2025-05-14T13:47:48-04:00 2024-06-30 990 2023-07-01 381303843 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL MUNS 9877312100 825 N CENTER AVE GAYLORD MI 49735 PAUL KONOPACKI CFO 9877312100 2025-05-13 false 2023 2025-03-06 01:10:19Z ROBERT RICHARDSON 825 N CENTER AVE GAYLORD MI 49735 129650846 false X WWW.MUNSONHEALTHCARE.ORG X 1946 MI TO PROVIDE EXCEPTIONAL HEALTHCARE THAT MEETS THE NEEDS OF OUR PATIENTS AND THE COMMUNITIES WE SERVE. 23 19 796 19 0 725899 1184886 114732267 127877792 72912 23891 596574 564277 116127652 129650846 0 0 53848568 52208290 0 121704 63603301 72823193 117451869 125031483 -1324217 4619363 54710301 64284514 11508836 14093216 43201465 50191298 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. false false 106190648 128003187 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 1,701 INPATIENT ADMISSIONS IN FISCAL YEAR 2024 AND OVER 122,500 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 3,200 SURGICAL CASES, 316 OBSTETRICAL BIRTHS, AND OVER 19,700 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS APPROXIMATELY 124 ACTIVE MEDICAL STAFF AND 19 VOLUNTEERS. 106190648 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 false false false false false false false false false false false false false true true true false false true 36 0 true 796 true false false false false false false false false false false false false X 23 19 false false false 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 2.00 40.00 X 0 2245580 251955 JAMES SHURLOW DO SURGEON 40.00 X 1013158 0 39405 LAURA GLENN MHC SYSTEM C 2.00 40.00 X 0 839007 105311 MICHAEL VANWAGNER DO ORTHOPEDIC S 1.00 39.00 X 9997 823993 18561 PAUL KONOPACKI CFO 2.00 40.00 X 0 720042 86525 LINDSAY HARDEN DO SURGEON 40.00 X 723810 0 34026 CHANGXIN LI MD PHYSICIAN 40.00 X 698019 0 36377 DINO RECCHIA MD DIRECTOR 40.00 X 0 691094 27597 MATTHEW DUBIEL MD ORTHOPEDIC S 1.00 39.00 X 7400 643300 41122 ELLEN SMITH PRESIDENT AM 2.00 40.00 X 0 464827 60006 CHRISTOPHER SQUIRE PRESIDENT 40.00 1.00 X X 0 334475 69550 VINCENT SCHULTZ MD DIRECTOR 40.00 X 0 313737 42486 KATHLEEN LARAIA VP ONCOLOGY 2.00 40.00 X 0 314675 35733 KATHLEEN MALY FORMER INTER X 0 222122 7314 DAWN HALLECK VP PATIENT C 40.00 1.00 X 175229 0 41632 CASEY KANDOW FORMER VP AN X 0 114566 0 KENNETH BLOEM PT-YR CHAIR 3.00 X X 0 5000 0 MATT BULLOCH DIRECTOR 1.00 X 0 5000 0 NICK CEGLAREK DIRECTOR 1.00 X 0 5000 0 ALAN CONRAD DIRECTOR 1.00 X 0 5000 0 KATHY DIXON DIRECTOR 1.00 X 0 5000 0 DOUG LUCIANI DIRECTOR 1.00 X 0 5000 0 DAVID MCCURDY DIRECTOR 3.00 X 0 5000 0 RUTH HOPPE MD PT-YR SEC/PT 3.00 X X 0 5000 0 DAVE MENGEBIER PT-YR TREASU 2.00 X X 0 5000 0 KIM MORLEY PT-YR VICE C 1.00 X X 0 5000 0 TIM NELSON PT-YR SEC/PT 3.00 X X 0 5000 0 BRIAN POSTMA DIRECTOR 2.00 X 0 5000 0 OWEN ROBERTS DIRECTOR 2.00 X 0 5000 0 MICHELLE RUSSELL DIRECTOR 1.00 X 0 5000 0 MARY SANDERS DIRECTOR 2.00 X 0 5000 0 KRISTINE THOMAS DIRECTOR 2.00 X 0 5000 0 TOM VERYSER DIRECTOR 1.00 X 0 5000 0 ELAINE WOOD PT-YR CHAIR 2.00 X X 0 5000 0 JENNIFER KING DIRECTOR 1.00 X 0 0 0 KARL KLIMEK DIRECTOR 1.00 X 0 0 0 BEN MULADORE DIRECTOR 1.00 X 0 0 0 ANDY PAGE DIRECTOR 1.00 X 0 0 0 SAKURA TAKANO DIRECTOR 1.00 X 0 0 0 2627613 7817418 897600 93 true true false MARY FREE BED REHABILITATION HOSP 235 WEALTHY ST SE GRAND RAPIDS MI 49503 REHABILITATION 2447387 AMERICAN HEALTHCARE STAFFING ASSOC PO BOX 670529 DALLAS TX 752670529 STAFFING 2235296 NORTHWESTERN MI EMERGENCY PHYS 4624 N SPIDER LAKE ROAD TRAVERSE CITY MI 49696 MEDICAL 1645562 MAYO CLINIC LABORATORIES PO BOX 9146 MINNEAPOLIS MN 554809146 LABORATORY 530953 HALLMARK HEALTHCARE SOLUTIONS PO BOX 22937 NEW YORK NY 100872938 STAFFING 382298 18 770708 414178 1184886 PATIENT SERVICE REVENUE 621990 75049074 75049074 MEDICARE/MEDICAID PAYMENTS 621990 50190471 50190471 INCENTIVE PAYMENT 621990 1335851 1335851 340B PRESCRIPTION REVENUE 621990 1279500 1279500 RENT FROM RELATED ORGS 531120 22476 22476 420 420 127877792 23891 23891 68373 68373 68373 68373 CAFETERIA REVENUE 722210 370509 370509 MISCELLANEOUS 621990 125395 125395 495904 129650846 128003187 462773 X 220375 220375 42608775 42434875 173900 1953956 1945935 8021 4848399 4828592 19807 2576785 2566312 10473 31396 31396 7444 7444 13931074 13896669 34405 4568 4568 469011 458099 10912 1289534 1288719 815 1260340 1260340 172075 170754 1321 119358 118464 894 749925 636920 113005 3870127 3286942 583185 532610 404485 128125 MEDICAL SUPPLIES 23055469 23055469 SHARED SERVICES 17689161 -5979 17573436 121704 BAD DEBT 4447439 4447439 QAAP TAXES 4194007 4194007 999655 977663 21992 125031483 106190648 18719131 121704 8765 8525 736005 989201 12179230 16935119 2028703 1487876 362295 197664 59368840 15802353 38570572 43566487 824731 1099642 54710301 64284514 6299249 8635185 5209587 5458031 11508836 14093216 X 43201465 50191298 43201465 50191298 54710301 64284514 X 4619363 2370470 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7444 7444 false SCHEDULE C, PART II-B, LINE 1 OTHER ACTIVITIES INDICATE THE PORTION OF DUES ALLOCATED TO LOBBYING EXPENSES PAID TO VARIOUS REGIONAL OR NATIONAL ORGANIZATIONS, SUCH AS THE THE AMERICAN HOSPITAL ASSOCIATION, THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS, THE MICHIGAN SOCIETY OF ANESTHESIOLOGISTS AND THE SOCIETY OF DIAGNOSTIC MEDICAL SONOGRAPHY. 1935760 1935760 31318408 6228929 25089479 1223111 612022 611089 17991498 8667744 9323754 6900063 293658 6606405 43566487 RESERVE FOR THIRD PARTY SETTLEMENTS 5114770 ESTIMATED THIRD PARTY SETTLEMENTS 327170 CAPITAL LEASE 16091 5458031 true true X true X true X true true false true true 449534 449534 0.00370 14402489 14402489 14852023 14402489 449534 0.00370 9133 9133 0.00010 20621 20621 0.00020 40573699 27169590 13404109 0.11120 3051 3051 40606504 27169590 13436914 0.11150 55458527 41572079 13886448 0.11520 8959 8959 0.00010 2986 2986 25383 25383 0.00020 12538 12538 0.00010 49866 49866 0.00040 true 4447439 1144000 14356335 11814619 2541716 X true true 1 1 MUNSON HEALTHCARE OTSEGO MEMORIAL H 825 N CENTER AVE GAYLORD MI 49735 WWW.MYOMH.ORG 1060000063 X X X LONG TERM CARE FACILITY MUNSON HEALTHCARE OTSEGO MEMORIAL H 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 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 OTSEGO MEMORIAL H - PART V, LINE 3E THE SIGNIFICANT PRIORITIZED HEALTH NEEDS OF THE COMMUNITY ARE IDENTIFIED IN THE CHNA UNDER THE KEY FINDINGS HEADING. IN THE NORTHEAST REGION, THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN ORDER OF PRIORITY: SUBSTANCE USE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND CHRONIC DISEASE. THESE THEMES WERE PRIORITIZED THROUGH A PRIORITIZATION MATRIX, FOR WHICH MITHRIVE DESIGN TEAM MEMBERS SORTED THE DATA RECEIVED FOR THE THREE REGIONS INTO PRIMARY AND SECONDARY DATA. THEY CLUSTERED DATA POINTS BASED ON TOPIC, THEME AND INTERCONNECTEDNESS. THE THEMES WHICH COULD BE FOUND IN THE HIGH SECONDARY DATA/ HIGH PRIMARY DATA QUADRANT WERE A COMBINATION OF THE ABOVE TOPICS BASED ON REGION. FACILITY 1, MUNSON HEALTHCARE 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 FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/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. 5 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 ELMIRA SPECIALTY CLINICS 2572 NORTH US 131 ELMIRA MI 48651 OCCUPATIONAL HEALTH AND MEDICINE 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 7G THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 29,813,131. 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 125,031,483. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 4,447,439. THE NET EXPENSE OF 120,584,044 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 BELIEVES COMMUNITY BUILDING ACTIVITIES PROMOTE HEALTH BY ADDRESSING UNDERLYING COMMUNITY HEALTH CHALLENGES. COMMUNITY BUILDING WORK IS DONE AT THE CORPORATE LEVEL ON BEHALF OF THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE HAS SHIFTED SIGNIFICANT RESOURCES TO THE DEVELOPMENT AND CONTINUATION OF REGION-WIDE COLLABORATIVES THAT ADDRESS ROOT CAUSES. CURRENT COMMUNITY BUILDING ACTIVITIES INCLUDE: THE NORTHERN MICHIGAN COMMUNITY HEALTH INNOVATION REGION (CHIR): THIS GROUP BRINGS TOGETHER CROSS-SECTOR PARTNERS ACROSS A 31-COUNTY AREA, INCLUDING HEALTH DEPARTMENTS, BUSINESSES, RESIDENTS, AND HUMAN SERVICES TO ALIGN SYSTEMS AND PRIORITIES, DEVELOP A SHARED AGENDA, AND CO-LEAD STRATEGIES THAT TRANSFORM HEALTH AND WELLNESS IN NORTHERN MICHIGAN. THIS INTERDISCIPLINARY GROUP CONDUCTS A COLLABORATIVE, REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, WITH CONTINUED COORDINATION AS IMPLEMENTATION PLANS ARE DEVELOPED AND IMPLEMENTED. THE WORK ENSURES STRATEGIES ADDRESS ROOT CAUSES, REDUCE DUPLICATION OF EFFORTS, AND IMPROVE IMPACT. TOGETHER, THE CHIR ALSO DEVELOPED AND CONTINUES TO SUPPORT THE COMMUNITY CONNECTIONS MODEL WHERE CLIENTS ARE UNIVERSALLY SCREENED IN A HEALTHCARE SETTINGINCLUDING AT MUNSON HEALTHCAREAND CONNECTED TO COMMUNITY HEALTH WORKERS FOR SUPPORT WITH BASIC NEEDS. THE BEHAVIORAL HEALTH INSTITUTE (BHI): THIS GROUP WAS FORMED IN RESPONSE TO THE BEHAVIORAL HEALTH CRISIS IN OUR REGION. TOGETHER, THE GROUP DEVELOPED A SHARED ROADMAP, INCLUDING TWELVE ACTION TEAMS, EACH OF WHICH MUNSON CONTRIBUTES TO. SOME OF THE GROUPS ACCOMPLISHMENTS INCLUDE: 1. RECRUIT BEHAVIORAL HEALTH INTERNS AND PROVIDERS: LAUNCH OF FIRST EVER BEHAVIORAL HEALTH INTERNSHIP WEBSITE WITH SEARCHABLE OPPORTUNITIES AND RESOURCES TO HELP STUDENTS RELOCATE TO RURAL, NORTHERN MICHIGAN. THIS TEAM ALSO DEVELOPED A HEALTHY WORKPLACES = THRIVING EMPLOYEES TOOLKIT, BEST PRACTICE GUIDES, AND A LUNCH AND LEARN WEBINAR SERIES FOCUSED ON ACTIONABLE STRATEGIES TO HELP EMPLOYERS BETTER SUPPORT AND RETAIN THEIR BEHAVIORAL HEALTH PROVIDERS.2. REDUCE STIGMA AROUND MENTAL HEALTH AND SUBSTANCE USE DISORDERS: STIGMA REDUCTION EFFORTS, INCLUDED SURVEYS TO BETTER UNDERSTAND COMMUNITY PERCEPTIONS AROUND MENTAL ILLNESS AND SUBSTANCE USE DISORDER, VIDEO-BASED STORIES HIGHLIGHTING PEOPLE WITH LIVED EXPERIENCES, A YOUTH PHOTOVOICE PROJECT TO EDUCATE AUDIENCES AND ENCOURAGE FURTHER LEARNING, PUBLIC SERVICE ANNOUNCEMENTS TO NORMALIZE CONVERSATIONS AROUND MENTAL HEALTH, AN IMPLICIT BIAS TRAINING FOR PROVIDERS, A WORDS HOLD POWER LANGUAGE GUIDE, AND MORE. 3. STRENGTHEN CRISIS SERVICES: THIS TEAM SUCCESSFULLY OBTAINED A 5 MILLION DOLLAR GRANT TO BUILD A CRISIS CENTER FOR THE REGION. CONSTRUCTION ON MUNSONS CAMPUS AND HIRING ARE WELL- UNDERWAY WITH AN EXPECTED OPEN DATE IN JANUARY OF 2025. 4. ENHANCE AVAILABILITY OF CHW NAVIGATION SUPPORT: COMMUNITY HEALTH WORKER PILOT PROGRAMS WERE DEVELOPED IN FOUR AREA SCHOOLS. ADDITIONALLY, A WEBSITE WITH A COMPREHENSIVE RESOURCE DIRECTORY WAS CREATED SO CHWS COULD EASILY ACCESS RESOURCES NEEDED TO SUPPORT CLIENTS, AS WELL AS A SHARED SLACK LINE TO LINK CHWS FOR ONGOING COLLABORATION. 5. RECRUIT BEHAVIORAL HEALTH PROVIDERS: THIS GROUP HELD A LISTENING SESSION TO BETTER UNDERSTAND RECRUITMENT CHALLENGES RELATED TO BEHAVIORAL HEALTH PROFESSIONALS, HOSTED TWO EDUCATION SESSIONS ON LOAN REPAYMENT PROGRAMS, AND CONTINUE TO MEET WITH COLLEGES AND UNIVERSITIES TO EXPLORE STRATEGIES THAT STRENGTHEN THE BEHAVIORAL HEALTH PROVIDER PIPELINE. 6. PROMOTE BEHAVIORAL HEALTH PARITY: THIS TEAM PUBLISHED AN INFOGRAPHIC AND SUBSEQUENT CASE STUDY GUIDE TO EDUCATE PATIENTS AND PROVIDERS ABOUT THEIR RIGHTS TO BEHAVIORAL HEALTH PARITY. MICHIGANS REGION 2 & 3 PERINATAL QUALITY COLLABORATIVE (RPQC): MUNSON SERVES AS THE CO-LEAD AND FIDUCIARY OF THIS GROUP, WORKING WITH SEVERAL OTHER PARTNERS, INCLUDING: OTHER HEALTHCARE SYSTEMS IN THE REGION, HOME VISITING AGENCIES, HEALTHCARE PROFESSIONALS, FAITH-BASED ORGANIZATIONS, GREAT START COLLABORATIVES, NONPROFIT ORGANIZATIONS, COMMUNITY OUTREACH GROUPS, AND HEALTH DEPARTMENTS. ITS PURPOSE IS TO IMPROVE PREGNANCY, BIRTH, AND POSTPARTUM OUTCOMES THROUGH A SUSTAINABLE AND COORDINATED NETWORK OF CARE.QUALITY IMPROVEMENT EFFORTS ARE DATA-DRIVEN AND ALIGNED WITH COMMUNITY FEEDBACK OBTAINED THROUGH LISTENING SESSIONS AND TAILORED TO REGIONAL STRENGTHS AND CHALLENGES. RECENT INITIATIVES INCLUDE: 1. THE INTEGRATION OF INDIGENOUS BIRTHING CULTURE AND EDUCATION WITHIN MUNSON HEALTHCARE, 2. BUILDING AND IMPLEMENTATION OF EVIDENCE-BASED SUPPORTS FOR FAMILIES EFFECTED BY PERINATAL SUBSTANCE USE DISORDER, 3. THE PROVISION OF CHILDBIRTH EDUCATION MATERIALS TO PREPARE BIRTHING PEOPLE FOR MORTALITY RISK INDICATORS SUCH AS HIGH BLOOD PRESSURE, AND 4. BUILDING A CULTURALLY SENSITIVE BIRTH PLAN WITH COMMUNITY INPUT, AND MORE. FINALLY, THE ORGANIZATION ACTIVELY ADVOCATES AT THE LOCAL, STATE, AND FEDERAL LEVEL ON ISSUES IMPACTING HEALTHCARE ACCESS IN RURAL AREAS. RECENT WORK INCLUDES SERVING IN BOTH A LEADERSHIP AND SUPPORTIVE ROLE IN PROJECTS TO SUPPORT POLICIES THAT WOULD PROVIDE SUPPORT FOR TELEHEALTH SERVICES, BEHAVIORAL HEALTHCARE CRISIS SERVICES, WELLNESS PROGRAMMING AND EDUCATION, AFFORDABLE HOUSING, AND TRANSPORTATION. 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 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 IS LOCATED IN GAYLORD, MI AND SERVES THE COUNTIES OF CHEBOYGAN, OTSEGO, MONTMORENCY AND ANTRIM. ALL FOUR COUNTIES SERVED ARE EXTREMELY RURAL. THE HOSPITAL HAS AN ACTIVE MEDICAL STAFF OF 124 (PRIMARY FACILITY) AND IS ONE OF THE LARGEST EMPLOYERS IN THE REGION. THE HOSPITAL SERVED OVER 3,200 SURGICAL CASES, MORE THAN 122,500 OUTPATIENT VISITS, OVER 19,700 EMERGENCY ROOM VISITS, 1,701 INPATIENT ADMISSIONS AND 316 BIRTHS IN FISCAL YEAR 2024. HOSPITAL SERVICES THIS 46-BED HOSPITAL OFFERS A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES: 24 HOUR EMERGENCY CARE SPECIALTIES INCLUDING ORTHOPEDICS, UROLOGY, CARDIOLOGY, EAR NOSE AND THROAT, CANCER SERVICES AND MORE. RADIOLOGY SERVICES WITH X-RAY, 3D MAMMOGRAPHY, MRI, ULTRASOUND AND CT. COMPREHENSIVE REHABILITATION SERVICES LONG-TERM CARE OBSTETRICS & GYNECOLOGY PHYSICIAN OFFICES LOCATED IN GAYLORD, LEWISTON & INDIAN RIVER AREA OFFER VARYING SERVICES INCLUDING PRIMARY CARE, BEHAVIORAL HEALTH, URGENT AND WALK-IN CARE AND MORE. OUTPATIENT LAB SERVICES GENERAL, ORTHOPEDIC AND OUTPATIENT SURGERY POPULATION SERVED OTSEGO HOSPITAL IS IN OTSEGO COUNTY, SERVING ANTRIM, CHEBOYGAN, AND MONTMORENCY COUNTY, WITH OTSEGO COUNTY BEING THE PRIMARY SERVICE AREA. WITHIN THIS COUNTY, THE FOLLOWING DEMOGRAPHIC DATA APPLIES: TOTAL POPULATION: 25,747. MEDIAN HOUSEHOLD INCOME: 62,865. 22% OF ADULTS ARE AGE 65 OR OLDER, SIGNIFICANTLY MORE THAN THE STATE AVERAGE OF 18.2%. THE RACIAL MAKEUP OF THE COUNTY IS 95% WHITE, 0.7% BLACK OR AFRICAN AMERICAN, .9% AMERICAN INDIAN/ALASKAN NATIVE, 0.7% ASIAN, 2% HISPANIC OR LATINO. OF PEOPLE AGED 25 OR OLDER, 94.3% HAVE A HIGH SCHOOL DIPLOMA OR HIGHER WHILE 26.3% HAVE A BACHELORS DEGREE OR HIGHER. THE UNEMPLOYMENT RATE IS 4.5% QUALITY 2024 CMS 5-STAR HOSPITAL SCHEDULE H, PART VI, LINE 5 MUNSON HEALTHCARE OTSEGO MEMORIAL 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 AND BENEFIT ENHANCEMENTS, 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 SUPPORT FOR EXISTING COMMUNITY HEALTH PROGRAMMING AND INITIATIVES WHILE INVESTING IN NEW AND EXPANDED OFFERINGS, INCLUDING: 1. FOR OVER 25 YEARS, HEALTHY FUTURES A PARTNERSHIP OF MUNSON, LOCAL HEALTH DEPARTMENTS, AND PROVIDER OFFICES HAS HELPED PARENTS AND BABIES HAVE A HEALTHY START. THIS INCLUDESA FREE AND UNIVERSAL POSTPARTUM HOME VISITING PROGRAM,1:1 BREASTFEEDING ASSISTANCE,INFANT SLEEP AND IMMUNIZATION EDUCATION, AND AGE-APPROPRIATE NEWSLETTERS AND TEXT MESSAGES FOR OVER 1,300 FAMILIES ANNUALLY.THE PROGRAM IS AVAILABLE TO ALL, WITH OR WITHOUT INSURANCE. 2. WORK CONTINUES TO CREATE A NO WRONG DOOR APPROACH TO SUBSTANCE USE DISORDER TREATMENT. THIS INCLUDES THE DEVELOPMENT AND IMPLEMENTATION OF A STANDARD BEST-PRACTICE PROTOCOL WITHIN EMERGENCY AND PRIMARY CARE SETTINGS. MUNSON ALSO EXPANDED IN-PERSON AND VIRTUAL PEER RECOVERY SERVICES, PEER SUPPORT FOR PROVIDERS TREATING PATIENTS WITH SUD, AND EXPANDED HARM REDUCTION RESOURCES, INCLUDING MEDSAFE RECEPTACLES AND NARCAN ACCESS. 3. HIGH TECH HIGH TOUCH (HTH2) IS A SCREENING-BASED PREVENTION TOOL TO SUPPORT SELF-DISCLOSURE OF SUBSTANCES USED DURING PREGNANCY AND CONNECT PATIENTS WITH BRIEF INTERVENTIONS AND EARLY TREATMENT. RECENT WORK HAS SUPPORTED THE SUCCESSFUL IMPLEMENTATION OF THE TOOL IN 60 PERCENT OF AREA CLINICS SERVING PREGNANT PEOPLE, WITH CONTINUED WORK TO IMPLEMENT WITHIN THE REMAINING OFFICES. 4. EAT SLEEP CONSOLE IS A FAMILY-CENTERED, BEST PRACTICE APPROACH FOR CARING FOR INFANTS WITH NEONATAL ABSTINENCE SYNDROME (NAS). MUNSON IMPLEMENTED THIS PRACTICE AT ALL BIRTHING HOSPITALS, INCLUDING THE PURCHASE OF EQUIPMENT AND HEALTHCARE TEAM EDUCATION, WHICH RESULTED IN IMPROVED CLINICAL OUTCOMES, DECREASING THE NEED FOR PHARMACOLOGICAL MANAGEMENT AND SHORTENING LENGTH OF STAY. 5. MUNSON IS CURRENTLY PARTNERED WITH THE UNIVERSITY OF MICHIGAN IN A PEDIATRIC BEHAVIORAL HEALTH EQUITY STUDY TO LOOK AT CARE DELIVERY AND IMPLEMENT QUALITY IMPROVEMENT PROJECTS. IN ADDITION, THE HOSPITAL PARTNERS WITH LOCAL SCHOOL SYSTEMS AND NORTHWEST EDUCATION TO HELP FIND COMMON LANGUAGE, COMMUNICATION TOOLS, BASELINE INTERVENTIONS AND RECOMMENDED NEXT STEPS TO BETTER SERVE KIDS WHEN THEY ARE EXPERIENCING A MENTAL HEALTH CRISIS. 6. THE PERINATAL GRIEF GRANT WAS FUNDED BY MDHHS WITH THE GOAL OFCREATINGLOCAL AND SUSTAINABLE BEREAVEMENT SUPPORT NETWORKS THROUGHA COLLECTIVE IMPACT APPROACH. THESE FUNDS WERE USED TO PROVIDE EVIDENCE-BASED TRAINING TO HEALTHCARE STAFF AND COMMUNITY PARTNERS, EMPOWERING THEM TO PROVIDE COMPASSIONATE CARE TO THOSE EXPERIENCING GRIEF AND LOSS. A TOTAL OF 54 MUNSON STAFF AND GRIEF SUPPORT PARTNERS COMPLETED THE RESOLVE THROUGH SHARING TRAINING. ADDITIONAL WORK INCLUDED VIRTUAL FOCUS GROUPS, EXPANDED SUPPORT GROUP OFFERINGS, PROCUREMENT OF GRIEF SUPPORT MATERIALS FOR MATERNITY UNITS, AND INCREASED AWARENESS AND OUTREACH TO OB OFFICES. 7. VOICES FOR COMMUNITY HEALTH IS AN ANNUAL ART PROGRAM THAT INVITES ARTWORK ADDRESSING IMPORTANT TOPICS LIKE YOUTH MENTAL HEALTH AND RECOVERY. THE MUNSON-OWNED PROJECT AIMS TO RAISE AWARENESS, REDUCE STIGMA, AND INSPIRE HOPE. THE COMMUNITY IS ENCOURAGED TO VISIT THE GALLERY AND MAKE A PLEDGE TO SUPPORT THESE CAUSES. LAST YEARS PROJECT COLLECTED OVER 130 PIECES AND 220 PLEDGES, WITH AN OVERALL REACH OF 30,000. 8. MUNSON COLLABORATES WITH TRAVERSE HEALTH CLINIC AND GOODWILL NORTHERN MICHIGAN TO OFFER THE STREET MEDICINE PROGRAM, WHICH EXTENDS PHYSICAL AND BEHAVIORAL HEALTHCARE TO INDIVIDUALS WHO ARE UNHOUSED IN THE TRAVERSE CITY AREA. THIS WORK ALSO CONNECTS PATIENTS WITH BASIC NEEDS, SUCH AS FOOD, CLOTHING, AND CLEAN WATER, WHILE ADVOCATING FOR AND CREATING PATHWAYS TO ATTAINABLE HOUSING. DURING FY24, MUNSON HEALTHCARE INVESTED AN ADDITIONAL 300,000 TO SUPPORT AN FTE TO INCREASE COORDINATION AND PROGRAM EXPANSION. 9. INITIATIVES AIMED AT THE REDUCTION AND MANAGEMENT OF CHRONIC DISEASE HAVE ALSO BEEN PRIORITIZED. THESE INCLUDE AN ENHANCED PARTNERSHIP WITH LOCAL HEALTH DEPARTMENTS TO IMPROVE THE REFERRAL AND FEEDBACK PROCESS FOR PATIENTS WHO USE TOBACCO. IN ADDITION, CONTINUED PARTNERSHIP WITH LOCAL GROCERY, FARMERS MARKETS, AND MICHIGAN STATE UNIVERSITY EXTENSION EXTENDS ACCESS TO FREE NUTRITION AND COOKING EDUCATION AND VOUCHERS TO PURCHASE FRUITS AND VEGETABLES THROUGH THE PRESCRIPTION FOR HEALTH PROGRAM. FINALLY, MUNSON ENHANCED THEIR DIRECT PATIENT OUTREACH BY USING TEXT MESSAGES TO PROVIDE RESOURCES, REMINDERS, AND EDUCATION AROUND TOPICS SUCH AS CANCER, DIABETES, HEART HEALTH, AND TOBACCO. 10. MUNSON MAKES FINANCIAL CONTRIBUTIONS TO COMMUNITY CAUSES AND EVENTS FOCUSED ON MENTAL HEALTH, CHRONIC DISEASE, AND HOUSING, WHILE PARTICIPATING ON COMMITTEES AND BOARDS THAT WORK TO ADDRESS SYSTEMATIC CHALLENGES FACING THESE PRIORITY AREAS. 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 153.5 MILLION OF COMMUNITY BENEFIT IN THE 2023 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 4.6 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2023. 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 179.2 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 true true false false false false false true false EDWIN A NESS DIRECTOR 1019734 200000 1025846 222314 29641 2497535 834836 JAMES SHURLOW DO SURGEON 759507 230732 22919 16533 22872 1052563 LAURA GLENN MHC SYSTEM COO 602996 150000 86011 81533 23778 944318 MICHAEL VANWAGNER DO ORTHOPEDIC SURGEON 9641 648221 153251 356 22521 50 16483 30 1998 10077 842474 PAUL KONOPACKI CFO 582360 70000 67682 65902 20623 806567 LINDSAY HARDEN DO SURGEON 583330 117603 22877 15597 18429 757836 CHANGXIN LI MD PHYSICIAN 648008 47238 2773 16533 19844 734396 DINO RECCHIA MD DIRECTOR 648678 17144 25272 16533 11064 718691 MATTHEW DUBIEL MD ORTHOPEDIC SURGEON 7133 642628 267 672 50 16483 303 24286 7753 684069 ELLEN SMITH PRESIDENT AMB SERVIC 398576 66251 56118 3888 524833 CHRISTOPHER SQUIRE PRESIDENT 303275 31200 45085 24465 404025 VINCENT SCHULTZ MD DIRECTOR 278379 19933 15425 15990 26496 356223 KATHLEEN LARAIA VP ONCOLOGY & PROF S 282571 32104 27111 8622 350408 KATHLEEN MALY FORMER INTERIM CFO 84251 75000 62871 2947 4367 229436 DAWN HALLECK VP PATIENT CAR SERVI 169371 5858 19503 22129 216861 CASEY KANDOW FORMER VP ANCILLARY 114566 114566 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 0 206,681 0 LAURA GLENN 0 65,000 0 PAUL KONOPACKI 0 56,002 0 ELLEN SMITH 0 40,000 0 CHRISTOPHER SQUIRE 0 30,975 0 KATHLEEN LARAIA 0 17,471 0 DAWN HALLECK 0 10,491 0 CASEY KANDOW 114,566 0 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 PART I, LINE 4A EXECUTIVE SEVERANCE PLAN: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, A COMPETITIVE BENEFIT PACKAGE IS OFFERED TO THE PRESIDENT AND VICE-PRESIDENTS, WHICH INCLUDES A SEVERANCE PLAN. MUNSON HAS A SEVERANCE PLAN FOR THE PRESIDENT AND VICE-PRESIDENT/EXECUTIVE LEVEL POSITIONS, WHICH PROVIDES FOR THE PRESIDENT UP TO TWO YEARS OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS AND FOR VICE-PRESIDENTS, UP TO ONE-YEAR OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS. THE PLAN PROVIDES FOR A 50% OFFSET FOR SUBSEQUENT EMPLOYMENT DURING THE SEVERANCE PERIOD. MEDICAL BENEFITS ARE PROVIDED DURING THE SEVERANCE PERIOD. PART I, LINE 4B 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. PART II, COLUMN B(III) IN JULY 2023, MUNSON HEALTHCARE TRANSITIONED EXECUTIVE PTO FROM AN ACCRUAL PLAN TO AN UP FRONT ANNUAL ALLOTMENT PLAN WITH A USE-IT-OR-LOSE-IT BALANCE DISPOSITION. CURRENT EXECUTIVES ON THE PTO ACCRUAL PLAN WERE PAID OUT THEIR EXISTING BALANCES IN JULY 2023. THE FIRST 80 HOURS OF ACCRUED PTO WAS PAID AT 90% OF VALUE AND THE BALANCE WAS PAID AT 80% OF VALUE. THIS PAYOUT IS LESS FAVORABLE THAN EXISTING POLICY, WHICH PAYS OUT ACCRUED PTO AT 100% UPON SEPARATION OF EMPLOYMENT. THIS ONE-TIME PAYOUT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J. PART II, LINE 1, COLUMN B(III) CEO EDWIN NESS, A 25 YEAR EMPLOYEE, HAS BEGUN VESTING IN HIS SERP PLAN. IN 2023, THE TAXABLE AMOUNT WAS 834,836. THIS ONE-TIME TAXABLE AMOUNT IS REFLECTED IN HIS 2023 COMPENSATION IN COLUMN B(III) OF SCHEULE J. OF THE AMOUNT REPORTED IN THE CURRENT FORM 990 SCHEDULE J, SERP PLAN CONTRIBUTIONS IN THE AMOUNT OF 834,836 WERE PREVIOUSLY REPORTED AS BENEFITS IN PRIOR YEAR FORMS 990. 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. 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 10,489,011 23,294 0 PROFESSIONAL FEES 3,407,658 11,111 0 TOTAL 13,896,669 34,405 0 FORM 990, PART XI, LINE 9 EQUITY TRANSFER FROM PARENT 2,000,000 INHERENT CONTRIBUTION DEPRECIATION 370,470 TOTAL 2,370,470 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 SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true true false true false false false false false false false false false true false true true true false false MUNSON HEALTHCARE C 2000000 ACTUAL AMOUNT PAID MUNSON HEALTHCARE M 16752799 ACTUAL AMOUNT PAID MUNSON HEALTHCARE O 1164321 ACTUAL AMOUNT PAID MUNSON HEALTHCARE P 11953460 ACTUAL AMOUNT PAID MUNSON HEALTHCARE Q 1091608 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS C 770708 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS M 121704 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING O 77434 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING P 464609 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING Q 129920 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER O 32029064 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER P 16642684 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER Q 15985751 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP A 22476 LEASE CONTRACT AMOUNT NORTHERN MICHIGAN SUPPLY ALLIANCE M 820637 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE Q 592518 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 2929752 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.