2023-05-15T10:00:03-04:00 2022-06-30 990 2021-07-01 471156297 MUNSON HEALTHCARE CADILLAC 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 PETER MARINOFF 1105 SIXTH STREET TRAVERSE CITY MI 49684 142326638 false X WWW.MUNSONHEALTHCARE.ORG X 2014 MI MUNSON HEALTHCARE CADILLAC AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. 24 22 847 24 48000 2476469 6760488 121278846 125859148 92976 5322 53075 411763 123901366 133036721 73292 63500 0 47420796 51430046 0 137528 62554803 68506083 110048891 119999629 13852475 13037092 113351457 79589718 46875945 39019042 66475512 40570676 MUNSON HEALTHCARE CADILLAC AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. false false 104952399 63500 125640049 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF CADILLAC, MICHIGAN AND THE SURROUNDING AREA WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE CADILLAC HAD 2,606 INPATIENT ADMISSIONS IN FISCAL YEAR 2022 AND OVER 149,000 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 5,200 SURGICAL CASES, 340 OBSTETRICAL BIRTHS, AND OVER 23,200 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE CADILLAC ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS APPROXIMATELY 95 ACTIVE MEDICAL STAFF AND 24 VOLUNTEERS. INCLUDED IN PROGRAM SERVICE EXPENSES ARE 641,000 OF COVID-19 EXPENSES FOR PATIENT CARE AND OTHER RELATED EXPENSES. 104952399 true true false true false false false false false false true true false false true false false true false false false false false false false false true true true false true true false false false false false false false false true true false false false false false true false false false true 57 0 true 847 true true true 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 KENT BOWDEN DO PHYSICIAN 40.00 X 726068 0 49556 DAVID HOBBS MD PHYSICIAN 40.00 X 735925 0 39364 LAURA GLENN PRESIDENT AM 2.00 40.00 X 0 607688 85269 TONYA SMITH DIRECTOR 1.00 40.00 X 0 529801 82494 PAUL BIZZIGOTTI MD ORTHOPEDIC S 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ASSSOCIATION FOR RESPIRATORY CARE. 1040000 1040000 22402235 5417435 16984800 63816 25881 37935 21023112 14238801 6784311 2369998 372178 1997820 26844866 INVESTMENT IN MUNSON HEALTHCARE FOUN 12750750 F 12750750 ESTIMATED THIRD PARTY SETTLEMENTS 8087815 RESERVE FOR THIRD PARTY SETTLEMENTS 2211517 LT OPERATING LEASE LIABILITY 1743080 ST OPERATING LEASE LIABILITY 351877 CAPITAL LEASE 113417 12507706 true true X true X true X true true false true true 363443 363443 0.00310 19232559 17818326 1414233 0.01220 19596002 17818326 1777676 0.01530 164537 1976 162561 0.00140 76424 8446 67978 0.00060 16906734 13391214 3515520 0.03020 54176 17124 37052 0.00030 17201871 13418760 3783111 0.03250 36797873 31237086 5560787 0.04780 2940 2940 428 428 12387 12387 0.00010 15755 15755 0.00010 true 3621638 1526128 23752318 22576916 1175402 X true true 1 1 MUNSON HEALTHCARE CADILLAC 400 HOBART ST CADILLAC MI 49601 WWW.MUNSONHEALTHCARE.ORG 1060000041 X X X MUNSON HEALTHCARE CADILLAC 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 CADILLAC - PART V, LINE 3E YES, THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND WERE IDENTIFIED THROUGH THE CHNA. FACILITY 1, MUNSON HEALTHCARE CADILLAC - 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 CADILLAC - 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 CADILLAC - 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 CADILLAC - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE CADILLAC - 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 CADILLAC - 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 CADILLAC - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE CADILLAC - 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 CADILLAC - PART V, LINE 20E MUNSON HEALTHCARE CADILLAC (CADILLAC) 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. CADILLAC 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 CADILLAC; 2.DOCUMENTING THAT CADILLAC 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 CADILLAC'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 CADILLAC DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. CADILLAC 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. 3 CADILLAC SURGICAL CARE 927 S CARMEL ST CADILLAC MI 49601 PHYSICIAN PRACTICE - SURGICAL SERVICES MUNSON HEALTHCARE CADILLAC REHABILI 704 OAK ST CADILLAC MI 49601 REHABILITAITON SERVICE MUNSON HEALTHCARE URGENT CARE 302 HOBART ST CADILLAC MI 49601 URGENT CARE 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 8,904,324. 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 119,999,629. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 3,621,638. THE NET EXPENSE OF 116,377,991 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. SCHEDULE H, PART II MUNSON HEALTHCARE CADILLAC (CADILLAC) BELIEVES COMMUNITY BUILDING ACTIVITIES PROMOTE HEALTH BY SUPPORTING THE UNDERLYING SUPPORT STRUCTURE OF COMMUNITY HEALTH. CADILLAC PROVIDED 15,755 OF COMMUNITY BUILDING ACTIVITIES DURING THE 2022 FISCAL YEAR. THESE DOLLARS SUPPORT PROVIDER RECRUITMENT, AN ESSENTIAL ACTIVITY TO ENSURE ACCESS TO NEEDED SPECIALTIES IN DESIGNATED MEDICALLY UNDERSERVED AREAS IS AVAILABLE. ADDITIONAL ACTIVITIES INCLUDED LEADERSHIP PARTICIPATION ON LOCAL BOARDS AND COMMITTEES AND COMMUNITY SPONSORSHIP OF EVENTS AND ACTIVITIES THAT ALIGN WITH MUNSON HEALTHCARE'S VISION. 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 SUCCESSFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT WERE DENIED. THEN WE APPLIED THAT PERCENTAGE TO THE VALUE OF 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. 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 CADILLAC (CADILLAC HOSPITAL) HAS SERVED THE GREATER WEXFORD COUNTY REGION SINCE 1908, WITH A LONG HISTORY AND HERITAGE OF KEEPING PATIENTS AT THE CENTER OF ALL WE DO. LOCATED WITHIN THE CITY OF CADILLAC, IT IS THE ONLY CITY IN THE NATION WITH TWO LOVELY LAKES WITHIN ITS CITY LIMITS LAKE MITCHELL AND LAKE CADILLAC. SHIFTING WINDS ACROSS NEARBY LAKE MICHIGAN KEEP CADILLAC WINTERS SNOW COVERED AND THE SUMMERS COMFORTABLE. LOCATED 50 MILES SOUTH OF TRAVERSE CITY, CADILLAC HOSPITAL IS ONE OF EIGHT COMMUNITY HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM, NORTHERN MICHIGANS LEADING AND LARGEST HEALTH CARE PROVIDER. CADILLAC HOSPITAL HAS 95 ACTIVE MEDICAL STAFF AND IS ONE OF THE LARGEST EMPLOYERS IN THE SURROUNDING AREA. OUR SERVICE AREA COVERING LAKE, MISSAUKEE, OSCEOLA, AND WEXFORD COUNTIES COVERS A TOTAL OF ABOUT 2,300 SQUARE MILES OF LAND. THE REGION IS CLASSIFIED AS RURAL BY THE US CENSUS BUREAU. IN GENERAL, RURAL LOCATIONS EXPERIENCE SIGNIFICANT HEALTH DISPARITIES, SUCH AS HIGHER INCIDENCE OF DISEASE AND DISABILITY, INCREASED MORTALITY RATES AND LOWER LIFE EXPECTANCY. RURAL RESIDENTS ARE MORE LIKELY TO HAVE A NUMBER OF CHRONIC CONDITIONS AND ARE LESS LIKELY TO RECEIVE RECOMMENDED PREVENTIVE SERVICES, IN PART DUE TO LACK OF ACCESS TO PHYSICIANS AND HEALTH CARE DELIVERY SITES AND/OR ADEQUATE TRANSPORTATION OPTIONS. CADILLAC HOSPITAL IS PROUD TO OFFER HIGH QUALITY HEALTHCARE SERVICES AND COMMUNITY HEALTH INTERVENTIONS AIMED AT REDUCING THESE DISPARITIES. HOSPITAL SERVICES THIS 49-BED HOSPITAL OFFERS A WIDE RANGE OF SERVICES INCLUDING: COMPREHENSIVE RADIOLOGY SERVICES WITH CT, MRI, CT, ULTRASOUND, MAMMOGRAPHY, AND X-RAY OUTPATIENT LABORATORY SERVICES COMPREHENSIVE REHABILITATION SERVICES, INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH AND HEARING, AND WOUND THERAPY PROGRAMS 24-HOUR EMERGENCY CARE, ACUTE CARE, URGENT CARE AND WALK-IN SERVICES WOMENS HEALTH SLEEP DISORDERS SPECIALTIES, INCLUDING ORTHOPEDICS, UROLOGY, OPHTHALMOLOGY, EAR NOSE AND THROAT, CARDIOLOGY, CANCER SERVICES AND MORE CARDIAC AND PULMONARY REHABILITATION PRIMARY CARE LONG-TERM CARE AND SKILLED REHABILITATION DIALYSIS MATERNITY CARE GENERAL, ORTHOPEDIC, OUTPATIENT AND HAND SURGERY THE HOSPITAL SERVED MORE THAN 5,200 SURGICAL CASES, OVER 149,000 OUTPATIENT VISITS, 2,606 INPATIENT ADMISSIONS, OVER 23,200 EMERGENCY ROOM VISITS, AND 340 BIRTHS IN FISCAL YEAR 2022. POPULATION SERVED CADILLAC HOSPITAL IS LOCATED IN CADILLAC, MICHIGAN AND SITUATED IN WEXFORD COUNTY. WEXFORD, MISSAUKEE, AND PARTS OF LAKE AND OSCEOLA COUNTIES ARE CONSIDERED THE HOSPITALS PRIMARY SERVICE AREA. WITHIN THE HOSPITALS PRIMARY SERVICE AREA, THE FOLLOWING DEMOGRAPHIC INFORMATION APPLIES: OF THE 84,000 PEOPLE WHO LIVE IN THE FOUR-COUNTY REGION, 95% ARE WHITE. THE LARGEST MINORITIES ARE AFRICAN AMERICAN (2%), HISPANIC/LATINO (2%) AND NATIVE AMERICAN (1%) THE PROPORTION OF ADULTS OVER 65 YEARS OLD IS LARGER IN WEXFORD COUNTY IS 30% A LARGER PERCENTAGE OF THE POPULATION OF MICHIGAN HAVE A COLLEGE DEGREE (29%) THAN IN IN THE FOUR-COUNTY REGION, WHERE COLLEGE ATTAINMENT IS BETWEEN 14% (OSCEOLA) AND 18% (WEXFORD) THE PROPORTION OF THE POPULATION WITH A HIGH SCHOOL DIPLOMA IS ABOUT THE SAME IN THESE FOUR COUNTIES AS IT IS FOR MICHIGAN OVERALL, AROUND 90% AMONG THESE FOUR COUNTIES, MEDIAN HOUSEHOLD INCOME IS HIGHEST IN WEXFORD COUNTY AT 54,114 THE PERCENT OF UNINSURED INDIVIDUALS IS 6.88% QUALITY THE HOSPITAL WAS NAMED A 2021 TOP 20 RURAL & COMMUNITY HOSPITALS BY THE CHARTIS CENTER FOR RURAL HEALTH. REGARDED AS ONE OF THE INDUSTRYS MOST SIGNIFICANT DESIGNATIONS OF PERFORMANCE EXCELLENCE, THE ANNUAL TOP 100 RURAL & COMMUNITY HOSPITALS AWARD IS BASED UPON THE RESULTS OF THE HOSPITAL STRENGTH INDEX FROM IVANTAGE HEALTH ANALYTICS. THE HOSPITAL STRENGTH INDEX IS THE INDUSTRY'S MOST COMPREHENSIVE AND OBJECTIVE ASSESSMENT OF RURAL HOSPITAL PERFORMANCE IN THE UNITED STATES. RURAL HOSPITALS ARE CHOSEN BASED ON SCORES OF PERFORMANCE IN 50 RURAL-RELEVANT INDICATORS. ADDITIONAL RECOGNITIONS INCLUDE: CADILLAC HOSPITAL IS KNOWN FOR HIGH QUALITY CARE BASED ON RATINGS FROM OUTSIDE AGENCIES, INCLUDING AN A PATIENT SAFETY RATING FROM THE LEAPFROG GROUP FOR FALL 2021. CADILLAC HOSPITAL HAS RECEIVED A 5-STAR CMS RATING FOR OVERALL HOSPITAL QUALITY CADILLAC 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. SCHEDULE H, PART VI, LINE 5 MUNSON HEALTHCARE CADILLAC'S 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. THE HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT THE 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. IN ADDITION, THE HOSPITAL CONTINUES TO INVEST IN PUBLIC HEALTH PROGRAMING AND INITIATIVES, SUCH AS: HEALTHY FUTURES: FOR OVER 20 YEARS, HEALTHY FUTURES A PARTNERSHIP OF MUNSON HEALTHCARE AND LOCAL HEALTH DEPARTMENTS HAS HELPED PARENTS AND BABIES HAVE A HEALTHY START. THIS INCLUDES A POSTPARTUM HOME VISITING PROGRAM, 1:1 BREASTFEEDING ASSISTANCE, INFANT SLEEP AND IMMUNIZATION EDUCATION AND AGE-APPROPRIATE NEWSLETTERS. HEALTHY FUTURES ENROLLS OVER 1,300 FAMILIES ANNUALLY. INVESTMENTS IN BEHAVIORAL HEALTH ACCESS, INCLUDING RECRUITMENT EFFORTS, INITIATION OF TELEMEDICINE, AND PARTNERSHIPS WITH PINE REST AND OTHER PROVIDERS. SUBSTANCE USE DISORDER TREATMENT AND PREVENTION, INCLUDING THE INITIATION OF A STANDARD PROTOCOL TO EXTEND BEST PRACTICE TREATMENT FOR SUBSTANCE USE DISORDERS ACROSS THE SERVICE AREA, INCLUDING IN PRIMARY CARE, EMERGENCY, AND MATERNAL AND CHILD SETTINGS. IMPLEMENTATION OF SCREENING TOOLS THAT ALLOW FOR SELF-DISCLOSURE OF SUBSTANCES USED DURING PREGNANCY TO CONNECT MOMS WITH EARLY TREATMENT. EXPANSION OF HARM REDUCTION EFFORTS, INCLUDING WITH NARCAN, MEDSAFE RECEPTACLES AND HIV TESTING. PROGRAMS AIMED AT THE REDUCTION AND MANAGEMENT OF CHRONIC DISEASE HAVE ALSO BEEN PRIORITIZED. THESE INCLUDE TOBACCO CESSATION, DIABETES EDUCATION, CULINARY MEDICINE, AND THE FRUIT AND VEGETABLE PRESCRIPTION PROGRAM. CULINARY MEDICINE TEACHES BOTH COOKING AND ENHANCED NUTRITION COUNSELING SKILLS TO HEALTHCARE PROVIDERS, ENABLING THEM TO COUNSEL THEIR PATIENTS MORE CONFIDENTLY AND EFFECTIVELY ON HEALTHY EATING PRACTICES. THE FRUIT AND VEGETABLE PRESCRIPTION PROGRAM OFFERS NUTRITIONAL EDUCATION AND FOOD TASTING, FARMERS MARKET TOKENS OR GROCERY CERTIFICATES TO PURCHASE FRESH FRUITS AND VEGETABLES CREATING HEALTHY HABITS FOR LONG TERM HEALTH. PROGRAMS AIMED AT CONNECTING PATIENTS WITH SOCIAL DETERMINANT OF HEALTH CHALLENGES TO RESOURCES THAT CAN HELP THROUGH THE COMMUNITY CONNECTIONS SCREENING AND REFERRAL PROCESS. IN ADDITION, THE CADILLAC HOSPITAL OPERATES THE FOLLOWING: SENIOR FIT: IN COLLABORATION WITH THE CADILLAC AREA YMCA, THE HOSPITAL OFFERS AN EVIDENCE-BASED MODEL DESIGNED TO IMPROVE THE OVERALL HEALTH OF SENIORS WHILE PROVIDING AN UNDERSTANDING OF HOW TO EXERCISE IN A SAFE AND EFFECTIVE MANNER. THIS PROGRAM HAS HAD POSITIVE CLINICAL OUTCOMES AND CONTINUES TO ENJOY MUCH SUCCESS WITH THE AVERAGE CLASS SIZE OF 70-80 PARTICIPANTS PARTICIPATING IN FOUR CLASSES TWICE A WEEK. STEHOUWER FREE CLINIC: MUNSON CADILLAC HOSPITAL IS AN IMPORTANT FUNDING SOURCE FOR THE CLINIC AND IS COMMITTED TO SERVING THOSE IN THE COMMUNITY THAT HAVE LIMITED OR NO ACCESS TO CARE OTHERWISE. IN ADDITION TO AN ANNUAL DONATION, THE HOSPITAL PROVIDES IN-KIND SUPPORT TO THE CLINIC IN THE WAY OF IMAGING AND LAB SERVICES AND SELECT MEDICATIONS AT NO CHARGE. MUNSON CADILLAC HOSPITAL FUNDS THE MEDICATION ACCESS PROGRAM, WHICH PROVIDES FREE PRESCRIPTION MEDICATIONS TO THOSE WHO ARE UNINSURED OR UNDERINSURED. SCHEDULE H, PART VI, LINE 6 MUNSON HEALTHCARE CADILLAC'S 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 true STEHOUWER FREE CLINIC 201 N MITCHELL ST STE L-1 CADILLAC MI 49601 611401888 501(C) 20000 MEDICALLY UNDERSERVE CADILLAC AREA YMCA 9845 CAMPUS DRIVE CADILLAC MI 49601 300013507 501(C) 7500 SENIOR/YOUTH FIT PRO WEXFORD PHO 117 N MITCHELL STREET SUITE 6 CADILLAC MI 49601 383100681 36000 MEDICATION ACCESS PR 2 1 SCHEDULE I, PAGE 1, PART I, LINE 2 MUNSON HEALTHCARE CADILLAC MAY AWARD A GRANT OR CONTRIBUTION TO ANOTHER TAX EXEMPT ORGANIZATION BASED ON AN EVALUATION OF THE USE OF THE FUNDS FOR THE PROMOTION OF HEALTH IN THE COMMUNITY. THE ONGOING RELATIONSHIP OF MUNSON HEALTHCARE CADILLAC WITH ITS PARTNERS IN THE COMMUNITY FOR THE PROMOTION OF HEALTH ALLOWS FOR THE MONITORING OF THE GRANT AWARD. X true true false true false false false false false true false EDWIN A NESS DIRECTOR 883584 280959 28690 190789 32369 1416391 KENT BOWDEN DO PHYSICIAN 553724 151831 20513 14529 35027 775624 DAVID HOBBS MD PHYSICIAN 539694 175718 20513 14529 24835 775289 LAURA GLENN PRESIDENT AMB SERVIC 462670 124952 20066 63530 21739 692957 TONYA SMITH DIRECTOR 409775 118506 1520 56121 26373 612295 PAUL BIZZIGOTTI MD ORTHOPEDIC SURGEON 466576 84877 6841 14529 19419 592242 LYNNE MCCORMICK DO PHYSICIAN 477639 17639 45000 12413 664 14529 19725 533 569306 18836 MARK HEPLER FORMER CFO 227786 109926 191072 11390 6919 547093 85313 TIMOTHY ISERI MD PHYSICIAN 412398 72773 1804 14529 23744 525248 ALICIA MAITLAND CFO 311916 46733 10173 46343 21608 436773 CASEY KANDOW VP ANCILLARY SERVICE 309195 46512 319 33286 22637 411949 PETER MARINOFF PRESIDENT 233012 78336 6966 35862 22185 376361 ELLEN SMITH COO PHYSICIAN NTWRK 274087 54320 1306 29033 2661 361407 KATHRYN BANDFIELD-KEOUGH VP PATIENT CARE SERV 177109 32617 8787 19120 20033 257666 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 ALICIA MAITLAND 0 32,080 0 CASEY KANDOW 0 18,912 0 PETER MARINOFF 0 23,915 0 ELLEN SMITH 0 16,524 0 KATHRYN BANDFIELD-KEOUGH 0 11,364 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 2014C 386004832 386523EH3 2014-12-17 16210267 PURCHASE THE ASSETS OF CADILLAC HOSPITAL false false false A 16210461 208029 16002432 2015 false false true true A false true true false false 0.00780 0.00780 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 2014C INVESTMENT INCOME EARNED PURPOSE OF ISSUE DESCRIPTION CNTY GRD TRAV HOSP FIN AUTH 2014C PURCHASE THE ASSETS OF CADILLAC HOSPITAL ADDITIONAL INFORMATION CNTY GRD TRAV HOSP FIN AUTH 2014C 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. PART III, QUESTION 3B AND D MUNSON HEALTHCARE CADILLAC 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. JENNIFER PIWOWARSKI SEE PART V 332626 COMPENSATION PAID false SCHEDULE L, PART V PART IV, LINE 1 JENNIFER PIWOWARSKI IS A FAMILY MEMBER OF BOARD MEMBER NATHAN PIWOWARSKI. FORM 990, PAGE 6, PART VI, LINE 4 EFFECTIVE 1/1/2022, THE MUNSON HEALTHCARE CADILLAC 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 CADILLAC 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, MUNSON HEALTHCARE CADILLAC. EFFECTIVE 1/1/2022, THE BOARD OF TRUSTEES OF MUNSON HEALTHCARE CADILLAC 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 CADILLAC (CAD) 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 CAD; 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 CAD; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF CAD; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR CAD; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY CAD 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 CAD 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 CAD; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY CAD; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE CADILLAC HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE CADILLAC HOSPITAL 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 COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES 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 CADILLAC AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE CADILLAC ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE CADILLAC 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 12,954,748 11,124,769 137,528 PROFESSIONAL FEES 3,920,379 438,801 0 TOTAL 16,875,127 11,563,570 137,528 FORM 990, PART XI, LINE 9 CHANGE IN INVESTEMENT IN MUNSON HEALTHCARE FOUNDAT -2,837,404 EQUITY TSF TO PARENT -36,000,000 TOTAL -38,837,404 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 HEALTHCARE GRAYLING 1105 SIXTH ST TRAVERSE CITY MI 49684 471161992 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 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 INC 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 ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true false true true false false false false false false false false true true false true true true true true MUNSON HEALTHCARE M 10818012 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE Q 965934 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE O 2176667 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE P 9079808 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE B 36000000 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS C 1251060 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS M 137528 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE GRAYLING P 60134 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE GRAYLING Q 50673 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE MANISTEE HOSPITAL M 196505 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE MANISTEE HOSPITAL O 153727 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE MANISTEE HOSPITAL L 308244 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER M 473196 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER P 19630618 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER Q 15333462 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER O 32048355 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP O 378427 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE M 649201 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 3730486 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE S 328424 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H Q 153761 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H P 51755 ACTUAL AMOUNTS PAID SCHEDULE R MUNSON HEALTHCARE CADILLAC 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.