2020-05-27T08:19:57-05:00 2019-06-30 381357951 PLANTE & MORAN PLLC 27400 NORTHWESTERN HIGHWAY SOUTHFIELD MI 48034 990 2018-07-01 386000029 MIDMICHIGAN MEDICAL CENTER - ALPENA MIDM 9898393181 1501 W CHISHOLM ST ALPENA MI 49707 FRANCINE M PADGETT SENIOR VP & CFO 9898393181 2020-05-27 1 DAVID LOWENTHAL P00378651 2483522500 2020-05-26 198.140.228.10 2020-05-27 08:19:53 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 402863DE1D58B7813072FE90D1EBF7EA8F9C073D 2018 2020-09-23 17:36:50Z CHUCK SHERWIN 1501 W CHISHOLM ST ALPENA MI 49707 155158350 0 X WWW.MIDMICHIGAN.ORG X 1940 MI TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. 10 8 995 150 2260716 0 0 0 131409074 143689793 2935178 477200 6741870 1211509 141086122 145378502 0 0 0 0 67148628 61431230 0 0 0 69115292 67773392 136263920 129204622 4822202 16173880 135111227 150031253 60416728 74563439 74694499 75467814 TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. 0 0 103701837 141825410 MIDMICHIGAN MEDICAL CENTER - ALPENA'S PRIMARY LINE OF BUSINESS IS AN ACUTE CARE HOSPITAL PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES. FOR THE REPORTING PERIOD, WE PROVIDED 4,588 TOTAL ADMISSIONS INCLUDING 3,636 ACUTE CARE, 374 NEWBORNS, 442 PSYCHIATRIC AND 136 INPATIENT REHABILITATION PATIENTS. WE ALSO PROVIDED 18,730 VISITS IN OUR EMERGENCY ROOM, 9,775 OUTPATIENT SURGERY CASES AND 103,313 OTHER OUTPATIENT VISITS. CARE IS PROVIDED REGARDLESS OF THE PATIENT'S ABILITY TO PAY. 103701837 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 995 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X FRANCINE M PADGETT 9898393181 4000 WELLNESS DR MIDLAND MI 48670 X CHUCK SHERWIN PRESIDENT 2.00 50.00 X X 249780 0 121733 GREGORY ROGERS DIRECTOR 2.00 64.00 X 0 668805 265423 JAMES ARBUCKLE DIRECTOR 2.00 0.00 X 0 0 0 JAMES DECKER MD DIRECTOR 2.00 0.00 X 0 0 0 JAMES FLORIP DIRECTOR 2.00 0.00 X 0 0 0 BEACH HALL DIRECTOR 2.00 0.00 X 0 0 0 DAVID MEINHARDT MD DIRECTOR 2.00 0.00 X 0 0 0 ERIC SMITH DIRECTOR 2.00 0.00 X 0 0 0 MARIE WILLIAMS DIRECTOR 2.00 0.00 X 0 0 0 RICHARD WILLIS MD DIRECTOR 2.00 0.00 X 0 0 0 DIANE POSTLER-SLATTERY DIRECTOR, PART-YEAR 2.00 58.00 X 0 1005371 196197 GEORGENE HILDEBRAND DIRECTOR, PART-YEAR 2.00 0.00 X 0 0 0 FRANCINE PADGETT SENIOR VP & CFO 2.00 68.00 X 0 560770 188336 DONNA RAPP SENIOR VP & SECRETARY 2.00 64.00 X 0 566427 494672 JEFFREY DOBROSKI MD PHYSICIAN 50.00 0.00 X 829740 0 45349 WILLIAM HITZELBERGER DO PHYSICIAN 50.00 0.00 X 654471 0 71714 ABRAHAM SALACATA MD PHYSICIAN 50.00 0.00 X 591525 0 18962 SANJEEV ARORA MD PHYSICIAN 50.00 0.00 X 585062 0 20723 KARMON BJELLA PRESIDENT 50.00 0.00 X 430453 0 9622 3341031 2801373 1432731 33 0 1 0 0 MEDICARE/MEDICAID PAYMENTS 621990 84306404 84306404 NET PATIENT REVENUE 621990 53966023 53966023 SUBSIDIARY RELATED INC 900099 2408183 2408183 RETAIL PHARMACY 446110 1884500 1884500 CONTRACTED CLINICAL SERVICES 621990 752707 752707 371976 371976 143689793 535364 -207238 742602 114808 29093 85715 85715 4240 81475 9692591 9678374 72381 14217 -72381 -58164 -58164 CAFETERIA/FOOD SERVICE 722514 526463 526463 JOINT VENTURE INCOME 900099 247946 247946 MEDICAL RECORDS INCOME 323100 56626 56626 294759 294759 1125794 145378502 141825410 2260716 1292376 X 305943 305943 46113979 37805460 8308519 4448407 3603210 845197 7461836 6044087 1417749 3101065 2511863 589202 56980 56980 25772026 17310634 8461392 17077 11034 6043 25855035 24748751 1106284 25100 25100 1706066 259623 1446443 365703 323397 42306 71190 41866 29324 5270637 4216510 1054127 1861262 32940 1828322 MEDICAL SUPPLIES 6772316 6767362 4954 129204622 103701837 25502785 0 1969398 3296 2148829 335951 14733150 14492735 1907086 2320786 1208018 963700 83988901 15823588 66168374 68165313 12361310 18804029 31065506 42003124 3549556 2942319 135111227 150031253 6431395 8035505 4331 53985333 66523603 60416728 74563439 X 73924099 74697414 770400 770400 74694499 75467814 135111227 150031253 X 16173880 2236883 -17637448 X X 0 1 X 1 0 X 2370000 2370000 64612200 9945176 54667024 745648 310162 435486 14575518 5568250 9007268 1685535 1685535 68165313 HEDGE FUNDS 2743575 F BLACKROCK DOMESTIC 10238504 F PARAMETRIC GLOBAL 2754563 F ALLIANZ GLOBAL 2836896 F BLACKROCK INTERNATIONAL 10957679 F BLACKROCK FIXED 6110007 F CLARION & CORNERSTONE 6361900 F 42003124 ACCRUED PENSION & POST RETIREMENT 59227660 SELF INSURANCE, DEFERRED COMP, OTHER 7295943 66523603 1 1 1 X 1 X 1 1 0 1 1 990452 990452 0.00770 1 21688031 18716164 2971867 0.02300 1 22678483 18716164 3962319 0.03070 62 555561 84912 665 84247 0.00070 55 215 246428 246428 0.00190 5 74 7970 7970 0.00010 240 251 81321 81321 0.00060 362 556101 420631 665 419966 0.00330 363 556101 23099114 18716829 4382285 0.03400 1 1 70 70 0.00000 15 226 211 211 0.00000 3 2 392 392 0.00000 19 229 673 673 0.00000 1 4105173 205259 50914100 54608036 -3693936 X 1 1 1 NE MI CANCER CENTER RADIATION ONCOLOGY DIAGNOSIS & TREATMENT 0.50000 0.00000 0.00000 1 1 MIDMICHIGAN MEDICAL CENTER - ALPENA 1501 W CHISHOLM ST ALPENA MI 49707 WWW.MIDMICHIGAN.ORG 1060000019 X X X INPATIENT PSYCHIATRIC & REHAB MIDMICHIGAN MEDICAL CENTER - ALPENA 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE SCHEDULE H, PART VI X 1 18 1 SEE SCHEDULE H, PART VI 0 1 X 150.000000000000 250.000000000000 X X X X X 1 1 X X X 1 X SEE SCHEDULE H, PART VI X SEE SCHEDULE H, PART VI X SEE SCHEDULE H, PART VI X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B, LINE 5 A. WE HAVE BEEN MEMBERS OF THE NORTHERN MICHIGAN CHRONIC DISEASE COORDINATING NETWORK AND THE NORTHERN MICHIGAN REGIONAL DIABETES PREVENTION PROGRAM NETWORK. WE ALSO HAVE PARTNERED WITH THE LOCAL HEALTH DEPARTMENT FOR HEALTH FAIRS.B. WE ARE WORKING WITH LOCAL PUBLIC SAFETY AS A PARTNER WITH OTHER GROUPS TO REFER PARENTS TO RECEIVE CAR SEATS. WE PARTNER WITH LOCAL LAW ENFORCEMENT REGARDING EDUCATION OF HOSPITAL POLICY AND PROCEDURES FOR INMATES IN THE HOSPITAL. WE ARE PARTNERED WITH THE LOCAL SEXUAL ABUSE PREVENTION TEAM TO ASSIST WITH POLICIES AND PROCEDURES IN OUR HOSPITAL WHEN PRESENTED WITH A SEXUAL ASSAULT VICTIM. WE ALSO HAVE COORDINATED WITH LOCAL FIRE STATION STAFF FOR AMERICAN HEART ASSOCIATION TRAINING.C. WE HAVE PARTNERED WITH CHURCHES TO COMMUNICATE COMMUNITY HEALTH PROGRAMS.D. WE HAVE PARTNERED WITH PRESCHOOLS AND ELEMENTARY SCHOOLS TO IMPLEMENT 5210 EDUCATION A PROGRAM AIMED AT INCREASING PROPER NUTRITION AND INCREASED EXERCISE.E. EXCHANGE INFORMATION AND SHARE RESOURCES FOR A SIMILAR MISSION TO ENHANCE THE CAPACITY OF THE OTHER PARTNER. FORMAL ALLIANCE FORMALIZED PARTNERSHIP (BINDING AGREEMENT) AMONG MULTIPLE ORGANIZATIONS WITH MERGED INITIATIVES, COMMON GOALS AND METRICS. PART V, SECTION B, LINE 11 AS A RESULT OF THE CHNA, TOBACCO CESSATION, OBESITY PREVENTION, AND PHYSICAL INACTIVITY WERE FOUND TO BE THE GREATEST EXPRESSED NEEDS OF THE COMMUNITY. TO ADDRESS THESE NEEDS THE FOLLOWING WAS EXECUTED:- INCREASE PARTICIPATION IN SMOKING CESSATION PROGRAMS THROUGH PHYSICAN BASED INTERVENTIONS, INCREASE COMMUNITY OUTREACH TO RAISE AWARENESS OF TOBACCO CESSATION SERVICES, AND BY OFFERING THE AMERICAN CANCER SOCIETY'S FREEDOM FROM SMOKING TOBACCO CESSATION PROGRAM.- IMPLEMENTATION OF A PATIENT POPULATION MANAGEMENT PROGRAM, A PILOT PROGRAM THAT SOUGHT TO LEARN FROM UNDERSTANDING AND ENGAGING ITS OWN EMPLOYEE/SPOUSE POPULATION TO PILOT STRATEGIES IN AN EFFORT TO GET CLOSER TO A TRUE POPULATION HEALTH MANAGEMENT PHILOSOPHY. THE HOSPITAL COMPARED A TEST GROUP FROM ITS POPULATION BY OFFERING SPECIALIZED COACHING IN FOUR SEPARATE AREAS: HEALTH, SPIRITUAL, PHYSIO-SOCIAL, AND FINANCIAL. THESE INDIVIDUALS WERE SELECTED FROM VOLUNTARY APPLICANTS AND PROVIDED TWO INDIVIDUALIZED SESSIONS PER MONTH OVER A 12 MONTH PERIOD. THESE SESSIONS WERE FINANCIALLY SUPPORTED BY THE HOSPITAL IN EXCHANGE FOR THE SELECTED APPLICANTS AGREEING TO ATTEND SESSIONS AND REASONABLY FOLLOW THROUGH WITH COLLABORATIVE RECOMMENDATIONS MADE BY EACH RESPECTIVE COACH. THE GOAL OF THIS PROGRAM IS TO CREATE AN ENVIRONMENT FOR AN INDIVIDUAL THAT IS SPECIFIC TO THEIR NEEDS AND MEETS ALL FOUR CORNERSTONES OF TOTAL WELL-BEING. THE INITIAL GOAL OF THIS PILOT IS 50 EMPLOYEES/SPOUSES. PROGRAM DETAILS, APPLICATION PROCESS, AND MEASUREMENT WERE RECOMMENDED THROUGH THE EMPLOYEE HEALTH AND SAFETY VALUE STREAM WHICH FALLS UNDER TEAMWORK ON THE ARMC PRODUCTION SYSTEM. PART V, SECTION B, LINE 13H PATIENTS RELIGIOUS BELIEFS PREVENT HIM/HER FROM PARTICIPATING DIRECTLY WITH AN INSURANCE COMPANY. PART V, SECTION B, LINES 7A AND 10B HTTPS://WWW.MIDMICHIGAN.ORG/ABOUT/COMMUNITY-BENEFITS/CHNA/ PART V, SECTION B, LINES 16A, 16B, 16C WWW.MIDMICHIGAN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/PATIENT-NOTICE-OF-FINANCIAL-AID/ 14 1 - CARDIOLOGY ASSOCIATES 460 LONG RAPIDS PLAZA ALPENA MI 49707 PHYSICIAN CLINIC 2 - ORTHOPAEDIC ASSOCIATES 401 LONG RAPIDS PLAZA ALPENA MI 49707 PHYSICIAN CLINIC 3 - HOME CARE & PRIVATE DUTY 1521 W CHISHOLM ST ALPENA MI 49707 HOME CARE ADMIN OFFICES 4 - ALPENA HOME MEDICAL EQUIPMENT 232 RIVER STREET ALPENA MI 49707 HOME MEDICAL EQUIPMENT 5 - OSCODA REHABILITATION SERVICES 5671 N SKEEL AVE STE 40 OSCODA MI 48750 REHABILITATION SERVICES 6 - PHYSICAL MEDICINE AND REHABILITATION 393 LONG RAPIDS ROAD ALPENA MI 49707 PHYSICIAN CLINIC 7 - ROGERS CITY REHABILITATION SERVICES 201 S BRADLEY HWY ROGERS CITY MI 49779 REHABILITATION SERVICES 8 - OSSINKE PHARMACY 11745 US 23 SOUTH OSSINEKE MI 49766 OUTPATIENT PHARMACY 9 - ATLANTA REHABILITATION SERVICES 11899 M-32 WEST ATLANTA MI 49709 REHABILITATION SERVICES 10 - ALPENA OPHTHAMOLOGY 346 LONG RAPIDS PLAZA ALPENA MI 49707 PHYSICIAN CLINIC 11 - ATLANTA HOME MEDICAL EQUIPMENT 12674 JEROME ST PO BOX 85 ATLANTA MI 49709 HOME MEDICAL EQUIPMENT 12 - OSCODA HOME MEDICAL EQUIPMENT 109 EVERGREEN OSCODA MI 49750 HOME MEDICAL EQUIPMENT 13 - REHABILITATION SERVICES 177 N BARLOW ROAD LINCOLN MI 48742 REHABILITATION SERVICES 14 - RADIOLOGY SERVICES 555 N BRADLEY HWY ROGERS CITY MI 49779 IMAGING SERVICES PART II, COMMUNITY BUILDING ACTIVITIES: COALITION BUILDING: TO PROMOTE THE HEALTH OF THE COMMUNITY, MIDMICHIGAN MEDICAL CENTER-ALPENA STAFF PARTICIPATED IN THE FOLLOWING COALITIONS AND COMMUNITY GROUPS IN FY19: HUMAN SERVICES COORDINATING COUNCILS (ALPENA AND OSCODA): THE COMMUNITY HEALTH SPECIALIST ATTENDED THE ALPENA AND OSCODA HUMAN SERVICES COUNCIL MEETINGS TO PROMOTE HEALTH THROUGH INTERAGENCY COLLABORATION. AS THE VICE CHAIR OF THE ALPENA HUMAN SERVICES COORDINATING COUNCIL, THE COMMUNITY HEALTH SPECIALIST HELPED TO PROMOTE HEALTH IN ALPENA COUNTY BY SHARING INFORMATION THROUGH TRADITIONAL COMMUNICATION CHANNELS AND SOCIAL MEDIA PLATFORMS TO BREAKDOWN SILOS. SUNRISE SIDE BREASTFEEDING COALITION: THE SUNRISE SIDE BREASTFEEDING COALITION WAS ESTABLISHED IN PARTNERSHIP WITH DISTRICT HEALTH DEPARTMENT #4 TO PROMOTE BREASTFEEDING IN ALPENA, CHEBOYGAN, MONTMORENCY, AND PRESQUE ISLE COUNTIES. DURING THE COALITION'S INAUGURAL YEAR, MIDMICHIGAN HEALTH STAFF WORKED TO ADVANCE WORKPLACE BREASTFEEDING RIGHTS, IDENTIFICATION OF BREASTFEEDING FRIENDLY BUSINESSES, AND HOSTED A BIG LATCH EVENT THAT WAS HELD IN AUGUST 2018. ALPENA-MONTMORENCY-ALCONA GREAT START COLLABORATIVE: IN EFFORTS TO PROMOTE MATERNAL AND INFANT HEALTH OUTCOMES IN THE ALPENA SERVICE AREA, MIDMICHIGAN HEALTH PARTICIPATED IN MATERNAL TOBACCO CESSATION WORKGROUP OF THE ALPENA-MONTMORENCY-ALCONA GREAT START COLLABORATIVE.NORTHERN MICHIGAN PERINATAL NETWORK: IN EFFORTS TO REDUCE THE MATERNAL TOBACCO PRODUCT USAGE RATE IN THE ALPENA SERVICE AREA, MIDMICHIGAN HEALTH PARTICIPATED IN THE SCRIPT WORKGROUP. NORTHERN MICHIGAN CHRONIC DISEASE COORDINATING NETWORK: NORTHERN MICHIGAN CHRONIC DISEASE COORDINATING NETWORK AIMS TO IMPLEMENT ENVIRONMENTAL AND POLICY CHANGE EFFORTS TO FIGHT THE ADVANCES OF CHRONIC DISEASE IN NORTHERN MICHIGAN. MIDMICHIGAN HEALTH STAFF AIDED IN THIS EFFORT BY HELPING TO REFINE THE NETWORK'S WORK PLAN AND IDENTIFY LOCAL SUPPORTS AVAILABLE. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: MIDMICHIGAN MEDICAL CENTER-ALPENA EMPLOYEES PARTICIPATED IN COMMUNITY BOARDS FOR LOCAL NON-PROFIT AGENCIES INCLUDING FEDERALLY QUALIFIED HEALTH CENTERS AND THE UNITED WAY IN FY 2019. IN ADDITION, EMPLOYEES PARTICIPATED IN LOCAL CIVIC ORGANIZATIONS AND COMMUNITY COALITIONS INCLUDING: LOCAL WORKFORCE DEVELOPMENT COALITION, LIONS CLUB, ALPENA ROTARY, ZONTA CLUB OF ALPENA, ALPENA HEALTH AND HUMAN SERVICES COORDINATING COUNCIL, CHILD ABUSE AND NEGLECT TEAM, GREAT START COLLABORATIVE, KNIGHTS OF COLUMBUS, ALPENA BABY PANTRY, AND THE ALPENA BOOSTERS CLUB. WORKFORCE DEVELOPMENT: IN EFFORTS TO INCREASE FUTURE MEDICAL PROFESSIONALS, VARIOUS DEPARTMENTS WITHIN MIDMICHIGAN MEDICAL CENTER-ALPENA PARTICIPATED IN ALPENA COMMUNITY COLLEGE BUSINESS INFORMATION SYSTEMS ADVISORY COMMITTEE. IN ADDITION, MIDMICHIGAN MEDICAL CENTER-ALPENA HAS PARTNERED WITH ALPENA COMMUNITY COLLEGE TO DEVELOP A STERILIZATION TECHNICIAN PROGRAM TO ALLEVIATE THE SHORTAGE OF TRAINED PRESENT THROUGHOUT THE GREATER NORTHEAST MICHIGAN REGION. PART III, LINE 2: BAD DEBT EXPENSE METHODOLOGY:OTHER UNCOMPENSATED CARE REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH PAYMENT IS EXPECTED AT THE TIME SERVICE IS PROVIDED, BUT PAYMENT IS NOT RECEIVED OR IS LESS THAN THE COST INCURRED TO PROVIDE THE SERVICE. THE FOLLOWING IS INCLUDED AS PROGRAMS AND SERVICES RELATED TOOTHER UNCOMPENSATED CARE: UNCOMPENSATED SERVICES, AT COST REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH A FEE HAS BEEN ASSESSED BUT NOT COLLECTED OR ONLY A PORTION OF THE COST OF THE RENDERED SERVICE HAS BEEN RECOVERED.COSTING METHODOLOGY:AN AVERAGE COST-TO-CHARGE RATIO IS APPLIED TO THE CHARGE WRITE-OFF. THE RATIO IS CALCULATED BY REMOVING FROM TOTAL EXPENSE THE OTHER OPERATING INCOME, UNCOMPENSATED CARE EXPENSE AND THE DIRECTLY ASSIGNED MEDICAID ASSESSMENT EXPENSE, THEN DIVIDING THIS NET EXPENSE BY TOTAL GROSS PATIENT REVENUES. THIS RATIO IS MULTIPLIED WITH THE CHARITY CARE CHARGES AND UNCOMPENSATED CARE CHARGES WRITTEN OFF FOR THE RELATED EXPENSE. PART III, LINE 3: THE BAD DEBT COST WAS REVIEWED BY THE HOSPITAL'S REVENUE CYCLE TEAM AND THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE QUALIFIED UNDER OUR CHARITY CARE PROGRAM IS 5% OF TOTAL BAD DEBTS. PART III, LINE 4: PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS PART III, LINE 8 THE SOCIAL SECURITY ACT AMENDMENT TO ESTABLISH MEDICARE STATES THAT MEDICARE WILL NOT PAY THE COST TO PROVIDE CARE TO NON-BENEFICIARIES AND NON-BENEFICIARIES WILL NOT PAY THE COST OF CARE FOR BENEFICIARIES. WHEN MEDICARE DOES NOT PAY RATES THAT COVER ALL THE COST OF CARE FORBENEFICARIES, IT BECOMES A COMMUNITY BURDEN. THEREFORE, THE FULL AMOUNT OF SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT.THIS ORGANIZATION BELIEVES THE AUDITED FINANCIAL STATEMENT CALCULATION IS A MORE ACCURATE DETERMINATION OF COST THAN THE MEDICARE ALLOWABLE COSTS USED FOR COST REPORTS THAT ARE REQUIRED TO BE UTILIZED ON THIS SCHEDULE IN PART III, SECTION B. THE AUDITED FINANCIAL STATEMENTSINCLUDE ALL MEDICARE REVENUES AND COSTS AND ALSO USE A COST-TO-CHARGE RATIO METHOD. PART III, LINE 9B MIDMICHIGAN HEALTH DOES NOT TRY TO COLLECT FROM THOSE WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. MIDMICHIGAN HEALTH'S POLICY STATES THAT THE PURPOSE OF THE POLICY "IS TO PROVIDE COST EFFECTIVE PAYMENT OPTIONS TO PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE (PER FINANCIAL AID/CHARITY CARE POLICY) AND EITHER HAVE NO INSURANCE OR HAVE A BALANCE AFTER INSURANCE WHICH IS THEIR RESPONSIBILITY TO PAY." PART VI, LINE 2: IN FY 2018, THE BOARD OF DIRECTORS FOR MIDMICHIGAN MEDICAL CENTER-ALPENA APPROVED THE COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 26, 2018. THE IMPLEMENTATION PLAN RESULTING FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS LATER APPROVED BY MIDMICHIGAN MEDICAL CENTER-ALPENA'S BOARD OF DIRECTORS ON OCTOBER 30, 2018. THE COMPLETED CHNA AND IMPLEMENTATION PLAN CAN BE ACCESSED BY THE PUBLIC ON THE MIDMICHIGAN HEALTH WEBSITE AT: HTTPS://WWW.MIDMICHIGAN.ORG/APP/FILES/PUBLIC/30845/ALPENA-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFIN ADDITION TO THE AFOREMENTIONED, THE COMMUNITY HEALTH SPECIALIST PARTICIPATED IN 31-COUNTRY REGIONAL CHNA (MITHRIVE) LED BY NORTHERN MICHIGAN PUBLIC HEALTH ALLIANCE. AS PART OF THE COMMUNITY HEALTH SPECIALIST WAS AN EXECUTIVE AND PLANNING COMMITTEE MEMBER AND AIDED IN EXECUTION OF COMMUNITY ENGAGEMENT ACTIVITIES. PART VI, LINE 3: THE PUBLIC IS MADE AWARE OF OUR FINANCIAL ASSISTANCE POLICY: THROUGH BROCHURES AVAILABLE AT ALL MIDMICHIGAN MEDICAL CENTER-ALPENA OFFICES, BY PATIENT ACCOUNTING COUNSELORS AND SOCIAL WORKERS, AND ON THE PATIENT AND FINANCIAL ASSISTANCE PROGRAM WEBPAGE ON OUR WEBSITE (HTTPS://WWW.MIDMICHIGAN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/PATIENT-NOTICE-OF-FINANCIAL-AID/). PART VI, LINE 4: MIDMICHIGAN MEDICAL CENTER-ALPENA IS LOCATED WITHIN ALPENA, MICHIGAN. AS RURAL COMMUNITY HOSPITAL, MIDMICHIGAN MEDICAL CENTER-ALPENA PROVIDES MEDICAL CARE TO ALCONA, ALPENA, MONTMORENCY, AND PRESQUE ISLE COUNTY; COMPRISED OF THE FOLLOWING 23 ZIP CODES: 49707 (ALPENA), 49744 (HERRON), 49747 (HUBBARD LAKE), 49753 (LACHINE), 49766 (OSSINEKE), 48705 (BARTON CITY), 48721 (BLACK RIVER), 48728 (CURRAN), 48737 (GLENNIE), 48738 (GREENBUSH), 48740 (HARRISVILLE), 48742 (LINCOLN), 48745 (MIKADO), 48762 (SPRUCE), 49709 (ATLANTA), 49746 (HILLMAN), 49756 (LEWISTON), 49743 (HAWKS), 49759 (MILLERSBURG), 49765 (ONAWAY), 49776 (POSEN), 49777 (PRESQUE ISLE), AND 49779 (ROGERS CITY).COMMUNITY DEMOGRAPHICS - ALPENA COUNTY:ACCORDING TO COUNTY HEALTH RANKINGS THERE ARE 28,929 RESIDENTS IN ALPENA COUNTY. OF THOSE, 19.5 PERCENT ARE UNDER 18 YEARS OF AGE AND 21.6 PERCENT ARE 65 AND OLDER. THE MEDIAN AGE IS 47.3 YEARS OLD. THE FOLLOWING IS THE RACIAL COMPOSITION OF ALPENA COUNTY: 96.9 PERCENT ARE WHITE ALONE, 0.5 PERCENT ARE AFRICAN AMERICAN/BLACK ALONE, 0.6 PERCENT ARE NATIVE AMERICAN AND ALASKA NATIVE ALONE, 0.6 PERCENT ARE ASIAN ALONE, 0.1 PERCENT NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER ALONE, AND 1.3 PERCENT ARE MULTIPLE RACES. ACCORDING THE TO THE UNITED STATES CENSUS BUREAU'S ETHNICITY ESTIMATES, 1.4 PERCENT OF THE ALPENA COUNTY RESIDENTS IDENTIFY AS HISPANIC OR LATINO. COMMUNITY DEMOGRAPHICS - ALCONA COUNTY:ACCORDING TO COUNTY HEALTH RANKINGS THERE ARE 10,461 RESIDENTS IN ALCONA COUNTY. OF THOSE, 13.3 PERCENT ARE UNDER 18 YEARS OF AGE AND 34.4 PERCENT ARE 65 AND OLDER. THE MEDIAN AGE IS 57.4 YEARS OLD. THE FOLLOWING IS THE RACIAL COMPOSITION OF ALCONA COUNTY: 97.1% PERCENT ARE WHITE ALONE, 0.5 PERCENT ARE AFRICAN AMERICAN/BLACK ALONE, 0.7 PERCENT ARE AMERICAN AND ALASKA NATIVE ALONE, 0.4 PERCENT ARE ASIAN ALONE, 0.1 PERCENT NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER ALONE, AND 1.2 PERCENT ARE MULTIPLE RACES. ACCORDING THE TO THE UNITED STATES CENSUS BUREAU'S ETHNICITY ESTIMATES, 1.6 PERCENT OF THE ALCONA COUNTY RESIDENTS IDENTIFY AS HISPANIC OR LATINO. COMMUNITY DEMOGRAPHICS - MONTMORENCY COUNTY:ACCORDING TO COUNTY HEALTH RANKINGS THERE ARE 9,317 RESIDENTS IN MONTMORENCY COUNTY. OF THOSE, 15.1 PERCENT ARE UNDER 18 YEARS OF AGE AND 29.4 PERCENT ARE 65 AND OLDER. THE MEDIAN AGE IS 55 YEARS OLD. THE FOLLOWING IS THE RACIAL COMPOSITION OF MONTMORENCY COUNTY: 96.8% PERCENT ARE WHITE ALONE, 0.5 PERCENT ARE AFRICAN AMERICAN/BLACK ALONE, 0.7 PERCENT ARE AMERICAN AND ALASKA NATIVE ALONE, 0.2 PERCENT ARE ASIAN ALONE, NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER ALONE*, AND 1.7 PERCENT ARE MULTIPLE RACES. ACCORDING THE TO THE UNITED STATES CENSUS BUREAU'S ETHNICITY ESTIMATES, 1.3 PERCENT OF THE MONTMORENCY COUNTY RESIDENTS IDENTIFY AS HISPANIC OR LATINO. *ACCORDING TO THE UNITED STATES CENSUS BUREAU'S, THE "VALUE IS GREATER THAN ZERO BUT LESS THAN HALF UNIT OF MEASURE SHOWN; MEANING THE INDIVIDUALS REPRESENTING THIS ETHIC GROUP COMPRISE LESS THAN 0.1 PERCENT OF THE TOTAL POPULATION.COMMUNITY DEMOGRAPHICS - PRESQUE ISLE COUNTY:ACCORDING TO COUNTY HEALTH RANKINGS THERE ARE 12,955 RESIDENTS IN PRESQUE ISLE COUNTY. OF THOSE, 16.5 PERCENT ARE UNDER 18 YEARS OF AGE AND 29.0 PERCENT ARE 65 AND OLDER. THE MEDIAN AGE IS 53.9 YEARS OLD. THE FOLLOWING IS THE RACIAL COMPOSITION OF PRESQUE ISLE COUNTY: 96.7% PERCENT ARE WHITE ALONE, 0.6 PERCENT ARE AFRICAN AMERICAN/BLACK ALONE, 1.0 PERCENT ARE AMERICAN AND ALASKA NATIVE ALONE, 0.6 PERCENT ARE ASIAN ALONE, NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER ALONE*, AND 1.1 PERCENT ARE MULTIPLE RACES. ACCORDING THE TO THE UNITED STATES CENSUS BUREAU'S ETHNICITY ESTIMATES, 1.5 PERCENT OF THE MONTMORENCY COUNTY RESIDENTS IDENTIFY AS HISPANIC OR LATINO. *ACCORDING TO THE UNITED STATES CENSUS BUREAU'S, THE "VALUE IS GREATER THAN ZERO BUT LESS THAN HALF UNIT OF MEASURE SHOWN; MEANING THE INDIVIDUALS REPRESENTING THIS ETHIC GROUP COMPRISE LESS THAN 0.1 PERCENT OF THE TOTAL POPULATION. PART VI, LINE 5: MIDMICHIGAN MEDICAL CENTER-ALPENA REACHED 562,687 PEOPLE AND SPENT $426,945 ON COMMUNITY BENEFIT PROGRAMS IN FISCAL YEAR 2019. OVER $2,965 WAS SPENT TO PROVIDE GENERAL COMMUNITY HEALTH EDUCATION AT COMMUNITY EVENTS AND HEALTH FAIRS THROUGHOUT NORTHEAST MICHIGAN FOR 1,536 PEOPLE ON TOPICS LIKE CPR/FIRST AID, DEPRESSION, DIABETES PREVENTION, VACCINATIONS, BREASTFEEDING PROMOTION, AND TRAUMA PREVENTION.IN ADDITION TO COMMUNITY EDUCATION EVENTS, MIDMICHIGAN MEDICAL CENTER-ALPENA PROVIDED: EDUCATION TO 553,228 COMMUNITY MEMBERS THROUGH ITS SOCIAL MEDIA PLATFORMS AND E-NEWSLETTERS ON OBESITY, MENTAL HEALTH, MATERNAL INFANT HEALTH, CANCER, HEART AND VASCULAR HEALTH, AND DIABETES. THE AMERICAN LUNG ASSOCIATION FREEDOM FROM SMOKING, A TOBACCO CESSATION PROGRAM, TO THREE COHORTS AND SUCCESSFULLY HELPED 22 PEOPLE QUIT SMOKING. A NEW SUPPORT GROUP FOR PERSONS WITH TRAUMATIC BRAIN INJURY AND THEIR FAMILY MEMBERS WAS LAUNCHED IN JANUARY 2019 IN PARTNERSHIP WITH THE MICHIGAN BRAIN INJURY NETWORK, WHICH PROVIDED SUPPORT TO 48 COMMUNITY MEMBERS. ONLINE HEALTH RISK ASSESSMENTS FOR COLORECTAL CANCER, JOINT HEALTH, BREAST CANCER, HEART HEALTH, AND LUNG HEALTH TO MORE THAN 658 COMMUNITY MEMBERS $81,000 TO SUPPORT LOCAL COMMUNITY ORGANIZATIONS EFFORTS TO PROMOTE HEALTH WITHIN OUR COMMUNITIES. MORE THAN 215 FUTURE MEDICAL PROFESSIONALS (MEDICAL, NURSING, AND OTHER STUDENTS) WITH INTERNSHIP/EDUCATIONAL OPPORTUNITIES. IN-KIND FINANCIAL DONATIONS TO COMMUNITY ORGANIZATIONS (EXP. ALCOHOLIC ANONYMOUS, NARCOTICS ANONYMOUS) THROUGH USE OF MEETING ROOMS AND SPACES. $1,877 WAS SPENT DEVELOPING THE IMPLEMENTATION PLAN RESULTING FROM MIDMICHIGAN MEDICAL CENTER ALPENA 2018 COMMUNITY HEALTH NEEDS ASSESSMENT AND PARTICIPATION IN THE MITHRIVE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY THE NORTHERN MICHIGAN PUBLIC HEALTH ALLIANCE. FUNDING TO SUPPORT A FULL-TIME COMMUNITY BENEFITS STAFF PERSON. PART VI, LINE 6: A TOTAL OF $426,945 IN COMMUNITY BENEFITS WAS PROVIDED BY MIDMICHIGAN MEDICAL CENTER - ALPENA IN FISCAL YEAR 2019 THROUGH COMMUNITY EDUCATION PROGRAMS, SCREENINGS, SPECIAL EVENTS AND HEALTH EXPERTISE, INCLUDING INSURANCE UNDER-REIMBURSEMENTS AND SERVICES TO THOSE WHO COULD NOT PAY. DURING FISCAL YEAR 2019, OVER $90 MILLION IN COMMUNITY BENEFITS WAS PROVIDED BY MIDMICHIGAN HEALTH TO THE COMMUNITIES IT SERVES. MIDMICHIGAN HEALTH COMMUNITY HEALTH STAFF CONTINUED TO MAKE A CONCENTRATED EFFORT THIS FISCAL YEAR TO CONNECT PEOPLE TO PHYSICIANS AND NEEDED HEALTH SERVICES. CONTACT INFORMATION FOR SERVICES WERE TAKEN TO EACH SCREENING AND COMMUNITY OUTREACH EVENT AND PROVIDED AT THE TIME OF PHYSICIAN APPOINTMENTS; WHEN SCHEDULING APPOINTMENTS OR INQUIRING ABOUT AN APPOINTMENT AT A COMMUNITY EVENT. THE MIDMICHIGAN HEALTH PHYSICIAN DIRECTORY HAS INFO ABOUT MIDMICHIGAN ACCESS LINE, AND PHYSICIAN LIAISONS TO PROVIDE INFORMATION TO OFFICES RE: MIDMICHIGAN ACCESS LINE TO HELP THEM DETERMINE IF A PROGRAM OR SERVICE IS AVAILABLE LOCALLY, OR TO TRANSFER THEM TO A PHYSICIAN OFFICE OR DEPARTMENT FOR REFERRALS. PART VI, LINE 7 MICHIGAN X X X X 0 1 0 0 0 0 0 1 0 CHUCK SHERWIN PRESIDENT 210334 0 28801 0 10645 0 103620 0 18113 0 371513 0 0 0 GREGORY ROGERS DIRECTOR 0 515014 0 124421 0 29370 0 240380 0 25043 0 934228 0 0 DIANE POSTLER-SLATTERY DIRECTOR, PART-YEAR 0 780909 0 219617 0 4845 0 175750 0 20447 0 1201568 0 0 FRANCINE PADGETT SENIOR VP & CFO 0 446928 0 89748 0 24094 0 173907 0 14429 0 749106 0 0 DONNA RAPP SENIOR VP & SECRETARY 0 347628 0 69489 0 149310 0 484198 0 10474 0 1061099 0 139268 JEFFREY DOBROSKI MD PHYSICIAN 595270 0 233352 0 1118 0 43703 0 1646 0 875089 0 0 0 WILLIAM HITZELBERGER DO PHYSICIAN 567237 0 86116 0 1118 0 45903 0 25811 0 726185 0 0 0 ABRAHAM SALACATA MD PHYSICIAN 469892 0 92408 0 29225 0 15 0 18947 0 610487 0 0 0 SANJEEV ARORA MD PHYSICIAN 511498 0 66241 0 7323 0 15 0 20708 0 605785 0 0 0 KARMON BJELLA PRESIDENT 169604 0 65370 0 195479 0 45 0 9577 0 440075 0 32685 0 PART I, LINE 4B: ROGERS, BJELLA, RAPP, PADGETT AND SHERWIN ARE PARTICIPANTS IN A 457(F) PLAN. BJELLA AND RAPP RECEIVED PAYMENTS IN 2018. THE SERP IS UNFUNDED AND BEGAN ON JANUARY 1, 2009. THE CURRENT PARTICIPANTS OF THE PLAN ARE THOSE WHO HOLD A CORPORATE OFFICE OF VICE PRESIDENT OR ABOVE. EACH PARTICIPANT'S ANNUAL AWARD IS A BENEFIT RESTORATION AMOUNT THAT PROVIDES THE ADDITIONAL BENEFITS THAT THE PARTICIPANT DID NOT EARN UNDER THE PENSION PLAN AND 403 (B) PLAN DURING A PLAN YEAR BECAUSE OF THE STATUTORY LIMITS. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MIDMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: ATTAINMENT OF NORMAL RETIREMENT AGE; DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; OR, ON THE THREE-YEAR ANNIVERSARY OF THEIR PARTICIPATION DATE. PART I, LINE 7: MIDMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE INDEPENDENT COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES (60% OF MEDIAN). THE COMPENSATION COMMITTEE, WHO IS AUTHORIZED TO ACT ON BEHALF OF THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS, APPROVED COMPENSATION FOR THE MIDMICHIGAN HEALTH CEO, SENIOR EXECUTIVES AND PHYSICIANS. SULLIVAN COTTER ISSUED ITS COMPREHENSIVE ASSESSMENT IN MAY 2019. AN INDEPENDENT ASSESSMENT IS COMPLETED EVERY 3-5 YEARS. THE COMPENSATION COMMITTEE REVIEWED THE RESULTS IN MAY 2019 PRIOR TO AWARDING ANY ANNUAL COMPENSATION ADJUSTMENTS. IN ADDITION, AS A PART OF THE PHYSICIAN ENTERPRISE ENGAGEMENT, KAUFMAN HALL ISSUED A SAFE HARBOR LETTER THAT WAS REVIEWED AT THE MAY 2018 COMPENSATION COMMITTEE MEETING. PART III: MIDMICHIGAN HEALTH'S COMPENSATION COMMITTEE CHARTER IS APPROVED ANNUALLY BY THE COMMITTEE AND BOARD AS ARE THE EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. MIDMICHIGAN HEALTH ALSO CONTINUES TO UTILIZE AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES, HOSPITAL LEVEL EXECUTIVES AND SELECTED OTHER EXECUTIVES. MIDMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MIDMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED NATIONALLY FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS MIDMICHIGAN HEALTH FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF ANY AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; AND G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE STAFF AT EACH SUBSIDIARY UPLOADS INFORMATION INTO THE SOFTWARE WHICH IS THEN REVIEWED BY THE CORPORATE CONTROLLER AT MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THIS CORPORATION. THE CORPORATE CONTROLLER REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. A FINAL REVIEW IS THEN DONE BY THE SVP AND TREASURER. IN ADDITION, ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MIDMICHIGAN HEALTH CEO PRIOR TO FILING. THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION IS REVIEWED BY THE COMPENSATION COMMITTEE PRIOR TO FILING. FORM 990, INCLUDING ALL SCHEDULES, IS MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS IN A SECURE ELECTRONIC FORMAT WITH A SUMMARY OF ALL THE MAJOR CHANGES FROM THE PRIOR YEAR RETURN. QUESTIONS OR CONCERNS ARE ADDRESSED BY THE SVP AND TREASURER. THE QUESTIONS OR CONCERNS OF THESE REVIEWS ARE PRESENTED TO THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS AND THIS ORGANIZATION'S BOARD OF DIRECTORS, IF ANY ARE INDENTIFIED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; AND 3) TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED SURVEYS ARE REVIEWED BY THE MIDMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES ARE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND AT A MINIMUM ARE REQUIRED TO ABSTAIN FROM VOTING ON ANY ISSUE IN WHICH THEY ARE NOT INDEPENDENT. FORM 990, PART VI, SECTION B, LINE 15 THE CEO, PRESIDENTS, AND OPERATING OFFICERS COMPENSATION IS ANNUALLY APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF MIDMICHIGAN HEALTH. THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). ALL OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, LINE 4: NO DIRECTORS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD IN 2018. THEY ARE CONSIDERED TO WORK AN AVERAGE OF 2 HOURS A WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK RELATED TO THEIR FULL-TIME POSITION. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MIDMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES ARE NOT TRACKED BY SUBSIDIARY. THEREFORE THE FULL-TIME SERVICE TO ALL SUBSIDIARIES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS. FORM 990, PART IX, LINE 11G CONSULTATION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 235,845. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 235,845. MEDICAID ASSESSMENT FEES: PROGRAM SERVICE EXPENSES 3,100,445. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,100,445. OTHER FEES: PROGRAM SERVICE EXPENSES 473,025. MANAGEMENT AND GENERAL EXPENSES 1,232,629. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,705,654. CORPORATE OVERHEAD: PROGRAM SERVICE EXPENSES 171,091. MANAGEMENT AND GENERAL EXPENSES 5,501,099. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,672,190. BILLING/COLLECTIONS FEES: PROGRAM SERVICE EXPENSES 240,551. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 240,551. RECRUITING FEES: PROGRAM SERVICE EXPENSES 262,183. MANAGEMENT AND GENERAL EXPENSES -10,443. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 251,740. CONTRACT LABOR, MAINTENANCE & SERVICES: PROGRAM SERVICE EXPENSES 5,021,895. MANAGEMENT AND GENERAL EXPENSES 1,497,865. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,519,760. PHYSICIAN SERVICE FEES: PROGRAM SERVICE EXPENSES 8,041,444. MANAGEMENT AND GENERAL EXPENSES 4,397. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,045,841. FORM 990, PART XI, LINE 9: POST RETIREMENT BENEFITS ADJUSTMENT -14,665,595. TRANSFER OF CAPITAL TO TAX EXEMPT ORGANIZATION -2,971,853. MIDMICHIGAN HEALTH 4000 WELLNESS DR MIDLAND MI 48670 382459948 SUPPORT MI 501(C)(3) LINE 12A, I 0 MIDMICHIGAN MEDICAL CENTER - MIDLAND 4000 WELLNESS DR MIDLAND MI 48670 380833014 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 MIDMICHIGAN MEDICAL CENTER - GRATIOT 300 E WARWICK DR ALMA MI 48801 381437919 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 MIDMICHIGAN MEDICAL CENTER - CLARE 703 N MCEWAN ST CLARE MI 48617 381518643 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 MIDMICHIGAN MEDICAL CENTER - GLADWIN 515 QUARTER ST GLADWIN MI 48624 386020434 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 MIDMICHIGAN VNA DBA MIDMICHIGAN HOME CARE 3007 N SAGINAW RD MIDLAND MI 48640 381459397 HOME CARE MI 501(C)(3) LINE 10 MIDMICHIGAN HEALTH 1 MIDMICHIGAN PHYSICIANS GROUP 2620 W SUGNET RD MIDLAND MI 48640 383317788 MEDICAL OFFICE MI 501(C)(3) LINE 12A, I MIDMICHIGAN HEALTH 1 MIDMICHIGAN HEALTH DEVELOPMENT ASSOCIATES 4000 WELLNESS DR MIDLAND MI 48670 382459947 OPERATIONS MI 501(C)(2) MIDMICHIGAN HEALTH 1 MIDMICHIGAN HEALTH FOUNDATION 4000 WELLNESS DR MIDLAND MI 48670 812813405 FOUNDATION MI 501(C)(3) LINE 12A, I MIDMICHIGAN HEALTH 1 MIDMICHIGAN MEDICAL CENTER - WEST BRANCH 2463 S M-30 WEST BRANCH MI 48661 464088182 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 TOLFREE FOUNDATION 335 E HOUGHTON AVE WEST BRANCH MI 48661 383067917 FUNDRAISING MI 501(C)(3) LINE 12A, I MIDMICHIGAN HEALTH 1 HOSPICE OF HELPING HANDS INC 322 W HOUGHTON AVE WEST BRANCH MI 48661 382424475 HOSPICE CARE MI 501(C)(3) LINE 10 MIDMICHIGAN HEALTH 1 MIDMICHIGAN HEALTH PAIN MANAGEMENT 2463 SOUTH M-30 WEST BRANCH MI 48661 834186622 HEALTHCARE PAIN MANAGEMENT MI N/A 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 MIDMICHIGAN PHYSICIANS GROUP B 2600000 COST MIDMICHIGAN HEALTH DEVELOPMENT ASSOCIATES B 535424 COST MIDMICHIGAN HEALTH P 5153519 COST MIDMICHIGAN MEDICAL CENTER - MIDLAND P 476576 COST MIDMICHIGAN MEDICAL CENTER - GRATIOT P 189569 COST MIDMICHIGAN HEALTH R 276268 COST MIDMICHIGAN PHYSICIANS GROUP P 240551 COST MIDMICHIGAN HEALTH Q 2210563 COST MIDMICHIGAN HEALTH FOUNDATION C 195001 COST MIDMICHIGAN PHYSICIANS GROUP A 132204 COST