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        <TakeIntoAccount>true</TakeIntoAccount>
        <OtherFacilities>false</OtherFacilities>
        <CHNAWidelyAvailable>true</CHNAWidelyAvailable>
        <OnRequest>X</OnRequest>
        <DevelopCommunityPlan>X</DevelopCommunityPlan>
        <PrioritizeHealthNeeds>X</PrioritizeHealthNeeds>
        <PrioritizeServices>X</PrioritizeServices>
        <AllNeedsAddressed>false</AllNeedsAddressed>
        <OrganizationIncurExciseTax>false</OrganizationIncurExciseTax>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
        <FPGFreePercent>100.0</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>200.0</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <AssetLevel>X</AssetLevel>
        <InsuranceStatus>X</InsuranceStatus>
        <UninsuredDiscount>X</UninsuredDiscount>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NotifyUponAdmission>X</NotifyUponAdmission>
        <NotifyBeforeDischarge>X</NotifyBeforeDischarge>
        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <AverageNegotiatedRates>X</AverageNegotiatedRates>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>true</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>8</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>MCKENZIE HEALTH AND WELLNESS</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>170 W ARGYLE STREET</AddressLine1>
            <City>SANDUSKY</City>
            <State>MI</State>
            <ZIPCode>48471</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN OFFICE/PT OFFICE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>AUSTIN STREET RURAL HEALTH CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>51 AUSTIN STREET</AddressLine1>
            <City>SANDUSKY</City>
            <State>MI</State>
            <ZIPCode>48471</ZIPCode>
          </Address>
          <FacilityType>RURAL HEALTH CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>MAIN STREET HELATH CENTER</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>74 S ELK ST</AddressLine1>
            <City>SANDUSKY</City>
            <State>MI</State>
            <ZIPCode>48471</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN ORTHOPEDIC OFFICE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>MCKENZIE FAMILY HEALTHCARE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>109 N DELAWARE STREET</AddressLine1>
            <City>SANDUSKY</City>
            <State>MI</State>
            <ZIPCode>48471</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN OFFICE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>LAKESHORE INTERNAL MEDICINE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>7307 CHERRY STREET</AddressLine1>
            <City>PORT SANILAC</City>
            <State>MI</State>
            <ZIPCode>48469</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN OFFICE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>CROSWEL CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>8 N HOWARD STREET</AddressLine1>
            <City>CROSWELL</City>
            <State>MI</State>
            <ZIPCode>48422</ZIPCode>
          </Address>
          <FacilityType>PHSICIAN OFFICE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>FAMILY PLANNING &amp; GERIATRIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>171 N DAWSON STREET</AddressLine1>
            <City>SANDUSKY</City>
            <State>MI</State>
            <ZIPCode>48471</ZIPCode>
          </Address>
          <FacilityType>FAMILY PLANNING &amp; GERIATRIC SERVICES</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>SANILAC MEDICAL PLAZA</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>100 W ARGYLE STREET</AddressLine1>
            <City>SANDUSKY</City>
            <State>MI</State>
            <ZIPCode>48471</ZIPCode>
          </Address>
          <FacilityType>PHYSICIAN OFFICE RENTAL</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Identifier>RELATED ORGANIZATION INFORMATION</Identifier>
        <ReturnReference>PART I LINE 6A</ReturnReference>
        <Explanation>A COMMUNITY BENEFIT REPORT WAS PREPARED DURING TAX YEAR 2013</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COSTING METHODOLOGY EXPLANATION</Identifier>
        <ReturnReference>PART I LINE 7</ReturnReference>
        <Explanation>MCKENZIE USES SCHEDULE H WORKSHEETS TO PREPARE THE INFORMATION IN BOX 7 USING OUR COST TO CHARGE RATIO</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY BUILDING ACTIVITIES</Identifier>
        <ReturnReference>PART II</ReturnReference>
        <Explanation>MCKENZIES COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY BY SUPPORTING THE LOCAL COMMUNITY THROUGH VARIOUS ACTIVITIES EXAMPLES OF THESE ACTIVITES ARE THE CHAMBER OF COMMERCE SOFTBALL LEAGUE COMMUNITY SENIOR FAIR SCHOOL TOURS SANILAC 4H FAIR AND VARIOUS SHOWCASES</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>BAD DEBT EXPENSE EXPLANATION</Identifier>
        <ReturnReference>PART III LINE 4</ReturnReference>
        <Explanation>BAD DEBT FOOTNOTE IS INCLUDED IN THE ATTACHED AUDITED FINANCIAL STATEMENTS ON PAGE 10 NOTE 1 PARAGRAPHS 3 AND 4</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>MEDICARE EXPLANATION</Identifier>
        <ReturnReference>PART III LINE 8</ReturnReference>
        <Explanation>THERE WAS NO SHORTFALL MEDICARE COST REPORT WORKSHEETS WERE USED TO CALCULATE THE AMOUNT ON LINE 6</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COLLECTION PRACTICES EXPLANATION</Identifier>
        <ReturnReference>PART III LINE 9B</ReturnReference>
        <Explanation>MCKENZIESS COLLECTION POLICY REFERENCES THE CHARITY CAREFINANCIAL ASSISTANCE POLICY FOR THOSE PATIENTS THAT ARE ELIGIBLE FOR CHARITY CAREFINANCIAL ASSISTANCE AS A METHOD OF PAYMENTCOLLECTIONS</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>NEEDS ASSESSMENT</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>PART VI LINE 2 THE PURPOSE OF THE 2013 MCKENZIE MEMORIAL HOSPITAL COMMUNITY NEEDS ASSESMENT WAS TO COLLECT DATA ON SPECIFIC INFORMATION REGARDING COMMUNITY PERCEPTION OF THE USE OF HEALTHCARE SERVICES COMMUNITY HEALTH AND HEALTH INSURANCE A COMPREHENSIVE NINE PAGE SURVEY WAS DEVELOPED A COVER LETTER AND SURVEY WERE SENT TO 1000 RANDOM COMMUNITY MEMBERS IN THE MCKENZIE SERVICE AREAS THE COMPANY ACCULEADS PROVIDED RANDOMIZED MAILING ADDRESSES FOR THE CITIES OF APPLEGATE CARSONVILLE DECKERVILLE LEXINGTON MARLETTE PECK PORT SANILAC SANDUSKY AND SNOVER IN ADDITION SEE ANSWER TO PART V LINE 3 ABOVE EXAMPLES OF SERVICE PROVIDED BASED ON COMMUNITY NEED ARE GERIATRICS PROGRAM IMMUNIZATIONS SPORTS PHYSICALS SENIOR FAIR HEALTH FAIRS FIRST AID BOOTH AND DIABETIC CLASSES</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>PART VI LINE 3 EVERY UNINSURED PATIENT THAT INCURS MORE THAN 1000 IN MEDICAL EXPENSES RECEIVES A CHARITY CAREFINANCIAL ASSISTANCE APPLICATION A MEDICAID APPLICATION AND HUMAN SERVICES REFERRAL ALL OTHER UNINSURED OR UNDER INSURED PATIENTS MAY REQUEST A CHARITY CAREFINANCIAL ASSISTANCE APPLICATION AT ANY TIME INSURANCE AND SELF PAY BROCHURES ARE AVAILABLE THROUTHOUT THE HOSIPTAL IN ADDITION THE SOCIAL WORKER WILL ASSIST PATIENTS WHO NEED HELP IN APPLYING FOR GOVERNMENT ASSISTANCE PROGRAMS</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY INFORMATION</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>PART VI LINE 4 MCKENZIE MEMORIAL HOSPITAL IS LOCATED IN SANILAC COUNTY WHICH HAS A POPULATION OF APPROXIMATELY 43000 SANILAC COUNTY CONSISTS OF MOSTLY FARMLAND WITH VERY FEW MANUFACTURING FACILITIES THE UNEMPLOYMENT RATE IN SANILAC COUNTY IS 99</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>PART III LINE 2 BAD DEBTS ARE ESTIMATED USING THE ALLOWANCE METHOD THE BAD DEBT EXPENSE LISTED ON LINE 2 IS DETERMINED USING COST BASED UPON THE COST TO CHARGE RATIO THAT IS DEVELOPED IN SCHEDULE H PART III LINE3 COST OF BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY ANALYZED FINANCIAL ASSISTANCECHARITY CARE APPLICATIONS THAT WERE DENNIED DUE TO INCOMPLETE DOCUMENTATION AND FAILURE TO PROVIDE REQUESTED INFORMATION AND APPLIED COST TO CHARGE RATIO AS DETERMINED IN SCHEDULE H THIS EXPENSE IS INCLUDED AS IT IS OUR COMMUNITY THAT CANNOT AFFORD TO PAY THEIR HEALTHCARE EXPENSES</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>MCKENZIE MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 3</Identifier>
        <ReturnReference>PART V LINE 3</ReturnReference>
        <Explanation>MCKENZIE MEMORIAL HOSPITAL PARTICIPATED IN A COMMUNITY MANAGERS COMMITTEE WHICH CONSISTS OF MEMBERS FROM THE FOLLOWING ORGANIZATIONS SANILAC COUNTY SANILAC COUNTY MEDICAL FACILITY SANILAC COUNTY INTERMEDIATE SCHOOL DISTRICT SANDUSKY COMMUNITY SCHOOLS SANILAC COUNTY COMMUNITY MENTAL HEALTH CITY OF SANDUSKY SANILAC COUNTY HEALTH DEPARTMENT AND THE SANILAC ROAD COMMISSION INPUT FROM THESE ORGANIZATIONS REGARDING THE HEALTH OF OUR COMMUNITY AND ITS NEEDS IS CONSIDERED IN ADDITION MCKENZIE HELD TWO PUBLIC MEETINGS IN APRIL 2013 WHERE WE INVITED OVER 1000 PARTICIPANTS TO COME AND SHARE THEIR CONCERNS ABOUT THE HEALTH OF THE COMMUNITY PARTICIPATING COMMUNITY EMPLOYERS INCUDED THE SANILAC COUNTY COURT HOUSE SANDUSKY SCHOOLS TELLEBORG INC JENSEN BRIDGE INC AND THE SANILAC MEDICAL CARE FACILTY</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>MCKENZIE MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 7</Identifier>
        <ReturnReference>PART V LINE 7</ReturnReference>
        <Explanation>MCKENZIE MEMORIAL HOSPITAL WAS NOT ABLE TO ADDRESS ALL THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA IT WAS IDENTIFIED THAT AN EAR NOSE AND THROAT ENT SPECIALIST IS NEEDED IN SANDUSKY IT IS VERY DIFFICULT TO RECRUIT SPECIALISTS TO OUR SMALL RURAL TOWN BECAUSE OF THE LACK OF VOLUME TO SUSTAIN THIS TYPE OF SPECIALIST WE HAVE BEEN UNSUCCESSFUL RECRUITING AN ENT HOWEVER WE ARE WORKING WITH A NEIGHBORING HOSPITAL TO RECRUIT SPECIALISTS THAT WE CAN SHARE IN BOTH TOWNS WHICH WOULD PROVIDE ENOUGH VOLUME TO SUSTAIN A PRACTICE IN ADDITION WE ARE WORKING TO BRING SPECIALIST TO OUR HOSPITAL VIA TELEMEDICINE AND HAVE A TENTATIVE COMMITMENT FOR AN ENT THROUGH TELEMEDICINE TO BEGIN IN OUR NEXT FISCAL YEAR THE SECOND ITEM THAT WE WERE UNABLE TO SOLVE IS LONGER PHYSICIAN OFFICE HOURS AND WEEKEND HOURS WE ARE CURRENTLY EVALUATING THE FINANCIAL VIABILITY OF AN URGENT CARE CLINIC THE PRIMARY HURDLE IN OPERATING A LOCAL URGENT CARE CLINIC IS THE AVAILABILITY OF HEALTH CARE PROVIDERS TO STAFF THE CLINIC</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>MCKENZIE MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 22</Identifier>
        <ReturnReference>PART V LINE 22</ReturnReference>
        <Explanation>FINANCIAL ASSISTANT PROGRAM FAP ELIGIBLE PATIENTS WHO HAD SERVICES OUTSIDE OF THE EMERGENCY ROOM AND DID NOT COMPLETE A CHARITY APPLICATION WOULD HAVE BEEN CHARGED AND BILLED GROSS CHARGES HOWEVER EFFECTIVE 10113 ALL UNINSURED PATIENTS WHETHER THEY APPLY FOR FAP OR NOT RECEIVED A DISCOUNT EQUAL TO THE AVERAGE OF THE HOSPITALS THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc8">
      <CompensationCommittee>X</CompensationCommittee>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>DR WILLIAM STARBIRD</NamePerson>
        <Title>MARLETTE PHYSICIAN</Title>
        <CompBasedOnRelatedOrgs>276149</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>1025</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>11855</DeferredCompRelatedOrgs>
        <TotalCompensationRelatedOrgs>289029</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DAN BABCOCK</NamePerson>
        <Title>MARLETTE CEO</Title>
        <CompBasedOnRelatedOrgs>183261</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>1025</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>1781</DeferredCompRelatedOrgs>
        <TotalCompensationRelatedOrgs>186067</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>STEVE BARNETT</NamePerson>
        <Title>MCKENZIE CEOPRES</Title>
        <BaseCompensationFilingOrg>183289</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>6291</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15069</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>204649</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MARK ENGLISH</NamePerson>
        <Title>CHIEF OF STAFF</Title>
        <BaseCompensationFilingOrg>159146</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>6085</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>18441</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>183672</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR ALFREDO DOMINGO</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>387140</BaseCompensationFilingOrg>
        <TotalCompensationFilingOrg>387140</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR MICHAEL MERKLER</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>216881</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>7637</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>14702</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>239220</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR JAMES SAMS</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>195521</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>7054</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>6103</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>208678</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR MATTHEW GORMLEY</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>189486</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>7110</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>15993</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>212589</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DR MELANIE KRAMER</NamePerson>
        <Title>PHYSICIAN</Title>
        <BaseCompensationFilingOrg>204954</BaseCompensationFilingOrg>
        <BonusFilingOrg>20926</BonusFilingOrg>
        <NontaxableBenefitsFilingOrg>18351</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>244231</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc9">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>BARNETT ANESTESIA INC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>CEO'S SPOUSE</Relationship>
        <AmountOfTransaction>108013</AmountOfTransaction>
        <DescriptionOfTransaction>CRNA SERVICES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc10">
      <GeneralExplanation>
        <Identifier>ANY SIGNIFICANT CHANGES IN CONDUCT FOR PROGRAM SERVICES</Identifier>
        <ReturnReference>FORM 990, PAGE 2, PART III, LINE 3</ReturnReference>
        <Explanation>FAMILY PLANNING OPERATIONS WERE TAKEN OVER BY THE HEALTH DEPARTMENT PART WAY THROUGH THE FISCAL YEAR. MCKENZIE MAINTAINED THE BOOKS UNTIL THE END OF THE FISCAL YEAR.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 4</ReturnReference>
        <Explanation>MCKENZIE MEMORIAL HOSPITAL RESTATED ITS BYLAWS TO BECOME A SUBSIDARY OF THE BLUE WATER HEALTHCARE NETWORK, WHICH IS AN ASSUMED NAME OF UNITED HEALTHCARE PARTNERS AS LISTED IN SCHEDULE R.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CLASSES OF MEMBERS OR STOCKHOLDERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 6</ReturnReference>
        <Explanation>CLASSES OF MEMBERS THAT MAKE UP THE BOARD OF DIRECTORS</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ELECTION OF MEMBERS AND THEIR RIGHTS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 7A</ReturnReference>
        <Explanation>THE BOARD MEMBERS MUST BE APPROVED FIRST BY THE BOARD OF MCKENIZE HEALTHCARE CORPORATION TO BECOME BOARD MEMBERS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DECISIONS SUBJECT TO APPROVAL OF MEMBERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 7B</ReturnReference>
        <Explanation>MCKENIZE HEALTHCARE CORPORATION MUST APPROVE ANY FINANCIAL TRANSACTIONS ABOVE ONE MILLION DOLLARS BEFORE ANY ACTION CAN BE TAKEN BY THE BOARD OF DIRECTORS OF MCKENZIE MEMORIAL HOSPITAL.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ORGANIZATION'S PROCESS USED TO REVIEW FORM 990</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 11B</ReturnReference>
        <Explanation>THE 990 IS REVIEWED BY THE FINANCE COMMITTEE FOR APPROVAL AND IS THEN SUBMITTED TO THE FULL BOARD FOR APPROVAL PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ENFORCEMENT OF CONFLICTS POLICY</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 12C</ReturnReference>
        <Explanation>BOARD MEMBERS AND ALL COMMITTEES MEMBERS ARE REQUIRED TO FILL OUT AND SIGN THE ANNUAL CONFLICT OF INTEREST POLICY FORM. IN THE EVENT OF A CONFLICT APPLICABLE BOARD MEMBERS MUST ABSTAIN FROM THE VOTE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION PROCESS FOR TOP OFFICIAL</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 15A</ReturnReference>
        <Explanation>COMPENSATION OF THE CEO/PRESIDENT IS APPROVED BY THE FULL BOARD BASED ON THE RECOMMENDATION OF THE EXECUTIVE COMMITTEE THROUGH EXECUTIVE SURVEY INFORMATION. ANY EXECUTIVE BONUSES ARE APPROVED BY THE BOARD AT THE END OF A FISCAL YEAR BASED ON GOALS AND SUCCESS OF THE ORGANIZATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION PROCESS FOR OFFICERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 15B</ReturnReference>
        <Explanation>COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE FULL BOARD THROUGH RECOMMENDATIONS BASED ON COMPENSATION SURVEYS AND APPROVAL OF THE HOSPITAL'S ANNUAL BUDGET. BONUS AMOUNTS ARE IN THE CONTRACTS APPROVED BY THE FULL BOARD.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>GOVERNING DOCUMENTS DISCLOSURE EXPLANATION</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 19</ReturnReference>
        <Explanation>THE HOSPITALS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR INSPECTION AT THE PRESIDENT/CEO'S OFFICE</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES</Identifier>
        <ReturnReference>FORM 990, PART IX, LINE 11G</ReturnReference>
        <Explanation>PROFESSIONAL MEDICAL SERVICES 2,562,274 0 0 MEDICAL SERVICE CONTRACTS 217,056 0 0 ADMINISTRATIVE PROFESSIONAL 0 209,897 0 ADMINISTRATIVE SERVICE CONT. 0 136,208 0 AQUA AEROBIC INSTRUCTIONS 0 20,068 0</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc11">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MCKENIZE HEALTHCARE CORPORATION</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>120 DELAWARE STREET</AddressLine1>
          <City>SANDUSKY</City>
          <State>MI</State>
          <ZIPCode>48471</ZIPCode>
        </AddressUS>
        <EIN>382702946</EIN>
        <PrimaryActivities>HEALTHCARE</PrimaryActivities>
        <LegalDomicileState>MI</LegalDomicileState>
        <ExemptCodeSection>501C3</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ITSELF</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>SANILAC HEALTHCARE CORP</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>120 DELAWARE STEET</AddressLine1>
          <City>SANDUSKY</City>
          <State>MI</State>
          <ZIPCode>48471</ZIPCode>
        </AddressUS>
        <EIN>382702948</EIN>
        <PrimaryActivities>HOMECARE</PrimaryActivities>
        <LegalDomicileState>MI</LegalDomicileState>
        <ExemptCodeSection>501C3</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>MCKENIZE</BusinessNameLine1>
          <BusinessNameLine2>HEALTHCARE CORPORATION</BusinessNameLine2>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MARLETTE REGIONAL HOSPITAL</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2770 MAIN STREET PO BOX 307</AddressLine1>
          <City>MARLETTE</City>
          <State>MI</State>
          <ZIPCode>48453</ZIPCode>
        </AddressUS>
        <EIN>381507302</EIN>
        <PrimaryActivities>HEALTH CAR</PrimaryActivities>
        <LegalDomicileState>MI</LegalDomicileState>
        <ExemptCodeSection>501C3</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>UHP</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>UNITED HEALTHCARE PARTNERS</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>120 DELWARE STREET</AddressLine1>
          <City>SANDUSKY</City>
          <State>MI</State>
          <ZIPCode>48471</ZIPCode>
        </AddressUS>
        <EIN>465444203</EIN>
        <PrimaryActivities>HEALTHCARE</PrimaryActivities>
        <LegalDomicileState>MI</LegalDomicileState>
        <ExemptCodeSection>501C3</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>ITSELF</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>SANILAC SERVICES INC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>78 SOUTH ELK</AddressLine1>
          <City>SANDUSKY</City>
          <State>MI</State>
          <ZIPCode>48471</ZIPCode>
        </AddressUS>
        <EIN>382774983</EIN>
        <PrimaryActivity>PHARMACY</PrimaryActivity>
        <LegalDomicileState>MI</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>MCKENIZE</BusinessNameLine1>
          <BusinessNameLine2>HEALTHCARE CORPORATION</BusinessNameLine2>
        </DirectControllingEntityName>
        <TypeOfEntity>C CORP</TypeOfEntity>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>SANILAC CATALOG INC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>78 SOUTH ELK</AddressLine1>
          <City>SANDUSKY</City>
          <State>MI</State>
          <ZIPCode>48471</ZIPCode>
        </AddressUS>
        <EIN>383254153</EIN>
        <PrimaryActivity>CATALOG</PrimaryActivity>
        <LegalDomicileState>MI</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>SANILAC</BusinessNameLine1>
          <BusinessNameLine2>SERVICES INC</BusinessNameLine2>
        </DirectControllingEntityName>
        <TypeOfEntity>C CORP</TypeOfEntity>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>SANILAC EQUIPMENT &amp; SUPPLY CO</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>120 DELAWARE STREET</AddressLine1>
          <City>SANDUSKY</City>
          <State>MI</State>
          <ZIPCode>48471</ZIPCode>
        </AddressUS>
        <EIN>382662256</EIN>
        <PrimaryActivity>SUPPLIES</PrimaryActivity>
        <LegalDomicileState>MI</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>MCKENIZE</BusinessNameLine1>
          <BusinessNameLine2>HEALTHCARE CORPORATION</BusinessNameLine2>
        </DirectControllingEntityName>
        <TypeOfEntity>C CORP</TypeOfEntity>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>false</DividendsRelatedOrganization>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>SANILAC SERVICES INC</BusinessNameLine1>
          <BusinessNameLine2>SANILAC PHARMACY</BusinessNameLine2>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>15000</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>SANILAC SERVICES INC</BusinessNameLine1>
          <BusinessNameLine2>SANILAC PHARMACY</BusinessNameLine2>
        </NameOfOtherOrganization>
        <TransactionType>P</TransactionType>
        <AmountInvolved>8313</AmountInvolved>
        <MethodOfAmtDetermination>COST BASIS</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>SANILAC SERVICES INC</BusinessNameLine1>
          <BusinessNameLine2>SANILAC PHARMACY</BusinessNameLine2>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>90000</AmountInvolved>
        <MethodOfAmtDetermination>COST BASIS</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MARLETE REGIONAL HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>18457</AmountInvolved>
        <MethodOfAmtDetermination>COST BASIS</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MARLETTE REGIONAL HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>269468</AmountInvolved>
        <MethodOfAmtDetermination>COST BASIS</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>