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            <BusinessNameLine1Txt>MICHIGAN EMERGENCY PHYSICI</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 674579</AddressLine1Txt>
            <CityNm>DETROIT</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>482674579</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ER PHYSICIANS</ServicesDesc>
        <CompensationAmt>1595938</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ORTHO-CLINICAL DIAG INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 3655</AddressLine1Txt>
            <CityNm>CAROL STREAM</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>601323655</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SUPPLIES</ServicesDesc>
        <CompensationAmt>349099</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MCKESSON</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>38220 PLYMOUTH ROAD</AddressLine1Txt>
            <CityNm>LIVONIA</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48150</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DRUGS</ServicesDesc>
        <CompensationAmt>329195</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>INTEGRATED SYSTEMS CONSULT</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <CityNm>TRAVERSE CITY</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49684</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT CONSULTANTS</ServicesDesc>
        <CompensationAmt>239572</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60693</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SUPPLIES</ServicesDesc>
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      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>13</CntrctRcvdGreaterThan100KCnt>
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      <TotalContributionsAmt>106661</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>1835578</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
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        <BusinessCd>621400</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>31433938</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Provider Office Rev</Desc>
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        <RelatedOrExemptFuncIncomeAmt>3761229</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RHC Revenue</Desc>
        <BusinessCd>621110</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>1151367</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Contractual Adjust</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>-15399347</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-15399347</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
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        <RelatedOrExemptFuncIncomeAmt>-761114</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>22021651</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
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        <RelatedOrExemptFuncIncomeAmt>25225</RelatedOrExemptFuncIncomeAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>32779</RealAmt>
      </GrossRentsGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>32779</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>32779</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>32779</UnrelatedBusinessRevenueAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>2365</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <OtherAmt>2365</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>2365</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2365</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>71499</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>44580</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>26919</TotalRevenueColumnAmt>
        <ExclusionAmt>26919</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <TotalRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>22049241</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>32779</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>26919</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>608885</TotalAmt>
        <ManagementAndGeneralAmt>608885</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
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        <ProgramServicesAmt>8232129</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2242005</ManagementAndGeneralAmt>
        <FundraisingAmt>15732</FundraisingAmt>
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        <ProgramServicesAmt>91476</ProgramServicesAmt>
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      </PensionPlanContributionsGrp>
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        <ProgramServicesAmt>234766</ProgramServicesAmt>
        <ManagementAndGeneralAmt>985297</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
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        <ProgramServicesAmt>572092</ProgramServicesAmt>
        <ManagementAndGeneralAmt>210815</ManagementAndGeneralAmt>
        <FundraisingAmt>1126</FundraisingAmt>
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      <FeesForServicesManagementGrp>
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        <ProgramServicesAmt>2809699</ProgramServicesAmt>
        <ManagementAndGeneralAmt>628707</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>118827</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>44250</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
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        <FundraisingAmt>6698</FundraisingAmt>
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        <ManagementAndGeneralAmt>216584</ManagementAndGeneralAmt>
        <FundraisingAmt>1149</FundraisingAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>33009</ProgramServicesAmt>
        <ManagementAndGeneralAmt>253154</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
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        <ManagementAndGeneralAmt>9648</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ManagementAndGeneralAmt>28288</ManagementAndGeneralAmt>
        <FundraisingAmt>2416</FundraisingAmt>
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      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>28025</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19761</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>9647</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4369</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>613096</ProgramServicesAmt>
        <ManagementAndGeneralAmt>108027</ManagementAndGeneralAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>105602</ProgramServicesAmt>
        <ManagementAndGeneralAmt>13506</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
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        <ProgramServicesAmt>767578</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>34104</ProgramServicesAmt>
        <ManagementAndGeneralAmt>448316</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>250538</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>Implants/Blood</Desc>
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        <ProgramServicesAmt>213260</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18409</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
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        <ManagementAndGeneralAmt>59664</ManagementAndGeneralAmt>
        <FundraisingAmt>278</FundraisingAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>true</AccountantCompileOrReviewInd>
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      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
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      <PublicSupportTotal170Amt>0</PublicSupportTotal170Amt>
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      <WrittenPolicyInd>true</WrittenPolicyInd>
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      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
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      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
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      <UnableToProvideCareInd>false</UnableToProvideCareInd>
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      <UnreimbursedMedicaidGrp>
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        <NetCommunityBenefitExpnsAmt>1422</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0001</TotalExpensePct>
      </CashAndInKindContributionsGrp>
      <TotalOtherBenefitsGrp>
        <ActivitiesOrProgramsCnt>143</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>5593</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>106292</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>43956</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>62337</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0029</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <ActivitiesOrProgramsCnt>145</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>10340</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>4400387</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>2183025</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>2217362</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.1015</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <EconomicDevelopmentGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <TotalCommunityBenefitExpnsAmt>411</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>411</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0000</TotalExpensePct>
      </EconomicDevelopmentGrp>
      <CommunitySupportGrp>
        <ActivitiesOrProgramsCnt>5</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>330</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>920</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>920</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0000</TotalExpensePct>
      </CommunitySupportGrp>
      <LeadershipDevelopmentGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>40</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>79</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>79</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0000</TotalExpensePct>
      </LeadershipDevelopmentGrp>
      <WorkforceDevelopmentGrp>
        <ActivitiesOrProgramsCnt>1</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>750</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>2439</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>2439</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0001</TotalExpensePct>
      </WorkforceDevelopmentGrp>
      <TotalCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>8</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>1120</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>3849</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>3849</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.0002</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>699944</BadDebtExpenseAmt>
      <ReimbursedByMedicareAmt>5848118</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>5942966</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-94848</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>MCKENZIE HEALTH SYSTEM</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>120 DELAWARE STREET</AddressLine1Txt>
          <CityNm>Sandusky</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48471</ZIPCd>
        </USAddress>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>MCKENZIE HEALTH SYSTEM</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>true</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>false</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>15</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>true</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>true</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>www.mckenziehealth.org</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <RptAvailableThruOtherMethodInd>X</RptAvailableThruOtherMethodInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>16</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>www.mckenziehealth.org/wp-content/uploads/2016/12/2</StrategyWebsiteURLTxt>
        <StrategyAttachedInd>false</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>250.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>www.mckenziehelath.org/patien</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>www.mckenziehealth.o</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>www.mckenzieh</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicarePrivateInd>X</LookBackMedicarePrivateInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>5</FormAndLineReferenceDesc>
        <ExplanationTxt>Hospital focus groups include reps from Sandusky City Council, Thumb Elite</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>5</FormAndLineReferenceDesc>
        <ExplanationTxt>athletics, Sandusky Arts Council, City Police Dept., parents, educational</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>5</FormAndLineReferenceDesc>
        <ExplanationTxt>Professionals &amp; churches. Key stakeholders interviewed with a rep from MI</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>5</FormAndLineReferenceDesc>
        <ExplanationTxt>Dept of health &amp; human services, Sanilac County Mental health &amp; Sanilac ISD</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Marlette Regional Hospital, Scheurer Hospital, Deckerville Hospital, Caro</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>6a</FormAndLineReferenceDesc>
        <ExplanationTxt>Community Hospital, Huron Medical Center &amp; Hills &amp; Dales Hospital.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>6b</FormAndLineReferenceDesc>
        <ExplanationTxt>Sanilac County HD, Tuscola County HD, Huron County HD</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>7d</FormAndLineReferenceDesc>
        <ExplanationTxt>CHNA was distributed to Lions Club, MHS BOD, Sanilac County Mental Health,</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>7d</FormAndLineReferenceDesc>
        <ExplanationTxt>Sanilac County Transportation, Sanilac County Dept of Health &amp; Human Serv.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>7d</FormAndLineReferenceDesc>
        <ExplanationTxt>Great Start collaborative, Blue water Center for Rural living, Sanilac Lit.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>7d</FormAndLineReferenceDesc>
        <ExplanationTxt>Sanilac probation &amp; Sanilac County Sherif's Dept.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>Committees address significant needs identified by the CHNA, including;</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>more evening &amp; weekend provider hours, more specialists, lack of health ins</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>awareness of health resources and services, jobs with livable wages, avail</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>of mental health services, crime &amp; safety, cost of ins. youth/adult obesity</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>committees work with local orgs, such as; law enforcement, mental health,</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>schools, Sanilac transportation, specialty practices in surrounding areas,</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>tele-health options, nurse hotlines and local media to advertise services</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>11</FormAndLineReferenceDesc>
        <ExplanationTxt>and programs</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>38-1738615</FormAndLineReferenceDesc>
        <ExplanationTxt>5</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>8</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE HEALTH &amp; WELLNESS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>170 W ARGYLE STREET</AddressLine1Txt>
            <CityNm>Sandusky</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE RURAL HEALTH CLIN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>75 DAWSON STREET</AddressLine1Txt>
            <CityNm>Sandusky</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE FAMILY HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>109 N DELAWARE STREET</AddressLine1Txt>
            <CityNm>Sandusky</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>LAKESHORE INTERNAL MEDICIN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7307 CHERRY STREET</AddressLine1Txt>
            <CityNm>Port Sanilac</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48469</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>CROSWELL CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>8 N HOWARD STREET</AddressLine1Txt>
            <CityNm>Croswell</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48422</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>PECK MEDICAL CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>251 E PECK ROAD</AddressLine1Txt>
            <CityNm>Peck</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48466</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>MCKENZIE AFTER-HOURS CLINI</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>115 DELAWARE STREET</AddressLine1Txt>
            <CityNm>Sandusky</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SANILAC MEDICAL PLAZA</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>100 W ARGYLE STREET</AddressLine1Txt>
            <CityNm>Sandusky</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48471</ZIPCd>
          </USAddress>
          <FacilityTxt>PROVIDER OFFICE/RENTAL</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I LINE 6A</FormAndLineReferenceDesc>
        <ExplanationTxt>A community benefit report was prepared during the 2015 tax year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule H worksheets were used to prepare the cost to charge ratio.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>McKenzie promoted Community health through various activities, such as;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Senior fair, school tours, County 4-H fair, &amp; various showcases.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad debts are est by the allowance method &amp; indp. audited annually; listed</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>net of discounts and payments rec'd on account post bad debt determination.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>See attached audited Financial Statements, page 11 &amp; 14, note 1.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>McKenzie is a critical access Hospital under medicare reg., reimbursed</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>based on cost.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The shortfall of $94,848 consists of 2% sequestration.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>Medicare cost report data was used to calculate these figures.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>Collection ploicy references the FAP for those patients that are eligable</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>for assistence as a method of payment for Hospital accounts.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>In addition to items in SCH H part V sec B, CNHA describes how identified</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>needs were prioritized &amp; strategy was implemented. MHS also continuously</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>monitors quality scores and patient satisfaction surveys. MHS leadership</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>is in constant contact with other healthcare agencies in the community and</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-2</FormAndLineReferenceDesc>
        <ExplanationTxt>accesses any findings indentified through collaboration.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-3</FormAndLineReferenceDesc>
        <ExplanationTxt>Uninsured patients receive a Financial policy brochure from staff. Dir. of</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-3</FormAndLineReferenceDesc>
        <ExplanationTxt>Human Services then follows up with the patient to help apply for medicare/</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-3</FormAndLineReferenceDesc>
        <ExplanationTxt>Medicaid and apply for FAP program; this info is also available in brochure</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-3</FormAndLineReferenceDesc>
        <ExplanationTxt>website, patient statement, hospital lobby, ER &amp; patient fin. services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-4</FormAndLineReferenceDesc>
        <ExplanationTxt>MHS is a CAH located in Sandusky County; population 41,587, 1,600 sq miles</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-4</FormAndLineReferenceDesc>
        <ExplanationTxt>and 90% rural. 52% of population is uninsured. Unemployment rate is 6.6%</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-4</FormAndLineReferenceDesc>
        <ExplanationTxt>and 23% of children live in poverty.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI-5</FormAndLineReferenceDesc>
        <ExplanationTxt>Gov. by board of directors, Serv.; Geriatrics, immunization, physicals, etc</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ-77-1" softwareId="17005300" softwareVersionNum="ta17mefv1.0">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTOPHER CLARK</PersonNm>
        <TitleTxt>Chairperson</TitleTxt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL DREYER</PersonNm>
        <TitleTxt>ViceChairperson</TitleTxt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SUE COOK</PersonNm>
        <TitleTxt>SecretaryTreasurer</TitleTxt>
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        <PersonNm>JAMES SAMS</PersonNm>
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        <PersonNm>MARK ENGLISH</PersonNm>
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        <PersonNm>GINA PATTERSON</PersonNm>
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        <TotalCompensationFilingOrgAmt>151246</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>20886</TotalCompensationRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BILLI JO HENNIKA</PersonNm>
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        <PersonNm>JAMES KOSIUR</PersonNm>
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        <BoardOrCommitteeApprovalInd>false</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>false</WrittenAgreementInd>
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        <RelationshipDescriptionTxt>DIRECTOR</RelationshipDescriptionTxt>
        <TransactionAmt>80618</TransactionAmt>
        <TransactionDesc>MARKETING SERVICES &amp; SUPPLIES</TransactionDesc>
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        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
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        <FormAndLineReferenceDesc>Part VI Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Classes of Members make up the Board of Directors.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Board Members must be approved by the Board of United Healthcare Partners</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>to become MHS board Members.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>United Healthcare Partners must approve any financial transaction above</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>$1 million dollars prior to being taken to MHS Board of Directors.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 11b</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 11b</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 12c</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 12c</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 15a or b</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 15a or b</FormAndLineReferenceDesc>
        <ExplanationTxt>and recent compensation surveys.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>All documents are available for review by the request at the</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI Line 19</FormAndLineReferenceDesc>
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