2018-08-15T15:47:40-05:00 2017-09-30 381357951 PLANTE & MORAN PLLC 27400 Northwestern Highway Southfield MI 48034 990 2016-10-01 352362438 STURGIS HOSPITAL INC STUR 2696594400 916 Myrtle Avenue Sturgis MI 49091 ROBERT J LABARGE CEO 2696594400 2018-08-15 1 David Lowenthal P00378651 2483522500 2018-08-15 2016 2022-09-23 18:48:47Z ROBERT J LABARGE 916 Myrtle Avenue Sturgis MI 49091 51955360 0 X www.sturgishospital.com X 2009 MI STURGIS HOSPITAL IS AN 84-BED LICENSED, ACUTE CARE FACILITY SERVING A POPULATION OF APPROXIMATELY 50,000. IT EXISTS TO ENSURE THAT THE COMMUNITY HAS ADEQUATE ACCESS TO HEALTHCARE. 11 11 440 91 0 0 284801 283005 48878601 51153476 209003 128849 154482 336718 49526887 51902048 0 0 0 0 27593737 28969901 0 0 0 24321656 25080292 51915393 54050193 -2388506 -2148145 28046993 26885710 29900869 27661474 -1853876 -775764 X Sturgis Hospital Inc. is committed to the provision of the highest quality primary and secondary healthcare to the community we serve. Sturgis Hospital Inc. strives, in all circumstances, to provide acute and preventative care that is consistent with the values and needs of the unique segments of our population. By exercising responsible stewardship of our resources, Sturgis Hospital Inc. will also endeavor to maximize the breadth and depth of care provided to our community. 0 0 39111592 51153476 STURGIS HOSPITAL IS AN 84-BED LICENSED, ACUTE CARE FACILITY. NEARLY 40 ACTIVE MEDICAL STAFF MEMBERS, AVAILABLE WITHIN THE STURGIS AND SURROUNDING COMMUNITIES, REPRESENT A WIDE VARIETY OF SPECIALTIES INCLUDING ANESTHESIOLOGY, FAMILY PRACTICE, GENERAL SURGERY, GYNECOLOGY, INTERNAL MEDICINE, OBSTETRICS, OPHTHALMOLOGY, ORTHOPAEDICS, PATHOLOGY, PEDIATRICS, PODIATRY, RADIOLOGY, UROLOGY AND VASCULAR SURGERY. ADDITIONAL SPECIALTIES ARE OFFERED THROUGH THE HOSPITAL'S COURTESY, CONSULTING AND AFFILIATE MEDICAL STAFF MEMBERS. THESE SERVICES INCLUDE CARDIOLOGY, NEUROLOGY, NEUROSURGERY, ONCOLOGY, AND PULMONARY MEDICINE. MEDICAL/SURGICAL CARE IS OFFERED ON AN INPATIENT AND OUTPATIENT LEVEL. BOTH LASER AND LAPAROSCOPIC PROCEDURES ARE PERFORMED IN THE HOSPITAL'S THREE ROOM SURGICAL SUITE. A FOUR-BED CORONARY/INTENSIVE CARE UNIT IS ALSO AVAILABLE FOR CRITICAL PATIENTS. THE 12-BED OBSTETRICAL DEPARTMENT OFFERS LABOR/DELIVERY/RECOVERY/POSTPARTUM ROOMS FOR THE EXPECTANT MOM AND HER FAMILY. EMERGENCY SERVICES ARE AVAILABLE 24 HOURS A DAY, 365 DAYS A YEAR, WITH FULL-TIME MEDICAL STAFF COVERAGE. CARDIAC REHABILITATION AND PHYSICAL THERAPY PROGRAMS AS WELL AS COMMUNITY EDUCATION PROGRAMS DESIGNED TO HELP OUR COMMUNITY LEAD A HEALTHIER LIFESTYLE, ARE ALSO AVAILABLE. STURGIS HOSPITAL HAS A COMMITMENT TO MAINTAIN STATE-OF-THE-ART DIAGNOSTIC TECHNOLOGY, WHICH INCLUDES ANGIOGRAPHY, 64-SLICE CT SCANNING, MAMMOGRAPHY, MOBILE MRI, A SLEEP DISORDER LABORATORY AND SPECT IMAGING AND ULTRASOUND.STURGIS HOME HEALTH CARE--A TOP 500 AGENCY IN THE NATION--IS A DIVISION OF STURGIS HOSPITAL. IT WORKS CLOSELY WITH PHYSICIANS TO PROVIDE QUALITY HOME HEALTH CARE SERVICES FOLLOWING DISCHARGE FROM A HOSPITAL OR FOR THOSE WITH SPECIAL MEDICAL NEEDS THAT DO NOT REQUIRE HOSPITALIZATION. THESE SERVICES INCLUDE NURSING ASSISTANCE, AIDS, COMPANIONS, PHYSICAL, OCCUPATIONAL, SPEECH AND LANGUAGE THERAPIES, AS WELL AS A MEDICAL SOCIAL WORKER. HOSPICE OF STURGIS PROVIDES SUPPORT AND CARE FOR PERSONS IN THE LAST PHASES OF AN INCURABLE DISEASE. THESE SERVICES CAN BE PROVIDED IN A PATIENT'S HOME, NURSING HOME OR ADULT FOSTER CARE SETTING. THE HOSPICE TEAM INCLUDES PHYSICIANS, NURSES, THERAPISTS, AIDES, SOCIAL WORKERS, NUTRITIONISTS, VOLUNTEERS AND CLERGY, AS WELL AS BEREAVEMENT AND SUPPORT GROUPS. 39111592 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 175 0 1 440 1 0 0 0 0 0 1 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X Robert J LaBarge 2696594400 916 Myrtle Avenue Sturgis MI 49091 X THOMAS ROCK BOARD SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 JOHN MAYER BOARD PRESIDENT 1.00 0.00 X X 0 0 0 P JOSEPH HAAS JR BOARD VICE-PRESIDENT 1.00 0.00 X X 0 0 0 VICKI WATSON BOARD DIRECTOR 1.00 0.00 X 0 0 0 BHARAT VAKHARIA BOARD DIRECTOR 1.00 0.00 X 0 0 0 ERIC JONES BOARD DIRECTOR 1.00 0.00 X 0 0 0 FLOYD KUNCE BOARD DIRECTOR 1.00 0.00 X 0 0 0 JEANNIE GERCHOW BOARD DIRECTOR 1.00 0.00 X 0 0 0 KIM BONTRAGER BOARD DIRECTOR 1.00 0.00 X 0 0 0 PHILIP WARD BOARD DIRECTOR 1.00 0.00 X 0 0 0 JOSE ALBARRAN BOARD DIRECTOR - PART YEAR 1.00 0.00 X 0 0 0 ERIC WYNES BOARD DIRECTOR 1.00 0.00 X 0 0 0 ROBERT LABARGE CEO 40.00 0.00 X 0 0 0 ROBERT MORIN CFO 40.00 0.00 X 0 0 0 KEYUR PATEL PHYSICIAN PRIMARY CARE 40.00 0.00 X 592053 0 32634 YAZDI AMARIA PHYSICIAN GENERAL SURGERY 40.00 0.00 X 621976 0 30582 ELIEZER MELENDEZ PHYSICIAN PEDIATRICS 40.00 0.00 X 492030 0 32634 ASHISH VERMA PHYSICIAN INTERNAL MEDICINE 40.00 0.00 X 541897 0 32634 JAMES M GRANNELL PHYSICIAN PRIMARY CARE 40.00 0.00 X 492414 0 22034 2740370 0 150518 23 0 1 0 EPMG 2000 GREEN ROAD STE 300 ANN ARBOR MI 37230 EMERGENCY PHYSICIANS 1356183 Quorum Health Resources PO Box 305172 Nashville TN 37230 Hospital Management 874267 PSI REHABILITATION LLC 5050 BRADENTON AVE DUBLIN OH 43017 REHAB SERVICES/MGMT 631494 Sodexo Operations LLC 4880 Paysphere Circle Chicago IL 60674 Diet/Maint./Environ. 622797 SOUTH BEND MEDICAL FOUNDATION INC PO BOX 2030 MISHAWAKA IN 46545 LAB SERVICES 615554 21 36100 246905 283005 NET PATIENT SERVICE REVENUE 621110 49534754 49534754 OTHER RELATED REVENUE 621110 841679 841679 340B REVENUE 621110 669964 669964 Cafeteria Revenue 722210 107079 107079 51153476 128849 128849 364457 45785 318672 318672 318672 25573 36100 7527 18046 18046 51902048 51153476 0 465567 X 530958 530958 22139994 18174110 3965884 1932947 147800 1785147 2893654 913001 1980653 1472348 420686 1051662 409639 409639 130812 3659 127153 124923 124923 8370010 6618882 1751128 86955 20835 66120 3341076 1779519 1561557 481139 481139 1357790 763080 594710 43160 43160 133675 111060 22615 427644 9765 417879 1144811 1138096 6715 538407 4083 534324 MEDICAL SUPPLIES 4573876 4566342 7534 BAD DEBT EXPENSE 2785254 2785254 340B PHARMACY COSTS 1082488 1082488 EQUIPMENT 48633 48633 54050193 39111592 14938601 0 650 650 2189368 2538854 4999901 5100632 971397 978286 808661 898937 51307711 36142453 15245642 15165258 0 150413 1795662 1141559 2035712 911121 28046993 26885710 7372915 7034583 10656252 10315928 547298 226103 11324404 10084860 29900869 27661474 X -1894671 -777478 40795 1714 0 0 -1853876 -775764 28046993 26885710 X -2148145 130005 3096252 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 109943 109943 27864757 15505406 12359351 22364262 20573960 1790302 968749 63087 905662 15165258 PENSION LIABILITY 7322346 DUE TO AFFILIATE 1005997 DUE TO THIRD-PARTY PAYERS 1756517 10084860 AUTUMN FEAST 43320 27825 15495 1400 SPRING GOLF OUTING 18353 8275 10078 2165 3950 12 61673 36100 25573 2165 1400 3950 12 7527 18046 1 1 1 X 1 X 1 1 1 0 1 1 1 0 91139 91139 0.00180 1 0 11290123 9748555 1541568 0.03010 2 11381262 9748555 1632707 0.03190 60 3183 44371 270 44101 0.00090 1 5 134 134 0.00000 53 0 6398 6398 0.00010 114 3188 50903 270 50633 0.00100 116 3188 11432165 9748825 1683340 0.03290 151 0 17973 17973 0.00040 1 15 212 212 0.00000 152 15 18185 18185 0.00040 1 2785254 1353614 12917048 16134659 -3217611 X 1 1 1 1 STURGIS HOSPITAL 916 MYRTLE AVENUE STURGIS MI 49091 www.sturgishospital.com 1060000047 X X X Sturgis Hospital 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X www.sturgishospital.com X 1 16 1 www.sturgishospital.com 0 1 X 200.000000000000 250.000000000000 X X X 1 1 X X X X 1 X https://www.sturgishospital.com/patient_portal.php X https://www.sturgishospital.com/patient_portal.php X https://www.sturgishospital.com/patient_portal.php X X X X X X 1 X 0 X X X 1 X 0 0 Sturgis Hospital Part V, Section B, Line 5: STURGIS HOSPITAL PARTNERED WITH QUORUM HEALTH RESOURCES TO CONDUCT THE CHNA. QUORUM TAKES A COMPREHENSIVE APPROACH TO ASSESS COMMUNITY HEALTH NEEDS. THEY PERFORM SEVERAL INDEPENDENT DATA ANALYSES BASED ON SECONDARY SOURCE DATA, AUGMENT THIS WITH LOCAL EXPERT ADVISOR OPINIONS, AND RESOLVE ANY DATA INCONSISTENCY OR DISCREPANCIES BY REVIEWING THE COMBINED OPINIONS FORMED FROM LOCAL EXPERTS. "LOCAL EXPERT" IS AN ADVISORY GROUP OF AT LEAST 15 LOCAL RESIDENTS WITH WHOM THE HOSPITAL SOLICITED TO PARTICIPATE IN THE QHR/HOSPITAL CHNA PROCESS. QUORUM RELIES ON SECONDARY SOURCE DATA, AND MOST SECONDARY SOURCES USE THE COUNTY AS THE SMALLEST UNIT OF ANALYSIS. THEY ASKED THEIR LOCAL EXPERT AREA RESIDENTS TO NOTE IF THEY PERCEIVED THE PROBLEMS OR NEEDS IDENTIFIED BY SECONDARY SOURCES EXISTED IN THEIR PORTION OF THE COUNTY. Sturgis Hospital Part V, Section B, Line 6a: THE HOSPITAL'S CHNA WAS CONDUCTED WITH THREE RIVERS HOSPITAL. Sturgis Hospital Part V, Section B, Line 6b: THE HOSPITAL COLLABORATED AND OBTAINED ASSISTANCE IN CONDUCTING THE CHNA FROM QUORUM HEALTH RESOURCES (QHR). Sturgis Hospital Part V, Section B, Line 11: THE CHNA IDENTIFIED MULTIPLE AREAS WITH SIGNIFICANT NEEDS. THE TOP 5 NEEDS ARE SHOWN BELOW BY ACTION STEPS STRUGIS HOSPITAL WILL TAKE TO ADDRESS THE NEEDS.1) OBESITY/PHYSICAL INACTIVITY-CONTINUE EXISTING PROGRAMS-PARTNERING WITH SENIOR ENRICHMENT CENTER FOR FREE HEALTH ASSESSMENTS AND FREE LUNCH N LEARNS WITH A REGISTERED DIETICIAN-PARTNERING WITH MEIJER TO OFFER HEALTH ASSESSMENTS AND WORKING WITH THE PRODUCE DEPARTMENT TO PROMOTE HEALTHY EATING-AS PART OF ACO, STARTING SENIOR WELLNESS PROGRAM TO ENCOURAGE ANNUAL VISITS AND HEALTH SCREENINGS-PARTNERING WITH STEP UP ST. JOSEPH TO PROMOTE AND ORGANIZE WALKING PROGRAM/ACTIVITIES (WALKING CLUB PROGRAM)-INVESTIGATING HISPANIC OBESITY PROGRAMS AND SEEKING GRANT FUNDING-UPCOMING LUNCH N LEARNS IN SCHOOLS INCLUDING RETHINK YOUR DRINK, HEALTHY EATING, ETC.2) MENTAL HEALTH/SUICIDE/SUBSTANCE ABUSE-COLLABORATING TO DEVELOP FQHC, WHICH INCLUDES BEHAVIORAL HEALTH SERVICES-LOOK AT PROVIDING EDUCATION SESSIONS TO LOCAL SCHOOLS ABOUT SUBSTANCE ABUSE/MENTAL HEALTH-COUNSELOR WITH SCHOOL-LINKED CLINIC WILL BE PROVIDING EDUCATION TO TEACHERS TO HELP IDENTIFY AND ADDRESS MENTAL HEALTH ISSUES IN STUDENTS -PARTNERING WITH CMH TO PLACE RECOVERY COACHES IN THE FACILITY TO PROVIDE OUTREACH-PARTICIPATING IN TRAINING PROVIDED BY CMH TO HELP PRIMARY CARE PROVIDERS IDENTIFY SUBSTANCE ABUSE-WORKING GERIATRIC-PSYCH INPATIENT UNIT3) PHYSICIAN SERVICES-CONTINUE EXISTING PROGRAMS-ADDING NEW FASTCARE TO CLINIC TO ADDRESS MINOR/NON-EMERGENT NEEDS-ACTIVELY RECRUITING A CARDIOLOGIST-WORKING GERIATRIC-PSYCH INPATIENT UNIT4) EDUCATION/PREVENTION-CONTINUE EXISTING PROGRAMS-EXPAND HEALTH AND WELLNESS ONLINE MARKETING INITIATIVES5) DIABETES-CONTINUE EXISTING PROGRAMS-COLLABORATING WITH MSU EXTENSION TO OFFER DINING WITH DIABETES CLASS IN SPANISHBY DEFINITION, THE NEEDS IDENTIFIED AS LOW PRIORITY AND FOR WHICH STURGIS HOSPITAL HOLDS LOW RESPONSIBILITY FOR IMPLEMENTATION ARE NEEDS THE HOSPITAL WILL MONITOR, BUT OTHERWISE NOT ADDRESS. SOME OF THE REASONS FOR THIS RESPONSE INCLUDE:- ACTIONS REQUIRED ARE BEYOND THE MISSION OF THE HOSPITAL-THE HOSPITAL DOES NOT POSSESS THE REQUIRED EXPERTISE-THE HOSPITAL CAN BE MORE EFFECTIVE APPLYING ITS RESOURCES TO HIGHER PRIORITY NEEDS-IMPLEMENTATION FALLS MORE APPROPRIATELY TO OTHER ORGANIZATIONS Part I, Line 3c: ACCORDING TO THE HOSPITAL'S EXISTING PUBLIC POLICY, ALL PATIENTS RECEIVING MEDICALLY NECESSARY SERVICES ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE NEED OF THE PATIENTS, LACK OF EXISTING INSURANCE, AND OTHER RESOURCES REQUIRED FOR PAYMENT. ELIGIBILITY CRITERIA IS FURTHER BASED ON THE FEDERAL POVERTY GUIDELINES AT A LEVEL OF 200% OF THAT GUIDELINE. Part I, Line 6a: STURGIS HOSPITAL PUBLISHES ITS ANNUAL REPORT WHICH INCLUDES ALL RELATED ORGANIZATIONS' PROGRAMS AND SERVICES DESIGNED TO LEAD THE COMMUNITY TO IMPROVED HEALTH AND PROMOTE HEALTHY LIFESTYLES. THE REPORT IS AVAILABLE ON STURGIS'S WEBSITE. Part I, Ln 7 Col(f): BAD DEBT EXPENSE IN THE AMOUNT OF $2,785,254 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. THE ORGANIZATION USES A COMBINATION OF THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H AND DIRECT COSTING METHOD OF CERTAIN PROGRAMS. Part III, Line 3: THE AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCEIS ESTIMATED BASED UPON PAST EXPERIENCE. Part III, Line 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. Part III, Line 8: COSTING METHODOLOGY TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MCR IS A STATISTICAL STEP DOWN ALLOCATION METHOD. ANY SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE THE HOSPITAL PROVIDES THESE SERVICES AS A COMMUNITY BENEFIT DESPITE THE FACT THAT THEY ARE PROVIDED AT A FINANCIAL LOSS. Part III, Line 9b: ONCE THE EVALUATION IS COMPLETED AND A DETERMINATION HAS BEEN MADE THAT PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, NO COLLECTION EFFORTS ARE MADE. CONSIDERATION FOR ASSISTANCE IS ALSO GIVEN TO OTHER TYPES OF PATIENTS IF THE NEED FOR ASSISTANCE IS REQUIRED. Part VI, Line 2: THE HOSPITAL HELD 25 GENERAL HEALTH EDUCATION EVENTS REACHING 2,126 PEOPLE, PROVIDED 13 COMMUNITY HEALTH EDUCATION SUPPORT GROUPS REACHING 176 PEOPLE, 19 HEALTH SCREENING CLINICAL SERVICES REACHING 829 PEOPLE, AND HELD 2 IMMUNIZATION CLINICS REACHING 52 PEOPLE.STURGIS HOSPITAL COLLABORATED AND OBTAINED ASSISTANCE IN CONDUCTING THE CHNA FROM QUORUM HEALTH RESOURCES (QHR). Part VI, Line 3: THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY AND AVAILABILITY OF FINANCIAL ASSISTANCE BY:-POSTING THE ORGANIZATIONS CHARITY CARE POLICY IN ACCESS AND REGISTRATION AREAS WITHIN THE HOSPITAL-INDIVIDUAL INTERVIEW OF PATIENTS BY FINANCIAL COUNSELORS AND PREADMISSION STAFF WITH DISCUSSION CONCERNING FINANCIAL ASSISTANCE, AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS AND ASSISTANCE WITH THE APPLICATION FOR ASSISTANCE.-THE HOSPITAL HAS ENTERED A MEMORANDUM OF UNDERSTANDING WITH THE COUNTY WHEREAS THE HOSPITAL MAKES A COMMITMENT TO PROVIDE HEALTH CARE SERVICES TO LOW INCOME RESIDENTS OF THE COUNTY (PUBLIC RECORD) Part VI, Line 4: ST. JOSEPH COUNTY IS LOCATED IN SOUTHWEST MICHIGAN, ON THE BORDER OF INDIANA. THE SERVICE AREA HAS APPROXIMATELY OF 23,000 HOUSEHOLDS COMPRISING OF AROUND 61,000 PEOPLE. THE ETHNIC MAKEUP IS 88% WHITE, 2.5% AFRICAN AMERICAN, 6.6% HISPANIC WITH THE REST BEING MADE UP OF NATIVE AMERICAN, ASIAN AND OTHERS. THE MEDIAN HOUSEHOLD INCOME IS ABOUT $44,000. Part VI, Line 5: THE HOSPITAL DEMONSTRATES ITS DESIRE TO FURTHER ITS EXEMPT PURPOSE AND MISSION BY:-A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED BY PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA, WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF.-THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY (OPEN MEDICAL STAFF).-ALL SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO PROMOTE SERVICE ENHANCEMENT TO ITS COMMUNITY AS WELL AS CAPITAL REPLACEMENT AND SERVICE DEVELOPMENT.-THE ORGANIZATION FURTHER PROMOTES ITS MISSION BY PARTICIPATION IN HEALTH CARE SCREENING, HEALTH CARE EDUCATION AND CERTAIN SERVICES MADE TO THE COMMUNITY AT NO COST TO THE COMMUNITY.-ORGANIZATION HAS ENTERED INTO MEMORANDUM OF UNDERSTANDING WITH ST. JOSEPH COUNTY COMMITTING TO PROVIDE SERVICES TO THE COMMUNITY REGARDLESS OF THE ABILITY TO PAY FOR THOSE SERVICES. Part VI, Line 6: THE HOSPITAL IS NOT A PART OF AN AFFILIATED HEALTH CARE SYSTEM. Part VI, Line 7, Reports Filed With States MI 0 0 0 0 0 0 0 0 0 KEYUR PATEL PHYSICIAN PRIMARY CARE 591873 0 0 0 180 0 10600 0 22034 0 624687 0 0 0 YAZDI AMARIA PHYSICIAN GENERAL SURGERY 619690 0 0 0 2286 0 10600 0 19982 0 652558 0 0 0 ELIEZER MELENDEZ PHYSICIAN PEDIATRICS 491256 0 0 0 774 0 10600 0 22034 0 524664 0 0 0 ASHISH VERMA PHYSICIAN INTERNAL MEDICINE 541627 0 0 0 270 0 10600 0 22034 0 574531 0 0 0 JAMES M GRANNELL PHYSICIAN PRIMARY CARE 491226 0 0 0 1188 0 0 0 22034 0 514448 0 0 0 A City of Sturgis Facilities & Hospital Authority 386004653 2010-04-28 2334795 Hospital Expansion Project 0 0 0 B City of Sturgis Building Authority 386004653 2014-07-10 9754034 Refund Series 2004 and 2005 Bonds 0 0 0 A 85599 2334795 43541 2291254 2012 0 0 0 1 B 9754034 174769 11578 9567687 2014 0 1 0 1 A 0 0 0 0 1 0 0 B 0 0 0 0 1 0 0 A 0 1 0 0 1 0 0 0 0 B 0 1 0 0 1 0 0 0 0 A 1 B 1 Nicole Happner Daughter to Shari Ransberger, Officer 27196 Employee Compensation 0 FORM 990, PART V, LINE 7B: THE ORGANIZATION WAS UNAWARE OF THE REQUIREMENT TO NOTIFY THE DONOR OF THE VALUE OF THE GOODS OR SERVICES PROVIDED AND HAS SINCE TAKEN ACTIONS TO ENSURE THAT ALL REQUIRED NOTIFICATIONS ARE SENT IN THE FUTURE. Form 990, Part VI, Section A, line 3 BOARD OF TRUSTEES HAS ENGAGED QUORUM HEALTH RESOURCES (QHR) TO PROVIDE MANAGEMENT SERVICES UNDER THE STRICT POLICIES AND BY-LAWS ADOPTED BY THE BOARD OF TRUSTEES. ROBERT LABARGE AND ROBERT MORIN WERE PAID BY QHR FOR SERVICES AS CEO AND CFO, RESPECTIVELY. COMPENSATION WAS PAID TO QHR BY STURGIS HOSPITAL IN THE FOLLOWING AMOUNTS FOR THE CALENDAR YEAR ENDING WITHIN THE ORGANIZATIONS TAX YEAR: CEO COMPENSATION FOR ROBERT LABARGE - $268,765 CFO COMPENSATION FOR ROBERT MORIN - $204,344 Form 990, Part VI, Section B, line 11b THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY MEMBERS OF THE FINANCE DEPARTMENT PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Section B, line 12c BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. DISCLOSURES ARE REVIEWED TO DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT EXISTS, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS RELATING TO THE CONFLICT. Form 990, Part VI, Section B, line 15 COMPENSATION LEVELS ARE DETERMINED AT THE BOARD LEVEL UTILIZING VARIOUS SALARY SURVEYS FROM STATE HOSPITAL ASSOCIATION AS WELL AS THE MANAGEMENT COMPANY'S DATA BASE OF SALARY SCALES AND PROFESSIONAL RECRUITMENT FIRMS. THIS PROCESS WAS LAST COMPLETED IN JUNE 2017. Form 990, Part VI, Section C, line 19 STURGIS HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. Form 990, Part IX, line 11g OUTSOURCED E/R: Program service expenses 1,127,057. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,127,057. OUTSOURCED PHYSICAL THERAPY: Program service expenses 484,744. Management and general expenses 0. Fundraising expenses 0. Total expenses 484,744. MOBILE MRI/PT-CT SCANNING: Program service expenses 599,923. Management and general expenses 0. Fundraising expenses 0. Total expenses 599,923. OUTSOURCED ANESTHESIA: Program service expenses 791,484. Management and general expenses 0. Fundraising expenses 0. Total expenses 791,484. OUTSOURCED PHARMACY: Program service expenses 571,518. Management and general expenses 0. Fundraising expenses 0. Total expenses 571,518. OUTSOURCED HOSPITAL MANAGEMENT: Program service expenses 825,368. Management and general expenses 1,509,106. Fundraising expenses 0. Total expenses 2,334,474. OTHER OUTSOURCED SERVICES: Program service expenses 1,562,952. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,562,952. OUTSOURCED LABORATORY: Program service expenses 655,836. Management and general expenses 0. Fundraising expenses 0. Total expenses 655,836. OUTSOURCED DIETARY: Program service expenses 0. Management and general expenses 242,022. Fundraising expenses 0. Total expenses 242,022. Form 990, Part XI, line 9: CHANGE IN DEFINED BENEFIT PENSION PLAN 3,096,252. Form 990, Part XII, Line 2c: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. Sturgis Hospital Pain Management 916 Myrtle Street Sturgis MI 49091 461734503 Healthcare MI Sturgis Hospital Related 159940 58291 0 1 0.51000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0