MUNSON HEALTHCARE GRAYLING: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: MUNSON HEALTHCARE GRAYLING (EIN 47-1161992)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-05-08
IRS object ID: 202011299349301141
Schema version: 2018v3.2
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-05-08T17:04:44-05:00	ReturnTs
Tax Period End	2019-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	471161992	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MARK A HEPLER	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	2319355000	PhoneNum
Signature	2020-05-08	SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	172.222.71.44	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-05-08	IPDt
IP Tm	17:04:44	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	3AD8FE5AAD7F1E7C8842AE1699DABE20D9503696	AtSubmissionCreationDeviceId
At Submission Filing Device Id	B12A1DA808F22A6A05E7483450C91465FF2D0CFC	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-22 18:59:49Z	BuildTS

Form 990 IRS990

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$94,137,311	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MUNSONHEALTHCARE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2014	FormationYr
Legal Domicile State	MI	LegalDomicileStateCd
Activity Or Mission	MUNSON HEALTHCARE GRAYLING AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	816	TotalEmployeeCnt
Total Volunteers	50	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$214,799	PYContributionsGrantsAmt
CY Contributions Grants	$58,514	CYContributionsGrantsAmt
PY Program Service Revenue	$91,515,819	PYProgramServiceRevenueAmt
CY Program Service Revenue	$93,515,533	CYProgramServiceRevenueAmt
PY Investment Income	$2,639	PYInvestmentIncomeAmt
CY Investment Income	-$20,079	CYInvestmentIncomeAmt
PY Other Revenue	$735,397	PYOtherRevenueAmt
CY Other Revenue	$557,656	CYOtherRevenueAmt
PY Total Revenue	$92,468,654	PYTotalRevenueAmt
CY Total Revenue	$94,111,624	CYTotalRevenueAmt
PY Grants And Similar Paid	$14,632	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$10,317	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$44,672,939	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$44,609,050	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$60,000	CYTotalFundraisingExpenseAmt
PY Other Expenses	$47,250,473	PYOtherExpensesAmt
CY Other Expenses	$48,739,750	CYOtherExpensesAmt
PY Total Expenses	$91,938,044	PYTotalExpensesAmt
CY Total Expenses	$93,359,117	CYTotalExpensesAmt
PY Revenues Less Expenses	$530,610	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$752,507	CYRevenuesLessExpensesAmt
Total Assets BOY	$37,752,643	TotalAssetsBOYAmt
Total Assets EOY	$38,875,135	TotalAssetsEOYAmt
Total Liabilities BOY	$23,462,092	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$23,832,077	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$14,290,551	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$15,043,058	NetAssetsOrFundBalancesEOYAmt
Mission	AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON HEALTHCARE GRAYLING EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$81,355,040	ExpenseAmt
Grant	$10,317	GrantAmt
Revenue	$93,489,846	RevenueAmt
Desc	EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF THE CRAWFORD COUNTY REGION WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE GRAYLING HAD 2,370 INPATIENT ADMISSIONS IN FISCAL YEAR 2019 AND OVER 108,000 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 2,900 SURGICAL CASES, 305 OBSTETRICAL BIRTHS, AND OVER 9,800 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE GRAYLING ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS 35 EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS AND 50 VOLUNTEERS.	Desc
Total Program Service Expenses	$81,355,040	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	75	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	816	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
EDWIN A NESS
DIRECTOR	1.00	40.00	Yes (X)	$0	$921,722	$182,202
STEPHANIE RIEMER
PT-YR PRESID	40.00		Yes (X)	$0	$309,506	$48,588	Yes (X)
KIRSTEN KORTH-WHITE
PT-YR PRESID	40.00		Yes (X)	$199,384	$0	$39,477	Yes (X)
THAD JACKSON DO
DIRECTOR	40.00		Yes (X)	$137,721	$0	$7,564
GARY D GANDOLFI
DIRECTOR	1.00		Yes (X)	$5,000	$0	$0
SONJA HANDRICH
DIRECTOR	1.00		Yes (X)	$5,000	$0	$0
WILLIAM HART
DIRECTOR	1.00		Yes (X)	$5,000	$0	$0
PAUL B LERG
DIRECTOR	1.00		Yes (X)	$5,000	$0	$0
ANITA MERCHANT
DIRECTOR	1.00		Yes (X)	$5,000	$0	$0
PAUL MESACK DVM
SECRETARY/TR	2.00		Yes (X)	$5,000	$0	$0	Yes (X)
KIMBERLY MORLEY
VICE CHAIR	2.00		Yes (X)	$5,000	$0	$0	Yes (X)
RALPH OPPERMANN DDS
CHAIR	2.00		Yes (X)	$5,000	$0	$0	Yes (X)
ALICE SNYDER
DIRECTOR	1.00		Yes (X)	$5,000	$0	$0
JAMES MANGUTZ DDS
DIRECTOR	1.00		Yes (X)	$3,750	$0	$0
SUSAN TYER
DIRECTOR	1.00		Yes (X)	$3,750	$0	$0
JANET BERSTED
DIRECTOR	1.00		Yes (X)	$0	$0	$0
MARK A HEPLER
CFO	2.00	40.00		$0	$503,212	$81,037	Yes (X)
CYNTHIA K RUBERT MD
PHYSICIAN	40.00			$546,809	$0	$40,863		Yes (X)
BRIAN N STIRLING DO
PHYSICIAN	40.00			$502,366	$0	$42,658		Yes (X)
JASON D BENNETT DO
PHYSICIAN	40.00			$459,235	$0	$36,205		Yes (X)
GARRICK CVITKOVICH MD
PHYSICIAN	40.00			$448,185	$0	$32,400		Yes (X)
CARL F SCHUBERT MD
PHYSICIAN	40.00			$445,990	$0	$30,753		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,792,190	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,734,440	TotReportableCompRltdOrgAmt
Total Other Compensation	$541,747	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	48	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
GRAYLING ANESTHESIA ASSOCIATES PC
450 MAMARONECK AVE SUITE 201	HARRISON	NY	10528	MEDICAL SERVICE	$1,907,948
AGILITY HEALTH GRAND RAPIDS
PO BOX 5509	CAROL STREAM	IL	601975509	MEDICAL SERVICE	$1,813,787
SOUND INPATIENT PHYSICIANS
PO BOX 742936	LOS ANGELES	CA	900742936	MEDICAL SERVICE	$1,777,472
EPMG OF MICH PC
7032 COLLECTION CENTER DRIVE	CHICAGO	IL	60693	MEDICAL SERVICE	$811,801
ALLIANCE PHYSICAL THERAPY GROUP
PO BOX 5509	CAROL STREAM	IL	601975509	MEDICAL	$735,136

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	18	CntrctRcvdGreaterThan100KCnt
Related Organizations	$22,696	RelatedOrganizationsAmt
Government Grants	$35,818	GovernmentGrantsAmt
Total Contributions	$58,514	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE/MEDICAID PAYMENTS	621990	$50,606,797	$50,606,797
PATIENT SERVICE REVENUE	621990	$37,856,864	$37,856,864
HEALTH SERVICE REVENUE	621990	$4,276,596	$4,276,596
QUALITY INCENTIVE PAYMENTS	621990	$772,776	$772,776
SERVICES TO OTHER ORGS	621990	$2,500	$2,500

Field	Value	IRS element (for citing)
Total Program Service Revenue	$93,515,533	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,608	TotalRevenueColumnAmt
Exclusion	$5,608	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$30,420	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$30,420	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,420	TotalRevenueColumnAmt
Exclusion	$30,420	ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$25,687	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$25,687	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$25,687	TotalRevenueColumnAmt
Related Or Exempt Func Income	-$25,687	RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA SALES	722210	$348,086	$348,086
MISCELLANEOUS INCOME	621990	$169,532	$169,532
GIFT SHOP SALES	446199	$9,618	$9,618

Field	Value	IRS element (for citing)
Other Revenue Total	$527,236	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$94,111,624	TotalRevenueColumnAmt
Related Or Exempt Func Income	$93,489,846	RelatedOrExemptFuncIncomeAmt
Exclusion	$563,264	ExclusionAmt

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

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$10,317	TotalAmt
Program Services	$10,317	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$346,911	TotalAmt
Program Services	$145,285	ProgramServicesAmt
Management And General	$201,626	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$36,885,532	TotalAmt
Program Services	$34,136,916	ProgramServicesAmt
Management And General	$2,748,616	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,341,353	TotalAmt
Program Services	$1,251,238	ProgramServicesAmt
Management And General	$90,115	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,547,145	TotalAmt
Program Services	$3,278,621	ProgramServicesAmt
Management And General	$268,524	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,488,109	TotalAmt
Program Services	$2,292,544	ProgramServicesAmt
Management And General	$195,565	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$15,518	TotalAmt
Management And General	$15,518	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$3,300	TotalAmt
Management And General	$3,300	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$3,794	TotalAmt
Management And General	$3,794	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$22,669,520	TotalAmt
Program Services	$14,864,489	ProgramServicesAmt
Management And General	$7,745,031	ManagementAndGeneralAmt
Fundraising	$60,000	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$13,426	TotalAmt
Program Services	$2,861	ProgramServicesAmt
Management And General	$10,565	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$496,230	TotalAmt
Program Services	$370,547	ProgramServicesAmt
Management And General	$125,683	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$897,375	TotalAmt
Program Services	$849,930	ProgramServicesAmt
Management And General	$47,445	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,440,347	TotalAmt
Program Services	$1,440,175	ProgramServicesAmt
Management And General	$172	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$121,412	TotalAmt
Program Services	$95,252	ProgramServicesAmt
Management And General	$26,160	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$146,256	TotalAmt
Program Services	$130,174	ProgramServicesAmt
Management And General	$16,082	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$502,397	TotalAmt
Program Services	$437,789	ProgramServicesAmt
Management And General	$64,608	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,013,406	TotalAmt
Program Services	$1,754,482	ProgramServicesAmt
Management And General	$258,924	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$218,098	TotalAmt
Program Services	$174,478	ProgramServicesAmt
Management And General	$43,620	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$15,893,785	$15,893,785
BAD DEBT EXPENSE	$3,655,712	$3,655,712
REPAIRS AND MAINTENANCE	$383,196	$381,250	$1,946
HOSPITAL SUPPORT	$125,186	$86,633	$38,553

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$140,792	TotalAmt
Program Services	$102,562	ProgramServicesAmt
Management And General	$38,230	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$93,359,117	TotalAmt
Program Services	$81,355,040	ProgramServicesAmt
Management And General	$11,944,077	ManagementAndGeneralAmt
Fundraising	$60,000	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,329	BOYAmt
EOY	$4,329	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,702,972	BOYAmt
EOY	$2,493,309	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$12,293,633	BOYAmt
EOY	$13,765,590	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$10,000	BOYAmt
EOY	$7,708	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,834,119	BOYAmt
EOY	$1,676,720	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$224,505	BOYAmt
EOY	$205,361	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$30,329,269	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$9,772,685	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$20,517,551	BOYAmt
EOY	$20,556,584	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$165,534	BOYAmt
EOY	$165,534	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$37,752,643	BOYAmt
EOY	$38,875,135	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,315,801	BOYAmt
EOY	$7,031,416	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$13,373,051	BOYAmt
EOY	$13,081,765	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,773,240	BOYAmt
EOY	$3,718,896	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$23,462,092	BOYAmt
EOY	$23,832,077	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$14,290,551	BOYAmt
EOY	$15,043,058	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$14,290,551	BOYAmt
EOY	$15,043,058	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$37,752,643	BOYAmt
EOY	$38,875,135	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$752,507	ReconcilationRevenueExpnssAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$3,794	OtherActivitiesAmt
Total Lobbying Expenditures	$3,794	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1	FormAndLineReferenceDesc
Explanation	OTHER ACTIVITIES INDICATE THE PORTION OF DUES ALLOCATED TO LOBBYING EXPENSES PAID TO REGIONAL OR NATIONAL ORGANIZATIONS.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

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

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,203,499	OtherCostOrOtherBasisAmt
Depreciation	$3,077,136	DepreciationAmt
Book Value	$13,126,363	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$11,284,864	OtherCostOrOtherBasisAmt
Depreciation	$6,567,279	DepreciationAmt
Book Value	$4,717,585	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,305,906	OtherCostOrOtherBasisAmt
Depreciation	$128,270	DepreciationAmt
Book Value	$1,177,636	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$20,556,584	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
RESERVE FOR THIRD PARTY SETTLEMENTS	$2,198,619
ESTIMATE FOR THIRD PARTY SETTLEMENTS	$1,351,340
CAPITAL LEASE	$168,937

Field	Value	IRS element (for citing)
Total Liability	$3,718,896	TotalLiabilityAmt

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$324,755	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$324,755	NetCommunityBenefitExpnsAmt
Total Expense	0.00360	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,026,639	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,231,307	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,795,332	NetCommunityBenefitExpnsAmt
Total Expense	0.03120	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,351,394	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,231,307	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,120,087	NetCommunityBenefitExpnsAmt
Total Expense	0.03480	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$346,094	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,185	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$334,909	NetCommunityBenefitExpnsAmt
Total Expense	0.00370	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$341,008	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$341,008	NetCommunityBenefitExpnsAmt
Total Expense	0.00380	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,010,263	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,642,890	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,367,373	NetCommunityBenefitExpnsAmt
Total Expense	0.02640	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$212,414	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$212,414	NetCommunityBenefitExpnsAmt
Total Expense	0.00240	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,909,779	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,654,075	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,255,704	NetCommunityBenefitExpnsAmt
Total Expense	0.03630	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,261,173	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,885,382	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,375,791	NetCommunityBenefitExpnsAmt
Total Expense	0.07110	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,663	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,663	NetCommunityBenefitExpnsAmt

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,759	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,759	NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,771	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,771	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,193	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,193	NetCommunityBenefitExpnsAmt

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,655,712	BadDebtExpenseAmt
Bad Debt Expense Attributable	$965,958	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$21,650,061	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$22,191,086	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$541,025	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

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

US Address USAddress

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

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTPS://TINYURL.COM/Y76JLS3C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://TINYURL.COM/YCRB5TA2	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://TINYURL.COM/YAHXNLEB	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://TINYURL.COM/YCS9ZNHL	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://TINYURL.COM/YBUEF65F	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 3E	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 HEALTHCARE GRAYLING - PART V, LINE 5	WE USED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) FRAMEWORK TO GUIDE THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. MAPP, DEVELOPED BY THE NATIONAL ASSOCIATION FOR COUNTY & CITY HEALTH OFFICIALS AND THE US CENTERS FOR DISEASE CONTROL AND PREVENTION, IS CONSIDERED THE GOLD STANDARD FOR COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLANNING. MAPP IS A COMMUNITY-DRIVEN PLANNING TOOL THAT APPLIES STRATEGIC THINKING TO PRIORITY ISSUES AND IDENTIFIES RESOURCES TO ADDRESS THEM. THE COMMUNITY HEALTH ASSESSMENT PORTION OF THE MAPP PROCESS INCLUDES FOUR PHASES. PHASE 1: ORGANIZE FOR SUCCESS IN SPRING 2018, WE BEGAN THE PROCESS OF BRINGING PARTNERS TOGETHER TO LAY THE FOUNDATIONS OF THE MITHRIVE PROJECT. WE ORGANIZED A STEERING COMMITTEE WITH REPRESENTATION FROM LOCAL HOSPITALS, LOCAL HEALTH DEPARTMENTS, FEDERALLY-QUALIFIED HEALTH CENTERS, COMMUNITY MENTAL HEALTH, AND THE AREA AGENCY ON AGING. FROM THE BEGINNING, WE LAID PLANS FOR REACHING OUT TO NEW PARTNERS IN OTHER SECTORS TO JOIN MITHRIVE. PHASE 2: VISIONING THE STEERING COMMITTEE TOGETHER SET THE VISION OF THE PROJECT FOR THE COMMUNITY: A VIBRANT, DIVERSE, AND CARING COMMUNITY IN WHICH REGIONAL COLLABORATION ALLOWS ALL PEOPLE THE ABILITY TO ACHIEVE OPTIMUM PHYSICAL, MENTAL, CULTURAL, SOCIAL, SPIRITUAL, AND ECONOMIC HEALTH AND WELL-BEING. PHASE 3: THE FOUR ASSESSMENTS 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 & PROBLEMS IN THEIR COMMUNITIES, AND DEFINE WHAT IS IMPORTANT TO THEM. COMMUNITY INPUT BOARDS THE PURPOSE OF THE COMMUNITY INPUT BOARDS WAS TO GATHER FEEDBACK FROM THE GENERAL PUBLIC ON HOW THEIR COMMUNITY CONTEXT IMPACTS HEALTH. AT LARGE COMMUNITY EVENTS, COMMUNITY MEMBERS ANSWER 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 COLLECTED DATA USING COMMUNITY INPUT BOARDS FROM JULY-OCTOBER 2018. MINI CLIENT INTERVIEWS THE PURPOSE OF THE MINI CLIENT INTERVIEWS WAS TO GATHER INPUT FROM SPECIFIC VULNERABLE POPULATIONS THROUGH PARTNERING WITH ORGANIZATIONS THAT SPECIALIZE IN WORKING WITH THESE POPULATIONS. OUR QUESTIONS FOCUSED ON BARRIERS TO ACCESSING HEALTHCARE: 1. IN THE PAST YEAR, WHAT CHALLENGES HAVE YOU OR YOUR FAMILY HAD TRYING TO GET HEALTHCARE YOU NEEDED? 2. WHAT KIND OF HEALTHCARE DID YOU HAVE TROUBLE GETTING? 3. WHAT WOULD MAKE IT EASIER TO GET CARE? 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 COUNTIES. 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. 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. FORCES OF CHANGE ASSESSMENT THE PURPOSE OF THIS ASSESSMENT WAS TO IDENTIFY FORCES TRENDS, FACTORS, AND EVENTS THAT ARE INFLUENCING OR WILL LIKELY 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.
FACILITY 1, MUNSON HEALTHCARE GRAYLING - 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 GRAYLING - 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. CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DISTRICT HEALTH DEPT. 2, AND 10, AS WELL AS, AUSABLE VALLEY COMMUNITY MENTAL HEALTH, NORTHERN LAKES COMMUNITY MENTAL HEALTH, MICHIGAN STATE UNIVERSITY EXTENSION, AND CATHOLIC HUMAN SERVICES TOOK PART IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. 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 HEALTHCARE GRAYLING - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/4989%20GRAYLING%20CHNA %20REPORT%202019.PDF FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/4989%20GRAYLING%20CHNA %20IMPLEMENTATION%20STRATEGY%202019.PDF
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 11	WE IDENTIFIED STRATEGIC ISSUES AS PART OF THE MITHRIVE COLLABORATIVE. STRATEGIC ISSUES ARE BROADER THAN INDIVIDUAL HEALTH CONDITIONS, AND REPRESENT UNDERLYING CHALLENGES THAT NEED TO BE ADDRESSED, WHICH WOULD LEAD TO IMPROVEMENT IN HEALTH CONDITIONS. EACH STRATEGIC ISSUE SHOULD IMPACT MORE THAN ONE HEALTH CONDITION. EACH STRATEGIC ISSUE WAS PRIORITIZED USING THE FOLLOWING CRITERIA: 1. MAGNITUDE: HOW MANY PEOPLE ARE IMPACTED BY THIS ISSUE? 2. SEVERITY: HOW URGENT IS THIS ISSUE AND WHAT ARE THE CONSEQUENCES OF NOT ADDRESSING IT NOW? 3. VALUES: DOES THE COMMUNITY CARE ABOUT THIS ISSUE? WHICH ISSUE IS MOST IMPORTANT TO THE COMMUNITY? 4. IMPACT: HOW MUCH IMPACT WOULD IMPROVING OR FOCUSING ON THIS ISSUE HAVE ON HEALTH, HEALTH EQUITY, AND QUALITY OF LIFE? 5. SUSTAINABILITY AND ACHIEVABILITY: IS THE ISSUE WITHIN OUR SPHERE OF CONTROL? WILL WE HAVE THE EXPERTISE NECESSARY TO ADDRESS IT? THROUGH THIS PROCESS THESE PRIORITY ISSUES WERE IDENTIFIED: 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? ADDITIONAL STRATEGIC ISSUES IDENTIFIED: 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? STRATEGIC ISSUES THAT WILL NOT BE TARGETED AND WHY MUNSON HEALTHCARE GRAYLING (GRAYLING HOSPITAL) 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, GRAYLING HOSPITAL 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. RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE ISSUES 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.
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 13H	PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, AT THE SOLE DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/FINANCIAL_ASSISTANCE_%20POLICY %20(10_16_17)12_4_19.PDF FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/GRAYLING%20HOSPITAL%20- %20FINANCIAL%20ASSISTANCE.PDF FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16J	IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE.
FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 20E	MUNSON HEALTHCARE GRAYLING(GRAYLING) REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. GRAYLING WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY GRAYLING; 2.DOCUMENTING THAT GRAYLING HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH GRAYLING 'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH GRAYLING DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. GRAYLING WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS.

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

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

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE	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.
PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION	THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 6,436,099. THESE COSTS ARE OFFSET BY RELATED REVENUES IN COMPUTING THE NET COMMUNITY BENEFIT.
PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE	TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 93,359,117. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 3,655,712. THE NET EXPENSE OF 89,703,405 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F).
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION OR ACTUAL CASH PAID.
PART II - COMMUNITY BUILDING ACTIVITIES	MUNSON HEALTHCARE GRAYLING (GRAYLING HOSPITAL) PROVIDED 10,420 OF COMMUNITY BUILDING ACTIVITIES DURING 2018 TAX YEAR. GRAYLING HOSPITAL BELIEVES COMMUNITY BUILDING ACTIVITIES PROMOTE HEALTH BY SUPPORTING THE UNDERLYING STRUCTURE OF THAT SUPPORTS COMMUNITY HEALTH. GRAYLING HOSPITAL'S COMMUNITY BUILDING ACTIVITY INVESTMENT IS DEDICATED TO THE RECRUITMENT OF PHYSICIANS AND ADVANCED PRACTICE PROVIDERS IN NEEDED SPECIALTIES IN OUR MEDICALLY UNDERSERVED AREA. ADDITIONAL ACTIVITIES INCLUDE COMMUNITY HEALTH IMPROVEMENT ADVOCACY, ECONOMIC DEVELOPMENT, WORKFORCE DEVELOPMENT AND COLLABORATIVE EFFORTS WITH OTHER COMMUNITY AGENCIES AND CARE PROVIDERS.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	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.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE	THE METHODOLOGY USED TO DETERMINE THE ESTIMATED AMOUNT OF CHARITY IN BAD DEBT IS AS FOLLOWS. WE DETERMINED THE APPROVAL RATE OF FINANCIAL COUNSELING BY TAKING THE VALUE OF THE ACCOUNTS THAT SUCCESFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	SEE NOTE 2 ON PAGE 8 OF ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8 - MEDICARE EXPLANATION	MUNSON HEALTHCARE GRAYLING CONSIDERS THE ENTIRE MEDICARE SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. THAT AMOUNT IS 541,025. 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.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	MUNSON HEALTHCARE'S INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684.
PART VI, LINE 2 - NEEDS ASSESSMENT	THE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE (CHC) TO SERVE THE MUNSON HEALTHCARE SYSTEM. THE CHC CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM MUNSON HEALTHCARE HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON HEALTHCARE BOARD CHAIRPERSON. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MHC 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 MHC COMMUNITY BENEFIT PROGRAMS AND SERVICES. THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT EMPLOYEE OF THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE SYSTEM ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN MUNSON HEALTHCARE'S 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 COMMUNITY-WIDE. THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM PARTICIPATE IN A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. THE ASSESSMENT IS ACCOMPLISHED THROUGH COLLABORATION WITH MANY OF THE HUMAN SERVICE ORGANIZATIONS IN THE COMMUNITY.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	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.
PART VI, LINE 4 - COMMUNITY INFORMATION	DESCRIPTION MUNSON HEALTHCARE GRAYLING (GRAYLING HOSPITAL) SERVES A SPARSELY POPULATED, RURAL REGION IN CENTRAL NORTHERN MICHIGAN COMPRISED OF ALL OF CRAWFORD COUNTY (WHERE THE HOSPITAL IS LOCATED) AND MOST OF ROSCOMMON COUNTY, AS WELL AS MUCH OF OSCODA COUNTY AND SMALL PORTIONS OF MONTMORENCY AND OTSEGO COUNTIES. GRAYLING HOSPITAL IS THE ONLY INPATIENT AND EMERGENCY SERVICE PROVIDER FOR THIS REGION, AND ONE OF ONLY NINE BIRTHING HOSPITALS IN THE NORTHERN 21 COUNTIES OF THE LOWER PENINSULA. GRAYLING HOSPITAL OFFERS QUALITY, PERSONALIZED CARE FOR PRIMARY, SPECIALTY, AND URGENT MEDICAL NEEDS. HOSPITAL SERVICES THE ORGANIZATION HAS 81 LICENSED INPATIENT BEDS, A 39-BED SKILLED NURSING/ LONG-TERM CARE UNIT, AN ACTIVE EMERGENCY DEPARTMENT, OUTPATIENT SURGERY DEPARTMENT, CANCER AND INFUSION DEPARTMENT, AND SIX PHYSICIAN OFFICES LOCATED IN GRAYLING, PRUDENVILLE AND ROSCOMMON OFFERING PRIMARY CARE, PEDIATRICS, OBSTETRICS AND GYNECOLOGY, UROLOGY, GENERAL SURGERY , ORTHOPEDIC SURGERY, WALK-IN CARE, ARE SERVED BY MORE THAT 35 EMPLOYED PHYSICIAN AND ADVANCED PRACTICE PROVIDERS. CLINICS IN GRAYLING ROSCOMMON AND PRUDENVILLE ALSO PROVIDE OUT-PATIENT PHYSICAL REHAB SERVICES. BEHAVIORAL HEALTH IS OFFERED AT THE GRAYLING COMMUNITY HEALTH CENTER, ROSCOMMON COMMUNITY HEALTH CENTER AND PRUDENVILLE COMMUNITY HEALTH CENTER. GRAYLING HOSPITAL OFFERS A DIABETES SELF MANAGEMENT EDUCATION PROGRAM THAT IS RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION. GRAYLING HOSPITAL IS SUPPORTED IN ITS MISSON CENTERED FOCUS BY A GROUP OF MORE THAT 80 DEDICATED DOCTORS IN MULTIPLE SPECIALTIES. VISITING SPECIALTY PHYSICIANS AND HEALTHCARE PROFESSIONALS PROVIDE LOCAL ACCESS TO ALLERGY AND IMMUNOLOGY SERVICES, CARDIOLOGY, NEUROLOGY, NEUROSURGERY, NEPHROLOGY, AND AUDIOLOGY SERVICES. POPULATION SERVED THERE ARE NEARLY 50,000 PEOPLE LIVING IN GRAYLING HOSPITAL'S THREE COUNTY SERVICE AREAS. ACCORDING TO THE 2017 CENSUS BUREAU'S POPULATION ESTIMATES PROGRAM THE POPULATION IN CRAWFORD, OSCODA AND ROSCOMMON COUNTIES HAS DECREASED, WITH THE LARGEST DECREASE OCCURRING IN OSCODA COUNTY. THE PERCENTAGE OF PERSONS BELOW POVERTY CONTINUES TO BE HIGHER IN ALL THREE COUNTIES THAN IN ALL OF MICHIGAN WITH ROSCOMMON HAVING THE HIGHEST RATE AT 20 % COMPARED TO MICHIGAN'S RATE OF 16%. THE PERCENTAGE OF PERSONS 65 AND OLDER ALSO IS HIGHER IN ALL THREE COUNTIES THAN IN ALL OF MICHIGAN (16.2%), WITH ROSCOMMON AT 31%, OSCODA AT 27%, AND CRAWFORD AT 25%, AND IS EXPECTED TO INCREASE. THE POPULATION WITH A DISABILITY UNDER AGE 65 IS ALSO HIGHER IN ALL THREE COUNTIES THAN IN ALL OF MICHIGAN (10.4%), WITH ROSCOMMON AT 21.1%, OSCODA AT 17.6%, AND CRAWFORD AT 16.3%. THE MEDIAN INCOME IN ALL THREE COUNTIES IS LOWER THAN IN ALL OF MICHIGAN (52,688), WITH CRAWFORD AT 42,666, OSCODA AT 36,833 AND ROSCOMMON AT 37,834. CRAWFORD, OSCODA AND ROSCOMMON COUNTIES ARE ALL DESIGNATED AS MEDICALLY UNDERSERVED AREAS. THE CONCERN FOR SINGLE PARENT STATUS SURFACES AS AN ONGOING ISSUE FOR OUR COMMUNITY FAMILIES TODAY. THE PERCENTAGE OF CHILDREN THAT ARE LIVING IN SINGLE PARENT HOUSEHOLDS IS HIGHER THAN MICHIGAN IN ROSCOMMON (43%) AND CRAWFORD (39%), WITH OSCODA (30%) ) BEING SLIGHTLY LOWER MICHIGAN'S RATE OF 34%. QUALITY GRAYLING HOSPITAL IS FULLY ACCREDITED BY THE JOINT COMMISSION AND HAS EARNED THE GOLD SEAL OF APPROVAL, 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. GRAYLING HOSPITAL ALSO HAS BEEN DESIGNATED BY BLUE CROSS BLUE SHIELD OF MICHIGAN AS A BLUE DISTINCTION CENTER+ FOR MATERNITY CARE AND KNEE AND HIP REPLACEMENT. GRAYLING HOSPITAL IS RECOGNIZED AS A LEVEL IV TRAUMA HOSPITAL BY THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES. THIS DESIGNATION MEANS THAT GRAYLING HOSPITAL IS PART OF A REGIONAL, COORDINATED, AND ACCOUNTABLE TRAUMA CARE NETWORK WITH A DEMONSTRATED ABILITY TO PROVIDE ADVANCED TRAUMA LIFE SUPPORT (ATLS) PRIOR TO TRANSFER OF PATIENTS TO A HIGHER LEVEL TRAUMA CENTER. GRAYLING HOSPITAL HAS RECEIVED A 4- STAR BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. 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. THE OVERALL RATING SHOWS HOW WELL EACH HOSPITAL PERFORMED, ON AVERAGE, COMPARED TO OTHER HOSPITALS IN THE US.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	MUNSON HEALTHCARE GRAYLING'S (GRAYLING HOSPITAL) BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, THE MAJORITY OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP. 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 DIRECTORS. GRAYLING HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA. EXAMPLES OF HOW GRAYLING HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PROGRAM SUPPORT INCLUDES: "THE GRAYLING HOSPITAL RESOURCE CORDINATION TEAM" IS SUPPORTED BY COMMUNITY BENEFIT FUNDING.THE RESOURCE COORDINATION TEAM CONTINUES TO ASSIST UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS PATIENTS WITH LIMITED FINANCIAL RESOURCES BY CONNECTING THEM WITH RESOURCES TO ADDRESS BARRIERS SUCH AS TRANSPORTATION, INABILITY TO PAY UTILITY BILLS, ACCESS TO PRIMARY CARE AND WALK-IN CARE, THE HIGH COST OF MEDICATIONS, AND REFERRALS TO OTHER COMMUNITY BASED RESOURCES. THE RESOURCE COORDINATION TEAM HAS BEEN ACTIVE IN CONNECTING PATIENTS WITH THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE COORDINATOR AND MEDICAID COORDINATOR FOR FREE HEALTH INSURANCE ENROLLMENT ASSISTANCE. MUNSON HEALTHCARE GRAYLING PHYSICIAN NETWORK CHRONIC DISEASE CARE COORDINATORS COLLABORATE WITH THE RESOURCE COORDINATION TEAM TO GET THEIR PATIENTS ASSISTANCE IN MEETING UNMET SOCIAL NEEDS. THE MEDICATION ACCESS PROGRAM OFFERED BY THE RESOURCE COORDINATION TEAM HELPS MANY PATIENTS WITH MORE AFFORDABLE OPTIONS TO OBTAIN MEDICATIONS. THE RESOURCE COORDINATION TEAM ALSO OFFERS ADVANCE CARE PLANNING WORKSHOPS AND RESOURCES TO COMMUNITY MEMBERS AT NO COST. "PRENATAL EDUCATION AND CARE COORDINATION - MUNSON HEALTHCARE GRAYLING HOSPITAL OFFERS CHILDBIRTH AND BREASTFEEDING EDUCATION. OB CARE COORDINATORS ASSIST HIGH RISK PATIENTS TO IMPROVE PREGNANCY OUTCOMES. MUNSON HEALTHCARE ALSO HELPS FUND THE HEALTHY FUTURES PROGRAM SO THAT EVERY MOTHER-TO-BE THAT HAS A CHILD BORN AT GRAYLING HOSPITAL AND CHILDREN UP TO AGE TWO, CAN HAVE ACCESS, REGARDLESS OF HEALTH INSURANCE COVERAGE, TO EVERYTHING NEEDED FOR A HEALTHY BEGINNING. "TRANSPORTATION - GRAYLING HOSPITAL SUBSIDIZES FUNDING FOR TRANSPORTATION WHICH PROVIDES ACCESS TO HEALTHCARE SERVICES FOR DISADVANTAGED PERSONS SUCH AS THE ELDERLY, PERSONS WITH DISABILITIES, AND PERSONS OF LOW INCOME WHO HAVE DIFFICULTY PROVIDING THEIR OWN TRANSPORTATION. "SUPPORT OF THE NEIGHBORHOOD CONNECTIONS RESOURCE FAIR IN CRAWFORD COUNTY AND THE PROJECT CONNECT RESOURCE FAIR IN OSOCDA COUNTY. "SUPPORT GROUPS AND ASSISTANCE ACTIVITIES FOR CHRONIC DISEASES SUCH AS: DIABETES, COPD, BARIATRIC PATIENTS, AND ALCOHOL RECOVERY. "NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 11 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. "SENIOR EXERCISE CLASSES LED BY GRAYLING HOSPITAL'S REHAB STAFF ARE HELD ON THURSDAYS AND FRIDAYS AT THE CRAWFORD COUNTY COMMISSION ON AGING AND SENIOR CENTER. "MEDICATION ASSISTANCE PROGRAM - PROVIDES ESSENTIAL PRESCRIPTIONS TO PATIENTS WHO HAVE LIMITED RESOURCES "CLINICAL TRAINING SITE FOR MEDICAL STUDENTS, NURSE PRACTITIONER STUDENTS, PHYSICIAN ASSISTANT STUDENTS, NURSING STUDENTS, SURGICAL TECH STUDENTS, PHLEBOTOMY STUDENTS, AND OTHER ALLIED HEALTH STUDENTS.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	MUNSON HEALTHCARE GRAYLINGS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM 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

Schedule I IRS990ScheduleI

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

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Non Cash AssistanceNonCashAssistanceAmt	Cash GrantCashGrantAmt
PATIENT MEDICATION ASSIST	99	$5,317
N. MI DIABETES INITIATIVE	93		$5,000

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	AWARDS GIVEN TO ASSIST INDVIDUALS ARE BASED ON AN EVALUATION OF THEIR ELIGIBILITY. SINCE THESE ARE SINGLE EVENTS FOR SPECIFIC NEEDS, THERE IS NO REASON TO MONITOR THE FURTHER USE OF FUNDS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount
EDWIN A NESS
DIRECTOR	$736,346	$176,677	$8,699	$154,003	$28,199	$1,103,924
STEPHANIE RIEMER
PT-YR PRESIDENT	$175,047		$134,459	$28,778	$19,810	$358,094
KIRSTEN KORTH-WHITE
PT-YR PRESIDENT							$198,206	$1,178	$18,925	$20,552	$238,861
MARK A HEPLER
CFO	$378,650	$62,803	$61,759	$60,161	$20,876	$584,249						$11,832
CYNTHIA K RUBERT MD
PHYSICIAN							$539,463	$2,346	$13,628	$27,235	$587,672		$5,000
BRIAN N STIRLING DO
PHYSICIAN							$480,122	$2,244	$13,628	$29,030	$545,024		$20,000
JASON D BENNETT DO
PHYSICIAN							$449,465	$1,020	$13,628	$22,577	$495,440		$8,750
GARRICK CVITKOVICH MD
PHYSICIAN							$445,063	$622	$10,173	$22,227	$480,585		$2,500
CARL F SCHUBERT MD
PHYSICIAN							$415,516	$20,474	$13,628	$17,125	$476,743		$10,000

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 STEPHANIE RIEMER 82,032 16,729 0 KIRSTEN KORTH-WHITE 0 11,198 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, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON HEALTHCARE'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON HEALTHCARE. EXECUTIVE SEVERANCE PLAN: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, A COMPETITIVE BENEFIT PACKAGE IS OFFERED TO THE PRESIDENT AND VICE-PRESIDENTS, WHICH INCLUDES A SEVERANCE PLAN. MUNSON HAS A SEVERANCE PLAN FOR THE PRESIDENT AND VICE-PRESIDENT/EXECUTIVE LEVEL POSITIONS, WHICH PROVIDES FOR THE PRESIDENT UP TO TWO YEARS OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS AND FOR VICE-PRESIDENTS, UP TO ONE-YEAR OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS. THE PLAN PROVIDES FOR A 50% OFFSET FOR SUBSEQUENT EMPLOYMENT DURING THE SEVERANCE PERIOD. MEDICAL BENEFITS ARE PROVIDED DURING THE SEVERANCE PERIOD.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CNTY GRD TRAV HOSP FIN AUTH 2014B	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	386004832	BondIssuerEIN
CUSIP	386523EH3	CUSIPNum
Bond Issued	2014-12-17	BondIssuedDt
Issue Price	$14,185,862	IssuePriceAmt
Purpose	PURCHASE HOSPITAL ASSETS	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$14,185,920	TotalProceedsAmt
Issuance Costs From Proceeds	$173,507	IssuanceCostsFromProceedsAmt
Capital Expenditures	$14,021,413	CapitalExpendituresAmt
Substantial Completion	2015	SubstantialCompletionYr
Refunding Tax Exempt Bonds	false	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	false	RefundingTaxableBondsInd
Final Allocation Made	false	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	Yes (true)	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	false	RebateNotDueYetInd
Exception To Rebate	Yes (true)	ExceptionToRebateInd
No Rebate Due	false	NoRebateDueInd
Variable Rate Issue	false	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE K - DIFFERENCES IN ISSUE PRICE EXPLANATION

CNTY GRD TRAV HOSP FIN AUTH 2014B INVESTMENT INCOME EARNED

SCHEDULE K - ADDITIONAL INFORMATION

CNTY GRD TRAV HOSP FIN AUTH 2014B MUNSON HEALTHCARE GRAYLING 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 CORPORATE 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 CONTACTS. SINCE NEW BONDS WERE ISSUED IN THE MUNSON HEALTHCARE SYSTEM IN 2019, OUTSIDE COUNSEL WAS ENGAGED DURING THAT TAX YEAR. 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.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
THAD JACKSON
SEE PART V	$255,102	COMPENSATION PAID	false
SONJA HANDRICH
SEE PART V	$89,946	COMPENSATION PAID	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART V	FormAndLineReferenceDesc
Explanation	PART IV, LINE 1 EMPLOYEE IS FAMILY MEMBER OF BOARD MEMBER THAD JACKSON. PART IV, LINE 2 EMPLOYEE IS FAMILY MEMBER OF BOARD MEMBER SONJA HANDRICH.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 6	MUNSON HEALTHCARE GRAYLING IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 7A	MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE 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 GRAYLING (GRY) TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF GRY; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF GRY; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF GRY; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR GRY; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY GRY WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF GRY WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF GRY; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY GRY; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT.
FORM 990, PAGE 6, PART VI, LINE 11B	THE MUNSON HEALTHCARE GRAYLING BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE GRAYLING BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE EXECUTIVE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE EXECUTIVE COMPENSATION PROCESS AND THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE 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 GRAYLING AND MUNSON HEALTHCARE.
FORM 990, PAGE 6, PART VI, LINE 19	THE MUNSON HEALTHCARE GRAYLING ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE GRAYLING DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES 8,728,141 7,736,774 60,000 PROFESSIONAL FEES 6,136,348 8,257 0 TOTAL 14,864,489 7,745,031 60,000

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd	Business Name Line2DisregardedEntityName/BusinessNameLine2Txt
MUNSON DIALYSIS CENTER
1105 SIXTH ST	TRAVERSE CITY	MI	49684	383097861	DIALYSIS	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HEALTHCARE
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382640544	HEALTHCARE	MI	C3	12B			false	N/A
MUNSON HEALTHCARE FOUNDATIONS
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382642724	RAISE FUND	MI	C3	7	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HOME CARE
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382191390	HOME HEALT	MI	C3	10	MUN HOME H	MUNSON HOME HEALTH	Yes (true)
MUNSON HOME HEALTH
1105 SIXTH ST	TRAVERSE CITY	MI	49684	383335362	HOME HEALT	MI	C3	12B	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HOME SERVICES
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382543463	HOME HEALT	MI	C3	10	MUN HOME H	MUNSON HOME HEALTH	Yes (true)
NORTH FLIGHT INC
1105 SIXTH ST	TRAVERSE CITY	MI	49684	382657917	MED TRANSP	MI	C3	12B	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
PAUL OLIVER MEMORIAL HOSPITAL
1105 SIXTH ST	TRAVERSE CITY	MI	49684	381415623	HEALTHCARE	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON MEDICAL GROUP
1105 SIXTH ST	TRAVERSE CITY	MI	49684	273600575	PHYSICIAN	MI	C3	10	MUNSON MED	MUNSON MEDICAL CENTER	Yes (true)
MUNSON MEDICAL CENTER
1105 SIXTH ST	TRAVERSE CITY	MI	49684	381362830	HOSPITAL	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HEALTHCARE CADILLAC
1105 SIXTH ST	TRAVERSE CITY	MI	49684	471156297	HOSPITAL	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HEALTHCARE CHARLEVOIX HOSPIT
1105 SIXTH ST	TRAVERSE CITY	MI	49684	381459366	HOSPITAL	MI	C3	3	MUNSON HC		Yes (true)
MUNSON HEALTHCARE MANISTEE HOSPITAL
1465 E PARKDALE AVE	MANISTEE	MI	496609709	380350304	HOSPITAL	MI	C3	3	MUNSON HC		Yes (true)
MUNSON HEALTHCARE MANISTEE
1465 E PARKDALE AVE	MANISTEE	MI	496609709	383565083	RAISE FUND	MI	C3	12A	MHC MANIST	HOSPITAL	Yes (true)		HOSPITAL FOUNDATION
MUNSON HEALTHCARE OTSEGO MEMORIAL H
825 N CENTER AVE	GAYLORD	MI	497351592	381303843	HOSPITAL	MI	C3	3	MUNSON HC	MUNSON HEALTHCARE	Yes (true)
MUNSON HEALTHCARE OTSEGO MEMORIAL
825 N CENTER AVE	GAYLORD	MI	497351592	382135473	RAISE FUND	MI	C3	12A	MHC OTSEGO	HOSPITAL	Yes (true)		HOSPITAL FOUNDATION

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd
MEDICAL OFFICE BUILDING CONDOMINIUM
PO BOX 1188	TRAVERSE CITY	MI	496851188	383567278	REAL ESTAT	MI	N/A	Yes (true)
MUNSON SERVICES INC
PO BOX 1188	TRAVERSE CITY	MI	496851188	383144382	PHARMACY	MI	N/A	Yes (true)
MUNSON SUPPORT SERVICES
PO BOX 1188	TRAVERSE CITY	MI	496851188	382872821	LAUNDRY	MI	N/A	Yes (true)
SIXTH STREET DRUGS INC
PO BOX 1188	TRAVERSE CITY	MI	496851188	382298290	PHARMACY	MI	N/A	Yes (true)
MEDICAL OFFICE CONDOMINIUM ASSOCIAT
PO BOX 1188	TRAVERSE CITY	MI	496851188	201902620	REAL ESTAT	MI	N/A	Yes (true)
MUNSON MOBILE IMAGING
PO BOX 1188	TRAVERSE CITY	MI	496851188	382704069	IMAGING	MI	N/A	Yes (true)

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

Transactions Related Org TransactionsRelatedOrgGrp (15 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MUNSON HEALTHCARE
M	$8,443,035	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE
P	$8,686,279	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE
Q	$4,534,171	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE CADILLAC
P	$156,731	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE CADILLAC
Q	$106,327	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE CADILLAC
O	$364,819	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE FOUNDATIONS
M	$60,000	ACTUAL AMOUNTS PAID
MUNSON MEDICAL CENTER
M	$613,860	ACTUAL AMOUNTS PAID
MUNSON MEDICAL CENTER
Q	$714,626	ACTUAL AMOUNTS PAID
MUNSON MEDICAL CENTER
P	$31,164,872	ACTUAL AMOUNTS PAID
MUNSON SUPPORT SERVICES
M	$249,268	ACTUAL AMOUNTS PAID
NORTHERN MI SUPPLY ALIANCE
M	$635,689	ACTUAL AMOUNTS PAID
NORTHERN MI SUPPLY ALIANCE
P	$2,101,635	ACTUAL AMOUNTS PAID
MUNSON MEDICAL GROUP
M	$782,985	ACTUAL AMOUNTS PAID
MUNSON HEALTHCARE MANISTEE HOSPITAL
Q	$73,500	ACTUAL AMOUNTS PAID

Supplemental Information Detail SupplementalInformationDetail

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