TY 2020 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) RAMY KURDI DO...................................................................... PHYSICIAN	40.00 .................				X	1,045,641	26,133
(2) RANY ABURASHED DO...................................................................... BOARD MEMBER/ PHYSICIAN	40.00 .................	X				983,842	26,889
(3) ASHRAF ELBANNA DO...................................................................... PHYSICIAN	40.00 .................				X	784,695	10,381
(4) TAREK PACHA DO...................................................................... PHYSICIAN	40.00 .................				X	779,169	25,939
(5) BRIAN LONG...................................................................... PRESIDENT/CEO	58.00 ................. 2.00	X	X			729,806	22,257
(6) MICHAEL SCHMIDT DO...................................................................... CHIEF OF STAFF	40.00 .................	X				573,972	26,656
(7) PANKAJ GUGLANI DO...................................................................... PHYSICIAN	40.00 .................				X	624,581	14,285
(8) JAMES NEMETH...................................................................... VP OF NURSING	40.00 .................			X		423,395	26,166
(9) JOSEPH BUSTAMANTE...................................................................... CHIEF MEDICAL OFFICER	40.00 .................			X		420,468	26,211
(10) JESSICA LAFOEST DO...................................................................... PHYSICIAN	40.00 .................				X	614,619	21,906
(11) COLLEEN KOPPENHAVER...................................................................... EXECUTIVE VP/CFO	40.00 .................			X		377,962	9,544
(12) RONALD BISHOP DO...................................................................... BOARD MEMBER	40.00 .................	X				297,502	17,446
(13) MICHAEL KRAMER DO...................................................................... BOARD MEMBER	40.00 .................	X				360,664	13,280
(14) ANTHONY PATSY DO...................................................................... BOARD MEMBER	39.00 ................. 1.00	X				274,125	24,665
(15) GREGORY BONTRAGER...................................................................... BOARD CHAIRMAN	2.00 .................	X	X			0	0
(16) ANTHONY YOUNG...................................................................... BOARD VICE CHAIRMAN	2.00 .................	X	X			0	0
(17) JERRY WALDEN...................................................................... BOARD SECRETARY	2.00 .................	X	X			0	0

(A) Name and business address	(B) Description of services	(C) Compensation
SPENCE BROTHERS 203 S WASHIGNGTON AVE SAGINAW,MI48607	CONSTRUCTION	9,538,882
ALLIANCE HNI PO BOX 772550 DETROIT,MI48277	RENTAL OF EQUIPMENT	1,717,735
ECS CENTRAL MICHIGAN 4100 EMBASSY DRIVE SE SUITE 400 GRAND RAPIDS,MI49546	CONTRACTED EMERGENCY ROOM PHYSICIANS	1,617,686
AHSA PO BOX 1928 EDMOND,OK73083	HOSPITAL STAFFING	1,090,219
PHYSICIANS ANESTHESIA SERVICES 1200 EAST MICHIGAN AVENUE LANSING,MI48912	ANESTHESIA SERVICES	742,177
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 54

- 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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

38-1358208

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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 ...............................

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

(i) Name of supported organization	(ii) EIN	(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)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. 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—2019. 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—2020. 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—2019. 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) 2020

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. 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—2019. 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) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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.

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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) 2020

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 lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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?

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).

By reason of the relationship described in line 2 above, 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.

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 lines 2a and 2b 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 line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", provide details in Part VI.

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.

Schedule A (Form 990 or 990-EZ) 2020

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 (explain in Part VI). 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 0.015 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 0.035	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) 2020

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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 (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

38-1358208

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization MEMORIAL HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization MEMORIAL HOSPITAL		Employer identification number 38-1358208

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization MEMORIAL HOSPITAL			Employer identification number 38-1358208
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

38-1358208

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2020

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2020

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

6,083

Total. Add lines 1c through 1i ....................................................................................................

6,083

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	MEMORIAL HEALTHCARE PAYS DUES TO MICHIGAN HEALTH AND HOSPITAL ASSOCIATION & MICHIGAN HEALTH COUNCIL. A PORTION OF THESE DUES GO TOWARDS LOBBYING.

Schedule C (Form 990 or 990EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

38-1358208

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2020

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	5,342,671	4,492,321	4,653,008	4,231,399	4,561,819
b	Contributions ...	7,082	36,587	76,952	32,323	108,586
c	Net investment earnings, gains, and losses	333,532	826,200	-225,393	550,486	273,144
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	17,814	12,437	12,246	161,200	712,150
f	Administrative expenses ....
g	End of year balance ......	5,665,470	5,342,671	4,492,321	4,653,008	4,231,399

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

58.900 %

Permanent endowment SchDMd Bullet

0 %

Term endowment SchDMd Bullet

41.100 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .......................

3a(i)

(ii) Related organizations .......................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	4,603,392		4,603,392
b	Buildings ....	66,249,965	40,811,869	25,438,096
c	Leasehold improvements	1,197,692	696,931	500,761
d	Equipment ....	80,079,069	57,285,758	22,793,311
e	Other .....	23,692,388	1,654,347	22,038,041
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				75,373,601

Schedule D (Form 990) 2020

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) WELLS FARGO MUTUAL FUNDS	52,635,557	F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	52,635,557

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS RECEIVABLE				1,635,679
(2)BOND ESCROW				28,261,641
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				29,897,320

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	674,234
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2020

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	219,924,758
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	643,813
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	2,127,501
e	Add lines 2a through 2d .....................			2e	2,771,314
3	Subtract line 2e from line 1..................			3	217,153,444
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	10,744,950
c	Add lines 4a and 4b....................			4c	10,744,950
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	227,898,394

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	214,918,457
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	2,012,782
e	Add lines 2a through 2d....................			2e	2,012,782
3	Subtract line 2e from line 1...................			3	212,905,675
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	10,740,838
c	Add lines 4a and 4b.....................			4c	10,740,838
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	223,646,513

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4:	THERE ARE VARIOUS PERMANENT AND BOARD DESIGNATED ENDOWMENT FUNDS. THE ONLY SPECIFICALLY IDENTIFIED USES OF THE VARIOUS FUNDS ARE AS FOLLOWS: NURSING SCHOLARSHIP AWARDS AND NURSING AND HEALTHCARE FOR THE ELDERLY.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	CONSOLIDATED ENTITY PER STATEMENTS NOT FORM 990 1,917,348. RENTAL EXPENSES 210,153.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	RENTAL REVENUE RECORDED AS EXPENSE PER STATEMENTS 1,520,257. BAD DEBT EXPENSE 8,917,057. INVESTMENT FEES 185,370. EXPENSES RECORDED AS REVENUE PER STATEMENTS 122,266.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	CONSOLIDATED ENTITY PER STATEMENTS NOT FORM 990 1,802,629. RENTAL EXPENSES 210,153.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 8,912,945. INVESTMENT FEES 185,370. RENTAL REVENUE RECORDED AS EXPENSE PER STATEMENTS 1,520,257. EXPENSES RECORDED AS REVENUE PER STATEMENTS 122,266.

Schedule D (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

38-1358208

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	1,334,101		1,334,101	0.620 %
b	Medicaid (from Worksheet 3, column a) . . . . .	38,332,120	28,359,513	9,972,607	4.640 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	39,666,221	28,359,513	11,306,708	5.260 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	350,258		350,258	0.160 %
f	Health professions education (from Worksheet 5) . . .	588,731		588,731	0.270 %
g	Subsidized health services (from Worksheet 6) . . . .	16,615,075	11,346,656	5,268,419	2.450 %
h	Research (from Worksheet 7) .	96,725		96,725	0.050 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	277,266		277,266	0.130 %
j	Total. Other Benefits . .	17,928,055	11,346,656	6,581,399	3.060 %
k	Total. Add lines 7d and 7j .	57,594,276	39,706,169	17,888,107	8.320 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	30,535	30,535	0.010 %
3	Community support	3,726	3,726	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	475,583	475,583	0.220 %
9	Other	36,108	36,108	0.020 %
10	Total	545,952	545,952	0.250 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

8,917,059

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

2,675,118

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

23,928,232

Enter Medicare allowable costs of care relating to payments on line 5.....

35,059,088

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-11,130,856

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2020

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)					Other (describe)
1	MEMORIAL HEALTHCARE 826 WEST KING ST OWOSSO,MI48867 MEMORIALHEALTHCARE.ORG 1060000059	X	X	X	LONG-TERM CARE HOSPITAL

Schedule H (Form 990) 2020

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	MEMORIAL HEALTHCARE
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://TINYURL.COM/YXEHQ8OW

Other website (list url): HTTPS://TINYURL.COM/WV9Z6YE5

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://TINYURL.COM/YXEHQ8OW

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MEMORIAL HEALTHCARE
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 250.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://TINYURL.COM/Y64NPHXE

The FAP application form was widely available on a website (list url):

HTTPS://TINYURL.COM/Y64NPHXE

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://TINYURL.COM/Y64NPHXE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	MEMORIAL HEALTHCARE
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	MEMORIAL HEALTHCARE
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2020

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
MEMORIAL HEALTHCARE	PART V, SECTION B, LINE 5: REFER TO THE COMMUNITY HEALTH NEEDS ASSESSMENT LOCATED AT THE FOLLOWING WEBSITE:HTTPS://WWW.MEMORIALHEALTHCARE.ORG/VISITORS/COMMUNITY-RESOURCESPARTICIPANTS IN THE CHNA:GREAT LAKES BAY HEALTHSAFECENTERSHIAWASSEE REGIONAL EDUCATION SERVICE DISTRICTSHIAWASSEE COUNTY HEALTH DEPARTMENTSHIAWASSEE HEALTH AND WELLNESSCATHOLIC CHARITIESMEMORIAL HEALTHCAREMEMORIAL HEALTHCARE FOUNDATIONMICHIGAN STATE UNIVERSITY EXTENSIONRESPITE VOLUNTEERS OF SHIAWASSEE COUNTYSHIAWASSEE GREAT START INITIATIVEGREATER LANSING FOOD BANKSHIAWASSEE HOPECOMMUNITY MEMBERSOWOSSO PUBLIC SCHOOLSSHIAWASSEE FAMILY YMCA - LIVE HEALTHYSHIAWASSEE HEALTH AND HUMAN SERVICES COUNCILSHIAWASSEE MINISTERIAL REPRESENTATIVESUNITED WAY OF GENESEE COUNTY (SHIAWASSEE)SHIAWASSEE COUNCIL ON AGINGHOMELESS ANGELSDISABILITY NETWORK CAPITAL AREABAKER PATHWAYSPARTICIPANTS IN THE IMPLEMENTATION PLANNING:BILL ARCHER, SHIAWASSEE COUNTY VASTEPHANIE ROWELL, MEMORIAL HEALTHCARE, TAYLOR LIFE CENTERDENNIS CHERNIN, SHIAWASSEE COUNTY HEALTH DEPARTMENT PENNY CORBIN, SHIAWASSEE COUNTY COMMUNITY MENTAL HEALTH AUTHORITY (SCCMHA) KRISTEN GILPIN, CATHOLIC CHARITIES NICOLE GREENWAY, SHIAWASSEE COUNTY HEALTH DEPARTMENT PHIL HATHAWAY, TOWN PLANS LLC, LIVE HEALTHY COALITIONCOURTNEY HERRICK, SHIAWASSEE EDUCATION SERVICE DISTRICT (SRESS)LARRY JOHNSON, SHIAWASSEE COUNTY HEALTH DEPARTMENTJEFF MCMANUS, RESPITE VOLUNTEERS OF SHIAWASSEE COUNTYMICHAEL DEWEY, SHIAWASSEE UNITED WAYMARLA PRICE, MEMORIAL HEALTHCARE DIETICIANCATHY SPRAGUE-EMANS, CATHOLIC CHARITIESTHOMAS TEAL, MD, MEMORIAL HEALTHCAREABBIE TIPTON. MEMORIAL HEALTHCAREJORRI TREMAIN, MEMORIAL HEALTHCAREMARLENE WEBSTER, SHIAWASSEE HOPESARA WRIGHT, GREAT LAKES BAY HEALTH CENTER SHIAWASSEE COUNTY
MEMORIAL HEALTHCARE	PART V, SECTION B, LINE 6B: MEMORIAL WAS THE LEAD ON THE CHNA BUT THERE WAS A SHIAWASSEE COMMUNITY HEALTH NEEDS TEAM THAT CONSISTED OF THE FOLLOWING ORGANIZATIONS:A. SHIAWASSEE UNITED WAYB. SHIAWASSEE REGIONAL EDUCATION SERVICEC. SHIAWASSEE COUNTY COMMUNITY MENTAL HEALTH AUTHORITYD. SHIAWASSEE COUNTY HEALTH DEPARTMENT
MEMORIAL HEALTHCARE	PART V, SECTION B, LINE 7D: A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITAL'S WEBSITE LOCATED AT HTTPS://WWW.MEMORIALHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2020/01/UPDATED-SHIAWASSEE-COUNTY-2019-CHA-1-21-20.PDFA COPY OF THE COMMUNIT HEALTH NEEDS ASSESSMENT IS ALSO AVAILABLE ON THE HOSPITAL COUNCIL OF NORTHWEST OHIO'S WEBSITE LOCATED AT HTTP://WWW.HCNO.ORG/COMMUNITY-SERVICES/COMMUNITY-HEALTH-ASSESSMENTS/
MEMORIAL HEALTHCARE	PART V, SECTION B, LINE 11: DUE TO COVID-19, MEMORIAL HEALTHCARE WILL BEGIN WORKING ON ITS IMPLEMENTATION PLAN IN JULY OF 2020. HOWEVER ,THE PRIMARY NEEDS IDENTIFIED IN THE SURVEY WERE MENTAL HEALTH, OBESITY, AND SUBSTANCE ABUSE BASED ON THE RESPONSES. THESE DOMAINS WILL BE THE FOCUS OF MEMORIAL HEALTHCARE'S EFFORTS MOVING FORWARD AND WILL ENCOMPASS BOTH ADULTS AND CHILDREN. REFER TO THE MOST CURRENT IMPLEMENTATION PLAN LOCATED AT THE FOLLOWING WEBSITE: HTTPS://WWW.MEMORIALHEALTHCARE.ORG/VISITORS/COMMUNITY-RESOURCES
MEMORIAL HEALTHCARE	PART V, SECTION B, LINE 16J: THE FAP POLICY IS ALSO STATED ON ALL BILLING STATEMENTS SENT FROM THE HOSPITAL.PART V, SECTION B, LINE 16I - THE HOSPITAL FACILITY HAS REVIEWED THE POPULATION OF ITS COMMUNITY AND CONCLUDED THAT ENGLISH IS THE ONLY PRIMARY LANGUAGE AS DEFINTED BY THE REGULATIONS OF MORE THAN 5% OR 1,000 PERSONS. THEREFORE, THE FAP, FAP APPLICATION FORM, OR PLAIN LANGUAGE SUMMARY HAVE NOT BEEN TRANSLATED INTO ANOTHER LANGUAGE. THE HOSPITAL FACILITY WILL CONTINUE TO MONITOR THIS GOING FORWARD AS NEW CENSUS DATA BECOMES AVAILABLE.
MEMORIAL HEALTHCARE	PART V, SECTION B, LINE 20E: SEND SELF-PAY ACCOUNTS TO ADVOMAS, A MEDICAL BILLING SERVICE, PRIOR TO SENDING TO CAREPAYMENT AND BEFORE SENDING TO BAD DEBT.

Schedule H (Form 990) 2020

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?47
Name and address		Type of Facility (describe)
1	1 - MEMORIAL HEALTHCARE CANCER CENTER 721 N SHIAWASSEE OWOSSO,MI48867	CANCER CARE SERVICES/ONCOLOGY/ANTICOAG
2	2 - MEMORIAL HEALTHCARE OUT PT SERVICES 1975 W M21 STE 102 OWOSSO,MI48867	HOME HEALTH/HOSPICE
3	3 - MEMORIAL HEALTHCARE HEALTH PARK OFFICES 100 HEALTH PARK DRIVE OWOSSO,MI48867	MH LAB/MH RAD
4	4 - MEMORIAL HEALTHCARE FAMILY MEDICINE MEMOR 100 HEALTH PARK DR STE 101 OWOSSO,MI48867	MMA DR. VORENKAMP & OCC HEALTH
5	5 - MEMORIAL HEALTHCARE PAIN CLINIC 818 W KING ST STE 300 OWOSSO,MI48867	PAIN MANAGEMENT
6	6 - MEMORIAL HEALTHCARE'S OWOSSO WOODARD 317 S ELM ST STE 116 OWOSSO,MI48867	PHYSICAL THERAPY REHAB SERVICES/CARDIAC REHAB
7	7 - MEMORIAL HEALTHCARE ORTHOPEDICS SPORTS ME 113 WILLIAMS STREET OWOSSO,MI48867	ORTHO, MH PHYSICAL THERAPY
8	8 - MID MICHIGAN ORTHOPEDICS 113 WILLIAMS STREET OWOSSO,MI48867	ORTHO SERVICES
9	9 - MEMORIAL HEALTHCARE OBGYN 1457 N M-52 STE 2 OWOSSO,MI48867	OBGYN
10	10 - MEMORIAL HEALTHCARE FAMILY MEDICINE 9480 E M-21 OVID,MI48866	PRIMARY CARE
11	11 - MEMORIAL HEALTHCARE INTERNAL MEDICINE 9480 E M-21 OVID,MI48866	INTERNAL MEDICINE
12	12 - MEMORIAL HEALTHCARE FAMILY MEDICINE 9099 E LANSING ROAD DURAND,MI48429	MMA FAMILY MED (GUTCHAK/MCARTHUR/KASIMOS/HORSKI)
13	13 - MEMORIAL HEALTHCARE URGENT CARE 9099 E LANSING ROAD DURAND,MI48429	URGENT CARE
14	14 - MEMORIAL HEALTHCARE OPHTHALMOLOGY 9099 E LANSING ROAD DURAND,MI48429	OPHTHALMOLOGY (QAHWASH)
15	15 - MEMORIAL HEALTHCARE FAMILY MEDICINE 3337 W BRITTON ROAD PERRY,MI48872	FAMILY MEDICINE
16	16 - MEMORIAL HEALTHCARE URGENT CARE 3337 W BRITTON ROAD PERRY,MI48872	URGENT CARE
17	17 - MEMORIAL HEALTHCARE PEDIATRIC & ADOLESCENT 802 W KING ST STE M OWOSSO,MI48867	PEDIATRICS
18	18 - MEMORIAL HEALTHCARE INSTITUTE FOR NEUROSCI 818 W KING STREET SUITE 101-103 OWOSSO,MI48867	NEUROLOGY
19	19 - MEMORIAL HEALTHCARE FAMILY MEDICINE 317 E GRAND RIVER LAINGSBURG,MI48848	FAMILY MEDICINE
20	20 - MEMORIAL SURGICAL ASSOCIATESWOUND CLINI 818 W KING ST STE 201 OWOSSO,MI48867	SURGERY/ WOUND CLINIC
21	21 - MEMORIAL HEALTHCARE FAMILY MEDICINE 300 S CHAPMAN CHESANING,MI48616	FAMILY MEDICINE
22	22 - MEMORIAL PHYSICAL REHABILITATION CENTER 8906 E LANSING ROAD DURAND,MI48429	REHAB SERVICES
23	23 - MEMORIAL HEALTHCARE GASTROENTEROLOGY 721 N SHIAWASSEE STE 202 OWOSSO,MI48867	GASTROENTEROLOGY
24	24 - MEMORIAL HEALTHCARE FAMILY MEDICINE 1975 W M-21 SUITE 204 OWOSSO,MI48867	FAMILY MEDICINE
25	25 - MEMORIAL OUTPATIENT SERVICES - CHESANING 305 S SAGINAW STREET CHESANING,MI48616	LAB, RAD, PT SERVICES
26	26 - MEMORIAL STATE ROAD OFFICES 239 N STATE ROAD OWOSSO,MI48867	MH LAB, MH RAD
27	27 - MEMORIAL HEALTHCARE FAMILY MEDICINE 239 N STATE ROAD OWOSSO,MI48867	MMA SHIAWASSEE FAMILY MED (W.IZA/ZULFIQAR)
28	28 - MEMORIAL HEALTHCARE URGENT CARE 239 N STATE ROAD OWOSSO,MI48867	URGENT CARE
29	29 - MEMORIAL HEALTHCARE EAR NOSE THROAT AND 818 W KING ST STE 301 OWOSSO,MI48867	ENT
30	30 - MEMORIAL HEALTHCARE FAMILY MEDICINE 802 W KING ST STE C OWOSSO,MI48867	FAMILY MEDICINE
31	31 - MEMORIAL HEALTHCARE INTERNAL MEDICINE 100 HEALTH PARK DR STE 302 OWOSSO,MI48867	INTERNAL MEDICINE
32	32 - MEMORIAL HEALTHCARE UROLOGY 503 E MAIN ST OWOSSO,MI48867	UROLOGY
33	33 - MEMORIAL HEALTHCARE PEDIATRIC & ADOLOSCENT 802 W KING ST STE J OWOSSO,MI48867	PEDIATRICS
34	34 - MEMORIAL HEALTHCARE ORTHOPEDICS SPORTS ME 818 W KING ST LOWER LEVEL OWOSSO,MI48867	ORTHOPAEDICS
35	35 - MEMORIAL HEALTHCARE FAMILY MEDICINE MEMOR 208 N SHIAWASSEE ST OWOSSO,MI48867	FAMILY PRACTICE & OCCUPATIONAL HEALTH
36	36 - MEMORIAL HEALTHCARE DIABETES AND ENDOCRINO 802 W KING ST STE E OWOSSO,MI48867	ENDOCRINOLOGY
37	37 - MEMORIAL HEALTHCARE UROLOGY 818 W KING ST STE 202 OWOSSO,MI48867	UROLOGY
38	38 - MEMORIAL PHYSICAL REHAB - PERRY 3737 W LANSING ROAD PERRY,MI48872	REHAB SERVICES
39	39 - MEMORIAL HEALTHCARE HOSPITAL MEDICINE 826 W KING ST 3RD FLOOR OWOSSO,MI48867	HOSPITALISTS
40	40 - MEMORIAL HEALTHCARE GASTROENTEROLOGY 1123 VILLA LINDE CT STE 38 FLINT,MI48532	PEDIATRICS
41	41 - MEMORIAL HEALTHCARE ALLERGY & IMMUNOLOGY 317 S ELM ST STE 205A OWOSSO,MI48867	ALLERGIST
42	42 - MEMORIAL HEALTHCARE INSTITUTE FOR NEUROSCI 4600 GARFIELD RD AUBURN,MI48611	NUERO
43	43 - MEMORIAL HEALTHCARE NUTRITION & DIABETES C 317 S ELM ST STE 202 OWOSSO,MI48867	DIABETES
44	44 - MEMORIAL HEALTHCARE PALLIATIVE MEDICINE 1457 N M-52 STE 1 OWOSSO,MI48867	PALLATIVE CARE
45	45 - MEMORIAL HEALTHCARE INSTITUTE FOR NEUROSCI 1501 WATERFORD PARKWAY STE B ST JOHNS,MI48879	NUERO
46	46 - MEMORIAL HEALTHCARE PULMONOLOGY 826 W KING ST STE 200 OWOSSO,MI48867	PULMOMOLGIST
47	47 - MEMORIAL HEALTHCARE PHYSICAL MEDICINE & RE 1501 WATERFORD PARKWAY STE B ST JOHNS,MI48879	PHYSICAL MEDICINE & REHABILITATION

Schedule H (Form 990) 2020

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7:	THE COSTING METHODOLOGY USED FOR LINE 7A WAS THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 IN ADDITION TO DISCOUNTS AT COST PER THE HOSPITAL'S ACCOUNTING RECORDS. THE COSTING METHODOLOGY USED FOR LINES 7B - 7C WAS THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE COSTING METHODOLOGY USED FOR LINES 7E - 7I WERE ACTUAL COSTS PER THE HOSPITAL'S ACCOUNTING RECORDS.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES INCLUDE EMERGENCY ROOM AND OR SERVICES. NO PHYSICIAN CLINICS ARE INCLUDED.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990 PART IX LINE 25 COLUMN A WAS SUBTRACTED FROM THE DENOMINATOR FOR PURPOSES OF CALCULATING THE PERCENT OF TOTAL EXPENSES. THE BAD DEBT EXPENSE EXCLUDED WAS $8,917,059.
PART II, COMMUNITY BUILDING ACTIVITIES:	MEMORIAL HEALTHCARE HAS A STRONG REPUTATION AS A COLLABORATOR AND SUPPORTER OF AGENCIES AND ORGANIZATIONS WORKING TO IMPROVE THE QUALITY OF LIFE IN OUR REGION. INCLUDED IN THESE EFFORTS IS A VIGOROUS SUPPORT BOTH FINANCIALLY AND IN-KIND OF THE ECONOMIC DEVELOPMENT EFFORTS IN OUR COUNTY. WE PLAY A LEADERSHIP ROLE IN THE HEALTH & HUMAN SERVICES COLLABORATIVE IN SHIAWASSEE COUNTY WHICH HAS MADE A DIFFERENCE IN IMPORTANT ISSUES TO OUR RESIDENTS SUCH AS: TRANSPORTATION, ACCESS TO HEALTH AND DENTAL CARE FOR THOSE ON MEDICAID OR UNINSURED, HOMELESSNESS PREVENTION, SUICIDE PREVENTION, ELDER CARE, ETC.DURING THE COVID-19 PANDEMIC, MEMORIAL PROVIDED THE COMMUNITY AS WELL AS THEIR OWN EMPLOYEES WITH TESTING SITES WHICH INCLUDED A DRIVE-THRU LOCATION WITH MINIMAL CONTACT. TO FURTHER THEIR EFFORTS TO MINIMIZE THE SPREAD OF COVID MEMORIAL ALSO EXTENDED BEYOND SHIAWASSEE COUNTY TO PROVIDE SERVICES TO WAYNE COUNTY TO PROVIDE EXCELLENT CARE IN TESTING ALL THE INMATES AND SHERIFFS. MEMORIAL WAS ALSO AMONG THE FIRST TO PROVIDE THE 1ST DOSE OF THE VACCINE TO THE COMMUNITY AND THEIR EMPLOYEES. MEMORIAL CONTINUES TO PROVIDE EXCEPTIONAL COMMUNITY SUPPORT INCLUDING ESTABLISHING ITSELF AS AN INDUSTRY LEADER IN THE CONTINUED FIGHT AGAINST THE SPREAD OF COVID-19.
PART III, LINE 2:	THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX.
PART III, LINE 3:	IT HAS BEEN ESTIMATED THAT APPROXIMATELY 30 PERCENT OF EXPENSES RELATING TO BAD DEBT ARE ATTRIBUTABLE TO PATIENTS THAT MAY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. THE ESTIMATE IS BASED ON THE HOSPITALS EXPERIENCE AND REVIEW OF CHARITY CARE APPLICATIONS.
PART III, LINE 4:	ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING MEMORIAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), MEMORIAL RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.
PART III, LINE 8:	MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. INPATIENT AND OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. COSTS ON STRESS, SUBACUTE AND LONG TERM CARE ARE ALSO INCLUDED. MEDICARE REVENUE AND COSTS RELATED TO THE SUBSIDIZED HEALTH SERVICES HAVE BEEN REMOVED IN ORDER TO AVOID DUPLICATION. ANY SHORTFALLS CALCULATED HERE ARE CONSIDERED TO BE A COMMUNITY BENEFIT.
PART III, LINE 9B:	PATIENTS RECEIVE A STATEMENT 14 DAYS AFTER THEIR INSURANCE PAYS OR 14 DAYS AFTER SERVICE FOR SELF PAY PATIENTS. PATIENT WILL RECEIVE A PAST DUE NOTICE (2ND STATEMENT) 30 DAYS AFTER FIRST STATEMENT IF NO PAYMENT MADE OR PAYMENT ARRANGEMENT SET UP. PATIENTS WILL THEN BE REFERRED TO OUR VENDOR CAREPAYMENT TO SET UP A 25 MONTH PAYMENT PLAN. IF THE PATIENT DEFAULTS (AFTER A MINIMUM OF 90 DAYS) ON THE PAYMENT PLAN THE ACCOUNT WILL BE RETURNED TO MEMORIAL AND THEN WILL BE SENT ONTO TO UNITED COLLECTION BUREAU FOR COLLECTION ACTIVITY. PATIENT WILL RECEIVE NOTICE OF ANY ECA'S 30 DAYS PRIOR TO BEING SENT TO COLLECTIONS.
PART VI, LINE 2:	WE ASSESS THE HEALTH NEEDS OF OUR RESIDENTS THROUGH COLLABORATIONS WITH THE COUNTY HEALTH DEPARTMENT, OUR 10 SCHOOL DISTRICTS, OUR COUNCIL OF HEALTH & HUMAN SERVICE AGENCIES AND THROUGH PHYSICIAN OBSERVATION AND REQUESTS.
PART VI, LINE 3:	WE COMMUNICATE THIS THROUGH SEVERAL METHODS INCLUDING: POSTING AT REGISTRATION POINTS, IN THE PATIENT HANDBOOK PROVIDED TO ALL INPATIENTS, IN A GUIDE TO THE BILLING PROCESS PAMPHLET HANDED OUT AT REGISTRATION POINTS, ON THE BACK OF OUR PATIENT STATEMENTS, VERBALLY THRU OUR FINANCIAL COUNSELING STAFF WHEN PATIENTS ARE IN-HOUSE AS WELL AS THROUGH PHONE CONVERSATIONS WITH PATIENTS CONCERNING THEIR BILLS.
PART VI, LINE 4:	MEMORIAL HEALTHCARE SERVES SHIAWASSEE COUNTY AND THE SURROUNDING REGION, APPROXIMATELY 105,000 PEOPLE. IT IS A RURAL COUNTY WITH A CENTRAL CITY OF OWOSSO (POPULATION 15,000). THE CENTER CORE OF THE COUNTY, OWOSSO, IS KNOWN AS A "MICROPOLITAN". THERE IS LITTLE RACIAL DIVERSITY, 94% OF THE RESIDENTS ARE WHITE, 4% ARE HISPANIC, 1% IS AFRICAN AMERICAN, AND 2% ARE OTHER/2 OR MORE RACES. THE DIVERSITY IS MORE APPARENT IN THE SOCIAL ECONOMIC DISPARITIES. IN JANUARY OF 2020, THE UNEMPLOYMENT RATE FOR SHIAWASSEE COUNTY WAS 4.40% WHICH WAS SLIGHTLY HIGHER THAN THE STATE AVERAGE OF 3.8%. IN MAY OF 2020, THE UNEMPLOYMENT RATE FOR SHIAWASSEE COUNTY WAS 29.2% WHICH WAS ALSO HIGHER THAN THE STATE AVERAGE OF 21.2%. 18.3% OF CHILDREN LIVE IN POVERTY.
PART VI, LINE 5:	MEMORIAL HEALTHCARE DEVELOPED A COLLABORATION WITH HEALTH DELIVERY, INC. OF SAGINAW TO SET UP A COMMUNITY HEALTH CENTER IN SHIAWASSEE COUNTY. THIS CENTER SERVES AS THE MEDICAL HOME FOR THOUSANDS WHO HAD NO ACCESS TO CARE. THROUGH A PARTNERSHIP WITH COMMUNITY MENTAL HEALTH, THIS CENTER ALSO NOW HAS A FULL TIME SOCIAL WORKER. CURRENTLY, WE ARE WORKING TO INCREASE ACCESS TO DENTAL HEALTH.
PART VI, LINE 6:	MEMORIAL HEALTHCARE FOUNDATION PROVIDES FUND DEVELOPMENT SERVICES TO ASSIST MEMORIAL HEALTHCARE. MEMORIAL HEALTHCARE OPERATES A SHORT-TERM, ACUTE-CARE FACILITY OFFERING INPATIENT AND OUTPATIENT HEALTHCARE, MENTAL HEALTH SERVICES, AND HOME CARE PRIMARILY TO CITIZENS OF SHIAWASSEE COUNTY, MICHIGAN.
PART VI, LINE 7, REPORTS FILED WITH STATES	MI

Schedule H (Form 990) 2020

Additional Data

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- 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
Graphic Arrow

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

Attach to Form 990.
Graphic Arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

38-1358208

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 on 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 .....

Yes

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 on Line 1a? ....

Yes

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? .............

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

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 nonfixed
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) 2020

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)
1RAMY KURDI DO PHYSICIAN	(i) (ii)	1,039,808 ------------- 0	5,833 ------------- 0	0 ------------- 0	0 ------------- 0	26,133 ------------- 0	1,071,774 ------------- 0	0 ------------- 0
2RANY ABURASHED DO BOARD MEMBER/ PHYSICIAN	(i) (ii)	961,538 ------------- 0	22,304 ------------- 0	0 ------------- 0	5,700 ------------- 0	21,189 ------------- 0	1,010,731 ------------- 0	0 ------------- 0
3ASHRAF ELBANNA DO PHYSICIAN	(i) (ii)	781,549 ------------- 0	3,146 ------------- 0	0 ------------- 0	0 ------------- 0	10,381 ------------- 0	795,076 ------------- 0	0 ------------- 0
4TAREK PACHA DO PHYSICIAN	(i) (ii)	665,385 ------------- 0	113,784 ------------- 0	0 ------------- 0	0 ------------- 0	25,939 ------------- 0	805,108 ------------- 0	0 ------------- 0
5BRIAN LONG PRESIDENT/CEO	(i) (ii)	585,213 ------------- 0	144,593 ------------- 0	0 ------------- 0	5,700 ------------- 0	16,557 ------------- 0	752,063 ------------- 0	0 ------------- 0
6MICHAEL SCHMIDT DO CHIEF OF STAFF	(i) (ii)	549,618 ------------- 0	24,354 ------------- 0	0 ------------- 0	5,700 ------------- 0	20,956 ------------- 0	600,628 ------------- 0	0 ------------- 0
7PANKAJ GUGLANI DO PHYSICIAN	(i) (ii)	537,001 ------------- 0	87,580 ------------- 0	0 ------------- 0	0 ------------- 0	14,285 ------------- 0	638,866 ------------- 0	0 ------------- 0
8JAMES NEMETH VP OF NURSING	(i) (ii)	366,349 ------------- 0	57,046 ------------- 0	0 ------------- 0	5,700 ------------- 0	20,466 ------------- 0	449,561 ------------- 0	0 ------------- 0
9JOSEPH BUSTAMANTE CHIEF MEDICAL OFFICER	(i) (ii)	364,998 ------------- 0	55,470 ------------- 0	0 ------------- 0	5,700 ------------- 0	20,511 ------------- 0	446,679 ------------- 0	0 ------------- 0
10JESSICA LAFOEST DO PHYSICIAN	(i) (ii)	348,655 ------------- 0	265,964 ------------- 0	0 ------------- 0	0 ------------- 0	21,906 ------------- 0	636,525 ------------- 0	0 ------------- 0
11COLLEEN KOPPENHAVER EXECUTIVE VP/CFO	(i) (ii)	333,597 ------------- 0	44,365 ------------- 0	0 ------------- 0	5,700 ------------- 0	3,844 ------------- 0	387,506 ------------- 0	0 ------------- 0
12RONALD BISHOP DO BOARD MEMBER	(i) (ii)	285,002 ------------- 0	12,500 ------------- 0	0 ------------- 0	1,560 ------------- 0	15,886 ------------- 0	314,948 ------------- 0	0 ------------- 0
13MICHAEL KRAMER DO BOARD MEMBER	(i) (ii)	255,588 ------------- 0	105,076 ------------- 0	0 ------------- 0	5,424 ------------- 0	7,856 ------------- 0	373,944 ------------- 0	0 ------------- 0
14ANTHONY PATSY DO BOARD MEMBER	(i) (ii)	219,690 ------------- 0	54,435 ------------- 0	0 ------------- 0	4,874 ------------- 0	19,791 ------------- 0	298,790 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

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 1A	PHYSICIANS LISTED IN FORM 990, PART VII (AS WELL AS ALL THE PHYSICIANS ON STAFF) ARE GENERALLY ALLOWED $4,000/YEAR PER THEIR CONTRACTS. USUALLY, THIS MONEY IS USED FOR BOOKS AND CONTINUING EDUCATION. THIS IS NOT REPORTED AS TAXABLE COMPENSATION TO THE PHYSICIANS.

Schedule J (Form 990) 2020

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
MEMORIAL HOSPITAL

Employer identification number
38-1358208

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MICHIGAN FINANCE AUTHORITY	38-1358208		07-29-2015	7,055,000	FUND $7 MILLION OF 2015 CAPITAL BUDGET		X		X		X
B	MICHIGAN FINANCE AUTHORITY	38-1358208	59447PXT3	08-06-2013	19,369,159	PAY DOWN DEBT - $12 MILLION / FUND $8 MILLION OF 2013 CAPITAL BUDGET		X		X		X
C	MICHIGAN FINANCE AUTHORITY	38-1358208		12-22-2020	40,000,000	FUNDING OF A NEW BUILDING		X		X		X
D	MICHIGAN FINANCE AUTHORITY	38-1358208		06-30-2020	10,000,000	FUND THE NEW EMR PROJECT		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	9,186,516		3,586,292				356,448
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	7,055,000		19,369,159		40,000,000		10,000,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	64,952		70,728		148,000		117,484
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	6,990,048		9,991,669		11,593,116		9,882,516
11 Other spent proceeds .............			9,306,762
12 Other unspent proceeds .............
13 Year of substantial completion .............	2015		2014		2052		2030
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2019, a current refunding issue)? ........	X		X			X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2019, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X			X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2020

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....					0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........					0 %		0 %
6 Total of lines 4 and 5 .............					0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X			X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X

Schedule K (Form 990) 2020

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?	X		X			X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2020

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

38-1358208

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT. THE CEO, CFO, AND THE FINANCE DIRECTOR ALL REVIEWED THE 990. TAX RETURNS WILL BE MADE AVAILABLE TO ALL FINANCE COMMITTEE MEMBERS AT THEIR MEETING OF NOVEMBER 17, 2021 AND TO ALL BOARD MEMBERS AT THEIR MEETING OF NOVEMBER 22, 2021.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS AND LEADERSHIP TEAM MEMBERS ARE COVERED BY THIS POLICY. EACH COVERED MEMBER IS REQUIRED TO COMPLETE A DISCLOSURE STATEMENT ANNUALLY. ANY POTENTIAL CONFLICT THAT ARISES DURING THE YEAR MUST BE DISCLOSED WITHIN 14 DAYS OF FIDUCIARY'S KNOWLEDGE THAT A CONFLICT MAY EXIST. THE BOARD CHAIR HAS ULTIMATE RESPONSIBILITY FOR ENFORCEMENT OF THE POLICY. IF A CONFLICT DOES EXIST, THE MEMBER WITH THE CONFLICT ABSTAINS FROM VOTING AND THE CONFLICT IS NOTED IN THE MINUTES OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15	THE COMPENSATION OF THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION UPON HIRING. THE FULL BOARD OF DIRECTORS REVIEWS THE CEO'S COMPENSATION ANNUALLY. A COMPENSATION COMMITTEE HAS BEEN FORMED AND ACTIVELY PARTICIPATES IN DECISIONS RELATED TO CEO AND EXECUTIVE PAY AND BENEFITS AS WELL AS PROVIDING INPUT AND OVERSIGHT FOR THE ORGANIZATIONS COMPENSATION PHILOSOPHY AND PROGRAM. CEO AND EXECUTIVE PAY IS REVIEWED AT LEAST ANNUALLY BY THIS COMMITTEE. THE MOST RECENT REVIEW OF CEO AND EXECUTIVE PAY WAS APRIL 2021. UPDATED SALARY RANGES ARE PROVIDED BY AN OUTSIDE COMPENSATION CONSULTING COMPANY.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	TRANSFER TO/ FROM AFFILIATES -633,762.
FORM 990, PART XI, LINE 2C:	THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

MEMORIAL HOSPITAL

Employer identification number

38-1358208

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)MEMORIAL HEALTHCARE FOUNDATION 826 WEST KING STREET OWOSSO,MI48867 38-3036586	TO PROVIDE FUND DEVELOPMENT SERVICES TO ASSIST MEMORIAL HEALTHCARE.	MI	501(C)(3)	LINE 12A, I	MEMORIAL HOSPITAL	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2020

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	(k) Percentage ownership
(1) MEMORIAL HEALTHCARE PAIN MANAGEMENT LLC 826 W KING STREET OWOSSO,MI48867 47-2218456	PROVIDE OUTPATIENT PAIN MANAGEMENT SERVICES	MI	MEMORIAL HOSPITAL	RELATED	54,713	260,738		No			No	51.000 %
(2) MEMORIAL ASSISTED LIVING LLC 826 W KING STREET OWOSSO,MI48867 46-4831571	PROVIDE HOUSING AND SUPPORT FOR THE ELDERLY	MI	N/A					No			No

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	(h) Percentage ownership	Yes	No
(1) MHC DEVELOPMENT CORPORATION 826 W KING STREET OWOSSO,MI48867 46-3742868	DEVELOPMENT OF ASSISTED LIVING PROPERTY	MI	MEMORIAL HOSPITAL	C	-378,792	4,835,881	100.000 %	Yes

Schedule R (Form 990) 2020

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) ............................

Yes

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

Yes

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) ...................

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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) MEMORIAL HEALTHCARE FOUNDATION	C	87,709	ACTUAL CASH
(2) MEMORIAL HEALTHCARE FOUNDATION	P	205,933	ACTUAL CASH

Schedule R (Form 990) 2020

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2020

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) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTHCARE SERVICES TO PATIENTS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	1,789
6	Total number of volunteers (estimate if necessary) .............	6	64
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	199,863
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	200,670	17,168,489
9	Program service revenue (Part VIII, line 2g) .........	202,883,643	205,750,661
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	12,509,486	2,516,241
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,195,685	2,463,003
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	217,789,484	227,898,394
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)	96,625,302	110,768,505
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)....	105,401,236	112,878,008
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	202,026,538	223,646,513
19	Revenue less expenses. Subtract line 18 from line 12.......	15,762,946	4,251,881
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	155,656,152	227,811,494
21	Total liabilities (Part X, line 26).............	42,200,112	110,093,522
22	Net assets or fund balances. Subtract line 21 from line 20.....	113,456,040	117,717,972

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 84,602,436 including grants of $ ) (Revenue $ 152,955,956 )
	ANCILLARY SERVICES (OUTPATIENT VISITS: 237,071, OUTPATIENT SURGERIES: 3,099, PAIN MANAGEMENT VISITS: 6,396)

4b	(Code: ) (Expenses $ 52,821,363 including grants of $ ) (Revenue $ 17,297,083 )
	MMA SERVICES (PHYSICIAN CLINICS, MMA RVU'S: 325,590)

4c	(Code: ) (Expenses $ 13,172,066 including grants of $ ) (Revenue $ 13,660,699 )
	A MEDICAL AND SURGICAL HOSPITAL THAT PROVIDES INPATIENT AND OUTPATIENT SERVICES TO ALL PATIENTS.INPATIENT DISCHARGES: 3,652, PATIENT DAYS: 22,275, INPATIENT SURGERIES: 879, BIRTHS: 441

	(Code: ) (Expenses $ 48,066,807 including grants of $ ) (Revenue $ 23,435,408 )
	ALL OTHER PROGRAM SERVICES

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 48,066,807 including grants of $ ) (Revenue $ 23,435,408 )
4e	Total program service expenses198,662,672

(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)		(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) WILFRED BILL FARRELL........................................................................ BOARD TREASURER	2.00 .......................	X	X	0	0	0
(19) MICHAEL ASH........................................................................ BOARD MEMBER	2.00 .......................1.00	X		0	0	0
(20) BARBARA BAKEROMEROD........................................................................ BOARD MEMBER	2.00 .......................	X		0	0	0
(21) THOMAS CAMPBELL........................................................................ BOARD MEMBER	2.00 .......................	X		0	0	0
(22) DALE ESPICH........................................................................ BOARD MEMBER	2.00 .......................	X		0	0	0
(23) SHANA ESPINOZA........................................................................ BOARD MEMBER	2.00 .......................	X		0	0	0
(24) JOHN HAGEL........................................................................ BOARD MEMBER	2.00 .......................	X		0	0	0
(25) DONNA MCAVOY........................................................................ BOARD MEMBER	2.00 .......................	X		0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,290,441	0	291,758

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	87,709
e	Government grants (contributions)		1e	17,080,780

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

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		17,168,489

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	193,371,148	193,371,148
b	340B REVENUE	622110	7,838,281	7,838,281
c	PHYSICIAN REVENUE	900099	4,507,120	4,507,120
d	BILLING SERVICES REVENUE	561000	34,112		34,112
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		205,750,661

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,044,346			2,044,346
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,842,750	6a
b	Less: rental expenses		210,153	6b
c	Rental income or (loss)		1,632,597	6c
d	Net rental income or (loss).......			1,632,597	1,632,597
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	139,076	2,201,863	7a
b	Less: cost or other basis and sales expenses	363,818	1,505,226	7b
c	Gain or (loss)	-224,742	696,637	7c
d	Net gain or (loss).........			471,895			471,895
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		722513	664,655			664,655
b	LAB COURIER		621500	162,649		162,649
c	OUTSIDE MEALS		722513	3,102		3,102
d	All other revenue ....
e	Total. Add lines 11a–11d ......			830,406
12	Total revenue. See instructions.....			227,898,394	207,349,146	199,863	3,180,896

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	4,634,849		4,634,849
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........	79,398,378	73,618,944	5,779,434
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,223,586	1,151,929	71,657
9	Other employee benefits .......	20,371,347	19,360,150	1,011,197
10	Payroll taxes ...........	5,140,345	4,839,312	301,033
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	284,777		284,777
c	Accounting ...........	89,416		89,416
d	Lobbying ...........	20,224		20,224
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	185,370		185,370
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	19,004,315	15,398,272	3,606,043
12	Advertising and promotion ....
13	Office expenses .......
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	13,000,161	9,508,553	3,491,608
17	Travel ............	167,684	138,293	29,391
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	500,600	461,675	38,925
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	9,394,114	7,985,657	1,408,457
23	Insurance ...	848,501	687,921	160,580
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	PHARMACEUTICAL EXPENSES	34,869,688	34,635,951	233,737
b	MEDICAL SUPPLIES	19,037,847	16,139,793	2,898,054
c	PROVISION FOR BAD DEBTS	9,003,911	9,003,911
d	QAAP TAX EXPENSE	4,769,354	4,769,354
e	All other expenses	1,702,046	962,957	739,089
25	Total functional expenses. Add lines 1 through 24e	223,646,513	198,662,672	24,983,841	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 ........			5,012,777	1	14,212,699
2	Savings and temporary cash investments .........			150,184	2	25,163,462
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			25,183,011	4	22,730,409
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			2,911,210	8	4,679,923
9	Prepaid expenses and deferred charges ......			1,569,296	9	3,118,523
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	175,822,506
b	Less: accumulated depreciation	10b	100,448,905	65,795,448	10c	75,373,601
11	Investments—publicly traded securities .			18,352,937	11
12	Investments—other securities. See Part IV, line 11 .....			33,205,424	12	52,635,557
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			3,475,865	15	29,897,320
16	Total assets. Add lines 1 through 15 (must equal line 33)...			155,656,152	16	227,811,494

17	Accounts payable and accrued expenses .....	22,085,989	17	28,575,033
18	Grants payable ...		18
19	Deferred revenue .........		19	14,964,135
20	Tax-exempt bond liabilities .........	15,609,578	20	62,976,639
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	3,705,928	23	2,903,481
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	798,617	25	674,234
26	Total liabilities. Add lines 17 through 25..	42,200,112	26	110,093,522

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	113,456,040	27	117,717,972
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	113,456,040	32	117,717,972
33	Total liabilities and net assets/fund balances ........	155,656,152	33	227,811,494