2021-08-10T15:49:18-05:00 2020-09-30 381357951 PLANTE & MORAN PLLC 3000 TOWN CENTER SUITE 100 SOUTHFIELD MI 48075 990 2019-10-01 382146751 MCLAREN NORTHERN MICHIGAN MCLA 2314874094 416 CONNABLE AVENUE PETOSKEY MI 49770 TODD C BURCH CEO 2314874094 2021-08-06 1 AMY CIMINELLO P00796388 2483522500 2021-08-06 2019 2022-09-23 18:48:47Z TODD C BURCH 416 CONNABLE AVENUE PETOSKEY MI 49770 295943380 0 X WWW.MCLAREN.ORG/NORTHERNMICHIGAN/ X 1977 MI MCLAREN HEALTH CARE, THROUGH ITS SUBSIDIARIES, WILL BE THE BEST VALUE IN HEALTH CARE AS DEFINED BY QUALITY OUTCOMES AND COST. 15 12 1633 65 22784 -31081 6948806 20375843 276028134 256901523 4168597 3409340 1401378 6934955 288546915 287621661 96715 93039 0 0 112512591 104027918 0 0 0 153712186 150411343 266321492 254532300 22225423 33089361 347588593 455983689 221370347 306372470 126218246 149611219 X MCLAREN HEALTH CARE, THROUGH ITS SUBSIDIARIES, WILL BE THE BEST VALUE IN HEALTH CARE AS DEFINED BY QUALITY OUTCOMES AND COST. 0 0 22712842 48417075 THE TREATMENT AND DIAGNOSIS OF CARDIAC DISEASE (22,756 CASES). 12209761 25023118 THE TREATMENT AND DIAGNOSIS OF GENERAL MEDICINE (2,720 CASES). 11456801 22522397 THE TREATMENT AND DIAGNOSIS OF GENERAL SURGERY (1,907 CASES). 120452977 93039 161721521 ALL OTHER PROGRAM SERVICES INCLUDING: ONCOLOGY, ORTHOPEDICS, RADIOLOGY, NEUROLOGY, GASTROENTEROLOGY, REHABILITATION, OBSTETRICS, AND NEUROSURGERY. 120452977 93039 161721521 166832381 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 98 0 1 1633 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 1 0 X MICHAEL PRUSAITIS 2314874011 416 CONNABLE AVENUE PETOSKEY MI 49770 PHIL INCARNATI TRUSTEE 1.00 49.00 X 0 7968695 186859 CLARENCE SEVILLIAN TRUSTEE 1.00 49.00 X 0 918356 32023 KAREN E DENBESTEN PHYSICIAN 40.00 0.00 X 374938 0 30987 DAVID BELLAMY FORMER VP OF FINANCE/CFO 20.00 25.60 X 357285 0 29370 ANDREW M MCDONAGH VP - CMO 25.00 15.50 X 339359 0 29317 TODD BURCH TRUSTEE & PRESIDENT/CEO 35.00 13.50 X X 0 356896 10876 JON A SANGEORZAN MD PHYSICIAN 40.00 0.00 X 275826 0 29856 MARGARET A ORR MEDICAL DIRECTOR 40.00 0.00 X 255595 0 17938 JENNIFER I WOODS VP - CNO 35.00 10.00 X 202193 0 27777 PATRICK SCHULTE VP-CHIEF DEV OFF/EX DIR FDN- PART YEAR 22.00 28.00 X 160831 39897 20879 ANAS ORFALI MEDICAL PHYSICIST 40.00 0.00 X 201222 0 19178 STEFANO PECA MEDICAL PHYSICIST 50.00 0.00 X 176510 0 10271 SHARI A SCHULT VP OF OPERATIONS 30.00 10.00 X 176306 0 10005 DAVID ZECHMAN FORMER TRUSTEE & PRESIDENT/CEO 36.00 14.00 X 0 175660 7655 DEREK M PETERS VP OF HUMAN RESOURCES 20.00 22.80 X 156308 0 21006 STEVEN THOMPSON VP OF FINANCE/CFO 5.00 40.00 X 91346 0 0 LEONARDO DAVE FRESCOLN TRUSTEE 1.00 0.00 X 0 24000 0 KATHY ERBER VICE CHAIRPERSON 1.00 0.50 X X 0 0 0 ROBERT HOLBEN CHAIRPERSON 1.00 0.00 X X 0 0 0 WALTER SHEAR SECRETARY 1.00 0.00 X X 0 0 0 CHANDRA DELORENZO TRUSTEE - PART YEAR 1.00 0.00 X 0 0 0 DENNIS HESSELINK TRUSTEE 1.00 0.00 X 0 0 0 ELISE HAYES TRUSTEE 1.00 5.00 X 0 0 0 ERIC BASMAJI MD TRUSTEE 1.00 0.00 X 0 0 0 H GUNNER DEERY MD TRUSTEE 1.00 0.00 X 0 0 0 JOHN STEVEN BROWN TRUSTEE 1.00 0.00 X 0 0 0 JULIE FASONE-HOLDER TRUSTEE 1.00 0.00 X 0 0 0 ROBERT WALKER TRUSTEE 1.00 0.00 X 0 0 0 THOMAS CATTEL TRUSTEE 1.00 0.00 X 0 0 0 2767719 9483504 483997 60 1 1 0 ACUTE CARE SURGERY MEDICAL GROUP INC 2450 DEL PASO RD STE 250 SACRAMENTO CA 95834 PHYSICIAN SERVICES 2446470 REHABCARE PO BOX 502096 ST LOUIS MO 631502096 MANAGEMENT & THERAPY SERVICES 2180392 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 303682289 MANAGEMENT & DIETARY SERVICES 1389412 AMERICAN HEALTHCARE STAFFING ASSOCIATION PO BOX 670529 DALLAS TX 752670529 PURCHASED LABOR 1288689 NORTHERN ANESTHESIA PROVIDERS 602 JACKSON PETOSKEY MI 49770 PHYSICIAN SERVICES 1273400 21 6717078 13658765 20375843 PATIENT SERVICE REV 621500 256623086 256623086 MEDICAL SERVICE REIMBURSEMENTS 621500 157344 157344 RELATED-PARTY RENT 531390 121093 121093 256901523 2643495 2643495 560336 468628 91708 91708 91708 8452251 166685 7853091 0 599160 166685 765845 765845 FRINGE BENEFIT REIMBURSEMENT 900099 5273727 5273727 CAFETERIA SALES 722210 764148 764148 ACO DISTRIBUTION 900099 613114 613114 192258 169474 22784 6843247 287621661 257684111 22784 9538923 93039 93039 83701729 74880953 8820776 1867001 1867001 13674788 4435847 9238941 4784400 4017962 766438 1767744 1767744 1323134 1323134 116274 116274 20416606 8829086 11587520 339496 3995 335501 4193775 2919987 1273788 1020836 644197 376639 5586472 1086058 4500414 724720 68346 656374 72478 53482 18996 817398 817398 8207463 2136284 6071179 919661 4578 915083 MEDICAL SUPPLIES/DRUGS 57944000 57698381 245619 CORPORATE ALLOCATION 29024728 29024728 PROVISION FOR BAD DEBT 9721481 9721481 QAAP TAX 5265127 5265127 2949950 238705 2711245 254532300 166832381 87699919 0 6451 6451 21045198 104228740 19004995 20429314 7607513 7752407 1354695 1187123 218280244 53849198 118764042 164431046 47493762 50161497 101314567 58054782 1808136 1477876 18576849 29189234 29677604 347588593 455983689 33485208 82943755 398615 2757918 157648199 154422822 29838325 66247975 221370347 306372470 X 114565776 134149254 11652470 15461965 126218246 149611219 347588593 455983689 X 33089361 902923 -10599311 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7002 7002 0 PART II-B, LINE 1: A PORTION OF OUR DUES TO MICHIGAN HEALTH AND HOSPITAL ASSOCIATION SUPPORT LOBBYING ACTIVITIES ON BEHALF OF MCLAREN NORTHERN MICHIGAN'S COMMON INTERESTS. 0 6454 -157 530 5767 14731 -277 8000 6454 14444 287 14731 12979 1465 14444 13235 3090 3346 12979 0.00000 1.00000 0.00000 0 1 1 6957348 6957348 62302654 13530758 48771896 5881544 1356185 4525359 53949637 38962255 14987382 89189061 89189061 164431046 BOND FUND 58054782 F 58054782 DUE FROM AFFILIATE 4000249 INVESTMENT IN FOUNDATION HELD ASSETS 15461964 DEFERRED EQUIPMENT FEES 10215391 29677604 DUE TO AFFILIATE 15220716 ACCRUED PENSION COST 21205509 COST REPORT SETTLEMENT PAYABLE 9094739 LTD OPERATING LEASES 18777011 DOJ LIABILITY 1950000 66247975 PART V, LINE 4: MCLAREN NORTHERN MICHIGAN FOUNDATION HOLDS ENDOWMENTS ON BEHALF OF THE HOSPITAL. THE INTENDED PURPOSE OF THE ABOVE ENDOWMENT IS TO ASSIST PEDIATRIC PATIENTS. 1 1 X 1 X 1 X 1 1 0 1 1 447859 447859 0.00180 32581600 26927395 5654205 0.02300 33029459 26927395 6102064 0.02480 21083195 11659369 9423826 0.03830 21083195 11659369 9423826 0.03830 54112654 38586764 15525890 0.06310 1 9721481 3866233 87411928 83084217 4327711 X 1 1 1 1 MCLAREN NORTHERN MICHIGAN 416 CONNABLE AVENUE PETOSKEY MI 49770 WWW.MCLAREN.ORG/NORTHERNMICHIGAN/NORTH 1060000053 X X X X MCLAREN NORTHERN MICHIGAN 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X HTTPS://TINYURL.COM/YAWXCYL4 X X 1 19 1 HTTPS://TINYURL.COM/YAWXCYL4 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X HTTPS://TINYURL.COM/YYA9C5OC X HTTPS://TINYURL.COM/YYA9C5OC X HTTPS://TINYURL.COM/YYA9C5OC X X X X X X 1 X 0 X X X X 1 X 0 0 MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 5: A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITAL'S WEBSITE LOCATED AT HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENTMCLAREN NORTHERN MICHIGAN IN CONJUNCTION WITH 12 OTHER HOSPITALS AND 7 DISTRICT HEALTH DEPARTMENTS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT. MORE THAN 150 ORGANIZATIONS IN THE 31 COUNTY REGION PARTICIPATED IN COLLECTING DATA BY CONDUCTING 4 ASSESSMENTS: COMMUNITY STATUS, LOCAL COMMUNITY SERVICES, COMMUNITY THEMES AND STRENGTHS, AND FORCES OF CHANGE. CONDUCTED COMMUNITY INPUT BOARDS, MINI CLIENT INTERVIEWS, (INCLUDING SPECIAL POPULATIONS, SENIORS, PERSONS/FAMILIES WITH PHYSICAL AND MENTAL DEVELOPMENTAL DISABILITIES, AND YOUNG CHILDREN 0 - 5 YRS, AND OTHERS), AND SURVEYED COMMUNITY AND HEALTH CARE PROVIDERS. MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN CONJUNCTION WITH 12 OTHER HOSPITALS INCLUDING KALKASKA MEMORIAL HEALTH CENTER, MCLAREN CENTRAL MICHIGAN, MID-MICHIGAN- ALPENA, MID-MICHIGAN HEALTH- CLARE/GLADWIN, MUNSON MEDICAL CENTER, MUNSON HEALTHCARE CADILLAC HOSPITAL, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE GRAYLING HOPSITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL, MUNSON HEALTHCARE PAUL OLIVER MEMORIAL HOSPITAL, AND SPECTRUM HEALTH AND 7 DISTRICT HEALTH DEPARTMENTS: BENZIE-LEELANAU, CENTRAL MICHIGAN, HEALTH DEPARTMENT #10, HEALTH DEPARTMENT #2, HEALTH DEPARTMENT #4, GRAND TRAVERSE COUNTY, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN. OTHER COLLABORATORS INCLUDED NORTH COUNTRY COMMUNITY MENTAL HEALTH, NORTHERN MICHIGAN COMMUNITY HEALTH INNOVATION REGION, AND GRAND TRAVERSE HEALTH. MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 7D: HOSPITAL REPRESENTATIVES PRESENTED THE COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS AND IMPLEMENTATION STRATEGY TO COMMUNITY ADVISORY COUNCILS, BUSINESS LEADERS, AND VARIOUS COMMUNITY GROUPS. MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 11: TWO MAJOR FOCUS AREAS WERE IDENTIFIED THROUGH THE ASSESSMENT PROCESS: MENTAL HEALTH & SUBSTANCE USE AND BASIC NEEDS OF LIVING. ANOTHER ISSUE OF IMPORTANCE WAS RISKS FOR LEADING CAUSES OF DEATH (CHRONIC DISEASE). AN IMPLEMENTATION STRATEGY WAS DEVELOPED TO ADDRESS THESE ISSUES. THE HOSPITAL AND OTHER COMMUNITY PARTNERS REVIEWED SEVEN COMMUNITY THEMES THAT RESULTED FROM THE ASSESSMENT: BASIC NEEDS, MENTAL HEALTH/SUBSTANCE USE, ACCESS TO HEALTHCARE, SENSE OF COMMUNITY, CHRONIC DISEASE, CROSS-SECTOR COLLABORATION, AND COMMUNITY VOICE. TWO PRIORITIES WERE IDENTIFIED: MENTAL HEALTH & SUBSTANCE USE AND BASIC NEEDS OF LIVING INCLUDING TRANSPORTATION & PHYSICAL ACTIVITY, HOUSING, FOOD, AND POVERTY/ECONOMIC SECURITY. THE HOSPITAL DID NOT ADDRESS SENSE OF COMMUNITY, CROSS-SECTOR COLLABORATION OR COMMUNITY VOICE IN THIS PLAN DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES ON THE THREE NEEDS IDENTIFIED ABOVE.A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITAL'S WEBSITE LOCATED AT HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 13B: PRESUMPTIVE FINANCIAL ASSISTANCE MAY BE APPLIED BASED ON THIRD PARTY INFORMATION OR A PRIOR FINANCIAL ASSISTANCE DETERMINATION. DESIGNATED PERSONNEL WILL MAKE REASONABLE EFFORT TO NOTIFY THE INDIVIDUAL OF ASSISTANCE. 3 1 - MCLAREN NORTHERN MICHIGAN-CHEBOYGAN CAMP 748 MAIN ST CHEBOYGAN MI 49721 OUTPATIENT SERVICES - RADIOLOGY, LAB, EMERGENT, SURGERY 2 - WELLNESS PAVILLION AND DIALYSIS CENTER 820 ARLINGTON AVENUE PETOSKEY MI 49770 OUTPATIENT SERVICES - DIALYSIS, PT, OT, CARDIAC REHAB, PHYSICIAN PRACTICE 3 - GREAT LAKES MOBILE PET 416 CONNABLE AVENUE PETOSKEY MI 49770 MOBILE UNIT - PET SERVICES PART I, LINE 3C: INCOME CRITERIA IS BASED ON A 200% FEDERAL POVERTY GUIDELINES PER THE FEDERAL REGISTER. COLLECTIONS MAY BE CONSIDERED IF THE PATIENT HAS SUFFICIENT LIQUID ASSETS. PART I, LINE 6A: OUR PARENT, MCLAREN HEALTH CARE CORPORATION, PREPARES AN ANNUAL REPORT OF ITS MEMBER HOSPITALS. THIS ANNUAL REPORT IS AVAILABLE ON OUR WEBSITE. PART I, LINE 7: A COST TO CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE. THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, AND CASH CONTRIBUTIONS (LINES 7E, 7F, 7G, AND 7I). PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE: ACUTE REHAB, PSYCHIATRY, NEWBORNS, OB, WOMEN'S SERVICES, ACUTE INPATIENT, OUTPATIENT FIXED AND HEMODIALYSIS. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24E - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $9,721,481. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES SUPPORT IDENTIFIED COMMUNITY NEEDS AND COMMUNITY COLLABORATIVES SUCH AS TRANSPORTATION, WORKFORCE DEVELOPMENT AND COMMUNITY HEALTH, BY PROVIDING IN-KIND SERVICES, FINANCIAL RESOURCES AND STAFF EXPERTISE FROM THE HOSPITAL. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX. PART III, LINE 3: TO DETERMINE THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY, ADMINISTRATION ESTIMATED A PERCENTAGE OF INDIVIDUALS WHO DID NOT COMPLETE THE CHARITY CARE APPLICATION PROCESS, OR DID NOT TAKE THE TIME TO APPLY - WHICH AMOUNTS TO $3,866,233. PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE CORPORATION'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: THE AMOUNTS REPORTED FOR MEDICARE ARE FROM THE MEDICARE COST REPORT, WHICH DO NOT SHOW A SHORTFALL. THIS IS BASED ON THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT. PART III, LINE 9B: THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY DOES NOT CONTAIN PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE BECAUSE IF POSSIBLE WE TRY TO IDENTIFY AND DETERMINE ELIGIBILITY FOR CHARITY CARE BEFORE SERVICES ARE PROVIDED. ALSO, IT IS STATED IN OUR CHARITY CARE POLICY THAT ONCE ELIGIBLE, NO COLLECTION AGENCIES OR OTHER COLLECTION PROCESSES WILL BE FOLLOWED UNLESS THE PATIENT'S FINANCIAL CIRCUMSTANCES MATERIALLY CHANGE. PART VI, LINE 2: MCLAREN NORTHERN MICHIGAN ASSESSES THE NEEDS AND ASSETS OF THE COMMUNITY BY COLLABORATING WITH COMMUNITY AND STRATEGIC PARTNERS TO REVIEW DEMOGRAPHICS, HEALTH INDICATORS, MORBIDITY AND MORTALITY DATA, ANALYZING COST DRIVERS, AND CONDUCTING FOCUS GROUPS, SURVEYS, AND COMMUNITY FORUMS. PART VI, LINE 3: AS PATIENTS ARE REGISTERED EITHER IN PERSON OR OVER THE PHONE THEY ARE GIVEN CONTACT INFORMATION FOR PATIENT FINANCIAL SERVICES REPRESENTATIVES IF THEY HAVE NO INSURANCE, ARE UNDER INSURED OR HAVE HIGH CO-PAY'S. THERE ARE PATIENT FINANCIAL SERVICES BROCHURES DISPLAYED AT ALL REGISTRATION AREAS THAT DESCRIBE THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS AVAILABLE. THROUGH OUR CARE COORDINATION PROGRAM ALL PATIENTS WITH NO INSURANCE ARE SEEN TO ASSIST WITH FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: MCLAREN NORTHERN MICHIGAN, A SUBSIDIARY OF MCLAREN HEALTH CARE, IS A 202-BED REGIONAL REFERRAL CENTER LOCATED IN PETOSKEY, SERVING RESIDENTS IN 22 COUNTIES ACROSS NORTHERN LOWER MICHIGAN AND THE EASTERN PART OF THE UPPER PENINSULA. A MEDICAL STAFF OF MORE THAN 230 PHYSICIANS REPRESENTS NEARLY ALL MEDICAL AND SURGICAL SPECIALTIES, ENABLING FULL-SERVICE CARE WITH AN EMPHASIS ON HEART, CANCER, ORTHOPEDICS, AND NEUROSCIENCE SERVICES. PREDICATED ON A VISION TO PROVIDE PATIENT-CENTERED CARE, EXTENSIVE EFFORTS IN TARGETING REGIONAL HEALTH CONCERNS HAS LED TO COLLABORATIVE PROGRAMS AND SERVICES IN PRIMARY CARE, HEART, CANCER AND DIAGNOSTICS. THIS APPROACH TO HIGH QUALITY, COST EFFECTIVE HEALTHCARE DELIVERY IN THIS RURAL AND REMOTE AREA HAS BEEN STRENGTHENED BY A LONG STANDING PRACTICE OF SPECIALTY PHYSICIANS HOSTING ON-SITE CLINIC VISITS TO OUTLYING COMMUNITIES. MCLAREN NORTHERN MICHIGAN IS WORKING TO INFLUENCE BEHAVIOR THROUGH EDUCATION, PREVENTION THROUGH SCREENING, AND PROVIDING ACCESSIBLE TREATMENT THROUGH PHYSICIAN CLINICS AND HEALTH CENTERS THROUGHOUT THE REGION. PART VI, LINE 5: THE HOSPITAL HAS AN ESTABLISHED REGIONAL COMMUNITY ADVISORY BOARD WHICH MEETS TO ACTIVELY ADDRESS HEALTHCARE ISSUES IN THE REGION. THE HOSPITAL PROVIDES COMMUNITY BENEFIT ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT AND HEALTH EDUCATION PROGRAMS AND SERVICES TO IMPROVE ACCESS TO HEALTHCARE, PROMOTE HEALTH AND WELLNESS, AND MANAGE CHRONIC DISEASE. PART VI, LINE 6: AFFILIATES OF MCLAREN NORTHERN MICHIGAN INCLUDE THE FOLLOWING ORGANIZATIONS, EACH OF WHICH CONTRIBUTE TO HEALTH PROMOTION IN THE MANNER INDICATED: * MCLAREN NORTHERN MICHIGAN FOUNDATION - RAISES, MANAGES, AND DISPENSES FUNDS TO SUPPORT THE MISSION OF MCLAREN NORTHERN MICHIGAN AND PROVIDE PROGRAMS THAT ENHANCE THE WELL-BEING OF THE COMMUNITY. * BOULDER PARK TERRACE - PROVIDES SKILLED NURSING AND SUB-ACUTE REHABILITATION SERVICES. * VITALCARE - PROVIDES HOME HEALTH SERVICES, HOME MEDICAL EQUIPMENT AND SUPPLIES, HOSPICE SERVICES, PRIVATE DUTY SERVICES, AND ADULT DAY SERVICES.* PHYSICIAN PRACTICES - OFFER THE OPPORTUNITY FOR SEAMLESS PATIENT CARE WITHIN THE REGION THROUGH A SYSTEM OF WHOLLY-OWNED SPECIALTY MEDICINE PRACTICES: MICHIGAN HEART & VASCULAR SPECIALISTS, NORTHERN MICHIGAN INFECTIOUS DISEASES, NORTHERN MICHIGAN HEMATOLOGY/ONCOLOGY, MCLAREN NORTHERN MICHIGAN NEUROSCIENCES, MCLAREN NORTHERN MICHIGAN NEPHROLOGY, MCLAREN NORTHERN MICHIGAN DIGESTIVE HEALTH AND PRIMARY CARE PRACTICES IN PETOSKEY, CHEBOYGAN, CHARLEVOIX, GAYLORD, INDIAN RIVER AND ROGERS CITY. * PRESCRIPTION SERVICES PHARMACY - OFFERS RETAIL PHARMACY SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES MI PART VI, PANDEMIC IMPACT IN MARCH OF 2020 COVID-19 MADE ITS PRESENCE AT MCLAREN NORTHERN MICHIGAN. THE EXISTENCE OF THIS VIRUS HAS CHANGED SO MUCH IN OUR WORLD, NATION AND LOCAL AREA, BUT ONE THING IT DIDN'T CHANGE IS MCLAREN NORTHERN MICHIGAN'S COMMITMENT TO THE COMMUNITY. MCLAREN NORTHERN MICHIGAN CONTINUED TO FOCUS ON THE HEALTH AND WELLNESS OF THOSE WE SERVE THROUGHOUT THE PANDEMIC. SAFETY PROTOCOLS WERE QUICKLY PUT INTO PLACE BY OUR INCIDENT COMMAND TEAM TO PROTECT OUR PATIENTS, EMPLOYEES AND PROVIDERS. WE PROVIDED STAFF WITH PPE AND EDUCATION ON EVOLVING POLICIES AND PROCEDURES. WE PUT A CONCERTED EFFORT INTO COMMUNICATING WITH OUR COMMUNITY MEMBERS TO ENSURE WE SHARED VITAL INFORMATION ABOUT COVID-19, THE IMPORTANCE OF CONTINUING TO SEEK HEALTH CARE SERVICES, AND RESOURCES FOR QUESTIONS ABOUT COVID. FACE-TO-FACE GROUP HEALTH EDUCATION PROGRAMS SHIFTED TO TELE-ELECTRONIC PLATFORMS AS A MEANS TO CONTINUE ADDRESSING NEEDS. OUR INFECTIOUS DISEASE EXPERTS REGULARLY PARTNERED WITH THE MEDIA, CHAMBER OF COMMERCE AND SCHOOL DISTRICT LEADERS TO SHARE THE LATEST COVID INFORMATION AND PROVIDE EXPERT MEDICAL ADVICE IN AN EVER CHANGING ENVIRONMENT. MCLAREN NORTHERN MICHIGAN PARTNERED WITH OTHER COMMUNITY ORGANIZATIONS FOR A UNIFIED APPROACH TO MESSAGING AND ATTAINMENT OF SUPPLIES LIKE HAND SANITIZER, MASKS, AND GLOVES NEEDED TO LIMIT THE SPREAD OF THE VIRUS. BREAKING COVID NEWS WAS SHARED IN A HOSPITAL COMMUNITY E-NEWSLETTER AND THROUGH VIDEOS EMAILED TO AREA RESIDENTS. DURING COMMUNITY EVENTS, LIKE THE LOCAL PARADE AND OUTDOOR GATHERINGS, MCLAREN NORTHERN MICHIGAN DISTRIBUTED HAND SANITIZER AND MASKS TO THE ATTENDEES. OUR FRONTLINE HEALTH CARE WORKERS TRULY BECAME HEALTH CARE HEROES, CARING FOR PATIENTS WITH COVID-19 AND SUPPORTING EACH OTHER DURING UNPRECEDENTED TIMES. 1 MCLAREN NORTHERN MICHIGAN FOUNDATION 360 CONNABLE AVENUE PETOSKEY MI 49770 382445611 501(C)(3) 93039 N/A N/A RENT/GENERAL OPERATIONS 1 0 PART I, LINE 2: GRANTS MADE TO RELATED ORGANIZATIONS ARE MONITORED THROUGH THE MONTHLY ACCOUNTING PROCESSES. 1 1 0 0 0 0 0 1 0 PHIL INCARNATI TRUSTEE 0 2197696 0 1470998 0 4300001 0 178353 0 8506 0 8155554 0 0 CLARENCE SEVILLIAN TRUSTEE 0 536485 0 143750 0 238121 0 14000 0 18023 0 950379 0 0 KAREN E DENBESTEN PHYSICIAN 335236 0 20012 0 19690 0 14000 0 16987 0 405925 0 0 0 DAVID BELLAMY FORMER VP OF FINANCE/CFO 355737 0 0 0 1548 0 10375 0 18995 0 386655 0 0 0 ANDREW M MCDONAGH VP - CMO 337037 0 0 0 2322 0 12629 0 16688 0 368676 0 0 0 TODD BURCH TRUSTEE & PRESIDENT/CEO 0 264261 0 0 0 92635 0 0 0 10876 0 367772 0 0 JON A SANGEORZAN MD PHYSICIAN 185543 0 88410 0 1873 0 14000 0 15856 0 305682 0 0 0 MARGARET A ORR MEDICAL DIRECTOR 251388 0 0 0 4207 0 11594 0 6344 0 273533 0 0 0 JENNIFER I WOODS VP - CNO 185951 0 15000 0 1242 0 10283 0 17494 0 229970 0 0 0 PATRICK SCHULTE VP-CHIEF DEV OFF/EX DIR FDN- PART YE 159589 39897 0 0 1242 0 4156 0 16723 0 181710 39897 0 0 ANAS ORFALI MEDICAL PHYSICIST 190878 0 0 0 10344 0 10074 0 9104 0 220400 0 0 0 STEFANO PECA MEDICAL PHYSICIST 176395 0 0 0 115 0 0 0 10271 0 186781 0 0 0 SHARI A SCHULT VP OF OPERATIONS 173984 0 0 0 2322 0 8851 0 1154 0 186311 0 0 0 DAVID ZECHMAN FORMER TRUSTEE & PRESIDENT/CEO 0 97055 0 0 0 78605 0 4452 0 3203 0 183315 0 0 DEREK M PETERS VP OF HUMAN RESOURCES 155815 0 0 0 493 0 7955 0 13051 0 177314 0 0 0 PART I, LINE 1A THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 1 BOXES HAVE BEEN CHECKED. THE CORPORATE CEO, SUBSIDIARY CEOS AND CORPORATE EXECUTIVE & SENIOR VICE-PRESIDENTS IN SOME INSTANCES HAVE RECEIVED TAX INDEMNIFICATION FOR THE FOLLOWING BENEFITS: VEHICLE COSTS, GROUP TERM LIFE INSURANCE, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS, AND HEALTH CLUB OR SOCIAL DUES. THESE BENEFITS HAVE BEEN INCLUDED IN TAXABLE COMPENSATION. PART I, LINE 3 THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 3 BOXES HAVE BEEN CHECKED. THE RELATED ORGANIZATION USED THE FOLLOWING METHODOLOGIES TO ESTABLISH THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B DAVID BELLAMY RECEIVED SEVERANCE PAYMENTS EACH PAY PERIOD FROM 9/14/19 - 2/1/20 IN THE AMOUNT OF $14,169. PATRICK SCHULTE RECEIVED SEVERANCE PAYMENTS EACH PAY PERIOD FROM 5/1/20 - 6/1/20 IN THE AMOUNT OF $10,179. MCLAREN MAINTAINS TWO SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES (THE "SERPS"). THE OLD SERP WAS CLOSED TO NEW PARTICIPANTS ON OCTOBER 1, 2006, AND THE NEW SERP BECAME EFFECTIVE AS OF JANUARY 1, 2007. NO EMPLOYEE MAY PARTICIPATE IN BOTH OF THE SERPS. THE OLD SERP IS STRUCTURED AS A DEFINED BENEFIT PLAN THAT ESSENTIALLY REPLACES THE BENEFITS THE PARTICIPANT IS NOT PERMITTED TO RECEIVE UNDER MCLAREN'S QUALIFIED RETIREMENT PLAN DUE TO IRS LIMITATIONS APPLICABLE TO QUALIFIED PLANS. THE BENEFIT UNDER THE OLD SERP IS PAYABLE IN EITHER THE FORM OF A LUMP SUM DISTRIBUTION OR IN MONTHLY PAYMENTS EQUAL TO THE ACTUARIAL EQUIVALENT OF THE PARTICIPANT'S ACCRUED BENEFIT. THE BENEFIT IS PAID AT AGE 55, AND IF THE PARTICIPANT REMAINS EMPLOYED, THE BENEFIT IS PAID UPON TERMINATION OF EMPLOYMENT, REDUCED TO TAKE INTO ACCOUNT THE BENEFIT PREVIOUSLY PAID. THE NEW SERP IS STRUCTURED AS A DEFINED CONTRIBUTION PLAN, AND MCLAREN CONTRIBUTES 15 PERCENT OF EACH PARTICIPANT'S COMPENSATION TO THE PLAN EACH YEAR FOR ALLOCATION TO THE PARTICIPANT'S ACCOUNT. PARTICIPANTS IN THE NEW SERP BECOME VESTED IN THEIR ACCOUNTS UPON THE EARLIER OF FIVE YEARS OF PARTICIPATION IN THE PLAN OR ATTAINMENT OF AGE 60. PARTICIPANTS IN THE NEW SERP SELF-DIRECT THE INVESTMENT OF THEIR ACCOUNTS AND HAVE THE ACTUAL INVESTMENT RETURN CREDITED OR DEBITED TO THEIR ACCOUNTS. THE BENEFIT UNDER THE NEW SERP IS EQUAL TO THE PARTICIPANT'S ACCOUNT BALANCE, AND THE BENEFIT IS PAID IN A SINGLE SUM WITHIN 60 DAYS OF THE PARTICIPANT'S TERMINATION DATE. BENEFITS UNDER BOTH SERPS ARE PROVIDED ON A TAX-NEUTRAL BASIS. BOTH SERPS ARE DESIGNED TO COMPLY WITH INTERNAL REVENUE CODE SECTIONS 457(F) AND 409A. PART I, LINE 7 MCLAREN HEALTH CARE (MHC) HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION, SUBSIDIARY EXECUTIVES AND DIRECTORS, MANAGERS AND SUPERVISORS. THE PURPOSE OF THE PLAN IS TO ENHANCE THE ORGANIZATION'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING TOP OFFICIALS AND THE BOARD OF DIRECTORS WITH A TOOL FOR (A) CLEARLY COMMUNICATING PERFORMANCE ON THE PART OF KEY LEADERS, (B) STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE ON THE PART OF KEY LEADERS WHICH WILL ULTIMATELY BENEFIT THE COMMUNITIES MHC SERVES, AND (C) PROTECTING MHC'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH-TALENT LEADERS. FORM 990, PART VI, SECTION A, LINE 6 MCLAREN HEALTH CARE CORPORATION IS THE SOLE MEMBER OF MCLAREN NORTHERN MICHIGAN. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER SHALL HAVE THE EXCLUSIVE RIGHT TO ELECT OR APPOINT THE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER MUST APPROVE THE FOLLOWING ACTIONS AUTHORIZED BY THE BOARD BEFORE THE ACTIONS CAN BECOME EFFECTIVE: (1) ANY AMENDMENT, MODIFICATION OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (2) THE ACQUISITION OR CREATION OF ALL WHOLLY-OWNED OR CONTROLLED CORPORATIONS AND ANY MERGER, CONSOLIDATION OR AFFILIATION OF THE CORPORATION WITH ANOTHER ENTITY; (3) ANY VOLUNTARY DISSOLUTION OF THE CORPORATION; (4) ANY NEW OR ADDITIONAL MEMBERS OF THE CORPORATION; (5) ANY CHANGE IN THE VOTING POWERS OF MCLAREN AS THE SOLE MEMBER; (6) ANY SALE, LEASE, OR OTHER TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; (7) THE DISCONTINUANCE OR MATERIAL MODIFICATION OF A MAJOR ACTIVITY, PROGRAM, OR SERVICE OF THE CORPORATION; (8) THE STRATEGIC AND LONG-RANGE PLANS AND THE ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS OF THE CORPORATION, AS DEVELOPED BY THE MANAGEMENT OF THE CORPORATION, WHICH APPROVAL THE MEMBER WILL NOT UNREASONABLY DENY; (9) THE CREATION OF ANY LONG-TERM OBLIGATION OF THE CORPORATION (OTHER THAN INDEBTEDNESS AS DESCRIBED BELOW), IF THE PRINCIPAL AMOUNT EXCEEDS 25% OF THE VALUE OF THE CORPORATION'S NET ASSETS (TOTAL ASSETS MINUS TOTAL LIABILITIES), EXCEPT THAT APPROVAL OF THE MEMBER IS NOT REQUIRED FOR ANY OBLIGATION INCURRED IN THE ORDINARY COURSE OF BUSINESS THAT IS PAYABLE ON DEMAND OR MATURES WITHIN 12 MONTHS FROM THE DATE OF ITS CREATION; (10) THE CORPORATION'S ISSUANCE OF NOTES, BONDS, OR OTHER EVIDENCE OF INDEBTEDNESS; (11) THE SALE, CONVEYANCE, ASSIGNMENT, TRANSFER, ALIENATION, PLEDGE, OR ENCUMBRANCE OF THE CORPORATION'S REAL PROPERTY WITH AN ANNUAL AGGREGATE VALUE IN EXCESS OF $250,000; (12) THE CORPORATION'S PURCHASE OR ACQUISITION OF ADDITIONAL REAL PROPERTY WITH AN ANNUAL AGGREGATE VALUE IN EXCESS OF $250,000; AND (13) APPROVE UNBUDGETED CAPITAL EXPENDITURES IN EXCESS OF $250,000 IN THE ANNUAL AGGREGATE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 DATA IS PREPARED INTERNALLY AND SUBMITTED TO OUR AUDITING FIRM FOR RETURN PREPARATION. ONCE THE RETURNS HAVE BEEN COMPLETED, THE FORMS ARE REVIEWED BY THE CORPORATE DIRECTOR OF BUDGET, THE CORPORATE SENIOR VICE PRESIDENT AND CFO OF MCLAREN HEALTH CARE CORPORATION (MHCC). COPIES OF RETURNS ARE MADE AVAILABLE TO THE MHC BOARD MEMBERS, WHO SERVE AS THE OVERALL GOVERNING BOARD. RETURNS ARE AVAILABLE FOR ALL CORPORATIONS OF WHICH MHC IS THE SOLE MEMBER AS WELL AS OTHER RELATED ENTITIES OF THOSE CORPORATIONS FOR REVIEW RATHER THAN HAVING THE LOCAL BOARDS REVIEW THE RETURNS. THE BOARD OF MHC IS THE ULTIMATE ACCOUNTABLE ORGANIZATION FOR THE SYSTEM; AS SUCH IT IS THE OVERALL GOVERNING BOARD OF THE SYSTEM, WHOSE RESPONSIBILITIES INCLUDE BUT ARE NOT LIMITED TO: APPROVING ALL SUBSIDIARY BOARD MEMBERS, FINANCIAL BUDGETS, AND ISSUANCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE MCLAREN HEALTH CARE (MHC) BOARD CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL MHC CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE MHC GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. CONFLICTS ARE DISCLOSED TO THE FULL BOARD AND BOARD COMMITTEES SO APPROPRIATE ACTIONS CAN BE TAKEN. ACTIONS MAY INCLUDE PROHIBITING A BOARD MEMBER FROM PARTICIPATING IN DELIBERATIONS INVOLVING TRANSACTIONS WITH A COMPANY WITH WHICH THEY CONDUCT FINANCIAL TRANSACTIONS; BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE RELIEVED OF THEIR SERVICE TO MHC. FORM 990, PART VI, SECTION B, LINE 15B THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS TO REVIEW THE PERFORMANCE AND RECOMMEND THE TOTAL COMPENSATION PACKAGE OF THE MCLAREN HEALTHCARE CORPORATION'S CEO TO THE BOARD. FURTHER THE COMMITTEE ESTABLISHES THE SALARY RANGES AND PERQUISITES OF THE OTHER MOST HIGHLY COMPENSATED OFFICERS (MHC EXECUTIVE & SENIOR VICE-PRESIDENTS AND CEOS OF MHC SUBSIDIARY ORGANIZATIONS) TO THE BOARD. THE MEMBERS OF THE COMMITTEE MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE APPLICABLE PROVISIONS OF SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND FINAL TREASURY REGULATIONS SECTION 53.4958-6(C)(1)(III). THE COMMITTEE RETAINS THE SERVICES ANNUALLY OF AN INDEPENDENT FIRM WITH SIGNIFICANT QUALIFICATIONS AND EXPERIENCE TO CONDUCT A REVIEW OF THE CORPORATION'S EXECUTIVE COMPENSATION PROGRAM. THE RETAINED FIRM UTILIZES APPROPRIATE COMPENSATION COMPARABILITY DATA. THE RETAINED FIRM CONDUCTS ANALYSIS OF THE COMPETITIVENESS OF THESE PROGRAMS AND EXPRESSES AN OPINION TO THE REASONABLENESS OF THESE COMPENSATION PROGRAMS. ALL DATA UTILIZED BY THE COMMITTEE, DELIBERATIONS OF THE COMMITTEE, AND FINAL COMPENSATION DECISIONS BY THE COMMITTEE ARE DOCUMENTED IN FORMAL REPORTS AND MINUTES. THE CORPORATE COMPENSATION COMMITTEE WORKS UNDER AND PERIODICALLY RENEWS THE MCLAREN HEALTH CARE CORPORATION COMPENSATION COMMITTEE CHARTER. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2020. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FOUNDATION HELD ASSETS 3,809,494. PENSION RELATED CHANGES -1,355,364. EQUITY TRANSFER TO AFFILIATES -6,999,101. NET ASSETS RELEASED FROM RESTRICTIONS -6,054,340. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MCLAREN BAY MEDICAL FOUNDATION 1900 COLUMBUS AVE BAY CITY MI 48708 382156534 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN BAY REGION 1 MCLAREN BAY REGION 1900 COLUMBUS AVE BAY CITY MI 48708 381976271 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 BAY REGIONAL MEDICAL CENTER AUXILIARY 1908 COLUMBUS AVENUE BAY CITY MI 48708 386081235 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I MCLAREN BAY REGION 1 MCLAREN BAY SPECIAL CARE 3250 E MIDLAND ROAD STE 1 BAY CITY MI 48706 383161753 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN BAY REGION 1 MCLAREN CENTRAL MICHIGAN 1221 SOUTH DRIVE MT PLEASANT MI 48858 381420304 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 CHARLEVOIX NURSING HOME CORPORATION DBA BOULDER PARK TERRACE 14676 WEST UPRIGHT CHARLEVOIX MI 49720 383038683 SKILLED NURSING FACILITY MI 501(C)(3) LINE 10 MCLAREN NORTHERN MICHIGAN 1 KARMANOS CANCER FOUNDATION 4100 JOHN R ST DETROIT MI 48201 383584572 CANCER CARE CENTER MI 501(C)(3) LINE 7 BARBARA ANN KARMANOS CANCER INSTITUTE 1 MCLAREN GREATER LANSING FOUNDATION 401 W GREENLAWN AVE LANSING MI 48910 382463637 FOUNDATION MI 501(C)(3) LINE 7 MCLAREN GREATER LANSING 1 MCLAREN GREATER LANSING 401 W GREENLAWN AVE LANSING MI 48910 381434090 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 BARBARA ANN KARMANOS CANCER HOSPITAL 4100 JOHN R ST DETROIT MI 48201 201649466 HOSPITAL MI 501(C)(3) LINE 3 BARBARA ANN KARMANOS CANCER INSTITUTE 1 BARBARA ANN KARMANOS CANCER INSTITUTE 4100 JOHN R ST DETROIT MI 48201 381613280 CANCER RESEARCH & CARE CENTER MI 501(C)(3) LINE 7 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN LAPEER REGION 1375 N MAIN ST LAPEER MI 48446 382689033 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN LAPEER REGION FOUNDATION 1375 N MAIN ST LAPEER MI 48446 382689603 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN LAPEER REGION 1 MARWOOD MANOR NURSING HOME PO BOX 5011 PORT HURON MI 48060 382683251 NURSING HOME MI 501(C)(3) LINE 10 MCLAREN PORT HURON 1 MCLAREN HEALTH CARE CORPORATION ONE MCLAREN PARKWAY GRAND BLANC MI 48439 382397643 SUPPORTING ORG MI 501(C)(3) LINE 12A, I N/A 0 MCLAREN HEALTH CARE VILLAGE FOUNDATION 401 S BALLENGER HIGHWAY FLINT MI 48532 262693350 SUPPORTING ORG MI 501(C)(3) LINE 12A, I MCLAREN HEALTH CARE CORPORATION 1 MCLAREN HEALTH PLAN COMMUNITY G-3245 BEECHER ROAD FLINT MI 48532 272204037 INSURANCE MI 501(C)(4) MCLAREN HEALTH PLAN 1 MCLAREN HEALTH PLAN INC G-3245 BEECHER ROAD FLINT MI 48532 383252216 HEALTH CARE SERVICES MI 501(C)(4) MCLAREN INTEGRTAED HMO GROUP 1 MCLAREN HOSPICE & HOME CARE FOUNDATION 1515 CAL DR DAVISON MI 48423 463643089 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN HEALTH MANAGEMENT GROUP 1 MCLAREN MEDICAL GROUP 401 S BALLENGER HWY FLINT MI 48532 382988086 MANAGEMENT COMPANY MI 501(C)(3) LINE 12A, I MCLAREN HEALTH CARE CORPORATION 1 MCLAREN NORTHERN MICHIGAN FOUNDATION 360 CONNABLE AVENUE PETOSKEY MI 49770 382445611 FOUNDATION MI 501(C)(3) LINE 7 MCLAREN NORTHERN MICHIGAN 1 MCLAREN PORT HURON 1221 PINE GROVE AVENUE PORT HURON MI 48060 381369611 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN FLINT 401 S BALLENGER HWY FLINT MI 48532 382383119 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MICHIGAN CANCER SOCIETY 4100 JOHN R ST DETROIT MI 48201 382823451 CANCER RESEARCH MI 501(C)(3) LINE 7 BARBARA ANN KARMANOS CANCER INSTITUTE 1 MOUNT CLEMENS REGIONAL HEALTHCARE FOUNDATION PO BOX 326 MOUNT CLEMENS MI 48046 382578873 FOUNDATION MI 501(C)(3) LINE 10 MCLAREN MACOMB 1 MCLAREN MACOMB 1000 HARRINGTON MOUNT CLEMENS MI 48043 381218516 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 NORTH OAKLAND NORTH MACOMB IMAGING INC 50 NORTH PERRY STREET PONTIAC MI 48342 382807040 MRI IMAGING MI 501(C)(3) LINE 3 MCLAREN OAKLAND 1 NORTHERN MICHIGAN HEMATOLOGY AND ONCOLOGY 416 CONNABLE AVENUE PETOSKEY MI 49770 320020293 PHYSICIAN PRACTICE MI 501(C)(3) LINE 3 MCLAREN NORTHERN MICHIGAN 1 NORTHERN MICHIGAN MEDICAL MANAGEMENT 416 CONNABLE AVENUE PETOSKEY 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