<?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="2021v4.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2022-11-15T20:46:53-06:00</ReturnTs>
    <TaxPeriodEndDt>2021-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>861065772</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>DELOITTE TAX LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1001 WOODWARD SUITE 700</AddressLine1Txt>
        <CityNm>DETROIT</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48226</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2021-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>382549505</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>BOTSFORD CONTINUING CARE CORPORATION</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>BOTS</BusinessNameControlTxt>
      <PhoneNum>6163912022</PhoneNum>
      <USAddress>
        <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
        <CityNm>SOUTHFIELD</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48033</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MATTHEW E COX</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>6163912022</PhoneNum>
      <SignatureDt>2022-11-15</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>MATTHEW</PersonFirstNm>
        <PersonLastNm>COX</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>ALICIA JANISCH</PreparerPersonNm>
      <PTIN>P00741382</PTIN>
      <PhoneNum>3133963000</PhoneNum>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2021</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <DoingBusinessAsName>
        <BusinessNameLine1Txt>BOTSFORD CONTINUING HEALTH CENTER</BusinessNameLine1Txt>
      </DoingBusinessAsName>
      <PrincipalOfficerNm>MARGARET LIGHTNER</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
        <CityNm>SOUTHFIELD</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48033</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>13479806</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.BEAUMONTCOMMONSFH.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1984</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO CREATE A FULLNESS OF LIFE THROUGH THE JOY OF RELATIONSHIPS, THE ART OF CARING, AND THE SPIRIT OF LIVING.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>3</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>0</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>185</TotalEmployeeCnt>
      <TotalVolunteersCnt>16</TotalVolunteersCnt>
      <TotalGrossUBIAmt>26761</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>934268</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>86830</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>15709714</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>13279463</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>4000</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>-662</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>44660</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>74829</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>16692642</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>13440460</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>8864246</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>8389947</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>11082115</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>9726770</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>19946361</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>18116717</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-3253719</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-4676257</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>28554348</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>28850593</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>65787800</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>77581555</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>-37233452</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>-48730962</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>IN THE INTEREST OF MEETING OUR COMMUNITY'S NEEDS FOR A CONTINUUM OF CARE, BOTSFORD CONTINUING CARE CORPORATION WILL PROVIDE AN ENVIRONMENT IN WHICH CLIENTS WILL RECEIVE PERSONAL ATTENTION BY HEALTH CARE PROFESSIONALS.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>16846138</ExpenseAmt>
      <RevenueAmt>13279463</RevenueAmt>
      <Desc>THE SKILLED NURSING UNIT (SNF) IS A 179-BED FACILITY.THE ASSISTED LIVING FACILITY IS A 63-BED FACILITY. IT IS A SAFE AND SUPPORTIVE ENVIRONMENT FOR OLDER ADULTS NEEDING SOME ASSISTANCE WITH THEIR DAILY ROUTINE. THE CENTER FEATURES RESIDENTIAL SUITES WITH PRIVATE BATHS AND GENEROUS LIVING SPACE FOR TREASURED PERSONAL FURNISHINGS. EACH IS EASILY ACCESSIBLE TO COMMUNITY LIVING, DINING, AND SOCIAL AREAS. THE INDEPENDENT LIVING APARTMENT IS A 51-APARTMENT FACILITY. EACH APARTMENT IS WHEELCHAIR ACCESSIBLE, HAS 24-HOUR SECURITY SERVICES AND ILLUMINATED THERMOSTATS. EACH APARTMENT INCLUDES COMPLETE KITCHEN AND LAUNDRY FACILITIES AND INCLUDES ACCESS TO ADJACENT TOWN COMMONS BUILDING. THE TOWN COMMONS BUILDING INCLUDES DINING SERVICES, A POOL, EXERCISE ROOM, AND LIBRARY WITH MEDIA SERVICES.</Desc>
      <TotalProgramServiceExpensesAmt>16846138</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039700001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">0</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>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <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>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>14</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>185</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>1</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>1</Form990TFiledInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>3</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>0</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>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MI</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>BARBARA HRIT</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>9475221515</PhoneNum>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <InfoInScheduleOPartVIIInd>X</InfoInScheduleOPartVIIInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUSAN GRANT</PersonNm>
        <TitleTxt>CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>48.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>978224</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>454657</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARGARET LIGHTNER</PersonNm>
        <TitleTxt>PRESIDENT &amp; SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>273318</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>75124</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARIA MILLER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>48.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>227239</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>73656</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATIENCE C UKACHUKWU</PersonNm>
        <TitleTxt>CLINICAL NURSE LTC</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>315903</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15136</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JULIE KASLLY</PersonNm>
        <TitleTxt>ADMIN SKILLED NURSING LTC</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>145910</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29340</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DENISE BAILEY</PersonNm>
        <TitleTxt>DIRECTOR OF NURSING LTC</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>126087</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36827</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DIANE BERI</PersonNm>
        <TitleTxt>ASSOCIATE ADMINISTRATOR LTC</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>136029</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14640</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CAROLINE STREET</PersonNm>
        <TitleTxt>LPN LTC</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>128700</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14813</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1125947</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>1205463</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>714193</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>11</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>READY NURSING SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 182466</AddressLine1Txt>
            <CityNm>SHELBY TOWNSHIP</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48318</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>NURSING SERVICES</ServicesDesc>
        <CompensationAmt>4891868</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>FAIRVIEW CONSTRUCTION SERVICES LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>28339 BECK RD UNIT F1</AddressLine1Txt>
            <CityNm>WIXOM</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48393</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION MANAGEMENT SERVICES</ServicesDesc>
        <CompensationAmt>572452</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SELECT REHABILITATION INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 71985</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606941985</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>THERAPY SERVICES</ServicesDesc>
        <CompensationAmt>530939</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MEDICAL SOLUTIONS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1010 NORTH 102ND ST STE 300</AddressLine1Txt>
            <CityNm>OMAHA</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68114</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>NURSE STAFFING SERVICES</ServicesDesc>
        <CompensationAmt>444820</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MORRISON MANAGEMENT SPECIALISTS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 102289</AddressLine1Txt>
            <CityNm>ATLANTA</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>303682289</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>FOOD SERVICE STAFFING</ServicesDesc>
        <CompensationAmt>282845</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>17</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>86830</GovernmentGrantsAmt>
      <TotalContributionsAmt>86830</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICES</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>11619002</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>11619002</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ASSISTED LIVING</Desc>
        <BusinessCd>623990</BusinessCd>
        <TotalRevenueColumnAmt>850642</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>850642</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>INDEPENDENT LIVING</Desc>
        <BusinessCd>623990</BusinessCd>
        <TotalRevenueColumnAmt>783256</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>783256</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>DIETARY SERVICES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>26563</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>26563</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>13279463</TotalProgramServiceRevenueAmt>
      <GrossRentsGrp>
        <RealAmt>65445</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>38684</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>26761</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>26761</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>26761</UnrelatedBusinessRevenueAmt>
      </NetRentalIncomeOrLossGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>662</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>-662</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-662</TotalRevenueColumnAmt>
        <ExclusionAmt>-662</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER SERVICES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>48068</TotalRevenueColumnAmt>
        <ExclusionAmt>48068</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>48068</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>13440460</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13279463</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>26761</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>47406</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>348442</TotalAmt>
        <ManagementAndGeneralAmt>348442</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>5956100</TotalAmt>
        <ProgramServicesAmt>5678067</ProgramServicesAmt>
        <ManagementAndGeneralAmt>278033</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>306900</TotalAmt>
        <ProgramServicesAmt>297693</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9207</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1294101</TotalAmt>
        <ProgramServicesAmt>1181048</ProgramServicesAmt>
        <ManagementAndGeneralAmt>113053</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>484404</TotalAmt>
        <ProgramServicesAmt>441885</ProgramServicesAmt>
        <ManagementAndGeneralAmt>42519</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>187668</TotalAmt>
        <ManagementAndGeneralAmt>187668</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>89530</TotalAmt>
        <ManagementAndGeneralAmt>89530</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>1395</TotalAmt>
        <ManagementAndGeneralAmt>1395</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>3730421</TotalAmt>
        <ProgramServicesAmt>3730421</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>29587</TotalAmt>
        <ProgramServicesAmt>5616</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23971</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>96148</TotalAmt>
        <ProgramServicesAmt>89525</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6623</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>24421</TotalAmt>
        <ManagementAndGeneralAmt>24421</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>741149</TotalAmt>
        <ProgramServicesAmt>684871</ProgramServicesAmt>
        <ManagementAndGeneralAmt>56278</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>1213</TotalAmt>
        <ManagementAndGeneralAmt>1213</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>1564</TotalAmt>
        <ProgramServicesAmt>1564</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>378303</TotalAmt>
        <ProgramServicesAmt>378303</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1090308</TotalAmt>
        <ProgramServicesAmt>1007445</ProgramServicesAmt>
        <ManagementAndGeneralAmt>82863</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>178765</TotalAmt>
        <ProgramServicesAmt>173402</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5363</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CORPORATE ALLOCATION</Desc>
        <TotalAmt>1588696</TotalAmt>
        <ProgramServicesAmt>1588696</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PROVIDER TAX QAAP</Desc>
        <TotalAmt>970797</TotalAmt>
        <ProgramServicesAmt>970797</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>412809</TotalAmt>
        <ProgramServicesAmt>412809</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EMPLOYEE EDUCATION</Desc>
        <TotalAmt>46068</TotalAmt>
        <ProgramServicesAmt>46068</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>157928</TotalAmt>
        <ProgramServicesAmt>157928</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>18116717</TotalAmt>
        <ProgramServicesAmt>16846138</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1270579</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>13972107</BOYAmt>
        <EOYAmt>14087162</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>73242</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>40180</BOYAmt>
        <EOYAmt>65058</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>170000</BOYAmt>
        <EOYAmt>170000</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>44372393</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>29917262</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>14314725</BOYAmt>
        <EOYAmt>14455131</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>57336</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>28554348</BOYAmt>
        <EOYAmt>28850593</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1632517</BOYAmt>
        <EOYAmt>1499167</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>155383</BOYAmt>
        <EOYAmt>206759</EOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>63999900</BOYAmt>
        <EOYAmt>75875629</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>65787800</BOYAmt>
        <EOYAmt>77581555</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>-37356540</BOYAmt>
        <EOYAmt>-48854050</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>123088</BOYAmt>
        <EOYAmt>123088</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>-37233452</BOYAmt>
        <EOYAmt>-48730962</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>28554348</BOYAmt>
        <EOYAmt>28850593</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-4676257</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>-6821253</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>934268</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1472008</CurrentTaxYearAmt>
        <TotalAmt>2406276</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>19983563</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>19291960</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>21736011</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>15709714</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11894285</CurrentTaxYearAmt>
        <TotalAmt>88615533</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>19983563</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>19291960</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>21736011</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16643982</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13366293</CurrentTaxYearAmt>
        <TotalAmt>91021809</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>91021809</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>73325</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>46751</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>49384</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>57948</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>65445</CurrentTaxYearAmt>
        <TotalAmt>292853</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>73325</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>46751</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>49384</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>57948</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>65445</CurrentTaxYearAmt>
        <TotalAmt>292853</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <NetIncomeFromOtherUBIGrp>
        <CurrentTaxYearMinus1YearAmt>57257</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>48068</CurrentTaxYearAmt>
        <TotalAmt>105325</TotalAmt>
      </NetIncomeFromOtherUBIGrp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>20056888</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>19338711</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>21785395</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>16759187</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13479806</CurrentTaxYearAmt>
        <TotalAmt>91419987</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99560</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99580</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00320</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00370</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <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="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>1395</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>1395</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>BOTSFORD CONTINUING CARE CORPORATION PAID DUES TO HEALTH CARE ASSOCIATION OF MICHIGAN (HCAM). HCAM IDENTIFIED THAT 11.1% OF OPERATION DUES AND 28% OF AMERICAN HEALTH CARE ASSOCIATION (AHCA) DUES WERE SPENT ON LOBBYING AND RELATED EXPENSES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>1</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>1</RelatedOrgListSchRInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>429384</OtherCostOrOtherBasisAmt>
        <BookValueAmt>429384</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>34440691</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>23002313</DepreciationAmt>
        <BookValueAmt>11438378</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>5030368</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4460237</DepreciationAmt>
        <BookValueAmt>570131</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>4471950</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2454712</DepreciationAmt>
        <BookValueAmt>2017238</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>14455131</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>I/C LOAN FROM WILLIAM BEAUMONT HOSPITAL</Desc>
        <Amt>67712457</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>I/C DEBT TO BEAUMONT HEALTH</Desc>
        <Amt>7708172</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>CONDO RESERVE FUND</Desc>
        <Amt>455000</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>75875629</TotalLiabilityAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART V, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE TAXPAYER IS A MEMBER OF A HEALTH SYSTEM, THE PARENT OF WHICH IS BEAUMONT HEALTH. DURING THE YEAR, BEAUMONT HEALTH FOUNDATION RECEIVED FUNDS FROM OTHER ENTITIES IN THE SYSTEM, OF WHICH A PORTION IS ATTRIBUTABLE TO RESTRICTED CONTRIBUTIONS. PLEASE SEE THE FORM 990, SCHEDULE D OF BEAUMONT HEALTH FOUNDATION FOR INFORMATION REGARDING THIS ENDOWMENT FUND.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUSAN GRANT</PersonNm>
        <TitleTxt>CHAIRPERSON</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>586730</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>292880</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>98614</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>435684</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>18973</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1432881</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>176500</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARGARET LIGHTNER</PersonNm>
        <TitleTxt>PRESIDENT &amp; SECRETARY</TitleTxt>
        <BaseCompensationFilingOrgAmt>160620</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>89561</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>23137</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>52975</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22149</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>348442</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>46700</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PATIENCE C UKACHUKWU</PersonNm>
        <TitleTxt>CLINICAL NURSE LTC</TitleTxt>
        <BaseCompensationFilingOrgAmt>312705</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>3000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>198</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>4915</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10221</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>331039</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARIA MILLER</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>185240</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>33700</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>8299</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>53979</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>19677</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>300895</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>33700</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JULIE KASLLY</PersonNm>
        <TitleTxt>ADMIN SKILLED NURSING LTC</TitleTxt>
        <BaseCompensationFilingOrgAmt>142892</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>3018</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>26186</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3154</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>175250</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DENISE BAILEY</PersonNm>
        <TitleTxt>DIRECTOR OF NURSING LTC</TitleTxt>
        <BaseCompensationFilingOrgAmt>113017</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>11853</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1217</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3782</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>33045</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>162914</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>7500</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DIANE BERI</PersonNm>
        <TitleTxt>ASSOCIATE ADMINISTRATOR LTC</TitleTxt>
        <BaseCompensationFilingOrgAmt>121827</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>12273</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>1929</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3908</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>10732</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>150669</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>7800</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>BEAUMONT HEALTH, THE PARENT CORPORATION AND SOLE MEMBER OF BOTSFORD GENERAL HOSPITAL, WHICH IS THE SOLE MEMBER OF BOTSFORD CONTINUING CARE CORPORATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE J, PART I, LINE 7, IS ANSWERED "YES" BECAUSE CERTAIN INDIVIDUALS, WHOSE SALARY AND BENEFITS ARE PAID BY THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION, RECEIVED A NONFIXED PAYMENT DURING THE YEAR. THE NON-FIXED PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN C.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B:</FormAndLineReferenceDesc>
        <ExplanationTxt>ALTHOUGH BEAUMONT HEALTH IS THE STATUTORY EMPLOYER OF MOST OF THE SYSTEM EMPLOYEES, BEAUMONT HEALTH IS NOT THE COMMON LAW EMPLOYER OF MOST, IF NOT ALL, OF THE EMPLOYEES. THE EMPLOYEES ARE REPORTED ON THE FORM 990 OF THEIR COMMON LAW EMPLOYER. ITS SUPPORTED ORGANIZATIONS PROVIDE CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN OFFICERS, KEY EMPLOYEES AND PHYSICIANS. THESE BENEFITS ARE PROVIDED THROUGH A NON-QUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH THE BENEFITS BEING EARNED ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. TO BECOME ENTITLED TO THE BENEFITS BEING PROVIDED, EACH COVERED EMPLOYEE MUST MEET SPECIFIED REQUIREMENTS RELATING TO FURTHER EMPLOYMENT. UNTIL THOSE REQUIREMENTS ARE SATISFIED, THE EMPLOYEE IS NOT ENTITLED TO THESE AMOUNTS. IF THE EMPLOYEE WERE TO HAVE TERMINATED EMPLOYMENT VOLUNTARILY IN THE YEAR TO WHICH THIS RETURN APPLIES, THOSE SUPPLEMENTAL RETIREMENT BENEFITS WOULD NOT HAVE BEEN PAID OUT. IT SHOULD BE NOTED THAT THESE SUPPLEMENTAL RETIREMENT BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR ALL YEARS OF SERVICE THAT THE EMPLOYEE PROVIDES TO THE ORGANIZATION. ANY RETIREMENT BENEFITS SHOULD BE VIEWED AS APPLYING TO THE ENTIRE LENGTH OF THE EMPLOYEE'S SERVICE TO THE ORGANIZATION. THE FOLLOWING INDIVIDUAL(S) LISTED ON PART VII RECEIVED SUPPLEMENTAL NON-QUALIFIED PLAN PAYMENTS DURING THE CALENDAR YEAR: SUSAN GRANT, NON-QUALIFIED PLAN DISTRIBUTION, SERP 457(F): $86,409</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II:</FormAndLineReferenceDesc>
        <ExplanationTxt>EXECUTIVE COMPENSATION AT BEAUMONT HEALTH BACKGROUND BEAUMONT HEALTH'S EXECUTIVE COMPENSATION PHILOSOPHY AND PROGRAM ALIGNS WITH OUR STRATEGIC OBJECTIVES, WHICH CONTRIBUTE TO THE HEALTH AND WELL-BEING OF THE RESIDENTS THROUGHOUT THE COMMUNITIES WE SERVE. AS BEAUMONT LOOKS TO RETAIN STRONG TALENT IN BOTH EXECUTIVE AND NON-EXECUTIVE POSITIONS ACROSS THE ORGANIZATION, SIMILAR PHILOSOPHIES ARE UTILIZED, WHICH ALIGN WITH OUR ORGANIZATIONAL VALUES OF COMPASSION, RESPECT, INTEGRITY, TEAMWORK, AND EXCELLENCE. TO SUCCESSFULLY LEAD SUCH A LARGE, COMPLEX ORGANIZATION LIKE BEAUMONT HEALTH, HIGHLY TALENTED EXECUTIVE LEADERSHIP IS ESSENTIAL. SUCCESSFUL RECRUITING, RETENTION, AND MOTIVATION OF LEADERS REQUIRES NATIONALLY COMPETITIVE COMPENSATION AND BENEFITS. BEAUMONT ALSO CONSIDERS RECRUITING EXECUTIVE LEADERS WHO COULD CHOOSE POSITIONS IN INDUSTRY SECTORS OTHER THAN HEALTH CARE. BASED ON A RIGOROUS OBJECTIVE METHODOLOGY, INCLUDING REVIEW OF AN INDEPENDENT CONSULTANT'S WRITTEN REASONABLENESS ASSESSMENT OPINION AND THEIR NATIONAL MARKET DATA FROM OTHER HEALTH SYSTEMS, ASSESSMENT OF JOB RESPONSIBILITIES, EVALUATION OF QUALIFICATIONS, AND REVIEW AND APPROVAL BY A BOARD COMMITTEE COMPRISED OF INDEPENDENT AND DISINTERESTED DIRECTORS, BEAUMONT HEALTH IS CONFIDENT THAT OUR EXECUTIVES' 2021 COMPENSATION IS BOTH COMPETITIVE AND REASONABLE. PHILOSOPHY OUR EXECUTIVE COMPENSATION PROGRAMS ARE BASED ON THE FOLLOWING KEY ATTRIBUTES: - BEAUMONT PROVIDES MARKET COMPETITIVE COMPENSATION AND BENEFITS THAT ARE COMMONLY PROVIDED BY HEALTH SYSTEMS OF OUR SIZE AND COMPLEXITY. BEAUMONT EXECUTIVE COMPENSATION IS ALSO ALIGNED WITH THE PERFORMANCE OF THE ORGANIZATION. - PERFORMANCE METRICS ARE TIED TO KEY STRATEGIC OBJECTIVES - MOST OF AN EXECUTIVE'S COMPENSATION AT BEAUMONT IS DEPENDENT ON HOW THE ORGANIZATION PERFORMS ON KEY GOALS AND METRICS INCLUDING PATIENT SAFETY, QUALITY OF CARE, AND PATIENT EXPERIENCE AND SATISFACTION. AS SUCH, A SUBSTANTIAL PORTION OF AN EXECUTIVE'S INCENTIVE PAY IS 'AT-RISK' (NOT GUARANTEED) BASED ON ORGANIZATIONAL PERFORMANCE. SOME OF THE 'AT RISK' PAY IS AWARDED OVER A MULTI-YEAR PERIOD AND THERE ARE NO GUARANTEES THE ENTIRE AMOUNT WILL BE PAID. THE EXECUTIVE'S ACTUAL TAKE HOME PAY IN ANY GIVEN YEAR MIGHT BE LESS THAN THE TOTAL COMPENSATION AS REPORTED ON THE 990 IF THE ORGANIZATION'S OBJECTIVES OVER MULTIPLE YEARS ARE NOT ACHIEVED. FURTHER, COLUMN E OF SCHEDULE J OF THE 990 CAN BE EASILY MISINTERPRETED AND IS OFTEN OVERSTATED DUE TO COUNTING COMPENSATION ACCRUED IN A GIVEN YEAR, BUT NOT YET VESTED. TO AVOID INADVERTENTLY "DOUBLE COUNTING" COMPENSATION, THE BEST REFLECTION OF A SINGLE YEAR'S COMPENSATION IS SCHEDULE J COLUMN B TOTALING COLUMNS (I) THROUGH (III) FOR 2021, WHICH CONTAINS THE MOST ACCURATE SOURCE OF INFORMATION RELATED TO AN EXECUTIVE'S PAID COMPENSATION IN ANY GIVEN YEAR. YEAR TO YEAR, AN EXECUTIVE'S TOTAL COMPENSATION WILL VARY BASED ON ORGANIZATIONAL PERFORMANCE AS WELL AS THE SCHEDULED TIMING OF PAYMENTS OF AMOUNTS EARNED BUT NOT YET VESTED IN EARLIER YEARS. GOVERNANCE OF EXECUTIVE COMPENSATION BEAUMONT IS COMMITTED TO MAINTAINING HIGH STANDARDS OF CORPORATE GOVERNANCE. OUR CORPORATE GOVERNANCE PROCESS IS COMPLIANT, TRANSPARENT AND ENSURES COMPENSATION IS ADMINISTERED IN A FAIR AND EQUITABLE MANNER CONSISTENT WITH IRS GUIDELINES. EXECUTIVE COMPENSATION IS GOVERNED BY THE ORGANIZATION AND COMPENSATION COMMITTEE (OCC) OF THE BOARD OF DIRECTORS OF BEAUMONT HEALTH, THE PARENT ORGANIZATION OF A MULTI-ENTITY HEALTH SYSTEM. THE COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS WHO HAVE NO CONFLICTS OF INTEREST AS IT RELATES TO THE ORGANIZATION'S EXECUTIVE COMPENSATION. THE COMMITTEE IS RESPONSIBLE FOR: - REVIEWING, VALIDATING AND APPROVING PERFORMANCE GOALS AND METRICS RELATED TO THE EXECUTIVE'S AT-RISK COMPENSATION PLANS. - REVIEWING, VALIDATING AND APPROVING PERFORMANCE ACHIEVED ON THE EXECUTIVE AT-RISK COMPENSATION PLANS. - REVIEWING AND APPROVING COMPENSATION FOR EACH MEMBER OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM. - ENSURING COMPENSATION IS REASONABLE AND APPROPRIATE BASED ON PERFORMANCE ACHIEVED AND THE ORGANIZATION'S MISSION. THE INDEPENDENT COMMITTEE ALSO RECEIVES SUPPORT FROM OUTSIDE ADVISORS WITH EXPERTISE IN HEALTH CARE ORGANIZATIONS AND EXECUTIVE COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>BOTSFORD GENERAL HOSPITAL, A WHOLLY-OWNED SUBSIDIARY OF BEAUMONT HEALTH, IS THE CORPORATE MEMBER OF BOTSFORD CONTINUING CARE CORPORATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>BEAUMONT HEALTH IS THE PARENT CORPORATION AND SOLE MEMBER OF BOTSFORD GENERAL HOSPITAL, WHICH IS THE SOLE MEMBER OF BOTSFORD CONTINUING CARE CORPORATION. BOTSFORD GENERAL HOSPITAL, ACTING SOLELY AT THE DIRECTION OF THE PARENT, HAS THE RIGHT TO ELECT ONE OR MORE MEMBERS OF BOTSFORD CONTINUING CARE CORPORATION'S GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>BEAUMONT HEALTH, AS THE PARENT OF BOTSFORD GENERAL HOSPITAL, AND BOTSFORD GENERAL HOSPITAL, AS THE CORPORATE MEMBER OF BOTSFORD CONTINUING CARE CORPORATION, HAVE DESIGNATED RESERVED POWERS OVER BOTSFORD CONTINUING CARE CORPORATION'S OPERATIONS, INCLUDING BUT NOT LIMITED TO BUDGET, ACQUISITIONS, CAPITAL PROJECTS, AND PARTICIPATION IN JOINT VENTURES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 WAS SUBJECTED TO A MULTI-STEP REVIEW PROCESS PRIOR TO FILING WITH THE GOVERNMENT BY THE STATUTORY DUE DATE. FORM 990 IS PREPARED BY BEAUMONT HEALTH'S INTERNAL TAX DEPARTMENT, REVIEWED BY ITS MANAGEMENT, AND SUBSEQUENTLY REVIEWED BY THE FILING ENTITY'S PAID PREPARER. AS THE FINAL STEP IN THIS REVIEW PROCESS, A COPY OF THE FINAL FILING VERSION OF FORM 990 IS PROVIDED TO EACH VOTING MEMBER OF THE FILING ENTITY'S GOVERNING BODY FOR THEIR REVIEW PRIOR TO THE FORM BEING FILED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BEAUMONT HEALTH, THE PARENT CORPORATION AND SOLE MEMBER OF BOTSFORD GENERAL HOSPITAL, WHICH IS THE SOLE MEMBER OF BOTSFORD CONTINUING CARE CORPORATION, RECOGNIZES THAT IT HAS AN OBLIGATION TO ITS PATIENTS, ITS PAYORS, ITS DESIGNEES AND THE COMMUNITIES IT SERVES TO OBSERVE THE HIGHEST LEVEL OF INTEGRITY TO ENSURE CLINICAL, BUSINESS AND ACADEMIC DECISION MAKING IS NOT COMPROMISED BY FINANCIAL OR OTHER RELATIONSHIPS WITH INDUSTRY. THE CORPORATE COMPLIANCE OFFICE, WITH THE ASSISTANCE OF HUMAN RESOURCES AND SPECIFIC INDIVIDUAL DEPARTMENTS, WILL COORDINATE UPON HIRE AND EACH CALENDAR YEAR THEREAFTER, A PROCESS OF OBTAINING CONFLICT OF INTEREST/DISCLOSURE OF REMUNERATION STATEMENTS. ALL AREAS OF THE INSTITUTION WILL FOLLOW THE HUMAN RESOURCES HIRING PROCESS PROTOCOL TO ASSURE COMPLIANCE WITH THE CONFLICT OF INTEREST PROGRAM. AT ANY TIME WHEN A DESIGNEE BECOMES INVOLVED IN A RELATIONSHIP THAT IS OR MAY BE PERCEIVED TO BE A CONFLICT OF INTEREST, THE DESIGNEE MUST COMPLETE THE CONFLICT OF INTEREST/DISCLOSURE OF REMUNERATION STATEMENT AND FORWARD TO THE CORPORATE COMPLIANCE OFFICER. A CONFLICT OF INTEREST OR NEED TO DISCLOSE REMUNERATION MAY EXIST IF A BEAUMONT DESIGNEE OR ANY MEMBER OF THEIR IMMEDIATE FAMILY RECEIVES COMPENSATION IN ANY FORM FOR SERVICES RENDERED IN ANY CAPACITY TO ANY ORGANIZATION OR INDIVIDUAL THAT HAS ANY PAST, PRESENT OR PROSPECTIVE BUSINESS DEALINGS WITH BEAUMONT, IF SUCH COMPENSATION MIGHT BE REASONABLY CONSTRUED AS TENDING TO PREVENT THE DESIGNEE FROM ACTING SOLELY AND WHOLLY IN THE BEST INTEREST OF BEAUMONT HEALTH.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>BEAUMONT HEALTH'S BOARD OF DIRECTORS, OF WHICH BOTSFORD CONTINUING CARE CORPORATION IS AFFILIATED, HAS DULY APPOINTED AN ORGANIZATION AND COMPENSATION COMMITTEE (THE "COMMITTEE"), WHICH IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF COMPENSATION AND BENEFITS PROVIDED TO BEAUMONT AND ITS AFFILIATED MEMBERS' EXECUTIVE MANAGEMENT TEAMS. THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT GOVERNING THE WORK AND REVIEW PROCESS OF THE COMMITTEE. THE COMMITTEE FOLLOWS THE PROCEDURES DESCRIBED IN THE PHILOSOPHY STATEMENT WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND EMPLOYEE BENEFITS PROVIDED TO SENIOR MANAGEMENT, INCLUDING THE CHIEF EXECUTIVE OFFICER AND OTHER OFFICERS. THE COMMITTEE REVIEWS ALL ASPECTS OF COMPENSATION, INCLUDING CURRENT AND DEFERRED COMPENSATION AND BENEFITS, INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS. THE COMMITTEE MEETS FOUR TIMES A YEAR, AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION FOR EACH EXECUTIVE. THE COMMITTEE CONSISTS OF SIX MEMBERS, ALL OF WHOM ARE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT TO PREPARE AND REVIEW IN ADVANCE COMPREHENSIVE DATA SHOWING THE COMPENSATION PROVIDED BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. THE COMMITTEE ALSO PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS DELIBERATIONS AND CONCLUSIONS. AS A RESULT, THE COMMITTEE'S REVIEW PROCESS IS DESIGNED TO SATISFY THE PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. THE COMMITTEE HAS EXPRESSLY DETERMINED THAT THE TOTAL COMPENSATION PROVIDED IS REASONABLE, BASED ON THE REVIEW OF THE MARKET DATA PRESENTED BY THE INDEPENDENT COMPENSATION CONSULTANT AND ON THE REVIEW OF ALL OTHER RELEVANT FACTS AND CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VII, SECTION B, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HEALTH SYSTEM HAS A CENTRALIZED ACCOUNTS PAYABLE FUNCTION, AND AS SUCH, ALL 1099'S ARE ISSUED BY BEAUMONT HEALTH.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRACTED DIETARY SERVICES: PROGRAM SERVICE EXPENSES 1,831,359. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,831,359. CONTRACTED NURSING SERVICES: PROGRAM SERVICE EXPENSES 1,186,299. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,186,299. CONTRACTED THERAPY AND OTHER SERVICES: PROGRAM SERVICE EXPENSES 701,907. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 701,907. SERVICES AGREEMENTS: PROGRAM SERVICE EXPENSES 236,841. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 236,841. CONTRACTED COURIER SERVICES: PROGRAM SERVICE EXPENSES 13,044. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,044. CONTRACTED RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 16,144. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,144. OTHER PROGRAM SERVICES: PROGRAM SERVICE EXPENSES -255,173. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -255,173.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>MERGER EQUITY 69,663. TRANSFER TO AFFILIATES -6,890,916.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>465718220</EIN>
        <PrimaryActivitiesTxt>PARENT COMPANY OF THE HEALTH SYSTEM</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12C, III-FI</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BEAUMONT MEDICAL TRANSPORTATION SERVICE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>950 W MAPLE SUITE C</AddressLine1Txt>
          <CityNm>TROY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48084</ZIPCd>
        </USAddress>
        <EIN>260203703</EIN>
        <PrimaryActivitiesTxt>MEDICAL TRANSPORTATION SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BOTSFORD GENERAL HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>381426919</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BH GRAND RIVER SOUTHFIELD INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>25400 W EIGHT MILE ROAD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>382410823</EIN>
        <PrimaryActivitiesTxt>EMERGENCY MEDICAL SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BOTSFORD GENERAL HOSPITAL</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MICHIGAN MOBILE PET IMAGING</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>331086165</EIN>
        <PrimaryActivitiesTxt>MOBILE PET SCANNING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>OAKWOOD HEALTHCARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>OAKWOOD HEALTHCARE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>381405141</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>OAKWOOD UNITED HOSPITALS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>382837961</EIN>
        <PrimaryActivitiesTxt>FACILITY LEASING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>OAKWOOD HEALTHCARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>OAKWOOD HOME CARE SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>382877338</EIN>
        <PrimaryActivitiesTxt>HOME HEALTH SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>OAKWOOD HEALTHCARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>OAKWOOD HEALTH PROMOTIONS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>382601965</EIN>
        <PrimaryActivitiesTxt>ASSISTED AND RESIDENT CARE FACILITIES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>OAKWOOD HEALTHCARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WILLIAM BEAUMONT HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>381459362</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>364852171</EIN>
        <PrimaryActivitiesTxt>FOUNDATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BEAUMONT MEDICAL GROUP-HOSPITAL BASED SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>822768899</EIN>
        <PrimaryActivitiesTxt>PHYSICIAN SUPPORT SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BEAUMONT MEDICAL GROUP-PRIMARY CARE SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>822796539</EIN>
        <PrimaryActivitiesTxt>PHYSICIAN SUPPORT SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BEAUMONT MEDICAL GROUP-SPECIALTY SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>822784244</EIN>
        <PrimaryActivitiesTxt>PHYSICIAN SUPPORT SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>DEARBORN SCHAEFFER OFFICE COMPANY LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BOULEVARD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>262448025</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>OAKMED LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1938 WOODSLEE DRIVE</AddressLine1Txt>
          <CityNm>TROY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48083</ZIPCd>
        </USAddress>
        <EIN>461459737</EIN>
        <PrimaryActivitiesTxt>PRIVATE DUTY NURSING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>BEAUMONT INDEMNITY COMPANY LTD</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>23 LIME TREE BAY AVENUE</AddressLine1Txt>
          <CityNm>GRAND CAYMAN</CityNm>
          <ProvinceOrStateNm>GRAND CAYMAN</ProvinceOrStateNm>
          <CountryCd>CJ</CountryCd>
        </ForeignAddress>
        <EIN>980512415</EIN>
        <PrimaryActivitiesTxt>PREMIUM DEPOSITS</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>BEAUMONT NURSING HOME SERVICES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>382799842</EIN>
        <PrimaryActivitiesTxt>ASSISTED CARE LIVING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>BEAUMONT PHYSICIANS INSURANCE COMPANY INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>274261262</EIN>
        <PrimaryActivitiesTxt>PROFESSIONAL INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>BOTSFORD COMMONS PROPERTY ASSOCATION</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>383203663</EIN>
        <PrimaryActivitiesTxt>PROPERTY MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BOTSFORD CONTINUING CARE CORPORATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>504097</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>232339</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>OAKWOOD AFFILIATED VENTURES INC AND SUBSIDIARIES</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>371753159</EIN>
        <PrimaryActivitiesTxt>OFFICE OF PHYSICIANS/NON-RESIDENTAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>BH SOUTHFIELD BILLING INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>26901 BEAUMONT BLVD</AddressLine1Txt>
          <CityNm>SOUTHFIELD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48033</ZIPCd>
        </USAddress>
        <EIN>382755982</EIN>
        <PrimaryActivitiesTxt>MANAGEMENT DISPATCH SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>WILLIAM BEAUMONT HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>31233452</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>BOTSFORD GENERAL HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>3766969</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>132443</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>WILLIAM BEAUMONT HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>E</TransactionTypeTxt>
        <InvolvedAmt>67712457</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>BEAUMONT HEALTH</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>E</TransactionTypeTxt>
        <InvolvedAmt>7708172</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>BOTSFORD GENERAL HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>283221</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
