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PAUL OLIVER MEMORIAL HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
PAUL OLIVER MEMORIAL HOSPITAL (EIN 38-1415623)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-15
IRS object ID
201511359349300811
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-15T07:00:50-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN381415623EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PAUL OLIVER MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlPAULBusinessNameControlTxt
Phone2313529621PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1224 PARK AVEAddressLine1
CityFRANKFORTCity
StateMIState
ZIP Code496359658ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK A HEPLERPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone2313529621PhoneNum
Signature2015-05-14SignatureDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPETER MARINOFFPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1224 PARK AVEAddressLine1
CityFRANKFORTCity
StateMIState
ZIP Code49635ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$18,091,484GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MUNSONHEALTHCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1944FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionPAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 38.5 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2013 TAX YEAR.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee187TotalEmployeeCnt
Total Volunteers43TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,109,812PYContributionsGrantsAmt
CY Contributions Grants$340,936CYContributionsGrantsAmt
PY Program Service Revenue$17,039,128PYProgramServiceRevenueAmt
CY Program Service Revenue$17,227,493CYProgramServiceRevenueAmt
PY Investment Income$265,348PYInvestmentIncomeAmt
CY Investment Income$413,860CYInvestmentIncomeAmt
PY Other Revenue$152,476PYOtherRevenueAmt
CY Other Revenue$83,093CYOtherRevenueAmt
PY Total Revenue$18,566,764PYTotalRevenueAmt
CY Total Revenue$18,065,382CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,626,741PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,987,653CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$79,370CYTotalFundraisingExpenseAmt
PY Other Expenses$9,251,410PYOtherExpensesAmt
CY Other Expenses$9,153,944CYOtherExpensesAmt
PY Total Expenses$15,878,151PYTotalExpensesAmt
CY Total Expenses$16,141,597CYTotalExpensesAmt
PY Revenues Less Expenses$2,688,613PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,923,785CYRevenuesLessExpensesAmt
Total Assets BOY$20,593,787TotalAssetsBOYAmt
Total Assets EOY$23,267,900TotalAssetsEOYAmt
Total Liabilities BOY$1,430,788TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,117,745TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$19,162,999NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$21,150,155NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 38.5 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2013 TAX YEAR.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$14,952,240ExpenseAmt
Revenue$17,009,741RevenueAmt
DescPROVIDING HOSPITAL AND LONG-TERM CARE SERVICES TO THE RESIDENTS OF THE BENZIE, MICHIGAN REGION.Desc
Total Program Service Expenses$14,952,240TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document41IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee187EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MUNSON HEALTHCAREBusinessNameLine1
FieldValueIRS element (for citing)
Phone2319357777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14230 COPPER RIDGE DRAddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49684ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerInd
PAUL M SHIRILLA
DIRECTOR40.00Yes (X)$0$319,842$47,873
JAMES D AUSTIN
FORMER PRESI24.00Yes (X)$0$269,577$40,31316.00Yes (X)
PETER MARINOFF
PRESIDENTYes (X)$117,131$0$24,90640.00Yes (X)
GERARD MAHONEY DO
DIRECTORYes (X)$11,340$0$02.00
GEORGE RYCKMAN DO
DIRECTORYes (X)$3,150$0$02.00
BRENDA SUE WEBBER
DIRECTORYes (X)$0$0$02.00Yes (X)
CHARLES TULL
DIRECTORYes (X)$0$0$02.00
DAVID MICINSKI
DIRECTORYes (X)$0$0$02.00
HON PAUL J CLULO
CHAIRYes (X)$0$0$02.00Yes (X)
IRENE A NUGENT
DIRECTORYes (X)$0$0$02.00Yes (X)
JOETTA RILEY PARRIS
SEC/TREASUREYes (X)$0$0$02.00Yes (X)
BETSY EVANS
DIRECTORYes (X)$0$0$02.00
ROGER PERRY
VICE CHAIRYes (X)$0$0$02.00Yes (X)
SUSAN BAYNARD
DIRECORYes (X)$0$0$02.00
WILLIAM J MCMILLAN MD
DIRECTORYes (X)$0$0$02.00
MARK A HEPLER
CFO40.00$0$356,013$63,875Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$131,621TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$945,432TotReportableCompRltdOrgAmt
Total Other Compensation$176,967TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
CRYSTAL LAKE EMERGE
6227 FRANKFORT HWYBENZONIAMI496169654EMERGENCY SERVI$876,978
MICHIGAN NEUROLOGY ASSOCIATES
1500 WEST PARK DR STE 390WESTBOROUGHMA01581MRI SERVICES$215,250
SPENCE BROTHERS
417 MCCORSKRY STSAGINAWMI48605CONSTRUCTION$179,981
SODEXO INC AND AFFILIATES
4880 PAYSHERE CIRCLECHICAGOIL60674FOOD SERVICE$170,270
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Fundraising$33,317FundraisingAmt
Government Grants$307,619GovernmentGrantsAmt
Total Contributions$340,936TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
MEDICARE AND MEDICAID PMTS621990$10,229,574$10,229,574
PATIENT SERVICE REVENUE621990$6,453,760$6,453,760
IN HOUSE CHILD CARE713940$270,149$270,149
COMMUNITY FITNESS CENTER624410$207,777$207,777
RENT FROM RELATED ORGS531120$66,233$66,233
FieldValueIRS element (for citing)
Total Program Service Revenue$17,227,493TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$73,081TotalRevenueColumnAmt
Exclusion$73,081ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,350RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,350RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,350TotalRevenueColumnAmt
Exclusion$2,350ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$340,779SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$340,779SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$340,779TotalRevenueColumnAmt
Exclusion$340,779ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$21,669FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$33,317ContriRptFundraisingEventAmt
Fundraising Direct Expenses$26,102FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$4,433TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
MISCELLANEOUS REVENUE722210$52,397$52,397
CAFETERIA SALES621990$32,779$32,779
FieldValueIRS element (for citing)
Other Revenue Total$85,176OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,065,382TotalRevenueColumnAmt
Related Or Exempt Func Income$17,009,741RelatedOrExemptFuncIncomeAmt
Exclusion$719,138ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$156,527TotalAmt
Management And General$156,527ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,984,704TotalAmt
Program Services$4,856,171ProgramServicesAmt
Management And General$128,533ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$485,342TotalAmt
Program Services$468,015ProgramServicesAmt
Management And General$17,327ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$993,939TotalAmt
Program Services$958,455ProgramServicesAmt
Management And General$35,484ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$367,141TotalAmt
Program Services$354,034ProgramServicesAmt
Management And General$13,107ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,813TotalAmt
Management And General$1,813ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$31,000TotalAmt
Management And General$31,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,258,803TotalAmt
Program Services$3,675,461ProgramServicesAmt
Management And General$503,972ManagementAndGeneralAmt
Fundraising$79,370FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$31,922TotalAmt
Program Services$18,494ProgramServicesAmt
Management And General$13,428ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$439,096TotalAmt
Program Services$382,224ProgramServicesAmt
Management And General$56,872ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$117,892TotalAmt
Program Services$108,967ProgramServicesAmt
Management And General$8,925ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$650,179TotalAmt
Program Services$650,179ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$68,647TotalAmt
Program Services$40,438ProgramServicesAmt
Management And General$28,209ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,925TotalAmt
Program Services$2,925ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$993,128TotalAmt
Program Services$924,701ProgramServicesAmt
Management And General$68,427ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$108,158TotalAmt
Program Services$85,009ProgramServicesAmt
Management And General$23,149ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$1,232,698$1,232,698
BAD DEBT$1,153,757$1,153,757
HOSPITAL SUPPORT$29,980$16,332$13,648
DUES AND SUBSCRIPTIONS$18,516$9,000$9,516

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$15,430TotalAmt
Program Services$15,380ProgramServicesAmt
Management And General$50ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$16,141,597TotalAmt
Program Services$14,952,240ProgramServicesAmt
Management And General$1,109,987ManagementAndGeneralAmt
Fundraising$79,370FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,050BOYAmt
EOY$1,050EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,599,948BOYAmt
EOY$6,766,425EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,108,588BOYAmt
EOY$2,033,073EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$108,570BOYAmt
EOY$180,202EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$21,503,626LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,569,812LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,603,747BOYAmt
EOY$5,933,814EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,618,518BOYAmt
EOY$4,137,630EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$3,376,501BOYAmt
EOY$3,984,137EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$176,865BOYAmt
EOY$231,569EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$20,593,787BOYAmt
EOY$23,267,900EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,006,145BOYAmt
EOY$891,134EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$5,000BOYAmt
EOY$4,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$419,643BOYAmt
EOY$1,222,611EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,430,788BOYAmt
EOY$2,117,745EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,786,498BOYAmt
EOY$17,166,017EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,376,501BOYAmt
EOY$3,984,138EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,162,999BOYAmt
EOY$21,150,155EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,593,787BOYAmt
EOY$23,267,900EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,923,785ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$388,720NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$325,349OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$5,577OtherActivitiesAmt
Total Lobbying Expenditures$5,577TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationOTHER GRASSROOTS LOBBYING INCLUDES THE PORTION OF DUES ALLOCATED TO LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,995,019BeginningYearBalanceAmt
Contributions$607,637ContributionsAmt
Investment Earnings Or Losses$540,861InvestmentEarningsOrLossesAmt
Administrative Expenses$21,751AdministrativeExpensesAmt
End Year Balance$8,121,766EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,148,049BeginningYearBalanceAmt
Contributions$420,511ContributionsAmt
Investment Earnings Or Losses$348,070InvestmentEarningsOrLossesAmt
Grants Or Scholarships$906,358GrantsOrScholarshipsAmt
Administrative Expenses$15,253AdministrativeExpensesAmt
End Year Balance$6,995,019EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,253,482BeginningYearBalanceAmt
Contributions$1,819,941ContributionsAmt
Investment Earnings Or Losses$91,515InvestmentEarningsOrLossesAmt
Administrative Expenses$16,889AdministrativeExpensesAmt
End Year Balance$7,148,049EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,052,095BeginningYearBalanceAmt
Contributions$757,959ContributionsAmt
Investment Earnings Or Losses$458,819InvestmentEarningsOrLossesAmt
Administrative Expenses$15,390AdministrativeExpensesAmt
End Year Balance$5,253,483EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,736,794BeginningYearBalanceAmt
Contributions$260,254ContributionsAmt
Investment Earnings Or Losses$288,192InvestmentEarningsOrLossesAmt
Other Expenditures$224,769OtherExpendituresAmt
Administrative Expenses$8,376AdministrativeExpensesAmt
End Year Balance$4,052,095EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.50940BoardDesignatedBalanceEOYPct
Term Endowment Balance EOY0.49060TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$193,750OtherCostOrOtherBasisAmt
Book Value$193,750BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,939,413OtherCostOrOtherBasisAmt
Depreciation$9,268,595DepreciationAmt
Book Value$3,670,818BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$120,618OtherCostOrOtherBasisAmt
Depreciation$34,678DepreciationAmt
Book Value$85,940BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,124,702OtherCostOrOtherBasisAmt
Depreciation$6,159,940DepreciationAmt
Book Value$1,964,762BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$125,143OtherCostOrOtherBasisAmt
Depreciation$106,599DepreciationAmt
Book Value$18,544BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,933,814TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVEST IN PAUL OLIVER MEM FOUNDATIONDesc
Book Value$3,984,137BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$3,984,137TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ESTIMATED THIRD PARTY PAYMENTS$1,150,028
CAREPAYMENT LIABILITY$72,583
FieldValueIRS element (for citing)
Total Liability$1,222,611TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 2, PART V, LINE 4THE FUNDS ARE INTENDED FOR THE OPERATIONS AND CAPITAL NEEDS OF THE PAUL OLIVER MEMORIAL HOSPITAL. A SIGNIFICANT PORTION OF THE TEMPORARILY RESTRICTED FUNDS ARE FOR THE CAPITAL NEEDS OF THE HOSPITAL.
SCHEDULE D, PAGE 3, PART XACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION, AND HAS CONCLUDED THAT AS OF JUNE 30, 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2010.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Licensed StatesMILicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1FALL EVENING TONameOfEvent1Amt
Gross Receipts Event1$26,556GrossReceiptsEvent1Amt
Charitable Contri Event1$19,927CharitableContriEvent1Amt
Gross Revenue Event1$6,629GrossRevenueEvent1Amt
Entertainment Event1$5,000EntertainmentEvent1Amt
Other Direct Expenses Event1$4,766OtherDirectExpensesEvent1Amt
Name Of Event2GOLF BENEFITNameOfEvent2Amt
Gross Receipts Event2$19,855GrossReceiptsEvent2Amt
Charitable Contri Event2$13,390CharitableContriEvent2Amt
Gross Revenue Event2$6,465GrossRevenueEvent2Amt
Food And Beverage Event2$6,345FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$1,459OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$8,575GrossReceiptsOtherEventsAmt
Gross Revenue Other Events$8,575GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$1,577OthDirectExpnssOtherEventsAmt
Gross Receipts Total$54,986GrossReceiptsTotalAmt
Charitable Contributions Tot$33,317CharitableContributionsTotAmt
Gross Revenue Total Events$21,669GrossRevenueTotalEventsAmt
Food And Beverage Total Events$6,345FoodAndBeverageTotalEventsAmt
Entertainment Total Events$5,000EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$7,802OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$19,147DirectExpenseSummaryEventsAmt
Net Income Summary$2,522NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1068PersonsServedCnt
Total Community Benefit Expns$138,441TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$138,441NetCommunityBenefitExpnsAmt
Total Expense0.00920TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served3730PersonsServedCnt
Total Community Benefit Expns$4,099,970TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,574,728DirectOffsettingRevenueAmt
Net Community Benefit Expns$525,242NetCommunityBenefitExpnsAmt
Total Expense0.03500TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Persons Served167PersonsServedCnt
Total Community Benefit Expns$38,428TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,323DirectOffsettingRevenueAmt
Net Community Benefit Expns$29,105NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served4965PersonsServedCnt
Total Community Benefit Expns$4,276,839TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,584,051DirectOffsettingRevenueAmt
Net Community Benefit Expns$692,788NetCommunityBenefitExpnsAmt
Total Expense0.04610TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served4320PersonsServedCnt
Total Community Benefit Expns$101,817TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$525DirectOffsettingRevenueAmt
Net Community Benefit Expns$101,292NetCommunityBenefitExpnsAmt
Total Expense0.00680TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served8PersonsServedCnt
Total Community Benefit Expns$7,184TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,184NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served820PersonsServedCnt
Total Community Benefit Expns$29,957TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$29,957NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served5148PersonsServedCnt
Total Community Benefit Expns$138,958TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$525DirectOffsettingRevenueAmt
Net Community Benefit Expns$138,433NetCommunityBenefitExpnsAmt
Total Expense0.00930TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served10113PersonsServedCnt
Total Community Benefit Expns$4,415,797TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,584,576DirectOffsettingRevenueAmt
Net Community Benefit Expns$831,221NetCommunityBenefitExpnsAmt
Total Expense0.05540TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,419TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,419NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,075TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,075NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,651TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,651NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,470TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,470NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,368TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,368NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,983TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$16,983NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,153,757BadDebtExpenseAmt
Bad Debt Expense Attributable$6,634BadDebtExpenseAttributableAmt
Reimbursed By Medicare$5,326,369ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$5,326,369CostOfCareReimbursedByMedcrAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PAUL OLIVER MEMORIAL HOSPITALBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1224 PARK AVEAddressLine1
CityFRANKFORTCity
StateMIState
ZIP Code49635ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.MUNSONHEALTHCARE.ORGWebsiteAddressTxt
State LicenseMI 100020StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PAUL OLIVER MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
OtherYes (X)OtherInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.MUNSONHEALTHCARE.ORGOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
Adopt BudgetYes (X)AdoptBudgetInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedfalseAllNeedsAddressedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (true)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (true)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Insurance StatusYes (X)InsuranceStatusInd
Other FactorsYes (X)OtherFactorsInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Available On RequestYes (X)AvailableOnRequestInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, PAUL OLIVER MEMORIAL HOSPITAL - PART V, LINE 3A COLLABORATIVE 12-MEMBER STEERING COMMITTEE GUIDED THE CHNA PROCESS. THIS STEERING COMMITTEE WAS COMPRISED OF HOSPITAL LEADERS AND PUBLIC HEALTH OFFICIALS. AS THE CHNA PROCESS PROGRESSED, 129 INDIVIDUALS FROM MULTIPLE AREA ORGANIZATIONS WERE INVOLVED TO ENSURE INPUT FROM THOSE WHO HAVE A BROAD KNOWLEDGE OF THE COMMUNITY. FURTHER, A GROUP OF KEY PHYSICIAN LEADERS FROM THE REGION ALSO WAS CONSULTED FOR INPUT. INDIVIDUALS POSSESSING BROAD KNOWLEDGE OF ALL SEGMENTS OF THE FIVE-COUNTY AREA PARTICIPATED IN 10 FOCUS GROUPS TO HELP ASSESS HEALTH CARE NEEDS. SESSIONS WERE CONDUCTED WITH FIVE AREA COUNTY COLLABORATIVES, AS WELL AS PEOPLE LIVING IN POVERTY, YOUTH, THOSE WHO PROVIDE SERVICES TO SENIORS, AND BEHAVIORAL HEALTH PROVIDERS. THESE GROUPS WERE SELECTED BECAUSE OF THEIR KNOWLEDGE OF PEOPLE AND AREAS MOST IMPACTED BY HEALTH DISPARITIES. BEHAVIORAL HEALTH PROVIDERS WERE AN IMPORTANT INITIAL FOCUS GROUP BECAUSE THERE IS ALMOST NO SECONDARY MENTAL HEALTH DATA AVAILABLE. FOCUS GROUPS SERVING A SPECIFIC POPULATION (I.E. SENIORS, BEHAVIORAL HEALTH) WERE ASKED ABOUT HEALTH NEEDS SPECIFIC TO THE GROUP'S AREA OF EXPERTISE. EACH FOCUS GROUP DETERMINED A COMPREHENSIVE LIST OF HEALTH NEEDS; THEN PRIORITIZED ITS TOP FOUR TO SIX HEALTH NEEDS. IN ADDITION, SIXTEEN KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN JANUARY 2012 TO JULY 2012 WITH INDIVIDUALS FROM THE COURTS, AREA FOUNDATIONS, FREE AND FEDERALLY QUALIFIED HEALTH CENTER CLINICS, THE MIGRANT CLINIC, THE TRIBAL CLINIC, ORGANIZATIONS WHO SERVE SENIORS, AND ADOLESCENT HEALTH CLINIC PROVIDERS TO ASSESS THE GREATEST HEALTH NEEDS THEY OBSERVE. KEY INFORMANTS WERE ASKED THE SAME FOUR QUESTIONS AS THE FOCUS GROUPS, FOCUSING ON THEIR SPECIFIC POPULATION AREA OF EXPERTISE. KEY INFORMANTS WERE CHOSEN BECAUSE OF THEIR KNOWLEDGE OF PEOPLE AND AREAS MOST IMPACTED BY HEALTH DISPARITIES.
FACILITY 1, PAUL OLIVER MEMORIAL HOSPITAL - PART V, LINE 4MUNSON MEDICAL CENTER
FACILITY 1, PAUL OLIVER MEMORIAL HOSPITAL - PART V, LINE 7LARGE HEALTH NEEDS NOT ADDRESSED BY POMH AT THIS TIME ARE MENTAL HEALTH AND SUBSTANCE ABUSE. POMH DOES NOT HAVE THE RESOURCES FOR MENTAL HEALTH OUTREACH OR AN IN-PATIENT PSYCHIATRIC UNIT. OUR REFERRALS FOR MENTAL HEALTH AND SUBSTANCE ABUSE CARE THAT CANNOT BE TREATED IN THE PRIMARY CARE SETTING ARE SENT TO MUNSON MEDICAL CENTER IN TRAVERSE CITY OR PINE REST IN GRAND RAPIDS. OUR GOAL IS TO WORK WITH PRIMARY CARE GROUPS TO IDENTIFY OPPORTUNITIES FOR ESTABLISHMENT OF GREAT ACCESS TO OUTPATIENT MENTAL HEALTH SERVICES IN THE REGION AND A PAIN CLINIC FOR IMPROVED MANAGEMENT. IN ADDITION POMH DOES NOT HAVE THE ABILITY TO ADDRESS DENTAL NEEDS AT THIS TIME. ACCESS TO DENTAL HEALTH PROVIDERS IS AN ISSUE IN MANY RURAL REGIONS. ALTHOUGH OUR OPTIONS ARE LIMITED IN THIS AREA WE WILL CONTINUE TO EXPLORE WAYS TO DEVELOP COLLABORATIVE OPPORTUNITIES WITH DENTAL CLINICS NORTH TO EXPAND FROM GRAND TRAVERSE COUNTY INTO BENZIE COUNTY. OUR COORDINATION WITH MUNSON HEALTHCARE ON HOW TO EXPAND PERINATAL SERVICES FOR GREATER ACCESS IN THE REGION IS ONGOING. WE DO NOT VIEW THIS AS DIRECTLY ADDRESSING THE NEEDS OF PERINATAL AND OBSTETRICAL SERVICES.
FACILITY 1, PAUL OLIVER MEMORIAL HOSPITAL - PART V, LINE 12IPATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES (I.E. HIGH DEBT-TO-INCOME RATIO), AT THE SOLE DISCRETION OF MUNSON HEALTHCARE.
FACILITY 1, PAUL OLIVER MEMORIAL HOSPITAL - PART V, LINE 14GIT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS, INFORMATION POSTED ON THE WEBSITE, STATEMENT ON BILLS, AND/OR SIGNS IN THE REGISTRATION AREAS.
FACILITY 1, PAUL OLIVER MEMORIAL HOSPITAL - PART V, LINE 18EPAUL OLIVER HOSPITAL REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. MUNSON HEALTHCARE WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTATION THAT PAUL OLIVER HOSPITAL HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTATION THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN.
FACILITY 1, PAUL OLIVER MEMORIAL HOSPITAL - PART V, LINE 20DSELF-PAY/NO INSURANCE PATIENTS ARE GIVEN A DISCOUNT EQUAL TO 15% OFF THEIR TOTAL BILL FOR ALL MEDICALLY NECESSARY AND EMERGENCY SERVICES. THIS RATE WAS DETERMINED BY TAKING THE AVERAGE OF COMMERCIAL RATES, NOT INCLUDING BLUE CROSS.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
PAUL OLIVER MEMORIAL HOSPITAL SNF
224 PARK AVEFRANKFORTMI49635LONG TERM CARE
PHYSICAL THERAPY
9975 W OTTAWA AVEEMPIREMI49630PT, LAB, RADIOLOGY
FITNESS CENTER
102 AIRPORT RDFRANKFORTMI49635PHYSICAL THERAPY, CARDIAC REHAB AND EDU
PHYSICAL THERAPY
6227 FRANKFORT HIGHWAYBENZONIAMI49616PT, LAB, RADIOLOGY
PHYSICAL THERAPY
1975 STIRLING DRINTERLOCHENMI49643PT, LAB, RADIOLOGY

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CAREINCOME UP TO 200% OF THE FPG = 100% DISCOUNT ON CHARGES INCOME BETWEEN 201% AND 300% FPG = 75% DISCOUNT ON CHARGES INCOME BETWEEN 301% AND 400% FPG = 50% DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE, OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS. FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG: INCLUDES EARNINGS, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES; CASH, CHECKING AND SAVINGS BALANCES, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, IRAS TRUSTS, INHERITANCES, ANNUITIES, SAVINGS BONDS, STOCKS, MUTUAL FUNDS, AND/OR CASH VALUE OF LIFE INSURANCE.
PART I, LINE 6A - RELATED ORGANIZATION INFORMATIONMUNSON MEDICAL CENTER, BROTHER CORPORATION
PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATIONTHERE ARE NO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES.
PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSETOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 16,198,598. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS 1,153,757. THE NET EXPENSE OF 15,044,841 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F).
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATIONCOST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION AND ACTUAL CASH PAID.
PART II - COMMUNITY BUILDING ACTIVITIESPOMH PROVIDED 16,983 TO COMMUNITY-BUILDING ACTIVITIES DURING THE 2014 FISCAL YEAR. WHILE WE BELIEVE THESE ACTIVITIES PROMOTE COMMUNITY HEALTH BY SUPPORTING THE UNDERLYING CAUSES OF COMMUNITY HEALTH THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON THE SCHEDULE H. THESE ACTIVITIES INCLUDE: ADMINISTRATIVE AND CASH SUPPORT FOR COALITION BUILDING ACTIVITIES IN BENZIE COUNTY, MEETING THE BASIC NEEDS OF PEOPLE IN POVERTY ON A LOCAL LEVEL BY MULTIPLE COLLABORATIVE ACTIVITIES, PARTICIPATION IN THE BENZIE COUNTY CHAMBER OF COMMERCE TO PROMOTE WORKFORCE DEVELOPMENT, AND SEVERAL ENVIRONMENTAL IMPROVEMENTS RELATED TO COMMUNITY GARDENING AND HEALTHY SCHOOL LUNCHES. ALSO BECAUSE BENZIE COUNTY IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA POMH INVESTS DOLLARS INTO THE RECRUITMENT OF CRITICALLY NEEDED PHYSICIANS TO THE AREA TO PROMOTE PATIENT ACCESS TO CARE.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGYTHE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX OF 1,153,757. THE BAD DEBT EXPENSE IS COMPRISED OF TWO COMPONENTS: 1) THE AMOUNT OF THE DIRECT WRITE-OFF FROM UNPAID ACCOUNTS THAT ARE THE PATIENTS' RESPONSIBILITY WHICH ARE DEEMED NO LONGER COLLECTIBLE AND 2) AN ESTIMATE OF THE AMOUNT OF BAD DEBT, NET OF DISCOUNTS, IN THE ACCOUNTS RECEIVABLE BALANCE, CONSIDERING THE EXPERIENCE OVER A DEFINED PERIOD OF TIME IN ACCORDANCE WITH THE HOSPITAL'S FORECASTING MODEL.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCEPAUL OLIVER HOSPITAL UTILIZES A HINDSIGHT ANALYSIS IN THEIR DATA EVALUATION. THE ESTIMATE OF THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS MADE USING AN ANALYSIS OF PATIENTS WITH SPECIFIED FINANCIAL CLASSES THAT WERE TURNED OVER TO BAD DEBT STATUS.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTSTHE ACCOUNTS RECEIVABLE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF MUNSON HEALTHCARE AND SUBSIDIARIES STATES: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER AMOUNTS DUE FROM THIRD-PARTY PAYORS ARE SATISFIED AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATIONMUNSON HEALTHCARE'S INTERNAL AND EXTERNAL COLLECTION PRACTICES (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTIONS ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE, AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MUNSON HEALTHCARE. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MUNSON HEALTHCARE MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY.
PART VI, LINE 2 - NEEDS ASSESSMENTTHE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE (CHC) TO SERVE THE MUNSON HEALTHCARE SYSTEM. THE CHC CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM MUNSON HEALTHCARE HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON HEALTHCARE BOARD CHAIRPERSON. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MHC RESPONSE TO ANY EMERGING HEALTH TRENDS AS IDENTIFIED BY COMMUNITY HEALTH NEEDS ASSESSMENT, AND REVIEW ANY NEW COMMUNITY HEALTH BASED COLLABORATION OR PROGRAM. THE CHC IS RESPONSIBLE FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MHC COMMUNITY BENEFIT PROGRAMS AND SERVICES. THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT OF MUNSON MEDICAL CENTER, A BROTHER CORPORATION. PAUL OLIVER MEMORIAL HOSPITAL (POMH), A MEMBER OF THE MUNSON HEALTHCARE SYSTEM, IS A CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN MUNSON HEALTHCARE'S EXTENSIVE GEOGRAPHICAL AREA. COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED, AS WELL AS WHERE PROGRESS HAS BEEN MADE. THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITY-WIDE. MUNSON MEDICAL CENTER (MMC) IS A SIGNIFICANT CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN THE MUNSON SYSTEM'S EXTENSIVE GEOGRAPHICAL AREA. MUNSON MEDICAL CENTER, IN CONJUNCTION WITH PAUL OLIVER MEMORIAL HOSPITAL PREPARED A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) DURING FISCAL 2013 IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. POMH REGULARLY SEEKS INFORMATION FROM AND PARTICIPATES IN: THE BENZIE COUNTY COLLABORATIVE; THE LOCAL UNITED WAY; AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY HEALTH NEEDS. POMH, IN CONJUNCTION WITH MUNSON HEALTHCARE, SEEKS TO COLLABORATE WITH REGIONAL PARTNERS, ASSESSING FOR EXISTING PROGRAMS AND STRATEGIES THAT ARE ALREADY WORKING WELL AND THEN PARTNERING, NOT REINVENTING. IF A NEW PROGRAMMING NEED IS IDENTIFIED, POMH SEEKS TO POOL ASSETS WITH 4 MULTI-COUNTY HEALTH DEPARTMENTS, OTHER NON-PROFITS, AND LOCAL GOVERNMENTAL SERVICES FOR THE MOST EFFECTIVE USAGE OF RESOURCES. ADDITIONALLY, MUNSON HEALTHCARE WORKS IN CONJUNCTION WITH EFFORTS BY THE FIVE-COUNTY COLLABORATIVES OF ANTRIM, BENZIE, GRAND TRAVERSE, LEELANAU, AND KALKASKA COUNTIES; THE TRAVERSE CITY CHAMBER OF COMMERCE; THE LOCAL UNITED WAY; AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY NEED.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEIT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: STATEMENT ON BILLS: STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL. SIGNS IN THE ER REGISTRATION AREA: ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY. REFERRAL BY REGISTRATION STAFF: AT THE TIME OF REGISTRATION, SELF-PAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF. PAUL OLIVER MEMORIAL HOSPITAL FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS. IF THE PATIENT WOULD LIKE HELP, THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID. ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR, THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS. AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: MEDICAID (AND ALL OF ITS SUBSETS), SOCIAL SECURITY DISABILITY, TRAVERSE HEALTH CLINIC, CHARITY CARE, CATASTROPHIC CARE COVERAGE, AND CAREPAYMENT.
PART VI, LINE 4 - COMMUNITY INFORMATIONPAUL OLIVER MEMORIAL HOSPITAL (POMH) IS LOCATED IN FRANKFORT, MICHIGAN. ONE OF EIGHT HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM, POMH OFFERS QUALITY, PERSONALIZED CARE FOR PRIMARY AND URGENT MEDICAL NEEDS. DUE TO ITS RURAL, GEOGRAPHIC LOCATION, POMH IS DESIGNATED AS A MICHIGAN CRITICAL ACCESS HOSPITAL. LABORATORY, RADIOLOGY, AND REHABILITATION SERVICES AT POMH ARE NETWORKED WITH MUNSON MEDICAL CENTER (MMC), ENSURING PROMPT AND CONVENIENT DIAGNOSIS AND TREATMENT. POMH HAS 8 ACUTE CARE BEDS AS WELL AS THE 39-BED PAUL OLIVER LIVING AND REHABILITATION CENTER, AN EXTENDED CARE UNIT WHERE RESIDENTS ENJOY A SAFE, WARM, AND COMFORTABLE HOME-LIKE SETTING FOUNDED ON PRINCIPLES OF QUALITY AND PERSONAL CARE. BECAUSE THE CENTER IS HOSPITAL-BASED, PHYSICIANS AND EMERGENCY MEDICAL CARE ARE AVAILABLE 24 HOURS A DAY. HOSPITAL SERVICES POMH PROVIDES 24-HOUR EMERGENCY CARE, ACUTE CARE, LONG-TERM CARE, OUTPATIENT SURGICAL SERVICES, AND RESPITE CARE. MMC SPECIALISTS REGULARLY HOLD CLINICS AT POMH, MAKING IT EASY TO RECEIVE SPECIALIZED CARE. POPULATION SERVED BY PAUL OLIVER MEMORIAL HOSPITAL IN THE POMH MAIN SERVICE AREA OF BENZIE COUNTY: 2010 CENSUS FOR BENZIE COUNTY IS 17,525 2013 POPULATION ESTIMATE IS 17,406 (DECREASE OF -0.7%) 23.5% OF THE POPULATION IS 65 YEARS OR OLDER (2013) UNEMPLOYMENT IS 8.4% (2014) 20.3 PERCENT OF ADULTS 18-64 LACK HEALTH INSURANCE (2012) "13.3% LIVE BELOW THE FEDERAL POVERTY LEVEL (2009-2013) QUALITY PAUL OLIVER MEMORIAL HOSPITAL HAS RECEIVED THE FOLLOWING AWARDS: AHA/HOSPITALS & HEALTH NETWORKS, HEALTH CARE'S MOST WIRED, 2014 PRESS GANEY ASSOCIATES GUARDIAN OF EXCELLENCE AWARD (FORMERLY SUMMIT AWARD) IN MULTIPLE CATEGORIES FOR RANKING IN THE TOP FIVE PERCENT IN THE NATION FOR PATIENT SATISFACTION FOR 12 CONSECUTIVE QUARTERS. OEMERGENCY CARE: 2009, 2010, 2011, 2012, 2013 OOUTPATIENT CARE: 2011, 2013 OPATIENT EXPERIENCE: 2014 MICHIGAN CENTER FOR RURAL HEALTH, RURAL HEALTH SPIRIT AWARD FOR SEPSIS IMPROVEMENT INITIATIVE, 2012 MICHIGAN GOVERNOR'S AWARD OF EXCELLENCE FOR IMPROVING PATIENT SAFETY AND QUALITY OF CARE IN THE CRITICAL ACCESS SETTING. THE AWARD HONORS MICHIGAN HOSPITALS THAT PERFORM QUALITY INITIATIVES AIMED AT IMPROVING PATIENT CARE. THE HOSPITAL HAS REPEATEDLY RECEIVED THIS AWARD, MOST RECENTLY IN 2014. MICHIGAN RURAL HEALTH QUALITY IMPROVEMENT AWARD OEXCELLENCE FOR ITS COMMITMENT TO QUALITY CARE AND EVIDENCE-BASED MEDICINE IN THE AREA OF EMERGENCY ROOM TRANSFERS: 2009, 2010, 2011 OEXCELLENCE FOR ITS COMMITMENT TO OUTPATIENT CARE: 2010, 2011 PAUL OLIVER LIVING AND REHABILITATION CENTER HAS RECEIVED THE FOLLOWING AWARDS: 5-STAR RATING BY CENTERS FOR MEDICARE & MEDICAID SERVICES, 2014
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTHTHE POMH BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, THE MAJORITY OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP. ALL BOARD MEMBERS SUPPORT THE HOSPITAL FINANCIALLY. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS. POMH UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA. A DESCRIPTION OF SEVERAL SIGNIFICANT PROGRAMS INITIATED BY THE HOSPITAL FOLLOWS: HEALTHY FUTURES- A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS, HEALTH DEPARTMENTS AND MUNSON HEALTHCARE (MUNSON HEALTHCARE SYSTEM PARENT AND SOLE MEMBER) CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UNDER AGE TWO. THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMES-BASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY, ACCESS TO HEALTH CARE AND IMMUNIZATIONS. BECAUSE OF THE RURAL NATURE OF THE COMMUNITY, TRAVEL TIME TO THE NEAREST MATERNAL CHILD HEALTHCARE SPECIALIST MAY BE GREATER THAN 30 MINUTES. COST AND AVAILABILITY OF TRANSPORTATION CAN BE A DIFFICULT BARRIER TO ACCESS HEALTHCARE FOR YOUNG FAMILIES. POMH PARTNERS WITH MUNSON MEDICAL CENTER TO BRING MATERNAL CHILD HEALTHCARE SPECIALISTS TO PAUL OLIVER, MAKING IT EASY AND CONVINENT TO RECEIVE THE SPECIALIZED CARE NEEDED. TRANSPORTATION- AS PART OF MUNSON HEALTHCARE, POMH SUBSIDIZES FUNDING FOR COUNTY TRANSPORTATION AUTHORITIES WHICH PROVIDES ACCESS TO HEALTHCARE SERVICES FOR DISADVANTAGED PERSONS SUCH AS THE ELDERLY, PERSONS WITH DISABILITIES, AND PERSONS OF LOW INCOME WHO HAVE DIFFICULTY PROVIDING THEIR OWN TRANSPORTATION. BETSIE HOSICK HEALTH AND FITNESS CENTER -THE BETSIE HOSICK HEALTH AND FITNESS CENTER IS OPEN TO PEOPLE OF ALL AGES, ABILITIES, AND FITNESS LEVELS TO ACHIEVE BETTER HEALTH. THE FITNESS CENTER OFFERS A FULL RANGE OF FITNESS EQUIPMENT AND CLASSES. MEDICALLY CREDENTIALED FITNESS PROFESSIONALS ARE ON STAFF TO ASSIST MEMBERS. THROUGH THE BETSIE HOSICK HEALTH AND FITNESS CENTER SENIOR MOVEMENT AND BALANCE CLASSES ARE HELD AT SENIOR SITES AROUND THE COUNTY FREE OF CHARGE TO PROMOTE WELLNESS. PAUL OLIVER HOLDS NUTRITIONAL EDUCATION CLASSES FOR COMMUNITY MEMBERS AT THE HOSPITAL. CAREGIVER LIBRARY- A LIBRARY, INCLUDING COMPUTERS, TO ASSIST THE PUBLIC TO OBTAIN HEALTHCARE INFORMATION. SUPPORT GROUPS AND ASSISTANT ACTIVITIES FOR CHRONIC DISEASES SUCH AS: ALZHEIMER'S DISEASE, PARKINSON'S, AND CANCER. SCREENING SERVICES SUCH AS: BLOOD PRESSURE CHECKS, MAMMOGRAMS, AND LABORATORY TESTS TO THOSE IN NEED. NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 11 COUNTY SERVICE AREA, WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES. NMDI IS COMMITTED TO PROVIDING LOCAL, REGIONAL, AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES. WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES, NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS: THE GENERAL COMMUNITY; THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION; AND RURAL PRIMARY CARE PROVIDERS (PCP) CARING FOR DIABETIC PATIENTS. COLLABORATION WITH THE TRAVERSE HEALTH CLINIC- THE TRAVERSE HEALTH CLINIC (THC) PROVIDES ACCESS TO AFFORDABLE HEALTH SERVICES THROUGH COMMUNITY COLLABORATION TO PEOPLE IN NEED IN BENZIE, LEELANAU, AND GRAND TRAVERSE COUNTIES. THC SERVES AS A PRIMARY CARE PROVIDER FOR THOSE ADULTS WITH MEDICAID AND RUNS THE COALITION HEALTH ACCESS PROGRAM (CHAP) FOR THOSE ADULTS WITH NO INSURANCE WHO QUALIFY (INCOME <200% OF FPG). POMH DONATES LABS, X-RAYS, AND OTHER SERVICES TO THC PATIENTS LIVING IN THEIR RURAL SERVICE AREA. THE JOURNEY PROGRAM IS A 6 WEEK CLASS OFFERING FOR PEOPLE UNDERGOING CANCER TREATMENT OR PEOPLE THAT HAVE JUST COMPLETED CANCER TREATMENT. WE PROVIDE COUNSELING, EXERCISE, AND NUTRITION TALKS AS A FREE SERVICE FOR PEOPLE WHO HAVE CLEARANCE FROM THEIR PHYSICIAN. THIS HELPS THEM TO BUILD STRENGTH, CONFIDENCE, AND FRIENDSHIP AS THEY RECOVER. THE ACTIVE STEPS PROGRAM IS A 6 WEEK PROGRAM OFFERED FOR INDIVIDUALS THAT HAVE DIABETES OR ARE IN DIALYSIS TREATMENT. WE PROVIDE EXERCISE CLASSES AND NUTRITION TALKS AS A FREE SERVICE FOR PEOPLE WHO HAVE CLEARANCE FROM THEIR PHYSICIAN. IF WE CAN HELP NEWLY DIAGNOSED DIABETICS IN THE FIRST FIVE YEARS TO CONTROL THEIR WEIGHT AND SUGARS THEN THEIR ABILITY TO AVOID SEVERE DAMAGE TO THEIR SYSTEMS IS GREATLY INCREASED.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEMPAUL OLIVER MEMORIAL HOSPITAL IS A MEMBER OF THE MUNSON HEALTHCARE SYSTEM, A COMMUNITY-OWNED HEALTH SYSTEM THAT INCLUDES SEVEN ACUTE CARE HOSPITALS, AS WELL AS NUMEROUS OUTPATIENT SERVICES AND CLINICS. ALL THE HOSPITALS IN THE SYSTEM ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR RESPECTIVE COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL INITIATIVES AND/OR PROMOTION ACTIVITIES AS WELL AS SHARED INITIATIVES. PAUL OLIVER'S SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. AFFILIATES OTHER THAN THE HOSPITALS INCLUDE TWO FOUNDATIONS, HOME HEALTH ORGANIZATIONS, MOBILE IMAGING COMPANIES, AND AN EMERGENCY TRANSPORTATION ORGANIZATION; ALL 501(C) ENTITIES. IN ADDITION TO DIRECTING COMMUNITY BENEFIT ACTIVITIES OF THE SYSTEM, MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFITS PROGRAMS FOR THE SYSTEM THROUGH PLANNING, DEVELOPING, IMPLEMENTING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS. POMH WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA. THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON CAMPUS. CLOSE TO 160,000 DOLLARS IN COMMUNITY BENEFIT, IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR. NORTH FLIGHT, INC. IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM. WITH ITS FIXED WING AND HELICOPTER AIR SERVICES, IN COMBINATION WITH GROUND TRANSPORT, PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE. NORTH FLIGHT, INC. PROVIDED 1.3 MILLION IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR. MUNSON MEDICAL GROUP, THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM, PROVIDED APPROXIMATELY 575,000 IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2013. PAUL OLIVER MEMORIAL HOSPITAL PARTICIPATES IN MUNSON HEALTHCARE SYSTEM NEEDS ASSESSMENT PROCESS. UTILIZING THIS NEEDS ASSESSMENT, MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING, DEVELOPING, IMPLEMENTING, EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS. IN TOTAL, THE MUNSON HEALTHCARE SYSTEM PROVIDED 38.5 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS, INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS, OUTREACH PROGRAMS, BAD DEBT, AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PAUL M SHIRILLA
DIRECTOR$270,552$46,350$2,940$32,694$15,179$367,715
JAMES D AUSTIN
FORMER PRESIDENT$151,172$51,187$67,218$21,559$18,754$309,890$3,881
MARK A HEPLER
CFO$255,473$72,580$27,960$41,711$22,164$419,888$7,891

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 3THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
SCHEDULE J, PAGE 1, PART I, LINE 4PAUL M. SHIRILLA 0 16,461 0 JAMES D. AUSTIN 0 12,489 0 PETER MARINOFF 0 2,543 0 MARK A. HEPLER 0 26,383 0
SCHEDULE J, PART IIIEXECUTIVE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
CRYSTAL LAKE CLINIC
OWNER DIRECTOR$88,174MEDICAL SERVICESfalse
CRYSTAL LAKE EMERGENCY SERVICES PC
OWNER DIRECTOR$973,445GROUP PHYSICIAN PRACfalse
NRTW LLC
OWNER DIRECTOR$62,247LEASEfalse
INTERLOCHEN MEDICAL PROPERTIES LLC
OWNER DIRECTOR$81,547LEASEfalse

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONPAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 38.5 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2013 TAX YEAR.
FORM 990, PAGE 6, PART VI, LINE 6PAUL OLIVER MEMORIAL HOSPITAL IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 7AMUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE TRUSTEES/DIRECTORS, FOR ALL SUBSIDIARY ENTITIES. NOMINATIONS TO MUNSON HEALTHCARE FOR SUBSIDIARY TRUSTEES/DIRECTORS ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE.
FORM 990, PAGE 6, PART VI, LINE 7BCERTAIN DECISIONS OF THE PAUL OLIVER MEMORIAL HOSPITAL DIRECTORS ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING THE AMENDMENT OF THE ARTICLES OF INCORPORATION; AMENDMENT OF THE MISSION STATEMENT; ADOPTION OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION OR REORGANIZATION; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL TO THE PROPERTY AND ASSETS; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF PAUL OLIVER MEMORIAL HOSPITAL; ACCEPTANCE OF THE ANNUAL BUDGET AND ANNUAL FINANCIAL STATEMENTS; INCURRENCE OF EXPENDITURES EXCEEDING BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT; INCURRENCE OF CERTAIN DEBT; CHANGE IN SCOPE OF SERVICES OR PROGRAMS PROVIDED BY PAUL OLIVER MEMORIAL HOSPITAL; AND APPOINTMENT OF THE PRESIDENT.
FORM 990, PAGE 6, PART VI, LINE 11BTHE PAUL OLIVER MEMORIAL HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. PAUL OLIVER MEMORIAL HOSPITAL BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12CTHE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER.
FORM 990, PAGE 6, PART VI, LINE 15ATHE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS.
FORM 990, PAGE 6, PART VI, LINE 15BCOMPENSATION OF OTHER OFFICERS IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES OF PAUL OLIVER MEMORIAL HOSPITAL AND MUNSON HEALTHCARE.
FORM 990, PAGE 6, PART VI, LINE 19THE PAUL OLIVER MEMORIAL HOSPITAL ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. PAUL OLIVER MEMORIAL HOSPITAL DOES NOT MAKE THE BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES 2,677,419 455,242 79,370 PROFESSIONAL FEES 998,042 48,730 0
FORM 990, PART XI, LINE 9INVESTMENT IN SUB - PAUL OLIVER HOSPITAL FND 607,637 TRANSFER FROM AFFILIATE 124,014 TRANSFER TO PARENT CORP -1,000,000 TRANSFER TO AFFLIIATE -57,000

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Business Name Line2DirectControllingEntityName/BusinessNameLine2Controlled OrganizationControlledOrganizationInd
MUNSON DIALYSIS CENTER
1105 SIXTH STTRAVERSE CITYMI49684383097861DIALYSISMIC33MUNSON HCMUNSON HEALTHCAREfalse
MUNSON HEALTHCARE
1105 SIXTH STTRAVERSE CITYMI49684382640544PARENTMIC311BNAfalse
MUNSON HEALTHCARE REGIONAL FOUNDATI
1105 SIXTH STTRAVERSE CITYMI49684382642724RAISE FUNDMIC37MUNSON HCMUNSON HEALTHCAREfalse
MUNSON HOME CARE
1105 SIXTH STTRAVERSE CITYMI49684382191390HOME HEALTMIC39MUN HOME HMUNSON HOME HEALTHfalse
MUNSON HOME HEALTH
1105 SIXTH STTRAVERSE CITYMI49684383335362HOME HEALTMIC311BMUNSON HCHEALTHCAREfalse
MUNSON HOME SERVICES
1105 SIXTH STTRAVERSE CITYMI49684382543463HOME HEALTMIC39MUN HOME HMUNSON HOME HEALTHfalse
MUNSON MEDICAL CENTER
1105 SIXTH STTRAVERSE CITYMI49684381362830HOSPITALMIC33MUNSON HCMUNSON HEALTHCAREfalse
NORTH FLIGHT INC
1105 SIXTH STTRAVERSE CITYMI49684382657917MED TRANSPMIC311BMUNSON HCMUNSON HEALTHCAREfalse
PAUL OLIVER MEMORIAL HOSPITAL FOUND
1105 SIXTH STTRAVERSE CITYMI49684237201619RAISE FUNDMIC33PAUL OLIVEPAUL OLIVER MEMORIAL HOSPITALYes (true)
MUNSON MEDICAL GROUP
1105 SIXTH STTRAVERSE CITYMI49684273600575HEALTHCAREMIC39MUNSON MEDMUNSON MEDICAL CENTERfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
MUNSON MEDICAL BUILDING PARTNERS
PO BOX 1188TRAVERSE CITYMI496851188382830005REAL ESTATMIN/Afalsefalse
NORTHERN MICHIGAN SUPPLY ALLIANCE
2651 AERO PARK DRTRAVERSE CITYMI49686383453378PURCHASINGMIN/Afalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Business Name Line2RelatedOrganizationName/BusinessNameLine2Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
MEDICAL OFFICE BUILDING CONDOMINIUM
MEDICAL OFFICE BUILDING CONDOMINIUMPO BOX 1188TRAVERSE CITYMI496851188383567278REAL ESTATMIN/Afalse
MUNSON SERVICES INC
PO BOX 1188TRAVERSE CITYMI496851188383144382PHARMACYMIN/Afalse
MUNSON SUPPORT SERVICES
PO BOX 1188TRAVERSE CITYMI496851188382872821LAUNDRYMIN/Afalse
SIXTH STREET DRUGS INC
PO BOX 1188TRAVERSE CITYMI496851188382298290PHARMACYMIN/Afalse
MEDICAL OFFICE CONDOMINIUM
MEDICAL OFFICE CONDOMINIUMPO BOX 1188TRAVERSE CITYMI496851188201902620REAL ESTATMIN/Afalse
MUNSON MOBILE IMAGING
PO BOX 1188TRAVERSE CITYMI496851188382704069IMAGINGMIN/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (14 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
MUNSON DIALYSIS CENTER
J$65,985ACTUAL AMOUNT PAID
MUNSON HEALTHCARE
B$1,000,000ACTUAL AMOUNT PAID
MUNSON HEALTHCARE
M$171,768ACTUAL AMOUNT PAID
MUNSON HEALTHCARE
O$104,920ACTUAL AMOUNT PAID
MUNSON HEALTHCARE
P$94,665ACTUAL AMOUNT PAID
MUNSON MEDICAL CENTER
P$5,045,361ACTUAL AMOUNT PAID
MUNSON MEDICAL CENTER
O$1,077,473ACTUAL AMOUNT PAID
MUNSON MEDICAL CENTER
M$825,403ACTUAL AMOUNT PAID
MUNSON MEDICAL CENTER
C$124,014AGREEMENT ALLOCATION
MUNSON SERVICES INC
M$64,550ACTUAL AMOUNT PAID
MUNSON SUPPORT SERVICES
M$85,662ACTUAL AMOUNT PAID
NORTHERN MICHIGAN SUPPLY ALLIANCE
P$194,380ACTUAL AMOUNT PAID
PAUL OLIVER MEM HOS FOUNDATION
M$79,370ACTUAL AMOUNT PAID
PAUL OLIVER MEM HOS FOUNDATION
R$57,000ACTUAL AMOUNT PAID

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE RFormAndLineReferenceDesc
ExplanationPAUL OLIVER MEMORIAL HOSPITAL USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.ExplanationTxt