2023-05-15T09:52:45-04:00 2022-06-30 990 2021-07-01 471161992 MUNSON HEALTHCARE GRAYLING MUNS 2319355000 1105 SIXTH STREET TRAVERSE CITY MI 49684 PAUL KONOPACKI CFO 2319355000 2023-05-15 PAUL KONOPACKI 999009999 2021 2023-04-26 12:10:37Z KIRSTEN KORTH-WHITE 1100 E MICHIGAN AVENUE GRAYLING MI 49738 116541991 false X WWW.MUNSONHEALTHCARE.ORG X 2014 MI MUNSON HEALTHCARE GRAYLING AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. 24 22 750 25 0 4682497 6397448 93357251 96973682 29275 4264 737310 795574 98806333 104170968 0 0 41752917 47037363 0 117923 51049864 54720582 92802781 101757945 6003552 2413023 58695179 57547384 34750497 31223640 23944682 26323744 AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON HEALTHCARE GRAYLING EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. false false 89727385 96845474 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF THE CRAWFORD COUNTY REGION WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE GRAYLING HAD 1,957 INPATIENT ADMISSIONS IN FISCAL YEAR 2022 AND OVER 109,000 OUTPATIENT VISITS. THE HOSPITAL SERVED 2,700 SURGICAL CASES, 286 OBSTETRICAL BIRTHS, AND OVER 16,800 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE GRAYLING ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS 68 ACTIVE MEDICAL STAFF. INCLUDED IN PROGRAM SERVICE EXPENSES ARE 823,000 OF COVID-19 EXPENSES FOR PATIENT CARE AND OTHER RELATED EXPENSES. 89727385 true true false true false false false false false false true false false false true false false true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true false false false true 43 0 true 750 true false false false false false false false false false false false false X 24 22 false false true false true true true true true false false true true true true true true true true false X NICOLE SULAK MUNSON HEALTHCARE 2319357777 4230 COPPER RIDGE DR TRAVERSE CITY MI 49684 EDWIN A NESS DIRECTOR 1.00 40.00 X 0 1193233 223158 LAURA GLENN PRESIDENT AM 2.00 40.00 X 0 607688 85269 BRIAN N STIRLING DO PHYSICIAN 40.00 X 627457 0 40555 TONYA SMITH DIRECTOR 1.00 40.00 X 0 529801 82494 JASON D BENNETT DO PHYSICIAN 40.00 X 526225 0 37459 MARK A HEPLER FORMER CFO X 0 528784 18309 GARRICK CVITKOVICH MD PHYSICIAN 40.00 X 458818 0 33466 CARL SCHUBERT MD PHYSICIAN 40.00 X 433340 4950 31951 KIRSTEN KORTH-WHITE PRESIDENT 40.00 2.00 X X 0 395505 68191 ALICIA MAITLAND CFO 2.00 40.00 X 0 368822 67951 DAVID LAGATTUTA MD PHYSICIAN 40.00 X 389959 0 42544 CASEY KANDOW VP ANCILLARY 2.00 40.00 X 0 356026 55923 ELLEN SMITH COO PHYSICIA 2.00 40.00 X 0 329713 31694 CHRISTOPHER SQUIRE VP ANCILLARY 2.00 40.00 X 0 273298 53734 MICHAEL HODNETT CNO 40.00 X 160168 0 37687 THEODORE BATZER DIRECTOR 1.00 X 0 0 0 JANET BERSTED DIRECTOR 1.00 X 0 0 0 KENNETH BLOEM VICE CHAIR P 0.00 2.00 X X 0 0 0 ALAN CONRAD DIRECTOR 0.00 1.00 X 0 0 0 CASEY COWELL DIRECTOR 0.00 1.00 X 0 0 0 RALPH OPPERMAN DDS DIRECTOR 1.00 X 0 0 0 TOM VERYSER DDS DIRECTOR 0.00 1.00 X 0 0 0 KATHY DIXON DIRECTOR 0.00 1.00 X 0 0 0 PAUL MESACK DVM SEC/TREAS PT 2.00 X X 0 0 0 NICK CEGLAREK EDD DIRECTOR 0.00 1.00 X 0 0 0 GARY D GANDOLFI DIRECTOR 1.00 X 0 0 0 SONJA HANDRICH DIRECTOR 1.00 X 0 0 0 WILLIAM HART DIRECTOR 1.00 X 0 0 0 MARLENE HULTEEN DIRECTOR 1.00 X 0 0 0 DOUG LUCIANI DIRECTOR 0.00 1.00 X 0 0 0 DAVID MCCURDY DIRECTOR 0.00 3.00 X 0 0 0 RUTH HOPPE MD SECRETARY PT 0.00 3.00 X X 0 0 0 ANITA MERCHANT DIRECTOR 1.00 X 0 0 0 KIMBERLY MORLEY CHAIR PT-YR 1.00 X X 0 0 0 BEN MULADORE DIRECTOR 0.00 1.00 X 0 0 0 TIM NELSON TREASURER PT 0.00 3.00 X X 0 0 0 BRIAN POSTMA DIRECTOR 0.00 2.00 X 0 0 0 OWEN ROBERTS DIRECTOR 0.00 2.00 X 0 0 0 MICHELLE RUSSELL DIRECTOR 0.00 1.00 X 0 0 0 MARY SANDERS DIRECTOR 0.00 2.00 X 0 0 0 ALICE SNYDER DIRECTOR 1.00 X 0 0 0 SAKURA TAKANO DIRECTOR 0.00 1.00 X 0 0 0 KRISTINE THOMAS DIRECTOR 0.00 2.00 X 0 0 0 SUSAN TYER VICE CHAIR P 2.00 X X 0 0 0 ELAINE WOOD CHAIR PT-YR 2.00 X X 0 0 0 BRUCE ZENNER DIRECTOR 0.00 1.00 X 0 0 0 2595967 4587820 910385 61 true true false SOUND PHYSICIANS PO BOX 742936 LOS ANGELES CA 900742936 MEDICAL 2025182 GRAYLING ANESTHESIA ASSOCIATES PC 450 MAMARONECK AVE STE 201 HARRISON NY 10528 MEDICAL 1844226 MARY FREE BED REHABILITATION HOSPITA 235 WEALTHY ST SE GRAND RAPDIS MI 49503 REHABILITATION 1570486 EPMG OF MICH PC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 MEDICAL 757155 MAYO CLINIC LABORATORIES PO BOX 9146 MINNEAPOLIS MN 554809146 LABORATORY 524960 16 81229 6316219 6397448 MEDICARE/MEDICAID PAYMENTS 621990 50541646 50541646 PATIENT SERVICE REVENUE 621990 42090306 42090306 340B PRESCRIPTION REVENUE 621990 3729128 3729128 QUALITY INCENTIVE PAYMENTS 621990 611162 611162 MISC HEALTHCARE REVENUE 621990 1440 1440 96973682 132472 132472 43070 43070 43070 43070 12224335 18480 12353417 17606 -129082 874 -128208 -128208 MISCELLANEOUS INCOME 722210 491820 491820 CAFETERIA SALES 621990 260684 260684 752504 104170968 96845474 928046 X 206759 206759 37775227 36463430 1311797 1785746 1723453 62293 4730795 4566471 164324 2538836 2451063 87773 23992 23992 4626 4626 26270053 16524152 9627978 117923 1073 1073 438298 342491 95807 842379 809925 32454 1420285 1417690 2595 124420 117497 6923 120391 111242 9149 466900 411700 55200 1896769 1672519 224250 435106 312010 123096 MEDICAL SUPPLIES 17685623 17685623 QAAP TAXES 2123130 2123130 BAD DEBT EXPENSE 1970735 1970735 REPAIRS AND MAINTENANCE 735209 725136 10073 161593 91286 70307 101757945 89727385 11912637 117923 3929 4129 24594425 19835149 10534435 12212036 1309871 2143738 300498 334899 36448287 15131660 20395410 21316627 522803 567301 1033808 1133505 58695179 57547384 6400662 9761828 624173 12469238 12143054 15256424 9318758 34750497 31223640 X 23421879 25756443 522803 567301 23944682 26323744 58695179 57547384 X 2413023 -78460 44499 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4626 4626 false SCHEDULE C, PART II-B, LINE 1 OTHER ACTIVITIES INDICATE THE PORTION OF DUES ALLOCATED TO LOBBYING EXPENSES PAID TO REGIONAL OR NATIONAL ORGANIZATIONS INCLUDING THE AMERICAN HOSPITAL ASSOCIATION, THE MICHIGAN SOCIETY OF HEMATOLOGY AND ONCOLOGY, AND THE AMERICAN SOCIETY FOR HEALTH. 1535000 1535000 18335656 5111854 13223802 13812598 9736674 4075924 2765033 283132 2481901 21316627 RESERVE FOR THIRD PARTY SETTLEMENTS 4383666 ESTIMATE FOR THIRD PARTY SETTLEMENTS 3809030 LT OPERATING LEASE LIABILITY 764402 ST OPERATING LEASE LIABILITY 283495 CAPITAL LEASE 78165 9318758 true true X true X true X true true false true true 157763 157763 0.00160 14924209 12231472 2692737 0.02700 15081972 12231472 2850500 0.02860 227724 227724 0.00230 24491 2126 22365 0.00020 19140010 12582445 6557565 0.06570 264 264 19392489 12584571 6807918 0.06820 34474461 24816043 9658418 0.09680 771 771 954 954 119697 119697 0.00120 121422 121422 0.00120 true 1970735 949214 17523559 17000775 522784 X true true 1 1 MUNSON HEALTHCARE GRAYLING 1100 E MICHIGAN AVE GRAYLING MI 49738 HTTP://WWW.MUNSONHEALTHCARE.ORG 1060000029 X X X X X MUNSON HEALTHCARE GRAYLING 1 false false true X X X X X X X X X X 21 true true true true X HTTPS://TINYURL.COM/YSZBXMYS X true 22 true HTTPS://TINYURL.COM/YSZBXMYS false true X 200.000000000000 400.000000000000 X X X X true true X X X true X HTTPS://TINYURL.COM/2TNSZ8PS X HTTPS://TINYURL.COM/2TNSZ8PS X HTTPS://TINYURL.COM/2TNSZ8PS X X X X X X X true X false X X X X X true X false false FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 3E THE SIGNIFICANT PRIORITIZED HEALTH NEEDS OF THE COMMUNITY ARE IDENTIFIED IN THE CHNA UNDER THE KEY FINDINGS HEADING. IN THE NORTHEAST REGION, THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN ORDER OF PRIORITY: SUBSTANCE USE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND CHRONIC DISEASE. THESE THEMES WERE PRIORITIZED THROUGH A PRIORITIZATION MATRIX, FOR WHICH MITHRIVE DESIGN TEAM MEMBERS SORTED THE DATA RECEIVED FOR THE THREE REGIONS INTO PRIMARY AND SECONDARY DATA. THEY CLUSTERED DATA POINTS BASED ON TOPIC, THEME AND INTERCONNECTEDNESS. THE THEMES WHICH COULD BE FOUND IN THE HIGH SECONDARY DATA/ HIGH PRIMARY DATA QUADRANT WERE A COMBINATION OF THE ABOVE TOPICS BASED ON REGION. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 5 WE ARE FOLLOWING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP FRAMEWORK TO GUIDE OUR PROCESS WHICH INCLUDES FOUR ASSESSMENTS TO GATHER INPUT. 1.COMMUNITY THEMES AND STRENGTHS ASSESSMENT: THIS ASSESSMENT PROVIDES A DEEP UNDERSTANDING OF THE ISSUES THAT RESIDENTS FEEL ARE SIGNIFICANT BY ANSWERING THE FOLLOWING QUESTIONS: WHAT IS IMPORTANT TO OUR COMMUNITY?; HOW IS QUALITY PERCEIVED IN OUR COMMUNITY?; WHAT ASSETS DO WE HAVE THAT CAN BE USED TO IMPROVE WELLBEING? IT CONSISTED OF THREE SURVEYS: COMMUNITY SURVEY, HEALTHCARE PROVIDER SURVEY, AND PULSE SURVEY. RESULTS FROM EACH WERE ANALYZED BY COUNTY, HOSPITAL SERVICE AREA, AND THE THREE MITHRIVE REGIONS. 2.COMMUNITY HEALTH STATUS ASSESSMENT: THE COMMUNITY HEALTH STATUS ASSESSMENT IDENTIFIES PRIORITY COMMUNITY HEALTH AND QUALITY OF LIFE ISSUES. IT ANSWERS THE QUESTIONS, HOW HEALTHY ARE OUR RESIDENTS? AND WHAT DOES THE HEALTH STATUS OF OUR COMMUNITY LOOK LIKE? ITS PURPOSE IS TO COLLECT QUANTITATIVE SECONDARY DATA ABOUT THE HEALTH AND WELL-BEING OF RESIDENTS AND COMMUNITIES. WE COLLECTED APPROXIMATELY 100 STATISTICS, BY COUNTY, FOR THE 31-COUNTY REGION FROM RELIABLE SOURCES SUCH AS THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE US CENSUS BUREAU. 3.COMMUNITY SYSTEM ASSESSMENT: THE COMMUNITY SYSTEM ASSESSMENT FOCUSES ON ORGANIZATIONS THAT CONTRIBUTE TO WELL-BEING. IT ANSWERS THE QUESTIONS, WHAT ARE THE COMPONENTS, ACTIVITIES, COMPETENCIES, AND CAPACITIES IN THE REGIONAL SYSTEM? AND HOW ARE SERVICES BEING PROVIDED TO OUR RESIDENTS? FIRST, COMMUNITY-WIDE VIRTUAL MEETINGS WERE CONVENED IN THE NORTHWEST, NORTHEAST, AND NORTH CENTRAL MITHRIVE REGIONS WHERE PARTICIPANTS DISCUSSED VARIOUS ATTRIBUTES OF THE COMMUNITY SYSTEM. THESE WERE FOLLOWED BY RELATED DISCUSSIONS AT LOCAL COMMUNITY COLLABORATIVE MEETINGS. 4.FORCES OF CHANGE ASSESSMENT: THE FORCES OF CHANGE ASSESSMENT IDENTIFIES FORCES SUCH AS LEGISLATION, TECHNOLOGY, AND OTHER FACTORS THAT AFFECT THE COMMUNITY CONTEXT. IT ANSWERS THE QUESTIONS, WHAT IS OCCURRING OR MIGHT OCCUR THAT AFFECTS THE HEALTH OF OUR COMMUNITY OR THE LOCAL SYSTEM? AND WHAT SPECIFIC THREATS OR OPPORTUNITIES ARE GENERATED BY THESE OCCURRENCES? LIKE THE COMMUNITY SYSTEM ASSESSMENT, THE FORCES OF CHANGE ASSESSMENT WAS COMPOSED OF COMMUNITY MEETINGS CONVENED VIRTUALLY IN THE NORTHWEST, NORTHEAST, AND NORTH CENTRAL REGIONS. AS ONE OF THE FIRST STEPS OF ACHIEVING HEALTH EQUITY IS TO UNDERSTAND CURRENT HEALTH DISPARITIES, WE INVITED DIVERSE COMMUNITY PARTNERS TO JOIN THE MITHRIVE STEERING COMMITTEE, DESIGN TEAM, AND WORKGROUPS, AND WE GATHERED PRIMARY AND SECONDARY DATA FROM MEDICALLY UNDERSERVED, MINORITY, AND LOW-INCOME POPULATIONS IN EACH OF THE FOUR MITHRIVE ASSESSMENTS, BY THE FOLLOWING METHODS: CROSS-TABULATING DEMOGRAPHIC INDICATORS SUCH AS AGE, RACE, AND SEX FOR THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT ENGAGING RESIDENTS EXPERIENCING BARRIERS TO SOCIAL DETERMINANTS OF HEALTH AND ORGANIZATIONS THAT SERVE THEM IN THE COMMUNITY SYSTEM ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT REACHING OUT TO MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS THROUGH PULSE SURVEYS ADMINISTERED BY ORGANIZATIONS THAT SERVE THEM INCREASING INCLUSION OF PEOPLE WITH DISABILITIES IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH PARTNERSHIP WITH THE DISABILITY NETWORK OF NORTHERN MICHIGAN SURVEYING PROVIDERS WHO CARE FOR PATIENTS/CLIENTS ENROLLED IN MEDICAID HEALTH PLANS RECRUITING 1) RESIDENTS EXPERIENCING BARRIERS TO SAFE, AFFORDABLE, AND ACCESSIBLE HOUSING; HEALTHY FOOD; TRANSPORTATION OPTIONS; AND OTHER SOCIAL DETERMINANTS OF HEALTH AND 2) REPRESENTATIVES FROM THE DIVERSE ORGANIZATIONS THAT SERVE THEM TO MITHRIVE DATA WALKS AND PRIORITY-SETTING EVENTS FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 6A MITHRIVE WAS IMPLEMENTED ACROSS A 31-COUNTY REGION THROUGH A PARTNERSHIP OF HOSPITAL SYSTEMS, LOCAL HEALTH DEPARTMENTS, AND OTHER COMMUNITY PARTNERS. OUR AIM IS TO LEVERAGE RESOURCES AND REDUCE DUPLICATION WHILE STILL ADDRESSING UNIQUE LOCAL NEEDS FOR HIGH QUALITY, COMPARABLE, COUNTY-LEVEL DATA. THE 2021 MITHRIVE COMMUNITY HEALTH NEEDS ASSESSMENT UTILIZED THREE REGIONS: NORTHWEST, NORTHEAST, AND NORTH CENTRAL. ALL OF THE MUNSON HEALTHCARE HOSPITALS WORKED TOGETHER ON REGIONAL CHNA EFFORTS AS PART OF THE MITHRIVE REGIONAL CHNA INITIATIVE. THESE INCLUDE: MUNSON MEDICAL CENTER, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL, AND KALKASKA MEMORIAL HEALTH CENTER. IN ADDITION, HOSPITALS FORM THE MCLAREN AND SPECTRUM HEALTH SYSTEMS COLLABORATED ON THIS EFFORT. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 6B IN ADDITION TO DOZENS OF LOCAL AND REGIONAL ORGANIZATIONS, ALL HEALTH DEPARTMENTS IN THE REGION SERVED PARTICIPATED, INCLUDING: GRAND TRAVERSE HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 10, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, BENZIE LEELANAU DISTRICT HEALTH DEPARTMENT, CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 2, DISTRICT HEALTH DEPARTMENT 4. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 11 WE IDENTIFIED STRATEGIC ISSUES AS PART OF THE MITHRIVE COLLABORATIVE. STRATEGIC ISSUES ARE BROADER THAN INDIVIDUAL HEALTH CONDITIONS, AND REPRESENT UNDERLYING CHALLENGES THAT NEED TO BE ADDRESSED, WHICH WOULD LEAD TO IMPROVEMENT IN HEALTH CONDITIONS. EACH STRATEGIC ISSUE SHOULD IMPACT MORE THAN ONE HEALTH CONDITION. THE TOP PRIORITY ISSUES TO BE ADDRESSED: MENTAL HEALTH AND SUBSTANCE USE DISORDERS SAFE, AFFORDABLE AND ACCESSIBLE HOUSING ACCESS TO HEALTHCARE CHRONIC DISEASE A COMPLETE LIST OF STRATEGIES PLANNED TO ADDRESS THE PRIORITIZED NEEDS MAY BE VIEWED WITHIN THE CHNA IMPLEMENTATION PLAN. GENERALLY, THE HOSPITAL SYSTEM IS COMMITTED TO PROVIDING RESOURCES TO SUPPORT PROGRAMMING, PARTICIPATION IN COLLABORATIVE PROJECTS, BOARDS, AND SUPPORT FOR OTHER COMMUNITY IMPROVEMENT PROJECTS RELATED TO OUR PRIORITY STRATEGIC ISSUES. IN ADDITION TO THE STRATEGIC ISSUES LISTED ABOVE, THE FOLLOWING CHALLENGES WERE ALSO UNCOVERED IN THE DATA: BROADBAND ACCESS COVID-19 ECONOMIC SECURITY EQUITY HEALTHY FOOD HEALTHY WEIGHT INFRASTRUCTURE FOR HEALTHY LIVES SAFETY AND WELL-BEING TRANSPORTATION MUNSON HEALTHCARE ACKNOWLEDGES THE WIDE RANGE OF ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT WITH THE BROAD NATURE OF THE STRATEGIC ISSUES WE COULD EFFECTIVELY FOCUS ON ONLY THOSE ISSUES THAT WERE PRIORITIZED THE HIGHEST BY OUR COMMUNITY. HOWEVER, SOME OF THESE ISSUES INCLUDING EQUITYARE FOUNDATIONAL COMPONENTS OF ALL THE WORK OF THE ORGANIZATION AND WILL BE INDIRECTLY TARGETED THROUGH MANY OF THE STRATEGIES LISTED IN THIS PLAN. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 13H PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, AT THE SOLE DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16J IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 20E MUNSON HEALTHCARE GRAYLING(GRAYLING) REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. GRAYLING WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY GRAYLING; 2.DOCUMENTING THAT GRAYLING HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH GRAYLING 'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH GRAYLING DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. GRAYLING WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS. 2 CRAWFORD CONTINUING CARE CENTER 1100 EAST MICHIGAN AVE GRAYLING MI 49738 EXTENDED CARE FACILITY GRAYLING SURGICAL SERVICES 1010 W NORTH DOWN RIVER RD GRAYLING MI 49738 SURGICAL SERVICES SCHEDULE H, PART I, LINE 3C INCOME UP TO 200% OF THE FPG = 100% DISCOUNT ON CHARGES INCOME BETWEEN 201% AND 300% FPG = 75% DISCOUNT ON CHARGES INCOME BETWEEN 301% AND 400% FPG = 65% DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE, OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS. FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG: EARNINGS, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES; CASH, CHECKING AND SAVINGS BALANCES, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, IRAS TRUSTS, INHERITANCES, ANNUITIES, SAVINGS BONDS, STOCKS, MUTUAL FUNDS, AND/OR CASH VALUE OF LIFE INSURANCE. SCHEDULE H, PART I, LINE 7G THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 17,368,702. THESE COSTS ARE OFFSET BY RELATED REVENUES IN COMPUTING THE NET COMMUNITY BENEFIT. SCHEDULE H, PART I, LINE 7, COLUMN (F) TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 101,757,945. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 1,970,735. THE NET EXPENSE OF 99,787,210 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). SCHEDULE H, PART I, LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION OR ACTUAL CASH PAID. SCHEDULE H, PART II MUNSON HEALTHCARE GRAYLING (GRAYLING HOSPITAL) PROVIDED 121,422 OF COMMUNITY BUILDING ACTIVITIES DURING THE 2021 TAX YEAR. THIS INCLUDED WORKFORCE DEVELOPMENT THROUGH PHYSICIAN RECRUITMENT, ASSISTANCE TO PATIENTS TO ENROLL IN PUBLIC MEDICAL PROGRAMS, AND THE MEDSAFE COLLECTION PROGRAM TO ACCEPT THE DISPOSAL OF UNUSED MEDICATIONS. REHAB SERVICES AND OCCUPATIONAL THERAPY HEALTH PROFESSIONALS PROVIDED INTERNSHIP STUDENT SUPERVISION. TO GARNER PARTICIPATION IN THE FIVE WISHES PROGRAM, A LEAD-UP TO BUILDING THE RECORDED ADVANCE DIRECTIVES DATABASE, THE FIVE WISHES PROGRAM DISTRIBUTED BROCHURES TO THE PUBLIC. SCHEDULE H, PART III, LINE 2 DIRECT WRITE-OFF FROM UNPAID ACCOUNTS WHICH ARE DEEMED NO LONGER COLLECTIBLE ARE RECORDED AGAINST THE ALLOWANCE FOR BAD DEBT. AN ESTIMATE OF BAD DEBT EXPENSE IS RECORDED BASED ON 1) AN ANALYSIS OF THE DIRECT WRITE- OFFS AND 2) AN ESTIMATE OF THE AMOUNT OF BAD DEBT, NET OF DISCOUNTS, IN THE ACCOUNTS RECEIVABLE BALANCE, CONSIDERING THE PAST EXPERIENCE AND CURRENT TRENDS OF PAYMENTS ON PATIENT ACCOUNTS FOR EACH OF THE MAJOR PAYOR SOURCES OF REVENUE. SCHEDULE H, PART III, LINE 3 THE METHODOLOGY USED TO DETERMINE THE ESTIMATED AMOUNT OF CHARITY IN BAD DEBT IS AS FOLLOWS. WE DETERMINED THE APPROVAL RATE OF FINANCIAL COUNSELING BY TAKING THE VALUE OF THE ACCOUNTS THAT SUCCESFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING. SCHEDULE H, PART III, LINE 4 SEE NOTE 2 ON PAGE 10 OF ATTACHED AUDITED FINANCIAL STATEMENTS UNDER ACCOUNTS RECEIVABLE. SCHEDULE H, PART III, LINE 9B MUNSON HEALTHCARE'S INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684. SCHEDULE H, PART VI, LINE 2 THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM PARTICIPATE IN A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. IN ADDITION, THE HOSPITAL IS A MEMBER OF THE MUNSON HEALTHCARE SYSTEM, WHICH WORKS TO UNDERSTAND THE NEEDS OF THE SERVICE AREA THROUGH VARIOUS SERVICE LINE AND DEPARTMENT-BASED ASSESSMENT AND BUSINESS PLANNING STRATEGIES. THE HOSPITAL ALSO REGULARLY SEEKS INFORMATION FROM AND PARTICIPATES IN THE COUNTY COLLABORATIVE, MITHRIVE WORKGROUPS, AND OTHER REGIONAL COLLABORATIVES TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY HEALTH NEEDS. THE HOSPITAL MAINTAINS A COMMUNITY HEALTHCARE COUNCIL MADE UP OF LOCAL LEADERS AND AREA ORGANIZATIONS WHICH PROVIDE INPUT INTO EMERGING TRENDS AND ISSUES SPECIFIC TO THEIR COMMUNITIES. FINALLY, HEALTHCARE SYSTEM MAINTAINS A STANDING COMMUNITY AND POPULATION HEALTH COMMITTEE WHICH CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM REGIONAL HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MHC RESPONSE TO EMERGING HEALTH TRENDS, AND REVIEW NEW COMMUNITY HEALTH-BASED COLLABORATION OR PROGRAMS. SCHEDULE H, PART VI, LINE 3 IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS: BROCHURES THAT DESCRIBE MUNSON HEALTHCARE'S FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES. THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR. STATEMENT ON BILLS: STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL. SIGNS IN THE ER REGISTRATION AREA: ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY. THE MUNSON HEALTHCARE INTERNET HAS THE FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, THE PLAIN LANGUAGE SUMMARY AND THE BILLING AND COLLECTIONS POLICY AVAILABLE TO REVIEW AND PRINT. REFERRAL BY REGISTRATION STAFF: AT THE TIME OF REGISTRATION, SELF-PAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF. MUNSON HEALTHCARE FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS. THE COUNSELOR VISIT ALL INPATIENTS THAT ARE DEEMED SELF-PAY, TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP. IF THE PATIENT WOULD LIKE HELP, THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID. GENERALLY, THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR. ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR, THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS. THE COUNSELORS ALSO IDENTIFY ALL SELF-PAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS, ONLY BY PHONE. THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION, BUT WHEN THAT IS NOT POSSIBLE, THE CALL IS MADE SOON AFTER DISCHARGE. AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: MEDICAID (AND ALL OF ITS SUBSETS), SOCIAL SECURITY DISABILITY, TRAVERSE HEALTH CLINIC, MUNSON HEALTHCARE FINANCIAL ASSISTANCE, AND MUNSON MEDICAL CENTER MEDS PROGRAM. MUNSON HEALTHCARE MAKES A PHONE CALL TO ALL PRIVATE-PAY PATIENTS PRIOR TO TRANSFERRING THEIR ACCOUNT TO A COLLECTION AGENCY TO INFORM THEM OF OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART VI, LINE 4 DESCRIPTION MUNSON HEALTHCARE GRAYLING (GRAYLING HOSPITAL) SERVES A SPARSELY POPULATED, RURAL REGION IN CENTRAL NORTHERN MICHIGAN COMPRISED OF ALL OF CRAWFORD COUNTY (WHERE THE HOSPITAL IS LOCATED) AND MOST OF ROSCOMMON COUNTY, AS WELL AS MUCH OF OSCODA COUNTY AND SMALL PORTIONS OF MONTMORENCY AND OTSEGO COUNTIES. GRAYLING HOSPITAL IS THE ONLY INPATIENT AND EMERGENCY SERVICE PROVIDER FOR THIS REGION, AND ONE OF ONLY EIGHT BIRTHING HOSPITALS IN THE NORTHERN 21 COUNTIES OF THE LOWER PENINSULA. GRAYLING HOSPITAL OFFERS QUALITY, PERSONALIZED CARE FOR PRIMARY, SPECIALTY, AND URGENT MEDICAL NEEDS. THE ORGANIZATION HAS 71 LICENSED INPATIENT BEDS, A 39-BED SKILLED NURSING/ LONG-TERM CARE UNIT, 68 ACTIVE MEDICAL STAFF (PRIMARY FACILITY), AND IS ONE OF THE LARGEST EMPLOYERS IN THE REGION. HOSPITAL SERVICES GRAYLING HOSPITAL HAS AN ACTIVE EMERGENCY DEPARTMENT, OUTPATIENT SURGERY DEPARTMENT, CANCER AND INFUSION DEPARTMENT, AND SIX PHYSICIAN OFFICES LOCATED IN GRAYLING, PRUDENVILLE AND ROSCOMMON OFFERING PRIMARY CARE, PEDIATRICS, OBSTETRICS AND GYNECOLOGY, UROLOGY, GENERAL SURGERY , ORTHOPEDIC SURGERY, WALK-IN CARE. CLINICS IN GRAYLING, ROSCOMMON AND PRUDENVILLE ALSO PROVIDE OUT-PATIENT PHYSICAL REHAB SERVICES. BEHAVIORAL HEALTH IS OFFERED AT THE GRAYLING COMMUNITY HEALTH CENTER, ROSCOMMON COMMUNITY HEALTH CENTER AND PRUDENVILLE COMMUNITY HEALTH CENTER. GRAYLING HOSPITAL OFFERS A DIABETES SELF MANAGEMENT EDUCATION PROGRAM THAT IS RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION. GRAYLING HOSPITAL IS SUPPORTED IN ITS MISSION WITH VISITING SPECIALTY PHYSICIANS AND HEALTHCARE PROFESSIONALS PROVIDE LOCAL ACCESS TO ALLERGY AND IMMUNOLOGY SERVICES, CARDIOLOGY, NEUROLOGY, NEUROSURGERY, NEPHROLOGY, AND AUDIOLOGY SERVICES. THE HOSPITAL SERVED MORE THAN 2,700 SURGICAL CASES, OVER 109,000 OUTPATIENT VISITS, 1,957 INPATIENT ADMISSIONS, OVER 16,800 EMERGENCY ROOM VISITS, AND 286 BIRTHS IN FISCAL YEAR 2022. POPULATION SERVED THERE ARE JUST OVER 61,500 PEOPLE LIVING IN GRAYLING HOSPITAL'S THREE COUNTY SERVICE AREAS. ACCORDING TO THE CENSUS BUREAU'S POPULATION ESTIMATES PROGRAM THE POPULATION IN CRAWFORD, OSCODA AND ROSCOMMON COUNTIES IS DESIGNATED AS RURAL. THE LARGEST RACIAL OR ETHNIC MINORITY GROUPS ARE HISPANIC OR LATINO (2.0%), AMERICAN INDIAN AND ALASKA NATIVE (1%) AND BLACK OR AFRICAN AMERICAN (.7%). THE MEDIAN HOUSEHOLD INCOME OF OSCODA COUNTY IS 45,659, LOWEST AMONG THE THREE COUNTIES. AND LOWER YET COMPARED TO THE STATE OF MICHIGAN AT 63,202. PERSONS OF POVERTY ARE LOWEST IN CRAWFORD COUNTY (15.8%), WHICH IS HIGHER THAN THE STATE OF MICHIGAN (13.1%) THE PERCENTAGE OF PERSONS 65 AND OLDER ALSO IS HIGHER IN ALL THREE COUNTIES THAN IN ALL OF MICHIGAN (18.1%), WITH ROSCOMMON AT 33.5%, OSCODA AT 28.7%, AND CRAWFORD AT 25.9%, AND IS EXPECTED TO INCREASE. CRAWFORD, OSCODA AND ROSCOMMON COUNTIES ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS. QUALITY GRAYLING HOSPITAL IS FULLY ACCREDITED BY THE JOINT COMMISSION AND HAS EARNED THE GOLD SEAL OF APPROVAL, AN INTERNATIONALLY-RECOGNIZED SYMBOL OF HEALTH CARE QUALITY. THE ACCREDITATION PROCESS DRIVES QUALITY CARE AND PATIENT SAFETY IMPROVEMENTS THROUGH NATIONALLY RECOGNIZED EVIDENCE-BASED STANDARDS WHICH ADDRESS CRITICAL PATIENT SAFETY AND QUALITY ISSUES, NATIONAL PATIENT SAFETY GOALS, AND PERFORMANCE MEASURES WHICH PROVIDE A FOUNDATION FOR QUALITY. GRAYLING HOSPITAL RECEIVED A GRADE "A" FROM THE LEAPFROG GROUP FOR SPRING 2021. GRAYLING HOSPITAL ALSO HAS BEEN DESIGNATED BY BLUE CROSS BLUE SHIELD OF MICHIGAN AS A BLUE DISTINCTION CENTER+ FOR MATERNITY CARE AND KNEE AND HIP REPLACEMENT. GRAYLING HOSPITAL IS RECOGNIZED AS A LEVEL IV TRAUMA HOSPITAL BY THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES. THIS DESIGNATION MEANS THAT GRAYLING HOSPITAL IS PART OF A REGIONAL, COORDINATED, AND ACCOUNTABLE TRAUMA CARE NETWORK WITH A DEMONSTRATED ABILITY TO PROVIDE ADVANCED TRAUMA LIFE SUPPORT (ATLS) PRIOR TO TRANSFER OF PATIENTS TO A HIGHER LEVEL TRAUMA CENTER. GRAYLING HOSPITAL HAS RECEIVED A 4- STAR BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE RATING SUMMARIZES UP TO 64 QUALITY MEASURES ON THE HOSPITAL COMPARE WEB SITE REFLECTING COMMON CONDITIONS THAT HOSPITALS TREAT, SUCH AS HEART ATTACKS OR PNEUMONIA. THE OVERALL RATING SHOWS HOW WELL EACH HOSPITAL PERFORMED, ON AVERAGE, COMPARED TO OTHER HOSPITALS IN THE US. SCHEDULE H, PART VI, LINE 5 MUNSON HEALTHCARE GRAYLING'S (GRAYLING HOSPITAL) BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, THE MAJORITY OF WHOM RESIDE IN THE MUNSON HEALTHCARE PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS. GRAYLING HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA. THESE FUNDS ARE REINVESTED INTO OUR HOSPITALS IN THE FORM OF EMPLOYEE WAGE ADJUSTMENTS, TECHNOLOGY, AND SERVICES NEEDED TO ENSURE THE HIGHEST QUALITY CARE IS AVAILABLE IN NORTHERN MICHIGAN. THE HOSPITAL ALSO HAS AN OPEN MEDICAL STAFF WHERE PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF TRUSTEES. EXAMPLES OF HOW GRAYLING HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PROGRAM SUPPORT INCLUDES: "THE GRAYLING HOSPITAL RESOURCE CORDINATION TEAM" IS SUPPORTED BY COMMUNITY BENEFIT FUNDING. THE RESOURCE COORDINATION TEAM CONTINUES TO ASSIST UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS PATIENTS WITH LIMITED FINANCIAL RESOURCES BY CONNECTING THEM WITH RESOURCES TO ADDRESS BARRIERS SUCH AS TRANSPORTATION, INABILITY TO PAY UTILITY BILLS, ACCESS TO PRIMARY CARE AND WALK-IN CARE, THE HIGH COST OF MEDICATIONS, AND REFERRALS TO OTHER COMMUNITY BASED RESOURCES. THE RESOURCE COORDINATION TEAM HAS BEEN ACTIVE IN CONNECTING PATIENTS WITH GRAYLING HOSPITAL'S PATIENT FINANCIAL ASSISTANCE COORDINATOR AND MEDICAID COORDINATOR FOR FREE HEALTH INSURANCE ENROLLMENT ASSISTANCE. GRAYLING HOSPITAL PHYSICIAN NETWORK CHRONIC DISEASE CARE COORDINATORS COLLABORATE WITH THE RESOURCE COORDINATION TEAM TO GET THEIR PATIENTS ASSISTANCE IN MEETING UNMET SOCIAL NEEDS. THE MEDICATION ACCESS PROGRAM OFFERED BY THE RESOURCE COORDINATION TEAM HELPS MANY PATIENTS WITH MORE AFFORDABLE OPTIONS TO OBTAIN MEDICATIONS. THE RESOURCE COORDINATION TEAM ALSO OFFERS ADVANCE CARE PLANNING WORKSHOPS AND RESOURCES TO COMMUNITY MEMBERS AT NO COST. "PRENATAL EDUCATION AND CARE COORDINATION - GRAYLING HOSPITAL OFFERS CHILDBIRTH AND BREASTFEEDING EDUCATION. OB CARE COORDINATORS ASSIST HIGH RISK PATIENTS TO IMPROVE PREGNANCY OUTCOMES. MUNSON HEALTHCARE ALSO HELPS FUND THE HEALTHY FUTURES PROGRAM SO THAT EVERY MOTHER-TO-BE THAT HAS A CHILD BORN AT GRAYLING HOSPITAL AND CHILDREN UP TO AGE TWO, CAN HAVE ACCESS, REGARDLESS OF HEALTH INSURANCE COVERAGE, TO EVERYTHING NEEDED FOR A HEALTHY BEGINNING. "TRANSPORTATION - GRAYLING HOSPITAL SUBSIDIZES FUNDING FOR TRANSPORTATION WHICH PROVIDES ACCESS TO HEALTHCARE SERVICES FOR DISADVANTAGED PERSONS SUCH AS THE ELDERLY, PERSONS WITH DISABILITIES, AND PERSONS OF LOW INCOME WHO HAVE DIFFICULTY PROVIDING THEIR OWN TRANSPORTATION. "SUPPORT OF THE NEIGHBORHOOD CONNECTIONS RESOURCE FAIR IN CRAWFORD COUNTY AND THE PROJECT CONNECT RESOURCE FAIR IN OSOCDA COUNTY. "SUPPORT GROUPS AND ASSISTANCE ACTIVITIES FOR CHRONIC DISEASES SUCH AS: DIABETES, COPD, BARIATRIC PATIENTS, AND ALCOHOL RECOVERY. "NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 11 COUNTY SERVICE AREA, WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES. NMDI IS COMMITTED TO PROVIDING LOCAL, REGIONAL, AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES. WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES, NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS: THE GENERAL COMMUNITY; THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION; AND RURAL PRIMARY CARE PROVIDERS (PCP) CARING FOR DIABETIC PATIENTS. "SENIOR EXERCISE CLASSES LED BY GRAYLING HOSPITAL'S REHAB STAFF ARE HELD ON THURSDAYS AND FRIDAYS AT THE CRAWFORD COUNTY COMMISSION ON AGING AND SENIOR CENTER. "MEDICATION ASSISTANCE PROGRAM - PROVIDES ESSENTIAL PRESCRIPTIONS TO PATIENTS WHO HAVE LIMITED RESOURCES "CLINICAL TRAINING SITE FOR MEDICAL STUDENTS, NURSE PRACTITIONER STUDENTS, PHYSICIAN ASSISTANT STUDENTS, NURSING STUDENTS, SURGICAL TECH STUDENTS, PHLEBOTOMY STUDENTS, AND OTHER ALLIED HEALTH STUDENTS. SCHEDULE H, PART VI, LINE 6 MUNSON HEALTHCARE GRAYLINGS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM WHICH INCLUDE MUNSON MEDICAL CENTER, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL AND MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL PROVIDED 141.2 MILLION OF COMMUNITY BENEFIT IN THE 2021 TAX YEAR. ADDITIONALLY, MMC WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA. THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON CAMPUS. COMMUNITY BENEFIT, IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR. MUNSON MEDICAL GROUP, THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM, PROVIDED 1.7 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2021. MMC PERFORMS THE NEEDS ASSESSMENTS FOR MUNSON HEALTHCARE. UTILIZING THIS NEEDS ASSESSMENT, MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING, DEVELOPING, IMPLEMENTING, EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS. IN TOTAL, THE MUNSON HEALTHCARE SYSTEM PROVIDED 153.3 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS, INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS, OUTREACH PROGRAMS, BAD DEBT, AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN. SCHEDULE H, PART VI, LINE 7 MICHIGAN X true true false true false false false false false true false EDWIN A NESS DIRECTOR 883584 280959 28690 190789 32369 1416391 LAURA GLENN PRESIDENT AMB SERVIC 462670 124952 20066 63530 21739 692957 BRIAN N STIRLING DO PHYSICIAN 424074 181624 21759 11529 29026 668012 TONYA SMITH DIRECTOR 409775 118506 1520 56121 26373 612295 JASON D BENNETT DO PHYSICIAN 524705 1520 14528 22931 563684 MARK A HEPLER FORMER CFO 227786 109926 191072 11390 6919 547093 85313 GARRICK CVITKOVICH MD PHYSICIAN 453542 5276 10773 22693 492284 CARL SCHUBERT MD PHYSICIAN 287367 4950 124485 21488 14529 17422 465291 4950 KIRSTEN KORTH-WHITE PRESIDENT 307495 78645 9365 44207 23984 463696 ALICIA MAITLAND CFO 311916 46733 10173 46343 21608 436773 DAVID LAGATTUTA MD PHYSICIAN 279674 87851 22434 14529 28015 432503 CASEY KANDOW VP ANCILLARY SERV 309195 46512 319 33286 22637 411949 ELLEN SMITH COO PHYSICIAN NETWOR 274087 54320 1306 29033 2661 361407 CHRISTOPHER SQUIRE VP ANCILLARY SER EAS 243934 29104 260 30989 22745 327032 MICHAEL HODNETT CNO 139410 20329 429 15914 21773 197855 SCHEDULE J, PAGE 1, PART I, LINE 1A MUNSON HEALTHCARE MAINTAINS A SOCIAL MEMBERSHIP AT THE TRAVERSE CITY COUNTRY CLUB. A REQUIREMENT OF THE COUNTRY CLUB IS THAT A MEMBERSHIP BE IN AN INDIVIDUAL NAME AND NOT A CORPORATE NAME, SO EDWIN NESS IS LISTED AS THE INDIVIDUAL FOR THE MEMBERSHIP. MUNSON HEALTHCARE USES THE SOCIAL MEMBERSHIP TO CONDUCT OFF-SITE MEETINGS AND RETREATS. SCHEDULE J, PAGE 1, PART I, LINE 3 THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 176,260 0 LAURA GLENN 0 49,001 0 TONYA SMITH 0 41,999 0 KIRSTEN KORTH-WHITE 0 33,001 0 ALICIA MAITLAND 0 32,080 0 CASEY KANDOW 0 18,912 0 ELLEN SMITH 0 16,524 0 CHRISTOPHER SQUIRE 0 24,310 0 MICHAEL HODNETT 0 8,701 0 SCHEDULE J, PAGE 1, PART I, LINE 7 MUNSON HEALTHCARE EXECUTIVES ARE ELIGIBLE FOR AN ANNUAL BONUS BASED ON MEETING ORGANIZATIONAL GOALS, WHICH ARE SET IN ADVANCE AND APPROVED BY THE COMPENSATION COMMITTEE OF THE MUNSON HEALTHCARE BOARD. THE GOALS INCLUDE A COMBINATION OF FINANCIAL TARGETS, STRATEGIC TARGETS AND OPERATIONAL TARGETS INCLUDING QUALITY HEALTHCARE DELIVERY, DISEASE MANAGEMENT, PATIENT SATISFACTION, EMPLOYEE SAFETY, AND EMPLOYEE ENGAGEMENT. AT THE END OF EACH FISCAL YEAR, THE COMPENSATION COMMITTEE OF THE MUNSON HEALTHCARE BOARD IS CHARGED WITH REVIEWING AND APPROVING EXECUTIVE BONUSES BASED ON PROGRESS TOWARD MEETING ORGANIZATIONAL GOALS. SCHEDULE J, PART III SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON HEALTHCARE'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON HEALTHCARE. A CNTY GRD TRAV HOSP FIN AUTH 2014B 386004832 386523EH3 2014-12-17 14185862 PURCHASE HOSPITAL ASSETS false false false A 14186031 173507 14012524 2015 false false true true A false true true false false false false true A false false true false false false false false true A true DIFFERENCES IN ISSUE PRICE EXPLANATION CNTY GRD TRAV HOSP FIN AUTH 2014B CNTY GRD TRAV HOSP FIN AUTH 2014B INVESTMENT INCOME EARNED PURPOSE OF ISSUE DESCRIPTION CNTY GRD TRAV HOSP FIN AUTH 2014B PURCHASE HOSPITAL ASSETS ADDITIONAL INFORMATION CNTY GRD TRAV HOSP FIN AUTH 2014B MUNSON HEALTHCARE GRAYLING MAINTAINS POLICIES AND PROCEDURES TO REVIEW AND MONITOR ALL CONTRACTS, INCLUDING LEASES, MANAGEMENT, SERVICE AND RESEARCH CONTRACTS. THE MONITORING PROCESS INCLUDES A REVIEW BY THE CORPORATE INTERNAL LEGAL DEPARTMENT. OUTSIDE COUNSEL MAY BE CONSULTED, AS NECESSARY. OUTSIDE COUNSEL IS RETAINED FOR ALL NEW EXEMPT BOND OFFERINGS, DURING WHICH A THOROUGH DUE DILIGENCE PROCESS REVIEWS APPLICABLE CONTACTS. SINCE NEW BONDS WERE ISSUED IN THE MUNSON HEALTHCARE SYSTEM IN 2021, OUTSIDE COUNSEL WAS ENGAGED DURING THAT TAX YEAR. OBLIGATED GROUP ISSUE RECORDED ON RELATED ORGANIZATIONS ON DECEMBER 17, 2014, THE MUNSON HEALTHCARE OBLIGATED GROUP ISSUED COUNTY OF GRAND TRAVERSE HOSPITAL FINANCE AUTHORITY REVENUE BONDS (MUNSON THE 2014 SERIES A BONDS WERE RECORDED ON MUNSON MEDICAL CENTER'S BOOKS AND RECORDS AT A PAR VALUE OF 27,620,000. THE 2014 SERIES B BONDS WERE RECORDED ON MUNSON HEALTHCARE GRAYLING'S BOOKS AND RECORDS AT A PAR VALUE OF 13,805,000. THE 2014 SERIES C BONDS WERE RECORDED ON MUNSON HEALTHCARE CADILLAC'S BOOKS AND RECORDS AT A PAR VALUE OF 15,870,000. THE RELATED BOND PREMIUM WAS RECORDED ON THE RESPECTIVE ENTITIES' BOOKS AND RECORDS. AMBER GOODRICH SEE PART V 114237 COMPENSATION PAID false SCHEDULE L, PART V PART IV, LINE 1 AMBER GOODRICH IS A FAMILY MEMBER OF BOARD MEMBER SONJA HANDRICH. FORM 990, PAGE 6, PART VI, LINE 4 EFFECTIVE 1/1/2022, THE MUNSON HEALTHCARE GRAYLING BYLAWS WERE AMENDED TO CHANGE THE SIZE OF THE BOARD. WITH THE BYLAWS CHANGE, THE BOARD WILL BE 10-20 ELECTED DIRECTORS PLUS UP TO 10 APPOINTED EX OFFICIO DIRECTORS, FOR A TOTAL OF 20-30 DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 6 MUNSON HEALTHCARE GRAYLING IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE TRUSTEES FOR ALL SUBSIDIARY ENTITIES, INCLUDING MUNSON HEALTHCARE GRAYLING. EFFECTIVE 1/1/2022, THE BOARD OF TRUSTEES OF MUNSON HEALTHCARE GRYALING CONSISTS OF THOSE INDIVIDUALS THAT ARE ELECTED OR APPOINTED TO SERVE AS THE DIRECTORS OF MUNSON HEALTHCARE. NOMINATIONS TO MUNSON HEALTHCARE ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON HEALTHCARE GRAYLING (GRY) TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF GRY; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF GRY; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF GRY; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR GRY; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY GRY WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF GRY WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF GRY; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY GRY; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE GRAYLING BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE GRAYLING BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE EXECUTIVE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE EXECUTIVE COMPENSATION PROCESS AND THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE FINANCE AND AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF EXECUTIVE COMPENSATION AND FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER. FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED THROUGH THE FOLLOWING PROCESS: FIRST, AN INDEPENDENT FIRM IS ENGAGED TO PROVIDE COMPARABILITY DATA. THEN, THAT DATA IS REVIEWED BY TWO MUNSON HEALTHCARE COMMITTEES, EACH OF WHICH ARE COMPRISED OF INDIVIDUALS WHO ARE NOT EMPLOYEES OR OTHERWISE INSIDERS (DEFINED AS BOARD MEMBERS, PHYSICIANS & EXECUTIVES) OF THE ORGANIZATION. FIRST, THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE EVALUATES THE DATA AND DETERMINES A RECOMMENDED COMPENSATION MODEL BASED ON THE COMPARABILITY DATA. NEXT, THE BOARD CONFLICT, VALUATION AND COMPLIANCE COMMITTEE REVIEWS THE RECOMMENDATIONS AS COMPARED TO THE COMPARABILITY DATA. THIS COMMITTEE'S ROLE IS TO DETERMINE WHETHER THE PROPOSED COMPENSATION IS CONSISTENT WITH FAIR MARKET VALUE. IF PHYSICIANS ARE INCLUDED IN THE DEFINITION OF KEY EMPLOYEE, THE BOARD CONFLICT, VALUATION, AND COMPLIANCE COMMITTEE REVIEWS ALL FINANCIAL RELATIONSHIPS WITH PHYSICIANS AND COMPARES THE PROPOSED FINANCIAL ARRANGEMENT WITH COMPARABILITY DATA PRODUCED BY AN OUTSIDE, INDEPENDENT FIRM. PHYSICIAN COMPENSATION DOES NOT GO TO THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMPARABILITY DATA AS WELL AS THE MINUTES OF EACH OF THESE COMMITTEE MEETINGS ARE MAINTAINED FOR FUTURE REFERENCE. THE MHC BOARD APPROVES THE MHC CEO'S COMPENSATION. THE MHC BOARD HAS DELEGATED TO THE CVC COMMITTEE THE AUTHORITY TO REVIEW AND APPROVE COMPENSATION ARRANGEMENTS WITH INSIDERS. FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES OF MUNSON HEALTHCARE GRAYLING AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE GRAYLING ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE GRAYLING DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. FORM 990, PART IX, LINE 11G PURCHASED SERVICES 11,618,232 9,621,831 117,923 PROFESSIONAL FEES 4,905,920 6,147 0 TOTAL 16,524,152 9,627,978 117,923 FORM 990, PART XI, LINE 9 CHANGE IN INVESTEMENT IN MUNSON HEALTHCARE FOUNDAT 44,499 MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 HEALTHCARE MI C3 12B N/A false MUNSON HEALTHCARE FOUNDATIONS 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE true MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true MUNSON HOME SERVICES 1105 SIXTH ST TRAVERSE CITY MI 49684 382543463 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 12B MUNSON HC MUNSON HEALTHCARE true PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI C3 10 MUNSON MED MUNSON MEDICAL CENTER true MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CADILLAC 1105 SIXTH ST TRAVERSE CITY MI 49684 471156297 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CHARLEVOIX HOSPIT 1105 SIXTH ST TRAVERSE CITY MI 49684 381459366 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE MANISTEE HOSPITAL 1465 E PARKDALE AVE MANISTEE MI 496609709 380350304 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE OTSEGO MEMORIAL H 825 N CENTER AVE GAYLORD MI 497351592 381303843 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A true SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true MEDICAL OFFICE CONDOMINIUM ASSOCIAT PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true false false true false false false false false false false false false true false true true true true true MUNSON HEALTHCARE M 9260976 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE O 2239252 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE P 7784829 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE Q 302788 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC P 50673 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC Q 60134 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS C 81229 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS M 117923 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H M 77665 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H P 60452 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER M 411957 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER O 29221199 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER P 14637789 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER Q 11018933 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP O 218018 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALIANCE M 556561 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALIANCE P 2329447 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALLIANCE S 238749 ACTUAL AMOUNTS PAID SCHEDULE R MUNSON HEALTHCARE GRAYLING USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.