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        <PersonNm>Sabrina Cole</PersonNm>
        <TitleTxt>Physician</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>273469</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>30835</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2469086</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>205156</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>15</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Lakeland Medical Providers</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>100 Michigan Street NE</AddressLine1Txt>
            <CityNm>Grand Rapids</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49503</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>OB Doctors</ServicesDesc>
        <CompensationAmt>633828</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Mapletronics Computers</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 136</AddressLine1Txt>
            <CityNm>Goshen</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46527</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT Services</ServicesDesc>
        <CompensationAmt>512979</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Frederick Construction Inc</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>120 E Prairie St Suite C</AddressLine1Txt>
            <CityNm>Vicksburg</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49097</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Construction</ServicesDesc>
        <CompensationAmt>490587</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Parata Systems LLC</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>106 Rouche Dr</AddressLine1Txt>
            <CityNm>Durham</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27703</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Technology Solutions</ServicesDesc>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Smith Haughey Rice Roegge</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>100 Monrow Center St NW</AddressLine1Txt>
            <CityNm>Grand Rapids</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49503</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Legal Services</ServicesDesc>
        <CompensationAmt>158525</CompensationAmt>
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      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>3101130</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>88982</AllOtherContributionsAmt>
      <NoncashContributionsAmt>144598</NoncashContributionsAmt>
      <TotalContributionsAmt>3190112</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>10228473</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10228473</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>340B Rebate</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>774008</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>774008</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Incentive Program</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>596798</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>596798</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Other</Desc>
        <BusinessCd>621300</BusinessCd>
        <TotalRevenueColumnAmt>28075</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>28075</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>11627354</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>16012</TotalRevenueColumnAmt>
        <ExclusionAmt>16012</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2400000</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>1975602</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>424398</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>424398</TotalRevenueColumnAmt>
        <ExclusionAmt>424398</ExclusionAmt>
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      <GrossSalesOfInventoryAmt>17113278</GrossSalesOfInventoryAmt>
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        <TotalRevenueColumnAmt>7893791</TotalRevenueColumnAmt>
        <ExclusionAmt>7893791</ExclusionAmt>
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      <TotalRevenueGrp>
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      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>1324159</ProgramServicesAmt>
        <ManagementAndGeneralAmt>202007</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
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      <FeesForServicesLegalGrp>
        <TotalAmt>169036</TotalAmt>
        <ProgramServicesAmt>32885</ProgramServicesAmt>
        <ManagementAndGeneralAmt>136151</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>57465</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
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        <ProgramServicesAmt>760557</ProgramServicesAmt>
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      <OfficeExpensesGrp>
        <TotalAmt>902089</TotalAmt>
        <ProgramServicesAmt>645676</ProgramServicesAmt>
        <ManagementAndGeneralAmt>256413</ManagementAndGeneralAmt>
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      <InformationTechnologyGrp>
        <TotalAmt>557360</TotalAmt>
        <ProgramServicesAmt>354471</ProgramServicesAmt>
        <ManagementAndGeneralAmt>202889</ManagementAndGeneralAmt>
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      <OccupancyGrp>
        <TotalAmt>155403</TotalAmt>
        <ProgramServicesAmt>118048</ProgramServicesAmt>
        <ManagementAndGeneralAmt>37355</ManagementAndGeneralAmt>
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      <ConferencesMeetingsGrp>
        <TotalAmt>55329</TotalAmt>
        <ProgramServicesAmt>21350</ProgramServicesAmt>
        <ManagementAndGeneralAmt>33979</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>383238</TotalAmt>
        <ManagementAndGeneralAmt>383238</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
        <TotalAmt>968649</TotalAmt>
        <ProgramServicesAmt>783778</ProgramServicesAmt>
        <ManagementAndGeneralAmt>184871</ManagementAndGeneralAmt>
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      <InsuranceGrp>
        <TotalAmt>92378</TotalAmt>
        <ProgramServicesAmt>58649</ProgramServicesAmt>
        <ManagementAndGeneralAmt>33729</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Medical Supplies</Desc>
        <TotalAmt>1251030</TotalAmt>
        <ProgramServicesAmt>1251030</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>Repair and maintenance</Desc>
        <TotalAmt>218774</TotalAmt>
        <ProgramServicesAmt>165441</ProgramServicesAmt>
        <ManagementAndGeneralAmt>53333</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Outreach</Desc>
        <TotalAmt>165697</TotalAmt>
        <ProgramServicesAmt>165697</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Recruiting</Desc>
        <TotalAmt>44078</TotalAmt>
        <ProgramServicesAmt>24498</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19580</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>111016</TotalAmt>
        <ProgramServicesAmt>14731</ProgramServicesAmt>
        <ManagementAndGeneralAmt>96285</ManagementAndGeneralAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>20235346</TotalAmt>
        <ProgramServicesAmt>16120100</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4115246</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>6985280</BOYAmt>
        <EOYAmt>7999795</EOYAmt>
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      <SavingsAndTempCashInvstGrp>
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      <AccountsReceivableGrp>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>258473</BOYAmt>
        <EOYAmt>286692</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>24166389</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>6274007</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>17334998</BOYAmt>
        <EOYAmt>17892382</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>480018</EOYAmt>
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      <OtherAssetsTotalGrp>
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      <TotalAssetsGrp>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>5427000</EOYAmt>
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      <OtherLiabilitiesGrp>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>7076802</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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        <EOYAmt>32763031</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>29445784</BOYAmt>
        <EOYAmt>32763031</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>36741350</BOYAmt>
        <EOYAmt>39839833</EOYAmt>
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      <ReconcilationRevenueExpnssAmt>2916321</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>400926</NetUnrlzdGainsLossesInvstAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>2993236</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4219019</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4156286</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>3564544</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3190112</CurrentTaxYearAmt>
        <TotalAmt>18123197</TotalAmt>
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      <GrossReceiptsAdmissionsGrp>
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        <CurrentTaxYearMinus3YearsAmt>15890734</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>20487251</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>24339284</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>28740632</CurrentTaxYearAmt>
        <TotalAmt>101095416</TotalAmt>
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      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>14630751</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>20109753</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>24643537</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>27903828</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>31930744</CurrentTaxYearAmt>
        <TotalAmt>119218613</TotalAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
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      <PublicSupportTotal509Amt>119218613</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
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        <CurrentTaxYearMinus2YearsAmt>53508</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7751</CurrentTaxYearMinus1YearAmt>
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        <CurrentTaxYearMinus3YearsAmt>67445</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>53508</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>7751</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>16012</CurrentTaxYearAmt>
        <TotalAmt>220863</TotalAmt>
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        <CurrentTaxYearAmt>31946756</CurrentTaxYearAmt>
        <TotalAmt>119439476</TotalAmt>
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      <PublicSupportCY509Pct>0.99820</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99720</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00180</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00280</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
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    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
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    <IRS990ScheduleD documentId="RetDoc1040000001">
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        <OtherCostOrOtherBasisAmt>183710</OtherCostOrOtherBasisAmt>
        <BookValueAmt>183710</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
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        <DepreciationAmt>3641311</DepreciationAmt>
        <BookValueAmt>15856079</BookValueAmt>
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      <EquipmentGrp>
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        <DepreciationAmt>2632696</DepreciationAmt>
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      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>216232</OtherCostOrOtherBasisAmt>
        <BookValueAmt>216232</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>17892382</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
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      <NetUnrealizedGainsInvstAmt>400926</NetUnrealizedGainsInvstAmt>
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      <RevenueSubtotalAmt>23151667</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>23151667</TotalRevenuePerForm990Amt>
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      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>20235346</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
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      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, Line 2d - Other Adjustments:</FormAndLineReferenceDesc>
        <ExplanationTxt>COGS 9,219,487.</ExplanationTxt>
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      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
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      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
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      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
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      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
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      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mary Middleton</PersonNm>
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        <PersonNm>Matthew Pazderka</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Harris Shaikh</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Sabrina Cole</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Alexander Schneider</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>John Zakhary</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Joseph Gavan</PersonNm>
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        <PersonNm>Tammy Howard</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kyleigh Kramb</PersonNm>
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    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="RetDoc1042900001">
      <DrugsAndMedicalSuppliesGrp>
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        <ContributionCnt>1765</ContributionCnt>
        <NoncashContributionsRptF990Amt>144598</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Dose Amount</MethodOfDeterminingRevenuesTxt>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 must be approved by the Board prior to filing</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Cassopolis Family Clinic provides the forms from the previous year at the Board of Directors Meeting. They inquire if there are updates and discuss any changes or issues of concern. Board members sign/re-sign the conflict of interest forms at the January board meeting. They must abstain from a vote if there is a conflict of interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Cassopolis Family Clinic uses salary surveys, including medical group management association and Guidestar for Non-Profit for CEO and other officer/key employee salary comparisons. Directors and the Executive Director have annual contracts and all payroll increases and salary reviews are approved by the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Documents are open to public inspection upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>