﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2015v2.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2016-11-14T15:10:30-06:00</ReturnTs>
    <TaxPeriodEndDt>2015-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>383133790</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>ANDREWS HOOPER PAVLIK PLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>4295 OKEMOS RD STE 200</AddressLine1Txt>
        <CityNm>OKEMOS</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>488646201</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2015-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>381360584</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>EDWARD W SPARROW HOSPITAL</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>EDWA</BusinessNameControlTxt>
      <PhoneNum>5173646060</PhoneNum>
      <USAddress>
        <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
        <CityNm>LANSING</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48912</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>PAULA REICHLE</PersonNm>
      <PersonTitleTxt>SR VP - CFO</PersonTitleTxt>
      <PhoneNum>5173646060</PhoneNum>
      <SignatureDt>2016-11-03</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>MARK E HOOPER</PreparerPersonNm>
      <PTIN>P00039887</PTIN>
      <PhoneNum>5177060800</PhoneNum>
      <PreparationDt>2016-11-14</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2015</TaxYr>
    <BuildTS>2017-02-10 21:41:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="11">
    <IRS990 documentId="RetDoc5" referenceDocumentId="RetDoc11">
      <PrincipalOfficerNm>DENNIS SWAN</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
        <CityNm>LANSING</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>48912</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>963849041</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.SPARROW.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1896</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>IMPROVING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES BY PROVIDING QUALITY, COMPASSIONATE CARE TO EVERYONE, EVERY TIME.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>15</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>8</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>6710</TotalEmployeeCnt>
      <TotalVolunteersCnt>2200</TotalVolunteersCnt>
      <TotalGrossUBIAmt>35421117</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>-626127</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>1243637</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1305992</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>844443668</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>899515920</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>22359468</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>25470023</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>29766692</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>35492773</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>897813465</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>961784708</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>27468</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>33044</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>460546639</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>497456637</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>369248090</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>392356677</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>829822197</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>889846358</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>67991268</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>71938350</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>1204134312</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>1294207078</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>737986413</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>793209651</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>466147899</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>500997427</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>IMPROVING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES BY PROVIDING QUALITY, COMPASSIONATE CARE TO EVERYONE, EVERY TIME.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>315441550</ExpenseAmt>
      <GrantAmt>30044</GrantAmt>
      <RevenueAmt>468901748</RevenueAmt>
      <Desc>SPARROW HOSPITAL HAS, SINCE ITS INCEPTION IN 1896, PROVIDED CARE TO PEOPLE REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. SPARROW IS A NON-PROFIT COMMUNITY-GOVERNED HOSPITAL AND THE FLAGSHIP OF THE SPARROW HEALTH SYSTEM, A COMPREHENSIVE INTEGRATED HEALTH DELIVERY SYSTEM COMMITTED WITHIN ITS RESOURCES TO IMPROVING THE HEALTH STATUS OF ALL PEOPLE THROUGHOUT THE MID-MICHIGAN REGION BY PROVIDING QUALITY, COMPASSIONATE CARE TO EVERYONE, EVERY TIME. SPARROW HOSPITAL IS A 703-BED, MAJOR TEACHING HOSPITAL (AFFILIATED WITH MICHIGAN STATE UNIVERSITY'S COLLEGES OF OSTEOPATHIC MEDICINE, HUMAN MEDICINE AND NURSING) AND THE MOST COMPREHENSIVE, ACUTE CARE CENTER IN MID-MICHIGAN. SPARROW IS THE REGIONAL MEDICAL CENTER FOR: PEDIATRICS CANCER CARE, INCLUDING RADIATION THERAPY TRAUMA CARE NEUROLOGICAL CARE HIGH-RISK OBSTETRICS NEONATAL INTENSIVE CARE BEHAVIORAL HEALTH CARDIOVASCULAR SERVICES SPARROW TREATED NEARLY 34,000 INPATIENTS, HAD APPROXIMATELY 1.5 MILLION OUTPATIENT ENCOUNTERS, AND PROVIDED SERVICES TO MORE THAN 122,500 EMERGENCY MEDICINE PATIENTS IN 2015. TODAY'S SPARROW HEALTH SYSTEM BLENDS THE KNOWLEDGE AND EXPERTISE OF OVER 900 PHYSICIANS, 8,279 CAREGIVERS AND APPROXIMATELY 2,331 VOLUNTEERS WITH THE MOST ADVANCED TECHNOLOGY, SERVING AS A COMPREHENSIVE HEALTH SYSTEM FOR AN EIGHT-COUNTY POPULATION. IN ADDITION, MORE PEOPLE CHOOSE SPARROW FOR THEIR MATERNITY NEEDS (MORE THAN 4,200 DELIVERIES ANNUALLY), REHABILITATION, AND EMERGENCY TREATMENT THAN ANY OTHER HOSPITAL IN MID-MICHIGAN. IN 2015 SPARROW ACHIEVED A NATIONAL BENCHMARK IN QUALITY CARE FOR MOTHERS AND BABIES, AS MID- MICHIGAN'S ONLY BABY-FRIENDLY HOSPITAL, A GLOBAL PROGRAM OF THE WORLD HEALTH ORGANIZATION (WHO) AND THE UNITED NATIONS CHILDREN'S FUND (UNICEF). SPARROW HEALTH SYSTEM'S REACH EXTENDS FAR BEYOND THE ACUTE CARE SETTING OF THE HOSPITAL. THERE ARE MANY WAYS OUR STAFF PROACTIVELY SUPPORTS THE COMMUNITY, ESPECIALLY THOSE WHO HAVE THE GREATEST NEED. BECAUSE OF SPARROW'S COMMITMENT, THE PEOPLE OF MID MICHIGAN HAVE ACCESS TO THE FULL RANGE OF COMPREHENSIVE ACUTE CARE SERVICES AND THE LATEST MEDICAL ADVANCES WITHOUT TRAVELING GREAT DISTANCES. THESE SERVICES ARE AVAILABLE TO ALL MID- MICHIGAN RESIDENTS, REGARDLESS OF THEIR ABILITY TO PAY. PROVIDING ACCESS TO PRIMARY CARE SPARROW RECOGNIZES THAT IF WE ARE TO ACHIEVE OUR VISION OF BEING A NATIONALLY RECOGNIZED LEADER IN QUALITY AND THE PATIENT EXPERIENCE, WE HAVE A RESPONSIBILITY TO TAKE THE LEAD IN FUNDAMENTALLY TRANSFORMING HEALTHCARE IN MICHIGAN. IN ORDER TO ADDRESS THE CHALLENGES OF INCREASING PREVALENCE OF CHRONIC DISEASE AND AN AGING POPULATION, TO IMPROVE THE QUALITY OF CARE AND THE PATIENT EXPERIENCE WHILE ALSO ENSURING GREATER AFFORDABILITY FOR PAYORS, SPARROW NEEDS TO IMPLEMENT PROFOUND CHANGES IN HOW CARE IS PROVIDED. SPARROW IS COMMITTED TO SEEKING NEW WAYS TO PARTNER WITH QUALITY CARE PROVIDERS TO CREATE GREATER ALIGNMENT AROUND IMPROVED QUALITY AND PATIENT EXPERIENCE, WORKING JOINTLY TO DEVELOP CLINICAL GUIDELINES TO ENSURE THE HIGHEST QUALITY OF CARE FOR PATIENTS WHO NEED TO BE TRANSFERRED TO DIFFERENT LEVELS OF CARE AND TO ENSURE THAT CARE IS ALWAYS DELIVERED IN THE BEST QUALITY AND MOST COST-ADVANTAGEOUS CLINICAL SETTING AS CLOSE TO THE PATIENT'S HOME AS POSSIBLE. SPARROW WAS SELECTED AS THE FIRST IN MICHIGAN TO BECOME A MEMBER OF THE MAYO CLINIC CARE NETWORK, SOLIDIFYING OUR DEDICATION TO MEETING OUR PATIENTS' HEALTHCARE NEEDS RIGHT HERE IN MID- MICHIGAN. SPARROW HEALTH SYSTEM INCLUDES SUBSIDIARY HOSPITALS SPARROW CLINTON HOSPITAL AND SPARROW IONIA HOSPITAL. CARSON HEALTH, AN AFFILIATE OF SPARROW HEALTH SYSTEM SINCE 1997, BECAME A FULLY INTEGRATED SUBSIDIARY AND JOINED THE SPARROW FAMILY AS SPARROW CARSON HOSPITAL IN FEBRUARY 2015. SPARROW ALSO HOLDS AN AFFILIATION WITH HAYES GREEN BEACH MEMORIAL HOSPITAL EXTENDING OUR REACH THROUGHOUT THE REGION. IN 2015, SPARROW CELEBRATED THE GRAND OPENING OF THE NEW SPARROW IONIA HOSPITAL, THE FIRST NEW HOSPITAL IN THE MID-MICHIGAN REGION IN DECADES. THE ALL-NEW, STATE-OF-THE-ART 65,0000-SQUARE-FOOT CRITICAL ACCESS HOSPITAL REPLACES THE ORIGINAL FACILITY WHICH WAS BUILT IN 1953. SPARROW OPENED TWO NEW FASTCARE CENTERS IN 2015, OFFERING THE FIRST NEW TREATMENT OPTION OF ITS KIND IN THE MID-MICHIGAN REGION. FASTCARE OFFERS PROMPT TREATMENT FOR COMMON, NON-LIFE-THREATENING CONDITIONS AND IS A MORE AFFORDABLE OPTION FOR BASIC MEDICAL SERVICES THAN A HOSPITAL EMERGENCY ROOM OR URGENT CARE CLINIC. THE SPARROW MEDICAL GROUP VOA, A JOINT MEDICAL CLINIC BETWEEN SPARROW AND VOLUNTEERS OF AMERICA MICHIGAN TO SERVE HOMELESS PATIENTS AND OTHERS, CELEBRATED ITS ONE YEAR ANNIVERSARY HAVING CARED FOR MORE THAN 3,000 PATIENTS. ALSO IN 2015, MARY FREE BED AT SPARROW, A JOINT VENTURE PROVIDING ADVANCED INPATIENT REHABILITATION CARE FOR PATIENTS IN THE MID- MICHIGAN REGION, OPENED A 40 PRIVATE BED REHABILITATION UNIT, INCLUDING TWO STATE-OF-THE-ART THERAPY GYMS, WITHIN SPARROW HOSPITAL. THE UNIT PROVIDES INTENSIVE NEUROLOGICAL, ORTHOPEDIC, AND STROKE REHABILITATION AND INCLUDES A FULL-SIZE CHEVROLET TRAVERSE AND A MOCK TRANSIT BUS TO AID PATIENTS IN RETURNING TO THEIR DAILY ACTIVITIES. SPARROW SPECIALTY HOSPITAL (SSH), A LONG-TERM ACUTE CARE HOSPITAL, RELOCATED TO THE 8TH FLOOR OF THE SPARROW TOWER TO IMPROVE THE PATIENT EXPERIENCE AND OFFER INCREASED ACCESS TO SPECIALTY SERVICES AND ANCILLARY SUPPORT SUCH AS NEUROLOGY, ORTHOPEDICS, CARDIOLOGY, AND MORE. THE 7TH FLOOR OF THE SPARROW TOWER OPENED IN JANUARY 2015, ADDING 30 PRIVATE MEDICAL SURGICAL ROOMS FOR PATIENTS WHO REQUIRE AN INPATIENT STAY. IN SUPPORT OF OUR GOAL TO TRANSFORM HOW CARE IS PROVIDED, SPARROW BROKE GROUND ON THE SPARROW PLAZA, A NEW FOUR-STORY BUILDING LOCATED CENTRALLY ON THE SPARROW CAMPUS ALONG MICHIGAN AVENUE. DESIGNED WITH THE FUTURE IN MIND, THIS FLEXIBLE SPACE CAN EASILY BE ADAPTED TO NEXT-GENERATION TECHNOLOGIES AND WILL BE HOME TO THE NEW HERBERT-HERMAN CANCER CENTER AND OTHER SERVICES AS WE STREAMLINE PATIENT CARE. SPARROW ALSO BROKE GROUND IN 2015 ON THE SPARROW GATHERING PLACE - A MODERN AND UPSCALE DINING AREA ON THE MAIN CAMPUS OF SPARROW HOSPITAL THAT WILL HELP TRANSFORM MICHIGAN AVENUE IN LANSING, AND THE SPARROW HEALTH CENTER LANSING, AN ALL-NEW CAMPUS THAT WILL EXPAND ACCESS TO PRIMARY CARE, PROVIDE SENIOR HEALTH SERVICES, AND OFFER STREAMLINED AND COMPREHENSIVE CARE IN ONE CONVENIENT LOCATION. THE 70,000- SQUARE-FOOT BUILDING WILL HOUSE A DRIVE-THRU PHARMACY, LABORATORY, ENDOSCOPY, DIAGNOSTIC IMAGING INCLUDING CT, ULTRASOUND, MAMMOGRAPHY, MRI AND MORE IN ADDITION TO THREE SPARROW MEDICAL GROUP PRACTICES. SPARROW ALSO OPENED A NEW PRIMARY CARE PRACTICE, SMG SARANAC, AND A BREASTFEEDING CLINIC AT THE HOSPITAL TO SUPPORT MOMS AND PROMOTE A POSITIVE EXPERIENCE WITH THEIR BABY. BY PROACTIVELY LOCATING SERVICES IN OUR SURROUNDING COMMUNITIES, WE ENSURE THAT RESIDENTS AND THEIR FAMILIES HAVE ACCESS TO THE CARE NECESSARY TO SAFEGUARD THEIR HEALTH. SPARROW COMMUNITY CARE - A NON-PROFIT ENTITY COMPRISING THE FORMER SPARROW MEDICAL SUPPLY AND SPARROW HOME CARE UNITS - AND SPARROW LABORATORIES AND SPARROW PHARMACY PLUS ROUND OUT SPARROW HEALTH SYSTEM'S NETWORK OF FACILITIES AND PRIMARY CARE SERVICES. THEY ARE DESIGNED TO PROVIDE QUALITY, CONVENIENT, COST EFFECTIVE HEALTH CARE TO THE PEOPLE OF MID MICHIGAN. EMERGENCY PREPAREDNESS SPARROW HAS DISTINGUISHED ITSELF AS A RECOGNIZED LEADER IN EMERGENCY PREPAREDNESS. THE HOSPITAL VIEWS PREPAREDNESS AS AN ONGOING PROCESS LED BY A MULTIDISCIPLINARY TEAM THAT INVOLVES ALL ASPECTS OF HOSPITAL OPERATIONS, INCLUDING MEDICAL AND NON-MEDICAL SERVICES. DRILLS ARE CONDUCTED YEAR-ROUND IN COLLABORATION WITH LOCAL, STATE AND FEDERAL AGENCIES TO ENSURE SPARROW IS PREPARED FOR ANY DISASTER, WHETHER IT IS THE RESULT OF A TERRORIST ACT OR A NATURAL DISASTER. SPARROW'S EMERGENCY PREPAREDNESS COMMITTEE REGULARLY TESTS THE HOSPITAL'S RESPONSE SKILLS INDEPENDENT OF ANY AGENCY OR GOVERNING BODY. THE HOSPITAL ALSO WORKS WITH LOCAL GOVERNMENT AGENCIES, INCLUDING THE POLICE DEPARTMENT, FIRE DEPARTMENT, AND PUBLIC HEALTH DEPARTMENT TO COORDINATE A PLANNED RESPONSE IN THE EVENT OF A TRUE EMERGENCY. ROUTINE DRILLS AND A FULL SCALE ACTIVE SHOOTER EXERCISE WERE CONDUCTED IN 2015 TO TEST THE HEALTH SYSTEM'S RESPONSE AND INTERACTION WITH LOCAL AGENCIES. SUPPORTING OUR COMMUNITY AND NEIGHBORHOODS SPARROW IS THE UNQUESTIONED LEADER IN MID-MICHIGAN IN PROVIDING HEALTHCARE SERVICES AND PROMOTING HEALTH-RELATED ACTIVITIES. SPARROW PROVIDES FIRST- AID SERVICES AT MANY SPECIAL EVENTS INCLUDING MICHIGAN STATE UNIVERSITY FOOTBALL GAMES, LANSING LUGNUTS BASEBALL GAMES AND THE CITY OF LANSING'S ANNUAL COMMON GROUND MUSIC FESTIVAL. SPARROW ALSO SPONSORS DOZENS OF HEALTH-RELATED ACTIVITIES, INCLUDING THE ANNUAL HIKE FOR HOSPICE, THE FEELIN' GOOD MILEAGE CLUB FOR ELEMENTARY SCHOOLS, FITKIDS AND THE SPARROW MICHIGAN MILE. SPARROW ALSO HAS A PARTNERSHIP WITH THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM'S SURVIVAL FLIGHT AIR MEDICAL TRANSPORT SERVICE. SURVIVAL FLIGHT PROVIDES 24-HOUR AIR M</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>363263168</ExpenseAmt>
        <RevenueAmt>433214489</RevenueAmt>
        <Desc>ANCILLARY SERVICES INCLUDING LABORATORY, RADIOLOGY, DIALYSIS, SOCIAL SERVICES, AND CLINICS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>79387245</ExpenseAmt>
        <RevenueAmt>4079185</RevenueAmt>
        <Desc>GENERAL SERVICES INCLUDING FOOD SERVICE, ENVIRONMENTAL SERVICES, LAUNDRY AND PLANT.</Desc>
      </ProgSrvcAccomActy3Grp>
      <TotalProgramServiceExpensesAmt>758091963</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc13">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc6">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc6">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc6">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc6">false</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc6">true</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc6">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc6">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc6">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc6">true</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc6">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc6">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc6">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc6">true</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd referenceDocumentId="RetDoc12">true</OperateHospitalInd>
      <AuditedFinancialStmtAttInd referenceDocumentId="RetDoc2">true</AuditedFinancialStmtAttInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc7">true</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc7">false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc8">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentId="RetDoc9">true</TaxExemptBondsInd>
      <InvestTaxExemptBondsInd>false</InvestTaxExemptBondsInd>
      <EscrowAccountInd>false</EscrowAccountInd>
      <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc10">false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc10">false</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc10">false</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc10">false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc10">false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc10">true</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd referenceDocumentId="RetDoc10">false</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc14">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc14">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>true</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc14">true</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc14">true</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc14">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>388</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>6710</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>true</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>true</Form990TFiledInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>15</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>8</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>true</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>true</InvestmentInJointVentureInd>
      <WrittenPolicyOrProcedureInd>true</WrittenPolicyOrProcedureInd>
      <StatesWhereCopyOfReturnIsFldCd>MI</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>WILLIAM HOWE</PersonNm>
        <PhoneNum>5173646060</PhoneNum>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <InfoInScheduleOPartVIIInd>X</InfoInScheduleOPartVIIInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>DENNIS SWAN</PersonNm>
        <TitleTxt>PRES/CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>1489796</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>70224</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREG BROGAN</PersonNm>
        <TitleTxt>BOARD MBR S</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>1350</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>580796</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES OLSON MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>334057</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>39255</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MAUDE GUERIN MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>44354</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID KAUFMAN DO</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>1350</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVE HUNT</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>1350</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFF BENSON</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>1350</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NANCY MCKEAGUE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>1350</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY HODGE DO</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD BRUNER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CURTIS KECK</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BARBARA GIVEN PHD</PersonNm>
        <TitleTxt>CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MIKE KING</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATT RUSH</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEAN PAULL</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOE RUTH</PersonNm>
        <TitleTxt>SR VP/COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>743459</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>52872</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAULA REICHLE</PersonNm>
        <TitleTxt>SR VP - CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>704158</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>55610</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS BRES</PersonNm>
        <TitleTxt>SR VP CHIEF</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>697583</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>47487</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK BRETT</PersonNm>
        <TitleTxt>SR VP/AFFILI</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>661520</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>54424</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRIAN SCHROEDER</PersonNm>
        <TitleTxt>SR VP/CHIEF</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>477829</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>50538</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DOUGLAS EDEMA MD</PersonNm>
        <TitleTxt>VP/SPARROW M</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>453887</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>49603</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DENNIS REESE</PersonNm>
        <TitleTxt>PHP PRESIDEN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>420841</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>46788</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY LOU WESLEY</PersonNm>
        <TitleTxt>SR VP - CNO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>381900</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>47071</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL ZAROUKIAN MD PHD</PersonNm>
        <TitleTxt>VP/CHIEF MED</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>378189</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>59684</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS OSTRANDER</PersonNm>
        <TitleTxt>VP PROFESSIO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>367551</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45994</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVE KRUGER</PersonNm>
        <TitleTxt>VP - PHYS PR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>350067</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45923</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STELLA CASH</PersonNm>
        <TitleTxt>VP DEVELOPME</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>347115</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>44902</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THEODORE GLYNN MD</PersonNm>
        <TitleTxt>VP/MEDICAL E</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>304468</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>64895</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHERRY SOHN</PersonNm>
        <TitleTxt>VP QUALITY/P</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>276608</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30287</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTINE JODOIN</PersonNm>
        <TitleTxt>VP OF NURSIN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>268876</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>39300</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIRA CARTER-ROBERTSON</PersonNm>
        <TitleTxt>VP POST ACUT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>268286</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>46701</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM HOWE</PersonNm>
        <TitleTxt>VP FINANCE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>259427</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41439</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREA KOSLOSKI</PersonNm>
        <TitleTxt>VP LEGAL SER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>251749</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>37506</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAUL STURGIS</PersonNm>
        <TitleTxt>VP/CHIEF HR</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>247038</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>40088</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD FELLOWS</PersonNm>
        <TitleTxt>VP - CORP CO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>242707</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35346</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SABARRAS GEORGE</PersonNm>
        <TitleTxt>VP GUEST SER</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>234441</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36222</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PATRICK BRILLANTES</PersonNm>
        <TitleTxt>VP CONS/CARE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>232370</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>37020</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MELISSA SEARS</PersonNm>
        <TitleTxt>VP STRATEGIC</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>187508</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20418</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA PASCOE</PersonNm>
        <TitleTxt>CORPORATE DI</TitleTxt>
        <AverageHoursPerWeekRt>20.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>121908</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23108</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ARA PRIDJIAN MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>890207</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>57516</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NORBERT BAUMGARTNER MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>840840</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>81579</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALONSO COLLAR DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>823618</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>73368</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MINDY LANE DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>687045</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>56173</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GORDON SRKALOVIC MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>648593</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>51014</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAWN SPRINGER MD</PersonNm>
        <TitleTxt>FORMER BOARD</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>231912</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32980</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LARRY WILHITE</PersonNm>
        <TitleTxt>FORMER OFFIC</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>185250</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28604</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LARRY RAWSTHORNE MD</PersonNm>
        <TitleTxt>FORMER OFFIC</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>67768</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>8371</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT WILKERSON</PersonNm>
        <TitleTxt>FORMER PHP P</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>40243</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>3094</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PETER GRAHAM MD</PersonNm>
        <TitleTxt>FORMER VP -</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>371971</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42105</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>15541889</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>580796</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>1597509</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>542</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>true</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>THE CHRISTMAN COMPANY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>208 N CAPITOL AVENUE</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48933</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
        <CompensationAmt>15244287</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GRANGER CONSTRUCTION COMPANY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6267 AURELIUS ROAD</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48911</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
        <CompensationAmt>8093279</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ARAMARK HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1101 MARKET STREET</AddressLine1Txt>
            <CityNm>PHILADELPHIA</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19107</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MED. DEVICE REP</ServicesDesc>
        <CompensationAmt>8092312</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CLARK CONSTRUCTION COMPANY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3535 MOORES RIVER DRIVE</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48911</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SERVICES</ServicesDesc>
        <CompensationAmt>6445402</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AMERICAN RED CROSS GREAT LAKES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 73013</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606737013</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>BLOOD SVC/PROD</ServicesDesc>
        <CompensationAmt>2806046</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>138</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>1305992</RelatedOrganizationsAmt>
      <TotalContributionsAmt>1305992</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>838844629</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>838844629</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>NONPATIENT SERVICE REVENUE</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>34945754</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>34945754</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>NONPATIENT SERVICE REVENUE</Desc>
        <TotalRevenueColumnAmt>25725537</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>25725537</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>899515920</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>8924413</TotalRevenueColumnAmt>
        <ExclusionAmt>8924413</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>2151016</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>1823518</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>327498</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>327498</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>104541</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>222957</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>16786425</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>240815</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>16545610</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>16545610</TotalRevenueColumnAmt>
        <ExclusionAmt>16545610</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>FOOD SERVICE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>3228526</TotalRevenueColumnAmt>
        <ExclusionAmt>3228526</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>SPARROW SPECIALTY REVENUE</Desc>
        <BusinessCd>623990</BusinessCd>
        <TotalRevenueColumnAmt>2869664</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2869664</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>DAYCARE REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>479837</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>479837</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>28587248</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>28216426</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>370822</UnrelatedBusinessRevenueAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>35165275</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>961784708</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>896136093</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>35421117</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>28921506</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>33044</TotalAmt>
        <ProgramServicesAmt>33044</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>12912019</TotalAmt>
        <ManagementAndGeneralAmt>12912019</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>389273811</TotalAmt>
        <ProgramServicesAmt>344626127</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44647684</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>32196945</TotalAmt>
        <ProgramServicesAmt>28037071</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4159874</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>34814799</TotalAmt>
        <ProgramServicesAmt>30530555</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4284244</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>28259063</TotalAmt>
        <ProgramServicesAmt>24261944</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3997119</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>1393152</TotalAmt>
        <ManagementAndGeneralAmt>1393152</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>594205</TotalAmt>
        <ManagementAndGeneralAmt>594205</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>861799</TotalAmt>
        <ManagementAndGeneralAmt>861799</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <AdvertisingGrp>
        <TotalAmt>3929414</TotalAmt>
        <ProgramServicesAmt>703851</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3225563</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OccupancyGrp>
        <TotalAmt>15074225</TotalAmt>
        <ProgramServicesAmt>14599474</ProgramServicesAmt>
        <ManagementAndGeneralAmt>474751</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>4747283</TotalAmt>
        <ProgramServicesAmt>2822039</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1925244</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>14307172</TotalAmt>
        <ProgramServicesAmt>12283486</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2023686</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>50037581</TotalAmt>
        <ProgramServicesAmt>47191827</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2845754</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>35271763</TotalAmt>
        <ProgramServicesAmt>30282729</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4989034</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>167455220</TotalAmt>
        <ProgramServicesAmt>167297415</ProgramServicesAmt>
        <ManagementAndGeneralAmt>157805</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PURCHASED SERVICES</Desc>
        <TotalAmt>31673235</TotalAmt>
        <ProgramServicesAmt>27505583</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4167652</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>RENT &amp; REPAIRS</Desc>
        <TotalAmt>25126471</TotalAmt>
        <ProgramServicesAmt>12757587</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12368884</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT</Desc>
        <TotalAmt>16246434</TotalAmt>
        <ManagementAndGeneralAmt>16246434</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>25638723</TotalAmt>
        <ProgramServicesAmt>15159231</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10479492</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>889846358</TotalAmt>
        <ProgramServicesAmt>758091963</ProgramServicesAmt>
        <ManagementAndGeneralAmt>131754395</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>36938434</BOYAmt>
        <EOYAmt>53707953</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>447549064</BOYAmt>
        <EOYAmt>494620790</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>80190707</BOYAmt>
        <EOYAmt>101783646</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>18400031</BOYAmt>
        <EOYAmt>18922654</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>24017435</BOYAmt>
        <EOYAmt>29974307</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>1110103836</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>637807340</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>460299158</BOYAmt>
        <EOYAmt>472296496</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>33899254</BOYAmt>
        <EOYAmt>20969360</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>102840229</BOYAmt>
        <EOYAmt>101931872</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>1204134312</BOYAmt>
        <EOYAmt>1294207078</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>107722241</BOYAmt>
        <EOYAmt>120824440</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>300900000</BOYAmt>
        <EOYAmt>342605000</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>13752308</BOYAmt>
        <EOYAmt>20553516</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>315611864</BOYAmt>
        <EOYAmt>309226695</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>737986413</BOYAmt>
        <EOYAmt>793209651</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>466147899</BOYAmt>
        <EOYAmt>500997427</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>466147899</BOYAmt>
        <EOYAmt>500997427</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>1204134312</BOYAmt>
        <EOYAmt>1294207078</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>71938350</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-26595629</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-10493193</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc13">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <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="RetDoc6">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>3411165</BeginningYearBalanceAmt>
        <ContributionsAmt>361583</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-49824</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>15000</GrantsOrScholarshipsAmt>
        <EndYearBalanceAmt>3707924</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>3184706</BeginningYearBalanceAmt>
        <ContributionsAmt>200566</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>40893</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>15000</GrantsOrScholarshipsAmt>
        <EndYearBalanceAmt>3411165</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>2926676</BeginningYearBalanceAmt>
        <ContributionsAmt>82387</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>187643</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>12000</GrantsOrScholarshipsAmt>
        <EndYearBalanceAmt>3184706</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>2641860</BeginningYearBalanceAmt>
        <ContributionsAmt>147795</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>149021</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>12000</GrantsOrScholarshipsAmt>
        <EndYearBalanceAmt>2926676</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>1779759</BeginningYearBalanceAmt>
        <ContributionsAmt>796243</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>97691</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>30000</GrantsOrScholarshipsAmt>
        <AdministrativeExpensesAmt>1833</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>2641860</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <PrmnntEndowmentBalanceEOYPct>1.00000</PrmnntEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>true</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>true</RelatedOrgListSchRInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>12612127</OtherCostOrOtherBasisAmt>
        <BookValueAmt>12612127</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>534750710</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>231388377</DepreciationAmt>
        <BookValueAmt>303362333</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>6377382</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>135022</DepreciationAmt>
        <BookValueAmt>6242360</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>520621519</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>406283941</DepreciationAmt>
        <BookValueAmt>114337578</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>35742098</OtherCostOrOtherBasisAmt>
        <BookValueAmt>35742098</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>472296496</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>DEFERRED PENSION</Desc>
        <BookValueAmt>45323845</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>INSURANCE - EXCESS LAYER</Desc>
        <BookValueAmt>27670000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OTHER ASSETS</Desc>
        <BookValueAmt>19330129</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>INVESTMENTS IN JOINT VENTURES</Desc>
        <BookValueAmt>6116590</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>DEFERRED FINANCING COSTS</Desc>
        <BookValueAmt>3491308</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>101931872</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>UNFUNDED PENSION OBLIGATION</Desc>
        <Amt>235948023</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>INSURANCE - EXCESS LAYER</Desc>
        <Amt>25770000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>PREMIUM ON 2015 BONDS</Desc>
        <Amt>20425885</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>MEDICAL MALPRACTICE CLAIMS RESERVE</Desc>
        <Amt>11444539</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>PREMIUM ON 2012 BONDS</Desc>
        <Amt>7257863</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>ASBESTOS ABATEMENT</Desc>
        <Amt>3583422</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>POST RETIREMENT BENEFITS PAYABLE</Desc>
        <Amt>2942139</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>PREMIUM ON 2007 BONDS</Desc>
        <Amt>1854824</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>PREMIUM ON 2005 BONDS</Desc>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>309226695</TotalLiabilityAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 2, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>EDWARD W. SPARROW HOSPITAL DOES NOT HOLD ENDOWMENTS. THE ENDOWMENTS ARE HELD BY SPARROW CLINTON HOSPITAL AND SPARROW FOUNDATION. SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF EDWARD W. SPARROW HOSPITAL, SPARROW CLINTON HOSPITAL, AND SPARROW FOUNDATION. THE ENDOWMENTS ARE MAINTAINED TO PROVIDE A PERMANENT SOURCE OF INCOME, WITH THE STIPULATION THE PRINCIPAL IS KEPT INTACT IN PERPETUITY AND THE INCOME GENERATED FROM INVESTMENTS OF THE ENDOWMENT FUNDS CAN BE USED FOR THE PURPOSE ESTABLISHED BY THE ENDOWMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc12">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <IndivHospitalTailoredPolicyInd>X</IndivHospitalTailoredPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent200DInd>X</Percent200DInd>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>false</ExpensesExceedBudgetInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>9503389</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>9503389</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01070</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>164154010</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>141228897</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>22925113</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02580</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>173657399</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>141228897</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>32428502</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03640</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>18874143</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>18874143</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02120</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <SubsidizedHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>6321749</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>3454149</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>2867600</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00320</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <ResearchGrp>
        <TotalCommunityBenefitExpnsAmt>552726</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>552726</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00060</TotalExpensePct>
      </ResearchGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>25748618</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>3454149</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>22294469</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02510</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>199406017</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>144683046</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>54722971</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.06150</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <CommunitySupportGrp>
        <ActivitiesOrProgramsCnt>38</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>29976</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>469292</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>469292</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00050</TotalExpensePct>
      </CommunitySupportGrp>
      <CoalitionBuildingGrp>
        <ActivitiesOrProgramsCnt>20</ActivitiesOrProgramsCnt>
        <TotalCommunityBenefitExpnsAmt>2700</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>2700</NetCommunityBenefitExpnsAmt>
      </CoalitionBuildingGrp>
      <HealthImprovementAdvocacyGrp>
        <ActivitiesOrProgramsCnt>15</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>25</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>1296</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>1296</NetCommunityBenefitExpnsAmt>
      </HealthImprovementAdvocacyGrp>
      <TotalCommuntityBuildingActyGrp>
        <ActivitiesOrProgramsCnt>73</ActivitiesOrProgramsCnt>
        <PersonsServedCnt>30001</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>473288</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>473288</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00050</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>4750961</BadDebtExpenseAmt>
      <ReimbursedByMedicareAmt>263333846</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>272673118</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-9339272</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
      <ManagementCoAndJntVenturesGrp>
        <EntityName>
          <BusinessNameLine1Txt>MID-MI REG DIALYSIS</BusinessNameLine1Txt>
        </EntityName>
        <PrimaryActivitiesTxt>RENTAL ACTIVITIES</PrimaryActivitiesTxt>
        <OrgProfitOrOwnershipPct>0.37000</OrgProfitOrOwnershipPct>
        <PhysiciansProfitOrOwnershipPct>0.25000</PhysiciansProfitOrOwnershipPct>
      </ManagementCoAndJntVenturesGrp>
      <HospitalFacilitiesCnt>2</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>EWSH - MAIN CAMPUS</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <EmergencyRoomOtherInd>X</EmergencyRoomOtherInd>
        <OtherDesc>URGENT CARE</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFacilitiesGrp>
        <FacilityNum>2</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>EWSH - ST LAWRENCE CAMPUS</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1210 W SAGINAW</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48915</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
        <OtherDesc>BEHAVIORAL HLTH HOSPICE SR SVC</OtherDesc>
        <FacilityReportingGroupCd>A</FacilityReportingGroupCd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>A</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>12</FacilityNum>
        <FirstLicensedCYOrPYInd>false</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>
        <InformationGapsInd>X</InformationGapsInd>
        <OtherInd>X</OtherInd>
        <CHNAConductedYr>13</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>true</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>false</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>WWW.SPARROW.ORG</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>13</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>false</StrategyPostedWebsiteInd>
        <StrategyAttachedInd referenceDocumentId="RetDoc2">true</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>200.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>true</CollectionActivitiesInd>
        <FAPNotifiedUponAdmissionInd>X</FAPNotifiedUponAdmissionInd>
        <FAPNotifiedBeforeDischargeInd>X</FAPNotifiedBeforeDischargeInd>
        <FAPNotifiedAllPatientsInd>X</FAPNotifiedAllPatientsInd>
        <DocumentedEligDeterminationInd>X</DocumentedEligDeterminationInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <OtherMethodUsedInd>X</OtherMethodUsedInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>true</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>AS A SUPPLEMENT TO THE HEALTHY CAPITAL COUNTIES (HCC) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), INTERVIEWEES AND FOCUS GROUP PARTICIPANTS WERE SOLICITED FROM A WIDE VARIETY OF COMMUNITY RESIDENTS WITHIN THE PRINCIPAL AREAS SERVED BY SPARROW HEALTH SYSTEM HOSPITALS. AMONG THOSE SOLICITED WERE COMMUNITY LEADERS AND HEALTH CARE LEADERS; STATE AND LOCAL ELECTED OFFICIALS; PHYSICIANS AND OTHER HEALTH CARE PROVIDERS OR WORKERS; LEADERS AND MEMBERS OF RACIAL, ETHNIC, AND RELIGIOUS MINORITIES; EDUCATORS; STUDENTS; RETIREES; SOCIAL SERVICE PROVIDERS; AND OTHERS. MINORITY GROUPS WITH WHOM THESE ISSUES WERE DISCUSSED INCLUDED AFRICAN AMERICANS, MEMBERS OF THE MUSLIM COMMUNITY FROM SEVERAL DIFFERENT ETHNIC BACKGROUNDS, INTERNATIONAL STUDENTS, AND MEMBERS OF THE EAST INDIAN COMMUNITY. HEALTH CARE ISSUES WITHIN THE HISPANIC COMMUNITY WERE ADDRESSED BY A PHYSICIAN THAT SERVES THE HISPANIC COMMUNITY. INTERNATIONAL STUDENTS WERE FROM CHINA AND THE MIDDLE EAST.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 6A</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HOSPITAL, CONSISTING OF FOUR COMMUNITY HOSPITALS, THREE OF WHICH ARE LOCATED IN THE THREE-COUNTY GREATER LANSING REGION: - EDWARD W SPARROW HOSPITAL, LANSING, MI - SPARROW SPECIALTY HOSPITAL, LANSING, MI - SPARROW CLINTON HOSPITAL, ST. JOHNS, MI - SPARROW IONIA HOSPITAL, IONIA, MI - MCLAREN GREATER LANSING - HAYES GREEN BEACH MEMORIAL HOSPITAL - EATON RAPIDS MEDICAL CENTER</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 11</FormAndLineReferenceDesc>
        <ExplanationTxt>EDWARD W SPARROW HOSPITAL HAS DEVELOPED AN IMPLEMENTATION STRATEGY FOR THE TOP THREE PRIORITY NEEDS THAT WERE IDENTIFIED IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS. THE TOP NEEDS IDENTIFIED WERE CHILDREN'S HEALTH, HEALTHY LIFESTYLES, AND ACCESS TO QUALITY HEALTH CARE. FOR EACH OF THE NEEDS IDENTIFIED MULTIPLE KEY OBJECTIVES WERE IDENTIFIED TO CREATE A STRATEGY ON HOW TO MEET THE NEEDS. FOR EACH KEY OBJECTIVE AN IMPLEMENTATION STRATEGY WAS CREATED, INCLUDING TIMING FOR THE IMPLEMENTATION AND GOALS TO MONITOR THE SUCCESS OF MEETING THE NEEDS. PLEASE FIND ENCLOSED A COPY OF THE IMPLEMENTATION STRATEGY. OTHER NEEDS IDENTIFIED IN THE CHNA BUT NOT ADDRESSED IN THIS STRATEGY INCLUDED OBESITY, SAFETY AND SOCIAL CONNECTION, AND CONNECTION TO RESOURCES. EACH OF THESE HEALTH NEEDS ARE IMPORTANT BUT THEY WERE NOT INCLUDED IN THE ATTACHED IMPLEMENTATION STRATEGY DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES TO EDWARD W SPARROW HOSPITAL'S TOP THREE PRIORITY HEALTH NEEDS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 22D</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL PATIENTS AND INSURANCES ARE CHARGED THE SAME GROSS CHARGE FROM OUR FEE SCHEDULE. DISCOUNTS ARE THEN PROVIDED TO UNINSURED PATIENTS BASED ON OUR FINANCIAL ASSISTANCE POLICY AND/OR INDIVIDUAL CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, EWSH - MAIN CAMPUS - PART V, LINE 24</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL PATIENTS AND INSURANCES ARE CHARGED THE SAME GROSS CHARGE FROM OUR FEE SCHEDULE. DISCOUNTS ARE THEN PROVIDED TO UNINSURED PATIENTS BASED ON OUR FINANCIAL ASSISTANCE POLICY AND/OR INDIVIDUAL CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 2, EWSH - ST. LAWRENCE CAMPUS - PART V, LINE 22D</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL PATIENTS AND INSURANCES ARE CHARGED THE SAME GROSS CHARGE FROM OUR FEE SCHEDULE. DISCOUNTS ARE THEN PROVIDED TO UNINSURED PATIENTS BASED ON OUR FINANCIAL ASSISTANCE POLICY AND/OR INDIVIDUAL CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 2, EWSH - ST. LAWRENCE CAMPUS - PART V, LINE 24</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL PATIENTS AND INSURANCES ARE CHARGED THE SAME GROSS CHARGE FROM OUR FEE SCHEDULE. DISCOUNTS ARE THEN PROVIDED TO UNINSURED PATIENTS BASED ON OUR FINANCIAL ASSISTANCE POLICY AND/OR INDIVIDUAL CIRCUMSTANCES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>46</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH MEDICAL ARTS BUILDING</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1322 E MICHIGAN</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>OCC HEALTH WOUND CLINIC OB/GYN</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW PROF BUILDING</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1200 E MICHIGAN AVE</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>CLINICS PHARMACY REHAB</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH MED CENTER WEST</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1100 W SAGINAW</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48915</ZIPCd>
          </USAddress>
          <FacilityTxt>PHARMACY PLUS OB/GYN CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH MASON COMMUNITY CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>800 E COLUMBIA</AddressLine1Txt>
            <CityNm>MASON</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48854</ZIPCd>
          </USAddress>
          <FacilityTxt>URGENT CARE/FAMILY PRACTICE/RADIOLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH LANSING OBGYN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1600 W GRAND RIVER</AddressLine1Txt>
            <CityNm>OKEMOS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48864</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY PRACTICE OB/GYN LAB RADIOLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW REG LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2035 ASHER CT STE 200</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG NORTH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2035 ASHER CT STE 200</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY PRACTICE PHYSICAL THERAPY RADIOLO</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH OP REHAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1288 W GRAND RIVER</AddressLine1Txt>
            <CityNm>WILLIAMSTON</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48895</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG MASON</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>230 TEMPLE ST STE 3</AddressLine1Txt>
            <CityNm>MASON</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48854</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY PRACTICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG WEST</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7335 WESTSHIRE DR STE 10</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY PRACTICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW REGIONAL LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>11615 HARTEL</AddressLine1Txt>
            <CityNm>GRAND LEDGE</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48837</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG POTTERVILLE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>133 W LANSING RD</AddressLine1Txt>
            <CityNm>POTTERVILLE</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48876</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY PRACTICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH RAMBLEWOOD IMG CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1575 RAMBLEWOOD DR</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
          <FacilityTxt>RADIOLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW REGIONAL LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2199 JOLLY ROAD STE 120</AddressLine1Txt>
            <CityNm>OKEMOS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48864</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW REGIONAL LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1650 RAMBLEWOOD DR</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH OKEMOS URGENT CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1600 W GRAND RIVER</AddressLine1Txt>
            <CityNm>OKEMOS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48864</ZIPCd>
          </USAddress>
          <FacilityTxt>URGENT CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW REGIONAL LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>6254 W SAGINAW</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW REGIONAL LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>6030 S PENNSYLVANIA</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48913</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>11653 HARTEL STE 1000</AddressLine1Txt>
            <CityNm>GRAND LEDGE</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48837</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH OUTPATIENT REHAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>13105 SCHAVEY ROAD</AddressLine1Txt>
            <CityNm>DEWITT</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48820</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>SOUTHPOINT MALL STE A14-A17</AddressLine1Txt>
            <CityNm>ST JOHNS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48879</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICAL THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG DEWITT</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>13191 SCHAVEY RD</AddressLine1Txt>
            <CityNm>DEWITT</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48820</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY PRACTICE LAB RADIOLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>138 SERVICE ROAD</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW PHARMACY PLUS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>129 S PUTNAM</AddressLine1Txt>
            <CityNm>WILLIAMSTON</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48895</ZIPCd>
          </USAddress>
          <FacilityTxt>PHARMACY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW PHARMACY PLUS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1015 CHARLEVOIX DRIVE</AddressLine1Txt>
            <CityNm>GRAND LEDGE</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48837</ZIPCd>
          </USAddress>
          <FacilityTxt>PHARMACY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW PHARMACY PLUS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>915 E MICHIGAN</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>PHARMACY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW PHARMACY PLUS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1200 E MICHIGAN STE 310</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>PHARMACY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG EAST LANSING</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2682 E GRAND RIVER</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY &amp; URGENT CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG HOLT</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2040 N AURELIUS</AddressLine1Txt>
            <CityNm>HOLT</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48842</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY PRACTICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG GRAND LEDGE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1015 CHARLEVOIX DRIVE</AddressLine1Txt>
            <CityNm>GRAND LEDGE</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48837</ZIPCd>
          </USAddress>
          <FacilityTxt>URGENT CARE &amp; PHARMACY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>TCI HEART CLINIC &amp; DIAGNOSTIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>300 HEALTH PARK DRIVE</AddressLine1Txt>
            <CityNm>OWOSSO</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48867</ZIPCd>
          </USAddress>
          <FacilityTxt>HEART CLINIC &amp; DIAGNOSTICS</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>TCI SPECIALTY CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1500 MAIN ST</AddressLine1Txt>
            <CityNm>EATON RAPIDS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48827</ZIPCd>
          </USAddress>
          <FacilityTxt>HEART CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW REGIONAL LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1650 HASLETT ROAD</AddressLine1Txt>
            <CityNm>HASLETT</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48840</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>TCI HEART CLINICPRIMARY CARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>839 S PUTNAM</AddressLine1Txt>
            <CityNm>WILLIAMSTON</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48895</ZIPCd>
          </USAddress>
          <FacilityTxt>HEART CLINIC &amp; PRIMARY CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SPARROW REGIONAL LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>5303 S CEDAR</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48910</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>TCI HEART CLINIC LANSING</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>405 W GREENLAWN</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48910</ZIPCd>
          </USAddress>
          <FacilityTxt>HEART CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG VOA</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>430 N LARCH</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48906</ZIPCd>
          </USAddress>
          <FacilityTxt>VOLUNTEER VOA CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG EASTSIDE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1651 W LAKE LANSING ROAD</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
          <FacilityTxt>FAMILY PRACTICE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG NEPHROLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1703 E MICHIGAN AVENUE</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>NEPHROLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG NEPHROLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2601 COOLIDGE ROAD SUITE B</AddressLine1Txt>
            <CityNm>EAST LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48823</ZIPCd>
          </USAddress>
          <FacilityTxt>NEPHROLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG NEPHROLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1540 LAKE LANSING RD SUITE 205</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>NEPHROLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG OBGYN</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1540 LAKE LANSING RD SUITE 204</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>OB/GYN</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH SMG NEPHROLOGY</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>123 LANSING RD</AddressLine1Txt>
            <CityNm>CHARLOTTE</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48813</ZIPCd>
          </USAddress>
          <FacilityTxt>NEPHROLOGY</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH FASTCARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>107 N WASHINGTON SQUARE</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48912</ZIPCd>
          </USAddress>
          <FacilityTxt>FASTCARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH FASTCARE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>716 N CLIPPERT ST</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48910</ZIPCd>
          </USAddress>
          <FacilityTxt>FASTCARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>EWSH CAP LAB</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2508 S CEDAR ST</AddressLine1Txt>
            <CityNm>LANSING</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48910</ZIPCd>
          </USAddress>
          <FacilityTxt>LABORATORY</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION</FormAndLineReferenceDesc>
        <ExplanationTxt>A COST TO CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B AND 7C). 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 (LINE 7E), SUBSIDIZED HEALTH SERVICES (LINE 7G) AND RESEARCH (LINE 7H).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II - COMMUNITY BUILDING ACTIVITIES</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HEALTH SYSTEM'S REACH EXTENDS FAR BEYOND THE ACUTE CARE SETTING OF THE HOSPITAL. THERE ARE MANY WAYS OUR STAFF PROACTIVELY SUPPORTS THE COMMUNITY, ESPECIALLY THOSE WHO HAVE THE GREATEST NEED. WHETHER THROUGH CHARITABLE CARE, SUBSIDIZED HOSPITAL PROGRAMS AND SERVICES, MEDICAL EDUCATION OR COMMUNITY HEALTH EDUCATION, SPARROW STRIVES TO RESPOND TO THE REGION'S MOST PRESSING HEALTH NEEDS. FOR MORE THAN 114 YEARS, SPARROW HAS BEEN DISTINGUISHED BY ITS PASSIONATE COMMITMENT TO CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. FINANCIAL ASSISTANCE IS AVAILABLE TO PATIENTS WHO MEET CERTAIN QUALIFICATIONS. SPARROW ALSO PROVIDES "SUBSIDIZED HEALTH SERVICES." THESE ARE SERVICES THAT ARE OFFERED DESPITE FINANCIAL LOSS BECAUSE THE COMMUNITY NEEDS THEM, BECAUSE OTHER PROVIDERS ARE NOT WILLING TO OFFER THEM, OR BECAUSE THE SERVICES WOULD OTHERWISE NOT BE ABLE TO MEET PATIENT DEMAND. THESE SERVICES INCLUDE HOSPICE AND PALLIATIVE CARE; MENTAL HEALTH SERVICES; SUBSTANCE ABUSE SERVICES; NEONATAL INTENSIVE CARE; OBSTETRICS; REHABILITATION; EMERGENCY AND TRAUMA SERVICES; GERIATRICS CLINICS; AND PEDIATRIC CLINICS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES. THE COST TO CHARGE RATIO IS USED IN DETERMINING BAD DEBT INFORMATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE</FormAndLineReferenceDesc>
        <ExplanationTxt>IN REVIEWING ACCOUNTS CLASSIFIED AS BAD DEBT, THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3, REFLECTS PATIENTS WHO HAD PREVIOUSLY QUALIFIED FOR MEDICAID OR OTHER MEANS-TESTED SUPPORT, BUT WHO AT THE TIME OF SERVICES, WERE NO LONGER ELIGIBLE FOR MEDICAID OR OTHER MEANS-TESTED SUPPORT OR THE SERVICES PROVIDED WERE NOT COVERED BENEFITS. THE HOSPITAL FURTHER REVIEWED THESE PATIENTS TO MAKE A DETERMINATION OF THE PATIENTS' ELIGIBILITY FOR ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT FOOTNOTE - SEE PAGE 13 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8 - MEDICARE EXPLANATION</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS, REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT, IS A RATIO OF COSTS TO CHARGES. THE HOSPITAL BELIEVES THE FULL AMOUNT OF THE SHORTFALL REPORTED ON PART III, SECTION B, LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS AND THAT SHORTFALL OF 9,339,272 SHOULD BE COUNTED AS COMMUNITY BENEFIT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHARGES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE ARE WRITTEN OFF THE SYSTEM TO CHARITY CARE AT THE TIME THE PATIENT'S CHARITY CARE STATUS IS DETERMINED. AS SUCH, NO FURTHER COLLECTION EFFORTS TAKE PLACE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2 - NEEDS ASSESSMENT</FormAndLineReferenceDesc>
        <ExplanationTxt>THROUGH CONTINUAL ANALYSIS OF OUR ANNUAL CASE MIX AND COLLABORATION WITH COMMUNITY PARTNERS, SPARROW IS ABLE TO MAKE ACCURATE ASSESSMENTS OF THE HEALTH CARE NEEDS OF THE REGION IT SERVES. FOR EXAMPLE, OUR REGIONAL COLLABORATION OF AREA HEALTH PARTNERS, WHICH INCLUDES SPARROW, MICHIGAN STATE UNIVERSITY, INGHAM REGIONAL MEDICAL CENTER, LANSING COMMUNITY COLLEGE, THE MICHIGAN STATE AND INGHAM COUNTY MEDICAL SOCIETIES, THE INGHAM COUNTY HEALTH DEPARTMENT, THE LANSING SCHOOL DISTRICT, THE ACCIDENT FUND, THE CAPITAL AREA HEALTH ALLIANCE AND OTHER ORGANIZATIONS RECENTLY ADOPTED A NEW GOAL OF DEVELOPING THE HEALTH PLAN CHAPTER FOR THE GREATER LANSING NEXT INITIATIVE. ASSESSING THE REGION'S HEALTH CARE NEEDS IS A KEY COMPONENT OF THIS STRATEGIC PLAN WHICH IS FOCUSED ON ECONOMIC DEVELOPMENT FOR THE REGION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HOSPITAL EMPLOYS SEVERAL METHODS TO COMMUNICATE ELIGIBILITY FOR ASSISTANCE TO PATIENTS. ALL UNINSURED IN-PATIENTS ARE DIRECTLY SCREENED FOR POTENTIAL MEDICAID ELIGIBILITY AND ANY OTHER GOVERNMENT PROGRAMS (COBRA BENEFITS, ETC). SIGNAGE IS POSTED IN OUR PATIENT REGISTRATION AREAS REGARDING AVAILABILITY OF SPARROW COMMUNITY FINANCIAL AID (CFA) PROGRAM (CHARITY CARE). ALL PATIENT BILLING STATEMENTS HAVE A NOTE REGARDING THE CFA PROGRAM AND OUR WEBSITE CONTAINS LINKS TO OUR CFA POLICY AND APPLICATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4 - COMMUNITY INFORMATION</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW SERVES THE MID-MICHIGAN REGION WHICH CONSISTS OF THE GREATER LANSING AREA (A POPULATION OF APPROXIMATELY 450,000). STRATEGICALLY LOCATED IN THE HEART OF MICHIGAN, SPARROW IS LOCATED WITHIN 90 MINUTES OF 90 PERCENT OF THE STATE'S POPULATION OF APPROXIMATELY 10 MILLION PEOPLE. THE STATE CAPITAL, MICHIGAN STATE UNIVERSITY, AND TWO GENERAL MOTORS ASSEMBLY FACILITIES MAKE THE LANSING REGION AMONG THE MOST STABLE AND DIVERSE ECONOMIES IN MICHIGAN. THE REGION IS EVOLVING AS A LEADING ECONOMIC FORCE IN RESEARCH AND DEVELOPMENT, WAREHOUSING AND DISTRIBUTION, INFORMATION TECHNOLOGY, BIO-TECHNOLOGY, HEALTHCARE, INSURANCE, AND FINANCIAL SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH</FormAndLineReferenceDesc>
        <ExplanationTxt>AS NOTED ABOVE, THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES. THESE SERVICES ARE PROVIDED UNDER THE MISSION OF THE ORGANIZATION - "IMPROVING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES BY PROVIDING QUALITY, COMPASSIONATE CARE TO EVERYONE, EVERY TIME."</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM</FormAndLineReferenceDesc>
        <ExplanationTxt>EDWARD W SPARROW HOSPITAL IS A WHOLLY-OWNED SUBSIDIARY OF SPARROW HEALTH SYSTEM. SPARROW HEALTH SYSTEM IS A NON-PROFIT, COMMUNITY GOVERNED, INTEGRATED HEALTH DELIVERY AND FINANCIAL SYSTEM SERVING MID-MICHIGAN. SPARROW HEALTH SYSTEM PROVIDES SERVICES TO THE COMMUNITIES IT SERVES THROUGH ITS WHOLLY-OWNED AND CONTROLLED SUBSIDIARIES: PHYSICIAN HEALTH PLAN, PHYSICIAN HEALTH NETWORK, EDWARD W SPARROW HOSPITAL, SPARROW CLINTON HOSPITAL, SPARROW SPECIALTY HOSPITAL, SPARROW CARSON HOSPITAL, SPARROW DEVELOPMENT, INC., SPARROW COMMUNITY CARE, INC., SPARROW IONIA HOSPITAL, SPARROW FOUNDATION, AND SPARROW CLINICAL RESEARCH INSTITUTE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT</FormAndLineReferenceDesc>
        <ExplanationTxt>MICHIGAN</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc7">
      <GrantRecordsMaintainedInd>false</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>SPARROW FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <RecipientEIN>386100687</RecipientEIN>
        <IRCSectionDesc>3</IRCSectionDesc>
        <CashGrantAmt>33044</CashGrantAmt>
        <PurposeOfGrantTxt>CHARITABLE DONATION</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE I, PAGE 1, PART I, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION DOES NOT ISSUE GRANTS. THE ORGANIZATION PROVIDES CHARITABLE CONTRIBUTIONS TO OTHER TAX-EXEMPT 501(C)(3) ORGANIZATIONS THAT HELPS TO SUPPORT THE COMMUNITY AND THE ORGANIZATION'S MISSION. THE CHARITABLE CONTRIBUTION ARE USED FOR CHARITABLE PURPOSES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc8">
      <IdemnificationGrossUpPmtsInd>X</IdemnificationGrossUpPmtsInd>
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>true</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>true</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>true</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>true</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>true</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DENNIS SWAN</PersonNm>
        <TitleTxt>PRES/CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>829199</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>623169</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>37428</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19610</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>50614</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>1560020</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GREG BROGAN</PersonNm>
        <TitleTxt>BOARD MBR SEE SCH O</TitleTxt>
        <BaseCompensationFilingOrgAmt>1350</BaseCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>580796</OtherCompensationRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1350</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>580796</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES OLSON MD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <BaseCompensationFilingOrgAmt>241841</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>90111</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2105</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19610</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>19645</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>373312</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOE RUTH</PersonNm>
        <TitleTxt>SR VP/COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>479782</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>241719</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>21958</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19610</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>33262</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>796331</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAULA REICHLE</PersonNm>
        <TitleTxt>SR VP - CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>452414</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>227884</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>23860</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>39860</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>759768</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS BRES</PersonNm>
        <TitleTxt>SR VP CHIEF ADMIN OF</TitleTxt>
        <BaseCompensationFilingOrgAmt>466889</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>227742</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2952</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>31737</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>745070</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK BRETT</PersonNm>
        <TitleTxt>SR VP/AFFILIATE OPER</TitleTxt>
        <BaseCompensationFilingOrgAmt>446334</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>211487</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3699</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>38674</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>715944</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRIAN SCHROEDER</PersonNm>
        <TitleTxt>SR VP/CHIEF MED OFC</TitleTxt>
        <BaseCompensationFilingOrgAmt>385638</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>69722</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>22469</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>34788</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>528367</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DOUGLAS EDEMA MD</PersonNm>
        <TitleTxt>VP/SPARROW MED GROUP</TitleTxt>
        <BaseCompensationFilingOrgAmt>381210</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>65658</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>7019</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>33853</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>503490</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DENNIS REESE</PersonNm>
        <TitleTxt>PHP PRESIDENT &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>315720</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>102981</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2140</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>23700</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23088</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>467629</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARY LOU WESLEY</PersonNm>
        <TitleTxt>SR VP - CNO</TitleTxt>
        <BaseCompensationFilingOrgAmt>320429</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>58260</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3211</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>23700</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23371</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>428971</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL ZAROUKIAN MD PHD</PersonNm>
        <TitleTxt>VP/CHIEF MED INF OFC</TitleTxt>
        <BaseCompensationFilingOrgAmt>299471</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>54756</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>23962</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>43934</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>437873</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS OSTRANDER</PersonNm>
        <TitleTxt>VP PROFESSIONAL SRVC</TitleTxt>
        <BaseCompensationFilingOrgAmt>292807</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>53798</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>20946</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>23700</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22294</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>413545</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVE KRUGER</PersonNm>
        <TitleTxt>VP - PHYS PRACT ADM</TitleTxt>
        <BaseCompensationFilingOrgAmt>279991</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>50554</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>19522</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>30173</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>395990</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STELLA CASH</PersonNm>
        <TitleTxt>VP DEVELOPMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>244785</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>79057</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>23273</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>29152</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>392017</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THEODORE GLYNN MD</PersonNm>
        <TitleTxt>VP/MEDICAL EDUCATION</TitleTxt>
        <BaseCompensationFilingOrgAmt>258645</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>44968</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>855</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>49145</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>369363</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHERRY SOHN</PersonNm>
        <TitleTxt>VP QUALITY/PERF IMPR</TitleTxt>
        <BaseCompensationFilingOrgAmt>216957</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>39887</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>19764</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>4665</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25622</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>306895</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRISTINE JODOIN</PersonNm>
        <TitleTxt>VP OF NURSING</TitleTxt>
        <BaseCompensationFilingOrgAmt>234103</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>33599</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>1174</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>12915</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>26385</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>308176</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KIRA CARTER-ROBERTSON</PersonNm>
        <TitleTxt>VP POST ACUTE CARE</TitleTxt>
        <BaseCompensationFilingOrgAmt>231049</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>36789</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>448</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>21605</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>25096</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>314987</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM HOWE</PersonNm>
        <TitleTxt>VP FINANCE</TitleTxt>
        <BaseCompensationFilingOrgAmt>230683</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>28418</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>326</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>22527</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>18912</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>300866</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANDREA KOSLOSKI</PersonNm>
        <TitleTxt>VP LEGAL SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>205914</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>43830</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2005</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19192</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>18314</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>289255</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL STURGIS</PersonNm>
        <TitleTxt>VP/CHIEF HR OFC</TitleTxt>
        <BaseCompensationFilingOrgAmt>200055</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>44968</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2015</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>22571</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>17517</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>287126</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RICHARD FELLOWS</PersonNm>
        <TitleTxt>VP - CORP COMPLIANCE</TitleTxt>
        <BaseCompensationFilingOrgAmt>186886</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>34923</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>20898</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>18101</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>17245</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>278053</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SABARRAS GEORGE</PersonNm>
        <TitleTxt>VP GUEST SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>202521</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>31503</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>417</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>12729</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>23493</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>270663</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PATRICK BRILLANTES</PersonNm>
        <TitleTxt>VP CONS/CAREGIVER</TitleTxt>
        <BaseCompensationFilingOrgAmt>204419</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>27677</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>274</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19243</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>17777</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>269390</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MELISSA SEARS</PersonNm>
        <TitleTxt>VP STRATEGIC/MKTG</TitleTxt>
        <BaseCompensationFilingOrgAmt>176538</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>10000</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>970</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>5376</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>15042</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>207926</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ARA PRIDJIAN MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>583037</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>285758</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>21412</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19610</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>37906</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>947723</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NORBERT BAUMGARTNER MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>599743</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>238475</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2622</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>65829</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>922419</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALONSO COLLAR DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>599490</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>216604</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>7524</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>57618</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>896986</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MINDY LANE DO</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>507975</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>159031</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>20039</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>15750</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>40423</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>743218</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GORDON SRKALOVIC MD</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>537355</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>91471</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>19767</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19610</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>31404</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>699607</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAWN SPRINGER MD</PersonNm>
        <TitleTxt>FORMER BOARD MEMBER</TitleTxt>
        <BaseCompensationFilingOrgAmt>177270</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>50929</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3713</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>16916</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>16064</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>264892</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LARRY WILHITE</PersonNm>
        <TitleTxt>FORMER OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>134351</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>39963</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>10936</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>13819</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>14785</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>213854</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LARRY RAWSTHORNE MD</PersonNm>
        <TitleTxt>FORMER OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>62461</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>5307</OtherCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8371</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>76139</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SCOTT WILKERSON</PersonNm>
        <TitleTxt>FORMER PHP PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>40243</BaseCompensationFilingOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>3094</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>43337</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PETER GRAHAM MD</PersonNm>
        <TitleTxt>FORMER VP - SMG</TitleTxt>
        <BaseCompensationFilingOrgAmt>294993</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>74641</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>2337</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>19610</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>22495</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>414076</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>PRESIDENT/CEO DENNIS SWAN RECEIVED A LIFE INSURANCE GROSS-UP PAYMENT OF 24,031. CERTAIN BOARD MEMBERS- AND EXECUTIVES' MICHIGAN ATHLETIC CLUB DUES ARE PAID BY EDWARD W. SPARROW HOSPITAL. THESE AMOUNTS ARE CONSIDERED TAXABLE COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>SCOTT WILKERSON 40,337 0 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 5A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 2015 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2015 AND WILL BE PAID IN 2016. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 5B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 2015 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2015 AND WILL BE PAID IN 2016. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 6A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 2015 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2015 AND WILL BE PAID IN 2016. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 6B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 2015 INCENTIVE COMPENSATION PLAN PAYMENTS WERE ACCRUED IN 2015 AND WILL BE PAID IN 2016. THE INCENTIVE COMPENSATION PLAN IS BASED, IN PART, ON THE OPERATING MARGIN OF SPARROW HEALTH SYSTEM AS WELL AS AFFILIATED COMPANIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NON-FIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>LARRY RAWSTHORNE, LARRY WILHITE, AND PETER GRAHAM ARE FORMER OFFICERS AND DAWN SPRINGER IS A FORMER BOARD MEMBER OF EDWARD W. SPARROW HOSPITAL. THESE FORMER OFFICERS AND BOARD MEMBER ARE BEING COMPENSATED BY SPARROW HEALTH SYSTEM AND AFFILIATES FOR SERVICES PROVIDED TO SPARROW HEALTH SYSTEM AND AFFILIATES IN POSITIONS OTHER THAN OFFICERS OR BOARD MEMBER. THE FORMER OFFICERS AND BOARD MEMBER ARE NOT BEING COMPENSATED FOR ANY PAST SERVICES PROVIDED TO EDWARD W. SPARROW HOSPITAL AS FORMER OFFICERS OR BOARD MEMBER. SCHEDULE J, PART II, COLUMN (B)(I) - PAYMENTS TO GREG BROGAN FOR BROKER'S SALES COMMISSIONS FOR PHP INSURANCE COMPANY (580,796).</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc9">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>MICHIGAN STATE HOSPITAL FINANCE</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>382889417</BondIssuerEIN>
        <CUSIPNum>59465HEQ5</CUSIPNum>
        <BondIssuedDt>2007-04-19</BondIssuedDt>
        <IssuePriceAmt>140209630</IssuePriceAmt>
        <PurposeDesc>SEE PART VI, SUPPLEMENTAL INFORMATION</PurposeDesc>
        <DefeasedInd>true</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>MICHIGAN STATE HOSPITAL FINANCE</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>382889417</BondIssuerEIN>
        <CUSIPNum>59447PQF1</CUSIPNum>
        <BondIssuedDt>2012-08-21</BondIssuedDt>
        <IssuePriceAmt>106840434</IssuePriceAmt>
        <PurposeDesc>SEE PART VI, SUPPLEMENTAL INFORMATION</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>MICHIGAN FINANCE AUTHORITY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>800596186</BondIssuerEIN>
        <CUSIPNum>59447TCT8</CUSIPNum>
        <BondIssuedDt>2015-04-23</BondIssuedDt>
        <IssuePriceAmt>202482721</IssuePriceAmt>
        <PurposeDesc>SEE PART VI, SUPPLEMENTAL INFORMATION</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>67760000</RetiredAmt>
        <TotalProceedsAmt>142636235</TotalProceedsAmt>
        <RefundingEscrowAmt>41432241</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>1203994</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>100000000</CapitalExpendituresAmt>
        <SubstantialCompletionYr>2008</SubstantialCompletionYr>
        <CurrentRefundingInd>false</CurrentRefundingInd>
        <AdvanceRefundingInd>true</AdvanceRefundingInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceedsAmt>106962665</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>1247782</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>95401441</CapitalExpendituresAmt>
        <UnspentAmt>10313442</UnspentAmt>
        <SubstantialCompletionYr>2014</SubstantialCompletionYr>
        <CurrentRefundingInd>false</CurrentRefundingInd>
        <AdvanceRefundingInd>false</AdvanceRefundingInd>
        <FinalAllocationMadeInd>false</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <TotalProceedsAmt>202482721</TotalProceedsAmt>
        <RefundingEscrowAmt>140461696</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>2021025</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>30237856</CapitalExpendituresAmt>
        <UnspentAmt>30690433</UnspentAmt>
        <CurrentRefundingInd>true</CurrentRefundingInd>
        <AdvanceRefundingInd>true</AdvanceRefundingInd>
        <FinalAllocationMadeInd>false</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>false</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>true</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>true</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1Txt>HYPO PUBLIC FIN</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>BANK</BusinessNameLine2Txt>
        </GICProviderName>
        <TermOfGICPct>2.700000000000</TermOfGICPct>
        <RegulatorySafeHarborStsfdInd>true</RegulatorySafeHarborStsfdInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>true</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE K - ADDITIONAL INFORMATION</FormAndLineReferenceDesc>
        <ExplanationTxt>MICHIGAN STATE HOSPITAL FINANCE LINE A, COLUMN F, PART I: REFUNDED 2001 BONDS; COMPLETED 10-STORY TOWER ADDITION TO THE MAIN CAMPUS LINE B, COLUMN F, PART I: COMPLETE 9TH &amp; 10TH FLOOR BUILDOUT, NEW FAMILY PRACTICE, NEW CAFETERIA, SURGERY REMODEL, ETC LINE C, COLUMN F, PART I: REFUNDED 2005 BONDS; PARTIAL REFUND OF 2007 BONDS; NEW CANCER CENTER CONSTRUCTION</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc10">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>TAMARA HODGE</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>FAMILY MEMBER</RelationshipDescriptionTxt>
        <TransactionAmt>84778</TransactionAmt>
        <TransactionDesc>EMPLOYEE</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>ALLISON SIRMEYER</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>FAMILY MEMBER</RelationshipDescriptionTxt>
        <TransactionAmt>28721</TransactionAmt>
        <TransactionDesc>EMPLOYEE</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>SHANNON KOPKE</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>FAMILY MEMBER</RelationshipDescriptionTxt>
        <TransactionAmt>12858</TransactionAmt>
        <TransactionDesc>EMPLOYEE</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>STEPHEN OLSON</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>FAMILY MEMBER</RelationshipDescriptionTxt>
        <TransactionAmt>44339</TransactionAmt>
        <TransactionDesc>EMPLOYEE</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>KATELIND OLSON</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>FAMILY MEMBER</RelationshipDescriptionTxt>
        <TransactionAmt>21535</TransactionAmt>
        <TransactionDesc>EMPLOYEE</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc11">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. PART IV, QUESTION 4 - THE ORGANIZATION HAS MEMBERSHIPS IN VARIOUS TRADE ASSOCIATIONS THAT USE A PORTION OF DUES PAID TO THE TRADE ASSOCIATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THE APPLICABLE TRADE ASSOCIATION INDUSTRIES, THUS INDIRECTLY BENEFITING THE ORGANIZATION. THE PERCENTAGE OF DUES ALLOCATED TO THIS INDUSTRY-WIDE LOBBYING ACTIVITY IS MINOR AND IS NOT CONSIDERED BY THE ORGANIZATION AS LOBBYING ACTIVITIES REQUIRED FOR DISCLOSURE ON SCHEDULE C, PART II.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>MID-MICHIGAN. SPARROW IS THE REGIONAL MEDICAL CENTER FOR: PEDIATRICS CANCER CARE, INCLUDING RADIATION THERAPY TRAUMA CARE NEUROLOGICAL CARE HIGH-RISK OBSTETRICS NEONATAL INTENSIVE CARE BEHAVIORAL HEALTH CARDIOVASCULAR SERVICES SPARROW TREATED NEARLY 34,000 INPATIENTS, HAD APPROXIMATELY 1.5 MILLION OUTPATIENT ENCOUNTERS, AND PROVIDED SERVICES TO MORE THAN 122,500 EMERGENCY MEDICINE PATIENTS IN 2015. TODAY'S SPARROW HEALTH SYSTEM BLENDS THE KNOWLEDGE AND EXPERTISE OF OVER 900 PHYSICIANS, 8,279 CAREGIVERS AND APPROXIMATELY 2,331 VOLUNTEERS WITH THE MOST ADVANCED TECHNOLOGY, SERVING AS A COMPREHENSIVE HEALTH SYSTEM FOR AN EIGHT-COUNTY POPULATION. IN ADDITION, MORE PEOPLE CHOOSE SPARROW FOR THEIR MATERNITY NEEDS (MORE THAN 4,200 DELIVERIES ANNUALLY), REHABILITATION, AND EMERGENCY TREATMENT THAN ANY OTHER HOSPITAL IN MID-MICHIGAN. IN 2015 SPARROW ACHIEVED A NATIONAL BENCHMARK IN QUALITY CARE FOR MOTHERS AND BABIES, AS MID- MICHIGAN'S ONLY BABY-FRIENDLY HOSPITAL, A GLOBAL PROGRAM OF THE WORLD HEALTH ORGANIZATION (WHO) AND THE UNITED NATIONS CHILDREN'S FUND (UNICEF). SPARROW HEALTH SYSTEM'S REACH EXTENDS FAR BEYOND THE ACUTE CARE SETTING OF THE HOSPITAL. THERE ARE MANY WAYS OUR STAFF PROACTIVELY SUPPORTS THE COMMUNITY, ESPECIALLY THOSE WHO HAVE THE GREATEST NEED. BECAUSE OF SPARROW'S COMMITMENT, THE PEOPLE OF MID MICHIGAN HAVE ACCESS TO THE FULL RANGE OF COMPREHENSIVE ACUTE CARE SERVICES AND THE LATEST MEDICAL ADVANCES WITHOUT TRAVELING GREAT DISTANCES. THESE SERVICES ARE AVAILABLE TO ALL MID- MICHIGAN RESIDENTS, REGARDLESS OF THEIR ABILITY TO PAY. PROVIDING ACCESS TO PRIMARY CARE SPARROW RECOGNIZES THAT IF WE ARE TO ACHIEVE OUR VISION OF BEING A NATIONALLY RECOGNIZED LEADER IN QUALITY AND THE PATIENT EXPERIENCE, WE HAVE A RESPONSIBILITY TO TAKE THE LEAD IN FUNDAMENTALLY TRANSFORMING HEALTHCARE IN MICHIGAN. IN ORDER TO ADDRESS THE CHALLENGES OF INCREASING PREVALENCE OF CHRONIC DISEASE AND AN AGING POPULATION, TO IMPROVE THE QUALITY OF CARE AND THE PATIENT EXPERIENCE WHILE ALSO ENSURING GREATER AFFORDABILITY FOR PAYORS, SPARROW NEEDS TO IMPLEMENT PROFOUND CHANGES IN HOW CARE IS PROVIDED. SPARROW IS COMMITTED TO SEEKING NEW WAYS TO PARTNER WITH QUALITY CARE PROVIDERS TO CREATE GREATER ALIGNMENT AROUND IMPROVED QUALITY AND PATIENT EXPERIENCE, WORKING JOINTLY TO DEVELOP CLINICAL GUIDELINES TO ENSURE THE HIGHEST QUALITY OF CARE FOR PATIENTS WHO NEED TO BE TRANSFERRED TO DIFFERENT LEVELS OF CARE AND TO ENSURE THAT CARE IS ALWAYS DELIVERED IN THE BEST QUALITY AND MOST COST-ADVANTAGEOUS CLINICAL SETTING AS CLOSE TO THE PATIENT'S HOME AS POSSIBLE. SPARROW WAS SELECTED AS THE FIRST IN MICHIGAN TO BECOME A MEMBER OF THE MAYO CLINIC CARE NETWORK, SOLIDIFYING OUR DEDICATION TO MEETING OUR PATIENTS' HEALTHCARE NEEDS RIGHT HERE IN MID- MICHIGAN. SPARROW HEALTH SYSTEM INCLUDES SUBSIDIARY HOSPITALS SPARROW CLINTON HOSPITAL AND SPARROW IONIA HOSPITAL. CARSON HEALTH, AN AFFILIATE OF SPARROW HEALTH SYSTEM SINCE 1997, BECAME A FULLY INTEGRATED SUBSIDIARY AND JOINED THE SPARROW FAMILY AS SPARROW CARSON HOSPITAL IN FEBRUARY 2015. SPARROW ALSO HOLDS AN AFFILIATION WITH HAYES GREEN BEACH MEMORIAL HOSPITAL EXTENDING OUR REACH THROUGHOUT THE REGION. IN 2015, SPARROW CELEBRATED THE GRAND OPENING OF THE NEW SPARROW IONIA HOSPITAL, THE FIRST NEW HOSPITAL IN THE MID-MICHIGAN REGION IN DECADES. THE ALL-NEW, STATE-OF-THE-ART 65,0000-SQUARE-FOOT CRITICAL ACCESS HOSPITAL REPLACES THE ORIGINAL FACILITY WHICH WAS BUILT IN 1953. SPARROW OPENED TWO NEW FASTCARE CENTERS IN 2015, OFFERING THE FIRST NEW TREATMENT OPTION OF ITS KIND IN THE MID-MICHIGAN REGION. FASTCARE OFFERS PROMPT TREATMENT FOR COMMON, NON-LIFE-THREATENING CONDITIONS AND IS A MORE AFFORDABLE OPTION FOR BASIC MEDICAL SERVICES THAN A HOSPITAL EMERGENCY ROOM OR URGENT CARE CLINIC. THE SPARROW MEDICAL GROUP VOA, A JOINT MEDICAL CLINIC BETWEEN SPARROW AND VOLUNTEERS OF AMERICA MICHIGAN TO SERVE HOMELESS PATIENTS AND OTHERS, CELEBRATED ITS ONE YEAR ANNIVERSARY HAVING CARED FOR MORE THAN 3,000 PATIENTS. ALSO IN 2015, MARY FREE BED AT SPARROW, A JOINT VENTURE PROVIDING ADVANCED INPATIENT REHABILITATION CARE FOR PATIENTS IN THE MID- MICHIGAN REGION, OPENED A 40 PRIVATE BED REHABILITATION UNIT, INCLUDING TWO STATE-OF-THE-ART THERAPY GYMS, WITHIN SPARROW HOSPITAL. THE UNIT PROVIDES INTENSIVE NEUROLOGICAL, ORTHOPEDIC, AND STROKE REHABILITATION AND INCLUDES A FULL-SIZE CHEVROLET TRAVERSE AND A MOCK TRANSIT BUS TO AID PATIENTS IN RETURNING TO THEIR DAILY ACTIVITIES. SPARROW SPECIALTY HOSPITAL (SSH), A LONG-TERM ACUTE CARE HOSPITAL, RELOCATED TO THE 8TH FLOOR OF THE SPARROW TOWER TO IMPROVE THE PATIENT EXPERIENCE AND OFFER INCREASED ACCESS TO SPECIALTY SERVICES AND ANCILLARY SUPPORT SUCH AS NEUROLOGY, ORTHOPEDICS, CARDIOLOGY, AND MORE. THE 7TH FLOOR OF THE SPARROW TOWER OPENED IN JANUARY 2015, ADDING 30 PRIVATE MEDICAL SURGICAL ROOMS FOR PATIENTS WHO REQUIRE AN INPATIENT STAY. IN SUPPORT OF OUR GOAL TO TRANSFORM HOW CARE IS PROVIDED, SPARROW BROKE GROUND ON THE SPARROW PLAZA, A NEW FOUR-STORY BUILDING LOCATED CENTRALLY ON THE SPARROW CAMPUS ALONG MICHIGAN AVENUE. DESIGNED WITH THE FUTURE IN MIND, THIS FLEXIBLE SPACE CAN EASILY BE ADAPTED TO NEXT-GENERATION TECHNOLOGIES AND WILL BE HOME TO THE NEW HERBERT-HERMAN CANCER CENTER AND OTHER SERVICES AS WE STREAMLINE PATIENT CARE. SPARROW ALSO BROKE GROUND IN 2015 ON THE SPARROW GATHERING PLACE - A MODERN AND UPSCALE DINING AREA ON THE MAIN CAMPUS OF SPARROW HOSPITAL THAT WILL HELP TRANSFORM MICHIGAN AVENUE IN LANSING, AND THE SPARROW HEALTH CENTER LANSING, AN ALL-NEW CAMPUS THAT WILL EXPAND ACCESS TO PRIMARY CARE, PROVIDE SENIOR HEALTH SERVICES, AND OFFER STREAMLINED AND COMPREHENSIVE CARE IN ONE CONVENIENT LOCATION. THE 70,000- SQUARE-FOOT BUILDING WILL HOUSE A DRIVE-THRU PHARMACY, LABORATORY, ENDOSCOPY, DIAGNOSTIC IMAGING INCLUDING CT, ULTRASOUND, MAMMOGRAPHY, MRI AND MORE IN ADDITION TO THREE SPARROW MEDICAL GROUP PRACTICES. SPARROW ALSO OPENED A NEW PRIMARY CARE PRACTICE, SMG SARANAC, AND A BREASTFEEDING CLINIC AT THE HOSPITAL TO SUPPORT MOMS AND PROMOTE A POSITIVE EXPERIENCE WITH THEIR BABY. BY PROACTIVELY LOCATING SERVICES IN OUR SURROUNDING COMMUNITIES, WE ENSURE THAT RESIDENTS AND THEIR FAMILIES HAVE ACCESS TO THE CARE NECESSARY TO SAFEGUARD THEIR HEALTH. SPARROW COMMUNITY CARE - A NON-PROFIT ENTITY COMPRISING THE FORMER SPARROW MEDICAL SUPPLY AND SPARROW HOME CARE UNITS - AND SPARROW LABORATORIES AND SPARROW PHARMACY PLUS ROUND OUT SPARROW HEALTH SYSTEM'S NETWORK OF FACILITIES AND PRIMARY CARE SERVICES. THEY ARE DESIGNED TO PROVIDE QUALITY, CONVENIENT, COST EFFECTIVE HEALTH CARE TO THE PEOPLE OF MID MICHIGAN. EMERGENCY PREPAREDNESS SPARROW HAS DISTINGUISHED ITSELF AS A RECOGNIZED LEADER IN EMERGENCY PREPAREDNESS. THE HOSPITAL VIEWS PREPAREDNESS AS AN ONGOING PROCESS LED BY A MULTIDISCIPLINARY TEAM THAT INVOLVES ALL ASPECTS OF HOSPITAL OPERATIONS, INCLUDING MEDICAL AND NON-MEDICAL SERVICES. DRILLS ARE CONDUCTED YEAR-ROUND IN COLLABORATION WITH LOCAL, STATE AND FEDERAL AGENCIES TO ENSURE SPARROW IS PREPARED FOR ANY DISASTER, WHETHER IT IS THE RESULT OF A TERRORIST ACT OR A NATURAL DISASTER. SPARROW'S EMERGENCY PREPAREDNESS COMMITTEE REGULARLY TESTS THE HOSPITAL'S RESPONSE SKILLS INDEPENDENT OF ANY AGENCY OR GOVERNING BODY. THE HOSPITAL ALSO WORKS WITH LOCAL GOVERNMENT AGENCIES, INCLUDING THE POLICE DEPARTMENT, FIRE DEPARTMENT, AND PUBLIC HEALTH DEPARTMENT TO COORDINATE A PLANNED RESPONSE IN THE EVENT OF A TRUE EMERGENCY. ROUTINE DRILLS AND A FULL SCALE ACTIVE SHOOTER EXERCISE WERE CONDUCTED IN 2015 TO TEST THE HEALTH SYSTEM'S RESPONSE AND INTERACTION WITH LOCAL AGENCIES. SUPPORTING OUR COMMUNITY AND NEIGHBORHOODS SPARROW IS THE UNQUESTIONED LEADER IN MID-MICHIGAN IN PROVIDING HEALTHCARE SERVICES AND PROMOTING HEALTH-RELATED ACTIVITIES. SPARROW PROVIDES FIRST- AID SERVICES AT MANY SPECIAL EVENTS INCLUDING MICHIGAN STATE UNIVERSITY FOOTBALL GAMES, LANSING LUGNUTS BASEBALL GAMES AND THE CITY OF LANSING'S ANNUAL COMMON GROUND MUSIC FESTIVAL. SPARROW ALSO SPONSORS DOZENS OF HEALTH-RELATED ACTIVITIES, INCLUDING THE ANNUAL HIKE FOR HOSPICE, THE FEELIN' GOOD MILEAGE CLUB FOR ELEMENTARY SCHOOLS, FITKIDS AND THE SPARROW MICHIGAN MILE. SPARROW ALSO HAS A PARTNERSHIP WITH THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM'S SURVIVAL FLIGHT AIR MEDICAL TRANSPORT SERVICE. SURVIVAL FLIGHT PROVIDES 24-HOUR AIR MEDICAL TRANSPORT SERVICES FOR IMPROVED ACCESS TO PATIENTS WHO NEED CRITICAL CARE. AS A TEACHING HOSPITAL, SPARROW HAS CONTINUED TO STRENGTHEN ITS AFFILIATION WITH MICHIGAN STATE UNIVERSITY THROUGH A JOINT INITIATIVE, THE SPARROW/MSU CENTER FOR INNOVATION, BY SUPPORTING FELLOWSHIPS AND RECRUITING ESTABLISHED RESEARCHERS TO DEVELOP, TEST, IMPLEMENT AND EVALUATE INNOVATIVE APPROACHES IN HEALTH CARE. SPARROW HAS MANY OTHER LONGSTANDING ARRANGEMENTS WITH MSU'S COLLEGES OF HUMAN MEDICINE, OSTEOPATHIC MEDICINE AND NURSING. SPARROW WORKS WITH MSU TO FACILITATE THE RECRUITMENT, TRAINING AND RETENTION OF CURRENT AND FUTURE GENERATIONS OF PHYSICIANS AND NURSES THROUGH FUTURE DOCS, MINI-MEDICAL SCHOOL, A</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HEALTH SYSTEM IS THE SOLE MEMBER OF EDWARD W. SPARROW HOSPITAL AND HAS 100% OWNERSHIP.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HEALTH SYSTEM HAS THE RIGHT TO ELECT MEMBERS OF THE EDWARD W. SPARROW HOSPITAL BOARD. THE PRESIDENT OF THE MEDICAL STAFF, WHICH IS A MEMBER OF THE GOVERNING BODY, IS ELECTED BY THE MEDICAL STAFF OF EDWARD W. SPARROW HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>SPARROW HEALTH SYSTEM HAS THE RIGHT TO ELECT, REPLACE, AND REMOVE DIRECTORS OF EDWARD W. SPARROW HOSPITAL. SPARROW HEALTH SYSTEM ALSO HAS THE AUTHORITY TO APPROVE DECISIONS OF THE EDWARD W. SPARROW HOSPITAL BOARD WHEN IT IS DEEMED NECESSARY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>COPIES OF THE 2015 FORM 990 ARE REVIEWED BY MANAGEMENT. THE FORM 990 COPIES WERE PROVIDED AT THE SEPTEMBER 2016 BOARD MEETING FOR ALL BOARD MEMBERS TO REVIEW AND COMMENT ON.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>1) CORPORATE COMPLIANCE SENDS OUT THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRES TO ALL VOTING BOARD MEMBERS AND THE EXECUTIVE TEAM ANNUALLY 2) ALL DISCLOSURES ARE RECEIVED AND REVIEWED BY CORPORATE COMPLIANCE 3) ALL DISCLOSURES ARE GIVEN A RESOLUTION CODE AND PRESENTED TO THE CEO AND GOVERNANCE COMMITTEE OF THE BOARD 4) ALL BOARD/COMMITTEE LEVEL DISCLOSURES ARE PROVIDED TO THE RESPECTIVE BOARD CHAIR AND EXECUTIVE LIAISON TO ENSURE ISSUES CAN BE ADDRESSED ON A TRANSACTION LEVEL (I.E. IF A VOTE IS REQUIRED ON A TRANSACTION INVOLVING AN INTERESTED PERSON)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INVOLVED THE FOLLOWING: UTILIZING THE COMPENSATION COMMITTEE, INDEPENDENT CONSULTANTS, REVIEWING OTHER SIMILAR ORGANIZATIONS' 990S, COMPENSATION SURVEYS, AND FINAL APPROVAL BY THE BOARD OF DIRECTORS, AS WELL AS FINALIZING THE SALARY PACKAGE WITH A WRITTEN EMPLOYMENT CONTRACT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON SEVERAL INTERNET WEBSITES, INCLUDING NMSIR AND MSHFA WEBSITES, AS WELL AS AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII</FormAndLineReferenceDesc>
        <ExplanationTxt>PART VII, SECTION A, COLUMN (E) REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS - PAYMENTS TO GREG BROGAN FOR BROKER'S SALES COMMISSIONS FOR PHP INSURANCE COMPANY (580,796).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSFERS FROM AFFILIATES 1,743,247 CHANGE IN UNFUNDED PENSION OBLIG 12,040,675 CHANGE IN UNFUNDED POSTRETIREMENT 282,653 ASSETS RELEASED FROM RESTRICTIONS 440,232 TRANSFER TO SPARROW HEALTH SYSTEM -25,000,000 TOTAL -10,493,193</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc14">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW HEALTH SYSTEM</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382542859</EIN>
        <PrimaryActivitiesTxt>PARENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW COMMUNITY CARE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3315 E MICHIGAN AVENUE STE 4</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382543305</EIN>
        <PrimaryActivitiesTxt>HOME HLTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>9</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PHYSICIANS HEALTH PLAN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382356288</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C4</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW PHP</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>364497604</EIN>
        <PrimaryActivitiesTxt>HMO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C4</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHP</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PHYSICIANS HEALTH NETWORK</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1400 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382594856</EIN>
        <PrimaryActivitiesTxt>HMO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C4</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>386100687</EIN>
        <PrimaryActivitiesTxt>FUNDRAISE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11B</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW CLINTON HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>805 S OAKLAND</AddressLine1Txt>
          <CityNm>ST JOHNS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48879</ZIPCd>
        </USAddress>
        <EIN>381358172</EIN>
        <PrimaryActivitiesTxt>HLTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW SPECIALTY HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1215 E MICH AVE 8W SPARROW TOWER</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>141885340</EIN>
        <PrimaryActivitiesTxt>LT ACUTE C</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW IONIA HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3565 S STATE RD</AddressLine1Txt>
          <CityNm>IONIA</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48846</ZIPCd>
        </USAddress>
        <EIN>383218134</EIN>
        <PrimaryActivitiesTxt>HLTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW CLINICAL RESEARCH INSTITUTE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1200 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>383075242</EIN>
        <PrimaryActivitiesTxt>RESEARCH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>4</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW WOMEN'S HOSPITAL ASSOCIATIO</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>386091657</EIN>
        <PrimaryActivitiesTxt>VOLUNTEER</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11D</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SPARROW CARSON HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>406 E ELM STREET PO BOX 879</AddressLine1Txt>
          <CityNm>CARSON CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48811</ZIPCd>
        </USAddress>
        <EIN>381490180</EIN>
        <PrimaryActivitiesTxt>HLTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CARSON CITY FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>406 E ELM STREET PO BOX 879</AddressLine1Txt>
          <CityNm>CARSON CITY</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48811</ZIPCd>
        </USAddress>
        <EIN>460877509</EIN>
        <PrimaryActivitiesTxt>FUNDRAISE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501C3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CCH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SPARROW DEVELOPMENT INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1215 E MICHIGAN AVE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382595963</EIN>
        <PrimaryActivitiesTxt>RENTAL PRO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDICAL CENTER WEST CONDO ASSOC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1322 E MICHIGAN AVENUE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>382635630</EIN>
        <PrimaryActivitiesTxt>CONDO ASSO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>EWSH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C CORP</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>22583</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>87114</ShareOfEOYAssetsAmt>
        <OwnershipPct>0.94605</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PHP INSURANCE COMPANY</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1400 EAST MICHIGAN AVE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>205565219</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PHP SERVICE COMPANY</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>1400 EAST MICHIGAN AVE</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48912</ZIPCd>
        </USAddress>
        <EIN>383344741</EIN>
        <PrimaryActivitiesTxt>MED SERV</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EAST LANSING ATHLETIC CLUB</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2900 HANNAH BLVD</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48823</ZIPCd>
        </USAddress>
        <EIN>382886420</EIN>
        <PrimaryActivitiesTxt>HLTH CLUB</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MAC RESTAURANT LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2900 HANNAH BLVD</AddressLine1Txt>
          <CityNm>LANSING</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48823</ZIPCd>
        </USAddress>
        <EIN>205120690</EIN>
        <PrimaryActivitiesTxt>RESTAURANT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>CLINTON SERVICES CORPORATION</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>805 SOUTH OAKLAND</AddressLine1Txt>
          <CityNm>ST JOHNS</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>48879</ZIPCd>
        </USAddress>
        <EIN>382494110</EIN>
        <PrimaryActivitiesTxt>SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MI</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>true</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>true</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>true</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW SPECIALTY HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>435873</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW COMMUNITY CARE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>237368</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>1305992</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW IONIA HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>1081310</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW CLINTON HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>240000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW DEVELOPMENT INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>393098</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW SPECIALTY HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>1287992</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW IONIA HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>665257</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHYSICIANS HEALTH PLAN</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>2336200</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW DEVELOPMENT INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>164022</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW CLINTON HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>189992</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHYSICIANS HEALTH PLAN</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>1863229</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SPARROW SPECIALTY HOSPITAL</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>1581672</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>