2021-05-17T09:03:31-05:00 2020-06-30 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2019-07-01 381362830 MUNSON MEDICAL CENTER MUNS 2319355000 1105 SIXTH STREET TRAVERSE CITY MI 49684 MARK A HEPLER CFO 2319355000 2021-05-13 true DAVID LOWENTHAL P00378651 3122071040 2021-05-17 2019 2022-09-23 18:48:47Z MATTHEW WILLE 1105 SIXTH STREET TRAVERSE CITY MI 49684 872815257 false X WWW.MUNSONHEALTHCARE.ORG X 1947 MI MUNSON MEDICAL CENTER AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. 18 12 5022 325 46030 7612164 38439303 650075866 638813655 19888616 22203153 4880674 4631858 682457320 704087969 377276 342564 0 273446363 278884146 0 1476651 338793034 357893315 612616673 637120025 69840647 66967944 961796711 1127601262 329641822 492270451 632154889 635330811 AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON MEDICAL CENTER EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. false false 550611741 342564 640927943 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF TRAVERSE CITY, MI AND THE SURROUNDING AREA WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON MEDICAL CENTER SERVES AS A RURAL REFERRAL CENTER FOR THE SURROUNDING 24-COUNTY AREA, WITH 19,753 INPATIENT ADMISSIONS IN FISCAL YEAR 2020 AND OVER 429,000 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 15,000 SURGICAL CASES, 1,891 OBSTETRICAL BIRTHS, AND OVER 48,000 EMERGENCY ROOM VISITS. MUNSON MEDICAL CENTER ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS 566 ACTIVE MEDICAL STAFF AND 325 VOLUNTEERS. 550611741 true true false true false false false false false true true false false false true false false true false false false false false false false false true true true true true true false false false false false false false false true false false false false false false true true true false false true 316 0 true 5022 true true true false false false false false false false false false false false X 18 12 false false false false true true true true true false false true true true true true true true true true true X NICOLE SULAK MUNSON HEALTHCARE 2319357777 4230 COPPER RIDGE DR TRAVERSE CITY MI 49684 EDWIN A NESS DIRECTOR 1.00 40.00 X 0 1005520 194310 THOMAS SCHERMERHORN MD NEUROSURGEON 40.00 X 1046045 0 39927 JOHN CAMPBELL MD NEUROSURGEON 40.00 X 974950 0 41373 MICHAEL NIZZI DO MED DIRECTOR 40.00 X 772692 0 37670 ASHLEY SACHTLEBEN DO PHYSICIAN 40.00 X 759974 0 30252 DAVID KAM MD PHYSICIAN 40.00 X 745298 0 34149 MARK A 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A PORTION OF THE TERM ENDOWMENT ASSETS ARE THOSE HELD FOR SPECIFIC MEDICAL PURPOSES, AS DEFINED BY DONORS. THOSE ASSETS ARE BEING HELD FOR A VARIETY OF DONOR INTERESTS INCLUDING ADAPTIVE SPORTS, PEDIATRIC THERAPY, OTHER PEDIATRIC MEDICAL NEEDS, RESEARCH, AND PATIENT ASSISTANCE. true true X true X true X true true false false 2130381 2130381 0.00340 88160133 74439011 13721122 0.02170 90290514 74439011 15851503 0.02510 1738577 109948 1628629 0.00260 1216651 582327 634324 0.00100 20044461 14672909 5371552 0.00850 234798 227 234571 0.00040 40548 40548 0.00010 23275035 15365411 7909624 0.01260 113565549 89804422 23761127 0.03770 26450 26450 34789 34789 0.00010 3519 3519 137338 137338 0.00020 202096 202096 0.00030 true 13929274 4338319 173910838 177971872 -4061034 X true true NW MI SURGERY CENTER AMBULATORY SURGERY CENTER 0.49000 0.51000 1 1 MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 HTTP://WWW.MUNSONHEALTHCARE.ORG 1060000048 X X X X X MUNSON MEDICAL CENTER 1 false false true X X X X X X X X X X 18 true true true true X HTTPS://TINYURL.COM/Y96S2AGP X true 19 true HTTPS://TINYURL.COM/YAX6X5HQ false true X 200.000000000000 400.000000000000 X X X true true X X X true X HTTPS://TINYURL.COM/4HVNZX67 X HTTPS://TINYURL.COM/YDYMFRVJ X HTTPS://TINYURL.COM/5MBBBV5X X X X X X X X true X false X X X X X true X false false FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 3E YES, THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND WERE IDENTIFIED THROUGH THE CHNA. FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 5 WE ARE FOLLOWING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP FRAMEWORK TO GUIDE OUR PROCESS WHICH INCLUDES FOUR ASSESSMENTS TO GATHER INPUT. 1) COMMUNITY THEMES AND STRENGTHS ASSESSMENT: THIS ASSESSMENT GATHERED INPUT (MOSTLY QUALITATIVE) FROM COMMUNITY MEMBERS TO FIND OUT HOW THEY PERCEIVE THEIR QUALITY OF LIFE, SEE ASSETS AND PROBLEMS IN THEIR COMMUNITIES, AND DEFINE WHAT IS IMPORTANT TO THEM. WE USED COMMUNITY INPUT BOARDS TO GATHER FEEDBACK FROM THE GENERAL PUBLIC ON HOW THEIR COMMUNITY CONTEXT IMPACTS HEALTH. AT LARGE COMMUNITY EVENTS, COMMUNITY MEMBERS ANSWERED TWO QUESTIONS BY WRITING THEIR ANSWER ON A STICKY NOTE AND STICKING IT TO THE QUESTION BOARD. THESE ARE THE QUESTIONS WE ASKED: 1. WHAT IN YOUR COMMUNITY HELPS YOU LIVE A HEALTHY LIFE? 2. WHAT CAN BE DONE IN YOUR COMMUNITY TO IMPROVE HEALTH AND QUALITY OF LIFE? WE ALSO USED MINI CLIENT INTERVIEWS TO GATHER INPUT FROM SPECIFIC VULNERABLE POPULATIONS BY PARTNERING WITH ORGANIZATIONS THAT SPECIALIZE IN WORKING WITH THESE POPULATIONS. OUR QUESTIONS FOCUSED ON BARRIERS TO ACCESSING HEALTH CARE: 1. IN THE PAST YEAR, WHAT CHALLENGES HAVE YOU OR YOUR FAMILY HAD TRYING TO GET HEALTH CARE YOU NEEDED? 2. WHAT KIND OF HEALTH CARE DID YOU HAVE TROUBLE GETTING? 3. WHAT WOULD MAKE IT EASIER TO GET CARE? 2) COMMUNITY HEALTH STATUS ASSESSMENT THIS PURPOSE OF THIS ASSESSMENT WAS TO COLLECT QUANTITATIVE, SECONDARY DATA ABOUT THE HEALTH, WELLNESS, AND SOCIAL DETERMINANTS OF HEALTH OF ALL RESIDENTS IN OUR SERVICE AREA. THIS INVOLVED GATHERING STATISTICS FROM SOURCES LIKE THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE CENTER FOR MEDICARE AND MEDICAID SERVICES, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, THE CENSUS BUREAU, AND OTHER ESTABLISHED SOURCES. 3) LOCAL COMMUNITY HEALTH SYSTEM ASSESSMENT THE PURPOSE OF THIS ASSESSMENT WAS TO GATHER INPUT FROM ORGANIZATIONS SERVING THE COMMUNITY, AND GET A SYSTEM PERSPECTIVE ON WORK BEING DONE IN THE COMMUNITY. FACILITATORS GUIDED DISCUSSIONS AT HUMAN SERVICES COORDINATING BODIES AND OTHER GROUPS. DISCUSSIONS FOCUSED ON DIFFERENT ASPECTS OF HOW ALL COMMUNITY ORGANIZATIONS AND ENTITIES WORK TOGETHER AS A UNIFIED SYSTEM TO SERVE THE COMMUNITIES. WE ORGANIZED NOTES BY LOOKING AT SYSTEM OPPORTUNITIES, SYSTEM WEAKNESSES, AND SYSTEM STRENGTHS. 4) FORCES OF CHANGE ASSESSMENT THE PURPOSE OF THIS ASSESSMENT WAS TO IDENTIFY FORCES TRENDS, FACTORS, AND EVENTS THAT ARE INFLUENCING OR LIKELY WILL INFLUENCE THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITY OR THAT IMPACT THE WORK OF THE LOCAL COMMUNITY HEALTH SYSTEM IN NORTHERN MICHIGAN. THIS ASSESSMENT PROVIDES CRITICAL INFORMATION ABOUT THE LARGER CONTEXT INFLUENCING THE POTENTIAL SUCCESS OF THE STRATEGIES WE DEVELOP. THIS ASSESSMENT WAS DONE THROUGH FOUR CROSS-SECTOR EVENTS, IN TRAVERSE CITY, WEST BRANCH, AND BIG RAPIDS. THE DISCUSSION FOCUSED ON SEVEN TYPES OF FORCES AFFECTING THE COMMUNITY: ECONOMIC; ENVIRONMENTAL; ETHICAL; SOCIAL/CULTURAL; TECH/SCIENCE/EDUCATION; POLITICAL/LEGISLATIVE. AFTER IDENTIFYING FORCES AT WORK, WE LOOKED AT THREATS AND OPPORTUNITIES PRESENTED BY THESE FORCES. THE FIRST THREE FORCES OF CHANGE EVENTS FOCUSED BROADLY ON ANY ISSUES AFFECTING THE COMMUNITY. AFTER AGING POPULATION WAS IDENTIFIED AT ALL THREE EVENTS AS ONE OF THE MOST POWERFUL FORCES IN OUR NORTHERN MICHIGAN COMMUNITIES, WE ADDED A FOURTH EVENT FOCUSED SPECIFICALLY ON HOW THESE SEVEN TYPES OF FORCES INTERSECT WITH ISSUES AROUND A GROWING AGING POPULATION. HOW WE SOUGHT INPUT FROM MEDICALLY UNDERSERVED, MINORITY, AND LOW-INCOME POPULATIONS? THROUGH MINI CLIENT INTERVIEWS, WE REACHED OUT TO MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS TO LEARN ABOUT BARRIERS THEY FACE ACCESSING CARE. COMMUNITY INPUT BOARDS WERE PART OF EVENTS SERVING LOW-INCOME POPULATIONS. WE SOUGHT INPUT FROM MINORITY POPULATIONS THROUGH INVITING REPRESENTATIVES FROM LOCAL TRIBES AND OTHER ORGANIZATIONS SERVING MINORITIES TO PARTICIPATE IN STEERING COMMITTEE MEETINGS, THE FORCES OF CHANGE ASSESSMENT, AND PRIORITIZATION. WE SURVEYED HEALTH CARE PROVIDERS WHO SERVE MEDICAID PATIENTS. ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS PARTICIPATED IN THE LOCAL COMMUNITY HEALTH SYSTEM ASSESSMENT, THE FORCES OF CHANGE ASSESSMENT, AND THE PRIORITIZATION PROCESS. FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 6A MUNSON MEDICAL CENTER, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL, AND KALKASKA MEMORIAL HEALTH CENTER ALL WORKED TOGETHER ON REGIONAL CHNA EFFORTS AS PART OF THE MITHRIVE REGIONAL CHNA INITIATIVE. FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 6B OUR CONTINUED COMMITMENT TO OUR MISSION OF WORKING TOGETHER WITH OUR PARTNERS TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH IS REFLECTED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AS WELL AS IN THE WORK WE DO EACH DAY TO BETTER UNDERSTAND AND ADDRESS THE HEALTH NEEDS OF OUR COMMUNITY. FOR THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, THIS COMMITMENT IS EVIDENT IN OUR PARTICIPATION IN MITHRIVE, A REGIONAL, COLLABORATIVE PROJECT DESIGNED TO BRING TOGETHER DOZENS OF ORGANIZATIONS ACROSS 31 COUNTIES OF NORTHERN MICHIGAN TO IDENTIFY LOCAL NEEDS AND WORK TOGETHER TO IMPROVE OUR COMMUNITIES. WHERE WE LIVE, LEARN, WORK, AND PLAY POWERFULLY INFLUENCES OUR HEALTH. IMPROVING COMMUNITY HEALTH REQUIRES A BROAD FOCUS AND COORDINATION AMONG DIVERSE AGENCIES AND STAKEHOLDERS. THE GOAL IS TO CONTINUE TO BUILD NEW PARTNERSHIPS AND GATHER INPUT FROM MORE ORGANIZATIONS AND RESIDENTS. OUR CHNA REPRESENTS A COLLABORATIVE, COMMUNITY-BASED APPROACH TO IDENTIFY, ASSESS, AND PRIORITIZE THE MOST IMPORTANT HEALTH ISSUES AFFECTING OUR COMMUNITY, GIVING SPECIAL ATTENTION TO THE POOR AND UNDERSERVED IN OUR SERVICE AREA. THE PROCESS IS ALSO THE FOUNDATION THAT WE WILL USE TO COLLABORATIVELY PLAN, DEVELOP, AND FOSTER PROGRAMS TO EFFECTIVELY ADDRESS THOSE NEEDS IN OUR COMMUNITY. FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/4986%20MMC%20CHNA%20REPORT %20FINAL%202019.PDF FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/4986%20MMC%20CHNA %20IMPLEMENTATION%20STRATEGY%202019.PDF FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 11 WE IDENTIFIED STRATEGIC ISSUES AS PART OF THE MITHRIVE COLLABORATIVE. STRATEGIC ISSUES ARE BROADER THAN INDIVIDUAL HEALTH CONDITIONS, AND REPRESENT UNDERLYING CHALLENGES THAT NEED TO BE ADDRESSED, WHICH WOULD LEAD TO IMPROVEMENT IN HEALTH CONDITIONS. EACH STRATEGIC ISSUE SHOULD IMPACT MORE THAN ONE HEALTH CONDITION. THE TWO TOP PRIORITY ISSUES TO BE ADDRESSED: HOW DO WE ENSURE A COMMUNITY THAT PROVIDES PREVENTIVE AND ACCESSIBLE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES? HOW DO WE ADDRESS BASIC NEEDS OF LIVING TO CREATE RESILIENCY AND PROMOTE EQUITY? WE PLAN TO COMMIT THE RESOURCES BELOW IN ORDER TO FACILITATE THE EXECUTION OF OUR IMPLEMENTATION STRATEGY. THESE RESOURCES INCLUDE: STAFF TIME NEEDED FOR PROGRAMMING, PARTICIPATION IN COLLABORATIVE PROJECTS, BOARDS, AND SUPPORT FOR OTHER COMMUNITY IMPROVEMENT PROJECTS RELATED TO OUR PRIORITY STRATEGIC ISSUES. SUPPORT (IN-KIND AND/OR FINANCIAL) FOR PROGRAMS, COMMUNITY COLLABORATIONS, AND ORGANIZATIONS WHO HAVE DEMONSTRATED A NEED FOR ASSISTANCE IN ADDRESSING THE PRIORITY STRATEGIC ISSUES. MUNSON MEDICAL CENTER ACKNOWLEDGES THE WIDE RANGE OF ISSUES THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED THAT WITH THE BROAD NATURE OF THE STRATEGIC ISSUES WE COULD EFFECTIVELY FOCUS ON ONLY THOSE ISSUES THAT WERE PRIORITIZED THE HIGHEST BY OUR COMMUNITY. DUE TO THE LOWER PRIORITIZATION, MUNSON MEDICAL CENTER WILL NOT TARGET THE FOLLOWING IDENTIFIED STRATEGIC ISSUES: HOW DO WE IMPROVE ACCESS TO COMPREHENSIVE HEALTH CARE FOR ALL? HOW DO WE FOSTER A SENSE OF COMMUNITY THAT PROMOTES TRUST, SOCIAL SUPPORT, AND INCLUSIVENESS? HOW DO WE IMPROVE PREVENTION AND REDUCE HEALTH RISKS FOR LEADING CAUSES OF DEATH? WHILE WE ARE NOT TARGETING THESE STRATEGIC ISSUES IN THIS IMPLEMENTATION STRATEGY, WE STILL COMMIT TO CONTINUING OUR EFFORTS TO IMPROVE THESE ISSUES AS WELL. FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 13H PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, AT THE SOLE DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/FINANCIAL_ASSISTANCE_POLICY.PDF FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/MUNSON%20MEDICAL%20CENTER%20- %20FINANCIAL%20ASSISTANCE.PDF FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/SYSTEM%20PLS.PDF FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 16J IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE. FACILITY 1, MUNSON MEDICAL CENTER - PART V, LINE 20E MUNSON MEDICAL CENTER (MUNSON) REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. MUNSON WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY MUNSON; 2.DOCUMENTING THAT MUNSON HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH MUNSON'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH MUNSON DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. MUNSON WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS. 11 FOSTER FAMILY COMMUNITY HEALTH CENT 550 MUNSON AVENUE TRAVERSE CITY MI 49686 OUTPATIENT COWELL FAMILY CANCER CENTER 217 S MADISON ST TRAVERSE CITY MI 49684 RADIATION THERAPY AND MRI SMITH FAMILY BREAST HEALTH CENTER 4100 PARK FOREST DR TRAVERSE CITY MI 49684 MAMMOGRAPHY AND WOMEN'S HEALTH INFUSION CLINIC 217 S MADISON ST TRAVERSE CITY MI 49684 IV THERAPY CHEMICAL DEPENDENCY CENTER 420 BROOK ST TRAVERSE CITY MI 49684 REHABILITATION MUNSON MANOR 1220 MEDICAL CAMPUS DR TRAVERSE CITY MI 49684 HOSPITALITY HOUSE ADVANCED WOUND CENTER 5085 ANNA DR TRAVERSE CITY MI 49684 PATIENT WOUND CARE MUNSON HOSPICE HOUSE 450 BROOK ST TRAVERSE CITY MI 49684 HOSPICE CARE HOUSE MUNSON RENAL DIALYSIS 4062 WEST ROYAL DRIVE TRAVERSE CITY MI 49684 RENAL DIALYSIS UNIT MMC SPECIALTY CLINIC 106 S MADISON STREET TRAVERSE CITY MI 49684 PEDIATRIC CARDIOLOGY THOMAS JUDD CARE CENTER 5041 NORTH ROYAL DRIVE TRAVERSE CITY MI 49684 HIV PREVENTION SCHEDULE H, PART I, LINE 3C INCOME UP TO 200% OF THE FPG = 100% DISCOUNT ON CHARGES INCOME BETWEEN 201% AND 300% FPG = 75% DISCOUNT ON CHARGES INCOME BETWEEN 301% AND 400% FPG = 65% DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE, OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS. FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG: EARNINGS, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES; CASH, CHECKING AND SAVINGS BALANCES, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, IRAS TRUSTS, INHERITANCES, ANNUITIES, SAVINGS BONDS, STOCKS, MUTUAL FUNDS, AND/OR CASH VALUE OF LIFE INSURANCE. SCHEDULE H, PART I, LINE 7G THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 9,646,665. THESE COSTS ARE OFFSET BY RELATED REVENUES IN COMPUTING THE NET COMMUNITY BENEFIT. SCHEDULE H, PART I, LINE 7, COLUMN (F) TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 637,120,025 AND THE PROPORTIONATE SHARE OF TOTAL EXPENSES OF THE AMBULATORY SURGERY CENTER IS 10,435,462. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS 13,929,274. THE NET EXPENSE OF 633,626,213 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). SCHEDULE H, PART I, LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION OR ACTUAL CASH PAID. SCHEDULE H, PART II MUNSON MEDICAL CENTER (MMC) PROVIDED 202,096 IN COMMUNITY-BUILDING ACTIVITIES DURING THE 2019 TAX YEAR. MMC'S COMMUNITY-BUILDING ACTIVITIES INVESTMENT CONSISTED OF MENTORING TBA ISD CAREER TECH ALLIED HEALTH STUDENTS, RECYCLING OF ELECTRONIC WASTE, RECRUITMENT OF PHYSICIANS TO UNDERSERVED AREAS, AND TIME SPENT AT COMMUNITY MEETINGS. SCHEDULE H, PART III, LINE 2 DIRECT WRITE-OFF FROM UNPAID ACCOUNTS WHICH ARE DEEMED NO LONGER COLLECTIBLE ARE RECORDED AGAINST THE ALLOWANCE FOR BAD DEBT. AN ESTIMATE OF BAD DEBT EXPENSE IS RECORDED BASED ON 1) AN ANALYSIS OF THE DIRECT WRITE- OFFS AND 2) AN ESTIMATE OF THE AMOUNT OF BAD DEBT, NET OF DISCOUNTS, IN THE ACCOUNTS RECEIVABLE BALANCE, CONSIDERING THE PAST EXPERIENCE AND CURRENT TRENDS OF PAYMENTS ON PATIENT ACCOUNTS FOR EACH OF THE MAJOR PAYOR SOURCES OF REVENUE. SCHEDULE H, PART III, LINE 3 THE METHODOLOGY USED TO DETERMINE THE ESTIMATED AMOUNT OF CHARITY IN BAD DEBT IS AS FOLLOWS. WE DETERMINED THE APPROVAL RATE OF FINANCIAL COUNSELING BY TAKING THE VALUE OF THE ACCOUNTS THAT SUCCESSFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT WERE DENIED. THEN WE APPLIED THAT PERCENTAGE TO THE VALUE OF ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING. SCHEDULE H, PART III, LINE 4 SEE NOTE 2 ON PAGE 8 OF ATTACHED AUDITED FINANCIAL STATEMENTS UNDER ACCOUNTS RECEIVABLE. SCHEDULE H, PART III, LINE 8 MUNSON MEDICAL CENTER CONSIDERS THE ENTIRE MEDICARE SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. THAT AMOUNT IS 4,061,034. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. SCHEDULE H, PART III, LINE 9B MUNSON HEALTHCARE'S (MHC) INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MHC, AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTATING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684. SCHEDULE H, PART VI, LINE 2 THE MUNSON MEDICAL CENTER BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE (CHC) TO SERVE MUNSON MEDICAL CENTER. THE CHC CONSISTS OF MUNSON MEDICAL CENTER BOARD MEMBERS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON MEDICAL CENTER BOARD CHAIRPERSON. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MMC RESPONSE TO ANY EMERGING HEALTH TRENDS AS IDENTIFIED BY COMMUNITY HEALTH NEEDS ASSESSMENT, AND REVIEW ANY NEW COMMUNITY HEALTH BASED COLLABORATION OR PROGRAM. THE CHC IS RESPONSIBLE FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MMC COMMUNITY BENEFIT PROGRAMS AND SERVICES. THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT OF MUNSON MEDICAL CENTER. MUNSON MEDICAL CENTER (MMC) IS A SIGNIFICANT CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN OUR EXTENSIVE GEOGRAPHICAL AREA. COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED, AS WELL AS WHERE PROGRESS HAS BEEN MADE. THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITYWIDE. MUNSON PREPARED A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) DURING FISCAL 2019 IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. ADDITIONALLY, MUNSON WORKS IN CONJUNCTION WITH COMMUNITY COLLABORATIVES IN FIVE COUNTIES ANTRIM, BENZIE, GRAND TRAVERSE, LEELANAU, AND KALKASKA; AREA HEALTH DEPARTMENTS, AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY NEED. SCHEDULE H, PART VI, LINE 3 IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS: BROCHURES THAT DESCRIBE MUNSON HEALTHCARE'S FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES. THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR. STATEMENT ON BILLS: STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL. SIGNS IN THE ER REGISTRATION AREA: ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY. THE MUNSON HEALTHCARE INTERNET HAS THE FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, THE PLAIN LANGUAGE SUMMARY AND THE BILLING AND COLLECTIONS POLICY AVAILABLE TO REVIEW AND PRINT. REFERRAL BY REGISTRATION STAFF: AT THE TIME OF REGISTRATION, SELF-PAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF. MUNSON HEALTHCARE FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS. THE COUNSELOR VISIT ALL INPATIENTS THAT ARE DEEMED SELF-PAY, TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP. IF THE PATIENT WOULD LIKE HELP, THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID. GENERALLY, THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR. ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR, THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS. THE COUNSELORS ALSO IDENTIFY ALL SELF-PAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS, ONLY BY PHONE. THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION, BUT WHEN THAT IS NOT POSSIBLE, THE CALL IS MADE SOON AFTER DISCHARGE. AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: MEDICAID (AND ALL OF ITS SUBSETS), SOCIAL SECURITY DISABILITY, TRAVERSE HEALTH CLINIC, MUNSON HEALTHCARE FINANCIAL ASSISTANCE, AND MUNSON MEDICAL CENTER MEDS PROGRAM. MUNSON HEALTHCARE MAKES A PHONE CALL TO ALL PRIVATE-PAY PATIENTS PRIOR TO TRANSFERRING THEIR ACCOUNT TO A COLLECTION AGENCY TO INFORM THEM OF OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART VI, LINE 4 DESCRIPTION MUNSON MEDICAL CENTER (MMC) IS THE LARGEST HOSPITAL IN NORTHERN LOWER PENINSULA OF MICHIGAN, WITH 442 LICENSED ACUTE CARE BEDS AND FACILITIES ON TWO MAJOR CAMPUSES. ONE OF NINE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM, MMC SERVES AS A RURAL REFERRAL CENTER FOR THE SURROUNDING 24-COUNTY AREA, WITH 19,753 INPATIENT ADMISSIONS IN FISCAL YEAR 2020. THE HOSPITAL SERVED MORE THAN 15,000 SURGICAL CASES, 1,891 OBSTETRICAL BIRTHS, AND OVER 48,000 EMERGENCY ROOM VISITS IN FISCAL YEAR 2020. THE HOSPITAL HAS 566 ACTIVE MEDICAL STAFF. WITH MORE THAN 4,000 EMPLOYEES, MMC IS THE LARGEST EMPLOYER IN NORTHERN MICHIGAN. DUE TO ITS GEOGRAPHIC LOCATION AND COMPREHENSIVE ARRAY OF SERVICES OFFERED, MMC IS DESIGNATED A RURAL REFERRAL CENTER BY THE CENTERS FOR MEDICARE AND MEDICAID. MMC IS ALSO RECOGNIZED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AS A SOLE COMMUNITY HOSPITAL. BECAUSE OF THIS STATUS, IT IS EQUIPPED TO PROVIDE CRITICAL CARE FOR PATIENTS ACROSS THE 24-COUNTY REGION. HOSPITAL SERVICES MMC PROVIDES SERVICES IN MORE THAN 76 DIFFERENT MEDICAL SPECIALTIES AND OFFERS A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICE. MMC HAS AN AWARD- WINNING OPEN-HEART SURGERY AND INTERVENTIONAL CARDIOLOGY PROGRAM, PLUS THE ONLY VERIFIED LEVEL II TRAUMA CENTER NORTH OF GRAND RAPIDS AND HAS THE ONLY NEONATAL INTENSIVE CARE UNIT IN NORTHERN MICHIGAN. MMC IS ALSO DESIGNATED AS A PRIMARY STROKE CENTER BY THE JOINT COMMISSION AND ACCREDITED AS A COMPREHENSIVE COMMUNITY CANCER CENTER BY THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS. SPECIALIZED INPATIENT UNITS AVAILABLE AT MMC INCLUDE MEDICAL/SURGICAL INTENSIVE CARE, CARDIAC INTENSIVE CARE, NEONATAL INTENSIVE CARE, ONCOLOGY, ORTHOPEDICS, INPATIENT MENTAL HEALTH, AND PHYSICAL MEDICINE AND REHABILITATION. COMPLEX SURGERIES INCLUDING CARDIOTHORACIC, HAND, NEURO, AND VASCULAR SURGERIES ARE AVAILABLE, AS WELL AS LESS COMPLEX SAME-DAY SURGERY. A BROAD SPECTRUM OF DIAGNOSTIC AND THERAPEUTIC SERVICES SUPPORT MMC'S PROGRAMS, INCLUDING: COMPREHENSIVE RADIOLOGY SERVICES WITH CT, MRI (TRADITIONAL, OPEN BORE, AND BREAST), PET/CT, ULTRASOUND, NUCLEAR MEDICINE, DIGITAL MAMMOGRAPHY, AND X-RAY COMPREHENSIVE CANCER TREATMENT INCLUDING RADIATION ONCOLOGY DELIVERED VIA BRACHYTHERAPY, IGRT AND IMRT RADIATION THERAPY, AND THE LATEST IN STEREOTACTIC RADIOSURGERY COMPUTERIZED INPATIENT AND OUTPATIENT LABORATORY SERVICES INCLUDING THE REGIONS ONLY MALDI-TOF SYSTEM FOR RAPID IDENTIFICATION OF MICROORGANISMS COMPREHENSIVE REHABILITATION SERVICES, INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH AND HEARING, AND WOUND THERAPY PROGRAMS A DEDICATED CARDIAC DIAGNOSTIC SUITE USING THE LATEST IN ECHOCARDIOGRAPHY, AN ADJACENT LAB FOR DIAGNOSTIC CATHETERIZATION AND ELECTROPHYSIOLOGY STUDIES, AND A DEDICATED CARDIAC REHABILITATION AND PREVENTION PROGRAM OBSTETRIC CLINIC FOR INDIGENT PATIENTS MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES HOME HEALTH, DME, AND DIALYSIS SERVICES POPULATION SERVED MMC SERVES PATIENTS FROM 24 COUNTIES IN NORTHERN LOWER MICHIGAN AND THE EASTERN PORTION OF THE UPPER PENINSULA - A POPULATION BASE OF APPROXIMATELY 540,000. IN THE 12-COUNTY REGION IMMEDIATELY SURROUNDING MMC: 24.5% OF THE POPULATION ARE 65 YEARS OR OLDER UNEMPLOYMENT RATE (CALENDAR YEAR 2020) IS ABOVE THE MICHIGAN RATE OF 9.9% IN 7 OF THE 12 COUNTIES SERVED, AVERAGING 10% WITH RATES RANGING FROM 8% TO 10.1% (SOURCE: MICHIGAN BUREAU OF LABOR MARKET INFORMATION AND STRATEGIC INITIATIVES) ABOUT 68% OF MMC INPATIENT DISCHARGES ORIGINATE FROM THE FIVE COUNTIES IN CLOSEST PROXIMITY TO MMC - ANTRIM, BENZIE, GRAND TRAVERSE, LEELANAU AND KALKASKA. 46% OF BIRTHS ARE COVERED BY MEDICAID IN THE FIVE COUNTIES IMMEDIATELY SURROUNDING MMC: 9.3 PERCENT OF ADULTS 18-64 YEARS OF AGE LACK HEALTH INSURANCE, COMPARED TO A STATE AVERAGE OF 7.7 PERCENT. (SOURCE: US CENSUS BUREAU, SMALL AREA HEALTH INSURANCE ESTIMATES (SAHIE), 2018) QUALITY MMCS REPUTATION FOR THE HIGHEST QUALITY CARE IS REPRESENTED BY REPEATED NATIONAL RECOGNITION RECEIVED. THE AMERICAN NURSES CREDENTIALING CENTER HAS RE-DESIGNATED MMC AS A MAGNET HOSPITAL FOR THE THIRD CONSECUTIVE TIME. MMC WAS FIRST DESIGNATED IN 2006. MMC IS ONE OF JUST TWO PERCENT OF HOSPITALS IN THE WORLD AND ONE OF TWO HOSPITALS IN MICHIGAN THAT HAS BEEN RE-DESIGNATED FOR A THIRD TIME. MAGNET DESIGNATION RECOGNIZES EXCELLENCE IN PATIENT CARE STANDARDS, RESPECT OF CULTURAL AND ETHNIC DIVERSITY, AND LEADERSHIP OF THE NURSE ADMINISTRATOR IN SUPPORTING PROFESSIONAL NURSING PRACTICE, AND THE MANAGEMENT AND PHILOSOPHY OF NURSING SERVICES. MAGNET HOSPITALS ARE KNOWN TO HAVE THE HIGHEST QUALITY OF PATIENT CARE, HIGH LEVELS OF PATIENT SATISFACTION, LOWER VACANCY AND TURNOVER RATES FOR REGISTERED NURSE POSITIONS, AND HIGHER RATES OF JOB SATISFACTION. MMC IS FULLY ACCREDITED BY THE JOINT COMMISSION, AN INTERNATIONALLY- RECOGNIZED SYMBOL OF HEALTH CARE QUALITY. THE ACCREDITATION PROCESS DRIVES QUALITY CARE AND PATIENT SAFETY IMPROVEMENTS THROUGH NATIONALLY RECOGNIZED EVIDENCE-BASED STANDARDS WHICH ADDRESS CRITICAL PATIENT SAFETY AND QUALITY ISSUES, NATIONAL PATIENT SAFETY GOALS, AND PERFORMANCE MEASURES WHICH PROVIDE A FOUNDATION FOR QUALITY. THE JOINT COMMISSION, ALONG WITH THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION HAS ALSO CERTIFIED MMC AS A PRIMARY STROKE CENTER SINCE 2012 FOR MEETING ALL CRITICAL ELEMENTS OF PERFORMANCE TO ACHIEVE LONG-TERM SUCCESS IN IMPROVING OUTCOMES FOR STROKE PATIENTS. CERTIFICATION RECOGNIZES HOSPITALS THAT HAVE A DEDICATED STROKE-FOCUSED PROGRAM, ARE STAFFED BY QUALIFIED MEDICAL PROFESSIONALS TRAINED IN STROKE CARE, INVOLVE THE PATIENT IN THEIR HOSPITAL CARE, AND WHO USE DATA TO ASSESS AND CONTINUALLY IMPROVE QUALITY OF CARE FOR STROKE PATIENTS. MMC IS RATED FIVE STARS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, PLACING IT AMONG THE TOP 10 PERCENT OF HOSPITALS IN THE NATION FOR 2020. THE RATING SUMMARIZES UP TO 64 QUALITY MEASURES ON THE HOSPITAL COMPARE WEB SITE REFLECTING COMMON CONDITIONS THAT HOSPITALS TREAT, SUCH AS HEART ATTACKS OR PNEUMONIA. HOSPITALS MAY PERFORM MORE COMPLEX SERVICES OR PROCEDURES NOT REFLECTED IN THE MEASURES ON HOSPITAL COMPARE. THE OVERALL RATING SHOWS HOW WELL EACH HOSPITAL PERFORMED, ON AVERAGE, COMPARED TO OTHER HOSPITALS IN THE U.S. MMC IS RECOGNIZED AS A BLUE DISTINCTION CENTER+ IN THREE AREAS - BARIATRIC, MATERNITY CARE AND KNEE AND HIP REPLACEMENT - BY BLUE CROSS BLUE SHIELD OF MICHIGAN FOR DEMONSTRATING ITS EXPERTISE IN DELIVERING SAFE AND EFFECTIVE CARE, MEETING OUTLINED QUALITY MEASURES AND DEMONSTRATING EXPERTISE IN THESE AREAS. MMC'S STROKE PROGRAM IS REPEATEDLY RECOGNIZED BY THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION FOR HIGH QUALITY CARE AND WAS HONORED WITH ITS 2020 GET WITH THE GUIDELINES STROKE GOLD PLUS AWARD AND THE TARGET STROKE HONOR ROLL ELITE PLUS AWARD. IN 2016, THE AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES CONFERRED A SILVER-LEVEL BEACON AWARD FOR EXCELLENCE ON MMCS A2 CARDIOTHORACIC NURSING UNIT IN THE WEBBER HEART CENTER. THE NURSING STAFF OF A4 WEBBER HEART CENTER WON THE SAME AWARD IN 2014. THE BEACON AWARD FOR EXCELLENCE RECOGNIZES UNIT CAREGIVERS WHO SUCCESSFULLY IMPROVE PATIENT OUTCOMES AND ALIGN PRACTICES WITH AACNS SIX STANDARDS FOR A HEALTHY WORK ENVIRONMENT. UNITS THAT ACHIEVE THIS THREE-YEAR, THREE-LEVEL AWARD WITH GOLD, SILVER, AND BRONZE DESIGNATIONS MEET NATIONAL CRITERIA CONSISTENT WITH MAGNET RECOGNITION, THE MALCOLM BALDRIDGE NATIONAL QUALITY AWARD, AND THE NATIONAL QUALITY HEALTHCARE AWARD. SEVEN MUNSON HEALTHCARE SYSTEM HOSPITALS WERE NAMED MOST WIRED FOR 2017 BY THE AMERICAN HOSPITAL ASSOCIATIONS JOURNAL HOSPITALS AND HEALTH NETWORKS. MMC HAS BEEN NAMED A MOST WIRED HOSPITAL IN SEVEN OUT OF THE EIGHT YEARS THE LIST HAS BEEN PUBLISHED, INCLUDING, 2011 (SMALL & RURAL), 2012 (MOST IMPROVED) AND 2013 2017. THE AMERICAN COLLEGE OF SURGEONS REVERIFIED MUNSON MEDICAL CENTER AS A LEVEL II TRAUMA CENTER IN 2015 AND WAS FIRST VERIFIED IN 2006. MMCS SMITH FAMILY BREAST HEALTH CENTER IS ACCREDITED BY THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC). THE THREE-YEAR RECOGNITION IS A PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS. THE NAPBC IS A CONSORTIUM OF PROFESSIONAL ORGANIZATIONS DEDICATED TO THE IMPROVEMENT OF THE QUALITY OF CARE AND MONITORING OF OUTCOMES OF PATIENTS WITH DISEASE OF THE BREAST. ACCREDITATION BY THE NAPBC IS ONLY GIVEN TO THOSE CENTERS THAT HAVE VOLUNTARILY COMMITTED TO PROVIDE THE HIGHEST QUALITY BREAST CARE AND THAT UNDERGO A RIGOROUS EVALUATION AND REVIEW OF THEIR PERFORMANCE. THE CENTER HAS BEEN DESIGNATED AS A BREAST IMAGING CENTER OF EXCELLENCE BY THE AMERICAN COLLEGE OF RADIOLOGY SINCE 2010. MMCS CARDIAC PREVENTION AND REHABILITATION PROGRAM WAS RECERTIFIED IN 2015 BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION FOR MEETING THE HIGHEST STANDARDS FOR CARDIOVASCULAR REHABILITATION CARE. CERTIFIED PROGRAMS ARE RECOGNIZED AS THE NATIONAL LEADERS IN CARDIOVASCULAR REHABILITATION. MMC WAS IN THE NATIONAL SPOTLIGHT IN 2008 AFTER BE SCHEDULE H, PART VI, LINE 5 THE MUNSON MEDICAL CENTER BOARD OF TRUSTEES IS MADE UP OF COMMUNITY MEMBERS THAT RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. ADDITIONALLY, 100% OF MUNSON MEDICAL CENTER TRUSTEES SUPPORT MUNSON FINANCIALLY. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF TRUSTEES. MUNSON MEDICAL CENTER UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA. EXAMPLES OF HOW MUNSON MEDICAL CENTER PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PROGRAMS INCLUDE: HEALTHY FUTURES- A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS, HEALTH DEPARTMENTS AND MUNSON HEALTHCARE, CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UP TO AGE FIVE. THE PROGRAM INCLUDES CENTRAL ACCESS/DATA MANAGEMENT, REGISTERED NURSE (RN) CARE COORDINATION, EDUCATIONAL MAILINGS, AND HEALTH CARE-RELATED FINANCIAL ASSISTANCE. THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMES-BASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY, ACCESS TO HEALTH CARE AND IMMUNIZATIONS. MEDS PROGRAM- A PROGRAM THAT PROVIDES TO PATIENTS WITHOUT RESOURCES BEING DISCHARGED FROM THE HOSPITAL NEEDED MEDICATIONS, AS WELL AS ENROLLING THOSE PATIENTS INTO PHARMACEUTICAL COMPANY SPONSORED ASSISTANCE PROGRAMS SO THEY MAY CONTINUE TO GET THE NEEDED PHARMACEUTICALS. NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 14 COUNTY SERVICE AREA, WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES. NMDI IS COMMITTED TO PROVIDING LOCAL, REGIONAL, AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES. WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES, NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS: THE GENERAL COMMUNITY; THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION; AND RURAL PRIMARY CARE PROVIDERS (PCP) CARING FOR DIABETIC PATIENTS. NORTHERN MICHIGAN VACCINE PREVENTABLE DISEASE TASK FORCE A GROUP COORDINATED AND LED BY MUNSON HEALTHCARE, IS WORKING TO INFORM, EDUCATE, AND SUPPORT POLICY CHANGE THAT REVERSES THE REGIONS ONGOING TREND OF VERY LOW VACCINATION RATES AND SUPPORTS HEALTHY COMMUNITIES. MEDICAL EDUCATION-THE MUNSON FAMILY PRACTICE RESIDENCY PROGRAM INTEGRATES OSTEOPATHIC AND ALLOPATHIC MEDICINE TOGETHER, WITH THE RESOURCES OF MUNSON MEDICAL CENTER. THIS DUALLY ACCREDITED 6/6/6 PROGRAM ACCEPTS BOTH DO AND MD TRAINEES. THE PROGRAM IS AFFILIATED WITH MICHIGAN STATE UNIVERSITY. MMC ALSO PARTNERS WITH SEVERAL COLLEGES AND SCHOOLS OF NURSING TO PROVIDE INTERNSHIPS AND CLINICAL EXPERIENCES FOR REGISTERED NURSES, RESPIRATORY THERAPISTS, PHARMACISTS, AND OTHER HEALTH PROFESSIONALS. SHAPE UP NORTH- A COMMUNITY COLLABORATIVE OF LIKEMINDED NONPROFIT ORGANIZATIONS WHO WORK TOGETHER TO INCREASE ACCESS TO HEALTHY FOOD AND CREATE A CULTURE OF HEALTH IN OUR COMMUNITIES. THE COLLABORATION ENCOURAGES CREATING PARTNERSHIP TO IMPACT HEALTH FROM A MULTI-FACETED APPROACH DESIGNED TO CREATE COMMUNITIES WHERE HEALTHY HABITS FORM AND THRIVE. FITKIDS 360 - FITKIDS360 IS A FREE HEALTHY LIFESTYLE PROGRAM FOR CHILDREN AGE 5-17 WHO HAVE A BMI OVER THE 95%. THE PROGRAM IS DESIGNED TO HELP THE WHOLE FAMILY MAKE HEALTHY CHANGES IN WHAT THEY EAT AND HOW THEY EXERCISE. THIS LEVEL 2 INTERVENTION IS LED BY A TEAM OF SOCIAL WORKERS, DIETITIANS, AND EXERCISE SPECIALISTS. TOGETHER THEY TEACH A COMPREHENSIVE PROGRAM THAT COMBINES BASIC EDUCATION ABOUT NUTRITION, BEHAVIOR, AND EXERCISE WITH A WIDE RANGE OF PHYSICAL ACTIVITIES. THE GOAL IS TO TEACH FAMILIES HOW TO MAKE ENVIRONMENTAL CHANGES THAT CAN IMPACT THEIR FAMILYS LONG TERM HEALTH. FRUIT AND VEGETABLE PROGRAM - OUR PROGRAM WORKS CLOSELY WITH LOCAL CLINICS AND NONPROFITS TO BUILD SYSTEMATIC SUPPORT FOR HEALTHY BEHAVIOR CHANGES IN PATIENTS WITH CHRONIC DISEASE. THE PROGRAM ALSO CREATES STRONGER PARTNERSHIPS BETWEEN HEALTH CARE PROVIDERS, PATIENTS AND THEIR LOCAL FOOD SECTOR. THE PROGRAM OFFERS NUTRITIONAL EDUCATION AND FOOD TASTING THROUGH OUR PARTNERS AT MICHIGAN STATE UNIVERSITY EXTENSION AND FARMERS MARKET TOKENS TO PURCHASE FRESH FRUITS AND VEGETABLES CREATING HEALTHY HABITS FOR LONG TERM HEALTH. SCHEDULE H, PART VI, LINE 6 MUNSON MEDICAL CENTERS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501 (C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM WHICH INCLUDE MUNSON MEDICAL CENTER, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL AND MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL PROVIDED 96.4 MILLION OF COMMUNITY BENEFIT IN THE 2019 TAX YEAR. ADDITIONALLY, MMC WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA. THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON CAMPUS. COMMUNITY BENEFIT, IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR. NORTH FLIGHT, INC. IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM. WITH ITS GROUND MEDICAL TRANSPORTATION SERVICES, PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE. NORTH FLIGHT, INC. PROVIDED 1 MILLION IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR. MUNSON MEDICAL GROUP, THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM, PROVIDED APPROXIMATELY 942,000 IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2019. MMC PERFORMS THE NEEDS ASSESSMENTS FOR MUNSON HEALTHCARE. UTILIZING THIS NEEDS ASSESSMENT, MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING, DEVELOPING, IMPLEMENTING, EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS. IN TOTAL, THE MUNSON HEALTHCARE SYSTEM PROVIDED 107.8 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS, INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS, OUTREACH PROGRAMS, BAD DEBT, AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN. SCHEDULE H, PART VI, LINE 7 MICHIGAN true TRAVERSE HEALTH CLINIC & COALITION 1719 S GARFIELD AVENUE TRAVERSE CITY MI 49686 300224028 501C3 8007 FMV MEDICATION MEDICALLY UNDERSERVE 1 TRANSPORT, SUPPORT GROUPS 843 142007 TRANSPORT, HOUSING, FOOD 1404 128444 MEALS FOR PATIENT FAMILY 477 12776 FMV MEALS MEDICAL, TRANSPORT & DRUG 166 48232 MEDICAL INSURANCE PAYMENT 2 3098 SCHEDULE I, PAGE 1, PART I, LINE 2 MUNSON MEDICAL CENTER AWARDS MOST GRANTS BASED ON AN APPLICATION PROCESS FOR PRE-APPROVED SERVICES AND PURCHASES IN ACCORDANCE WITH PROTOCOLS ESTABLISHED WITH CASE MANAGERS WORKING FOR THE DEPARTMENTS WHICH APPLY FOR ASSISTANCE. THE ASSISTANCE CAN EITHER BE REQUESTED FOR THE DEPARTMENT OR ON BEHALF OF PATIENTS WHO INDICATE AN UNMET NEED THAT POSES A BARRIER TO THE RECEIPT OF HEALTH CARE SERVICES. CASE MANAGERS MONITOR THE USE OF THE FUNDS IN LINE WITH THE PROTOCOLS. MUNSON MEDICAL CENTER MAINTAINS RECORDS OF SUPPORT FOR EXPENSES USED FOR FUNDED REQUESTS. MUNSON MEDICAL CENTER MAY AWARD A GRANT OR CONTRIBUTION TO ANOTHER TAX- EXEMPT ORGANIZATION BASED ON A REQUEST FOR REIMBURSEMENT FOR PRE-APPROVED SERVICES OR PURCHASES. THE AWARD IS BASED ON AN EVALUATION OF THE USE OF THE FUNDS FOR THE PROMOTION OF HEALTH IN THE COMMUNITY. THE ONGOING RELATIONSHIP OF MUNSON MEDICAL CENTER WITH ITS PARTNERS IN THE COMMUNITY FOR THE PROMOTION OF HEALTH ALLOWS FOR THE MONITORING OF THE GRANT AWARD. X X X X false true false false false false false false false EDWIN A NESS DIRECTOR 798100 198983 8437 164228 30082 1199830 THOMAS SCHERMERHORN MD NEUROSURGEON 1025453 20592 14028 25899 1085972 JOHN CAMPBELL MD NEUROSURGEON 952207 22743 14028 27345 1016323 MICHAEL NIZZI DO MED DIRECTOR BARIATR 668346 83356 20990 14028 23642 810362 ASHLEY SACHTLEBEN DO PHYSICIAN 680358 79257 359 8400 21852 790226 DAVID KAM MD PHYSICIAN 647843 76741 20714 14028 20121 779447 MARK A HEPLER CFO 418294 71314 66405 65664 14020 635697 12893 LAURA GLENN PRESIDENT AMB SERVIC 343499 52033 318 53857 21511 471218 DERK PRONGER PT-YR INTERIM PRES 342452 39950 2171 46028 25037 455638 LORAINE FRANK-LIGHTFOOT VP PATIENT CARE SERV 275517 28020 4305 31048 17342 356232 JILL E VOLLBRECHT MD DIRECTOR 269076 25000 16922 14028 23670 348696 WALTER NOBLE MD DIRECTOR 288547 17960 1876 14028 10679 333090 ALICIA MAITLAND CORPORATE CONTROLLER 197849 25155 275 22350 20922 266551 DAVID MCGREAHAM MD FORMER VP MED AFFAIR 261420 261420 261420 MATTHEW WILLE PT-YR CEO & PRES 108679 2667 107528 12884 4269 233360 2667 ALFRED PILONG PART-YR CEO & PRES 152762 67654 4447 6174 231037 SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 150,200 0 MARK A. HEPLER 0 44,749 0 LAURA GLENN 0 40,000 0 DERK PRONGER 0 32,000 0 LORAINE FRANK-LIGHTFOOT 0 17,566 0 ALICIA MAITLAND 0 12,204 0 MATTHEW WILLE 0 12,884 0 SCHEDULE J, PART III PART I, LINE 4B SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. FOR THE PRESIDENT, THE PLAN PROVIDES A TARGETED BENEFIT AT AGE 62. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. VICE-PRESIDENTS ARE ELIGIBLE TO PARTICIPATE IN AN AMOUNT NOT TO EXCEED 6% OF BASE COMPENSATION, FUNDED ANNUALLY, AT THE SOLE DISCRETION OF MUNSON. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON. A CNTY GRD TRAVSE HOSP FIN AUTH 2011 386004832 386523EE0 2011-08-10 128728067 REFUND PRIOR BONDS CNTY GRD TRAVSE HOSP FIN AUTH 2011 THE SERIES 2011A, 2011B AND 2011C BONDS WERE I false false false B CNTY GRAD TRAV HOSP FIN AUTH 2014 A 386004832 386523EH3 2014-12-17 30370807 CONSTRUCT CANCER CENTER false false false C CNTY GRND TRAV HOSP FIN AUTH 2019C 386004832 386523HR8 2019-01-16 22300000 REFUND PRIOR BONDS CNTY GRND TRAV HOSP FIN AUTH 2019C THE SERIES 2019C BONDS WERE ISSUED TO REFINANC false false false A 22000000 128728067 1756787 126971280 true false true true B 30374200 370807 30003393 2016 false false true true C 22300000 300000 22000000 true false true true A false true true false true false 0.00030 0.00030 false false true B false false false true false false false true C false true true false true false false false true A false false false true true false false false true B false false true false false false false false true C false false true false true false false false true A true B true C true DIFFERENCES IN ISSUE PRICE EXPLANATION CNTY GRAD TRAV HOSP FIN AUTH 2014 A INVESTMENT INCOME EARNED PURPOSE OF ISSUE DESCRIPTION CNTY GRD TRAVSE HOSP FIN AUTH 2011 REFUND PRIOR BONDS CNTY GRD TRAVSE HOSP FIN AUTH 2011 THE SERIES 2011A, 2011B AND 2011C BONDS WERE ISSUED TO PURCHASE AND CANCEL TENDERED BONDS, TENDERED DURING A TENDER PROGRAM INITIATED BY MUNSON HEALTHCARE. THE TENDERED BONDS INCLUDED COUNTY OF GRAND TRAVERSE HOSPITAL AUTHORITY (MUNSON HEALTHCARE OBLIGATED GROUP) HOSPITAL REVENUE AND REFUNDING BONDS SERIES 1998A, ISSUED 9/1/98; REVENUE BONDS SERIES 2001A, ISSUED 1/9/01; REVENUE REFUNDING BONDS SERIES 2002A, ISSUED 9/17/02; REVENUE REFUNDING BONDS SERIES 2005A, ISSUED 11/3/05 AND REVENUE BONDS SERIES 2005B, ISSUED 11/3/05. PURPOSE OF ISSUE DESCRIPTION CNTY GRAD TRAV HOSP FIN AUTH 2014 A CONSTRUCT CANCER CENTER PURPOSE OF ISSUE DESCRIPTION CNTY GRND TRAV HOSP FIN AUTH 2019C REFUND PRIOR BONDS CNTY GRND TRAV HOSP FIN AUTH 2019C THE SERIES 2019C BONDS WERE ISSUED TO REFINANCE THE COUNTY OF GRAND TRAVERSE HOSPITAL AUTHORITY (MUNSON HEALTHCARE OBLIGATED GROUP) HOSPITAL REVENUE AND REFUNDING BONDS SERIES 2011C ISSUED 08/10/11. DATE REBATE COMPUTATION PERFORMED CNTY GRD TRAVSE HOSP FIN AUTH 2011 02/05/14 ADDITIONAL INFORMATION CNTY GRD TRAVSE HOSP FIN AUTH 2011 SCHEDULE K - ADDITIONAL INFORMATION CNTY GRAD TRAV HOSP FIN AUTH 2014 A OBLIGATED GROUP ISSUE RECORDED ON RELATED ORGANIZATIONS ON DECEMBER 17, 2014, THE MUNSON HEALTHCARE OBLIGATED GROUP ISSUED COUNTY OF GRAND TRAVERSE HOSPITAL FINANCE AUTHORITY REVENUE BONDS (MUNSON HEALTHCARE OBLIGATED GROUP) SERIES 2014A, 2014B AND 2014C, AT A PREMIUM. THE 2014 SERIES A BONDS ARE RECORDED ON MUNSON MEDICAL CENTER'S BOOKS AND RECORDS AT A PAR VALUE OF 27,620,000. THE 2014 SERIES B BONDS ARE RECORDED ON MUNSON HEALTHCARE GRAYLING'S BOOKS AND RECORDS AT A PAR VALUE OF 13,805,000. THE 2014 SERIES C BONDS ARE RECORDED ON MUNSON HEALTHCARE CADILLAC'S BOOKS AND RECORDS AT A PAR VALUE OF 15,870,000. THE RELATED BOND PREMIUM WAS RECORDED ON THE RESPECTIVE ENTITIES' BOOKS AND RECORDS. ADDITIONAL INFORMATION CNTY GRND TRAV HOSP FIN AUTH 2019C CNTY GRND TRAV HOSP FIN AUTH 2019C OBLIGATED GROUP ISSUE RECORDED ON RELATED ORGANIZATIONS ON JANUARY 16, 2019, THE MUNSON HEALTHCARE OBLIGATED GROUP ISSUED COUNTY OF GRAND TRAVERSE HOSPITAL FINANCE AUTHORITY REVENUE BONDS (MUNSON HEALTHCARE OBLIGATED GROUP) SERIES 2019A, 2019B AND 2019C. THE 2019 SERIES A BONDS ARE RECORDED ON MUNSON HEALTHCARE MANISTEE HOSPITAL'S BOOKS AND RECORDS AT A PAR VALUE OF 18,360,000. THE 2019 SERIES B BONDS ARE RECORDED ON MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL'S BOOKS AND RECORDS AT A PAR VALUE OF 14,520,000. THE RELATED BOND PREMIUM WAS RECORDED ON THE RESPECTIVE ENTITIES' BOOKS AND RECORDS. PART III, QUESTION 3B AND D MUNSON MEDICAL CENTER MAINTAINS POLICIES AND PROCEDURES TO REVIEW AND MONITOR ALL CONTRACTS, INCLUDING LEASES, MANAGEMENT, SERVICE AND RESEARCH CONTRACTS. THE MONITORING PROCESS INCLUDES A REVIEW BY THE INTERNAL LEGAL DEPARTMENT. OUTSIDE COUNSEL MAY BE CONSULTED, AS NECESSARY. OUTSIDE COUNSEL IS RETAINED FOR ALL NEW EXEMPT BOND OFFERINGS, DURING WHICH A THOROUGH DUE DILIGENCE PROCESS REVIEWS APPLICABLE CONTRACTS. SINCE NEW BONDS WERE ISSUED IN 2019, OUTSIDE COUNSEL WAS ENGAGED DURING THAT TAX YEAR. KRISTINE NAVIN SEE PART V 21707 COMPENSATION PAID false SCHEDULE L, PART V KRISTINE NAVIN IS THE WIFE OF BOARD MEMBER DANIEL NAVIN. FORM 990, PAGE 6, PART VI, LINE 6 MUNSON MEDICAL CENTER IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. IN THE EVENT OF DISSOLUTION, MUNSON MEDICAL CENTER'S NET ASSETS WOULD BE DISTRIBUTED TO MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 7A MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE TRUSTEES FOR ALL SUBSIDIARY ENTITIES, INCLUDING MUNSON MEDICAL CENTER. NOMINATIONS TO MUNSON HEALTHCARE FOR SUBSIDIARY TRUSTEES ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. FOUR TRUSTEES OF MUNSON MEDICAL CENTER ALSO ARE DIRECTORS OF MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON MEDICAL CENTER (MMC) TRUSTEES ARE APPROVED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING: ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF MMC; ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION INVOLVING MMC; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF MMC; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF MMC; ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR MMC; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY MMC WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF MMC, WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF MMC'S BUDGET; ADOPTION OR CHANGE IN THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF MMC; CHANGING SUBSTANTIALLY THE SCOPE OF MMC'S CLINICAL SERVICES AND PROGRAMS OFFERED BY MMC; AND APPOINTMENT OR REMOVAL THE PRESIDENT OF MMC. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON MEDICAL CENTER BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. THE MUNSON MEDICAL CENTER BOARD RECEIVES A COPY OF THE FORM 990 PRIOR TO FILING WITH THE IRS. MUNSON MEDICAL CENTER BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON EXECUTIVES IS DETERMINED IN PART BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES FOR MUNSON MEDICAL CENTER. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON MEDICAL CENTER ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON MEDICAL CENTER DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. ADDITIONALLY, MUNSON MEDICAL CENTER PREPARES AND DISTRIBUTES AN ANNUAL REPORT TO THE COMMUNITY, WHICH CONTAINS FINANCIAL AS WELL AS PROGRAM DATA. FORM 990, PART IX, LINE 11G PURCHASED SERVICES 31,807,071 62,476,108 1,476,651 PROFESSIONAL FEES 33,610,936 50,904 0 TOTAL 65,418,007 62,527,012 1,476,651 FORM 990, PART XI, LINE 9 INVEST IN MUNSON HEALTHCARE FOUNDATION CONTRIBUTIO 2,013,578 TRANSFERS TO AFFILIATES -15,230,000 PENSION AND POST RETIREMENT CHANGES -54,424,606 SWAP MARKET VALUE CHANGE -855,839 TOTAL -68,496,867 MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 HEALTHCARE MI C3 12B N/A false MUNSON HEALTHCARE FOUNDATIONS 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE true MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true MUNSON HOME HEALTH 1105 SIXTH ST TRAVERSE CITY MI 49684 383335362 HOME HEALT MI C3 12B MUNSON HC MUNSON HEALTHCARE true MUNSON HOME SERVICES 1105 SIXTH ST TRAVERSE CITY MI 49684 382543463 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 12B MUNSON HC MUNSON HEALTHCARE true PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI C3 10 MUNSON MED MUNSON MEDICAL CENTER true MUNSON HEALTHCARE CADILLAC 1105 SIXTH ST TRAVERSE CITY MI 49684 471156297 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE GRAYLING 1105 SIXTH ST TRAVERSE CITY MI 49684 471161992 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CHARLEVOIX HOSPIT 14700 LAKE SHORE DRIVE CHARLEVOIX MI 49720 381459366 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE MANISTEE HOSPITAL 1465 E PARKDALE AVE MANISTEE MI 496609709 380350304 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE OTSEGO MEMORIAL H 825 N CENTER AVE GAYLORD MI 497351592 381303843 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL FOUNDATION 825 N CENTER AVE GAYLORD MI 497351592 382135473 RAISE FUND MI C3 12A MHC OTSEGO HOSPITAL true NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true SIXTH STREET DRUGS PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true true true true false false false false false false false true true true true true true true true true MUNSON DIALYSIS CENTER L 114156 ACTUAL AMOUNT PAID MUNSON DIALYSIS CENTER M 109882 ACTUAL AMOUNT PAID MUNSON DIALYSIS CENTER O 1672917 ACTUAL AMOUNT PAID MUNSON DIALYSIS CENTER P 711186 ACTUAL AMOUNT PAID MUNSON DIALYSIS CENTER Q 1805651 ACTUAL AMOUNT PAID MUNSON DIALYSIS CENTER R 158176 ACTUAL AMOUNT PAID MUNSON HEALTHCARE B 15230000 ACTUAL AMOUNT PAID MUNSON HEALTHCARE M 55746621 ACTUAL AMOUNT PAID MUNSON HEALTHCARE O 30805445 ACTUAL AMOUNT PAID MUNSON HEALTHCARE P 114357122 ACTUAL AMOUNT PAID MUNSON HEALTHCARE Q 16010456 ACTUAL AMOUNT PAID MUNSON HEALTHCARE R 6293090 ACTUAL AMOUNT PAID MUNSON HEALTHCARE S 303465 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC L 2448148 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC M 96168 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC O 27312055 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC P 1308357 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC Q 1992005 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC R 6116067 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC S 5381368 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT L 464536 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT O 18014015 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT P 128019 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT Q 312110 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS C 1149897 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS M 1808982 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS O 826617 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS Q 52556 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING L 2149378 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING O 26911820 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING P 784150 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING Q 1119629 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING R 2022140 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING S 1584462 ACTUAL AMOUNT PAID MUNSON HEALTHCARE MANISTEE HOSPITAL L 164252 ACTUAL AMOUNT PAID MUNSON HEALTHCARE MANISTEE HOSPITAL O 15821574 ACTUAL AMOUNT PAID MUNSON HEALTHCARE MANISTEE HOSPITAL P 317382 ACTUAL AMOUNT PAID MUNSON HEALTHCARE MANISTEE HOSPITAL Q 762030 ACTUAL AMOUNT PAID MUNSON HEALTHCARE MANISTEE HOSPITAL R 3648627 ACTUAL AMOUNT PAID MUNSON HEALTHCARE MANISTEE HOSPITAL S 3659401 ACTUAL AMOUNT PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H L 355076 ACTUAL AMOUNT PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H O 129232 ACTUAL AMOUNT PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H P 544499 ACTUAL AMOUNT PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H Q 740789 ACTUAL AMOUNT PAID MUNSON HOME CARE A 169315 LEASE CONTRACT AMOUNT MUNSON HOME CARE L 258836 ACTUAL AMOUNT PAID MUNSON HOME CARE M 294185 ACTUAL AMOUNT PAID MUNSON HOME CARE O 14131487 ACTUAL AMOUNT PAID MUNSON HOME CARE P 80657 ACTUAL AMOUNT PAID MUNSON HOME CARE Q 124307 ACTUAL AMOUNT PAID MUNSON HOME SERVICES M 203523 ACTUAL AMOUNT PAID MUNSON HOME SERVICES O 3452832 ACTUAL AMOUNT PAID MUNSON HOME SERVICES Q 174065 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP M 2281345 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP O 15032979 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP P 389081 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP Q 173059 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP R 3323296 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP S 2443484 ACTUAL AMOUNT PAID MUNSON SERVICES INC A 75324 LEASE CONTRACT AMOUNT MUNSON SERVICES INC O 1814075 ACTUAL AMOUNT PAID MUNSON SERVICES INC P 381629 ACTUAL AMOUNT PAID MUNSON SERVICES INC Q 7515306 ACTUAL AMOUNT PAID MUNSON SERVICES INC R 383496 ACTUAL AMOUNT PAID MUNSON SUPPORT SERVICES M 1562832 ACTUAL AMOUNT PAID MUNSON SUPPORT SERVICES O 1219085 ACTUAL AMOUNT PAID MUNSON SUPPORT SERVICES P 79336 ACTUAL AMOUNT PAID MUNSON SUPPORT SERVICES Q 207722 ACTUAL AMOUNT PAID NORTH FLIGHT INC O 3719938 ACTUAL AMOUNT PAID NORTH FLIGHT INC P 64316 ACTUAL AMOUNT PAID NORTH FLIGHT INC Q 70420 ACTUAL AMOUNT PAID NORTH FLIGHT INC R 63903 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE A 277040 LEASE CONTRACT AMOUNT NORTHERN MICHIGAN SUPPLY ALLIANCE M 4647639 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE O 3224861 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 17059046 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE Q 2798423 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE R 1413174 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE S 952923 ACTUAL AMOUNT PAID PAUL OLIVER MEMORIAL HOSPITAL L 428737 ACTUAL AMOUNT PAID PAUL OLIVER MEMORIAL HOSPITAL O 6407759 ACTUAL AMOUNT PAID PAUL OLIVER MEMORIAL HOSPITAL P 1133383 ACTUAL AMOUNT PAID PAUL OLIVER MEMORIAL HOSPITAL Q 2236036 ACTUAL AMOUNT PAID PAUL OLIVER MEMORIAL HOSPITAL R 303596 ACTUAL AMOUNT PAID PAUL OLIVER MEMORIAL HOSPITAL S 220580 ACTUAL AMOUNT PAID SIXTH STREET DRUGS O 656079 ACTUAL AMOUNT PAID SCHEDULE R MUNSON MEDICAL CENTER USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.