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        <ProgramServicesAmt>780660</ProgramServicesAmt>
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      <OtherExpensesGrp>
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      <FSAuditedInd>true</FSAuditedInd>
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        <ContributorUSAddress>
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        <TotalExpensePct>0.0000</TotalExpensePct>
      </WorkforceDevelopmentGrp>
      <TotalCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>3</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>90</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>1989</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>1989</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0001</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>887835</BadDebtExpenseAmt>
      <ReimbursedByMedicareAmt>5181793</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>5270136</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-88343</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>MCKENZIE HEALTH SYSTEM</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>120 DELAWARE STREET</AddressLine1Txt>
          <CityNm>SANDUSKY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48471</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>WWW.MCKENZIEHEALTH.ORG</WebsiteAddressTxt>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>MCKENZIE HEALTH SYSTEM</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>false</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>21</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>true</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>WWW.MCKENZIEHEALTH.ORG</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>21</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>HTTPS://WWW.MCKENZIEHEALTH.ORG/DOCUMENTS/46490_MKHS</StrategyWebsiteURLTxt>
        <StrategyAttachedInd>false</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>250.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>WWW.MCKENZIEHEALTH.ORG</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>WWW.MCKENZIEHEALTH.O</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>WWW.MCKENZIEH</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>5</FormAndLineReferenceDesc>
        <ExplanationTxt>STAKEHOLDERS WERE DEFINED AS AGENCY &amp; COMMUNINTY LEADERS THAT HAVE A WIDE</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>5</FormAndLineReferenceDesc>
        <ExplanationTxt>KNOWLEDGE BASE OF THE REGION, INCLUDING HUMAN SERVICES AGENCIES, BEHAVIOR</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>5</FormAndLineReferenceDesc>
        <ExplanationTxt>HEALTH AGENCIES, GREAT START COLLAB., EDUCATION, GOV'T, LAW ENFORCEMENT,</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>5</FormAndLineReferenceDesc>
        <ExplanationTxt>AND MSU EXTENSION. 2,519 SURVEY PARTICIPANTS FROM 4 COUNTIES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>6B</FormAndLineReferenceDesc>
        <ExplanationTxt>MICHIGAN THUMB PUBLIC HEALTH ALLIANCE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMITTIES ADDRESS SIGNIFICANT NEEDS INDENTIFED BY THE CHNA, INCLUDING;</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>BEHAVIORAL HEALTH, CHRONIC DISEASE, SOCIAL HEALTH DETERMINATES, AWARENESS</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>OF SERVICES, ACCESS TO SPECIALISTS, TELE-HEALTH SERVICES, IN-HOME CARE,</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSPORTATION, FINANCIAL ASSISTENCE &amp; HEALTH INSURANCE, PRENATAL CARE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>MHS IS EXPLORING INTEGRATING BEHAVIOR HEALTH WITH PRIMARY CARE, CONSULTING</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>ER PATIENTS WITH SOCIAL WORK &amp; TELE-PSYCH PROVIDERS, AND IMPLEMENTING</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COLLABORATIVE CARE MODEL. MHS WILL GROW CHRONIC CARE MGMT PROGRAM AND</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>INCREASE DIETITIAN SERVICES AND EDUCATION AT PRIMARY CARE OFFICES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>MHS WILL CONTINUE TO USE COMMUNITY PARAMEDICINE TO INCREASE ACCESS TO CARE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>MHS CONTINUES TO ASSIST INDIVIDUALS IN REDUCING COST BARRIERS TO ACCESSING</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>CARE, INCLUDING NAVIGATOR GRANT PROGRAM, AND WORK WITH COMMUNITY PARTNERS</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>TO IDENTIFY STRATEGIES TO IMPROVE ACCESS TO TIMELY PRENATAL CARE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>MHS WILL CONTINUE TO WORK WITH COMMUNITY PARTNERS TO EDUCATE THE PUBLIC</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>ABOUT HEALTH NEEDS &amp; SERVICES AVAILABLE; INCLUDING TELE-HEALTH SERVICES &amp;</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>SPECIALIST SERVICES. MHS WILL ALSO EVALUATE AND MAKE IMPROVEMENTS AS NEEDED</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>TO SCREENING &amp; REFERRAL PRACTICES FOR SOCIAL DETERMINANTS OF HEALTH NEEDS,</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>INVESTIGATE HOW LOCAL WHEELCHAIR TRANSPORTATION IS ACCESSABLE IN &amp; OUT OF</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>COUNTY, &amp; UTILIZE BEST PRACTICE TO MEET PATIENTS WHERE THEY ARE.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>38-1738615</FormAndLineReferenceDesc>
        <ExplanationTxt>5</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>9</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE HEALTH &amp; WELLNESS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>170 W ARGYLE STREET</AddressLine1Txt>
            <CityNm>SANDUSKY</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE RURAL HEALTH CLIN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>75 DAWSON STREET</AddressLine1Txt>
            <CityNm>SANDUSKY</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE FAMILY HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>109 N DELAWARE STREET</AddressLine1Txt>
            <CityNm>SANDUSKY</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>LAKESHORE INTERNAL MEDICIN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7307 CHERRY STREET</AddressLine1Txt>
            <CityNm>PORT SANILAC</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48469</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>CROSWELL CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>8 N HOWARD</AddressLine1Txt>
            <CityNm>CROSWELL</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48422</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PECK MEDICAL CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>251 E PECK ROAD</AddressLine1Txt>
            <CityNm>PECK</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48466</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE AFTER HOURS CLINI</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>120 DELAWARE STREET</AddressLine1Txt>
            <CityNm>SANDUSKY</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE ORTHOPEDICS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>100 W ARGYLE STREET</AddressLine1Txt>
            <CityNm>SANDUSKY</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE/RENTAL</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE GI CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>115 DELAWARE STREET</AddressLine1Txt>
            <CityNm>SANDUSKY</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>SCH H WORKSHEETS WERE USED TO PREPARE THE COST TO CHARGE RATIO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II</FormAndLineReferenceDesc>
        <ExplanationTxt>MHS PROMOTED COMMUNITY HEALTH THROUGH SENIOR FAIR, SCHOOL TOURS, COUNTY 4-H</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II</FormAndLineReferenceDesc>
        <ExplanationTxt>TOWN HALLS, VIRTUAL HEALTHY LIVING EVENTS, CAREER FAIRS, ETC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBTS ARE ESTIMATED BY ALLOWANCE METHOD &amp; AUDITED INDEPENDENTLY ANNUALY</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>NET OF DISCOUNTS/PAYMENTS REC'D ON ACCT POST BAD DEBT DETERMINATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE ATTACHED AUDITED FINANCIAL STATEMENTS, PAGE 10' NOTE 1.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>MHS IS A CRITICAL ACCESS HOSPITAL UNDER MEDICARE REG, COST BASED REIMBURSED</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SHORTFALL OF $88,343 CONSISTS OF 2% SEQUESTRATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICARE COST REPORT DATA WAS USED TO CALCULATE THESE FIGURES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III LINE 9B</FormAndLineReferenceDesc>
        <ExplanationTxt>COLLECTION POLICY REFERENCES THE FAP FOR THOSE PATIENTS THAT ARE ELIGABLE</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III LINE 9B</FormAndLineReferenceDesc>
        <ExplanationTxt>FOR ASSISTENCE AS A METHOD OF PAYMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>CNHA DESCRIBES HOW IDENTIFIED NEEDS WERE PRIORITIZED &amp; STRATEGIES WERE IMP-</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>LEMENTED. MHS ALSO MONITORS QUALITY SCORES &amp; PATIENT SURVEYS, LEADERSHIP</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>IS IN CONTACT IWTH COMMUNITY HEALTHCARE AGENCIES &amp; ACCESSES FINDINGS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>THROUGH COLLABORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-3</FormAndLineReferenceDesc>
        <ExplanationTxt>UNISURED PATIENTS RECEIVE A FINANCIAL POLICY BROCURE MHS DIR HUMAN SERVICES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-3</FormAndLineReferenceDesc>
        <ExplanationTxt>FOLLOWS UP TO ASSIST IN APPLICATIONS FOR MEDICARE, MEDICAID, &amp; FAP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-3</FormAndLineReferenceDesc>
        <ExplanationTxt>THIS INFO IS ALSO LOCATED IN BROCHURE, WEBSITE, PATIENT STATEMENT, HOSPITAL</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-3</FormAndLineReferenceDesc>
        <ExplanationTxt>LOBBY, ER, &amp; PATIENT FINANCIAL SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-4</FormAndLineReferenceDesc>
        <ExplanationTxt>MHS IS A CAH IN SANILAC COUNTY, MI. POPULATION 40,747, OVER 1,600 SQ MILES</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-4</FormAndLineReferenceDesc>
        <ExplanationTxt>90% RURAL, 11% OF ADULTS ARE UNINSURED, UNEMPLOYMENT RATE IS 6%,</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-4</FormAndLineReferenceDesc>
        <ExplanationTxt>AND 26% OF CHILDREN UNDER AGE 6 LIVE IN A HOME WITH INCOME BELOW POVERTY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI-5</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNED BY BOD, SERV., GERIATRICS, IMMUNIZATION, PHYSICALS, ECT.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
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      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
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      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LARRY MITCHELL</PersonNm>
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        <PersonNm>STEVE BARNETT</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES SAMS</PersonNm>
        <TitleTxt>CHIEF OF STAFF</TitleTxt>
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        <PersonNm>AMY RUEDISUELI</PersonNm>
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        <PersonNm>BILLI JO HENNIKA</PersonNm>
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        <PersonNm>GINA PATTERSON</PersonNm>
        <TitleTxt>DIRECTOR PHARMACY</TitleTxt>
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        <TotalCompensationFilingOrgAmt>183397</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>23276</TotalCompensationRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES KOSIUR</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK ENGLISH</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRANDON GUIBORD</PersonNm>
        <TitleTxt>SECRETARYTREASURER</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAY SMITH</PersonNm>
        <TitleTxt>DIAGNOSTIC DIRECTOR</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>6170</DeferredCompensationFlngOrgAmt>
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        <TotalCompensationFilingOrgAmt>172787</TotalCompensationFilingOrgAmt>
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      <LoansBtwnOrgInterestedPrsnGrp>
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      <LoansBtwnOrgInterestedPrsnGrp>
        <DefaultInd>false</DefaultInd>
        <BoardOrCommitteeApprovalInd>false</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>false</WrittenAgreementInd>
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        <NameOfInterested>
          <PersonNm>BARNETT ANESTHESIA</PersonNm>
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        <TransactionDesc>CRNA SERVICES</TransactionDesc>
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      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>BOD ARE PROVIDED A FULL COPY OF 990 AS WELL AS A RECONCILIATION TO</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>AUDITED FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL DOCUMENTS ARE AVAILABLE FOR REVIEW BY REQUEST AT THE REQUEST</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AT THE CEO'S OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>CLASSES OF MEMBERS MAKE UP THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS MUST BE APPROVED BY THE BOARD OF MCKENZIE HEALTHCARE CORP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>MCKENZIE HEALTHCARE CORP APPROVE FINANCIAL TRANSACTIONS OVER $1 MILLION</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIOR TO THOSE TRANSACTIONS BEING TAKEN TO MHS BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD AND COMMITTEE MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>OF INTEREST POLICY &amp; ABSTAIN FROM ANY CONFLICTING VOTE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION IS APPROVED BY THE FULL MHS BOARD, BASED ON RECOMMENDATIONS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>AND RECENT COMPENSATION SURVEYS.</ExplanationTxt>
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          <StateAbbreviationCd>MI</StateAbbreviationCd>
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          <StateAbbreviationCd>MI</StateAbbreviationCd>
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        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
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          <AddressLine1Txt>78 S ELK STREET</AddressLine1Txt>
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        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
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