Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2018 , and ending 06-30-2019
BCheck if applicable:
CName of organization
Spectrum Health System Group Return
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
100 Michigan St NE MC 498
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Grand Rapids, MI49503
D Employer identification number

61-1740292
E Telephone number

(616) 774-5083
G Gross receipts $ 3,709,955,344
F Name and address of principal officer:
Christina Freese Decker
100 Michigan St NE MC 498
Grand Rapids,MI49503
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.spectrumhealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions) Click to see attachment
H(c)
Group exemption number MediumBullet5981
K Form of organization:  
L Year of formation:  
M State of legal domicile:
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: to improve health, inspire hope and save lives.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 181
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 102
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 25,651
6 Total number of volunteers (estimate if necessary) ............. 6 2,518
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 3,844,026
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 568,426
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 36,959,919 35,597,350
9 Program service revenue (Part VIII, line 2g) ......... 3,210,956,256 3,457,251,094
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 8,799,516 13,377,035
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 16,830,365 17,480,744
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 3,273,546,056 3,523,706,223
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,850,412 2,365,034
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,635,362,501 1,682,744,736
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet2,561,227    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,527,331,784 1,673,311,621
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 3,164,544,697 3,358,421,391
19 Revenue less expenses. Subtract line 18 from line 12....... 109,001,359 165,284,832
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,549,742,190 2,644,725,310
21 Total liabilities (Part X, line 26)............. 1,176,332,583 1,137,174,371
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,373,409,607 1,507,550,939
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet 2020-03-11
Signature of officer Date
JumboBullet Matthew E CoxSVP, Chief Financial Officer
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
 
PTIN
P01240455
Firm's name MediumBullet
BDO USA LLP
 
Firm's EIN MediumBullet13-5381590
Firm's address MediumBullet
200 OTTAWA AVE NW SUITE 300
 
GRAND RAPIDS, MI49503
Phone no. (616) 774-7000
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2018)
Page 2
Form 990 (2018)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: to improve health, inspire hope and save lives.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,447,274,551 including grants of $ 1,939,006 ) (Revenue $ 3,040,284,026 )
SPECTRUM HEALTH SYSTEM GROUP REFLECTS THE COMPOSITE INFORMATION AND OPERATIONS OF 15 TAX EXEMPT ENTITIES, INCLUDING 11 SEPARATELY LICENSED HOSPITALS, A SKILLED NURSING FACILITY, LONG-TERM ACUTE REHABILITATION AND HOME CARE, A MULTISPECIALTY PHYSICIAN GROUP, AND A CHARITABLE FOUNDATION. THE SPECTRUM HEALTH SYSTEM GROUP INCLUDES MORE THAN 175 SERVICE SITES, PHYSICIAN OFFICES AND OUTPATIENT LOCATIONS, PROVIDING CONVENIENT ACCESS TO SERVICES THROUGHOUT OUR 13-COUNTY SERVICE AREA. DURING THE FISCAL YEAR ENDED JUNE 30, 2019 THE SPECTRUM HEALTH INTEGRATED HEALTH SYSTEM PROVIDED NEARLY $467 MILLION IN COMMUNITY BENEFIT PROGRAMS TO WEST MICHIGAN. THE COMMUNITY BENEFIT ACTIVITIES INCLUDED HEALTH CLINICS, RESEARCH, DONATIONS, CHARITY CARE, BAD DEBTS RELATED TO CARING FOR THE UNINSURED AND UNDERINSURED, COSTS FOR GOVERNMENT PROGRAM PATIENTS, COMMUNITY PARTNERSHIP PROGRAMS, HEALTH PROFESSION EDUCATION, AND DISCOUNTED CARE UNDER HEALTHY MICHIGAN PLAN (UNDER 250% FEDERAL POVERTY LEVEL). SPECTRUM HEALTH HOSPITAL GROUP - SEE SCHEDULE O
4b (Code:   ) (Expenses $ 619,160,257 including grants of $   ) (Revenue $ 417,568,173 )
SPECTRUM HEALTH MEDICAL GROUP - SEE SCHEDULE O
4c (Code:   ) (Expenses $ 1,691,348 including grants of $ 426,028 ) (Revenue $   )
SPECTRUM HEALTH FOUNDATION - SEE SCHEDULE O
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet3,068,126,156
Form 990 (2018)
Page 3
Form 990 (2018)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II..............
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part IIIClick to see attachment.............
8
Yes
 
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
Form 990 (2018)
Page 4
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV........................Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
1,247
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2018)
Page 5
Form 990 (2018)
Page 5
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
25,651
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
Yes
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Page 6
Form 990 (2018)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
181
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
102
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCeleste M Mcintyre100 Michigan St NE MC498   Grand Rapids,MI49503 (616) 774-5083
Form 990 (2018)
Page 7
Form 990 (2018)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Lynnette Ferrell-Robinson
 
Chair, SHH
 2.0
.................
0 		X   X       35,000 0 0
(2) Barbara Wynn MD
 
Vice Chair, SHH
 1.0
.................
0 		X   X       22,500 0 0
(3) Mark Wilson
 
See Schedule O
 3.0
.................
0 		X   X       22,500 0 0
(4) Gwen Sandefur
 
See Schedule O
 50.0
.................
0 		X   X       1,249,095 0 381,550
(5) Barbara Geno
 
Chair, SHGM
 2.0
.................
0 		X   X       0 0 0
(6) Eugene Ford
 
Vice Chair, SHGM
 1.0
.................
0 		X   X       0 0 0
(7) MELISSA MILLER
 
Secretary, SHGM
 1.0
.................
0 		X   X       0 0 0
(8) David Robinson
 
Secretary, SHGM - Part Year
 1.0
.................
0 		X   X       0 0 0
(9) William Leaver
 
Treasurer, SHGM
 1.0
.................
0 		X   X       0 0 0
(10) Randall Kelley
 
See Schedule O
 50.0
.................
0 		X   X       385,039 0 113,837
(11) Randall Stasik
 
President, SHGM - Part Year
 50.0
.................
0 		X   X       599,279 0 24,700
(12) Kenneth Rocco
 
Chair, SHL
 2.0
.................
0 		X   X       0 0 0
(13) Marc Lenz
 
Vice Chair, SHL
 1.0
.................
0 		X   X       0 0 0
(14) Anthony Fabaz DO
 
Secretary, SHL
 1.0
.................
0 		X   X       0 0 0
(15) Hon Anthony Monton
 
Treasurer, SHL
 1.0
.................
0 		X   X       0 0 0
(16) Sheryl Thompson
 
Chair, SHBR & SHRC
 4.0
.................
0 		X   X       0 0 0
(17) Terry Nerbonne
 
Vice Chair, SHBR & SHRC
 2.0
.................
0 		X   X       0 0 0
Form 990 (2018)
Page 8
Form 990 (2018)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) David Langworthy
 
SECRETARY, SHBR & SHRC
 4.0
.......................0 		X   X       0 0 0
(19) Richard Saladin
 
Secretary, SHBR & SHRC - Part Year
 2.0
.......................0 		X   X       0 0 0
(20) David Nicol
 
Treasurer, SHBR & SHRC
 2.0
.......................0.0 		X   X       0 0 0
(21) Andrea Leslie
 
See Schedule O
 50.0
.......................0 		X   X       322,852 0 120,190
(22) Mary Kay Vandriel
 
President, SHBR & SHRC - Part Year
 50.0
.......................0.0 		X   X       398,318 0 107,725
(23) Nathan Tagg
 
Chair, SHP
 2.0
.......................0 		X   X       0 0 0
(24) Bradley Johnson
 
Chair, SHP - Part Year
 2.0
.......................0 		X   X       0 0 0
(25) Luann Forbes
 
VICE CHAIR, SHP
 1.0
.......................0 		X   X       0 0 0
(26) Kimberly Norris MD
 
Secretary, SHP
 1.0
.......................0 		X   X       0 0 0
(27) Jeff Weiden
 
Treasurer, SHP
 1.0
.......................0 		X   X       0 0 0
(28) Angela Ditmar
 
President, SHP
 50.0
.......................0 		X   X       311,430 0 67,804
(29) Sheryl Lewis-Blake
 
President, SHP - Part Year
 50.0
.......................0 		X   X       402,888 0 110,635
(30) Steve Bowser
 
Chair, SHU & SHK
 4.0
.......................0 		X   X       0 0 0
(31) Frances Schuleit
 
Vice Chair, SHU & SHK - Part Year
 2.0
.......................0 		X   X       0 0 0
(32) Matthew DeKraker DC
 
Secretary / Treasurer, SHU & SHK
 2.0
.......................0 		X   X       0 0 0
(33) Bradley Dykstra DDS
 
Vice Chair, SHZ
 1.0
.......................0 		X   X       0 0 0
(34) Harold Vanden Bosch
 
Secretary, SHZ
 1.0
.......................0 		X   X       0 0 0
(35) John Walters
 
Treasurer, SHZ
 1.0
.......................0 		X   X       0 0 0
(36) Ron Lewis
 
President, SHZ
 50.0
.......................0 		X   X       395,501 0 126,260
(37) Scott Davis
 
See Schedule O
 50.0
.......................0 		X   X       240,959 0 51,753
(38) Douglas Welday
 
See Schedule O
 50.0
.......................0 		X   X       537,156 0 180,206
(39) Chad Tuttle
 
See Schedule O
 50.0
.......................0 		X   X       338,153 0 126,499
(40) Kevin Smith
 
See Schedule O
 50.0
.......................0 		X   X       224,273 0 34,032
(41) Karen Pakkala
 
See Schedule O
 50.0
.......................0 		X   X       227,595 0 18,590
(42) Jason Slaikeu MD
 
See Schedule O
 50.0
.......................0 		X   X       583,098 0 47,727
(43) John Schuen MD
 
Vice Chair, SHMG
 50.0
.......................0 		X   X       351,686 0 69,009
(44) Brian Phillips
 
Treasurer, SHMG
 50.0
.......................0 		X   X       405,996 0 50,433
(45) Darryl Elmouchi MD
 
See Schedule O
 50.0
.......................1.0 		X   X       1,246,829 0 471,928
(46) Marge Potter
 
Chair, SHF
 2.0
.......................0 		X   X       0 0 0
(47) Maria DeVos
 
Vice Chair, SHF
 1.0
.......................0 		X   X       0 0 0
(48) Ronald Alvesteffer
 
Secretary, SHF
 1.0
.......................0 		X   X       0 0 0
(49) Michael Ellis
 
Treasurer, SHF
 1.0
.......................0 		X   X       0 0 0
(50) Vicki Weaver
 
President, SHF
 50.0
.......................0 		X   X       398,075 0 37,142
(51) Joan A BUDDEN
 
See Schedule O
 2.0
.......................48.0 		X           0 1,766,290 506,915
(52) Christina Freese Decker
 
See Schedule O
 3.0
.......................47.0 		X           0 2,291,815 701,421
(53) Richard DeVos III
 
DIRECTOR, SHH
 1.0
.......................0 		X           0 0 0
(54) Jeff Helminski
 
Director, SHH
 1.0
.......................0 		X           15,000 0 0
(55) Ronald Hofman MD
 
Director, SHH
 1.0
.......................0 		X           20,250 0 0
(56) Charles Holmquist
 
See Schedule O
 3.0
.......................0 		X           17,000 0 0
(57) Kenneth Johnson
 
Director, SHH
 1.0
.......................0 		X           0 0 0
(58) Joseph Jones
 
Director, SHH
 1.0
.......................0 		X           25,000 0 0
(59) David Mack
 
Director, SHH - Part Year
 1.0
.......................0 		X           17,000 0 0
(60) Bill Pink
 
Director, SHH
 1.0
.......................0 		X           13,000 0 0
(61) Karl Roberts
 
Director, SHH
 1.0
.......................0 		X           23,000 0 0
(62) Sam Watson
 
See Schedule O
 2.0
.......................0 		X           0 0 0
(63) Marianne Boerigter
 
Director, SHGM
 1.0
.......................0 		X           0 0 0
(64) John Buckley
 
Director, SHGM
 1.0
.......................0 		X           0 0 0
(65) Michael Danhof
 
Director, SHGM
 1.0
.......................0 		X           0 0 0
(66) M Jane Drake
 
Director, SHGM - Part Year
 1.0
.......................0 		X           0 0 0
(67) David KRHOVSKY MD
 
See Schedule O
 50.0
.......................0 		X           539,412 0 87,003
(68) Ross Nelson
 
Director, SHGM
 1.0
.......................0 		X           0 0 0
(69) Patrick O'Hare
 
See Schedule O
 3.0
.......................47.0 		X           0 1,163,042 247,009
(70) Jordan Sall
 
See Schedule O
 50.0
.......................0 		X           529,782 0 42,591
(71) Shawn Ulreich
 
See Schedule O
 50.0
.......................0 		X           613,706 0 208,478
(72) Linda Cronenwett
 
Director, SHL
 1.0
.......................0 		X           0 0 0
(73) Allen Deering
 
Director, SHL - Part Year
 1.0
.......................0 		X           0 0 0
(74) Melissa Fuehring
 
Director, SHL
 1.0
.......................0 		X           0 0 0
(75) Zane Knoer
 
See Schedule O
 50.0
.......................0 		X           303,848 0 46,181
(76) Allan Nelson MD
 
Director, SHL - Part Year
 50.0
.......................0 		X           250,214 0 59,420
(77) Mark Platt
 
Director, SHL
 1.0
.......................0 		X           0 0 0
(78) James Scatena
 
Director, SHL
 1.0
.......................0 		X           0 0 0
(79) Richard Vandenheuvel
 
Director, SHL
 1.0
.......................0 		X           0 0 0
(80) Carolyn Curtin
 
Director, SHBR & SHRC
 2.0
.......................0 		X           0 0 0
(81) Jerry Garner
 
Director, SHBR & SHRC
 2.0
.......................0 		X           0 0 0
(82) Steven Heacock
 
See Schedule O
 5.0
.......................45.0 		X           0 2,568,918 177,557
(83) Patricia Hoepner
 
Director, SHRC
 50.0
.......................0 		X           250,994 0 39,486
(84) Jason Joseph
 
Director, SHBR & SHRC
 2.0
.......................48.0 		X           0 542,844 160,329
(85) Amy Keller
 
Director, SHBR & SHRC
 2.0
.......................0 		X           0 0 0
(86) Mitchell Miller
 
Director, SHBR & SHRC
 2.0
.......................0 		X           0 0 0
(87) Lisa Price
 
Director, SHBR
 50.0
.......................0 		X           321,005 0 39,943
(88) Deborah Smith-Olson
 
Director, SHBR & SHRC
 2.0
.......................0 		X           0 0 0
(89) David Baum
 
Director, SHP - Part Year
 1.0
.......................0 		X           0 0 0
(90) Cortney Collison
 
Director, SHP
 1.0
.......................0 		X           0 0 0
(91) Kathryn DeCamp
 
Director, SHP
 1.0
.......................0 		X           0 0 0
(92) Nancy Goodin
 
Director, SHP - Part Year
 1.0
.......................0 		X           0 0 0
(93) Donald Haney
 
Director, SHP
 1.0
.......................0 		X           0 0 0
(94) Dan King
 
Director, SHP
 1.0
.......................0 		X           0 0 0
(95) Evan McManus
 
Director, SHP
 1.0
.......................0 		X           0 0 0
(96) Andrew Parsons
 
See Schedule O
 50.0
.......................0 		X           376,874 0 43,244
(97) Pamela Ries
 
Director, SHP
 1.0
.......................49.0 		X           0 996,614 299,629
(98) Eric Ward MD
 
Director, SHP - Part Year
 1.0
.......................0 		X           0 0 0
(99) Domenico Ausiello
 
Director, SHU & SHK
 2.0
.......................0 		X           24,500 0 0
(100) Ovell Barbee
 
See Schedule O
 2.0
.......................0 		X           332,852 0 96,551
(101) Mary Anne Jones
 
Director, SHU & SHK
 2.0
.......................48.0 		X           0 625,572 201,743
(102) Nicole McConnell
 
See Schedule O
 2.0
.......................0 		X           342,950 0 130,973
(103) John Merchun
 
Director, SHU & SHK
 2.0
.......................0 		X           0 0 0
(104) Carolyn Slocum
 
Director, SHU & SHK
 2.0
.......................0 		X           0 0 0
(105) Raymi Sunabe
 
Director, SHU & SHK
 2.0
.......................0 		X           0 0 0
(106) Linda Van Houten
 
Director, SHU & SHK
 2.0
.......................0 		X           0 0 0
(107) Tammy Warner
 
Director, SHU & SHK
 2.0
.......................0 		X           0 0 0
(108) Eduardo Amaya
 
Director, SHZ
 1.0
.......................0 		X           0 0 0
(109) Ulrica Bowen
 
Director, SHZ
 1.0
.......................0 		X           0 0 0
(110) Matthew Cox
 
Director, SHZ
 1.0
.......................49.0 		X           0 1,169,013 518,400
(111) Sabina Otteman
 
Director, SHZ
 1.0
.......................0 		X           0 0 0
(112) Jennifer Owens
 
Director, SHZ
 1.0
.......................0 		X           0 0 0
(113) James Schoettle
 
Director, SHZ
 1.0
.......................0 		X           0 0 0
(114) Thomas Visser MD
 
Director, SHZ
 50.0
.......................0 		X           484,128 0 52,873
(115) Annica Waalkes
 
Director, SHZ
 1.0
.......................0 		X           286,762 0 16,145
(116) Kurt Wassink
 
Director, SHZ
 1.0
.......................0 		X           0 0 0
(117) Tricia Baird
 
See Schedule O
 50.0
.......................0 		X           335,824 0 36,240
(118) Matthew Denenberg MD
 
See Schedule O
 50.0
.......................0 		X           472,192 0 77,339
(119) Gregory Gadbois MD
 
See Schedule O
 1.0
.......................49.0 		X           0 361,551 48,050
(120) JAY LABINE
 
Director, SHCC - Part Year
 1.0
.......................49.0 		X           0 512,071 174,074
(121) Stephanie Murray
 
See Schedule O
 50.0
.......................0 		X           138,815 0 33,815
(122) Simin Beg
 
Director, SHMG
 50.0
.......................0 		X           292,136 0 51,524
(123) Lee Begrow DO
 
Director, SHMG
 50.0
.......................0 		X           340,326 0 53,365
(124) Robert Fitzgerald MD
 
Director, SHMG
 50.0
.......................0 		X           448,484 0 57,523
(125) JAMES FORSHEE MD
 
DIRECTOR, SHMG
 1.0
.......................49.0 		X           0 537,502 152,846
(126) Michael Harrison MD
 
Director, SHMG
 50.0
.......................0 		X           630,028 0 65,205
(127) Melinda Johnson
 
Director, SHMG
 50.0
.......................0 		X           587,972 0 44,358
(128) Harry Knopke PHD
 
Director, SHMG
 1.0
.......................0.0 		X           0 0 0
(129) Mary O'Callaghan
 
Director, SHMG
 50.0
.......................0 		X           288,497 0 29,307
(130) Matthew Steensma MD
 
Director, SHMG
 50.0
.......................0 		X           575,925 0 42,344
(131) Johannie Torres
 
Director, SHMG
 30.0
.......................0 		X           72,222 0 26,321
(132) Brett Zimmerman DO
 
Director, SHMG
 50.0
.......................0 		X           424,106 0 45,052
(133) Richard Antonini
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(134) Jeffrey Bennett
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(135) Patricia Betz
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(136) David Bottrall
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(137) Richard Breon
 
Director, SHF - PART YEAR
 1.0
.......................49.0 		X           0 4,764,822 46,091
(138) Ryan Cook
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(139) Dale Dehaan
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(140) Nancy Hanenburg
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(141) Donnalee Holton
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(142) Candace Matthews
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(143) David Mehney
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(144) Jane Meilner
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(145) Patrick Miles
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(146) Janet Nisbett
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(147) Sarla Puri MD
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(148) Scott Robinson
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(149) Joan Secchia
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(150) Sharon Seys
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(151) Andrew Shannon
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(152) Mary Wachter
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(153) Andrew Weirda
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(154) Aaron Wong
 
Director, SHF
 1.0
.......................0 		X           0 0 0
(155) Brian Brasser
 
See Schedule O
 50.0
.......................0.0 		    X       598,466 0 163,425
(156) Marc Chircop
 
See Schedule O
 50.0
.......................0 		    X       2,357,448 0 236,116
(157) Leslie Flake
 
SVP, Finance - Hospital Group
 50.0
.......................0 		    X       0 0 0
(158) William Jewell
 
Secretary, SHH
 50.0
.......................0 		    X       505,774 0 165,281
(159) Martha Boonstra
 
Secretary, SHMG
 50.0
.......................0 		    X       393,686 0 61,809
(160) Paul Konopacki
 
SVP, Finance, SHMG
 50.0
.......................0 		    X       93,718 0 15,229
(161) Robert Connors
 
President, HDVCH, SHH
 50.0
.......................0 		      X     869,292 0 42,793
(162) Douglas Apple MD
 
Chief Medical Officer, Delivery System - Part Year
 50.0
.......................0 		        X   2,081,146 0 227,350
(163) Konstantin Elisevich
 
VP, Dept. Chief, Neurosciences
 50.0
.......................0 		        X   1,310,374 0 48,405
(164) Marcus Haw
 
Dept Chief, HDVCH Cardiothorac, SHH
 50.0
.......................0 		        X   1,139,686 0 57,926
(165) Peter Jebson
 
VP, Dept. Chief, Orthopaedics, SHMG
 50.0
.......................0 		        X   1,076,915 0 44,404
(166) Charles Sherry
 
Section Chief - Physician, SHMG
 50.0
.......................0 		        X   1,056,863 0 51,947
(167) Ronald Knaus
 
See Schedule O
 0.0
.......................0.0 		          X 0 6,482,565 75,013
(168) Kenneth Fawcett Jr MD
 
See Schedule O
 50.0
.......................0 		          X 405,102 0 111,768
(169) Julie Lepzinski
 
Former SVP, Chief Operating Officer, SHMG
 0.0
.......................0 		          X 372,976 0 0
(170) Seth Wolk MD
 
Former President, SHMG
 0.0
.......................50.0 		          X 0 1,598,854 308,608
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 30,353,472 25,381,473 8,409,439
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet1,787
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
VISIONPRO LLC

3031 WEST GRAND BLVD
SUITE 600
DETROIT,MI48202 		STAFFING 33,973,799
CROSS COUNTRY STAFFING INC

5201 CONGRESS AVE
BOCA RATON,FL33487 		STAFFING 11,756,116
IMPACT ADVISORS LLC

400 E DIEHL RD
SUITE 190
NAPERVILLE,IL60563 		IT CONSULTING 8,011,705
EMERGENCY CARE SPECIALISTS

4100 EMBASSY RD SE 400
GRAND RAPIDS,MI49546 		MEDICAL SERVICES 7,582,626
WEST MICHIGAN SHARED HOSPITAL LAUNDRY

3003 WALKENT DR NW
GRAND RAPIDS,MI49544 		LAUNDRY SERVICES 5,285,492
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet181
Form 990 (2018)
Page 9
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 1,375,281
d Related organizations1d 1,402,630
e Government grants (contributions)1e 6,968,909
f All other contributions, gifts, grants, and similar amounts not included above1f 25,850,530
g Noncash contributions included in lines 1a - 1f:$ 433,264
h Total. Add lines 1a-1f.......MediumBullet 35,597,350
Program Service RevenueAmt Business Code
2a Program Service Revenue 622110 3,395,516,570 3,395,516,570    
b Retail Pharmacy 900099 12,974,017 12,974,017    
c Meaningful Use Revenue - Medicare & Medicaid 900099 1,921,099 1,921,099    
d Reference Lab 900099 3,666,872 0 3,666,872  
e VISITOR PARKING 900099 1,793,479 1,793,479    
f All other program service revenue. 41,379,057 38,104,250 177,154 3,097,653
g Total. Add lines 2a–2f ....MediumBullet 3,457,251,094
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 10,730,166     10,730,166
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   2,892,723
b Less: rental expenses   1,042,029
c Rental income or (loss) 0 1,850,694
d Net rental income or (loss)......MediumBullet 1,850,694     1,850,694
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 1,772,549 184,856,478
b Less: cost or other basis and sales expenses 1,171,444 182,810,714
c Gain or (loss) 601,105 2,045,764
d Net gain or (loss).....MediumBullet 2,646,869 601,105   2,045,764
8a Gross income from fundraising events (not including $ 1,375,281of contributions reported on line 1c). See Part IV, line 18 ....
a 719,828
b Less: direct expenses ...b 1,224,934
c Net income or (loss) from fundraising events..MediumBullet -505,106   -505,106
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a Cafeteria 722514 16,135,156     16,135,156
b            
c            
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... MediumBullet 16,135,156
12 Total revenue. See Instructions......MediumBullet 3,523,706,223 3,450,910,520 3,844,026 33,354,327
Form 990 (2018)
Page 10
Form 990 (2018)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 2,359,034 2,359,034
2 Grants and other assistance to domestic individuals. See Part IV, line 22 6,000 6,000
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 27,160,364 25,223,682 1,936,682  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 881,184 818,351 62,833  
7 Other salaries and wages 1,299,984,895 1,191,683,719 106,740,059 1,561,117
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 52,140,130 47,894,958 4,245,172  
9 Other employee benefits ....... 216,533,246 199,042,394 17,137,487 353,365
10 Payroll taxes ........... 86,044,917 79,204,991 6,839,926  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 555,186   555,186  
c Accounting ........... 58,876   58,876  
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) 92,806,096 85,775,629 6,717,591 312,876
12 Advertising and promotion .... 1,976,565 402,713 1,541,336 32,516
13 Office expenses ....... 46,657,548 37,082,108 9,431,748 143,692
14 Information technology ...... 3,382,745 2,632,558 742,706 7,481
15 Royalties ..        
16 Occupancy ........... 93,702,639 74,953,231 18,748,965 443
17 Travel ............ 6,194,527 4,910,587 1,266,249 17,691
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 8,304,714 6,587,675 1,675,781 41,258
20 Interest ........... 29,231,855 29,231,855    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 172,134,538 154,984,065 17,150,473  
23 Insurance ... 27,614,579 23,117,034 4,497,545  
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 and other Supplies 478,181,273 477,932,551 248,722  
b Shared SVS/MGMT Fees 426,042,844 340,714,920 85,238,565 89,359
c Bad debts 160,697,204 160,697,204    
d QAAP Expense 80,613,740 80,613,740 0  
e All other expenses 45,156,692 42,257,157 2,898,106 1,429
25 Total functional expenses. Add lines 1 through 24e 3,358,421,391 3,068,126,156 287,734,008 2,561,227
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2018)
Page 11
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 82,792 1 0
2 Savings and temporary cash investments ......... 198,458,738 2 406,418,369
3 Pledges and grants receivable, net ...... 28,080,338 3 24,035,024
4 Accounts receivable, net ............. 426,076,033 4 365,182,287
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
191,480 5 64,098
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
0 6 0
7 Notes and loans receivable, net .... 0 7  
8 Inventories for sale or use ........ 43,539,291 8 45,013,306
9 Prepaid expenses and deferred charges ...... 28,955,682 9 26,724,316
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 3,218,782,617
b Less: accumulated depreciation 10b 1,770,073,398 1,482,438,595 10c 1,448,709,219
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 0 12  
13 Investments—program-related. See Part IV, line 11 .. 68,016,091 13 59,071,504
14 Intangible assets ............... 3,429,953 14 3,144,953
15 Other assets. See Part IV, line 11 ........... 270,473,197 15 266,362,234
16 Total assets. Add lines 1 through 15 (must equal line 34)... 2,549,742,190 16 2,644,725,310
Liabilities 17 Accounts payable and accrued expenses ..... 279,337,179 17 285,896,124
18 Grants payable ... 3,101,334 18 3,482,651
19 Deferred revenue ......... 9,578,221 19 3,642,271
20 Tax-exempt bond liabilities ......... 676,723,098 20 648,710,456
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.. 0 22 0
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties .. 70,288,819 24 62,178,968
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 137,303,932 25 133,263,901
26 Total liabilities. Add lines 17 through 25.. 1,176,332,583 26 1,137,174,371
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 1,192,876,512 27 1,332,028,566
28 Temporarily restricted net assets ........... 112,890,694 28 128,699,070
29 Permanently restricted net assets 67,642,401 29 46,823,303
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 1,373,409,607 33 1,507,550,939
34 Total liabilities and net assets/fund balances ........ 2,549,742,190 34 2,644,725,310
Form 990 (2018)
Page 12
Form 990 (2018)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
3,523,706,223
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
3,358,421,391
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
165,284,832
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,373,409,607
5
Net unrealized gains (losses) on investments ...............
5
1,374,166
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-32,517,666
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,507,550,939
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
Form 990, Special Condition Description:
Special Condition Description