2019-11-14T12:46:29-06:00 2018-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-01-01 742517055 Schoolcraft Memorial Hospital SCHO 9063413200 7870 US Hwy 2 Manistique MI 49854 Boyd Chappell Chief Financial Officer 9063413200 2019-11-14 1 Kim Hunwardsen CPA P00484560 6122536500 2019-11-13 216.147.181.49 2019-11-14 11:43:54 CS P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC EFC25E59FA7409AE560978A003AFB9E955B778C6 2018 2020-03-31 21:24:44Z Robert Crumb 7870 US Hwy 2 Manistique MI 49854 40378988 0 X www.SCMH.org X 1950 MI Provide comprehensive inpatient, outpatient, emergency, medical clinic, and home health services. 9 9 331 21 0 22558 18652 50634 36781084 40070348 54209 232470 28729 22569 36882674 40376021 0 0 0 0 20315172 22903435 0 0 0 14411695 16528262 34726867 39431697 2155807 944324 31107319 32493639 29858769 30300765 1248550 2192874 X Schoolcraft Memorial Hospital is committed to providing quality healthcare and wellness for the people of our community. 0 0 25824604 28200255 Schoolcraft Memorial Hospital (SMH), a component unit of Schoolcraft County, is organized under Public Act of 230 and is a county hospital corporation that operates a 12-bed acute care facility. SMH provides comprehensive inpatient, outpatient, emergency, medical clinic, and home health services in total. Healthcare is offered in at least 30 specialties, some of which include cardiology, neurology, general and orthopedic surgery, a 24-hour physician staffed emergency room, a walk-in clinic, physical and occupational therapy, cardiac rehabilitation, and a wide range of diagnostic services including a full-service laboratory, x-ray, mammography, CT scans, MRI's, and nuclear medicine. SMH is an equal opportunity provider and employer. During 2018 SMH had 1,677 acute and swing bed patient days, 842 inpatient and outpatient surgeries, 43,881 outpatient visits, and 347 home health admits.The Hospital provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Hospital does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated cost of providing these services was $86,000 in 2018, calculated by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. 5262323 5851722 SMH owns a provider based rural health clinic, which had ten physicians, two physician assistants, and four nurse practitioners. SMH had 22,988 RHC visits in 2018. 2087770 6018371 SMH offers 24/7 emergency services staffed with a physician who is on-site. SMH treats all patients, regardless of their ability to pay. SMH had 4,633 ER visits in 2018. 33174697 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 38 0 1 331 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X Boyd Chappell 9063413233 7870 US Hwy 2 Manistique MI 49854 Donald J Perigo Chair 1.00 X X 1665 0 0 Donald Bedwell Vice Chairperson 1.00 X X 1330 0 0 Clyde Strasler Treasurer 1.00 X X 2650 0 0 Marcia Tevelde Secretary 1.00 X X 1090 0 0 James Harmes Trustee 1.00 X 940 0 0 Richard Hueter Trustee 1.00 X 1080 0 0 Peter Hood Trustee 1.00 X 0 0 0 Jennifer Watson Trustee 1.00 X 630 0 0 Ernie Krueger Trustee 1.00 X 0 0 0 Robert Crumb CEO 40.00 X 184583 0 38799 Boyd Chappell CFO 40.00 X 131836 0 33723 John Galey Orthopedic Surgeon 40.00 X 612363 0 42177 Nicholas Hoeve Cardiologist 40.00 X 510553 0 45085 Gregory Bambach General Surgeon 40.00 X 503392 0 44870 Mark Cardamone Rayner Otolaryngologist 40.00 X 457756 0 43501 David Schoenow ER Physican 40.00 X 450456 0 43282 2860324 0 291437 30 0 1 0 Ni2 Health 22121 17th Ave SE Suite 109 Bothell WA 98021 Revenue/Expense Integrity Services 1322654 UP Health Care Solutions 853 W Washington St Marquette MI 49855 MRI Services 380681 Green Bay Oncology Ltd 1726 Shawano Ave Green Bay WI 54303 Oncology Services 296683 Marquette General Hospital 580 W College Ave Marquette MI 498542711 Lab & EKG Services 269893 CompHealth PO Box 972670 Dallas TX 753972670 Medical Staffing Services 212550 7 50634 50634 Net Patient Revenue 621990 38012787 38012787 Pharmacy Revenue 900099 1613160 1613160 444401 444401 40070348 230762 230762 25536 2967 22569 22569 22569 1708 0 1708 1708 1708 40376021 40070348 0 255039 X 398769 398769 95175 95175 17627721 16176333 1451388 1375672 1257950 117722 2358738 1763381 595357 1047360 944721 102639 26056 26056 51605 51605 2965 2965 4889437 2788532 2100905 14686 14686 2242614 2071677 170937 896622 840923 55699 114567 65836 48731 112615 80741 31874 919640 919640 2054141 2054141 61327 61327 Medical Supplies 3388902 3388902 Provision for Bad Debts 1377962 1377962 Dietary 155087 155087 Dues and Licenses 136658 71248 65410 83378 27402 55976 39431697 33174697 6257000 0 2140651 3690919 5989788 5934516 1731 53263 95731 535631 689761 277272 346443 36393699 18885620 17532874 17508079 3042078 3230911 1534031 997279 31107319 32493639 2481782 3053367 21941587 21552765 5435400 5694633 29858769 30300765 X 0 0 0 0 1248550 2192874 1248550 2192874 31107319 32493639 944324 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2965 2965 0 Part II-B, Line 1: SMH is a member of the American Hospital Association (AHA), the Michigan Health and Hospital Association (MHA), and the Medical Group Management Association (MGMA). A portion of the membership dues for these organizations is used for lobbying $1,255 MHA, $1,640 AHA, and $70 MGMA. 668758 668758 23043001 9735677 13307324 12049860 9145591 2904269 632080 4352 627728 17508079 Capital Leases 1136421 Pension Liability 3993951 Estimated Third Party Payor Settlements 198141 Deferred Pension Inflow 366120 5694633 38061448 -1377962 -1377962 39439410 919640 16971 936611 40376021 37131804 -2291 -2291 37134095 919640 1377962 2297602 39431697 Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Reported in Revenue on Financial Statements -1,377,962. Part XI, Line 4b - Other Adjustments: Rental Expenses Reported in Expenses on Financial Statements -2,967. Capital Contributions Reported in Fund Balance on Financial Statements 14,680. Contributions Reported in Expenses on Financial Statements 5,258. Part XII, Line 2d - Other Adjustments: Rental Expenses Reported in Expenses on Financial Statements 2,967. Contributions Reported in Expenses on Financial Statements -5,258. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Reported in Revenue on Financial Statements 1,377,962. 1 1 X 1 X 0 1 1 0 1 1 86000 86000 0.00230 5625395 2229973 3395422 0.08920 5711395 2229973 3481422 0.09150 1314313 469031 845282 0.02220 1314313 469031 845282 0.02220 7025708 2699004 4326704 0.11370 0 1377962 826777 10905739 10991898 -86159 X 1 1 1 1 Schoolcraft Memorial Hospital 7870 US Hwy 2 Manistique MI 49854 www.SCMH.org M899262 X X X X Provider Based Rural Health Clinic Schoolcraft Memorial Hospital 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X See Part V, Page 8 X X 1 16 1 See Part V, Page 8 0 1 X 200.000000000000 X X X 1 1 X X X 1 X www.scmh.org/financial-assistance-policy X www.scmh.org/financial-assistance-policy X www.scmh.org/financial-assistance-policy X X X X X X 1 X 0 X X X X 1 X 0 0 Schoolcraft Memorial Hospital Part V, Section B, Line 5: A broad cross-section of health & human service professionals was called together as an assessment advisory committee. At the initial meeting, there was a great deal of discussion about the health needs of the community, In the two months following this meeting, there were four focus groups held in four locations in the hospital's service area. The focus groups were made up of non-professional community residents - the elderly, clients of goodwill industries, Sault tribal members were some of the groups represented. Schoolcraft Memorial Hospital Part V, Section B, Line 7d: As a part of the implementation strategy, there will be hard copy binders containing the report that will be distributed to various communities within Manistique, such as the public library, etc. There have been several newsletter articles in hospital-based publications, some of which are distributed in the community, keeping the community apprised about progress on the CHNA and availability of the report & implementation strategy. Schoolcraft Memorial Hospital Part V, Section B, Line 11: Schoolcraft Memorial Hospital completed a Community Health Needs Assessment in 2016 and the following reflects the implementation strategies and results. Schoolcraft Memorial Hospital partnered with the entire Upper Peninsula of Michigan in 2018 to complete another assessment that will be evaluated in 2019 through 2021. Need #1: Parent education on nutrition, health, child development, job skills, and other topics to help strengthen families, especially those caught in an intergenerational cycle of poverty, low educational attainment and low expectations, to improve the health of the next generation.Objective 1.a: Develop SMH as a community learning center, in collaboration with a variety of community partners, to promote knowledge and behavior changes for a healthier population.Schoolcraft Memorial Hospital implemented a new position called the Patient Navigator to guide patients, community members and agency to vital resources in our community. During medical appointments, providers can call the patient navigator into the patient room to discuss behavioral health issues, address basic needs (food, housing, childcare) and refer to necessary external services. Objective 1.b: Be a partner in a new coalition to be led by MDHHS to reduce and manage childhood trauma that can manifest in poor outcomes later in life.Schoolcraft Memorial Hospital meets monthly with the Trauma Team at the MDHHS office. The trauma team is comprised of professionals such as counselors, DHHS workers, law enforcement, ministry, health department, Communities that Care, Victim advocate workers, and school workers. We attend and participate in this community group as part of our community outreach and education. Vital resources are shared and new programs and services are spotlighted. Need #2: HPSA designation for mental health services, and primary care (and provider shortages for medical specialties.) Objective 2.a: Research, plan and develop a provider network to improve access to care for behavioral health (mental health counseling and substance abuse treatment) through telehealth, in collaboration with neighboring underserved counties.In 2018, SMH received grant funds to invest in a therapist that could provide mental health counseling and substance abuse treatment. Plans to hire the therapist were made for 2019. SMH has partnered with the MC3 program through U of M for consultation for child psychiatry. Our physicians and providers can speak with psychiatrists over the phone for pediatric cases. Objective 2.b: Research, plan and develop a provider network to improve access to primary and specialty medical care through telehealth, in collaboration with neighboring underserved counties.Schoolcraft Memorial Hospital has expanded its network by providing specialty visits (ENT and Cardiology) in Newberry and Munising. SMH has plans to open a satellite clinic in Naubinway, MI in 2019. Need #3: A growing population of elderly residents, many living in rural isolation, with limited means, diminishing capabilities, and chronic diseases.Objective 3.a: Strengthen and publicize the system of free medical transport to bring elderly patients to the rural clinic and other hospital services.SMH has always provided free one-way transportation to medical appointments. In 2019, SMH will present a $10,000 grant to the transit authority to provide free 2-way transportation for medical appointments, specialty visits, and mental health counseling in Manistique and Escanaba. Objective 3.b: Work with community partners including agencies and volunteers to improve access for the elderly to food assistance and help with chores and household needs.Schoolcraft Memorial Hospital has partnered with Good Neighbor Services to provide monthly Feeding America Food Trucks at the hospital's convenient location. We have set up a drive through style pick up where residents of Schoolcraft County can receive 1 box of food per household monthly. Food insecurity affects 1 in 8 people in our region - an estimated 285,000 people. Children are particularly vulnerable with 1 in 7 at risk of hunger - approximately 80,000 total. As of 2017, nationally, 52.4% of food insecure households had at least one adult family member working full time, another 10% working part-time, with 13.3% being retired and 15.1% not working because of a disability. Low-wage and part-time jobs - or even full-time jobs - often do not pay enough to keep a family out of poverty especially when they do not include health benefits. Locally, the 20,000 pounds trucks help feed 500 households in Schoolcraft County monthly.Schoolcraft Memorial Hospital takes care of all advertising related to the food truck in local papers and on social media. We recruit volunteers from our organization and promote sponsorships from local businesses to continue ongoing access to the food in our community. Schoolcraft Memorial Hospital Part V, Section B, Line 13h: Schoolcraft Memorial Hospital offers a self-pay discount of 41% of gross charges for uninsured patients regardless of income. Schedule H, Part V, Section B, Line 7a: http://www.scmh.org/community/community-health-needs-assessment/ Schedule H, Part V, Section B, Line 10a: http://www.scmh.org/community/ 1 1 - SMH Homecare & Hospice Agency 115 N Lake St Manistique MI 49854 Homecare and Hospice Part I, Line 3c: Schoolcraft Memorial Hospital offers a self-pay discount of 41% of gross charges for uninsured patients regardless of income. Part I, Line 6a: The community benefit report was made available to the public on the Hospital's website at www.SCMH.org/community/community-benefits/. Part I, Line 7: Financial assistance was calculated using the cost-to-charge ratio. Unreimbursed Medicaid and subsidized health services were calculated using the cost report and analyzing the Medicare ratio of cost to charge for the respective cost centers. Part I, Ln 7 Col(f): The amount of bad debt expense backed out of total expenses to determine the percentage was $1,377,962. Part III, Line 2: Bad debt is reported at charges. Self-pay discounts are applied to patient accounts before balances are deemed to be bad-debt. Part III, Line 3: The amount listed on line 3 is an estimate of community care applications not returned. Approximately 60% of applications were not returned that may have qualified for community care. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expense can be found on page 15 of the attached audited financial statements. Part III, Line 8: The shortfall should be considered as community benefit as this amount is not included in bad debt and no effort is made to collect this shortfall. In addition, providing services to the Medicare population is a community benefit as the elderly are a charitable class and providing them with healthcare helps the community. Part III, Line 9b: Schoolcraft Memorial Hospital works with patients to help them qualify for financial assistance. If a patient does not complete the financial assistance application or provide the required documentation, SCMH follows the same collection efforts as it does with other delinquent accounts. SCMH will attempt to work with the patient to set up a payment plan or make payment on the amount. If the patient does not respond the SCMH efforts, the account is referred to an external collection agency. Part VI, Line 2: The CHNA is the only formal assessment of broad scope that the hospital has utilized in recent years to assess the health care needs of the community. The CHNA was completed in 2018 and is posted to the website www.SCMH.org. The needs identified in the CHNA include steps to: research, plan and develop a provider network to improve access to care for behavioral health; work with community partners to improve access to food assistance for elderly and low income residents of Schoolcraft County. Part VI, Line 3: Schoolcraft Memorial Hospital posts a summary of its charity care policy, and financial assistance contact information in admissions areas, emergency rooms, and other areas of the organization's facilities in which eligible patients are likely to be present; (2) provides a summary of the policy, and financial assistance contact information to patients as part of the intake process; (3) includes a statement regarding the policy, along with financial assistance contact information, on patient bills; and assists the patient with qualification for charity care where applicable. Part VI, Line 4: Schoolcraft Memorial Hospital primarily provides services to the residents of Schoolcraft County. The county is 1,884 square miles of which 1,178 is land, and 706 is water. As of July 1, 2016 the population is estimated to be 8,001. Approximately 28.7% is estimated to be 62 years and older. As of 2015 the median household income in the county was $34,118. The unemployment rate was at 7.4%. The percentage of individuals whose income was below the poverty level was 21.4% as of July, 2015.Schoolcraft Memorial Hospital is the only hospital in the county. The nearest hospital is approximately 50 miles from Schoolcraft Memorial Hospital. Schoolcraft County is not designated as a Medically Underserved Area. It has been designated as a low-income health care professional shortage area. Part VI, Line 5: SMH donates staff (board members) and health care services in the amount of $70,000/year to the low-income uninsured clients of the Medical Care Access Coalition, Schoolcraft County Office. The hospital has one staff person on the executive board of the Eastern Upper Peninsula Crisis Response team, and several additional staff who provide critical incident response interventions to first responders, schools, hospital staff, businesses, etc., throughout the region following an emotionally traumatic critical/crisis incident. The hospital has taken a leading role with the Sault Tribe Strategic Alliance for Health in planning and developing a farmers' market (the first in Manistique), as well as assisting in the planning for several miles of new sidewalk and safer intersections for the benefit of local schoolchildren and to encourage increased physical activity among all residents to fight the obesity epidemic. The hospital has a staff person who participates as a part of a local suicide & bullying prevention coalition and gives time to local awareness activities such as the annual suicide memorial vigil. The hospital has several staff who actively participate as a part of the local substance abuse prevention task force. The hospital wellness committee plans and implements activities in the schools to encourage nutritious eating habits and increase physical activity. The hospital donates staff time to the Great Start Collaborative and other early childhood programs toward the development of annual strategic plans, fundraising efforts, etc. One of the hospital's social workers is a trained Medicare/Medicaid assistance program counselor who sees about 200 people per year during the "open window" for Medicare Part D enrollment, and assists others throughout the year upon request. A hospital social worker is a certified child passenger safety seat technician and assists low income families that are unable to afford safety seats by providing a new seat and instructing in their safe installment. The hospital has the majority of the vendor booths and low cost or free screenings and services provided at the annual community health fair. The social workers educate and assist community members in completing advance directives. A social worker actively participates in the planning and on the day of the Walk to End Alzheimer's Diesease as well as sitting on the regional board of the Alzheimer's Association. Part VI, Line 7, Reports Filed With States MI X X 0 0 0 0 0 0 0 0 0 Robert Crumb CEO 175128 0 0 0 9455 0 14992 0 24249 0 223824 0 0 0 Boyd Chappell CFO 131716 0 0 0 120 0 3955 0 29768 0 165559 0 0 0 John Galey Orthopedic Surgeon 598286 0 0 0 14077 0 18371 0 24036 0 654770 0 0 0 Nicholas Hoeve Cardiologist 501490 0 0 0 9063 0 15317 0 29800 0 555670 0 0 0 Gregory Bambach General Surgeon 478892 0 0 0 24500 0 15102 0 29848 0 548342 0 0 0 Mark Cardamone Rayner Otolaryngologist 433256 0 0 0 24500 0 13733 0 30210 0 501699 0 0 0 David Schoenow ER Physican 426456 0 0 0 24000 0 13514 0 29848 0 493818 0 0 0 Theresa Crumb Family Member of Robert Crumb, CEO 37088 Compensation 0 Holly Livermore Family Member of Tanya Hoar, Former CEO 29882 Compensation 0 Alice Chappell Family Member of Boyd Chappell, CFO 28205 Compensation 0 Form 990, Part VI, Section A, line 1 The Executive Committee shall consist of the officers of the Board of Trustees and shall have power to transact business of the hospital during the interim between meetings of the Board of Trustees. The Bylaws allow for an Executive Committee but they did not meet in the current year. Form 990, Part VI, Section A, line 7a Board members may elect new board members as vacancies occur. Appointments to the Board must be ratified by the county commissioners. Form 990, Part VI, Section A, line 7b The Articles of Incorporation may be amended by resolution approved by affirmative vote of the majority of the members serving on the Schoolcraft County Board of Commissioners. The Corporation, if it has completed the purposes for which it was organized, shall be dissolved by the adoption of a resolution by the affirmative vote of two-thirds of the members serving on the Board of Trustees, and approved by a majority of the members serving on the Schoolcraft County Board of Commissioners. Form 990, Part VI, Section A, line 8b The organization does have an Executive Committee with the authority to act on behalf of the board but the Committee did not meet during the year. Form 990, Part VI, Section B, line 11b SMH sends Form 990 and all accompanying schedules to the full board for review and ratification. The CEO/CFO will present the 990 to the full board. The full board has opportunity to ask questions prior to ratification of the 990. Form 990, Part VI, Section B, line 12c All board members and officers are required to complete the conflict of interest statement annually. This is reviewed by the board annually to identify any potential issues. Any board member or officer having a conflict of interest or possible conflict of interest should not vote or use their personal influence on the matter and they should not be counted as a part of the quorum for the meeting. Form 990, Part VI, Section B, line 15a Salary guidelines are set by independent committees using comparability data. These guidelines are then used to negotiate a contract with the CEO. The CEO determines the CFO's compensation by using comparabilty data. Both processes are completed on an annual basis. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Purchased Services: Program service expenses 893,258. Management and general expenses 1,822,198. Fundraising expenses 0. Total expenses 2,715,456. Contracted Services: Program service expenses 1,368,035. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,368,035. Maintenance: Program service expenses 527,239. Management and general expenses 278,707. Fundraising expenses 0. Total expenses 805,946. Schoolcraft County Board of Commissioners 300 Walnut Street 155 Manistique MI 49854 386004891 Enact and administer local ordinances MI N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0