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      <FSAudited>true</FSAudited>
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      <ContribByControllingIndividual>false</ContribByControllingIndividual>
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        <Description>EST PROF LIAB UNDER SELF-INSURANCE</Description>
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      <OtherLiabilities>
        <Description>PAYABLE TO HOSPITALS</Description>
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      <OtherLiabilities>
        <Description>NOTES PAYABLE TO HOSPITALS</Description>
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      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
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      <Form990ScheduleJPartII>
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        <NontaxableBenefitsFilingOrg>3233</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>304212</TotalCompensationFilingOrg>
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        <NontaxableBenefitsFilingOrg>1018</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>290538</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
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        <NontaxableBenefitsFilingOrg>3233</NontaxableBenefitsFilingOrg>
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        <NontaxableBenefitsFilingOrg>4689</NontaxableBenefitsFilingOrg>
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      <GeneralExplanation>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>FORM 990</ReturnReference>
        <Explanation>ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CLASSES OF MEMBERS OR STOCKHOLDERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 6</ReturnReference>
        <Explanation>THE CORPORATION IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ELECTION OF MEMBERS AND THEIR RIGHTS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 7A</ReturnReference>
        <Explanation>BASED ON THE BY-LAWS, THE BOARD MEMBERS CONSIST OF SIX INDIVIDUALS: PRESIDENT AND CEO OF COVENANT, A PHYSICIAN APPOINTED BY COVENANT, PRESIDENT AND CEO OF ST. MARY'S, A PHYSICIAN APPOINTED BY ST. MARY'S, DEAN OF COLLEGE OF MEDICINE OF CENTRAL MICHIGAN UNIVERSITY AND OTHER OTHER CMU EMPLOYEE APPOINTED BY THE DEAN OF THE COLLEGE OF MEDICINE. IN ADDITION, THE EXECUTIVE DIRECTOR, DIRECTOR OF FINANCE AND DIRECTOR OF MEDICAL EDUCATION ARE INVITED TO ATTEND THE MEETINGS AS A NON-VOTING MEMBER.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DECISIONS SUBJECT TO APPROVAL OF MEMBERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 7B</ReturnReference>
        <Explanation>THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE MEMBERS: A. TO APPROVE THE STATEMENT OF PHILOSOPHY AND MISSION OF THE CORPORATION, B. TO APPROVE THE ADOPTION OF ANY STRATEGIC PLAN OF THE CORPORATION OR ANY MAJOR CHANGE IN THE PROGRAMS OR SERVICES OF THE CORPORATION, C. TO SELECT A QUALIFIED AUDIT FIRM FOR THE CORPORATION, D. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS AND EXPENDITURES OF THE CORPORATION, E. TO APPROVE ANY INDEBTEDNESS OF THE CORPORATION, F. TO APPROVE THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION, G. TO APPROVE ANY AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION, H. TO APPROVE ANY AMENDMENT OF THE BYLAWS OF THE CORPORATION, I. TO APPROVE THE MERGER, CONSOLIDATION, DISSOLUTION, SALE OR OTHER TRANSFER OF SUBSTANTIALLY ALL ASSETS OF THE CORPORATION, AND J. TO APPROVE THE PURCHASE, SALE, TRANSFER OR OTHER ENCUMBRANCE OF ASSETS OF THE CORPORATION.</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 BOARD OF DIRECTORS REVIEWS AND PROVIDES FINAL APPROVAL OF THE FORM 990.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ENFORCEMENT OF CONFLICTS POLICY</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 12C</ReturnReference>
        <Explanation>ALL MEMBERS OF THE BOARD ARE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. THE FORM IS THEN REVIEWED FOR ANY POSSIBLE CONFLICTS OF INTEREST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION PROCESS FOR TOP OFFICIAL</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 15A</ReturnReference>
        <Explanation>COMPENSATION FOR THE CEO IS DETERMINED BY A COMPENSATION COMMITTEE COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS. DATA FROM THE MGMA AND VARIOUS OTHER NATIONAL SALARY SURVEYS ARE USED TO DETERMINE THE SALARY OF THE CEO, WHICH IS THEN TAKEN TO THE ENTIRE MEMBERSHIP OF THE BOARD OF DIRECTORS FOR APPROVAL.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION PROCESS FOR OFFICERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 15B</ReturnReference>
        <Explanation>COMPENSATION FOR ALL OTHER OFFICERS AND KEY EMPLOYEES IS BASED ON VARIOUS MARKET SURVEYS. COMPENSATION IS REVIEWED ANNUALLY AND TAKEN TO THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS FOR APPROVAL.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>GOVERNING DOCUMENTS DISCLOSURE EXPLANATION</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 19</ReturnReference>
        <Explanation>DOCUMENTS ARE AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>FORM 990, PART VII</ReturnReference>
        <Explanation>NO TRUSTEEES OR OFFICERS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD. THEY ARE CONSIDERED TO WORK 1 HOUR PER WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS PER WEEK RELATED TO THEIR FULL-TIME POSITION.</Explanation>
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      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS EXPLANATION</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5</ReturnReference>
        <Explanation>CHANGES IN NET ASSETS: UNREALIZED LOSS ON INVESTMENTS (21,332) RECLASSIFICATION OF DEBT TO MEMBERS EQUITY 3,495,701 ------------ TOTAL CHANGE IN NET ASSETS 3,474,369</Explanation>
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        <MethodOfAmtDetermination>CONTRACT</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>CENTRAL MICHIGAN UNIVERSITY</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>N</TransactionType>
        <AmountInvolved>1004108</AmountInvolved>
        <MethodOfAmtDetermination>CONTRACT SALARY BENEFIT</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>