2015-05-07T09:02:06-05:00 2014-06-30 346565596 Ernst & Young US LLP 41 South High Street Columbus OH 43215 990 2013-07-01 382027689 WA Foote Memorial Hospital WAFO 5177884800 205 N East Avenue Jackson MI 49201 Georgia Fojtasek President & CEO 5177884800 2015-04-30 1 Diane L Bean P00104972 6142245678 2013 2016-02-25 16:41:14Z Allegiance Health Georgia Fojtasek 205 N East Avenue Jackson MI 49201 568956668 0 X www.allegiancehealth.org X 1970 MI We lead our community to better health and well-being at every stage of life. 15 7 4482 604 3485840 -180627 3873688 2029401 404465728 427625746 9911659 26393683 8953035 9835554 427204110 465884384 643000 610370 0 0 230033028 245691463 0 0 0 207310272 211483802 437986300 457785635 -10782190 8098749 498210237 511854393 292252910 277190759 205957327 234663634 X See Schedule OOur MissionWe lead our community to better health and well-being at every stage of life.Our ValuesCompetence: expertise in carrying out responsibilities and inspiring others to have confidence in you.Integrity: behavior that is honest, fair, trustworthy and sincere, strength of character and respect for others.Teamwork: working together in an environment of mutual respect.Diversity: respect for individual beliefs, uniqueness, and differences.Quality: committment to excellence in care.Compassion: acknowledging the feelings of others with empathy, support, encouragement, and sensitivity. Listening and responding to individual needs in a patient and caring manner.Customer Service: taking pride in providing service beyond expectations.Healing Environment: providing an environment that promotes an atmosphere of trust, comfort, healing and security 0 0 367311223 610370 434057257 See Schedule OThe Hospital devotes substantial efforts and resources to providing health services to people in its communities. The Hospital is engaged in the following activities to ensure that our mission is accomplished:Unreimbursed Services Provided to the Underserved:The Hospital provides a substantial portion of its services to the underserved (elderly and low income residents). During the fiscal year ended June 30, 2014, approximately 39% of the value of services rendered were to elderly patients under the Medicare program, and approximately 17% of the services were provided to patients who were deemed indigent under state, county, or Medicaid Center guidelines.In the spirit of our mission and values, the Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare services to all persons. During the fiscal year ended June 30, 2014, the Hospital provided charity care of $47.7 million and recorded a provision for bad debts of $40.9 million. Consistent with Schedule H reporting, charity care at cost for fiscal year 2014 was $13.9 million.Patient Services:The Hospital serves seven counties with a medical staff of more than 450 physicians. A complete listing of services is available at AllegianceHealth.org.The Hospital supports unprofitable/subsidized health services, including inpatient and outpatient behavioral health and substance abuse services, obstetrics, emergency and trauma services, general medicine, family/general practice, senior services, cardiac and pulmonary rehabilitation, palliative care, wound care, pain clinic and diabetes clinic.Community Benefit Activities:The Hospital is engaged in community programs and services that address identified community health needs regardless of source or availability of payment and provide measurable improvement in health access, health status, and the use of health care resources. These programs address one of the six criteria:Supports the Hospital's community-based missionTargets the problems of the poor or medically underservedImpacts the health status of the identified communityReduces community health costsIs accessible to the entire target community regardless of ability to payStimulates external community partnershipsHealth Improvement Organization:The Health Improvement Organization (HIO) was created by Allegiance Health in 2001 to promote a culture of continuous health improvement in our community and integrate wellness and prevention throughout our services. The Allegiance Health Department of Prevention and Community Health provides staff and infrastructure to facilitate the coordination of local health improvement activities. The HIO Coordinating Council (HIO CC) is a multi-disciplinary stakeholders group led by Allegiance Health with representation from local government, public health, health care, health and human service agencies, nonprofits, school districts, health plans, mental health, employers and the faith community. The HIO CC coordinates efforts across community leaders in health to create unprecedented alignment of goals and resources, as well as a strong community platform for advocacy. The work of the HIO CC has culminated in the completion of a Community Action Plan including goals, objectives and strategies to address physical activity, nutrition, tobacco use, and depression in Jackson County. The Plan is based on assessment and data-driven processes, as well as input from over 30 representatives from local health and human service agencies, and over 100 community stakeholders. The overarching tactics that the Community Action Plan relies upon include evidence-based activities to:Enhance media attention and public recognition of healthy lifestyle practices;Improve access to healthy foods and safe, attractive, affordable places for activity through supportive policies and physical environment changes;Provide social support and services that promote consistent screening, referral and supportive relationships for physical activity, nutrition, mental health and smoking behavior change.The HIO builds upon existing community strengths and infrastructure to support implementation of health initiatives that have been prioritized as part of a community wide plan with significant community engagement and an established infrastructure to support longevity. In addition to operational support for the HIO CC, the Allegiance Health Department of Prevention and Community Health provides subject matter expertise on wellness and prevention at the Board, Service Line and community level, and direct service delivery (including employer-based health management, tobacco treatment services, weight management, faith community nursing, etc.) to a broad base of community members to support the health improvement priorities identified by the HIO. The Department of Prevention and Community Health has an annual budget of around $1 million. Since 2001, the Hospital has committed over $22.4 million of funding to this program.Other Community Benefit Activities:Through Community Education and Outreach, the Hospital provided educational sessions and clinics that reached 87,811 individuals at a cost of $300,641 in fiscal year 2014. The sessions/clinics included education on asthma, AIDS/HIV, diabetes, family planning, fitness/exercise, overall health, cardiovascular health, nutrition and weight management, pulmonary, smoking cessation and womens health. These educational offerings were located at the Hospital, community fairs, parishes, schools, work sites and by phone. Free Medical Screenings for high blood pressure, diabetes, mental health/depression, vascular disease and womens health served 1,414 community members at a cost of $23,159 in fiscal year 2014.The Hospital funded a 24-hour nurse call center to provide health information to the community. The cost of the center in fiscal year 2014 was $376,700.Free and discounted prescription drug and medical supplies were provided to community members at a cost of $127,840 during fiscal year 2014. Through Meals on Wheels and other food programs, the Hospital donated $63,703 in food.Patient transportation assistance was provided in fiscal year 2014, including wheelchair van, ambulance, transport to and from cancer centers and cab service at a cost of $174,072.Partnerships:The Hospital played a leadership role in the establishment of the Center for Family Health, a Federally Qualified Health Center, providing $500,000 in fiscal year 2014 support for the uninsured.The Hospital played a leadership role in the establishment of the Jackson County Health Plan, whose mission is to improve healthcare coverage in Jackson County for the underserved.The Hospital partnered with the medical staff and community to establish Project Access, a program which provides free physician and hospital care for over 500 community members that do not qualify for federal or state financial assistance and are uninsured. The Hospital provides free care for medically necessary hospital based services. Hospital executive staff sit on a number of governance boards of non-profit organizations in our community, such as Center for Family Health, Ella Sharp Museum of Art and History, Jackson Community Foundation, Fitness Council of Jackson, Health Improvement Organization, Allegiance Hospice, Allegiance Health Foundation, CareLink, Healthlink, Jackson Community Ambulance, Huron Valley Ambulance, Jackson Community Medical Record, Michigan Health Information Network, United Way of Jackson, Jackson Health Network, and Junior Achievement of Michigan Edge.The Hospital is also represented on public and private organizations including The Enterprise Group of Jackson, Inc. (promotes economic development), Jackson Citizens for Economic Growth, and South Central Michigan Works. The Hospital donates office space to two area non-profit organizations. These organizations are the Enterprise Group of Jackson, Inc. and Birthline of Jackson. 367311223 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 1 1 1 0 0 0 0 1 1 1 1 0 0 1 290 0 1 4482 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 15 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X Jeanne' Wickens 5177884800 205 N East Avenue Jackson MI 49201 X Georgia Fojtasek President & CEO 55.00 5.00 X X 704743 0 69099 Aaron Boatin Trustee 2.00 2.00 X 0 0 0 Neeta Delaney Trustee 2.00 1.00 X 0 0 0 Doug Finch Trustee 4.00 1.00 X 0 0 0 David Halsey Trustee 4.00 1.00 X 34870 0 0 Steven Hogwood Trustee 2.00 1.00 X 0 0 0 John Mogerman Chief of Staff 5.00 1.00 X 351257 0 48682 Steven Rick Trustee 2.00 1.00 X 0 0 0 Tim Levy Vice Chairman 3.00 1.00 X 0 0 0 John Nally Secretary/Treasurer 3.00 1.00 X X 0 0 0 Larry Schultz Chairman 5.00 1.00 X 0 0 0 Allan Tompkins Trustee 3.00 2.00 X 4590 0 0 Gregg Patten Trustee as of 05/29/14 3.00 1.00 X 2000 0 0 Michael Shore Trustee 3.00 2.00 X 2400 0 0 Mohan Kulkarni Trustee 3.00 1.00 X 152735 0 0 Karen Chaprnka SVP & COO 55.00 5.00 X 416975 0 55339 Jeanne' Wickens SVP & CFO 55.00 5.00 X 440577 0 67460 Richard Warren VP & CIO 55.00 5.00 X 363067 0 61490 Kenneth Empey General Counsel 55.00 5.00 X 256253 0 61367 Anthony Gardner VP Marketing 55.00 1.00 X 182618 0 30232 Beth Smith VP Organizational Excellence 55.00 1.00 X 203160 0 30386 Gerald Grannan VP Physician Integrationg & Planning 55.00 1.00 X 194654 0 32084 John Hyden Chief Compliance Officer 55.00 5.00 X 134787 0 13513 Ondrea Bates SVP Patient Care as of 08/30/13 55.00 5.00 X 93174 0 10681 Ray King Chief Medical Officer 55.00 5.00 X 394795 0 64084 George Hunter VP Human Resources as of 07/08/13 55.00 5.00 X 121456 0 9038 Kevin Leonard VP Finance 55.00 5.00 X 155355 0 10129 Vishal Gupta Physician 50.00 0.00 X 979026 0 89136 Ryan Beekman Physician 50.00 0.00 X 882110 0 71684 Shawn Obi Physician 50.00 0.00 X 648607 0 9091 Brian Daly Physician 50.00 0.00 X 643057 0 71950 Christopher Pfeifer Physician 50.00 0.00 X 623284 0 24200 Cheryl Lamborn VP Human Resources thru 11/12/12 0.00 0.00 X 174463 0 0 8160013 0 829645 219 1 1 0 St Joseph Mercy Health System PO Box 992 Ann Arbor MI 48106 Healthcare Services 7435742 Mckesson Technologies Inc PO Box 98347 Chicago IL 60693 Healthcare Consulting 3578739 Independent Emergency Physicians PO Box 100 Royal Oak MI 48068 Healthcare Services 3555714 GE Healthcare Services PO Box 96483 Chicago IL 60693 Healthcare Consulting 2913195 Cogent Healthcare Management Inc PO Box 645037 Cinncinnati OH 45264 Hospitalists 2800371 244 978310 1051091 2029401 Patient Services 621990 426553062 424661954 1891108 FHC, JCA, and JCMR 621910 1072684 1072684 427625746 6080030 6080030 140312 140312 906015 853613 52402 52402 52402 122392012 101613322 605349 20778690 -605349 20173341 20173341 Services to Affiliates 561000 4167403 3179776 987627 Cafeteria 722210 1756909 1756909 Contracted Pharmacy Revenue 621110 1152127 1152127 2706713 2099608 607105 9783152 465884384 432166149 3485840 28202994 X 610370 610370 5059045 5059045 1278392 939421 338971 194517526 162045981 32471545 9535271 7715757 1819514 21681056 17543892 4137164 13620173 11021181 2598992 259328 259328 2968429 2401995 566434 358736 358736 148547 148547 331145 331145 49811054 33154371 16656683 1125813 910986 214827 20842334 16865214 3977120 11485288 9293673 2191615 8770570 7096976 1673594 346207 280144 66063 346207 280144 66063 5849792 4733539 1116253 25716796 20809535 4907261 473532 383173 90359 Drugs 36666641 36666641 Medical Supplies 31291193 31291193 Swap Loss Transaction 7104151 7104151 Food 2162932 2162932 5425107 1104105 4321002 457785635 367311223 90474412 0 8560443 11037168 1980897 1864583 50532032 54353819 75661 115000 205009 2594211 0 6874186 6370488 9480192 9112567 343562725 196745923 154971366 146816802 249871604 265050768 13230306 16967528 498210237 511854393 53947584 60468136 169988808 165047191 3367990 3367990 18000000 17000000 46948528 31307442 292252910 277190759 X 205957327 234663634 205957327 234663634 498210237 511854393 X 8098749 5076546 15531012 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 148547 0 0 148547 0 Part II-B, Line 1: Health care is a highly-regulated field, requiring frequent and high-level communication with regulators and elected officials. A small investment in lobbying enables us to remain in contact with legislators and government agencies, maximize the resources with which we are entrusted and assure that we provide the best care to our community. W.A. Foote Memorial Hospital(also referred to herein as Allegiance Health, Hospital, Corporation or Organization)enlists the services of several lobbying consultants, attorneys and healthcare trade associations. In addition, the Hospital employs a corporate accounts specialist. The specialist spends a portion of his time contacting legislators, participating in grass roots advocacy, and other activities closely related to lobbying. 1552189 694089 75992 1009783 1312487 1250833 671894 370538 1552189 1124117 2790346 5025 2015249 653406 1250833 642729 2045207 -5012 849502 709305 1124117 42176 946077 345524 642729 1.00000 0 1 1 9630527 9630527 183845674 97070172 86775502 136745467 96246278 40499189 13341057 3429473 9911584 146816802 Retirement Plan Liability 26563278 Settlement payable to third party payor 123049 Note Payable 182509 Income Guarantee 343507 Tax Abatement Liability 192411 Deferred Comp 3902688 31307442 Part V, Line 4: The Organization's endowment funds are used for various charitable hospital programs including treatment of uninsured patients and community preventative health education. Cayman Islands 0 1 Program Services Self & Malpractice Insurance 2311262 0 1 0 0 0 1 2311262 0 2311262 0 0 1 0 0 0 1 1 1 X 1 X 1 1 1 0 1 1 13902789 13902789 0.03040 66262629 52381336 13881293 0.03030 80165418 52381336 27784082 0.06070 441512 441512 0.00100 1273793 1273793 0.00280 1715305 1715305 0.00380 81880723 52381336 29499387 0.06450 25000 25000 0.00010 251625 251625 0.00050 276625 276625 0.00060 0 40927175 0 167896943 202314740 -34417797 X 1 1 1 Foote Health Center Associates Entity leases medical office space. 0.54430 0.00000 0.45570 2 Jackson Community Medical Records Entity provides electronic medical records to hospital & community doctors. 0.51000 0.00000 0.49000 1 1 WA Foote Memorial Hospital 205 NEast Avenue Jackson MI 49201 www.allegiancehealth.org X X X WA Foote Memorial Hospital 1 1 X X X X X X X X X 12 1 1 1 X www.allegiancehealth.org X www.myhio.org X X X X X X X X X X 0 0 1 1 200.000000000000 1 350.000000000000 1 X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 W.A. Foote Memorial Hospital Part V, Section B, Line 3: The Health Improvement Organization Coordinating Council, founded by Allegiance Health, is a collaborative of community stakeholders committed to improving the health status of the community through an integrated health improvement infrastructure that addresses Jackson's priority health issues. The HIO Coordinating Council serves as the stakeholder planning committee for Allegiance Health's Board HIO Committee, Jackson County's Healthy Community initiative, the United Way of Jackson County's Community Solutions Team on Health, and the Health Strand of the Jackson 2020 initiative. The scope of our responsibility includes monitoring community level indicators, identifying specific health priorities and developing community action plans to address common goals.In this model, community stakeholders work with public health experts to develop and complete a community health assessment for Jackson County. This assessment provides a data collection mechanism that better aligns efforts among community partners and creates a more strategic framework for local health improvement activities.Individuals contributing input for Allegiance Health's recent CHNA:Megan Albertson, Allegiance HealthKellie Baker, LifeWaysMarilyn Bell, Michigan Purchasers Health AllianceSara Benedetto, Center for Family Health Adam Brown, Jackson County AdministrationCindy Bruner, Meridian Health PlanShelly Bullinger, Jackson County Health DepartmentKathleen Clark, YMCA Storer CampsMark Fall, CareLinkAndrew Farmer, AARP of MichiganKevin Ford, MSUTed Hilleary, Community MemberJennifer Johnson, Great Lakes IndustryDavid King, LifeWaysRay King, Allegiance HealthDavid Kirk, Allegiance HealthIrene LeCrone, United WayKatie Luke, Partnership Park Neighborhood Assoc.Katherine Martin, Community Action AgencyRebecca Mayer, AWAREPamela McCrum, Catholic Charities of Jackson Dani Meier, Jackson Public SchoolsMonica Moser, Jackson Community Foundation Wendy Murdock, United Way of Jackson CountyErin Norton, United WayAmy Pelletier, Marriage MattersRhonda Rudolph, Jackson County Health DepartmentScott Schmidt, United Way of Jackson County Amy Schultz, Allegiance HealthSteve Sukta, Intermediate School DistrictScott TenBrink, Fitness Council of Jackson Shaina Tinsey, Allegiance HealthJulie Weisbrod, Jackson County Health DepartmentTed Westmeier, Jackson County Health Department W.A. Foote Memorial Hospital Part V, Section B, Line 4: CareLink of Jackson, a Community Owned Specialty Hospital W.A. Foote Memorial Hospital Part V, Section B, Line 5d: The CHNA is posted on several websites, presented at public forums, and hard copies of the assessment are available upon request. W.A. Foote Memorial Hospital Part V, Section B, Line 7: Allegiance Health and their community partners have a comprehensive implementation strategy to meet needs identified in the Community Health Needs Assessment (CHNA). The CHNA implementation strategy is rolled out in stages. A need not yet addressed is developing tools and resources accessible to local employers, schools, and restaurants for on-site health promotion. The organization did not have the resources to work on all community needs addressed in the first year the implementation strategy was adopted. Steps were taken in the 2nd year to address this need. These steps include advertising free wellness challenges to the community and working with local school districts to offer healthy concession stand options. W.A. Foote Memorial Hospital Part V, Section B, Line 14g: Invoice provides patient with a number to call if they believe they may qualify for financial assistance. Patients calling the number are guided through the financial assistance application process by hospital representatives. 35 Allegiance Hematology Oncology 1100 E Michigan Avenue Jackson MI 49201 Cancer Treatment Allegiance Vascular Health 300 W Washington Avenue Jackson MI 49201 Vascular Health Allegiance Orthopaedics 1201 E Michgan Avenue Jackson MI 49201 Orthopaedics Allegiance Gastroenterology 1100 E Michigan Avenue Ste 310 Jackson MI 49201 Gastroenterology Allegiance General Surgery 300 W Washington Avenue Jackson MI 49201 Surgery Center Allegiance Hospitalist Service 205 N East Avenue Jackson MI 49201 Hospitalists Group Allegiance Family Medicine - Townsend 400 Hinckley Blvd Jackson MI 49203 Family Medicine Allegiance Cardio Surgery 1125 E Michigan Avenue Jackson MI 49201 Surgery Center Allegiance Family Medicine - Leslie 130 N Sherman Leslie MI 49251 Family Medicine Allegiance Intensivist Services 205 N East Avenue Jackson MI 49201 Internal Medicine Allegiance Behavioral Health 205 N East Avenue Jackson MI 49201 Behavioral Health Allegiance Rheumatology 1201 E Michgan Avenue Ste 100 Jackson MI 49201 Rheumatology Allegiance Family Medicine - Summit Wood 2585 Spring Arbor Road Jackson MI 49203 Family Medicine Allegiance Family Medicine - Spring Arbo 7845 Spring Arbor Road Spring Arbor MI 49283 Family Medicine Allegiance EKG 205 N East Avenue Jackson MI 49201 Pulmonary Medicine Allegiance Family Medicine - Mason 810 Hogsback Road Mason MI 48854 Family Medicine Allegiance Hearing Center 1111 Teneyck Jackson MI 49201 Hearing Loss Treatment Allegiance Family Medicine - Albion 27931 C Drive North Albion MI 49224 Family Medicine Allegiance Neuropsychiatry 205 N East Avenue Jackson MI 49201 Neuropsychiatry Allegiance Internal Medicine 900 E Michigan Avenue Jackson MI 49201 Internal Medicine Allegiance Family Medicine - Grass Lake 12369 E Michigan Avenue Grass Lake MI 49240 Family Medicine Allegiance Family Medicine - Cascade Rd 3333 Spring Arbor Road Ste 100 Jackson MI 49203 Family Medicine Allegiance Family Medicine - MI CTR 4304 Page Avenue Michigan Center MI 49254 Family Medicine Allegiance Senior Health Center 205 N East Avenue Jackson MI 49201 Geriatric Services Allegiance Palliative Care 205 N East Avenue Jackson MI 49201 Palliative Care Allegiance Neurology 1201 E Michgan Avenue Jackson MI 49201 Neurology Allegiance Diabetes Center 817 W High Street Jackson MI 49203 Diabetes Allegiance EEG 205 N East Avenue Jackson MI 49201 Brain Diagnostics Allegiance Occupational Health Urgent Ca One Jackson Square Jackson MI 49201 Urgent Care Allegiance Family Medicine - North Stree 1401 W North Street Jackson MI 49202 Family Medicine Allegiance Family Medicine - East Michig 3235 E Michigan Avenue Jackson MI 49202 Family Medicine Allegiance Family Medicine - Onsted 8958 West M-50 Onsted MI 49265 Family Medicine Allegiance Family Medicine - Springport 2282 Springport Road Ste B Jackson MI 49202 Family Medicine Michigan Heart 309 Page Avenue Jackson MI 49201 Cardiovascular Care Allegiance Digestive Health 4400 Ann Arbor Road Jackson MI 49202 Digestive Health Part I, Line 6a: The Hospital prepares an annual community benefit report, which can be accessed at allegiancehealth.org/givingback. Part I, Line 7: The Hospital used a cost-to-charge ratio to calculate the cost of charity care and Medicaid shortfall. Community Health Improvement Services and Cash and In-Kind Contributions are actual amounts. Part I, Ln 7 Col(f): Our total expense from Form 990, Part IX, line 25, column (A) was $457,785,635. This expense is used as the denominator for purposes of calculating Part I, Line 7, column(f). The denominator does not include bad debt expense. Bad debt expense is subtracted from net patient services revenue. Part II, Community Building Activities: The Hospital is involved in numerous community building activities. We believe these activities, such as supporting affordable housing, working in partnership with the local community college to develop skilled nurses and supporting economic development programs directly improve the general health and wellness of the community. Also, staff at every level of the organization are encouraged to serve community groups that promote education, health and economic advocacy for the less fortunate. Part III, Line 2: Our total expense from Form 990, Part IX, line 25, column (A) was $457,785,636. This expense is used as the denominator for purposes of calculating Part I, Line 7, column(f). The denominator does not include bad debt expense. Bad debt expense is subtracted from net patient services revenue. Part III, Line 4: Accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its historical experience and identifies trends for each of its major payor sources to estimate the appropriate allowance for uncollectible accounts and the provision for bad debts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party health care coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and provision for bad debts. For receivables associated with self-pay accounts (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 and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. The provision for bad debts has been reported as a deduction from net patient service revenue.The amount of bad debt reported in the fiscal year 2014 audited financial statements was $40,927,175. Part III, Line 8: The Organization believes the entire Medicare shortfall reported on Line 7 should be treated as Community Benefit. Allegiance Health is nationally recognized by Healthgrades as being in the top five percent nationally for clinical excellence and patient safety. Allegiance Health also benchmarks favorably on overall cost per case and is deemed to be an efficient provider. The Organization is subsidizing a government program and sustaining significant losses in providing health care to Medicare receipients. By continuing to treat patients eligible for Medicare, hospitals alleviate the federal government's burden for directly providing medical services. Part III, Line 9b: The Hospital does not collect from patients known to qualify for charity care or other financial assistance. Patients having difficulty paying their bills are directed to financial counselors. These counselors review the patient's information in order to see if they qualify for assistance. In addition, bills sent to patients include a number to call for help in providing the required financial information to qualify for charity care. Part VI, Line 2: Allegiance Health conducts a telephone survey every three years in order to gather information on the health status of Jackson County. Through a statistically valid survey, we collect responses from over 1,000 Jackson County residents age 18 and older to a 180 question survey about their health status, insurance coverage, personal health habits and health care experiences. The specific steps involve collecting and analyzing health information for our County (including subpopulations within our County); measuring our health status against other communities, the state and the nation; prioritizing health issues within the community; creating a system for sharing this data with community organizations and residents; initiating strategic planning to address these issues through collaborative activities; and monitoring impact of health initiatives on community health outcomes. Part VI, Line 3: Uninsured inpatients and observation patients are referred to a financial counselor (contracted agent/partner) for assistance with Medicaid, SSI, and Allegiance Health program applications. Many outpatients needing or having received hospital services are also referred to the agent/partner for assistance. ER patients are provided with a packet of information at discharge from the department. This packet includes information about how assistance may be obtained through the local Medicaid office and about how to apply for our income structured payment plan and uncompensated care programs. When patients are billed for balances they owe, we solicit them to call the Business Office with any questions or for assistance. Additionally, a series of letters are sent to patients to apprise them of payment and assistance options. Allegiance has a printed brochure that is available through Registration that includes information regarding Medicaid application assistance and our internal programs. The Allegiance Health website includes a series of web pages related to transparency, quality, pricing, and our financial policies, procedures, and programs. Uninsured patients needing mental health services are screened for eligibility through our partnership with the Jackson Community Mental Health Agency, which funds care for indigent, dual diagnosis, and Medicaid patients. Patients seeking substance abuse care are linked with the Mid-South Substance Abuse Commission. Registration and Business Office team members receive direct training on our programs and scripting for ensuring information is provided to the patients and families with whom our staff interact. Education is provided to organizational leaders to ensure that team members outside of Finance are aware of our programs and where to direct patients and families who may need or who are seeking assistance. Part VI, Line 4: Allegiance Health's population is determined geographically by the boundaries of Jackson County. The hospital is a tax exempt Health System that serves the collective health needs of the more than 160,000 residents of Jackson County. The gender distribution of Jackson County residents is 49% female and 51% male. The age distribution of Jackson County is 26% of residents 19 years and under, 18% between 20 and 34 years, 29% between 35 and 54 years, 13% between 55 and 64 years, and 14% of residents are 65 years and older. Racial distribution of Jackson County residents according to the 2011 Census Data is 88.0% as white, 7.9% as African American, 0.7% as Asian, 0.4% as American Indian or Alaska Native, and 3.0% as some other race or two or more races. Of males aged 15 years and over, 33.0% have never married, 50.4% are married, 1.5% are separated, 2.9% are widowed, and 12.3% are divorced. Of females aged 15 and over, 25.0% have never married, 50.4% are married, 1.7% are separated, 9.8% are widowed, and 13.2% are divorced. According to the Bureau of Labor Statistics (2013), Jackson County also experiences a high unemployment rate of 8.8%. With 69,400 individuals in the civilian labor force, 6,100 residents are currently unemployed. Of those employed, major industries represented include educational services, health care, and social assistance (23.9%); manufacturing (18.7%); retail trade (12.1%); professional, scientific, management, administrative, and waste management services (7.7%); and arts, entertainment, recreation, accommodation, and food services (7.5%). Approximately 39% of Allegiance Hospital patients were covered by Medicare, while 17% were on Medicaid and 14% were uninsured. During the 2014 fiscal year, Allegiance Health had 9,158 Medicare discharges and 4,243 Medicaid discharges from inpatient services. Physician practice visits totaled 224,089 during FY 2014, with 123,861 primary care visits and 100,228 visits to specialists. Allegiance Health also provides financial and leadership support of primary care services for the underserved, regardless of their ability to pay, through the Center for Family Health (CFH), a federally qualified health center. In fiscal 2014, CFH saw 27,290 patients, which 64% were on Medicaid, 7% were on Medicare and 12% were uninsured. Part VI, Line 5: Allegiance Health was honored to have received national recognition in recent years, including the American Hospital Associations 2010 Foster G. McGaw Prize for excellence in community service, which is presented to only one hospital in the United States each year. This award is the ultimate recognition of Allegiance Health's commitment to community health improvement and partnership.In 2014, Allegiance Health earned two prestigious awards for patient safety. For the third year in a row, Allegiance earned a top rating of A on the Hospital Safety ScoreSM from the Leapfrog Group, an independent national nonprofit organization that monitors hospital safety and quality.Allegiance Health also received the 2014 Patient Safety Excellence Award from Healthgrades, a leading online resource for comprehensive information about physicians and hospitals. Out of the 131 Michigan hospitals evaluated, Allegiance Health was the only hospital to receive this award for six years in a row.2014 was a year of progress for the Allegiance Health Patient Portal, a website that allows patients to have personalized and secure 24-hour access to portions of their medical records. This service allows patients to be more engaged partners in their health care and promotes patient-provider communication.The Health Improvement Organization (HIO) was created by Allegiance Health in 2001 to promote a culture of continuous health improvement in our community and integrate wellness and prevention throughout our services. The Allegiance Health Department of Prevention and Community Health provides staff and infrastructure to facilitate the coordination of local health improvement activities. The HIO Coordinating Council (HIO CC) is a multi-disciplinary stakeholders group led by Allegiance Health with representation from local government, public health, health care, health and human service agencies and nonprofits, school districts, health plans, mental health, employers and the faith community. The HIO CC coordinates efforts across community leaders in health to create unprecedented alignment of goals and resources, as well as a strong community platform for advocacy. The work of the HIO CC has culminated in the completion of a Community Action Plan including Goals, Objectives and Strategies to address physical activity, nutrition, tobacco, and depression in Jackson County based on assessment and data-driven processes, as well as input from over 30 representatives from local health and human service agencies, and over 100 community stakeholders. The overarching tactics that the Community Action Plan relies upon include evidence-based activities to: Enhance media attention and public recognition of healthy lifestyle practices.Improve access to healthy foods and safe, attractive, affordable places for activity through supportive policies and physical environment changes. Provide social support and services that promote consistent screening, referral and supportive relationships for physical activity, nutrition, mental health and smoking behavior change.See Form 990, Schedule O, Program Service Accomplishments for more detail. Part VI, Line 6: The Hospital's sole corporate member is Allegiance Health Services, a 501(c)(3) organization. Other affiliates include a Foundation, a Hospice, a Long Term Acute Care Hospital (LTACH), a Volunteer Organization and a Home Health Care company, all 501(c)(3) organizations. Additionally, the Hospital recently formed a clinically integrated network.The Hospital, Hospice, LTACH and Home Health Care organization work together to provide necessary medical services to the Jackson Community. The Foundation and the Volunteer Organization work closely with Allegiance Health Services and the Hospital in raising funds for projects and services that would benefit the overall well-being of the community. The most recent campaign is raising funds for a Graduate Medical Education program. Previous campaigns successfully raised funds to expand and improve our cancer care service line and provided free medical care to indigent patients. The clinically intergrated network works to improve patient clinical outcomes thru coordinated care and lowering overall health care costs. 1 Center for Family Health 2298 Springport Road Jackson MI 49202 383251354 501(c)(3) 500000 0 N/A The Center for Family Health grant provides operational support for medically underserved populations. Healthlink 205 N East Avenue Jackson MI 49201 382756425 501(c)(3) 30000 0 N/A The Helping Hands Home Care grant supports respite care for families without the financial means to pay for needed assistance. United Way of Jackson County 536 North Jackson Street Jackson MI 49201 381368341 501(c)(3) 7000 0 N/A The Great Start grant supported collaborative network training for community partners on systems change. Enterprise Group of Jackson INC One Jackson Square Jackson MI 49201 383326101 501(c)(6) 25000 0 N/A Contribution to support the health and economic growth of Jackson County. 3 1 Part I, Line 2: The Organization sends out an award letter to all grantee recipents. The letter outlines what the funding may be used for and requests a final report detailing the year's activities. Further funding is contingent upon satisfactory completion of this report. X X 1 1 X X X X 1 1 0 0 0 0 0 1 0 Georgia Fojtasek President & CEO 624547 0 0 0 80196 0 48893 0 20206 0 773842 0 24480 0 John Mogerman Chief of Staff 70550 0 277766 0 2941 0 24413 0 24269 0 399939 0 0 0 Mohan Kulkarni Trustee 152735 0 0 0 0 0 0 0 0 0 152735 0 0 0 Karen Chaprnka SVP & COO 352567 0 0 0 64408 0 42966 0 12373 0 472314 0 42006 0 Jeanne' Wickens SVP & CFO 386908 0 0 0 53669 0 42086 0 25374 0 508037 0 34459 0 Richard Warren VP & CIO 226925 0 0 0 136142 0 40299 0 21191 0 424557 0 106859 0 Kenneth Empey General Counsel 234610 0 0 0 21643 0 34570 0 26797 0 317620 0 18226 0 Anthony Gardner VP Marketing 171655 0 0 0 10963 0 21182 0 9050 0 212850 0 9668 0 Beth Smith VP Organizational Excellence 184713 0 0 0 18447 0 19626 0 10760 0 233546 0 8889 0 Gerald Grannan VP Physician Integrationg & Planning 193186 0 0 0 1468 0 28742 0 3342 0 226738 0 0 0 Ray King Chief Medical Officer 347030 0 0 0 47765 0 37548 0 26536 0 458879 0 27169 0 Kevin Leonard VP Finance 127464 0 21000 0 6891 0 4625 0 5504 0 165484 0 0 0 Vishal Gupta Physician 34655 0 925731 0 18640 0 61172 0 27964 0 1068162 0 0 0 Ryan Beekman Physician 81965 0 781925 0 18220 0 66286 0 5398 0 953794 0 0 0 Shawn Obi Physician 35010 0 407672 0 205925 0 1913 0 7178 0 657698 0 0 0 Brian Daly Physician 94521 0 521885 0 26651 0 49540 0 22410 0 715007 0 0 0 Christopher Pfeifer Physician 43450 0 347973 0 231861 0 1913 0 22287 0 647484 0 0 0 Cheryl Lamborn VP Human Resources thru 11/12/12 0 0 9918 0 164545 0 0 0 0 0 174463 0 17801 0 Part I, Line 1a Georgia Fojtasek flew on a charter plane with a delegation of Michigan hospital delegates to a Regional Policy Board meeting. The hospital paid Georgia's proportionate charter flight cost. Allegiance Health provides a country club membership to two executives. The executives are Georgia Fojtasek and Karen Chaprnka. Executives reimburse the hospital for any personal use of the club. These benefits did not result in taxable compensation during FY 14. Part I, Line 3 The CEO is accountable for ensuring that Allegiance Health's mission is efficiently carried out with the highest levels of quality, safety and service, while at the same time ensuring that the organization is financially healthy. Executive compensation is reviewed annually by the Executive Compensation Committee of the Board of Trustees. This committee works with an independent compensation consultant to ensure that Allegiance Health compensation practices are consistent with industry standards and that compensation levels are fair compared to similar healthcare organizations nationally. The compensation consultant benchmarks Allegiance Health's positions against data from multiple published surveys of health care executive compensation in the national health care labor market. Based upon the consultants recommendations, the Executive Compensation Committee makes a recommendation to the Board of Trustees for approval of the executive compensation program. Only independent Trustees vote on this recommendation. Part I, Lines 4a-b The following former executives received severance payments in calendar year 2013. Cheryl Lamborn $146,744 Allegiance Health's officers and highest compensated employees participated in a non-qualified deferred compensation plan. The plan which began in 2005 partially vested for some executives in 2013. Payout of vested amounts resulted in an increase of salary for several executives. The calendar year 2013 contribution and payout amounts are as follows: 457(f) Contributions reported in Schedule J, Part II, column (C): Georgia Fojtasek $24,480, Karen Chaprnka $21,054, Jeanne Wickens $22,673, Ray King $20,635, Richard Warren $6,204, Kenneth Empey $13,496, Anthony Gardner $9,944, Gerald Grannan $9,921, Beth Smith $4,049, Kevin Leonard $4,625, George Hunter $5,743, Andrea Bates $5,014, Ryan Beekman $64,374, Vishal Gupta $59,260, Brian Daly $47,628, 457(f) Payouts reported in Schedule J, Part II, column B(iii): Georgia Fojtasek $48,984, Karen Chaprnka $42,006, Ray King $27,169 Jeanne Wickens $34,459, Richard Warren $113,138, Cheryl Lamborn $17,801, Anthony Gardner $9,668 Kenneth Empey $18,226, Beth Smith $14,436, Shawn Obi $205,226, Christopher Pfeifer $213,443 Part I, Line 7 Column B(ii) of Part II, Schedule J includes non-fixed payments to certain physicians based on their productivity and other performance metrics. A County of Jackson Hospital Finance Authority 386004845 467148EH1 2011-04-21 65375000 See Part VI - Supplemental Information 0 0 0 B County of Jackson Hospital Finance Authority 386004845 467148DC3 2010-11-02 140238036 See Part VI - Supplemental Information 0 0 0 A 65375000 540128 18425 64816447 2011 1 0 1 1 B 76436447 144799531 4811795 840059 495263 137792714 859700 2010 1 0 1 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 1 Royal Bank of Canada 25.000000000000 0 0 0 1 B 0 1 0 0 0 0 0 1 A 1 B 1 Part I, Line A, Column (f) Primarily to add marketability to underlying variable rates and refund Bonds. The Bonds refunded are as follows: $36,500,000 County of Jackson Hospital Finance Authority Variable Rate Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2011A were issued to refund the Series 2006A bonds. $28,875,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2011B were issued to refund the Series 2010 bonds. Part I, Line B, column (f) Primarily to obtain traditional fixed interest on bond debt at a time of low prevailing rates and to reissue and refund bonds. The bonds reissued and refunded are as follows: $29,925,000 County of Jackson Hospital Finance Authority Hospital Variable Rate Demand Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan), Series 2006B-1, reissued for tax purposes on 11/02/2010 $8,940,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan) Series 2006B-2, reissued for tax purposes on 11/02/2010 $47,400,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan) Series 2006C, reissued for tax purposes on 11/02/2010 $51,655,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2010A were issued to refund the Series 2007A and Series 1997A bonds. Part II, Line 3, Column B The difference of $4,679,592 between Part I, column (e) and Part II, Line 3 is due to net investment losses and investment income. Part IV, Line 6 No gross proceeds were invested beyond an available temporary period. The box is shown blank due to a software glitch that only allows the answer to be checked yes. Part V The organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program. These written procedures were established in fiscal year 2014. Patrick Nally Son of John Nally, Secretary/Treas of Allegiance Health Employee Recruitment Loan X 115000 115000 0 1 1 Mohan Kulkarni Trustee and Employee Physician Recruitment Loan X 79772 75661 0 1 1 Harish Rawal Former Trustee (Thru 04/01/13) Physician Recruitment Loan X 119235 90009 0 1 1 280670 Amy Schultz Daughter of Larry Schultz, Chairman of Allegiance Health 190103 Employee Wages 0 Patrick Nally Son of John Nally, Secretary/Treasurer of Allegiance Health 117740 Employee Wages 0 Pulmonary Clinics of Southern Michigan Gregg Patten, Director of Allegiance Health, is an officer of PCSM 2707608 Reported amount is payments Allegiance Health made to Pulmonary Clinics of Southern Michigan (PCSM) for medical services. 0 Clark & King Investments LLC Ray King, an Allegiance Health officer, is a partner in Clark & King 412029 Reported amount is for lease payments made by Allegiance Health to Clark & King Investments LLC (Clark & King) for a medical office building. 0 Ambs Call Center Aaron Boatin, an Allegiance Health Trustee, is an Ambs Call Center Officer. 125500 Reported amount is payments Allegiance Health made to Ambs Call Center for call center services. 0 Form 990, Part VI, Section A, line 6 The Corporation is organized on a membership basis. The sole corporate member of the Corporation is Allegiance Health Services. Form 990, Part VI, Section A, line 7a The sole Member of the organization may elect and remove, with or without cause, the Corporation's Trustees. Form 990, Part VI, Section A, line 7b The following powers are reserved for the sole corporate Member of the hospital. Approve any change in the Articles of Incorporation, purposes or philosophy of the Corporation; Approve changes in those provisions of the Corporation's Bylaws which affect the size, composition, and method of selection of the Board of Trustees, or which affect this Article; Approve plans of merger, consolidation or dissolution of the Corporation; Elect and remove, with or without cause, the Corporation's Trustees, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present; Approve guarantees by the Corporation of the debt of others in excess of maximum limits established by the Member, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present; Authorize the sale, lease, mortgage or other disposition of all or substantially all of the assets owned, held or leased by or to the Corporation, approve any decision by the Corporation which would have the net effect of diminution of governance control of the Member, and any decision by the Corporation which would have the net effect of diminution in the Corporation's governance control over it's own subsidiary; Ratify or reject operating and capital budgets developed by the Board and any non-budgetary expenditures or creations of debt in excess of an amount designated by the Member from time to time, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present; and Authorize the formation or acquisition of new subsidiaries of the Corporation or the sale or other disposition of existing subsidiaries. Form 990, Part VI, Section B, line 11 Form 990 is reviewed by the Organization's Director and VP of Finance, Chief Executive Officer, Chief Financial Officer, General Counsel, Compliance Officer and its public accounting firm. Final copies of the return are distributed to the Hospital's Board of Trustees before the return is e-filed. Form 990, Part VI, Section B, line 12c The Board Compliance Committee has ultimate responsibility over the enforcement of the Hospital's Conflict of Interest Policy. When a potential conflict of interest is identified, the Compliance Committee is responsible for review of the conflict of interest for compliance with the policy. Also, General Counsel routinely reviews upcoming Board and Committee meeting agendas to assess potential conflict situations. All employees are responsible to complete a conflict of interest statment. Trustees, directors, and key employees are required to fill out an annual conflict of interest questionnaire. Board Trustees identified as having a conflict of interest are permitted to discuss the potential transaction. They are not allowed to deliberate in the decision or vote on the matter. Form 990, Part VI, Section B, line 15 The Organization performs an annual review and assessment of the compensation of the Chief Executive Officer and each of the executives listed in Part VII of the Form 990. This review includes an independent compensation committee and the engagement of an independent compensation consultant. This process is usually undertaken during the Fall. The Compensation Committee, an independent committee of the Board of Trustees, is responsible for the executive compensation program. This committee performs an annual review of the competitiveness, reasonablenes and effectiveness of all executive cash compensation and benefit programs. The committee also leads the Board in evaluating the performance of the Chief Executive Officer and recommends all aspects of the Chief Executive Officer's compensation. The committee reviews the Chief Executive Officer's recommendations regarding the compensation of all other members of executive leadership. The Compensation Committee engages an independent compensation consulting firm to conduct a comprehensive market analysis of total compensation for executive leadership. This firm uses data representing compensation levels and practices from national not-for-profit healthcare markets as Allegiance Health typically competes in the the national healthcare marketplace for executive talent. National data also provides more comparable information for size and operational characteristics so that comparisons are made to organizations with similiar scope and complexity. Form 990, Part VI, Section C, line 19 Forms 1023, 990 and 990-T are available upon request. Form 990 and the Organization's conflict of interest policy are posted on the Organization's website. Form 990, Part VII, Section A, Line 1a Allegiance Health Trustees are not paid to serve on the Board. Compensation listed for Dr. David Halsey, Dr. Gregg Patten, Dr. Allan Tompkins, Dr. Mohan Kulkarni, and Dr. John Mogerman in Part VII of the Form 990 is pay for on call medical service, medical director fees, employment compensation, and/or committee participation. Form 990, Part IX, line 11g Professional Other: Program service expenses 33,154,371. Management and general expenses 7,818,395. Fundraising expenses 0. Total expenses 40,972,766. Non Employed Physician Services: Program service expenses 0. Management and general expenses 8,838,288. Fundraising expenses 0. Total expenses 8,838,288. Form 990, Part XI, line 9: Transfer to Parent -511,293. Change in Accounting for Pensions SFAS 158 7,606,270. Change in fair value of interest rate swap 8,436,035. Physicians Choice Network LLC 205 N East Avenue Jackson MI 49201 Provider Network MI 659 0 WA Foote Memorial Hospital Jackson Health Network L3C 205 N East Avenue Jackson MI 49201 453253643 Clinically Integrated Network MI -1648582 707643 WA Foote Memorial Hospital Allegiance Health Services 205 N East Avenue Jackson MI 49201 382756428 Exempt Health System MI 501(c)(3) Line 11b, II N/A 0 Allegiance Health Foundation 205 N East Avenue Jackson MI 49201 383607833 Supports Allegiance Health MI 501(c)(3) Line 11b, II Allegiance Health Services 1 Hospice of Jackson dba Allegiance Hospice 205 N East Avenue Jackson MI 49201 382336367 Hospice Care MI 501(c)(3) Line 7 Heathlink 1 The Hospice of Jackson Endowment Fund One Jackson Square Jackson MI 49201 383422146 Raise Funds for Allegiance Hospice MI 501(c)(3) Line 11c, III-FI Allegiance Hospice 1 Healthlink 205 N East Avenue Jackson MI 49201 382756425 Home Health Care MI 501(c)(3) Line 11a, I Allegiance Health Services 1 Allegiance Health Volunteers 205 N East Avenue Jackson MI 49201 386082835 Exempt Association MI 501(c)(3) Line 11d, III-O Allegiance Health Services 1 CareLink of Jackson 110 North Elm Avenue Jackson MI 49202 381218485 Long Term Acute Care Hospital MI 501(c)(3) Line 3 Allegiance Health Services 1 Jackson Community Medical Records 205 N East Avenue Jackson MI 49201 371502443 Electronic Medical Records MI WA Foote Memorial Hospital Related 410118 0 0 0.51000 Foote Health Center Associates 1100 E Michigan Avenue Jackson MI 49201 383017711 Lessor of Medical Condominiums MI WA Foote Memorial Hospital Related 121871 1011093 0 0 0.54430 Viking Health System Inc 205 N East Avenue Jackson MI 49201 382756161 Idle Healthcare Administration Corporation MI WA Foote Memorial Hospital C 1.00000 1 Cascades Insurance Company LTD 205 N East Avenue Jackson MI 49201 981132982 Hospital Malpractice Insurance Captive CJ WA Foote Memorial Hospital C 1715476 18151349 1.00000 1 Cascades Professional Staffing Corporation 205 N East Avenue Jackson MI 49201 383370242 Idle Staffing Corporation MI WA Foote Memorial Hospital C 1.00000 1 1 1 1 1 0 0 0 0 0 1 1 1 1 0 1 1 1 1 0 Foote Health Center Associates A 30000 FMV Allegiance Health Services R 511293 FMV Hospice of Jackson dba Allegiance Hospice J 419037 COST Hospice of Jackson dba Allegiance Hospice L 1243977 COST Hospice of Jackson dba Allegiance Hospice Q 984297 FMV Cascades Insurance Company LTD P 1902276 FMV Cascades Insurance Company LTD L 1941023 FMV Jackson Community Medical Records A 8056 FMV Jackson Community Medical Records A 58687 FMV Jackson Community Medical Records L 1987856 FMV Jackson Community Medical Records M 1948823 FMV Jackson Community Medical Records D 2412889 FMV Allegiance Health Foundation C 948932 FMV Healthlink K 618497 COST Healthlink D 531000 FMV CareLink of Jackson Q 4646937 COST CareLink of Jackson M 775459 FMV CareLink of Jackson K 218228 COST