﻿<?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="2019v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2021-02-01T13:37:35-06:00</ReturnTs>
    <TaxPeriodEndDt>2020-09-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>382157642</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>MANER COSTERISAN PC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>2425 E GRAND RIVER SUITE 1</AddressLine1Txt>
        <CityNm>LANSING</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>489123291</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2019-10-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>383180997</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MICHIGAN CENTER FOR RURAL HEALTH</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>MICH</BusinessNameControlTxt>
      <PhoneNum>5174329216</PhoneNum>
      <USAddress>
        <AddressLine1Txt>MSU B-218 FEE HALL</AddressLine1Txt>
        <CityNm>EAST LANSING</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>488241316</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>JOHN BARNAS</PersonNm>
      <PersonTitleTxt>EXECUTIVE DIRECTOR</PersonTitleTxt>
      <PhoneNum>5173557979</PhoneNum>
      <SignatureDt>2021-01-25</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>BRANDY L TERWILLIGER CPA</PreparerPersonNm>
      <PTIN>P00645694</PTIN>
      <PhoneNum>5173237500</PhoneNum>
      <PreparationDt>2021-01-21</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2019</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>JOHN BARNAS</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>MSU B-218 FEE HALL</AddressLine1Txt>
        <CityNm>EAST LANSING</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>488241316</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>8018928</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.MCRH.MSU.EDU</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1994</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO COORDINATE, PLAN, &amp; ADVOCATE FOR IMPROVED HEALTH FOR MICHIGAN'S RURAL RESIDENTS &amp; COMMUNITIES.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>11</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>11</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>15</TotalEmployeeCnt>
      <TotalVolunteersCnt>11</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>2432829</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>7881579</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>298966</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>133448</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>6769</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>3901</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>2738564</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>8018928</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>1122278</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>6369871</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>671633</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>851432</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>873207</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>728971</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>2667118</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>7950274</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>71446</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>68654</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>747261</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>897690</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>149948</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>231723</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>597313</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>665967</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>THE PURPOSE OF THE CORPORATION IS TO DEVELOP A COORDINATED RURAL HEALTH PROGRAM, TO CONDUCT RESEARCH REGARDING RURAL HEALTH ISSUES, TO ASSIST RURAL COMMUNITIES IN HEALTH RELATED AREAS, AND SUCH OTHER PURPOSES AS THE BOARD SHALL DETERMINE FROM TIME TO TIME, IN GENERAL CONFORMANCE WITH THE STATUTE AUTHORIZING THE CREATION OF THE CORPORATION.</MissionDesc>
      <SignificantNewProgramSrvcInd>1</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>5059020</ExpenseAmt>
      <GrantAmt>5050800</GrantAmt>
      <Desc>SMALL RURAL HOSPITAL IMPROVEMENT PROGRAM - COVID-19: PROGRAM TO PROVIDE GRANT DOLLARS TO RURAL HOSPITALS WITH 49 OR FEWER STAFFED BEDS TO OFFSET THE COST OF PERSONAL PROTECTIVE EQUIPMENT AND STAFFING.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>746000</ExpenseAmt>
        <GrantAmt>746000</GrantAmt>
        <Desc>PRIMARY CARE CONTRACT: PROGRAM TO INCREASE ACCESS TO PRIMARY CARE SERVICES ON MICHIGAN'S INHABITED ISLANDS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>596103</ExpenseAmt>
        <GrantAmt>509600</GrantAmt>
        <Desc>SMALL RURAL HOSPITAL IMPROVEMENT PROGRAM: PROGRAM TO IMPLEMENT VALUE-BASED ACTIVITIES AND SERVICES FOR IMPROVING SMALL HOSPITALS IN RURAL AREAS OF MICHIGAN.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <ExpenseAmt>1503039</ExpenseAmt>
        <GrantAmt>63471</GrantAmt>
        <RevenueAmt>133448</RevenueAmt>
        <Desc>OTHER PROGRAM SERVICES: INCLUDES THE TRANSFORMING CLINICAL PRACTICE INITIATIVE AND SAFER OPIOID PRESCRIBING PRACTICES AND DATA COLLECTION.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcExpenseAmt>1503039</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>63471</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>133448</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>7904162</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>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">0</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">0</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</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>0</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>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>7</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>15</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <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>11</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>11</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</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>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MI</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>JOHN BARNAS</PersonNm>
        <PhoneNum>5174329216</PhoneNum>
        <USAddress>
          <AddressLine1Txt>MSU B-218 FEE HALL</AddressLine1Txt>
          <CityNm>EAST LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48824</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>CURT VANDERWALL</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREA AMALFITANODO</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NANCY L SPENCER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NICHOLAS DERUSHA</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUE ALLOR</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHY WAHL</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EDWARD CANFIELD DO</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MEGHAN GROEN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BETH NAGEL</PersonNm>
        <TitleTxt>SECRETARY/TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID B JAHN</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALFONSO C FERREIRA MD</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN BARNAS</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>103980</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33000</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>103980</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>33000</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>7881579</GovernmentGrantsAmt>
      <TotalContributionsAmt>7881579</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>CONSULTING</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>105507</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>105507</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONFERENCE REGISTRATIO</Desc>
        <BusinessCd>611710</BusinessCd>
        <TotalRevenueColumnAmt>27941</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>27941</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>133448</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>3901</TotalRevenueColumnAmt>
        <ExclusionAmt>3901</ExclusionAmt>
      </InvestmentIncomeGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>8018928</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>133448</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>3901</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>6369871</TotalAmt>
        <ProgramServicesAmt>6369871</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>143423</TotalAmt>
        <ProgramServicesAmt>141032</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2391</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>571730</TotalAmt>
        <ProgramServicesAmt>562199</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9531</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>27653</TotalAmt>
        <ProgramServicesAmt>27192</ProgramServicesAmt>
        <ManagementAndGeneralAmt>461</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>55766</TotalAmt>
        <ProgramServicesAmt>43766</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12000</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>52860</TotalAmt>
        <ProgramServicesAmt>48388</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4472</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>64115</TotalAmt>
        <ProgramServicesAmt>57154</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6961</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>222378</TotalAmt>
        <ProgramServicesAmt>222378</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>22263</TotalAmt>
        <ProgramServicesAmt>20294</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1969</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <TravelGrp>
        <TotalAmt>67462</TotalAmt>
        <ProgramServicesAmt>62488</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4974</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>68872</TotalAmt>
        <ProgramServicesAmt>68872</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InsuranceGrp>
        <TotalAmt>33448</TotalAmt>
        <ProgramServicesAmt>32268</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1180</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>EMS SERVICE</Desc>
        <TotalAmt>154878</TotalAmt>
        <ProgramServicesAmt>154878</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CAH EXPENSES</Desc>
        <TotalAmt>48296</TotalAmt>
        <ProgramServicesAmt>48296</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SITE IMPROVEMENTS</Desc>
        <TotalAmt>30000</TotalAmt>
        <ProgramServicesAmt>30000</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND MEMBERSHIPS</Desc>
        <TotalAmt>17259</TotalAmt>
        <ProgramServicesAmt>15086</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2173</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>7950274</TotalAmt>
        <ProgramServicesAmt>7904162</ProgramServicesAmt>
        <ManagementAndGeneralAmt>46112</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>83369</BOYAmt>
        <EOYAmt>43424</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>527184</BOYAmt>
        <EOYAmt>708069</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>136708</BOYAmt>
        <EOYAmt>146197</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <TotalAssetsGrp>
        <BOYAmt>747261</BOYAmt>
        <EOYAmt>897690</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2819</BOYAmt>
        <EOYAmt>2480</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>147129</BOYAmt>
        <EOYAmt>229243</EOYAmt>
      </DeferredRevenueGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>149948</BOYAmt>
        <EOYAmt>231723</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>597313</BOYAmt>
        <EOYAmt>665967</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>597313</BOYAmt>
        <EOYAmt>665967</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>747261</BOYAmt>
        <EOYAmt>897690</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>68654</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>1853353</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1666357</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2834430</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2432829</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7881579</CurrentTaxYearAmt>
        <TotalAmt>16668548</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>1853353</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1666357</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>2834430</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2432829</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>7881579</CurrentTaxYearAmt>
        <TotalAmt>16668548</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>16668548</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>2370</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3317</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3394</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>6769</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3901</CurrentTaxYearAmt>
        <TotalAmt>19751</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <TotalSupportAmt>16688299</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>1295947</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.99880</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99840</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </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>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <TotalBookValueLandBuildingsAmt>0</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>8032628</TotalRevEtcAuditedFinclStmtAmt>
      <DonatedServicesAndUseFcltsAmt>13700</DonatedServicesAndUseFcltsAmt>
      <RevenueNotReportedAmt>13700</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>8018928</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>8018928</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>7963974</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>13700</DonatedServicesUseFcltsAmt>
      <ExpensesNotReportedAmt>13700</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>7950274</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>7950274</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>IN THE PREPARATION OF TAX RETURNS, TAX POSITIONS ARE TAKEN BASED ON INTERPRETATION OF FEDERAL, STATE AND LOCAL INCOME TAX LAWS. MANAGEMENT PERIODICALLY REVIEWS AND EVALUATES THE STATUS OF UNCERTAIN TAX POSITIONS AND MAKES ESTIMATES OF AMOUNTS, INCLUDING INTEREST AND PENALTIES, ULTIMATELY DUE OR OWED. NO AMOUNTS HAVE BEEN IDENTIFIED, OR RECORDED, AS UNCERTAIN TAX POSITIONS. FEDERAL, STATE AND LOCAL TAX RETURNS GENERALLY REMAIN OPEN FOR EXAMINATION BY THE VARIOUS TAXING AUTHORITIES FOR A PERIOD OF THREE TO FOUR YEARS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASCENSION ALLEGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>555 LINN ST</AddressLine1Txt>
          <CityNm>ALLEGAN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49010</ZIPCd>
        </USAddress>
        <RecipientEIN>382802463</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASCENSION TAWAS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>200 E M 55</AddressLine1Txt>
          <CityNm>TAWAS CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48763</ZIPCd>
        </USAddress>
        <RecipientEIN>381443395</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS GRAND VIEW HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>10561 N GRAND VIEW LN</AddressLine1Txt>
          <CityNm>IRONWOOD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49938</ZIPCd>
        </USAddress>
        <RecipientEIN>232330671</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS IRON RIVER</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>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS KEWEENAW</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>205 OSCEOLA ST</AddressLine1Txt>
          <CityNm>LAURIUM</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>499132199</ZIPCd>
        </USAddress>
        <RecipientEIN>381443361</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ASPIRUS ONTONAGON HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>601 S SEVENTH ST</AddressLine1Txt>
          <CityNm>ONTONAGON</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>499531496</ZIPCd>
        </USAddress>
        <RecipientEIN>382860882</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BARAGA COUNTY MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>770 N MAIN ST</AddressLine1Txt>
          <CityNm>LANSE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49946</ZIPCd>
        </USAddress>
        <RecipientEIN>382892565</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BEAVER ISLAND RHC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3730 KINGS HIGHWAY</AddressLine1Txt>
          <CityNm>BEAVER ISLAND</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49782</ZIPCd>
        </USAddress>
        <RecipientEIN>383299988</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>250000</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 3.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BMH-WIND DOWN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>901 LAKE SHORE DRIVE</AddressLine1Txt>
          <CityNm>ISHPEMING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49849</ZIPCd>
        </USAddress>
        <RecipientEIN>381394903</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BOIS BLANC MEDICAL CLINIC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>431 SIOUX AVE</AddressLine1Txt>
          <CityNm>POINTE AUX PINS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49775</ZIPCd>
        </USAddress>
        <RecipientEIN>208756459</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 3.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BORGESS-LEE MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>420 W HIGH ST</AddressLine1Txt>
          <CityNm>DOWAGIAC</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49047</ZIPCd>
        </USAddress>
        <RecipientEIN>381490190</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BRONSON LAKEVIEW HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>601 JOHN STREET</AddressLine1Txt>
          <CityNm>KALAMAZOO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49007</ZIPCd>
        </USAddress>
        <RecipientEIN>381359218</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BRONSON SOUTH HAVEN HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>601 JOHN STREET</AddressLine1Txt>
          <CityNm>KALAMAZOO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49007</ZIPCd>
        </USAddress>
        <RecipientEIN>381676780</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CARO COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 N HOOPER PO BOX 435</AddressLine1Txt>
          <CityNm>CARO</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>487230435</ZIPCd>
        </USAddress>
        <RecipientEIN>383426063</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DECKERVILLE COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3559 PINE ST PO BOX 126</AddressLine1Txt>
          <CityNm>DECKERVILLE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48427</ZIPCd>
        </USAddress>
        <RecipientEIN>381415390</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DRUMMOND ISLAND MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 98</AddressLine1Txt>
          <CityNm>DRUMMOND ISLAND</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49726</ZIPCd>
        </USAddress>
        <RecipientEIN>383503863</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>172451</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 3.</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>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HARBOR BEACH COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>210 S FIRST ST</AddressLine1Txt>
          <CityNm>HARBOR BEACH</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>484410040</ZIPCd>
        </USAddress>
        <RecipientEIN>381565380</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</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>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HILLS &amp; DALES HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4675 HILL ST</AddressLine1Txt>
          <CityNm>CASS CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>487261099</ZIPCd>
        </USAddress>
        <RecipientEIN>381619577</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HILLSDALE HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>168 SOUTH HOWELL STREET</AddressLine1Txt>
          <CityNm>HILLSDALE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49242</ZIPCd>
        </USAddress>
        <RecipientEIN>386005550</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>HURON MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1100 S VAN DYKE RD</AddressLine1Txt>
          <CityNm>BAD AXE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48413</ZIPCd>
        </USAddress>
        <RecipientEIN>381474929</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>KALKASKA HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>419 S CORAL ST PO BOX 249</AddressLine1Txt>
          <CityNm>KALKASKA</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496469348</ZIPCd>
        </USAddress>
        <RecipientEIN>386032904</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>LAKE SUPERIOR STATE UNIVERSITY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>650 WEST EASTERDAY AVENUE</AddressLine1Txt>
          <CityNm>SAULT STE MARIE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49783</ZIPCd>
        </USAddress>
        <RecipientEIN>382576021</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>9250</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 3.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MACKINAC ISLAND MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>7474 MARKET STREET</AddressLine1Txt>
          <CityNm>MACKINAC ISLAND</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49757</ZIPCd>
        </USAddress>
        <RecipientEIN>382218858</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>250000</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 3.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MACKINAC STRAITS HEALTH SYSTEM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1140 N STATE STREET</AddressLine1Txt>
          <CityNm>ST IGNACE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49781</ZIPCd>
        </USAddress>
        <RecipientEIN>208756459</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MARLETTE COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2770 MAIN ST PO BOX 307</AddressLine1Txt>
          <CityNm>MARLETTE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>484530307</ZIPCd>
        </USAddress>
        <RecipientEIN>381507302</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MCKENZIE HEALTH SYSTEM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>120 DELAWARE ST</AddressLine1Txt>
          <CityNm>SANDUSKY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>484711087</ZIPCd>
        </USAddress>
        <RecipientEIN>381738615</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MERCY HEALTH PARTNERS LAKESHORE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>720 S STATE STREET</AddressLine1Txt>
          <CityNm>SHELBY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49455</ZIPCd>
        </USAddress>
        <RecipientEIN>382549295</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MIDMICHIGAN MEDICAL CENTER-CLARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>703 N MCEWAN ST</AddressLine1Txt>
          <CityNm>CLARE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48617</ZIPCd>
        </USAddress>
        <RecipientEIN>381518643</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MIDMICHIGAN MEDICAL CENTER-GLADWIN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>515 S QUARTER ST</AddressLine1Txt>
          <CityNm>GLADWIN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48624</ZIPCd>
        </USAddress>
        <RecipientEIN>386020434</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>325 E GRAND RIVER AVE SUITE 275</AddressLine1Txt>
          <CityNm>EAST LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48823</ZIPCd>
        </USAddress>
        <RecipientEIN>237326030</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 4.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNISING MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1500 SAND POINT RD</AddressLine1Txt>
          <CityNm>MUNISING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49862</ZIPCd>
        </USAddress>
        <RecipientEIN>381507046</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1105 SIXTH ST</AddressLine1Txt>
          <CityNm>TRAVERSE CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49684</ZIPCd>
        </USAddress>
        <RecipientEIN>382640544</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE CHARLEVOIX</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>14700 LAKE SHORE DRIVE</AddressLine1Txt>
          <CityNm>CHARLEVOIX</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49720</ZIPCd>
        </USAddress>
        <RecipientEIN>381459366</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE GRAYLING</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1100 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>GRAYLING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49738</ZIPCd>
        </USAddress>
        <RecipientEIN>471161992</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE MANISTEE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1465 E PARKDALE AVE</AddressLine1Txt>
          <CityNm>MANISTEE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49660</ZIPCd>
        </USAddress>
        <RecipientEIN>380350304</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OSF ST FRANCIS</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3401 LUDINGTON</AddressLine1Txt>
          <CityNm>ESCANABA</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49829</ZIPCd>
        </USAddress>
        <RecipientEIN>381359528</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PAUL OLIVER MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>224 PARK AVE</AddressLine1Txt>
          <CityNm>FRANKFORT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>496359348</ZIPCd>
        </USAddress>
        <RecipientEIN>381415623</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PROMEDICA HERRICK HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>500 E POTTAWATAMIE STREET</AddressLine1Txt>
          <CityNm>TECUMSEH</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49286</ZIPCd>
        </USAddress>
        <RecipientEIN>383049015</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</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>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SCHOOLCRAFT MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>500 MAIN ST</AddressLine1Txt>
          <CityNm>MANISTIQUE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49854</ZIPCd>
        </USAddress>
        <RecipientEIN>742517055</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SHERIDAN COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>301 N MAIN ST</AddressLine1Txt>
          <CityNm>SHERIDAN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>488849775</ZIPCd>
        </USAddress>
        <RecipientEIN>381369796</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SPARROW CARSON CITY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>406 E ELM STREET PO BOX 879</AddressLine1Txt>
          <CityNm>CARSON CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48811</ZIPCd>
        </USAddress>
        <RecipientEIN>381490180</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SPARROW CLINTON HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>805 S OAKLAND/PO BOX 260</AddressLine1Txt>
          <CityNm>ST JOHNS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>488792253</ZIPCd>
        </USAddress>
        <RecipientEIN>381358172</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SPARROW IONIA</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>479 LAFAYETTE ST</AddressLine1Txt>
          <CityNm>IONIA</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48846</ZIPCd>
        </USAddress>
        <RecipientEIN>383218134</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SPECTRUM HEALTH SYSTEM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>100 MICHIGAN ST NE</AddressLine1Txt>
          <CityNm>GRAND RAPIDS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49503</ZIPCd>
        </USAddress>
        <RecipientEIN>381360529</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>651660</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ST MARY'S STANDISH HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>805 W CEDAR ST</AddressLine1Txt>
          <CityNm>STANDISH</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48658</ZIPCd>
        </USAddress>
        <RecipientEIN>381671120</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>STURGIS HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>916 MYRTLE ST</AddressLine1Txt>
          <CityNm>STURGIS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49091</ZIPCd>
        </USAddress>
        <RecipientEIN>352362438</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TEN SIXTEEN RECOVERY NETWORK</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>133 N SAGINAW RD</AddressLine1Txt>
          <CityNm>MIDLAND</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48640</ZIPCd>
        </USAddress>
        <RecipientEIN>382278390</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>44043</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 4.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>THREE RIVERS HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1111 W BROADWAY</AddressLine1Txt>
          <CityNm>THREE RIVERS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49093</ZIPCd>
        </USAddress>
        <RecipientEIN>382317300</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TOWNSHIP OF BURT ALGER COUNTY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 430</AddressLine1Txt>
          <CityNm>GRAND MARAIS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49839</ZIPCd>
        </USAddress>
        <RecipientEIN>386006889</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>7713</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 3.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>WEST MACKINAC HEALTH ASSOCIATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 182</AddressLine1Txt>
          <CityNm>ENGADINE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49827</ZIPCd>
        </USAddress>
        <RecipientEIN>382784832</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>25901</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 3.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>500 OSBORN BOULEVARD</AddressLine1Txt>
          <CityNm>SAULT STE MARIE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49783</ZIPCd>
        </USAddress>
        <RecipientEIN>382602147</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PORTAGE HEALTH SYSTEM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>500 CAMPUS DRIVE</AddressLine1Txt>
          <CityNm>HANCOCK</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49930</ZIPCd>
        </USAddress>
        <RecipientEIN>473913466</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SPARROW EATON</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>321 E HARRIS ST</AddressLine1Txt>
          <CityNm>CHARLOTTE</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48813</ZIPCd>
        </USAddress>
        <RecipientEIN>382007629</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>94580</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENTS 1 AND 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DICKINSON COUNTY HEALTHCARE SYSTEM</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1721 S STEPHENSON AVE</AddressLine1Txt>
          <CityNm>IRON MOUNTAIN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49801</ZIPCd>
        </USAddress>
        <RecipientEIN>386093161</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MCLAREN CENTRAL MICHIGAN</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>12221 SOUTH DRIVE</AddressLine1Txt>
          <CityNm>MOUNT PLEASANT</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48858</ZIPCd>
        </USAddress>
        <RecipientEIN>381420304</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MIDMICHIGAN MEDICAL CENTER - WEST BRANCH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2463 S M 30</AddressLine1Txt>
          <CityNm>WEST BRANCH</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48661</ZIPCd>
        </USAddress>
        <RecipientEIN>464088182</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MIDMICHIGAN MEDICAL CENTER - GRATIOT</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>300 E WARWICK DR</AddressLine1Txt>
          <CityNm>ALMA</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48801</ZIPCd>
        </USAddress>
        <RecipientEIN>381437919</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>825 N CENTER AVE</AddressLine1Txt>
          <CityNm>GAYLORD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49735</ZIPCd>
        </USAddress>
        <RecipientEIN>381303843</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>EMMA L BIXBY MEDICAL CENTER</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>5640 N ADRIAN HWY</AddressLine1Txt>
          <CityNm>ADRIAN</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49221</ZIPCd>
        </USAddress>
        <RecipientEIN>382796005</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>PROMEDICA COLDWATER</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>84180</CashGrantAmt>
        <PurposeOfGrantTxt>SEE STATEMENT 2.</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>63</Total501c3OrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS FOR GRANT FUNDS INCLUDED WITH STATEMENT 1 - WHEN MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES, THE ORGANIZATION'S PROCEDURES INCLUDE OBSERVING THE DETAIL OF EXPENDITURES PROVIDED BY THE HOSPITALS IN THE APPLICATION FOR FUNDS IN THE UPCOMING YEAR. FOR GRANT FUNDS INCLUDED WITH STATEMENT 2 - WHEN MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES, THE ORGANIZATION'S PROCEDURES INCLUDE THE COLLECTION OF DATA SUBMITTED BY THE GRANT RECIPIENTS WITH REGARD TO THE USAGE OF GRANT FUND EQUIPMENT. THE GRANT RECIPIENT IS ALSO REQUIRED TO SIGN A MAINTENANCE AGREEMENT FOR THE EQUIPMENT AND PROVIDE AN ANNUAL INSPECTION FORM TO THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES. FOR GRANT FUNDS INCLUDED WITH STATEMENT 3 - WHEN MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES, THE ORGANIZATION'S PROCEDURES INCLUDE GATHERING INFORMATION REGARDING HOW THE FUNDS WERE USED BY EACH OF THE CLINICS IN ORDER TO SUBMIT A REPORT TO THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES. FOR GRANT FUNDS INCLUDED WITH STATEMENT 4 - WHEN MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES, THE ORGANIZATION'S PROCEDURES INCLUDE DISBURSING SCHOLARSHIP FUNDS DIRECTLY TO THE ACCREDITED UNIVERSITY. FOR GRANT FUNDS INCLUDED WITH STATEMENT 5 - WHEN MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES, THE ORGANIZATION'S PROCEDURES INCLUDE FOLLOWING UP WITH THE GRANT RECIPIENTS AFTER ONE YEAR TO ENSURE GRANT FUNDS WERE USED FOR INTENDED PURPOSES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, SCHEDULE I, PART II, COLUMN H: DESCRIPTION OF GRANT OR ASSISTANCE</FormAndLineReferenceDesc>
        <ExplanationTxt>STATEMENT 1: IMPROVE HOSPITAL INPATIENT CARE- PROGRAM TO IMPLEMENT ACTIVITIES AND PROVIDE SERVICES FOR IMPROVING SMALL HOSPITALS IN RURAL AREAS OF MICHIGAN. STATEMENT 2: SMALL RURAL HOSPITAL IMPROVEMENT PROGRAM - COVID-19 - PROVIDED GRANT DOLLARS TO RURAL HOSPITALS WITH 49 OR FEWER STAFFED BEDS TO OFFSET THE COST OF PERSONAL PROTECTIVE EQUIPMENT AND STAFFING. STATEMENT 3: INCREASE ACCESS TO PRIMARY CARE SERVICES ON MICHIGAN'S INHABITED ISLANDS AND RURAL CLINICS. STATEMENT 4: SCHOLARSHIPS FOR STUDENTS TO ATTEND RURAL OSTEOCHAMPS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE WERE THREE NEW PROGRAMS IN THE CURRENT YEAR: (1) SMALL RURAL HOSPITAL IM PROVEMENT PROGRAM - COVID-19 PROGRAM TO PROVIDE GRANT DOLLARS TO RURAL HOSPITALS WITH 49 OR FEWER STAFFED BEDS TO OFFSET THE COST OF PERSONAL PROTECTIVE EQUIPMENT AND STAFFING. (2) PROJECT ECHO OPIOID INTERVENTION PROGRAM CONNECTS SPECIALISTS WITH THE ON-THE-GROUND PRACTITIONERS TO BRIDGE HEALTH GAPS IN RURAL COMMUNITIES. (3) ENHANCING TEAM-BASED RURAL HEALTH PROGRAM WORKS WITH PRIMARY CARE PROVIDERS TO REDUCE CARDIAC DISEASE AND COPD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS MAY AUTHORIZE ANY OFFICER OR OFFICERS, AGENT OR AGENTS, TO ENTER INTO ANY CONTRACT OR EXECUTE OR DELIVER ANY CONVEYANCE OR OTHER INSTRUMENT IN THE NAME OF THE CORPORATION, AND SUCH AUTHORITY MAY BE GENERAL OR CONFINED TO SPECIFIC INSTANCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CPA FIRM PRESENTS THE FORM 990 TO THE EXECUTIVE COMMITTEE FOR REVIEW; ONE WEEK LATER, THE FORM 990 IS PRESENTED BY THE CPA FIRM TO THE FULL BOARD OF DIRECTORS AT THE JANUARY BOARD MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>A COPY OF THE CONFLICT OF INTEREST POLICY IS PROVIDED ANNUALLY TO ALL BOARD MEMBERS AND TO EACH NEW BOARD MEMBER AS THEY ARE ADDED TO THE BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SECRETARY/TREASURER REVIEWS MICHIGAN NONPROFIT ASSOCIATION COMPENSATION SURVEY DATA AND THE STATE OF MICHIGAN EMPLOYEE DATA AND PRESENTS THE INFORMATION/RECOMMENDATION TO THE EXECUTIVE COMMITTEE FOR APPROVAL; THEN IT IS PRESENTED TO THE FULL BOARD FOR APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>