2025-01-15T09:17:33-06:00 2023-09-30 331498605 PLANTE & MORAN PLLC 3000 TOWN CENTER SUITE 100 SOUTHFIELD MI 48075 990 2022-10-01 382146751 MCLAREN NORTHERN MICHIGAN MCLA 2314874094 416 CONNABLE AVENUE PETOSKEY MI 49770 DAVID MAZURKIEWICZ SENIOR VICE PRESIDENT & CFO 2314874094 2025-01-14 1 1 AMY CIMINELLO P00796388 2483522500 2025-01-14 2022 2024-10-15 13:58:12Z X GARFIELD ATCHISON 416 CONNABLE AVENUE PETOSKEY MI 49770 272527529 0 X WWW.MCLAREN.ORG/NORTHERNMICHIGAN/ X 1977 MI MCLAREN HEALTH CARE, THROUGH ITS SUBSIDIARIES, WILL BE THE BEST VALUE IN HEALTH CARE AS DEFINED BY QUALITY OUTCOMES AND COST. 14 11 1392 21 24322 0 17590087 14349489 250994873 254721562 11368472 1513286 2556704 1022932 282510136 271607269 36174 36174 0 0 106172305 100486743 0 0 0 145672789 148302915 251881268 248825832 30628868 22781437 411971616 384770690 243850868 207112631 168120748 177658059 MCLAREN HEALTH CARE, THROUGH ITS SUBSIDIARIES, WILL BE THE BEST VALUE IN HEALTH CARE AS DEFINED BY QUALITY OUTCOMES AND COST. 0 0 174283539 36174 254721562 ACUTE MEDICAL AND SURGICAL HOSPITAL, 7,472 DISCHARGES, 31,079 PATIENT DAYS, 32,439 EMERGENCY ROOM VISITS AND 7,383 SURGERIES 174283539 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 143 0 1 1392 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 11 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 1 0 X MICHAEL PRUSAITIS 2314874011 416 CONNABLE AVENUE PETOSKEY MI 49770 X TODD BURCH DIRECTOR & PRESIDENT/CEO 39.00 6.00 X X 0 630578 137289 DENNIS HESSELINK CHAIRPERSON 1.00 0.00 X X 0 0 0 JULIE FASONE-HOLDER VICE CHAIRPERSON 1.00 0.00 X X 0 0 0 TOM CATTEL SECRETARY 1.00 0.00 X X 0 28000 0 CHAD GRANT MHC CHIEF OPERATING OFFICER 1.00 53.00 X 0 1580849 36868 STEVE BROWN DIRECTOR 1.00 0.00 X 0 0 0 KATHY ERBER DIRECTOR 1.00 0.50 X 0 0 0 ELISE FISHER DIRECTOR 1.00 5.00 X 0 0 0 MATTHEW FRENTZ DIRECTOR 1.00 2.50 X 0 0 0 CHRISTINE GEBHARD DIRECTOR 1.00 0.00 X 0 0 0 PATRICIA HEMINGWAY HALL DIRECTOR 1.00 0.00 X 0 0 0 KEN KREUCHAUF MD DIRECTOR 1.00 0.00 X 0 0 0 JULIA MUELLER DIRECTOR 1.00 0.00 X 0 0 0 CRAIG ROGERSON DIRECTOR 1.00 0.00 X 0 0 0 CHANDRA DELORENZO DIRECTOR-PART YEAR 1.00 0.00 X 0 0 0 BOB WALKER DIRECTOR-PART YEAR 1.00 0.00 X 0 0 0 ANDREW M MCDONAGH VP - CMO 39.00 6.00 X 428982 0 34731 MICHAEL PRUSAITIS VP OF FINANCE/CFO 39.00 6.00 X 321164 0 25234 SHARI A SCHULT VP OF OPERATIONS 39.00 6.00 X 250702 0 12349 LAURA DANIEL VP OF OPERATIONS - PART YEAR 39.00 6.00 X 218636 0 16959 JULIE JAREMA VP - PHILANTHROPY 1.00 44.00 X 0 193268 25410 DAVID MONAN VP - CNO 39.00 6.00 X 156419 0 23514 BRETT MALEK VP HR - START 2023 39.00 6.00 X 0 0 0 ANAS ORFALI MEDICAL PHYSICIST 40.00 0.00 X 229311 0 22307 MARLA CLARK SENIOR DIRECTOR OF CATDIOVASCULAR SV 40.00 0.00 X 197118 0 15047 KELLY JOHNSON RN, TEAM LEAD CC 40.00 0.00 X 168273 0 18956 KATHLEEN ST PIERRE DIRECTOR PATIENT CARE SVCS 40.00 0.00 X 160253 0 15358 JAMES STRADLING REG NURSE TEMP 40.00 0.00 X 155783 0 5466 JENNIFER I WOODS VP - CNO - FORMER 39.00 6.00 X 299425 0 17340 DEBBIE ROSENBURG VP HR - FORMER 39.00 6.00 X 256532 0 11386 2842598 2432695 418214 61 1 1 0 AMERICAN HEALTHCARE STAFFING ASSOCIATIO PO BOX 670529 DALLAS TX 752670529 CONTRACT LABOR 8610238 APOGEE MEDICAL MANAGEMENT INC 15059 N SCOTTSDALE RD STE 600 SCOTTSDALE AZ 85254 PHYSICIAN SERVICES 3981474 PCO PC PO BOX 208365 DALLAS TX 75320 PHYSICIAN SERVICES 2929542 DELPHI OF TEAM HEALTH PO BOX 634850 CINCINNATI OH 452634850 PHYSICIAN SERVICES 2347127 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 303682289 MANAGEMENT & DIETARY SERVICES 2163009 30 13750809 580330 18350 14349489 PATIENT SERVICE REV 621500 254321875 254321875 RELATED-PARTY RENT 531390 399687 399687 254721562 1740370 1740370 776328 693176 83152 83152 83152 227084 -227084 -227084 -227084 CAFETERIA SALES 722210 497596 497596 CLINICAL INTEGRATION PAYMENT 900099 230494 230494 LAUNDRY 900099 24322 24322 187368 187368 939780 271607269 254721562 24322 2511896 X 36174 36174 1527441 1527441 82020117 58173346 23846771 12447661 2491385 9956276 4491524 3511373 980151 150579 150579 106550 106550 51123137 19380252 31742885 4787496 3134623 1652873 15458527 12138693 3319834 MEDICAL SUPPLIES 66851462 66535430 316032 PROVISION FOR BAD DEBT 8528715 8528715 NET PERIODIC PENSION CO 942901 942901 RELATED PARTY RENT EXPE 353548 353548 248825832 174283539 74542293 0 5348 4548 42205270 6903672 39576037 30034314 7915370 8058017 1102210 1478360 322654307 84025873 231314978 238628434 51506736 60025455 24629 12926 145759 608279 18610478 16601927 19564801 22414758 411971616 384770690 52162759 25327004 1982340 1877297 149366154 147413111 40339615 32495219 243850868 207112631 X 168120748 177658059 168120748 177658059 411971616 384770690 X 22781437 6073937 -19318064 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4719 4719 0 PART II-B, LINE 1: A PORTION OF OUR DUES TO MICHIGAN HEALTH AND HOSPITAL ASSOCIATION SUPPORT LOBBYING ACTIVITIES ON BEHALF OF MCLAREN NORTHERN MICHIGAN'S COMMON INTERESTS. 0 4276 659 4935 6864 -1565 1023 4276 5767 1097 6864 6454 -157 530 5767 14731 -277 8000 6454 0.00000 1.00000 0.00000 0 1 1 7278303 7278303 190836151 28568023 162268128 6788662 2231701 4556961 76668931 47842351 28826580 41082260 5383798 35698462 238628434 DUE FROM AFFILIATE 10521982 DEFERRED EQUIPMENT FEES 11892776 22414758 PENSION 457B 585279 LTD OPERATING LEASES 17380668 DUE TO AFFILIATE 3920698 OTHER NONCURRENT LIABILITIES 650033 COST REPORT SETTLEMENT PAYABLE 9958541 32495219 PART V, LINE 4: MCLAREN NORTHERN MICHIGAN FOUNDATION HOLDS ENDOWMENTS ON BEHALF OF THE HOSPITAL. THE INTENDED PURPOSE OF THE ABOVE ENDOWMENT IS TO ASSIST PEDIATRIC PATIENTS. 1 1 X 1 X 400.000000000000 1 X 1 1 1 0 1 1 1884145 1884145 0.00780 34803388 28701754 6101634 0.02540 36687533 28701754 7985779 0.03320 193115 193115 0.00080 823600 823600 0.00340 18491009 11168965 7322044 0.03050 43583 43583 0.00020 19551307 11168965 8382342 0.03490 56238840 39870719 16368121 0.06810 31 3580 3580 0.00000 50 5968 5968 0.00000 81 9548 9548 0.00000 1 8528715 2832651 65189398 58952393 6237005 X 1 1 1 1 MCLAREN NORTHERN MICHIGAN 416 CONNABLE AVENUE PETOSKEY MI 49770 WWW.MCLAREN.ORG/NORTHERNMICHIGAN/NORTH 1060000053 X X X X MCLAREN NORTHERN MICHIGAN 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X HTTPS://TINYURL.COM/YAWXCYL4 X X 1 22 1 HTTPS://TINYURL.COM/YAWXCYL4 0 1 X 400.000000000000 400.000000000000 X X X 1 1 X X X 1 X HTTPS://TINYURL.COM/YYA9C5OC X HTTPS://TINYURL.COM/YYA9C5OC X HTTPS://TINYURL.COM/YYA9C5OC X X X X X X 1 X 0 X X X X 1 X 0 0 MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 5: A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITAL'S WEBSITE LOCATED AT HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENTMCLAREN NORTHERN MICHIGAN IN CONJUNCTION WITH 12 OTHER HOSPITALS AND 7 DISTRICT HEALTH DEPARTMENTS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT. MORE THAN 150 ORGANIZATIONS IN THE 31 COUNTY REGION PARTICIPATED IN COLLECTING DATA BY CONDUCTING 4 ASSESSMENTS: COMMUNITY STATUS, LOCAL COMMUNITY SERVICES, COMMUNITY THEMES AND STRENGTHS, AND FORCES OF CHANGE. CONDUCTED COMMUNITY INPUT BOARDS, MINI CLIENT INTERVIEWS, (INCLUDING SPECIAL POPULATIONS, SENIORS, PERSONS/FAMILIES WITH PHYSICAL AND MENTAL DEVELOPMENTAL DISABILITIES, AND YOUNG CHILDREN 0 - 5 YRS, AND OTHERS), AND SURVEYED COMMUNITY AND HEALTH CARE PROVIDERS. MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN CONJUNCTION WITH 12 OTHER HOSPITALS INCLUDING KALKASKA MEMORIAL HEALTH CENTER, MCLAREN CENTRAL MICHIGAN, MID-MICHIGAN- ALPENA, MID-MICHIGAN HEALTH- CLARE/GLADWIN, MUNSON MEDICAL CENTER, MUNSON HEALTHCARE CADILLAC HOSPITAL, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE GRAYLING HOPSITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL, MUNSON HEALTHCARE PAUL OLIVER MEMORIAL HOSPITAL, AND SPECTRUM HEALTH. MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN CONJUNCTION WITH 7 DISTRICT HEALTH DEPARTMENTS: BENZIE-LEELANAU, CENTRAL MICHIGAN, HEALTH DEPARTMENT #10, HEALTH DEPARTMENT #2, HEALTH DEPARTMENT #4, GRAND TRAVERSE COUNTY, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN. OTHER COLLABORATORS INCLUDED NORTH COUNTRY COMMUNITY MENTAL HEALTH, NORTHERN MICHIGAN COMMUNITY HEALTH INNOVATION REGION, AND GRAND TRAVERSE HEALTH. MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 7D: HOSPITAL REPRESENTATIVES PRESENTED THE COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS AND IMPLEMENTATION STRATEGY TO COMMUNITY ADVISORY COUNCILS, BUSINESS LEADERS, AND VARIOUS COMMUNITY GROUPS. MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 11: FOUR MAJOR FOCUS AREAS WERE IDENTIFIED THROUGH THE ASSESSMENT PROCESS: AFFORDABLE HOUSING, MENTAL HEALTH AND SUBSTANCE USE, ACCESS TO HEALTHCARE, AND CHRONIC DISEASE. AN IMPLENTATION STRATEGY WAS DEVELOPED TO ADDRESS THESE ISSUES. THE HOSPITAL AND OTHER COMMUNITY PARTNERS REVIEWED ELEVEN COMMUNITY THEMES THAT RESULTED FROM THE ASSESSMENT: ACCESS TO HEALTHCARE/CHRONIC DISEASE PREVENTION, AFFORDABLE HOUSING, ECONOMIC SECURITY, EQUITY, MENTAL HEALTH, SAFETY AND WELL-BEING, SUBSTANCE USE, TRANSPORTATION, COVID-19, AND INFRASTRUCTURE OF HEALTHY LIVES. FOUR PRIORITIES WERE IDENTIFIED. THESE FOUR PRIORITIES MATCH THE FOUR MAJOR FORCUS AREAS IDENTITIFED. A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITAL'S WEBSITE LOCATED AT HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT MCLAREN NORTHERN MICHIGAN PART V, SECTION B, LINE 13B: PRESUMPTIVE FINANCIAL ASSISTANCE MAY BE APPLIED BASED ON THIRD PARTY INFORMATION OR A PRIOR FINANCIAL ASSISTANCE DETERMINATION. DESIGNATED PERSONNEL WILL MAKE REASONABLE EFFORT TO NOTIFY THE INDIVIDUAL OF ASSISTANCE. PART V, LINE 13A: FINANCIAL ASSISTANCE GUIDELINES ARE BASED ON 400% OF THE FEDERAL POVERTY GUIDELINES (FPG) PUBLISHED ANNUALLY IN THE FEDERAL REGISTER. CARE IS DISCOUNTED 100% UP TO 400% OF THE FPG. DESIGNATED PERSONNEL WILL ACCESS THE FEDERAL REGISTER AND UPDATE THE FINANCIAL ASSISTANCE GUIDELINES ANNUALLY. THE DISCOUNT IS BASED ON FAMILY SIZE AND ANNUAL INCOME. 3 1 - MCLAREN NORTHERN MICHIGAN-CHEBOYGAN CAMP 748 MAIN ST CHEBOYGAN MI 49721 OUTPATIENT SERVICES - RADIOLOGY, LAB, EMERGENT, SURGERY 2 - WELLNESS PAVILLION AND DIALYSIS CENTER 820 ARLINGTON AVENUE PETOSKEY MI 49770 OUTPATIENT SERVICES - DIALYSIS, PT, OT, CARDIAC REHAB, PHYSICIAN PRACTICE 3 - GREAT LAKES MOBILE PET 416 CONNABLE AVENUE PETOSKEY MI 49770 MOBILE UNIT - PET SERVICES PART I, LINE 3C: INCOME CRITERIA IS BASED ON A 400% FEDERAL POVERTY GUIDELINES PER THE FEDERAL REGISTER. COLLECTIONS MAY BE CONSIDERED IF THE PATIENT HAS SUFFICIENT LIQUID ASSETS. PART I, LINE 6A: OUR PARENT, MCLAREN HEALTH CARE CORPORATION, PREPARES AN ANNUAL REPORT OF ITS MEMBER HOSPITALS. THIS ANNUAL REPORT IS AVAILABLE ON OUR WEBSITE. PART I, LINE 7: A COST TO CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE. THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, AND CASH CONTRIBUTIONS (LINES 7E, 7F, 7G, AND 7I). PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE ACUTE REHAB, PSYCHIATRY, NEWBORNS, OB, WOMEN'S SERVICES, ACUTE INPATIENT, OUTPATIENT FIXED AND HEMODIALYSIS. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24E - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $8,528,715. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES SUPPORT IDENTIFIED COMMUNITY NEEDS AND COMMUNITY COLLABORATIVES SUCH AS TRANSPORTATION, WORKFORCE DEVELOPMENT AND COMMUNITY HEALTH, BY PROVIDING IN-KIND SERVICES, FINANCIAL RESOURCES AND STAFF EXPERTISE FROM THE HOSPITAL. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX. PART III, LINE 3: TO DETERMINE THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY, ADMINISTRATION ESTIMATED A PERCENTAGE OF INDIVIDUALS WHO DID NOT COMPLETE THE CHARITY CARE APPLICATION PROCESS, OR DID NOT TAKE THE TIME TO APPLY - WHICH AMOUNTS TO $2,832,651. PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF THE CORPORATION'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CORPORATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: THE AMOUNTS REPORTED FOR MEDICARE ARE FROM THE MEDICARE COST REPORT, WHICH DO NOT SHOW A SHORTFALL. THIS IS BASED ON THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT. PART III, LINE 9B: A FORMAL WRITTEN DEBT COLLECTION POLICY IS IN PLACE. THE COLLECTION POLICY WILL ASSESS A PATIENT'S ABILITY TO PAY FOR SERVICES INCLUDING METHODS OF PAYMENTS, ENTITLEMENT PROGRAMS, CHARITY CARE POLICIES, DISCOUNT POLICIES, INQUIRIES OF CREDIT REPORT AND OTHER AVAILABLE INFORMATION RELATIVE TO THE PATIENT'S FINANCIAL SITUATION. THE COLLECTION PROCESS BEGINS AT THE POINT OF SERVICE AND IS COMPLETED WHEN THE BALANCE IS RECONCILED AND MAY INCLUDE USE OF EXTERNAL COLLECTION AGENCIES AND OR ATTORNEY'S. PART VI, LINE 2: MCLAREN NORTHERN MICHIGAN ASSESSES THE NEEDS AND ASSETS OF THE COMMUNITY BY COLLABORATING WITH COMMUNITY AND STRATEGIC PARTNERS TO REVIEW DEMOGRAPHICS, HEALTH INDICATORS, MORBIDITY AND MORTALITY DATA, ANALYZING COST DRIVERS, AND CONDUCTING FOCUS GROUPS, SURVEYS, AND COMMUNITY FORUMS. PART VI, LINE 3: AS PATIENTS ARE REGISTERED EITHER IN PERSON OR OVER THE PHONE THEY ARE GIVEN CONTACT INFORMATION FOR PATIENT FINANCIAL SERVICES REPRESENTATIVES IF THEY HAVE NO INSURANCE, ARE UNDER INSURED OR HAVE HIGH CO-PAY'S. THERE ARE PATIENT FINANCIAL SERVICES BROCHURES DISPLAYED AT ALL REGISTRATION AREAS THAT DESCRIBE THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS AVAILABLE. THROUGH OUR CARE COORDINATION PROGRAM ALL PATIENTS WITH NO INSURANCE ARE SEEN TO ASSIST WITH FINANCIAL ASSISTANCE PROGRAMS. PART VI, LINE 4: MCLAREN NORTHERN MICHIGAN, A SUBSIDIARY OF MCLAREN HEALTH CARE, IS A 202-BED REGIONAL REFERRAL CENTER LOCATED IN PETOSKEY, SERVING RESIDENTS IN 22 COUNTIES ACROSS NORTHERN LOWER MICHIGAN AND THE EASTERN PART OF THE UPPER PENINSULA. A MEDICAL STAFF OF NEARLY 200 PHYSICIANS REPRESENTS NEARLY ALL MEDICAL AND SURGICAL SPECIALTIES, ENABLING FULL-SERVICE CARE WITH AN EMPHASIS ON HEART, CANCER, ORTHOPEDICS, AND NEUROSCIENCE SERVICES. PREDICATED ON A VISION TO PROVIDE PATIENT-CENTERED CARE, EXTENSIVE EFFORTS IN TARGETING REGIONAL HEALTH CONCERNS HAS LED TO COLLABORATIVE PROGRAMS AND SERVICES IN PRIMARY CARE, HEART, CANCER AND DIAGNOSTICS. THIS APPROACH TO HIGH QUALITY, COST EFFECTIVE HEALTHCARE DELIVERY IN THIS RURAL AND REMOTE AREA HAS BEEN STRENGTHENED BY A LONG STANDING PRACTICE OF SPECIALTY PHYSICIANS HOSTING ON-SITE CLINIC VISITS TO OUTLYING COMMUNITIES. MCLAREN NORTHERN MICHIGAN IS WORKING TO INFLUENCE BEHAVIOR THROUGH EDUCATION, PREVENTION THROUGH SCREENING, AND PROVIDING ACCESSIBLE TREATMENT THROUGH PHYSICIAN CLINIS AND HEALTH CENTERS THROUGHOUT THE REGION. PART VI, LINE 5: THE HOSPITAL HAS AN ESTABLISHED REGIONAL COMMUNITY ADVISORY BOARD WHICH MEETS TO ACTIVELY ADDRESS HEALTHCARE ISSUES IN THE REGION. THE HOSPITAL PROVIDES COMMUNITY BENEFIT ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT AND HEALTH EDUCATION PROGRAMS AND SERVICES TO IMPROVE ACCESS TO HEALTHCARE, PROMOTE HEALTH AND WELLNESS, AND MANAGE CHRONIC DISEASE. PART VI, LINE 6: AFFILIATES OF MCLAREN NORTHERN MICHIGAN INCLUDE THE FOLLOWING ORGANIZATIONS, EACH OF WHICH CONTRIBUTE TO HEALTH PROMOTION IN THE MANNER INDICATED: * MCLAREN NORTHERN MICHIGAN FOUNDATION - RAISES, MANAGES, AND DISPENSES FUNDS TO SUPPORT THE MISSION OF MCLAREN NORTHERN MICHIGAN AND PROVIDE PROGRAMS THAT ENHANCE THE WELL-BEING OF THE COMMUNITY. * BOULDER PARK TERRACE - PROVIDES SKILLED NURSING AND SUB-ACUTE REHABILITATION SERVICES. * VITAL CARE - PROVIDES HOME HEALTH SERVICES, HOME MEDICAL EQUIPMENT ADN SUPPLIES, HOSPICE SERVICES, PRIVATE DUTY SERVICES, AND ADULT DAY SERVICES. * PHYSICIAN PRACTICES - OFFER THE OPPORTUNITY FOR SEAMLESS PATIENT CARE WITHIN THE REGION THROUGH A SYSTEM OF WHOLLY-OWNED SPECIALTY MEDICINE PRACTICES: MICHIGAN HEART & VASCULAR SPECIALISTS, NORTHERN MICHIGAN INFECTIOUS DISEASES, NORTHERN MICHIGAN HEMATOLOGY/ONCOLOGY, ROGERS CITY MEDICAL GROUP (PRIMARY CARE), AND MCLAREN NORTHERN MICHIGAN NEUROSURGERY SERVICES. * PRESCRIPTION SERVICES PHARMACY - OFFERS RETAIL PHARMACY SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES MI 1 MCLAREN NORTHERN MICHIGAN FOUNDATION 360 CONNABLE AVENUE PETOSKEY MI 49770 382445611 501(C)(3) 36174 0 N/A N/A RENT/GENERAL OPERATIONS 1 0 PART I, LINE 2: GRANTS MADE TO RELATED ORGANIZATIONS ARE MONITORED THROUGH THE MONTHLY ACCOUNTING PROCESSES. 1 1 0 0 0 0 0 1 0 CHAD GRANT MHC CHIEF OPERATING OFFICER 0 851712 0 257835 0 471302 0 0 0 36868 0 1617717 0 0 TODD BURCH DIRECTOR & PRESIDENT/CEO 0 450972 0 139606 0 40000 0 101536 0 35753 0 767867 0 0 ANDREW M MCDONAGH VP - CMO 356201 0 69217 0 3564 0 15250 0 19481 0 463713 0 0 0 MICHAEL PRUSAITIS VP OF FINANCE/CFO 290081 0 28761 0 2322 0 9556 0 15678 0 346398 0 0 0 JENNIFER I WOODS VP - CNO - FORMER 104674 0 35898 0 158853 0 4574 0 12766 0 316765 0 0 0 DEBBIE ROSENBURG VP HR - FORMER 169799 0 0 0 86733 0 218 0 11168 0 267918 0 0 0 SHARI A SCHULT VP OF OPERATIONS 214669 0 33711 0 2322 0 11030 0 1319 0 263051 0 0 0 ANAS ORFALI MEDICAL PHYSICIST 207535 0 1000 0 20776 0 11403 0 10904 0 251618 0 0 0 LAURA DANIEL VP OF OPERATIONS - PART YEAR 184938 0 30134 0 3564 0 4420 0 12539 0 235595 0 0 0 JULIE JAREMA VP - PHILANTHROPY 0 163135 0 26578 0 3555 0 9328 0 16082 0 218678 0 0 MARLA CLARK SENIOR DIRECTOR OF CATDIOVASCULAR SV 176818 0 16736 0 3564 0 9011 0 6036 0 212165 0 0 0 KELLY JOHNSON RN, TEAM LEAD CC 164205 0 4000 0 68 0 8556 0 10400 0 187229 0 0 0 DAVID MONAN VP - CNO 142899 0 12491 0 1029 0 8000 0 15514 0 179933 0 0 0 KATHLEEN ST PIERRE DIRECTOR PATIENT CARE SVCS 149116 0 8030 0 3107 0 8180 0 7178 0 175611 0 0 0 JAMES STRADLING REG NURSE TEMP 153783 0 2000 0 0 0 5452 0 14 0 161249 0 0 0 PART I, LINE 1A THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 1 BOXES HAVE BEEN CHECKED. THE CORPORATE CEO, SUBSIDIARY CEOS AND CORPORATE EXECUTIVE & SENIOR VICE-PRESIDENTS IN SOME INSTANCES HAVE RECEIVED TAX INDEMNIFICATION FOR THE FOLLOWING BENEFITS: VEHICLE COSTS, GROUP TERM LIFE INSURANCE, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS, AND HEALTH CLUB OR SOCIAL DUES. THESE BENEFITS HAVE BEEN INCLUDED IN TAXABLE COMPENSATION. PART I, LINE 3 THE CEO/EXECUTIVE DIRECTOR WAS COMPENSATED BY A RELATED ORGANIZATION, AND THEREFORE NONE OF THE LINE 3 BOXES HAVE BEEN CHECKED. THE RELATED ORGANIZATION USED THE FOLLOWING METHODOLOGIES TO ESTABLISH THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B SEVERANCE PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: - JENNIFER WOODS: 158,284 - DEBBIE ROSENBURG: 75,000 MCLAREN MAINTAINS TWO SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES (THE "SERPS"). THE OLD SERP WAS CLOSED TO NEW PARTICIPANTS ON OCTOBER 1, 2006, AND THE NEW SERP BECAME EFFECTIVE AS OF JANUARY 1, 2007. NO EMPLOYEE MAY PARTICIPATE IN BOTH OF THE SERPS. THE OLD SERP IS STRUCTURED AS A DEFINED BENEFIT PLAN THAT ESSENTIALLY REPLACES THE BENEFITS THE PARTICIPANT IS NOT PERMITTED TO RECEIVE UNDER MCLAREN'S QUALIFIED RETIREMENT PLAN DUE TO IRS LIMITATIONS APPLICABLE TO QUALIFIED PLANS. THE BENEFIT UNDER THE OLD SERP IS PAYABLE IN EITHER THE FORM OF A LUMP SUM DISTRIBUTION OR IN MONTHLY PAYMENTS EQUAL TO THE ACTUARIAL EQUIVALENT OF THE PARTICIPANT'S ACCRUED BENEFIT. THE BENEFIT IS PAID AT AGE 55, AND IF THE PARTICIPANT REMAINS EMPLOYED, THE BENEFIT IS PAID UPON TERMINATION OF EMPLOYMENT, REDUCED TO TAKE INTO ACCOUNT THE BENEFIT PREVIOUSLY PAID. THE NEW SERP IS STRUCTURED AS A DEFINED CONTRIBUTION PLAN, AND MCLAREN CONTRIBUTES 15 PERCENT OF EACH PARTICIPANT'S COMPENSATION TO THE PLAN EACH YEAR FOR ALLOCATION TO THE PARTICIPANT'S ACCOUNT. PARTICIPANTS IN THE NEW SERP BECOME VESTED IN THEIR ACCOUNTS UPON THE EARLIER OF FIVE YEARS OF PARTICIPATION IN THE PLAN OR ATTAINMENT OF AGE 60. PARTICIPANTS IN THE NEW SERP SELF-DIRECT THE INVESTMENT OF THEIR ACCOUNTS AND HAVE THE ACTUAL INVESTMENT RETURN CREDITED OR DEBITED TO THEIR ACCOUNTS. THE BENEFIT UNDER THE NEW SERP IS EQUAL TO THE PARTICIPANT'S ACCOUNT BALANCE, AND THE BENEFIT IS PAID IN A SINGLE SUM WITHIN 60 DAYS OF THE PARTICIPANT'S TERMINATION DATE. BENEFITS UNDER BOTH SERPS ARE PROVIDED ON A TAX-NEUTRAL BASIS. BOTH SERPS ARE DESIGNED TO COMPLY WITH INTERNAL REVENUE CODE SECTIONS 457(F) AND 409A. PART I, LINE 7 MCLAREN HEALTH CARE (MHC) HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION, SUBSIDIARY EXECUTIVES AND DIRECTORS, MANAGERS AND SUPERVISORS. THE PURPOSE OF THE PLAN IS TO ENHANCE THE ORGANIZATION'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING TOP OFFICIALS AND THE BOARD OF DIRECTORS WITH A TOOL FOR (A) CLEARLY COMMUNICATING PERFORMANCE ON THE PART OF KEY LEADERS, (B) STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE ON THE PART OF KEY LEADERS WHICH WILL ULTIMATELY BENEFIT THE COMMUNITIES MHC SERVES, AND (C) PROTECTING MHC'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH-TALENT LEADERS. FORM 990, PART VI, SECTION A, LINE 6 MCLAREN HEALTH CARE CORPORATION IS THE SOLE MEMBER OF MCLAREN NORTHERN MICHIGAN. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER SHALL HAVE THE EXCLUSIVE RIGHT TO ELECT OR APPOINT THE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER MUST APPROVE THE FOLLOWING ACTIONS AUTHORIZED BY THE BOARD BEFORE THE ACTIONS CAN BECOME EFFECTIVE: (1) ANY AMENDMENT, MODIFICATION OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (2) THE ACQUISITION OR CREATION OF ALL WHOLLY-OWNED OR CONTROLLED CORPORATIONS AND ANY MERGER, CONSOLIDATION OR AFFILIATION OF THE CORPORATION WITH ANOTHER ENTITY; (3) ANY VOLUNTARY DISSOLUTION OF THE CORPORATION; (4) ANY NEW OR ADDITIONAL MEMBERS OF THE CORPORATION; (5) ANY CHANGE IN THE VOTING POWERS OF MCLAREN AS THE SOLE MEMBER; (6) ANY SALE, LEASE, OR OTHER TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; (7) THE DISCONTINUANCE OR MATERIAL MODIFICATION OF A MAJOR ACTIVITY, PROGRAM, OR SERVICE OF THE CORPORATION; (8) THE STRATEGIC AND LONG-RANGE PLANS AND THE ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS OF THE CORPORATION, AS DEVELOPED BY THE MANAGEMENT OF THE CORPORATION, WHICH APPROVAL THE MEMBER WILL NOT UNREASONABLY DENY; (9) THE CREATION OF ANY LONG-TERM OBLIGATION OF THE CORPORATION (OTHER THAN INDEBTEDNESS AS DESCRIBED BELOW), IF THE PRINCIPAL AMOUNT EXCEEDS 25% OF THE VALUE OF THE CORPORATION'S NET ASSETS (TOTAL ASSETS MINUS TOTAL LIABILITIES), EXCEPT THAT APPROVAL OF THE MEMBER IS NOT REQUIRED FOR ANY OBLIGATION INCURRED IN THE ORDINARY COURSE OF BUSINESS THAT IS PAYABLE ON DEMAND OR MATURES WITHIN 12 MONTHS FROM THE DATE OF ITS CREATION; (10) THE CORPORATION'S ISSUANCE OF NOTES, BONDS, OR OTHER EVIDENCE OF INDEBTEDNESS; (11) THE SALE, CONVEYANCE, ASSIGNMENT, TRANSFER, ALIENATION, PLEDGE, OR ENCUMBRANCE OF THE CORPORATION'S REAL PROPERTY WITH AN ANNUAL AGGREGATE VALUE IN EXCESS OF $250,000; (12) THE CORPORATION'S PURCHASE OR ACQUISITION OF ADDITIONAL REAL PROPERTY WITH AN ANNUAL AGGREGATE VALUE IN EXCESS OF $250,000; AND (13) APPROVE UNBUDGETED CAPITAL EXPENDITURES IN EXCESS OF $250,000 IN THE ANNUAL AGGREGATE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 DATA IS PREPARED INTERNALLY AND SUBMITTED TO OUR AUDITING FIRM FOR RETURN PREPARATION. ONCE THE RETURNS HAVE BEEN COMPLETED, THE FORMS ARE REVIEWED BY THE CORPORATE DIRECTOR OF BUDGET, THE CORPORATE SENIOR VICE PRESIDENT AND CFO OF MCLAREN HEALTH CARE CORPORATION (MHCC). COPIES OF RETURNS ARE MADE AVAILABLE TO THE MHC BOARD MEMBERS, WHO SERVE AS THE OVERALL GOVERNING BOARD. RETURNS ARE AVAILABLE FOR ALL CORPORATIONS OF WHICH MHC IS THE SOLE MEMBER AS WELL AS OTHER RELATED ENTITIES OF THOSE CORPORATIONS FOR REVIEW RATHER THAN HAVING THE LOCAL BOARDS REVIEW THE RETURNS. THE BOARD OF MHC IS THE ULTIMATE ACCOUNTABLE ORGANIZATION FOR THE SYSTEM; AS SUCH IT IS THE OVERALL GOVERNING BOARD OF THE SYSTEM, WHOSE RESPONSIBILITIES INCLUDE BUT ARE NOT LIMITED TO: APPROVING ALL SUBSIDIARY BOARD MEMBERS, FINANCIAL BUDGETS, AND ISSUANCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE MCLAREN HEALTH CARE (MHC) BOARD CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL MHC CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE MHC GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. CONFLICTS ARE DISCLOSED TO THE FULL BOARD AND BOARD COMMITTEES SO APPROPRIATE ACTIONS CAN BE TAKEN. ACTIONS MAY INCLUDE PROHIBITING A BOARD MEMBER FROM PARTICIPATING IN DELIBERATIONS INVOLVING TRANSACTIONS WITH A COMPANY WITH WHICH THEY CONDUCT FINANCIAL TRANSACTIONS; BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE RELIEVED OF THEIR SERVICE TO MHC. FORM 990, PART VI, SECTION B, LINE 15B THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS TO REVIEW THE PERFORMANCE AND RECOMMEND THE TOTAL COMPENSATION PACKAGE OF THE MCLAREN HEALTHCARE CORPORATION'S CEO TO THE BOARD. FURTHER THE COMMITTEE ESTABLISHES THE SALARY RANGES AND PERQUISITES OF THE OTHER MOST HIGHLY COMPENSATED OFFICERS (MHC EXECUTIVE & SENIOR VICE-PRESIDENTS AND CEOS OF MHC SUBSIDIARY ORGANIZATIONS) TO THE BOARD. THE MEMBERS OF THE COMMITTEE MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE APPLICABLE PROVISIONS OF SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND FINAL TREASURY REGULATIONS SECTION 53.4958-6(C)(1)(III). THE COMMITTEE RETAINS THE SERVICES ANNUALLY OF AN INDEPENDENT FIRM WITH SIGNIFICANT QUALIFICATIONS AND EXPERIENCE TO CONDUCT A REVIEW OF THE CORPORATION'S EXECUTIVE COMPENSATION PROGRAM. THE RETAINED FIRM UTILIZES APPROPRIATE COMPENSATION COMPARABILITY DATA. THE RETAINED FIRM CONDUCTS ANALYSIS OF THE COMPETITIVENESS OF THESE PROGRAMS AND EXPRESSES AN OPINION TO THE REASONABLENESS OF THESE COMPENSATION PROGRAMS. ALL DATA UTILIZED BY THE COMMITTEE, DELIBERATIONS OF THE COMMITTEE, AND FINAL COMPENSATION DECISIONS BY THE COMMITTEE ARE DOCUMENTED IN FORMAL REPORTS AND MINUTES. THE CORPORATE COMPENSATION COMMITTEE WORKS UNDER AND PERIODICALLY RENEWS THE MCLAREN HEALTH CARE CORPORATION COMPENSATION COMMITTEE CHARTER. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2023. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. PART VII AND SCHEDULE J THIS FY 2023 RETURN IS BEING AMENDED TO PROPERLY CATEGORIZE COMPENSATION AND HOURS ON PART VII AND SCHEDULE J. FORM 990, PART IX, LINE 11G MEDICAL SUPPORT SERVICES: PROGRAM SERVICE EXPENSES 12,005,604. MANAGEMENT AND GENERAL EXPENSES 30,798,918. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,804,522. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 7,374,648. MANAGEMENT AND GENERAL EXPENSES 943,967. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,318,615. FORM 990, PART XI, LINE 9: PENSION RELATED CHANGES 252,602. EQUITY TRANSFER TO AFFILIATES -19,570,666. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MCLAREN BAY MEDICAL FOUNDATION 1900 COLUMBUS AVE BAY CITY MI 48708 382156534 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN BAY REGION 1 MCLAREN BAY REGION 1900 COLUMBUS AVE BAY CITY MI 48708 381976271 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 BAY REGIONAL MEDICAL CENTER AUXILIARY 1908 COLUMBUS AVENUE BAY CITY MI 48708 386081235 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I MCLAREN BAY REGION 1 MCLAREN BAY SPECIAL CARE 3250 E MIDLAND ROAD STE 1 BAY CITY MI 48706 383161753 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN BAY REGION 1 MCLAREN CENTRAL MICHIGAN 1221 SOUTH DRIVE MT PLEASANT MI 48858 381420304 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 CHARLEVOIX NURSING HOME CORPORATION DBA BOULDER PARK TERRACE 14676 WEST UPRIGHT CHARLEVOIX MI 49720 383038683 SKILLED NURSING FACILITY MI 501(C)(3) LINE 10 MCLAREN NORTHERN MICHIGAN 1 KARMANOS CANCER FOUNDATION 4100 JOHN R ST DETROIT MI 48201 383584572 FOUNDATION MI 501(C)(3) LINE 7 BARBARA ANN KARMANOS CANCER 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