SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MUNSON MEDICAL GROUP
 
Employer identification number

27-3600575
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to 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" to 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?
Yes No
(1) MUNSON DIALYSIS CENTER

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-3097861 		DIALYSIS MI C3 3 MUNSON HC
MUNSON HEALTHCARE
 
No
(2) MUNSON HEALTHCARE

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2640544 		PARENT MI C3 11B NA
 
 
No
(3) MUNSON HEALTHCARE REGIONAL FOUNDATI
FOUNDATION
1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2642724 		RAISE FUND MI C3 7 MUNSON HC
MUNSON HEALTHCARE
 
No
(4) MUNSON HOME CARE

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2191390 		HOME HEALT MI C3 9 MUNSON HOM
MUNSON HOME HEALTH
 
No
(5) MUNSON HOME HEALTH

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-3335362 		HOME HEALT MI C3 11B MUNSON HC
MUNSON HEALTHCARE
 
No
(6) MUNSON HOME SERVICES

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2543463 		HOME HEALT MI C3 9 MUNSON HOM
MUNSON HOME HEALTH
 
No
(7) MUNSON MEDICAL CENTER

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-1362830 		HOSPITAL MI C3 3 MUNSON HC
MUNSON HEALTHCARE
 
No
(8) NORTH FLIGHT INC

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2657917 		MED TRANSP MI C3 11B MUNSON HC
MUNSON HEALTHCARE
 
No
(9) PAUL OLIVER MEMORIAL HOSPITAL

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-1415623 		HEALTHCARE MI C3 3 MUNSON HC
MUNSON HEALTHCARE
 
No
(10) PAUL OLIVER MEMORIAL HOSPITAL FOUND
FOUNDATION
1105 SIXTH ST

TRAVERSE CITY,MI49684
23-7201619 		RAISE FUND MI C3 7 PAUL OLIVE
PAUL OLIVER MEMORIAL HOSPITAL
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Page 2
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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
Yes No Yes No
(1) MUNSON MEDICAL BUILDING PARTNERS

PO BOX 1188
TRAVERSE CITY,MI49685
38-2830005 		REAL ESTAT MI N/A
         No     No  
(2) NORTHERN MICHIGAN SUPPLY ALLIANCE

2651 AERO PARK DR
TRAVERSE CITY,MI49686
38-3453378 		PURCHASING MI N/A
         No     No  
(3) MUNSON MEDICAL BUILDING PARTNERS

PO BOX 1188
TRAVERSE CITY,MI49685
38-2830005 		REAL ESTAT MI N/A
         No     No  
(4) NORTHERN MICHIGAN SUPPLY ALLIANCE

2651 AERO PARK DR
TRAVERSE CITY,MI49686
38-3453378 		PURCHASING MI N/A
         No     No  






Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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?
Yes No
(1) MUNSON SUPPORT SERVICES

PO BOX 1188
TRAVERSE CITY,MI49685
38-2872821 		LAUNDRY MI N/A
           No
(2) MUNSON SERVICES INC

PO BOX 1188
TRAVERSE CITY,MI49685
38-3144382 		PHARMACY MI N/A
           No
(3) MEDICAL OFFICE BUILDING CONDOMINUM
MEDICAL OFFICE BUILDING CONDOMINUM
PO BOX 1188
TRAVERSE CITY,MI49685
38-3567278 		REAL ESTAT MI N/A
           No
(4) SIXTH STREET DRUGS INC

PO BOX 1188
TRAVERSE CITY,MI49685
38-2298290 		PHARMACY MI N/A
           No
(5) MEDICAL OFFICE CONDOMINIUM
MEDICAL OFFICE CONDOMINIUM
PO BOX 1188
TRAVERSE CITY,MI49685
20-1902620 		REAL ESTAT MI N/A
           No
(6) MUNSON MOBILE IMAGING

PO BOX 1188
TRAVERSE CITY,MI49685
38-2704069 		IMAGING MI N/A
           No
(7) MUNSON SUPPORT SERVICES

PO BOX 1188
TRAVERSE CITY,MI49685
38-2872821 		LAUNDRY MI N/A
           No
(8) MUNSON SERVICES INC

PO BOX 1188
TRAVERSE CITY,MI49685
38-3144382 		PHARMACY MI N/A
           No
(9) MEDICAL OFFICE BUILDING CONDOMINUM
MEDICAL OFFICE BUILDING CONDOMINUM
PO BOX 1188
TRAVERSE CITY,MI49685
38-3567278 		REAL ESTAT MI N/A
           No
(10) SIXTH STREET DRUGS INC

PO BOX 1188
TRAVERSE CITY,MI49685
38-2298290 		PHARMACY MI N/A
           No
(11) MEDICAL OFFICE CONDOMINIUM
MEDICAL OFFICE CONDOMINIUM
PO BOX 1188
TRAVERSE CITY,MI49685
20-1902620 		REAL ESTAT MI N/A
           No
(12) MUNSON MOBILE IMAGING

PO BOX 1188
TRAVERSE CITY,MI49685
38-2704069 		IMAGING MI N/A
           No
Schedule R (Form 990) 2012
Page 3
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to 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
No
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 . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
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 other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MUNSON MEDICAL CENTER

 C 4,900,000 FMV
(2) MUNSON MEDICAL CENTER

 L 482,674 FMV
(3) MUNSON HEALTHCARE

 M 85,512 FMV
(4) MUNSON MEDICAL CENTER

 Q 86,697 FMV
(5) MUNSON MEDICAL CENTER

 M 440,712 FMV
(6) MUNSON MEDICAL CENTER

 O 5,901,702 FMV
(7) MUNSON HEALTHCARE

 P 85,529 FMV
(8) MUNSON MEDICAL CENTER

 P 17,062,339 FMV
(9) NORTHERN MICHIGAN SUPPLY ALLIANCE

 P 112,643 FMV
(10) MUNSON MEDICAL CENTER

 C 4,900,000 FMV
(11) MUNSON MEDICAL CENTER

 L 482,674 FMV
(12) MUNSON HEALTHCARE

 M 85,512 FMV
(13) MUNSON MEDICAL CENTER

 Q 86,697 FMV
(14) MUNSON MEDICAL CENTER

 M 440,712 FMV
(15) MUNSON MEDICAL CENTER

 O 5,901,702 FMV
(16) MUNSON HEALTHCARE

 P 85,529 FMV
(17) MUNSON MEDICAL CENTER

 P 17,062,339 FMV
(18) NORTHERN MICHIGAN SUPPLY ALLIANCE

 P 112,643 FMV
Schedule R (Form 990) 2012
Page 4
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(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
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Page 5
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation

Additional Data


Software ID:  
Software Version: