2018-05-11T10:24:08-07:00 2017-06-30 990 2016-07-01 380593405 METROPOLITAN HOSPITAL METR 5900 Byron Center Avenue S W Wyoming MI 49519 Kris Kurtz CFO 6162524844 2018-05-10 2016 2022-09-23 18:48:47Z METRO HEALTH HOSPITAL Kris Kurtz 5900 Bryon Center Avenue S W Wyoming MI 49519 383181148 0 X www.metrohealth.net X 1942 MI See Schedule O 19 11 3254 195 4412525 0 567289 911107 355917573 380793463 1574604 1476578 0 358059466 383181148 0 0 137141418 172654805 0 364451 219841254 238701463 356982672 411356268 1076794 -28175120 395062166 388908340 340775502 350013835 54286664 38894505 Metro Health's mission is to improve the health and well-being of our communities. To that end the organization believes the foundation of good health is based on excellent quality primary care. The organization is anchored by a 208-BED, general acute care community hospital. Additionally, it operates 13 neighborhood outpatient centers, student health facilities at Grand Valley State University and a community clinic for the underserved. The neighborhood outpatient centers ring the organization's service area, allowing patients access to quality healthcare close to home; services at them include primary care, lab services, mammography, x-ray and physical therapy. In addition to primary care services, the organization provides specialty care at its heart and vascular practice, cancer center, ambulatory surgery center, ophthalmology office, sleep lab and other sites. The organization also focuses on improving the health of the community before people need healthcare. 0 0 344863752 376380938 Metro Health hospital is a 208-BED teaching hospital that provides a comprehensive suite of impatient and outpatient healthcare services, including fast emergency services, cancer and cardiac care,robotic and traditional surgery, family practice, internal medicine, sports medicine and others. The organization's mission is to improve the health and well-being of the communities it serves. To that end, Metro provides education and screening programs for the community, education opportunities for future doctors, nurses and other health professions, financial assistance programs, care for the underserved, and much more. During fiscal year 2017, Metro health welcomed 1,475 babies into our community, cared for 63,355 emergency room visits, performed 1,344,268 laboratory tests and 153,714 diagnostic radiology procedures and counted 42,869 patient days. The Metro health community clinic, which provides medical care to the underserved, provided care for 19,756 patient visits. Metro health's medical education program included 121 medical students, residents and fellows. 0 0 0 344863752 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 211 0 1 3254 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 11 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MI X Kris Kurtz 6162524844 5900 Byron Center Avenue S W Wyoming MI 49519 David Spahlinger Vice Chairperson 5.00 0.00 X X 0 983018 103026 Jeffery Desmond Board member 5.00 0.00 X 0 620383 50092 Quinta Vreede Board member 5.00 0.00 X 0 386704 33233 Ronald Grifka Board member 5.00 0.00 X 0 310278 53961 Lance Owens Board member 60.00 0.00 X 308545 0 27252 David Albrecht D O Board member 60.00 0.00 X 269644 0 27659 Michael Wood Board member 5.00 0.00 X 0 230081 42092 Therese Rouse Board member 60.00 0.00 X 111835 0 436 Bill Barkeley Chairperson 5.00 0.00 X X 0 0 0 Connie Bohatch Board member 5.00 0.00 X 0 0 0 Scott Epstein Board member 5.00 0.00 X 0 0 0 Paul Gauthier Board member 5.00 0.00 X 0 0 0 Laura Hopson Board member 5.00 0.00 X 0 0 0 John Keller Board member 5.00 0.00 X 0 0 0 Carlos Sanchez Board member 5.00 0.00 X 0 0 0 Robert Brown Board member 5.00 0.00 X 0 0 0 Bruce Courtade Board member 5.00 0.00 X 0 0 0 Judith Frey Board member 5.00 0.00 X 0 0 0 Larry Robson Board member 5.00 0.00 X 0 0 0 Michael Faas CEO 60.00 9.00 X 1336800 0 23022 Frank Belsto CPEN 60.00 0.00 X 536272 0 23022 Jeffery Postlewaite VP-Medical Affairs 60.00 0.00 X 393145 0 22509 Peter Hahn CMO 60.00 0.00 X 392810 0 12525 Floyd Wilson Jr CAO-Part year 60.00 0.00 X 385894 0 27609 William Lewkowski EVP-CSO 60.00 0.00 X 346188 0 27499 Kris Kurtz CFO 60.00 0.00 X 327297 0 27239 Veronica Marsich VP-Legal service 60.00 0.00 X 325732 0 16381 Bradley Clegg CMIO 60.00 0.00 X 312794 0 24959 Mary Marks CNO-Part year 60.00 0.00 X 305220 0 8742 Joshua Wilda CIO 60.00 0.00 X 183172 0 23307 Steven Polega CNO 60.00 0.00 X 134630 0 21769 Tom Heetderks VP-HR-Part year 60.00 0.00 X 100732 0 7378 William Cunningham EVP-Systems development 60.00 0.00 X 66000 0 258 Jihad Mustapha Physician 60.00 0.00 X 1187559 0 27809 Matthew Sevensma Physician 60.00 0.00 X 888467 0 27386 Paul Kovack Physician 60.00 0.00 X 872995 0 27609 Fadi Saab Physician 60.00 0.00 X 855518 0 27609 Barbara Karenko Physician 60.00 0.00 X 718435 0 16407 10359684 2530464 730790 218 0 1 0 Great Lakes Neurosurgical Associates 414 Plymouth N E Grand Rapids MI 49505 Medical service 7824408 Epic systems corp PO box 88314 Milwaukee WI 53288 Medical IS 2664687 Anesthesia Medical Consultants 333 Evergreen dr NE Grand Rapids MI 49525 Medical Service 1764941 Sodexo CTM INC PO box 415000 Nashville TN 37241 Medical Equip 1524777 West MI Surgical Specialists PC 1045 Gezon Parkway SW Wyoming MI 49509 Medical service 1458015 71 911107 911107 Net Patient Revenue 541380 354937241 354937241 0 0 Other Revenue 541380 21443697 21443697 0 0 Lab Tests For Outside Patient 541380 4412525 0 4412525 0 0 0 0 0 380793463 1360874 1360874 0 0 115704 0 115704 115704 115704 0 383181148 376380938 4412525 1476578 X 5836710 4527240 1302558 6912 145981774 119028200 26701682 251892 -9076868 -9076868 15882825 656617 15226208 14030364 12733946 1277051 19367 2332635 2332635 2149492 2149492 120135 120135 44692327 40517239 4173874 1214 2380059 302671 2077388 8850833 7506192 1297974 46667 12835190 669876 12165314 26972316 26234343 737973 3261433 2276099 960707 24627 14146793 13060331 1086462 20561141 18735713 1825428 7830261 5507190 2323071 MEDICAL SUPPLIES 66042393 66109089 -66696 BAD DEBT 11391361 11391361 0 EQUIPMENT 7803886 7778576 25310 OTHER 3765081 3765081 0 3566127 1731353 1821002 13772 411356268 344863752 66128065 364451 50111833 1697865 1131136 40000000 33329722 40164754 1003258 950753 7318229 8105932 1415970 923222 462939741 220038559 238765614 242901182 50079432 34895402 4333197 11906972 14936033 395062166 388908340 31970083 35544466 897084 1710292 177455000 16943276 12366877 113510059 300392200 340775502 350013835 X 54286664 38894505 0 0 0 0 54286664 38894505 395062166 388908340 X -28175120 689073 12093888 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 12901592 12901592 0 246182877 69610781 176572096 0 11609701 5189943 6419758 0 184230475 145237835 38992640 0 8015096 0 8015096 242901182 DUE TO AFFILIATE 207620554 CAPITAL LEASE OBLIGATIONS 50166991 DEFINED BENEFIT PENSION PLAN 17280863 LIABILITY CLAIMS 13180066 ACCRUED LIABILITIES 5968675 COST REPORT SETTLEMENT PAYABLE 3197736 GAIN ON REFUNDING 2977315 300392200 383181148 0 0 0 0 0 383181148 0 0 0 383181148 411356268 0 0 0 0 0 411356268 0 0 0 411356268 1 1 X 1 X 1.75 1 X 2.25 1 1 0 0 3790589 3790589 0.0092 72105807 61999056 10106751 0.0246 0 0.00 0 0 75896396 61999056 13897340 0.0338 62092 17647 44445 0.0001 9201363 3160445 6040918 0.0147 0 0.00 1082770 752442 330328 0.0008 906883 906883 0.0022 0 0 11253108 3930534 7322574 0.0178 0 0 87149504 65929590 21219914 0.0516 0 0.00 0 0.00 0 0 2 2000 4000 4000 0 0 0 0 0 0 0 0 0 0 2 2000 4000 0 4000 0.00 1 5916092 0 128055175 155581290 -27526115 X 1 1 1 1 Metropolitan Hospital 5900 Byron Center Avenue S W Wyoming MI 49519 X X X X Metropolitan Hospital 1 0 0 1 X X X X X X X X 15 1 1 1 1 X www.Metrohealth.net X 1 15 1 www.Metrohealth.net 0 0 1 X 175 225 X X X X X 1 1 X X X 1 X see part V page 8 X see part V page 8 X see part V page 8 X X X X X X X 1 X 0 X X X X 1 X 0 1 Schedule H, Part V, Section B, Line 5-Metropolitan Hospital Additional data collection methods were used by the community input workgroup to gather data from the community members whose voice and health status may not be represented through the local, state, and national secondary data sources. The additional data collection methods included community input walls (strategy involving gathering input from community members directly by posting large sheets of paper in public space and asking community members to answer questions about the community by writing their thoughts on the wall), focus groups with community members participating to generate community input from various populations about the health and well-being of Kent county and intercept interviews (method designed to engage participants who may not be inclined to attend a focus group or town hall meeting). The intercept interviews were translated into Spanish for the Latino/Hispanic community and other languages spoken by the Asian community. Schedule H, Part V, Section B, Line 6a-Metropolitan Hospital Spectrum health, Mercy health, Mary free bed, Pine rest christian mental health services. Schedule H, Part V, Section B, Line 6b-Metropolitan Hospital Kent county health department, YMCA, Network 180 Schedule H, Part V, Section B, Line 11-Metropolitan Hospital 1. Obesity: Educate employees and the community about obesity and health complications that can result from it, for example heart complications. Focus on healthy lifestyle choices and the importance of fitness. Metro health offers free cooking demos to the community focused on healthy recipes with Metro health cardiologist's input. Metro health offers and promotes low cost and free exercise classes to the community year round ranging from low to high intensity. Metro sponsors and hosts multiple walks and runs in the community. 2. Poor nutrition: Poor nutrition can lead to obesity but here we focus on the importance of access to healthy foods. Educate employees and the community about healthy eating and nutrition. Access to healthy food is always a priority for our farm market. We accept all major Michigan food assistance program that promote healthy eating. Located at the Metro health hospital we have a garden where we have learning sessions open and free to the community. 3. Violence and safety: Metro has been working with one Wyoming with monitoring programs in our community that focuses on our youth in need. Metro health will be working with the Wyoming fire department to have all of their staff EMT trained and certified. Fire fighters are often the first responders to an emergency scene and their training is critical to the safety of our community. Metro health is providing classes that focus on the CHNA strategy #1 and #3. We offer stress management/meditation classes for free and we also offer free smoking cessation classes partnering with the cessation center of tobacco free partners to the community. Even though they are not considered a focus, they are important to us and we will do everything we can to help the needs of our community. Schedule H, Part V, Section B, Line 13b-Metropolitan Hospital A parent whose hospital bills after payment by third-party payers exceed 15% of the person's annual gross income as set forth in this policy and who is unable to pay the remaining bill may be considered medically indigent and is eligible to apply for financial assistance. Other financial assets and liabilities of the person may be considered when determining ability to pay. A determination of a patient's ability to pay the remainder of the bill will be based on whether the patient reasonably can be expected to pay the account in full over whether the patient reasonably can be expected to pay the account in full over a 25 metropolitan hospital month period. If the determination is made that a patient has the ability to pay the remainder of the bill, such determination does not prevent a reassessment of the patient's ability to pay at a later date. Schedule H, Part V, Section B, Line 16a-Metropolitan Hospital HTTPS://METROHEALTH.NET/ABOUT-METRO-HEALTH/BILLING-PAYMENT-OPTIONS/FINANCIA Schedule H, Part V, Section B, Line 16b-Metropolitan Hospital HTTPS://METROHEALTH.NET/ABOUT-METRO-HEALTH/BILLING-PAYMENT-OPTIONS/FINANCIA Schedule H, Part V, Section B, Line 16c-Metropolitan Hospital HTTPS://METROHEALTH.NET/ABOUT-METRO-HEALTH/BILLING-PAYMENT-OPTIONS/FINANCIA Schedule H, Part V, Section B, Line 16i-Metropolitan Hospital It is the goal of metro health hospital to communicate to patients and the public of the availability of financial assistance to those who qualify. This is achieved through various methods including, but not limited to, "a patient's guide", metro health's website (www.metrohealth.net), patient billing statements, word of mouth, community public locations, financial assistance applications will be translated into languages appropriate to the hospital's community. Schedule H, Part V, Section B, Line 16j-Metropolitan Hospital Metropolitan hospital Schedule H, Part V, Section B, Line 24-Metropolitan Hospital In accordance with medicare policy we charge the full amount but for people who did not have insurance we discounted the charge by 40%. If they had insurance the amount was discounted by the contract percentage. 24 Alger Heights 806 Alger Street SE Grand Rapids MI 49507 Family Practice Aquinas 1607 Robinson rd Grand Rapids MI 49506 Family practice Cancer Services 5950 Metro Way Wyoming MI 49519 Cancer Center GVSU 10383 42nd Ave Ste A Allendale MI 49401 Family practice Healthpark 2093 Health Drive Wyoming MI 49519 Sleep lab & Endoscopy, Internal medicine Metro health Allendale 11160 W J Presley Parkway Ste 100 Allendale MI 49401 Family practice, PT, Radiology & Mommogr Metro health Caledonia plaza 8941 North Rodger Court Caledonia MI 49316 Family practice, PT, Radiology & Mammogr Metro health Cascade 4300 Cascade Grand Rapids MI 49546 Family practice, PT, Radiology & Mammogr Metro health Cedar Springs 14211 White Creek Cedar Springs MI 49319 Family practice, PT, Radiology, Mammogr Metro health community clinic 785 36th St SE Wyoming MI 49519 Clinic for low income & offices Metro health Comstock park 4200 N Division Comstock Park MI 49321 Family practice, PT, Radiology & Mammogr Metro health ENT 1179 East Paris SE Grand Rapids MI 49546 Ear, Nose & Throat Metro health Greenville 1915 West Washington Greenville MI 48838 Heart & Vascular, Family practice Metro health Hudsonville 3912 32nd Ave Hudsonville MI 49426 Family practice, PT, Radiology & Mammogr Metro health Jenison 7686 Georgetown Center Dr Jenison MI 49428 Family practice, PT, Radiology & Mammogr Metro health Lowell 2550 West Main Lowell MI 49331 Family practice, PT, Radiology & Mammogr Metro health Ophthalmology 2221 Health Drive SW Wyoming MI 49519 Ophthalmology Metro health professional building 2122 Health Drive SW Wyoming MI 49519 Wound clinic, Lab & Pulmonary rehab Metro health Rockford 4685 Belding Road Rockford MI 49341 Family practice, Diabetes ed, PT, Radiology Metro health Wayland 893 E Superior Wayland MI 49348 Family practice, Radiology, PT & Mammogr Metro health park east 4055 Cascade Rd SE Grand Rapids MI 49546 Urgent care, Surgery center Metro health southwest plaza 2215 44th Street SW Wyoming MI 49519 Family practice, Diabetes ed, PT, Radiology Midtowne 555 Midtown Suite 105 Grand rapids MI 49503 Heart & Vascular YMCA 5722 Metro Way SW Wyoming MI 49519 Sports Medicine Schedule H, Part I, Line 7 The information used to calculate Line 7 is on the paid claims basis. The cost-to-charge ratio was derived from worksheet 2. Schedule H, Part I, Line 7, Column f The bad debt expense included on form 990, part IX, line 25(A) but subtracted for purposes of calculating the percentage in this column is $11,391,361. Schedule H, Part II Although many such activities are often not quantifiable, we continue to build on our strong record of collaboration with community groups, businesses academic institutions, and governmental and non- governmental organizations with the goal of improving health outcomes and reducing health disparities. Emphasis is placed on addressing the social determinants of health, the health care delivery system and community economic development. Metro Health takes seriously the opportunity and obligation we have to help build our community. All members of the organization's leadership team are required to volunteer a minimum of 12 hours to community-benefit initiatives. General staff members are also encouraged to volunteer at community-benefit initiatives. Many Metro employees play an active role on the boards and/or committees of several health and human service agencies in our community, such as YMCA, Grand Rapids Chamber of Commerce Health Care committee, Ele's Place Grand Rapids, Grand Rapids African American Health Institute, Goodwill Industries, Mel Trotter Ministries, Community Transformation Grant Committee, Kid's Food Basket, West Michigan Hispanic Chamber of Commerce and more. In addition, Metro leaders and staff members participate in one- day community activities, such as presenting health or career information in area schools from elementary schools to colleges and universities. As an Osteopathic teaching hospital, we have a significant presence with the Michigan Association of Osteopathic Directors and Medical Educators. This association helps train new physicians and develops the curriculum used for medical residents and student interns throughout our state. Several members of our staff are involved in this group at the state level and spend a large number of hours every year serving in this capacity. Metro Health is also the education site for over one hundred medical fellows, residents and students. Metro also promotes health in our community and stewardship of natural resources by collaborating with the City of Wyoming to host two Drug Take Back Days each year. By working together we are able to bring this U.S. Department of Justice/Drug Enforcement Administration program to our community. The City of Wyoming provides disposal and law enforcement personnel, while Metro Health provides pharmacists to answer community member questions and help sort drugs and a convenient location for community members to drop off unused and expired drugs. By properly disposing of the materials, we are able to keep these drugs out of the community's water system and away from children who might find them in a home. Metro is currently working with the City of Wyoming fire department with EMT training for their staff. Schedule H, Part III, Section A, Line 2 Bad debt is any portion of patient account that is deemed uncollectible after reasonable collection efforts have been made, including financial assistance. Bad debt does not include contractual discounts, community benefit or charity care. Schedule H, Part III, Section A, 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 collectibility of accounts receivable, the hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co payment 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 that standard rates (or the discounted rate 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. Schedule H, Part III, Section B, Line 8 Healthcare payment reforms implemented through the affordable care act have shifted some of the expense burden of providing healthcare services to medicare beneficiaries from the government on to healthcare providers through reduced payments. These payment reductions have increased the losses incurred by healthcare providers for treating medicare beneficiaries. By reducing the governments financial burden providing healthcare services to medicare beneficiaries, Metro health believes that medicare shortfalls provide a valuable community benefit. On December 31, 2014 the treasury department and the internal revenue service (IRS) issued final regulations that implement the requirements under IRC section 501(R). This provision imposes additional requirements on 501(C)(3) organizations that operate one or more hospital facilities. These regulations became effective for tax years beginning after December 29, 2015. With respect to Metropolitan hospital (MH), the effective date was July 1, 2016. MH had developed policies based on previous precedential authority, notices 2011-52, 2014-2, and 2014-3, However, it revised its policies in accordance with the final regulations a few months beyond the effective date. The revisions were minor and inadvertent and resulted in no meaningful harm or additional costs to the patients and other members of the community. The slight delay was due to an affliction that MH was undergoing at the time with Michigan medicine (MM), an operating division of the regents of the University of Michigan (U-M) and was corrected as soon as possible after such affiliation occurred. Schedule H, Part III, Section C, Line 9b Metro tries to inform the patient if they qualify for charity care as soon as possible because the patient benefits from knowing about their financial obligations and the hospital can avoid a costly collections process if the patient has the inability to pay. Every patient bill has the federal poverty guidelines on the back and its on Metro's website. Both explain the procedures and limits for charity care and discounting programs. Patient financial representatives are available to discuss filling out the paperwork for government medical assistance programs. Schedule H, Part VI, Line 2 For more than 20 years, healthy Kent has engaged a broad array of community partner organizations to address data-driven priority areas, ranging from infant mortality to violence. During its tenure, healthy Kent has yielded many noteworthy community-based successes, and continues to achieve results through its successful community collaborations on topics ranging from maternal and child health to suicide prevention. In 2013, healthy Kent also took on the role of convener for the fiscal year end 2015 community health needs assessment. (CHNA) Process. This is the second iteration of Kent county's community health improvement efforts. The first countywide CHNA was published in fiscal year end 2012, followed the next year by a community health improvement plan (CHIP), which outlined community priorities as well as goals, objectives, and strategies aimed at impacting those key priorities. Many lessons were learned from the first iteration of the CHNA/CHIP process within our community. As a result, significant improvements have been made to the health improvement process in Kent county. Some of the improvements include a stronger focus on community input, enhanced data collection and reporting, as well as an expanded breadth of involvement in various phases of the process by key community agencies and organizations. Additionally, the responsibility for coordinating the CHNA/CHIP process in our community has shifted from Kent county working together for a healthier tomorrow to healthy Kent. The mission of the Kent county CHNA process was to ensure that the people of Kent county are empowered to achieve life-long physical, mental and social well-being through 1) equal access to high quality, affordable healthcare; 2) a coordinated system of care that is local, preventive, holistic and patient centered; and 3) an environment that supports healthy living for all. Five priority health issues that were discovered were 1) mental health issues, 2) obesity, 3) substance abuse, 4) poor nutrition, and 5) violence and safety. For the fiscal year end 2015 healthy Kent CHNA process, the Mapp core team opted to adopt a slightly modified version of the vision and mission that were utilized during the fiscal year end 2012 CHNA process in Kent county. The vision statement remained "High quality of life, health, and well-being for all people in Kent county." The slight modification came in the mission statement, where the bullet points that originally accompanied the statement were removed. The new mission statement is "The people of Kent county are empowered to achieve lifelong physical, mental, and social well-being." Schedule H, Part VI, Line 3 Metro health recognizes that individuals and families who are facing financial instability or hardship often neglect healthcare needs until they become emergent conditions. This practice places stress on patients, families and the healthcare system. Metro health seeks to inform patients of their eligibility for charity care as soon as possible in the healthcare process so that patients know there is help for them and so that the organization avoids costly collections process. Metro health posts information on financial assistance on the organization web site. There are also brochures in waiting rooms and at registration desks with information about our financial assistance programs. Patients who report having no coverage at registration are provided information about or community benefit discount. This program provides a 40% discount to all patients without coverage as well as an interest free payment plan (carepayment) for those patients with a balance they are unable to pay in the near future. In addition, every patient bill includes the federal poverty guidelines on the back and explains the procedures and limits for charity care and discounting programs. Patient financial representatives are available to discuss filling out paperwork for government medical assistance programs. There is also a phone number listed on the application for financial assistance which patients can call if they have questions. Schedule H, Part VI, Line 4 The fiscal year end 2015 community health survey asked respondents to provide data on a number of demographic topics, including gender, race, age, relationship status, home ownership, employment status, educational attainment, household income, geographic location of residence, and BMI. The majority of survey respondents were female (77.2%), white (59.9%), and reported a household income of less than $20,000 per year (43.8%). Most survey respondents fell within the age categories of 25 to 34 years (25.2%), 35 to 44 years (21.7%), and 45 to 54 years (20.0%). Just over half of the survey participants reported owning their own home (52.8%) and over 66% reported that they had an educational attainment level of at least some college. Sixty-one percent of survey participants reported some variation of employment, whether self-employed (4.7%), employed part-time (17.2%), or employed full-time (39.1%). More than half of survey respondents had a BMI that is indicative of overweight (29.2%) or obesity (35.5%). The majority of the participants of the survey were from Grand Rapids, Wyoming, and Kentwood, with 24 other cities , townships or villages being represented in the results. Grand Rapids represents the vast majority, with over 60% of participants residing in the city. The next community health survey will be aligned with the community health needs assessment of fiscal year end 2018. Kent county, where the majority of Metro health patients reside, is the fourth largest county in Michigan. In 2014, there were 609,000 people living in Kent county. Kent county includes a diverse mix of demographics. According to the United States census bureau web site (2014 census), 79.8 percent of the population is white (not Hispanic). The Hispanic population is 7.5 percent of residence; the African American population is 8.5 percent of the community, and Asian Americans comprise 1.2 percent of the population. An estimated 14.3 percent of Kent county adults do not have a personal doctor or healthcare provider, a rate which is notably lower than the statewide (17.0%) and nationwide rates (22.9%). Hispanics (34.6%) are the most likely cohort to report having no personal healthcare provider. The likelihood of having a personal provider is lowest among respondents under the age of 35. Schedule H, Part VI, Line 5 In fiscal year 2016, Metro health hospital continued to provide community benefit by providing high quality, coordinated patient care, education, research and advocacy programs. We provided these services in Kent county, Michigan and the surrounding west Michigan areas. Metro's governance structure, open medical staff, outreach programming and more contribute to how we promote community health. Broad service is a commitment to help further the hospital's mission of improving the health and well-being of our community. Members represent a wide spectrum of industries, including healthcare, banking, real estate, marketing, office furniture, non-profit leadership and more. While the majority of board members are Caucasian, members also represent the African american and Latino communities. Metro health maintains an open medical staff, meaning community practitioners can hold privileges at the hospital. There are more than 500 members of the medical staff, representing employed and independent physicians and a mix of primary care and specialty physicians. Metro health hospital offers a variety of programs to improve the heath of our community. Our live healthy community outreach programs provides free and low-cost health education promotion events, classes and more to out community. The majority of these programs are designed to address recognized health needs in the community. These classes and events grow in popularity every year and include topics such as living with diabetes, CPR, classes cooking with the cardiologist and more. Low-cost exercise classes offer activity to beginners, as well as to very fit participants. Other free offerings are tobacco cessation, pre-diabetes, nutrition, joint pain, injury and fall prevention, child safety seat, healthy cooking classes, stress management classes and many more. While all of the live healthy classes are free or low cost, if cost is a difference for people being able to attend, the community outreach department waives the fee. Free health screens are also an important component of the live healthy program. AS examples, free blood pressure screens are health monthly in the hospital and at three offsite physician offices. Holding screens at these remote locations makes it easier for more people in our service area to take advantage of the free service. For example, metro also offered free screening events for peripheral artery disease (PAD) and sudden cardiac death in high school athletes. PAD can result as a side effect of diabetes or other illnesses; all people at risk of heart disease are at risk of PAD. Left untreated PAD can result in critical limb ischemia and/or amputation. By treating PAD before it escalates, physicians are helping patients avoid costly and life-changing major amputations. Our community was directly affected by the death of a young athlete on the basketball court. Parents and school administrators alike sought resources for identifying risks of sudden cardiac death. As a result, Metro's sports medicine and cardiology physicians partner to offer screenings to high school students. The hospital also hosts a number of free support groups and meetings for community organizations. Some support groups are run by Metro health professionals and others are community-based groups to whom Metro offers free conference room space. Some of the support groups meeting at Metro include include those for Alzheimer's, breastfeeding and cancer services. As a teaching hospital, Metro also offers educational opportunities to medical residents, nurses, radiology techs, Phlebotomist and even high school students who are interested in medical professions. The metro health farm market is another way Metro seeks to improve the health of the community. For ten consecutive years now, our market has grown in popularity among community members, patients and employees. On farm market days, it is common to see outpatients and visitors mingle with community members as they shop for fresh, locally grown and produced foods. Metro continued its efforts to make healthy foods available to our entire community by continuing to offer farm market shoppers on food assistance ways to use the assistance at the market. Metro accepts project fresh coupons and snap benefits. We also accept double up food bucks, senior project fresh, and WIC. As an added benefit, Metro offered free health screens and cooking classes at the market so that area residents could learn about their health and learn ways to cook the delicious, healthy foods available at the market - regardless of their income level. Metro health is also committed to protecting the environment through a number of green initiatives. Our hospital building is one of the first hospitals in the nation designed and built to be leed-certified (leadership in energy and environmental design), and it is located in the Metro health village which requires all buildings on the property to be designed and built for leed certification. Employee and community participation in recycling and composting programs at the hospital continues to grow each year. The hospital kitchen recycling and composting is very successful and would not be possible without the buy-in of the employee team. We have created a sustainable committee that includes employee leadership throughout the organization that play an important role in our sustainability initiatives. Beyond the walls of the hospital, Metro's leadership team is working to make an impact on the community. Every member of the leadership team is expected to volunteer a minimum of 12 hours during the year to community-benefit initiatives. Many leaders go well above the 12-hour threshold and volunteer much more in the community. They also allow team building through service to other organizations. Teams of Metro employees have worked together to assist area food programs, provide flu shots for area residents in need and more. Schedule H, Part VI, Line 7 Michigan X 1 1 X X X X 0 1 0 0 0 0 0 0 0 David Spahlinger Vice Chairperson 0 983018 0 0 0 0 0 86500 0 16526 0 1086044 Jeffery Desmond Board member 0 620383 0 0 0 0 0 35355 0 14737 0 670475 Quinta Vreede Board member 0 386704 0 0 0 0 0 23850 0 9383 0 419937 Ronald Grifka Board member 0 310278 0 0 0 0 0 26500 0 27461 0 364239 Lance Owens Board member 283947 0 23835 0 763 0 10178 0 17074 0 335797 0 David Albrecht D O Board member 268984 0 0 0 660 0 10450 0 17209 0 297303 0 Michael Wood Board member 0 230081 0 0 0 0 0 21450 0 20642 0 272173 Michael Faas CEO 968175 0 293000 0 75625 0 10600 0 12422 0 1359822 0 Frank Belsto CPEN 410491 0 89425 0 36356 0 10600 0 12422 0 559294 0 Jeffery Postlewaite VP-Medical Affairs 392601 0 0 0 544 0 10391 0 12118 0 415654 0 Peter Hahn CMO 355485 0 34363 0 2962 0 0 0 12525 0 405335 0 William Lewkowski EVP-CSO 266734 0 57800 0 21654 0 10290 0 17209 0 373687 0 Kris Kurtz CFO 243217 0 53128 0 30952 0 10030 0 17209 0 354536 0 Veronica Marsich VP-Legal service 268529 0 46325 0 10878 0 10096 0 6285 0 342113 0 Bradley Clegg CMIO 254525 0 44713 0 13556 0 7950 0 17009 0 337753 0 Floyd Wilson Jr CAO-Part year 295094 0 64863 0 25937 0 10600 0 17009 0 413503 0 Mary Marks CNO-Part year 227011 0 48240 0 29969 0 7950 0 792 0 313962 0 Joshua Wilda CIO 151224 0 26350 0 5598 0 6625 0 16682 0 206479 0 Steven Polega CNO 116530 0 17556 0 544 0 5325 0 16444 0 156399 0 Jihad Mustapha Physician 1186569 0 0 0 990 0 10600 0 17209 0 1215368 0 Matthew Sevensma Physician 585225 0 302582 0 660 0 10600 0 16786 0 915853 0 Paul Kovack Physician 584210 0 285947 0 2838 0 10600 0 17009 0 900604 0 Fadi Saab Physician 580179 0 274679 0 660 0 10600 0 17009 0 883127 0 Barbara Karenko Physician 586056 0 131785 0 594 0 10600 0 5807 0 734842 0 Schedule J, Part I, Line 1a Mike Faas received club dues. These payments are treated as taxable compensation. Schedule J, Part I, Line 4 David Spahlinger received $60,000 from a supplemental nonqualified retirement plan and Mike Faas received $105,600 from a supplemental nonqualified retirement plan Form 990, Part I, Line 1 Metro health's mission is to improve the health and well-being of our communities. To that end the organization believes the foundation of good health is based on excellent quality primary care. The organization is anchored by a 208-bed, general acute care community hospital. Additionally, it operates 13 neighborhood outpatient centers, student health facilities at grand valley state university and a community clinic for the underserved. The neighborhood outpatient centers ring the organization's service area, allowing patients access to quality healthcare close to home; services at them include primary care, lab services, mammography, x-ray and physical therapy. In addition to primary care services, the organization provides specialty care at its heart and vascular practice, cancer center, ambulatory surgery center, ophthalmology office, sleep lab and other sites. The organization also focuses on improving the health of the community before people need healthcare. It does this through its live healthy community outreach program that offers free and low-cost classes, seminars and community health screens. In the past year, screens have been done for high blood pressure, peripheral vascular disease, memory issues and sudden cardiac death. Metro health is also a major provider of osteopathic medical education. In fiscal year 2017, 121 medical students, residents and fellows participated in its medical education program. Affiliation with the regents of the University of Michigan this fiscal year metropolitan health corporation (MHC) which is the parent entity of metropolitan hospital (MH) affiliated with Michigan medicine (mm) which is an operating division of the regents of the University of Michigan (u-m). The amendment to the articles of incorporation of MHC, dated December 15, 2016, state that its primary purpose is to operate exclusively for the benefit of, to perform any of the functions of, and to carry out any of the purposes of u-m, a Michigan constitutional body corporate that also maintains a charitable status under internal revenue code (IRC) section 501(c)(3). The bylaws of MHC provide that its sole member is u-m health, a nonprofit entity that is a wholly owned subsidiary of u-m. As sole member, u-m health may exercise certain reserved powers, including approval of any strategic plans, annual or other budgets, capital expenditures not included in the budget that exceeds $500,000, among others. The bylaws of MH state its corporate member, MHC, and by attribution, u-m health, may exercise similar reserved powers mentioned above. MH, like MHC, is a related entity to u-m and u-m health whose primary purpose is to operate and function as part of mm. Consequently, certain accounting changes have been made to MHC's financial statements to meet certain reporting requirements under governmental accounting standards board(GASB). MH is included in the consolidated financial statements of u-m health for fiscal year ended June 30, 2017. Form 990, Part VI, Section A, Line 4 See 2nd paragraph, page 1- Affiliation with the regents of the University of Michigan. Form 990, Part VI, Section A, Line 6 See 2nd paragraph, page 1. Affiliation with the regents of the University of Michigan Form 990, Part VI, Section A, Line 7a See 2nd paragraph, page 1. Affiliation with the regents of the University of Michigan. Form 990, Part VI, Section A, Line 7b See 2nd paragraph, page 1. Affiliation with the regents of the University of Michigan Form 990, Part VI, Section B, Line 11b Form 990 was prepared by the University of Michigan (U-M) tax department of the newly contracted affiliate whose exempt subsidiary, U-M health, is its sole member. U-M worked closely with the fiscal services department of Metro to ensure the information provided was complete and accurate. The completed form 990 was reviewed by the chief financial officer and controller. Also, prior to filing the form 990, the full metro board of directors was notified that the completed form 990 was available for review at the board meeting. Form 990, Part VI, Section B, Line 12c Each board member, key employed and non-employed personnel is required annually to complete a conflict of interest statement. The statements are compiled and the hospital's compliance department reviews them for any potential conflicts. Any conflicts are noted and appropriate action is taken as required. Form 990, Part VI, Section B, Line 15 (a)The CEO and other executive compensation is determined by use of consultants and comparability data from other hospitals of similar size. The executive committee reviews and approves the CEO compensation. Their discussion is documented in the minutes of the meeting. The most recent year this process was undertaken was in 2017. (b) The executive's compensation is determined by use of consultants and comparability data from other hospitals of similar size. The executive committee reviews and approves the executive compensation. Their discussion is documented in the minutes of the meeting.as of 1/1/2016, the executive team all went on contracts. As a part of that process, compensation studies by an independent firm were completed to ensure the executives were at market value. Form 990, Part VI, Section C, Line 19 Documents are available upon request. Form 990, Part IX, Line 11g Total expense is $44,692,327 which consists of (A) Purchased services for $28,708,538 as Program Service, $3,051,635 as MGT & General, and $1,214 as Fundraising. (B) Contract Labor for 11,808,701 as Program Service and $1,122,239 as MGT & General. Form 990, Part XI, Line 9 Change in equity investment: $2,806,822. Prior adjustment GASB conversion: $9,287,066. Total: $12,093,888. Form 990, Part XII, Line 2c Metropolitan hospital along with U-M Health, a related entity, assumed responsibility for the oversight of the audit and selection of an independent accounting firm for metropolitan foundation. Land Metro LLC 5900 Byron Ave SW Wyoming MI 49519 202863709 Real estate MI 0 0 Metro Hos Metropolitan Foundation 5900 Byron Center Ave SW Wyoming MI 49519 383033329 Supp Hosp MI 501c3 7 MHC 1 Metropolitan Health Corporation 5900 Byron Center Ave SW Wyoming MI 49519 382745509 Parent Org MI 501c3 12A UM health 1 Regents of the Univ of Michigan G359 Wolverine Twr 3003 S State Ann Arbor MI 48109 386006309 School MI 501c 2 N/A 0 UM Health 5082 Wolverine tower 3003 S State Ann Arbor MI 48109 814913150 Sup School MI 501c3 12A UM 1 Metro health ASC LLC 5900 Byron Center Ave SW Wyoming MI 49519 261805066 Ambulator MI N/A Related 2723503 2566105 0 1 0.51 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 Metropolitan Foundation c 911107 Cash Metro health ASC LLC f 2460750 Cash Metropolitan Foundation m 401883 Allocation of costs