EMMA L BIXBY MEDICAL CENTER: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: EMMA L BIXBY MEDICAL CENTER (EIN 38-2796005)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-08
IRS object ID: 202223129349302532
Schema version: 2021v4.2
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 I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-08T12:18:05-06:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	382796005	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EMMA L BIXBY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	EMMA	BusinessNameControlTxt
Phone	4192525772	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 MADISON AVE ATTN TAX DEPARTM	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	LOUIS ROBICHAUX	PersonNm
Person Title	TREASURER	PersonTitleTxt
Phone	4192525772	PhoneNum
Signature	2022-11-07	SignatureDt
Discuss With Paid Preparer	0	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	LOUIS	PersonFirstNm
Person Last	ROBICHAUX	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	PROMEDICA CHARLES AND VIRGINIA HICKMAN	BusinessNameLine1Txt
Business Name Line2	HOSPITAL	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Principal Officer	LOUIS ROBICHAUX	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 MADISON AVE	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$139,351,898	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.PROMEDICA.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1989	FormationYr
Legal Domicile State	MI	LegalDomicileStateCd
Activity Or Mission	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL IS AN ACUTE CARE HOSPITAL THAT PROVIDES HEALTHCARE SERVICES PRIMARILY TO INDIVIDUALS OF LENAWEE COUNTY.	ActivityOrMissionDesc
Voting Members Governing Body	20	VotingMembersGoverningBodyCnt
Voting Members Independent	15	VotingMembersIndependentCnt
Total Employee	681	TotalEmployeeCnt
Total Volunteers	29	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$14,268,874	PYContributionsGrantsAmt
CY Contributions Grants	$4,855,455	CYContributionsGrantsAmt
PY Program Service Revenue	$89,628,113	PYProgramServiceRevenueAmt
CY Program Service Revenue	$132,177,597	CYProgramServiceRevenueAmt
PY Investment Income	$524,842	PYInvestmentIncomeAmt
CY Investment Income	$26,427	CYInvestmentIncomeAmt
PY Other Revenue	$2,659,819	PYOtherRevenueAmt
CY Other Revenue	$2,143,373	CYOtherRevenueAmt
PY Total Revenue	$107,081,648	PYTotalRevenueAmt
CY Total Revenue	$139,202,852	CYTotalRevenueAmt
PY Grants And Similar Paid	$96,834	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$10,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$39,422,017	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$45,598,185	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$53,230,010	PYOtherExpensesAmt
CY Other Expenses	$64,711,302	CYOtherExpensesAmt
PY Total Expenses	$92,748,861	PYTotalExpensesAmt
CY Total Expenses	$110,319,487	CYTotalExpensesAmt
PY Revenues Less Expenses	$14,332,787	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$28,883,365	CYRevenuesLessExpensesAmt
Total Assets BOY	$240,319,755	TotalAssetsBOYAmt
Total Assets EOY	$214,732,301	TotalAssetsEOYAmt
Total Liabilities BOY	$109,108,695	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$141,064,883	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$131,211,060	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$73,667,418	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	EMMA L. BIXBY MEDICAL CENTER IS DEDICATED TO IMPROVING HUMAN LIFE AND DEVOTED TO THE PATIENTS AND FAMILIES WE SERVE THROUGH INNOVATIVE CARE, SUPERIOR QUALITY, AND PREMIER CUSTOMER SERVICE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$86,933,510	ExpenseAmt
Grant	$10,000	GrantAmt
Revenue	$132,727,321	RevenueAmt
Desc	EMMA L. BIXBY MEDICAL CENTER IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O.	Desc
Total Program Service Expenses	$86,933,510	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	681	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	20	GoverningBodyVotingMembersCnt
Independent Voting Member	15	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	Yes (1)	LocalChaptersInd
Policies Reference Chapters	Yes (1)	PoliciesReferenceChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JENNIFER SARPALIUS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5675855652	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 MADISON AVE	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MARCY L BROWN
CHAIRMAN	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
JULIE K YAROCH DO
PRES., EX OFFICIO	1.00	54.00	Yes (X)	Yes (X)	$0	$413,256	$29,767
DAWN M BUSKEY
EX OFFICIO, PRES. ACUTE CARE	1.00	54.00	Yes (X)		$0	$805,499	$49,161
MICHAEL B ADAMS
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
JOHN C AKENS
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
CHRISTI L ANSBERG
TRUSTEE,VP, PHILANTHROPY	1.00	51.00	Yes (X)		$0	$213,120	$23,900
DARRIN ARQUETTE
TRUSTEE, PRES. REGIONAL ACUTE CARE	1.00	42.00	Yes (X)		$0	$481,180	$38,136
MARCIA J BOYNTON JD
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
VICTOR J CHERFAN DO
TRUSTEE (PARTIAL YEAR), PHYSICIAN	1.00	41.00	Yes (X)		$0	$511,524	$20,698
MARSHA L DAVIS
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
RUSSELL L DEMPSEY
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
FRANK DICK
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
EDWARD J ENGLE
TRUSTEE (PARTIAL YEAR)	1.00	0.00	Yes (X)		$0	$0	$0
GRACE M GARNO
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
PAUL E GIETZEN MD
TRUSTEE, PHYSICIAN	1.00	40.00	Yes (X)		$0	$311,175	$21,753
ELIZABETH A KENNEDY
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
RICK K KNIERIM
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
GARY E MCDOWELL
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
DENNIS M SMOKE
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
AARON D SWIGGUM
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
MICHAEL J UCKELE
TRUSTEE	1.00	0.00	Yes (X)		$0	$0	$0
PAULA K HOLTZ
VICE CHAIRMAN	1.00	0.00	Yes (X)		$0	$0	$0
RANDALL OOSTRA
PHS PRES. & CEO	1.00	55.00		Yes (X)	$0	$7,155,772	$300,344
JEFFREY C KUHN
SECRETARY, CHIEF LEGAL OFFICER	1.00	55.00		Yes (X)	$0	$1,347,615	$68,186
STEVEN M CAVANAUGH
TREASURER, CFO	1.00	55.00		Yes (X)	$0	$3,497,904	$60,660
DEANA SIEVERT
SR VP, PAT CARE/CNO, SYSTEM	1.00	54.00			$0	$530,514	$33,176	Yes (X)
GARY W AKENBERGER
COO, ACUTE CARE & SVP, DIAG	0.00	50.00			$0	$525,467	$38,467	Yes (X)
JENNIFER FOSS
DIRECTOR OF PHARMACY	22.00	18.00			$169,770	$169,745	$9,615		Yes (X)
ALEXA SIMKOW
DIR-SURGICAL SVCS.	40.00	0.00			$144,137	$0	$26,711		Yes (X)
MELISSA THOMPSON
CLINICAL PHARMACIST	40.00	0.00			$142,194	$0	$11,579		Yes (X)
CHRISTINA BELL
DIRECTOR OF PHARMACY	17.00	23.00			$140,716	$140,716	$30,434		Yes (X)
CINNAMON BERNARDO
DIR NURSE LEAD	40.00	0.00			$138,499	$0	$18,435		Yes (X)
ALAN M SATTLER
FORMER TREASURER, VP BUSINESS DEV.	0.00	40.00			$0	$269,627	$37,223			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$735,316	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$16,373,114	TotReportableCompRltdOrgAmt
Total Other Compensation	$818,245	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	35	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Related Organizations	$435,658	RelatedOrganizationsAmt
Government Grants	$4,211,014	GovernmentGrantsAmt
All Other Contributions	$208,783	AllOtherContributionsAmt
Total Contributions	$4,855,455	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
NET PATIENT SERVICES	622110	$131,104,924	$131,104,924
AFFILIATED ORG RENT	531120	$1,072,673		$1,072,673

Field	Value	IRS element (for citing)
Total Program Service Revenue	$132,177,597	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$26,427	TotalRevenueColumnAmt
Exclusion	$26,427	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,874	TotalRevenueColumnAmt
Exclusion	$1,874	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$418,880	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$149,046	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$269,834	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$269,834	TotalRevenueColumnAmt
Exclusion	$269,834	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	ER MEDICAL PROF. SVCS	Desc
Business	621493	BusinessCd
Total Revenue Column	$1,560,727	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,560,727	RelatedOrExemptFuncIncomeAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$310,938	TotalRevenueColumnAmt
Related Or Exempt Func Income	$61,670	RelatedOrExemptFuncIncomeAmt
Exclusion	$249,268	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,871,665	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$139,202,852	TotalRevenueColumnAmt
Related Or Exempt Func Income	$132,727,321	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$1,620,076	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$10,000	TotalAmt
Program Services	$10,000	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$37,452,627	TotalAmt
Program Services	$29,613,861	ProgramServicesAmt
Management And General	$7,838,766	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,372,914	TotalAmt
Program Services	$1,085,566	ProgramServicesAmt
Management And General	$287,348	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,555,476	TotalAmt
Program Services	$3,602,023	ProgramServicesAmt
Management And General	$953,453	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,217,168	TotalAmt
Program Services	$1,753,119	ProgramServicesAmt
Management And General	$464,049	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$295,932	TotalAmt
Management And General	$295,932	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$70,179	TotalAmt
Management And General	$70,179	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$6,380	TotalAmt
Management And General	$6,380	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$19,504,021	TotalAmt
Program Services	$13,846,869	ProgramServicesAmt
Management And General	$5,657,152	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$331,799	TotalAmt
Program Services	$31,806	ProgramServicesAmt
Management And General	$299,993	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,064,150	TotalAmt
Program Services	$102,008	ProgramServicesAmt
Management And General	$962,142	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$76,081	TotalAmt
Program Services	$46,780	ProgramServicesAmt
Management And General	$29,301	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,193,916	TotalAmt
Program Services	$3,098,099	ProgramServicesAmt
Management And General	$95,817	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$76,103	TotalAmt
Program Services	$7,295	ProgramServicesAmt
Management And General	$68,808	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$3,358,948	TotalAmt
Program Services	$3,358,948	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,685,808	TotalAmt
Program Services	$6,843,568	ProgramServicesAmt
Management And General	$842,240	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,087,983	TotalAmt
Management And General	$1,087,983	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
DRUGS	$9,296,355	$9,296,355
INTERCOMPANY SERVICES	$6,046,400	$6,046,400
MEDICAL SUPPLIES	$5,168,436	$5,168,436
PROVIDER TAXES	$2,553,080	$2,553,080

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,895,731	TotalAmt
Program Services	$469,297	ProgramServicesAmt
Management And General	$4,426,434	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$110,319,487	TotalAmt
Program Services	$86,933,510	ProgramServicesAmt
Management And General	$23,385,977	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$16,869,433	BOYAmt
EOY	$7,075,986	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$13,823,838	BOYAmt
EOY	$16,548,901	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,920,380	BOYAmt
EOY	$2,557,469	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$176,159	BOYAmt
EOY	$189,074	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$164,387,481	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$17,519,819	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$153,138,026	BOYAmt
EOY	$146,867,662	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$841,052	BOYAmt
EOY	$886,381	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$685,083	BOYAmt
EOY	$1,047,603	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$52,865,784	BOYAmt
EOY	$39,559,225	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$240,319,755	BOYAmt
EOY	$214,732,301	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$22,978,816	BOYAmt
EOY	$14,172,579	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
EOY	$49,361,865	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$86,129,879	BOYAmt
EOY	$77,530,439	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$109,108,695	BOYAmt
EOY	$141,064,883	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	$94,277,823	BOYAmt
EOY	$34,593,529	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$36,933,237	BOYAmt
EOY	$39,073,889	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$131,211,060	BOYAmt
EOY	$73,667,418	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$240,319,755	BOYAmt
EOY	$214,732,301	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$28,883,365	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$86,427,007	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	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 (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

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	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$6,380	OtherActivitiesAmt
Total Lobbying Expenditures	$6,380	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	EMMA L. BIXBY MEDICAL CENTER PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE MICHIGAN HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATIONS.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$22,620,000	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,929,793	InvestmentEarningsOrLossesAmt
Other Expenditures	$30,647	OtherExpendituresAmt
End Year Balance	$24,519,146	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$771,892	BeginningYearBalanceAmt
Contributions	$19,420,909	ContributionsAmt
Investment Earnings Or Losses	$2,927,199	InvestmentEarningsOrLossesAmt
Other Expenditures	$500,000	OtherExpendituresAmt
End Year Balance	$22,620,000	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$689,791	BeginningYearBalanceAmt
Investment Earnings Or Losses	$82,101	InvestmentEarningsOrLossesAmt
End Year Balance	$771,892	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,270,935	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$81,144	InvestmentEarningsOrLossesAmt
Other Expenditures	$500,000	OtherExpendituresAmt
End Year Balance	$689,791	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,391,415	BeginningYearBalanceAmt
Investment Earnings Or Losses	$44,786	InvestmentEarningsOrLossesAmt
Other Expenditures	$165,266	OtherExpendituresAmt
End Year Balance	$1,270,935	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.94300	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.05700	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,244,583	OtherCostOrOtherBasisAmt
Book Value	$1,244,583	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$131,529,658	OtherCostOrOtherBasisAmt
Depreciation	$8,936,077	DepreciationAmt
Book Value	$122,593,581	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,748	OtherCostOrOtherBasisAmt
Depreciation	$13,363	DepreciationAmt
Book Value	$10,385	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$27,001,035	OtherCostOrOtherBasisAmt
Depreciation	$8,237,089	DepreciationAmt
Book Value	$18,763,946	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,588,457	OtherCostOrOtherBasisAmt
Depreciation	$333,290	DepreciationAmt
Book Value	$4,255,167	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$146,867,662	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
BENEFICIAL INTEREST IN FOUNDATION	$38,597,312
ESTIMATED THIRD PARTY PAYOR RECEIVABLE	$943,996
OTHER RECEIVABLE	$17,917

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$39,559,225	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
ESTIMATED THIRD PARTY PAYOR RECEIVABLE	$4,446,020
INTERCOMPANY DEBT TO THE TOLEDO HOSPITAL	$68,756,761
OPERATING LEASE LIABILITY	$807,416
OTHER LIABILITIES	$2,546,574
PROVIDER TAX PAYABLE	$973,668

Field	Value	IRS element (for citing)
Total Liability	$77,530,439	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART V, LINE 4:	FormAndLineReferenceDesc
Explanation	THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT EMMA L. BIXBY MEDICAL CENTER CONSISTENT WITH DONOR INTENT.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	600.000000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$612,697	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$612,697	NetCommunityBenefitExpnsAmt
Total Expense	0.00560	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,846,467	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,584,102	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,262,365	NetCommunityBenefitExpnsAmt
Total Expense	0.01140	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,177	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,891	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,286	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,464,341	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,587,993	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,876,348	NetCommunityBenefitExpnsAmt
Total Expense	0.01700	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$473,218	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$67,738	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$405,480	NetCommunityBenefitExpnsAmt
Total Expense	0.00370	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$241,276	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$241,276	NetCommunityBenefitExpnsAmt
Total Expense	0.00220	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,430,857	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$736,626	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$694,231	NetCommunityBenefitExpnsAmt
Total Expense	0.00630	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,784	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$26,784	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,172,135	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$804,364	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,367,771	NetCommunityBenefitExpnsAmt
Total Expense	0.01240	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,636,476	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,392,357	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,244,119	NetCommunityBenefitExpnsAmt
Total Expense	0.02940	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$250,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$250,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00230	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$217,667	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$217,667	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$467,667	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$467,667	NetCommunityBenefitExpnsAmt
Total Expense	0.00430	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,554,307	BadDebtExpenseAmt
Bad Debt Expense Attributable	$69,915	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$25,061,237	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$24,859,965	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$201,272	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 HERRICK MEMORIAL OFFICE PLAZA CONDO ASSOCIATION
FACILITY SUPPORT	0.71800	0.28200
2 LENAWEE CLINICAL PARTNERS
PHYSICIAN MGMT SERVICES	0.50000	0.38460

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5640 N ADRIAN HWY	AddressLine1Txt
City	ADRIAN	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49221	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.PROMEDICA.ORG	WebsiteAddressTxt
State License	1060000004	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	PROMEDICA CHARLES AND VIRGINIA HICKMAN H	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	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
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	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	600.000000000000	FPGFamilyIncmLmtDscntCarePct
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	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
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	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
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY ASSESSMENT SURVEY PROCESS, THE LENAWEE HEALTH NETWORK, COMPRISED OF MULTIPLE COMMUNITY ORGANIZATIONS, COLLABORATED TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LENAWEE COUNTY, WITH PROMEDICA BIXBY AND HERRICK HOSPITALS REPRESENTED ON THIS CHIP COMMITTEE. A GAP ANALYSIS AND RESOURCE ASSESSMENT WAS CONDUCTED AS PART OF THIS PROCESS.IN 2019, PROMEDICA BIXBY AND HERRICK HOSPITALS CONVENED A CHNA COMMITTEE TO REVIEW THE MOST RECENT LENAWEE COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY HEALTH INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS. THE CHNA AND STRATEGIC IMPLEMENTATION PLAN WAS DEVELOPED WITH FEEDBACK FROM THE LENAWEE COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE. THE LENAWEE HEALTH NETWORK STRATEGIC PLANNING PROCESS INCLUDED INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED:ADRIAN FARMER'S MARKET, CARE PREGNANCY CENTER OF LENAWEE, CATHOLIC CHARITIES OF LENAWEE AND JACKSON, COMMUNITY ACTION AGENCY, FAMILY MEDICAL CENTER, GOODWILL INDUSTRIES, INTERCONNECTIONS DROP IN CENTER, LENAWEE COMMUNITY FOUNDATION, LENAWEE COMMUNITY MENTAL HEALTH AUTHORITY, LENAWEE COUNTY HEALTH DEPARTMENT, LENAWEE DEPARTMENT ON AGING, LENAWEE DEPARTMENT OF HUMAN SERVICES, LENAWEE DEPARTMENT OF VETERANS AFFAIRS, LENAWEE INTERMEDIATE SCHOOL DISTRICT, LENAWEE SUBSTANCE ABUSE PREVENTION COALITION, MCCULLOUGH, VARGAS & ASSOCIATES, MHP SALUD, MICHIGAN OPIOID COLLABORATIVE, MSU EXTENSION, ONE LENAWEE, PROMEDICA BIXBY HOSPITAL, PROMEDICA HERRICK HOSPITAL, REGION 2 AREA AGENCY ON AGING, SIENA HEIGHTS, THE UNITED WAY OF MONROE AND LENAWEE COUNTIES, YMCA OF LENAWEE
PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITY: HERRICK MEMORIAL HOSPITAL, INC.
PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO.
PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL	PART V, SECTION B, LINE 11: EMMA L. BIXBY MEDICAL CENTER (DBA PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL) CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - OPIOIDS AND SUBSTANCE ABUSE - CHRONIC DISEASE PREVENTION - MENTAL HEALTH- CANCER THIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019, THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022. EMMA L. BIXBY MEDICAL CENTER DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2019 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN INCLUDE: ADULT - HEALTHCARE COVERAGE, UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL USE, ADULT SEXUAL BEHAVIOR, ADULT MENTAL HEALTH, CANCER, QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, PARENTING; CHILD HEALTH HEALTH AND FUNCTIONAL STATUS. HEALTH CARE ACCESS, EARLY CHILDHOOD, MIDDLE CHILDHOOD, FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2021 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. EMMA L. BIXBY MEDICAL CENTER DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: OPIOIDS AND SUBSTANCE ABUSESTRATEGY #1 - PARTICIPATE IN COMMUNITY DRUG TAKE BACK DAYS ANNUALLY AND MED SAFE COLLECTION AND DISPOSAL.ACTIONS TAKEN: - 1,048 POUNDS OF DRUGS WERE COLLECTED FROM MEDSAFE BOXES AND DRUG TAKE BACK DAY EVENTS AND DISPOSED OF APPROPRIATELY . STRATEGY #2 - OFFER PEER RECOVERY COACHES FOR THOSE PATIENTS SEEKING HELP WITH SUBSTANCE ABUSE.ACTIONS TAKEN: - FIFTEEN (15) PATIENTS WERE CONNECTED TO PEER RECOVERY COACHES WITH COMMUNITY MENTAL HEALTH & PATHWAYS FOR POST DISCHARGE TREATMENT.STRATEGY #3 - CONTINUE THE ALTO (ALTERNATIVES TO OPIOIDS) PROJECT TO REDUCE THE AMOUNT OF OPIOIDS PRESCRIBED AT DISCHARGE FOR PATIENT PAIN MANAGEMENT. ACTIONS TAKEN:- USING ALTO PROGRAM, IN 2020, THE AVERAGE NUMBER OF DAYS OPIOIDS WERE PRESCRIBED AT DISCHARGE WAS DECREASED TO 3.06 DAYS BY DECEMBER 2020 AND DECREASED FURTHER TO 2.836 IN 2021.HEALTH NEED IDENTIFIED: CHRONIC DISEASE PREVENTION STRATEGY #1 - PROVIDE ANNUAL BLOOD PRESSURE SCREENINGS AT KEY COMMUNITY LOCATIONS. ACTIONS TAKEN: - PROVIDED 82 COMMUNITY PARTICIPANTS WITH BLOOD PRESSURE SCREENINGS AND EDUCATION IN 2021. STRATEGY #2 - PROVIDE ANNUAL BLOOD SUGAR SCREENINGS AT KEY COMMUNITY LOCATIONS.ACTIONS TAKEN: - HOSPITAL PROVIDED THREE(3) NO COST BLOOD SUGAR SCREENINGS AND EDUCATION AT KEY COMMUNITY LOCATIONS IN 2021 DUE TO COVID RESTRICTIONS THESE SCREENINGS WERE ONLY OFFERED IN 4TH QUARTER 2021.STRATEGY #3 - PROVIDE EDUCATION TO THE COMMUNITY ABOUT BLOOD PRESSURE AND BLOOD SUGAR SELF-MONITORING VIA VIRTUAL SUPPORT GROUP MEETINGS.ACTIONS TAKEN: - 40 COMMUNITY MEMBERS RECEIVED SELF-MONITORING EDUCATION RELATED EDUCATION AT BLOOD PRESSURE SUPPORT GROUPS AND DIABETES SUPPORT GROUPSSTRATEGY #4 PROVIDE EDUCATION MATERIALS RELATED TO RESPIRATORY DISEASE (COPD) PREVENTION AND SELF-MANAGEMENT TO PATIENTS AT DISCHARGE AND AT KEY COMMUNITY LOCATIONS.ACTIONS TAKEN: - SECOND QUARTER, DISTRIBUTED TOBACCO CESSATION EDUCATION TO FIVE (5) COMMUNITY MEMBERS AT SCREENING STATION. - 4TH QUARTER DISTRIBUTED COPD EDUCATIONAL TO 30 COMMUNITY MEMBERS AT RESIDENT COALITION 2ND FRIDAY EVENT.STRATEGY #5 CONTINUE TO FUND PROMEDICA FARMS AND VEGGIE MOBILE PROGRAM TO EXPAND THE OUTREACH OF FRESH PRODUCE ACCESS THROUGH COLLABORATIONS WITH LOCAL PRODUCERS AND COMMUNITY AGENCIES.ACTIONS TAKEN: - TOTAL FRESH PRODUCE DONATED TO THE COMMUNITY WAS 5,022.8 POUNDS.STRATEGY #6 SCREEN INPATIENTS FOR FOOD INSECURITY, AND PROVIDE COMMUNITY RESOURCE LISTING, IMMEDIATE FOOD SOURCE, AND VEGGIE MOBILE VOUCHER. ACTIONS TAKEN: - FOUR (4) FOOD AT DISCHARGE BOXES WERE PROVIDED TO INPATIENTS WHO SCREENED POSITIVE FOR FOOD INSECURITY IN 2021.HEALTH NEED IDENTIFIED: MENTAL HEALTHSTRATEGY #1 - DEVELOP AND DISTRIBUTE A MENTAL HEALTH RESOURCE GUIDE TO PATIENTS AND THE COMMUNITY.ACTIONS TAKEN: - 860 MENTAL HEALTH RESOURCE GUIDES WERE DISTRIBUTED TO PATIENTS AND THE COMMUNITY IN 2021, TO IMPROVE ACCESS TO THESE RESOURCESSTRATEGY #2 - PROVIDE COMMUNITY MEMBERS AND PATIENTS WITH MENTAL HEALTH SELF-MANAGEMENT AND PREVENTION EDUCATION MATERIALS.ACTIONS TAKEN:- PROVIDED 682 PACKETS OF MENTAL HEALTH SELF-MANAGEMENT AND PREVENTION EDUCATION MATERIALS TO COMMUNITY MEMBERS AND PATIENTS IN 2021.HEALTH NEED IDENTIFIED: CANCERSTRATEGY #1 - PROVIDE HEALTH EDUCATION RELATED TO SCREENING AND PREVENTION OF CANCER IN LENAWEE COUNTY BY TRAINING HAIR STYLISTS, FOOD PANTRIES, AND KEY COMMUNITY ORGANIZATIONS TO BE CANCER HEALTH ADVOCATES THROUGH THE DELIVERY OF MESSAGES AND EDUCATION TO THE COMMUNITY. ACTIONS TAKEN:-50 EDUCATIONAL PACKETS ABOUT COPD AND LUNG CANCER WERE DISTRIBUTED TO COMMUNITY MEMBERS AT ALL ABOUT ADRIAN RESIDENT EVENTSTRATEGY #2 - CONTINUE PARTICIPATION IN BREAST AND CERVICAL CANCER CONTROL PROGRAM (BCCP) FOR FREE WOMEN'S HEALTH SCREENINGS.ACTIONS TAKEN:- 13 WOMEN WERE PROVIDED WITH NO COST WOMEN'S HEALTH SCREENINGS IN 2021 THROUGH THE BREAST AND CERVICAL CANCER CONTROL PROGRAM (BCCP).
PART V, SECTION B, LINE 7A	THE 2019 CHNA CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-BIXBY-AND-HERRICK-HOSPITALS-2019-JOINT-CHNA.PDF
PART V, SECTION B, LINE 10A	THE 2020-2022 CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-BIXBY-AND-HERRICK-HOSPITAL-2019-JOINT-CHNA-IMPLEMENTATION-PLAN-2020-2022-.PDF
PART V, SECTION B, LINE 16A:	THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/UNINSURED_DISCOUNT_POLICY.PDF
PART V, SECTION B, LINE 16B:	THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/FINANCIAL_ASSISTANCE_APPLICATION.PDF
PART V, SECTION B, LINE 16C:	A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/PLAIN_LANGUAGE_FINANCIAL_ASSISTANCE.PDF

Field	Value	IRS element (for citing)
Facility	9	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - HICKMAN CANCER CTR
777 KIMOLE LANE STE 130	ADRIAN	MI	492211400	CANCER CARE
2 - CTR TOTAL REHAB
5660 ADRIAN HWY	ADRIAN	MI	492218318	PHYSICAL THERAPY
3 - WOLF CREEK
901 KIMOLE LN	ADRIAN	MI	492211491	LAB
4 - PROMEDICA LABORATORIES- ADRIAN
3245 N ADRIAN HWY STE E	ADRIAN	MI	492211139	LAB
5 - BIXBY-ONSTED HEALTH CENTER
400 N MAIN ST	ONSTED	MI	492659202	PHYSICAL THERAPY/LAB
6 - BIXBY-TECUMSEH HEALTH CENTER
501 E CUMMINS STREET UNIT A	TECUMSEH	MI	492862070	LAB
7 - TOTAL REHAB AT DUNDEE
119 WATERSTRADT-COMMERCE DR UNIT 5	DUNDEE	MI	481319696	PHYSICAL THERAPY
8 - PROMEDICA HUDSON HEALTH CTR
331 W MAIN ST	HUDSON	MI	492471051	LAB
9 - BLISSFIELD HEALTH CTR
157 W BROOKE LN	BLISSFIELD	MI	492288601	LAB

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A:	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.
PART III, LINE 2:	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY.
PART III, LINE 3:	PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT.
PART III, LINE 4:	PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 18 AND 19 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION.
PART III, LINE 9B:	FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING.
PART VI, LINE 2:	PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE.
PART VI, LINE 3:	THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.
PART VI, LINE 4:	EMMA L. BIXBY MEDICAL CENTER, DOING BUSINESS AS PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL, LOCATED IN ADRIAN, MI, SERVES AN AREA PRIMARILY AROUND LENAWEE COUNTY AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 80,000. APPROXIMATELY, 19% OF THE SERVICE AREA IS AGE 65 OR OVER; 60% IS BETWEEN AGE 18 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $55,000; 91% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 45% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. LENAWEE COUNTY HAS A POPULATION OF APPROXIMATELY 99,000 WITH APPROXIMATELY 10% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 21% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 7% OF LENAWEE COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE AT THE END OF 2021 FOR LENAWEE COUNTY WAS 4.3%. THE LEADING CAUSES OF DEATH IN LENAWEE COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, UNINTENTIONAL INJURIES/ACCIDENTS, STROKE, LUNG DISEASE, ALZHEIMER'S, AND DIABETES. ACCORDING TO THE 2021 COUNTY HEALTH RANKINGS, LENAWEE COUNTY RANKED 26 OF 83 COUNTIES FOR HEALTH OUTCOMES, 25 OF 83 FOR LENGTH OF LIFE, AND 32 OF 83 FOR QUALITY OF LIFE. THERE ARE NINE HOSPITALS WITHIN A 30-MILE RADIUS OF CHARLES AND VIRGINIA HICKMAN HOSPITAL: HERRICK MEMORIAL HOSPITAL, INC., ST. JOSEPH MERCY SALINE HOSPITAL, FLOWER HOSPITAL, FULTON COUNTY HEALTH CENTER, ST. ANNE MERCY HOSPITAL, CHELSEA COMMUNITY HOSPITAL, THE TOLEDO HOSPITAL, HENRY FORD ALLEGIANCE HEALTH, AND UNIVERSITY OF TOLEDO MEDICAL CENTER.
PART VI, LINE 5:	EMMA L. BIXBY IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2021:- THERE WERE APPROXIMATELY 300 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), SERVING ON MORE THAN 25 DIFFERENT BOARDS, COMMITTEES, COUNCILS AND FOUNDATIONS. OF THOSE BOARD MEMBERS, MOST LIVE WITHIN PROMEDICA'S OHIO AND MICHIGAN ACUTE CARE SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN THE GREATER TOLEDO AREA WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. BOARD MEMBERSHIP IS COMPOSED OF 43% FEMALES, 20% PHYSICIANS, 11% UNDER THE AGE OF 40, AND 18% RACIAL OR ETHNIC MINORITIES. - PROMEDICA NON-PARENT BOARD MEMBERS' DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, WERE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS AT OUR METRO TOLEDO AND REGIONAL HOSPITALS. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES, UPON THEIR REQUEST.- AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED TWO SYSTEM-WIDE UPGRADES TO THE EPIC PLATFORM. THE UPGRADES ALLOW PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.- PROMEDICA CANCER INSTITUTE (PCI) COMPLETED MORE THAN 3,300 LUNG CANCER SCREENINGS, NEARLY 55,000 SCREENING MAMMOGRAMS AND NEARLY 13,000 SCREENING COLONOSCOPIES. ADDITIONALLY, PCI CONTINUES TO BE INSTRUMENTAL IN HELPING PROMEDICA IMPLEMENT MONOCLONAL ANTIBODY TREATMENT AT ITS INFUSION CENTERS FOR COVID-19 PATIENTS TO IMPROVE SYMPTOM MANAGEMENT. IN 2021, APPROXIMATELY 8,000 DOSES OF THE TREATMENT WERE PROVIDED. - PROMEDICA SENIOR CARE SKILLED NURSING FACILITIES AND HOME HEALTH AND HOSPICE AGENCIES PROVIDE UNIQUE SERVICES TO VETERANS, HOLIDAY SUPPORT, SUPPORT GROUPS, AND WORKSHOPS TO ANYONE IN THE COMMUNITY WHO NEEDS ADDITIONAL HELP TO GET THROUGH THE LOSS OF A LOVED ONE. PATIENTS AND RESIDENTS' WISHES ARE GRANTED THROUGH THE ORGANIZATION'S HEART'S DESIRE PROGRAM. THROUGH GRANTS FROM THE HOSPICE MEMORIAL FUND, GRIEF CAMPS FOR CHILDREN AND ADULTS ARE OFFERED AS WELL AS EDUCATIONAL SESSIONS AND LIFE CELEBRATION EVENTS. THE FUND ALSO PROVIDES STABILIZING RESOURCES FOR HOSPICE PATIENTS AND FAMILIES IN FINANCIAL DISTRESS DUE TO THE LACK OF OR REDUCTION IN INCOME FROM TERMINAL ILLNESS OR DISEASE.- PROMEDICA CONTINUES TO EXPAND ITS OPTIONS FOR HOSPITAL-LEVEL CARE IN THE COMFORT OF A PATIENT'S HOME. PROMEDICA ACUTE CARE AT HOME COMBINES PROMEDICA'S EXTENSIVE NETWORK OF IN-HOME CARE PROVIDERS WITH A SOPHISTICATED TECHNOLOGY PLATFORM TO DELIVER SEAMLESS AND EFFECTIVE CARE AT HOME FOR PATIENTS WITH SELECT CHRONIC CONDITIONS OR DIAGNOSES SUCH AS HEART FAILURE, PNEUMONIA OR COPD. IN 2021, PROMEDICA ACUTE CARE AT HOME EXPANDED ITS SERVICES TO INCLUDE CARE FOR SELECT ONCOLOGY PATIENTS BY COLLABORATING THE PROMEDICA CANCER CENTER. THE CARE TEAM CONSISTS OF PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, AND MAY INCLUDE OTHER HEALTHCARE PROFESSIONALS, SUCH AS PHYSICAL OR OCCUPATIONAL THERAPISTS, AS NEEDED.- IN THE METRO TOLEDO AREA, PROMEDICA WORKED CLOSELY WITH LUCAS COUNTY DEPARTMENT OF HEALTH OFFICIALS TO ASSIST WITH MASS COVID VACCINE CLINICS AS WELL AS CLINICS IN UNDERSERVED AREAS OF THE COMMUNITY WHERE VACCINE HESITANCY WAS AN ONGOING CONCERN. ONE OF THE PROJECTS PROMEDICA HELPED SPEARHEAD WAS THE V PROJECT, WHICH WORKED ACROSS THE NORTHWEST OHIO COMMUNITY TO INCREASE VACCINE PARTICIPATION. THE V PROJECT HELPED TO BRING RESOURCES TO PEOPLE IN ZIP CODES THAT HAD LOWER VACCINATION PARTICIPATION RATES WITH THE GOAL OF EASING ANY BARRIERS THAT MAY HAVE PROHIBITED THEM FROM PREVIOUSLY GETTING THEIR VACCINE. - PROMEDICA ALSO ALLOCATED 20% OF THE VACCINES IT RECEIVED TO UNDERSERVED COMMUNITIES. THIS LED TO OTHER OPPORTUNITIES SUCH AS THE PARTNERSHIP WITH THE FIRST CHURCH OF GOD ON COLLINGWOOD IN TOLEDO. LED BY THE PPG CLINICAL OPERATIONS TEAM, VARIOUS TEAMS FROM ACROSS PROMEDICA CAME TOGETHER AND HELD VACCINATION CLINICS ON SUNDAYS. PROMEDICA ALSO EXPANDED PARTICIPATION IN COMMUNITY MASS COVID VACCINE CLINICS AT AN ARE UAW HALL TO REACH A LARGER PROPORTION OF THE UNDERSERVED COMMUNITIES.
PART VI, LINE 6:	PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A NATIONWIDE, MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2021 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, NEARLY 850 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING APPROXIMATELY 1,200 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP ('PPG")WHO FORM A PROVIDER NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. IN 2021:- PROMEDICA MEMBERS AND AFFILIATE HOSPITALS INCLUDED: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL,; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL. PROMEDICA ALSO INCLUDES PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION AS WELL AS HUNDREDS OF SKILLED NURSING AND REHABILITATION CENTERS, ASSISTED LIVING FACILITIES AND MEMORY CARE COMMUNITIES, ALL UNDER THE PROMEDICA SENIOR CARE/HCR MANORCARE UMBRELLA.- PROMEDICA MANAGED APPROXIMATELY 2.28 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 57,200 SURGERIES, 6,000 BIRTHS, AND MORE THAN 262,600 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $259,433,000.- PROMEDICA CONTINUED TO OPERATE THREE COMMUNITY FOOD CLINICS, LOCATED AT PROMEDICA BAY PARK HOSPITAL, THE PROMEDICA HEALTH AND WELLNESS CENTER AND PROMEDICA'S CENTER FOR HEALTH SERVICES, TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEMSELVES AND THEIR FAMILY FROM ONE OF THESE FOOD CLINICS. AS PART OF THE PROGRAM, PATIENTS CAN RECEIVE TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. THROUGH DECEMBER 2021, APPROXIMATELY 5,794 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 2,093 UNIQUE HOUSEHOLDS, FURTHERED PROMEDICA'S EFFORTS TO REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 44,100 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 132,300 MEALS.- FOR ITS MICHIGAN PATIENTS, PROMEDICA PARTNERED WITH THE SOUTH MICHIGAN FOOD BANK TO DISTRIBUTE FOOD RESOURCES TO PROMEDICA PHYSICIANS GROUP OFFICES FOR PATIENTS SCREENING POSITIVE FOR FOOD INSECURITY. IN 2021, 49 PEOPLE WERE SUPPORTED BY THE INITIATIVE. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL PROVIDE THE $5 VOUCHERS AT DISCHARGE SO PATIENTS CAN REDEEM FRESH PRODUCE FROM THE VEGGIE MOBILE THAT IS SOURCED FROM PROMEDICA FARMS, LOCAL GROWERS, AND A WHOLESALER. IN 2021, NEARLY 2,560 POUNDS OF PRODUCE WAS GROWN AT PROMEDICA FARMS, 21 PATIENTS IDENTIFIED AS FOOD INSECURE REDEEMED A VOUCHER ISSUED BY A PHYSICIAN OR DISCHARGE PLANNING, AND AN ADDITIONAL 4 PATIENTS WERE PROVIDED A FOOD BOX AND VEGGIE VOUCHER UPON DISCHARGE. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDED BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD. ADDITIONALLY, TWO NEW FINANCIAL OPPORTUNITY CENTERS (FOC) WERE OPENED IN FREMONT AND DEFIANCE, OHIO. MUCH LIKE THE FOC LOCATED IN UPTOWN TOLEDO, THE NEW LOCATIONS OFFER SERVICES AND ASSIST LOW TO MODERATE-INCOME FAMILIES WITH SECURING LIVING WAGE JOBS, BUILDING CREDIT, REDUCING DEBT, AND GAINING WEALTH. THE FOC ALSO HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING AS WELL AS FREE TAX PREPARATION.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PROMEDICA FOUNDATION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	444 N SUMMIT STREET	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	341517672	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$10,000	CashGrantAmt
Non Cash Assistance	$0	NonCashAssistanceAmt
Purpose Of Grant	OPERATING GRANT	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RANDALL OOSTRA
PHS PRES. & CEO	$0	$1,956,043	$0	$5,028,392	$0	$171,337	$0	$283,814	$0	$16,530	$0	$7,456,116	$0	$0
STEVEN M CAVANAUGH
TREASURER, CFO	$0	$1,300,553	$0	$2,196,109	$0	$1,242	$0	$35,041	$0	$25,619	$0	$3,558,564	$0	$0
JEFFREY C KUHN
SECRETARY, CHIEF LEGAL OFFICER	$0	$724,534	$0	$616,992	$0	$6,089	$0	$53,463	$0	$14,723	$0	$1,415,801	$0	$0
DAWN M BUSKEY
EX OFFICIO, PRES. ACUTE CARE	$0	$545,228	$0	$256,990	$0	$3,281	$0	$32,280	$0	$16,881	$0	$854,660	$0	$0
GARY W AKENBERGER
COO, ACUTE CARE & SVP, DIAG	$0	$387,188	$0	$133,715	$0	$4,564	$0	$20,943	$0	$17,524	$0	$563,934	$0	$0
DEANA SIEVERT
SR VP, PAT CARE/CNO, SYSTEM	$0	$330,172	$0	$190,593	$0	$9,749	$0	$10,552	$0	$22,624	$0	$563,690	$0	$0
VICTOR J CHERFAN DO
TRUSTEE (PARTIAL YEAR), PHYSICIAN	$0	$371,087	$0	$139,597	$0	$840	$0	$0	$0	$20,698	$0	$532,222	$0	$0
DARRIN ARQUETTE
TRUSTEE, PRES. REGIONAL ACUTE CARE	$0	$322,925	$0	$153,338	$0	$4,917	$0	$14,385	$0	$23,751	$0	$519,316	$0	$0
JULIE K YAROCH DO
PRES., EX OFFICIO	$0	$304,806	$0	$105,625	$0	$2,825	$0	$12,351	$0	$17,416	$0	$443,023	$0	$0
JENNIFER FOSS
DIRECTOR OF PHARMACY	$146,166	$169,545	$23,454	$0	$150	$200	$4,229	$0	$5,206	$180	$179,205	$169,925	$0	$0
PAUL E GIETZEN MD
TRUSTEE, PHYSICIAN	$0	$268,715	$0	$39,134	$0	$3,326	$0	$0	$0	$21,753	$0	$332,928	$0	$0
CHRISTINA BELL
DIRECTOR OF PHARMACY	$136,715	$140,366	$204	$350	$3,797	$0	$2,842	$0	$24,371	$3,221	$167,929	$143,937	$0	$0
ALAN M SATTLER
FORMER TREASURER, VP BUSINESS DEV.	$0	$210,556	$0	$50,619	$0	$8,452	$0	$10,550	$0	$26,673	$0	$306,850	$0	$0
CHRISTI L ANSBERG
TRUSTEE,VP, PHILANTHROPY	$0	$174,102	$0	$37,533	$0	$1,485	$0	$4,058	$0	$19,842	$0	$237,020	$0	$0
ALEXA SIMKOW
DIR-SURGICAL SVCS.	$120,729	$0	$23,108	$0	$300	$0	$2,941	$0	$23,770	$0	$170,848	$0	$0	$0
CINNAMON BERNARDO
DIR NURSE LEAD	$103,744	$0	$28,804	$0	$5,951	$0	$4,881	$0	$13,554	$0	$156,934	$0	$0	$0
MELISSA THOMPSON
CLINICAL PHARMACIST	$141,544	$0	$350	$0	$300	$0	$0	$0	$11,579	$0	$153,773	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	CHARTER TRAVEL: 1 OFFICER- NOT INCLUDED IN TAXABLE COMPENSATION
PART I, LINE 3	PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF EMMA L. BIXBY MEDICAL CENTER, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B	ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII.
SCHEDULE J, SUPPLEMENTAL INFORMATION:	IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4:	EMMA L. BIXBY MEDICAL CENTER PROGRAM SERVICE ACCOMPLISHMENTS FOUNDED IN 1911, EMMA L. BIXBY MEDICAL CENTER (D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL) CONTINUES TO MEET THE HEALTHCARE NEEDS OF ADRIAN, MICHIGAN AND SURROUNDING SOUTHEAST MICHIGAN COMMUNITIES AS THE LARGEST ACUTE CARE FACILITY IN LENAWEE COUNTY. IT IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE HEALTH CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL (CVHH) IS A 50-BED, FULL-SERVICE, ACUTE CARE HOSPITAL STAFFED BY MORE THAN 120 ACTIVE PROVIDERS WORKING TO MEET IDENTIFIED NEEDS OF THE COMMUNITY. THE FACILITY IS MORE THAN 200,000 SQUARE FEET, CONSISTING OF 40 MEDICAL-SURGICAL BEDS, 10 CRITICAL CARE BED, FOUR OPERATING ROOMS WITH THREE MINOR PROCEDURE ROOMS, 27 EMERGENCY ROOMS AND EIGHT LABOR AND DELIVERY ROOMS AS WELL AS A FULL ARRAY OF DIAGNOSTIC SERVICES. THE HOSPITAL ALSO PROVIDES NUMEROUS INPATIENT AND OUTPATIENT SERVICES, WITH ITS STAFF OF PROFESSIONALS OFFERING CARE IN GENERAL SURGERY, HEART AND VASCULAR CARE, WOMEN'S HEALTH, ORTHOPAEDICS, PEDIATRICS, FAMILY MEDICINE, CRITICAL CARE, AND CANCER TREATMENT SERVICES. IN 2021, CVHH WAS NAMED A TOP RURAL HOSPITAL FOR THE SECOND YEAR IN A ROW BY THE LEAPFROG GROUP FOR OUTSTANDING QUALITY AND SAFETY. CVHH WAS ONE OF JUST 23 RURAL HOSPITALS NATIONWIDE TO RECEIVE THE HONOR. IN 2021, CVHH SERVED 3,448 INPATIENTS; 64,104 OUTPATIENTS; AND 29,987 EMERGENCY CENTER PATIENTS. THE HICKMAN CANCER CENTER, ON THE HICKMAN HOSPITAL CAMPUS, IS ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS. AS PART OF THE PROMEDICA CANCER INSTITUTE, HICKMAN CANCER CENTER OFFERS DIAGNOSTIC SERVICES, AS WELL AS RADIATION AND MEDICAL ONCOLOGY TREATMENT FOR HUNDREDS OF NEW PATIENTS ANNUALLY. AS A MEMBER OF THE TOLEDO COMMUNITY HOSPITAL ONCOLOGY PROGRAM, HICKMAN CANCER CENTER OFFERS PATIENTS THE OPPORTUNITY TO PARTICIPATE IN NATIONAL CANCER TRIALS. FURTHER, CVHH'S CARDIAC AND PULMONARY REHABILITATION PROGRAM IS CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. ADDITIONALLY, CVHH OFFERS TELEMEDICINE SERVICE TO ITS INPATIENT CARE UNITS TO HELP PROVIDE REAL-TIME PATIENT DIAGNOSIS AND TREATMENT FROM A PHYSICIAN. THE SERVICE ALLOWS A DOCTOR'S VISIT TO BE CONDUCTED WITH A SPECIAL COMPUTER AND INTERNET CONNECTION AND HELPS THE HOSPITAL PROVIDE SAFE, QUALITY CARE WHEN IT'S NEEDED DURING NIGHT SHIFTS WHEN FEWER PHYSICIANS MAY BE AVAILABLE. CVHH HAS ALSO RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES GOLD PLUS ACHIEVEMENT FOR ITS COMMITMENT TO ENSURING STROKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED STANDARDS OF CARE. THE HOSPITAL CONTRIBUTED $3,244,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE IN 2021. THROUGH COMMUNITY HEALTH SERVICES, HEALTH PROFESSIONAL EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH ACTIVITIES, CASH AND IN-KIND CONTRIBUTIONS, AND COMMUNITY BENEFIT OPERATIONS, CVHH CONTRIBUTED $1,367,000 TO THE COMMUNITY DURING 2021. THE FOLLOWING ARE EXAMPLES OF SUCH CONTRIBUTIONS: - SUPPORT OF PROMEDICA FARMS AND SOUTH MICHIGAN FOOD BANK TO PROVIDE FRESH PRODUCE TO THE LENAWEE COUNTY COMMUNITY, INCLUDING CVHH PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY. - SUPPORT GROUPS FOR INDIVIDUALS WITH CHRONIC DISEASES, FOCUSED ON PATIENTS' EMOTIONAL, PHYSIOLOGICAL AND PSYCHOLOGICAL NEEDS; - CHILDHOOD AND ADULT IMMUNIZATIONS AND ASTHMA CARE - COMMUNITY HEALTH AND WELLNESS SERVICES, WHICH INCLUDED TOBACCO CESSATION PROGRAMS, NUTRITION AND HEALTHY LIFESTYLES CLASSES, PRENATAL CLASSES, AND CPR TRAINING; AND - COLLECTION AND RESPONSIBLE DISPOSAL OF UNUSED MEDICATIONS THROUGH TWO COMMUNITY TAKE BACK EVENTS AND MEDSAFE COLLECTION BINS WITH THE EMERGENCY DEPARTMENT. CVHH PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2021, OF WHICH $613,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. CVHH'S COST OF BAD DEBT FOR 2021 WAS $102,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $3,244,000 NOTED ABOVE. FURTHER, CVHH PROVIDED $1,264,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. ALSO, IN 2021, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $2,040,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $3,244,000 NOTED ABOVE. CVHH PROVIDED 681 JOBS THROUGH DIRECT EMPLOYMENT IN 2021, EXPENDING $24,095,000 IN NET PAYROLL. A TOTAL OF $1,119,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, CVHH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES TO OUR LOCAL COMMUNITY TO
PART V, LINE 1A	THE PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY. ALL 1099 FORMS FOR PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES ARE FILED UNDER PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671.
FORM 990, PART VI, SECTION A, LINE 6	AS A MICHIGAN NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF EMMA L. BIXBY MEDICAL CENTER. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF EMMA L. BIXBY MEDICAL CENTER, AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION, OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE, OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, AND (VI) ANY MERGER, CONSOLIDATIONS, REORGANIZATION, DISSOLUTION, OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE 990 RETURNS OF PROMEDICA HEALTH SYSTEM, INC. (PHS) AND ITS SUBSIDIARIES ARE PREPARED BY THE PHS TAX DEPARTMENT WITH THE ASSISTANCE OF FINANCE. THE RETURNS ARE REVIEWED BY THE AVP OF TAX BEFORE BEING PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL BONUS-ELIGIBLE SENIOR LEADERSHIP AND SPECIFICALLY IDENTIFIED ADDITIONAL EMPLOYEES, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PROVIDERS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. ADDITIONALLY, AS PART OF THE ANNUAL MANDATORY COMPLIANCE TRAINING ASSIGNED TO ALL PROMEDICA EMPLOYEES, EACH EMPLOYEE IS REQUIRED TO ELECTRONICALLY ACKNOWLEDGE THAT THEY HAVE RECEIVED A COPY OF THE PROMEDICA STANDARDS OF CONDUCT, THAT THEY UNDERSTAND HOW THE STANDARDS APPLY TO THEM, ACKNOWLEDGE THEIR OBLIGATION TO FOLLOW THEM, THEIR OBLIGATION TO REPORT VIOLATIONS OF THE STANDARDS OR REQUESTS THAT WOULD RESULT IN VIOLATIONS OF THE STANDARDS TO APPROPRIATE COMPANY OFFICERS AND THAT THEY HAVE REPORTED ALL VIOLATIONS KNOWN TO THEM AS REQUIRED BY THE STANDARDS. IN ADDITION THE ATTESTATION STATES ANY CONFLICTS OF INTEREST OR OTHER MATTERS FOR WHICH THE STANDARDS REQUIRE WRITTEN DISCLOSURE TO THE COMPANY HAVE BEEN SO DISCLOSED BY THE EMPLOYEE AND THEY UNDERSTAND AND ACKNOWLEDGE THAT TO THE EXTENT THEY ARE AN AT-WILL EMPLOYEE, THE STANDARDS DO NOT AFFECT THE AT-WILL NATURE OF MY EMPLOYMENT RELATIONSHIP WITH THE COMPANY. EMPLOYED PROVIDERS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PROVIDERS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PROVIDER CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER FOR PROMEDICA PHYSICIAN GROUP, INC. (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE OFFICE OF THE PROMEDICA HEALTH SYSTEM, INC. ("PHS") V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PROVIDER CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE PHS AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PROVIDERS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PROVIDER STANDARD OF CONDUCT AND THE PROVIDER CERTIFICATION STATEMENT WHICH THE NEW PROVIDER IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, OR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE PHS V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PROVIDER AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 15	EMMA L. BIXBY MEDICAL CENTER'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19	PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 16B:	JOINT VENTURE OPERATING AGREEMENTS INVOLVING PROMEDICA HEALTH SYSTEM, INC. OR ITS SUBSIDIARIES (COLLECTIVELY, PHS) INCLUDE PROVISIONS TO PROTECT PHS'S TAX-EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. PHS CONTINUALLY ENSURES THAT ITS TAX-EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL PHS JOINT VENTURES.
PART VII, SECTION B	PROMEDICA HEALTH SYSTEM PROCESSES ALL ACCOUNTS PAYABLE THROUGH ONE PAY COMPANY, PROMEDICA HEALTH SYSTEM, INC. THE INDEPENDENT CONTRACTORS OVER $100,000 WILL BE LISTED ON THE 990 FILED FOR PROMEDICA HEALTH SYSTEM, INC. FEIN 34-1517671.
FORM 990, PART IX, LINE 11G	CONTRACTED PHYSICIANS: PROGRAM SERVICE EXPENSES 4,553,724. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,553,724. TEMP AGENCY FEES: PROGRAM SERVICE EXPENSES 3,077,759. MANAGEMENT AND GENERAL EXPENSES 1,927,766. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,005,525. LAB HOSPITAL FEES: PROGRAM SERVICE EXPENSES 2,468,004. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,468,004. TESTING FEES: PROGRAM SERVICE EXPENSES 431,759. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 431,759. OTHER CONTRACT FEES: PROGRAM SERVICE EXPENSES 3,315,623. MANAGEMENT AND GENERAL EXPENSES 3,729,386. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,045,009.
FORM 990, PART XI, LINE 9:	PENSION/POST-RETIREMENT EXPENSE ADJUSTMENT 68,829. BENEFICIAL INTEREST IN FOUNDATION 1,817,072. TRANSFERS BETWEEN RELATED ENTITIES -88,312,908.
FORM 990, PART XII, LINE 2C	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	WOLF CREEK ASSOCIATES LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	901 KIMOLE LN	AddressLine1Txt
City	ADRIAN	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49221	ZIPCd

Field	Value	IRS element (for citing)
EIN	383164818	EIN
Primary Activities	FACILITY LEASING	PrimaryActivitiesTxt
Legal Domicile State	MI	LegalDomicileStateCd
Total Income	-$96,040	TotalIncomeAmt
End Of Year Assets	$1,830,959	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	EMMA L BIXBY MEDICAL CENTER	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (44 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	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
BAY PARK COMMUNITY HOSPITAL
100 MADISON AVE	TOLEDO	OH	43604	341883132	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
COMMUNITY HEALTH CENTER OF BRANCH COUNTY
100 MADISON AVE	TOLEDO	OH	43604	386108110	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
DEFIANCE HOSPITAL AUXILIARY
1200 RALSTON	DEFIANCE	OH	43512	510173779	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes (1)
DEFIANCE HOSPITAL INC
100 MADISON AVE	TOLEDO	OH	43604	344446484	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
EMMA L BIXBY MEDICAL CENTER AUXILIARY
818 RIVERSIDE AVE	ADRIAN	MI	43604	382149602	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	EMMA L BIXBY MEDICAL CENTER	Yes (1)
FOSTORIA HOSPITAL ASSOCIATION
100 MADISON AVE	TOLEDO	OH	43604	340898745	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
FOSTORIA HOSPITAL AUXILIARY
PO BOX 907	FOSTORIA	OH	44830	346517634	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	FOSTORIA HOSPITAL ASSOCIATION	Yes (1)
HCR MANORCARE FOUNDATION INC
444 N SUMMIT ST	TOLEDO	OH	43604	522031975	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes (1)
HCR MANORCARE INC
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	825373223	SKILLED NURSING FACILITIES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes (1)
HEARTLAND HOSPICE MEMORIAL FUND INC
444 N SUMMIT ST	TOLEDO	OH	43604	270497199	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes (1)
HERRICK MEDICAL CENTER AUXILIARY
500 E POTTAWATAMIE ST	TECUMSEH	MI	49286	383076105	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	HERRICK MEMORIAL HOSPITAL INC	Yes (1)
HERRICK MEMORIAL HOSPITAL INC
100 MADISON AVE	TOLEDO	OH	43604	383049015	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
KAITLYN'S COTTAGE INC
100 MADISON AVE	TOLEDO	OH	43604	454781053	RESPITE CARE	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes (1)
LENAWEE LONG TERM CARE
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	382879330	LONG TERM CARE	MI	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF GIG HARBOR WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624719	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF LACEY WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624391	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF LYNNWOOD WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624675	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF SALMON CREEK WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624375	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF SPOKANE WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624687	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MANOR CARE OF TACOMA WA ASSOCIATION
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	260624696	SKILLED NURSING FACILITY	DE	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
MEMORIAL HOSPITAL
100 MADISON AVE	TOLEDO	OH	43604	344430849	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
MEMORIAL PROFESSIONAL SERVICES
100 MADISON AVE	TOLEDO	OH	43604	273763993	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
MERCY MEMORIAL HOSPITAL CORPORATION
100 MADISON AVE	TOLEDO	OH	43604	381984289	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
MONROE COMMUNITY HEALTH SERVICES
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	382934134	LONG TERM CARE	MI	501(C)(3)	10	HCR MANORCARE INC	Yes (1)
PARAMOUNT ADVANTAGE
1901 INDIAN WOOD CIR	MAUMEE	OH	43537	203376102	HEALTH INSURANCE	OH	501(C)(3)	10	PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES	Yes (1)
PROMEDICA CENTRAL PHYSICIANS
100 MADISON AVE	TOLEDO	OH	43604	341881137	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA CHILDRENS SPECIALISTS
100 MADISON AVE	TOLEDO	OH	43604	208734161	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA CONTINUING CARE SERVICES CORP
100 MADISON AVE	TOLEDO	OH	43604	344492440	LONG TERM AND HOME HEALTH CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes (1)
PROMEDICA CONTINUUM SERVICES
100 MADISON AVE	TOLEDO	OH	43604	341880767	PHYSICIAN MANAGEMENT SERVICES	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA COURIER SERVICES INC
100 MADISON AVE	TOLEDO	OH	43604	260324790	COURIER SERVICE	OH	501(C)(3)	12B, II	PROMEDICA CONTINUUM SERVICES	Yes (1)
PROMEDICA FOUNDATION
444 N SUMMIT ST	TOLEDO	OH	43604	341517672	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA GENITO-URINARY SURGEONS
100 MADISON AVE	TOLEDO	OH	43604	461120436	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA HEALTH SYSTEM INC
100 MADISON AVE	TOLEDO	OH	43604	341517671	PARENT COMPANY OF HEALTH SYSTEM	OH	501(C)(3)	12B, II		0	N/A
PROMEDICA INDEMNITY CORP
ONE CHURCH ST 5TH FLOOR	BURLINGTON	VT	05401	341931936	PROFESSIONAL & GENERAL LIABILITY	VT	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA MONROE CARDIOLOGY
100 MADISON AVE	TOLEDO	OH	43604	272920342	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA MONROE PHYSICIANS
100 MADISON AVE	TOLEDO	OH	43604	461111822	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC
100 MADISON AVE	TOLEDO	OH	43604	454976786	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS
100 MADISON AVE	TOLEDO	OH	43604	263888045	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA PHYSICIAN GROUP INC
100 MADISON AVE	TOLEDO	OH	43604	341899439	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA PHYSICIANS AT HOME INC
100 MADISON AVE	TOLEDO	OH	43604	852181349	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
PROMEDICA PRIMARY CARE PROVIDERS
100 MADISON AVE	TOLEDO	OH	43604	831731861	PHYSICIAN HEALTH CARE SERVICES	MI	501(C)(3)	10	PROMEDICA PHYSICIAN GROUP INC	Yes (1)
THE HUG FUND
444 N SUMMIT ST	TOLEDO	OH	43604	202272848	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA FOUNDATION	Yes (1)
THE TOLEDO HOSPITAL
100 MADISON AVE	TOLEDO	OH	43604	344428256	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
VISITING NURSE HOSPICE AND HEALTH CARE
100 MADISON AVE	TOLEDO	OH	43604	341831624	HOSPICE HOME CARE	OH	501(C)(3)	10	HCR MANORCARE INC	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
EAST-WEST HOLDINGS LTD
715 SOUTH TAFT AVE	FREMONT	OH	43420	204066818	REAL ESTATE	OH	N/A	0	0
AIR DIVERTER SOLUTIONS LLC
100 MADISON AVE	TOLEDO	OH	43604	853725776	DEVELOPMENT	OH	N/A	0	0
MERCYMANOR PARTNERSHIP
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43604	521931012	SKILLED NURSING	PA	N/A	0	Yes (1)
NORMAN SPECIALTY HOSPITAL LLC
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43604	421627672	HEALTH CARE	DE	N/A	0	Yes (1)
NORTHWEST OHIO DEDICATED BREAST MRI LLC
100 MADISON AVE	TOLEDO	OH	43604	260679898	MEDICAL DIAGNOSTICS	OH	N/A	0	0
PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC
100 MADISON AVE	TOLEDO	OH	43604	473163945	REAL ESTATE	OH	N/A	0	Yes (1)
PROMEDICA MASTER TENANT LLC
100 MADISON AVE	TOLEDO	OH	43604	475288490	REAL ESTATE	OH	N/A	0	Yes (1)
PROMEDICA PATHOLOGY LABORATORIES LLC
2130 W CENTRAL AVE STE 300	TOLEDO	OH	43606	831022842	CLINICAL LABORATORY	DE	N/A	0	0
PROMEDICA SENIOR CARE OF GEORGIA LLC
100 MADISON AVE	TOLEDO	OH	43604	871802834	SKILLED NURSING	OH	N/A	0	Yes (1)
PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC
100 MADISON AVE	TOLEDO	OH	43604	461989695	PHYSICIAN MANAGEMENT SERVICES	OH	N/A	0	0
REYNOLDS ROAD SURGICAL CENTER LTD
2865 N REYNOLDS RD	TOLEDO	OH	43615	311569454	FREESTANDING AMBULATORY SURGICAL CENTER	OH	N/A	0	0
ROCKET VENTURE FUND II LLC
2865 N REYNOLDS RD STE 220	TOLEDO	OH	43615	475603627	INVESTMENT FUND	OH	N/A	0	0
SENIOR & REHAB CARE AT METROHEALTH LLC
100 MADISON AVE ATTN TAX DEPT	TOLEDO	OH	43604	872465544	SKILLED NURSING	OH	N/A	0	Yes (1)
THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC
1051 S TELEGRAPH RD	MONROE	MI	48161	270843485	AMBULATORY SURGICAL CENTER	MI	N/A	0	0
WEST CENTRAL SURGICAL CENTER LLC
7055 W CENTRAL	TOLEDO	OH	43617	200088459	AMBULATORY SURGICAL CENTER	OH	N/A	0	Yes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
HERRICK MEMORIAL DEVELOPMENT CORP
500 E POTTAWATAMIE TR	ADRIAN	MI	49221	383146907	FACILITY LEASING	MI	EMMA L BIXBY MEDICAL CENTER	C	$180,916	$1,210,591	1.00000	0
HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION
818 RIVERSIDE AVE	ADRIAN	MI	49221	383639616	FACILITY MANAGEMENT	MI	HERRICK MEMORIAL DEVELOPMENT CORP	C	$47,589	$36,002	0.71800	0
MONROE HEALTH VENTURES INC
718 N MACOMB	MONROE	MI	48164	382704426	PHARMACY	MI		C				0	N/A
PROMEDICA AT HOME INC
100 MADISON AVE	TOLEDO	OH	43604	852320857	PHYSICAN SUPPORT	MI		C				0	N/A
PROMEDICA CENTRAL CORPORATION OF MICHIGAN
100 MADISON AVE	TOLEDO	OH	43604	383322278	PHYSICIAN HEALTH CARE SERVICES	OH		C				0	N/A
PROMEDICA HEALTH NETWORK INC
100 MADISON AVE	TOLEDO	OH	43604	474006496	PHYSICIAN MANAGEMENT SERVICES	OH		C				0	N/A
PROMEDICA INNOVATIONS LLC
100 MADISON AVE	TOLEDO	OH	43604	301221601	INVESTMENT COMPANY	OH		C				0	N/A
PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES
1901 INDIAN WOOD CIR	MAUMEE	OH	43537	341570675	HEALTH CARE INSURANCE	OH		C				0	N/A
PROMEDICA MANAGER MEMBER LLC
100 MADISON AVE	TOLEDO	OH	43604	475168737	REAL ESTATE	OH		C				0	N/A
PROMEDICA NORTH PHYSICIAN CORPORATION
100 MADISON AVE	TOLEDO	OH	43604	383482148	PHYSICIAN HEALTH CARE SERVICES	OH		C				0	N/A
PROMEDICA SENIOR CARE OF PISCATAWAY NJ LLC
PO BOX 10086 ATTN TAX-5	TOLEDO	OH	43699	861179270	SKILLED NURSING	NJ		C				0	N/A

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd