EMMA L BIXBY MEDICAL CENTER: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: EMMA L BIXBY MEDICAL CENTER (EIN 38-2796005)
Tax period: 2017-01-01 to 2017-12-31
Filed: 2018-11-15
IRS object ID: 201803199349312065
Schema version: 2017v2.3
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 L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-11-15T14:26:14-06:00	ReturnTs
Tax Period End	2017-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	861065772	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	DELOITTE TAX LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE STE 4200	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	462045108	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	382796005	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EMMA L BIXBY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	EMMA	BusinessNameControlTxt
Phone	5172650133	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	818 RIVERSIDE AVE	AddressLine1Txt
City	ADRIAN	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	492211488	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MICHAEL P BROWNING	PersonNm
Person Title	TREASURER	PersonTitleTxt
Phone	5172650133	PhoneNum
Signature	2018-11-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	SAMANTHA BOKORI	PreparerPersonNm
PTIN	P01057347	PTIN
Phone	3174648600	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	47.44.8.66	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-11-15	IPDt
IP Tm	10:44:50	IPTm
IP Timezone	CS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	10D40757338076D52CC4237D125AC571E9019363	AtSubmissionCreationDeviceId
At Submission Filing Device Id	D6063055A6803F1C5210E032C865658A36853698	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	PROMEDICA BIXBY HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	MICHAEL P BROWNING	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 MADISON AVE	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$214,076,202	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.PROMEDICA.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1989	FormationYr
Legal Domicile State	MI	LegalDomicileStateCd
Activity Or Mission	EMMA L. BIXBY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL THAT PROVIDES HEALTHCARE SERVICES PRIMARILY TO INDIVIDUALS OF LENAWEE COUNTY.	ActivityOrMissionDesc
Voting Members Governing Body	19	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	760	TotalEmployeeCnt
Total Volunteers	109	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$781,444	PYContributionsGrantsAmt
CY Contributions Grants	$1,816,044	CYContributionsGrantsAmt
PY Program Service Revenue	$84,841,456	PYProgramServiceRevenueAmt
CY Program Service Revenue	$86,077,437	CYProgramServiceRevenueAmt
PY Investment Income	$3,050,584	PYInvestmentIncomeAmt
CY Investment Income	$8,377,359	CYInvestmentIncomeAmt
PY Other Revenue	$1,528,533	PYOtherRevenueAmt
CY Other Revenue	$1,755,742	CYOtherRevenueAmt
PY Total Revenue	$90,202,017	PYTotalRevenueAmt
CY Total Revenue	$98,026,582	CYTotalRevenueAmt
PY Grants And Similar Paid	$4,758,297	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$6,937,037	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$40,966,366	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$40,042,568	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$38,733,007	PYOtherExpensesAmt
CY Other Expenses	$44,186,111	CYOtherExpensesAmt
PY Total Expenses	$84,457,670	PYTotalExpensesAmt
CY Total Expenses	$91,165,716	CYTotalExpensesAmt
PY Revenues Less Expenses	$5,744,347	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$6,860,866	CYRevenuesLessExpensesAmt
Total Assets BOY	$130,438,224	TotalAssetsBOYAmt
Total Assets EOY	$141,858,745	TotalAssetsEOYAmt
Total Liabilities BOY	$25,299,539	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$26,488,173	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$105,138,685	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$115,370,572	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	EMMA L. BIXBY MEDICAL CENTER IS DEDICATED TO IMPROVING HUMAN LIFE AND DEVOTED TO THE PATIENTS AND FAMILIES WE SERVE THROUGH INNOVATIVE CARE, SUPERIOR QUALITY AND PREMIER CUSTOMER SERVICE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$77,996,470	ExpenseAmt
Grant	$6,937,037	GrantAmt
Revenue	$86,682,707	RevenueAmt
Desc	EMMA L. BIXBY MEDICAL CENTER IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$2,546,157	ExpenseAmt
Desc	CONSISTENT WITH OUR MISSION, EMMA L. BIXBY MEDICAL CENTER PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY. - SEE SCHEDULE O.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$89,169	ExpenseAmt
Revenue	$310	RevenueAmt
Desc	CONSISTENT WITH OUR MISSION, EMMA L. BIXBY MEDICAL CENTER PROVIDES ADDITIONAL COMMUNITY BENEFIT INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES AND HEALTH PROFESSIONAL EDUCATION. - SEE SCHEDULE O.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$80,631,796	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	58	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	760	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	19	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	Yes (1)	LocalChaptersInd
Policies Reference Chapters	Yes (1)	PoliciesReferenceChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	STANTON E RISSER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5675853618	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 MADISON AVE	AddressLine1Txt
City	TOLEDO	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	43604	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ANDRES LOPEZ
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
BARBARA A MITZEL
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
BARBARA J PETEE
TRUSTEE	1.00	41.00	Yes (X)	$0	$343,902	$64,916
EMORY M SCHMIDT
CHAIRPERSON	1.00	9.00	Yes (X)	$0	$0	$0	Yes (X)
GRACE M GARNO
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
JAMES D PHILP
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
JULIE K YAROCH DO
PRESIDENT, EX OFFICIO	40.00	1.00	Yes (X)	$0	$297,010	$44,109	Yes (X)
KEVIN C WEBB PHD
EX OFFICIO	1.00	52.50	Yes (X)	$0	$655,627	$240,675
L CHARLES FORCE
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
MARCY L BROWN
EX OFFICIO	1.00	1.00	Yes (X)	$0	$0	$0
MICHAEL J UCKELE
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
MICHAEL R HERR DVM
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
MICHAEL R OLSAVER
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
PAUL E GIETZEN MD
TRUSTEE	1.00	41.00	Yes (X)	$0	$366,002	$36,593
PAUL R WALKER MD
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
ROBERT L VOGEL
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
RUSSELL L DEMPSEY
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
SAMANTHA M MUCHA MD
TRUSTEE	1.00	41.00	Yes (X)	$7,500	$568,056	$31,252
STACEY L BOCK
TRUSTEE	1.00	41.00	Yes (X)	$0	$243,226	$30,348
VICTOR J CHERFAN DO
TRUSTEE	1.00	41.00	Yes (X)	$46,666	$552,070	$37,715
WILLIAM B NOE
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
JEFFREY C KUHN
SECRETARY	0.50	52.00		$0	$616,424	$244,159	Yes (X)
MICHAEL P BROWNING
TREASURER	0.50	50.50		$0	$697,115	$246,414	Yes (X)
RANDALL OOSTRA
PHS PRES & CEO, EX OFFICIO	0.50	54.50		$0	$1,749,816	$483,218	Yes (X)
DARRIN M ARQUETTE
SR. VP, NEURO, HEART AND VASC	0.50	45.50		$0	$335,318	$46,341		Yes (X)
GARY W AKENBERGER
SR. VP DIAG, FACILITIES & SEC	0.50	44.00		$0	$379,804	$91,320		Yes (X)
KATHRYN M GREENLEE
VP, PATIENT CARE/CNO, BMC & HH	40.00	0.50		$0	$165,137	$45,414		Yes (X)
SCOTT FOUGHT
VP, FINANCE, ACUTE CARE OPS	0.50	44.50		$0	$281,158	$46,283		Yes (X)
JENNIFER FOSS
MANAGER, PHARMACY	40.00	0.00		$128,073	$0	$25,640			Yes (X)
MARY ABRAHAM
PHARMACIST	40.00	0.00		$120,170	$0	$44,762			Yes (X)
MATTHEW J HAMMOND
VP OPERATIONS, PPG	1.00	40.00		$27,698	$129,738	$11,766			Yes (X)
MELISSA THOMPSON
PHARMACIST	40.00	0.00		$120,802	$0	$14,407			Yes (X)
RONDA WINANS
ASSOCIATE VP, OPERATIONS	40.00	1.00		$78,175	$43,458	$29,691			Yes (X)
ALAN M SATTLER
FORMER OFFICER	0.00	40.00		$0	$389,038	$80,933				Yes (X)
KATHLEEN S HANLEY
FORMER OFFICER	0.00	0.00		$0	$571,790	$1,351				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$529,084	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,384,689	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,897,307	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	6	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
INDIGO HOSPITAL MEDICINE
10850 TRAVERSE HWY 4400	TRAVERSE CITY	MI	49684	LOCUM TENENS	$3,405,127
HKS INC
1919 MCKINNEY AVE	DALLAS	TX	75201	DESIGN ARCHITECTURAL	$1,781,335
BIXBY ANESTHESIA ASSOCIATES PC
818 RIVERSIDE AVE	ADRIAN	MI	49221	ANESTHESIA SERVICES	$1,129,000
CROTHALL LAUNDRY SERVICES
1010 E HIGH ST	LIMA	OH	45804	LINEN SERVICES	$661,466
LOCUMTENENSCOM
2655 NORTHWINDS PARKWAY	ALPHARETTA	GA	30009	LOCUM TENENS	$522,555

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	15	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,415,596	RelatedOrganizationsAmt
Government Grants	$397,781	GovernmentGrantsAmt
All Other Contributions	$2,667	AllOtherContributionsAmt
Total Contributions	$1,816,044	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
NET PATIENT SERVICES	622110	$83,250,646	$83,250,646
RESIDENT SERVICES FEES	623110	$2,206,155	$2,206,155
AFFIL. ORG. RENT REV.	531120	$620,636		$620,636

Field	Value	IRS element (for citing)
Total Program Service Revenue	$86,077,437	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,848,545	TotalRevenueColumnAmt
Exclusion	$1,848,545	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,889	TotalRevenueColumnAmt
Exclusion	$14,889	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$293,563	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$157,378	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$136,185	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$136,185	TotalRevenueColumnAmt
Exclusion	$136,185	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$122,345,036	SecuritiesAmt
Other	$76,020	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$115,834,244	SecuritiesAmt
Other	$57,998	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$6,510,792	SecuritiesAmt
Other	$18,022	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,528,814	TotalRevenueColumnAmt
Related Or Exempt Func Income	$18,022	RelatedOrExemptFuncIncomeAmt
Exclusion	$6,510,792	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
ER MEDICAL PROF. SVCS.	621493	$1,111,656	$1,111,656
DIETARY AND CAFETERIA	722514	$203,422		$203,422
SCHOOL PHYSICALS	900099	$96,538	$96,538

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$193,052	TotalRevenueColumnAmt
Exclusion	$193,052	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,604,668	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$98,026,582	TotalRevenueColumnAmt
Related Or Exempt Func Income	$86,683,017	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$9,527,521	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$6,937,037	TotalAmt
Program Services	$6,937,037	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$54,166	TotalAmt
Management And General	$54,166	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$32,845,184	TotalAmt
Program Services	$28,903,762	ProgramServicesAmt
Management And General	$3,941,422	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$492,309	TotalAmt
Program Services	$433,232	ProgramServicesAmt
Management And General	$59,077	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,990,973	TotalAmt
Program Services	$3,512,056	ProgramServicesAmt
Management And General	$478,917	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,659,936	TotalAmt
Program Services	$2,340,744	ProgramServicesAmt
Management And General	$319,192	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$135,506	TotalAmt
Management And General	$135,506	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$134,638	TotalAmt
Management And General	$134,638	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$12,856	TotalAmt
Management And General	$12,856	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$269,069	TotalAmt
Management And General	$269,069	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$10,624,457	TotalAmt
Program Services	$9,983,802	ProgramServicesAmt
Management And General	$640,655	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$200,165	TotalAmt
Program Services	$8,007	ProgramServicesAmt
Management And General	$192,158	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$819,756	TotalAmt
Program Services	$631,212	ProgramServicesAmt
Management And General	$188,544	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$2,435,338	TotalAmt
Management And General	$2,435,338	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,928,356	TotalAmt
Program Services	$1,870,505	ProgramServicesAmt
Management And General	$57,851	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$184,797	TotalAmt
Program Services	$88,703	ProgramServicesAmt
Management And General	$96,094	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$566,812	TotalAmt
Program Services	$566,812	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,624,474	TotalAmt
Program Services	$4,115,782	ProgramServicesAmt
Management And General	$508,692	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,048,105	TotalAmt
Program Services	$932,813	ProgramServicesAmt
Management And General	$115,292	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$7,396,023	$7,396,023
INTERCOMPANY SERVICES	$3,840,018	$3,417,616	$422,402
DRUGS	$3,767,576	$3,767,576
PROVIDER TAXES	$2,826,369	$2,826,369

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,371,796	TotalAmt
Program Services	$2,899,745	ProgramServicesAmt
Management And General	$472,051	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$91,165,716	TotalAmt
Program Services	$80,631,796	ProgramServicesAmt
Management And General	$10,533,920	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$13,660,514	BOYAmt
EOY	$6,375,473	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$10,670,180	BOYAmt
EOY	$10,745,541	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,117,903	BOYAmt
EOY	$1,362,574	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$223,960	BOYAmt
EOY	$180,412	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$100,662,981	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$74,130,857	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$24,847,069	BOYAmt
EOY	$26,532,124	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$72,561,012	BOYAmt
EOY	$86,689,578	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$681,388	BOYAmt
EOY	$648,529	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$6,676,198	BOYAmt
EOY	$9,324,514	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$130,438,224	BOYAmt
EOY	$141,858,745	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,315,539	BOYAmt
EOY	$7,786,488	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$17,984,000	BOYAmt
EOY	$18,701,685	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$25,299,539	BOYAmt
EOY	$26,488,173	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$100,112,289	BOYAmt
EOY	$108,904,033	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,634,982	BOYAmt
EOY	$5,195,603	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,391,414	BOYAmt
EOY	$1,270,936	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$105,138,685	BOYAmt
EOY	$115,370,572	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$130,438,224	BOYAmt
EOY	$141,858,745	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$6,860,866	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,779,544	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$1,591,477	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	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 (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$12,856	OtherActivitiesAmt
Total Lobbying Expenditures	$12,856	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	EMMA L. BIXBY MEDICAL CENTER PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE MICHIGAN HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATIONS.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,391,415	BeginningYearBalanceAmt
Investment Earnings Or Losses	$44,786	InvestmentEarningsOrLossesAmt
Other Expenditures	$165,266	OtherExpendituresAmt
End Year Balance	$1,270,935	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,386,780	BeginningYearBalanceAmt
Investment Earnings Or Losses	$4,635	InvestmentEarningsOrLossesAmt
End Year Balance	$1,391,415	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,428,306	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$41,526	InvestmentEarningsOrLossesAmt
End Year Balance	$1,386,780	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,436,934	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$8,628	InvestmentEarningsOrLossesAmt
End Year Balance	$1,428,306	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,391,000	BeginningYearBalanceAmt
Contributions	$26,281	ContributionsAmt
Investment Earnings Or Losses	$19,653	InvestmentEarningsOrLossesAmt
End Year Balance	$1,436,934	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.39340	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.60660	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,283,984	OtherCostOrOtherBasisAmt
Book Value	$1,283,984	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$26,419,917	OtherCostOrOtherBasisAmt
Depreciation	$17,715,557	DepreciationAmt
Book Value	$8,704,360	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$324,748	OtherCostOrOtherBasisAmt
Depreciation	$308,926	DepreciationAmt
Book Value	$15,822	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$33,277,262	OtherCostOrOtherBasisAmt
Depreciation	$27,831,832	DepreciationAmt
Book Value	$5,445,430	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$39,357,070	OtherCostOrOtherBasisAmt
Depreciation	$28,274,542	DepreciationAmt
Book Value	$11,082,528	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$26,532,124	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM AFFILIATES	$1,509,422
BENEFICIAL INTEREST IN FOUNDATION	$6,523,386
ESTIMATED THIRD PARTY PAYOR RECEIVABLE	$1,082,751
OTHER RECEIVABLE	$208,955

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$9,324,514	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
DUE TO AFFILIATES	$2,289,697
ASBESTOS REMEDIATION	$1,398,325
ESTIMATED THIRD PARTY SETTLEMENTS PAYABLE	$3,714,103
INTERCOMPANY DEBT TO THE TOLEDO HOSPITAL	$11,299,560

Field	Value	IRS element (for citing)
Total Liability	$18,701,685	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART V, LINE 4:	FormAndLineReferenceDesc
Explanation	THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT EMMA L. BIXBY MEDICAL CENTER CONSISTENT WITH DONOR INTENT.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$529,878	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$529,878	NetCommunityBenefitExpnsAmt
Total Expense	0.00580	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,881,793	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,867,348	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,014,445	NetCommunityBenefitExpnsAmt
Total Expense	0.02210	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,716	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,882	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,834	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,417,387	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,871,230	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,546,157	NetCommunityBenefitExpnsAmt
Total Expense	0.02790	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,428	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$310	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,118	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$84,741	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$84,741	NetCommunityBenefitExpnsAmt
Total Expense	0.00090	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$89,169	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$310	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$88,859	NetCommunityBenefitExpnsAmt
Total Expense	0.00090	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,506,556	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,871,540	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,635,016	NetCommunityBenefitExpnsAmt
Total Expense	0.02880	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$6,314,738	BadDebtExpenseAmt
Bad Debt Expense Attributable	$379,169	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$21,780,336	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$23,989,261	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,208,925	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 LENAWEE PHYSICIAN HOSPITAL ORGANIZATION LLC
PHYSICIAN MGMT. SERVICES	0.50000	0.50000
2 HERRICK MEMORIAL OFFICE PLAZA CONDO ASSOCIATION
FACILITY SUPPORT	0.71800	0.28200
3 LENAWEE CLINICAL PARTNERS
PHYSICIAN MGMT. SERVICES	0.50000	0.29550

Field	Value	IRS element (for citing)
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	EMMA L BIXBY MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	818 RIVERSIDE AVE	AddressLine1Txt
City	ADRIAN	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49221	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.PROMEDICA.ORG	WebsiteAddressTxt
State License	1060000004	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	EMMA L BIXBY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	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
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/DEFAULT.ASPX	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	0	StrategyPostedWebsiteInd
Strategy Attached	Yes (1)	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	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
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	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
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	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
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
EMMA L. BIXBY MEDICAL CENTER	PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT SURVEY PROCESSES, LENAWEE COUNTY CONDUCTED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS TO DEVELOP A COUNTY STRATEGIC PLAN, UTILIZING THE MAPP PROCESS THAT INCLUDES FOUR ASSESSMENTS: COMMUNITY THEMES & STRENGTHS, FORCES OF CHANGE, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND THE COMMUNITY HEALTH STATUS ASSESSMENT. THESE FOUR ASSESSMENTS WERE USED BY THE RESPECTIVE COUNTY CHIP COMMITTEES TO PRIORITIZE SPECIFIC HEALTH ISSUES AND POPULATION GROUPS WHICH ARE THE FOUNDATION OF THE PLAN. A RESOURCE ASSESSMENT AND GAP ANALYSIS WAS PART OF THIS FORMAL PROCESS. THE FINAL CHIP PLANS WERE APPROVED BY THE RESPECTIVE COUNTY CHIP STRATEGIC PLANNING COMMITTEES. THE HOSPITAL THEN UTILIZED THESE DATA AND PLANS TO DEVELOP THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN. FEEDBACK FROM THE LOCAL HEALTH DEPARTMENT WAS REQUESTED AFTER THE HOSPITAL PLAN WAS DRAFTED. PERSONS WHO REPRESENTED THE LENAWEE COUNTY COMMUNITY THROUGH THESE PROCESSES INCLUDED: ADRIAN FARMER'S MARKET, ADRIAN PUBLIC SCHOOLS (HEAD START), AMERICAN CANCER SOCIETY, BOYS & GIRLS CLUB, CATHOLIC CHARITIES, COMMUNITY ACTION AGENCY, FAMILY COUNSELING AND CHILDREN'S SERVICES, FAMILY MEDICAL CENTER, GOODWILL INDUSTRIES, HOPE COMMUNITY CENTER, INTERCONNECTIONS DROP IN CENTER, LENAWEE COMMUNITY FOUNDATION, LENAWEE COMMUNITY MENTAL HEALTH AUTHORITY, LENAWEE COUNTY HEALTH DEPARTMENT, LENAWEE DEPARTMENT ON AGING, LENAWEE GREAT START, LENAWEE DEPARTMENT OF HUMAN SERVICES, LENAWEE INTERMEDIATE SCHOOL DISTRICT, LENAWEE SUBSTANCE ABUSE COALITION, LENAWEE UNITED WAY, MCCULLOUGH, VARGAS & ASSOCIATES, MSU EXTENSION, ONE LENAWEE, PROMEDICA BIXBY HOSPITAL, PROMEDICA HERRICK HOSPITAL, SIENA HEIGHTS, THE CENTRE, THE SALVATION ARMY, YMCA OF LENAWEE, AND PARTICIPATING SCHOOLS IN THE MIPHY SURVEY: BLISSFIELD MIDDLE AND HIGH SCHOOLS, CLINTON HIGH SCHOOL, HUDSON HIGH SCHOOL, MADISON HIGH SCHOOL, ONSTED MIDDLE AND HIGH SCHOOLS, SAND CREEK MIDDLE AND HIGH SCHOOLS, AND TECUMSEH MIDDLE AND HIGH SCHOOLS.
EMMA L. BIXBY MEDICAL CENTER	PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE FOLLOWING HOSPITAL FACILITY: HERRICK MEMORIAL HOSPITAL, INC.
EMMA L. BIXBY MEDICAL CENTER	PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO.
EMMA L. BIXBY MEDICAL CENTER	PART V, SECTION B, LINE 11: EMMA L. BIXBY MEDICAL CENTER CONDUCTED AND ADOPTED ITS SECOND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2016 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- CANCER- CHRONIC DISEASE PREVENTIONTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2016; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2017-2019.EMMA L. BIXBY MEDICAL CENTER DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2016 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2016 IMPLEMENTATION PLAN INCLUDE: ASTHMA, OBESITY, TOBACCO USE, ALCOHOL USE, MARIJUANA AND OTHER DRUG USE, WOMEN'S HEALTH, MEN'S HEALTH, PREVENTIVE MEDICINE AND HEALTH SCREENINGS, ADULT SEXUAL BEHAVIOR AND PREGNANCY OUTCOMES, ENVIRONMENTAL HEALTH/DISASTER PREPAREDNESS, QUALITY OF LIFE, SOCIAL CONTEXT AND SAFETY, MENTAL HEALTH AND SUICIDE, CARDIOVASCULAR HEALTH, DIABETES, AND ORAL HEALTH.EMMA L. BIXBY MEDICAL CENTER DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2017 WITH RESPECT TO ITS MOST RECENTLY CONDUCTED CHNA IN 2016: HEALTH NEED IDENTIFIED: CANCERSTRATEGY #1 - CONTINUE PARTICIPATION IN REFERRING PATIENTS THAT QUALIFY TO THE LENAWEE COUNTY HEALTH DEPARTMENT FOR FREE WOMEN'S HEALTH SCREENINGS.ACTIONS TAKEN:- 113 PATIENTS WERE REFERRED TO THE LENAWEE COUNTY HEALTH DEPARTMENT FOR FREE WOMEN'S HEALTH SCREENINGS TO INCREASE THE EARLY DETECTION OF CANCER. STRATEGY #2 - PROVIDE HEALTH EDUCATION ON SCREENING AND PREVENTION OF BREAST AND COLORECTAL CANCER IN LENAWEE COUNTY BY TRAINING HAIR STYLISTS TO BE BREAST AND COLORECTAL HEALTH ADVOCATES THROUGH THE DELIVERY OF MESSAGES TO THEIR CUSTOMERS.ACTIONS TAKEN:- 10 STYLISTS PARTICIPATED IN EDUCATION AND TRAINING PROGRAMS TO PROVIDE EDUCATION TO THEIR CLIENTS RELATED TO CANCER SCREENINGS TO INCREASE THE EARLY DETECTION OF CANCER.- 150 PIECES OF LITERATURE WERE DISTRIBUTED TO SALONS FOR CUSTOMER OUTREACH EDUCATION TO PROVIDE EDUCATION AND AWARENESS ABOUT CANCER SCREENINGS TO INCREASE THE EARLY DETECTION OF CANCER.HEALTH NEED IDENTIFIED: CHRONIC DISEASE PREVENTIONSTRATEGY #1 - ANNUAL BLOOD PRESSURE SCREENINGS AND EDUCATION TO BE HELD AT COMMUNITY EVENTS. EARLY DETECTION AND TREATMENT OF HIGH BLOOD PRESSURE WOULD DECREASE THE RISK OF DEATH DUE TO CARDIOVASCULAR DISEASE. ACTIONS TAKEN:- 224 COMMUNITY MEMBERS OBTAINED A BLOOD PRESSURE SCREENING AT COMMUNITY EVENTS.STRATEGY #2 - GLUCOSE SCREENINGS AND DIABETES EDUCATION EVENTS TO BE HELD AT COMMUNITY EVENTS.ACTIONS TAKEN:- 165 COMMUNITY MEMBERS OBTAINED A GLUCOSE SCREENING AT COMMUNITY EVENTS.STRATEGY #3 - HOST STROKE SUPPORT GROUPS FOR THOSE AFFECTED BY THE DISEASE IN OUR COUNTY.ACTIONS TAKEN:- 22 ATTENDED THE STROKE SUPPORT GROUP HOSTED BY THE HOSPITAL.
EMMA L. BIXBY MEDICAL CENTER:	PART V, SECTION B, LINE 16A: THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXEMMA L. BIXBY MEDICAL CENTER:PART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXEMMA L. BIXBY MEDICAL CENTER:PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPX

Field	Value	IRS element (for citing)
Facility	16	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - HICKMAN CANCER CTR
777 KIMOLE LANE SUITE 130	ADRIAN	MI	49221	CANCER CARE
2 - SPORTSCARE AT ADRIAN
1136 COUNTRY CLUB RD SUITE A	ADRIAN	MI	49221	PHYSICAL THERAPY
3 - WOLF CREEK
901 KIMOLE LANE	ADRIAN	MI	49221	LAB
4 - PROMEDICA LABORATORIES - ADRIAN
3425 N ADRIAN HWY SUITE E	ADRIAN	MI	49221	LAB
5 - PROMEDICA HUDSON HEALTH CTR
331 W MAIN ST	HUDSON	MI	49247	LAB
6 - BLISSFIELD HEALTH CTR
157 WEST BROOKE LANE	BLISSFIELD	MI	49228	LAB
7 - BLISSFIELD HEALTH CTR
157 WEST BROOKE LANE	BLISSFIELD	MI	49228	RADIOLOGY
8 - FAMILY MEDICAL CENTER
1200 N MAIN ST	ADRIAN	MI	49221	LAB
9 - TECUMSEH HEALTH CENTER
501 E CUMMINS ST	TECUMSEH	MI	49186	LAB
10 - PROMEDICA RADIOLOGY
770 RIVERSIDE AVE	ADRIAN	MI	49221	RADIOLOGY
11 - TOTAL REHAB AT ONSTED
400 N MAIN STREET SUITE B	ONSTED	MI	49265	PHYSICAL THERAPY
12 - ONSTED HEALTH CENTER
400 N MAIN STREET SUITE B	ONSTED	MI	49265	LAB
13 - LENAWEE COMMUNITY HEALTH
1040 S WINTER ST STE 1022	ADRIAN	MI	49221	LAB
14 - PROMEDICA LABORATORIES - MONROE
811 N MACOMB ST	MONROE	MI	48161	LAB
15 - PROMEDICA HUDSON HEALTH CTR
458 CROSS STREET	HUDSON	MI	49247	RADIOLOGY
16 - PROMEDICA OCCUHEALTH
1801 W MAUMEE ST STE 140	ADRIAN	MI	49221	OCCUPATIONAL MEDICINE

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A:	EMMA L. BIXBY MEDICAL CENTER REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	EMMA L. BIXBY MEDICAL CENTER CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.
PART III, LINE 2:	EMMA L. BIXBY MEDICAL CENTER'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY.
PART III, LINE 3:	EMMA L. BIXBY MEDICAL CENTER ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT.
PART III, LINE 4:	PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGES 12 AND 13 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION.
PART III, LINE 8:	MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM.- THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS.- MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER.- MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.EMMA L. BIXBY MEDICAL CENTER USED THE MEDICARE ALLOWABLE COSTS PER ITS 2017 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS.
PART III, LINE 9B:	FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING.
PART VI, LINE 2:	PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE.
PART VI, LINE 3:	THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.
PART VI, LINE 4:	EMMA L. BIXBY MEDICAL CENTER, LOCATED IN ADRIAN, MI, SERVES AN AREA PRIMARILY AROUND LENAWEE COUNTY AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 81,000. APPROXIMATELY, 18% OF THE SERVICE AREA IS AGE 65 OR OVER; 39% IS BETWEEN AGE 35 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $51,000; 48% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 49% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. LENAWEE COUNTY HAS A POPULATION OF APPROXIMATELY 99,000 WITH APPROXIMATELY 13% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 17% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 9% OF LENAWEE COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE AT THE END OF 2017 FOR LENAWEE COUNTY WAS 4.8%. THE LEADING CAUSES OF DEATH IN LENAWEE COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, LUNG DISEASE, STROKE, DIABETES, ALZHEIMER'S, AND UNINTENTIONAL INJURIES/ACCIDENTS. ACCORDING TO THE 2017 COUNTY HEALTH RANKINGS, LENAWEE COUNTY RANKED 48 OF 83 COUNTIES FOR HEALTH OUTCOMES, 47 OF 83 FOR LENGTH OF LIFE, AND 47 OF 83 FOR QUALITY OF LIFE. THERE ARE TEN HOSPITALS WITHIN A 30-MILE RADIUS OF EMMA L. BIXBY MEDICAL CENTER: HERRICK MEMORIAL HOSPITAL, INC., ST. JOSEPH MERCY SALINE HOSPITAL, FLOWER HOSPITAL, FULTON COUNTY HEALTH CENTER, ST. ANNE MERCY HOSPITAL, CHELSEA COMMUNITY HOSPITAL, THE TOLEDO HOSPITAL, ALLEGIANCE HEALTH, UNIVERSITY OF TOLEDO MEDICAL CENTER, AND UNIVERSITY OF MICHIGAN HOSPITALS.
PART VI, LINE 5:	EMMA L. BIXBY MEDICAL CENTER IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC. WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. - IN 2017, THERE WERE 450 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), INCLUDING ITS SUBSIDIARIES. OF THESE, 99% LIVED WITHIN PROMEDICA'S 27-COUNTY SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN METRO TOLEDO WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. TRUSTEE REPRESENTATION IS COMPRISED OF DIVERSE MEMBERS, INCLUDING 75 PHYSICIANS, FROM NORTHWEST OHIO AND SOUTHEAST MICHIGAN. ADDITIONALLY, PROMEDICA BOARD MEMBERS INCLUDED 151 WOMEN AND 58 RACIAL/ETHNIC MINORITIES.- BOARD MEMBERS ARE NOT COMPENSATED BY PROMEDICA FOR THEIR SERVICE TO OUR HOSPITALS AND OTHER BUSINESS UNITS; THEIR DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, ARE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITIES WHICH PROMEDICA SERVES. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MEETS THOSE QUALIFICATIONS MAY BE GRANTED PRIVILEGES.- IN 2017, PROMEDICA INVESTED SIGNIFICANT TIME AND FINANCIAL RESOURCES TO COMPLETING THE ROLL OUT OF ITS ELECTRONIC HEALTH RECORD (EHR), EPIC. GO-LIVES TOOK PLACE IN MAY AT PROMEDICA BIXBY AND HERRICK, MONROE REGIONAL, AND MEMORIAL HOSPITALS, AS WELL AS THE 30 PROMEDICA PHYSICIANS OFFICES THAT SUPPORT THESE FACILITIES IN MICHIGAN AND FREMONT. THE FINAL GO-LIVES WERE FOLLOWED IN THE FALL WITH A SYSTEM-WIDE UPGRADE TO THE LATEST OPERATING PLATFORM FOR EPIC, FURTHER ENABLING ONE PATIENT, ONE RECORD, AND ONE BILL FOR PATIENTS REGARDLESS OF SERVICE PROVIDED OR THE LOCATION OF SERVICE ACROSS PROMEDICA.- PROMEDICA PROVIDED NEARLY 18,000 HEALTH SCREENINGS TO COMMUNITY MEMBERS THROUGHOUT 2017, INCLUDING BLOOD PRESSURE, BLOOD GLUCOSE AND BODY MASS INDEX SCREENINGS AT NUMEROUS HEALTH FAIRS AND SPORTING EVENTS. ADDITIONALLY, FREE SCREENING MAMMOGRAMS, AS WELL AS SKIN CANCER AND LUNG CANCER SCREENINGS AND COLORECTAL CANCER EDUCATION WERE PROVIDED FOR EARLY DETECTION. PROSTATE CANCER SCREENING EDUCATION AND NUTRITIONAL PROGRAMS WERE DEVELOPED TO KEEP PEOPLE HEALTHY.- PROMEDICA'S FOUNDATION RAISES FUNDS FOR PHILANTHROPY IN SUPPORT OF PROMEDICA'S MISSION TO IMPROVE HEALTH AND WELL-BEING. ANNUAL DONOR PROGRAMS, CAPITAL CAMPAIGNS, PLANNED GIVING, AND EVENT FUNDRAISING ACTIVITIES ARE CONDUCTED TO RAISE FUNDS THAT SUPPORT PATIENTS AND FAMILIES, AS WELL AS LOCAL COMMUNITIES, THROUGH HEALTH-RELATED PROGRAMS, SERVICES, EQUIPMENT, AND FACILITY CONSTRUCTION/RENOVATION THAT HAVE BEEN IDENTIFIED, IN PART, THROUGH A COMMUNITY NEEDS ASSESSMENT.
PART VI, LINE 6:	PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2017 PROMEDICA WAS COMPRISED OF MORE THAN 17,000 EMPLOYEES, APPROXIMATELY 2,500 VOLUNTEERS AND MORE THAN 2,000 HEALTHCARE PROVIDERS, INCLUDING APPROXIMATELY 900 PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP, WHO HAVE JOINED TOGETHER TO FORM A NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO HELP ENSURE AREA RESIDENTS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. - PROMEDICA MEMBERS INCLUDE: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA BIXBY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC. D/B/A PROMEDICA HERRICK HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP, A NETWORK OF SYSTEM-EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION, WITH SERVICES SUCH AS SENIOR CARE, HOSPICE, REHABILITATION SERVICES, AND HOME CARE.- IN 2017, PROMEDICA MANAGED APPROXIMATELY 4.1 MILLION PATIENT ENCOUNTERS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $191 MILLION, WHICH INCLUDED FREE HEALTH SCREENINGS AND PARTICIPATION IN PUBLIC HEALTH FAIRS TO MEDICAL LECTURES AT AREA SENIOR CENTERS AND NUTRITION EDUCATION IN ELEMENTARY SCHOOLS, PLUS MUCH MORE. - PROMEDICA CONTINUES TO OPERATE TWO FOOD CLINICS - ONE AT THE PROMEDICA HEALTH AND WELLNESS CENTER AND THE OTHER AT PROMEDICA'S CENTER FOR HEALTH SERVICES - TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEM AND THEIR FAMILY FROM THIS LOCATION OR THE ORIGINAL FOOD PHARMACY LOCATED AT PROMEDICA'S CENTER FOR HEALTH SERVICES. AS PART OF THE PROGRAM, EACH PATIENT RECEIVES TWO TO THREE DAYS OF SUPPLEMENTAL FOOD FOR THEIR FAMILY. THROUGH DECEMBER 2017, THERE WERE MORE THAN 9,700 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 3,200 UNIQUE HOUSEHOLDS. THIS TRANSLATES TO ABOUT 74,520 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 223,560 MEALS. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDES BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD, AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS.- IN 2017, PROMEDICA ESTABLISHED THE EBEID PROMISE, A 10-YEAR, $50 MILLION COMMUNITY REVITALIZATION INITIATIVE THANKS TO A GENEROUS $28.5 MILLION GIFT FROM THE FAMILY OF PHILANTHROPIST AND FORMER BOARD MEMBER RUSSELL J. EBEID. THE EBEID PROMISE WILL EXPAND THE SCOPE AND PURPOSE OF THE EBEID INSTITUTE WITH A KEY FOCUS ON THE SOCIAL DETERMINANTS OF HEALTH - HEALTH, NUTRITION, EDUCATION, JOB CREATION, AND FAMILY STABILITY. THIS LONG-TERM INVESTMENT WILL START WITH THE UPTOWN TOLEDO NEIGHBORHOOD AND BE EXPANDED TO TOLEDO'S MONROE STREET CORRIDOR, NEAR PROMEDICA TOLEDO HOSPITAL. PLANS INCLUDE REPLICATING THIS CONCEPT IN COMMUNITIES ACROSS PROMEDICA'S SERVICE AREA IN COMING YEARS.- WITH REGARD TO HEALTH PROFESSIONS EDUCATION, BIWEEKLY, MONTHLY AND ANNUAL PROGRAMS WERE OFFERED THROUGHOUT 2017 FOR CONTINUING MEDICAL EDUCATION CREDIT. MORE THAN 1,500 CREDIT HOURS OF PHYSICIAN EDUCATION WERE OFFERED TO EMPLOYED PROMEDICA PHYSICIANS AND MEDICAL STAFF MEMBERS AS WELL AS NURSES AND OTHER ALLIED HEALTH PROFESSIONALS.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
PROMEDICA HEALTH SYSTEM INC
100 MADISON AVE	TOLEDO	OH	43604	341517671	501(C)(3)	$3,000,000	OPERATING GRANT
PROMEDICA PHYSICIAN GROUP
100 MADISON AVE	TOLEDO	OH	43604	341899439	501(C)(3)	$3,559,500	OPERATING GRANT
PROMEDICA FOUNDATION
444 N SUMMIT ST	TOLEDO	OH	43604	341517672	501(C)(3)	$366,787	OPERATING GRANT

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	Yes (1)	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BARBARA J PETEE
TRUSTEE	$0	$282,149	$0	$52,536	$0	$9,217	$0	$62,561	$0	$2,355	$0	$408,818	$0	$0
JULIE K YAROCH DO
PRESIDENT, EX OFFICIO	$0	$251,052	$0	$45,000	$0	$958	$0	$20,931	$0	$23,178	$0	$341,119	$0	$0
KEVIN C WEBB PHD
EX OFFICIO	$0	$510,025	$0	$135,703	$0	$9,899	$0	$226,149	$0	$14,526	$0	$896,302	$0	$0
PAUL E GIETZEN MD
TRUSTEE	$0	$245,118	$0	$118,701	$0	$2,183	$0	$6,053	$0	$30,540	$0	$402,595	$0	$0
SAMANTHA M MUCHA MD
TRUSTEE	$7,500	$561,946	$0	$5,000	$0	$1,110	$0	$8,100	$0	$23,152	$7,500	$599,308	$0	$0
STACEY L BOCK
TRUSTEE	$0	$212,047	$0	$25,348	$0	$5,831	$0	$13,078	$0	$17,270	$0	$273,574	$0	$0
VICTOR J CHERFAN DO
TRUSTEE	$46,666	$336,718	$0	$197,826	$0	$17,526	$0	$5,418	$0	$32,297	$46,666	$589,785	$0	$0
JEFFREY C KUHN
SECRETARY	$0	$479,712	$0	$108,013	$0	$28,699	$0	$229,520	$0	$14,639	$0	$860,583	$0	$0
MICHAEL P BROWNING
TREASURER	$0	$586,938	$0	$70,000	$0	$40,177	$0	$222,483	$0	$23,931	$0	$943,529	$0	$0
RANDALL OOSTRA
PHS PRES & CEO, EX OFFICIO	$0	$1,086,659	$0	$577,159	$0	$85,998	$0	$468,579	$0	$14,639	$0	$2,233,034	$0	$159,048
DARRIN M ARQUETTE
SR. VP, NEURO, HEART AND VASC	$0	$215,123	$0	$92,356	$0	$27,839	$0	$20,942	$0	$25,399	$0	$381,659	$0	$0
GARY W AKENBERGER
SR. VP DIAG, FACILITIES & SEC	$0	$322,399	$0	$48,208	$0	$9,197	$0	$71,258	$0	$20,062	$0	$471,124	$0	$0
KATHRYN M GREENLEE
VP, PATIENT CARE/CNO, BMC & HH	$0	$143,696	$0	$14,489	$0	$6,952	$0	$28,045	$0	$17,369	$0	$210,551	$0	$0
SCOTT FOUGHT
VP, FINANCE, ACUTE CARE OPS	$0	$258,000	$0	$21,808	$0	$1,350	$0	$23,604	$0	$22,679	$0	$327,441	$0	$0
JENNIFER FOSS
MANAGER, PHARMACY	$123,241	$0	$0	$0	$4,832	$0	$3,059	$0	$22,581	$0	$153,713	$0	$0	$0
MARY ABRAHAM
PHARMACIST	$119,632	$0	$0	$0	$538	$0	$26,981	$0	$17,781	$0	$164,932	$0	$0	$0
MATTHEW J HAMMOND
VP OPERATIONS, PPG	$23,978	$124,092	$1,500	$0	$2,220	$5,646	$0	$8,064	$815	$2,887	$28,513	$140,689	$0	$0
RONDA WINANS
ASSOCIATE VP, OPERATIONS	$77,905	$43,283	$0	$0	$270	$175	$7,551	$0	$20,620	$1,520	$106,346	$44,978	$0	$0
ALAN M SATTLER
FORMER OFFICER	$0	$381,523	$0	$0	$0	$7,515	$0	$54,182	$0	$26,751	$0	$469,971	$0	$0
KATHLEEN S HANLEY
FORMER OFFICER	$0	$0	$0	$0	$0	$571,790	$0	$0	$0	$1,351	$0	$573,141	$0	$258,776

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	TAX INDEMNIFICATION AND GROSS-UP PAYMENTS 4 HIGHEST COMPENSATED EMPLOYEES INCLUDED IN TAXABLE COMPENSATION
PART I, LINE 3	PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF EMMA L. BIXBY MEDICAL CENTER, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4A:	UNDER A VOLUNTARY TERMINATION AGREEMENT ENTERED INTO BY THE EMPLOYEE AND THE ORGANIZATION OR UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM PROMEDICA. SEVERANCE PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: KATHLEEN S. HANLEY $258,776 PART I, LINE 4B: ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR. PART I, LINE 6: CERTAIN LISTED PERSONS RECEIVED INCENTIVES BASED ON INDIVIDUAL PRODUCTIVITY NET EARNINGS.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PART V	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	PART V	RelationshipDescriptionTxt
Transaction	$12,596	TransactionAmt
Transaction	PART V	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	FormAndLineReferenceDesc
Explanation	(A) NAME OF INTERESTED PERSON: REBECCA GAUNA(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: REBECCA GAUNA IS A FAMILY MEMBER OF KATHRYN M. GREENLEE (KEY EMPLOYEE).(C) AMOUNT OF TRANSACTION: $12,596(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART IV, LINE 24A:	EMMA L. BIXBY MEDICAL CENTER IS A HEALTH FACILITY THAT IS A SUBSIDIARY OF PROMEDICA HEALTH SYSTEM, INC. (PHS). EMMA L. BIXBY MEDICAL CENTER HOLDS AN INTERCOMPANY NOTE PAYABLE TO THE TOLEDO HOSPITAL, WHICH IS ALSO A SUBSIDIARY OF PHS. THE NOTE PAYABLE REPRESENTS EMMA L. BIXBY MEDICAL CENTER'S PORTION OF TAXABLE AND TAX-EXEMPT BONDS ISSUED BY PROMEDICA HEALTHCARE OBLIGATED GROUP.
FORM 990, PART VI, SECTION A, LINE 6	AS A MICHIGAN NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF EMMA L. BIXBY MEDICAL CENTER. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF EMMA L. BIXBY MEDICAL CENTER, AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11B	UNDER THE GUIDANCE OF PROMEDICA HEALTH SYSTEM, INC.'S (PHS) TAX CONSULTANTS, FORM 990S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH AFFILIATE AND REVIEWED BY THE AFFILIATE'S FINANCE LEADERSHIP. AFTER AFFILIATE'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR PHS AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND ARE REVIEWED AND SIGNED BY A PRINCIPAL OFFICER PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES AND SPECIFICALLY IDENTIFIED HOURLY EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER FOR PROMEDICA PHYSICIAN GROUP (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PHYSICIANS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PHYSICIAN STANDARD OF CONDUCT AND THE PHYSICIAN CERTIFICATION STATEMENT WHICH THE NEW PHYSICIAN IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER OR THEIR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PHYSICIAN AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE APPROPRIATE PHYSICIAN BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PROMEDICA HEALTH SYSTEM, INC. WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE.
FORM 990, PART VI, SECTION B, LINE 15	EMMA L. BIXBY MEDICAL CENTER'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF EMMA L. BIXBY MEDICAL CENTER'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19	PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 16B:	JOINT VENTURE OPERATING AGREEMENTS INVOLVING PROMEDICA HEALTH SYSTEM, INC. OR ITS SUBSIDIARIES (COLLECTIVELY, PHS) INCLUDE PROVISIONS TO PROTECT PHS'S TAX-EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. PHS CONTINUALLY ENSURES THAT ITS TAX-EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL PHS JOINT VENTURES.
FORM 990, PART IX, LINE 11G	PURCHASE SERVICES - NON-PHYSICIAN: PROGRAM SERVICE EXPENSES 3,087,945. MANAGEMENT AND GENERAL EXPENSES 198,151. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,286,096. PURCHASE SERVICES - PHYSICIAN: PROGRAM SERVICE EXPENSES 4,763,975. MANAGEMENT AND GENERAL EXPENSES 305,702. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,069,677. PURCHASE SERVICES - OTHER: PROGRAM SERVICE EXPENSES 2,131,882. MANAGEMENT AND GENERAL EXPENSES 136,802. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,268,684.
FORM 990, PART XI, LINE 9:	PENSION/POST RETIREMENT EXPENSE ADJUSTMENT 20,620. BENEFICIAL INTEREST IN FOUNDATION 1,570,857.
FORM 990, PART III, LINE 4:	PROMEDICA HEALTH SYSTEM, INC. - PROGRAM SERVICE ACCOMPLISHMENTS ESTABLISHED IN 1986, PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN CUTTING-EDGE TECHNOLOGY, INNOVATIVE PROGRAMS AND FAMILY-CENTERED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF A PATIENT'S ABILITY TO PAY. BASED ON NEEDS THAT WE HAVE ASSESSED WITHIN THE COMMUNITIES WE SERVE, PROMEDICA LAUNCHED NEW SERVICES AND PROGRAMS IN 2017 TO HELP MEET THE GROWING DEMANDS OF LOCAL CONSUMERS ACROSS ALL SPECTRUMS OF LIFE, INCLUDING THOSE INDIVIDUALS WHO ARE OFTEN THE MOST VULNERABLE WHEN IT COMES TO HEALTH CARE: THE ELDERLY, POOR AND UNDERSERVED. PROMEDICA'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. THIS IS REFLECTED IN OUR FOUR CORE VALUES, INCLUDING: COMPASSION - WE TREAT OUR PATIENTS AND EACH OTHER WITH RESPECT, INTEGRITY AND DIGNITY; INNOVATION - WE CONTINUALLY SEARCH TO FIND A BETTER WAY FORWARD; TEAMWORK - WE PARTNER WITH OTHERS BECAUSE WE ARE BETTER TOGETHER THAN APART; AND EXCELLENCE - WE STRIVE TO BE THE BEST IN ALL WE DO. PROMEDICA AND ITS AFFILIATES COMPRISE 220 SITES, MORE THAN 2,000 PHYSICIANS AND APPROXIMATELY 17,000 EMPLOYEES AND VOLUNTEERS. DURING 2017, PROMEDICA DISCHARGED 66,395 INPATIENTS AND SERVED 1,195,393 OUTPATIENTS, WHILE HANDLING 286,408 EMERGENCY VISITS SYSTEM-WIDE AS WELL AS 77,180 URGENT CARE VISITS AND MORE THAN 800 VIRTUAL VISITS THROUGH PROMEDICA ONDEMAND. AMONG THE REGION'S LARGEST EMPLOYERS, PROMEDICA PLAYS A SIGNIFICANT ROLE IN ECONOMIC DEVELOPMENT AND STABILITY IN OUR REGION. DURING 2017, FOR EVERY ONE DOLLAR OF REVENUE, ANOTHER 27 CENTS WAS CREATED IN OUR SERVICE-AREA ECONOMY, WITH A TOTAL ECONOMIC OUTPUT OF $4.0 BILLION. WE ALSO CREATE A DIRECT ECONOMIC IMPACT WITH OUR REVENUE, PAYROLL AND EMPLOYMENT. ADDITIONALLY, SPENDING ON SERVICES AND MATERIALS WITH VENDORS IN OUR REGION CREATES AN INDIRECT ECONOMIC BENEFIT. OUR PHYSICIANS AND PROVIDERS, LEADERSHIP TEAM MEMBERS, PHYSICIANS AND RESIDENTS, AND EMPLOYEES INDIVIDUALLY CONTRIBUTE PERSONAL RESOURCES TO THE COMMUNITY IN NUMEROUS WAYS - SUCH AS THROUGH TUTORING ELEMENTARY STUDENTS IN READING AND OTHER LIFE SKILLS, PROVIDING MONTHLY HEALTH LECTURES AT LOCAL SENIOR CENTERS, GENEROUSLY CONTRIBUTING TO COMMUNITY FUNDRAISING CAMPAIGNS SUCH AS UNITED WAY, PARTICIPATING IN MEDICAL MISSIONS, SERVING ON LOCAL NOT-FOR-PROFIT BOARDS, AND DONATING NONPERISHABLE FOODS AND CLOTHING ITEMS TO NUMEROUS LOCAL COMMUNITY ORGANIZATIONS AND CHURCHES - UNDERSCORING A KEY BENEFIT OF PROMEDICA BEING LOCALLY OWNED AND OPERATED. PROMEDICA'S MEMBER AND AFFILIATE HOSPITALS INCLUDE: THE TOLEDO HOSPITAL; TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF THE TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL); FLOWER HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION; DEFIANCE HOSPITAL, INC.; BAY PARK COMMUNITY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC.; EMMA L. BIXBY MEDICAL CENTER; MEMORIAL HOSPITAL; AND MERCY MEMORIAL HOSPITAL CORPORATION. IN 2017 PROMEDICA ALSO PROVIDED INTEGRATED SERVICES, COMPRISED OF: - PROMEDICA CONTINUING CARE SERVICES CORPORATION, PROVIDING REHABILITATION, HOSPICE, HOME CARE, AMBULATORY AND SENIOR SERVICES, COMMUNITY HEALTH, MEDICAL TRANSPORTATION SERVICES, AND CARE COORDINATION. - PROMEDICA PHYSICIAN GROUP (PROMEDICA PHYSICIANS), WITH APPROXIMATELY 900 HEALTHCARE PROVIDERS, INCLUDING PRIMARY CARE, OBSTETRICS AND SPECIALTY PHYSICIANS, AS WELL AS ADVANCED PRACTICE PROVIDERS. TOGETHER, THIS GROUP HELPS PROMEDICA BROADEN THE CARE WE OFFER TO AREA RESIDENTS, INCLUDING IN SMALLER, OUTLYING COMMUNITIES. - PROMEDICA INSURANCE CORPORATION, THE LARGEST HEALTH MAINTENANCE ORGANIZATION PHYSICALLY LOCATED IN NORTHWEST OHIO. IN 2017, PARAMOUNT ADVANTAGE PROVIDED MEDICAID COVERAGE TO MORE THAN 238,000 MEMBERS ACROSS ALL OF OHIO'S 88 COUNTIES. - PROMEDICA INDEMNITY CORPORATION, PROVIDING MEDICAL PROFESSIONAL AND COMPREHENSIVE GENERAL LIABILITY COVERAGE FOR PROMEDICA, INCLUDING IN OUTLYING AREAS WHERE PRIMARY-CARE PHYSICIAN RECRUITMENT IS DIFFICULT. - TWELVE CONTROLLED FOUNDATIONS THAT SERVE AS FUNDRAISING ENTITIES FOR THEIR RESPECTIVE HOSPITALS/BUSINESS UNITS AND FACILITIES, SUCH AS THE EBEID HOSPICE RESIDENCE ON THE PROMEDICA FLOWER HOSPITAL CAMPUS AND THE MARY ELLEN FALZONE DIABETES CENTER ON THE CAMPUS OF PROMEDICA TOLEDO HOSPITAL. PROMEDICA'S SPECIALIZED CARE INCLUDES ONCOLOGY, ORTHOPAEDICS, HEART AND VASCULAR, NEUROLOGY, REHABILITATIVE, AND BEHAVIORAL MEDICINE, AS WELL AS WOMEN'S AND PEDIATRIC CARE. A FUNDAMENTAL PART OF OUR MISSION IS THAT OUR SERVICES ARE TAILORED TO THE NEEDS OF OUR COMMUNITIES AND THEY ARE AVAILABLE TO EVERYONE IN OUR COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION TO BEING A STRONG ADVOCATE FOR THE HEALTH AND WELL-BEING OF OTHERS, PROMEDICA PROVIDES AND PROMOTES COMMUNITY WELLNESS, COLLABORATING WITH APPROXIMATELY 300 NONPROFIT AGENCIES AND ORGANIZATIONS ACROSS OUR REGION IN 2017 THAT HAD VALUES AND MISSIONS SIMILAR TO OUR OWN.
PROMEDICA IS CONTINUALLY IMPROVING ITS SERVICES, FACILITIES,	TECHNOLOGIES, AND OUTREACH EFFORTS TO MEET THE EVER-CHANGING NEEDS OF ITS DIVERSE POPULATIONS. IN DIRECT RESPONSE TO COMMUNITY NEEDS, A FEW EXAMPLES FROM 2017 INCLUDE THE FOLLOWING: - IN 2017, PROMEDICA ESTABLISHED THE EBEID PROMISE, A 10-YEAR, $50 MILLION COMMUNITY REVITALIZATION INITIATIVE THANKS TO A GENEROUS $28.5 MILLION GIFT FROM THE FAMILY OF PHILANTHROPIST AND FORMER BOARD MEMBER RUSSELL J. EBEID. THE EBEID PROMISE WILL EXPAND THE SCOPE AND PURPOSE OF THE EBEID INSTITUTE WITH A KEY FOCUS ON THE SOCIAL DETERMINANTS OF HEALTH - HEALTH, NUTRITION, EDUCATION, JOB CREATION, AND FAMILY STABILITY. THIS LONG-TERM INVESTMENT WILL START WITH THE UPTOWN TOLEDO NEIGHBORHOOD AND BE EXPANDED TO TOLEDO'S MONROE STREET CORRIDOR, NEAR PROMEDICA TOLEDO HOSPITAL. PLANS INCLUDE REPLICATING THIS CONCEPT IN COMMUNITIES ACROSS PROMEDICA'S SERVICE AREA IN COMING YEARS. - PROMEDICA ALSO ESTABLISHED A NATIONAL RESEARCH CENTER DEVOTED TO STUDYING THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON INDIVIDUALS AND COMMUNITIES. THE CENTER IS BEING DEVELOPED IN COOPERATION WITH THE UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE AND LIFE SCIENCES. IT WILL BE ONE OF THE FIRST OF ITS KIND IN THE NATION AND USES A MULTIDISCIPLINARY APPROACH TO UNDERSTAND AND PROPOSE SOLUTIONS TO ADDRESS THE CONDITIONS IN WHICH PEOPLE ARE BORN, LIVE, WORK AND AGE THAT AFFECT THEIR HEALTH AND WELL-BEING. - THREE PROMEDICA HOSPITALS RECEIVED A 5-STAR RATING FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) IN ITS MOST RECENT COMPARISON OF ACUTE CARE QUALITY. THE THREE HOSPITALS ARE PROMEDICA BAY PARK, MEMORIAL AND TOLEDO HOSPITALS. THE CMS STAR RATING SYSTEM IS A WAY OF SUMMARIZING AND COMPARING HOSPITALS ACROSS THE NATION BASED ON A STANDARDIZED SET OF METRICS AND DEFINITIONS. THE STAR RATING EXAMINES MORE THAN 50 INPATIENT AND OUTPATIENT MEASURES THAT INDICATE GOOD PATIENT OUTCOMES SUCH AS 30-DAY MORTALITY (HEART ATTACK, HEART FAILURE, PNEUMONIA), 30-DAY READMISSIONS, INPATIENT SATISFACTION, HOSPITAL ACQUIRED INFECTIONS, AND MORE. - PROMEDICA CONTINUES TO EMPHASIZE A CULTURE OF SAFETY ACROSS ITS HOSPITALS AND OUTPATIENT SERVICES. THE YEAR-END SERIOUS SAFETY EVENT RATE (SSER) WAS 0.65, REFLECTING A 20% DECREASE IN SERIOUS SAFETY EVENTS. - IN 2017, PROMEDICA OPENED ITS NEW HEADQUARTERS IN DOWNTOWN TOLEDO, OHIO, BRINGING NEARLY 1,000 EMPLOYEES TO THE AREA AND SUPPORTING DOWNTOWN REVITALIZATION AND ECONOMIC GROWTH. - IN 2017, PROMEDICA WELCOMED 130 RESIDENTS/FELLOWS AND 460 MEDICAL STUDENTS FROM THE UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE AND LIFE SCIENCES AS PART OF THE ACADEMIC AFFILIATION CREATED IN 2015. THE COLLABORATION IS HELPING TO ADVANCE MEDICAL EDUCATION AND CLINICAL RESEARCH IN NORTHWEST OHIO, BUILDING A LEGACY MODEL OF HEALTH CARE THAT WILL BENEFIT COMMUNITY MEMBERS ACROSS THE REGION FOR GENERATIONS TO COME. - PROMEDICA BROKE GROUND FOR ITS NEW LENAWEE COUNTY HOSPITAL IN MICHIGAN, TO BE NAMED THE PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL. THE HICKMAN FAMILY GIFT IS THE LARGEST DONATION IN THE HISTORY OF PROMEDICA AND WILL ALLOW FOR THE CONSOLIDATION OF THE PROMEDICA BIXBY AND HERRICK HOSPITALS INTO ONE LOCATION TO BETTER SERVE THE LENAWEE COUNTY COMMUNITY. - PROMEDICA COMPLETED THE ROLL OUT OF ITS NEW ELECTRONIC HEALTH RECORD (EHR), EPIC, IN 2017 AND UPGRADED THE ENTIRE SYSTEM TO THE MOST RECENT VERSION OF EPIC. THE UPGRADED VERSION ALLOWS PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON INPUT FROM CUSTOMERS. EPIC FURTHER ENABLES ONE PATIENT, ONE RECORD, AND ONE BILL FOR PATIENTS REGARDLESS OF SERVICE PROVIDED OR THE LOCATION OF SERVICE ACROSS PROMEDICA. - PARAMOUNT IMPLEMENTED THE FINAL PHASE OF ITS NEW TRUCARE CARE MANAGEMENT SYSTEM. THE TRUCARE SYSTEM MOVES PARAMOUNT TO A STATE-OF-THE-ART CARE MANAGEMENT SYSTEM AND PROVIDES MANY OPERATIONAL EFFICIENCIES THAT ALLOW PARAMOUNT TO MEET THE RIGOROUS CARE MANAGEMENT DEMANDS THAT ARE REQUIRED TO SERVE THE MEDICAID POPULATION IN OHIO. - PROMEDICA PHYSICIANS LAUNCHED A NEW EDUCATION PROGRAM INTENDED TO HELP BRING AN END TO OHIO'S OPIOID EPIDEMIC. TO DO THIS, PROMEDICA PARTNERED WITH THE OHIO STATE MEDICAL ASSOCIATION TO OFFER SMART RX - SAFE MEDICINE AND RESPONSIBLE TREATMENT PROGRAM. SMART RX IS AN HOUR-LONG ONLINE TRAINING PROGRAM AND PUBLIC AWARENESS CAMPAIGN THAT BRINGS MEDICAL PROFESSIONALS UP-TO-DATE ON OHIO'S OPIOID PRESCRIBING RULES AND REGULATIONS AS WELL AS BEST PRACTICES FOR TREATING PAIN, AND TIPS FOR PATIENTS ON HOW TO APPROPRIATELY HANDLE AND DISPOSE OF POTENTIALLY ADDICTIVE PRESCRIPTION MEDICINES. - PROMEDICA OPENED FOUR ADDITIONAL URGENT CARE CENTERS IN THE METRO-TOLEDO AREA, TO SERVE PATIENTS WHO HAVE MEDICAL CONCERNS THAT DO NOT REQUIRE AN EMERGENCY CENTER. A TOTAL OF NINE URGENT CARE CENTERS ARE NOW OPEN 8 A.M. TO 8 P.M., 365 DAYS PER YEAR, AND ARE STAFFED BY HIGHLY-TRAINED CERTIFIED NURSE PRACTITIONERS. - PROMEDICA OPENED A NEW SPECIALTY PHARMACY TO AID PATIENTS WHO ARE LIVING WITH CHRONIC AND COMPLEX HEALTH CONDITIONS AND NEED SPECIALIZED THERAPIES OR PERSONALIZED CARE. THE PHARMACY PROVIDES DISPENSING FOR SPECIALTY MEDICATIONS USED TO TREAT CHRONIC HEALTH CONDITIONS, INCLUDING CYSTIC FIBROSIS, ULCERATIVE COLITIS AND CHRON'S DISEASE, HEPATITIS C, MULTIPLE SCLEROSIS, AUTOIMMUNE DISEASE, CANCER, AND MUCH MORE. THE NEW PHARMACY IS ABLE TO SHIP MEDICATIONS DIRECTLY TO THE PATIENT FOR IMPROVED ACCESS TO CARE. - PROMEDICA PARTICIPATED IN DOZENS OF COMMUNITY HEALTH FAIRS ACROSS THE REGION THAT INCLUDED FREE PUBLIC SCREENINGS FOR HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, BODY MASS INDEX AND BONE DENSITY. - PROMEDICA CANCER INSTITUTE'S (PCI) COMMUNITY OUTREACH INCLUDED CANCER SCREENINGS AND EDUCATION TO THE MOST VULNERABLE IN OUR COMMUNITY. FREE SCREENING MAMMOGRAMS AS WELL AS LUNG CANCER SCREENINGS WERE PROVIDED FOR EARLY DETECTION. COLORECTAL CANCER EDUCATION AND NUTRITIONAL PROGRAMS WERE DEVELOPED TO KEEP PEOPLE HEALTHY, WHILE SUN SAFETY EDUCATION WAS PROVIDED TO ELEMENTARY SCHOOL CHILDREN TO HELP PREVENT FUTURE CASES OF SKIN CANCER. PCI ALSO HOSTED ANNUAL CANCER SURVIVOR CELEBRATIONS FOR SURVIVORS, FRIENDS AND CAREGIVERS ACROSS THE REGION AND SPONSORED COMMUNITY EVENTS INCLUDING THE ANNUAL NW OHIO SUSAN G. KOMEN, RACE FOR THE CURE AND AMERICAN CANCER SOCIETY RELAY FOR LIFE IN LUCAS COUNTY. - PROMEDICA CONTINUES TO OPERATE TWO FOOD CLINICS - ONE AT THE PROMEDICA HEALTH AND WELLNESS CENTER AND THE OTHER AT PROMEDICA'S CENTER FOR HEALTH SERVICES - TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEM AND THEIR FAMILY FROM THIS LOCATION OR THE ORIGINAL FOOD PHARMACY LOCATED AT PROMEDICA'S CENTER FOR HEALTH SERVICES. AS PART OF THE PROGRAM, EACH PATIENT RECEIVES TWO TO THREE DAYS OF SUPPLEMENTAL FOOD FOR THEIR FAMILY. THROUGH DECEMBER 2017, THERE HAVE BEEN MORE THAN 9,700 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 3,200 UNIQUE HOUSEHOLDS. THIS TRANSLATES TO ABOUT 74,520 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 223,560 MEALS. - PROMEDICA ALSO OFFERS ITS PRESCRIPTION FOR HEALTH PROGRAM IN THE ADRIAN, MICHIGAN, COMMUNITY. THROUGH THIS PROGRAM, PROMEDICA PROVIDERS ARE ABLE TO WRITE A PRESCRIPTION FOR FOOD FOR ELIGIBLE PATIENTS, WHICH ALLOWS THE INDIVIDUAL TO REDEEM TOKENS FOR THE PURCHASE OF FRESH FRUITS AND VEGETABLES AT THE ADRIAN FARMERS MARKET. THE PROGRAM IS DESIGNED FOR PATIENTS AGE 55 AND OLDER, OR LESS THAN 55 YEARS WITH CHILDREN LIVING IN THE HOUSEHOLD, WHO HAVE A DIAGNOSIS OF HIGH CHOLESTEROL, HIGH BLOOD PRESSURE, OBESITY, PREDIABETES OR DIABETES. - PROMEDICA'S FINANCIAL OPPORTUNITY CENTER (FOC), PROVIDED EDUCATION AND COUNSELING TO NEARLY 1,000 INDIVIDUALS. HOUSED IN THE EBEID INSTITUTE, FOC HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING, AS WELL AS FREE TAX PREPARATION THROUGH THE OHIO BENEFIT BANK. FOC ALSO OFFERS A DIGITAL LITERACY SERIES TO ASSIST INDIVIDUALS WISHING TO IMPROVE THEIR COMPUTER LITERACY AND SKILLS TO BE MORE MARKETABLE TO PROSPECTIVE EMPLOYERS. - IN 2017, PROMEDICA PRIMARY CARE PROVIDERS BEGAN SCREENING PATIENTS FOR SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREEN POSITIVE FOR ANY OF THE FACTORS ARE CONNECTED TO NECESSARY COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE. - PROMEDICA TOLEDO HOSPITAL BECAME THE FIRST HOSPITAL IN OHIO TO ACQUIRE SYNAPTIVE MEDICAL'S BRIGHTMATTER TECHNOLOGY, WHICH COMBINES ADVANCED IMAGING, PLANNING, NAVIGATION AND ROBOTIC VISUALIZATION WITH A DIGITAL MICROSCOPE FOR COMPLEX BRAIN TUMOR AND SPINAL SURGERY. THE NEW TECHNOLOGY ALLOWS FOR BETTER SURGICAL ERGONOMICS, FACILITATES COLLABORATION AMONG OPERATING ROOM STAFF, AND CONSUMES LESS SURGICAL TIME, ALL FACTORS THAT COULD LEAD TO IMPROVED PATIENT OUTCOMES.
- PROMEDICA'S SUMMER YOUTH EMPLOYMENT PROGRAM PARTNERED 40 CENTRAL-CITY	TEENS AGES 16 - 19 WITH MENTORS IN DEPARTMENTS SUCH AS HUMAN RESOURCES, RADIOLOGY, DIETARY, AND INFORMATION TECHNOLOGY TO LEARN SKILLS INCLUDING CUSTOMER SERVICE, PUNCTUALITY AND BEING ACCOUNTABLE TO OTHERS. - PROMEDICA INNOVATION'S BUSINESS INCUBATOR ALLOWS CLIENT COMPANIES IN THE HEALTHCARE FIELD TO ACCELERATE DEVELOPMENT AND COMMERCIALIZATION OF MEDICAL DEVICES AND HEALTH INFORMATION TECHNOLOGY TO IMPROVE PATIENT CARE LOCALLY AND NATIONALLY. - ADDITIONALLY, IN 2017, PROMEDICA INNOVATIONS FORMED A COLLABORATIVE ORGANIZATION CALLED NEXTTECH WITH THE UNIVERSITY OF TOLEDO, BOWLING GREEN STATE UNIVERSITY, AND MERCY HEALTH. NEXTTECH RECEIVED THE OHIO THIRD FRONTIER GRANT OF $8.7 MILLION TO SERVE AS THE ENTREPRENEURIAL SERVICES PROVIDER (ESP) FOR 18 COUNTIES IN NORTHWEST OHIO. THE ESP OFFERS A NETWORK OF ENTREPRENEURIAL SERVICES AND CAPITAL TO ACCELERATE THE GROWTH OF EARLY STAGE OHIO TECHNOLOGY COMPANIES. IN 2017, PROMEDICA CONTRIBUTED $191,681,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THESE NUMBERS NOT ONLY INDICATE PROMEDICA'S LONG-STANDING COMMITMENT TO THE COMMUNITY, BUT ALSO FULFILL OUR NOT-FOR-PROFIT STATUS BY IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS IN THE COMMUNITIES WE SERVE. SPECIFICALLY, THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, PROMEDICA CONTRIBUTED $50,124,000 IN 2017. THESE PROGRAMS INCLUDED FREE COMMUNITY HEALTH SCREENINGS, SUCH AS DIABETES TESTING, BLOOD PRESSURE, BONE DENSITY, BODY MASS, AND CANCER CHECKUPS; MAMMOGRAM SCREENINGS FOR LOW-INCOME AND UNINSURED WOMEN; CHILDHOOD IMMUNIZATIONS; REDUCED-COST SCHOOL-ATHLETIC PHYSICALS; FIRST-AID COVERAGE AT COMMUNITY EVENTS; VOLUNTEER ELEMENTARY SCHOOL MENTORS; PUBLIC HEALTH EDUCATION LECTURES AND SEMINARS; A CHILDHOOD OBESITY PROGRAM; AND MANY OTHER COMMUNITY-BASED INITIATIVES. PROMEDICA ALSO CONTRIBUTED $11,054,000 IN FINANCIAL ASSISTANCE FOR PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. THIS AMOUNT REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. IN ADDITION, PROMEDICA'S COST OF BAD DEBT FOR 2017 WAS $28,737,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $191,681,000 NOTED ABOVE. FURTHER, PROMEDICA CONTINUES TO BE A LEADING PARTICIPANT IN THE LUCAS COUNTY CARENET INITIATIVE - A COLLABORATIVE EFFORT AMONG PROMEDICA, MERCY HEALTH PARTNERS, THE UNIVERSITY OF TOLEDO MEDICAL CENTER, THE CITY OF TOLEDO, AND OTHERS. CARENET WAS CREATED TO PROVIDE FREE OR LOWER-COST HEALTH CARE FOR LOW-INCOME LUCAS COUNTY RESIDENTS. ESTABLISHED IN 2003, CARENET BRIDGES THE GAP BETWEEN ADULTS WITHOUT HEALTH INSURANCE AND NEEDED HEALTHCARE SERVICES. WHILE SOME INDIVIDUALS MAY QUALIFY FOR GOVERNMENTAL INSURANCE PROGRAMS SUCH AS MEDICAID, OTHERS DO NOT; IT IS FOR THESE INDIVIDUALS THAT CARENET WAS ESTABLISHED. ADDITIONALLY DURING 2017, PROMEDICA PROVIDED $130,504,000 OF COMMUNITY BENEFIT THROUGH THE COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. PROMEDICA'S TOTAL COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS DURING 2017 WAS $139,149,000 AND IS NOT REFLECTED IN THE COMMUNITY BENEFIT AMOUNT OF $191,681,000 NOTED ABOVE. INDEED, PROMEDICA GOES BEYOND INDUSTRY STANDARDS IN MEETING THE GOAL OF PROVIDING CARE TO EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE HOSPITAL CARE FREE-OF-CHARGE TO ALL FAMILIES WITHOUT INSURANCE WITH INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO FREE CARE FOR THOSE FAMILIES UNDER THIS FEDERAL POVERTY LEVEL, PROMEDICA HOSPITALS PROVIDE SIGNIFICANT DISCOUNTS TO FAMILIES WITH INCOMES OF UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN MANY SITUATIONS, OTHER FUNDING SOURCES ARE SECURED AND ACCOMMODATIONS MADE. PROMEDICA'S POLICIES ARE POSTED AND AVAILABLE IN WRITING IN ALL PROMEDICA FACILITIES. ALSO, FINANCIAL ADVOCATES ARE AVAILABLE TO HELP PATIENTS BY EXPLAINING OUR FREE CARE AND DISCOUNT PROGRAMS, AND TO ASSIST WITH THE PAPERWORK NECESSARY TO QUALIFY FOR GOVERNMENT FUNDING. PATIENT BILLS PROVIDE CLEAR EXPLANATIONS, QUALIFICATIONS AND REMINDERS OF THESE PROGRAMS. IN SUMMARY, PROMEDICA DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE.
EMMA L. BIXBY MEDICAL CENTER - PROGRAM SERVICE ACCOMPLISHMENTS	FOUNDED IN 1911, EMMA L. BIXBY MEDICAL CENTER (D/B/A PROMEDICA BIXBY HOSPITAL) CONTINUES TO MEET THE HEALTHCARE NEEDS OF ADRIAN, MICHIGAN AND SURROUNDING SOUTHEAST MICHIGAN COMMUNITIES AS THE LARGEST ACUTE CARE FACILITY IN LENAWEE COUNTY. IT IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN, AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE HEALTH CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. PROMEDICA BIXBY HOSPITAL (BH) IS AN 88-BED, FULL-SERVICE, ACUTE CARE HOSPITAL STAFFED BY MORE THAN 120 ACTIVE PROVIDERS WORKING TO MEET IDENTIFIED NEEDS OF THE COMMUNITY. THE HOSPITAL OFFERS NUMEROUS INPATIENT AND OUTPATIENT SERVICES, WITH ITS STAFF OF PROFESSIONALS OFFER CARE IN GENERAL SURGERY, HEART AND VASCULAR CARE, WOMEN'S HEALTH, BEHAVIORAL MEDICINE INCLUDING AUTISM PROGRAMMING ORTHOPAEDICS, PEDIATRICS, FAMILY MEDICINE, PAIN MANAGEMENT, WOUND CARE, CRITICAL CARE AND CANCER TREATMENT SERVICES. BH ALSO OFFERS EMERGENCY MEDICINE SERVICES AND IS ACCREDITED AS A PRIMARY STROKE CARE CENTER BY HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP). IN 2017, BH RECEIVED THE AMERICAN HEART ASSOCIATION GOLD PLUS ACHIEVEMENT AND HONOR ROLL AWARDS FOR STROKE PATIENT CARE. THE HOSPITAL ALSO IS A NICHE (NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS) DESIGNATED HOSPITAL, A NATIONAL NURSE-DRIVEN PROGRAM DESIGNED TO HELP HOSPITALS IMPROVE THE CARE OF OLDER ADULTS. IN 2017, BH SERVED 4,025 INPATIENTS; 93,294 OUTPATIENTS; AND 30,777 EMERGENCY CENTER PATIENTS. BH PROVIDES INPATIENT AND OUTPATIENT SERVICES WITH STATE-OF-THE-ART TECHNOLOGY AND STRIVES TO OFFER EXCEPTIONAL CARE TO BEST RESPOND TO COMMUNITY NEED. THIS IS REFLECTED IN THE PROGRAMS AND SERVICES OFFERED, SUCH AS THE HICKMAN CANCER CENTER. AS PART OF THE PROMEDICA CANCER INSTITUTE, HICKMAN CANCER CENTER OFFERS DIAGNOSTIC SERVICES, AS WELL AS RADIATION AND MEDICAL ONCOLOGY TREATMENT FOR HUNDREDS OF NEW PATIENTS ANNUALLY. AS A MEMBER OF THE TOLEDO COMMUNITY HOSPITAL ONCOLOGY PROGRAM, HICKMAN CANCER CENTER OFFERS PATIENTS THE OPPORTUNITY TO PARTICIPATE IN NATIONAL CANCER TRIALS. FURTHER, BH'S CARDIAC REHABILITATION PROGRAM IS CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. IN 2017, BH ADDED TELEMEDICINE SERVICE TO ITS INPATIENT CARE UNITS TO HELP PROVIDE REAL-TIME PATIENT DIAGNOSIS AND TREATMENT FROM A PHYSICIAN. THE SERVICE ALLOWS A DOCTOR'S VISIT TO BE CONDUCTED WITH A SPECIAL COMPUTER AND INTERNET CONNECTION AND HELPS THE HOSPITAL PROVIDE SAFE, QUALITY CARE WHEN IT'S NEEDED DURING NIGHT SHIFTS WHEN FEWER PHYSICIANS MAY BE AVAILABLE. THE HOSPITAL CONTRIBUTED $2,635,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE IN 2017. THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, AND OTHER COMMUNITY BENEFIT OPERATIONS, BH CONTRIBUTED $89,000 TO THE COMMUNITY DURING 2017. THE FOLLOWING ARE EXAMPLES OF SUCH CONTRIBUTIONS: - SUPPORT OF THE LENAWEE HEALTH NETWORK VEGGIE MOBILE, WHICH BRINGS FRESH PRODUCE TO THE LENAWEE COUNTY COMMUNITY. - SUPPORT GROUPS FOR INDIVIDUALS WITH CHRONIC DISEASES, FOCUSED ON PATIENTS' EMOTIONAL, PHYSIOLOGICAL AND PSYCHOLOGICAL NEEDS; - ANNUAL CANCER SURVIVORSHIP PROGRAM FOR CANCER SURVIVORS AND THEIR FAMILIES, FRIENDS AND CAREGIVERS TO SHARE STORIES OF INSPIRATION AND HOPE. - CHILDHOOD AND ADULT IMMUNIZATIONS, ASTHMA CARE, AND INDIGENT AND SENIOR HEALTH FAIRS FOR THE UNDERPRIVILEGED AND LOCAL COMMUNITY AT LARGE; - COMMUNITY HEALTH AND WELLNESS SERVICES, WHICH INCLUDED TOBACCO CESSATION PROGRAMS, NUTRITION AND FITNESS CLASSES, PRENATAL AND FAMILY PLANNING CLASSES, AND CPR TRAINING; AND - FREE BLOOD PRESSURE, BODY MASS INDEX (BMI), CHOLESTEROL, CANCER, AND DIABETES SCREENINGS FOR AREA RESIDENTS, INCLUDING AT LOCAL SENIOR CENTERS. - PRESCRIPTION FOR HEALTH PROGRAM TO HELP REDUCE FOOD INSECURITY WHERE PATIENTS CAN RECEIVE VOUCHERS FROM THEIR DOCTOR TO USE AT THE ADRIAN FARMERS MARKET. BH PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2017, OF WHICH $530,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. BH'S COST OF BAD DEBT FOR 2017 WAS $1,238,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $2,635,000 NOTED ABOVE. FURTHER, BH PROVIDED $2,016,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. ALSO IN 2017, THE TOTAL COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $3,775,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $2,635,000 NOTED ABOVE. BH PROVIDED 627 JOBS THROUGH DIRECT EMPLOYMENT IN 2017, EXPENDING $21,771,000 IN NET PAYROLL. A TOTAL OF $1,002,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, BH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE.
COMMUNITY BENEFIT DEFINITIONS	PROMEDICA HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES (PROMEDICA) PREPARES ITS COMMUNITY BENEFIT REPORTS CONSISTENT WITH GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES AND CONSISTENT WITH FORM 990, SCHEDULE H, HOSPITALS, REPORTING. COMMUNITY BENEFITS ARE PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFITS REPORTED BY PROMEDICA RESPOND TO IDENTIFIED COMMUNITY NEEDS AND MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: - IMPROVE ACCESS TO HEALTHCARE SERVICE. - ENHANCE THE HEALTH OF THE COMMUNITY. - ADVANCE HEALTHCARE KNOWLEDGE. - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. FINANCIAL ASSISTANCE CONSISTENT WITH ITS MISSION, PROMEDICA PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY THEIR BILL. PROMEDICA HOSPITALS PROVIDE FREE CARE TO THOSE UNINSURED PATIENTS WITH INCOMES UP TO 200% OF THE FEDERAL POVERTY LEVEL. SIGNIFICANT DISCOUNTS ARE ALSO PROVIDED ON A SLIDING SCALE TO UNINSURED PATIENTS UP TO 400% OF THE FEDERAL POVERTY LEVEL. FINANCIAL ASSISTANCE IS REPORTED IN THE FORM OF COST TO PROVIDE SERVICES AND HAS BEEN REDUCED TO REFLECT REIMBURSEMENT RECEIVED FROM STATE PROGRAMS DESIGNED TO RELIEVE THE BURDEN OF PROVIDING FINANCIAL ASSISTANCE. THE COST OF FINANCIAL ASSISTANCE DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS THAT DO NOT PAY THEIR BILL. GOVERNMENT-SPONSORED HEALTH CARE GOVERNMENT-SPONSORED HEALTH CARE INCLUDE SERVICES THAT ARE REIMBURSED OR PARTIALLY REIMBURSED THROUGH GOVERNMENT MEANS-TESTED PROGRAMS SUCH AS MEDICAID. PROMEDICA INCLUDES THE UNPAID COSTS OF THESE PUBLIC PROGRAMS TO THE EXTENT THAT PAYMENTS RECEIVED ARE LESS THAN THE COSTS OF PROVIDING SERVICES. THE UNPAID COSTS OF TREATING MEDICARE PATIENTS IS REPORTED SEPARATELY AND IS NOT INCLUDED IN PROMEDICA'S COMMUNITY BENEFIT REPORT. ADDITIONALLY, THE COST OF FINANCIAL ASSISTANCE HAS BEEN ELIMINATED FROM ANY AMOUNTS REPORTED IN THIS CATEGORY. COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE ACTIVITIES CARRIED OUT FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH. THESE ACTIVITIES GENERALLY DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS AS THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND ARE SUBSIDIZED BY PROMEDICA. COMMUNITY BENEFIT OPERATIONS INCLUDE COSTS ASSOCIATED WITH DEDICATED STAFF, COMMUNITY HEALTH NEED AND/OR ASSESSMENT, AND OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT PLANNING AND ADMINISTRATION. HEALTH PROFESSIONS EDUCATION HEALTH PROFESSIONS EDUCATION INCLUDE COSTS FOR ALL EDUCATIONAL PROGRAMS PROMEDICA IS INVOLVED WITH, THE PROVISION OF A CLINICAL SETTING FOR TRAINING FOR HEALTHCARE STUDENTS OUTSIDE THE ORGANIZATION, AND FUNDING FOR HEALTHCARE EDUCATION. SUBSIDIZED HEALTH SERVICES SUBSIDIZED HEALTH SERVICES ARE SERVICES PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS. THESE SERVICES GENERATE A BILL FOR REIMBURSEMENT, AND INCLUDE CLINICAL PATIENT CARE SERVICES THAT ARE PROVIDED BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND OTHER PROVIDERS ARE UNWILLING, OR UNABLE, TO PROVIDE THE SERVICES, OR THE SERVICES OTHERWISE WOULD NOT BE AVAILABLE TO MEET COMMUNITY NEEDS. RESEARCH RESEARCH ACTIVITIES INCLUDE CLINICAL AND COMMUNITY HEALTH RESEARCH, AS WELL AS STUDIES ON HEALTHCARE DELIVERY. THE AMOUNT REPORTED FOR PROMEDICA IS REDUCED BY ANY EXTERNAL SUBSIDIES, SUCH AS GRANTS. CASH AND IN-KIND CONTRIBUTIONS CASH AND IN-KIND CONTRIBUTIONS INCLUDE FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY ORGANIZATIONS AND THE COMMUNITY AT LARGE. IN-KIND SERVICES INCLUDE HOURS DONATED BY STAFF FOR COMMUNITY NEEDS WHILE ON WORK TIME; AS WELL AS DONATIONS OF FOOD, EQUIPMENT AND SUPPLIES.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (26 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MIDWEST CARDIOVASCULAR CONSULTANTS LLC
100 MADISON AVE	TOLEDO	OH	43604	611448753	EMPLOYS PHYSICIANS	OH	$0	$535,504	PROMEDICA PHYSICIAN GROUP
PROMEDICA CENTRAL PHYSICIANS LLC
100 MADISON AVE	TOLEDO	OH	43604	341881137	EMPLOYS PHYSICIANS	OH	$315,619,235	$214,946,527	PROMEDICA PHYSICIAN GROUP
PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS LLC
100 MADISON AVE	TOLEDO	OH	43604	263888045	EMPLOYS PHYSICIANS	OH	$16,615,923	-$109,590,353	PROMEDICA PHYSICIAN GROUP
THE PHARMACY COUNTER LLC
100 MADISON AVE	TOLEDO	OH	43604	271325141	MEDICAL EQUIPMENT & PHARMACY	OH	$71,348,604	$19,350,264	PROMEDICA PHYSICIAN GROUP
WOLF CREEK ASSOCIATES LLC
901 KIMOLE LN	ADRIAN	MI	49221	383164818	FACILITY LEASING	MI	$118,769	$1,534,004	EMMA L BIXBY MEDICAL CENTER
PROMEDICA MONROE CARDIOLOGY PLLC
100 MADISON AVE	TOLEDO	OH	43604	272920342	EMPLOYS PHYSICIANS	MI	$1,024,708	-$7,073,357	PROMEDICA PHYSICIAN GROUP
ERIE WEST HOSPICE & PALLIATIVE CARE LTD
100 MADISON AVE	TOLEDO	OH	43604	205752995	PROVIDES HOSPICE CARE	OH	$5,202,956	$7,817,719	PROMEDICA CONTINUUM SERVICES
PROMEDICA PHYSICIANS MANAGEMENT SERVICES LLC
100 MADISON AVE	TOLEDO	OH	43604	453230331	PRACTICE MANAGEMENT	OH	$0	-$3,428,754	PROMEDICA PHYSICIAN GROUP
PROMEDICA SURGICAL SERVICES LLC
100 MADISON AVE	TOLEDO	OH	43604		EMPLOYS PHYSICIANS	OH	$0	$0	PROMEDICA PHYSICIAN GROUP
MISSION POINTE GOLF COURSE LLC
2142 NORTH COVE	TOLEDO	OH	43606		GOLF COURSE	OH	$0	$393,845	PROMEDICA FOUNDATION
PROMEDICA INNOVATIONS LLC
100 MADISON AVE	TOLEDO	OH	43604		INVESTMENT COMPANY	OH	$0	$0	PROMEDICA HEALTH SYSTEM INC
PROMEDICA GENITO-URINARY SURGEONS LLC
100 MADISON AVE	TOLEDO	OH	43604	461120436	EMPLOYS PHYSICIANS	OH	$5,890,901	-$31,531,683	PROMEDICA PHYSICIAN GROUP
PROMEDICA MONROE PHYSICIANS PLLC
100 MADISON AVE	TOLEDO	OH	43604	461111822	EMPLOYS PHYSICIANS	MI	$9,111,473	-$7,258,286	PROMEDICA PHYSICIAN GROUP
PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC
100 MADISON AVE	TOLEDO	OH	43604	454976786	EMPLOYS PHYSICIANS	OH	$0	$159,482	PROMEDICA PHYSICIAN GROUP
PROMEDICA HOSPITALISTS LLC
100 MADISON AVE	TOLEDO	OH	43604		EMPLOYS PHYSICIANS	OH	$0	$0	PROMEDICA PHYSICIAN GROUP
PROMEDICA HOSPITALISTS PLLC
100 MADISON AVE	TOLEDO	OH	43604		EMPLOYS PHYSICIANS	MI	$0	$0	PROMEDICA PHYSICIAN GROUP
MEMORIAL ANESTHESIA LTD
715 SOUTH TAFT AVE	FREMONT	OH	43420	205763680	EMPLOYS PHYSICIANS	OH	$0	$0	PROMEDICA PHYSICIAN GROUP
MEMORIAL PROFESSIONAL SERVICES LTD
715 SOUTH TAFT AVE	FREMONT	OH	43420	273763993	EMPLOYS PHYSICIANS	OH	$6,984,482	-$10,347,427	PROMEDICA PHYSICIAN GROUP
PHS VENTURES LLC
100 MADISON AVE	TOLEDO	OH	43604	341880473	HEALTH CARE MANAGEMENT SERVICES	DE	$0	$0	PROMEDICA HEALTH SYSTEM INC
300 MADISON BUILDING LLC
100 MADISON AVE	TOLEDO	OH	43604	822062486	REAL ESTATE	OH	$2,474,668	$16,139,456	PROMEDICA HEALTH SYSTEM INC
MARINA DISTRICT DEVELOPMENT LLC
100 MADISON AVE	TOLEDO	OH	43604		REAL ESTATE	OH	$0	$3,915,257	PROMEDICA HEALTH SYSTEM INC
PHS INVESTMENTS LLC
100 MADISON AVE	TOLEDO	OH	43604		INVESTMENT COMPANY	OH	$0	$0	THE TOLEDO HOSPITAL
PROMEDICA INTERNATIONAL LLC
100 MADISON AVE	TOLEDO	OH	43604		CONSULTING SERVICES	OH	$100,000	$0	PROMEDICA HEALTH SYSTEM INC
PROMEDICA ACTIVE MOBILITY LLC
100 MADISON AVE	TOLEDO	OH	43604	815178173	DURABLE MEDICAL EQUIPMENT	OH	$231,981	$39,267	PROMEDICA HEALTH SYSTEM INC
1611 MONROE INVESTORS LLC
100 MADISON AVE	TOLEDO	OH	43604		REAL ESTATE	OH	$0	$151,840	PROMEDICA HEALTH SYSTEM INC
BALL PARK PROPERTIES LLC
100 MADISON AVE	TOLEDO	OH	43604	823954332	REAL ESTATE	OH	$0	$961,491	PROMEDICA HEALTH SYSTEM INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 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	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
BAY PARK COMMUNITY HOSPITAL
2801 BAY PARK DR	OREGON	OH	43616	341883132	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
DEFIANCE HOSPITAL AUXILIARY
1200 RALSTON	DEFIANCE	OH	43512	510173779	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes (1)
DEFIANCE HOSPITAL INC
1200 RALSTON	DEFIANCE	OH	43512	344446484	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
EMMA L BIXBY MEDICAL CENTER AUXILIARY
818 RIVERSIDE AVE	ADRIAN	MI	49221	382149602	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	EMMA L BIXBY MEDICAL CENTER	Yes (1)
FLOWER HOSPITAL
5200 HARROUN RD	SYLVANIA	OH	43560	344428794	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
FOSTORIA HOSPITAL ASSOCIATION
501 VAN BUREN STREET	FOSTORIA	OH	44830	340898745	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
FOSTORIA HOSPITAL AUXILIARY
PO BOX 907	FOSTORIA	OH	44830	346517634	HOSPITAL / FOUNDATION SUPPORT	OH	501(C)(3)	10	FOSTORIA HOSPITAL ASSOCIATION	Yes (1)
HERRICK MEDICAL CENTER AUXILIARY
500 E POTTAWATAMIE ST	TECUMSEH	MI	49286	383076105	HOSPITAL / FOUNDATION SUPPORT	MI	501(C)(3)	12B, II	HERRICK MEMORIAL HOSPITAL INC	Yes (1)
HERRICK MEMORIAL HOSPITAL INC
500 E POTTAWATAMIE ST	TECUMSEH	MI	49286	383049015	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
LENAWEE LONG TERM CARE
700 LAKESHIRE TR	ADRIAN	MI	49221	382879330	LONG TERM CARE	MI	501(C)(3)	10	EMMA L BIXBY MEDICAL CENTER	Yes (1)
PROMEDICA CONTINUING CARE SERVICES CORP
100 MADISON AVE	TOLEDO	OH	43604	344492440	LONG TERM AND HOME HEALTH CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes (1)
PROMEDICA COURIER SERVICES INC
3170 W CENTRAL AVE	TOLEDO	OH	43606	260324790	COURIER SERVICE	OH	501(C)(3)	12B, II	PROMEDICA CONTINUUM SERVICES	Yes (1)
PROMEDICA HEALTH SYSTEM INC
100 MADISON AVE	TOLEDO	OH	43604	341517671	PARENT COMPANY OF HEALTH SYSTEM	OH	501(C)(3)	12B, II		0	N/A
PROMEDICA INDEMNITY CORP
ONE CHURCH ST 5TH FLOOR	BURLINGTON	VT	05401	341931936	PROFESSIONAL & GENERAL LIABILITY	VT	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA CONTINUUM SERVICES
100 MADISON AVE	TOLEDO	OH	43604	341880767	PHYSICIAN MANAGEMENT SERVICES	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA PHYSICIAN GROUP
100 MADISON AVE	TOLEDO	OH	43604	341899439	PHYSICIAN HEALTH CARE SERVICES	OH	501(C)(3)	10	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PROMEDICA FOUNDATION
444 N SUMMIT ST	TOLEDO	OH	43604	341517672	FOUNDATION	OH	501(C)(3)	12B, II	PROMEDICA HEALTH SYSTEM INC	Yes (1)
THE TOLEDO HOSPITAL
2142 N COVE BLVD	TOLEDO	OH	43606	344428256	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
TOLEDO DISTRICT NURSE ASSOCIATION
1946 N 13TH STREET	TOLEDO	OH	43624	344427949	SKILLED HOME CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes (1)
VISITING NURSE HOSPICE AND HEALTH CARE
5855 MONROE ST	SYLVANIA	OH	43560	341831624	HOSPICE HOME CARE	OH	501(C)(3)	10	PROMEDICA CONTINUUM SERVICES	Yes (1)
KAITLYN'S COTTAGE INC
1260 RALSTON AVE	DEFIANCE	OH	43512	454781053	RESPITE CARE	OH	501(C)(3)	10	DEFIANCE HOSPITAL INC	Yes (1)
MEMORIAL HOSPITAL
715 SOUTH TAFT AVE	FREMONT	OH	43420	344430849	HOSPITAL	OH	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
MONROE CANCER CENTER
800 STEWART RD	MONROE	MI	48162	271302183	CANCER CENTER	MI	501(C)(3)	10	MERCY MEMORIAL HOSPITAL CORPORATION	Yes (1)
MONROE COMMUNITY HEALTH SERVICES
718 N MACOMB	MONROE	MI	48162	382934134	LONG TERM CARE	MI	501(C)(3)	10	MERCY MEMORIAL HOSPITAL CORPORATION	Yes (1)
MERCY MEMORIAL HOSPITAL CORPORATION
718 N MACOMB	MONROE	MI	48162	381984289	HOSPITAL	MI	501(C)(3)	3	PROMEDICA HEALTH SYSTEM INC	Yes (1)
PARAMOUNT ADVANTAGE
1901 INDIAN WOOD CIR	MAUMEE	OH	43537	203376102	HEALTH INSURANCE	OH	501(C)(3)	10	PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
REYNOLDS ROAD SURGICAL CENTER LLC
2865 N REYNOLDS RD	TOLEDO	OH	43615	311569454	FREESTANDING AMBULATORY SURGICAL CENTER	OH	THE TOLEDO HOSPITAL	RELATED	$730,726	$2,459,714	0	0	0.67200
NORTHWEST OHIO DEDICATED BREAST MRI LLC
100 MADISON AVE	TOLEDO	OH	43604	260679898	MEDICAL DIAGNOSTICS	OH	THE TOLEDO HOSPITAL	RELATED	$485,835	$633,357	0	0	0.50000
WEST CENTRAL SURGICAL CENTER LLC
7055 W CENTRAL	TOLEDO	OH	43617	200088459	AMBULATORY SURGICAL CENTER	OH	THE TOLEDO HOSPITAL	RELATED	$265,700	$3,107,897	0	Yes (1)	0.50000
LENAWEE PHYSICIAN HOSPITAL ORGANIZATION LLC
818 RIVERSIDE AVE	ADRIAN	MI	49221	383605511	PHYSICIAN MANAGEMENT SERVICES	MI	EMMA L BIXBY MEDICAL CENTER	RELATED	$84		0	Yes (1)	0.50000
EAST-WEST HOLDINGS LTD
715 SOUTH TAFT AVE	FREMONT	OH	43420	204066818	REAL ESTATE	OH	MEMORIAL HOSPITAL	RELATED	$5,823	$298,145	0	0	0.50000
SURGICAL INSTITUTE OF MONROE LLC
1051 S TELEGRAPH RD	MONROE	MI	48161	270843485	AMBULATORY SURGICAL CENTER	MI	PROMEDICA CONTINUUM SERVICES	RELATED	-$6,335	$3,421,071	0	0	0.54000
PROMEDICA MASTER TENANT LLC
100 MADISON AVE	TOLEDO	OH	43604	475288490	REAL ESTATE	OH	PROMEDICA MANAGER MEMBER LLC	RELATED	-$2,656	$6,294,069	0	Yes (1)	0.01000
PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC
100 MADISON AVE	TOLEDO	OH	43604	473163945	REAL ESTATE	OH	PROMEDICA MANAGER MEMBER LLC	RELATED	-$1,371,608	$43,364,051	0	Yes (1)	0.90000
ROCKET VENTURE FUND II LLC
2865 N REYNOLDS RD STE 220	TOLEDO	OH	43615	475603627	INVESTMENT FUND	OH	PROMEDICA HEALTH SYSTEM INC	RELATED	-$12,298	$283,602	0	0	0.66660
APM PLUS LLC
1120 G ST NW STE 1000	WASHINGTON	DC	20005	813082229	ALTERNATIVE PAYMENT MODEL DEVELOPMENT	DE	PROMEDICA HEALTH SYSTEM INC	UNRELATED	-$256,787		0	Yes (1)	0.50000
KAPIOS LLC
2865 N REYNOLDS RD	TOLEDO	OH	43615	812624635	SOFTWARE DEVELOPMENT	OH	PROMEDICA HEALTH SYSTEM INC	UNRELATED	-$198,188	$47,430	0	Yes (1)	0.50000

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
HERRICK MEMORIAL DEVELOPMENT CORP
500 E POTTAWATAMIE TR	ADRIAN	MI	49221	383146907	FACILITY LEASING	MI	EMMA L BIXBY MEDICAL CENTER	C	$63,138	$1,011,261	1.00000	Yes (1)
PROMEDICA CENTRAL CORPORATION OF MICHIGAN
100 MADISON AVE	TOLEDO	OH	43604	383322278	PHYSICIAN HEALTH CARE SERVICES	OH	PROMEDICA PHYSICIAN GROUP	C	-$6,499,459	$12,888,746	1.00000	Yes (1)
PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES
1901 INDIAN WOOD CIR	MAUMEE	OH	43537	341570675	HEALTH CARE INSURANCE	OH	PROMEDICA HEALTH SYSTEM INC	C	-$10,797,881	$516,654,254	1.00000	Yes (1)
PROMEDICA NORTH PHYSICIAN CORPORATION
100 MADISON AVE	TOLEDO	OH	43604	383482148	PHYSICIAN HEALTH CARE SERVICES	OH	PROMEDICA PHYSICIAN GROUP	C		$149,134	1.00000	Yes (1)
PROMEDICA RETAIL GROUP INC
3890 MONROE ST	TOLEDO	OH	43606	341159928	FLORIST	OH	PROMEDICA CONTINUUM SERVICES	C	-$57,281	$938,903	1.00000	Yes (1)
HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION
818 RIVERSIDE AVE	ADRIAN	MI	49221	383639616	FACILITY MANAGEMENT	MI	HERRICK MEMORIAL DEVELOPMENT CORP	C	$52	$55,674	0.71800	Yes (1)
PROMEDICA HEALTH NETWORK INC
100 MADISON AVE	TOLEDO	OH	43604	474006496	PHYSICIAN MANAGEMENT SERVICES	OH	PROMEDICA HEALTH SYSTEM INC	C	-$590,439	$8,227	1.00000	Yes (1)
MONROE HEALTH VENTURES
718 N MACOMB	MONROE	MI	48164	382704426	PHARMACY	MI	MERCY MEMORIAL HOSPITAL CORPORATION	C			1.00000	Yes (1)
PROMEDICA MANAGER MEMBER LLC
100 MADISON AVE	TOLEDO	OH	43604	475168737	REAL ESTATE	OH	PROMEDICA HEALTH SYSTEM INC	C	-$1,297,042	$25,980,065	1.00000	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd