2025-01-15T09:52:33-06:00 2023-09-30 331498605 PLANTE & MORAN PLLC 3000 TOWN CENTER SUITE 100 SOUTHFIELD MI 48075 990 2022-10-01 344428232 ST LUKE'S HOSPITAL STLU 8103421169 5901 MONCLOVA ROAD MAUMEE OH 43537 DAVID MAZURKIEWICZ SENIOR VICE PRESIDENT & CFO 8103421169 2025-01-14 1 1 AMY CIMINELLO P00796388 2483522500 2025-01-14 2022 2024-10-15 13:58:12Z X MCLAREN ST LUKE'S BRIAN BALUTANSKI 5901 MONCLOVA ROAD MAUMEE OH 43537 82444236 0 X WWW.MCLAREN.ORG/ST-LUKES/MCLAREN-ST-LUKES-HOME X 1906 OH ST. LUKE'S HOSPITAL IS COMMITTED TO PROVIDING QUALITY, COST-EFFECTIVE HEALTHCARE SERVICES THROUGH THE USE OF ADVANCED SERVICES WHILE FOSTERING WELLNESS. X 14 8 1566 150 0 0 4049768 780502 163834189 73046983 2242602 -49928755 1717221 330652 171843780 24229382 340202 101345 0 0 95324393 56819468 0 0 0 115962830 97060538 211627425 153981351 -39783645 -129751969 199430419 0 187888238 0 11542181 0 X ST. LUKE'S HOSPITAL PROVIDES EXCEPTIONAL CARE FOR OUR COMMUNITY, INSPIRING HOPE AND PROMOTING WELLNESS. OUR VALUES OF EXCELLENCE, COMPASSION, INTEGRITY, DEDICATION, RESPECT AND TEAMWORK ALLOW US TO FULFILL OUR MISSION EVERY DAY IN OUR WORK WITH PATIENTS, FAMILIES, PHYSICIANS AND ONE ANOTHER. WE ENHANCE INDIVIDUAL AND COMMUNITY HEALTH BY DELIVERING THE BEST QUALITY, SERVICE, SAFETY AND VALUE IN HEALTHCARE. BY DISTINGUISHING OURSELVES BY THE QUALITY OF OURPEOPLE AND VALUING OUR PHYSICIAN PARTNERS WE ARE ABLE TO BUILD A SEAMLESS CONTINUUM OF CARE AROUND OUR CORE SERVICES FOR THE COMMUNITY WE SERVE. 0 1 103866955 101345 72485962 ST. LUKE'S HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. ST. LUKE'S HOSPITAL WAS TERMINATED DURING FY23 AND ALL PROGRAMS HAVE CEASED AS OF 5/8/23. 4153196 0 0 CONSISTENT WITH OUR MISSION, ST. LUKE'S HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY. 5227100 0 975304 CONSISTENT WITH OUR MISSION, ST. LUKE'S HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES, SUBSIDIZED HEALTH SERVICES, HEALTH PROFESSIONS EDUCATION, AND CASH AND IN-KIND CONTRIBUTIONS. 113247251 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 1 0 0 1 182 0 1 1566 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 8 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 1 0 X LAURA MURPHY 4197050599 5901 MONCLOVA ROAD MAUMEE OH 43537 X BARBARA MACHIN SECRETARY 1.00 1.00 X X 0 0 0 CINDY SMITH VICE-CHAIRPERSON 1.00 0.00 X X 0 0 0 DALE SEYMOUR TREASURER 1.00 0.00 X X 0 0 0 GREGORY LANE MCLAREN EXEC VP & CAO 1.00 43.00 X X 0 2305007 44131 JANET EATON SMITH TRUSTEE 1.00 0.00 X 0 0 0 JENNIFER MONTGOMERY PRESIDENT/CEO EX-OFFICIO 41.00 1.00 X X 0 770465 35972 JOHN BACHEY TRUSTEE 1.00 0.00 X 0 0 0 LALAINE MATTISON MD TRUSTEE/PHYSICIAN 41.00 0.00 X 280925 0 26672 MARY ARQUETTE TRUSTEE 1.00 0.00 X 0 0 0 MOHAMMED EL SAYYAD MD TRUSTEE/PHYSICIAN 41.00 0.00 X 353554 0 29194 PHILIP INCARNATI MCLAREN PRESIDENT & CEO 1.00 46.00 X X 0 10748364 35341 SALVADOR PERON MD TRUSTEE/PHYSICIAN 41.00 0.00 X 558220 0 28265 STEPHEN BAUERLE TRUSTEE 1.00 0.00 X 0 0 0 TIMOTHY GOLIGOSKI CHAIRPERSON 1.00 1.00 X X 0 0 0 ALISON AVENDT CHIEF OPERATING OFFICER 41.00 1.00 X 262036 0 21064 ANGELA LONG VP CHIEF NURSING OFFICER 41.00 0.00 X 279868 0 23680 STEPHEN P BAZELEY CHIEF MEDICAL OFFICER 41.00 0.00 X 248488 0 25826 STEVE THOMPSON VP CHIEF FINANCIAL OFFICER-PART YEAR 41.00 1.00 X 323800 0 16664 BENJAMIN J SALPIETRO PHYSICIAN 40.00 0.00 X 813319 0 813319 BRIAN HOEFLINGER PHYSICIAN 40.00 0.00 X 1012225 0 1012225 DAVID LEWIS PHYSICIAN 40.00 0.00 X 815433 0 815433 JAMES D LYIONS PHYSICIAN 40.00 0.00 X 747042 0 747042 LAWRENCE SPETKA PHYSICIAN 40.00 0.00 X 910080 0 910080 CONNIE SESSLER FORMER VP HUMAN RESOURCES 41.00 0.00 X 224177 0 20897 JEFF KIM FORMER VP INFORMATION 41.00 0.00 X 275018 0 0 JILL TROSIN FORMER VP CHIEF NURSING OFFICER 41.00 0.00 X 156540 0 0 KEVIN RILEY FORMER CHIEF FINANCIAL OFFICER 41.00 0.00 X 100487 0 0 7361212 13823836 4605805 106 1 1 0 AMERICAN HEALTHCARE STAFFING ASSOC LLC PO BOX 670529 DALLAS TX 75627 AGENCY SERVICES 5920563 QUALIVIS LLC 5930 CORNERSTONE CT W 300 SAN DIEGO CA 92121 AGENCY SERVICES 5009197 TOLEDO CLINIC INC 4235 SECOR RD TOLEDO OH 43623 SURGERY ON CALL & BILLING SVCS 4234453 CERNER CORPORATION 2800 ROCK CREEK PARKWAY KANSAS CITY MO 64117 IT SERVICES 3368750 TRIMEDX INC 5451 LAKEVIEW PARKWAY S DRIVE INDIANAPOLIS IN 46268 BIOMED SERVICES 3115645 59 131077 649425 41875 780502 NET PATIENT SERVICES 621110 73046983 73046983 73046983 -4706428 -4706428 906917 1172151 -265234 -265234 -265234 138673 11681703 0 57042703 138673 -45361000 -45222327 -45222327 CAFETERIA 722514 181603 181603 INCENTIVES 900099 105261 105261 MED STAFF/AUXILIARY/GIFT SHOP 459420 58431 58431 250591 250591 595886 24229382 73461266 0 -50012386 X 101345 101345 3087788 1079734 2008054 47215705 33230413 13985292 1026499 722450 304049 1359534 956840 402694 4129942 2906653 1223289 1245513 1245513 1108600 1108600 107993 107993 4614 4614 26309 26309 18137753 13249875 4887878 235548 176661 58887 1324461 331115 993346 22751221 20476099 2275122 2949225 2369997 579228 115716 86787 28929 1076811 969130 107681 5344208 4294606 1049602 8175461 8175461 MEDICAL SUPPLIES AND DR 15224785 15224785 INTERCOMPANY SERVICES 9843316 196866 9646450 OHIO HOSPITAL FRANCHISE 5668174 5668174 BAD DEBT EXPENSE 2206605 2206605 1514225 823655 690570 153981351 113247251 40734100 0 2606785 8870357 3386844 2143401 0 63657532 24777854 1448762 74793618 17745266 0 199430419 0 27865603 7705034 152317601 0 187888238 0 X -5099305 0 16641486 0 11542181 0 199430419 0 X -129751969 2465857 51349210 64394721 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 4614 4614 0 PART II-B, LINE 1: ST. LUKE'S HOSPITAL PAYS DUES TO THE OHIO HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATION. 1 1 X 1 X 400.000000000000 1 X 1 1 0 1 1 2059368 1625865 433503 0.00290 16462930 2393396 14069534 0.09270 18522298 4019261 14503037 0.09560 1989 1989 0.00000 3304085 968549 2335536 0.01540 1876276 6755 1869521 0.01230 44750 44750 0.00030 5227100 975304 4251796 0.02800 23749398 4994565 18754833 0.12360 2961 2961 0.00000 2961 2961 0.00000 1 2206605 17417651 22140114 -4722463 X 1 1 1 1 ST LUKE'S HOSPITAL 5901 MONCLOVA ROAD MAUMEE OH 43537 WWW.MCLAREN.ORG/ST-LUKES/MCLAREN-ST-LU 1224 X X X X ST LUKE'S HOSPITAL 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X HTTPS://TINYURL.COM/YAWXCYL4 X 1 20 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 ST. LUKE'S HOSPITAL PART V, SECTION B, LINE 5: ST. LUKE'S HOSPITAL WAS TERMINATED DURING FY23 AND ALL PROGRAMS HAVE CEASED AS OF 5/8/23. NO CHNA WAS DONE FOR 2023 AS NONE IS REQUIRED IN THE YEAR A HOSPITAL CEASES OPERATIONS.ST. LUKE'S HOSPITAL HAS ACTIVELY PARTICIPATED IN THE LUCAS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) SINCE ITS EARLY BEGINNINGS. THROUGH THE COURSE OF A PRIMARY MARKET RESEARCH SURVEY (WHICH IS CONSISTENT WITH THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM [BRFSS] QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION) AND PUBLISHED HEALTH AND DEMOGRAPHIC DATA, A CHNA IS COMPLETED EVERY THREE YEARS. A MULTI-DISCIPLINARY, COMPREHENSIVE GROUP OF STAKEHOLDERS (INCLUDING A ST. LUKE'S HOSPITAL REPRESENTATIVE) FROM LUCAS COUNTY DISCUSS, DEBATE AND RANK FINDINGS FROM THE CHNA. ST. LUKE'S. HOSPITAL THEN REVIEWS THE CHNA RESULTS AND LUCAS COUNTY FINDINGS REPORT TO DEVELOP ITS OWN CHNA REPORT AND IMPLEMENTATION PLAN FOR ITS PRIMARY SERVICE AREA, MOST OF WHICH IS LOCATED IN LUCAS COUNTY. PROGRAMS IDENTIFY RESOURCES AND GAPS IN SERVICES TO ADDRESS KEY HEALTH ISSUES FOR HEALTHY LUCAS COUNTY. THE PROGRAMS THAT WERE IDENTIFIED AS HEALTH NEEDS AND PRIORITIES ARE: CARDIOVASCULAR HEALTH/STROKE; ADDICTION/DRUGS (OPIATES)/PAIN MANAGEMENT; AGE/GERIATRIC-RELATED INITIATIVES; CHRONIC DISEASE; YOUTH/STUDENT ISSUES. ST. LUKE'S HOSPITAL PART V, SECTION B, LINE 11: ST. LUKE'S HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES TO ADDRESS THE MOST CRITICAL HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: CARDIOVASCULAR HEALTH - STROKE AGE/GERIATRIC-RELATED INITIATIVES - NUTRITION, DEMENTIA, AND/OR FALL PREVENTION CHRONIC DISEASE (DIABETES/OBESITY/NUTRITION) ADDICTION/DRUGS (OPIATES) /PAIN MANAGEMENT YOUTH/STUDENT ISSUES PRIMARY AREAS OF FOCUS FOR 2023 WERE OFFERING SIX IN-PERSON LUNCH AND LEARN EVENTS TO MORE THAN 300 INDIVIDUALS IN THE COMMUNITY. ST. LUKE'S HOSPITAL OFFERED 5 COMMUNITY TALKS AND 6 EDUCATIONAL RADIO INTERVIEWS AMONG PHYSICIANS. ST. LUKE'S ALSO FOCUSED ON BLOOD PRESSURE SCREENINGS AND PARTICIPATED IN OUTDOOR HEALTH FAIRS TO ADDRESS CHRONIC DISEASE AND CARDIOVASCULAR HEALTH. THE NUMBER OF BLOOD PRESSURE TAKEN AT OUTREACH EVENTS WERE 116. TO ADDRESS THE DRUG ADDICTION STRATEGY, ST. LUKE'S OFFERED ONE DRUG TAKE-BACK EVENT TO SAFELY DISPOSE OF OPIOIDS AND UNUSED OR EXPIRED MEDICATIONS. MORE THAN 300 POUNDS OF MEDICATIONS WERE COLLECTED. YOUTH EVENTS, AS PART OF THE STRATEGY, INCLUDED OFFERING COMMUNITY PRESENTATIONS RELATED TO VAPING EDUCATION, ADHD AND VACCINATION. MORE THAN 700 POUNDS OF FOOD AND OTHER PRODUCTS WERE ALSO COLLECTED TO ASSIST THE COMMUNITY WITH HYGIENE AND FOOD PANTRY ITEMS AND 35 PEOPLE ENJOYED MEALS DELIVERED BY OUR MEDICAL RESIDENTS WHO VOLUNTEERED FOR MEALS ON WHEELS. ST. LUKE'S EXECUTIVES ANNOUNCED THE CLOSURE OF THE HOSPITAL IN EARLY MARCH 2023. THE HOSPITAL CLOSED ITS DOOR FOR ALL PATIENT CARE IN MAY 2023. THEREFORE, THE REMAINING CHNA STRATEGIES FOR 2023 WERE NOT FULFILLED AFTER THE WIND DOWN OPERATIONS TOOK EFFECT IN MARCH 2023. ST. LUKE'S HOSPITAL 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. 15 1 - REGENCY CT RADIOLOGY SERVICES 300 REGENCY COURT STE 105 TOLDEO OH 43623 RADIOLOGY 2 - FALLEN TIMBERS RADIOLOGY 5757 MONCLOVA ROAD STE 31 MAUMEE OH 43537 RADIOLOGY 3 - SLH OUTPATIENT SURGERY- SURGICARE 5959 MONCLOVA ROAD MAUMEE OH 43537 OUTPATIENT SURGERY 4 - FALLEN TIMBERS LAB 5757 MONCLOVA ROAD MAUMEE OH 43537 LAB 5 - WATERVILLE SATELLITE LAB 900 WATERVILLE-MONCLOVA RD STE 8 WATERVILLE OH 43566 LAB 6 - ST LUKE'S DIABETES CARE CENTER 5871 MONCLOVA ROAD MAUMEE OH 43537 WOUND CARE 7 - WATERVILLE REHAB 900 WATERVILLE-MONCLOVA RD STE B WATERVILLE OH 43566 PHYSICAL THERAPY 8 - SWANTON REHAB 1 TURTLE CREEK CIRCLE SWANTON OH 43558 PHYSICAL THERAPY 9 - MAUMEE VALLEY REHAB 6005 MONCLOVA ROAD STE 225 MAUMEE OH 43537 PHYSICAL THERAPY 10 - MAUMEE VALLEY IMAGING 6005 MONCLOVA ROAD MAUMEE OH 43537 RADIOLOGY 11 - PAIN CENTER 5759 MONCLOVA ROAD MAUMEE OH 43537 PAIN CENTER 12 - MAUMEE VALLEY LAB 6005 MONCLOVA ROAD STE 210 MAUMEE OH 43537 LAB 13 - FAMILY MEDICINE CLINIC SATELLITE LAB 7045 LIGHTHOUSE WAY PERRYSBURG OH 43551 LAB 14 - ST LUKE'S FAMILY MEDICINE RESIDENCY 7045 LIGHTHOUSE WAY PERRYSBURG OH 43551 RESIDENCY PROGRAM 15 - LIGHTHOUSE WAY REHAB 7015 LIGHTHOUSE WAY STE 500 PERRYSBURG OH 43551 PHYSICAL THERAPY PART I, LINE 7: ST. LUKE'S HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS. 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 $2,206,605. PART II, COMMUNITY BUILDING ACTIVITIES: OFFERING SIX IN-PERSON LUNCH AND LEARN EVENTS TO MORE THAN 300 INDIVIDUALS IN THE COMMUNITY. ST. LUKE'S HOSPITAL OFFERED 5 COMMUNITY TALKS AND 6 EDUCATIONAL RADIO INTERVIEWS AMONG PHYSICIANS. ST. LUKE'S ALSO FOCUSED ON BLOOD PRESSURE SCREENINGS AND PARTICIPATED IN OUTDOOR HEALTH FAIRS TO ADDRESS CHRONIC DISEASE AND CARDIOVASCULAR HEALTH. THE NUMBER OF BLOOD PRESSURE TAKEN AT OUTREACH EVENTS WERE 116. TO ADDRESS THE DRUG ADDICTION STRATEGY, ST. LUKE'S OFFERED ONE DRUG TAKE-BACK EVENT TO SAFELY DISPOSE OF OPIOIDS AND UNUSED OR EXPIRED MEDICATIONS. MORE THAN 300 POUNDS OF MEDICATIONS WERE COLLECTED. YOUTH EVENTS, AS PART OF THE STRATEGY, INCLUDED OFFERING COMMUNITY PRESENTATIONS RELATED TO VAPING EDUCATION, ADHD AND VACCINATION. MORE THAN 700 POUNDS OF FOOD AND OTHER PRODUCTS WERE ALSO COLLECTED TO ASSIST THE COMMUNITY WITH HYGIENE AND FOOD PANTRY ITEMS AND 35 PEOPLE ENJOYED MEALS DELIVERED BY OUR MEDICAL RESIDENTS WHO VOLUNTEERED FOR MEALS ON WHEELS. ST. LUKE'S EXECUTIVES ANNOUNCED THE CLOSURE OF THE HOSPITAL IN EARLY MARCH 2023. THE HOSPITAL CLOSED ITS DOOR FOR ALL PATIENT CARE IN MAY 2023. THEREFORE, THE REMAINING CHNA STRATEGIES FOR 2023 WERE NOT FULFILLED AFTER THE WIND DOWN OPERATIONS TOOK EFFECT IN MARCH 2023. PART III, LINE 2: ST. LUKE'S HOSPITAL'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS LOOK-BACK METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS COPAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY. 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 MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS:- THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM.- THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS.- MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER.- MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.ST. LUKE'S HOSPITAL USED THE MEDICARE ALLOWABLE COSTS PER ITS FISCAL YEAR ENDED 2023 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. PART III, LINE 9B: FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/ORREQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOTTHEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT. PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCESDEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITYDETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE AND WILL FORWARDAPPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING. PART VI, LINE 2: PRIMARY AND SECONDARY MARKET RESEARCH IS CONDUCTED BY AND THROUGH COMMUNITY-BASED HEALTH COALITIONS, ACADEMIC INSTITUTIONS, THIRD PARTY DATA ANALYTICS ORGANIZATIONS, HEALTH NEEDS ASSESSMENTS AND SURVEYS, HISTORIC HEALTH SERVICES UTILIZATION PATTERNS, DEMOGRAPHIC ANALYSIS AND POPULATION-BASED HEALTH CARE SERVICES UTILIZATION FORECASTS. PART VI, LINE 3: AVAILABILITY OF FINANCIAL ASSISTANCE INFORMATION AND EDUCATION IS PROVIDED AT ALL INPATIENT AND OUTPATIENT REGISTRATION POINTS-OF-SERVICE. INFORMATION AND EDUCATION IS ALSO AVAILABLE THROUGH THE ORGANIZATION'S WEBSITE(S). FINANCIAL AND APPLICATION FORMS ARE AVAILABLE AT ALL INPATIENT AND OUTPATIENT POINTS-OF-SERVICE, INCLUDING PROVIDING ASSISTANCE IN COMPLETING THE APPLICATION. ORGANIZATION AND ITS SUBSIDIARIES/AFFILIATES ALSO PROVIDE SPECIALLY-TRAINED COUNSELORS TO ASSIST PATIENTS AND REVIEW ELIGIBILITY FOR FEDERAL, STATE AND OTHER GOVERNMENT PROGRAMS, INCLUDING, BUT NOT LIMITED TO, MEDICAID, DISABILITY, SOCIAL SECURITY, AND ANY OTHER FORMS OF THIRD PARTY PAYMENT. PART VI, LINE 4: ST. LUKE'S HOSPITAL IS LOCATED IN MAUMEE, OHIO, WHICH IS IN THE SOUTHWEST PORTION OF LUCAS COUNTY. AS OF THE 2020 CENSUS, THERE WERE 431,279 PEOPLE, 181,383 HOUSEHOLDS, AND 111,551 FAMILIES RESIDING IN LUCAS COUNTY. PRIMARY SERVICE AREA DEMOGRAPHIC DISTRIBUTIONS HOUSEHOLD INCOME DISTRIBUTIONMEDIAN HOUSEHOLD INCOME $57,265PER CAPITA INCOME $34,399BELOW THE POVERTY LINE: 17.9% OF THE POPULATION RACE/ETHNICITYWHITE ALONE 73.4%BLACK ALONE 20.6%AMERICAN INDIAN ALONE .4%ASIAN ALONE 1.8%ALL OTHERS 3.8% PART VI, LINE 5: THE PARENT ORGANIZATION AND EACH OF ITS SUBSIDIARY/AFFILIATE MEMBERS MAINTAIN A LOCAL COMMUNITY-BASED BOARD WITH POWERS, RESPONSIBILITIES AND ACCOUNTABILITIES FOR THE OVERSIGHT OF THE OPERATION OF THEIR RESPECTIVE ORGANIZATIONS. EACH SUBSIDIARY/AFFILIATE ORGANIZATION MAINTAINS AN OPEN MEDICAL STAFF ALLOWING ANY PHYSICIAN OR OTHER CARE PROVIDER WITH PROPER CREDENTIALS TO JOIN THE STAFF AND PROVIDE APPROVED CARE. THE ORGANIZATION FUNDS AND MAINTAINS OVER 500 MEDICAL RESIDENCY AND FELLOWSHIP PROGRAMS TO TRAIN FUTURE GENERATIONS OF PHYSICIANS; ORGANIZATION FUNDS, OPERATES AND MAINTAINS NUMEROUS HEALTH CARE EDUCATION PROGRAMS AT THE HIGH SCHOOL, COMMUNITY COLLEGE, UNIVERSITY AND POST-GRADUATE LEVELS OF EDUCATION. ORGANIZATION PROVIDES SPONSORSHIP (FINANCIAL AND IN-KIND RESOURCES) SUPPORT TO COMMUNITY-LEVEL ACTIVITIES (HEALTH WALKS AND RACES, FITNESS TRAINING, DISEASE AWARENESS EVENTS, CULTURAL EVENTS AND OTHER HEALTH-RELATED NON-PROFIT ACTIVITIES, EVENTS AND ORGANIZATIONS). ORGANIZATION ALSO DIRECTS, FUNDS, SUPPORTS AND PARTICIPATES IN FUNDRAISING ACTIVITIES THAT SUPPORT HEALTH PREVENTION/EDUCATION, DIAGNOSIS AND TREATMENT PROVIDED BY OTHER NON-PROFIT COMMUNITY ORGANIZATIONS. PART VI, LINE 6: THE ROLE OF THE PARENT ORGANIZATION IS TO SET THE VISION AND STRATEGIC DIRECTION FOR THE ORGANIZATION AS A WHOLE. THIS INCLUDES THE DEVELOPMENT OF THE ANNUAL STRATEGIC PLAN WHICH DEFINES THE STRATEGIC PRIORITIES FOR THE ORGANIZATION AND ITS MEMBERS, THE METRICS TO BE MEASURED FOR EACH STRATEGIC PROGRAMS AND THE BENCHMARK OR TARGET/GOALS FOR EACH METRIC. STRATEGIC PRIORITIES DIRECTLY ADDRESS AND MEASURE (AT A SUBSIDIARY LEVEL) CLINICAL QUALITY AND CLINICAL OUTCOMES; PATIENT, PHYSICIAN, EMPLOYEE AND COMMUNITY SATISFACTION WITH THE ORGANIZATION AND ITS SUBSIDIARY/AFFILIATE MEMBERS; AND DEVELOPMENT OF NEW SERVICES TO IMPROVE ACCESS TO, QUALITY OF, AND COST OF HEALTH SERVICES.THE ROLE OF THE ORGANIZATION'S SUBSIDIARIES/AFFILIATES IS THE DEVELOPMENT AND IMPLEMENTATION OF ANNUAL STRATEGIC AND OPERATIONAL PLANS THAT SUPPORT AND ADVANCE THE STRATEGIC PLAN OF THE PARENT ORGANIZATION. ALL LOCAL PLANS ARE DEVELOPED AND DESIGNED TO REFLECT THE UNIQUE POPULATION-BASED HEALTH CARE NEEDS AND REQUIREMENTS OF THE COMMUNITIES SERVED BY THE SUBSIDIARY/AFFILIATE ORGANIZATION.ALL LOCAL SUBSIDIARIES/AFFILIATES HAVE FULL AUTHORITY AND DECISION-MAKING POWERS TO DEFINE AND EXECUTE THE STRATEGIC AND OPERATIONAL PLANS INTENDED TO IMPROVE THE HEALTH AND WELFARE OF THE COMMUNITIES THEY SERVE. PART VI, LINE 7, REPORTS FILED WITH STATES OH 1 ST LUKE'S HOSPITAL FOUNDATION 5901 MONCLOVA ROAD MAUMEE OH 43537 311292849 501(C)(3) 79495 0 OPERATING SUPPORT NATURES NURSERY CENTER FOR WILDLIFE REHABILITIATION AND CONSERVATION EDUCAT PO BOX 2395 WHITEHOUSE OH 43571 341603377 501(C)(3) 10000 0 CHARITABLE DONATION 2 0 PART I, LINE 2: REQUESTS FOR FUNDS ARE REVIEWED BY SENIOR LEADERSHIP FOR CONSISTENCY WITH THE ORGANIZATION'S MISSION AND PURPOSE. FUNDS ARE DISTRIBUTED TO 501(C)(3) AND OTHER COMMUNITY ORGANIZATIONS, TYPICALLY FOR GENERAL SUPPORT PURPOSES. 1 1 0 0 0 0 0 1 0 PHILIP INCARNATI MCLAREN PRESIDENT & CEO 0 2557928 0 1412352 0 6778084 0 0 0 35341 0 10783705 0 0 GREGORY LANE MCLAREN EXEC VP & CAO 0 990628 0 641971 0 672408 0 0 0 44131 0 2349138 0 0 BRIAN HOEFLINGER PHYSICIAN 989447 0 22778 0 0 0 15250 0 20339 0 1047814 0 0 0 LAWRENCE SPETKA PHYSICIAN 772317 0 137763 0 0 0 12730 0 17052 0 939862 0 0 0 BENJAMIN J SALPIETRO PHYSICIAN 794319 0 19000 0 0 0 14547 0 19499 0 847365 0 0 0 DAVID LEWIS PHYSICIAN 796433 0 19000 0 0 0 15250 0 15055 0 845738 0 0 0 JENNIFER MONTGOMERY PRESIDENT/CEO EX-OFFICIO 0 559520 0 0 0 210945 0 0 0 35972 0 806437 0 0 JAMES D LYIONS PHYSICIAN 669760 0 77282 0 0 0 12593 0 2841 0 762476 0 0 0 SALVADOR PERON MD TRUSTEE/PHYSICIAN 539220 0 19000 0 0 0 11730 0 16535 0 586485 0 0 0 MOHAMMED EL SAYYAD MD TRUSTEE/PHYSICIAN 328580 0 24974 0 0 0 9748 0 19446 0 382748 0 0 0 STEVE THOMPSON VP CHIEF FINANCIAL OFFICER-PART YEAR 323800 0 0 0 0 0 15250 0 1414 0 340464 0 0 0 LALAINE MATTISON MD TRUSTEE/PHYSICIAN 234308 0 46617 0 0 0 12612 0 14060 0 307597 0 0 0 ANGELA LONG VP CHIEF NURSING OFFICER 216324 0 63544 0 0 0 0 0 23680 0 303548 0 0 0 ALISON AVENDT CHIEF OPERATING OFFICER 262036 0 0 0 0 0 13280 0 7784 0 283100 0 0 0 JEFF KIM FORMER VP INFORMATION 0 0 0 0 275018 0 0 0 0 0 275018 0 0 0 STEPHEN P BAZELEY CHIEF MEDICAL OFFICER 228488 0 20000 0 0 0 13086 0 12740 0 274314 0 0 0 CONNIE SESSLER FORMER VP HUMAN RESOURCES 186817 0 0 0 37360 0 8525 0 12372 0 245074 0 0 0 JILL TROSIN FORMER VP CHIEF NURSING OFFICER 0 0 0 0 156540 0 0 0 0 0 156540 0 0 0 KEVIN RILEY FORMER CHIEF FINANCIAL OFFICER 0 0 0 0 100487 0 0 0 0 0 100487 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 KEVIN RILEY RECEIVED SEVERANCE PAYMENTS TOTALING $412,500, STARTING NOVEMBER 2020 THROUGH APRIL 2022. HE RECEIVED A TOTAL OF $101,487 DURING THE CALENDAR YEAR 2022. JILL TROSIN RECEIVED SEVERANCE PAYMENTS TOTALING $220,002, STARTING SEPTEMBER 2021 THROUGH SEPTEMBER 2022. SHE RECEIVED A TOTAL OF $156,540 DURING THE CALENDAR YEAR 2022. JEFF KIM RECEIVED SEVERANCE PAYMENTS TOTALING $412,526, STARTING OCTOBER 2021 THROUGH APRIL 2023. HE RECEIVED A TOTAL OF $275,018 DURING THE CALENDAR YEAR 2022. CONNIE SESSLER RECEIVED SEVERANCE PAYMENTS TOTALING $291,408, STARTING OCTOBER 2022 THROUGH APRIL 2024. SHE RECEIVED A TOTAL OF $37,360 DURING THE CALENDAR YEAR 2022. ALISON AVENDT, ANGELA LONG, STEPHEN BAZELEY, AND REBECCA SNOW WILL RECEIVE SEVERANCE PAYMENTS BEGINNING 6/2024 WITH THE CLOSURE OF THE HOSPITAL. 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 THE PARTICIPANT'S ACCOUNT BALANCE, AND THE BENEFIT IS PAID IN A SINGLE SUM SERPS ARE PROVIDED ON A TAX-NEUTRAL BASIS. BOTH SERPS ARE DESIGNED TO OR DEBITED TO THEIR ACCOUNTS. THE BENEFIT UNDER THE NEW SERP IS EQUAL TO WITHIN 60 DAYS OF THE PARTICIPANT'S TERMINATION DATE. BENEFITS UNDER BOTH COMPLY WITH INTERNAL REVENUE CODE SECTIONS 457(F) AND 409A. PART I, LINE 7 MCLAREN HEALTH CARE CORPORATION (MHCC) HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION, SUBSIDIARY EXECUTIVES AND DIRECTORS, AND MANAGERS. 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 MHCC SERVES, AND (C) PROTECTING MHCC'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH-TALENT LEADERS. X MINOR EQUIPMENT 1 41875 FMV 0 0 0 PART I, COLUMN (B): THE AMOUNT REPORTED IN LINE 25, COLUMN B IS THE NUMBER OF DONORS WHO CONTRIBUTED EQUIPMENT TO THE FOUNDATION. NET ASSETS OF ST. LUKE'S HOSPITAL 2023-09-30 50850193 COST BASIS 382397643 MCLAREN HEALTH CARE CORPORATION ONE MCLAREN PARKWAY GRAND BLANC MI 48439 501(C)(3) NET ASSETS OF WELLCARE PHYSICIANS GROUP, LLC 2023-09-30 499017 COST BASIS 382397643 MCLAREN HEALTH CARE CORPORATION ONE MCLAREN PARKWAY GRAND BLANC MI 48439 501(C)(3) 0 0 0 0 1 1 1 1 0 FORM 990, PART III, LINE 3 MCLAREN ST. LUKE'S HOSPITAL OFFICIALS ANNOUNCED THE CLOSURE OF THE HOSPITAL AND OPERATIONS CEASED ON MAY 8, 2023. WELLCARE PHYSICIANS GROUP AND THE RESIDENTS OF ST. LUKE'S HOSPITAL OPERATED UNTIL MAY 31, 2023. BON SECOURS MERCY PURCHASED THE BUILDING, LAND, AND EQUIPMENT ON JUNE 1, 2023. ALL PHYSICIANS AND RESIDENTS THEN BEGAN EMPLOYMENT THROUGH OTHER HEATH SYSTEMS IN THE SURROUNDING AREAS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS ORGANIZATION IS MCLAREN HEALTH CARE CORPORATION. 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 DECISIONS BY THE GOVERNING BODY ARE SUBJECT TO THE POWERS OF THE MEMBER. 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 THE RETURNS ARE MADE AVAILABLE TO THE MHCC BOARD MEMBERS, WHO SERVE AS THE OVERALL GOVERNING BOARD. RETURNS ARE AVAILABLE FOR ALL CORPORATIONS OF WHICH MHCC 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 MHCC IS THE ULTIMATE ACCOUNTABLE ORGANIZATION FOR THE SYSTEM; AS SUCH IT IS THE OVERALL GOVERNING BOARD OF OUR SYSTEM WHOSE RESPONSIBILITIES INCLUDES 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 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 PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 5,734,049. MANAGEMENT AND GENERAL EXPENSES 6,990. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,741,039. CONTRACT MEDICAL LABOR SERVICES: PROGRAM SERVICE EXPENSES 4,428,665. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,428,665. CONTRACT SUPPORT SERVICES: PROGRAM SERVICE EXPENSES 2,557,291. MANAGEMENT AND GENERAL EXPENSES 3,346,776. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,904,067. BILLING SERVICES: PROGRAM SERVICE EXPENSES 529,870. MANAGEMENT AND GENERAL EXPENSES 5,082. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 534,952. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,529,030. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,529,030. FORM 990, PART XI, LINE 9: PENSION/POST-RETIREMENT EXPENSE ADJUSTMENT -7,537,138. BENEFICIAL INTEREST IN FOUNDATION -16,641,486. NET ASSETS TRANSFERRED 87,049. DISCONTINUED OPERATIONS - HOSPITAL CLOSURE 160,233,400. WRITE-OFF INTANGIBLE ASSET -71,747,104. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. WELLCARE PHYSICIANS GROUP LLC 5901 MONCLOVA ROAD MAUMEE OH 43537 611528443 EMPLOYS PHYSICIANS OH 7575593 0 ST LUKE'S HOSPITAL BARBARA ANN KARMANOS CANCER HOSPITAL 4100 JOHN R ST DETROIT MI 48201 201649466 HOSPITAL MI 501(C)(3) LINE 3 BARBARA ANN KARMANOS CANCER INSTITUTE 1 BARBARA ANN KARMANOS CANCER INSTITUTE 4100 JOHN R ST DETROIT MI 48201 381613280 CANCER RESEARCH & CARE CENTER MI 501(C)(3) LINE 7 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 CARO COMMUNITY HOSPITAL 401 N HOOPER ST CARO MI 48723 383426063 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 CARO COMMUNITY HOSPITAL ENDOWMENT FOUNDATION 401 N HOOPER ST CARO MI 48724 382422995 FOUNDATION MI 501(C)(3) LINE 12C, III-FI CARO COMMUNITY HOSPITAL 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 HURON MEMORIAL FOUNDATION 1100 S VAN DYKE ROAD BAD AXE MI 48413 382717147 FOUNDATION MI 501(C)(3) LINE 7 HURON MEMORIAL HOSPITAL 1 HURON MEMORIAL HOSPITAL 1100 S VAN DYKE ROAD BAD AXE MI 48413 381474929 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 KARMANOS CANCER FOUNDATION 4100 JOHN R ST DETROIT MI 48201 383584572 FOUNDATION MI 501(C)(3) LINE 7 BARBARA ANN KARMANOS CANCER INSTITUTE 1 LAKE ORION NURSING CENTER CORPORATION 50 NORTH PERRY STREET PONTIAC MI 48342 382895426 NURSING HOME MI 501(C)(3) LINE 10 MCLAREN OAKLAND 1 MARWOOD MANOR NURSING HOME PO BOX 5011 PORT HURON MI 48060 382683251 NURSING HOME MI 501(C)(3) LINE 10 PORT HURON HOSPITAL 1 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 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 MCLAREN FLINT 401 S BALLENGER HWY FLINT MI 48532 382383119 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN FLINT FOUNDATION 401 S BALLENGER HIGHWAY FLINT MI 48532 381358053 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I MCLAREN FLINT 1 MCLAREN GREATER LANSING 2900 COLLINS ROAD LANSING MI 48910 381434090 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN GREATER LANSING FOUNDATION 2900 COLLINS ROAD LANSING MI 48910 382463637 FOUNDATION MI 501(C)(3) LINE 7 MCLAREN GREATER LANSING 1 MCLAREN HEALTH CARE CORPORATION ONE MCLAREN PARKWAY GRAND BLANC MI 48439 382397643 SUPPORTING ORG MI 501(C)(3) LINE 12A, I N/A 0 MCLAREN HEALTH CARE VILLAGE FOUNDATION 401 S BALLENGER HIGHWAY FLINT MI 48532 262693350 SUPPORTING ORG MI 501(C)(3) LINE 12A, I MCLAREN HEALTH CARE CORPORATION 1 MCLAREN HEALTH MANAGEMENT GROUP 1515 CAL DRIVE DAVISON MI 48423 383491714 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN HEALTH PLAN COMMUNITY G-3245 BEECHER ROAD FLINT MI 48532 272204037 INSURANCE MI 501(C)(4) 1 MCLAREN HEALTH PLAN 1 MCLAREN HEALTH PLAN INC G-3245 BEECHER ROAD FLINT MI 48532 383252216 HEALTH CARE SERVICES MI 501(C)(4) MCLAREN INTEGRATED HMO GROUP 1 MCLAREN HOSPICE AND HOME CARE FOUNDATION 1515 CAL DR DAVISON MI 48423 463643089 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN HEALTH MANAGEMENT GROUP 1 MCLAREN INTEGRATED HMO GROUP G-3245 BEECHER ROAD FLINT MI 48532 824449304 HEALTH CARE SERVICES MI 501(C)(4) MCLAREN HEALTH CARE CORPORATION 1 MCLAREN LAPEER REGION 1375 N MAIN ST LAPEER MI 48446 382689033 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN LAPEER REGION FOUNDATION 1375 N MAIN ST LAPEER MI 48446 382689603 FOUNDATION MI 501(C)(3) LINE 12A, I MCLAREN LAPEER REGION 1 MCLAREN MACOMB 1000 HARRINGTON MOUNT CLEMENS MI 48043 381218516 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN MEDICAL GROUP 401 S BALLENGER HWY FLINT MI 48532 382988086 MANAGEMENT COMPANY MI 501(C)(3) LINE 12A, I MCLAREN HEALTH CARE CORPORATION 1 MCLAREN NORTHERN MICHIGAN 416 CONNABLE AVENUE PETOSKEY MI 49770 382146751 ACUTE CARE HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN NORTHERN MICHIGAN FOUNDATION 360 CONNABLE AVENUE PETOSKEY MI 49770 382445611 FOUNDATION MI 501(C)(3) LINE 7 MCLAREN NORTHERN MICHIGAN 1 MCLAREN OAKLAND 50 NORTH PERRY STREET PONTIAC MI 48342 381428164 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MCLAREN OAKLAND FOUNDATION 50 NORTH PERRY STREET PONTIAC MI 48342 200442217 FOUNDATION MI 501(C)(3) LINE 12C, III-FI MCLAREN OAKLAND 1 MCLAREN PORT HURON 1221 PINE GROVE AVENUE PORT HURON MI 48060 381369611 HOSPITAL MI 501(C)(3) LINE 3 MCLAREN HEALTH CARE CORPORATION 1 MDWISE INC 2955 N MERIDIAN STREET SUITE 201 INDIANAPOLIS IN 46208 351931354 HEALTH MAINTENANCE ORGANIZATION IN 501(C)(4) MCLAREN INTEGRATED HMO GROUP 1 MDWISE MEDICAID NETWORK INC 2955 N MERIDIAN STREET SUITE 201 INDIANAPOLIS IN 46208 473192307 HEALTH CARE SERVICES IN 501(C)(4) MCLAREN INTEGRATED HMO GROUP 1 MICHIGAN CANCER SOCIETY 4100 JOHN R ST DETROIT MI 48201 382823451 CANCER RESEARCH MI 501(C)(3) LINE 7 BARBARA ANN KARMANOS CANCER INSTITUTE 1 MOUNT CLEMENS REGIONAL HEALTHCARE FOUNDATION PO BOX 326 MOUNT CLEMENS MI 48046 382578873 FOUNDATION MI 501(C)(3) LINE 10 MCLAREN MACOMB 1 NORTH OAKLAND NORTH MACOMB IMAGING INC 50 NORTH PERRY STREET PONTIAC MI 48342 382807040 MRI IMAGING MI 501(C)(3) LINE 3 MCLAREN OAKLAND 1 NORTHERN MICHIGAN HEMATOLOGY AND ONCOLOGY 416 CONNABLE AVENUE PETOSKEY MI 49770 320020293 PHYSICIAN PRACTICE MI 501(C)(3) LINE 3 MCLAREN NORTHERN MICHIGAN 1 NORTHERN MICHIGAN MEDICAL MANAGEMENT 416 CONNABLE AVENUE PETOSKEY MI 49770 208458840 PHYSICIAN PRACTICE MI 501(C)(3) LINE 12A, I MCLAREN NORTHERN MICHIGAN 1 PORT HURON HOSPITAL FOUNDATION PO BOX 5011 PORT HURON MI 48060 382777750 FOUNDATION MI 501(C)(3) LINE 12A, I PORT HURON HOSPITAL 1 SPARTAN IMAGING INC 2900 COLLINS ROAD LANSING MI 48910 853196614 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 MCLAREN GREATER LANSING 1 ST LUKE'S HOSPITAL FOUNDATION 5901 MONCLOVA ROAD MAUMEE OH 43537 341292849 FOUNDATION OH 501(C)(3) LINE 12A, I ST LUKE'S HOSPITAL 1 THE CARDIAC INSTITUTE DBA MICHIGAN HEART & VASCULAR SPECIALISTS 416 CONNABLE AVENUE PETOSKEY MI 49770 262774689 PHYSICIAN PRACTICE MI 501(C)(3) LINE 3 MCLAREN NORTHERN MICHIGAN 1 VITALCARE INC 761 LAFAYETTE AVENUE CHEBOYGAN MI 49721 382527255 HOSPICE CARE/HOME HEALTH SERVICES MI 501(C)(3) LINE 10 MCLAREN NORTHERN MICHIGAN 1 MCLAREN - NORTHERN EQUITIES CANCER CENTER PROJECT LLC 39000 COUNTRY CLUB DRIVE FARMINGTON HILLS MI 48331 263112935 RENTAL REAL ESTATE MI N/A 0 1 MOUNT CLEMENS REGIONAL HEALTH BUILDING HEALTH PARTNERS 101 W BIG BEAVER RD STE 200 TROY MI 48084 262524717 BUILDING MANAGEMENT MI N/A 0 1 SOUTH VAN DYKE MEDICAL COMPLEX-A 125 N HANSELMAN ST BAD AXE MI 48413 383372174 VARIOUS HEALTHCARE ACTIVITIES MI N/A 0 1 WATERVILLE MEDICAL CENTER LLC 5901 MONCLOVA ROAD MAUMEE OH 43537 320160784 RENTAL REAL ESTATE OH N/A 0 1 CLARKSTON ASC PARTNERS 5701 BOW POINTE DR STE 145 CLARKSTON MI 48346 203360827 SURGERY CENTER MI N/A 0 1 CLARKSTON PROPERTY ASSOCIATES 50 NORTH PERRY STREET PONTIAC MI 48342 432006072 REAL ESTATE MI N/A C 1 DELPHINUS INVESTMENT INC 4100 JOHN R ST DETROIT MI 48075 454758176 HOLD PASSIVE INVESTMENT MI N/A C 1 HEALTH ADVANTAGE INC G3245 BEECHER ROAD FLINT MI 48532 912141720 INSURANCE MI N/A C 1 MCLAREN INSURANCE COMPANY LTD 10 MAIN ST GRAND CAYMAN CJ INSURANCE CJ N/A C 1 MID-MICHIGAN PHYSICIANS PC 2510 KERRY STREET SUITE 200 LANSING MI 48912 383267121 PHYSICIAN PRACTICE MI N/A C 1 MCLAREN PHYSICIAN PARTNERS ONE MCLAREN PARKWAY GRAND BLANC MI 48439 383136458 MANAGED CARE MI N/A C 1 VITALCARE HOME MEDICAL EQUIPMENT INC 761 LAFAYETTE AVENUE CHEBOYGAN MI 49721 382662954 SALE AND RENTAL OF DURABLE MEDICAL EQUIPMENT MI N/A C 1 HURON CLINIC CONDOMINIUMS OWNERS 125 N HANSELMAN ST BAD AXE MI 48413 412144341 VARIOUS HEALTHCARE ACTIVITIES MI N/A S 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 ST LUKE'S HOSPITAL FOUNDATION B 79495 CASH ST LUKE'S HOSPITAL FOUNDATION C 131077 FMV