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        <BusinessNameLine1>MERCY MEMORIAL HOSPITAL CORPORATION</BusinessNameLine1>
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        <City>Monroe</City>
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        <ZIPCode>48162</ZIPCode>
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        <NamePerson>SEALWILLIAM L</NamePerson>
        <Title>CRNA</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>262825</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>10486</OtherCompensation>
      </Form990PartVIISectionA>
      <Form990PartVIISectionA>
        <NamePerson>Moosa Mahmood F</NamePerson>
        <Title>Doctor</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>253074</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>14974</OtherCompensation>
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      <Form990PartVIISectionA>
        <NamePerson>Memon Mubeen A</NamePerson>
        <Title>Doctor</Title>
        <AverageHoursPerWeek>40.00</AverageHoursPerWeek>
        <HighestCompensatedEmployee>X</HighestCompensatedEmployee>
        <ReportableCompFromOrganization>207978</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>13815</OtherCompensation>
      </Form990PartVIISectionA>
      <TotalReportableCompFromOrg>2052228</TotalReportableCompFromOrg>
      <TotalReportableCompFrmRltdOrgs>0</TotalReportableCompFrmRltdOrgs>
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      <NumberIndividualsGT100K>49</NumberIndividualsGT100K>
      <FormersListed>0</FormersListed>
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      <CompensationFromOtherSources>0</CompensationFromOtherSources>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Contracting Resources LLC</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>403 E Grand River Suite C</AddressLine1>
            <City>Brighton</City>
            <State>MI</State>
            <ZIPCode>48116</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Construction Management</DescriptionOfServices>
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      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Auch George W Co</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>735 S Paddock</AddressLine1>
            <City>Pontiac</City>
            <State>MI</State>
            <ZIPCode>48341</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Construction Management</DescriptionOfServices>
        <Compensation>1202186</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Crothall Services Group</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>955 Chesterbrook Blvd Suite 300</AddressLine1>
            <City>Wayne</City>
            <State>PA</State>
            <ZIPCode>19087</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
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        <Compensation>1200871</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Quest Diagnostics</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>4444 Giddings Road</AddressLine1>
            <City>Auburn Hills</City>
            <State>MI</State>
            <ZIPCode>48326</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Equipment Service</DescriptionOfServices>
        <Compensation>791598</Compensation>
      </ContractorCompensation>
      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>GE Healthcare</BusinessNameLine1>
          </NameBusiness>
        </NameOfContractor>
        <AddressOfContractor>
          <AddressUS>
            <AddressLine1>101 Carnegie Center</AddressLine1>
            <City>Princeton</City>
            <State>NJ</State>
            <ZIPCode>08540</ZIPCode>
          </AddressUS>
        </AddressOfContractor>
        <DescriptionOfServices>Equipment Service</DescriptionOfServices>
        <Compensation>721272</Compensation>
      </ContractorCompensation>
      <NumberOfContractorsGT100K>41</NumberOfContractorsGT100K>
      <FundraisingEvents>103314</FundraisingEvents>
      <GovernmentGrants>49361</GovernmentGrants>
      <AllOtherContributions>931486</AllOtherContributions>
      <NoncashContributions>50000</NoncashContributions>
      <TotalContributions>1084161</TotalContributions>
      <ProgramServiceRevenue>
        <Description>Hospital Based SVCS</Description>
        <BusinessCode>621990</BusinessCode>
        <TotalRevenueColumn>158422603</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>158422603</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>Non-Patient Pharmacy</Description>
        <BusinessCode>446110</BusinessCode>
        <TotalRevenueColumn>3984663</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>3984663</UnrelatedBusinessRevenue>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>Reference Lab</Description>
        <BusinessCode>621500</BusinessCode>
        <TotalRevenueColumn>371561</TotalRevenueColumn>
        <UnrelatedBusinessRevenue>371561</UnrelatedBusinessRevenue>
      </ProgramServiceRevenue>
      <ProgramServiceRevenue>
        <Description>Hospital Guild</Description>
        <BusinessCode>621990</BusinessCode>
        <TotalRevenueColumn>15296</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>15296</RelatedOrExemptFunctionIncome>
      </ProgramServiceRevenue>
      <TotalProgramServiceRevenue>162794123</TotalProgramServiceRevenue>
      <InvestmentIncome>
        <TotalRevenueColumn>877326</TotalRevenueColumn>
        <ExclusionAmount>877326</ExclusionAmount>
      </InvestmentIncome>
      <GrossRents>
        <Real>951409</Real>
      </GrossRents>
      <LessRentalExpenses>
        <Real>1008866</Real>
      </LessRentalExpenses>
      <RentalIncomeOrLoss>
        <Real>-57457</Real>
      </RentalIncomeOrLoss>
      <NetRentalIncomeOrLoss>
        <TotalRevenueColumn>-57457</TotalRevenueColumn>
        <ExclusionAmount>-57457</ExclusionAmount>
      </NetRentalIncomeOrLoss>
      <GrossAmountSalesAssets>
        <Securities>34885463</Securities>
        <Other>22420</Other>
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      <LessCostOthBasisSalesExpenses>
        <Securities>16281463</Securities>
        <Other>507780</Other>
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      <GainOrLoss>
        <Securities>18604000</Securities>
        <Other>-485360</Other>
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      <NetGainOrLossInvestments>
        <TotalRevenueColumn>18118640</TotalRevenueColumn>
        <ExclusionAmount>18118640</ExclusionAmount>
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      <GrossIncomeFundraisingEvents>53142</GrossIncomeFundraisingEvents>
      <CntrbtnsRprtdFundraisingEvents>103314</CntrbtnsRprtdFundraisingEvents>
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      <NetIncomeFromFundraisingEvents>
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        <ExclusionAmount>-13504</ExclusionAmount>
      </NetIncomeFromFundraisingEvents>
      <GrossIncomeGaming>36126</GrossIncomeGaming>
      <GamingDirectExpenses>10389</GamingDirectExpenses>
      <NetIncomeFromGaming>
        <TotalRevenueColumn>25737</TotalRevenueColumn>
        <ExclusionAmount>25737</ExclusionAmount>
      </NetIncomeFromGaming>
      <GrossSalesOfInventory>242324</GrossSalesOfInventory>
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      <NetIncomeOrLoss>
        <TotalRevenueColumn>81467</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>81467</RelatedOrExemptFunctionIncome>
      </NetIncomeOrLoss>
      <TotalRevenue>
        <TotalRevenueColumn>182910493</TotalRevenueColumn>
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        <UnrelatedBusinessRevenue>4356224</UnrelatedBusinessRevenue>
        <ExclusionAmount>18950742</ExclusionAmount>
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      <GrantsToDomesticOrgs>
        <Total>1000</Total>
        <ProgramServices>1000</ProgramServices>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>2000</Total>
        <ProgramServices>2000</ProgramServices>
      </GrantsToDomesticIndividuals>
      <CompCurrentOfficersDirectors>
        <Total>710235</Total>
        <ManagementAndGeneral>710235</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <OtherSalariesAndWages>
        <Total>61202650</Total>
        <ProgramServices>52553544</ProgramServices>
        <ManagementAndGeneral>8588566</ManagementAndGeneral>
        <Fundraising>60540</Fundraising>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
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        <ProgramServices>465572</ProgramServices>
        <ManagementAndGeneral>82378</ManagementAndGeneral>
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      <OtherEmployeeBenefits>
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        <ProgramServices>9005123</ProgramServices>
        <ManagementAndGeneral>1593363</ManagementAndGeneral>
        <Fundraising>10374</Fundraising>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>4534050</Total>
        <ProgramServices>3848640</ProgramServices>
        <ManagementAndGeneral>680976</ManagementAndGeneral>
        <Fundraising>4434</Fundraising>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>281557</Total>
        <ManagementAndGeneral>281557</ManagementAndGeneral>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>275335</Total>
        <ManagementAndGeneral>275335</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>428592</Total>
        <ManagementAndGeneral>428592</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>12933</Total>
        <ManagementAndGeneral>12933</ManagementAndGeneral>
      </FeesForServicesLobbying>
      <FeesForServicesInvstMgmntFees>
        <Total>129985</Total>
        <ManagementAndGeneral>129985</ManagementAndGeneral>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>13762406</Total>
        <ProgramServices>11089202</ProgramServices>
        <ManagementAndGeneral>2673204</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
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        <ProgramServices>14555</ProgramServices>
        <ManagementAndGeneral>300650</ManagementAndGeneral>
        <Fundraising>877</Fundraising>
      </Advertising>
      <OfficeExpenses>
        <Total>1574299</Total>
        <ProgramServices>1009630</ProgramServices>
        <ManagementAndGeneral>564669</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>1688857</Total>
        <ManagementAndGeneral>1688857</ManagementAndGeneral>
      </InformationTechnology>
      <Occupancy>
        <Total>2842955</Total>
        <ProgramServices>2623286</ProgramServices>
        <ManagementAndGeneral>219669</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>303113</Total>
        <ProgramServices>216712</ProgramServices>
        <ManagementAndGeneral>84486</ManagementAndGeneral>
        <Fundraising>1915</Fundraising>
      </Travel>
      <ConferencesMeetings>
        <Total>155764</Total>
        <ProgramServices>125678</ProgramServices>
        <ManagementAndGeneral>30086</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>2471306</Total>
        <ProgramServices>2471306</ProgramServices>
      </Interest>
      <DepreciationDepletion>
        <Total>8728240</Total>
        <ProgramServices>8053827</ProgramServices>
        <ManagementAndGeneral>674413</ManagementAndGeneral>
      </DepreciationDepletion>
      <Insurance>
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        <ProgramServices>1960609</ProgramServices>
        <ManagementAndGeneral>153200</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>Hospital Supplies</Description>
        <Total>27149483</Total>
        <ProgramServices>27149483</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Bad Debt</Description>
        <Total>15133827</Total>
        <ProgramServices>15133827</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>Miscellaneous</Description>
        <Total>6151419</Total>
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        <Fundraising>663</Fundraising>
      </OtherExpenses>
      <TotalFunctionalExpenses>
        <Total>161127243</Total>
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        <Fundraising>79339</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
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      </CashNonInterestBearing>
      <SavingsAndTempCashInvestments>
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      </SavingsAndTempCashInvestments>
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      </AccountsReceivable>
      <InventoriesForSaleOrUse>
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      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
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        <EOY>1752094</EOY>
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      <LandBuildingsEquipmentBasisNet>
        <BOY>79757317</BOY>
        <EOY>74614933</EOY>
      </LandBuildingsEquipmentBasisNet>
      <InvestmentsPubTradedSecurities>
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        <EOY>39020475</EOY>
      </InvestmentsPubTradedSecurities>
      <InvestmentsOtherSecurities>
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        <EOY>157643</EOY>
      </InvestmentsOtherSecurities>
      <OtherAssetsTotal>
        <BOY>658400</BOY>
        <EOY>1925768</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>146714281</BOY>
        <EOY>166919072</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>33284579</BOY>
        <EOY>41489181</EOY>
      </AccountsPayableAccruedExpenses>
      <TaxExemptBondLiabilities>
        <BOY>46302040</BOY>
        <EOY>45543392</EOY>
      </TaxExemptBondLiabilities>
      <TotalLiabilities>
        <BOY>79586619</BOY>
        <EOY>87032573</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>62153740</BOY>
        <EOY>76779573</EOY>
      </UnrestrictedNetAssets>
      <TemporarilyRestrictedNetAssets>
        <BOY>4922397</BOY>
        <EOY>3051924</EOY>
      </TemporarilyRestrictedNetAssets>
      <PermanentlyRestrictedNetAssets>
        <BOY>51525</BOY>
        <EOY>55002</EOY>
      </PermanentlyRestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>67127662</BOY>
        <EOY>79886499</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>146714281</BOY>
        <EOY>166919072</EOY>
      </TotalLiabNetAssetsFundBalances>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>0</AccountantCompileOrReview>
      <FSAudited>1</FSAudited>
      <AuditCommittee>1</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>0</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
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      <MediaAdvertisements>0</MediaAdvertisements>
      <MailingsMembers>0</MailingsMembers>
      <PublicationsOrBroadcast>0</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>0</GrantsOtherOrganizations>
      <DirectContactLegislators>0</DirectContactLegislators>
      <RalliesDemonstrations>0</RalliesDemonstrations>
      <OtherActivities>1</OtherActivities>
      <OtherActivitiesAmount>12933</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>12933</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>0</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>Part II-B, Line 1i:</Identifier>
        <ReturnReference>Explanation of Other Lobbying Activities:</ReturnReference>
        <Explanation>The organization paid dues to organizations which performed lobbying activiites.</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <CurrentYear>
        <BeginningOfYearBalance>4973922</BeginningOfYearBalance>
        <Contributions>1132367</Contributions>
        <InvestmentEarningsOrLosses>168896</InvestmentEarningsOrLosses>
        <OtherExpenditures>3168259</OtherExpenditures>
        <EndOfYearBalance>3106926</EndOfYearBalance>
      </CurrentYear>
      <CurrentYearMinus1Year>
        <BeginningOfYearBalance>5308021</BeginningOfYearBalance>
        <Contributions>1121436</Contributions>
        <InvestmentEarningsOrLosses>-178473</InvestmentEarningsOrLosses>
        <GrantsOrScholarships>3000</GrantsOrScholarships>
        <OtherExpenditures>1274062</OtherExpenditures>
        <EndOfYearBalance>4973922</EndOfYearBalance>
      </CurrentYearMinus1Year>
      <BoardDesignatedEOYBalance>0.99000</BoardDesignatedEOYBalance>
      <PermanentEndowmentEOYBalance>0.01000</PermanentEndowmentEOYBalance>
      <EndowmentsHeldByUnrelatedOrgs>0</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>0</EndowmentsHeldByRelatedOrgs>
      <Land>
        <OtherCostOrOtherBasis>12915114</OtherCostOrOtherBasis>
        <BookValue>12915114</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>51456196</OtherCostOrOtherBasis>
        <Depreciation>25065177</Depreciation>
        <BookValue>26391019</BookValue>
      </Buildings>
      <Equipment>
        <OtherCostOrOtherBasis>104952146</OtherCostOrOtherBasis>
        <Depreciation>70636409</Depreciation>
        <BookValue>34315737</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>993063</OtherCostOrOtherBasis>
        <BookValue>993063</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>74614933</TotalOfBookValueLandBuildings>
      <TotalRevenue>182910493</TotalRevenue>
      <TotalExpenses>161127243</TotalExpenses>
      <ExcessOrDeficitForYear>21783250</ExcessOrDeficitForYear>
      <NetUnrealizedGLOnInvestments>2316057</NetUnrealizedGLOnInvestments>
      <DonatedServicesAndFacilities>83500</DonatedServicesAndFacilities>
      <OtherAmount>-11423970</OtherAmount>
      <TotalAdjustments>-9024413</TotalAdjustments>
      <ExcessOrDeficitPerFS>12758837</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>186763137</TotRevenueEtcAuditedFinclStmt>
      <NetUnrealizedGainsInvestments>2316057</NetUnrealizedGainsInvestments>
      <DonatedSrvcAndUseOfFacilities>83500</DonatedSrvcAndUseOfFacilities>
      <OtherRevenues>1580419</OtherRevenues>
      <RevenueNotRptdF990>3979976</RevenueNotRptdF990>
      <RevenueSubtotal>182783161</RevenueSubtotal>
      <OtherRevenuesNotIncluded>127332</OtherRevenuesNotIncluded>
      <RevenueNotRptdOnFinStmt>127332</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>182910493</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>174004300</TotExpensesEtcAuditedFinclStmt>
      <OtherExpensesIncluded>14705137</OtherExpensesIncluded>
      <ExpensesNotRptdF990>14705137</ExpensesNotRptdF990>
      <ExpensesSubtotal>159299163</ExpensesSubtotal>
      <OtherExpensesNotIncluded>1828080</OtherExpensesNotIncluded>
      <ExpensesNotRptdOnFinStmt>1828080</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>161127243</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIV>
        <Identifier>Part V, Line 4:</Identifier>
        <ReturnReference>Description of Intended Use of Endowment Funds:</ReturnReference>
        <Explanation>True endowment funds are intended to be used for nursing scholarships. Quasi-endowment funds have been designated for various uses to further the hospital's mission to provide quality, comprehensive health care services. Some of these designations include hospice, chaplaincy, capital improvements, and pharmacy assistance.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XI, Line 8 - Other Adjustments:</Identifier>
        <Explanation>Net assets released from Restrictions for capital: 3023989. income from bond fund not under hospital control : 202708. release restricted contributions : 155578. GUILD AND MEDICAL STAFF EXPENSES : 51264. NONCAP NONCASH CONTRIBUTION RELEASED : 26000. ENDOWMENT INVESTMENT INCOME : 22642. Equity Investment Loss MHV : -51040. GUILD &amp; MED STAFF REVENUES : -62572. CONTRIBUTIONS : -1158367. Decrease in Temp Restricted Net Assets: -1866998. Pension Liability accrual : -11767174.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XII, Line 2d - Other Adjustments:</Identifier>
        <Explanation>Equity investment in MHV (loss): -51040. Released Restricted Contributions: 155578. Extraordinary item in gain on FS exp on 990: -1750816. Income from Bond fund not under hospital control: 202708. Net assets released from Restrictions for capital: 3023989.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XII, Line 4b - Other Adjustments:</Identifier>
        <Explanation>Rental Expenses: -1008865. Contributions: 1158367. Fundraising &amp; Gaming Expenses: -62100. Endowment investment income: -22642. Guild &amp; Med Staff Revenues: 62572.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XIII, Line 2d - Other Adjustments:</Identifier>
        <Explanation>Fundraising &amp; Gaming Expenses : 62100. Rental Expenses: 1008865. Pension Liability accrual : 11767174. Decrease in Temp Restricted Net Assets: 1866998.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>Part XIII, Line 4b - Other Adjustments:</Identifier>
        <Explanation>Settlement included in Rev &amp; Gains on FS: 1750816. NonCap Noncash contribution Released: 26000. Guild &amp; Medical Staff Expenses: 51264.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="RetDoc1040500001">
      <AcctsActvsOutUSTable>
        <Region>Central America &amp; the Caribbean</Region>
        <TypeOfActivitiesConducted>Insurance</TypeOfActivitiesConducted>
      </AcctsActvsOutUSTable>
      <TotalNumberOfOffices>0</TotalNumberOfOffices>
      <TotalNumberOfEmployees>0</TotalNumberOfEmployees>
      <TotalAmountSpent>0</TotalAmountSpent>
    </IRS990ScheduleF>
    <IRS990ScheduleG documentId="RetDoc1041300001">
      <EventsInformation>
        <NameOfEvent1>Fantasy of Trees 2009</NameOfEvent1>
        <GrossReceiptsEvent1>74900</GrossReceiptsEvent1>
        <CharitableContributionsEvent1>66900</CharitableContributionsEvent1>
        <GrossRevenueEvent1>8000</GrossRevenueEvent1>
        <NonCashPrizesEvent1>197</NonCashPrizesEvent1>
        <RentFacilityCostsEvent1>3618</RentFacilityCostsEvent1>
        <FoodAndBeverageEvent1>7741</FoodAndBeverageEvent1>
        <EntertainmentEvent1>800</EntertainmentEvent1>
        <OtherDirectExpensesEvent1>10347</OtherDirectExpensesEvent1>
        <NameOfEvent2>Golf Outing 2010</NameOfEvent2>
        <GrossReceiptsEvent2>34621</GrossReceiptsEvent2>
        <CharitableContributionsEvent2>18821</CharitableContributionsEvent2>
        <GrossRevenueEvent2>15800</GrossRevenueEvent2>
        <CashPrizesEvent2>600</CashPrizesEvent2>
        <NonCashPrizesEvent2>4762</NonCashPrizesEvent2>
        <RentFacilityCostsEvent2>9607</RentFacilityCostsEvent2>
        <FoodAndBeverageEvent2>8023</FoodAndBeverageEvent2>
        <OtherDirectExpensesEvent2>196</OtherDirectExpensesEvent2>
        <TotalNumberOfOtherEvents>3</TotalNumberOfOtherEvents>
        <GrossReceiptsOtherEvents>46934</GrossReceiptsOtherEvents>
        <CharitableContribOtherEvents>17593</CharitableContribOtherEvents>
        <GrossRevenueOtherEvents>29341</GrossRevenueOtherEvents>
        <RentFacilityCostsOtherEvents>1547</RentFacilityCostsOtherEvents>
        <FoodAndBeverageOtherEvents>1665</FoodAndBeverageOtherEvents>
        <EntertainmentOtherEvents>150</EntertainmentOtherEvents>
        <OtherDirectExpensesOtherEvents>17393</OtherDirectExpensesOtherEvents>
        <GrossReceiptsTotal>156455</GrossReceiptsTotal>
        <CharitableContributionsTotal>103314</CharitableContributionsTotal>
        <GrossRevenueTotalEvents>53141</GrossRevenueTotalEvents>
        <CashPrizesTotalEvents>600</CashPrizesTotalEvents>
        <NonCashPrizesTotalEvents>4959</NonCashPrizesTotalEvents>
        <RentFacilityCostsTotalEvents>14772</RentFacilityCostsTotalEvents>
        <FoodAndBeverageTotalEvents>17429</FoodAndBeverageTotalEvents>
        <EntertainmentTotalEvents>950</EntertainmentTotalEvents>
        <OtherDirectExpensesTotalEvents>27936</OtherDirectExpensesTotalEvents>
        <DirectExpenseSummaryEvents>66646</DirectExpenseSummaryEvents>
        <NetIncomeSummary>-13505</NetIncomeSummary>
      </EventsInformation>
      <GamingInformation>
        <GrossRevenueOtherGaming>36126</GrossRevenueOtherGaming>
        <CashPrizesOtherGaming>500</CashPrizesOtherGaming>
        <NonCashPrizesOtherGaming>9889</NonCashPrizesOtherGaming>
        <VolunteerLaborOtherGaming>1</VolunteerLaborOtherGaming>
        <VolunteerLaborPrcntOtherGaming>1.00000</VolunteerLaborPrcntOtherGaming>
        <GrossRevenueTotalGaming>36126</GrossRevenueTotalGaming>
        <CashPrizesTotalGaming>500</CashPrizesTotalGaming>
        <NonCashPrizesTotalGaming>9889</NonCashPrizesTotalGaming>
        <DirectExpenseSummaryGaming>10389</DirectExpenseSummaryGaming>
        <NetGamingIncomeSummary>25737</NetGamingIncomeSummary>
      </GamingInformation>
      <StatesWhereGamingConducted>MI</StatesWhereGamingConducted>
      <Licensed>1</Licensed>
      <LicenseSuspendedEtc>0</LicenseSuspendedEtc>
      <GamingWithNonmembers>0</GamingWithNonmembers>
      <MemberOfOtherEntity>0</MemberOfOtherEntity>
      <PercentageOfGamingOwnFacility>0.10000</PercentageOfGamingOwnFacility>
      <PercentageOfGamingOthrFacility>0.90000</PercentageOfGamingOthrFacility>
      <NameOfGamingRecKeeperBus>
        <BusinessNameLine1>Molly Moore</BusinessNameLine1>
      </NameOfGamingRecKeeperBus>
      <AddressOfGamingRecKeeperUS>
        <AddressLine1>718 N Macomb Street</AddressLine1>
        <City>Monroe</City>
        <State>MI</State>
        <ZIPCode>48162</ZIPCode>
      </AddressOfGamingRecKeeperUS>
      <ContractWith3rdPartyForGamRev>0</ContractWith3rdPartyForGamRev>
      <CharitableDistribRequired>0</CharitableDistribRequired>
    </IRS990ScheduleG>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <CharityCarePolicy>1</CharityCarePolicy>
      <WrittenPolicy>1</WrittenPolicy>
      <FPGReferenceFreeCare>1</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>0</FPGReferenceDiscountedCare>
      <FreeDiscCareMedicallyIndigent>1</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>1</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>1</ExpensesExceededBudget>
      <UnableToProvideCare>0</UnableToProvideCare>
      <AnnualCommunityBenefitReport>1</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>1</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>808890</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>808890</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00550</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>27120707</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>17225738</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>9894969</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.06780</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>27929597</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>17225738</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>10703859</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.07330</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>258470</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>59733</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>198737</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00140</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>11095</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>11095</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <Research>
        <TotalCommunityBenefitExpense>116878</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>15230</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>101648</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00070</PercentOfTotalExpense>
      </Research>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>106019</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>106019</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00070</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>492462</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>74963</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>417499</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00290</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>28422059</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>17300701</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>11121358</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.07620</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <EconomicDevelopment>
        <TotalCommunityBuildingExpense>7293</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>7293</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00000</PercentOfTotalExpense>
      </EconomicDevelopment>
      <CoalitionBuilding>
        <TotalCommunityBuildingExpense>16540</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>16540</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </CoalitionBuilding>
      <HealthImprovementAdvocacy>
        <TotalCommunityBuildingExpense>11100</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>11100</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </HealthImprovementAdvocacy>
      <Total>
        <TotalCommunityBuildingExpense>34933</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>34933</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00020</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>1</BadDebtExpenseReported>
      <BadDebtExpenseAmount>7491244</BadDebtExpenseAmount>
      <AmountAttributableTo>749124</AmountAttributableTo>
      <AmountReimbursedByMedicare>44719028</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>46493718</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-1774690</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>1</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>1</ProvisionForCharityCare>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Mercy Memorial Hospital</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>718 N Macomb Street</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>MMH POB</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>730 N Macomb Street</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>MMH Rehab</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>650 Stewart Rd</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Rehab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Westside Medical</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>100 Powell</AddressLine1>
          <City>Dundee</City>
          <State>MI</State>
          <ZIPCode>48131</ZIPCode>
        </Address>
        <Other>Diagnostic, Therapy, Lab Services, Sleep Lab</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Newport Medical</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>7825 North Dixie</AddressLine1>
          <City>Newport</City>
          <State>MI</State>
          <ZIPCode>48166</ZIPCode>
        </Address>
        <Other>Sleep Lab &amp; lab services, Also Patient Accounting &amp;&amp; Centralized Scheduling</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Dr Ahadi Office Complex</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>55 Cole Road</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Phlebotomy- Dr Dona's</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>7505 Grafton Rd Suite 5</AddressLine1>
          <City>Newport</City>
          <State>MI</State>
          <ZIPCode>48166</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Phlebotomy - Dr Stewart</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>811 N Macomb</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Outpatient Therapy</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>214 Elm St</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Occupational Therapy Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Sleep Lab Macomb</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>717 N Monroe</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Sleep Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Diagnostic Center</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>901 N Macomb Street</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Diagnostic, Cardiopulmonary, Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Phlebotomy - Delisle Center</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1056 N Monroe</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Phlebotomy - Dr Qureshi</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>5290 W Brookshire</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48161</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Temperance</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1715 W Dean Rd</AddressLine1>
          <City>Temperance</City>
          <State>MI</State>
          <ZIPCode>48182</ZIPCode>
        </Address>
        <Other>Sleep Lab &amp; lab services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Phlebotomy - Dr Roecker</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>14430 Laplaisance Rd</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48161</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Phlebotomy-Carleton Family Medical</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>130 Medical Center</AddressLine1>
          <City>Carleton</City>
          <State>MI</State>
          <ZIPCode>48117</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Phlebotomy - Dr Kabir</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>219 W Front Street</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Karpenko</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>323 Stewart Rd</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Outreach Lab Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Homecare Connection</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1070 N Monroe</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Homecare Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Mercy Memorial Hospice</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1070 N Monroe</AddressLine1>
          <City>Monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Hospice Services</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartV>
        <Name>
          <BusinessNameLine1>Home Respiratory Care</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>811 N Macomb</AddressLine1>
          <City>monroe</City>
          <State>MI</State>
          <ZIPCode>48162</ZIPCode>
        </Address>
        <Other>Home Respiratory Care (DME)</Other>
      </Form990ScheduleHPartV>
      <Form990ScheduleHPartVI>
        <CostingMethodUsed>Part I, Line 7: COST TO CHARGE RATIO FROM FILED 2010 MEDICARE COST REPORT.</CostingMethodUsed>
        <BadDebtFootnote>Part III, Line 4: The provision for bad debts is based upon management's assessment of historical and expected net collections considering business and economic conditions, trends in health care 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 by payor category. 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 Corporation follows established guidelines for placing certain past-due patient balances with collection agencies.</BadDebtFootnote>
        <ShortfallAsCommunityBenefit>Part III, Line 8: ALL OF THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, INCLUDING A PROFIT MARGIN WHICH WAS ADDED TO COVER THE REPLACEMENT OF CAPITAL. THE NUMBERS ARE 100% MEDICARE COST REPORT. The MHA and the industry in general have always looked at Medicare underpayment of cost as being community benefit, it is the same as Medicaid underpayment of cost.</ShortfallAsCommunityBenefit>
        <DebtCollectionPolicy>Part III, Line 9b: OUR EARLY OUT VENDOR RETURNS ANY ACCOUNTS THAT QUALIFY FOR CHARITY CARE TO US FOR ADJUSTMENT. The industry does not demand that all self pay patients must fill out a charity care application to see if they qualify for free or reduced care. Some patients do not present the required information until after they are in bad debt. Most never present the required information.</DebtCollectionPolicy>
        <NumberOfFacilityTypeExpln>Part V: 1 REHAB FACILITY, 1 SKILLED NURSING FACILITY, 1 DIAGNOSTIC CENTER</NumberOfFacilityTypeExpln>
        <NeedsAssessment>Part VI, Line 2: TO IDENTIFY COMMUNITY NEEDS TO BE ADDRESSED IN THE ORGANIZATION'S 2010-2013 STRATEGIC PLAN INTERVIEWS WITH ELECTED COMMUNITY LEADERS, EMPLOYERS, PHYSICIANS AND THE PUBLIC SUPPLEMENTED ANALYSIS OF DATA FROM SOURCES SUCH AS THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH BEHAVIORAL RISK FACTOR SURVEY, ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS, AND THE HHS COMMUNITY HEALTH STATUS REPORT FOR MONROE COUNTY.</NeedsAssessment>
        <PatientEducationAssistance>Part VI, Line 3: WHEN IT IS DETERMINED THAT A PATIENT IS UNABLE TO PAY FOR SERVICES (EITHER BEFORE OR AFTER SERVICES ARE RENDERED) A FINANCIAL COUNSELOR WILL SPEAK TO THE PATIENT TO EXPLAIN FINANCIAL ASSISTANCE. THE FIRST OPTION OFFERED IS STATE MEDICAID. THE PATIENT IS ASSESSED FOR MEDICAID QUALIFICATION AND IF IT IS DETERMINED THE PATIENT DOES NOT QUALIFY, THEY ARE OFFERED CHARITY CARE ASSISTANCE. THE PATIENT IS GIVEN A CHARITY CARE APPLICATION AND REQUESTED TO COMPLETE AND RETURN TO THE FINANCIAL COUNSELOR WITH THE APPROPRIATE DOCUMENTATION. ONCE THE APPLICATION IS RETURNED TO THE FINANCIAL COUNSELOR, IT IS ASSEMBLED AND SENT TO THE PATIENT ACCOUNTING OFFICE FOR APPROVAL. SUPERVISOR APPROVAL IS DONE FOR ANY AMOUNT UP TO $24,999, THE DIRECTOR FOR $25,000 TO $49,999 AND THE CFO FOR ALL ACCOUNTS OVER $50,000.</PatientEducationAssistance>
        <CommunityInformation>Part VI, Line 4: CONSISTENT WITH THE US CENTERS FOR MEDICARE AND MEDICAID SERVICES, THE PRIMARY SERVICE AREA INCLUDES CONTIGUOUS ZIP CODES FOR THE CITY OF MONROE AND NEWPORT THAT PROVIDE 75 PERCENT OF MERCY MEMORIAL HOSPITALS DISCHARGES. THE SECONDARY SERVICE AREA IS THE REMAINDER OF MONROE COUNTY. IN 2009 THE TOTAL COUNTY POPULATION WAS ESTIMATED AT 152,721 WITH APPROXIMATELY 45% RESIDING IN THE PRIMARY SERVICE AREA. UNEMPLOYMENT WITH OUTMIGRATION HAVE RESULTED IN A SLIGHT DECLINE OVER THE PAST DECADE. THE MOST RAPIDLY GROWING COHORT IN A POPULATION THAT'S APPROXIMATELY 95% WHITE AND 2.5% EACH BLACK AND HISPANIC, IS THE 65+ AGE GROUP. SOME NORTHERN AND SOUTHERN PORTIONS OF MONROE COUNTY ARE FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS.</CommunityInformation>
        <CommunityBuildingActivities>Part VI, Line 5: PARTICIPATION IN TASK FORCES AND COMMITTEES ASSURES A MORE COORDINATED APPROACH TO SERVICES FOR AN AGING COUNTY POPULATION, EMERGENCY PREPAREDNESS AND COORDINATION OF EFFORT AMONG AGENCIES PROVIDING HUMAN SERVICES. SPECIFIC AREAS OF IMPROVEMENT INCLUDE PRE-HOSPITAL AMBULANCE CARE, REFERRAL OF SENIORS TO SUPPORTIVE COMMUNITY SERVICES, SUICIDE PREVENTION, SUBSTANCE ABUSE, AND BREASTFEEDING FOR IMPROVED CHILD HEALTH. THE ORGANIZATION PROVIDED TRAINING FOR MENTALLY CHALLENGED YOUNG ADULTS TO PREPARE THEM FOR GAINFUL EMPLOYMENT AND SELF-SUPPORT.</CommunityBuildingActivities>
        <OtherInformation>Part VI, Line 6: OPEN MEDICAL STAFF WITH ACTIVE RECRUITMENT OF PHYSICIANS IN SPECIALTY AREAS OF IDENTIFIED COMMUNITY NEED AND PLACEMENT OF PHYSICIANS IN COUNTY TO ENHANCE PATIENT ACCESS, PURSUIT OF GRANTS TO SUPPORT MAMMOGRAPHY SCREENING FOR INDIGENT WOMEN. SUPPORT OF EMPLOYEE VOLUNTARY EFFORTS TO SUPPLY FOOD BANKS FOR IMPROVED NUTRITION AND HEALTH PRODUCTS TO ENHANCE HYGIENE, PRO-ACTIVELY EDUCATING AND ENROLLING ELIGIBLE PEOPLE IN MEDICAID. SOLICITING DONATIONS TO SUBSIDIZE PRESCRIPTIONS AND TRANSPORTATION FOR PEOPLE IN NEED. THE ORGANIZATION'S EMPLOYEES SERVE ON VARIOUS HUMAN SERVICE AGENCY BOARDS THAT IMPACT SOCIAL OR MEDICAL ASPECTS OF HEALTH.</OtherInformation>
        <ReportsFiledWithStates>MI</ReportsFiledWithStates>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <ClubDuesOrFees>X</ClubDuesOrFees>
      <WrittenPolicyReTAndEExpenses>1</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>1</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>0</SeverancePayment>
      <SupplementalNonqualRetirePlan>0</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>0</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>0</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>0</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>0</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>0</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>0</AnyNonFixedPayments>
      <InitialContractException>0</InitialContractException>
      <Form990ScheduleJPartII>
        <NameBusiness>
          <BusinessNameLine1>Phillips Annette</BusinessNameLine1>
        </NameBusiness>
        <BaseCompensationFilingOrg>299354</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>64550</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>7039</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>4933</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>1873</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>377749</TotalCompensationFilingOrg>
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      <Form990ScheduleJPartII>
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          <BusinessNameLine1>Burgos Gilbert</BusinessNameLine1>
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      <Form990ScheduleJPartII>
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          <BusinessNameLine1>Sorosiak Michael J</BusinessNameLine1>
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          <BusinessNameLine1>SEALWILLIAM L</BusinessNameLine1>
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          <BusinessNameLine1>Moosa Mahmood F</BusinessNameLine1>
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      <Form990ScheduleJPartII>
        <NameBusiness>
          <BusinessNameLine1>Memon Mubeen A</BusinessNameLine1>
        </NameBusiness>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Line 1a</ReturnReference>
        <Explanation>SCHEDULE J PART I ITEM 1A THE HOSPITAL MAINTAINS A MEMBERSHIP WITH A COMMUNITY GOLF / COUNTRY CLUB. THE MEMBERSHIP IS INTENDED FOR THE GENERAL USE OF THE HOSPITAL, AND IS MAINTAINED UNDER THE NAME OF THE CEO (AS A REPRESENTATIVE MUST BE NAMED IN THIS INSTANCE). USE OF THE MEMBERSHIP IS MADE AVAILABLE FOR BUSINESS PURPOSES ONLY, AND PERSONAL USE IS PROHIBITED. FACILITIES AT THE COUNTRY CLUB ARE USED FOR HOSPITAL FUNCTIONS, BUSINESS MEETINGS, VOLUNTEER RECOGNITION, AND FUND RAISING.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>County of Monroe Hospital Finance Authority</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>386004873</IssuerEIN>
        <CUSIPNumber>610648AR8</CUSIPNumber>
        <DateIssued>2006-06-15</DateIssued>
        <IssuePrice>50405076</IssuePrice>
        <DescriptionOfPurpose>CONSTRUCTION PROJECT ADDING 58,995 SQ FEET; RENOVATING 66,910 SQ FT.</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <TotalProceeds>52639779</TotalProceeds>
        <AmountInReserveFund>3812411</AmountInReserveFund>
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        <CapitalExpenditures>36382719</CapitalExpenditures>
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        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
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        <AnyLeaseArrangements>0</AnyLeaseArrangements>
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        <AnyResearchAgreements>0</AnyResearchAgreements>
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        <GrossProceedsInvested>0</GrossProceedsInvested>
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    </IRS990ScheduleK>
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        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>MARY CARTER</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>FAMILY MEMBER OF KURT CARTER, BOARD MEMBER</Relationship>
        <AmountOfTransaction>19898</AmountOfTransaction>
        <DescriptionOfTransaction>EMPLOYMENT</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>LARRY CSOKASY</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
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        <AmountOfTransaction>98161</AmountOfTransaction>
        <DescriptionOfTransaction>EMPLOYMENT</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
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    </IRS990ScheduleL>
    <IRS990ScheduleM documentId="RetDoc1042900001">
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        <NonCashCheckbox>X</NonCashCheckbox>
        <NoncashContribsRptdF990>22750</NoncashContribsRptdF990>
        <MethodOfDeterminingRevenues>Cost or selling price</MethodOfDeterminingRevenues>
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        <MethodOfDeterminingRevenues>Cost or selling price</MethodOfDeterminingRevenues>
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        <Description>other</Description>
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        <MethodOfDeterminingRevenues>OPINIONS OF EXPERTS</MethodOfDeterminingRevenues>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 2</Identifier>
        <Explanation>Board members and officers of Mercy Memorial Hospital also serve on the board of Monroe Health Ventures (a 100% owned subsidiary). Dr. Kenneth McNamee and Dr. James Miller are both part-owners of Monroe Equipment Leasing.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 11</Identifier>
        <Explanation>Data was analyzed and reviewed by controller and submitted to certified public accounting firm for preparation. The completed 990 form was returned by the firm to the CFO and CEO for final review and approval. The 990 form was provided to the governing board before it was filed.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 12c</Identifier>
        <Explanation>On an annual basis, the hospital's conflict of interest policy and questionnaire is distributed to officers, employees, and trustees. Potential conflicts of interest are analyzed by the hospital's legal department and are given rankings of low, moderate and severe risk. This analysis is given to the board chair and the hospital's chief executive officer. Any member with an identified conflict of interest is excused from the meeting during discussions pertaining to the issue of conflict, and the member is not permitted to vote on any issue of conflict.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 15</Identifier>
        <Explanation>The Executive Compensation Committee of the Board of Trustees determines and approves all compensation for those designated in senior leadership positions such as: CEO and President, Chief Medical Officer and Vice President of Medical Affairs, Chief Financial Officer and Senior Vice President of Finance, Senior Vice President of Clinical Operations and Chief Nursing officer, and other vice-presidents. The independent board committee retains an outside consultant to analyze and assist in making these determinations through a variety of market surveys/studies. This process is undertaken annually.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section C, line 19</Identifier>
        <Explanation>DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Schedule K : Supplemental information</Identifier>
        <Explanation>Bond issue price was $50,405,076.35 with a redemption price of $49,550,000 at maturity. Proceeds of the issue were used for issuance costs, required reserve fund, refund prior issue bonds and indebtedness (02/01/1994 bonds) and building expansion and equipment.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Schedule R, Part V, Line 2:</Identifier>
        <Explanation>The cost of the services or items purchased for a related organization are recorded at market value.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A,LINE 6 :</Identifier>
        <Explanation>THE SOLE MEMBER HAS THE POWERS AND VOTING RIGHTS TO: (a) APPOINT, ELECT, AND REMOVE TRUSTEES; (b) APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION; (c) ADOPT, AMEND, OR REPEAL THE BYLAWS; (d) APPROVE EACH BUDGET AND LONG-RANGE PLAN;(e) APPROVE CONTRACT OR LOAN OBLIGATING THE CORPORATION TO EXPEND/REPAY AN AMOUNT IN EXCESS OF $50,000 WHICH WAS NOT INCLUDED IN PREVIOUSLY APPROVED BUDGET; (f) APPROVE CONTRACT OUTSIDE THE ORDINARY COURSE OF THE BUSINESS OF THE CORPORATION; (g) APPROVE ALL PLANS OF MERGER OR CONSOLIDATION; (h) APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION; AND (i) APPROVE A VOLUNTARY DISSOLUTION OF THE CORPORATION.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>MONROE COMMUNITY HEALTH SERVICES</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>718 N MACOMB STREET</AddressLine1>
          <City>MONROE</City>
          <State>MI</State>
          <ZIPCode>48164</ZIPCode>
        </AddressUS>
        <EIN>382934134</EIN>
        <PrimaryActivities>SKILLED NURSING AND OUTPATIENT SURGERY</PrimaryActivities>
        <LegalDomicileState>MI</LegalDomicileState>
        <ExemptCodeSection>Section 501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>LINE 9: 509(a)(2)</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
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          <BusinessNameLine1>MONROE HEALTH VENTURES</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>718 N MACOMB STREET</AddressLine1>
          <City>MONROE</City>
          <State>MI</State>
          <ZIPCode>48164</ZIPCode>
        </AddressUS>
        <EIN>382704426</EIN>
        <PrimaryActivity>PHARMACY</PrimaryActivity>
        <LegalDomicileState>MI</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
        <ShareOfTotalIncome>-51040</ShareOfTotalIncome>
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      <TransactionsRelatedOrgsTable>
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      <TransactionsRelatedOrgsTable>
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    </IRS990ScheduleR>
  </ReturnData>
</Return>