EMMA L BIXBY MEDICAL CENTER: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization: EMMA L BIXBY MEDICAL CENTER (EIN 38-2796005)
Tax period: 2023-01-01 to 2023-12-31
Filed: 2024-11-12
IRS object ID: 202433179349302818
Schema version: 2023v5.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-11-12T10:11:26-06:00	ReturnTs
Tax Period End	2023-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	381357951	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	PLANTE & MORAN PLLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	10 S RIVERSIDE PLAZA 9TH FLOOR	AddressLine1Txt
City	CHICAGO	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60606	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2023-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	382796005	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EMMA L BIXBY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	EMMA	BusinessNameControlTxt
Phone	4192525772	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 MADISON AVE ATTN TAX DEPARTM	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TERRENCE METZGER	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4192525772	PhoneNum
Signature	2024-11-08	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (1)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	AMY CIMINELLO	PreparerPersonNm
PTIN	P00796388	PTIN
Phone	3122071040	PhoneNum
Preparation	2024-11-08	PreparationDt

Field	Value	IRS element (for citing)
Tax	2023	TaxYr
Build TS	2024-10-15 13:58:12Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	TERRENCE METZGER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 MADISON AVE ATTN TAX DEPARTMENT	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$135,607,293	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.PROMEDICA.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1989	FormationYr
Legal Domicile State	MI	LegalDomicileStateCd
Activity Or Mission	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL IS AN ACUTE CARE HOSPITAL THAT PROVIDES HEALTHCARE SERVICES PRIMARILY TO INDIVIDUALS OF LENAWEE COUNTY.	ActivityOrMissionDesc
Voting Members Governing Body	20	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	674	TotalEmployeeCnt
Total Volunteers	78	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,477,078	PYContributionsGrantsAmt
CY Contributions Grants	$972,844	CYContributionsGrantsAmt
PY Program Service Revenue	$131,691,698	PYProgramServiceRevenueAmt
CY Program Service Revenue	$132,915,911	CYProgramServiceRevenueAmt
PY Investment Income	$135,856	PYInvestmentIncomeAmt
CY Investment Income	$72,831	CYInvestmentIncomeAmt
PY Other Revenue	$1,648,670	PYOtherRevenueAmt
CY Other Revenue	$1,645,707	CYOtherRevenueAmt
PY Total Revenue	$134,953,302	PYTotalRevenueAmt
CY Total Revenue	$135,607,293	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,072,641	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$38,331,295	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$38,765,650	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$86,287,808	PYOtherExpensesAmt
CY Other Expenses	$91,537,385	CYOtherExpensesAmt
PY Total Expenses	$125,691,744	PYTotalExpensesAmt
CY Total Expenses	$130,303,035	CYTotalExpensesAmt
PY Revenues Less Expenses	$9,261,558	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$5,304,258	CYRevenuesLessExpensesAmt
Total Assets BOY	$223,622,255	TotalAssetsBOYAmt
Total Assets EOY	$202,967,096	TotalAssetsEOYAmt
Total Liabilities BOY	$152,517,755	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$169,385,389	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$71,104,500	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$33,581,707	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	EMMA L. BIXBY MEDICAL CENTER IS DEDICATED TO IMPROVING HUMAN LIFE AND DEVOTED TO THE PATIENTS AND FAMILIES WE SERVE THROUGH INNOVATIVE CARE, SUPERIOR QUALITY, AND PREMIER CUSTOMER SERVICE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$112,780,692	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$132,915,911	RevenueAmt
Desc	EMMA L. BIXBY MEDICAL CENTER IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. FOUNDED IN 1911, EMMA L. BIXBY MEDICAL CENTER (D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL CONTINUES TO MEET THE HEALTHCARE NEEDS OF ADRIAN, MICHIGAN AND SURROUNDING SOUTHEAST MICHIGAN COMMUNITIES AS THE LARGEST ACUTE CARE FACILITY IN LENAWEE COUNTY. IT IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE HEALTH CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL (CVHH) IS A 50-BED, FULL-SERVICE, ACUTE CARE HOSPITAL STAFFED BY MORE THAN 120 ACTIVE PROVIDERS WORKING TO MEET IDENTIFIED NEEDS OF THE COMMUNITY. THE FACILITY IS MORE THAN 200,000 SQUARE FEET, CONSISTING OF 40 MEDICAL-SURGICAL BEDS, 10 CRITICAL CARE BED, FOUR OPERATING ROOMS WITH THREE MINOR PROCEDURE ROOMS, 27 EMERGENCY ROOMS AND EIGHT LABOR AND DELIVERY ROOMS AS WELL AS A FULL ARRAY OF DIAGNOSTIC SERVICES. THE HOSPITAL ALSO PROVIDES NUMEROUS INPATIENT AND OUTPATIENT SERVICES, WITH ITS STAFF OF PROFESSIONALS OFFERING CARE IN GENERAL SURGERY, HEART AND VASCULAR CARE, WOMEN'S HEALTH, ORTHOPAEDICS, PEDIATRICS, FAMILY MEDICINE, CRITICAL CARE, AND CANCER TREATMENT SERVICES. IN 2023, CVHH WAS NAMED A TOP RURAL HOSPITAL FOR THE THIRD YEAR IN A ROW BY THE LEAPFROG GROUP FOR OUTSTANDING QUALITY AND SAFETY. CVHH WAS ONE OF JUST 23 RURAL HOSPITALS NATIONWIDE TO RECEIVE THE HONOR.IN 2023, CVHH SERVED 2,807 INPATIENTS; 86,660 OUTPATIENTS; AND 28,259 EMERGENCY CENTER PATIENTS. THE HICKMAN CANCER CENTER, ON THE HICKMAN HOSPITAL CAMPUS, IS ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS. AS PART OF THE PROMEDICA CANCER INSTITUTE, HICKMAN CANCER CENTER OFFERS DIAGNOSTIC SERVICES, AS WELL AS RADIATION AND MEDICAL ONCOLOGY TREATMENT FOR HUNDREDS OF NEW PATIENTS ANNUALLY. AS A MEMBER OF THE TOLEDO COMMUNITY HOSPITAL ONCOLOGY PROGRAM, HICKMAN CANCER CENTER OFFERS PATIENTS THE OPPORTUNITY TO PARTICIPATE IN NATIONAL CANCER TRIALS. FURTHER, CVHH'S CARDIAC AND PULMONARY REHABILITATION PROGRAM IS CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. ADDITIONALLY, CVHH OFFERS TELEMEDICINE SERVICE TO ITS INPATIENT CARE UNITS TO HELP PROVIDE REAL-TIME PATIENT DIAGNOSIS AND TREATMENT FROM A PHYSICIAN. THE SERVICE ALLOWS A DOCTOR'S VISIT TO BE CONDUCTED WITH A SPECIAL COMPUTER AND INTERNET CONNECTION AND HELPS THE HOSPITAL PROVIDE SAFE, QUALITY CARE WHEN IT'S NEEDED DURING NIGHT SHIFTS WHEN FEWER PHYSICIANS MAY BE AVAILABLE. CVHH HAS ALSO RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES GOLD PLUS ACHIEVEMENT FOR ITS COMMITMENT TO ENSURING STROKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED STANDARDS OF CARE.THE HOSPITAL CONTRIBUTED $22,540,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE IN 2023.THROUGH COMMUNITY HEALTH SERVICES, HEALTH PROFESSIONAL EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH ACTIVITIES, CASH AND IN-KIND CONTRIBUTIONS, AND COMMUNITY BENEFIT OPERATIONS, CVHH CONTRIBUTED $503,000 TO THE COMMUNITY DURING 2023. THE FOLLOWING ARE EXAMPLES OF SUCH CONTRIBUTIONS: -FOOD SECURITY PROGRAMS PROVIDING FOOD AT DISCHARGE AND OUT IN THE COMMUNITY THROUGH PROMEDICA, FARMS, VEGGIE MOBILE AND PARTNERSHIP WITH THE SOUTH MICHIGAN FOOD BANK. - COMPLEMENTARY TRANSPORTATION AT DISCHARGE FOR PATIENTS EXPERIENCING TRANSPORTATION AND FINANCIAL STRAIN BARRIERS. - SUPPORT GROUPS FOR INDIVIDUALS WITH CHRONIC DISEASES, FOCUSED ON PATIENTS' EMOTIONAL, PHYSIOLOGICAL AND PSYCHOLOGICAL NEEDS; - CHILDHOOD AND ADULT IMMUNIZATIONS AND ASTHMA CARE - COMMUNITY HEALTH AND WELLNESS SERVICES, WHICH INCLUDED TOBACCO CESSATION PROGRAMS, NUTRITION AND HEALTHY LIFESTYLES CLASSES, PRENATAL CLASSES, AND CPR TRAINING; COLLABORATION WITH THE UNITED WAY OF MONROE AND LENAWEE COUNTIES HEALTH CHECK EVENTS - COLLECTION AND RESPONSIBLE DISPOSAL OF UNUSED MEDICATIONS THROUGH TWO COMMUNITY TAKE BACK EVENTS AND MEDSAFE COLLECTION BINS WITH THE EMERGENCY DEPARTMENT.CVHH PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2023, OF WHICH $4,939,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. CVHH'S COST OF BAD DEBT FOR 2023 WAS $5,793,000 . THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $22,540,000 NOTED ABOVE.FURTHER, CVHH PROVIDED $5,688,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. ALSO, IN 2023, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $1,065,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $22,540,000 NOTED ABOVE.CVHH PROVIDED 474 JOBS THROUGH DIRECT EMPLOYMENT IN 2023, EXPENDING $28,883,000 IN NET PAYROLL. A TOTAL OF $1,769,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, CVHH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE.	Desc
Total Program Service Expenses	$112,780,692	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	674	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	20	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	TERRENCE METZGER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	4192525772	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 MADISON AVE	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DAWN BUSKEY
TRUSTEE/PRESIDENT	1.00	54.00	Yes (X)	$0	$1,412,400	$5,337
STEVE SADOWSKI
SECRETARY/CHIEF LEGAL OFFICER	1.00	54.00	Yes (X)	$0	$1,407,180	$6,028	Yes (X)
TERRENCE METZGER
TRUSTEE/TREASURER	1.00	54.00	Yes (X)	$0	$1,055,090	$4,079	Yes (X)
DARRIN ARQUETTE
TRUSTEE/PRESIDENT	1.00	44.00	Yes (X)	$0	$439,707	$3,272
JULIE YAROCH DO
TRUSTEE/PRESIDENT	1.00	44.00	Yes (X)	$0	$390,716	$4,244	Yes (X)
PAUL GIETZEN
TRUSTEE/PHYSICIAN	1.00	44.00	Yes (X)	$0	$332,763	$4,120
CHRISTI ANSBERG
TRUSTEE/VP PHILANTHROPY	1.00	44.00	Yes (X)	$0	$236,562	$0
MICHAEL ADAMS
TRUSTEE/RESPIRATORY THERAPIST	1.00	44.00	Yes (X)	$0	$110,362	$1,619
MARCY BROWN
CHAIRMAN	1.00	14.00	Yes (X)	$0	$0	$0	Yes (X)
LOUIS ROBICHAUX
TREASURER - PART YEAR	1.00	54.00	Yes (X)	$0	$0	$0	Yes (X)
MARCIA BOYNTON JD
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
MARSHA DAVIS
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
BRANDON FARVER
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
RUDY FLORES
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
MARK HAAG
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
KATIE E MATTISON
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
GARY MCDOWELL
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
DENNIS SMOKE
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
AARON SWIGGUM
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
JENNIFER HUNTER
TRUSTEE	1.00	0.00	Yes (X)	$0	$0	$0
ELIZABETH KENNEDY
TRUSTEE - PART YEAR	1.00	0.00	Yes (X)	$0	$0	$0
ARTURO POLIZZI
CHIEF OPERATING OFFICER	1.00	54.00		$0	$2,121,593	$5,857	Yes (X)
CHRISTINA BELL
DIRECTOR OF PHARMACY	45.00	0.00		$156,652	$0	$11,097		Yes (X)
MELISSA THOMPSON
CLINICAL PHARMACIST	45.00	0.00		$149,739	$0	$2,546		Yes (X)
GARY AUSTIN
RN, HOSPITAL	45.00	0.00		$145,576	$0	$4,095		Yes (X)
LISA BACHMAYER
PHYSICAL-THERAPIST	45.00	0.00		$145,979	$0	$2,202		Yes (X)
HANI BLAIH
PHARMACIST	45.00	0.00		$136,942	$0	$1,811		Yes (X)
STEVEN M CAVANAUGH
TREASURER, CFO - FORMER	0.00	0.00		$0	$1,335,180	$5,657			Yes (X)
JEFFREY C KUHN
SECRETARY, CHIEF LEGAL OFFICER - FORMER	0.00	0.00		$0	$748,426	$30,922			Yes (X)
GARY AKENBERGER
CHIEF OFFICER - FORMER	0.00	0.00		$0	$528,647	$43,532			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$734,888	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$10,118,626	TotReportableCompRltdOrgAmt
Total Other Compensation	$136,418	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	52	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Related Organizations	$688,724	RelatedOrganizationsAmt
Government Grants	$284,120	GovernmentGrantsAmt
Total Contributions	$972,844	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICES	621110	$131,979,175	$131,979,175
AFFILIATED ORG RENT	531120	$936,736	$936,736

Field	Value	IRS element (for citing)
Total Program Service Revenue	$132,915,911	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$72,831	TotalRevenueColumnAmt
Exclusion	$72,831	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$81,922	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$81,922	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$81,922	TotalRevenueColumnAmt
Exclusion	$81,922	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	AUXILARY INCOME	Desc
Business	900099	BusinessCd
Total Revenue Column	$1,563,785	TotalRevenueColumnAmt
Exclusion	$1,563,785	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,563,785	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$135,607,293	TotalRevenueColumnAmt
Related Or Exempt Func Income	$132,915,911	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$1,718,538	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$31,624,188	TotalAmt
Program Services	$25,005,304	ProgramServicesAmt
Management And General	$6,618,884	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,903,819	TotalAmt
Program Services	$3,877,459	ProgramServicesAmt
Management And General	$1,026,360	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,237,643	TotalAmt
Program Services	$1,769,308	ProgramServicesAmt
Management And General	$468,335	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$79,997	TotalAmt
Management And General	$79,997	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$5,543	TotalAmt
Management And General	$5,543	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$16,863,332	TotalAmt
Program Services	$11,425,006	ProgramServicesAmt
Management And General	$5,438,326	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,083	TotalAmt
Program Services	$296	ProgramServicesAmt
Management And General	$2,787	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,576,530	TotalAmt
Program Services	$246,983	ProgramServicesAmt
Management And General	$2,329,547	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$13,394	TotalAmt
Program Services	$8,236	ProgramServicesAmt
Management And General	$5,158	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,646,150	TotalAmt
Program Services	$3,536,766	ProgramServicesAmt
Management And General	$109,384	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$177,296	TotalAmt
Program Services	$16,995	ProgramServicesAmt
Management And General	$160,301	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,966,316	TotalAmt
Program Services	$2,966,316	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,705,766	TotalAmt
Program Services	$6,861,339	ProgramServicesAmt
Management And General	$844,427	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
INTERCOMPANY SERVICES	$24,799,371	$24,799,371
DRUGS	$15,240,646	$15,240,646
MEDICAL SUPPLIES	$8,234,008	$8,234,008
PROVISION FOR BAD DEBT	$5,793,215	$5,793,215

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,432,738	TotalAmt
Program Services	$2,999,444	ProgramServicesAmt
Management And General	$433,294	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$130,303,035	TotalAmt
Program Services	$112,780,692	ProgramServicesAmt
Management And General	$17,522,343	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$26,220,159	BOYAmt
EOY	$8,996,491	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$18,155,916	BOYAmt
EOY	$17,823,720	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,695,744	BOYAmt
EOY	$2,661,854	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$225,851	BOYAmt
EOY	$264,891	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$164,813,514	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$31,524,484	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$140,293,382	BOYAmt
EOY	$133,289,030	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,736,886	BOYAmt
EOY	$1,531,709	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$34,294,317	BOYAmt
EOY	$38,399,401	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$223,622,255	BOYAmt
EOY	$202,967,096	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$6,494,807	BOYAmt
EOY	$6,930,694	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$49,389,706	BOYAmt
EOY	$49,417,548	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$96,633,242	BOYAmt
EOY	$113,037,147	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$152,517,755	BOYAmt
EOY	$169,385,389	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$70,181,253	BOYAmt
EOY	$32,798,286	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$923,247	BOYAmt
EOY	$783,421	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$71,104,500	BOYAmt
EOY	$33,581,707	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$223,622,255	BOYAmt
EOY	$202,967,096	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$5,304,258	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$42,827,051	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$5,543	OtherActivitiesAmt
Total Lobbying Expenditures	$5,543	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	EMMA L. BIXBY MEDICAL CENTER PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION, A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ORGANIZATION.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,409,191	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,891,445	InvestmentEarningsOrLossesAmt
End Year Balance	$22,300,636	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$24,519,146	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$4,022,944	InvestmentEarningsOrLossesAmt
Other Expenditures	$87,011	OtherExpendituresAmt
End Year Balance	$20,409,191	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$22,620,000	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,929,793	InvestmentEarningsOrLossesAmt
Other Expenditures	$30,647	OtherExpendituresAmt
End Year Balance	$24,519,146	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$771,892	BeginningYearBalanceAmt
Contributions	$19,420,909	ContributionsAmt
Investment Earnings Or Losses	$2,927,199	InvestmentEarningsOrLossesAmt
Other Expenditures	$500,000	OtherExpendituresAmt
End Year Balance	$22,620,000	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$689,791	BeginningYearBalanceAmt
Investment Earnings Or Losses	$82,101	InvestmentEarningsOrLossesAmt
End Year Balance	$771,892	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.94410	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.05590	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,244,583	OtherCostOrOtherBasisAmt
Book Value	$1,244,583	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$129,760,192	OtherCostOrOtherBasisAmt
Depreciation	$14,501,634	DepreciationAmt
Book Value	$115,258,558	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,748	OtherCostOrOtherBasisAmt
Depreciation	$15,918	DepreciationAmt
Book Value	$7,830	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$28,392,146	OtherCostOrOtherBasisAmt
Depreciation	$16,075,678	DepreciationAmt
Book Value	$12,316,468	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,392,845	OtherCostOrOtherBasisAmt
Depreciation	$931,254	DepreciationAmt
Book Value	$4,461,591	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$133,289,030	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
BENEFICIAL INTEREST IN FOUNDATION	$36,998,252
ESTIMATED THIRD PARTY PAYOR RECEIVABLE	$1,401,149

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$38,399,401	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
ESTIMATED THIRD PARTY PAYOR RECEIVABLE	$3,801,659
INTERCOMPANY DEBT TO THE TOLEDO HOSPITAL	$102,058,083
OPERATING LEASE LIABILITY	$1,678,622
ACCRUED SALARIES & BENEFITS	$2,720,411
REMEDIATION	$2,778,372

Field	Value	IRS element (for citing)
Total Liability	$113,037,147	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART V, LINE 4:	FormAndLineReferenceDesc
Explanation	THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT EMMA L. BIXBY MEDICAL CENTER CONSISTENT WITH DONOR INTENT.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	600.000000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$954,634	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$954,634	NetCommunityBenefitExpnsAmt
Total Expense	0.00770	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,082,647	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,394,388	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,688,259	NetCommunityBenefitExpnsAmt
Total Expense	0.04570	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,037,281	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,394,388	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,642,893	NetCommunityBenefitExpnsAmt
Total Expense	0.05340	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	118	ActivitiesOrProgramsCnt
Persons Served	2237	PersonsServedCnt
Total Community Benefit Expns	$115,312	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$115,312	NetCommunityBenefitExpnsAmt
Total Expense	0.00090	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$322,130	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$322,130	NetCommunityBenefitExpnsAmt
Total Expense	0.00260	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$65,476	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$65,476	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	118	ActivitiesOrProgramsCnt
Persons Served	2237	PersonsServedCnt
Total Community Benefit Expns	$502,918	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$502,918	NetCommunityBenefitExpnsAmt
Total Expense	0.00400	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	118	ActivitiesOrProgramsCnt
Persons Served	2237	PersonsServedCnt
Total Community Benefit Expns	$22,540,199	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,394,388	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,145,811	NetCommunityBenefitExpnsAmt
Total Expense	0.05740	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	367	PersonsServedCnt
Total Community Benefit Expns	$750	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$750	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	367	PersonsServedCnt
Total Community Benefit Expns	$750	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$750	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,793,215	BadDebtExpenseAmt
Bad Debt Expense Attributable	$235,523	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$25,538,881	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$26,604,047	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,065,166	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 HERRICK MEMORIAL OFFICE PLAZA CONDO ASSOCIATION
FACILITY SUPPORT	0.71800	0.28200
2 LENAWEE CLINICAL PARTNERS
PHYSICIAN MGMT SERVICES	0.50000	0.38460

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5640 N ADRIAN HWY	AddressLine1Txt
City	ADRIAN	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49221	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.PROMEDICA.ORG	WebsiteAddressTxt
State License	1060000004	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	PROMEDICA CHARLES AND VIRGINIA HICKMAN H	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	22	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	22	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	600.000000000000	FPGFamilyIncmLmtDscntCarePct
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY ASSESSMENT SURVEY PROCESS PROMEDICA CHARLES & VIRGINIA HICKMAN HOSPITAL WITH THE LENAWEE HEALTH NETWORK, COMPRISED OF MULTIPLE COMMUNITY ORGANIZATIONS, COLLABORATED TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LENAWEE COUNTY. A RESOURCE ASSESSMENT AND GAP ANALYSIS WERE COMPILED AS PART OF THIS PROCESS.IN 2022, PROMEDICA CHARLES & VIRGINIA HICKMAN HOSPITAL CONVENED A CHNA COMMITTEE TO REVIEW THE MOST RECENT LENAWEE COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY HEALTH INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS. THE HOSPITAL RECEIVED FEEDBACK ON THE CHNA PLAN FROM THE LENAWEE COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LENAWEE HEALTH NETWORK STRATEGIC PLANNING PROCESS INCLUDED INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED:CATHOLIC CHARITIES OF JACKSON, HILLSDALE, & LENAWEE COUNTIES, COMMUNITY ACTION AGENCY OF JACKSON, LENAWEE & HILLSDALE COUNTIES, CRADLE TO CAREER, FAMILY MEDICAL CENTER OF MICHIGAN, GOODWILL INDUSTRIES OF SE MICHIGAN, HEAD START, ADRIAN PUBLIC SCHOOLS, HOSPICE OF LENAWEE, INTERCONNECTIONS DROP-IN CENTER, LENAWEE COMMUNITY FOUNDATION, LENAWEE COUNTY DEPARTMENT OF VETERANS AFFAIRS, LENAWEE COUNTY HEALTH DEPARTMENT, LENAWEE COMMUNITY MENTAL HEALTH AUTHORITY, LENAWEE DEPARTMENT ON AGING, LENAWEE DEPARTMENT OF HEALTH AND HUMAN SERVICES, LENAWEE INTERMEDIATE SCHOOL DISTRICT, LENAWEE SUBSTANCE ABUSE PREVENTION COALITION, MSU-EXTENSION, ONE LENAWEE, PROMEDICA CHARLES & HICKMAN HOSPITAL, REGION 2 AREA AGENCY ON AGING, THE CARE PREGNANCY CENTER OF LENAWEE, UNITED WAY OF MONROE/LENAWEE COUNTIES, THOME PACE, YMCA OF LENAWEE COUNTY
PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2022 CHNA WITH THE FOLLOWING HOSPITAL FACILITY: HERRICK MEMORIAL HOSPITAL, INC.
PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2022 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO.
PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	PART V, SECTION B, LINE 11: EMMA L. BIXBY MEDICAL CENTER CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2022 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - BEHAVIORAL & MENTAL HEALTH - SOCIAL DETERMINANTS OF HEALTH- CHRONIC CONDITIONS- HEALTH EQUITY THIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2022, THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2023-2025. EMMA L. BIXBY MEDICAL CENTER DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2022 IMPLEMENTATION PLAN INCLUDE: OLDER ADULT SOCIAL ISOLATION, EXPANDED SERVICES FOR OLDER ADULTS, ACCESS TO HEALTHY NUTRITION, YOUTH MENTORING BY ADULTS, ACCESS TO PHYSICAL ACTIVITY IN THE COMMUNITY, SUBSTANCE ABUSE PREVENTION, TREATMENT AND RECOVERY SERVICES, TRAUMA SERVICES, AFTER SCHOOL PROGRAMS AND ACTIVITIES FOR YOUTH AND TEENS, LOW COST AND CONFIDENTIAL FAMILY PLANNING AND STD SERVICES, CASE MANAGEMENT FOR CHILDREN WITH ELEVATED LEAD LEVELS, FUNDING/SERVICES FOR HOMELESS STUDENTS, MENTORING SYSTEM FOR YOUTH, DENTAL SERVICES, AND EXPANSION OF PRIMARY CARE, DENTAL, MENTAL HEALTH, AND PREVENTATIVE HEALTH SERVICES FOR UNINSURED/UNDERINSURED PATIENTS. EMMA L. BIXBY MEDICAL CENTER DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2023 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2022:HEALTH NEED IDENTIFIED: BEHAVIORAL & MENTAL HEALTH STRATEGY #1 CONTINUE THE ALTERNATIVES TO OPIOIDS (ALTO) TO DECREASE THE VOLUME OF OPIOID PRESCRIPTIONS AT DISCHARGEACTIONS TAKEN: - IN 2022, AVERAGE NUMBER OF DAYS OPIOIDS WERE PRESCRIBED AT DISCHARGE WAS 2.89 DAYS. IN 2023, THE AVERAGE WAS 2.83 DAYS. STRATEGY #2 CONVENE BIANNUAL MEETINGS WITH LEGAL REPRESENTATION, COMMUNITY MENTAL HEALTH, AND FIRST RESPONDERS TO ASSESS THE COMMUNITY NEEDS AND LINKAGES TO RESOURCES. ACTIONS TAKEN: - SIX (6) MEETINGS WERE HELD WITH COMMUNITY MENTAL HEALTH, LAW ENFORCEMENT, FIRST RESPONDERS AND THE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT OPIOID ACTION PLANNING SUPPORTING COMMUNITY NEEDS AND COLLABORATIONS FOR LINKAGES TO LOCAL RESOURCES.- FIVE (5) SECTORS ATTENDED THESE MEETINGS, WHICH INCLUDE HEALTHCARE, LAW ENFORCEMENT, MENTAL HEALTH, GOVERNMENT, AND COMMUNITY MEMBERS.- IN 2023, LENAWEE COUNTY APPOINTED A COUNTY EMPLOYEE TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT INFORMING THE DEVELOPMENT OF A COUNTY OPIOID ASSESSMENT. THE HOSPITAL COLLABORATED WITH THIS MULTI-SECTOR INITIATIVE IN 2023 BY PARTICIPATED IN ALL PLANNING SESSIONS AND PROVIDED ROBUST DATA REPORTS PERTAINING TO MENTAL HEALTH AND SUBSTANCE AND OPIOID USE DISORDERS.STRATEGY #3 UPDATE LENAWEE MENTAL HEALTH RESOURCE GUIDE ANNUALLY & DISTRIBUTE TO COMMUNITY. ACTIONS TAKEN:- THE LENAWEE MENTAL HEALTH RESOURCE GUIDE WAS UPDATED IN AUGUST 2023. - 51 PAPER COPIES OF THE MENTAL HEALTH RESOURCE GUIDE WERE DISTRIBUTED. A POSTCARD WITH A QR CODE IS DISTRIBUTED SO THAT PEOPLE CAN ACCESS THE DIGITAL FILE THAT PROCESSES REAL-TIME UPDATES TO INFORMATION WITHIN THE DOCUMENT. STRATEGY #4 LAUNCH AND CONTINUE NALOXONE DISTRIBUTION PROGRAM IN THE EMERGENCY DEPARTMENT & EDUCATION WITH LOCAL LAW ENFORCEMENT. ACTIONS TAKEN:- SIX (6) PATIENTS RECEIVED NALOXONE IN THE EMERGENCY DEPARTMENT. STRATEGY #5 CONTINUE HOSTING DRUG TAKE BACK DAY EVENTS AND THE MEDSAFE DISPOSAL SITE IN THE EMERGENCY DEPARTMENT FOR MEDICATION DISPOSAL ACTIONS TAKEN:- 264 POUNDS OF UNUSED MEDICATIONS WERE COLLECTED AND DISPOSED OF RESPONSIBLY THROUGH THE HOSPITAL'S MEDSAFE COLLECTION SITE. - 1360 POUNDS OF UNUSED MEDICATIONS, SHARPS, INHALERS, AND LIQUIDS WERE COLLECTED AND DISPOSED OF RESPONSIBLY THROUGH DEA APPROVED DRUG TAKE BACK DAY EVENTS AT THE HOSPITAL IN APRIL AND OCTOBER. - 620 COMMUNITY MEMBERS PARTICIPATED IN DISPOSING OF THEIR MEDICATIONS IN DRUG TAKE BACK DAY EVENTS IN 2023. HEALTH NEED IDENTIFIED: SOCIAL DETERMINANTS OF HEALTH STRATEGY #1 CONTINUE PARTNERSHIP WITH MICHIGAN TRANSPORTATION CONNECTION TO PROVIDE COMPLEMENTARY TRANSPORT TO PATIENTS AT DISCHARGE, WITH INSECURITY. ACTIONS TAKEN: - 214 PATIENTS WERE PROVIDED WITH TRANSPORTATION AT DISCHARGE THROUGH PARTNERSHIP WITH MICHIGAN TRANSPORTATION CONNECTION IN 2023. STRATEGY #2 REFER PATIENTS TO RESOURCES ADDRESSING SOCIAL DETERMINANTS OF HEALTH (FINANCIAL STRAIN, FOOD INSECURITY). ACTIONS TAKEN: - 17 PATIENTS SCREENING POSITIVE FOR FOOD INSECURITY RECEIVED FOOD AT DISCHARGE. - 5 EMPLOYEES EXPERIENCING FOOD INSECURITY RECEIVED FOOD IN 2023. - 727 PATIENTS WERE REFERRED TO THE FINANCIAL OPPORTUNITY CENTER TO WORK DIRECTLY WITH A FINANCIAL COACH. - THROUGH COLLABORATION WITH COMMUNITY ACTION AGENCY, 31 NO-COST AND EVIDENCE-BASED FINANCIAL LITERACY WORKSHOPS WERE OFFERED TO THE COMMUNITY IN 2023. INFORMATION ABOUT WORKSHOPS IS SHARED WITH PATIENTS THROUGH CARE NAVIGATION AND THE ADRIAN EBEID NEIGHBORHOOD PROMISE. STRATEGY #3 REFER PATIENTS TO REGION 2 AAA EVIDENCE-BASED PROGRAMS PROMOTING HEALTHY AGING (FRIENDLY REASSURANCE, AND PERSONAL ACTIONS TOWARD HEALTH).ACTIONS TAKEN:- THROUGH COLLABORATION WITH REGION 2 AAA, 21 NO-COST AND EVIDENCE-BASED WORKSHOPS WERE OFFERED TO THE COMMUNITY, WHICH INCLUDED PERSONAL ACTION TOWARD HEALTH AND CONVERSATION CAF'S. INFORMATION ABOUT WORKSHOPS IS SHARED WITH PATIENTS THROUGH CARE NAVIGATION AND THE ADRIAN EBEID NEIGHBORHOOD PROMISE.STRATEGY #4 CONTINUE FARM AND VEGGIE MOBILE PROGRAM TO PROVIDE ACCESS TO FRESH PRODUCE AND GARDENING EDUCATION. ACTIONS TAKEN: - 5074 COMMUNITY MEMBERS WERE SERVED WITH FRESH PRODUCE THROUGH THE VEGGIE MOBILE IN 2023. - 19 VOUCHERS FOR FRESH PRODUCE WERE REDEEMED BY PATIENTS SCREENING POSITIVE FOR FOOD INSECURITY AT HOSPITAL DISCHARGE AND REFERRING PHYSICIAN OFFICES.- 52 GARDENING WORKSHOPS WERE OFFERED TO THE COMMUNITY IN 2023.HEALTH NEED IDENTIFIED: CHRONIC CONDITIONS STRATEGY #1 PROVIDE THE COMMUNITY WITH EDUCATION PERTAINING TO RESPIRATORY HEALTH (SMOKING/VAPING, COPD, GREAT AMERICAN SMOKE OUT)ACTIONS TAKEN: - IN 2023, THE HOSPITAL RESPIRATORY DEPARTMENT BUILT COLLABORATIONS WITH THE LOCAL SCHOOLS. AS A RESULT, A VAPING 101 WORKSHOP WAS DEVELOPED AND SESSIONS WERE SCHEDULED STARTING IN JANUARY ACROSS SCHOOL DISTRICTS. THE PROGRAM WAS DEVELOPED IN 2023 BASED ON FEEDBACK FROM THE SCHOOLS AND COMMUNITY. STRATEGY #2 COLLABORATE WITH SENIOR CENTERS AND COMMUNITY LOCATIONS TO PROVIDE HEALTH RELATED EDUCATION, SCREENINGS, SELF-MONITORING RESOURCES (STROKE, BLOOD PRESSURE, CHF, DIABETES)ACTIONS TAKEN:- 129 COMMUNITY MEMBERS RECEIVED BLOOD PRESSURE, BLOOD SUGAR, OR NO-COST CANCER SCREENINGS IN 2023. - SEVEN (7) HEALTH EDUCATION WORKSHOPS WERE HELD IN 2023 TO INCREASE KNOWLEDGE OF SELF-MONITORING OF CHRONIC CONDITIONS AND AWARENESS OF LOCAL RESOURCES. STRATEGY #3 COLLABORATE WITH COMMUNITY PARTNERS TO HOST EVIDENCE-INFORMED WORKSHOPS AT PROMEDICA FARMS FOR PATIENTS AND COMMUNITY MEMBERS. ACTIONS TAKEN:- THROUGH COLLABORATION WITH MICHIGAN STATE UNIVERSITY EXTENSION, 23 NO-COST AND EVIDENCE-BASED COOKING MATTERS CLASSES WERE OFFERED TO PROVIDE THE COMMUNITY WITH NUTRITION EDUCATION AND COOKING DEMONSTRATIONS AT THE FARM. FRESH PRODUCE FROM THE CAMPUS IS INCORPORATED INTO THE CURRICULUM. - 431 COMMUNITY MEMBERS PARTICIPATED IN GARDENING WORKSHOPS AND EVIDENCE-BASED WORKSHOPS WITH MSU-E IN 2023. HEALTH NEED IDENTIFIED: HEALTH EQUITYSTRATEGY #1 CONTINUE PARTNERSHIP WITH ALL ABOUT ADRIAN RESIDENT COALITION TO MOBILIZE SCREENING AND HEALTH EDUCATION TO SECOND FRIDAY'S AND OTHER COMMUNITY EVENTS IN UNDERSERVED CENSUS TRACTS. ACTIONS TAKEN:- THROUGH COLLABORATION WITH NEIGHBORHOOD BASED COMMUNITY EVENTS, 47 COMMUNITY MEMBERS RECEIVED BLOOD PRESSURE SCREENINGS AND HEALTH EDUCATION. STRATEGY #2 CONTINUE PARTNERSHIP WITH THE UNITED WAY HEALTH CHECK EVENT TO PROVIDE HEALTH SCREENINGS AND BLOOD PANEL TESTING. ACTIONS TAKEN:- THROUGH COLLABORATION WITH THE UNITED WAY OF LENAWEE COUNTY, THE HOSPITAL LAB DEPARTMENT PROVIDED IN-KIND SUPPORT TOWARD PROVIDING 22-PANEL BLOOD TESTING AT 2 HEALTH CHECK EVENTS. - 136 PARTICIPANTS RECEIVED BLOOD PANEL TESTING AT THE HEALTH CHECK EVENT- 167 PARTICIPANTS ATTENDED THE UNITED WAY HEALTH CHECK EVENTS AND RECEIVED A CONTINUUM OF RESOURCES AND WRAP AROUND SUPPORT
PART V, SECTION B, LINE 7A	THE 2022 CHNA CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ABOUT-PROMEDICA/COMMUNITY
PART V, SECTION B, LINE 10A	THE 2023-2025 CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ABOUT-PROMEDICA/COMMUNITY
PART V, SECTION B, LINE 16A:	THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/PAY-MY-BILL/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 16B:	THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/PAY-MY-BILL/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 16C:	A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/PAY-MY-BILL/FINANCIAL-ASSISTANCE

Field	Value	IRS element (for citing)
Facility	15	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (15 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - PROMEDICA DUNDEE - TOTAL REHAB
100 POWELL DR STE 3	DUNDEE	MI	48131	TOTAL REHAB
2 - PROMEDICA BLISSFIELD - LAB
157 WEST BROOKE LANE	BLISSFIELD	MI	49228	LAB
3 - LENAWEE MEDICAL CARE FACILITY
200 SAND CREEK HWY	ADRIAN	MI	49221	LAB LENAWEE MEDICAL
4 - PROMEDICA CVHH N ADRIAN HWY - LAB
3245 N ADRIAN HWY	ADRIAN	MI	49221	LAB
5 - PROMEDICA HUDSON - LAB
331 W MAIN ST	HUDSON	MI	49247	LAB
6 - CAMBRIAN ASSISTED LIVING AND MEMORY CARE
333 N OCCIDENTAL HWY	TECUMSEH	MI	49286	LAB CAMBRIAN
7 - PROMEDICA ONSTED - LAB
400 N MAIN ST	ONSTED	MI	49265	LAB
8 - PROMEDICA ONSTED -TOTAL REHAB
400 N MAIN ST STE B	ONSTED	MI	49265	TOTAL REHAB
9 - PROMEDICA CVHH TECUMSEH FAMILY PRACTICE LA
501 E CUMMINS ST	TECUMSEH	MI	49286	LAB
10 - YMCA ON PROMEDICA CVHH CAMPUS TOTAL REHAB
5660 ADRIAN HWY	ADRIAN	MI	49221	TOTAL REHAB
11 - ADRIAN URGENT CARE
715 N MAIN ST	ADRIAN	MI	49221	LAB ADRIAN URGENT CARE
12 - LYNWOOD MANOR
730 KIMOLE LN	ADRIAN	MI	49221	LAB LYNWOOD MANOR
13 - PROMEDICA BIXBY GRACE CHRISTMAN - DIABETES
777 KIMOLE LANE STE 110	ADRIAN	MI	49221	DIABETES CENTER
14 - PROMEDICA CVHH GRACE CHRISTMAN - RADIATION
777 KIMOLE LANE STE 130	ADRIAN	MI	49221	RADIATION ONCOLOGY
15 - PROMEDICA CVHH WOLF CREEK- LAB
901 KIMOLE LN	ADRIAN	MI	49221	LAB

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 7:	PROMEDICA CHARLES AND VIRGINIA HICKMAN 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, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,793,215.
PART III, LINE 2:	PROMEDICA CHARLES AND VIRGINIA HICKMAN 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 CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATEDCOLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY.
PART III, LINE 3:	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT.
PART III, LINE 4:	PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 16 AND 17 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION.
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/OR REQUESTED 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 NOT THEY 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 CIRCUMSTANCES DEMONSTRATING 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 CHARITY DETERMINATION. 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 FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING.
PART VI, LINE 2:	PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THIS DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE.
PART VI, LINE 3:	THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.
PART VI, LINE 4:	EMMA L. BIXBY MEDICAL CENTER, DOING BUSINESS AS PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL, LOCATED IN ADRIAN, MI, SERVES AN AREA PRIMARILY AROUND LENAWEE COUNTY. THERE IS A COUNTY POPULATION OF APPROXIMATELY 99,000. APPROXIMATELY, 20% OF THE SERVICE AREA IS AGE 65 OR OVER; 60% IS BETWEEN AGE 18 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $62,000; 91% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; APPROXIMATELY 15% OF FAMILIES ARE BELOW THE POVERTY LEVEL. APPROXIMATELY, 7% OF LENAWEE COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE AT THE END OF 2023 FOR LENAWEE COUNTY WAS 5.5%. THE LEADING CAUSES OF DEATH IN LENAWEE COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, UNINTENTIONAL INJURIES/ACCIDENTS, STROKE, LUNG DISEASE, ALZHEIMER'S, AND DIABETES. ACCORDING TO THE 2023 COUNTY HEALTH RANKINGS, LENAWEE COUNTY RANKED 26 OF 83 COUNTIES FOR HEALTH OUTCOMES AND 38 OF 83 FOR HEALTH FACTORS. THERE ARE NINE HOSPITALS WITHIN A 30-MILE RADIUS OF CHARLES AND VIRGINIA HICKMAN HOSPITAL: HERRICK MEMORIAL HOSPITAL, INC., ST. JOSEPH MERCY SALINE HOSPITAL, FLOWER HOSPITAL, FULTON COUNTY HEALTH CENTER, ST. ANNE MERCY HOSPITAL, CHELSEA COMMUNITY HOSPITAL, THE TOLEDO HOSPITAL, HENRY FORD ALLEGIANCE HEALTH, AND UNIVERSITY OF TOLEDO MEDICAL CENTER.
PART VI, LINE 5:	EMMA L. BIXBY MEDICAL CENTER IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2023:- THERE WERE APPROXIMATELY 300 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), SERVING ON MORE THAN 25 DIFFERENT BOARDS, COMMITTEES, COUNCILS AND FOUNDATIONS. OF THOSE BOARD MEMBERS, MOST LIVE WITHIN PROMEDICA'S OHIO AND MICHIGAN ACUTE CARE SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN THE GREATER TOLEDO AREA WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. - PROMEDICA NON-PARENT BOARD MEMBERS' DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, WERE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS AT OUR METRO TOLEDO AND REGIONAL HOSPITALS. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES, UPON THEIR REQUEST.- AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED TWO SYSTEM-WIDE UPGRADES TO THE EPIC PLATFORM. THE UPGRADES ALLOW PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.- PROMEDICA CANCER INSTITUTE (PCI) COMPLETED LUNG CANCER SCREENINGS, SCREENING MAMMOGRAMS AND SCREENING COLONOSCOPIES. ADDITIONALLY, PCI CONTINUES TO BE INSTRUMENTAL IN HELPING PROMEDICA IMPLEMENT MONOCLONAL ANTIBODY TREATMENT AT ITS INFUSION CENTERS FOR COVID-19 PATIENTS TO IMPROVE SYMPTOM MANAGEMENT. - PROMEDICA SENIOR CARE SKILLED NURSING FACILITIES AND HOME HEALTH AND HOSPICE AGENCIES PROVIDE UNIQUE SERVICES TO VETERANS, HOLIDAY SUPPORT, SUPPORT GROUPS, AND WORKSHOPS TO ANYONE IN THE COMMUNITY WHO NEEDS ADDITIONAL HELP TO GET THROUGH THE LOSS OF A LOVED ONE. PATIENTS AND RESIDENTS' WISHES ARE GRANTED THROUGH THE ORGANIZATION'S HEART'S DESIRE PROGRAM. THROUGH GRANTS FROM THE HOSPICE MEMORIAL FUND, GRIEF CAMPS FOR CHILDREN AND ADULTS ARE OFFERED AS WELL AS EDUCATIONAL SESSIONS AND LIFE CELEBRATION EVENTS. THE FUND ALSO PROVIDES STABILIZING RESOURCES FOR HOSPICE PATIENTS AND FAMILIES IN FINANCIAL DISTRESS DUE TO THE LACK OF OR REDUCTION IN INCOME FROM TERMINAL ILLNESS OR DISEASE.- PROMEDICA CONTINUES TO EXPAND ITS OPTIONS FOR HOSPITAL-LEVEL CARE IN THE COMFORT OF A PATIENT'S HOME. PROMEDICA ACUTE CARE AT HOME COMBINES PROMEDICA'S EXTENSIVE NETWORK OF IN-HOME CARE PROVIDERS WITH A SOPHISTICATED TECHNOLOGY PLATFORM TO DELIVER SEAMLESS AND EFFECTIVE CARE AT HOME FOR PATIENTS WITH SELECT CHRONIC CONDITIONS OR DIAGNOSES SUCH AS HEART FAILURE, PNEUMONIA OR COPD. RECENTLY, PROMEDICA ACUTE CARE AT HOME EXPANDED ITS SERVICES TO INCLUDE CARE FOR SELECT ONCOLOGY PATIENTS BY COLLABORATING THE PROMEDICA CANCER CENTER. THE CARE TEAM CONSISTS OF PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, AND MAY INCLUDE OTHER HEALTHCARE PROFESSIONALS, SUCH AS PHYSICAL OR OCCUPATIONAL THERAPISTS, AS NEEDED.
PART VI, LINE 6:	PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A NATIONWIDE, MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2023 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, NEARLY 850 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING APPROXIMATELY 1,200 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP (PPG) WHO FORM A PROVIDER NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. IN 2023:- PROMEDICA MEMBERS AND AFFILIATE HOSPITALS INCLUDED: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL (D/B/A PROMEDICA BAY PARK HOSPITAL); EMMA L. BIXBY MEDICAL CENTER (D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL); FOSTORIA HOSPITAL ASSOCIATION (D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL); DEFIANCE HOSPITAL, INC. (D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL); MERCY MEMORIAL HOSPITAL CORPORATION (D/B/A PROMEDICA MONROE REGIONAL HOSPITAL); MEMORIAL HOSPITAL (D/B/A PROMEDICA MEMORIAL HOSPITAL); AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY (D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL). PROMEDICA ALSO INCLUDES PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION AS WELL AS HUNDREDS OF SKILLED NURSING AND REHABILITATION CENTERS, ASSISTED LIVING FACILITIES AND MEMORY CARE COMMUNITIES, ALL UNDER THE PROMEDICA SENIOR CARE/HCR MANORCARE UMBRELLA.- PROMEDICA CONTINUED TO OPERATE THREE COMMUNITY FOOD CLINICS, LOCATED AT PROMEDICA BAY PARK HOSPITAL, THE PROMEDICA HEALTH AND WELLNESS CENTER AND PROMEDICA'S CENTER FOR HEALTH SERVICES, TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEMSELVES AND THEIR FAMILY FROM ONE OF THESE FOOD CLINICS. AS PART OF THE PROGRAM, PATIENTS CAN RECEIVE TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. - FOR ITS MICHIGAN PATIENTS, PROMEDICA PARTNERED WITH THE SOUTH MICHIGAN FOOD BANK TO DISTRIBUTE FOOD RESOURCES TO PROMEDICA PHYSICIANS GROUP OFFICES FOR PATIENTS SCREENING POSITIVE FOR FOOD INSECURITY. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL PROVIDE THE $5 VOUCHERS AT DISCHARGE SO PATIENTS CAN REDEEM FRESH PRODUCE FROM THE VEGGIE MOBILE THAT IS SOURCED FROM PROMEDICA FARMS, LOCAL GROWERS, AND A WHOLESALER. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDED BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD. ADDITIONALLY, TWO NEW FINANCIAL OPPORTUNITY CENTERS (FOC) WERE OPENED IN FREMONT AND DEFIANCE, OHIO. MUCH LIKE THE FOC LOCATED IN UPTOWN TOLEDO, THE NEW LOCATIONS OFFER SERVICES AND ASSIST LOW TO MODERATE-INCOME FAMILIES WITH SECURING LIVING WAGE JOBS, BUILDING CREDIT, REDUCING DEBT, AND GAINING WEALTH. THE FOC ALSO HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING AS WELL AS FREE TAX PREPARATION.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ARTURO POLIZZI
CHIEF OPERATING OFFICER	$0	$1,315,647	$0	$789,979	$0	$15,967	$0	$0	$0	$5,857	$0	$2,127,450	$0	$0
DAWN BUSKEY
TRUSTEE/PRESIDENT	$0	$658,750	$0	$751,150	$0	$2,500	$0	$0	$0	$5,337	$0	$1,417,737	$0	$0
STEVE SADOWSKI
SECRETARY/CHIEF LEGAL OFFICER	$0	$625,095	$0	$774,925	$0	$7,160	$0	$0	$0	$6,028	$0	$1,413,208	$0	$0
STEVEN M CAVANAUGH
TREASURER, CFO - FORMER	$0	$0	$0	$0	$0	$1,335,180	$0	$0	$0	$5,657	$0	$1,340,837	$0	$0
TERRENCE METZGER
TRUSTEE/TREASURER	$0	$480,090	$0	$575,000	$0	$0	$0	$0	$0	$4,079	$0	$1,059,169	$0	$0
JEFFREY C KUHN
SECRETARY, CHIEF LEGAL OFFICER - FOR	$0	$26,526	$0	$0	$0	$721,900	$0	$26,526	$0	$4,396	$0	$779,348	$0	$0
GARY AKENBERGER
CHIEF OFFICER - FORMER	$0	$246,095	$0	$83,570	$0	$198,982	$0	$36,639	$0	$6,893	$0	$572,179	$0	$0
DARRIN ARQUETTE
TRUSTEE/PRESIDENT	$0	$378,559	$0	$58,262	$0	$2,886	$0	$0	$0	$3,272	$0	$442,979	$0	$0
JULIE YAROCH DO
TRUSTEE/PRESIDENT	$0	$322,281	$0	$67,193	$0	$1,242	$0	$0	$0	$4,244	$0	$394,960	$0	$0
PAUL GIETZEN
TRUSTEE/PHYSICIAN	$0	$286,544	$0	$43,130	$0	$3,089	$0	$0	$0	$4,120	$0	$336,883	$0	$0
CHRISTI ANSBERG
TRUSTEE/VP PHILANTHROPY	$0	$191,661	$0	$40,375	$0	$4,526	$0	$3,803	$0	$4,009	$0	$244,374	$0	$0
CHRISTINA BELL
DIRECTOR OF PHARMACY	$150,986	$0	$5,591	$0	$75	$0	$0	$0	$11,097	$0	$167,749	$0	$0	$0
MELISSA THOMPSON
CLINICAL PHARMACIST	$149,432	$0	$0	$0	$307	$0	$0	$0	$2,546	$0	$152,285	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINE 3

PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF EMMA L. BIXBY MEDICAL CENTER, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

PART I, LINES 4A-B

ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. -STEVEN CAVANAUGH RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $1,335,180 DURING 2023. -JEFFERY KUHN RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $721,900 DURING 2023. -MATTHEW KANG RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $583,664 DURING 2023. -GARY AKENBERGER RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, THE TOLEDO HOSPITAL, IN THE AMOUNT OF $195,150 DURING 2023.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 1A:	THE PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY. ALL 1099 FORMS FOR PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES ARE FILED UNDER PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671
FORM 990, PART VI, SECTION A, LINE 6	AS A MICHIGAN NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF EMMA L. BIXBY MEDICAL CENTER. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF EMMA L. BIXBY MEDICAL CENTER, AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION, OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE, OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, AND (VI) ANY MERGER, CONSOLIDATIONS, REORGANIZATION, DISSOLUTION, OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE RETURN IS REVIEWED BY MANAGEMENT BEFORE BEING PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER STATEMENT OF CONFLICT (SOC) SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL BONUS-ELIGIBLE SENIOR LEADERSHIP AND SPECIFICALLY IDENTIFIED ADDITIONAL EMPLOYEES, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. ADDITIONALLY, AS PART OF THE ANNUAL MANDATORY COMPLIANCE TRAINING ASSIGNED TO ALL PROMEDICA EMPLOYEES, EACH EMPLOYEE IS REQUIRED TO ELECTRONICALLY ACKNOWLEDGE THAT THEY HAVE RECEIVED A COPY OF THE PROMEDICA STANDARDS OF CONDUCT, THAT THEY UNDERSTAND HOW THE STANDARDS APPLY TO THEM, ACKNOWLEDGE THEIR OBLIGATION TO FOLLOW THEM, THEIR OBLIGATION TO REPORT VIOLATIONS OF THE STANDARDS OR REQUESTS THAT WOULD RESULT IN VIOLATIONS OF THE STANDARDS TO APPROPRIATE COMPANY OFFICERS AND THAT THEY HAVE REPORTED ALL VIOLATIONS KNOWN TO THEM AS REQUIRED BY THE STANDARDS. IN ADDITION THE ATTESTATION STATES ANY CONFLICTS OF INTEREST OR OTHER MATTERS FOR WHICH THE STANDARDS REQUIRE WRITTEN DISCLOSURE TO THE COMPANY HAVE BEEN SO DISCLOSED BY THE EMPLOYEE AND THEY UNDERSTAND AND ACKNOWLEDGE THAT TO THE EXTENT THEY ARE AN AT-WILL EMPLOYEE, THE STANDARDS DO NOT AFFECT THE AT-WILL NATURE OF MY EMPLOYMENT RELATIONSHIP WITH THE COMPANY. EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PROVIDERS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PROVIDER CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER FOR PROMEDICA PHYSICIAN GROUP, INC. (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE OFFICE OF THE PROMEDICA HEALTH SYSTEM, INC. ("PHS") V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PROVIDER CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE PHS AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PROVIDERS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PROVIDER STANDARD OF CONDUCT AND THE PROVIDER CERTIFICATION STATEMENT WHICH THE NEW PROVIDER IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE PHS V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PROVIDER AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 15	EMMA L. BIXBY MEDICAL CENTER'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19	PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 16B:	JOINT VENTURE OPERATING AGREEMENTS INVOLVING PROMEDICA HEALTH SYSTEM, INC. OR ITS SUBSIDIARIES (COLLECTIVELY, PHS) INCLUDE PROVISIONS TO PROTECT PHS'S TAX-EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. PHS CONTINUALLY ENSURES THAT ITS TAX-EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL PHS JOINT VENTURES.
PART VII, SECTION B	PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY, PROMEDICA HEALTH SYSTEM, INC. THE INDEPENDENT CONTRACTORS OVER $100,000 WILL BE LISTED ON THE 990 FILED FOR PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671.
FORM 990, PART VII, SECTION A	LOUIS ROBICHAUX IS EMPLOYED BY A MANAGEMENT AGENCY THAT IS UNDER A CONTRACT TO PROVIDE MANAGEMENT SERVICES TO PROMEDICA HEALTH SERVICES.
FORM 990, PART IX, LINE 11G	PHYSICIAN AND MEDICAL STAFFING FEES: PROGRAM SERVICE EXPENSES 5,012,128. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,012,128. SERVICE CONTRACT FEES: PROGRAM SERVICE EXPENSES 947,791. MANAGEMENT AND GENERAL EXPENSES 1,066,067. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,013,858. TEMPORARY AGENCY FEES: PROGRAM SERVICE EXPENSES 3,560,774. MANAGEMENT AND GENERAL EXPENSES 2,230,304. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,791,078. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,904,313. MANAGEMENT AND GENERAL EXPENSES 2,141,955. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,046,268.
FORM 990, PART XI, LINE 9:	PENSION/POST-RETIREMENT EXPENSE ADJUSTMENT 171,072. REVERSE OF BOOK ENTRY FOR AUXILIARY ACTIVITY 3,498,325. TRANSFERS BETWEEN RELATED ENTITIES -46,496,448.
FORM 990, PART XII, LINE 2C	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	WOLF CREEK ASSOCIATES LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	901 KIMOLE LN	AddressLine1Txt
City	ADRIAN	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49221	ZIPCd

Field	Value	IRS element (for citing)
EIN	383164818	EIN
Primary Activities	FACILITY LEASE	PrimaryActivitiesTxt
Legal Domicile State	MI	LegalDomicileStateCd
Total Income	$120,703	TotalIncomeAmt
End Of Year Assets	$2,065,934	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	EMMA L BIXBY MEDICAL CENTER	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (44 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
BAY PARK COMMUNITY HOSPITAL
100 MADISON AVE	TOLEDO	OH	43604	341883132	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
COMMUNITY HEALTH CENTER OF BRANCH COUNTY
100 MADISON AVE	TOLEDO	OH	43604	386108110	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
DEFIANCE HOSPITAL AUXILIARY
1200 RALSTON	DEFIANCE	OH	43512	510173779	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes (1)
DEFIANCE HOSPITAL INC
100 MADISON AVE	TOLEDO	OH	43604	344446484	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
EMMA L BIXBY MEDICAL CENTER AUXILIARY
818 RIVERSIDE AVE	ADRIAN	MI	43604	382149602	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	EMMA L BIXBY MEDICAL CENTER	Yes (1)
FOSTORIA HOSPITAL ASSOCIATION
100 MADISON AVE	TOLEDO	OH	43604	340898745	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
FOSTORIA HOSPITAL AUXILIARY
PO BOX 907	FOSTORIA	OH	44830	346517634	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	FOSTORIA HOSPITAL ASSOCIATION	Yes (1)
HCR MANORCARE FOUNDATION INC
444 N SUMMIT ST	TOLEDO	OH	43604	522031975	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes (1)
HCR MANORCARE INC
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	825373223	SKILLED NURSING FACILITIES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes (1)
HEARTLAND HOSPICE MEMORIAL FUND INC
444 N SUMMIT ST	TOLEDO	OH	43604	270497199	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes (1)
HERRICK MEDICAL CENTER AUXILIARY
500 E POTTAWATAMIE ST	TECUMSEH	MI	49286	383076105	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	HERRICK MEMORIAL HOSPITAL INC	Yes (1)
HERRICK MEMORIAL HOSPITAL INC
100 MADISON AVE	TOLEDO	OH	43604	383049015	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
KAITLYN'S COTTAGE INC
100 MADISON AVE	TOLEDO	OH	43604	454781053	RESPITE CARE	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes (1)
LENAWEE LONG TERM CARE
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	382879330	LONG TERM CARE	MI	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF GIG HARBOR WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624719	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF LACEY WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624391	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF LYNNWOOD WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624675	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF SALMON CREEK WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624375	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF SPOKANE WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624687	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF TACOMA WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624696	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MEMORIAL HOSPITAL
100 MADISON AVE	TOLEDO	OH	43604	344430849	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
MEMORIAL PROFESSIONAL SERVICES
100 MADISON AVE	TOLEDO	OH	43604	273763993	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
MERCY MEMORIAL HOSPITAL CORPORATION
100 MADISON AVE	TOLEDO	OH	43604	381984289	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
MONROE COMMUNITY HEALTH SERVICES
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	382934134	LONG TERM CARE	MI	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
PARAMOUNT ADVANTAGE
1901 INDIAN WOOD CIR	MAUMEE	OH	43537	203376102	HEALTH INSURANCE	OH	501(C)(3)	10	PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES	Yes (1)
PROMEDICA CENTRAL PHYSICIANS
100 MADISON AVE	TOLEDO	OH	43604	341881137	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA CHILDRENS SPECIALISTS
100 MADISON AVE	TOLEDO	OH	43604	208734161	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA CONTINUING CARE SERVICES CORP
100 MADISON AVE	TOLEDO	OH	43604	344492440	LONG TERM AND HOME HEALTH CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes (1)
PROMEDICA CONTINUUM SERVICES
100 MADISON AVE	TOLEDO	OH	43604	341880767	PHYSICIAN MANAGEMENT SERVICES	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA COURIER SERVICES INC
100 MADISON AVE	TOLEDO	OH	43604	260324790	COURIER SERVICE	OH	501(C)(3)	12B, II	PROMEDICA CONTINUUM SERVICES	Yes (1)
PROMEDICA FOUNDATION
444 N SUMMIT ST	TOLEDO	OH	43604	341517672	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA GENITO-URINARY SURGEONS
100 MADISON AVE	TOLEDO	OH	43604	461120436	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA INDEMNITY CORP
ONE CHURCH ST 5TH FLOOR	BURLINGTON	VT	05401	341931936	PROFESSIONAL & GENERAL LIABILITY	VT	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA MONROE CARDIOLOGY
100 MADISON AVE	TOLEDO	OH	43604	272920342	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA MONROE PHYSICIANS
100 MADISON AVE	TOLEDO	OH	43604	461111822	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC
100 MADISON AVE	TOLEDO	OH	43604	454976786	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS
100 MADISON AVE	TOLEDO	OH	43604	263888045	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA PHYSICIAN GROUP INC
100 MADISON AVE	TOLEDO	OH	43604	341899439	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA PHYSICIANS AT HOME INC
100 MADISON AVE	TOLEDO	OH	43604	852181349	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA PRIMARY CARE PROVIDERS
100 MADISON AVE	TOLEDO	OH	43604	831731861	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
THE HUG FUND
444 N SUMMIT ST	TOLEDO	OH	43604	202272848	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes (1)
THE TOLEDO HOSPITAL
100 MADISON AVE	TOLEDO	OH	43604	344428256	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
VISITING NURSE HOSPICE AND HEALTH CARE
100 MADISON AVE	TOLEDO	OH	43604	341831624	HOSPICE HOME CARE	OH	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
PROMEDICA HEALTH SYSTEM INC
100 MADISON AVE	TOLEDO	OH	43604	341517671	PARENT COMPANY OF HEALTH SERVICES	OH	501(C)(3)	12B, II		0	N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
NORMAN SPECIALTY HOSPITAL LLC
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43604	421627672	HEALTH CARE	DE	N/A	0	Yes (1)
MERCYMANOR PARTNERSHIP
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43604	521931012	SKILLED NURSING	PA	N/A	0	Yes (1)
THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC
1051 S TELEGRAPH RD	MONROE	MI	48161	270843485	AMBULATORY SURGICAL CENTER	MI	N/A	0	0
PROMEDICA SENIOR CARE OF GEORGIA LLC
100 MADISON AVE	TOLEDO	OH	43604	871802834	SKILLED NURSING	OH	N/A	0	Yes (1)
PROMEDICA VENTURES INNOVATION FUND III LLC
100 MADISON AVE	TOLEDO	OH	43604	873197533	HOLDING COMPANY	OH	N/A	0	0
ROCKET VENTURE FUND II LLC
2865 N REYNOLDS RD STE 220	TOLEDO	OH	43615	475603627	INVESTMENT FUND	OH	N/A	0	0
SENIOR & REHAB CARE AT METROHEALTH LLC
100 MADISON AVE ATTN TAX DEPT	TOLEDO	OH	43604	872465544	SKILLED NURSING	OH	N/A	0	Yes (1)
AIR DIVERTER SOLUTIONS LLC
100 MADISON AVE	TOLEDO	OH	43604	853725776	DEVELOPMENT	OH	N/A	0	0
PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC
100 MADISON AVE	TOLEDO	OH	43604	473163945	REAL ESTATE	OH	N/A	0	Yes (1)
NORTHWEST OHIO DEDICATED BREAST MRI LLC
100 MADISON AVE	TOLEDO	OH	43604	260679898	MEDICAL DIAGNOSTICS	OH	N/A	0	Yes (1)
PROMEDICA INTUITIVE MANAGEMENT OF OHIO LLC
100 MADISON AVE	TOLEDO	OH	43604	852085627	HEALTH CARE	MI	N/A	0	0
REYNOLDS ROAD SURGICAL CENTER LTD
2865 N REYNOLDS RD	TOLEDO	OH	43615	311569454	FREESTANDING AMBULATORY SURGICAL CENTER	OH	N/A	0	0
WEST CENTRAL SURGICAL CENTER LLC
7055 W CENTRAL	TOLEDO	OH	43617	200088459	AMBULATORY SURGICAL CENTER	OH	N/A	0	Yes (1)
PROMEDICA MASTER TENANT LLC
100 MADISON AVE	TOLEDO	OH	43604	475288490	REAL ESTATE	OH	N/A	0	Yes (1)
ARROWHEAD BEHAVIORAL HEALTH LLC
367 SOUTH GULPH ROAD PO BOX 61558	KING OF PRUSSIA	PA	19406	270608044	HEALTH CARE	PA	N/A	0	Yes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
HERRICK MEMORIAL DEVELOPMENT CORP
500 E POTTAWATAMIE TR	ADRIAN	MI	49221	383146907	FACILITY LEASING	MI	EMMA L BIXBY MEDICAL CENTER	C	$184,186	$1,206,924	1.00000	Yes (1)
LENAWEE CLINICAL PARTNERS
100 MADISON AVE	TOLEDO	OH	43604	821072356	PHYSICIAN SUPPORT	OH	EMMA L BIXBY MEDICAL CENTER	C	$122,344	$301,940	0.50000	Yes (1)
PROMEDICA SENIOR CARE OF PISCATAWAY NJ LLC
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	861179270	SKILLED NURSING	NJ		C				Yes (1)	N/A
HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION
818 RIVERSIDE AVE	ADRIAN	MI	49221	383639616	FACILITY MANAGEMENT	MI		C				Yes (1)	N/A
MONROE HEALTH VENTURES INC
718 N MACOMB	MONROE	MI	48164	382704426	PHARMACY	MI		C				Yes (1)	N/A
PROMEDICA MANAGER MEMBER LLC
100 MADISON AVE	TOLEDO	OH	43604	475168737	REAL ESTATE	OH		C				Yes (1)	N/A
PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES
1901 INDIAN WOOD CIR	MAUMEE	OH	43537	341570675	HEALTH CARE INSURANCE	OH		C				Yes (1)	N/A
PROMEDICA INNOVATIONS LLC
100 MADISON AVE	TOLEDO	OH	43604	301221601	INVESTMENT COMPANY	OH		C				Yes (1)	N/A
PROMEDICA HEALTH NETWORK INC
100 MADISON AVE	TOLEDO	OH	43604	474006496	PHYSICIAN MANAGEMENT SERVICES	OH		C				Yes (1)	N/A
PHS TOLEDO INNOVATION CENTER HOLDINGS LLC
100 MADISON AVE	TOLEDO	OH	43604	871433009	HOLDING COMPANY	OH		C				Yes (1)	N/A
FORT INDUSTRY JV PARTNER LLC
100 MADISON AVE	TOLEDO	OH	43604	844675266	REAL ESTATE	OH		C				Yes (1)	N/A
PROMEDICA NORTH PHYSICIAN CORPORATION
100 MADISON AVE	TOLEDO	OH	43604	383482148	PHYSICIAN HEALTH CARE SERVICES	OH		C				Yes (1)	N/A
PROMEDICA AT HOME INC
100 MADISON AVE	TOLEDO	OH	43604	852320857	PHYSICIAN SUPPORT	MI		C				Yes (1)	N/A
PROMEDICA CENTRAL CORPORATION OF MICHIGAN
100 MADISON AVE	TOLEDO	OH	43604	383322278	PHYSICIAN HEALTH CARE SERVICES	OH		C				Yes (1)	N/A

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd