2023-02-01T08:04:53-06:00 2022-03-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2021-04-01 381507046 MUNISING MEMORIAL HOSPITAL ASSOCIATION MUNI 9063874110 1500 SAND POINT ROAD MUNISING MI 49862 JAMES PARKER CFO 9063874110 2023-01-30 1 JAMES PARKER 999009999 TERRI REXRODE CPA MST P00096513 9206620016 2023-01-30 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z JAMES PARKER 1500 SAND POINT ROAD MUNISING MI 49862 15000732 0 X WWW.MUNISINGMEMORIAL.ORG X 1961 MI THE MISSION OF MUNISING MEMORIAL HOSPITAL IS TO BE THE PROVIDER OF CHOICE FOR PRIMARY MEDICAL AND HOSPITAL CARE FOR THE RESIDENTS OF ALGER COUNTY. WITH UNSURPASSED PERSONAL AND PROFESSIONAL INTEGRITY, OUR EMPLOYEES AND PRACTITIONERS WILL PROVIDE THE HIGHEST LEVEL OF QUALITY CARE WITHIN OUR RESOURCES. 10 7 102 7 0 0 1670611 958009 12688316 13563526 37049 -1879 0 0 14395976 14519656 0 0 0 0 6178829 6674611 0 0 0 6170570 6892339 12349399 13566950 2046577 952706 15829951 14156656 12877904 10116957 2952047 4039699 X THE MISSION OF MUNISING MEMORIAL HOSPITAL IS TO BE THE PROVIDER OF CHOICE FOR PRIMARY MEDICAL AND HOSPITAL CARE FOR THE RESIDENTS OF ALGER COUNTY. WITH UNSURPASSED PERSONAL AND PROFESSIONAL INTEGRITY, OUR EMPLOYEES AND PRACTITIONERS WILL PROVIDE THE HIGHEST LEVEL OF QUALITY CARE WITHIN OUR RESOURCES. 0 0 10140727 0 11279879 TO PROVIDE INPATIENT AND OUTPATIENT CARE TO THE COMMUNITY AND SURROUNDING AREA. DURING 2022, THERE WERE 121 ADMISSIONS, 501 PATIENT DAYS AND 18,699 OUTPATIENT VISITS. 1782544 0 2258346 BAYCARE PHYSICIAN OFFICE PROVIDING REGULAR OFFICE AND WALK-IN CARE TO OUR PATIENTS. BAYCARE HAD 8,997 VISITS DURING THE 2022 YEAR. GRAND MARAIS PHYSICIAN CLINIC PROVIDING REGULAR OFFICE AND WALK IN CARE TO OUR PATIENTS. GRAND MARAIS HAD 132 VISITS DURING 2022 YEAR. 11923271 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 13 0 102 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X KEVIN CARLSON 9063874110 1500 SAND POINT ROAD MUNISING MI 49862 PAUL HADUCK PHYSICIAN 40.00 X 298749 0 40861 BONNIE KILPELA NURSE PRACTIONER 40.00 X 250030 0 38522 SANDRA MCGOVERN CEO 40.00 X 194428 0 0 SARA CARTER NURSE PRACTIONER 40.00 X 175748 0 6609 RODNEY RIESLAND NURSE PRACTIONER 40.00 X 156337 0 15460 JEFFREY SHIPKEY PHYSICIAN 40.00 X 131808 0 0 KEVIN CARLSON CFO 40.00 X 115999 0 4150 CHRISTI SALO CNO 40.00 X 103467 0 4061 MARILYN BEVERLY PRESIDENT 0.30 0.30 X X 0 0 0 KATHY REYNOLDS VICE PRESIDENT 0.30 0.30 X X 0 0 0 JOHN MADIGAN TREASURER 0.30 0.30 X X 0 0 0 DEBORAH NEDEAU SECRETARY 0.30 0.30 X X 0 0 0 ALLISON BOWERMAN-JOHNSON TRUSTEE 0.30 0.30 X 0 0 0 RUTH ANN POKELA TRUSTEE 0.30 0.30 X 0 0 0 BILL VALIMA TRUSTEE 0.30 0.30 X 0 0 0 1426566 0 109663 9 0 1 0 CERNER PO BOX 959156 ST LOUIS MO 631959156 EHR SOFTWARE COMPANY 528471 UP REHAB 841 W WASHINGTON ST MARQUETTE MI 49855 REHABILIATION SERVICES 507144 DLP MGH 850 BARAGA AVE MARQUETTE MI 498554550 LAB TESTING 277097 JACOB MACKENZIE 5548 HIGH RIDGE DRIVE YPSILANTI MI 48197 ED PROVIDER 232500 BARTON ASSOCIATES PO BOX 417844 BOSTON MA 022417844 TEMP PROVIDER SERVICES 223567 5 956846 1163 958009 NET PATIENT SERVICE REVENUE 621610 12283340 12283340 340B PROGRAM REVENUE 621610 1074227 1074227 CAFETERIA SALES 722210 25301 25301 CLINIC RENTAL INCOME 900099 8220 8220 172438 172438 13563526 49277 49277 429920 481076 -51156 -51156 -51156 14519656 13538225 0 23422 X 442162 114800 327362 4954977 4715837 239140 124532 122788 1744 793006 793006 359934 306510 53424 58582 58582 59450 59450 15743 15743 2167515 2086729 80786 62081 60307 1774 951832 889493 62339 284077 281888 2189 19984 5467 14517 37933 30001 7932 288407 288407 804607 603794 200813 102384 62222 40162 MEDICAL SUPPLIES 907815 907815 BAD DEBT EXPENSE 255392 255392 DUES & SUBSCRIPTIONS 145114 69977 75137 REPAIRS & MAINTENANCE 92409 92409 639014 236429 402585 13566950 11923271 1643679 0 292913 364668 5705103 5248667 1692407 1642961 169869 91638 45603 89761 18211111 13903283 4619040 4307828 2300238 2411133 1004778 0 15829951 14156656 574821 793622 3857342 590015 8002803 7840771 442938 892549 12877904 10116957 X 2952047 4039699 2952047 4039699 15829951 14156656 952706 134946 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1008 1008 0 PART II-B, LINE 1: MEMBERSHIP DUES RENEWAL PACKAGE TO MHA 20275 20275 11461194 8838209 2622985 45492 30217 15275 6684150 5034857 1649293 4307828 COST REPORT SETTLEMENT 549223 CAPITAL LEASE OBLIGATION 343326 892549 1 1 X 1 X 1 X 1 1 0 0 80104 80104 0.00620 3565954 821954 2744000 0.21240 3646058 821954 2824104 0.21860 3646058 821954 2824104 0.21860 1 649964 3860728 3842406 18322 X 1 1 1 1 MUNISING MEMORIAL HOSPITAL ASSOCIATION 1500 SAND POINT ROAD MUNISING MI 49862 WWW.MUNISINGMEMORIAL.ORG 5301002603 X X X X MUNISING MEMORIAL HOSPITAL ASSOCIATION 1 0 0 1 X X X X X X X X X 19 1 0 1 1 X SEE SUPPLMENTAL SECTION X 1 19 1 HTTPS://MUNISINGMEMORIAL.ORG/COMMUNITY-HEALTH/ 0 1 X 100.000000000000 250.000000000000 X X X X 1 1 X X X 1 X HTTPS://MUNISINGMEMORIAL.ORG/CREDIT-COLLECTION-POLICY/ X HTTPS://MUNISINGMEMORIAL.ORG/CREDIT-COLLECTION-POLICY/ X HTTPS://MUNISINGMEMORIAL.ORG/CREDIT-COLLECTION-POLICY/ X X X X X X 1 X 0 X X X X 1 X 0 0 MUNISING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: SURVEY ON OUR WEBSITE MUNISING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: GREATER MUNISING BAY PARTNERSHIP FOR COMMERCE DEVELOPMENT PART V, LINE 7A HTTPS://MUNISINGMEMORIAL.ORG/COMMUNITY-HEALTH/ 1 1 - BAY CARE MEDICAL CENTER 1500 SAND POINT RD MUNISING MI 49862 GENERAL PRACTIONERS PART I, LINE 7: A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 IS USED. EXCEPT FOR PART 1 LINE 7G, WHERE A COST TO CHARGE RATIO BASED ON DIRECT COST AND STEPDOWN WAS MORE APPROPRIATE. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGES EQUALS $649,964. PART III, LINE 2: PERCENTAGE OF ACCOUNTS RECEIVABLES PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICES ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: THE AMOUNTS REPORTED FOR MEDICARE ARE FROM THE MEDICARE COST REPORT. THE HOSPITAL USED THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT. PART III, LINE 9B: THE ACCOUNT IS CREDITED THE AMOUNT DETERMINED BY THE PERCENTAGE PATIENTS QUALIFY FOR, IF THERE IS A SELF PAY BALANCE THE PATIENT HAS UP TO 10 MONTHS TO PAY THE BALANCE IF OVER $1000.00 OR IF UNDER THEY HAVE UP TO 4 MONTHS BEFORE THE ACCOUNT IS TRANSFERRED TO BAD DEBT. PART VI, LINE 3: WHEN A PATIENT ARRIVES WITHOUT HEALTHCARE COVERAGE THEY ARE INFORMED OF OUR FINANCIAL ASSISTANCE POLICY AND GIVEN AN APPLICATION. THE APPLICATION ALSO STATES THAT THERE IS A POSSIBILITY THEY COULD BE ELIGIBLE FOR THE STATE MEDICAID PLANS. PART VI, LINE 4: IT IS SMALL RURAL COMMUNITY WITH THE NEAREST REGIONAL HOSPITAL 45 MILES AWAY. WE HAVE SEVERE WINTERS THAT AFFECT TRAVEL OUT OF THE COMMUNITY PERIODICALLY. WE SERVE A MIX OF ELDERLY, LOW INCOME AND WORKING CLASS PATIENTS. PART VI, LINE 5: PROVIDED STAFF FOR LOCAL HEALTH DEPARTMENT COVID TESTING EVENT IN JULY 2020 AND PROVIDED STAFF FOR THE LOCAL HEALTH DEPARTMENT COVID VACCINE EVENT IN FEBRUARY 2021. THE HOSPITAL IS DONATING SPACE TO GREAT LAKES RECOVERY WHICH TREATS PEOPLE WITH SUBSTANCE ABUSE PROBLEMS. X X X 0 0 0 0 0 0 0 0 0 PAUL HADUCK PHYSICIAN 298213 0 0 0 536 0 10769 0 30092 0 339610 0 0 0 BONNIE KILPELA NURSE PRACTIONER 249754 0 0 0 276 0 8430 0 30092 0 288552 0 0 0 SANDRA MCGOVERN CEO 194428 0 0 0 0 0 0 0 0 0 194428 0 0 0 SARA CARTER NURSE PRACTIONER 175658 0 0 0 90 0 6609 0 0 0 182357 0 0 0 RODNEY RIESLAND NURSE PRACTIONER 155841 0 0 0 496 0 5721 0 9739 0 171797 0 0 0 DEBORAH NEDEAU BOARD SECRETARY 1074227 PAYMENTS FOR DRUGS PURCHASED FOR 340B PROGRAM 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. THE MEMBERSHIP OF THE ASSOCIATION SHALL CONSIST OF THE FOLLOWING CLASSES; CHARTER MEMBERS AND ASSOCIATION MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A ASSOCIATION MEMBERS IF THEY HAVE PAID THEIR DUES, MAY PARTICIPATE IN THE VOTE TO ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS EMAILED TO EACH BOARD MEMBER AND GIVEN A DEADLINE TO WHICH THEY NEED TO RESPOND. THEY EACH HAVE A CHANCE TO REVIEW THE 990 AND ASK QUESTIONS REGARDING THE DATA WITHIN THE FORM BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C INDIVIDUALS REQUIRED TO COMPLY WITH THE CONFLICT OF INTEREST POLICY INCLUDE THE CHIEF EXECUTIVE OFFICER, THE CHIEF FINANCIAL OFFICER, AND ALL OF THE MEMBERS OF THE BOARD. ON AN ANNUAL BASIS, DOCUMENTS ARE DISTRIBUTED AND SIGNED BY EACH INDIVIDUAL DISCLOSING ALL CONFLICTS. IF THERE IS A CONFLICT IDENTIFIED, THAT INDIVIDUAL CANNOT VOTE ON THE MATTER AND IT MUST BE INDICATED IN THE MEETING MINUTES THAT A DISCLOSURE WAS MADE AND THE BOARD MEMBER ABSTAINED FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 MICHIGAN HOSPITAL ASSOCIATION'S WAGE SURVEY IS CONSULTED. THE BOARD OF DIRECTORS APPROVE THE COMPENSATION OF THE CEO'S EMPLOYMENT CONTRACT DURING MEETINGS. UPON RECOMMENDATION FROM THE CEO, THE BOARD ALSO APPROVES THE COMPENSATION FOR THE CFO, WHICH IS INCLUDED IN THE APPROVAL OF THE ANNUAL BUDGET. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,086,729. MANAGEMENT AND GENERAL EXPENSES 80,786. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,167,515. MUNISING BAY HEALTHCARE 1500 SAND POINT RD MUNISING MI 49862 474314554 PROVIDE THE OWNERSHIP, FINANCING, CONSTRUCTION, ETC OF A HOSPITAL BUILDING MI 501(C)(3) LINE 9 MUNISING MEMORIAL HOSPITAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0