2017-11-10T15:22:14-06:00 2016-12-31 381357951 PLANTE & MORAN PLLC 10 S Riverside Plaza 9th Floor Chicago IL 60606 990 2016-01-01 381359087 Bronson Methodist Hospital BRON 2693416000 601 John Street Kalamazoo MI 49007 REBECCA EAST Senior VP/CFO 2693416000 2017-11-07 1 David Lowenthal P00378651 3122071040 2017-11-07 73.73.21.99 2017-11-07 23:13:41 CS P BF9D7D99261A9F87F2634A04C53CF2C7827B7599 75C7EC6AC54A61BA087900A4F9B91D17BA572CD0 2016 2017-02-10 21:41:12Z Frank Sardone 301 John Street Kalamazoo MI 49007 840051380 0 X bronsonhealth.com X 1920 MI TOGETHER, WE ADVANCE THE HEALTH OF OUR COMMUNITIES. 19 12 5260 330 14083933 576040 236748 612650 708507224 818442411 12461862 9538452 5399263 6097192 726605097 834690705 24700000 4200000 0 0 331802337 435319626 0 0 0 301058984 336309515 657561321 775829141 69043776 58861564 839849711 922160918 329572677 332331011 510277034 589829907 X TOGETHER, WE ADVANCE THE HEALTH OF OUR COMMUNITIES 0 0 511908249 4200000 673742289 Bronson Methodist Hospital (BMH) is the flagship of Bronson Healthcare Group, a not-for-profit healthcare system serving all of Southwest Michigan. BMH provides care in virtually every specialty with advanced capabilities in burn treatment and critical care as a Level I trauma center; In neurological care as a Joint Commission certified primary stroke center; In cardiac care as the regions first accredited chest pain emergency center; In obstetrics as the leading birthplace and only high-risk pregnancy center in Southwest Michigan, and in pediatrics as one of the only six Childrens hospitals in the state and the only inpatient pediatric care provider in the area. The BMH emergency department which is open 24 hours per day, handles over 98,000 visits per year. BMH treats all patients regardless of their ability to pay. BMH was the recipient of the 2005 Malcolm Baldridge National Quality award, the nation's highest Presidential honor for quality and organizational performance excellence. In 2009, the hospital received the AHA McKesson quest for quality prize awarded annually to only one U.S. Hospital, and joined the top five percent of hospitals in the nation to be designated a Magnet hospital for nursing excellence.BMH provides a disproportionate amount of care to the segment of the population using Medicaid. BMH is the largest Medicaid provider of any large hospital in Michigan outside of the Detroit area (on a percenatage basis). In 2016, approximately 20% of BMHs patients were Medicaid recipients. We have three Medicaid enrollers on site to help those without insurance enroll in Medicaid, or refer them to community resources. Expenditures related to the operation of the hospital.In 2016, in furtherance of its mission, BMH provided $9,761,951 in charity care expense. 142747197 130626124 In 2016, BMH's Medicaid cost was $142,747,197 and Medicaid net revenue was $130,626,124. 29645257 In 2016, In furtherance of its mission, BMH incurred $29,645,257 in bad debt to provide care to its patients. 684300703 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 193 0 1 5260 1 1 1 0 0 0 0 0 0 0 0 0 X 19 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X REBECCA EAST SENIOR VPCFO 2693416000 301 John Street Kalamazoo MI 49007 Donald Parfet chairperson 1.00 8.00 X X 0 2119 0 Randall Eberts Vice-Chair 1.00 8.00 X X 0 2467 0 Nelson Karre vice Chairperson 1.00 8.00 X X 0 0 0 Barbara James Treasurer 1.00 8.00 X X 0 2100 0 Geoffrey Wardwell President 1.00 8.00 X X 0 962 0 La June Montgomery Tabron director 1.00 8.00 X 0 0 0 Eileen Wilson-Oyelaran Director 1.00 8.00 X 0 0 0 James Gunderson Director 1.00 8.00 X 0 1615 0 James E Greene Director 1.00 8.00 X 0 1863 0 Charles Zeller MD Director 1.00 8.00 X 0 1751 0 Mark B Atkinson MD director 1.00 8.00 X 0 1921 0 William Richardson Director 1.00 8.00 X 0 1549 0 William Johnston Director 1.00 8.00 X 0 0 0 Scott Gibson MD director 1.00 8.00 X 73540 0 0 Brenda Hunt Director 1.00 8.00 X 0 0 0 Steven J Lins MD Director 1.00 8.00 X 0 150 0 Neil Nyberg Director 1.00 8.00 X 0 1471 0 Mahesh C Karamchandani director 1.00 8.00 X 785883 0 28745 Aaron Lane-Davies Director 1.00 8.00 X 267643 0 35444 John Lawlor director 1.00 8.00 X 420294 0 28103 James Liggins Jr director 1.00 8.00 X 0 0 0 Michael Odar director 1.00 8.00 X 0 0 0 Frank J Sardone President and CEO 23.60 16.40 X X 0 1583818 401445 Kenneth L Taft Executive Vice President 23.60 16.40 X 0 749450 156989 James Falahee Sr VP Legal & Leg. Affairs 23.60 16.40 X 0 624777 174097 Scott Larson MD Sr VP Medical Affairs/CMO 23.60 16.40 X 0 687269 151899 John Hayden SR. VP & Chief HR Officer 23.60 16.40 X 0 531240 128510 Rebecca East Sr VP CFO 23.60 16.40 X 0 528562 164887 Kathleen M Harrelson Sr VP, Clinical Operations 23.60 16.40 X 0 504933 187565 John L Jones Jr Sr. VP, Reg. & Phys. Svs. 23.60 16.40 X 0 467239 173331 Michael S Way SR. VP Mat. Mgt. & Facilit 23.60 16.40 X 0 280413 98206 Denise Neeley VP CNO 23.60 16.40 X 0 322925 87626 REBECCA TRELLA VP POST ACUTE CARE 23.60 16.40 X 0 262274 55376 Alain Y Fabi Physician 40.00 X 3079633 0 33559 Gregory C Wiggins Physician 40.00 X 1775842 0 33353 Michael Kasten Physician 40.00 X 1521453 0 34201 Jason Roberts Physician 40.00 X 1207677 0 33440 Mark Sytsma Physician 40.00 X 1251752 0 33819 10383717 6560868 2040595 404 0 1 1 ADVANCED CARDIAC HEALTHCARE PLC 601 John Street Suite 100 KALAMAZOO MI 49007 Medical Services 1944747 KALAMAZOO ANESTHESIOLOGY PC 900 PEELER CHICAGO IL 60689 Medical Services 1625000 SW MI EMERGENCY SERVICES PC 125 S KALAMAZOO MALL SUITE 204 KALAMAZOO MI 49007 Medical Services 1547481 Hayes Locums LLC 6700 N Andre Street 600 Fort Lauderdale FL 33309 Medical Services 777281 Pathology Services 555 W Crosstown Parkway KalaMAZOO MI 49008 medical Services 525837 32 598850 13800 612650 Net Patient Revenue 621500 801252057 801252057 Pharmacy Revenue 446110 7083700 7083700 Laboratory Revenue 541380 6990298 6990298 Outside Service Revenue 900099 2761982 2761982 Meaningful Use Revenue 900099 354374 354374 818442411 9538452 9538452 1152166 50044 5312571 48104 -4160405 1940 -4158465 1940 -4160405 Cafeteria 722210 4685301 7995 4677306 5570356 5570356 10255657 834690705 804368413 14083933 15625709 4200000 4200000 1547360 1547360 358574133 340645426 17928707 7134000 1070100 6063900 49077048 44169343 4907705 18987085 17503009 1484076 2930667 2930667 54671277 49204149 5467128 47267 47267 99860423 89874381 9986042 1140 1026 114 10146732 9132059 1014673 849106 849106 737067 737067 11995231 10795708 1199523 29818922 29818922 4953802 4258951 694851 Unrelated Business Inco 195854 195854 Pharmacy Expense 45807559 45807559 BHG Allocation Expense 38399863 38399863 Bad Debt Expense 29645257 29645257 6249348 6345519 -96171 775829141 684300703 91528438 0 10261 13310 412993398 463921401 95905343 108005284 11374472 10734027 917686 701013 664241363 389171043 268438813 275070320 35660786 35822797 11571142 27203696 2977810 689070 839849711 922160918 49067680 54394868 251838209 257082232 28666788 20853911 329572677 332331011 X 510277034 589829907 510277034 589829907 839849711 922160918 X 58861564 10407030 10284279 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11152699 11152699 389312235 192934586 196377649 871902 305341 566561 251325838 195931116 55394722 11578689 11578689 275070320 Deferred Compensation 1611138 Third Party Contractual settlements 19242773 20853911 809807000 0 809807000 24883705 24883705 834690705 746375000 -29454141 -29454141 775829141 0 775829141 Part XI, Line 4b - Other Adjustments: rent expense -5,360,675. bad debt reclass to expense 29,645,257. Contribution reclass 598,850. rounding 273. Part XII, Line 2d - Other Adjustments: Joint Venture Gain/(Loss) -965,284. Office Rental Expense 5,360,675. Bad debt expense -29,645,257. GENERAL SUPPORT TO RELATED ORGANIZATION -4,200,000. Rounding -4,275. Central America and the Caribbean 0 0 Bronson Methodist Hospital Invested in a foriegn insurance company 109864 0 0 0 0 0 0 109864 0 109864 0 0 1 0 0 0 1 1 X 1 X 1 X 1 1 0 1 1 3758649 3758649 0.00500 115147 152235943 130626124 21609819 0.02900 115147 155994592 130626124 25368468 0.03400 130 8903 565833 565833 0.00080 25 895 21439084 7702572 13736512 0.01840 37 27 1430532 1430532 0.00190 192 9825 23435449 7702572 15732877 0.02110 192 124972 179430041 138328696 41101345 0.05510 1 708 708 0.00000 6 652 15397 15397 0.00000 2 262 863 863 0.00000 9 914 16968 16968 0.00000 1 29645257 1113074 124082571 132532946 -8450375 X 1 1 1 1 Bronson Methodist Hospital 601 John Street Kalamazoo MI 49007 bronsonhealth.com X X X X X Bronson Methodist Hospital 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X See Part V, Page 8 X 1 16 1 See Part V, Page 8 0 1 X 200.000000000000 350.000000000000 X X X X X X 1 1 X X X X 1 X https://www.bronsonhealth.com/medical-financial-assistance-policy X https://www.bronsonhealth.com/medical-financial-assistance/financial-assist X https://www.bronsonhealth.com/medical-financial-assistance/plain-language-p X X X X X X 1 X 0 X 1 X 0 0 Bronson Methodist Hospital Part V, Section B, Line 5: Bronson Methodist Hospital took into account input from persons who represented the community using three methods; focus groups, surveys, and key informant interviews. Five demographic-specific focus groups were conducted with older adults, seniors, low income families, men with children and individuals with disabilities to gain a deeper insight into community health needs among vulnerable populations. A community wide survey seeking input from community members pertaining to health needs and barriers was conducted January 7, 2016 and January 31, 2016. The survey was available in both on-line and written form and was widely promoted and available throughout the community. Focused efforts were undertaken to increase participation by vulnerable populations. As a result, 3190 completed surveys were received and analyzed. In addition, 13 key informant interviews were conducted assessing stakeholder perceptions of the county's health status and unmet needs. These key informants included persons representing broad interests of the community and knowledge and expertise of public health. Key informants included: -Lisa Marshall, Director Sindecuse Medical Center-Larry Schaffer, Manager City of Portage-Grace Lubwama, CEO YWCA-Rachel Villanueva, Gospel Mission Homeless Shelter-Yasaman Black, Kalamazoo Health Department-Jeff Patton, CEO KCMHSAS-Gitti Rossi, Leader Loy Norrix High School Childcare Center-Dale Anderson, Owner Confections with Covictions-Lisa Fuller, CEO Senior Services-Michelle Smith, Clinical Nurse Leader Bronson Methodist Hospital Emergency Department-Dr. Bill Mayer, CEO Federation Care Network-Lisa Ailstock, Director Student Health Kalamazoo College-Thomas Harwood, Deputy Superintendent KRESA Bronson Methodist Hospital Part V, Section B, Line 6a: Bronson Lakeview HospitalBronson Battle Creek Hospital Bronson Methodist Hospital Part V, Section B, Line 6b: Kalamazoo Family Health CenterKalamazoo Community Mental Health & Substance Abuse Services Bronson Methodist Hospital Part V, Section B, Line 11: The CHNA process included a prioritization of health needs based upon consensus criteria, including: magnitude of need, measurable outcomes, Bronson capabilities, evidence for effective interventions, community commitment, and consistency with Bronson Strategy. At the conclusion of this prioritization process, improving access to care was selected as the focus for Community Health activities in 2016-2019. This focused effort will require substantial financial and staffing resources as well as significant collaborations with community organizations. Given the extraordinary challenge of substantially and measurably improving access to care in an environment of limited resources, Bronson leaders and Community Health Board Committee members have chosen to limit our initial focus to this top priority health need. Other needs identified include obesity, lack of mental health support, chronic disease management, addiction prevention, safety, social health, and sexual health. While these health needs were not the priority area, Bronson continues to collaborate and partner with those agencies better suited to have an impact in these areas and Bronson anticipates that improving access to quality care will impact and improve outcomes for many of the other needs identified in the CHNA. The Access of Care Plan is attached to the 990 for reference of areas not being addressed at this time. Bronson Methodist Hospital Part V, Section B, Line 20e: The hospital acknowledges that all individuals are not equally capable of paying for healthcare services, either by themselves or through a third party insurance carrier. The hospital recognizes its responsibility to offer care for persons in need, and therefore provides and promotes access to emergency or medically necessary services without regard to ability to pay.The hospital has signs at entrances to the emergency department that inform patients of the financial assistance policy as well as the admitting and financial counseling departments. The policy is also on the hospital's website (www.bronsonhealth.com). The plain language summary is included on all patient statements.Patients may request an application to determine if they qualify for financial assistance by calling a patient financial counselor or Bronson's billing department. The application is also available on the hospital's website (www.bronsonhealth.com). Line 7A www.bronsonhealth.com/app/files/public/2302/BMH-Community-Health-Needs-Assessment-Report.pdf Line 10A www.bronsonhealth.com/app/files/public/5040/bmh-access-to-care-implementation-2017.pdf 2 1 - Bronson Vicksburg Outpatient Center 601 John Street Kalamazoo MI 49007 Therapies, Lab and Radiology 2 - Bronson Outpatient Surgery Center 125 W Walnut St Kalamazoo MI 49007 Outpatient Surgery Part I, Line 3c: The organization uses the following FPG to determine eligibility for providing discounted care to low income individuals.250% of FPL is entitled to a 90% reduction300% of FPL is entitled to a 75% reduction350% of FPL is entitled to a 65% reduction Part I, Line 7: (A-C)- Costing methodology is a cost to charge ratio as defined by the IRS instructions for lines A-C.Part I, Line 7: (E-I)- Costing methodology is actual costs per the hospital accounting system for lines E-I. Part I, Ln 7 Col(f): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A),BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE INTHIS COLUMN IS $ 29,645,257. Part II, Community Building Activities: Bronson Methodist Hospitals community building activities generally fall within one of the three Areas: Community Support, Coalition Building, or Community Health Improvement. In Community Support, Bronson supported early childhood literacy by providing the families of every newborn a book to promote reading; by training area clergy in pastoral care for ill and end-of-life patients; by staffing the County Safe Kids Coalition and by offering health-related educational seminars throughout the community. Bronson's Coalition Building activities include supporting a youth resident reading program at the Kalamazoo County Juvenile Home. Community Health Improvement has involved patient advocacy through case management, enrollment outreach and collaboration with community agencies to serve vulnerable populations like the veteran community action team healthcare subcommittee and violence prevention task force. In addition, Bronson financially supports the County Medical Control Authority, offender success task force, cradle kalamazoo to reduce infant mortality, the substance abuse task force and sits on the West Michigan Cancer Center Institutional Review Board evaluating cancer research protocols involving patients.Bronson Methodist Hospital (and the other hospitals that are part of the Bronson Healthcare Group) conducted an extensive Community Health Needs Assessment (CHNA) in 2016. Please refer to Schedule H, Part V, Section B, Community Health Needs Assessment, along with Schedule H, Part V, Section C Supplemental Information, for a full description of the CHNA. The CHNA process included a prioritization of health needs based upon consensus criteria, including: magnitude of need, measurable outcomes, Bronson capabilities, evidence for effective interventions, community commitment, and consistency with Bronson Strategy. At the conclusion of this prioritization process, improving access to care was selected as the focus for Community Health activities in 2016-2019. Part III, Line 2: Uncollectible amounts are writen off against the allowance for doubtful accounts in the period they are determined to be uncollectible. Bad debt expense is disclosed based on gross charges. Part III, Line 3: Bad debt writeoffs support the community by providing a portion of services without payment. The amount of bad debt expenses attributable to patients eligible under the financial assistance policy was estimated by reviewing the bad debt detail for a specific write-off code. Part III, Line 4: An allowance for contractual adjustments and interim payment advances is based on expected payment rates from payors based on current reimburesment methodologies. 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 related to 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 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. This can be found in the attached Audited financial statements on page 6 under Note 2 Significant Accounting Policies for Accounts Receivable. Part III, Line 8: Costing methodology is a cost to charge ratio as defined by the IRS 990 instructions. Shortfall should be considered a community benefit due to its representation of cost of a portion of services provided to the community without payment.Part III, Line 7: Bronson Methodist Hospital experiences additional community benefit expense of $87,510,488 and direct offsetting revenue of $67,643,341 for a net community benefit of $19,867,147 related to services provided to Medicare Advantage insureds. Part III, Line 9b: The policy requires the collection agency be notified and activity suspended when a request for financial assistance is made and a patient submits an application on a previously listed account. If a patient qualifies for full financial assistance, the account is returned to Bronson from the agency and any initiated ECA is reversed. If the patient qualifies for partial financial assistance, a determination is sent to the agency indicating the new balance and any initiated ECA is reversed. If the patient does not provide complete application information or is determined to be ineligible, a denial letter is issued and the agency resumes collection activity. Part VI, Line 2: Bronson Methodist Hospital utilizes a strategic management model to develop both a long term (3 year) and annual strategic plan. Inputs into the plan are documented in our strategic input document. One of the important inputs into this plan is the health of our community. Several sources are utilized to perform this assessment. The sources for the latest strategic input document are listed below.Statistical sources for determining community health needs included:- U. S. Census Bureau American Community Survey- Michigan Inpatient Database- Michigan Resident Inpatient Files, Division for Vital Records and Health Statistics- Michigan Campaign to End Homelessness- 2015 County Health Rankings- Michigan Department of Community Health- Behavioral Risk Factor Survey, Epidemiology Counts for Sexually Transmitted Infections, 2013 Geocoded Michigan Death Registry, Michigan Resident Birth File, Reportable Infectious Diseases, Survey of Physcians- Kalamazoo Department of Community Health, Kalamazoo Behavioral Risk Factor Survey- Center for Disease Control and Prevention, Youth Risk Behavior Surveillance System- Michigan Department of Education, The Michigan Profile for Healthy YouthIn addition, a community specific survey was developed and deployed to collect real-time data and allow for input from the community on issues related to health. Key informant interviews were conducted with leaders, community members, and representatives of organizations servicing vulnerable and minority populations. Focus groups were held with demographic-specific populations, particularly the vulnerable, in an effort to gain deeper insight into community health needs. These included seniors, families with low income, at-risk youth, and minorities.The community assessment is shared with the board every three years using our community leadership model. Three year priorities are then set for our community health and an implementation plan is developed.Bronson Methodist Hospital also collaborates with the Kalamazoo County Health and Human Services for the gathering of health statistics. In addition, Bronson has been a leader in the following community health collaboratives: Healthy futures, immunize-by-two, healthy baby/healthy start, ready to read, african-american health initiative, youth violence coalition, health connect, cradle kalamazoo, enroll kalamazoo, children's health access program (CHAP), Frequent user ststem engagement (FUSE) and emergency prescription program. Part VI, Line 3: The financial assistance policy is posted on the hospital's website, and is available in the emergency room, the admitting department, the patient financial counseling office, and the hospital's website (www.bronsonhealth.com). The plain language summary is also included in the patient's discharge documents, on patient statements and the hospital's website. Both the policy and the plain language summary are available upon request. Part VI, Line 4: Bronson Methodist Hospital serves a nine county region in Southwest Michigan. About 66% of patients served come from within Kalamazoo County and the other 33% come from the regional counties of: Allegan, Barry, Berrien, Branch, Cass, Van Buren, Calhoun, Eaton and St. Joseph. Patient Demographics 14.60% <21 years of age 23.18% 21-39 years of age 36.22% 40-64 years of age 26.01% 65 years of age and older Patient Diversity Demographics 79.05% Caucasian12.47% African-American 0.73% Asian 7.75% Other Patient Insurance Demographics 44.54% Private insurance 17.15% Medicare 12.36% Medicare and supplemental insurance 20.12% Medicaid or other public assistance 5.83% No coverage Part VI, Line 5: Bronson Methodist Hospital (BMH) is a community-owned and governed not-for-profit hospital with 434 licensed beds and an open medical staff. It is governed by the Bronson Healthcare Group Board comprised of 21 members of the community. Founded in 1900, BMH has as one of its five core values, commitment to our community and has historically demonstrated this value by continuing to deliver the full continuum of needed medical services and working within community collaboratives to address community needs. BMH provides a disproportionate amount of care to the segment of the population using Medicaid. We are the largest Medicaid provider of any large hospital in Michigan outside of the Detroit area (on a percentage basis). In 2016, approximately 20% of BMHs patients were Medicaid recipients. We have three Medicaid enrollers on site to help those without insurance enroll in Medicaid, or refer them to community resourcesMuch of BMHs service to the community is directed at womens and childrens needs. Bronson is the only childrens hospital in southwest Michigan and, therefore, the sole provider of inpatient pediatrics including pediatric intensive care and neonatal intensive care. In fact, over half the patients in the Childrens Hospital are Medicaid recipients. As a regional perinatal center, BMH is also the regional destination for high-risk pregnancy care. BMH's Level I Trauma Center and burn center, along with advanced capabilities in neurovascular and cardiovascular care, serve all patient populations regardless of ability to pay.Service to communityIn recent years, BMH collaboratives have included Healthy Futures (broad community initiative to address health and economic issues), Healthy Baby/ Healthy Start (reduce infant mortality), Immunize-by-Two, Health Connect (provide community-wide primary care access) and the African-American Health Initiative (health promotion and screening program offered through Kalamazoos African-American Faith Community).In 2016, BMH documented in excess of 201 events in providing community benefit activities with a net value of approximately $55,000,000 in community benefit activities. Activities included but not limited to: Enroll Kalamazoo county, CHAP, FUSE and Neonatal abstinence syndrome collaborative.Adressing disparitiesBMH is located in the heart of downtown Kalamazoo, Michigan and is the city's largest employer. BMH opened a new, replacement hospital in December of 2000 across the street from its previous facility. This location was chosen because of another of Bronson's core values, care and respect for all people. BMH is located where persons most in need can utilize our services and access us through public transportation. The alignment of our Mission, Vision and Values creates an environment where all persons are welcome and patients are treated regardless of their ability to pay. For example, Bronson's Trauma and Emergency Department sees more than 99,000 patient visits per year. In addition, BMHs outreach services with the federally qualified Family Health Center provide for an improved continuum of care for patients who are on Medicaid or are under-insured. Bronson also lead the enroll kalamazoo county to ensure insurance access and lead and collaborate with cradle kalamazoo to decrease infant mortalityCommunity Health StatusBMH collaborates with Kalamazoo County Health and Human Services, WMED, Borgess, the Family Health Center and the county medical officer and regularly discuss health needs and emerging health trends. This collaborative, an off-shoot of Healthy Futures, monitors Kalamazoo Countys performance against Healthy People 2010 goals. It was these community health indicators that initiated Healthy Baby/Healthy Start, Immunize-by-Two and the African-American Health Initiative.Collaboration with Community StakeholdersAs previously mentioned, BMH seeks community collaborators and stakeholders as partners in meeting community health needs. Towards this end, BMH administrators serve on several community boards including: The Family Health Center, Salvation Army, Ministry with Community, neighborhood associations, Greater Kalamazoo United Way, Family and Childrens services, Hospice Care of Southwest Michigan, Hospitality house, girls on the run, communities in schools, great start collaborative, Douglas Community Association and the Safe Kids collaborative, which BMH staffs. BMH has a three-prong approach for community leadership focusing on community health, community service and economic development.Community Health Initiatives:(see implmentation plan)- Improving access to healthcare, mental health and substance abuse services, and complex care coordination- Improving overall community health- Citizen-based education and research on health outcomes- Reduce disparities in health outcomes -the recent focus was on childhood safety and prevention and access/screening/education, infant mortality, frequent utillizers of the emergency department who are homless and CHAP- Collaborate with social service agenciesAn example of improving access: BMH has worked with community agencies to reduce barriers and improve access for underserved populations. The hospital co-funds a graduate medical residency program with nine subspecialties and an ambulatory clinic with 90,000 patient visits annually. In addition, BMH has a leadership role at Kalamazoo's Family Health Center that has 120,000 visits each year.Bronson also leads enrollment outreach across southwest michigan and staffs a full time mobile outreach person and staffs DHS workers in BMH.Community Service:- Participate on public and not-for-profit committees and boards- Participate in important community issues- Lead disaster/emergency efforts- Provide financial support and sponsorships for arts and human service organizationsAn example of an employee-driven effort reflective of our values, BMH employees donate monies to the United Way, which impacts charities throughout the Greater Kalamazoo Area. In 2016 the Bronson Employees raised $118,875Economic Development:- Support grassroots neighborhood development- Stimulate economic vitality- Invest in educational institutions to ensure access to healthcare curriculum (WMU Bronson School of Nursing)- Commit to local vendors and businessesAn economic development example would be our Bronson Home Ownership Program (BHOP). Since 1998, Bronson has invested approximately $357,525 to help employees purchase homes, downtown, close to the Bronson campus. Our program is a loan, employees start paying us back in year six, at no interest. What is collected is then re-loaned.BMH participates in the ban the box initivie to reduce employment barriers for people with felonies.Thus far, our $357,525 has resulted in approximately $460,000 being loaned to over 55 employees. This is economic development at the neighborhood level.Bronson has a volunteer time off program where each employee can get up to four hours of paid volunteer time to support community nonprofits.BMH identifies ways to treat the diseases faced by those we serve, and also seek ways to foster an environment in which we can create health and prevention measures. This includes looking at our communities economic issues, such as people without health insurance, and environmental issues, such as clean air and water. BMH has been acknowledged by Practice Greenhealth (formerly Hospitals for a Healthy Environment) awards for 10 years in a row, in recognition of significant progress in reducing waste, preventing pollution and eliminating mercury. BMH also holds the ENERGY STAR label for energy efficiency from the Environmental Protection Agency, and has been named one of Americas top 10 hospitals by the Green Guide publication. Because of this, we also play a significant role in many community organizations that have a broader focus than healthcare.Reporting to the CommunityBMH conducts an annual Community Benefit Inventory to aggregate the non-mission mandated services we provide to the community. This inventory is shared with Bronson stakeholders and reported to the community. Information is also available through bronsonhealth.com. Examples include quality report, nursing outcomes, patient satisfaction data, and links to public reporting websites Part VI, Line 6: Bronson Methodist Hospital is part of an affiliated system that includes two other hospitals, Bronson Battle Creek Hospital and Bronson LakeView Hospital. All of these hospitals are controlled by Bronson Healthcare Group, which is a community-owned and governed not-for-profit holding company. The Bronson Healthcare Group (BHG) Board is comprised of 21 members of the community.Each of the three hospitals in the BHG system admits patients regardless of ability to pay and provides outreach services to their respective communities. Bronson Methodist Hospital is the largest of the three hospitals in the BHG system. As such, it has a larger role in providing services and promoting the health of the many communities it serves. The health promotion activities of Bronson Methodist Hospital are described in #5 above. In addition to the three hospitals, the BHG system includes several smaller entities whose effects support the hospitals and their mission of providing excellent healthcare to their communities. These entities include: Bronson Healthcare Group, Bronson Medical Group, Bronson Commons, Bronson Lifestyle Improvement & Research Center, Bronson Health Foundation, Bronson At Home, VBEMS, & Bronson Properties Corporation. Part VI, Line 7, Reports Filed With States MI 1 Bronson Healthcare Group 601 John Street Kalamazoo MI 49007 382418383 501(c)(3) 4200000 General Support 1 Part I, Line 2: There is no formal procedure. Grants are made by the organization on a discretionary basis for purposes consistent with the organization's mission. Grants are unrestricted. X 0 0 0 1 0 0 0 0 0 0 0 Mahesh C Karamchandani director 726349 0 34762 0 24772 0 13250 0 15495 0 814628 0 0 0 Aaron Lane-Davies Director 225585 0 40448 0 1610 0 16773 0 18671 0 303087 0 0 0 John Lawlor director 357170 0 42966 0 20158 0 13250 0 14853 0 448397 0 0 0 Frank J Sardone President and CEO 0 821008 0 313794 0 449016 0 388076 0 13369 0 1985263 0 217342 Kenneth L Taft Executive Vice President 0 389703 0 161920 0 197827 0 141843 0 15146 0 906439 0 77646 James Falahee Sr VP Legal & Leg. Affairs 0 373899 0 112620 0 138258 0 154646 0 19451 0 798874 0 65507 Scott Larson MD Sr VP Medical Affairs/CMO 0 422437 0 104558 0 160274 0 139079 0 12820 0 839168 0 77408 John Hayden SR. VP & Chief HR Officer 0 309950 0 96950 0 124340 0 118281 0 10229 0 659750 0 83769 Rebecca East Sr VP CFO 0 347116 0 96304 0 85142 0 149763 0 15124 0 693449 0 0 Kathleen M Harrelson Sr VP, Clinical Operations 0 357002 0 79401 0 68530 0 172434 0 15131 0 692498 0 0 John L Jones Jr Sr. VP, Reg. & Phys. Svs. 0 328319 0 72000 0 66920 0 153922 0 19409 0 640570 0 0 Michael S Way SR. VP Mat. Mgt. & Facilit 0 205537 0 55468 0 19408 0 83388 0 14818 0 378619 0 0 Denise Neeley VP CNO 0 255438 0 47700 0 19787 0 75046 0 12580 0 410551 0 0 REBECCA TRELLA VP POST ACUTE CARE 0 233417 0 27900 0 957 0 42871 0 12505 0 317650 0 0 Alain Y Fabi Physician 953080 0 2106000 0 20553 0 13250 0 20309 0 3113192 0 0 0 Gregory C Wiggins Physician 1756458 0 0 0 19384 0 13250 0 20103 0 1809195 0 0 0 Michael Kasten Physician 1479937 0 15961 0 25555 0 13250 0 20951 0 1555654 0 0 0 Jason Roberts Physician 1193051 0 13421 0 1205 0 13250 0 20190 0 1241117 0 0 0 Mark Sytsma Physician 1211753 0 20787 0 19212 0 13250 0 20569 0 1285571 0 0 0 Part I, Line 1a HEALTH CLUB DUES ARE AVAILABLE FOR BOARD OF DIRECTORS. THOSE WHO PARTICIPATE RECEIVE A 1099 AND THE DUES ARE TREATED AS A TAXABLE FRINGE BENEFIT. Part I, Line 3 BRONSON HEALTHCARE GROUP, A RELATED ORGANIZATION, USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY AND/OR STUDY AND APPROVAL BY BOARD AND/OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. Part I, Line 4b Taft,Kenneth L $77,646 SERP Distribution Taft,Kenneth L $87,018 SERP Contribution Falahee Jr.,James B $65,507 SERP Distribution Falahee Jr.,James B $67,724 SERP Contribution Sardone,Frank J $217,342 SERP Distribution Sardone,Frank J $190,920 SERP Contribution Larson,Scott D $77,408 SERP Distribution Larson,Scott D $74,846 SERP Contribution Hayden,John T $83,769 SERP Distribution Hayden,John T $38,389 SERP Contribution East,Rebecca L $66,751 SERP Contribution Harrelson,Kathleen M $48,820 SERP Contribution Jones Jr., John L $44,861 SERP Contribution INCLUDED IN PART II, COLUMN (B) (III) AND (F) ARE AMOUNTS THAT WERE PAID TO THE EXECUTIVE UNDER THE BRONSON HEALTHCARE GROUP, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THESE AMOUNTS WERE CREDITED TO AN ACCOUNT FOR THE EXECUTIVE IN PRIOR YEARS AND WERE PREVIOUSLY REPORTED IN COLUMN C IN THE PRIOR YEAR, BUT THE EXECUTIVE WAS REQUIRED TO REMAIN EMPLOYED UNTIL THE YEAR FOR WHICH THIS FORM IS BEING FILED IN ORDER TO BECOME VESTED IN HIS OR HER ACCOUNT. AMOUNTS HAVE BEEN CREDITED TO THESE EXECUTIVES' ACCOUNTS EACH YEAR SINCE THE SERP WAS ADOPTED IN 1994, AND THE ACCOUNTS HAVE ALSO BEEN ADJUSTED FOR GAINS AND LOSSES SINCE THAT TIME. THEREFORE, THESE AMOUNTS SHOULD BE VIEWED AS HAVING BEEN EARNED OVER THE EXECUTIVE'S ENTIRE PERIOD OF EMPLOYMENT AS AN EXECUTIVE OF BRONSON. THE AMOUNT CREDITED TO EACH EXECUTIVE'S ACCOUNT IN THE SERP EACH YEAR AND EACH EXECUTIVE'S TOTAL COMPENSATION PACKAGE WAS APPROVED BY AN INDEPENDENT CONSULTANT TO ENSURE THAT THESE AMOUNTS ARE COMPARABLE TO OR LESS THAN THE AMOUNTS AWARDED TO EXECUTIVES OF COMPARABLE HEALTH CARE ORGANIZATIONS. A City of Kalamazoo Hospital Finance Authority 386004627 483233LQ3 2008-04-30 93622103 See supplemental information 0 0 0 B City of Kalamazoo Hospital Finance Authority 386004627 483233MA7 2010-09-28 192508168 See supplemental information 1 0 0 C City of Kalamazoo Hospital Finance Authority 386004627 483233NY4 2016-10-25 110163643 See supplemental information 0 0 0 A 34600000 93622103 718703 92903400 2003 1 0 1 1 B 9910000 93720000 192871900 2389449 14363732 176118719 2010 1 0 1 1 C 110169643 109279114 890529 2016 0 1 1 1 A 0 0 1 1 0 0 0 1 B 0 1 1 1 0 0.00250 0.00250 0 0 1 C 0 1 1 1 0 0.00250 0.00250 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 0 B 0 C 0 Bond issue A, Part I, Line (f) Description of purpose bond issue a was issued to currently refund a prior issue with an original issue date of 11/13/03. the bonds issued on 11/13/03 were issued to refund a prior issue that was issued before 1/1/03 Bond Issue B, Part I, Line (f) Description of Purpose proceeds of bond issue B were used to currently refund prior issues originally issued on 5/13/98, 6/14/06, and 3/25/09. Additional proceeds of bond issue b were used for building renovations, and other medical technology equipment. Bond Issue A, Part I, Line (D) Date Issued Bond issue A was originally issued on 11/13/2003, and was reissued for federal income tax purposes on 4/30/08. The information reported in schedule K for bond issue A is for the bonds as reissued on 4/30/2008. Bond Issue b, Part I, Line (D) Date Issued bond issue b consists of two series bonds: series 2006 and series 2010. The series 2006 bonds were originally issued on 6/14/06 and were reissued for federal income tax purposes on 9/28/10. the information reported on schedule k for the bond issue b is for the series 2006 bonds as reissued on 9/28/10 and the series 2010 bonds as originally issued on 9/28/10. Bond issue C, Part I, Line (f) - description of purpose proceeds of bond issue C were used to advance refund portions of Bond issue B. Bond issue b, part II, line 3 total proceeds of bond issue b include investment earnings in the amount of $363,731 Part III, Column A this is not applicable due to the special rules for refunding of pre 2003 isses; however, due to software limitations we are unable to leave blank. schedule K Part V We have general written procedures that we will comply with all tax laws. Kimberly James Daughter of Board Member, Barbara James 86152 Total compensation for being an employee of Bronson Methodist Hospital 0 Marla Atkinson spouse of board member Mark Atkinson 136953 Total compensation for being an employee of Bronson Methodist Hospital 0 jaideep Karamchandani son of board member mahesh Karamchandani 17091 Total compensation for being an employee of Bronson Methodist Hospital 0 Form 990, Part VI, Section A, line 2 Kenneth Taft, Frank Sardone, Steven J. Lins, M.D. and Scott C. Gibson, M.D. have a business relationship. All board members have a business relationship with all Bronson subsidiaries due to being on Bronson Healthcare Group Board of Directors. Form 990, Part VI, Section A, line 6 Bronson Healthcare Group is the sole member of Bronson Methodist Hospital. Form 990, Part VI, Section A, line 7a Bronson Healthcare Group (BHG) is the sole member of Bronson Methodist Hospital (BMH) and as such member it elects 10 of the total 19 members of the BMH Board. Community partners shall, after consulting with and seeking input from the nominating committee of BHG, appoint 6 members to the board. The remaining 3 members of the board should be ex officio, with vote, and shall consist of the President, the Chief of Staff, and immediate past Chief of the Medical staff of the hospital. Form 990, Part VI, Section A, line 7b Bronson Healthcare Group (BHG) is the sole member of the Bronson Methodist Hospital (BMH) and has certain reserved powers over the actions of BMH. The Board of Directors has the power to: - Amendment, restatement, or repeal of the hospitals articles of incorporation or bylaws. - Adoption, execution, revocation, or abandonment of a plan of dissolution, merger, consolidation, reorganization, or other major change in corporate structure involving the hospital. - Sale, lease exchange or other disposition of all or substantially all of the hospitals property and assets. - Acquisition of any other entity or the establishment of any subsidiary or affiliate. - Adoption of all operating and capital expenditure budgets. - Incur operating or capital expenditures which cause aggregate operating or capital expenditures to exceed budgeted aggregates and/or the dollar amount specified by BHG. - Secure borrowings, with the exception of equipment leases and purchase money security interests approved as a part of a budget. - Change the mission statement, purposes, or strategic goals of the hospital. - Any significant change in the scope of services or programs. - Appointment, removal or compensation of the president or any director or officer. Form 990, Part VI, Section B, line 11b THE SR VP/CFO & CONTROLLER REVIEWS THE 990S. THE SR VP/CFO MET WITH THE FINANCE COMMITTEE CHAIRPERSON ON OCTOBER 5TH, 2017 TO REVIEW THE PREPARED FORM 990 AND SCHEDULES. THE FINANCE COMMITTEE OF THE BOARD REVIEWED THE PREPARED FORM 990S AT ITS REGULARLY SCHEDULED MEETING ON OCTOBER 23RD, 2017. THE REVIEW WAS LED BY THE SR VP/CFO AND PLANTE MORAN. THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY WERE PROVIDED THE PREPARED FORM 990 FOR REVIEW. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy. The conflict of interest policy and its accompanying questionnaire are reviewed, and revised, if necessary, on an annual basis by the organization's general counsel/corporate compliance officer and the Boards executive committee. All board members and all employees holding the title of Vice President and above are covered by the conflict of interest policy and annually complete the conflict of interest questionnaire. All completed conflict of interest questionnaires are reviewed by the organization's general counsel/corporate compliance officer and the executive committee. Determinations as to whether a conflict exists are made by the General Counsel/corporate compliance officer and the executive committee. Actual conflicts are reviewed by the general counsel/corporate compliance officer and the executive committee. Persons with a conflict are prohibited from participating in the governing bodys deliberations and decisions on the transaction in question. Form 990, Part VI, Section B, line 15 For the CEO, Officers and other key employees, the Executive committee of the Board of Directors, which functions as the compensation committee for Bronson HealthCare Group, retains the services of an external executive compensation consultant (Sullivan, Cotter and Associates) who conducts a thorough compensation and benefit survey process that is used to determine the appropriate adjustment in cash compensation and benefits provided. This process is done annually and was under taken in 2016. The consultant uses three to five national healthcare-based surveys for comparability data, each one of like revenue sized healthcare systems to the Bronson Healthcare Group. The consultant prepares a detailed report with recommendations for pay and/or benefit adjustments, and presents the information to the executive committee of the Board of Directors (when the CEOs survey data and recommendations are presented, the CEO and staff are excused from the deliberations). After all questions of the Board members are answered, formal motions are proposed, seconded and voted on (for any pay adjustments and for receipt of the consultants report). At the subsequent meeting of the full Board of Directors, the Chair presents recommendations of the Executive Committee, and the full Board acts on a formal motion that is seconded and voted on. Form 990, Part VI, Section C, line 19 The organization makes its governing documents and conflict of interest policy available to the public by posting them on the organization's website and providing copies on request. The Organization's financial statements, other than the Form 990, are not available to the public. Form 990, Part XI, line 9: Joint Venture Gain/(loss) 965,283. Loss on Extinguishment of Debt -13,173,666. Transfer of Equity 22,492,662. Form 990, Part XII, Line 2c: Bronson Healthcare group has an audit committee that assumes responsibility for oversight of the audit and selection of an independent accounting firm. This process has not changed from the prior year. Bronson Healthcare Group 601 John Street Kalamazoo MI 49007 382418383 Provide support services for healthcare subsidiaries MI 501(c)(3) Line 12c, III-FI N/A 0 Bronson Health Foundation 601 John Street Kalamazoo MI 49007 382415081 Supports Healthcare organization MI 501(c)(3) Line 7 Bronson Healthcare Group 0 Bronson Lakeview Hospital 601 John Street Kalamazoo MI 49007 381359218 Hospital MI 501(c)(3) Line 3 Bronson Healthcare Group 0 Bronson Commons 601 John Street Kalamazoo MI 49007 382842451 Skilled Nursing Facility MI 501(c)(3) Line 10 bronson Healthcare Group 0 VBEMS Inc 601 John Street Kalamazoo MI 49007 382745910 Ambulance service MI 501(c)(3) Line 10 bronson Healthcare Group 0 Bronson Properties Corporation 601 John Street Kalamazoo MI 49007 386052573 Provide support services for healthcare subsidiaries MI 501(c)(3) Line 12b, II Bronson Healthcare Group 0 Bronson Battle Creek Hospital 300 North Avenue Battle Creek MI 49016 382776791 hospital MI 501(c)(3) Line 3 bronson Healthcare Group 0 Bronson At Home 601 John Street kalamazoo MI 49007 383298476 Nursing, Hospice, equip sales MI 501(c)(3) Line 10 bronson Healthcare Group 0 Bronson Healthcare Midwest 601 John Street Kalamazoo MI 49007 462134675 Physician Services MI 501(c)(3) Line 3 Bronson Healthcare Group 0 Hospital Network Inc Leasing 6212 American Ave Portage MI 49002 383638430 support services MI N/A Hospital Network Healthcare Services 6212 American Ave portage MI 49002 300057075 support services MI N/A Hospital Network Ventures LLC 6212 American Ave portage MI 49002 383302979 support services MI N/A Bronson Management Services Corporation 601 John Street Kalamazoo MI 49007 382415032 other medical services MI N/A C 0 Bronson Lifestyle Improvement and Research Center 601 John Street kalamazoo MI 49007 383552556 rehabiliation services MI N/A C 0 Bronson Practice Management 601 John Street kalamazoo MI 49007 382511179 other medical services MI N/A C 0 Westley Development Company 301 John Street Kalamazoo MI 49007 383619232 Real Estate Ownership MI N/A C 0 0 1 1 0 0 0 0 0 1 0 0 1 1 0 1 1 1 1 1 Bronson Healthcare Group M 85300751 method based on actual cost bronson Healthcare Group O 49956454 method based on actual cost bronson Properties Corporation M 5445929 method based on actual cost Bronson Battle Creek Hospital M 15162282 method based on actual cost Bronson Lakeview Hospital M 841375 method based on actual cost Bronson Lakeview Hospital O 536640 method based on actual cost Bronson Lifestyle Improvement and Research Center M 4717361 method based on actual cost Bronson healthcare Group L 20259141 method based on actual cost bronson healthcare Group B 4200000 cash transfer bronson healthcare Group P 526934 method based on actual cost Bronson Properties Corporation L 1242785 method based on actual cost Bronson Battle Creek Hospital L 3281480 method based on actual cost Bronson Commons O 52027 method based on actual cost Bronson Health Foundation M 2257003 method based on actual cost Bronson Battle Creek Hospital O 2722143 method based on actual cost Bronson At Home L 85667 cash transfer bronson lifestyle Improvement and Research Center L 74994 method based on actual cost bronson Properties Corporation I 225571 cash transfer Bronson Commons M 65517 method based on actual cost BRONSON Health Foundation C 598850 Cash transfer bronson lakeview Hospital L 432047 method based on actual cost bronson health Foundation L 54687 method based on actual cost bronson health Foundation O 88733 method based on actual cost bronson health Foundation P 399926 method based on actual cost bronson management services corp O 437813 method based on actual cost