TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) CHRISTOPHER J BLAKE...................................................................... DIRECTOR	2.00 ................. 6.00	X			0	0
(2) GERSON COOPER...................................................................... VICE-CHAIRMAN	2.00 ................. 12.00	X			0	0
(3) JOHN T FOX...................................................................... PRESIDENT AND CEO (START 3/15/15)	50.00 ................. 8.00	X	X		1,951,887	364,015
(4) JULIE FREAM...................................................................... SECRETARY	2.00 ................. 8.00	X	X		0	0
(5) MALCOLM HENOCH MD...................................................................... DIRECTOR	2.00 ................. 56.00	X			735,079	190,964
(6) STEPHEN R HOWARD...................................................................... VICE-CHAIRMAN	2.00 ................. 6.00	X			0	0
(7) JOHN LEWIS...................................................................... CHAIRMAN	2.00 ................. 6.00	X			0	0
(8) HARRIS MAINSTER DO...................................................................... DIRECTOR	2.00 ................. 8.00	X			9,151	0
(9) EUGENE F MICHALSKI...................................................................... PRESIDENT & CEO (THRU 3/15/15)	50.00 ................. 2.00	X	X		1,187,812	38,194
(10) JOHN NEMES...................................................................... TREASURER	2.00 ................. 10.00	X	X		0	0
(11) TIMOTHY O'BRIEN...................................................................... DIRECTOR	2.00 ................. 6.00	X			0	0
(12) MARTHA JAMES QUAY...................................................................... DIRECTOR	2.00 ................. 6.00	X			0	0
(13) THOMAS SAELI...................................................................... DIRECTOR	2.00 ................. 6.00	X			0	0
(14) S EVAN WEINER...................................................................... DIRECTOR	2.00 ................. 6.00	X			0	0
(15) DAVID WOOD MD...................................................................... DIRECTOR	50.00 ................. 8.00	X			716,248	255,484
(16) JOHN KEUTEN...................................................................... EXEC VP - CHIEF FINANCIAL OFFICER	50.00 ................. 10.00		X		879,465	268,893
(17) BRIAN CONNOLLY...................................................................... PRESIDENT NETWORK DEVP	50.00 ................. 4.00			X	2,296,749	554,296

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

BEAUMONT HEALTH

Employer identification number

46-5718220

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............. 3

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 9 above (see instructions))	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) BOTSFORD GENERAL HOSPITAL	381426919	3	Yes		0	5,169,175
(B) OAKWOOD HEALTHCARE INC	381405141	3	Yes		0	10,000,868
(C) WILLIAM BEAUMONT HOSPITAL	381459362	3	Yes		0	19,845,485
Total 3					0	35,015,528

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Yes

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Yes

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

Yes

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Yes

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Yes

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Yes

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
SCHEDULE A, PART 1, LINE 11G, COLUMN (VI)	BEAUMONT HEALTH IS ORGANIZED TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF BOTSFORD GENERAL HOSPITAL, OAKWOOD HEALTHCARE, INC. AND WILLIAM BEAUMONT HOSPITAL (THE "SUPPORTED ORGANIZATIONS"). BEAUMONT HEALTH PROVIDED PROGRAM ADMINISTRATION SUPPORT SERVICES TO THE SUPPORTED ORGANIZATIONS DURING ITS 2015 TAX YEAR.
SCHEDULE A, PART IV, SECTION D, LINE 3	BEAUMONT HEALTH IS THE PARENT AND SUPPORTING ORGANIZATION OF AN INTEGRATED HEALTH CARE SYSTEM CONSISTING OF BOTSFORD GENERAL HOSPITAL, OAKWOOD HEALTHCARE, INC., AND WILLIAM BEAUMONT HOSPITAL (THE "SUPPORTED ORGANIZATIONS"). BEAUMONT HEALTH MANAGES AND DIRECTS THE SUPPORTED ORGANIZATIONS' DELIVERY OF HEALTH CARE INCLUDING PROVIDING LONG-RANGE AND STRATEGIC PLANNING, FINANCIAL CONTROL, AND PROGRAMS AND POLICIES THAT CAUSE THE SUPPORTED ORGANIZATIONS TO FUNCTION AS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. BEAUMONT HEALTH'S GOVERNING BODY IS COMPOSED OF AT LEAST ONE OR MORE MEMBERS OF THE GOVERNING BODIES OF EACH OF THE SUPPORTED ORGANIZATIONS. IN ADDITION, THERE IS AN OVERLAP OF OFFICERS BETWEEN ORGANIZATIONS TO HELP ENSURE THAT THERE IS A CLOSE AND CONTINUOUS WORKING RELATIONSHIP WITH EACH SUPPORTED ORGANIZATION. THE SUPPORTED ORGANIZATIONS HAVE A SIGNIFICANT VOICE IN BEAUMONT HEALTH'S OPERATIONS, INCLUDING THE USE OF ITS INCOME OR ASSETS. FOR EXAMPLE, BUDGETS ARE SUBMITTED BY THE SUPPORTED ORGANIZATIONS TO BEAUMONT HEALTH FOR APPROVAL. THIS SUBMISSION ALLOWS THE SUPPORTED ORGANIZATIONS TO ARTICULATE THEIR NEEDS (BUDGETING, CAPITAL ACQUISITIONS, OPERATING CASH FLOW, ETC.) FOR CONSIDERATION OF FUNDING. IN ADDITION, THE SUPPORTED ORGANIZATIONS HAVE INPUT INTO ALL THE INVESTMENT POLICIES OF BEAUMONT HEALTH THROUGH EACH SUPPORTED ORGANIZATION'S PRESENCE ON THE GOVERNING BOARD OF BEAUMONT HEALTH.
SCHEDULE A, PART IV, SECTION E, LINE 3A	BEAUMONT HEALTH IS SOLELY RESPONSIBLE FOR THE DIRECT APPOINTMENT OR ELECTION OF THE OFFICERS, DIRECTORS AND TRUSTEES OF EACH OF THE SUPPORTED ORGANIZATIONS.
SCHEDULE A, PART IV, SECTION E, LINE 3B	BEAUMONT HEALTH IS ORGANIZED TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF BOTSFORD GENERAL HOSPITAL, OAKWOOD HEALTHCARE, INC. AND WILLIAM BEAUMONT HOSPITAL (THE "SUPPORTED ORGANIZATIONS"). BEAUMONT HEALTH FUNCTIONS AS AN INTEGRATED OPERATING COMPANY THAT MANAGES AND DIRECTS THE SUPPORTED ORGANIZATIONS' DELIVERY OF HEALTH CARE, INCLUDING PROVIDING LONG-RANGE AND STRATEGIC PLANNING, FINANCIAL CONTROL, AND PROGRAMS AND POLICIES THAT CAUSE THE SUPPORTED ORGANIZATIONS TO FUNCTION AS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. BEAUMONT HEALTH IS RESPONSIBLE FOR THE OVERALL COORDINATION AND SUPERVISION OF THE HEALTH SYSTEM'S SUPPORTED ORGANIZATIONS AND IS RESPONSIBLE FOR APPROVAL OF THE SUPPORTED ORGANIZATIONS' BUDGETS, STRATEGIC PLANNING, MARKETING, RESOURCE ALLOCATION, AND COMMUNITY BENEFIT ACTIVITIES. BEAUMONT HEALTH ALSO IS RESPONSIBLE FOR THE MANAGEMENT AND INVESTMENT OF THE ENDOWMENTS OF THE SUPPORTED ORGANIZATIONS.

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

BEAUMONT HEALTH

Employer identification number

46-5718220

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOHN T FOXPRESIDENT AND CEO (START 3/15/15)	(i) (ii)	0 ------------- 1,298,411	0 ------------- 250,000	0 ------------- 403,476	0 ------------- 346,753	0 ------------- 17,262	0 ------------- 2,315,902	0 ------------- 0
2MALCOLM HENOCH MDDIRECTOR	(i) (ii)	0 ------------- 442,622	0 ------------- 261,960	0 ------------- 30,497	0 ------------- 171,333	0 ------------- 19,631	0 ------------- 926,043	0 ------------- 114,250
3EUGENE F MICHALSKIPRESIDENT & CEO (THRU 3/15/15)	(i) (ii)	0 ------------- 392,121	0 ------------- 175,040	0 ------------- 620,651	0 ------------- 15,850	0 ------------- 22,344	0 ------------- 1,226,006	0 ------------- 0
4DAVID WOOD MDDIRECTOR	(i) (ii)	0 ------------- 680,318	0 ------------- 3,120	0 ------------- 32,810	0 ------------- 243,269	0 ------------- 12,215	0 ------------- 971,732	0 ------------- 0
5JOHN KEUTENEXEC VP - CHIEF FINANCIAL OFFICER	(i) (ii)	0 ------------- 549,959	0 ------------- 282,736	0 ------------- 46,770	0 ------------- 245,253	0 ------------- 23,640	0 ------------- 1,148,358	0 ------------- 116,538
6BRIAN CONNOLLYPRESIDENT NETWORK DEVP	(i) (ii)	0 ------------- 849,554	0 ------------- 775,058	0 ------------- 672,137	0 ------------- 503,271	0 ------------- 51,025	0 ------------- 2,851,045	0 ------------- 388,452
7J PAUL CONWAYSR VP - CHIEF HR OFFICER	(i) (ii)	0 ------------- 341,057	0 ------------- 141,610	0 ------------- 33,374	0 ------------- 187,247	0 ------------- 23,352	0 ------------- 726,640	0 ------------- 70,246
8SAMUEL FLANDERS MDEXEC VP - QUALITY & SAFETY	(i) (ii)	0 ------------- 517,125	0 ------------- 185	0 ------------- 34,398	0 ------------- 88,712	0 ------------- 18,871	0 ------------- 659,291	0 ------------- 0
9SUSAN GRANTEXEC VP - CHIEF NURSING OFFICER	(i) (ii)	0 ------------- 36,869	0 ------------- 125,000	0 ------------- 25,000	0 ------------- 0	0 ------------- 0	0 ------------- 186,869	0 ------------- 0
10PAUL LACASSE DOEXEC VP - POST-ACUTE CARE / DIVERSE	(i) (ii)	0 ------------- 509,885	0 ------------- 0	0 ------------- 47,928	0 ------------- 15,900	0 ------------- 19,668	0 ------------- 593,381	0 ------------- 0
11SUBRA SRIPADAEXEC VP - CAO & CIO	(i) (ii)	0 ------------- 526,799	0 ------------- 225	0 ------------- 30,235	0 ------------- 169,288	0 ------------- 17,623	0 ------------- 744,170	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 3	BOTSFORD GENERAL HOSPITAL, OAKWOOD HEALTHCARE, INC., AND WILLIAM BEAUMONT HOSPITAL, RELATED TAX-EXEMPT ORGANIZATIONS OF BEAUMONT HEALTH, USE THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT CONSULTANTS - WRITTEN EMPLOYMENT CONTRACTS - COMPENSATION SURVEYS AND STUDIES - APPROVAL BY BOARD OR COMPENSATION COMMITTEE
SCHEDULE J, PART I, LINE 4A	FOR SOME INDIVIDUALS, THE EMPLOYMENT AGREEMENT MAY PROVIDE IF THE EMPLOYER TERMINATES THE AGREEMENT AND THE PARTIES SEPARATE OTHER THAN FOR CAUSE, THE EMPLOYEE MAY BE ENTITLED TO SEVERANCE PAY. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM THE COMPANY. SEVERANCE PAYMENTS WERE MADE DURING THE TAX YEAR TO THE FOLLOWING INDIVIDUAL LISTED IN PART VII: EUGENE MICHALSKI, SEVERANCE PAYMENT, $589,622
SCHEDULE J, PART I, LINE 4B	BEAUMONT HEALTH HAS NO EMPLOYEES. ITS SUPPORTED ORGANIZATIONS PROVIDE CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN OFFICERS, KEY EMPLOYEES AND PHYSICIANS. THESE BENEFITS ARE PROVIDED THROUGH A NON QUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH THE BENEFITS BEING EARNED ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. TO BECOME ENTITLED TO THE BENEFITS BEING PROVIDED, EACH COVERED EMPLOYEE MUST MEET SPECIFIED REQUIREMENTS RELATING TO FURTHER EMPLOYMENT. UNTIL THOSE REQUIREMENTS ARE SATISFIED, THE EMPLOYEE IS NOT ENTITLED TO THESE AMOUNTS. IF THE EMPLOYEE WERE TO HAVE TERMINATED EMPLOYMENT VOLUNTARILY IN THE YEAR TO WHICH THIS RETURN APPLIES, THOSE SUPPLEMENTAL RETIREMENT BENEFITS WOULD NOT HAVE BEEN PAID OUT. IT SHOULD BE NOTED THAT THESE SUPPLEMENTAL RETIREMENT BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR ALL YEARS OF SERVICE THAT THE EMPLOYEE PROVIDES TO THE ORGANIZATION. ANY RETIREMENT BENEFITS SHOULD BE VIEWED AS APPLYING TO THE ENTIRE LENGTH OF THE EMPLOYEE'S SERVICE TO THE ORGANIZATION. BRIAN CONNOLLY, NON-QUALIFIED PLAN DISTRIBUTION, SERP 457(F), $599,757

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

BEAUMONT HEALTH

Employer identification number

46-5718220

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	PAUL LACASSE AND GERSON COOPER HAVE A BUSINESS RELATIONSHIP AS THEY ARE BOARD MEMBERS OR SHARED OFFICERS OF A TAXABLE ENTITY WITHIN THE BEAUMONT HEALTH SYSTEM.
FORM 990, PART VI, SECTION B, LINE 11	THE 2015 FORM 990 WAS SUBJECTED TO A MULTI-STEP REVIEW PROCESS CULMINATING IN THE PROVISION OF SUCH FORM TO ALL VOTING MEMBERS OF THE BEAUMONT HEALTH BOARD OF DIRECTORS PRIOR TO ITS FILING. THE FORM 990 IS PREPARED BY BEAUMONT'S DIRECTOR OF TAX AND REVIEWED BY LEADERSHIP WITHIN THE FINANCE DEPARTMENT FOR COMPLETENESS AND CORRECTNESS. THE FORM 990 IS THEN REVIEWED BY THE CORPORATION'S OUTSIDE ACCOUNTING FIRM. AS THE FINAL STEP IN THE MULTI-LEVEL REVIEW PROCESS, A COPY OF THE FINAL VERSION OF THE FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF BEAUMONT HEALTH'S GOVERNING BODY FOR THEIR REVIEW BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	BEAUMONT HEALTH RECOGNIZES THAT IT HAS AN OBLIGATION TO ITS PATIENTS, ITS PAYERS, ITS DESIGNEES AND THE COMMUNITIES IT SERVES, THROUGH ITS SUPPORTED ORGANIZATIONS, TO OBSERVE THE HIGHEST LEVEL OF INTEGRITY TO ENSURE CLINICAL, BUSINESS AND ACADEMIC DECISION MAKING IS NOT COMPROMISED BY FINANCIAL OR OTHER RELATIONSHIPS WITH INDUSTRY. THE CORPORATE RESPONSIBILITY OFFICE COORDINATES A PROCESS OF OBTAINING CONFLICT OF INTEREST/DISCLOSURE OF REMUNERATION STATEMENTS. AT ANY TIME WHEN A DESIGNEE BECOMES INVOLVED IN A RELATIONSHIP THAT IS OR MAY BE PERCEIVED TO BE A CONFLICT OF INTEREST, THE DESIGNEE MUST COMPLETE THE CONFLICT OF INTEREST/DISCLOSURE OF REMUNERATION STATEMENT AND FORWARD TO THE CORPORATE RESPONSIBILITY OFFICER. A CONFLICT OF INTEREST OR NEED TO DISCLOSE REMUNERATION MAY EXIST IF A BEAUMONT HEALTH DESIGNEE OR ANY MEMBER OF THEIR IMMEDIATE FAMILY RECEIVES COMPENSATION IN ANY FORM FOR SERVICES RENDERED IN ANY CAPACITY TO ANY ORGANIZATION OR INDIVIDUAL THAT HAS ANY PAST, PRESENT OR PROSPECTIVE BUSINESS DEALINGS WITH BEAUMONT HEALTH, IF SUCH COMPENSATION MIGHT BE REASONABLY CONSTRUED AS TENDING TO PREVENT THE DESIGNEE FROM ACTING SOLELY AND WHOLLY IN THE BEST INTEREST OF BEAUMONT HEALTH.
FORM 990, PART VI, SECTION B, LINE 15	BEAUMONT HEALTH HAS NO EMPLOYEES. THE INDIVIDUALS RESPONSIBLE FOR THE DAY-TO-DAY ACTIVITIES OF THE ORGANIZATION ARE EMPLOYED BY AND COMPENSATED BY THE SUPPORTED ORGANIZATIONS. EACH SUPPORTED ORGANIZATION HAS WRITTEN POLICIES AND PROCEDURES THAT WERE ADOPTED BY THE BOARD OF DIRECTORS TO REVIEW COMPENSATION ARRANGEMENTS WITH CERTAIN PERSONS. EACH SUPPORTED ORGANIZATION HAS COMMITTEES THAT REVIEW THE COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES OF BEAUMONT HEALTH. THE COMMITTEES REVIEW PROCESSES ARE DESIGNED TO SATISFY THE PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. THE COMMITTEES HAVE EXPRESSLY DETERMINED THAT THE TOTAL COMPENSATION PROVIDED IS REASONABLE, BASED ON THE REVIEW OF THE MARKET DATA PRESENTED BY AN INDEPENDENT COMPENSATION CONSULTANT AND THE REVIEW OF ALL OTHER RELEVANT FACTS AND CIRCUMSTANCES.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION WILL PROVIDE THE LISTED DOCUMENTS TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	OUTSIDE CONSULTING FEES: PROGRAM SERVICE EXPENSES 2,636,698. MANAGEMENT AND GENERAL EXPENSES 3,340,301. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,976,999. IT HARDWARE CONSULTING: PROGRAM SERVICE EXPENSES 974,637. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 974,637. IT SOFTWARE CONSULTING: PROGRAM SERVICE EXPENSES 8,287,583. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,287,583.
990 PART XII, LINE 2C	IN 2015, BEAUMONT HEALTH, THE PARENT ORGANIZATION AND SOLE MEMBER OF BOSTFORD GENERAL HOSPITAL, OAKWOOD HEALTHCARE, INC., AND WILLIAM BEAUMONT HOSPITAL, RESOLVED TO SELECT ONE INDEPENDENT ACCOUNTING FIRM FOR THE SYSTEM, AND PUT THE WORK OUT TO BID WITH SEVERAL QUALIFIED FIRMS. AFTER REVIEW OF THE FIRMS' PROPOSALS AND CONSIDERATION OF THE QUALIFICATIONS OF EACH, THE FINAL DECISION WAS MADE BY THE GOVERNING BODY OF BEAUMONT HEALTH.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

BEAUMONT HEALTH

Employer identification number

46-5718220

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)BEAUMONT MEDICAL TRANSPORTATION SERVICE 950 W MAPLE SUITE C TROY,MI48084 26-0203703	MEDICAL TRANSPORTATION SERVICES	MI	501(C)(3)	9	WILLIAM BEAUMONT HOSPITAL	Yes
(2)BOTSFORD CONTINUING CARE CORPORATION 28050 GRAND RIVER AVENUE FARMINGTON HILLS,MI48336 38-2549505	LONG TERM NURSING CARE	MI	501(C)(3)	9	BOTSFORD GENERAL HOSPITAL	Yes
(3)BOTSFORD GENERAL HOSPITAL 28050 GRAND RIVER AVENUE FARMINGTON HILLS,MI48336 38-1426919	HOSPITAL	MI	501(C)(3)	3	BEAUMONT HEALTH	Yes
(4)COMMUNITY EMERGENCY MEDICAL SERVICE INC 25400 W EIGHT MILE ROAD SOUTHFIELD,MI48033 38-2410823	EMERGENCY MEDICAL SERVICES	MI	501(C)(3)	9	BOTSFORD GENERAL HOSPITAL	Yes
(5)HEALTHLINK MEDICAL TRANSPORTATION SERVICES INC 26150 NORTHLINE ROAD TAYLOR,MI48180 38-3338298	MEDICAL TRANSPORTATION SERVICES	MI	501(C)(3)	9	COMMUNITY EMERGENCY MEDICAL SERVICE INC	Yes
(6)MICHIGAN MOBILE PET IMAGING 15500 LUNDY PARKWAY DEARBORN,MI48126 33-1086165	MOBILE PET SCANNING	MI	501(C)(3)	11A, I	OAKWOOD HEALTHCARE INC	Yes
(7)OAKWOOD HEALTHCARE INC 15500 LUNDY PARKWAY DEARBORN,MI48126 38-1405141	HOSPITAL	MI	501(C)(3)	3	BEAUMONT HEALTH	Yes
(8)OAKWOOD UNITED HOSPITALS INC 15500 LUNDY PARKWAY DEARBORN,MI48126 38-2837961	FACILITY LEASING	MI	501(C)(3)	11A, I	OAKWOOD HEALTHCARE INC	Yes
(9)OAKWOOD HOME CARE SERVICES 1633 FAIRLANE CIRCLE NO 100 ALLEN PARK,MI48101 38-2877338	HOME HEALTH SERVICES	MI	501(C)(3)	9	OAKWOOD HEALTHCARE INC	Yes
(10)OAKWOOD HEALTH PROMOTIONS INC 16351 ROTUNDA DRIVE DEARBORN,MI48120 38-2601965	ASSISTED AND RESIDENT CARE FACILITIES	MI	501(C)(3)	9	OAKWOOD HEALTHCARE INC	Yes
(11)OAKWOOD HEALTHCARE FOUNDATION 15500 LUNDY PARKWAY DEARBORN,MI48126 38-3432073	FOUNDATION	MI	501(C)(3)	11A, I	OAKWOOD HEALTHCARE INC	Yes
(12)WILLIAM BEAUMONT HOSPITAL 16500 WEST TWELVE MILE ROAD SOUTHFIELD,MI48076 38-1459362	HOSPITAL	MI	501(C)(3)	3	BEAUMONT HEALTH	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) BEAUMONT KIDNEY SPECIALTY SERVICES LLC 26400 WEST TWELVE MILE ROAD SOUTHFIELD,MI48034 26-2200439	DIALYSIS SERVICES	MI	WILLIAM BEAUMONT HOSPITAL	RELATED	-194,732	1,222,269		No			No	55.900 %
(2) BOTSFORD CARE PARTNERS LLC 28050 GRAND RIVER AVENUE FARMINGTON HILLS,MI48336 45-4854213	HEALTHCARE SERVICES	MI	BOTSFORD GENERAL HOSPITAL	RELATED		1,292,749	Yes				No	50.000 %
(3) DEARBORN SCHAEFFER OFFICE COMPANY LLC ONE TOWNE SQUARE SUITE 1600 SOUTHFIELD,MI48076 26-2448025	REAL ESTATE	MI	OAKWOOD HEALTHCARE INC	RELATED	911,573	38,093,314		No	-3,361		No	99.000 %
(4) OAKMED LLC 1938 WOODSLEE DRIVE TROY,MI48083 46-1459737	PRIVATE DUTY NURSING	MI	OAKWOOD HEALTHCARE INC	RELATED	229,079	520,115		No			No	60.000 %
(5) BEAUMONT HEALTH POOLED INVESTMENT PARTNERSHIP 16500 WEST TWELVE MILE ROAD SOUTHFIELD,MI48076 61-1775558	INVESTMENT MANAGEMENT	MI	OAKWOOD HEALTHCARE FOUNDATION	RELATED	543,560	51,740,229		No		Yes		100.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) BEAUMONT INDEMNITY COMPANY LTD 23 LIME TREE BAY AVENUE GRAND CAYMAN,GRAND CAYMAN CJ 98-0512415	PREMIUM DEPOSITS	CJ	WILLIAM BEAUMONT HOSPITAL	C		53,834,778	100.000 %	Yes
(2) BEAUMONT NURSING HOME SERVICES INC 16500 WEST TWELVE MILE ROAD SOUTHFIELD,MI48076 38-2799842	ASSISTED CARE LIVING	MI	WILLIAM BEAUMONT HOSPITAL	C	2,973,096	7,302,081	100.000 %	Yes
(3) BEAUMONT PHYSICIANS INSURANCE COMPANY INC 16500 WEST TWELVE MILE ROAD SOUTHFIELD,MI48076 27-4261262	PROFESSIONAL INSURANCE	MI	WILLIAM BEAUMONT HOSPITAL	C	-7,584	2,871,163	100.000 %	Yes
(4) BOTSFORD COMMONS PROPERTY ASSOCIATION 28050 GRAND RIVER AVENUE FARMINGTON HILLS,MI48336 38-3203663	PROPERTY MANAGEMENT	MI	BOTSFORD CONTINUING CARE CORPORATION	C		70,401	100.000 %	Yes
(5) CAPITAL RISK SOLUTIONS PO BOX 1109GT STRATHVALE HOUSE GEORGETOWN,GRAND CAYMAN CJ 38-1426919	CAPTIVE INSURANCE (CELL)	CJ	BOTSFORD GENERAL HOSPITAL	C	173,042		100.000 %	Yes
(6) OAKWOOD AFFILIATED VENTURES INC AND SUBSIDIARIES 15500 LUNDY PARKWAY DEARBORN,MI48126 37-1753159	OFFICE OF PHYSICIANS/NON-RESIDENTIAL RENTAL	MI	OAKWOOD HEALTHCARE INC	C	-2,122,790	55,287,276	100.000 %	Yes
(7) OAKWOOD ASSURANCE COMPANY LTD BARCLAYS HOUSE 3RD FLOOR SHEDDEN GEORGETOWN,GRAND CAYMAN CJ 98-0128325	REINSURANCE	CJ	OAKWOOD HEALTHCARE INC	C		48,051,151	100.000 %	Yes
(8) PARASTAR EMERGENCY SYSTEMS INC 25250 W EIGHT MILE ROAD SOUTHFIELD,MI48034 38-2755982	MANAGEMENT AND DISPATCH SERVICES	MI	COMMUNITY EMERGENCY MEDICAL SERVICE INC	C	-1,538,718	4,863,972	100.000 %	Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) WILLIAM BEAUMONT HOSPITAL	Q	19,845,485	FMV
(2) OAKWOOD HEALTHCARE INC	Q	10,000,867	FMV
(3) BOTSFORD GENERAL HOSPITAL	Q	5,169,176	FMV

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	2,987,563	35,015,528
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	0	0
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,987,563	35,015,528
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	2,902,881
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	2,987,563	32,112,647
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,987,563	35,015,528
19	Revenue less expenses. Subtract line 18 from line 12.......	0	0
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	0	0
21	Total liabilities (Part X, line 26).............	0	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	0	0

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 28,764,021 including grants of $ ) (Revenue $ 35,015,528 )
	BEAUMONT HEALTH, A MICHIGAN NON-PROFIT CORPORATION, IS THE PARENT CORPORATION OVERSEEING THE TAX-EXEMPT HEALTHCARE SYSTEMS OF BOTSFORD GENERAL HOSPITAL, OAKWOOD HEALTHCARE, INC. AND WILLIAM BEAUMONT HOSPITAL (THE "SUPPORTED ORGANIZATIONS"). THROUGH ITS OVERSIGHT, BEAUMONT HEALTH AND ITS SUPPORTED ORGANIZATIONS PROVIDE HIGH QUALITY, EFFICIENT AND ACCESSIBLE HEALTH SERVICES IN A CARING ENVIRONMENT, FURNISH CHARITY CARE AND COMMUNITY SERVICE, AND ARE ESSENTIAL CONTRIBUTORS TO THE HEALTH AND WELL-BEING OF INDIVIDUALS AND FAMILIES IN THE COMMUNITIES SERVED BY THE SUPPORTED ORGANIZATIONS. BEAUMONT HEALTH MANAGES AND DIRECTS THE SUPPORTED ORGANIZATIONS' DELIVERY OF HEALTH CARE THROUGH PROVIDING LONG-RANGE AND STRATEGIC PLANNING, FINANCIAL CONTROL, AND PROGRAMS AND POLICIES.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses28,764,021

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) J PAUL CONWAY........................................................................ SR VP - CHIEF HR OFFICER	50.00 .......................6.00	X	0	516,041	210,599
(19) SAMUEL FLANDERS MD........................................................................ EXEC VP - QUALITY & SAFETY	50.00 .......................0.00	X	0	551,708	107,583
(20) SUSAN GRANT........................................................................ EXEC VP - CHIEF NURSING OFFICER	50.00 .......................0.00	X	0	186,869	0
(21) PAUL LACASSE DO........................................................................ EXEC VP - POST-ACUTE CARE / DIVERSE BUS OPS	50.00 .......................10.00	X	0	557,813	35,568
(22) SUBRA SRIPADA........................................................................ EXEC VP - CAO & CIO	50.00 .......................2.00	X	0	557,259	186,911

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	10,146,081	2,212,507

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE OVERSIGHT AND LONG TERM STRATEGIC MANAGEMENT OF BEAUMONT HEALTH'S SUPPORTED ORGANIZATIONS, IN ORDER TO ENHANCE THEIR ABILITY TO CONTINUE 1) TO PROVIDE HIGH QUALITY, EFFICIENT AND ACCESSIBLE HEALTHCARE SERVICES IN A CARING ENVIRONMENT, AND 2) TO BE AN ESSENTIAL CONTRIBUTOR TO THE HEALTH AND WELL-BEING OF INDIVIDUALS AND FAMILIES, REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES IN THE COMMUNITIES SERVED.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	10
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......

			Business Code
2a	PROG ADMIN SUPPORT SVC	561000	35,015,528	35,015,528
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			35,015,528

3 Investment income (including dividends, interest, and othersimilar amounts) ..........
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			35,015,528	35,015,528	0	0

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	2,902,881		2,902,881
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	8,325		8,325
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	15,239,219	11,898,918	3,340,301
12	Advertising and promotion ....	633,011	633,011
13	Office expenses .......	170,050	170,050
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	97,463	97,463
17	Travel ............	79,674	79,674
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	169,994	169,994
20	Interest ...........	9,880,094	9,880,094
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...	4,613,315	4,613,315
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DUES AND SUBSCRIPTIONS	1,153,999	1,153,999
b
c
d
e	All other expenses	67,503	67,503
25	Total functional expenses. Add lines 1 through 24e	35,015,528	28,764,021	6,251,507	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1
2	Savings and temporary cash investments .........			2
3	Pledges and grants receivable, net ......			3
4	Accounts receivable, net .............			4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				6
7	Notes and loans receivable, net ....			7
8	Inventories for sale or use ........			8
9	Prepaid expenses and deferred charges ......			9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c
11	Investments—publicly traded securities .			11
12	Investments—other securities. See Part IV, line 11 .....			12
13	Investments—program-related. See Part IV, line 11 ..			13
14	Intangible assets ...............			14
15	Other assets. See Part IV, line 11 ...........			15
16	Total assets. Add lines 1 through 15 (must equal line 34)...		0	16	0

17	Accounts payable and accrued expenses .....		17
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	0	26	0

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets		27
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	0	33	0
34	Total liabilities and net assets/fund balances ........	0	34	0