MUNSON HEALTHCARE GRAYLING: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization: MUNSON HEALTHCARE GRAYLING (EIN 47-1161992)
Tax period: 2023-07-01 to 2024-06-30
Filed: 2025-05-14
IRS object ID: 202531349349306783
Schema version: 2023v6.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2025-05-14T13:55:30-04:00	ReturnTs
Tax Period End	2024-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2023-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	471161992	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MUNSON HEALTHCARE GRAYLING	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MUNS	BusinessNameControlTxt
Phone	2319355000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1105 SIXTH STREET	AddressLine1Txt
City	TRAVERSE CITY	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49684	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	PAUL KONOPACKI	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	2319355000	PhoneNum
Signature	2025-05-13	SignatureDt

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	false	IRSResponsiblePrtyInfoCurrInd
Tax	2023	TaxYr
Build TS	2025-03-06 01:10:19Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	KIRSTEN KORTH-WHITE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1100 E MICHIGAN AVENUE	AddressLine1Txt
City	GRAYLING	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49738	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$97,862,044	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MUNSONHEALTHCARE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2014	FormationYr
Legal Domicile State	MI	LegalDomicileStateCd
Activity Or Mission	MUNSON HEALTHCARE GRAYLING AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH.	ActivityOrMissionDesc
Voting Members Governing Body	23	VotingMembersGoverningBodyCnt
Voting Members Independent	19	VotingMembersIndependentCnt
Total Employee	658	TotalEmployeeCnt
Total Volunteers	22	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$370,437	PYContributionsGrantsAmt
CY Contributions Grants	$602,696	CYContributionsGrantsAmt
PY Program Service Revenue	$93,424,593	PYProgramServiceRevenueAmt
CY Program Service Revenue	$96,381,475	CYProgramServiceRevenueAmt
PY Investment Income	$54,996	PYInvestmentIncomeAmt
CY Investment Income	$22,645	CYInvestmentIncomeAmt
PY Other Revenue	$627,017	PYOtherRevenueAmt
CY Other Revenue	$855,228	CYOtherRevenueAmt
PY Total Revenue	$94,477,043	PYTotalRevenueAmt
CY Total Revenue	$97,862,044	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$45,679,773	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$44,868,206	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$91,353	CYTotalFundraisingExpenseAmt
PY Other Expenses	$53,271,060	PYOtherExpensesAmt
CY Other Expenses	$54,266,351	CYOtherExpensesAmt
PY Total Expenses	$98,950,833	PYTotalExpensesAmt
CY Total Expenses	$99,134,557	CYTotalExpensesAmt
PY Revenues Less Expenses	-$4,473,790	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,272,513	CYRevenuesLessExpensesAmt
Total Assets BOY	$37,925,022	TotalAssetsBOYAmt
Total Assets EOY	$37,383,364	TotalAssetsEOYAmt
Total Liabilities BOY	$14,385,593	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$15,116,448	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$23,539,429	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$22,266,916	NetAssetsOrFundBalancesEOYAmt
Mission	AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON HEALTHCARE GRAYLING EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$84,162,231	ExpenseAmt
Revenue	$96,387,763	RevenueAmt
Desc	EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF THE CRAWFORD COUNTY REGION WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE GRAYLING HAD 1,792 INPATIENT ADMISSIONS IN FISCAL YEAR 2024 AND OVER 106,000 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 2,900 SURGICAL CASES, 300 OBSTETRICAL BIRTHS, AND OVER 18,000 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE GRAYLING ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS 104 ACTIVE MEDICAL STAFF AND 22 VOLUNTEERS.	Desc
Total Program Service Expenses	$84,162,231	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	37	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	658	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	23	GoverningBodyVotingMembersCnt
Independent Voting Member	19	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	NICOLE SULAK MUNSON HEALTHCARE	PersonNm
Phone	2319357777	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4230 COPPER RIDGE DR	AddressLine1Txt
City	TRAVERSE CITY	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49684	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (40 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	OfficerOfficerInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
EDWIN A NESS
DIRECTOR	2.00	40.00	Yes (X)	$0	$2,245,580	$251,955
LAURA GLENN
COO	2.00	40.00		$0	$839,007	$105,311	Yes (X)
MICHAEL VANWAGNER DO
ORTHOPEDIC S	1.00	39.00		$2,499	$831,491	$18,561		Yes (X)
PAUL KONOPACKI
CFO	2.00	40.00		$0	$720,042	$86,525			Yes (X)
DINO RECCHIA MD
DIRECTOR		40.00	Yes (X)	$0	$691,094	$27,597
BRIAN STIRLING MD
PHYSICIAN	40.00			$651,377	$0	$46,112		Yes (X)
MATTHEW DUBIEL MD
ORTHOPEDIC S	1.00	39.00		$7,403	$643,297	$41,122		Yes (X)
JASON BENNETT DO
ORTHOPEDIC S	40.00			$595,287	$0	$42,579		Yes (X)
PAUL REYNOLDS DO
SURGEON	38.00	2.00		$542,899	$39,492	$29,422		Yes (X)
ELLEN SMITH
PRESIDENT AM	2.00	40.00		$0	$464,827	$60,006	Yes (X)
KIRSTEN KORTH-WHITE
PRESIDENT	2.00	40.00	Yes (X)	$0	$392,486	$76,950			Yes (X)
CHRISTOPHER SQUIRE
VP ANCILLARY	2.00	40.00		$0	$334,475	$69,550	Yes (X)
VINCENT SCHULTZ MD
DIRECTOR	5.00	35.00	Yes (X)	$42,911	$270,826	$42,486
KATHLEEN LARAIA
VP ONCOLOGY	2.00	40.00		$0	$314,675	$35,733	Yes (X)
MICHAEL HODNETT
CNO/COO	40.00			$201,749	$0	$44,007	Yes (X)
KATHLEEN MALY
FORMER INTER				$0	$222,122	$7,314				Yes (X)
CASEY KANDOW
FORMER VP AN				$0	$114,566	$0				Yes (X)
KENNETH BLOEM
PT-YR CHAIR		3.00	Yes (X)	$0	$5,000	$0			Yes (X)
MATT BULLOCH
DIRECTOR		1.00	Yes (X)	$0	$5,000	$0
NICK CEGLAREK
DIRECTOR		1.00	Yes (X)	$0	$5,000	$0
ALAN CONRAD
DIRECTOR		1.00	Yes (X)	$0	$5,000	$0
KATHY DIXON
DIRECTOR		1.00	Yes (X)	$0	$5,000	$0
DOUG LUCIANI
DIRECTOR		1.00	Yes (X)	$0	$5,000	$0
DAVID MCCURDY
DIRECTOR		3.00	Yes (X)	$0	$5,000	$0
RUTH HOPPE MD
PT-YR SEC/PT		3.00	Yes (X)	$0	$5,000	$0			Yes (X)
DAVE MENGEBIER
PT-YR TREASU		2.00	Yes (X)	$0	$5,000	$0			Yes (X)
KIM MORLEY
PT-YR VICE C		1.00	Yes (X)	$0	$5,000	$0			Yes (X)
TIM NELSON
PT-YR SEC/PT		3.00	Yes (X)	$0	$5,000	$0			Yes (X)
BRIAN POSTMA
DIRECTOR		2.00	Yes (X)	$0	$5,000	$0
OWEN ROBERTS
DIRECTOR		2.00	Yes (X)	$0	$5,000	$0
MICHELLE RUSSELL
DIRECTOR		1.00	Yes (X)	$0	$5,000	$0
MARY SANDERS
DIRECTOR		2.00	Yes (X)	$0	$5,000	$0
KRISTINE THOMAS
DIRECTOR		2.00	Yes (X)	$0	$5,000	$0
TOM VERYSER
DIRECTOR		1.00	Yes (X)	$0	$5,000	$0
ELAINE WOOD
PT-YR CHAIR		2.00	Yes (X)	$0	$5,000	$0			Yes (X)
JENNIFER KING
DIRECTOR		1.00	Yes (X)	$0	$0	$0
KARL KLIMEK
DIRECTOR		1.00	Yes (X)	$0	$0	$0
BEN MULADORE
DIRECTOR		1.00	Yes (X)	$0	$0	$0
ANDY PAGE
DIRECTOR		1.00	Yes (X)	$0	$0	$0
SAKURA TAKANO
DIRECTOR		1.00	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,044,125	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,213,980	TotReportableCompRltdOrgAmt
Total Other Compensation	$985,230	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	72	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MARY FREE BED REHABILITATION HOSP
235 WEALTHY ST SE	GRAND RAPDIS	MI	49503	REHABILITATION	$2,605,628
GRAYLING ANESTHESIA ASSOCIATES PC
450 MAMARONECK AVE STE 201	HARRISON	NY	10528	MEDICAL	$1,747,941
SOUND PHYSICIANS
PO BOX 742936	LOS ANGELES	CA	900742936	MEDICAL	$1,588,198
EPMG OF MICH PC
7032 COLLECTION CENTER DRIVE	CHICAGO	IL	60693	MEDICAL	$1,107,481
WEST MI SHARED HOSPITAL LAUNDRY
3003 WALKENT DR	GRAND RAPIDS	MI	49544	LAUNDRY	$711,052

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	11	CntrctRcvdGreaterThan100KCnt
Related Organizations	$220,760	RelatedOrganizationsAmt
Government Grants	$381,936	GovernmentGrantsAmt
Total Contributions	$602,696	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE	621990	$48,858,249	$48,858,249
MEDICARE/MEDICAID PAYMENTS	621990	$45,202,982	$45,202,982
340B PRESCRIPTION REVENUE	621990	$1,557,244	$1,557,244
QUALITY INCENTIVE PAYMENTS	621990	$763,000	$763,000

Field	Value	IRS element (for citing)
Total Program Service Revenue	$96,381,475	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,357	TotalRevenueColumnAmt
Exclusion	$16,357	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$55,025	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$55,025	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$55,025	TotalRevenueColumnAmt
Exclusion	$55,025	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$6,288	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$6,288	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,288	TotalRevenueColumnAmt
Related Or Exempt Func Income	$6,288	RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA SALES	722210	$410,954	$410,954
MISCELLANEOUS INCOME	621990	$389,249	$389,249

Field	Value	IRS element (for citing)
Other Revenue Total	$800,203	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$97,862,044	TotalRevenueColumnAmt
Related Or Exempt Func Income	$96,387,763	RelatedOrExemptFuncIncomeAmt
Exclusion	$871,585	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$270,973	TotalAmt
Program Services	$270,973	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$36,529,061	TotalAmt
Program Services	$35,699,630	ProgramServicesAmt
Management And General	$829,431	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,701,022	TotalAmt
Program Services	$1,662,172	ProgramServicesAmt
Management And General	$38,850	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,506,563	TotalAmt
Program Services	$4,404,287	ProgramServicesAmt
Management And General	$102,276	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,860,587	TotalAmt
Program Services	$1,818,599	ProgramServicesAmt
Management And General	$41,988	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$30,234	TotalAmt
Management And General	$30,234	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$7,458	TotalAmt
Management And General	$7,458	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$11,308,912	TotalAmt
Program Services	$11,291,243	ProgramServicesAmt
Management And General	$17,669	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$2,285	TotalAmt
Program Services	$2,285	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$455,822	TotalAmt
Program Services	$378,067	ProgramServicesAmt
Management And General	$77,755	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$953,562	TotalAmt
Program Services	$953,562	ProgramServicesAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$715	TotalAmt
Management And General	$715	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,420,434	TotalAmt
Program Services	$1,420,434	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$165,562	TotalAmt
Program Services	$139,734	ProgramServicesAmt
Management And General	$25,828	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$80,319	TotalAmt
Program Services	$77,538	ProgramServicesAmt
Management And General	$2,781	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$395,667	TotalAmt
Program Services	$335,909	ProgramServicesAmt
Management And General	$59,758	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,124,827	TotalAmt
Program Services	$1,803,914	ProgramServicesAmt
Management And General	$320,913	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$413,683	TotalAmt
Program Services	$314,167	ProgramServicesAmt
Management And General	$99,516	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$16,921,657	$16,921,657
SHARED SERVICES	$13,071,730	-$210,238	$13,190,615	$91,353
QAAP TAXES	$3,161,252	$3,161,252
BAD DEBT EXPENSE	$3,145,479	$3,145,479

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$606,753	TotalAmt
Program Services	$571,567	ProgramServicesAmt
Management And General	$35,186	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$99,134,557	TotalAmt
Program Services	$84,162,231	ProgramServicesAmt
Management And General	$14,880,973	ManagementAndGeneralAmt
Fundraising	$91,353	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,129	BOYAmt
EOY	$4,129	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,380,681	BOYAmt
EOY	$339,493	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$9,584,360	BOYAmt
EOY	$13,316,603	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,447,705	BOYAmt
EOY	$2,067,608	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$437,211	BOYAmt
EOY	$207,191	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$39,802,606	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$19,323,086	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$20,067,809	BOYAmt
EOY	$20,479,520	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,003,127	BOYAmt
EOY	$968,820	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$37,925,022	BOYAmt
EOY	$37,383,364	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,323,213	BOYAmt
EOY	$7,773,368	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$7,062,380	BOYAmt
EOY	$7,343,080	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$14,385,593	BOYAmt
EOY	$15,116,448	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$23,539,429	BOYAmt
EOY	$22,266,916	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$23,539,429	BOYAmt
EOY	$22,266,916	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$37,925,022	BOYAmt
EOY	$37,383,364	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$1,272,513	ReconcilationRevenueExpnssAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$7,458	OtherActivitiesAmt
Total Lobbying Expenditures	$7,458	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1	FormAndLineReferenceDesc
Explanation	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 AND THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,535,000	OtherCostOrOtherBasisAmt
Book Value	$1,535,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$19,055,296	OtherCostOrOtherBasisAmt
Depreciation	$6,675,841	DepreciationAmt
Book Value	$12,379,455	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$18,477,577	OtherCostOrOtherBasisAmt
Depreciation	$12,262,940	DepreciationAmt
Book Value	$6,214,637	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$734,733	OtherCostOrOtherBasisAmt
Depreciation	$384,305	DepreciationAmt
Book Value	$350,428	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$20,479,520	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
RESERVE FOR THIRD PARTY SETTLEMENTS	$6,653,595
LT OPERATING LEASE LIABILITY	$310,008
ST OPERATING LEASE LIABILITY	$292,172
ESTIMATE FOR THIRD PARTY SETTLEMENTS	$69,655
CAPITAL LEASE	$17,650

Field	Value	IRS element (for citing)
Total Liability	$7,343,080	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$155,369	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$155,369	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,256,183	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,256,183	DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,411,552	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,256,183	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$155,369	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,908	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,908	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,018	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,702	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$23,316	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$35,881,599	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$28,482,763	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,398,836	NetCommunityBenefitExpnsAmt
Total Expense	0.07710	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,475	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,475	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$35,920,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$28,485,465	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,434,535	NetCommunityBenefitExpnsAmt
Total Expense	0.07750	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$47,331,552	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$39,741,648	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,589,904	NetCommunityBenefitExpnsAmt
Total Expense	0.07910	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,145,479	BadDebtExpenseAmt
Bad Debt Expense Attributable	$806,000	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$11,645,628	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,127,478	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$2,518,150	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MUNSON HEALTHCARE GRAYLING	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1100 E MICHIGAN AVE	AddressLine1Txt
City	GRAYLING	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49738	ZIPCd

Field	Value	IRS element (for citing)
Website Address	HTTP://WWW.MUNSONHEALTHCARE.ORG	WebsiteAddressTxt
State License	1060000029	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Research Facility	Yes (X)	ResearchFacilityInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MUNSON HEALTHCARE GRAYLING	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTPS://TINYURL.COM/YSZBXMYS	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	22	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://TINYURL.COM/YSZBXMYS	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://TINYURL.COM/2TNSZ8PS	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://TINYURL.COM/2TNSZ8PS	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://TINYURL.COM/2TNSZ8PS	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 3E	THE SIGNIFICANT PRIORITIZED HEALTH NEEDS OF THE COMMUNITY ARE IDENTIFIED IN THE CHNA UNDER THE KEY FINDINGS HEADING. IN THE NORTHEAST REGION, THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN ORDER OF PRIORITY: SUBSTANCE USE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND CHRONIC DISEASE. THESE THEMES WERE PRIORITIZED THROUGH A PRIORITIZATION MATRIX, FOR WHICH MITHRIVE DESIGN TEAM MEMBERS SORTED THE DATA RECEIVED FOR THE THREE REGIONS INTO PRIMARY AND SECONDARY DATA. THEY CLUSTERED DATA POINTS BASED ON TOPIC, THEME AND INTERCONNECTEDNESS. THE THEMES WHICH COULD BE FOUND IN THE HIGH SECONDARY DATA/ HIGH PRIMARY DATA QUADRANT WERE A COMBINATION OF THE ABOVE TOPICS BASED ON REGION.
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 5	WE ARE FOLLOWING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP FRAMEWORK TO GUIDE OUR PROCESS WHICH INCLUDES FOUR ASSESSMENTS TO GATHER INPUT. 1.COMMUNITY THEMES AND STRENGTHS ASSESSMENT: THIS ASSESSMENT PROVIDES A DEEP UNDERSTANDING OF THE ISSUES THAT RESIDENTS FEEL ARE SIGNIFICANT BY ANSWERING THE FOLLOWING QUESTIONS: WHAT IS IMPORTANT TO OUR COMMUNITY?; HOW IS QUALITY PERCEIVED IN OUR COMMUNITY?; WHAT ASSETS DO WE HAVE THAT CAN BE USED TO IMPROVE WELLBEING? IT CONSISTED OF THREE SURVEYS: COMMUNITY SURVEY, HEALTHCARE PROVIDER SURVEY, AND PULSE SURVEY. RESULTS FROM EACH WERE ANALYZED BY COUNTY, HOSPITAL SERVICE AREA, AND THE THREE MITHRIVE REGIONS. 2.COMMUNITY HEALTH STATUS ASSESSMENT: THE COMMUNITY HEALTH STATUS ASSESSMENT IDENTIFIES PRIORITY COMMUNITY HEALTH AND QUALITY OF LIFE ISSUES. IT ANSWERS THE QUESTIONS, HOW HEALTHY ARE OUR RESIDENTS? AND WHAT DOES THE HEALTH STATUS OF OUR COMMUNITY LOOK LIKE? ITS PURPOSE IS TO COLLECT QUANTITATIVE SECONDARY DATA ABOUT THE HEALTH AND WELL-BEING OF RESIDENTS AND COMMUNITIES. WE COLLECTED APPROXIMATELY 100 STATISTICS, BY COUNTY, FOR THE 31-COUNTY REGION FROM RELIABLE SOURCES SUCH AS THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE US CENSUS BUREAU. 3.COMMUNITY SYSTEM ASSESSMENT: THE COMMUNITY SYSTEM ASSESSMENT FOCUSES ON ORGANIZATIONS THAT CONTRIBUTE TO WELL-BEING. IT ANSWERS THE QUESTIONS, WHAT ARE THE COMPONENTS, ACTIVITIES, COMPETENCIES, AND CAPACITIES IN THE REGIONAL SYSTEM? AND HOW ARE SERVICES BEING PROVIDED TO OUR RESIDENTS? FIRST, COMMUNITY-WIDE VIRTUAL MEETINGS WERE CONVENED IN THE NORTHWEST, NORTHEAST, AND NORTH CENTRAL MITHRIVE REGIONS WHERE PARTICIPANTS DISCUSSED VARIOUS ATTRIBUTES OF THE COMMUNITY SYSTEM. THESE WERE FOLLOWED BY RELATED DISCUSSIONS AT LOCAL COMMUNITY COLLABORATIVE MEETINGS. 4.FORCES OF CHANGE ASSESSMENT: THE FORCES OF CHANGE ASSESSMENT IDENTIFIES FORCES SUCH AS LEGISLATION, TECHNOLOGY, AND OTHER FACTORS THAT AFFECT THE COMMUNITY CONTEXT. IT ANSWERS THE QUESTIONS, WHAT IS OCCURRING OR MIGHT OCCUR THAT AFFECTS THE HEALTH OF OUR COMMUNITY OR THE LOCAL SYSTEM? AND WHAT SPECIFIC THREATS OR OPPORTUNITIES ARE GENERATED BY THESE OCCURRENCES? LIKE THE COMMUNITY SYSTEM ASSESSMENT, THE FORCES OF CHANGE ASSESSMENT WAS COMPOSED OF COMMUNITY MEETINGS CONVENED VIRTUALLY IN THE NORTHWEST, NORTHEAST, AND NORTH CENTRAL REGIONS. AS ONE OF THE FIRST STEPS OF ACHIEVING HEALTH EQUITY IS TO UNDERSTAND CURRENT HEALTH DISPARITIES, WE INVITED DIVERSE COMMUNITY PARTNERS TO JOIN THE MITHRIVE STEERING COMMITTEE, DESIGN TEAM, AND WORKGROUPS, AND WE GATHERED PRIMARY AND SECONDARY DATA FROM MEDICALLY UNDERSERVED, MINORITY, AND LOW-INCOME POPULATIONS IN EACH OF THE FOUR MITHRIVE ASSESSMENTS, BY THE FOLLOWING METHODS: CROSS-TABULATING DEMOGRAPHIC INDICATORS SUCH AS AGE, RACE, AND SEX FOR THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT ENGAGING RESIDENTS EXPERIENCING BARRIERS TO SOCIAL DETERMINANTS OF HEALTH AND ORGANIZATIONS THAT SERVE THEM IN THE COMMUNITY SYSTEM ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT REACHING OUT TO MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS THROUGH PULSE SURVEYS ADMINISTERED BY ORGANIZATIONS THAT SERVE THEM INCREASING INCLUSION OF PEOPLE WITH DISABILITIES IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH PARTNERSHIP WITH THE DISABILITY NETWORK OF NORTHERN MICHIGAN SURVEYING PROVIDERS WHO CARE FOR PATIENTS/CLIENTS ENROLLED IN MEDICAID HEALTH PLANS RECRUITING 1) RESIDENTS EXPERIENCING BARRIERS TO SAFE, AFFORDABLE, AND ACCESSIBLE HOUSING; HEALTHY FOOD; TRANSPORTATION OPTIONS; AND OTHER SOCIAL DETERMINANTS OF HEALTH AND 2) REPRESENTATIVES FROM THE DIVERSE ORGANIZATIONS THAT SERVE THEM TO MITHRIVE DATA WALKS AND PRIORITY-SETTING EVENTS
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 6A	MITHRIVE WAS IMPLEMENTED ACROSS A 31-COUNTY REGION THROUGH A PARTNERSHIP OF HOSPITAL SYSTEMS, LOCAL HEALTH DEPARTMENTS, AND OTHER COMMUNITY PARTNERS. OUR AIM IS TO LEVERAGE RESOURCES AND REDUCE DUPLICATION WHILE STILL ADDRESSING UNIQUE LOCAL NEEDS FOR HIGH QUALITY, COMPARABLE, COUNTY-LEVEL DATA. THE 2021 MITHRIVE COMMUNITY HEALTH NEEDS ASSESSMENT UTILIZED THREE REGIONS: NORTHWEST, NORTHEAST, AND NORTH CENTRAL. ALL OF THE MUNSON HEALTHCARE HOSPITALS WORKED TOGETHER ON REGIONAL CHNA EFFORTS AS PART OF THE MITHRIVE REGIONAL CHNA INITIATIVE. THESE INCLUDE: MUNSON MEDICAL CENTER, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL, AND KALKASKA MEMORIAL HEALTH CENTER. IN ADDITION, HOSPITALS FORM THE MCLAREN AND SPECTRUM HEALTH SYSTEMS COLLABORATED ON THIS EFFORT.
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 6B	IN ADDITION TO DOZENS OF LOCAL AND REGIONAL ORGANIZATIONS, ALL HEALTH DEPARTMENTS IN THE REGION SERVED PARTICIPATED, INCLUDING: GRAND TRAVERSE HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 10, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, BENZIE LEELANAU DISTRICT HEALTH DEPARTMENT, CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 2, DISTRICT HEALTH DEPARTMENT 4. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 11	WE IDENTIFIED STRATEGIC ISSUES AS PART OF THE MITHRIVE COLLABORATIVE. STRATEGIC ISSUES ARE BROADER THAN INDIVIDUAL HEALTH CONDITIONS, AND REPRESENT UNDERLYING CHALLENGES THAT NEED TO BE ADDRESSED, WHICH WOULD LEAD TO IMPROVEMENT IN HEALTH CONDITIONS. EACH STRATEGIC ISSUE SHOULD IMPACT MORE THAN ONE HEALTH CONDITION. THE TOP PRIORITY ISSUES TO BE ADDRESSED: MENTAL HEALTH AND SUBSTANCE USE DISORDERS SAFE, AFFORDABLE AND ACCESSIBLE HOUSING ACCESS TO HEALTHCARE CHRONIC DISEASE A COMPLETE LIST OF STRATEGIES PLANNED TO ADDRESS THE PRIORITIZED NEEDS MAY BE VIEWED WITHIN THE CHNA IMPLEMENTATION PLAN. GENERALLY, THE HOSPITAL SYSTEM IS COMMITTED TO PROVIDING RESOURCES TO SUPPORT PROGRAMMING, PARTICIPATION IN COLLABORATIVE PROJECTS, BOARDS, AND SUPPORT FOR OTHER COMMUNITY IMPROVEMENT PROJECTS RELATED TO OUR PRIORITY STRATEGIC ISSUES. IN ADDITION TO THE STRATEGIC ISSUES LISTED ABOVE, THE FOLLOWING CHALLENGES WERE ALSO UNCOVERED IN THE DATA: BROADBAND ACCESS COVID-19 ECONOMIC SECURITY EQUITY HEALTHY FOOD HEALTHY WEIGHT INFRASTRUCTURE FOR HEALTHY LIVES SAFETY AND WELL-BEING TRANSPORTATION MUNSON HEALTHCARE ACKNOWLEDGES THE WIDE RANGE OF ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT WITH THE BROAD NATURE OF THE STRATEGIC ISSUES WE COULD EFFECTIVELY FOCUS ON ONLY THOSE ISSUES THAT WERE PRIORITIZED THE HIGHEST BY OUR COMMUNITY. HOWEVER, SOME OF THESE ISSUES INCLUDING EQUITYARE FOUNDATIONAL COMPONENTS OF ALL THE WORK OF THE ORGANIZATION AND WILL BE INDIRECTLY TARGETED THROUGH MANY OF THE STRATEGIES LISTED IN THIS PLAN.
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 13H	PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, AT THE SOLE DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16J	IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE.
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 20E	MUNSON HEALTHCARE GRAYLING(GRAYLING) REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. GRAYLING WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY GRAYLING; 2.DOCUMENTING THAT GRAYLING HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH GRAYLING 'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH GRAYLING DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. GRAYLING WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS.

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CRAWFORD CONTINUING CARE CENTER
1100 EAST MICHIGAN AVE	GRAYLING	MI	49738	EXTENDED CARE FACILITY
GRAYLING SURGICAL SERVICES
1010 W NORTH DOWN RIVER RD	GRAYLING	MI	49738	SURGICAL SERVICES

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	INCOME UP TO 200% OF THE FPG = 100% DISCOUNT ON CHARGES INCOME BETWEEN 201% AND 300% FPG = 75% DISCOUNT ON CHARGES INCOME BETWEEN 301% AND 400% FPG = 65% DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE, OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS. FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG: EARNINGS, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES; CASH, CHECKING AND SAVINGS BALANCES, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, IRAS TRUSTS, INHERITANCES, ANNUITIES, SAVINGS BONDS, STOCKS, MUTUAL FUNDS, AND/OR CASH VALUE OF LIFE INSURANCE.
SCHEDULE H, PART I, LINE 7G	THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 23,487,050. 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 99,134,557. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 3,145,479. THE NET EXPENSE OF 95,989,078 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F).
SCHEDULE H, PART I, LINE 7	COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION OR ACTUAL CASH PAID.
SCHEDULE H, PART II	MUNSON HEALTHCARE GRAYLING 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 SETTING INCLUDING 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 SUCCESFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING.
SCHEDULE H, PART III, LINE 4	SEE NOTE 2 ON PAGE 10 OF ATTACHED AUDITED FINANCIAL STATEMENTS UNDER ACCOUNTS RECEIVABLE.
SCHEDULE H, PART III, LINE 9B	MUNSON HEALTHCARE'S INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684.
SCHEDULE H, PART VI, LINE 2	THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM PARTICIPATE IN A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. IN ADDITION, THE HOSPITAL IS A MEMBER OF THE MUNSON HEALTHCARE SYSTEM, WHICH WORKS TO UNDERSTAND THE NEEDS OF THE SERVICE AREA THROUGH VARIOUS SERVICE LINE AND DEPARTMENT-BASED ASSESSMENT AND BUSINESS PLANNING STRATEGIES. THE HOSPITAL ALSO REGULARLY SEEKS INFORMATION FROM AND PARTICIPATES IN THE COUNTY COLLABORATIVE, MITHRIVE WORKGROUPS, AND OTHER REGIONAL COLLABORATIVES TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY HEALTH NEEDS. THE HOSPITAL MAINTAINS A COMMUNITY HEALTHCARE COUNCIL MADE UP OF LOCAL LEADERS AND AREA ORGANIZATIONS WHICH PROVIDE INPUT INTO EMERGING TRENDS AND ISSUES SPECIFIC TO THEIR COMMUNITIES. FINALLY, HEALTHCARE SYSTEM MAINTAINS A STANDING COMMUNITY AND POPULATION HEALTH COMMITTEE WHICH CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM REGIONAL HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MHC RESPONSE TO EMERGING HEALTH TRENDS, AND REVIEW NEW COMMUNITY HEALTH-BASED COLLABORATION OR PROGRAMS.
SCHEDULE H, PART VI, LINE 3	IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS: BROCHURES THAT DESCRIBE MUNSON HEALTHCARE'S FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES. THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR. STATEMENT ON BILLS: STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL. SIGNS IN THE ER REGISTRATION AREA: ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY. THE MUNSON HEALTHCARE INTERNET HAS THE FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, THE PLAIN LANGUAGE SUMMARY AND THE BILLING AND COLLECTIONS POLICY AVAILABLE TO REVIEW AND PRINT. REFERRAL BY REGISTRATION STAFF: AT THE TIME OF REGISTRATION, SELF-PAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF. MUNSON HEALTHCARE FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS. THE COUNSELOR VISIT ALL INPATIENTS THAT ARE DEEMED SELF-PAY, TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP. IF THE PATIENT WOULD LIKE HELP, THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID. GENERALLY, THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR. ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR, THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS. THE COUNSELORS ALSO IDENTIFY ALL SELF-PAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS, ONLY BY PHONE. THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION, BUT WHEN THAT IS NOT POSSIBLE, THE CALL IS MADE SOON AFTER DISCHARGE. AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: MEDICAID (AND ALL OF ITS SUBSETS), SOCIAL SECURITY DISABILITY, TRAVERSE HEALTH CLINIC, MUNSON HEALTHCARE FINANCIAL ASSISTANCE, AND MUNSON MEDICAL CENTER MEDS PROGRAM. MUNSON HEALTHCARE MAKES A PHONE CALL TO ALL PRIVATE-PAY PATIENTS PRIOR TO TRANSFERRING THEIR ACCOUNT TO A COLLECTION AGENCY TO INFORM THEM OF OUR FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART VI, LINE 4	DESCRIPTION MUNSON HEALTHCARE GRAYLING HOSPITAL SERVES A SPARSELY POPULATED, RURAL REGION IN CENTRAL NORTHERN MICHIGAN COMPRISED OF ALL OF CRAWFORD COUNTY (WHERE THE HOSPITAL IS LOCATED) AND MOST OF ROSCOMMON COUNTY, AS WELL AS MUCH OF OSCODA COUNTY AND SMALL PORTIONS OF MONTMORENCY AND OTSEGO COUNTIES. IT IS ONE OF NINE COMMUNITY HOSPITALS THAT ARE PART OF THE MUNSON HEALTHCARE SYSTEM. THE HOSPITAL HAS 39 LONG-TERM CARE BEDS, 104 ACTIVE MEDICAL STAFF (PRIMARY FACILITY), AND 658 EMPLOYEES MAKING IT ONE OF THE LARGEST EMPLOYERS IN THE REGION. THE HOSPITAL SERVED OVER 2,900 SURGICAL CASES, MORE THAN 106,000 OUTPATIENT VISITS, 1,792 INPATIENT ADMISSIONS, OVER 18,000 EMERGENCY ROOM VISITS, AND 300 BIRTHS IN FISCAL YEAR 2024. HOSPITAL SERVICES THIS 71-BED HOSPITAL OFFERS A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES: 24 HOUR EMERGENCY CARE SPECIALTIES INCLUDING ORTHOPEDICS, UROLOGY, CARDIOLOGY, CANCER SERVICES AND MORE. RADIOLOGY SERVICES WITH X-RAY, 3D MAMMOGRAPHY, MRI, ULTRASOUND AND CT. OBSTETRICS & GYNECOLOGY PHYSICIAN OFFICES LOCATED IN GRAYLING, PRUDENVILLE AND ROSCOMMON AREA OFFER VARYING SERVICES: PRIMARY CARE, BEHAVIORAL HEALTH, LAB SERVICES, URGENT AND WALK-IN CARE. LONG-TERM CARE AT CRAWFORD CONTINUING CARE CENTER ATTACHED TO GRAYLING HOSPITAL GENERAL, ORTHOPEDIC AND OUTPATIENT SURGERY POPULATION SERVED GRAYLING HOSPITAL IS IN CRAWFORD COUNTY. CRAWFORD, OSCODA, AND ROSCOMMON COUNTIES ARE CONSIDERED THE HOSPITALS SERVICE AREA, WITH CRAWFORD BEING THE MOST PRIMARY. WITHIN THIS COUNTY, THE FOLLOWING DEMOGRAPHIC DATA APPLIES: TOTAL POPULATION: 13,538 MEDIAN HOUSEHOLD INCOME: 57,998 27% OF ADULTS ARE AGE 65 OR OLDER, SIGNIFICANTLY MORE THAN THE STATE AVERAGE OF 18.2% THE RACIAL MAKEUP OF THE COUNTY IS 96% WHITE, 0.9% BLACK OR AFRICAN AMERICAN, .8% AMERICAN INDIAN/ALASKAN NATIVE, 0.7% ASIAN, 2.4% HISPANIC OR LATINO OF PEOPLE AGED 25 OR OLDER, 91% HAVE A HIGH SCHOOL DIPLOMA OR HIGHER AND 19.6% HAVE A BACHELORS DEGREE OR HIGHER THE UNEMPLOYMENT RATE IS 5.3% QUALITY 2024 THE LEAPFROG GROUP GRADE A FOR FALL AND SPRING; CMS 5-STAR HOSPITAL BLUE CROSS/BLUE SHIELD DISTINCTION CENTER FOR KNEE AND HIP REPLACEMENT AND MATERNITY CARE BLUE CROSS/BLUE SHIELD DESIGNATION FOR HOSPITALS MEETING AND EXCEEDING THEIR CARE BENCHMARKS
SCHEDULE H, PART VI, LINE 5	MUNSON HEALTHCARE GRAYLING 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 GRAYLINGS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM WHICH INCLUDE MUNSON MEDICAL CENTER, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL AND MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL PROVIDED 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

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount
EDWIN A NESS
DIRECTOR	$1,019,734	$200,000	$1,025,846	$222,314	$29,641	$2,497,535	$834,836
LAURA GLENN
COO	$602,996	$150,000	$86,011	$81,533	$23,778	$944,318
MICHAEL VANWAGNER DO
ORTHOPEDIC SURGEON	$655,450	$153,251	$22,790	$16,483	$2,020	$849,994		$2,412	$87	$50	$8	$2,557
PAUL KONOPACKI
CFO	$582,360	$70,000	$67,682	$65,902	$20,623	$806,567
DINO RECCHIA MD
DIRECTOR	$648,678	$17,144	$25,272	$16,533	$11,064	$718,691
BRIAN STIRLING MD
PHYSICIAN								$506,176	$26,603	$16,533	$29,579	$697,489	$118,598
MATTHEW DUBIEL MD
ORTHOPEDIC SURGEON	$642,618		$679	$16,483	$24,294	$684,074		$7,143	$260	$50	$295	$7,748
JASON BENNETT DO
ORTHOPEDIC SURGEON								$571,271	$24,016	$16,533	$26,046	$637,866
PAUL REYNOLDS DO
SURGEON	$39,492				$1,763	$41,255		$356,683	$378	$10,954	$16,705	$570,558	$185,838
ELLEN SMITH
PRESIDENT AMB SERVIC	$398,576		$66,251	$56,118	$3,888	$524,833
KIRSTEN KORTH-WHITE
PRESIDENT	$316,124		$76,362	$51,184	$25,766	$469,436
CHRISTOPHER SQUIRE
VP ANCILLARY SER EAS	$303,275		$31,200	$45,085	$24,465	$404,025
VINCENT SCHULTZ MD
DIRECTOR	$253,050	$3,333	$14,443	$15,152	$24,464	$310,442		$25,329	$982	$838	$2,032	$45,781	$16,600
KATHLEEN LARAIA
VP ONCOLOGY & PROF S	$282,571		$32,104	$27,111	$8,622	$350,408
MICHAEL HODNETT
CNO/COO								$178,533	$23,216	$20,058	$23,949	$245,756
KATHLEEN MALY
FORMER INTERIM CFO	$84,251	$75,000	$62,871	$2,947	$4,367	$229,436
CASEY KANDOW
FORMER VP ANCILLARY			$114,566			$114,566

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 KIRSTEN KORTH-WHITE 0 34,651 0 CHRISTOPHER SQUIRE 0 30,975 0 KATHLEEN LARAIA 0 17,471 0 MICHAEL HODNETT 0 10,709 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 EXECUTIVE SUPPLEMENTAL 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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 6	MUNSON HEALTHCARE GRAYLING IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 7A	MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE TRUSTEES FOR ALL SUBSIDIARY ENTITIES, INCLUDING MUNSON HEALTHCARE GRAYLING. THE BOARD OF TRUSTEES OF MUNSON HEALTHCARE GRYALING CONSISTS OF THOSE INDIVIDUALS THAT ARE ELECTED OR APPOINTED TO SERVE AS THE DIRECTORS OF MUNSON HEALTHCARE. NOMINATIONS TO MUNSON HEALTHCARE ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE.
FORM 990, PAGE 6, PART VI, LINE 7B	CERTAIN DECISIONS OF THE MUNSON HEALTHCARE GRAYLING (GRY) TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF GRY; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF GRY; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF GRY; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR GRY; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY GRY WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF GRY WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF GRY; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY GRY; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT.
FORM 990, PAGE 6, PART VI, LINE 11B	THE MUNSON HEALTHCARE GRAYLING BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE GRAYLING BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE EXECUTIVE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE EXECUTIVE COMPENSATION PROCESS AND THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE FINANCE AND AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12C	THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF EXECUTIVE COMPENSATION AND FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER.
FORM 990, PAGE 6, PART VI, LINE 15A	COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED THROUGH THE FOLLOWING PROCESS: FIRST, AN INDEPENDENT FIRM IS ENGAGED TO PROVIDE COMPARABILITY DATA. THEN, THAT DATA IS REVIEWED BY TWO MUNSON HEALTHCARE COMMITTEES, EACH OF WHICH ARE COMPRISED OF INDIVIDUALS WHO ARE NOT EMPLOYEES OR OTHERWISE INSIDERS (DEFINED AS BOARD MEMBERS, PHYSICIANS & EXECUTIVES) OF THE ORGANIZATION. FIRST, THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE EVALUATES THE DATA AND DETERMINES A RECOMMENDED COMPENSATION MODEL BASED ON THE COMPARABILITY DATA. NEXT, THE BOARD CONFLICT, VALUATION AND COMPLIANCE COMMITTEE REVIEWS THE RECOMMENDATIONS AS COMPARED TO THE COMPARABILITY DATA. THIS COMMITTEE'S ROLE IS TO DETERMINE WHETHER THE PROPOSED COMPENSATION IS CONSISTENT WITH FAIR MARKET VALUE. IF PHYSICIANS ARE INCLUDED IN THE DEFINITION OF KEY EMPLOYEE, THE BOARD CONFLICT, VALUATION, AND COMPLIANCE COMMITTEE REVIEWS ALL FINANCIAL RELATIONSHIPS WITH PHYSICIANS AND COMPARES THE PROPOSED FINANCIAL ARRANGEMENT WITH COMPARABILITY DATA PRODUCED BY AN OUTSIDE, INDEPENDENT FIRM. PHYSICIAN COMPENSATION DOES NOT GO TO THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMPARABILITY DATA AS WELL AS THE MINUTES OF EACH OF THESE COMMITTEE MEETINGS ARE MAINTAINED FOR FUTURE REFERENCE. THE MHC BOARD APPROVES THE MHC CEO'S COMPENSATION. THE MHC BOARD HAS DELEGATED TO THE CVC COMMITTEE THE AUTHORITY TO REVIEW AND APPROVE COMPENSATION ARRANGEMENTS WITH INSIDERS.
FORM 990, PAGE 6, PART VI, LINE 15B	COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES OF MUNSON HEALTHCARE GRAYLING AND MUNSON HEALTHCARE.
FORM 990, PAGE 6, PART VI, LINE 19	THE MUNSON HEALTHCARE GRAYLING ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE GRAYLING DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES 6,309,500 6,558 0 PROFESSIONAL FEES 4,981,743 11,111 0 TOTAL 11,291,243 17,669 0

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
MUNSON DIALYSIS CENTER
1105 SIXTH ST	TRAVERSE CITY	MI	49684	383097861	DIALYSIS	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HEALTHCARE
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382640544	HEALTHCARE	MI	C3	12B			false	N/A
MUNSON HEALTHCARE FOUNDATIONS
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382642724	RAISE FUND	MI	C3	7	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HOME CARE
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382191390	HOME HEALT	MI	C3	10	MUN HOME H	MUNSON HOME HEALTH	Yes (true)
MUNSON HOME SERVICES
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382543463	HOME HEALT	MI	C3	10	MUN HOME H	MUNSON HOME HEALTH	Yes (true)
NORTH FLIGHT INC
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382657917	MED TRANSP	MI	C3	12B	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
PAUL OLIVER MEMORIAL HOSPITAL
1105 SIXTH ST	TRAVERSE CITY	MI	49684	381415623	HEALTHCARE	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON MEDICAL GROUP
1105 SIXTH ST	TRAVERSE CITY	MI	49684	273600575	PHYSICIAN	MI	C3	10	MUNSON MED	MUNSON MEDICAL CENTER	Yes (true)
MUNSON MEDICAL CENTER
1105 SIXTH ST	TRAVERSE CITY	MI	49684	381362830	HOSPITAL	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HEALTHCARE CADILLAC
1105 SIXTH ST	TRAVERSE CITY	MI	49684	471156297	HOSPITAL	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HEALTHCARE CHARLEVOIX HOSPIT
1105 SIXTH ST	TRAVERSE CITY	MI	49684	381459366	HOSPITAL	MI	C3	3	MUNSON HC		Yes (true)
MUNSON HEALTHCARE MANISTEE HOSPITAL
1465 E PARKDALE AVE	MANISTEE	MI	496609709	380350304	HOSPITAL	MI	C3	3	MUNSON HC		Yes (true)
MUNSON HEALTHCARE OTSEGO MEMORIAL H
825 N CENTER AVE	GAYLORD	MI	497351592	381303843	HOSPITAL	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	NORTHERN MICHIGAN SUPPLY ALLIANCE	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2651 AERO PARK DR	AddressLine1Txt
City	TRAVERSE CITY	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49686	ZIPCd

Field	Value	IRS element (for citing)
EIN	383453378	EIN
Primary Activities	PURCHASING	PrimaryActivitiesTxt
Legal Domicile State	MI	LegalDomicileStateCd
Direct Controlling NA	N/A	DirectControllingNACd
Disproportionate Allocations	false	DisproportionateAllocationsInd
General Or Managing Partner	false	GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd
MEDICAL OFFICE BUILDING CONDOMINIUM
PO BOX 1188	TRAVERSE CITY	MI	496851188	383567278	REAL ESTAT	MI	N/A	Yes (true)
MUNSON SERVICES INC
PO BOX 1188	TRAVERSE CITY	MI	496851188	383144382	PHARMACY	MI	N/A	Yes (true)
SIXTH STREET DRUGS INC
PO BOX 1188	TRAVERSE CITY	MI	496851188	382298290	PHARMACY	MI	N/A	Yes (true)
MEDICAL OFFICE CONDOMINIUM ASSOCIAT
PO BOX 1188	TRAVERSE CITY	MI	496851188	201902620	REAL ESTAT	MI	N/A	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (24 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MUNSON HEALTHCARE FOUNDATIONS
C	$220,760	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE
M	$12,574,646	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE FOUNDATIONS
M	$91,353	ACTUAL AMOUNTS PAID
MUNSON MEDICAL CENTER
M	$885,613	ACTUAL AMOUNTS PAID
NORTHERN MI SUPPLY ALIANCE
M	$615,968	ACTUAL AMOUNTS PAID
MUNSON MEDICAL GROUP
M	$170,013	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE
O	$1,331,905	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE OTSEGO MEMORIAL H
O	$77,434	ACTUAL AMOUNTS PAID
MUNSON MEDICAL CENTER
O	$27,729,580	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE CHARLEVOIX HOSPIT
O	$129,812	ACTUAL AMOUNTS PAID
MUNSON MEDICAL GROUP
O	$656,393	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE
P	$9,405,323	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE CADILLAC
P	$865,307	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE OTSEGO MEMORIAL H
P	$129,920	ACTUAL AMOUNT PAID
MUNSON MEDICAL CENTER
P	$11,457,408	ACTUAL AMOUNTS PAID
NORTHERN MI SUPPLY ALIANCE
P	$2,231,648	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE
Q	$100,808	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE CADILLAC
Q	$479,005	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE OTSEGO MEMORIAL H
Q	$464,609	ACTUAL AMOUNTS PAID
MUNSON MEDICAL CENTER
Q	$10,578,323	ACTUAL AMOUNTS PAID
NORTHERN MI SUPPLY ALLIANCE
Q	$243,616	ACTUAL AMOUNTS PAID
MUNSON HELATHCARE MANISTEE HOSPITAL
Q	$453,918	ACTUAL AMOUNTS PAID
PAUL OLIVER MEMORIAL HOSPITAL
Q	$409,027	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE CHARLEVOIX HOSPIT
Q	$153,235	ACTUAL AMOUNTS PAID

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE R	FormAndLineReferenceDesc
Explanation	MUNSON HEALTHCARE GRAYLING USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.	ExplanationTxt