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      <ReconcilationRevenueExpnssAmt>-334429</ReconcilationRevenueExpnssAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>1</AccountantCompileOrReviewInd>
      <AcctCompileOrReviewBasisGrp>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
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      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part III, Line 12</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICAL RECORDS - 2018 AMOUNT: $468; 2019 AMOUNT: $85; 2020 AMOUNT: $0; 2021 AMOUNT: $11; 2022 AMOUNT: $ | GOLF OUTING - 2021 AMOUNT: $16,858; 2022 AMOUNT: $24,121 | MERCHANDISE - 2021 AMOUNT: $674; 2022 AMOUNT: $627</ExplanationTxt>
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          <State>RESTRICTED</State>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Members of the corporation shall consist of Bronson Methodist Hospital and Borgess Ascension</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Both Bronson Methodist Hospital and Borgess Ascension appoint their respective three board members</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The 990 is prepared and initially reviewed by the Accounting department, reviewed by the Management team, then made available to the Board prior to filing. Final Review and approval from the Board is set to be completed shortly after the filing deadline during the next Board meeting if not discussed before filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Board members are provided the conflict of interest questionnaire prior to the 3rd quarter Board meeting (calendar year) and required to complete and submit it at the meeting to be kept on record with the meeting records. Compliance is monitored by the Compliance Officer. Any Board member found to have a conflict of interest shall not participate in discussion or vote in the matter.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation is discussed as part of the budget approval process every May and discussions are documented in the May Board minutes. When compensation changes are made, compensation data from surveys collected by the Managed Service Organization (MSO) Human Resources Department is collected. The data is used by the MSO Human Resource Director and designated Board member who formally approve the annual compensation of the top management officials. The MSO Human Resource Director and Program Director determine all other compensation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Documents that are required to be made available for public inspection will be provided upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>FIXED EXPENSES - AVIATION: 1,712,455 | VARIABLE EXPENSES - AVIATION: 528,175 | AIRCRAFT LEASE: 79 | CONTRACTED SERVICES: 112,222 | AMORTIZATION EXPENSE: 771,225 | EQUIPMENT RENTAL: 1,138</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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</Return>
