2019-11-15T12:51:21-06:00 2018-12-31 381357951 PLANTE & MORAN PLLC 600 E FRONT ST STE 300 TRAVERSE CITY MI 49686 990 2018-01-01 382602147 CHIPPEWA CNTY WAR MEMORIAL HOSPITAL INC CHIP 9066354460 500 OSBORN BOULEVARD SAULT STE MARIE MI 49783 KEVIN KALCHIK CFO 9066354460 2019-11-14 1 DAVID LOWENTHAL CPA P00378651 2319477800 2019-11-14 67.59.56.30 2019-11-14 10:12:05 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EBB51160BF2136090E0706D858221EDFD566B897 2018 2020-03-31 21:24:44Z WAR MEMORIAL HOSPITAL DAVID JAHN CEO 500 OSBORN BOULEVARD SAULT STE MARIE MI 49783 108380685 0 X WWW.WARMEMORIALHOSPITAL.ORG X 1985 MI TO PROVIDE HEALTH CARE SERVICES AND ACCESS TO THE RESIDENTS OF SAULT STE. MARIE AND THE EASTERN UPPER PENINSULA. OUR COMMITMENT IS TO IMPROVE THE QUALITY OF LIFE AND HEALTH THROUGH PARTNERSHIPS WITH THOSE WE SERVE. 10 9 1096 261 0 77797 232831 243565 107357070 106334577 263496 766932 590628 506265 108444025 107851339 0 0 0 0 62886441 61014754 0 0 50129 48228972 51652009 111115413 112666763 -2671388 -4815424 77054820 66477662 49558526 43782196 27496294 22695466 X OUR COMMITMENT IS TO IMPROVE THE QUALITY OF LIFE AND HEALTH THROUGH PARTNERSHIPS WITH THOSE WE SERVE. 0 0 62216342 87769965 HOSPITAL INPATIENT AND OUTPATIENT SERVICES - WAR MEMORIAL HOSPITAL PROVIDED INPATIENT CARE TO 2,452 PATIENTS AND THERE WERE OVER 192,657 PATIENT REGISTRATIONS FOR THE HOSPITAL'S MULTIPLE OUTPATIENT SERVICE DEPARTMENTS (LAB, RADIOLOGY, CARDIOPULMONARY, REHABILITATION, NUCLEAR MEDICINE, SURGICAL SERVICES).OUR OBSTETRICS/NURSERY UNIT REPORTED 352 BIRTHS AND OUR SURGICAL SERVICES DEPARTMENT PROVIDED SURGICAL CARE FOR 5,749 PATIENTS.THE REHABILITATION DEPARTMENT CONTINUED ITS EXPANSION OF SERVICES IN CONTRACTING TO PROVIDE REHABILITATION SERVICES WITH MULTIPLE ORGANIZATIONS IN THE REGION; INCLUDING, BUT NOT LIMITED TO, AREA SCHOOLS, HOSPITALS, AND HOME HEALTH AGENCIES. NEARLY 364,439 REHABILITATION TREATMENTS WERE REPORTED IN THE DISCIPLINES OF PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY AND AUDIOLOGY SERVICES. 17577710 12475615 PROFESSIONAL SERVICES - THE HOSPITAL'S TWENTY FOUR HOUR EMERGENCY DEPARTMENT AND THE COMMUNITY CARE CLINIC (WALK-IN URGENT CARE CENTER) RECORDED 15,781 VISITS AND 11,667 VISITS RESPECTIVELY FOR A TOTAL CARE PROVIDED TO 27,448 PATIENTS.VISITS BY PHYSICIAN CLINIC:WMH DERMATOLOGY - 760WMH PRIMARY CARE - DRUMMOND ISLAND - 1,489WMH ENDOCRINOLOGY - 133WMH PRIMARY CARE - CEDARVILLE - 2,588WMH FAST CARE - 2,709WMH PODIATRY - 772WMH GENERAL SURGERY - 4,257WMH INFECTIOUS DISEASE - 192WMH PRIMARY CARE - SAULT - 3,871WMH COMMUNITY CARE - KINROSS - 2,951WMH NEPHROLOGY - 1,486WMH ORTHOPEDICS - 8,687WMH OUTPATIENT PSYCHIATRY - 1,840WMH PAIN MANAGEMENT - KINROSS - 2,008WMH PAIN MANAGEMENT - SAULT STE. MARIE - 1,642WMH PEDIATRICS - 1,605WMH PULMONOLOGY - 1,378WMH SLEEP DISORDERS CENTER - 1,931WMH COMMUNITY CARE - SAULT STE. MARIE - 11,667WMH UROLOGY - 4,032WMH WOMENS HEALTH - 7,664 4395990 3683904 INPATIENT/ OUTPATIENT PSYCH WITH 626 ADMISSIONS AND 4,543 PATIENT DAYS. 3543107 2428790 OTHER PROGRAM SERVICES - WHICH INCLUDES, BUT IS NOT LIMITED TO, OBSTETRICS WITH 352 ADMISSIONS AND 645 PATIENT DAYS. 3543107 2428790 87733149 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 114 0 1 1096 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X KEVIN KALCHIK CFO 9066354456 500 OSBORN BOULEVARD SAULT STE MARIE MI 49783 JOHN JORGENSON SR SECRETARY 1.50 X X 6075 0 0 FRANK SASSO CHAIR 1.50 X X 7350 0 0 SCOTT SHACKLETON TREASURER 1.50 X X 6345 0 0 HOLLY KIBBLE TRUSTEE 1.50 X 6615 0 0 MAXINE ANDERSON TRUSTEE 1.50 X 6425 0 0 TED POSTULA TRUSTEE 1.50 X 6580 0 0 GARY MCDOWELL TRUSTEE 1.50 X 6390 0 0 ANTHONY ANDARY TRUSTEE 1.50 X 6390 0 0 PAULA RECHNER TRUSTEE/PHYSICIAN 40.00 X 669994 0 31366 RALPH DUMAN TRUSTEE 1.50 X 5580 0 0 DAVID JAHN CEO 40.00 X 268036 0 37721 KEVIN KALCHIK CFO 40.00 X 188263 0 31452 MARLA BUNKER VP OF CLINICAL OPERATIONS 40.00 X 170254 0 27676 JOEL SLADE PHYSICIAN 40.00 X 511353 0 31366 ZARA MASOOD PHYSICIAN 40.00 X 476609 0 31366 LYNNE MCCORMICK PHYSICIAN 40.00 X 526825 0 26557 ALI DAHA PHYSICIAN 40.00 X 474542 0 31366 KYLE RAYCRAFT PHYSICIAN 40.00 X 468611 0 27721 3812237 0 276591 60 0 1 0 WOOLEVER SHANE DO PC 5012 WEST 5 MILE ROAD SAULT STE MARIE MI 49783 PROFESSIONAL FEES 1296629 ADAIR JAMIE D 3360 LAKESHORE DR SAULT STE MARIE MI 49783 PROFESSIONAL FEES 877063 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 PROFESSIONAL FEES 855410 PHILIPS MEDICAL SYSTEMS NA COMPANY PO BOX 100355 ATLANTA GA 30384 CONTRACT SERVICES 742790 MARQUETTE GENERAL HOSPITAL DEPT 4608 CAROL STREAM IL 60122 PROFESSIONAL SERVICES 737894 30 5600 27764 210201 243565 PATIENT SERVICE REVENUE 622110 106040555 106040555 OTHER RELATED REVENUE 622110 294022 294022 106334577 798388 798388 258847 235150 23697 23697 23697 248884 280340 -31456 -31456 -31456 54845 5600 13856 40989 40989 CAFETERIA REVENUE 722210 441579 441579 441579 107851339 106358274 0 1249500 X 723400 197929 525471 47095803 36532151 10563652 1893631 7655 1885976 8079121 7469384 609737 3222799 2658505 564294 354470 31976 322494 87300 87300 9146 9146 11956965 8386276 3570358 331 223018 285 222733 4297233 3494695 799690 2848 343227 128178 214949 100 1443307 1082026 349479 11802 128693 91279 37414 547684 93748 453936 1479998 992322 482460 5216 4888964 3277996 1593738 17230 595664 139171 456493 MEDICAL SUPPLIES 13262493 13262493 PROVISION FOR BAD DEBTS 4966241 4966241 QUALITY ASSESSMENT FEES 3252558 3252558 REPAIRS AND MAINTENANCE 2986979 1355371 1631608 828069 312910 502557 12602 112666763 87733149 24883485 50129 5600 5820 6254587 3598317 12650408 9645284 2604725 2404814 972004 1091236 93090372 55618323 41574943 37472049 10561745 10266452 256681 256681 2174127 1737009 77054820 66477662 9859824 8170540 35622420 33750634 4076282 1861022 49558526 43782196 X 27496294 22695466 27496294 22695466 77054820 66477662 -4815424 14596 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9146 9146 0 PART II-B, LINE 1: PORTION OF ANNUAL DUES TO THE MICHIGAN HEALTH & HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION THAT ARE USED TOWARD LOBBYING ACTIVITIES. 2831855 2831855 58941386 34111608 24829778 774988 512192 262796 30542143 20994523 9547620 37472049 ACCRUED POST-RETIREMENT BENEFIT 292300 ACCRUED INSURANCE 1050000 ACCRUED MALPRACTICE LIABILITY 518722 1861022 103173342 14595 284441 299036 102874306 4977033 4977033 107851339 107974170 284441 284441 107689729 4977033 4977033 112666762 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL/FUNDRAISING EXPENSES 284,441. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 4,966,241. EXPENSES NET AGAINST REVENUE 10,792. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING/RENTAL EXPENSES 284,441. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 4,966,241. EXPENSES NET AGAINST REVENUE 10,792. GOLF OUTING 60445 5600 54845 6667 6448 741 60445 5600 54845 6667 6448 741 13856 40989 1 1 X 1 X 1 X 1 1 1 0 1 1 204773 204773 0.00190 18576362 19445149 0 0.00000 18781135 19445149 204773 0.00190 2661 25276 218474 218474 0.00200 361 1087 666798 666798 0.00620 14215752 6451411 7764341 0.07210 114 5270 65440 65440 0.00060 3136 31633 15166464 6451411 8715053 0.08090 3136 31633 33947599 25896560 8919826 0.08280 0 4966241 2483121 23503457 17734749 5768708 X 1 1 1 1 CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL 500 OSBORN BOULEVARD SAULT STE MARIE MI 49783 HTTP://WWW.WARMEMORIALHOSPITAL.ORG/ABO 1060000093 X X X CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 0 1 1 X HTTPS://TINYURL.COM/Y27E2PYZ X 1 16 1 HTTPS://TINYURL.COM/Y27E2PYZ 0 1 X 200.000000000000 250.000000000000 X X X X 1 1 X X X X 1 X HTTPS://TINYURL.COM/YXQD3PEK X HTTPS://TINYURL.COM/YXQD3PEK X HTTPS://TINYURL.COM/YXQD3PEK X X X X X X 1 0 X X X X X 1 X 0 0 CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITALS WEBSITE LOCATED AT HTTP://WWW.WARMEMORIALHOSPITAL.ORG/ABOUT-WMH-7/CHIPPEWA WAR MEMORIAL HOSPITAL IN CONJUNCTION WITH CHIPPEWA COUNTY HEALTH DEPARTMENT AND WESTERN UPPER PENINSULA HEALTH DEPARTMENT (WUPHD) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT. THE ASSESSMENT PRIMARILY COVERS THE HEALTH OF RESIDENTS OF CHIPPEWA COUNTY BUT ALSO INCLUDES SOME DATA FROM NEIGHBORING COUNTIES IN THE LUCE-MACKINAW-ALGER-SCHOOLCRAFT PUBLIC HEALTH DISTRICT, AND FROM THE ENTIRE UPPER PENINSULA, AND MICHIGAN AS A WHOLE, FOR COMPARISON OR WHERE SINGLE COUNTY DATA ARE NOT AVAILABLE. THE PURPOSE OF THIS ASSESSMENT IS TO PROVIDE A PICTURE OF THE HEALTH STATUS AND NEEDS OF CHIPPEWA COUNTY'S 38,000 RESIDENTS (ACTUALLY LESS THAN 34,000 NON-INCARCERATED). DATA FOR THE ASSESSMENT REPORT WERE GATHERED FROM A WIDE ARRAY OF PUBLISHED SOURCES INCLUDED THE U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY, MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, FEDERAL RESERVE BANK OF ST. LOUIS, MICHIGAN DEPARTMENT OF EDUCATION'S MICHIGAN PROFILE FOR HEALTHY YOUTH (MIPHY) SURVEY, THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA), AND OTHER GOVERNMENT AND PRIVATE AGENCIES. ADDITIONALLY, TWO COMMUNITY FOCUS GROUPS WERE HELD WITH A DIVERSE GROUP OF HOSPITAL EMPLOYEES AND COMMUNITY MEMBERS PARTICIPATING. CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: CHIPPEWA COUNTY HEALTH DEPARTMENT AND WESTERN UPPER PENINSULA HEALTH DEPARTMENT (WUPHD) CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: WHILE THE CHNA IDENTIFIED OTHER HEALTH NEEDS, THEY WERE SEEN TO BE BEYOND THE SCOPE OF OUR SERVICES OR WE COULD NOT MAKE A SIGNIFICANT IMPACT UPON THEM DUE TO LIMITED PERSONNEL AND/OR FINANCIAL RESOURCES.THE FULL COPY OF THE IMPLEMENTATION PLAN CAN BE FOUND AT A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITALS WEBSITE LOCATED AT HTTP://WWW.WARMEMORIALHOSPITAL.ORG/ABOUT-WMH-7/ CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL PART V, SECTION B, LINE 16J: PART V, SECTION B, LINE 16I - THE HOSPITAL FACILITY HAS REVIEWED THE POPULATION OF ITS COMMUNITY AND CONCLUDED THAT ENGLISH IS THE ONLY PRIMARY LANGUAGE AS DEFINTED BY THE REGULATIONS OF MORE THAN 5% OR 1,000 PERSONS. THEREFORE, THE FAP, FAP APPLICATION FORM, OR PLAIN LANGUAGE SUMMARY HAVE NOT BEEN TRANSLATED INTO ANOTHER LANGUAGE. THE HOSPITAL FACILITY WILL CONTINUE TO MONITOR THIS GOING FORWARD AS NEW CENSUS DATA BECOMES AVAILABLE. CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL PART V, SECTION B, LINE 20E: THE HOSPITAL FACILITY MAILS A FINANCIAL ASSISTANCE POLICY APPLICATION WHEN SETTING UP A PAYMENT PLAN FOR A PATIENT AND WHEN SENDING PAST DUE LETTERS. 2 1 - LONG TERM CARE 500 OSBORN BOULEVARD SAULT STE MARIE MI 49783 SKILLED NURSING FACILITY 2 - BEHAVIORAL HEALTH CENTER 500 OSBORN BOULEVARD SAULT STE MARIE MI 49783 INPATIENT PSYCHIATRIC FACILITY PART I, LINE 3C: THE HOSPITAL, THROUGH ITS PARTNERSHIP WITH COMMUNITY HEALTH ACCESS COALITION (CHAC), UTILIZES 200% OF POVERTY GUIDELINES FOR INITIAL ACCESS AND APPLICATION FOR MEDICAID. FOR THOSE COMMUNITY MEMBERS THAT DO NOT QUALIFY, 250% OF POVERTY GUIDELINES ARE UTILIZED FOR ADDITIONAL OPTIONS FOR IMMEDIATE DISCOUNTS. ALL PATIENTS ARE ABLE TO REQUEST ADDITIONAL DISCOUNTS OR FREE CARE ON REMAINING BALANCES AND NON-COVERED SERVICES THROUGH THE HOSPITAL FINANCIAL ASSITANCE PROGRAM (FAP). PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE. THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS (LINE 7E) AND HEALTH PROFESSIONS EDUCATION (LINE 7F).A DIRECT COST AND STEP-DOWN APPROACH WAS USED TO COMPLETE THE SUBSIDIZED HEALTH SERVICES PROGRAMS (LINE 7G). PART I, LINE 7G: INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE: ORTHO SURGERY, GENERAL SURGERY, SURGICAL ASSISTANT, ER PROFESSIONAL SERVICES, BEHAVIORAL HEALTH, OB PROFESSIONAL, AND OB PROGRAM. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $4,966,241 SCHEDULE H, PART I, LINE 7B: THE HOSPITAL PARTICIPATES IN THE MICHIGAN DISPROPORTIONATE SHARE PROGRAM (DSH) AS WELL AS THE MICHIGAN QUALITY ASSURANCE ASSESSMENT PROGRAMS (QAAP). THE DSH PROGRAM IS SET UP TO SUPPLEMENT FOR SHORTFALLS INCURRED DUE TO SERVING INDIGENT POPULATIONS IN THE COMMUNITY (SELF-PAY, MEDICAID, MEDICAID ADVANTAGE). THE QAAP PROGRAM IS SET UP TO SUPPLEMENT FOR SHORTFALLS INCURRED DUE TO SERVING MEDICAID PATIENTS. THE HOSPITAL PAID IN AMOUNTS TO FUND THE PROGRAM AND IN RETURN RECEIVED THEIR RESPECTIVE SHARE OF THE STATE DSH AND QAAP FUNDS. THE RESULT WAS A GAIN TO THE HOSPITAL, AS DETAILED BELOW: DSH PROGRAM QAAP PROGRAMREVENUE $566,275 $7,396,308EXPENSE - $3,277,369 --------- -----------GAIN $566,275 $4,118,939 IF THESE PROGRAMS DID NOT EXIST, THE HOSPITAL WOULD HAVE REPORTED A SHORTFALL FROM PROVIDING SERVICES TO MEDICAID PATIENTS. PART II, COMMUNITY BUILDING ACTIVITIES: WAR MEMORIAL HOSPITAL IS ACTIVE IN BOTH THE PROMOTION OF HEALTHY LIFESTYLES FOR BOTH ITS EMPLOYEES AND COMMUNITY MEMBERS. WAR MEMORIAL HOSPITAL WILL TAKE A LEAD ROLE IN MANY OF THESE ENDEAVORS, BUT ALSO IS WILLING TO BE A SUPPORTIVE PARTNER AND TEAM MEMBER AS WELL. PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. WAR MEMORIAL HOSPITAL PROVIDES CARE TO PATIENTS COVERED BY GOVERNMENTAL PROGRAMS AT REIMBURSEMENT LESS THAN WHAT IS NEEDED IN ORDER TO PROVIDE STABILITY OF OPERATIONS. AS THE NUMBER OF UNINSURED OR UNDERINSURED CITIZENS CONTINUES TO INCREASE, THE HOSPITAL'S ABILITY TO COLLECT REIMBURSEMENTS FOR SERVICES PROVIDED CONTINUES TO BE A CHALLENGE. THEREFORE, HOSPITAL LEADERS HAVE SERVED IN LEADERSHIP CAPACITIES IN THE DEVELOPMENT OF A COMMUNITY HEALTH ACCESS COALITION WHICH HAS A MISSION TO PROVIDE ACCESS TO QUALITY HEALTH CARE FOR THE UNINSURED OR UNDER INSURED RESIDENTS OF CHIPPEWA, LUCE, AND MACKINAC COUNTIES BY COORDINATING SERVICES OF VARIOUS HEALTH CARE PROVIDERS TO OFFER AN AFFORDABLE, DIGNIFIED AND ENHANCE CONTINUUM OF CARE. THE HOSPITAL AS WELL AS LOCAL PHYSICIANS AGREE TO PROVIDE CARE THAT IS UNCOMPENSATED OR AT A REDUCED FEE. OVER THE PAST YEAR, THE HOSPITAL HAS EITHER BEEN ACTIVE OR SUPPORTED THE ACTIVITIES TO DEVELOP COMMUNITY AWARENESS FOR BOTH THE HEALTH EXCHANGES AND MEDICAID EXPANSION. PART III, LINE 8: THE MEDICARE SURPLUS (SHORTFALL) WAS CALCULATED BY UTILIZING COST ACCOUNTING WHEN APPROPRIATE AND AVAILABLE. IN SOME AREAS A COST TO CHARGE METHODOLOGY WAS REQUIRED. THE SURPLUS SHOULD BE CONSIDERED AND INCLUDED IN THE COMMUNITY BENEFIT AS THE REIMBURSEMENT DID NOT MEET THE "COST" OF THE EXPENSE BASED ON REASONABLE COSTING METHODOLOGIES. PART III, LINE 9B: WAR MEMORIAL HOSPITAL UTILIZES AN ON-LINE INSURANCE VERIFICATION PROCESS TO INITIATE THE EDUCATION AND ELIGIBILITY FROM THE ON-SET OF SERVICES. UPFRONT COLLECTIONS ARE AN ACTIVE PART OF THE PROCESS TO BOTH EDUCATE THE PATIENT AND TO REDUCE BACK-END COSTS OF COLLECTIONS. AT ANY TIME DURING THE PROCESS STAFF ARE TRAINED TO ADDRESS THE PERCEIVED FINANCIAL ASSISTANT NEEDS AND PROVIDE ACCESS TO THE IN-HOUSE PATIENT FINANCIAL COUNSELOR, COMMUNITY HEALTH ACCESS COALITION, OR THE DEPARTMENT OF HEALTH SERVICES REPRESENTATIVE. IN THE BILLING PROCESS, PATIENTS ARE STILL OFFERED ANY EDUCATION NECESSARY TO OBTAIN ASSISTANCE. ONCE SERVICES ARE RECEIVED AND THE PATIENT CHARGES HAVE ACCUMULATED PRIMARY SOURCES OF COVEAGE ARE BILLED. AFTER ALL EFFORTS OF COLLECTION FROM PRIMARY PAYOR (INSURANCE) THE PATIENT IS BALANCED BILL AND PROVIDED THE OPPORTUNITY FOR PAYMENT IN FULL OR OTHER PAYMENT OPTIONS. SCHEDULE H, PART III, LINES 5 AND 6: OTHER INFORMATION: AS PER THE INSTRUCTIONS, SCHEDULE H, PART III, LINES 5 AND 6 ARE DERIVED DIRECTLY FROM THE MEDICARE COST REPORT. THOSE MEDICARE COSTS NOT INCLUDED IN THE MEDICARE COST REPORT (MEDICARE ADVANTAGE AND FEE FOR SERVICE PHYSICIANS) ARE SUMMARIZED AS FOLLOWS:TOTAL COST: 12,532,202TOTAL REIMBURSEMENT 11,700,812COST IN EXCESS OF REIMBURSEMENT 831,389 PART VI, LINE 2: WAR MEMORIAL HOSPITAL WORKS IN CONJUNCTION WITH MANY OF THE HOSPITALS IN THE NORTHERN MICHIGAN AND THE UPPER PENINSULA. IN THESE EFFORTS "NEEDS" OF THE COMMUNITIES ARE ASSESSED THROUGH WORK WITH OTHER HOSPITALS, HEALTH RELATED ORGANIZATIONS, AND IN COMMUNITY FORUMS. IN ADDITION, WAR MEMORIAL HOSPITAL HAS ENGAGED OUTSIDE ASSISTANCE IN THE PLANNING FOR "NEEDS" OF BOTH SERVICES AND PHYSICIANS TO BEST PLAN FOR CAPITAL AND RECRUITMENT APPROPRIATIONS. PART VI, LINE 3: WAR MEMORIAL HOSPITAL PRIDES ITSELF ON PROVIDING NEEDED CARE TO THE INDIGENT OF THE EASTERN UPPER PENINSULA IN A DIGNIFIED MANNER. THIS EDUCATION AND ASSISTANCE IS DONE THROUGH PARTNERSHIPS WITH OTHER "ACCESS" POINTS. SPECIFICALLY, WAR MEMORIAL HOSPITAL HAS PROVIDED RESOURCES TO THE CHAC (COMMUNITY HEALTH ACCESS COALTION) AND WAR MEMORIAL HOSPITAL HAS ENTERED INTO AN AGREEMENT WITH THE STATE OF MICHIGAN TO PROVIDE A DHS (DEPARTMENT OF HEALTH SERVICES) WORKER ON-SITE FOR READY ACCESS FOR OUR PATIENTS. THROUGH THE COLLABORATION OF THESE RELATIONSHIPS OUR PATIENTS ARE FIRST NOTIFIED AND REFERRED TO THE APPROPRIATE RESOURCE FROM THE ON-SET OF RECEIVING HEALTH CARE SERVICES. PART VI, LINE 4: WAR MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA IS THE EASTERN UPPER PENINSULA OF MICHIGAN. IN THIS AREA THERE ARE THREE COUNTIES WHICH CONSIST OF CHIPPEWA, MACKINAC, AND LUCE. WAR MEMORIAL HOSPITAL PRIDES ITSELF ON THE QUALITY OF SERVICES IT PROVIDES AS A RURAL SOLE COMMUNITY HOSPITAL. THE CLOSEST HOSPITAL IS 50 MILES AWAY AND IS A CRITICAL CARE HOSPITAL. THE CLOSEST TERTIARY FACILITY IS OVER 90 MILES AWAY. WAR MEMORIAL HOSPITAL STRIVES FOR PROVIDING SERVICES TO THE COMMUNITY FOR WHICH OTHERWISE THE COMMUNITY MEMBER WOULD MOST LIKELY HAVE TO TRAVEL TO A TERTIARY FACILITY. THROUGH ITS OWN EFFORTS AND JOINT VENTURES AREAS OF CARE SUCH AS OBSTETRICS AND DELIVERY, DIALYSIS, ONCOLOGY, CARDIOLOGY, PULMONOLOGY, INFECTIOUS DISEASE, AND I/P PSYCHIATRIC SERVICES WOULD NOT BE AVAILABLE.WAR MEMORIAL HOSPITAL IS ONE OF THE TOP THREE LARGEST EMPLOYERS IN OUR REGION. WE EMPLOY MORE THAN 950 PEOPLE AND HAVE AN ANNUAL PAYROLL OF APPROXIMATELY $48 MILLION; PROVIDING A POSITIVE ECONOMIC IMPACT IN THE COMMUNITY. PART VI, LINE 5: WAR MEMORIAL HOSPITAL PROVIDES MANY POINTS OF ACCESS THAT ARE NOT PROFITABLE, BUT OTHERWISE WOULD REQUIRE OUR COMMUNITY MEMBERS TO TRAVEL GREAT DISTANCES. THE HOSPITAL MANAGEMENT AND STAFF PARTICIPATE ACTIVELY IN MANY HEALTH AND EDUCATIONAL ENDEAVORS. AN EXAMPLE IS PROVIDING CLINICAL STAFF TO THE LOCAL STATE UNIVERSITY TO ASSIST IN THE EDUCATION OF REGISTERED NURSES. OTHER EXAMPLES INCLUDE INFORMAL PARTNERSHIPS WITH TWO LOCALLY RECOGNIZED NATIVE AMERICAN TRIBES AND FULL SUPPORT OF COUNTY HEALTH INITIATIVES. PROGRAM EXAMPLES WOULD INCLUDE INDIGENT HEALTH ACCESS, FLU-CLINIC, DIALYSIS, DIABETIC EDUCATION, COUNTY HEALTH DEPARTMENT COLON SCREENING, PHYSICALS FOR STUDENT ATHLETES, AND REGIONAL CHARITY CARE INITIATIVES.WAR MEMORIAL HOSPITAL CONTINUES TO PARTNER WITH TERTIARY FACILITIES TO PROVIDE CONSISTENT ACCESS TO PROVIDERS OF CARDIOLOGY. DUE TO THE HOSPITAL'S GEOGRAPHIC LOCATION AND COMMUNITY SIZE, THE HOSPITAL HAS CONTINUED TO INDEPENDENTLY RECRUIT OTHER SPECIALISTS TO ENSURE THAT COMMUNITY ACCESS TO SERVICES AND PROVIDERS IS ACCOMPLISHED THROUGH PROVIDER BASED CLINICS. THE HOSPITAL CONTINUES ITS EFFORTS IN PROVIDING PRIMARY CARE IN OUTREACH AREAS OF THE EASTERN UPPER PENINSULA. WITH THESE EFFORTS AND PARTNERSHIPS THE HOSPITAL HAS BEEN SUCCESSFUL IN MAINTAINING ALL OTHER SERVICES.WAR MEMORIAL HOSPITAL CONTINUED ITS LEADERSHIP AND INVOLVEMENT WITHIN THE COMMUNITY AND THE HEALTHCARE PROVIDER COMMUNITY BY PROVIDING EDUCATION AND TRAINING. EXAMPLES OF COMMUNITY EDUCATION AND/OR HEALTH SCREENINGS INCLUDED A SENIOR HEALTH FAIR, EARLY PRE-NATAL EDUCATION AND CHILDBIRTH CLASSES. THE HOSPITAL'S INVOLVEMENT IN HEALTHCARE PROVIDER EDUCATION AND TRAINING INCLUDED NURSE AIDE TRAINING PROGRAMS AND SERVING AS CLINICAL INTERNSHIP SITE FOR MANY COLLEGE AND UNIVERSITY TRAINING PROGRAMS FOR STUDENTS IN REGISTERED NURSING, PHARMACY, MEDICAL TECHNOLOGY, HEALTH INFORMATION MANAGEMENT, AND PHYSICIAN ASSISTANT PROGRAMS. THE HOSPITAL IS ALSO DESIGNATED AS A COMMUNITY TRAINING CENTER OFFERING TRAINING TO AREA PHYSICIANS AND STAFF ON PEDIATRIC ADVANCED LIFE SUPPORT, ADVANCED CARDIAC LIFE SUPPORT AND BASIC LIFE SUPPORT. THE HOSPITAL IS ALSO CERTIFIED TO PROVIDE CONTINUING MEDICAL EDUCATION TO AREA PHYSICIANS AND STAFF AND CONDUCTS MORE THAN 25 ON-SITE PROGRAMS PER YEAR. VIDEO CONFERENCING CAPABILITIES ALSO PROVIDE ACCESS TO COMMUNITY AND HEALTHCARE PROVIDER TRAINING THROUGHOUT THE YEAR.WAR MEMORIAL HOSPITAL EMPLOYEES HAVE EMPLOYMENT BENEFITS WHICH INCLUDE PAYMENT FOR EXPENSES FOR THE COMPLETION OF A BACHELOR OF SCIENCE IN NURSING FOR CURRENT REGISTERED NURSES. ADDITIONALLY, OTHER EMPLOYEES HAVE ANNUAL EDUCATION BENEFITS FOR CONTINUING OR ADVANCING THEIR EDUCATION IN A HEALTHCARE FIELD. THE HOSPITAL ALSO OFFERS AN EDUCATIONAL LOAN PROGRAM WITH A PERIOD OF NO-INTEREST LOANS WHILE ENROLLED IN AN EDUCATIONAL PROGRAM. FOR NEWLY HIRED EMPLOYEES IN JOB SHORTAGE CLASSIFICATIONS, EMPLOYEES CAN RECEIVE FUNDS FOR STUDENT LOAN REPAYMENT FOR A COMMITMENT TO SERVE WAR MEMORIAL HOSPITAL FOR A SPECIFIED NUMBER OF YEARS. PART VI, LINE 6: NOT AFFILIATED. PART VI, LINE 7, REPORTS FILED WITH STATES MI X X X X X 0 0 0 0 0 0 0 0 0 PAULA RECHNER TRUSTEE/PHYSICIAN 627211 0 41933 0 850 0 13750 0 17616 0 701360 0 0 0 DAVID JAHN CEO 267486 0 0 0 550 0 23750 0 13971 0 305757 0 0 0 KEVIN KALCHIK CFO 179685 0 0 0 8578 0 13836 0 17616 0 219715 0 0 0 MARLA BUNKER VP OF CLINICAL OPERATIONS 165843 0 0 0 4411 0 13705 0 13971 0 197930 0 0 0 JOEL SLADE PHYSICIAN 503314 0 0 0 8039 0 13750 0 17616 0 542719 0 0 0 ZARA MASOOD PHYSICIAN 463328 0 0 0 13281 0 13750 0 17616 0 507975 0 0 0 LYNNE MCCORMICK PHYSICIAN 404942 0 88012 0 33871 0 13750 0 12807 0 553382 0 0 0 ALI DAHA PHYSICIAN 463704 0 0 0 10838 0 13750 0 17616 0 505908 0 0 0 KYLE RAYCRAFT PHYSICIAN 468611 0 0 0 0 0 13750 0 13971 0 496332 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE DEPARTMENT WORKS WITH THE APPROPRIATE DEPARTMENTS TO PROVIDE RELEVANT INFORMATION TO THE PREPARER OF THE 990 (AN OUTSIDE FIRM SPECIALIZING IN TAX PREPARATION). REVIEW AND DISCUSSION OF ALL INFORMATION TAKES PLACE BETWEEN THE FINANCE DEPARTMENT AND THE CFO. THE FORM 990 IS THEN PROVIDED TO THE FULL BOARD, BEFORE FILING, WHERE THEY ARE GIVEN AN OPPORTUNITY TO ASK QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST STATEMENT IS COMPLETED ANNUALLY FOR ALL BOARD MEMBERS AND SENIOR LEVEL ADMINISTRATION. ANY CONFLICTS WOULD BE REVIEWED AND KEPT UNDER CONSIDERATION ON AN ONGOING BASIS. BOARD MEMBERS AND ADMINISTRATION INFORM OR REMIND THE ATTENDEES IN THESE SITUATIONS AND ABSTAIN FROM BOTH DISCUSSION AND VOTE ON THE ITEM UNDER DISCUSSION. FORM 990, PART VI, SECTION B, LINE 15 MANAGEMENT: THE HOSPITAL IS COMMITTED TO COMPENSATING ALL EMPLOYEES AN EQUITABLE AND FAIR WAGE. THE HOSPITAL HAS CONSULTED AND CONTINUES TO WORK WITH AN INDEPENDENT SPECIALIST TO REVIEW ALL JOB DESCRIPTIONS TO ASSIST IN THE CLASSIFICATION OF WAGES BASED ON LOCAL, REGIONAL, AND NATIONAL STANDARDS. THE CLASSIFICATION AND COMPARISON OF LOCALITY IS BASED ON THE ABILITY TO RECRUIT AND TRAIN THE SPECIFIC JOB CLASSIFICATION. THIS SAME PROCESS IS FIRST UTILIZED FOR MANAGEMENT AND SENIOR LEADERS. IN ADDITION, SENIOR LEADERS ARE COMPARED TO THE MHA SURVEY THAT IS PUBLICIZED. ANY INCREASES IN SENIOR LEADERS IS PROPOSED BY THE PRESIDENT/CEO AND APPROVED BY THE BOARD OF TRUSTEES. THE CEO AND HUMAN RESOURCES DIRECTOR PROVIDES THE BOARD WITH CEO WAGE INFORMATION AND THE BOARD (CEO IS REQUESTED TO LEAVE THE MEETING AND IS NOT INVOLVED IN THE VOTE) APPROVES AND MAKES ANY CHANGES THAT ARE NECESSARY. THESE RECOMMENDATIONS ARE NOT ANNUAL AS THEY ARE ALSO BASED ON THE FINANCIAL PERFORMANCE OF THE HOSPITAL AND THE CONTRACTUAL ARRANGEMENT OF THE CEO. THESE RECOMMENDATIONS ARE FURTHER COMPARED TO LIKE SIZE" HOSPITAL'S WITHIN THE MHA SURVEY. HUMAN RESOURCES MONITORS THIS PROCESS ANNUALLY AT VARIOUS LEVELS AND WAS LAST COMPLETED IN 2018. PHYSICIANS: AS A RURAL HOSPITAL AND DESIGNATED AS UNDERSERVED, WAR MEMORIAL HOSPITAL HAS BEEN FACED WITH THE NEED TO EMPLOY PHYSICIANS IN ORDER TO RECRUIT AND RETAIN PROVIDERS TO MEET THE NEEDS OF THE COMMUNITY. THE NEEDS OF OUR COMMUNITY ARE BASED ON INDEPENDENT EVALUATIONS AND COMMUNITY SURVEYS. BASED ON THESE NEEDS THE HOSPITAL UTILIZES MGMA DATA BASED ON SPECIALTY FOR ALL PROVIDERS IN THE UNITED STATES. THIS DATA PROVIDES INFORMATION SUCH AS RELATIVE VALUE UNITS, ENCOUNTER, AND COMPENSATION. THE INFORMATION IS CLASSIFIED BY THE 25TH, MEDIAN, 75TH, AND 90TH PERCENTILE AND IS USED TO DESIGNATE THE PHYSICIAN COMPENSATION AS THE HOSPITAL ESTABLISHES COMPENSATION DURING RECRUITMENT AND RETENTION EFFORTS. MEDIAN BASED COMPENSATION IS MOST TYPICAL FOR PHYSICIAN CONTRACTS WITH THE ABILITY FOR THE PROVIDER TO EARN ADDITIONAL COMPENSATION BASED ON THEIR ACTUAL WORKLOAD/ PRODUCTIVITY (RVU AND ENCOUNTER) WITH NO RELATIONSHIP TO REFERRALS TO THE HOSPITAL. IN RETENTION CONTRACTS THE BASE COMPENSATION IS SOMETIMES INCREASED BASED ON HISTORICAL WORKLOADS/ PRODUCTIVITY AND BASED ON THE MARKET COMPETITIVENESS FOR THE RESPECTIVE SPECIALTY. FORM 990, PART VI, SECTION C, LINE 19 THE 990 AND THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH A DISSEMINATION AGENT AND UPON REQUEST. FORM 990, PART IX, LINE 11G DIETARY: PROGRAM SERVICE EXPENSES 19,557. MANAGEMENT AND GENERAL EXPENSES 678,044. FUNDRAISING EXPENSES 301. TOTAL EXPENSES 697,902. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 8,366,719. MANAGEMENT AND GENERAL EXPENSES 2,892,314. FUNDRAISING EXPENSES 30. TOTAL EXPENSES 11,259,063. FORM 990, PART XII, LINE 2C: NO CHANGES FROM PRIOR YEAR.