2020-05-22T13:58:52-05:00 2019-06-30 990 2018-07-01 381303843 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL MUNS 9877312100 825 N CENTER AVE GAYLORD MI 49735 MARK A HEPLER CFO 9877312100 2020-05-22 172.222.71.44 2020-05-22 13:58:52 CD P 3AD8FE5AAD7F1E7C8842AE1699DABE20D9503696 B12A1DA808F22A6A05E7483450C91465FF2D0CFC 2018 2020-09-23 17:36:50Z THOMAS LEMON 825 N CENTER GAYLORD MI 49735 130420418 false X WWW.MUNSONHEALTHCARE.ORG X 1946 MI TO PROVIDE EXCEPTIONAL HEALTHCARE THAT MEETS THE NEEDS OF OUR PATIENTS AND THE COMMUNITIES WE SERVE. 13 9 915 107 0 24385 1023280 53005928 113564808 504415 1048353 181202 464483 53715930 116100924 0 0 33286509 66348607 0 0 18960278 42229086 52246787 108577693 1469143 7523231 75228377 97969489 31891114 46250501 43337263 51718988 X TO PROVIDE EXCEPTIONAL HEALTHCARE THAT MEETS THE NEEDS OF OUR PATIENTS AND THE COMMUNITIES WE SERVE. false false 58619617 78916453 ACUTE INPATIENT AND OUTPATIENT CARE FOR DIAGNOSTIC AND MEDICAL CARE - 90,186 ENCOUNTERS. 32648648 29046826 PHYSICIAN DIAGNOSTIC OFFICES AND URGENT CARE CLINIC - 181,958 ENCOUNTERS 3575340 3865072 LONG TERM CARE FOR ELDERLY - 10,941 PATIENT DAYS 3377719 1870661 ALL OTHER HOSPITAL SERVICES INCLUDING OVER 15,000 EMERGENCY ROOM VISITS AND OVER 5,000 SURGICAL CASES. 3377719 1870661 98221324 true true false true false false false false false false true false false false true false false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true true true false false true 33 0 true 915 true false false false false false false false false false false false false X 13 9 false false false false true true true true true false false true true true true true true true true false X AMY BILYEA 9897312100 825 N CENTER GAYLORD MI 49735 EDWIN A NESS DIRECTOR 1.00 40.00 X 0 921722 182202 MATTHEW MAZUR DO DIRECTOR 40.00 X 696483 0 30172 KASEY NELSON DO DIRECTOR 40.00 X 528571 0 28492 THOMAS LEMON PRESIDENT 40.00 2.00 X X 272949 208899 32587 MARY SANDERS CHAIR 2.00 1.00 X X 0 5000 0 BECKY ASHLEY MD DIRECTOR 1.00 X 2500 0 0 DAVID BRINEY DIRECTOR 1.00 1.00 X 2500 0 0 CHRISTOPHER COLLINS VICE CHAIR 2.00 X X 2500 0 0 JIM HILGENDORF DIRECTOR 1.00 X 2500 0 0 KEVIN REYNOLDS DIRECTOR 1.00 X 2500 0 0 STEVEN SELLA MD DIRECTOR 40.00 X 2500 0 0 DONALD SKLARCZYK SECRETARY 2.00 X X 2500 0 0 DANIEL SMITH TREASURER 2.00 X X 2500 0 0 MARK A HEPLER CFO 2.00 40.00 X 0 503212 81037 ROBERT COURTOIS VP FINANCE 40.00 X 235015 0 26235 CHRIS SQUIRE VP ANCILLARY 40.00 X 166311 0 25219 JAMES FLICKEMA VP PATIENT C 40.00 X 164338 0 27295 JOHN MOFFAT MD SURGEON 40.00 X 959684 0 32331 CHANGXIN LI MD PHYSICIAN 40.00 X 804110 0 29836 JAMES SHURLOW DO SURGEON 40.00 X 713141 0 27348 JANELLE HENDRIAN DO ANESTHESIOLO 40.00 X 570193 0 34667 LOUIS HABRYL DO SURGEON 40.00 X 548881 0 28852 5679676 1638833 586273 91 false true false BURDCO 122 VETERANS DRIVE TRAVERSE CITY MI 49684 CONSTRUCTION 2601030 AMERICAN HEALTHCARE SERVICES PO BOX 1928 EDMOND OK 73083 MEDICAL 512367 GREENWAY HEALTH PO BOX 203658 DALLAS TX 75320 SOFTWARE SUPPOR 426603 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 55480 DIAGNOSTIC 422454 INTUITIVE SURGICAL PO BOX 39000 SAN FRANCISCO CA 94139 SURGICAL SERV 414507 17 1023280 1023280 PATIENT SERVICE REVENUE 621990 68878734 68878734 MEDICARE/MEDICAID PAYMENTS 621990 38687197 38687197 HEALTH SERVICES REVENUE 621990 5165369 5165369 INCENTIVE PAYMENT 621990 798728 798728 RENT FROM RELATED ORGS 531120 34780 34780 113564808 568059 568059 87065 75394 11671 11671 11671 14665277 59117 14128463 115637 536814 -56520 480294 -56520 536814 CAFETERIA REVENUE 722210 262088 262088 MISCELLANEOUS 621990 190724 190724 452812 116100924 113699012 1378632 1760173 1298673 461500 51025488 46982726 4042762 1561594 1436227 125367 8713268 8006409 706859 3288084 3009830 278254 105964 105964 8388 8388 3552 3552 94197 94197 9514775 6667291 2847484 51613 296 51317 1333332 853713 479619 1903742 1289448 614294 1053120 1050942 2178 193951 157394 36557 454699 402226 52473 680518 615609 64909 2901917 2625126 276791 211628 129174 82454 MEDICAL SUPPLIES 18501059 18501059 BAD DEBT 4384560 4384560 REPAIRS AND MAINTENANCE 555838 552236 3602 DUES AND SUBSCRIPTIONS 92926 81536 11390 183307 176849 6458 108577693 98221324 10356369 0 1240789 8747 386245 13616706 9382534 11983747 53523 1470937 1471843 3319193 682705 44059923 2047516 35051267 42012407 21653317 25461602 2677559 2724095 650 75228377 97969489 11758433 12244151 16104834 30701805 2141927 1885920 3304545 31891114 46250501 X 43337263 51718988 43337263 51718988 75228377 97969489 7523231 858494 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3552 3552 false SCHEDULE C, PART II-B, LINE 1 OTHER GRASSROOTS LOBBYING INCLUDES THE PORTION OF DUES ALLOCATED TO LOBBYING. 1960000 1960000 27478711 690064 26788647 1115219 1115219 12502682 1357452 11145230 1003311 1003311 42012407 RESERVE FOR THIRD PARTY SETTLEMENT 1766701 ESTIMATED THIRD PARTY SETTLEMENT 933333 AP AFFILIATE 396332 CAPITAL LEASE 208179 3304545 true true X true X true X true true true false true true 381051 381051 0.00370 18411014 13201087 5209927 0.05000 18792065 13201087 5590978 0.05370 242371 45 242326 0.00230 2891 2891 245262 45 245217 0.00230 19037327 13201132 5836195 0.05600 8890 8890 0.00010 1732 1732 10622 10622 0.00010 true 4384560 1420839 18448656 16935028 1513628 X true true 1 1 MUNSON HEALTHCARE OTSEGO MEMORIAL H 825 N CENTER AVE GAYLORD MI 49735 WWW.MYOMH.ORG 1060000063 X X X LONG TERM CARE FACILITY MUNSON HEALTHCARE OTSEGO MEMORIAL H 1 false true true X X X X X X X X X X 18 true true true true X HTTPS://TINYURL.COM/YBF2T46T X true 19 true HTTPS://TINYURL.COM/YCJDWU2K false true X 100.000000000000 350.000000000000 X X X X X true true X X X true X HTTPS://TINYURL.COM/YAHXNLEB X HTTPS://TINYURL.COM/YCGR7M57 X HTTPS://TINYURL.COM/YBUEF65F X X X X X X X true X false X X X X X true X false false FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 2 ON JUNE 1, 2018, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL INTEGRATED INTO THE MUNSON HEALTHCARE SYSTEM AS A SUBSIDIARY OF MUNSON HEALTHCARE, A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 3E YES, SIGNIFICANT HEALTH NEEDS ARE PRIORTIZED AND IDENTIFIED THROUGH CHNA. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 5 IN CONDUCTING THE MOST RECENT CHNA OMH IN CONJUNCTION WITH ITS PARTNERING HOSPITALS CONDUCTED A DAYLONG SESSION WITH HEALTH PROFESSIONALS AND SECTOR REPRESENTATIVES IN LATE 2019. ADDITIONALLY, MORE THAN 1,200 INDIVIDUALS PARTICIPATED IN SURVEYS AND/OR FOCUS GROUPS THROUGHOUT NORTHERN MICHIGAN IN 2019 FOR THE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT. ABOUT 1,100 RESIDENTS COMPLETED A "WHAT MATTER'S TO YOU' SURVEY, INCLUDING 445 RESIDENTS FROM ANTRIM, CHEBOYGAN, OTSEGO AND MONTMORENCY COUNTIES. MORE 122 PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS COMPLETED A "HEALTH CARE PROVIDER" SURVEY. ADDITIONALLY, EXTRA EFFORT WAS MADE TO REACH LOW-INCOME RESIDENTS, MINORITIES, AND THE UNINSURED. THE COMMUNITY MEETINGS WERE HELD MOSTLY AT HEALTH DEPARTMENT OFFICES AND MARKETED THROUGH EXISTING SOCIAL SERVICE ORGANIZATIONS WORKING WITH THOSE POPULATIONS. A COMBINED TOTAL OF 74 PARTICIPANTS TOOK PART IN THE FOUR COMMUNITY CONVERSATIONS HELD IN CHEBOYGAN, MONTMORENCY, ANTRIM AND OTSEGO COUNTIES. IN ADDITION TO THE HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, CHARLEVOIX AREA HOSPITAL, AND MCLAREN NORTHERN MICHIGAN HOSPITAL, ALL PARTNERED WITH OTSEGO MEMORIAL HOSPITAL IN CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE ASSESSMENT COMMITTEE INCLUDED REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: OTSEGO COUNTY MSU EXTENSION, ALCONA HEALTH CENTER, HEALTH DEPT OF NW MICHIGAN, OTSEGO MEMORIAL HOSPITAL, COP EDUCATION SERVICE DISTRICT, CHARLEVOIX AREA HOSPITAL, NORTH COUNTY CMH SERVICES, MCLAREN NORTHERN MICHIGAN, THUNDER BAY COMMUNITY HEALTH SERVICE, WOMEN'S RESOURCE CENTER, HARBOR HALL, NE MICHIGAN CMH AUTHORITY, CHAR-EM UNITED WAY, EAST JORDAN FAMILY HEALTH CENTER, DISTRICT HEALTH DEPT 4, NORTHERN HEALTH PLAN, MUNSON MEDICAL CENTER, NORTHERN MICHIGAN REGIONAL ENTITY, ALPENA REGIONAL MEDICAL CENTER, MSU COLLEGE OF HUNMAN MEDICINE, AND NORTHERN MICHIGAN SUBSTANCE ABUSE SERVICES. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - 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 HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 6B HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, HEALTH DEPARTMENT DISTRICT 4 FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/4992%20OMH%20CHNA%20REPORT %202019.PDF FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/4992%20OMH%20CHNA %20IMPLEMENTATION%20STRATEGY%202019.PDF FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 11 FROM THE MOST RECENT CHNA, THE TOP THREE AREAS OF HEALTH CONCERN IDENTIFIED ARE: EXPANDING ACCESS TO CARE, CHRONIC DISEASE EDUCATION AND MANAGEMENT, AND MATERNAL AND CHILD HEALTH AND WELLNESS ACTIVITIES. FOR ALL THREE AREAS OMH BELIEVES THEY COULD DIRECT RESOURCES TO HELP ADDRESS THE GROWING HEALTH CONCERN. REGARDING ACCESS TO CARE, OMH IS WORKING TO EXPAND SERVICES IN RURAL COMMUNITIES, OFFER ONSITE SCREENINGS AND EXPANDING OFFERINGS FOR SERVICES AT LOCAL HEALTH FAIRS, AND SIGNING INDIVIDUALS UP FOR INSURANCE THROUGH A CERTIFIED APPLICATION COUNSELOR. FOR CHRONIC DISEASE, OMH IS COMMITTED TO OFFERING AND EXPANDING A CDC DIABETES PREVENTION PROGRAM, DOUBLING THE NUMBER OF CLASSES OFFERED. OMH WILL CONTINUE TO EDUCATE THE COMMUNITY ON IMPORTANT CHRONIC DISEASE TOPICS SUCH AS CANCER, HEART HEALTH, COPD, DEPRESSION & ANXIETY, AND DIABETES THROUGH PRINT AND SPEAKING EVENTS. FOR MATERNAL AND CHILD HEALTH, OMH WILL CONTINUE TO OFFER CLASSES TO NEW PARENTS IN ORDER TO BETTER PREPARE GROWING FAMILIES FOR THEIR TRANSITION AHEAD. OMH WILL CONTINUE TO OFFER OB/GYN SERVICES IN INDIAN RIVER, AND WILL WORK TO EDUCATE COMMUNITY MEMBERS ON SERVICES OFFERED FOR MOTHER AND CHILD IN THIS VERY RURAL SETTING. OTHER NEEDS IDENTIFIED IN THE MOST RECENT CHNA INCLUDE: SUBSTANCE USE, MENTAL HEALTH AND HEALTH DISPARITIES. THESE ISSUES RANKED 4-6 IN THE CHNA. OMH FEELS THAT BASED ON AVAILABLE RESOURCES AND EXPERTISE OF STAFF, THE TOP THREE ISSUES CAN BE BEST ADDRESSED BY THE HOSPITAL. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 13H BASED ON THE STATE OF MICHIGAN MEDICAID EXPANSION RULE EXCEPTIONS ALLOWED UNDER THE AFFORDABLE CARE ACT, WE ARE REQUIRED TO OFFER A DISCOUNTED CHARGE TO UNINSURED PATIENTS WHO EARN LESS THAN 250% OF THE FPG BASED ON 115% OF THE MEDICARE ALLOWABLE AMOUNT. ADDITIONALLY, WE ARE REQUIRED UNDER 501(R) TO OFFER AN AMOUNT GENERALLY BILLED DISCOUNT TO PATIENTS MEETING OUR FINANCIAL ASSISTANCE GUIDELINES. WE OFFER THIS TO PATIENTS UP TO 350% OF THE FPG. THE DISCOUNT IS BASED ON AN AVERAGE OF OUR INSURANCE DISCOUNTS FROM MEDICARE, MEDICAID AND COMMERCIAL INSURANCE DISCOUNTS AND IS RECALCULATED EACH YEAR AS PROSCRIBED UNDER THE 501(R) RULE. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/FINANCIAL_ASSISTANCE_%20POLICY %20(10_16_17)12_4_19.PDF FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/20191120%20STANDARDCHARITYAPPOM H_FAP%20PLAIN.PDF FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 16J IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 20E MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. MUNSON WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2.DOCUMENTING THAT MUNSON HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH MUNSON DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. MUNSON WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS. 3 MEDCARE CLINIC 1996 WALDEN DRIVE GAYLORD MI 49735 URGENT CARE ORTHOPEDICS CLINIC 2147 PROFESSIONAL DRIVE GAYLORD MI 49735 ORTHOPEDICS AND REHABILITATION MCREYNOLDS HALL 825 N CENTER AVENUE GAYLORD MI 49735 LONG-TERM CARE PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE UNDER IT'S ASSISTANCE PROGRAM MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO) WILL MAKE AVAILABLE A REASONABLE AMOUNT OF UNCOMPENSATED OR REDUCED PRICE SERVICES TO PERSONS ELIGIBLE UNDER APPLICABLE GUIDELINES. OTSEGO ASSISTANCE PROGRAM SERVICES ARE NOT LIMITED TO ANY SPECIFIC HOSPITAL SERVICE. INDIVIDUAL ELIGIBILITY FOR ASSISTANCE IS DETERMINED BY MEASURING FAMILY INCOME IN RELATION TO FAMILY SIZE AGAINST THE INCOME POVERTY GUIDELINE ESTABLISHED BY THE COMMUNITY SERVICE ADMINISTRATION. IF THE HOSPITAL DETERMINES THAT SERVICES ARE ELECTIVE OR OTHERWISE NOT MEDICALLY NECESSARY, THE HOSPITAL CAN DENY SERVICES UNDER THE FINANCIAL ASSISTANCE PROGRAM. ASSETS INCLUDING THE PATIENT'S PLACE OF RESIDNCE ARE ALSO CONSIDERED AS PART OF THE EVALUATION. PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 108,577,693. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 4,384,560. THE NET EXPENSE OF 104,193,133 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION A COST-TO-CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNEMNT PROGEAMS (LINE 7B). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE. PART II - COMMUNITY BUILDING ACTIVITIES MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OMH) OFFERS A VARIETY OF PROGRAMS AND SERVICES WITH THE END GOAL OF PROMOTING THE GREATER HEALTH OF THE COMMUNITY. OMH PROVIDED DISCOUNTED SPORTS PHYSICALS TO AREA STUDENT ATHLETES, DONATING ONE HUNDRED PERCENT OF THE PROCEEDS BACK TO THE LOCAL SCHOOL ATHLETIC DEPARTMENTS. THE HOSPITAL OFFERED FREE PROFILE SCREENINGS FOR THAN 65 PATICIPANTS AT A MENS HEALTH FAIR PRIOR TO HUNTING SEASON; SCREENINGS INCLUDED BLOOD PRESSURE, PULMONARY, BMI, HEIGHT AND WEIGHT. OMH HOSTS MONTHLY WELLNESS WEDNESDAYS, OFFERING CHOLESTEROL, BLOOD PRESSURE, BMI, HEIGHT, WEIGHT AT A DISCOUNTED RATE TO COMMUNITY MEMBERS AND FREE TO ANYONE WHO IS UNABLE TO PAY THE NOMINAL RATE. WELLNESS WEDNESDAYS HAVE ALSO EXPANDED TO OPERATE AS A SAFE NEEDLE DROP OFF FOR AREA RESIDENTS. A NEW MEDSAFE DISPOSAL CONTAINER IS INSTALLED ON THE HOSPITAL CAMPUS TO OFFER AREA RESIDENTS A SAFE AND EASY METHOD TO DISPOSE OF UNUSED OR EXPIRED MEDICATIONS. THE HOSPITAL OFFERS A MAMMOGRAPHY ASSISTANCE PROGRAM, TO ENSURE THAT WOMEN WHO DO NOT QUALIFY FOR A FREE MAMMOGRAM THROUGH THE LOCAL HEALTH DEPARTMENT, YET HAVE NO MEANS TO PAY FOR IT PRIVATELY, ARE COVERED AND RECEIVE A SCREENING AND IF NECESSARY DIAGNOSTIC MAMMOGRAM AND OTHER SERVICES AT NO CHARGE. ADDITIONALLY, THE HOSPITAL OFFERS A DIABETES ASSISTANCE PROGRAM AND AN ONCOLOGY ASSISTANCE PROGRAM DESIGNED TO HELP THOSE DIAGNOSED WITH THOSE DISEASES AND STRUGGLING FINANCIALLY TO RECEIVE THE ASSISTANCE THEY NEED TO ATTEND TREATMENTS AND TEST REGULARLY FOR DIABETES. OMH CONTINUES TO OFFER THE CDC'S YEAR-LONG DIABETES PREVENTION PROGRAM, WORKING WITH INDIVIDUALS WHO HAVE BEEN DIAGNOSED AS PRE DIABETIC TO REDUCE CALORIE INTAKE, INCREASE EXERCISE, AND UNDERSTAND PORTION CONTROL AMONG OTHERS. THIS PROGRAM HAS SEEN A HIGH SUCCESS RATE OF COMPLETION AND BMI REDUCTION. THE PROGRAM AT OMH IS ONE OF THE ONLY RECOGNIZED PROGRAMS IN NORTHERN MICHIGAN. OMH ALSO WORKS CLOSELY WITH THE LOCAL SCHOOLS TO ASSIST THE HIGH SCHOOL LEVEL MEDICAL OCCUPATIONAL PROGRAM IN JOB SHADOWING AND EDUCATION PROGRAM FOR STUDENTS THROUGHOUT THE FACILITY AND SCHOOL YEAR. NEW PARENTS ARE INVITED TO PARTICIPATE IN CHILDBIRTH EDUCATION CLASSES OFFERED BY OMH STAFF FOR A NOMINAL FEE OR FREE TO THOSE UNABLE TO PAY. ON A BIMONTHLY BASIS, THE HOSPITAL PRODUCES AND DISTRIBUTES TO MORE THAN 47,000 HOUSEHOLDS THROUGHOUT THE SERVICE AREA LITERATURE ON VARIOUS HEALTHCARE ISSUES AND TOPICS, INCLUDING INFORMATION ON LOCAL FREE HEALTH EVENTS. IN THE OFF MONTHS, AN EMAIL NEWSLETTER IS DEPLOYED TO MORE THAN 17,000 RECIPIENTS WITH SIMILAR CONTENT. OMH HAS NUMEROUS MEDICAL PRACTICES THAT ARE FEDERALLY QUALIFIED RURAL HEALTHCARE CLINICS. ADDITIONALLY, OMH IS LOCATED WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA. BOTH OF THESE QUALIFICATIONS DEMONSTRATE OMH'S ISOLATED SERVICE AREA WHICH HAS RESULTED IN CHALLENGING PHYSICIAN RECRUITMENT AND RETENTION. OMH'S COMMITMENT TO PROVIDING THE HIGHEST LEVEL OF CARE STARTS WITH PHYSICIAN AND OTHER PROVIDERS. EXTENSIVE RECRUITMENT ACTIVITIES MUST TAKE PLACE IN ORDER TO PROVIDE CARE TO THESE HEALTH PROFESSIONAL SHORTAGE AREAS. ADDITIONALLY, OMH IS WORKING DILIGENTLY TO BRING SERVICES INTO THE RURAL SETTING. THIS INCLUDES THE COMPLETION OF THE NEWLY RENOVATED OMH MEDICAL GROUP-LEWISTON, WHICH NOT ONLY EXPANDED REHABILITATIVE SERVICES, BUT BROUGHT ULTRASOUND SERVICES TO THAT RURAL AREA (NOTE: THIS CLINIC IS A FEDERALLY RECOGNIZED RURAL HEALTH CENTER) (1). A MAJORITY OF THE HOSPITALS BOARD OF TRUSTEES IS MADE UP OF COMMUNITY REPRESENTATIVES RESIDING WITHIN THE HOSPITALS SERVICE AREA. (2). THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS AS APPROVED BY OUR HOSPITAL BOARD OF DIRECTORS. DUE TO THE SIZE AND RURAL NATURE OF THE HOSPITAL SERVICE AREA, NOT ALL HEALTHCARE SPECIALTIES ARE OFFERED THROUGH THE HOSPITAL. (3). THE HOSPITAL APPLIES SURPLUS FUNDS, INCLUDING DONATIONS FROM THE FOUNDATION, TO ASSIST IN PURCHASING EQUIPMENT FOR PATIENT USE AND FUNDING MANY OF THE COMMUNITY HEALTH EDUCATION PROGRAMS LISTED ABOVE. ADDITIONALLY, THE HOSPITAL WORKS TO USE ANY SURPLUS FUNDS TO CONTINUE TO ADVANCE THE MISSION OF THE ORGANIZATION THROUGH GROWTH AND DEVELOPMENT OPPORTUNITIES. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO) REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. OTSEGO PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS AND TRENDS. THE COSTING METHOD USED IS THE COST TO CHARGE RATE. PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ESTIMATES BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY BASED UPON 33% OF BAD DEBTS, WHICH IS BASED ON HISTORICAL DATA. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS SEE NOTE 2 ON PAGE 8 OF ATTACHED AUDITED FINANCIAL STATEMENTS UNDER ACCOUNTS RECEIVABLE. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION ALL PATIENTS RECEIVING TREATMENT AT MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ARE RESPONSIBLE FOR PAYING IN FULL ALL CHARGES FOR SUCH TREATMENT, LESS ANY AMOUNTS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, DISCOUNT CONSIDERATIONS OR INSURANCE COVERAGE, PER POINT OF SERVICE COLLECTION POLICY. PART VI, LINE 2 - NEEDS ASSESSMENT FROM THE MOST RECENT CHNA, THE TOP THREE AREAS OF HEALTH CONCERN IDENTIFIED ARE: EXPANDING ACCESS TO CARE, CHRONIC DISEASE EDUCATION AND MANAGEMENT, AND MATERNAL AND CHILD HEALTH AND WELLNESS ACTIVITIES. FOR ALL THREE AREAS OMH BELIEVES THEY COULD DIRECT RESOURCES TO HELP ADDRESS THE GROWING HEALTH CONCERN. REGARDING ACCESS TO CARE, OMH IS WORKING TO EXPAND SERVICES IN RURAL COMMUNITIES, OFFER ONSITE SCREENINGS AND EXPANDING OFFERINGS FOR SERVICES AT LOCAL HEALTH FAIRS, AND SIGNING INDIVIDUALS UP FOR INSURANCE THROUGH A CERTIFIED APPLICATION COUNSELOR. FOR CHRONIC DISEASE, OMH IS COMMITTED TO OFFERING AND EXPANDING A CDC DIABETES PREVENTION PROGRAM, DOUBLING THE NUMBER OF CLASSES OFFERED. OMH WILL CONTINUE TO EDUCATE THE COMMUNITY ON IMPORTANT CHRONIC DISEASE TOPICS SUCH AS CANCER, HEART HEALTH, COPD, DEPRESSION & ANXIETY, AND DIABETES THROUGH PRINT AND SPEAKING EVENTS. FOR MATERNAL AND CHILD HEALTH, OMH WILL CONTINUE TO OFFER CLASSES TO NEW PARENTS IN ORDER TO BETTER PREPARE GROWING FAMILIES FOR THEIR TRANSITION AHEAD. OMH WILL CONTINUE TO OFFER OB/GYN SERVICES IN INDIAN RIVER, AND WILL WORK TO EDUCATE COMMUNITY MEMBERS ON SERVICES OFFERED FOR MOTHER AND CHILD IN THIS VERY RURAL SETTING. OTHER NEEDS IDENTIFIED IN THE MOST RECENT CHNA INCLUDE: SUBSTANCE USE, MENTAL HEALTH AND HEALTH DISPARITIES. THESE ISSUES RANKED 4-6 IN THE CHNA. OMH FEELS THAT BASED ON AVAILABLE RESOURCES AND EXPERTISE OF STAFF, THE TOP THREE ISSUES CAN BE BEST ADDRESSED BY THE HOSPITAL. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE OMH REGISTRATION MANAGER OR THE CERTIFIED APPLICATION COUNSELOR (CAC) ATTEMPTS TO SEE THE PATIENTS IN ER OR IP. REGISTRATION STAFF HAS ALSO BEEN TRAINED TO HAND OUT ASSISTANCE PACKAGES AND TO DIRECT PATIENTS TO SEE THE CERTIFIED APPLICATION COUNSELOR (CAC)/FINANCIAL ADVISOR. WHEN THE PATIENT COMES IN ON THE WORK LIST THEY ARE ALSO INFORMED OF ASSISTANCE PACKAGE AND/OR APPLICATION. THE FORM IS ON THE OMH WEBSITE. THERE ARE ALSO WRITTEN NOTICES AT THE BOTTOM OF PATIENT STATEMENTS. WHEN THERE IS A SCHEDULED PROCEDURE AND THE PATIENT DOES NOT HAVE INSURANCE, A CALL IS MADE FOR PAYMENT, CAC APPOINTMENT AND/OR CHARITY ARRANGEMENTS. PATIENTS IDENTIFIED WITHOUT INSURANCE OR NEEDING FINANCIAL EDUCATION, ARE SCHEDULED FOR AN APPOINTMENT WITH THE CERTIFIED APPLICATION COUNSELOR (CAC) OR WITH A FINANCIAL ADVOCATE. THE CAC HELPS PATIENTS TO APPLY FOR MEDICAID, INSURANCE EXCHANGE PLANS, OTHER PROGRAMS OR FINANCIAL ASSISTANCE. THE FINANCIAL ADVOCATE HELPS PATIENTS APPLY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4 - COMMUNITY INFORMATION DESCRIPTION MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO HOSPITAL) IS LOCATED IN GAYLORD, MI AND SERVES THE COUNTIES OF CHEBOYGAN, OTSEGO, MONTMORENCY AND ANTRIM. ALL FOUR COUNTIES SERVED BY OTSEGO HOSPITAL ARE EXTREMELY RURAL. IN OTSEGO, CHEBOYGAN, MONTMORENCY, AND ANTRIM COUNTIES, 94% OF RESIDENTS ARE NON-HISPANIC WHITE. HISPANICS REPRESENT THE LARGEST MINORITY GROUP IN OTSEGO (1.8%), MONTMORENCY (1.3%), AND ANTRIM (2.1%) COUNTIES WHILE NATIVE AMERICANS REPRESENT THE LARGEST MINORITY GROUP IN CHEBOYGAN COUNTY WITH 2.9%. AT 20.3%, OLDER ADULTS REPRESENT A LARGER PROPORTION OF THE POPULATION IN OTSEGO COUNTY THAN THEY DO STATEWIDE (16.2%), 26.3% PERCENT OF ANTRIM COUNTYS POPULATION IS AGE 65 AND OLDER FOLLOWED CLOSELY BY CHEBOYGAN COUNTY WITH 26% AND IN MONTMORENCY COUNTY, SENIORS REPRESENT AN EVEN LARGER SHARE AT 30.4%. (SOURCE: COUNTYHEALTHRANKINGS.ORG). OMH SERVES A VERY RURAL AGING POPULATION. HOSPITAL SERVICES OTSEGO HOSPITAL IS LOCATED IN GAYLORD, MI AND SERVES THE COUNTIES OF CHEBOYGAN, OTSEGO, MONTMORENCY AND ANTRIM. OTSEGO PROVIDES IT'S RESIDENCE WITH ACUTE INPATIENT STAYS (INCLUDING MEDICAL, INTENSIVE CARE AND OBSTETRICS), 4 SURGICAL SUITES THAT PERFORM BOTH IN AND OUT-PATIENT SERVICES (GENERAL, ORTHOPEDIC AND GASTROINTESTINAL), LABORTORY, DIAGNOSTIC RADIOLGY SERVICES (GENERAL, ULTRASOUND, NUCLEAR MEDICINE, MAMMOGRAPHY, PET, CT AND MRI), REPIRATORY THERAPY, THERAPIES, INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH AND WOUND CARE. EMERGENCY ROOM SERVICES OPEN 24 HOURS A DAY 365 DAYS A YEAR. OTSEGO ALSO PROVIDES A LONG-TERM CARE STAY FACILITY (INCLUDING SKILLED AND NON-SKILLED CARE). CARDIAC REHAB AND PREVENTION SERVICES ARE ALSO OFFERED AT OTSEGO HOSPITAL. IN ADDITION, OTSEGO HOSPITAL OFFERS MANY OUTPATIENT SERVICES CLINICS INCLUDING URGENT CARE, GYNECOLOGIC AND OBSTETRICS, INTERNAL MEDICINE, UROLOGY, ORTHOPEDICS, SURGICAL CARE, ONCOLOGY, PEDIATRICS AND FAMILY PRACTICES. POPULATION SERVED OTSEGO HOSPITAL IS LOCATED IN GAYLORD, MI AND SERVES THE COUNTIES OF CHEBOYGAN, OTSEGO, MONTMORENCY AND ANTRIM. ALL FOUR COUNTIES SERVED BY OTSEGO HOSPITAL ARE EXTREMELY RURAL. IN OTSEGO, CHEBOYGAN, MONTMORENCY, AND ANTRIM COUNTIES, 94% OF RESIDENTS ARE NON-HISPANIC WHITE. HISPANICS REPRESENT THE LARGEST MINORITY GROUP IN OTSEGO (1.7%), MONTMORENCY (1.3%), AND ANTRIM (2.3%) COUNTIES WHILE NATIVE AMERICANS REPRESENT THE LARGEST MINORITY GROUP IN CHEBOYGAN COUNTY WITH 2.9%. AT 20.4%, OLDER ADULTS REPRESENT A LARGER PROPORTION OF THE POPULATION IN OTSEGO COUNTY THAN THEY DO STATEWIDE (16.2%), 26.6% PERCENT OF CHEBOYGAN COUNTYS POPULATION IS AGE 65 AND OLDER FOLLOWED CLOSELY BY ANTRIM COUNTY WITH 26.5% AND IN MONTMORENCY COUNTY, SENIORS REPRESENT AN EVEN LARGER SHARE AT 31.5%. (SOURCE: COUNTYHEALTHRANKINGS.ORG). OTSEGO HOSPITAL SERVES A VERY RURAL AGING POPULATION. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO HOSPITAL) 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 OTSEGO HOSPITAL TRUSTEES SUPPORT OTSEGO HOSPITAL FINANCIALLY. MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO HOSPITAL) OFFERS A VARIETY OF PROGRAMS AND SERVICES WITH THE END GOAL OF PROMOTING THE GREATER HEALTH OF THE COMMUNITY. OTSEGO HOSPITAL PROVIDED DISCOUNTED SPORTS PHYSICALS TO AREA STUDENT ATHLETES, DONATING ONE HUNDRED PERCENT OF THE PROCEEDS BACK TO THE LOCAL SCHOOL ATHLETIC DEPARTMENTS. THE HOSPITAL OFFERED FREE PROFILE SCREENINGS FOR MORE THAN 65 PARTICIPANTS AT A MENS HEALTH FAIR PRIOR TO HUNTING SEASON; SCREENINGS INCLUDED BLOOD PRESSURE, PULMONARY, BMI, HEIGHT AND WEIGHT. OTSEGO HOSPITAL HOSTS MONTHLY WELLNESS WEDNESDAYS, OFFERING CHOLESTEROL, BLOOD PRESSURE, BMI, HEIGHT, WEIGHT AT A DISCOUNTED RATE TO COMMUNITY MEMBERS AND FREE TO ANYONE WHO IS UNABLE TO PAY THE NOMINAL RATE. WELLNESS WEDNESDAYS HAVE ALSO EXPANDED TO OPERATE AS A SAFE NEEDLE DROP OFF FOR AREA RESIDENTS. A NEW MEDSAFE DISPOSAL CONTAINER IS BEING INSTALLED ON THE HOSPITAL CAMPUS TO OFFER AREA RESIDENTS A SAFE AND EASY METHOD TO DISPOSE OF UNUSED OR EXPIRED MEDICATIONS. THE HOSPITAL OFFERS A MAMMOGRAPHY ASSISTANCE PROGRAM, TO ENSURE THAT WOMEN WHO DO NOT QUALIFY FOR A FREE MAMMOGRAM THROUGH THE LOCAL HEALTH DEPARTMENT, YET HAVE NO MEANS TO PAY FOR IT PRIVATELY, ARE COVERED AND RECEIVE A SCREENING AND IF NECESSARY DIAGNOSTIC MAMMOGRAM AND OTHER SERVICES AT NO CHARGE. ADDITIONALLY, THE HOSPITAL OFFERS A DIABETES ASSISTANCE PROGRAM AND AN ONCOLOGY ASSISTANCE PROGRAM DESIGNED TO HELP THOSE DIAGNOSED WITH THOSE DISEASES AND STRUGGLING FINANCIALLY TO RECEIVE THE ASSISTANCE THEY NEED TO ATTEND TREATMENTS AND TEST REGULARLY FOR DIABETES. OTSEGO HOSPITAL CONTINUES TO OFFER THE CDC'S YEAR-LONG DIABETES PREVENTION PROGRAM, WORKING WITH INDIVIDUALS WHO HAVE BEEN DIAGNOSED AS PRE DIABETIC TO REDUCE CALORIE INTAKE, INCREASE EXERCISE, AND UNDERSTAND PORTION CONTROL AMONG OTHERS. THIS PROGRAM HAS SEEN A HIGH SUCCESS RATE OF COMPLETION AND BMI REDUCTION. THE PROGRAM AT OTSEGO HOSPITAL IS ONE OF THE ONLY RECOGNIZED PROGRAMS IN NORTHERN MICHIGAN. OTSEGO HOSPITAL ALSO WORKS CLOSELY WITH THE LOCAL SCHOOLS TO ASSIST THE HIGH SCHOOL LEVEL MEDICAL OCCUPATIONAL PROGRAM IN JOB SHADOWING AND EDUCATION PROGRAM FOR STUDENTS THROUGHOUT THE FACILITY AND SCHOOL YEAR. NEW PARENTS ARE INVITED TO PARTICIPATE IN CHILDBIRTH EDUCATION CLASSES OFFERED BY OTSEGO HOSPITAL STAFF FOR A NOMINAL FEE OR FREE TO THOSE UNABLE TO PAY. ON A BIMONTHLY BASIS, THE HOSPITAL PRODUCES AND DISTRIBUTES TO MORE THAN 47,000 HOUSEHOLDS THROUGHOUT THE SERVICE AREA LITERATURE ON VARIOUS HEALTHCARE ISSUES AND TOPICS, INCLUDING INFORMATION ON LOCAL FREE HEALTH EVENTS. IN THE OFF MONTHS, AN EMAIL NEWSLETTER IS DEPLOYED TO MORE THAN 17,000 RECIPIENTS WITH SIMILAR CONTENT. OTSEGO HOSPITAL HAS NUMEROUS MEDICAL PRACTICES THAT ARE FEDERALLY QUALIFIED RURAL HEALTHCARE CLINICS. ADDITIONALLY, OTSEGO HOSPITAL IS LOCATED WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA. BOTH OF THESE QUALIFICATIONS DEMONSTRATE OTSEGO HOSPITAL'S ISOLATED SERVICE AREA WHICH HAS RESULTED IN CHALLENGING PHYSICIAN RECRUITMENT AND RETENTION. OTSEGO HOSPITAL'S COMMITMENT TO PROVIDING THE HIGHEST LEVEL OF CARE STARTS WITH PHYSICIAN AND OTHER PROVIDERS. EXTENSIVE RECRUITMENT ACTIVITIES MUST TAKE PLACE IN ORDER TO PROVIDE CARE TO THESE HEALTH PROFESSIONAL SHORTAGE AREAS. ADDITIONALLY, OTSEGO HOSPITAL IS WORKING DILIGENTLY TO BRING SERVICES INTO THE RURAL SETTING. THIS INCLUDES THE COMPLETION OF THE NEWLY RENOVATED OTSEGO HOSPITAL MEDICAL GROUP- LEWISTON, WHICH NOT ONLY EXPANDED REHABILITATIVE SERVICES, BUT BROUGHT ULTRASOUND SERVICES TO THAT RURAL AREA (NOTE: THIS CLINIC IS A FEDERALLY QUALIFIED RURAL HEALTH CENTER) (1). A MAJORITY OF THE HOSPITALS BOARD OF TRUSTEES IS MADE UP OF COMMUNITY REPRESENTATIVES RESIDING WITHIN THE HOSPITALS SERVICE AREA. (2). THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS AS APPROVED BY OUR HOSPITAL BOARD OF DIRECTORS. DUE TO THE SIZE AND RURAL NATURE OF THE HOSPITAL SERVICE AREA, NOT ALL HEALTHCARE SPECIALTIES ARE OFFERED THROUGH THE HOSPITAL. (3). THE HOSPITAL APPLIES SURPLUS FUNDS, INCLUDING DONATIONS FROM THE FOUNDATION, TO ASSIST IN PURCHASING EQUIPMENT FOR PATIENT USE AND FUNDING MANY OF THE COMMUNITY HEALTH EDUCATION PROGRAMS LISTED ABOVE. ADDITIONALLY, THE HOSPITAL WORKS TO USE ANY SURPLUS FUNDS TO CONTINUE TO ADVANCE THE MISSION OF THE ORGANIZATION THROUGH GROWTH AND DEVELOPMENT OPPORTUNITIES. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITALS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS,EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM 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. MMC WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN SYSTEM 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 FIXED WING AND GROUND TRANSPORT, PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE. UTILIZING THE COMMUNITY HEALTH NEEDS ASSESSMENTS, MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS AMONG THE MEMBER ORGANIZATIONS THROUGH PLANNING, DEVELOPING, IMPLEMENTING, EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS. IN TOTAL, THE MUNSON HEALTHCARE SYSTEM PROVIDES SUBSTANTIAL 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. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT MICHIGAN false true false false false false false false false EDWIN A NESS DIRECTOR 736346 176677 8699 154003 28199 1103924 MATTHEW MAZUR DO DIRECTOR 660287 36196 11000 19172 726655 KASEY NELSON DO DIRECTOR 463963 32500 32108 9320 19172 557063 THOMAS LEMON PRESIDENT 134819 207945 78600 59530 954 10244 9445 12898 292638 221797 MARK A HEPLER CFO 378650 62803 61759 60161 20876 584249 11832 ROBERT COURTOIS VP FINANCE 189586 45429 6717 19518 261250 CHRIS SQUIRE VP ANCILLARY SERVICE 147764 18547 4762 20457 191530 JAMES FLICKEMA VP PATIENT CARE SERV 151315 13023 4650 22645 191633 JOHN MOFFAT MD SURGEON 935064 24620 11000 21331 992015 CHANGXIN LI MD PHYSICIAN 704655 74996 24459 11000 18836 833946 JAMES SHURLOW DO SURGEON 676487 36654 11000 16348 740489 JANELLE HENDRIAN DO ANESTHESIOLOGIST 533270 36923 10079 24588 604860 LOUIS HABRYL DO SURGEON 526311 22570 9635 19217 577733 SCHEDULE J, PAGE 1, PART I, LINE 3 THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 140,375 0 MARK A HEPLER 0 37,442 0 SCHEDULE J, PART III SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS OF MUNSON HEALTHCARE, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE RETIREMENT FUNDS ARE AVAILABLE TO THE PARTICIPANTS UPON THEIR RETIREMENT FROM MUNSON. A CNTY OF OTSEGO HOSPITAL FIN 2013A 386004882 689065AA8 2013-10-31 10000000 REFINANCE false false false B GAYLORD HOSPITAL FIN AUTH 2014B 383635769 368175AA8 2013-10-31 6095324 REFINANCE false false false C GAYLORD HOSPITAL FIN AUTH 2015C 383635769 368175AB1 2013-10-31 1885925 REFINANCE false false false D CNTY GRD TRAVSE HOSP FIN AUTH 2019B CONSTRUCT RENOVATE PURCHASE BLDG 386004852 386523HQ0 2019-01-16 15191945 CONSTRUCT, RENOVATE, PURCHASE BLDG false false false A 10022999 200000 9822999 2013 false true true true B 6103380 6103380 2014 true false true true C 1885925 1885925 2015 true false true true D 15224729 175340 7081494 3900000 4067895 false true false true A false false true false false false false true B false false true false false false false true C false false true false false false false true D false true true false false 0.01890 0.01890 false false true A false false false true false false false false true B false false false true false false false false true C false false true false false false false false true D false true false false false false false false true A true B true C true D true SCHEDULE K - DIFFERENCES IN ISSUE PRICE EXPLANATION CNTY OF OTSEGO HOSPITAL FIN 2013A INVESTMENT INCOME EARNED GAYLORD HOSPITAL FIN AUTH 2014B INVESTMENT INCOME EARNED SCHEDULE K - PURPOSE OF ISSUE DESCRIPTION CNTY GRD TRAVSE HOSP FIN AUTH 2019B THE SERIES 2019B BONDS WERE ISSUED TO (1) REFINANCE A TAXABLE LINE OF CREDIT WHICH FINANCED THE ACQUISITION OF A FACILITY USED FOR PHYSICAL AND OCCUPATIONAL THERAPY, AND (2) FINANCE THE CONSTRUCTION, RENOVATION, EXPANSION AND EQUIPPING OF THE HOSPITAL FACILITIES. SCHEDULE K - DATE REBATE COMPUTATION PERFORMED CNTY OF OTSEGO HOSPITAL FIN 2013A 03/30/15 GAYLORD HOSPITAL FIN AUTH 2014B 02/23/15 SCHEDULE K - ADDITIONAL INFORMATION CNTY OF OTSEGO HOSPITAL FIN 2013A THE COUNTY OF OTSEGO HOSPITAL FINANCE AUTHORITY SERIES 2013A BONDS WERE ISSUED TO REFINANCE THE GAYLORD HOSPITAL FINANCE AUTHORITY HOSPITAL REVENUE AND REFUNDING BONDS (OTSEGO MEMORIAL HOSPITAL OBLIGATED GROUP) SERIES 2004 ISSUED 11/23/04. CNTY GRD TRAVSE HOSP FIN AUTH 2019B OBLIGATED GROUP ISSUE RECORDED ON RELATED ORGANIZATIONS ON JANUARY 16, 2019, THE MUNSON HEALTHCARE OBLIGATED GROUP ISSUED COUNTY OF GRAND TRAVERSE HOSPITAL FINANCE AUTHORITY REVENUE BONDS (MUNSON HEALTHCARE OBLIGATED GROUP) SERIES 2019A, 2019B AND 2019C. THE 2019 SERIES A BONDS 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. THE 2019C BONDS ARE RECORDED ON MUNSON MEDICAL CENTER'S BOOKS AND RECORDS AT A PAR VALUE OF 22,300,000. PART III, QUESTION 3B AND D MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPTIAL MAINTAINS POLICIES AND PROCEDURES TO REVIEW AND MONITOR ALL CONTRACTS, INCLUDING LEASES, MANAGEMENT, SERVICE AND RESEARCH CONTRACTS. THE MONITORING PROCESS INCLUDES A REVIEW BY THE INTERNAL LEGAL DEPARTMENT. OUTSIDE COUNSEL MAY BE CONSULTED, AS NECESSARY. OUTSIDE COUNSEL IS RETAINED FOR ALL NEW EXEMPT BOND OFFERINGS, DURING WHICH A THOROUGH DUE DILIGENCE PROCESS REVIEWS APPLICABLE CONTRACTS. SINCE NEW BONDS WERE ISSUED IN 2019, OUTSIDE COUNSEL WAS ENGAGED DURING THAT TAX YEAR. FORM 990, PAGE 2, PART III, LINE 4D ALL OTHER HOSPITAL SERVICES INCLUDING OVER 15,000 EMERGENCY ROOM VISITS AND OVER 5,000 SURGICAL CASES. FORM 990, PAGE 6, PART VI, LINE 6 MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE DIRECTORS FOR SUBSIDIARY ENTITIES. NOMINATIONS TO MUNSON HEALTHCARE FOR SUBSIDIARY DIRECTORS ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OMH) TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF OMH; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF OMH; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF OMH; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR OMH; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY MAN WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF OMH WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF OMH; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY OMH; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF EXECUTIVE COMPENSATION AND FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. 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 HEALTHCARE SYSTEM 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 OFFICERS AND KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES OF MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE MANISTEE HOSPITAL DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 PARENT MI C3 12B NA false MUNSON HEALTHCARE CADILLAC 1105 SIXTH ST TRAVERSE CITY MI 49684 471156297 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE GRAYLING 1105 SIXTH ST TRAVERSE CITY MI 49684 471161992 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE FOUNDATIONS 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE true MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true MUNSON HOME HEALTH 1105 SIXTH ST TRAVERSE CITY MI 49684 383335362 HOME HEALT MI C3 12B MUNSON HC 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 MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 HEALTHCARE MI C3 10 MUNSON MED MUNSON MEDICAL CENTER true NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 12B MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CHARLEVOIX HOSPIT 1105 SIXTH ST TRAVERSE CITY MI 49684 381459366 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE MANISTEE HOSPITAL 1465 E PARKDALE AVE MANISTEE MI 496609709 380350304 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE MANISTEE HOSPITAL FOUNDATION 1465 E PARKDALE AVE MANISTEE MI 496609709 383565083 RAISE FUND MI C3 12A MHC MANIST HOSPITAL true PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC 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 MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI N/A false false NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true MEDICAL OFFICE CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true MUNSON MOBILE IMAGING PO BOX 1188 TRAVERSE CITY MI 496851188 382704069 IMAGING MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A true SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true false false true false false false false false false false false false true false true true true false false MHC OTSEGO MEMORIAL FOUNDATION M 162230 ACTUAL AMOUNT PAID MHC OTSEGO MEMORIAL FOUNDATION C 1023280 ACTUAL AMOUNT PAID MUNSON HEALTHCARE P 891474 ACTUAL AMOUNT PAID MUNSON HEALTHCARE Q 63459 ACTUAL AMOUNT PAID MUNSON HEALTHCARE M 1271073 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 194054 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER M 273599 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER Q 78810 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER P 111332 ACTUAL AMOUNT PAID MUNSON SUPPORT SERVICES M 223168 ACTUAL AMOUNT PAID SCHEDULE R MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.