANT'S ACCRUED BENEFIT. THE BENEFIT IS PAID AT AGE 55, AND IF THE PARTICIPANT REMAINS EMPLOYED, THE BENEFIT IS PAID UPON TERMINATION OF EMPLOYMENT, REDUCED TO TAKE INTO ACCOUNT THE BENEFIT PREVIOUSLY PAID. THE NEW SERP IS STRUCTURED AS A DEFINED CONTRIBUTION PLAN, AND MCLAREN CONTRIBUTES 15 PERCENT OF EACH PARTICIPANT'S COMPENSATION TO THE PLAN EACH YEAR FOR ALLOCATION TO THE PARTICIPANT'S ACCOUNT. PARTICIPANTS IN THE NEW SERP BECOME VESTED IN THEIR ACCOUNTS UPON THE EARLIER OF FIVE YEARS OF PARTICIPATION IN THE PLAN OR ATTAINMENT OF AGE 60. PARTICIPANTS IN THE NEW SERP SELF-DIRECT THE INVESTMENT OF THEIR ACCOUNTS AND HAVE THE ACTUAL INVESTMENT RETURN CREDITED OR DEBITED TO THEIR ACCOUNTS. THE BENEFIT UNDER THE NEW SERP IS EQUAL TO THE PARTICIPANT'S ACCOUNT BALANCE, AND THE BENEFIT IS PAID IN A SINGLE SUM WITHIN 60 DAYS OF THE PARTICIPANT'S TERMINATION DATE. BENEFITS UNDER BOTH SERPS ARE PROVIDED ON A TAX-NEUTRAL BASIS. BOTH SERPS ARE DESIGNED TO COMPLY WITH INTERNAL REVENUE CODE SECTIONS 457(F) AND 409A. THE INDIVIDUALS LISTED IN PART VII WHO PARTICIPATED IN THE OLD SERP ARE PHILIP INCARNATI AND DONALD KOOY. THE INDIVIDUAL LISTED IN PART VII WHO PARTICIPATED IN THE NEW SERP IS DAVID MAZURKIEWICZ. PART I, LINE 6 MCLAREN HEALTH CARE CORPORATION (MHCC) HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION, SUBSIDIARY EXECUTIVES AND DIRECTORS, AND CORPORATE MANAGERS. THE PURPOSE OF THE PLAN IS TO ENHANCE THE ORGANIZATION'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING TOP OFFICIALS AND THE BOARD OF DIRECTORS WITH A TOOL FOR (A) CLEARLY COMMUNICATING PERFORMANCE ON THE PART OF KEY LEADERS, (B) STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE ON THE PART OF KEY LEADERS WHICH WILL ULTIMATELY BENEFIT THE COMMUNITIES MHCC SERVES, AND (C) PROTECTING MHCC'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH-TALENT LEADERS. SUPPLEMENTAL INFORMATION PART III SCHEDULE J, PART I, LINE 3: THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 3 BOXES HAVE BEEN CHECKED. THE RELATED ORGANIZATION USED THE FOLLOWING METHODOLOGIES TO ESTABLISH THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ANTHELIO (PREVIOUSLY PHNS) PHILIP INCARNATI, BOARD MEMBER AND SHAREHOLDER OF ANTHELIO 3963025 MHCC IS THE CO-FOUNDER AND HAS A MINORITY INTEREST IN ANTHELIO (PREVIOUSLY PHNS). AS PART OF THE AGREEMENT MHCC IS ENTITLED TO APPOINT TWO DIRECTORS TO THE ANTHELIO BOARD. MHCC APPOINTED JAMES FITZGERALD AND PHILIP INCARNATI TO HOLD THOSE POSITIONS. FEES PAID TO ANTHELIO FOR INFORMATION TECHNOLOGY SERVICES, MEDICAL RECORDS, TRANSCRIPTION, CODING, AND SYSTEM INSTALLATION. 0 PROTOM INTERNATIONAL PHILIP INCARNATI, BOARD MEMBER OF PROTOM INTERNATIONAL 11106451 SERVICES AND EQUIPMENT WERE PROVIDED FOR THE PROTON BEAM PROJECT. 0 FORM 990, PART VI, SECTION A, LINE 2 PHILIP INCARNATI AND DONALD KOOY HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS ORGANIZATION IS MCLAREN HEALTH CARE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER SHALL HAVE THE EXCLUSIVE RIGHT TO ELECT OR APPOINT THE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS BY THE GOVERNING BODY ARE SUBJECT TO THE POWERS OF THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 DATA IS PREPARED INTERNALLY AND SUBMITTED TO OUR AUDITING FIRM FOR RETURN PREPARATION. ONCE THE RETURNS HAVE BEEN COMPLETED, THE FORMS ARE REVIEWED BY THE CORPORATE DIRECTOR OF BUDGET, THE CORPORATE SENIOR VICE PRESIDENT AND CFO OF MCLAREN HEALTH CARE CORPORATION (MHCC). COPIES OF THE RETURNS ARE MADE AVAILABLE TO THE MHCC BOARD MEMBERS, WHO SERVE AS THE OVERALL GOVERNING BOARD. RETURNS ARE AVAILABLE FOR ALL CORPORATIONS OF WHICH MHCC IS THE SOLE MEMBER AS WELL AS OTHER RELATED ENTITIES OF THOSE CORPORATIONS FOR REVIEW RATHER THAN HAVING THE LOCAL BOARDS REVIEW THE RETURNS. THE BOARD OF MHCC IS THE ULTIMATE ACCOUNTABLE ORGANIZATION FOR THE SYSTEM; AS SUCH IT IS THE OVERALL GOVERNING BOARD OF OUR SYSTEM WHOSE RESPONSIBILITIES INCLUDES BUT ARE NOT LIMITED TO: APPROVING ALL SUBSIDIARY BOARD MEMBERS, FINANCIAL BUDGETS, AND ISSUANCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE MCLAREN HEALTH CARE (MHC) BOARD CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL MHC CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT, THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES, AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE MHC GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. CONFLICTS ARE DISCLOSED TO THE FULL BOARD AND BOARD COMMITTEES SO APPROPRIATE ACTIONS CAN BE TAKEN. ACTIONS MAY INCLUDE PROHIBITING A BOARD MEMBER FROM PARTICIPATING IN DELIBERATIONS INVOLVING TRANSACTIONS WITH A COMPANY WITH WHICH THEY CONDUCT FINANCIAL TRANSACTIONS; BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE ASKED TO RESIGN. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF MCLAREN HEALTH CARE CORPORATION BASED UPON THE PERFORMANCE OF THE CEO. THE COMPENSATION OF THE CEO IS WITHIN THE SALARY RANGES DETERMINED BY THE COMPENSATION COMMITTEE OF MCLAREN HEALTH CARE CORPORATION. THE PROCESS OF THE COMPENSATION COMMITTEE IS AS FOLLOWS: THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS TO REVIEW THE PERFORMANCE AND RECOMMEND THE TOTAL COMPENSATION PACKAGE OF MCLAREN HEALTH CARE CORPORATION'S CEO TO THE BOARD. FURTHER THE COMMITTEE ESTABLISHES THE SALARY RANGES AND PREREQUISITES OF THE CORPORATION'S OTHER MOST HIGHLY COMPENSATED OFFICERS (MHC VICE-PRESIDENTS AND MHC HOSPITAL/SUBSIDIARIES CEO'S) TO THE BOARD. THE MEMBERS OF THE COMMITTEE MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE APPLICABLE PROVISIONS OF SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND FINAL TREASURY REGULATIONS SECTION 53.4956-6(C)(1)(III). THE COMMITTEE RETAINS THE SERVICES OF AN INDEPENDENT FIRM WITH SIGNIFICANT QUALIFICATIONS AND EXPERIENCE TO CONDUCT A REVIEW OF THE CORPORATION'S EXECUTIVE COMPENSATION PROGRAM. THE RETAINED FIRM UTILIZES APPROPRIATE COMPENSATION COMPARABILITY DATA. THE RETAINED FIRM CONDUCTS ANALYSIS OF THE COMPETITIVENESS OF THESE PROGRAMS AND EXPRESSES AN OPINION AS TO THE REASONABLENESS OF THESE COMPENSATION PROGRAMS. ALL DATA UTILIZED BY THE COMMITTEE, DELIBERATIONS OF THE COMMITTEE, AND FINAL COMPENSATION DECISIONS BY THE COMMITTEE ARE DOCUMENTED IN FORMAL REPORTS AND MINUTES. THE CORPORATE COMPENSATION COMMITTEE WORKS UNDER AND PERIODICALLY RENEWS THE MCLAREN HEALTH CARE CORPORATION COMPENSATION COMMITTEE CHARTER AND MCLAREN HEALTH CARE CORPORATION COMPENSATION PHILOSOPHY. FOR SUBSIDIARY VICE PRESIDENTS AND DIRECTORS, THE CORPORATE HUMAN RESOURCES COMMITTEE COORDINATES THE GATHERING OF MARKET INFORMATION FROM A NUMBER OF INDEPENDENT SOURCES. THIS DATA IS ANALYZED ALONG WITH EXPECTED BUDGETARY GUIDELINES. THE CORPORATE VICE PRESIDENT OF HUMAN RESOURCES DETERMINES THE AMOUNT, IF ANY, THAT PAY RANGES INCREASE. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS 2011. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A: THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO A RELATED ORGANIZATION FOR WHICH COMPENSATION IS REPORTED IN COLUMNS E & F: DAVID MAZURKIEWICZ 40 HOURS MCLAREN HEALTH CARE CORPORATION PHILIP INCARNATI 40 HOURS MCLAREN HEALTH CARE CORPORATION CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -4,925,013. MIMIMUM PENSION LIABILITY ADJUSTMENT -26,608,342. UNREALIZED GAIN/LOSS ON INVESTMENT IN SUB -427,924. TOTAL TO FORM 990, PART XI, LINE 5: -31,961,279. FORM 990, PART XI, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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