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      </Form990ScheduleJPartIII>
      <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 2011.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>DOCUMENTS ARE AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VII:</ReturnReference>
        <Explanation>J. PATRICK DYSON WORKED AN AVERAGE OF AT LEAST 1 HOUR PER WEEK AT RELATED ORGANIZATIONS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES:</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5:</ReturnReference>
        <Explanation>PRIOR PERIOD ADJUSTMENTS: 813,444. CHANGE IN ASSETS HELD IN CHARITABLE REMAINDER TRUST 8,751. TOTAL TO FORM 990, PART XI, LINE 5: 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>
          <BusinessNameLine1>WEST MICHIGAN AIR CARE INC</BusinessNameLine1>
        </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>
      </Form990ScheduleRPartII>
      <ReceiptOfIntAnnRentsRoyalties>0</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>0</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>0</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>0</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>0</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>0</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>0</PurchaseOfAssetsFromOtherOrg>
      <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>
      <OtherTransferToOtherOrg>0</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>0</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>