2023-05-15T09:52:45-04:00 2022-06-30 990 2021-07-01 381303843 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL MUNS 9877312100 825 N CENTER AVE GAYLORD MI 49735 PAUL KONOPACKI CFO 9877312100 2023-05-15 PAUL KONOPACKI 999009999 2021 2023-04-26 12:10:37Z CHRISTOPHER SQUIRE 825 N CENTER GAYLORD MI 49735 140900099 false X WWW.MUNSONHEALTHCARE.ORG X 1946 MI TO PROVIDE EXCEPTIONAL HEALTHCARE THAT MEETS THE NEEDS OF OUR PATIENTS AND THE COMMUNITIES WE SERVE. 24 22 898 22 0 2686846 6140044 111900959 115992369 2951494 1753074 446909 556934 117986208 124442421 0 0 59614454 59952072 0 146734 47661046 56714683 107275500 116666755 10710708 7775666 125430745 101925172 45304419 29562015 80126326 72363157 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. false false 102417395 116221174 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF GAYLORD, MICHIGAN AND THE SURROUNDING AREA WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL HAD 1,581 INPATIENT ADMISSIONS IN FISCAL YEAR 2022 AND OVER 109,000 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 2,700 SURGICAL CASES, 353 OBSTETRICAL BIRTHS, AND OVER 18,900 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS APPROXIMATELY 59 ACTIVE MEDICAL STAFF AND 22 VOLUNTEERS. INCLUDED IN PROGRAM SERVICE EXPENSES ARE 712,000 OF COVID-19 EXPENSES FOR PATIENT CAREAND OTHER RELATED EXPENSES. 102417395 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 false false false false false false false true true true false false true 50 0 true 898 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 2319357792 4230 COPPER RIDGE DR TRAVERSE CITY MI 49684 EDWIN A NESS DIRECTOR 1.00 40.00 X 0 1193233 223158 JAMES SHURLOW DO SURGEON 40.00 X 850339 0 33805 CHANGXIN LI MD PHYSICIAN 40.00 X 749470 0 29829 JOHN MOFFAT MD SURGEON 40.00 X 695651 0 36756 LAURA GLENN PRESIDENT AM 2.00 40.00 X 0 607688 85269 JANELLE HENDRIAN DO ANESTHESIOLO 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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 OTSEGO MEMORIAL H - 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 OTSEGO MEMORIAL H - 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 OTSEGO MEMORIAL H - 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 OTSEGO MEMORIAL HOSPITAL - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - 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 OTSEGO MEMORIAL H - 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 SOLD DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - 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 OTSEGO MEMORIAL H - PART V, LINE 20E MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL 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. MUNSON 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 MUNSON 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. THE METHOD IN WHICH MUNSON DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. MUNSON 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. 4 MEDCARE CLINIC 1996 WALDEN DRIVE GAYLORD MI 49735 URGENT CARE ORTHOPEDICS CLINIC 2147 PROFESSIONAL DRIVE GAYLORD MI 49735 ORTHOPEDICS AND REHABILITATION MCREYNOLDS HALL 825 N CENTER AVENUE GAYLORD MI 49735 LONG-TERM CARE CANCER & INFUSION CENTER 701 N OTSEGO AVENUE GAYLORD MI 49735 IV THERAPY SCHEDULE H, PART I, LINE 3C UNDER IT'S ASSISTANCE PROGRAM MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO) WILL MAKE AVAILABLE A REASONABLE AMOUNT OF UNCOMPENSATED OR REDUCED PRICE SERVICES TO PERSONS ELIGIBLE UNDER APPLICABLE GUIDELINES. OTSEGO ASSISTANCE PROGRAM SERVICES ARE NOT LIMITED TO ANY SPECIFIC HOSPITAL SERVICE. INDIVIDUAL ELIGIBILITY FOR ASSISTANCE IS DETERMINED BY MEASURING FAMILY INCOME IN RELATION TO FAMILY SIZE AGAINST THE INCOME POVERTY GUIDELINE ESTABLISHED BY THE COMMUNITY SERVICE ADMINISTRATION. IF THE HOSPITAL DETERMINES THAT SERVICES ARE ELECTIVE OR OTHERWISE NOT MEDICALLY NECESSARY, THE HOSPITAL CAN DENY SERVICES UNDER THE FINANCIAL ASSISTANCE PROGRAM. ASSETS ARE NOT CONSIDERED AS PART OF EVALUATION FOR ASSISTANCE AS REQUIRED UNDER THE NATIONAL HEALTH SERVICE CORP. AGREEMENT FOR WHICH OTSEGO PARTICIPATES. SCHEDULE H, PART I, LINE 7, COLUMN (F) TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 116,666,755. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 3,889,550. THE NET EXPENSE OF 112,777,205 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 OTSEGO MEMORIAL HOSPITAL (OTSEGO HOSPITAL) PROVIDED 10,969 OF COMMUNITY BUILDING ACTIVITIES DURING THE 2022 FISCAL YEAR. OTSEGO HOSPITAL PROVIDED A MENU REVIEW FOR PRESQUE ISLE JAIL. OTSEGO HOSPITAL GAVE PATIENTS ASSISTANCE TO ENROLL IN PUBLIC MEDICAL HEALTH PROGRAMS AND PROVIDED TRANSPORTATION. THE MEDSAFE PROGRAM WAS CONTINUED IN OTSEGO, AS WAS THE PRECEPTORSHIP PROGRAM FOR GRAND VALLEY DIETETICS STUDENTS. ADVANCED DIRECTIVE BROCHURES CONTINUE TO BE DISTRIBUTED 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 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 UNDER ACCOUNTS RECEIVABLE. SCHEDULE H, PART III, LINE 8 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL CONSIDERS THE ENTIRE MEDICARE SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. THAT AMOUNT IS 314,410. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. SCHEDULE H, PART III, LINE 9B ALL PATIENTS RECEIVING TREATMENT AT MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ARE RESPONSIBLE FOR PAYING IN FULL ALL CHARGES FOR SUCH TREATMENT, LESS ANY AMOUNTS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, DISCOUNT CONSIDERATIONS OR INSURANCE COVERAGE, PER POINT OF SERVICE COLLECTION POLICY. MUNSON HEALTHCARES 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 PATIENTS GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENTS 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 HOSPITALS 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.OMH PATIENT ACCESS SERVICES (PAS) EDUCATOR/COORDINATOR OR THE FINANCIAL ASSISTANCE SPECIALIST ATTEMPTS TO SEE THE PATIENTS IN ER OR IP. PAS STAFF HAS ALSO BEEN TRAINED TO HAND OUT ASSISTANCE PACKAGES AND TO DIRECT PATIENTS TO SEE THE FINANCIAL ASSISTANCE SPECIALIST/FINANCIAL ADVISOR. WHEN THE PATIENT COMES IN ON THE WORK LIST THEY ARE ALSO INFORMED OF ASSISTANCE PACKAGE AND/OR APPLICATION. THE FORM IS ON THE OMH WEBSITE. WHEN THERE IS A SCHEDULED PROCEDURE AND THE PATIENT DOES NOT HAVE INSURANCE, A CALL IS MADE FOR PAYMENT, FINANCIAL ASSISTANCE APPOINTMENT AND/OR CHARITY ARRANGEMENTS. PATIENTS IDENTIFIED WITHOUT INSURANCE OR NEEDING FINANCIAL EDUCATION, ARE SCHEDULED FOR AN APPOINTMENT WITH THE FINANCIAL ASSISTANCE SPECIALIST. THE FINANCIAL ASSISTANCE SPECIALIST HELPS PATIENTS TO APPLY FOR MEDICAID, INSURANCE EXCHANGE PLANS, OTHER PROGRAMS OR FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE SPECIALIST HELPS PATIENTS APPLY FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 DESCRIPTION MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO HOSPITAL) IS LOCATED IN GAYLORD, MI AND SERVES THE COUNTIES OF CHEBOYGAN, OTSEGO, MONTMORENCY AND ANTRIM. ALL FOUR COUNTIES SERVED BY OTSEGO HOSPITAL ARE EXTREMELY RURAL. THE ORGANIZATION HAS AN ACTIVE MEDICAL STAFF (PRIMARY FACILITY) OF 59 AND IS ONE OF THE LARGEST EMPLOYERS IN THE REGION. HOSPITAL SERVICES OTSEGO HOSPITAL PROVIDES IT'S RESIDENCE WITH ACUTE INPATIENT STAYS (INCLUDING MEDICAL, INTENSIVE CARE AND OBSTETRICS), 4 SURGICAL SUITES THAT PERFORM BOTH IN AND OUT-PATIENT SERVICES (GENERAL, ORTHOPEDIC AND GASTROINTESTINAL), LABORATORY, DIAGNOSTIC RADIOLOGY SERVICES (GENERAL, ULTRASOUND, NUCLEAR MEDICINE, MAMMOGRAPHY, PET, CT AND MRI), RESPIRATORY THERAPY, THERAPIES, INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH AND WOUND CARE. EMERGENCY ROOM SERVICES OPEN 24 HOURS A DAY 365 DAYS A YEAR. OTSEGO HOSPITAL ALSO PROVIDES A LONG-TERM CARE STAY FACILITY (INCLUDING SKILLED AND NON-SKILLED CARE). CARDIAC REHAB AND PREVENTION SERVICES ARE ALSO OFFERED AT OTSEGO HOSPITAL. IN ADDITION, OTSEGO HOSPITAL OFFERS MANY OUTPATIENT SERVICES CLINICS INCLUDING URGENT CARE, GYNECOLOGIC AND OBSTETRICS, INTERNAL MEDICINE, UROLOGY, ORTHOPEDICS, SURGICAL CARE, ONCOLOGY, PEDIATRICS AND FAMILY PRACTICES. THE HOSPITAL SERVED OVER 2,700 SURGICAL CASES, OVER 109,000 OUTPATIENT VISITS, OVER 18,900 EMERGENCY ROOM VISITS, 1,581 INPATIENT ADMISSIONS AND 353 BIRTHS IN FISCAL YEAR 2022. POPULATION SERVED IN OTSEGO 94% OF RESIDENTS ARE NON-HISPANIC WHITE AND 95% IN ANTRIM COUNTY, 91.5% IN CHEBOYGAN COUNTY AND 94.9% IN MONTMORENCY COUNTY. HISPANICS REPRESENT THE LARGEST MINORITY GROUP IN OTSEGO (1.9%), MONTMORENCY (1.6%), AND ANTRIM (2.4%) COUNTIES WHILE NATIVE AMERICANS REPRESENT THE LARGEST MINORITY GROUP IN CHEBOYGAN COUNTY WITH 3,1%. AT 21.8%, OLDER ADULTS REPRESENT A LARGER PROPORTION OF THE POPULATION IN OTSEGO COUNTY THAN THEY DO STATEWIDE (18.1%), 28% PERCENT OF CHEBOYGAN COUNTY AND ANTRIM COUNTY'S POPULATION IS AGE 65 AND OLDER AND IN MONTMORENCY COUNTY, THEY REPRESENT AN EVEN LARGER SHARE AT 33.5%. (SOURCE: CENSUS BUREAU QUICKFACTS). OTSEGO HOSPITAL SERVES A VERY RURAL AGING POPULATION. QUALITY OTSEGO HOSPITAL HAS A FIVE-STAR RATING FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL IS AT THE FOREFRONT OF MEDICAL TECHNIQUES, TREATMENTS, AND TECHNOLOGY TO ENSURE A HIGH QUALITY EXPERIENCE FOR ITS PATIENTS INCLUDING ADVANCED BREAST CANCER SCREENINGS WITH 3-D TOMOGRAPHY. SCHEDULE H, PART VI, LINE 5 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL'S (OTSEGO 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. 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. OTSEGO HOSPITAL PROVIDED DISCOUNTED SPORTS PHYSICALS TO AREA STUDENT ATHLETES; OTSEGO HOSPITAL HOSTS MONTHLY WELLNESS WEDNESDAYS, OFFERING CHOLESTEROL, BLOOD PRESSURE, BMI, HEIGHT, WEIGHT AT A DISCOUNTED RATE TO COMMUNITY MEMBERS AND FREE TO ANYONE WHO IS UNABLE TO PAY THE NOMINAL RATE. WELLNESS WEDNESDAYS HAVE ALSO EXPANDED TO OPERATE AS A SAFE NEEDLE DROP OFF FOR AREA RESIDENTS. A NEW MEDSAFE DISPOSAL CONTAINER IS BEING INSTALLED ON THE HOSPITAL CAMPUS TO OFFER AREA RESIDENTS A SAFE AND EASY METHOD TO DISPOSE OF UNUSED OR EXPIRED MEDICATIONS. THE HOSPITAL OFFERS A MAMMOGRAPHY ASSISTANCE PROGRAM, TO ENSURE THAT WOMEN WHO DO NOT QUALIFY FOR A FREE MAMMOGRAM THROUGH THE LOCAL HEALTH DEPARTMENT, YET HAVE NO MEANS TO PAY FOR IT PRIVATELY, ARE COVERED AND RECEIVE A SCREENING AND IF NECESSARY DIAGNOSTIC MAMMOGRAM AND OTHER SERVICES AT NO CHARGE. ADDITIONALLY, THE HOSPITAL OFFERS A DIABETES ASSISTANCE PROGRAM AND AN ONCOLOGY ASSISTANCE PROGRAM DESIGNED TO HELP THOSE DIAGNOSED WITH THOSE DISEASES AND STRUGGLING FINANCIALLY TO RECEIVE THE ASSISTANCE THEY NEED TO ATTEND TREATMENTS AND TEST REGULARLY FOR DIABETES. OTSEGO HOSPITAL CONTINUES TO OFFER THE CDC'S YEAR-LONG DIABETES PREVENTION PROGRAM, WORKING WITH INDIVIDUALS WHO HAVE BEEN DIAGNOSED AS PRE DIABETIC TO REDUCE CALORIE INTAKE, INCREASE EXERCISE, AND UNDERSTAND PORTION CONTROL AMONG OTHERS. THIS PROGRAM HAS SEEN A HIGH SUCCESS RATE OF COMPLETION AND BMI REDUCTION. THE PROGRAM AT OTSEGO HOSPITAL IS ONE OF THE ONLY RECOGNIZED PROGRAMS IN NORTHERN MICHIGAN. OTSEGO HOSPITAL ALSO WORKS CLOSELY WITH THE LOCAL SCHOOLS TO ASSIST THE HIGH SCHOOL LEVEL MEDICAL OCCUPATIONAL PROGRAM IN JOB SHADOWING AND EDUCATION PROGRAM FOR STUDENTS THROUGHOUT THE FACILITY AND SCHOOL YEAR. NEW PARENTS ARE INVITED TO PARTICIPATE IN CHILDBIRTH EDUCATION CLASSES OFFERED BY OTSEGO HOSPITAL STAFF FOR A NOMINAL FEE OR FREE TO THOSE UNABLE TO PAY. ON A BIMONTHLY BASIS, THE HOSPITAL PRODUCES AND DISTRIBUTES TO MORE THAN 47,000 HOUSEHOLDS THROUGHOUT THE SERVICE AREA LITERATURE ON VARIOUS HEALTHCARE ISSUES AND TOPICS, INCLUDING INFORMATION ON LOCAL FREE HEALTH EVENTS. IN THE OFF MONTHS, AN EMAIL NEWSLETTER IS DEPLOYED TO MORE THAN 17,000 RECIPIENTS WITH SIMILAR CONTENT. OTSEGO HOSPITAL HAS NUMEROUS MEDICAL PRACTICES THAT ARE FEDERALLY QUALIFIED RURAL HEALTHCARE CLINICS. ADDITIONALLY, OTSEGO HOSPITAL IS LOCATED WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA. BOTH OF THESE QUALIFICATIONS DEMONSTRATE OTSEGO HOSPITAL'S ISOLATED SERVICE AREA WHICH HAS RESULTED IN CHALLENGING PHYSICIAN RECRUITMENT AND RETENTION. OTSEGO HOSPITAL'S COMMITMENT TO PROVIDING THE HIGHEST LEVEL OF CARE STARTS WITH PHYSICIAN AND OTHER PROVIDERS. EXTENSIVE RECRUITMENT ACTIVITIES MUST TAKE PLACE IN ORDER TO PROVIDE CARE TO THESE HEALTH PROFESSIONAL SHORTAGE AREAS. ADDITIONALLY, OTSEGO HOSPITAL IS WORKING DILIGENTLY TO BRING SERVICES INTO THE RURAL SETTING. THE HOSPITAL APPLIES SURPLUS FUNDS, INCLUDING DONATIONS FROM THE FOUNDATION, TO ASSIST IN PURCHASING EQUIPMENT FOR PATIENT USE AND FUNDING MANY OF THE COMMUNITY HEALTH EDUCATION PROGRAMS LISTED ABOVE. ADDITIONALLY, THE HOSPITAL WORKS TO USE ANY SURPLUS FUNDS TO CONTINUE TO ADVANCE THE MISSION OF THE ORGANIZATION THROUGH GROWTH AND DEVELOPMENT OPPORTUNITIES. SCHEDULE H, PART VI, LINE 6 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITALS 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 JAMES SHURLOW DO SURGEON 744169 86409 19761 11600 22205 884144 CHANGXIN LI MD PHYSICIAN 643678 104494 1298 11600 18229 779299 JOHN MOFFAT MD SURGEON 695605 46 11600 25156 732407 LAURA GLENN PRESIDENT AMB SERVIC 462670 124952 20066 63530 21739 692957 JANELLE HENDRIAN DO ANESTHESIOLOGIST 619905 20084 11599 26056 677644 TONYA SMITH DIRECTOR 409775 118506 1520 56121 26373 612295 MATTHEW MAZUR DO SURGEON 523877 32690 19752 11600 24018 611937 MARK A HEPLER FORMER CFO 227786 109926 191072 11390 6919 547093 85313 ALICIA MAITLAND CFO 311916 46733 10173 46343 21608 436773 CASEY KANDOW VP ANCILLARY SERV 309195 46512 319 33286 22637 411949 PETER HANDLEY FORMER DIRECTOR 328496 19335 11600 25843 385274 ELLEN SMITH COO, PHYSICIAN NTWK 274087 54320 1306 29033 2661 361407 CHRISTOPHER SQUIRE PRESIDENT 143780 100154 29104 107 153 27241 3748 15299 7446 215531 111501 THOMAS LEMON FORMER PRESIDENT 151105 88313 4828 7445 251691 JAMES FLICKEMA VP PAT CARE SERV 178456 27449 962 18308 19711 244886 DAWN HALLECK VP PATIENT CARE SERV 157641 26332 331 16322 23637 224263 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 ELLEN SMITH 0 16,524 0 CHRISTOPHER SQUIRE 0 24,310 0 JAMES FLICKEMA 0 10,987 0 DAWN HALLECK 0 9,796 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 OF MUNSON HEALTHCARE, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE RETIREMENT FUNDS ARE AVAILABLE TO THE PARTICIPANTS UPON THEIR RETIREMENT FROM MUNSON. A CNTY GRD TRAVSE HOSP FIN AUTH 2019B CONSTRUCT RENOVATE PURCHASE BLDG 386004852 386523HQ0 2019-01-16 15191945 CONSTRUCT, RENOVATE, PURCHASE BLDG THE SERIES 2019B BONDS WERE ISSUED TO (1) REFINANCE A TAXABLE LIN false false false A 15275282 175340 11199942 3900000 false true false true A false true true false false 0.01000 0.01000 false false true A false true false false false false false false true A true DIFFERENCES IN ISSUE PRICE EXPLANATION CNTY GRD TRAVSE HOSP FIN AUTH 2019B INVESTMENT INCOME EARNED PURPOSE OF ISSUE DESCRIPTION CNTY GRD TRAVSE HOSP FIN AUTH 2019B CONSTRUCT, RENOVATE, PURCHASE BLDG THE SERIES 2019B BONDS WERE ISSUED TO (1) REFINANCE A TAXABLE LINE OF CREDIT WHICH FINANCED THE ACQUISITION OF A FACILITY USED FOR PHYSICAL AND OCCUPATIONAL THERAPY, AND (2) FINANCE THE CONSTRUCTION, RENOVATION, EXPANSION AND EQUIPPING OF THE HOSPITAL FACILITIES. ADDITIONAL INFORMATION CNTY GRD TRAVSE HOSP FIN AUTH 2019B OBLIGATED GROUP ISSUE RECORDED ON RELATED ORGANIZATIONS ON JANUARY 16, 2019, THE MUNSON HEALTHCARE OBLIGATED GROUP ISSUED COUNTY OF GRAND TRAVERSE HOSPITAL FINANCE AUTHORITY REVENUE BONDS (MUNSON HEALTHCARE OBLIGATED GROUP) SERIES 2019A, 2019B AND 2019C. THE 2019 SERIES A BONDS WERE RECORDED ON MUNSON HEALTHCARE MANISTEE HOSPITAL'S BOOKS AND RECORDS AT A PAR VALUE OF 18,360,000. THE 2019 SERIES B BONDS WERE RECORDED ON MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL'S BOOKS AND RECORDS AT A PAR VALUE OF 14,520,000. THE RELATED BOND PREMIUM WAS RECORDED ON THE RESPECTIVE ENTITIES' BOOKS AND RECORDS. THE 2019C BONDS WERE RECORDED ON MUNSON MEDICAL CENTER'S BOOKS AND RECORDS AT A PAR VALUE OF 22,300,000. PART III, QUESTION 3B AND D MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPTIAL 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 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 CONTRACTS. SINCE NEW BONDS WERE ISSUED IN 2021, OUTSIDE COUNSEL WAS ENGAGED DURING THAT TAX YEAR. FORM 990, PAGE 6, PART VI, LINE 4 EFFECTIVE 1/1/2022, THE MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL 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 OTSEGO MEMORIAL HOSPITAL 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 OTSEGO MEMORIAL HOSPITAL. EFFECTIVE 1/1/2022, THE BOARD OF TRUSTEES OF MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL 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 OTSEGO MEMORIAL HOSPITAL (OMH) 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 OMH; 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 OMH; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF OMH; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR OMH; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY MAN 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 OMH 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 OMH; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY OMH; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE OTSEGO MEMORIAL 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 OTSEGO MEMORIAL HOSPITAL AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE MANISTEE HOSPITAL 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 8,731,337 8,337,156 146,734 PROFESSIONAL FEES 2,740,821 550,804 0 TOTAL 11,472,158 8,887,960 146,734 FORM 990, PART XI, LINE 9 CHANGE IN INVESTMENT IN MUNSON HEALTHCARE FOUND 450,331 INHERENT CONTRIBUTION DEPRECIATION 370,470 EQUITY TSF TO PARENT -9,702,317 TOTAL -8,881,516 MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 PARENT MI C3 12B NA false MUNSON HEALTHCARE CADILLAC 1105 SIXTH ST TRAVERSE CITY MI 49684 471156297 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE GRAYLING 1105 SIXTH ST TRAVERSE CITY MI 49684 471161992 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE true 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 MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 HEALTHCARE MI C3 10 MUNSON MED MUNSON MEDICAL CENTER true NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 12B 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 PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC 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 ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true MEDICAL OFFICE CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 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 true true true false false false false false false false false true true false true true true true true MUNSON HEALTHCARE FOUNDATIONS M 146734 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS C 147888 ACTUAL AMOUNT PAID MUNSON HEALTHCARE B 9702317 ACTUAL AMOUNT PAID MUNSON HEALTHCARE P 10313687 ACTUAL AMOUNT PAID MUNSON HEALTHCARE Q 622027 ACTUAL AMOUNT PAID MUNSON HEALTHCARE M 6958524 ACTUAL AMOUNT PAID MUNSON HEALTHCARE O 1751511 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 1936993 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE S 314811 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE M 692929 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER M 61800 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER Q 12091575 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER P 15878698 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER O 37018001 ACTUAL AMOUNT PAID MUNSON HEALTHCARE MANISTEE HOSPITAL O 103724 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING L 77665 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING Q 60452 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC Q 51755 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC P 153761 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT L 51906 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT Q 69415 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP O 242957 ACTUAL AMOUNT PAID SCHEDULE R MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL 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.