<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2022v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-05-13T15:18:45-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>381357951</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>PLANTE &amp; MORAN PLLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>10 S RIVERSIDE PLAZA 9TH FLOOR</AddressLine1Txt>
        <CityNm>CHICAGO</CityNm>
        <StateAbbreviationCd>IL</StateAbbreviationCd>
        <ZIPCd>60606</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>381458751</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MICHIGAN HEALTH &amp; HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>D/B/A MHA</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>MICH</BusinessNameControlTxt>
      <PhoneNum>5178868254</PhoneNum>
      <USAddress>
        <AddressLine1Txt>2112 UNIVERSITY PARK DRIVE</AddressLine1Txt>
        <CityNm>OKEMOS</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48864</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>SCOTT PILLION</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>5178868254</PhoneNum>
      <SignatureDt>2024-05-13</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>SCOTT</PersonFirstNm>
        <PersonLastNm>PILLION</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>DAVID LOWENTHAL</PreparerPersonNm>
      <PTIN>P00378651</PTIN>
      <PhoneNum>3122071040</PhoneNum>
      <PreparationDt>2024-05-13</PreparationDt>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>MHA</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>BRIAN PETERS</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>2112 UNIVERSITY PARK DRIVE</AddressLine1Txt>
        <CityNm>OKEMOS</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48864</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>214016762</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501cInd organization501cTypeTxt="6">X</Organization501cInd>
      <WebsiteAddressTxt>WWW.MHA.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationAssocInd>X</TypeOfOrganizationAssocInd>
      <FormationYr>1919</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROMOTE THE INTERESTS OF THE HEALTH CARE INDUSTRY.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>20</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>19</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>65</TotalEmployeeCnt>
      <TotalVolunteersCnt>19</TotalVolunteersCnt>
      <TotalGrossUBIAmt>352597</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>86970989</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>192197454</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>20568148</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>20693941</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>239335</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>814052</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>107778472</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>213705447</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>86361059</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>192912484</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>11949501</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>16978689</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>5932749</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>7130548</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>104243309</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>217021721</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>3535163</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-3316274</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>61401145</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>85656318</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>40309369</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>67823927</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>21091776</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>17832391</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>WE ADVANCE THE HEALTH OF INDIVIDUALS AND COMMUNITIES.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <Desc>THE ASSOCIATION PROMOTES THE INTERESTS OF THE HEALTHCARE INDUSTRY FOR ITS MEMBERS, WHICH CONSIST OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF MICHIGAN. IN ADDITION, THE ASSOCIATION HAS FOUR DESIGNATED FUNDS: THE MICHIGAN HOSPITAL ASSOCIATION PUBLIC POLICY INITIATIVE FUND, WHICH IS PRIMARILY FOCUSED ON HEALTHCARE REFORM AND RELATED POLICY ISSUES; MHA COLLABORATIVE HOSPITAL ASSISTANCE PROGRAM (CHAP), WHICH INVOLVES THE VOLUNTARY CONTRIBUTION BY HOSPITALS OF FUNDS WHICH ARE REDISTRIBUTED TO HOSPITALS AS A RESULT OF THE MEDICAID QUALITY ASSURANCE ASSESSMENT PROGRAM (QAAP).</Desc>
      <DescribedInSection501c3Ind>0</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039500001">1</PoliticalCampaignActyInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039500001">1</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>29</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>65</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>1</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>1</Form990TFiledInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>1</NondeductibleContributionsInd>
      <NondeductibleContriDisclInd>1</NondeductibleContriDisclInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>1</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>20</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>19</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>0</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>SCOTT PILLION CFO</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5173233443</PhoneNum>
        <USAddress>
          <AddressLine1Txt>2112 UNIVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN PETERS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1370171</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>272831</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANTHONY DENTON</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHANNON STRIEBICH</PersonNm>
        <TitleTxt>CHAIR-ELECT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JULIE YAROCH</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTINA FREESE-DECKER</PersonNm>
        <TitleTxt>PAST CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DOUG APPLE</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GAR ATCHISON</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BETH CHARLTON</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAREN CHEESEMAN</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES DOVER</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK EASTBURG</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEREMIAH HODSHIRE</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY LANE</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRITTANY LAVIS</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BILL MANNS</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EDWIN NESS</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HUNTER NOSTRANT</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT RINEY</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KENT RIDDLE</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHELLEYE YAKLIN</PersonNm>
        <TitleTxt>AT-LARGE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT PILLION</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>324179</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>74296</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NANCY MCKEAGUE</PersonNm>
        <TitleTxt>SENIOR VP, CHIEF OF STAFF</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>864758</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>164834</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY ROTH</PersonNm>
        <TitleTxt>SENIOR VP, CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>350457</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>101242</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PETER SCHONFELD</PersonNm>
        <TitleTxt>SENIOR VP, POLICY</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>434453</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>118412</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SAM WATSON</PersonNm>
        <TitleTxt>SENIOR VP, FIELD ENGAGEMENT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>432099</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>117950</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURA APPEL</PersonNm>
        <TitleTxt>SENIOR VP, HEALTH &amp; INNOVATION</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>546987</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>132065</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4323104</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>981630</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>29</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CAPITAL TOWER LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>110 W MICHIGAN AVE</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48933</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
        <CompensationAmt>533801</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GRAND HOTEL</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 286</AddressLine1Txt>
            <CityNm>MACKINAC ISLAND</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49757</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
        <CompensationAmt>418782</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PLANTE &amp; MORAN PLLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1111 MICHIGAN AVE</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
        <CompensationAmt>241800</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CYBERFORCE Q LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>47911 HALYARD ROAD</AddressLine1Txt>
            <CityNm>PLYMOUTH</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48170</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
        <CompensationAmt>123385</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>4</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>192067954</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>129500</AllOtherContributionsAmt>
      <TotalContributionsAmt>192197454</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>SERVICE FEES</Desc>
        <BusinessCd>561499</BusinessCd>
        <TotalRevenueColumnAmt>9284545</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9284545</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEMBERSHIP DUES</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>7399630</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7399630</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGEMENT FEES</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>1959916</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1959916</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ADMINISTRATIVE FEES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>408166</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>408166</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>1641684</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1289087</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>352597</UnrelatedBusinessRevenueAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>20693941</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>710367</TotalRevenueColumnAmt>
        <ExclusionAmt>710367</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>415000</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>311315</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>103685</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>103685</TotalRevenueColumnAmt>
        <ExclusionAmt>103685</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>213705447</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>20341344</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>352597</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>814052</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>192912484</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2041477</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>7909742</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>4519852</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>2036232</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>471386</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>325250</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>57982</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2362844</TotalAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>554701</TotalAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>1164585</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>1481717</TotalAmt>
      </TravelGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>384461</TotalAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>88520</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MISC. OTHER EXPENSES</Desc>
        <TotalAmt>319866</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>192738</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BANK FEES</Desc>
        <TotalAmt>114663</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>TAXES</Desc>
        <TotalAmt>83221</TotalAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>217021721</TotalAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>1566031</BOYAmt>
        <EOYAmt>1045838</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>12229323</BOYAmt>
        <EOYAmt>9392037</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>30419489</BOYAmt>
        <EOYAmt>54849334</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>3495523</BOYAmt>
        <EOYAmt>7079017</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>854524</BOYAmt>
        <EOYAmt>549154</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>15350250</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>5875516</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>9702991</BOYAmt>
        <EOYAmt>9474734</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>3076202</BOYAmt>
        <EOYAmt>1240054</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>57062</BOYAmt>
        <EOYAmt>2026150</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>61401145</BOYAmt>
        <EOYAmt>85656318</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>34339822</BOYAmt>
        <EOYAmt>58204558</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>153723</BOYAmt>
        <EOYAmt>684653</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>4335991</BOYAmt>
        <EOYAmt>4117065</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>1479833</BOYAmt>
        <EOYAmt>4817651</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>40309369</BOYAmt>
        <EOYAmt>67823927</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>21091776</BOYAmt>
        <EOYAmt>17832391</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>21091776</BOYAmt>
        <EOYAmt>17832391</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>61401145</BOYAmt>
        <EOYAmt>85656318</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-3316274</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>56889</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039500001">
      <PoliticalExpendituresAmt>730000</PoliticalExpendituresAmt>
      <InternalFundsContributedAmt>730000</InternalFundsContributedAmt>
      <TotalExemptFunctionExpendAmt>730000</TotalExemptFunctionExpendAmt>
      <Form1120POLFiledInd>1</Form1120POLFiledInd>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>MICHIGAN DEMOCRATIC STATE CENTRAL COMMITTEE</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>606 TOWNSEND</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <EIN>381323848</EIN>
        <PaidInternalFundsAmt>390000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>PUT MICHIGAN FIRST</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>1225 EYE STREET NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
        </USAddress>
        <EIN>871484192</EIN>
        <PaidInternalFundsAmt>200000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>SENATOR MIKE SHIRKEY</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>106 WEST ALLEGAN SUITE 200</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <EIN>050532524</EIN>
        <PaidInternalFundsAmt>50000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>REPUBLICAN LEGISLATIVE CAMPAIGN COMMITTEE</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>1202 F ST NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20004</ZIPCd>
        </USAddress>
        <EIN>050532524</EIN>
        <PaidInternalFundsAmt>25000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>REPRESENTATIVE MATT HALL</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 14097</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <EIN>833939983</EIN>
        <PaidInternalFundsAmt>25000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>SENATOR ARIC NESBITT</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 10030</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48901</ZIPCd>
        </USAddress>
        <EIN>862905593</EIN>
        <PaidInternalFundsAmt>25000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>MICHIGAN RULE OF LAW PROJECT</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 2066</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49501</ZIPCd>
        </USAddress>
        <EIN>882227808</EIN>
        <PaidInternalFundsAmt>5000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>JUSTICE FOR ALL - MICHIGAN</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>326 S WALNUT ST</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48934</ZIPCd>
        </USAddress>
        <EIN>825471655</EIN>
        <PaidInternalFundsAmt>5000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <Section527PoliticalOrgGrp>
        <OrganizationBusinessName>
          <BusinessNameLine1Txt>REPRESENTATIVE SARAH ANTHONY</BusinessNameLine1Txt>
        </OrganizationBusinessName>
        <USAddress>
          <AddressLine1Txt>401 S WASHINGTON ST APT 207</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <EIN>843535326</EIN>
        <PaidInternalFundsAmt>5000</PaidInternalFundsAmt>
      </Section527PoliticalOrgGrp>
      <SubstantiallyAllDuesNondedInd>1</SubstantiallyAllDuesNondedInd>
      <OnlyInHouseLobbyingInd>0</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>0</AgreeCarryoverPriorYearInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I-A, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>MHA CONTRIBUTED TO A POLITICAL ACTION COMMITTEES WHICH SUPPORT CANDIDATES THAT ADVOCATE FOR HOSPITALS AND PATIENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>798431</OtherCostOrOtherBasisAmt>
        <BookValueAmt>798431</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>9959162</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1781463</DepreciationAmt>
        <BookValueAmt>8177699</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1097227</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>757574</DepreciationAmt>
        <BookValueAmt>339653</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3495430</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3336479</DepreciationAmt>
        <BookValueAmt>158951</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>9474734</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATES</Desc>
        <Amt>2843755</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>LEASE LIABILITIES- OPERATING</Desc>
        <Amt>1973896</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>4817651</TotalLiabilityAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASCENSION MACOMB OAKLAND HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 45998</AddressLine1Txt>
          <CityNm>ST LOUIS</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>63145</ZIPCd>
        </USAddress>
        <RecipientEIN>383322109</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>44964</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASCENSION ST JOHN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 45998</AddressLine1Txt>
          <CityNm>ST LOUIS</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>63145</ZIPCd>
        </USAddress>
        <RecipientEIN>381359063</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10231867</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS IRON RIVER HOSPITAL &amp; CLINICS INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1400 W ICE LAKE RD</AddressLine1Txt>
          <CityNm>IRON RIVER</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49935</ZIPCd>
        </USAddress>
        <RecipientEIN>383236977</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500654</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS IRONWOOD HOSPITAL &amp; CLINICS INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>N10561 GRANDVIEW LN</AddressLine1Txt>
          <CityNm>IRONWOOD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49938</ZIPCd>
        </USAddress>
        <RecipientEIN>382908586</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>471127</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS KEWEENAW</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>205 OSCEOLA ST</AddressLine1Txt>
          <CityNm>LAURIUM</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49913</ZIPCd>
        </USAddress>
        <RecipientEIN>381443361</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>377008</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS ONTONAGON HOSPITAL INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>601 S 7TH ST</AddressLine1Txt>
          <CityNm>ONTONAGON</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49953</ZIPCd>
        </USAddress>
        <RecipientEIN>260806477</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>125211</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BARAGA COUNTY MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>18341 US HIGHWAY 41</AddressLine1Txt>
          <CityNm>LANSE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49946</ZIPCd>
        </USAddress>
        <RecipientEIN>382892565</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BCA STONECREST CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>15000 GRATIOT AVE</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48205</ZIPCd>
        </USAddress>
        <RecipientEIN>263333652</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>275000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BEAUMONT BEHAVIORAL HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>18001 ROTUNDA DR</AddressLine1Txt>
          <CityNm>DEARBORN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48124</ZIPCd>
        </USAddress>
        <RecipientEIN>831978365</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>275000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BRIGHTWELL BEHAVIORAL HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>802 E 86TH STREET</AddressLine1Txt>
          <CityNm>INDIANAPOLIS</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>46240</ZIPCd>
        </USAddress>
        <RecipientEIN>823868732</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>275000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BRONSON METHODIST HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>601 JOHN ST 26</AddressLine1Txt>
          <CityNm>KALAMAZOO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49007</ZIPCd>
        </USAddress>
        <RecipientEIN>381359087</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>7746008</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CEDAR CREEK HOSPITAL OF MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>101 W TOWNSEND RD</AddressLine1Txt>
          <CityNm>SAINT JOHNS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48879</ZIPCd>
        </USAddress>
        <RecipientEIN>382409580</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>275000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CITIZENS FOR RESPONSIBLE GOVERNMENT</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>201 TOWNSEND ST SUITE 900</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <RecipientEIN>300991892</RecipientEIN>
        <IRCSectionDesc>501(C)(4)</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>COALITION TO PROTECT AMERICAS HEALTH CARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>800 10TH ST NW STE 400</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20001</ZIPCd>
        </USAddress>
        <RecipientEIN>522253225</RecipientEIN>
        <IRCSectionDesc>501(C)(4)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>COVENANT MEDICAL CENTER INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1447 N HARRISON ST</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48602</ZIPCd>
        </USAddress>
        <RecipientEIN>383369438</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>2350000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DECKERVILLE COMMUNITY HOSPITAL INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3559 PINE ST</AddressLine1Txt>
          <CityNm>DECKERVILLE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48427</ZIPCd>
        </USAddress>
        <RecipientEIN>381415390</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>750000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DETROIT REGIONAL CHAMBER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>777 WOODWARD AVE STE 800</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48226</ZIPCd>
        </USAddress>
        <RecipientEIN>380477570</RecipientEIN>
        <IRCSectionDesc>501(C)(6)</IRCSectionDesc>
        <CashGrantAmt>65000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DICKINSON COUNTY MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1721 S STEPHENSON AVE</AddressLine1Txt>
          <CityNm>IRON MOUNTAIN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49801</ZIPCd>
        </USAddress>
        <RecipientEIN>382780429</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>537698</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DMC DETROIT RECEIVING HOSPITAL &amp; UNIVERSITY HEALTH CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4201 SAINT ANTOINE ST</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48201</ZIPCd>
        </USAddress>
        <RecipientEIN>272844942</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10394475</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>EATON RAPIDS MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1500 S MAIN ST</AddressLine1Txt>
          <CityNm>EATON RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48827</ZIPCd>
        </USAddress>
        <RecipientEIN>381559180</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>398563</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>EDWARD W SPARROW HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <RecipientEIN>381360584</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>6725000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>EMMA L BIXBY MEDICAL CENTER - HICKMAN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>100 MADISON AVE</AddressLine1Txt>
          <CityNm>TOLEDO</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43604</ZIPCd>
        </USAddress>
        <RecipientEIN>382796005</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>FOODBANK COUNCIL OF MICHIGAN INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>330 MARSHALL STREET SUITE 102</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <RecipientEIN>382515765</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>30000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>FOREST HEALTH MEDICAL CENTER INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>135 S PROSPECT ST</AddressLine1Txt>
          <CityNm>YPSILANTI</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48198</ZIPCd>
        </USAddress>
        <RecipientEIN>383527511</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>FOREST VIEW PSYCHIATRIC HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1055 MEDICAL PARK DR SE</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49546</ZIPCd>
        </USAddress>
        <RecipientEIN>232285657</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>125000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>GARDEN CITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>6245 INKSTER RD</AddressLine1Txt>
          <CityNm>GARDEN CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48135</ZIPCd>
        </USAddress>
        <RecipientEIN>464719451</RecipientEIN>
        <IRCSectionDesc>501(C)(6)</IRCSectionDesc>
        <CashGrantAmt>750000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HARBOR BEACH COMMUNITY HOSPITAL INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>210 S 1ST ST</AddressLine1Txt>
          <CityNm>HARBOR BEACH</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48441</ZIPCd>
        </USAddress>
        <RecipientEIN>381565380</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>238423</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HARBOR OAKS HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>35031 23 MILE RD</AddressLine1Txt>
          <CityNm>NEW BALTIMORE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48047</ZIPCd>
        </USAddress>
        <RecipientEIN>043232990</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>275000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HAVENWYCK HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1525 UNIVERSITY DR</AddressLine1Txt>
          <CityNm>AUBURN HILLS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48326</ZIPCd>
        </USAddress>
        <RecipientEIN>382409580</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>275000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HEALTHSOURCE SAGINAW INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3340 HOSPITAL RD</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48603</ZIPCd>
        </USAddress>
        <RecipientEIN>386804889</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>9678</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HELEN NEWBERRY JOY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>502 W HARRIE ST</AddressLine1Txt>
          <CityNm>NEWBERRY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49868</ZIPCd>
        </USAddress>
        <RecipientEIN>382873485</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>331874</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HENRY FORD HEALTH SYSTEM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1 FORD PLACE 5F</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48202</ZIPCd>
        </USAddress>
        <RecipientEIN>381357020</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>20075000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HILLS &amp; DALES GENERAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4675 HILL ST</AddressLine1Txt>
          <CityNm>CASS CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48726</ZIPCd>
        </USAddress>
        <RecipientEIN>381619577</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>449500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HILLSDALE COMMUNITY HEALTH CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>168 S HOWELL ST</AddressLine1Txt>
          <CityNm>HILLSDALE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49242</ZIPCd>
        </USAddress>
        <RecipientEIN>386005550</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HOLLAND COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>602 MICHIGAN AVE</AddressLine1Txt>
          <CityNm>HOLLAND</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49423</ZIPCd>
        </USAddress>
        <RecipientEIN>382800065</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>1600000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HURLEY MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1 HURLEY PLAZA</AddressLine1Txt>
          <CityNm>FLINT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48503</ZIPCd>
        </USAddress>
        <RecipientEIN>386005601</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>2000000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>INSIGHT SURGICAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>28000 DEQUINDRE RD</AddressLine1Txt>
          <CityNm>WARREN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48092</ZIPCd>
        </USAddress>
        <RecipientEIN>134257646</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>177244</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>LAKE HURON MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2601 ELECTRIC AVE</AddressLine1Txt>
          <CityNm>PORT HURON</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48060</ZIPCd>
        </USAddress>
        <RecipientEIN>472361878</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>294073</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MACKINAC STRAITS HEALTH SYSTEM INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1140 N STATE ST</AddressLine1Txt>
          <CityNm>SAINT IGNACE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49781</ZIPCd>
        </USAddress>
        <RecipientEIN>208756459</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MADISON COMMUNITY HOSPITAL INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4050 E 12 MILE RD</AddressLine1Txt>
          <CityNm>WARREN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48092</ZIPCd>
        </USAddress>
        <RecipientEIN>381901104</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>125000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MARLETTE REGIONAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 307</AddressLine1Txt>
          <CityNm>MARLETTE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48453</ZIPCd>
        </USAddress>
        <RecipientEIN>381507302</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>653324</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MARQUETTE GENERAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>850 W BARAGA AVE</AddressLine1Txt>
          <CityNm>MARQUETTE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49855</ZIPCd>
        </USAddress>
        <RecipientEIN>800818718</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>1450000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MARY FREE BED REHABILITATION HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>235 WEALTHY ST SE</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49503</ZIPCd>
        </USAddress>
        <RecipientEIN>381359265</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MCKENIZE MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>120 N DELAWARE ST</AddressLine1Txt>
          <CityNm>SANDUSKY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48471</ZIPCd>
        </USAddress>
        <RecipientEIN>381738615</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>603374</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MCLAREN FLINT</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 S BALLENGER HWY</AddressLine1Txt>
          <CityNm>FLINT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48532</ZIPCd>
        </USAddress>
        <RecipientEIN>382383119</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>13800000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MCLAREN OAKLAND</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>50 N PERRY ST</AddressLine1Txt>
          <CityNm>PONTIAC</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48342</ZIPCd>
        </USAddress>
        <RecipientEIN>381428164</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>18896</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MEMORIAL HEALTHCARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>826 W KING ST</AddressLine1Txt>
          <CityNm>OWOSSO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48867</ZIPCd>
        </USAddress>
        <RecipientEIN>381358208</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>1175000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MERCY-MEMORIAL HOSPITAL CORPORATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>100 MADISON AVE</AddressLine1Txt>
          <CityNm>TOLEDO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>43604</ZIPCd>
        </USAddress>
        <RecipientEIN>381984289</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>775000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>METROPOLITAN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>5900 BYRON CENTER AVE SW</AddressLine1Txt>
          <CityNm>WYOMING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49519</ZIPCd>
        </USAddress>
        <RecipientEIN>380593405</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>2300000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MICHIGAN DEMOCRATIC STATE CENTRAL COMMITTEE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>606 TOWNSEND</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <RecipientEIN>381323848</RecipientEIN>
        <IRCSectionDesc>527</IRCSectionDesc>
        <CashGrantAmt>390000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MICHIGAN STATE SOCIETY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>7400 SALFORD CT</AddressLine1Txt>
          <CityNm>ALEXANDRIA</CityNm>
          <StateAbbreviationCd>VA</StateAbbreviationCd>
          <ZIPCd>22315</ZIPCd>
        </USAddress>
        <RecipientEIN>473069304</RecipientEIN>
        <IRCSectionDesc>501(C)(4)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MICHIGAN STATE UNIVERSITY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>535 CHESTNUT RD RM 300</AddressLine1Txt>
          <CityNm>EAST LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48823</ZIPCd>
        </USAddress>
        <RecipientEIN>386005984</RecipientEIN>
        <IRCSectionDesc>GOV</IRCSectionDesc>
        <CashGrantAmt>72354</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MICHIGAN STRONG</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 10058</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48901</ZIPCd>
        </USAddress>
        <RecipientEIN>832430496</RecipientEIN>
        <IRCSectionDesc>501(C)(4)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MICHIGAN VALUES</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 10030</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48901</ZIPCd>
        </USAddress>
        <RecipientEIN>862905593</RecipientEIN>
        <IRCSectionDesc>501(C)(4)</IRCSectionDesc>
        <CashGrantAmt>75000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNISING MEMORIAL HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1500 SANDPOINT RD</AddressLine1Txt>
          <CityNm>MUNISING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49862</ZIPCd>
        </USAddress>
        <RecipientEIN>381507046</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>632606</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1105 6TH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <RecipientEIN>381362830</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>4000000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH STREET</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <RecipientEIN>381362830</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>100000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MYMICHIGAN MEDICAL CENTER MIDLAND</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4000 WELLNESS DR</AddressLine1Txt>
          <CityNm>MIDLAND</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48670</ZIPCd>
        </USAddress>
        <RecipientEIN>380833014</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>5075000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OAKLAND REGIONAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>22401 FOSTER WINTER DR</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48075</ZIPCd>
        </USAddress>
        <RecipientEIN>383162435</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>678210</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OAKLAWN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>200 N MADISON ST</AddressLine1Txt>
          <CityNm>MARSHALL</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49068</ZIPCd>
        </USAddress>
        <RecipientEIN>381368347</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>750000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OSF HEALTHCARE SYSTEM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>124 SW ADAMS ST</AddressLine1Txt>
          <CityNm>PEORIA</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61602</ZIPCd>
        </USAddress>
        <RecipientEIN>370813229</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>564205</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PINE REST CHRISTIAN MENTAL HEALTH SERVICES</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>300 68TH ST SE</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49548</ZIPCd>
        </USAddress>
        <RecipientEIN>381368360</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>2350000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PINE REST FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>300 68TH STREET SE</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49548</ZIPCd>
        </USAddress>
        <RecipientEIN>381676540</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>5500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PIONEER SPECIALTY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>50 N PERRY ST</AddressLine1Txt>
          <CityNm>PONTIAC</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48342</ZIPCd>
        </USAddress>
        <RecipientEIN>462020627</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PONTIAC GENERAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>461 W HURON ST</AddressLine1Txt>
          <CityNm>PONTIAC</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48341</ZIPCd>
        </USAddress>
        <RecipientEIN>262512089</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>728990</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PROMEDICA COLDWATER REGIONAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>100 MADISON AVE</AddressLine1Txt>
          <CityNm>TOLEDO</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>43604</ZIPCd>
        </USAddress>
        <RecipientEIN>386108110</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PUT MICHIGAN FIRST</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1225 EYE STREET NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
        </USAddress>
        <RecipientEIN>871484192</RecipientEIN>
        <IRCSectionDesc>527</IRCSectionDesc>
        <CashGrantAmt>200000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>REGENTS OF THE UNIVERSITY OF MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>500 S STATE STREET</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48109</ZIPCd>
        </USAddress>
        <RecipientEIN>386006309</RecipientEIN>
        <IRCSectionDesc>GOV</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>REGENTS OF THE UNIVERSITY OF MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>500 S STATE STREET</AddressLine1Txt>
          <CityNm>ANN ARBOR</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48109</ZIPCd>
        </USAddress>
        <RecipientEIN>386006309</RecipientEIN>
        <IRCSectionDesc>GOV</IRCSectionDesc>
        <CashGrantAmt>16600000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>REPRESENTATIVE MATT HALL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 14097</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48901</ZIPCd>
        </USAddress>
        <RecipientEIN>833939983</RecipientEIN>
        <IRCSectionDesc>527</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>REPUBLICAN LEGISTLATIVE COMPAIGN COMMITTEE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1202 F ST NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20004</ZIPCd>
        </USAddress>
        <RecipientEIN>050532524</RecipientEIN>
        <IRCSectionDesc>527</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SCHEURER HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>170 N CASEVILLE RD</AddressLine1Txt>
          <CityNm>PIGEON</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48755</ZIPCd>
        </USAddress>
        <RecipientEIN>381456056</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SCHOOLCRAFT MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>7870W US HIGHWAY 2</AddressLine1Txt>
          <CityNm>MANISTIQUE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49854</ZIPCd>
        </USAddress>
        <RecipientEIN>742517055</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>737500</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - ANN ARBOR</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>5301 E HURON RIVER DR 7 FLOOR</AddressLine1Txt>
          <CityNm>YPSILANTI</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48197</ZIPCd>
        </USAddress>
        <RecipientEIN>383389548</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>106080</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - BATTLE CREEK</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>300 NORTH AVE 6TH FLOOR</AddressLine1Txt>
          <CityNm>BATTLE CREEK</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49017</ZIPCd>
        </USAddress>
        <RecipientEIN>752962822</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>51844</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - DOWNRIVER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2333 BIDDLE AVE 8TH FLOOR</AddressLine1Txt>
          <CityNm>WYANDOTTE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48192</ZIPCd>
        </USAddress>
        <RecipientEIN>263231685</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>125000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - FLINT</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 SOUTH BALLENGER HIGHWAY 5TH</AddressLine1Txt>
          <AddressLine2Txt>FLOOR</AddressLine2Txt>
          <CityNm>FLINT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48532</ZIPCd>
        </USAddress>
        <RecipientEIN>383329100</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>86296</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - GROSS POINTE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>22101 MOROSS RD 6TH FLOOR</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48236</ZIPCd>
        </USAddress>
        <RecipientEIN>050597929</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>125000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - MACOMB COUNTY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>215 NORTH AVE SUITE 200</AddressLine1Txt>
          <CityNm>MT CLEMENS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48043</ZIPCd>
        </USAddress>
        <RecipientEIN>383345654</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>109523</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - NORTHWEST</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>6071 W OUTER DR</AddressLine1Txt>
          <CityNm>DETROIT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48235</ZIPCd>
        </USAddress>
        <RecipientEIN>833353703</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>125000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - PONTIAC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>44405 WOODWARD AVE</AddressLine1Txt>
          <CityNm>PONTIAC</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48341</ZIPCd>
        </USAddress>
        <RecipientEIN>383389212</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>78784</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL - SAGINAW</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1447 N HARRISON ST 8TH FLOOR</AddressLine1Txt>
          <CityNm>SAGINAW</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48602</ZIPCd>
        </USAddress>
        <RecipientEIN>251890958</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>87023</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SELECT SPECIALTY HOSPITAL SPECTRUM HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1840 WEALTHY ST SE 5TH FLOOR</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49506</ZIPCd>
        </USAddress>
        <RecipientEIN>384031103</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>86662</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SENATOR MIKE SHIRKEY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>106 WEST ALLEGAN SUITE 200</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <RecipientEIN>050532524</RecipientEIN>
        <IRCSectionDesc>527</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SHERIDAN COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>301 N MAIN ST</AddressLine1Txt>
          <CityNm>SHERIDAN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48884</ZIPCd>
        </USAddress>
        <RecipientEIN>381369796</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>250000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SMALL BUSINESS ASSOCIATION OF MICHIGAN (SBAM) FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>101 S WASHINGTON SQ STE 900</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48933</ZIPCd>
        </USAddress>
        <RecipientEIN>883293504</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>42375</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>STRAITH HOSPITAL FOR SPECIAL SURGERY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>23901 LAHSER RD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <RecipientEIN>381455020</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>636908</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>STURGIS HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>916 MYRTLE AVE</AddressLine1Txt>
          <CityNm>STURGIS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49091</ZIPCd>
        </USAddress>
        <RecipientEIN>352362438</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>THE BEHAVIORAL CENTER OF MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4050 TWELVE MILE RD 2534</AddressLine1Txt>
          <CityNm>WARREN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48092</ZIPCd>
        </USAddress>
        <RecipientEIN>383473188</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>125000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>THE CENTER FOR MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>220 W MICHIGAN AVE</AddressLine1Txt>
          <CityNm>YPSILANTI</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48197</ZIPCd>
        </USAddress>
        <RecipientEIN>320167398</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>THE ROAD TO MICHIGAN'S FUTURE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 12248</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48901</ZIPCd>
        </USAddress>
        <RecipientEIN>844298056</RecipientEIN>
        <IRCSectionDesc>501(C)(4)</IRCSectionDesc>
        <CashGrantAmt>100000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>THREE RIVERS HEALTH SYSTEM INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>701 S HEALTH PKWY</AddressLine1Txt>
          <CityNm>THREE RIVERS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49093</ZIPCd>
        </USAddress>
        <RecipientEIN>451257972</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TRINITY HEALTH GRAND HAVEN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1309 SHELDON RD</AddressLine1Txt>
          <CityNm>GRAND HAVEN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49417</ZIPCd>
        </USAddress>
        <RecipientEIN>383330803</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>600000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TRINITY HEALTH ST JOSEPH MERCY ANN ARBOR</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>200 JEFFERSON AVE SE</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49503</ZIPCd>
        </USAddress>
        <RecipientEIN>382113393</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>22974640</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UP HEALTH SYSTEM - BELL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>901 LAKESHORE DR</AddressLine1Txt>
          <CityNm>ISHPEMING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49849</ZIPCd>
        </USAddress>
        <RecipientEIN>800935981</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>500000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UP HEALTH SYSTEM - PORTAGE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>500 CAMPUS DR</AddressLine1Txt>
          <CityNm>HANCOCK</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49930</ZIPCd>
        </USAddress>
        <RecipientEIN>900998484</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>525000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>VOTERS FOR TRANSPARENCY AND TERM LIMITS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 10015</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48901</ZIPCd>
        </USAddress>
        <RecipientEIN>881011079</RecipientEIN>
        <IRCSectionDesc>501(C)(4)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GENERAL SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>WILLIAM BEAUMONT HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3601 W THIRTEEN MILE RD</AddressLine1Txt>
          <CityNm>ROYAL OAK</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48073</ZIPCd>
        </USAddress>
        <RecipientEIN>381459362</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>38000000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>GRANT PASS THROUGH</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>88</Total501c3OrgCnt>
      <TotalOtherOrgCnt>21</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES A CONTRIBUTION TO ORGANIZATIONS WITH SIMILAR MISSIONS FOR THE GENERAL SUPPORT OF THE ORGANIZATION. SINCE THE FUNDS ARE TO BE USED FOR THE GENERAL SUPPORT OF THEIR MISSION, WE DO NOT REQUIRE THE ORGANIZATION TO SUBSTANTIATE THEIR EXPENDITURES RELATED TO THESE CONTRIBUTIONS. PASS THROUGH GRANTS SUBMIT EXPENDITURES FOR REIMBURSEMENT IN ACCORDANCE WITH GRANT AGREEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <FirstClassOrCharterTravelInd>X</FirstClassOrCharterTravelInd>
      <DiscretionarySpendingAcctInd>X</DiscretionarySpendingAcctInd>
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRIAN PETERS</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>737018</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>259688</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>373465</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>216969</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>55862</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1643002</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>356577</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NANCY MCKEAGUE</PersonNm>
        <TitleTxt>SENIOR VP, CHIEF OF STAFF</TitleTxt>
        <BaseCompensationFilingOrgAmt>397542</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>160000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>307216</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>140316</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24518</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1029592</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>258042</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LAURA APPEL</PersonNm>
        <TitleTxt>SENIOR VP, HEALTH &amp; INNOVATION</TitleTxt>
        <BaseCompensationFilingOrgAmt>375640</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>160000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>11347</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>92899</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>39166</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>679052</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PETER SCHONFELD</PersonNm>
        <TitleTxt>SENIOR VP, POLICY</TitleTxt>
        <BaseCompensationFilingOrgAmt>314440</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>80000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>40013</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>76031</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>42381</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>552865</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SAM WATSON</PersonNm>
        <TitleTxt>SENIOR VP, FIELD ENGAGEMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>313082</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>85000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>34017</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>75675</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>42275</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>550049</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>24495</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GARY ROTH</PersonNm>
        <TitleTxt>SENIOR VP, CHIEF MEDICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>302230</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>40000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>8227</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>62865</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>38377</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>451699</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SCOTT PILLION</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>246065</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>70000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>8114</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>33550</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>40746</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>398475</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>CHARTER TRAVEL IS USED BY BOARD MEMBERS FOR BUSINESS ONLY AND IS NOT TAXED AS COMPENSATION. DISCRETIONARY SPENDING ACCOUNTS ARE USED FOR SELECT INDIVIDUALS AND IS TAXED AS COMPENSATION. BUSINESS CLUBS ARE FOR EXECUTIVE STAFF AND IS NOT TAXED AS COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: - LAURA APPEL - CHARLIE JOHNSON - NANCY MCKEAGUE - BRIAN PETERS - SAM WATSON - SCOTT PILLION THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE CURRENT YEAR: - CHARLIE JOHNSON - $15,040 - NANCY MCKEAGUE - $258,042 - BRIAN PETERS - $356,577 - SAM WATSON - $24,495</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION PROVIDES NON-FIXED PAYMENTS TO EMPLOYEES ON AN ANNUAL BASIS. THESE BONUSES ARE DISCRETIONARY IN NATURE. THE NON-FIXED PAYMENTS ARE REPORTED AS AMOUNT PROVIDED TO EACH INDIVIDUAL IS DETERMINED BY THE BOARD AND IS BONUS/INCENTIVE COMPENSATION IN PART II OF SCHEDULE J.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ASSOCIATION IS A MEMBER BASED ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>EXECUTIVE COMMITTEE CONSISTS OF MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>HOUSE OF DELEGATES APPROVES SOME DECISIONS OF GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 AND RELATED SCHEDULES ARE PREPARED BY INDEPENDENT ACCOUNTING/AUDIT FIRM AND ARE SUBSEQUENTLY REVIEWED BY THE ASSOCIATION'S CONTROLLER, CFO AND PRESIDENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>WE REQUIRE BOARD MEMBERS TO SIGN CONFLICT OF INTEREST STATEMENTS AND VERBALLY REMIND THEM OF THAT PERIODICALLY DURING THE YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR IS ESTABLISHED USING THE FOLLOWING METHODS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ADDITIONALLY, THE INDEPENDENT COMPENSATION COMMITTEE RECEIVES COMPARABILITY DATA ANNUALLY AND DOCUMENTS DECISION IN WRITTEN FORM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>PUBLIC DISCLOSURE DOCUMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MHA HEALTH FOUNDATION DBA MHA CENTER FOR HEALTH RESOURCES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2112 UNVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
        <EIN>386091188</EIN>
        <PrimaryActivitiesTxt>PERFORM CHARITABLE AND EDUCATIONAL FUNCTIONS OF THE MHA.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MICHIGAN HEALTH &amp; HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HEALTH POLITICAL ACTION COMMITTEE MICHIGAN HEALTH &amp; HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2112 UNVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
        <EIN>382769064</EIN>
        <PrimaryActivitiesTxt>PROMOTE GOOD HEALTH CARE FOR MICHIGAN CITIZENS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>527</ExemptCodeSectionTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MHA KEYSTONE CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2112 UNVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
        <EIN>462128815</EIN>
        <PrimaryActivitiesTxt>ASSIST AND EDUCATE HEALTH CARE PROVIDERS WITH PATIENT SAFETY AND CARE.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MHA HEALTH FOUNDATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2112 UNIVERSITY PARK DRIVE</AddressLine1Txt>
          <CityNm>OKEMOS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48864</ZIPCd>
        </USAddress>
        <EIN>382259766</EIN>
        <PrimaryActivitiesTxt>SERVICES TO HOSPITALS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MICHIGAN HEALTH &amp; HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>-958650</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>6137123</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>1</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>55200</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>119249</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>94094</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA SERVICE CORPORATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>979219</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA KEYSTONE CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>696000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA KEYSTONE CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>102036</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA HEALTH FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>500000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>BOOK MAINTAINED AT FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
