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        <Total>3800000</Total>
        <ProgramServices>3800000</ProgramServices>
      </GrantsToDomesticOrgs>
      <CompCurrentOfficersDirectors>
        <Total>1348972</Total>
        <ProgramServices>674486</ProgramServices>
        <ManagementAndGeneral>674486</ManagementAndGeneral>
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      <OtherSalariesAndWages>
        <Total>14445473</Total>
        <ProgramServices>13566808</ProgramServices>
        <ManagementAndGeneral>878665</ManagementAndGeneral>
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      <PensionPlanContributions>
        <Total>521646</Total>
        <ProgramServices>461942</ProgramServices>
        <ManagementAndGeneral>59704</ManagementAndGeneral>
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      <OtherEmployeeBenefits>
        <Total>1278096</Total>
        <ProgramServices>1130247</ProgramServices>
        <ManagementAndGeneral>147849</ManagementAndGeneral>
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      <PayrollTaxes>
        <Total>879113</Total>
        <ProgramServices>799646</ProgramServices>
        <ManagementAndGeneral>79467</ManagementAndGeneral>
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      <FeesForServicesLegal>
        <Total>196081</Total>
        <ManagementAndGeneral>196081</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>57500</Total>
        <ProgramServices>8800</ProgramServices>
        <ManagementAndGeneral>48700</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesOther>
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        <ProgramServices>393076</ProgramServices>
        <ManagementAndGeneral>343291</ManagementAndGeneral>
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      <Advertising>
        <Total>166989</Total>
        <ProgramServices>44840</ProgramServices>
        <ManagementAndGeneral>122149</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>236795</Total>
        <ProgramServices>198511</ProgramServices>
        <ManagementAndGeneral>38284</ManagementAndGeneral>
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      <InformationTechnology>
        <Total>128922</Total>
        <ProgramServices>11032</ProgramServices>
        <ManagementAndGeneral>117890</ManagementAndGeneral>
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      <Occupancy>
        <Total>126087</Total>
        <ProgramServices>11629</ProgramServices>
        <ManagementAndGeneral>114458</ManagementAndGeneral>
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      <Travel>
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        <ProgramServices>8259</ProgramServices>
        <ManagementAndGeneral>19064</ManagementAndGeneral>
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      <ConferencesMeetings>
        <Total>163965</Total>
        <ProgramServices>128723</ProgramServices>
        <ManagementAndGeneral>35242</ManagementAndGeneral>
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      <Interest>
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        <ProgramServices>44572</ProgramServices>
        <ManagementAndGeneral>22286</ManagementAndGeneral>
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      <DepreciationDepletion>
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        <ProgramServices>1265725</ProgramServices>
        <ManagementAndGeneral>632862</ManagementAndGeneral>
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      <Insurance>
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        <ProgramServices>176341</ProgramServices>
        <ManagementAndGeneral>88171</ManagementAndGeneral>
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      <OtherExpenses>
        <Description>SUPPLIES</Description>
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        <ProgramServices>26461936</ProgramServices>
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      <OtherExpenses>
        <Description>BAD DEBT EXPENSE</Description>
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        <ProgramServices>3336231</ProgramServices>
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      <OtherExpenses>
        <Description>REPAIRS AND MAINTENANCE</Description>
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      <OtherExpenses>
        <Description>DUES AND SUBSCRIPTIONS</Description>
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      <AllOtherExpenses>
        <Total>744204</Total>
        <ProgramServices>383808</ProgramServices>
        <ManagementAndGeneral>360396</ManagementAndGeneral>
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        <Fundraising>0</Fundraising>
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        <Identifier>DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:</Identifier>
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        <Identifier>DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:</Identifier>
        <ReturnReference>PART X, LINE 2:</ReturnReference>
        <Explanation>THE CENTER IS A 501(C)(3) CORPORATION AND, THEREFORE, IS NOT SUBJECT TO FEDERAL INCOME TAX. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF JUNE 30, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO FISCAL YEAR 2010.</Explanation>
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      <RecipientTable>
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      <Form990ScheduleJPartIII>
        <ReturnReference>PART I, LINE 7</ReturnReference>
        <Explanation>COMPENSATION PACKAGES OF PHYSICIANS INCLUDES A BONUS COMPONENT. BONUSES ARE BASED ON PERFORMANCE RELATED GOALS, SUCH AS PATIENT SATISFACTION.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 6</ReturnReference>
        <Explanation>THE SOLE MEMBERS OF THE CORPORATION SHALL BE BRONSON METHODIST HOSPITAL AND BORGESS MEDICAL CENTER.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 7A</ReturnReference>
        <Explanation>THE MEMBERS HAVE THE AUTHORITY TO APPOINT OR REMOVE ANY OFFICER OR DIRECTOR OF THE CORPORATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 7B</ReturnReference>
        <Explanation>CERTAIN DECISIONS MADE BY THE GOVERNING BODY ARE SUBJECT TO APPROVAL OF THE MEMBERS AS STATED IN THE BY-LAWS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 11</ReturnReference>
        <Explanation>THE 990 WAS CIRCULATED TO THE BOARD VIA EMAIL PRIOR TO SUBMISSION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>BOARD MEMBERS WILL CONDUCT AN ANNUAL REVIEW OF THE POLICY AND BE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY BEGINNING IN FISCAL YEAR 2012. IF THERE IS A CONFLICT OF INTEREST ON THE PART OF A BOARD MEMBER, THEY WILL ABSTAIN FROM VOTING.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15A</ReturnReference>
        <Explanation>THE CEO'S SALARY IS REVIEWED EVERY OTHER YEAR BY THE BOARD OF DIRECTORS. IT IS COMPARED WITH COMPENSATION FROM SIMILAR ORGANIZATIONS OR NOT-FOR-PROFITS WITH SIMILAR SIZE AND SCOPE. COMPENSATION FOR OTHER EXECUTIVES AND EMPLOYEES ARE DETERMINED BY THE CEO FOLLOWING POLICIES AND PROCEDURES IN PLACE. DOCUMENTATION OF CEO COMPENSATION BOARD DISCUSSION WILL BE IMPLEMENTED GOING FORWARD. THE MOST RECENT YEAR THE PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2012.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>DOCUMENTS ARE AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES:</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 9:</ReturnReference>
        <Explanation>CHANGE IN ASSETS HELD IN CHARITABLE REMAINDER TRUST -822,195.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART XII, LINE 2C</ReturnReference>
        <Explanation>THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MICHIGAN STATE UNIVERSITY KALAMAZOO CENTER FOR MEDICAL STUDIES</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1000 OAKLAND DRIVE</AddressLine1>
          <City>KALAMAZOO</City>
          <State>MI</State>
          <ZIPCode>49008</ZIPCode>
        </AddressUS>
        <EIN>382015695</EIN>
        <PrimaryActivities>HEALTHCARE SERVICES</PrimaryActivities>
        <LegalDomicileState>MI</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>LINE 11A, I</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>1</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
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        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1535 GULL ROAD</AddressLine1>
          <City>KALAMAZOO</City>
          <State>MI</State>
          <ZIPCode>49048</ZIPCode>
        </AddressUS>
        <EIN>383067256</EIN>
        <PrimaryActivities>HEALTHCARE SERVICES</PrimaryActivities>
        <LegalDomicileState>MI</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>LINE 9</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>1</ControlledOrg>
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      <GiftGrantOrCapContrFrOtherOrg>0</GiftGrantOrCapContrFrOtherOrg>
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      <LoansOrGuaranteesFromOtherOrg>0</LoansOrGuaranteesFromOtherOrg>
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      <ExchangeOfAssets>0</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>0</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>0</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>0</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>0</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>0</SharingOfFacilities>
      <SharingOfPaidEmployees>0</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>0</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>0</ReimbursementPaidByOtherOrg>
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