TY 2024 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/1099-NEC)
(1) PAT CURTIS...................................................................... CHAIRMAN	1.00 ................. 1.00	X	X		0	0	0
(2) GAIL DENTON...................................................................... VICE-CHAIRMAN	1.00 ................. 1.00	X	X		0	0	0
(3) DAVID MESSING...................................................................... SECRETARY/TREASURER	1.00 ................. 1.00	X	X		0	0	0
(4) CAROL STARLING...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(5) ERIK TAMLYN...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(6) FAITH FAHRNER RN...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(7) JUDY BROWN...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(8) PAUL ROHLING...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(9) SCOTT ORR...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(10) STEVE ELLIS...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(11) VICTORIA MEIBURG...................................................................... DIRECTOR	1.00 ................. 1.00	X			0	0	0
(12) ANGELA MCCONNACHIE...................................................................... CO-CEO	13.00 ................. 27.00		X		61,538	307,307	6,523
(13) ANDREW DANIELS...................................................................... CO-CEO	13.00 ................. 27.00		X		61,574	328,918	41,884
(14) KIM GENTNER...................................................................... CFO	13.00 ................. 27.00		X		45,865	213,777	11,093
(15) MICHAEL KITTO...................................................................... PHYSICIAN	40.00 ................. 0.00			X	481,658	0	58,000
(16) CHRISTOPHER HANZCARUK...................................................................... PHYSICIAN	40.00 ................. 0.00			X	468,178	0	12,194
(17) ABBAS RAZA HAMDANI...................................................................... PHYSICIAN	40.00 ................. 0.00			X	372,274	0	61,469

(A) Name and business address	(B) Description of services	(C) Compensation
NET REVENUE ASSOCIATES LLC 1330 CORPORATE DR STE 100 HUDSON,OH44236	CONSULTING	538,933
ZEMNICKAS WV II DO 5510 HOSNER RD METAMORA,MI48455	PHYSICIAN	282,840
JBARA MD PLLC 18672 GARY LN LIVONIA,MI48152	PHYSICIAN	213,600
ALEX DANDASHLY 26926 COOLIDGE ST DEARBORN HEIGHTS,MI48127	PHYSICIAN	212,923
NITIN KG GOLECHHA MD PC 2734 MAIN ST MARLETTE,MI48453	PHYSICIAN	204,386
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 9

- TIN:

SCHEDULE A
(Form 990)

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

2024

Open to Public
Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2024

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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 2024 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2023 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2024. 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—2023. 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—2024. 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—2023. 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) 2024

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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 on 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 2024 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2023 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2024 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2023 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2024. 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—2023. 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) 2024

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) .

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

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 on 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 on 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) 2024

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

11a

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

11b

A 35% controlled entity of a person described on 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 on 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) 2024

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) 2024

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 2024 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-2024	(iii) Distributable Amount for 2024
1 Distributable amount for 2024 from Section C, line 6
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2024:
a From 2019.......
b From 2020.......
c From 2021.......
d From 2022.......
e From 2023.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2024 distributable amount
i Carryover from 2019 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2024 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2024 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2020.....
b Excess from 2021.....
c Excess from 2022.....
d Excess from 2023.....
e Excess from 2024.....

Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024

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) 2024

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)
(Rev. January 2025)

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

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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 ......... Right Arrow

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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025) Page 2

Name of organization MARLETTE REGIONAL HOSPITAL

Part I	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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 3

Name of organization MARLETTE REGIONAL HOSPITAL		Employer identification number 38-1507302

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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 4


Name of organization MARLETTE REGIONAL HOSPITAL			Employer identification number 38-1507302
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) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

right arrow

Complete if the organization is described below. 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

2024

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

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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 .................................................................... right arrow

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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.

Cat. No. 50084S

Schedule C (Form 990) 2024

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 right arrow

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 right arrow

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) 2021	(b) 2022	(c) 2023	(d) 2024	(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) 2024

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

(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

563

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

563

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:	THE ORGANIZATION PAYS ANNUAL DUES TO AMERICAN HEALTH CARE ASSOCIATION (AHCA), HEALTH CARE ASSOCIATION OF MICHIGAN (HCAM), MICHIGAN HEALTH AND HOSPITAL ASSOCIATION (MHA), LEADING AGE MICHIGAN, LEADING AGE NATIONAL, AND SKILLED NURSING FACILITIES AND A PORTION OF THOSE DUES GOES TOWARD LOBBYING. THE MHA WORKS WITH ITS MEMBER HOSPITAL AND HEALTH SYSTEMS TO INFORM DECISION-MAKERS ABOUT THE IMPACT OF HOSPITALS ON LOCAL HEALTH AND HEALTHCARE DELIVERY, AND ON CREATING THRIVING COMMUNITIES. THEY SPEND TIME IN MICHIGAN AND WASHINGTON DC TO ADVOCATE ON BEHALF OF THE INTERESTS OF ITS MEMBERS.

Return Reference

Explanation

PART II-B, LINE 1:

THE ORGANIZATION PAYS ANNUAL DUES TO AMERICAN HEALTH CARE ASSOCIATION (AHCA), HEALTH CARE ASSOCIATION OF MICHIGAN (HCAM), MICHIGAN HEALTH AND HOSPITAL ASSOCIATION (MHA), LEADING AGE MICHIGAN, LEADING AGE NATIONAL, AND SKILLED NURSING FACILITIES AND A PORTION OF THOSE DUES GOES TOWARD LOBBYING. THE MHA WORKS WITH ITS MEMBER HOSPITAL AND HEALTH SYSTEMS TO INFORM DECISION-MAKERS ABOUT THE IMPACT OF HOSPITALS ON LOCAL HEALTH AND HEALTHCARE DELIVERY, AND ON CREATING THRIVING COMMUNITIES. THEY SPEND TIME IN MICHIGAN AND WASHINGTON DC TO ADVOCATE ON BEHALF OF THE INTERESTS OF ITS MEMBERS.

Schedule C (Form 990) 2024

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.
right arrow

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) (Rev. 1-2025)

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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

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)

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

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 .....	570,923		570,923
b	Buildings ....	25,486,985	17,346,316	8,140,669
c	Leasehold improvements
d	Equipment ....	16,031,247	11,471,333	4,559,914
e	Other .....	354,461		354,461
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				13,625,967

Schedule D (Form 990) (Rev. 1-2025)

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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)RELATED PARTY RECEIVABLE				704,097
(2)RIGHT-OF-USE ASSETS				767,919
(3)ESTIMATED THIRD PARTY PAYOR SETTLEMENTS				685,178
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,157,194

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
FINANCE LEASE OBLIGATIONS	594,078
DUE TO AFFILIATES	453







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	594,531
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) (Rev. 1-2025)

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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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
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
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
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
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

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

Schedule D (Form 990) (Rev. 1-2025)

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 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2024

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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"? . . . . . . . . . . . . .

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		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(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) . . .			18,611		18,611	0.060 %
b	Medicaid (from Worksheet 3, column a) . . . . .			6,185,915	5,042,627	1,143,288	3.990 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			6,204,526	5,042,627	1,161,899	4.050 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	34	204	26,540		26,540	0.090 %
f	Health professions education (from Worksheet 5) . . .	6	255	9,634	5,071	4,563	0.020 %
g	Subsidized health services (from Worksheet 6) . . . .	5		1,490,066	1,329,256	160,810	0.560 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2	550	212		212	0 %
j	Total. Other Benefits . .	47	1,009	1,526,452	1,334,327	192,125	0.670 %
k	Total. Add lines 7d and 7j .	47	1,009	7,730,978	6,376,954	1,354,024	4.720 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2024

Schedule H (Form 990) 2024

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	6	600	281		281	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	6	600	281		281	0 %

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. ......

1,514,065

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. ......

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).....

3,839,230

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

4,489,875

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

-650,645

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) 2024

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	MARLETTE REGIONAL HOSPITAL 2770 MAIN STREET PO BOX 307 MARLETTE,MI48453 WWW.ASPIRERHS.ORG/ 1060000165	X	X	X	RHC(S)

Schedule H (Form 990) 2024

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)

	MARLETTE REGIONAL HOSPITAL
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 24

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

Yes

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): SEE PART V, LINE 7D

Other website (list url):

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 24

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

Yes

If "Yes" (list url): SEE PART V, LINE 7D

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) 2024

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MARLETTE REGIONAL HOSPITAL
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 100.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

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):

SEE PART V, SECTION B, LINE 16J

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

SEE PART V, SECTION B, LINE 16J

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, LINE 16J

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) 2024

Page 6

Part VFacility Information (continued)

Billing and Collections

	MARLETTE REGIONAL HOSPITAL
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) 2024

Page 7

Part VFacility Information (continued)

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

	MARLETTE REGIONAL HOSPITAL
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) 2024

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
MARLETTE REGIONAL HOSPITAL	PART V, SECTION B, LINE 5: A SURVEY WAS SENT OUT TO THE COMMUNITY TO ENSURE COLLECTION OF ADEQUATE HEALTH INDICATORS AND INPUT OF STAKEHOLDERS AND VULNERABLE POPULATIONS. WE CONDUCTED A FOUR-COUNTY REGIONAL ASSESSMENT PROCESS IN PARTNERSHIP WITH THE THUMB COMMUNITY HEALTH PARTNERSHIP ALONG WITH A STAKEHOLDER MEETING. THE SURVEY AND PARTNERSHIP CONSISTED OF HOSPITALS, LOCAL PUBLIC HEALTH DEPARTMENTS, MENTAL HEALTH AGENCIES, COMMUNITY MEMBERS AND OTHER HUMAN SERVICE PROVIDERS IN HURON, LAPEER, SANILAC, AND TUSCOLA COUNTIES. ADDITIONALLY, SOCIAL SERVICE ORGANIZATIONS THAT SERVE VULNERABLE POPULATIONS WERE PROVIDED SURVEYS. AGENCIES INCLUDED HUMAN DEVELOPMENT COMMISSION, MENTAL HEALTH AGENCIES, THE PUBLIC HEALTH AND SOCIAL SERVICES DIVISION OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, SOCIAL WORKERS, INTERMEDIATE SCHOOL DISTRICTS, STAFF FROM HEALTH CARE SECTOR WITH FREE OR LOW-COST HEALTH CLINICS, EARLY CHILDHOOD SERVICE PROVIDERS, AND LAW ENFORCEMENT.
MARLETTE REGIONAL HOSPITAL	PART V, SECTION B, LINE 6A: THERE WERE MULTIPLE HOSPITAL FACILITIES IN THE FOUR COUNTIES OF HURON, LAPEER, SANILAC, AND TUSCOLA THAT RECEIVED SUPPORT FROM THE MICHIGAN CENTER FOR RURAL HEALTH AND MICHIGAN THUMB PUBLIC HEALTH ALLIANCE (HURON, LAPEER, SANILAC, AND TUSCOLA).
MARLETTE REGIONAL HOSPITAL	PART V, SECTION B, LINE 6B: MARLETTE REGIONAL HOSPITAL WORKS IN PARTNERSHIP WITH A WIDE VARIETY OF HEALTH AND COMMUNITY ORGANIZATIONS TO MEET THE NEEDS OF THE COMMUNITY. THE CHNA PROCESS WAS CONDUCTED WITH THE SAME PRINCIPLES OF COLLABORATION. SPECIFICALLY, MRH UTILIZED ITS MEMBERSHIP IN THE THUMB COMMUNITY HEALTH PARTNERSHIP. THIS PARTNERSHIP ALLOWED US TO SURVEY A GREATER NUMBER OF PEOPLE IN OUR COMMUNITY. THE MOST IMPORTANT PARTNER IN MEETING HEALTH NEEDS OF OUR COMMUNITY IS THE RESIDENTS WE SERVE.
MARLETTE REGIONAL HOSPITAL	PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ON OUR WEBSITE AT: HTTPS://ASPIRERHS.ORG/COMMUNITY-RESOURCES/DIRECT LINK:HTTPS://ASPIRERHS.ORG/WP-CONTENT/UPLOADS/2024/12/MARLETTE-REGIONAL-HOSPITAL_CHNA-REPORT_2024-FINAL.PDFIF A READER USES THIS INFORMATION TO ACCESS THE FORM ONLINE, BE SURE TO FORMAT THE URL WITH LOWERCASE LETTERS WHEN COPYING AND PASTING THE DIRECT LINKS.
MARLETTE REGIONAL HOSPITAL	PART V, SECTION B, LINE 11: IN REVIEW OF EXISTING EFFORTS, THE TEAM DETERMINED THAT MARLETTE REGIONAL HOSPITAL WOULD HAVE THE GREATEST IMPACT ON COMMUNITY HEALTH BY TARGETING SIX FOCUS AREAS. 1. ACCESS TO HEALTH INSURANCE2. SERVICE AWARENESS3. HEART DISEASE4. TOBACCO USE AND VAPING5. CANCER6. BEHAVIORAL HEALTH1. ACCESS TO HEALTH INSURANCE- CARE COORDINATORS PROMOTE WELLNESS SCREENINGS AND ASSIST WITH REMOVING BARRIERS TO ACCESS CARE SUCH AS COST, NAVIGATING INSURANCE, AND TRANSPORTATION. REMOVING BARRIERS TO HEALTH INSURANCE INCLUDE KNOW YOUR NUMBERS, LOW COST SCREENINGS, BCUPS, AND $10 SPORTS PHYSICALS.- OFFER A POINT OF CONTACT FOR PATIENTS TO CALL WITH QUESTIONS, CONCERNS AND FEEDBACK IN REGARDS TO HEALTH INSURANCE.- EXPANDING ACCESS BY INCREASING TELEHEALTH SERVICES INCLUDING INPATIENT CARE COVERAGE AND SPECIALTY CONSULTATIONS.- OFFER HELP US HELP OUR OWN FUND AT ASPIRE FOUNDATION, WHICH PROVIDES FINANCIAL ASSISTANCE TO ASPIRE EMPLOYEES IN THE WAKE OF A CHANGE IN HEALTH OR OTHER EMERGENT NEED.- EXPANDED RESOURCES INCLUDING INSURANCE EDUCATION, AND HUMAN RESOURCES SUPPORT TEAMS TO PROVIDE GUIDANCE IN THE INSURANCE PROCESS.- REGULARLY UPDATE ACCEPTED INSURANCES ON ASPIRE WEBSITE.2. SERVICE AWARENESS- PROVIDER DIRECTORY AND SERVICES OFFERED ARE POSTED ON THE MARLETTE REGIONAL HOSPITAL WEBSITE AND ALL MARLETTE REGIONAL HOSPITAL FAMILY HEALTH CARE OFFICES.- SERVICE AREAS ARE HIGHLIGHTED ON SOCIAL MEDIA- MRH HAS SENT OUT AN EVERY DOOR DIRECT MAILING.- MRH CREATES AN ANNUAL REPORT THAT INCLUDES SERVICES OFFERED.- WITH PATIENT CONSENT, MRH PROVIDES PATIENT TESTIMONIALS.- WORK IN PARTNERSHIP WITH THE CRTN. THIS NETWORK ENHANCES AND STRENGTHENS HIGH-QUALITY HEALTHCARE PROVIDED BY YOUR COMMUNITY HOSPITAL WITH IMPROVED ACCESS TO MORE RESOURCES WHEN ADDITIONAL SPECIALIZED SUPPORT IS NEEDED.- PROVIDES MORE BOARD-CERTIFIED SPECIALIST COVERAGE AND SPECIALTY CLINICS RIGHT IN YOUR COMMUNITY.- ENHANCES HOSPITAL ALIGNMENT WITH PROCESSES IN PLACE TO EXPEDITE PATIENT TRANSFERS WHEN NEEDED- INCREASES LOCAL ACCESS TO CARE, WHILE IMPROVING THE AFFORDABILITY OF QUALITY HEALTHCARE IN THE REGION- PRESERVES COMPLETE INDEPENDENCE OF LOCAL COMMUNITY HOSPITALS IN THE NETWORK STREAMLINING COMMUNICATION, ENSURING THAT ALL UPDATES, NEWS, AND RESOURCES ARE SHARED IN ONE PLACE. BY FOCUSING ON A SINGLE ACCOUNT, WE CAN BETTER ENGAGE WITH OUR COMMUNITY, PROVIDE MORE CONSISTENT AND TIMELY INFORMATION, AND STRENGTHEN OUR ONLINE PRESENCE.- PUBLISHES ASPIRE-WIDE EMAIL NEWSLETTER TO IMPROVE AWARENESS OF SERVICES.- THROUGH OUR THUMB MRI PARTNERSHIP, MRH HAS EXPANDED THE AWARENESS OF RADIOLOGY SERVICES AT MRH AND WITHIN ASPIRE.- UPDATED MRH'S PROFILE ON 2-1-1, ONLINE STATE RESOURCE FOR TELEPHONE AND ONLINE RESOURCES.- CONTINUING WEEKLY RADIO CAMPAIGN ON LOCAL RADIO STATION TO HIGHLIGHT MRH AND OTHER ASPIRE SERVICES.3. HEART DISEASE- DIABETIC EDUCATION CLASSES EXTENDED HOURS.- DIABETIC EDUCATION APPOINTMENTS AND CLASSES EXPANDED INTO TELEHEALTH OPTIONS.- OFFER COMMUNITY GARDEN PLOTS AND PLANTS FREE OF CHARGE AT MRH.- DEVELOPMENT OF THE HEARTLANDS SENIOR LIVING INCLUDES EXERCISE CLASSES, A FITNESS CENTER, AND A WALKING TRAIL NEARBY.- WALKING TRAIL SUPPORTER.- MRH HELPS COORDINATE A 5K IN BROWN CITY.- EMERGENCY TELEHEALTH SERVICES FOR POSSIBLE STROKE PATIENTS BEGAN IN 2016.- SPECIALTY SERVICES ADDED INCLUDE OUTPATIENT CLINIC SERVICES INCLUDING TELE-PSYCHIATRY, CARDIOLOGY, ENT, ORTHOPEDICS, NEPHROLOGY, AND VASCULAR MEDICINE.- CAMPAIGNING FOR AMERICAN HEART MONTH IN FEBRUARY.4. TOBACCO USE AND VAPING- MRH DISTRIBUTES LUNG SCREENING CARDS AT COMMUNITY EVENTS AND HEALTH CARE OFFICES.- SHARE RESOURCES TOBACCO USE OF VAPING PRODUCTS WITH THE COMMUNITY FROM MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES.- LUNG CANCER SCREENING CAMPAIGN IN JUNE HIGHLIGHTS TOBACCO USE OF VAPING PRODUCTS.- EXPAND PARTNERSHIP(S) WITH SCHOOLS TO SPREAD AWARENESS OF NEGATIVE EFFECTS OF TOBACCO AND VAPING PRODUCTS.5. CANCER- MRH PROVIDES FINANCIAL ASSISTANCE FOR MAMMOGRAMS AND DIAGNOSTIC TESTING SERVICES THROUGH THE B.C.U.P.S. PROGRAM, HOUSED WITHIN THE ASPIRE RURAL HEALTH SYSTEM FOUNDATION.- ASPIRE RURAL HEALTH SYSTEM FOUNDATION IS HOME TO THE P.C.U.P.S. FOUNDATION TO RAISE FUNDS AND CREATE A HIGHER AWARENESS IN THE FIGHT AGAINST PROSTATE CANCER. P.C.U.P.S. STANDS FOR PROSTATE CANCER UNDERSTANDING, PREVENTION AND SCREENINGS.- MARLETTE REGIONAL HOSPITAL REOPENED THE COVENANT CANCER CARE AT ASPIRE MARLETTE IN FALL 2023 WITH COVENANT.- CAMPAIGN FOR BREAST CANCER AWARENESS MONTH IN OCTOBER.6. BEHAVIORAL HEALTH- PHYSICIAN OFFICES AND EMERGENCY DEPARTMENT CONTINUE TO ABIDE BY STRICT GUIDELINES IN THE PRESCRIBING AND ADMINISTRATION OF OPIOIDS AND NARCOTICS.- MEMBER OF THUMB OPIOID RESPONSE CONSORTIUM (TORC) TO REDUCE THE HARM OF SUBSTANCE USE DISORDERS BY WORKING TOGETHER AS A REGION (HURON, SANILAC, TUSCOLA AND THE RURAL TRACKS OF LAPEER COUNTY) TO ENSURE THAT PREVENTION, TREATMENT, AND RECOVERY SERVICES ARE ALIGNED WITH THE NEEDS OF THE COMMUNITY.- PREVIOUSLY COMPLETED SBIRT TRAINING THROUGH THE TORC.- MEMBER OF THUMB COMMUNITY HEALTH PARTNERSHIP TO PROVIDE MAN THERAPY.
MARLETTE REGIONAL HOSPITAL	PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT:HTTPS://ASPIRERHS.ORG/BILLING/.DIRECT LINK: HTTPS://ASPIRERHS.ORG/BILLING/THE FINANCIAL ASSISTANCE POLICY APPLICATION IS AVAILABLE AT: HTTPS://ASPIRERHS.ORG/BILLING/DIRECT LINK: HTTPS://ASPIRERHS.ORG/WP-CONTENT/UPLOADS/2025/01/PA-102-FAP-APPLICATION.PDFTHE FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT: HTTPS://ASPIRERHS.ORG/BILLING/DIRECT LINK: HTTPS://ASPIRERHS.ORG/WP-CONTENT/UPLOADS/2025/10/ASPIRE-FINANCIAL-ASSISTANCE-PLAIN-LANGUAGE-SUMMARY-1.DOCXIF A READER USES THIS INFORMATION TO ACCESS THE FORM ONLINE, BE SURE TO FORMAT THE URL WITH LOWERCASE LETTERS WHEN COPYING AND PASTING THE DIRECT LINKS.

Schedule H (Form 990) 2024

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?14
Name and address		Type of Facility (describe)
1	1 - MARLETTE WOUND CARE CLINIC 2750 MAIN STREET SUITE 4 MARLETTE,MI48423	WOUND CARE CLINIC
2	2 - MARLETTE FAMILY HEALTHCARE 2750 MAIN STREET SUITE 2 MARLETTE,MI48453	RURAL HEALTH CLINIC
3	3 - UNITED HOSPICE SERVICE RESIDENCE 2770 MAIN ST MARLETTE,MI48453	HOSPICE
4	4 - FAMILY HEALTHCARE OF BROWN CITY 4472 MAIN STREET BROWN CITY,MI48416	RURAL HEALTH CLINIC
5	5 - MAYVILLE FAMILY HEALTHCARE 2180 OHMER ROAD MAYVILLE,MI48744	RURAL HEALTH CLINIC
6	6 - NORTH BRANCH FAMILY HEALTHCARE 4000 HURON ST PO BOX 180 NORTH BRANCH,MI48461	HEALTH CLINIC
7	8 - PORT SANILAC HEALTHCARE 245 S RIDGE STREET PORT SANILAC,MI48469	RURAL HEALTH CLINIC
8	9 - UHP QUICK CARE 2771 ANGLE STREET MARLETTE,MI48453	CLINIC
9	10 - ASPIRE MARLETTE PAIN CLINIC 2750 MAIN STREET SUITE 5 MARLETTE,MI48453	PAIN CLINIC
10	11 - ASPIRE SPINE CLINIC 2770 MAIN ST MARLETTE,MI48453	SPINE CLINIC
11	12 - MARLETTE GENERAL SURGERY CLINIC 2770 MAIN ST MARLETTE,MI48453	GENERAL SURGICAL CLINIC
12	13 - MARLETTE ORTHOPEDIC CLINIC 2770 MAIN ST MARLETTE,MI48453	ORTHOPEDIC CLINIC
13	15 - MARLETTE SPECIALITY CLINIC 2734 MAIN ST MARLETTE,MI48453	SPECIALITY CLINIC
14	16 - MARLETTE THERAPY SERVICES 2770 MAIN ST MARLETTE,MI48453	THERAPY DEPARTMENT

Schedule H (Form 990) 2024

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 3C:	ELIGIBILITY FOR ASSISTANCE WILL BE CONSIDERED FOR THOSE INDIVIDUALS WHO ARE UNINSURED, UNDER INSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE, BASED UPON A DETERMINATION OF FINANCIAL NEED IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE IF THEY (A) RECEIVE MEDICALLY NECESSARY CARE AT MARLETTE REGIONAL HOSPITAL, (B) COMPLETE THE FINANCIAL ASSISTANCE APPLICATION, INCLUDING REQUIRED SUPPORTING DOCUMENTS, AND (C) HAVE FAMILY INCOME BELOW 100% OF FEDERAL POVERTY LEVELS (FOR FREE CARE) OR 300% (FOR DISCOUNTED CARE).
PART I, LINE 7:	THE ORGANIZATION USES THE COST TO CHARGE RATIO RECOMMENDED BY WORKSHEET 2 OF THE IRS FORM 990, SCHEDULE H INSTRUCTIONS.
PART I, LINE 7G:	THE ORGANIZATION IS REPORTING THE FOLLOWING SERVICE LINES FROM THEIR CLINICS UNDER THE SUBSIDIZED HEALTH SERVICES.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,514,065.
PART III, LINE 2:	THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL.
PART III, LINE 3:	$0 IS REPORTED IN LINE 3 BECAUSE MARLETTE REGIONAL HOSPITAL DOES NOT HAVE A METHOD OF ACCURATELY CALCULATING THE PORTION OF OUR BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT FAILED TO COMPLETE AN APPLICATION.
PART III, LINE 4:	FOR INFORMATION ABOUT BAD DEBT EXPENSE, SEE THE "PATIENT SERVICE REVENUE" SECTION OF NOTE 1 PAGES 16-19 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE AMOUNT OF MEDICARE ALLOWABLE COST WAS TAKEN DIRECTLY FROM THE MEDICARE COST REPORT. WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES TO MEDICARE BENEFICIARIES, THESE PATIENTS, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.THE TOTAL MEDICARE REVENUE SHOWN ON SCHEDULE H IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY THE CHARGES FROM MEDICARE PROGRAM BENEFICIARIES THAT ARE REPORTED ON THE HOSPITAL'S MEDICARE COST REPORT. THE AMOUNT LISTED FOR MEDICARE REVENUE DOES NOT INCLUDE PHYSICIAN SERVICES PROVIDED AT THE HOSPITAL, OUTLYING CLINIC LOCATIONS. PHYSICIAN COVERAGE ISREIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARE FOR PATIENTS. PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AN ADDITIONAL COMMUNITY BENEFIT THE HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDINGAREA. THE COST METHOD USED ABOVE FOR IRS 990 COMPLIANCES REPORTING IS BASED ON THE OVERALL AVERAGE COST TO CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE DIVIDED BY THE HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES, WHICH ARE REIMBURSED BASED ON MEDICARE REGULATIONS. INCLUDING THE FEE SCHEDULE ITEMS, SUCH AS PHYSICIAN SERVICES, WOULD PRODUCE A LOSS OR SHORTFALL ON THESE SERVICES TO BE REPORTED ON THE FORM 990 IN ANY GIVEN YEAR.
PART III, LINE 9B:	DURING THE UP FRONT COLLECTION PROCESS PATIENTS ARE SCREENED FOR PRESUMPTIVE ELIGIBILITY OF FINANCIAL ASSISTANCE IF THEY ARE UNABLE TO PAY FOR THE REQUIRED DEPOSIT AMOUNT FOR OUTPATIENT TESTING. THE STAFF MEMBERS THAT ESTIMATE THE ELIGIBILITY OF FINANCIAL ASSISTANCE EXTEND THEAPPLICATION AND PLAIN LANGUAGE SUMMARY TO THE PATIENT IF THEY ARE SCREEN AS PRESUMPTIVELY ELIGIBLE PRIOR TO THE OUTPATIENT SERVICES BEING RENDERED TO THE PATIENTS. ALL UNINSURED PATIENTS THAT PRESENT TO THE ER ARE CALLED BY THE BUSINESS OFFICE TO EXTEND FINANCIAL ASSISTANCE ELIGIBILITYINFORMATION OR ACQUIRE INSURANCE INFORMATION. ALL PATIENT STATEMENTS CONTAIN WORDING REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE PRE-COLLECT AGENCY IS AWARE OF THE FINANCIAL ASSISTANCE AVAILABILITY WHEN THEY ARE PERFORMING OUTREACH ACTION TO PATIENTS PRIOR TO EXTRAORDINARY COLLECTION ACTION.
PART VI, LINE 2:	THE HOSPITAL HAS PARTNERED WITH PRESS GANEY WHICH IS A COMPANY THAT HELPS US DO SURVEYS FOR PATIENT SATISFACTION. WE USE FEEDBACK FROM THOSE SURVEYS TO BETTER UNDERSTAND THE NEEDS OF OUR PATIENTS. ALSO, WITH WORKING CLOSELY WITH DCH WE GAIN A BETTER UNDERSTANDING OF THE NEEDS OF OUR PATIENTS IN OUR COUNTY BY ANALYZING DATA AT BOTH FACILITIES FOR POTENTIAL NEEDS. THE HOSPITAL ALSO UTILIZES THE RELATIONSHIP WITH THE CRTN GROUP TO GATHER INFORMATION ON WHAT SERVICES WE MAY NEED IN OUR COMMUNITIES
PART VI, LINE 3:	FOR INPATIENT SERVICES WE SEEK ANY INFORMATION REGARDING INSURANCE COVERAGE. IF NO COVERAGE IS AVAILABLE, WE REFER THE PATIENT TO OUR SOCIAL WORKER WHO HELPS THE PATIENT APPLY FOR GOVERNMENT ASSISTANCE IF APPLICABLE AND AVAILABLE, AND IF IT IS NOT, THEN WE HELP THEM COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. FOR OUTPATIENT SERVICES THE REGISTRATION STAFF OFFER FINANCIAL ASSISTANCE APPLICATIONS TO PATIENTS WHO CANNOT PAY THEIR UPFRONT COLLECTIONS. THE BILLING DEPARTMENT ALSO ASSISTS THE PATIENT IN APPLYING FOR GOVERNMENTAL ASSISTANCE. IF NOT APPLICABLE OR AVAILABLE, THE PATIENT IS ASSISTED IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION AND APPLICATIONS TO SPECIAL ORGANIZATIONS THAT MIGHT OFFER ASSISTANCE AS WELL. NOTICES OF AVAILABILITY OF FINANCIAL ASSISTANCE ARE ALSO POSTED IN THE HOSPITAL LOBBY.
PART VI, LINE 4:	MARLETTE REGIONAL HOSPITAL SERVES RURAL COMMUNITIES IN SANILAC COUNTY AND PORTIONS OF LAPEER AND TUSCOLA COUNTIES. THE HOSPITAL'S SERVICE AREA INCLUDES NUMEROUS MUNICIPALITIES: BROWN CITY, DECKER, DEFORD, MARLETTE, MELVIN, PECK, SANDUSKY, SNOVER, FOSTORIA, KINGSTON, MAYVILLE, NORTH BRANCH, CLIFFORD, YALE, AND SILVERWOOD. BASED ON CENSUS DATA FOR MUNICIPALITIES, APPROXIMATELY 47,157 PEOPLE LIVE IN THE SERVICE AREA. THE HOSPITAL PROVIDES SERVICE TO COMMUNITIES IN WHICH THERE ARE A WIDE RANGE OF NEEDS (CENSUS-AMERICAN COMMUNITY SURVEY 5 YEAR AVERAGE (2020). EIGHTEEN AND ONE HALF PERCENT OF THE POPULATION IS OVER THE AGE OF 65 AND ONLY 23% ARE UNDER AGE 18. THE POPULATION HAS LIMITED RACIAL DIVERSITY WITH 98.5% OF THE POPULATION WHITE. THE SERVICE AREA HAS A COLLEGE DEGREE RATE OF 11.2% COMPARED TO MICHIGAN'S 30.5% AND UNITED STATES 32.9%. AVERAGE HOUSEHOLD INCOME IN THE SERVICE AREA IS $67,887 AS COMPARED TO MICHIGAN'S AVERAGE INCOME OF $80,803 AND THE UNITED STATES AVERAGE INCOME OF $91,547. UNEMPLOYMENT IN THE SERVICE AREA RANGED FROM 3.9 TO 13.4% COMPARED TO MICHIGAN AT 6% AND THE U.S. AT 5.4%. OF THE CIVILIAN NONINSTITUTIONALIZED POPULATION 8.5% HAVE NO HEALTH INSURANCE COVERAGE COMPARED TO MICHIGAN AT 5.4% AND THE U.S. AT 8.7%. THE PERCENTAGE OF PEOPLE WHO HAD INCOMES BELOW POVERTY IN PAST 12 MONTHS WAS 14.88% BUT RANGED BY MUNICIPALITY FROM 7.8% TO 28.4%.
PART VI, LINE 5:	THE HOSPITAL IS GOVERNED BY A COMMUNITY BOARD AND HAS AN OPEN MEDICAL STAFF. IT ALSO PARTICIPATES IN FREE OR REDUCED HEALTH SCREENINGS AND FAIRS THAT ARE AVAILABLE TO THE GENERAL PUBLIC. AT THE END OF FY2022 THE HOSPITAL PARTIALLY OPENED UP ITS SENIOR LIVING COMMUNITY, THE HEARTLANDS, WHICH ENCOMPASSES 20 INDEPENDENT VILLAS, 20 ASSISTED LIVING, AND 12 MEMORY CARE ROOMS AND A COMMUNITY CENTER. WE HAD A HANDFUL OF INDEPENDENT VILLA RESIDENTS MOVE IN AT THE END OF THE FISCAL YEAR AND AT THE END OF FY2023 WE HAD OUR ASSISTED LIVING AND MEMORY CARE ROOMS AVAILABLE AS WELL AS OUR COMMUNITY CENTER. AT THE COMMUNITY CENTER A COMMUNITY MEMBER HOSTS FREE WORKOUT CLASSES FOR THE RESIDENTS. IN FY23 WE BECAME OFFICIAL PARTNERS WITH THE CRTN CANCER CENTER TO OFFER CANCER TREATMENTS LOCALLY. DURING THE END OF FY23 WE BEGAN WORKING TO OPEN A QUICK CARE FOR OUR PATIENTS WHICH OPENED IN FY24.
PART VI, LINE 6:	IN AN EFFORT TO CONTINUE MEETING THE EVER-CHANGING NEEDS OF THE COMMUNITY, MARLETTE REGIONAL HOSPITAL MADE THE DECISION EARLIER THIS YEAR TO JOIN TWO OTHER RURAL HEALTHCARE PROVIDERS (DECKERVILLE COMMUNITY HOSPITAL AND HILLS AND DALES HEALTHCARE) TO FORM THE ASPIRE RURAL HEALTH SYSTEM. THE GOALS OF ASPIRE RURAL HEALTH SYSTEM INCLUDE: - ENSURING HIGH-QUALITY HEALTHCARE CONTINUES FOR ALL PATIENTS ACROSS THE THUMB.- MAINTAINING AND ENHANCING THE IMMEDIATE AND LONG-TERM VIABILITY OF THE COMBINED HEALTH SYSTEM.- UPDATING AND EXPANDING EXISTING FACILITIES AND INVESTING TO BUILD NEW ONES.- RETAINING AN EXPERT TEAM OF CLINICIANS AND RECRUITING ADDITIONAL PROVIDERS TO ENSURE HIGH-QUALITY CARE REMAINS NEARBY.- PRESERVING ITS CHARITABLE, NOT-FOR-PROFIT MISSIONS TO SERVE, AND TO CONTINUE OFFERING CHARITY CARE AND SERVICES TO ALL MEMBERS OF THE COMMUNITY, INCLUDING THE UNDERSERVED.- BROADENING AND DEEPENING COMMUNITY SUPPORT AND ENGAGEMENT ACROSS THE THUMB.
PART VI, LINE 7, REPORTS FILED WITH STATES	MI

Schedule H (Form 990) 2024

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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 .....

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? ....

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) (Rev. 1-2025)

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1MICHAEL KITTO PHYSICIAN	(i) (ii)	479,870 ------------- 0	0 ------------- 0	1,788 ------------- 0	58,000 ------------- 0	0 ------------- 0	539,658 ------------- 0	0 ------------- 0
2FARAAZ AHMED PHYSICIAN	(i) (ii)	183,560 ------------- 271,318	4,326 ------------- 6,394	10,088 ------------- 14,912	9,281 ------------- 13,719	2,677 ------------- 3,957	209,932 ------------- 310,300	0 ------------- 0
3CHRISTOPHER HANZCARUK PHYSICIAN	(i) (ii)	463,190 ------------- 0	0 ------------- 0	4,988 ------------- 0	5,242 ------------- 0	6,952 ------------- 0	480,372 ------------- 0	0 ------------- 0
4ABBAS RAZA HAMDANI PHYSICIAN	(i) (ii)	358,897 ------------- 0	0 ------------- 0	13,377 ------------- 0	44,787 ------------- 0	16,682 ------------- 0	433,743 ------------- 0	0 ------------- 0
5ANDREW DANIELS CO-CEO	(i) (ii)	46,004 ------------- 245,743	13,801 ------------- 73,723	1,769 ------------- 9,452	5,084 ------------- 27,155	1,521 ------------- 8,124	68,179 ------------- 364,197	0 ------------- 0
6ANJANETTE KEMP PHYSICIAN	(i) (ii)	313,791 ------------- 0	0 ------------- 0	3,480 ------------- 0	52,548 ------------- 0	20,851 ------------- 0	390,670 ------------- 0	0 ------------- 0
7ANGELA MCCONNACHIE CO-CEO	(i) (ii)	47,774 ------------- 238,571	13,764 ------------- 68,736	0 ------------- 0	0 ------------- 0	1,088 ------------- 5,435	62,626 ------------- 312,742	0 ------------- 0
8KIM GENTNER CFO	(i) (ii)	38,446 ------------- 179,197	7,419 ------------- 34,580	0 ------------- 0	1,959 ------------- 9,134	0 ------------- 0	47,824 ------------- 222,911	0 ------------- 0

Schedule J (Form 990) (Rev. 1-2025)

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
PART I, LINE 3	THE ORGANIZATION'S COMPENSATION IS DETERMINED BY BLUEWATER HEALTHCARE NETWORK DBA ASPIRE RURAL HEALTH, A RELATED ORGANIZATION. THE FOLLOWING WERE USED IN DETERMINING THE COMPENSATION: 1. COMPENSATION SURVEY OR STUDY 2. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE 3. WRITTEN EMPLOYMENT CONTRACT

Schedule J (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)
(Rev. January 2025)
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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

Return Reference	Explanation
FORM 990, PART V, LINE 1A:	FORM 1099/1096 FILING - VENDORS FOR THE FILING ORGANIZATION ARE PAID BY BLUEWATER HEALTHCARE NETWORK (EIN 46-5444203) AS OF 04/15/2024. AS SUCH, ALL REQUIRED FORM 1099 AND FORM 1096 REPORTING IS MADE FOR THE ENTIRE BLUEWATER HEALTHCARE NETWORK (WITH LIMITED EXCEPTIONS) UNDER THE BLUEWATER HEALTHCARE NETWORK (EIN 46-5444203).
FORM 990, PART V, LINE 2A:	W-3 FILING - EMPLOYEES ARE PAID BY A RELATED ORGANIZATION UNDER A COMMON PAYMASTER ARRANGEMENT AS OF 04/15/2024. AS SUCH, REQUIRED PAYROLL FILINGS (INCLUDING W-2 AND W-3S) AFTER 04/15/2024 ARE REPORTED UNDER THE RELATED ORGANIZATION, BLUEWATER HEALTHCARE NETWORK (EIN 46-5444203).
FORM 990, PART VI, SECTION A, LINE 6	BLUEWATER HEALTHCARE NETWORK IS THE SOLE MEMBER OF MARLETTE REGIONAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	THE HOSPITAL HAS ONLY 1 MEMBER, WHICH IS BLUEWATER HEALTHCARE NETWORK WHICH MAY APPOINT ONE OR MORE OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B	THE SINGLE MEMBER HAS THE RIGHT TO APPOINT AN OFFICER OR DIRECTOR OR ANYONE ELSE TO ACT ON ITS BEHALF IN THE CAPACITY OF THE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICES.
FORM 990, PART VI, SECTION B, LINE 12C	THE HOSPITAL'S CONFLICT OF INTEREST POLICY COVERS THE BOARD OF DIRECTORS, MEDICAL STAFF, MANAGERS AND EMPLOYEES OF THE HOSPITAL. THE POLICY DEFINES A CONFLICT OF INTEREST AND THE PROCEDURE TO FOLLOW IN ANY CIRCUMSTANCE WHERE A REAL OR PERCEIVED CONFLICT EXISTS. BOARD OF DIRECTORS - PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS OF INTEREST SHALL FILE FORMAL STATEMENTS DISCLOSING ACTUAL OR POTENTIAL CONFLICTS WHENEVER AN ACTUAL OR POTENTIAL CONFLICT ARISES; BEFORE ANY TRANSACTIONS CONSTITUTING A CONFLICT OR POTENTIAL CONFLICT IS CONSUMMATED; AND ONCE EACH CALENDAR YEAR SO LONG AS THE CONFLICT OR POTENTIAL CONFLICT CONTINUES TO EXIST. THE DISCLOSURE STATEMENT SHALL INCLUDE A DESCRIPTION OF THE RELATIONSHIP OR INTEREST CAUSING THE CONFLICT OR POTENTIAL CONFLICT, THE ROLE IN THE RELATIONSHIP OR TRANSACTION PLAYED BY THE PERSON HAVING THE CONFLICT, AND THE BENEFITS AND DETERMENTS ACCRUING TO THE HOSPITAL AND TO THE PERSON HAVING THE CONFLICT AS A RESULT OF THE CONTRACT, TRANSACTION, OR RELATIONSHIP. ANY MEMBER OF THE BOARD OF DIRECTORS HAVING AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER CONSTITUTING A CONFLICT. THE INTERESTED DIRECTOR MAY, HOWEVER, BE COUNTED FOR THE PURPOSE OF DETERMINING WHETHER A QUORUM OF THE BOARD, OR OF A COMMITTEE OF THE BOARD, EXISTS. THE MATTER CONSTITUTING THE CONFLICT SHALL BE APPROVED IF IT IS APPROVED BY A MAJORITY OF DISINTERESTED DIRECTORS VOTING ON THE MATTER. THE CONFLICT OF INTEREST POLICY SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF THE BOARD OF DIRECTORS AND THAT ANY NEW MEMBERS OF THE SAID BOARD OF DIRECTORS BE ADVISED OF THE POLICY UPON ENTERING ON THE DUTIES OF HIS/HER OFFICE. IN ADDITION TO THE BOARD OF DIRECTORS BEING HELD TO THE CONFLICT OF INTEREST POLICY, COPIES OF THE POLICY ARE AVAILABLE TO ALL MANAGEMENT EMPLOYEES. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED ANNUALLY BY ALL DIRECTORS, OFFICERS, MANAGING EMPLOYEES, AND EMPLOYED MEDICAL STAFF. THE COMPLETED FORMS ARE KEPT ON FILE BY THE HOSPITAL'S COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL IS BASED UPON APPLICABLE STATEWIDE COMPENSATION SURVEYS. IN ADDITION, THE COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. THE COMPENSATION OF OTHER TOP OFFICIALS ARE BASED UPON APPLICABLE STATEWIDE COMPENSATION SURVEYS. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2024.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND OTHER ORGANIZING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	CHANGE IN INVESTMENT IN UNCONSOLIDATED 540,178. EQUITY TRANSFERS -7,078,002.

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

Cat. No. 51056K

Schedule O (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)
(Rev. January 2025)

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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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)BLUEWATER HEALTHCARE NETWORK 2770 MAIN STREET MARLETTE,MI48453 46-5444203	PARENT	MI		LINE 12A, I	N/A		No
(2)DECKERVILLE COMMUNITY HOSPITAL 3559 PINE STREET DECKERVILLE,MI48427 38-1415390	HOSPITAL	MI		LINE 3	BLUEWATER HEALTHCARE NETWORK		No
(3)MARLETTE SENIOR LIVING 6305 BLUEWATER COURT MARLETTE,MI48453 84-3210271	SENIOR LIVING	MI		LINE 10	BLUEWATER HEALTHCARE NETWORK		No
(4)HILLS & DALES GENERAL HOSPITAL 4675 HILL STREET CASS CITY,MI48726 38-1619577	HOSPITAL	MI		LINE 3	BLUEWATER HEALTHCARE NETWORK		No
(5)HILLS & DALES HEALTH CARE CORPORATION 4675 HILL STREET CASS CITY,MI48726 38-2622537	MANAGE EXCESS FUNDS ON BEHALF OF SUBSIDIARIES	MI	501(C)(3)	LINE 12B, II	BLUEWATER HEALTHCARE NETWORK		No
(6)ASPIRE RURAL HEALTH SYSTEM FOUNDATION 4675 HILL STREET CASS CITY,MI48726 35-2368240	SOLICIT FUNDS ON BEHALF OF HOSPITAL	MI	501(C)(3)	LINE 12A, I	BLUEWATER HEALTHCARE NETWORK		No
(7)NORTHEAST TUSCOLA HEALTHCARE 4675 HILL STREET CASS CITY,MI48726 47-5387652	RENTAL OF BUILDING TO HOSPITAL	MI	501(C)(3)	LINE 12B, II	HILLS & DALES GENERAL HOSPITAL INC		No
(8)NSB LAND HOLDING INC 4675 HILL STREET CASS CITY,MI48726 88-3867204	LAND HOLDING	MI	501(C)(3)	LINE 12A, I	HILLS & DALES HEALTHCARE CORPORATION		No

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

Cat. No. 50135Y

Schedule R (Form 990) (Rev. 1-2025)

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) THUMB MRI LLC 6320 VAN DYKE ROAD CASS CITY,MI48726 36-4107673	IMAGING	MI	N/A	RELATED	1,002,620	1,161,509		No		Yes		33.330 %

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) SELAD CORPORATION 4675 HILL STREET CASS CITY,MI48726 38-2680346	RETAIL PHARMACY	MI	N/A	C					No

Schedule R (Form 990) (Rev. 1-2025)

Page 3

Part V

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

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

Yes

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

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) (Rev. 1-2025)

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) (Rev. 1-2025)

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) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDING EXCEPTIONAL CARE CLOSE TO HOME AS THE LEADING RURAL HEALTHCARE ORGANIZATION.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2024 (Part V, line 2a) ......	5	409
6	Total number of volunteers (estimate if necessary) .............	6	34
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	726,082	238,292
9	Program service revenue (Part VIII, line 2g) .........	44,763,322	29,404,953
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	481,320	577,461
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	571,345	511,026
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	46,542,069	30,731,732
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	17,135	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)	26,942,540	18,537,044
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)....	18,275,028	11,639,382
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	45,234,703	30,176,426
19	Revenue less expenses. Subtract line 18 from line 12.......	1,307,366	555,306
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	36,247,043	31,634,110
21	Total liabilities (Part X, line 26).............	4,017,703	5,523,499
22	Net assets or fund balances. Subtract line 21 from line 20.....	32,229,340	26,110,611

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 25,279,159 including grants of $ 0 ) (Revenue $ 29,404,953 )
	DURING THE REPORTING PERIOD FROM JULY 1, 2024 TO DECEMBER 31, 2024, MARLETTE REGIONAL HOSPITAL SERVED 1,430 ACUTE AND SWING BED DAYS, 5,086 EMERGENCY DEPARTMENT VISITS, AND SERVED 20,068 VISITS IN ITS FAMILY HEALTH PRACTICES.RECOGNIZING ITS MISSION TO THE COMMUNITY, THE HOSPITAL PARTICIPATES IN THE FEDERAL GOVERNMENT'S MEDICARE PROGRAM AND NUMEROUS MEDICAID HEALTH PLANS, OFTEN PROVIDING CHARITY CARE OR SERVICE AT RATES OF REIMBURSEMENT THAT ARE BELOW THE HOSPITAL'S ACTUAL COST. OTHER COMMUNITY BENEFITS ARE PROVIDED THROUGH MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED ON ACTIVITIES AND SERVICES THAT MRH BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. A SAMPLING OF THESE COMMUNITY BENEFITS IS PROVIDED BELOW: EDUCATIONAL SERVICES/PROGRAMS:- ABUSE AND NEGLECT RECOGNITION TRAINING FOR HOSPITAL STAFF- CAREER GUIDANCE FOR AREA SCHOOL STUDENTS- COOPERATIVE PROFESSIONAL TRAINING WITH LOCAL COLLEGES- DISEASE/CONDITION-SPECIFIC EDUCATION, E.G., DIABETES- EDUCATION/COUNSELING FOR FAMILIES OF PATIENTS- EDUCATION/COUNSELING FOR PATIENTS- EDUCATIONAL PROGRAMS FOR EMPLOYEES (ADULT EDUCATION)- ORGAN DONATION INFORMATION CAMPAIGNS- SUPPORT GROUPS FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY- TRAINING OF PUBLIC HEALTH AND SAFETY PERSONNELCOMMUNITY WELLNESS CAMPAIGNS/PROGRAMS:- HEALTH PROMOTION AND PREVENTIONS ACTIVITIES- DISCHARGE PLANNING WITH FOLLOW-UP SUPPORT PROGRAMS- HEALTH PROMOTION/WELLNESS PROGRAMS- HEALTH SCREENING/HEALTH FAIRS- NUTRITION AND WEIGHT CONTROL- KNOW YOUR NUMBERS LOW-COST SCREENING, MARLETTE REGIONAL HOSPITAL OFFERED A REDUCED RATE HEALTH SCREENING INCLUDING ACHILLES BONE DENSITY, BASIC METABOLIC PANEL, COMPLETE BLOOD COUNT, GLUCOSE, HBA1C, LIPID PROFILE, LIVER PANEL, POTASSIUM, PROSTATE-SPECIFIC ANTIGEN (PSA), MICROALBUMIN, SPIROMETRY, THYROID-STIMULATING HORMONE (TSH), AND VITAMIN D. - B.C.U.P.S. (THE BREAST CANCER UNDERSTANDING PREVENTION AND SCREENING) PROGRAM IS IN PLACE TO FINANCIALLY ASSIST PATIENTS IN ACQUIRING IMPORTANT SCREENING MAMMOGRAMS AND DIAGNOSTIC TESTING SERVICES.- $10 SPORTS PHYSICALS IN JUNE, JULY & AUGUST. MARLETTE REGIONAL HOSPITAL'S FAMILY HEALTHCARE OFFICES WILL OFFER REDUCED-PRICE SPORTS PHYSICALS TO AREA ATHLETES FOR A COST OF TEN DOLLARS IN THE MONTHS OF JUNE, JULY AND AUGUST, AND HALF OF THE PROCEEDS WILL BE DONATED BACK TO LOCAL SCHOOLS' ATHLETIC PROGRAMS.- MARLETTE REGIONAL HOSPITAL HOSTS BLOOD DRIVES THROUGHOUT THE YEAR AND PROVIDES FOOD FOR DONORS AND PARTICIPANTS.MRH SERVICES/PROGRAMS:- EMERGENCY SERVICES DEPARTMENT- ADVANCED LIFE SUPPORT AMBULANCE SERVICE- FIRE AND POLICE ASSISTANCE- HELICOPTER TRANSFER ASSISTANCE- CLINICAL SERVICES- CERTIFIED RURAL HEALTH CLINICS- CHILDHOOD & ADULT IMMUNIZATIONS- TELE-STROKE VIRTUAL MEDICINE- PRIMARY CARE SERVICES- ACUTE MEDICAL AND SURGICAL SERVICES- RESIDENTIAL AND HOME-BASED HOSPICE SERVICES- UNIQUELY-ACCREDITED HOSPITAL, LABORATORY, CARDIOPULMONARY, HOSPICE AND LONG-TERM CARE SERVICES- MOBILE PET AND BONE DENSITY TESTING TECHNOLOGY- COORDINATION OF PATIENT CARE SERVICES IN HOSPITAL- FREE OR LOW-COST SERVICES TO LOW-INCOME FAMILIES- GENERAL HEALTH SCREENING CLINICS- RESPIRATORY/PULMONARY DISEASE SERVICES- SCHOOL SPORTS PHYSICALS- SKILLED NURSING SERVICES/INTERMEDIATE CARE FACILITY- WOUND CARE CLINIC- PEDIATRIC SERVICES- CRTN CANCER CENTER SERVICES - ADVOCACY ON BEHALF OF SPECIFIC PATIENTS NEEDING INTERVENTION WITH PUBLIC AGENCIES (SOCIAL SERVICES)- GUIDANCE AND REFERRAL TO COMMUNITY SERVICES AND PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICAID- TRANSLATION OR INTERPRETER SERVICES FOR NON-ENGLISH-SPEAKING PATIENTS- SUPPORT FOR OTHER HEALTH CARE PROVIDERS- VISITING MEDICAL AND SURGICAL SPECIALISTS TO COMPLEMENT PRIMARY CARE- TRANSITIONS PROGRAM THIS IS A FREE SERVICE RAN THROUGH HOSPICE.- FREE MATTER OF BALANCE PROGRAM- CENTRAL MICHIGAN UNIVERSITY COLLEGE OF MEDICINE- COVENANT REGIONAL THUMB NETWORK (CRTN)- DECKERVILLE COMMUNITY HOSPITAL- THE HEARTLANDS, INDEPENDENT LIVING, MEMORY CARE AND ASSISTED LIVING - MICHIGAN CENTER FOR RURAL HEALTH- SANILAC COUNTY HEALTH DEPARTMENT- THUMB COMMUNITY HEALTH PARTNERSHIP (TCHP)- THUMB OPIOID RESPONSE CONSORTIUM (TORC)- HILLS & DALES HEALTHCARE- AFTER HOURS CARE (MARLETTE QUICK CARE)- AQUABLATION THERAPY- PODIATRY- ORTHOPEDICS- SPINEHELP US HELP OUR OWN - THIS IS A PROGRAM THAT THE FOUNDATION RUNS WHERE THE PROCEEDS GO TO A FUND THAT SUPPORT ASPIRE EMPLOYEES IN NEED. A REQUEST CAN BE SUBMITTED TO THE FOUNDATION BOARD ON BEHALF OF AN EMPLOYEE WHO IS IN NEED DUE TO A TRAUMATIC EVENT WHETHER IT IS THEIR HEALTH/FAMILY HEALTH/TERRIBLE ACCIDENT, ETC AND THE BOARD CAN APPROVE THE SITUATION AND GIVE XX DOLLARS FROM THIS FUND TO AN EMPLOYEE TO HELP THEM OUT DURING THIS TIME.5TH SATURDAY - THIS IS A PROGRAM WHERE ASPIRE EMPLOYEES VOLUNTEER TO DO A COMMUNITY SERVICE IN ONE OF THE ASPIRE COMMUNITIES.MARLETTE REGIONAL HOSPITAL IS COMMITTED TO SERVING OUR PATIENTS IN WAYS THAT RESPECT THE ORIGINAL VALUES OF OUR COMMUNITY - COMPASSION FOR OUR NEIGHBORS AND A SENSE OF DUTY TO SERVE THOSE IN NEED. IN RESPECTING THESE VALUES, MARLETTE REGIONAL HOSPITAL ACKNOWLEDGES ITS OBLIGATION TO OFFER SERVICES TO PATIENTS THAT MAY NOT BE ABLE TO FULLY AFFORD THE CARE THEY NEED, WHILE ALSO SERVING THE HEALTH IMPROVEMENT NEEDS OF OUR LARGER COMMUNITY. TO THAT END, THE HOSPITAL HAS ADOPTED POLICIES THAT DESCRIBE HOW.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses25,279,159

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) ANJANETTE KEMP........................................................................ PHYSICIAN	40.00 .......................0.00	X	317,271	0	73,399
(19) FARAAZ AHMED........................................................................ PHYSICIAN	16.00 .......................24.00	X	197,974	292,624	29,634

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	2,006,332	1,142,626	294,196

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

f	All other contributions, gifts, grants, and similar amounts not included above		1f	238,292

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

h Total. Add lines 1a-1f.......		238,292

		Business Code
2a	NET PATIENT REVENUE	621500	29,320,678	29,320,678
b	PHARMACY REVENUE	456110	84,275	84,275
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		29,404,953

3 Investment income (including dividends, interest, and othersimilar amounts) ......			172,824			172,824
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	245,616
b	Less: rental expenses	6b	95,617
c	Rental income or (loss)	6c	149,999
d	Net rental income or (loss).......			149,999			149,999
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		576,959
b	Less: cost or other basis and sales expenses	7b		172,322
c	Gain or (loss)	7c		404,637
d	Net gain or (loss).........			404,637			404,637
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
11a	COST RECOVERY REVENUE		900099	156,269			156,269
b	CONTRACTED SERVICE REVENUE		900099	94,512			94,512
c	CAFETERIA REVENUE		900099	78,356			78,356
d	All other revenue ....			31,890			31,890
e	Total. Add lines 11a–11d ......			361,027
12	Total revenue. See instructions.....			30,731,732	29,404,953	0	1,088,487

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 ...........	178,629		178,629
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........	14,438,487	12,638,008	1,800,479
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	450,203	395,598	54,605
9	Other employee benefits .......	2,481,412	2,149,112	332,300
10	Payroll taxes ...........	988,313	854,985	133,328
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	22,177		22,177
c	Accounting ...........	399		399
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,462,941	2,306,926	156,015
12	Advertising and promotion ....	139,011	44,935	94,076
13	Office expenses .......	334,316	108,067	226,249
14	Information technology ......	550,518	177,954	372,564
15	Royalties ..
16	Occupancy ...........	442,745	392,883	49,862
17	Travel ............	41,452	13,399	28,053
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	39,121	12,646	26,475
20	Interest ...........	11,527	9,483	2,044
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	874,121	747,377	126,744
23	Insurance ...	212,899	212,899
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	MEDICAL SUPPLIES	3,074,922	2,877,589	197,333
b	BAD DEBT EXPENSE	1,514,065	1,514,065
c	TAXES AND LICENSES	853,871	276,012	577,859
d	REPAIRS AND MAINTENANCE	559,876	383,845	176,031
e	All other expenses	505,421	163,376	342,045
25	Total functional expenses. Add lines 1 through 24e	30,176,426	25,279,159	4,897,267	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 ........			2,191,295	1	2,569,514
2	Savings and temporary cash investments .........			7,098,594	2	368,717
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			9,440,918	4	10,972,846
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 ............			271,241	8	256,425
9	Prepaid expenses and deferred charges ......			203,385	9	317,067
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	42,443,616
b	Less: accumulated depreciation	10b	28,817,649	13,367,146	10c	13,625,967
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			845,805	13	1,354,694
14	Intangible assets ...............			0	14	11,686
15	Other assets. See Part IV, line 11 ...........			2,828,659	15	2,157,194
16	Total assets. Add lines 1 through 15 (must equal line 33)...			36,247,043	16	31,634,110

17	Accounts payable and accrued expenses .....	3,578,457	17	4,564,815
18	Grants payable ...	130,964	18	0
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to 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 ..	7,093	23	364,153
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	301,189	25	594,531
26	Total liabilities. Add lines 17 through 25..	4,017,703	26	5,523,499

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	32,183,619	27	26,110,611
28	Net assets with donor restrictions ...........	45,721	28	0
	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 ...........	32,229,340	32	26,110,611
33	Total liabilities and net assets/fund balances ........	36,247,043	33	31,634,110