2014-11-14T09:15:33-06:00 2013-12-31 861065772 DELOITTE TAX LLP 200 RENAISSANCE CENTER SUITE 3900 DETROIT MI 48243 990 2013-01-01 381405141 OAKWOOD HEALTHCARE INC OAKW 3135865052 15500 LUNDY PARKWAY DEARBORN MI 48126 JOHN KEUTEN SVP AND CFO 3135865052 2014-11-14 1 LORI BOYCE P00121981 3133963000 2013 2015-11-30 17:44:51Z JOHN KEUTEN 15500 LUNDY PARKWAY DEARBORN MI 48126 1674975972 0 X WWW.OAKWOOD.ORG X 1948 MI PROVIDE EXCELLENCE IN CARE, HEALING AND HEALTH TO THE INDIVIDUALS AND COMMUNITIES WE SERVE. 20 17 10004 1315 13084004 288469 6144190 5926298 1189722682 1155861675 15882524 22583183 3498259 3410539 1215247655 1187781695 15786732 16286449 0 0 543548537 537407377 0 0 464463 616996455 593108461 1176331724 1146802287 38915931 40979408 1083828738 1119730666 749860874 657044332 333967864 462686334 X PROVIDE EXCELLENCE IN CARE, HEALING AND HEALTH TO THE INDIVIDUALS AND COMMUNITIES WE SERVE. 0 0 599670086 3367951 906975989 PATIENT CARE SERVICES OAKWOOD HEALTHCARE SYSTEM (OHS) OPERATES 4 ACUTE CARE HOSPITALS AND 65 OUTPATIENT CARE SITES SERVING 30 COMMUNITIES. WITH 1,243 LICENSED ACUTE CARE BEDS, OAKWOOD CARED FOR APPROXIMATELY 54,250 ADMISSIONS AND AVERAGED A DAILY INPATIENT CENSUS OF 728 PATIENTS IN 2013. OHS PERFORMED ABOUT 14,700 INPATIENT SURGERIES AND 43,400 OUTPATIENT SURGERIES OF WHICH 461 WERE OPEN HEART. WITH ALMOST 193,500 EMERGENCY ROOM VISITS ACROSS FIVE LOCATIONS AND 235,800 ACUTE CARE OUTPATIENT REGISTRATIONS, OAKWOOD OFFERS A COMPREHENSIVE MENU OF SERVICES ACROSS THE CONTINUUM, INCLUDING TRAUMA, ACUTE CARE, REHABILITATION AND MENTAL HEALTH SERVICES. OAKWOOD CURRENTLY HOLDS APPROXIMATELY 38.2% OF THE INPATIENT MARKET SHARE IN A PRIMARY SERVICE AREA COVERING 500 SQUARE MILES SERVING A POPULATION OF ALMOST 1 MILLION PEOPLE. OAKWOOD CLINICIANS DELIVER EVIDENCE BASED CARE USING PROTOCOLS AND STANDARD ORDER SETS AND WAS THE FIRST SYSTEM IN SOUTHEASTERN MICHIGAN TO VOLUNTARILY PROVIDE QUALITY AND PRICING INFORMATION ON ITS WEBSITE. OAKWOOD HAS DEVELOPED A SET OF KEY SERVICE LINES THAT REPRESENT NEARLY 43% OF THE INPATIENT ADMISSIONS. THE SERVICE LINES FOCUS ON HEART AND VASCULAR SERVICES, WOMEN'S HEALTH, ORTHOPEDICS, NEUROSCIENCES AND CANCER CARE. 69274404 12918498 37484436 GRADUATE MEDICAL EDUCATIONOAKWOOD OFFERS ALLOPATHIC, OSTEOPATHIC AND PODIATRIC MEDICAL RESIDENCY PROGRAMS TO ENHANCE THE DELIVERY OF PATIENT CARE. THERE ARE APPROXIMATELY 60 FACULTY AND OVER 260 MEDICAL RESIDENTS COVERING 23 PROGRAMS. PROGRAMS INCLUDE PRIMARY CARE SPECIALTIES, OB/GYN, GERIATRICS, RADIOLOGY, PODIATRY, TRANSITIONAL EDUCATION, OPHTHALMOLOGY AND OTHERS. OAKWOOD PARTICIPATES IN WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE (WSU SOM) SPONSORED PROGRAMS INCLUDING OTOLARYNGOLOGY, UROLOGY, DERMATOLOGY, PHYSICAL MEDICINE AND REHABILITATION AND ORTHOPEDICS RESIDENCY PROGRAMS. ALL OF THE ALLOPATHIC RESIDENCY PROGRAMS ARE AFFILIATED WITH THE NATIONALLY RANKED WSU SOM. THE OSTEOPATHIC PROGRAMS ARE AFFILIATED WITH MICHIGAN STATE UNIVERSITY'S COLLEGE OF OSTEOPATHIC MEDICINE. THE RESIDENCY PROGRAMS HAVE FILLED NEARLY 100% OF THEIR SLOTS OFFERED IN THE MATCH OVER THE LAST 3 YEARS AND HAVE GRADUATING CLASSES WITH NEAR 100% BOARD PASS RATES. THE SYSTEM PARTICIPATED IN APPROXIMATELY 100 CLINICAL TRIALS AND WAS ACTIVE IN ORIGINAL RESEARCH. OAKWOOD'S MEDICAL EDUCATION PROGRAMS ARE ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION AND THE AMERICAN OSTEOPATHIC ASSOCIATION. 255790261 158190888 UNCOMPENSATED AND UNDER-COMPENSATED CARE SERVICESOAKWOOD'S UNCOMPENSATED CARE FOR OUR COMMUNITIES IS EXEMPLIFIED BY CARE PROVIDED TO PERSONS NEEDING EMERGENCY AND INPATIENT CARE AS WELL AS OTHER SERVICES. OAKWOOD DELIVERED PATIENT CARE SERVICES TO OUR COMMUNITY'S UN-INSURED AND UNDER-INSURED THROUGH OUR CHARITY CARE (OAK ASSIST) PROGRAM. OAKWOOD WROTE OFF APPROXIMATELY 24,600 CASES AT AN ESTIMATED $61.4 MILLION IN CHARGES AT A COST OF $15.8 MILLION TO CHARITY CARE IN 2013. FEDERAL POVERTY GUIDELINES, ABSENCE OF ASSETS, CREDIT SCORES AND A NUMBER OF OTHER CRITERIA ARE USED TO ENSURE THAT OAKWOOD PROVIDES THE CARE TO THE MOST DESERVING OF OUR POPULATION. ANOTHER COMPONENT TO OAKWOOD'S TOTAL UNCOMPENSATED CARE IS COMPRISED OF BAD DEBT AND LOSSES INCURRED ON OUR MEDICAID BOOK OF BUSINESS. IN 2013, OAKWOOD WROTE OFF APPROXIMATELY $92.5 MILLION IN BAD DEBT AT A COST OF APPROXIMATELY $26.3 MILLION. IN ADDITION, 18.6% OF OAKWOOD'S PATIENT REVENUE IS FROM THE MEDICAID PROGRAMS. UNFORTUNATELY, MEDICAID REIMBURSEMENT IS INSUFFICIENT TO COVER COSTS OF THE CARE AND FALLS ABOUT $55 MILLION SHORT. IN TOTAL, OAKWOOD PROVIDED ALMOST $255.8 MILLION (GROSS CHARGES) IN UNCOMPENSATED CARE IN 2013. 924734751 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 1 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 894 0 1 10004 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 20 17 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MI X MATT ELSEY 3135865052 15500 LUNDY PARKWAY DEARBORN MI 48126 LEWIS JOHN CHAIRPERSON 1.00 0.00 X X 0 0 0 CONNOLLY BRIAN PRESIDENT & CEO 40.00 10.00 X X 1961046 0 336892 HENOCH MALCOLM MD SVP & CMO 40.00 0.00 X 585598 0 100224 ARDISANA LIZABETH TRUSTEE 1.00 0.00 X 0 0 0 FREAM JULIE TRUSTEE 1.00 1.00 X 0 0 0 HALL RONALD JR TRUSTEE 1.00 0.00 X 0 0 0 JUDD LEON TRUSTEE 1.00 1.00 X 0 0 0 KRAMER ROBERT TRUSTEE 1.00 1.00 X 0 0 0 KUMAR NEELAM MD TRUSTEE 1.00 1.00 X 13093 0 0 MULLOY MARTIN TRUSTEE 1.00 0.00 X 0 0 0 NORCIA JERRY TRUSTEE 1.00 0.00 X 0 0 0 O'BRIEN TIMOTHY TRUSTEE 1.00 0.00 X 0 0 0 PRASAD PINNAMANENI MD TRUSTEE 1.00 0.00 X 0 0 0 RASHID CARL TRUSTEE 1.00 0.00 X 0 0 0 ROSOWSKI ROBERT TRUSTEE 1.00 1.00 X 0 0 0 ROSS MICHAEL TRUSTEE 1.00 1.00 X 0 0 0 SAELI THOMAS TRUSTEE 1.00 0.00 X 0 0 0 SCRIBNER EDGAR TRUSTEE 1.00 0.00 X 0 0 0 KUGHN RICHARD TRUSTEE 1.00 1.00 X 0 0 0 SETTY A BALA TRUSTEE 1.00 0.00 X 0 0 0 LLOYD SETH SECRETARY, SVP/CORPORATE COUNSEL 40.00 3.00 X 392360 0 18263 KEUTEN JOHN SVP & CFO 31.00 24.00 X 565017 0 82133 CAMPBELL DAVID EVP OPS. SYS. STRAT. & GROWTH 50.00 1.00 X 470268 0 88285 CONWAY PAUL SVP HUMAN RESOURCES 50.00 0.00 X 370189 0 69148 D'AGOSTINO MAUREEN SVP ORGANIZ. EXCELLENCE 50.00 0.00 X 290186 0 72949 GEHEB MICHAEL EVP PHYS. PLAN & OPS. 50.00 1.00 X 741015 0 122045 HUGHES EDITH SITE PRESIDENT 50.00 0.00 X 372817 0 50039 ISENSTEIN BILL SVP MANAGED CARE 50.00 0.00 X 444448 0 41042 MEDVEC BARBARA SVP, CHIEF NURSING OFFICER 45.00 7.00 X 374270 0 57595 ODOM LEE ANN SITE PRESIDENT 50.00 0.00 X 228760 0 22613 O'MALLEY CARLA EXECUTIVE DIRECTOR FOUNDATION 1.00 40.00 X 364910 0 99553 SMITH KELLY SVP & SITE PRESIDENT 50.00 0.00 X 367142 0 67147 SMITH PAULA SVP & CHIEF INFORMATION OFFICER 50.00 0.00 X 477397 0 100273 WELDAY DOUGLAS EVP 43.00 12.00 X 843579 0 178045 WIDNER ERIC SITE PRESIDENT 50.00 0.00 X 323161 0 42952 ZATINA MARY SVP GOVERNMENT RELATIONS 50.00 0.00 X 350489 0 63947 DABIR REZA R STAFF PHYSICIAN 50.00 0.00 X 676033 0 20579 FATH JOHN JOSEPH STAFF PHYSICIAN 50.00 0.00 X 689624 0 32581 JUNN FREDRICK SONG CHUN STAFF PHYSICIAN 50.00 0.00 X 1466127 0 39760 PANNU TEJPAUL SINGH STAFF PHYSICIAN 50.00 0.00 X 822592 0 39595 SPRAGUE KEVIN JOSEPH STAFF PHYSICIAN 50.00 0.00 X 793895 0 21252 DIEDERICH JOSEPH FORMER OFFICER 0.00 0.00 X 138396 0 0 14122412 0 1766912 587 1 1 0 DELL USA LP PO BOX 676044 DALLAS TX 752676044 BILLING SOLUTIONS/OFFICE MANAGEMENT 25161179 CARETECH SOLUTIONS INC 901 WILSHIRE DR SUITE 250 TROY MI 48048 INFORMATION TECHNOLOGY SERVICES 22678478 WAYNE STATE UNIVERSITY 540 E CANFIELD DETROIT MI 48201 MEDICAL RESIDENT FEES 8887205 GEORGE MCINTOSH INC 3040 HILTON RD FERNDALE MI 48220 CONSTRUCTION MANAGEMENT 8413108 MORRISON MANAGEMENT SPECIALISTS INC 5801 PEACHTREE DUNWOODY RD ATLANTA GA 30342 FOOD/RETAIL SERVICES 7716896 208 4264532 765516 896250 5926298 PATIENT CARE SERVICES 622110 1118377239 1064152290 12840158 41384791 GRADUATE MEDICAL EDU. 900099 37484436 37484436 1155861675 11339493 206758 11132735 1083584 1136527 -52943 -52943 -90031 37088 496843431 458009 485873830 183920 10969601 274089 11243690 11243690 CAFETERIA REVENUE 722514 1030428 1030428 GIFT SHOP 900099 852400 852400 CHILD CARE 453220 339450 339450 1241204 1104618 136586 3463482 1187781695 1102651313 13084004 66120080 X 3183375 3183375 13103074 13103074 11117622 223537 10429622 464463 138396 138396 443210398 359857626 83352772 24671043 19572484 5098559 26019254 20737462 5281792 32250664 25585688 6664976 7410883 2096907 5313976 2222972 2222972 572892 572892 98336 98336 1235569 1235569 118217132 81277456 36939676 3609432 322963 3286469 11624736 3930482 7694254 18980172 10010633 8969539 41126844 34567235 6559609 1274015 467159 806856 893252 536289 356963 14004607 14004607 56953603 39926573 17027030 7464780 6375588 1089192 MEDICAL SUPPLIES 110447108 110447108 BAD DEBT 92446552 92446552 PHARMACEUTICALS 46774078 46774078 EQUIPMENT RENTAL & MAIN 31911248 18974336 12936912 25840250 20313539 5526711 1146802287 924734751 221603073 464463 547289 -618432 26955473 24301525 112716351 101681168 12586837 9992502 12337371 12867578 8628336 8153009 1080896219 751214985 330804181 329681234 344000249 381035134 36637134 36802327 13010461 15210461 185605056 200624160 1083828738 1119730666 121220061 117819080 3362288 3846426 289225117 280682932 41070775 31249231 294982633 223446663 749860874 657044332 X 333967864 462686334 0 0 333967864 462686334 1083828738 1119730666 X 40979408 27205599 60533463 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 32593 0 1 65743 98336 0 PART II-B, LINE 1: OAKWOOD HEALTHCARE, INC. ENGAGES OUTSIDE CONSULTANTS TO CONDUCT STATE AND FEDERAL LOBBYING ACTIVITIES ON MATTERS PERTAINING TO NON-PROFIT HEALTHCARE. ALSO, THE COMPANY (ALONG WITH THE VAST MAJORITY OF HOSPITALS LOCATED IN THE STATE OF MICHIGAN) PAYS ANNUAL DUES TO THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION, A PORTION OF WHICH PERTAINS TO LOBBYING ACTIVITIES CONDUCTED BY THAT ORGANIZATION. 19695737 792571 3310579 184576 -345071 23959382 16445484 795005 1723128 138317 -870437 19695737 15028139 877025 150293 123936 -513963 16445484 13622220 252570 1467421 94773 219299 15028139 11979183 253884 1954301 109800 455348 13622220 0.59000 0.41000 0.00000 0 1 1 26813167 26813167 299685349 212040752 87644597 16960095 9606910 7353185 551796633 411435862 140360771 185640975 118131461 67509514 329681234 DEFERRED BOND ISSUE COSTS 2414394 DUE FROM (TO) AFFILIATES 132683473 MISC. RECEIVABLES 6745340 PROFESSIONAL LIABILITY EXCESS 12152388 CAPITAL LEASE 46628565 200624160 ACCRUED COMPENSATION 15431432 CLAIMS LIABILITY 62857343 WORKERS COMPENSATION 2032011 ASSET RETIREMENT OBLIGATION 577881 ACCRUED PENSION 80596980 DUE TO THIRD PARTY PAYORS 15322451 OTHER 46628565 223446663 X PART V, LINE 4: OAKWOOD HEALTHCARE FOUNDATION MAINTAINS ENDOWMENT FUNDS ON BEHALF OF OAKWOOD HEALTHCARE, INC. THE INTENDED USE OF OAKWOOD HEALTHCARE FOUNDATION'S ENDOWMENT FUNDS IS TO PROVIDE FUNDS TO SUPPORT THE MISSION AND VISION OF THE OAKWOOD HEALTHCARE SYSTEM. OAKWOOD HEALTHCARE FOUNDATION PROVIDES FUNDING FOR ONGOING CAPITAL AND OPERATIONAL NEEDS, COMMUNITY OUTREACH PROGRAMS, SCHOLARSHIPS AND EDUCATION. PART X, LINE 2: THE COMPANY ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. ACCORDINGLY, OHI HAS REVIEWED ALL TAX POSITIONS, EVALUATED POTENTIAL EXPOSURE, AND FOUND IT NOT TO BE MATERIAL. CENTRAL AMERICA & THE CARIBBEAN 0 1 INVESTMENTS 120000 0 1 0 0 0 1 120000 0 120000 0 0 1 0 0 0 1 1 X 1 X 1 X 1 1 0 1 1 24651 17770 18997255 417977 18579278 0.01380 301173 151062 213178627 158190888 54987739 0.04100 0 0 0 0 325824 168832 232175882 158608865 73567017 0.05480 1255 188141 7091437 4058710 3032727 0.00230 25 1789 70273004 37484436 32788568 0.02440 4000755 2385011 1615744 0.00120 1162046 342715 819331 0.00060 92 126489 0 126489 0.00010 1280 190022 82653731 44270872 38382859 0.02860 327104 358854 314829613 202879737 111949876 0.08340 6 79 467223 278169 189054 0.00010 6 79 467223 278169 189054 0.00010 1 26344693 96510 422526254 464365391 -41839137 X 1 1 1 SLEEP APNEA SPECIALTY CENTER-RIVERVIEW LLC SLEEP APNEA TESTING AND TREATMENT 0.30580 0.00000 0.44630 2 OAKLANE MEDICAL SUITES INC MEDICAL FACILITY 0.76100 0.00000 0.23900 3 OAKWOOD ACCOUNTABLE CARE ORGANIZATION REDUCE HEALTHCARE COSTS AND MANAGE POPULATION WELLNESS 0.49000 0.00300 0.51000 4 1 OAKWOOD HOSPITAL & MEDICAL CENTER 18101 OAKWOOD BLVD DEARBORN MI 481244089 WWW.OAKWOOD.ORG L2280773 X X X X X A 2 OAKWOOD SOUTHSHORE MEDICAL CENTER 5450 FORT STREET TRENTON MI 481834625 WWW.OAKWOOD.ORG L2307184 X X X X A 3 OAKWOOD ANNAPOLIS HOSPITAL 33155 ANNAPOLIS WAYNE MI 481842493 WWW.OAKWOOD.ORG L2554579 X X X X A 4 OAKWOOD HERITAGE HOSPITAL 10000 TELEGRAPH TAYLOR MI 481803349 WWW.OAKWOOD.ORG L2558464 X X X X A FACILITY REPORTING GROUP - A 1 X X X X X X X X X X 13 1 1 1 X WWW.OAKWOOD.ORG/CHNA X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X X X 1 1 X X 1 0 X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: OAKWOOD HOSPITAL & MEDICAL CENTER, - FACILITY 2: OAKWOOD SOUTHSHORE MEDICAL CENTER, - FACILITY 3: OAKWOOD ANNAPOLIS HOSPITAL, - FACILITY 4: OAKWOOD HERITAGE HOSPITAL FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 1J: CHNA REGULATION REQUIRES EACH HOSPITAL TO DEFINE THEIR "COMMUNITY SERVED" FOR THE PURPOSES OF THE ASSESSMENT. THE OAKWOOD HEALTHCARE HOSPITAL COMMUNITIES ARE DEFINED AS ZIP CODES THAT COMPRISE 80% OF INPATIENT DISCHARGES AND ARE CONTIGUOUS. THE OVERALL OAKWOOD HEALTHCARE COMMUNITY IS THE AGGREGATE OF EACH HOSPITAL'S COMMUNITY. IT IS IMPORTANT TO NOTE THAT INDIVIDUAL HOSPITAL COMMUNITIES OVERLAP. OAKWOOD HEALTHCARE HOSPITALS ARE LOCATED IN WAYNE COUNTY, MICHIGAN, AND THE COMMUNITY THEY SERVE CONSISTS OF ZIP CODES IN WAYNE COUNTY WITH SOME OVERLAP INTO NORTHEASTERN MONROE COUNTY, MICHIGAN. OAKWOOD HEALTHCARE APPROACHED THE CHNA PROCESS AS A COLLABORATIVE EFFORT BETWEEN THEIR HOSPITALS BUT ALSO INCLUDED INFORMATION SPECIFIC TO EACH HOSPITAL COMMUNITY WHERE THE DATA COLLECTION WAS ABLE TO PROVIDE HOSPITAL COMMUNITY SPECIFIC INFORMATION. TO ASSESS HEALTH NEEDS OF THE OAKWOOD HEALTHCARE COMMUNITIES, A QUANTITATIVE AND QUALITATIVE APPROACH WAS USED. IN ADDITION TO COLLECTING DATA FROM A NUMBER OF PUBLIC SOURCES AND TRUVEN HEALTH PROPRIETARY SOURCES, INTERVIEWS (BOTH IN-PERSON AND TELEPHONE) AND FOCUS GROUPS WERE CONDUCTED WITH INDIVIDUALS REPRESENTING COMMUNITY LEADERS/GROUPS, PUBLIC ORGANIZATIONS, PATIENTS, PROVIDERS, AND OAKWOOD HEALTHCARE REPRESENTATIVES FROM THE HOSPITAL AND CORPORATE LEVELS. IN ADDITION TO THE QUALITATIVE FEEDBACK, QUANTITATIVE HEALTH INDICATORS WERE COLLECTED AND ANALYZED TO ASSESS COMMUNITY HEALTH NEEDS. ONE HUNDRED-SIX INDICATORS WERE EVALUATED FOR EACH OF THE COUNTIES OR TOWNS (DEPENDING ON LEVEL OF DATA AVAILABLE) IN THE OAKWOOD HEALTHCARE COMMUNITY SERVED. SUPPLEMENTED HEALTH INDICATOR DATA WITH ZIP CODE ESTIMATES (COMMUNITY NEEDS INDEX) WERE USED TO IDENTIFY SPECIFIC POPULATIONS WITHIN A COMMUNITY WHERE HEALTH NEEDS MAY BE GREATER. FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 3: TO TAKE INTO ACCOUNT THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, TRUVEN HEALTH CONDUCTED INTERVIEWS (BOTH ONE-ON-ONE AND IN SMALL GROUPS) AS WELL AS FOCUS GROUPS IN FEBRUARY 2013. THE INTERVIEW QUESTIONNAIRE WAS DESIGNED TO UNDERSTAND HOW PARTICIPANTS FEEL ABOUT THE GENERAL HEALTH STATUS OF THE COMMUNITY AND THE VARIOUS DRIVERS CONTRIBUTING TO HEALTH ISSUES. FORTY-SIX INTERVIEWS WERE COMPLETED FOR THE CHNA PROCESS FOR OAKWOOD HEALTHCARE, INC. INDIVIDUALS WERE GROUPED INTO THE FOLLOWING CATEGORIES TO ENSURE BROAD PARTICIPATION: COMMUNITY LEADERS/GROUPS, PUBLIC HEALTH AND OTHER HEALTH-CARE ORGANIZATIONS, OTHER PROVIDERS (INCLUDING PHYSICIANS), AND OAKWOOD HEALTHCARE REPRESENTATIVES (CORPORATE AND HOSPITAL). FIVE FOCUS GROUPS WERE ALSO CONDUCTED TO SOLICIT FEEDBACK FROM COMMUNITY MEMBERS. FOCUS GROUPS WERE DESIGNED TO FAMILIARIZE COMMUNITY MEMBERS WITH THE CHNA PROCESS AND GAIN A BETTER UNDERSTANDING OF THE COMMUNITY'S PERSPECTIVE OF SIGNIFICANT HEALTH NEEDS. FOCUS GROUPS WERE FORMATTED FOR INDIVIDUAL AS WELL AS SMALL-GROUP FEEDBACK; THESE FOCUS GROUPS ALSO HELPED IDENTIFY OTHER COMMUNITY ORGANIZATIONS ALREADY ADDRESSING HEALTH NEEDS IN THE COMMUNITY. FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 4: OAKWOOD HOSPITAL & MEDICAL CENTER'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:- OAKWOOD ANNAPOLIS HOSPITAL (OAH)- OAKWOOD HERITAGE HOSPITAL (OHH)- OAKWOOD SOUTHSHORE MEDICAL CENTER (OSMC) FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 5D: IN ADDITION TO THE POSTING OF THE CHNA ON THE OAKWOOD WEBSITE, THE CHNA REPORT WAS SENT TO ALL OF THE ORGANIZATIONS THAT PARTICIPATED IN THE INTERVIEWS AND FOCUS GROUPS. THE CHNA WAS ALSO SHARED THROUGH COMMUNITY PRESENTATIONS AND WITH COMMUNITY PARTNERS. FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 7: THE HOSPITALS PRIORITIZED THE SIGNIFICANT HEALTH CARE NEEDS BASED ON THE FOLLOWING CRITERIA WITH AN UNDERLYING FOUNDATIONAL PURPOSE OF SERVING VULNERABLE POPULATIONS: MAGNITUDE OF THE NEED, SEVERITY OF THE NEED, ALIGNMENT OF THE PROBLEM WITH ORGANIZATIONAL STRENGTHS, EXISTING RESOURCES, AND ABILITY TO MEASURE CHANGE. THE FOLLOWING WERE DETERMINED NOT TO BE INCLUDED IN THE IMPLEMENTATION PLAN BASED ON THE ABOVE CRITERIA: MENTAL HEALTH, MATERNAL HEALTH, ENVIRONMENTAL ISSUES AND SOCIOECONOMIC ISSUES. WHILE EACH OF THESE NEEDS ARE IMPORTANT, OAKWOOD WILL CONTINUE TO ADDRESS THESE NEEDS IN EXISTING PROGRAMS OR WITH OAKWOOD PARTNER ORGANIZATIONS. FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 12I: ALL SELF-PAY PATIENTS ARE BILLED FULL CHARGES AND THEN THE CHARGES ARE REDUCED PER OUR FINANCIAL ASSISTANCE POLICY. ALL SELF-PAY, UNINSURED PATIENTS RECEIVE, AT A MINIMUM, A 45% DISCOUNT OFF OF FULL CHARGES WITHOUT HAVING TO SUBMIT A FORMAL APPLICATION FOR OR INQUIRE ABOUT FINANCIAL ASSISTANCE. THE MINIMUM DISCOUNT PERCENTAGE IS UPDATED ANNUALLY BASED ON AVERAGE PAYMENT RATES FROM COMMERCIAL PAYORS. OAKWOOD ATTEMPTS TO SCREEN ALL SELF-PAY PATIENTS UPON SCHEDULING THROUGH CENTRAL SCHEDULING, WHILE ACCESSING CARE THROUGH OUR EMERGENCY DEPARTMENTS, AND UPON INPATIENT ADMISSION INTO OUR HOSPITALS. OAKASSIST FINANCIAL COUNSELORS GATHER INFORMATION ON THE PATIENT'S OVERALL FINANCIAL SITUATION. PATIENTS APPLYING FOR AN ADDITIONAL LEVEL OF DISCOUNT OR APPLYING FOR A CATASTROPHIC MEDICAL DEBT DISCOUNT NEED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION FORM OR REQUEST A DETERMINATION AS TO WHETHER OR NOT A THEY QUALIFY FOR FREE OR DISCOUNTED CARE. SELF-PAY DISCOUNTS ARE BASED UPON THE FOLLOWING:1) FEDERAL POVERTY GUIDELINES/INCOME LEVEL2) EARNING CAPACITY3) EMPLOYMENT STATUS 4) ASSETS5) INSURANCE STATUS AND THE POSSIBILITY OF QUALIFYING FOR SOME FORM OF GOVERNMENT ASSISTANCE OR SOURCE OF COVERAGE FOR UNINSURED PATIENT6) THE LEVEL OF SELF PAY DISCOUNTING CURRENTLY BEING OFFERED THROUGH THE FINANCIAL ASSISTANCE POLICY. FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 14G: THE ORGANIZATION'S WEBSITE DIRECTS PATIENTS TO CONTACT OUR OAKASSIST FINANCIAL COUNSELORS FOR ASSISTANCE AND PROVIDES SUMMARY LEVEL INFORMATION ON THE TYPES AND ELIGIBILITY REQUIREMENTS OF FINANCIAL ASSISTANCE AVAILABLE. FINANCIAL ASSISTANCE INFORMATION IS INCLUDED IN OUR ADMISSION PACKETS AND IS MADE AVAILABLE TO ALL HOSPITAL INPATIENTS THAT CONTAIN THE TELEPHONE NUMBER DIRECTLY TO OAKWOOD'S FINANCIAL COUNSELORS. OUR PATIENT STATEMENTS INCLUDE A BOLD STATEMENT INDICATING "FINANCIAL ASSISTANCE AVAILABLE" AND THERE IS A NOTICE TO PATIENTS, ON THE STATEMENT, AS FOLLOWS: "IF YOU CANNOT PAY THIS BALANCE IN FULL, PLEASE CALL A CUSTOMER SERVICE REPRESENTATIVE AS SOON AS POSSIBLE AT THE NUMBERS LISTED BELOW TO DISCUSS OTHER OPTIONS. MONTHLY PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE TO THOSE WHO QUALIFY." THE TELEPHONE NUMBER FOR CUSTOMER SERVICE IS LISTED AND OAKWOOD'S WEBSITE ADDRESS. THERE ARE POSTINGS NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND THE CONTACT INFORMATION TO OBTAIN FINANCIAL ASSISTANCE IS POSTED IN OUR EMERGENCY DEPARTMENTS AND HOSPITAL REGISTRATION/PATIENT ACCESS AREAS. THE POLICY WAS MADE AVAILABLE TO PATIENTS UPON REQUEST. FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 18E: THE HOSPITAL ROUTES ALL SELF PAY INPATIENTS AND EMERGENCY PATIENTS TO OUR OAKASSIST FINANCIAL COUNSELORS WHO ASSESS THE PATIENTS FOR ELIGIBILITY UNDER OUR FINANCIAL ASSISTANCE POLICY. IN ADDITION, SELF PAY PATIENTS, SCHEDULED THROUGH OUR CENTRAL SCHEDULING DEPARTMENT, ARE ALSO ROUTED THROUGH OUR FINANCIAL CLEARANCE CENTER AND, IF DEEMED ELIGIBLE OR A DETERMINATION CANNOT BE MADE, THE PATIENT IS ROUTED TO OUR OAKASSIST FINANCIAL COUNSELORS FOR FURTHER SCREENING. PATIENTS ARE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING THEIR INPATIENT STAY THROUGH A SECTION OF THE ADMISSION PACKET WHERE PATIENTS WHO ARE CONCERNED ABOUT THEIR FINANCIAL RESPONSIBILITY CAN SPEAK TO FINANCIAL COUNSELORS FOR OPTIONS TO ASSIST THEM WITH PAYMENTS. THERE ARE POSTINGS IN THE EMERGENCY DEPARTMENTS AND MAIN REGISTRATION/PATIENT ACCESS AREAS INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE. PATIENTS ARE ALSO PROVIDED INFORMATION ABOUT HOW TO ACCESS OAKWOOD PROGRAMS AND HOW TO CONTACT OUR FINANCIAL COUNSELORS FOR MORE INFORMATION AND ASSISTANCE. PATIENTS ARE ALSO NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ON THE MONTHLY PATIENT STATEMENTS WHICH INCLUDES WEBSITE AND TELEPHONE CONTACT INFORMATION. IN ADDITION, THE UNINSURED ARE PROVIDED A SELF-PAY DISCOUNT BASED ON AVERAGE COMMERCIAL PAYMENT RATES WITHOUT A FORMAL REQUEST FOR FINANCIAL ASSISTANCE. INFORMATION ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IS AVAILABLE ON OUR WEBSITE AND TELEPHONE CONTACT DATA REGARDING FINANCIAL ASSISTANCE OPTIONS IS LISTED ON OUR WEBSITE. PRIOR TO SENDING PATIENT PAY ACCOUNTS TO OUR EXTERNAL COLLECTION AGENCY, OUR EXTERNAL CUSTOMER SERVICE VENDOR PROCESSES THE ACCOUNTS THROUGH THEIR PROPRIETARY "PROPENSITY TO PAY" MODEL AND ASSIGNS A "PROPENSITY TO PAY SCORE" ON EACH ACCOUNT. PER OAKWOOD POLICY, THOSE PATIENT ACCOUNTS SCORED AT 650 OR LESS, WITH NO INSURANCE INFORMATION ATTACHED, AN OUTSTANDING BALANCE OF $100.00 OR MORE, AND CONTAINING DEMOGRAPHIC INFORMATION INDICATING MICHIGAN RESIDENCY ARE AUTOMATICALLY ADJUSTED OFF TO CHARITY CARE WITHOUT A FORMAL APPLICATION PROCESS. ALL OF THESE EFFORTS ARE MADE PRIOR TO INITIATING ANY COLLECTION ACTIONS. FACILITY 1 -- OAKWOOD HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 20D: A DISCOUNT OF 45 PERCENT WAS DERIVED BY CALCULATING AN AVERAGE OF OUR COMMERCIAL DISCOUNTS. FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 1J: CHNA REGULATION REQUIRES EACH HOSPITAL TO DEFINE THEIR "COMMUNITY SERVED" FOR THE PURPOSES OF THE ASSESSMENT. THE OAKWOOD HEALTHCARE HOSPITAL COMMUNITIES ARE DEFINED AS ZIP CODES THAT COMPRISE 80% OF INPATIENT DISCHARGES AND ARE CONTIGUOUS. THE OVERALL OAKWOOD HEALTHCARE COMMUNITY IS THE AGGREGATE OF EACH HOSPITAL'S COMMUNITY. IT IS IMPORTANT TO NOTE THAT INDIVIDUAL HOSPITAL COMMUNITIES OVERLAP. OAKWOOD HEALTHCARE HOSPITALS ARE LOCATED IN WAYNE COUNTY, MICHIGAN, AND THE COMMUNITY THEY SERVE CONSISTS OF ZIP CODES IN WAYNE COUNTY WITH SOME OVERLAP INTO NORTHEASTERN MONROE COUNTY, MICHIGAN. OAKWOOD HEALTHCARE APPROACHED THE CHNA PROCESS AS A COLLABORATIVE EFFORT BETWEEN THEIR HOSPITALS BUT ALSO INCLUDED INFORMATION SPECIFIC TO EACH HOSPITAL COMMUNITY WHERE THE DATA COLLECTION WAS ABLE TO PROVIDE HOSPITAL COMMUNITY SPECIFIC INFORMATION. TO ASSESS HEALTH NEEDS OF THE OAKWOOD HEALTHCARE COMMUNITIES, A QUANTITATIVE AND QUALITATIVE APPROACH WAS USED. IN ADDITION TO COLLECTING DATA FROM A NUMBER OF PUBLIC SOURCES AND TRUVEN HEALTH PROPRIETARY SOURCES, INTERVIEWS (BOTH IN-PERSON AND TELEPHONE) AND FOCUS GROUPS WERE CONDUCTED WITH INDIVIDUALS REPRESENTING COMMUNITY LEADERS/GROUPS, PUBLIC ORGANIZATIONS, PATIENTS, PROVIDERS, AND OAKWOOD HEALTHCARE REPRESENTATIVES FROM THE HOSPITAL AND CORPORATE LEVELS. IN ADDITION TO THE QUALITATIVE FEEDBACK, QUANTITATIVE HEALTH INDICATORS WERE COLLECTED AND ANALYZED TO ASSESS COMMUNITY HEALTH NEEDS. ONE HUNDRED-SIX INDICATORS WERE EVALUATED FOR EACH OF THE COUNTIES OR TOWNS (DEPENDING ON LEVEL OF DATA AVAILABLE) IN THE OAKWOOD HEALTHCARE COMMUNITY SERVED. SUPPLEMENTED HEALTH INDICATOR DATA WITH ZIP CODE ESTIMATES (COMMUNITY NEEDS INDEX) WERE USED TO IDENTIFY SPECIFIC POPULATIONS WITHIN A COMMUNITY WHERE HEALTH NEEDS MAY BE GREATER. FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 3: TO TAKE INTO ACCOUNT THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, TRUVEN HEALTH CONDUCTED INTERVIEWS (BOTH ONE-ON-ONE AND IN SMALL GROUPS) AS WELL AS FOCUS GROUPS IN FEBRUARY 2013. THE INTERVIEW QUESTIONNAIRE WAS DESIGNED TO UNDERSTAND HOW PARTICIPANTS FEEL ABOUT THE GENERAL HEALTH STATUS OF THE COMMUNITY AND THE VARIOUS DRIVERS CONTRIBUTING TO HEALTH ISSUES. FORTY-SIX INTERVIEWS WERE COMPLETED FOR THE CHNA PROCESS FOR OAKWOOD HEALTHCARE, INC. INDIVIDUALS WERE GROUPED INTO THE FOLLOWING CATEGORIES TO ENSURE BROAD PARTICIPATION: COMMUNITY LEADERS/GROUPS, PUBLIC HEALTH AND OTHER HEALTH-CARE ORGANIZATIONS, OTHER PROVIDERS (INCLUDING PHYSICIANS), AND OAKWOOD HEALTHCARE REPRESENTATIVES (CORPORATE AND HOSPITAL). FIVE FOCUS GROUPS WERE ALSO CONDUCTED TO SOLICIT FEEDBACK FROM COMMUNITY MEMBERS. FOCUS GROUPS WERE DESIGNED TO FAMILIARIZE COMMUNITY MEMBERS WITH THE CHNA PROCESS AND GAIN A BETTER UNDERSTANDING OF THE COMMUNITY'S PERSPECTIVE OF SIGNIFICANT HEALTH NEEDS. FOCUS GROUPS WERE FORMATTED FOR INDIVIDUAL AS WELL AS SMALL-GROUP FEEDBACK; THESE FOCUS GROUPS ALSO HELPED IDENTIFY OTHER COMMUNITY ORGANIZATIONS ALREADY ADDRESSING HEALTH NEEDS IN THE COMMUNITY. FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 4: OAKWOOD SOUTHSHORE MEDICAL CENTER'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:- OAKWOOD ANNAPOLIS HOSPITAL (OAH)- OAKWOOD HERITAGE HOSPITAL (OHH)- OAKWOOD HOSPITAL & MEDICAL CENTER (OHMC) FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 5D: IN ADDITION TO THE POSTING OF THE CHNA ON THE OAKWOOD WEBSITE, THE CHNA REPORT WAS SENT TO ALL OF THE ORGANIZATIONS THAT PARTICIPATED IN THE INTERVIEWS AND FOCUS GROUPS. THE CHNA WAS ALSO SHARED THROUGH COMMUNITY PRESENTATIONS AND WITH COMMUNITY PARTNERS. FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 7: THE HOSPITALS PRIORITIZED THE SIGNIFICANT HEALTH CARE NEEDS BASED ON THE FOLLOWING CRITERIA WITH AN UNDERLYING FOUNDATIONAL PURPOSE OF SERVING VULNERABLE POPULATIONS: MAGNITUDE OF THE NEED, SEVERITY OF THE NEED, ALIGNMENT OF THE PROBLEM WITH ORGANIZATIONAL STRENGTHS, EXISTING RESOURCES, AND ABILITY TO MEASURE CHANGE. THE FOLLOWING WERE DETERMINED NOT TO BE INCLUDED IN THE IMPLEMENTATION PLAN BASED ON THE ABOVE CRITERIA: MENTAL HEALTH, MATERNAL HEALTH, ENVIRONMENTAL ISSUES AND SOCIOECONOMIC ISSUES. WHILE EACH OF THESE NEEDS ARE IMPORTANT, OAKWOOD WILL CONTINUE TO ADDRESS THESE NEEDS IN EXISTING PROGRAMS OR WITH OAKWOOD PARTNER ORGANIZATIONS. FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 12I: ALL SELF-PAY PATIENTS ARE BILLED FULL CHARGES AND THEN THE CHARGES ARE REDUCED PER OUR FINANCIAL ASSISTANCE POLICY. ALL SELF-PAY, UNINSURED PATIENTS RECEIVE, AT A MINIMUM, A 45% DISCOUNT OFF OF FULL CHARGES WITHOUT HAVING TO SUBMIT A FORMAL APPLICATION FOR OR INQUIRE ABOUT FINANCIAL ASSISTANCE. THE MINIMUM DISCOUNT PERCENTAGE IS UPDATED ANNUALLY BASED ON AVERAGE PAYMENT RATES FROM COMMERCIAL PAYORS. OAKWOOD ATTEMPTS TO SCREEN ALL SELF-PAY PATIENTS UPON SCHEDULING THROUGH CENTRAL SCHEDULING, WHILE ACCESSING CARE THROUGH OUR EMERGENCY DEPARTMENTS, AND UPON INPATIENT ADMISSION INTO OUR HOSPITALS. OAKASSIST FINANCIAL COUNSELORS GATHER INFORMATION ON THE PATIENT'S OVERALL FINANCIAL SITUATION. PATIENTS APPLYING FOR AN ADDITIONAL LEVEL OF DISCOUNT OR APPLYING FOR A CATASTROPHIC MEDICAL DEBT DISCOUNT NEED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION FORM OR REQUEST A DETERMINATION AS TO WHETHER OR NOT A THEY QUALIFY FOR FREE OR DISCOUNTED CARE. SELF-PAY DISCOUNTS ARE BASED UPON THE FOLLOWING:1) FEDERAL POVERTY GUIDELINES/INCOME LEVEL2) EARNING CAPACITY3) EMPLOYMENT STATUS 4) ASSETS5) INSURANCE STATUS AND THE POSSIBILITY OF QUALIFYING FOR SOME FORM OF GOVERNMENT ASSISTANCE OR SOURCE OF COVERAGE FOR UNINSURED PATIENT6) THE LEVEL OF SELF PAY DISCOUNTING CURRENTLY BEING OFFERED THROUGH THE FINANCIAL ASSISTANCE POLICY. FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 14G: THE ORGANIZATION'S WEBSITE DIRECTS PATIENTS TO CONTACT OUR OAKASSIST FINANCIAL COUNSELORS FOR ASSISTANCE AND PROVIDES SUMMARY LEVEL INFORMATION ON THE TYPES AND ELIGIBILITY REQUIREMENTS OF FINANCIAL ASSISTANCE AVAILABLE. FINANCIAL ASSISTANCE INFORMATION IS INCLUDED IN OUR ADMISSION PACKETS AND IS MADE AVAILABLE TO ALL HOSPITAL INPATIENTS THAT CONTAIN THE TELEPHONE NUMBER DIRECTLY TO OAKWOOD'S FINANCIAL COUNSELORS. OUR PATIENT STATEMENTS INCLUDE A BOLD STATEMENT INDICATING "FINANCIAL ASSISTANCE AVAILABLE" AND THERE IS A NOTICE TO PATIENTS, ON THE STATEMENT, AS FOLLOWS: "IF YOU CANNOT PAY THIS BALANCE IN FULL, PLEASE CALL A CUSTOMER SERVICE REPRESENTATIVE AS SOON AS POSSIBLE AT THE NUMBERS LISTED BELOW TO DISCUSS OTHER OPTIONS. MONTHLY PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE TO THOSE WHO QUALIFY." THE TELEPHONE NUMBER FOR CUSTOMER SERVICE IS LISTED AND OAKWOOD'S WEBSITE ADDRESS. THERE ARE POSTINGS NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND THE CONTACT INFORMATION TO OBTAIN FINANCIAL ASSISTANCE IS POSTED IN OUR EMERGENCY DEPARTMENTS AND HOSPITAL REGISTRATION/PATIENT ACCESS AREAS. THE POLICY WAS MADE AVAILABLE TO PATIENTS UPON REQUEST. FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 18E: THE HOSPITAL ROUTES ALL SELF PAY INPATIENTS AND EMERGENCY PATIENTS TO OUR OAKASSIST FINANCIAL COUNSELORS WHO ASSESS THE PATIENTS FOR ELIGIBILITY UNDER OUR FINANCIAL ASSISTANCE POLICY. IN ADDITION, SELF PAY PATIENTS, SCHEDULED THROUGH OUR CENTRAL SCHEDULING DEPARTMENT, ARE ALSO ROUTED THROUGH OUR FINANCIAL CLEARANCE CENTER AND, IF DEEMED ELIGIBLE OR A DETERMINATION CANNOT BE MADE, THE PATIENT IS ROUTED TO OUR OAKASSIST FINANCIAL COUNSELORS FOR FURTHER SCREENING. PATIENTS ARE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING THEIR INPATIENT STAY THROUGH A SECTION OF THE ADMISSION PACKET WHERE PATIENTS WHO ARE CONCERNED ABOUT THEIR FINANCIAL RESPONSIBILITY CAN SPEAK TO FINANCIAL COUNSELORS FOR OPTIONS TO ASSIST THEM WITH PAYMENTS. THERE ARE POSTINGS IN THE EMERGENCY DEPARTMENTS AND MAIN REGISTRATION/PATIENT ACCESS AREAS INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE. PATIENTS ARE ALSO PROVIDED INFORMATION ABOUT HOW TO ACCESS OAKWOOD PROGRAMS AND HOW TO CONTACT OUR FINANCIAL COUNSELORS FOR MORE INFORMATION AND ASSISTANCE. PATIENTS ARE ALSO NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ON THE MONTHLY PATIENT STATEMENTS WHICH INCLUDES WEBSITE AND TELEPHONE CONTACT INFORMATION. IN ADDITION, THE UNINSURED ARE PROVIDED A SELF-PAY DISCOUNT BASED ON AVERAGE COMMERCIAL PAYMENT RATES WITHOUT A FORMAL REQUEST FOR FINANCIAL ASSISTANCE. INFORMATION ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IS AVAILABLE ON OUR WEBSITE AND TELEPHONE CONTACT DATA REGARDING FINANCIAL ASSISTANCE OPTIONS IS LISTED ON OUR WEBSITE. PRIOR TO SENDING PATIENT PAY ACCOUNTS TO OUR EXTERNAL COLLECTION AGENCY, OUR EXTERNAL CUSTOMER SERVICE VENDOR PROCESSES THE ACCOUNTS THROUGH THEIR PROPRIETARY "PROPENSITY TO PAY" MODEL AND ASSIGNS A "PROPENSITY TO PAY SCORE" ON EACH ACCOUNT. PER OAKWOOD POLICY, THOSE PATIENT ACCOUNTS SCORED AT 650 OR LESS, WITH NO INSURANCE INFORMATION ATTACHED, AN OUTSTANDING BALANCE OF $100.00 OR MORE, AND CONTAINING DEMOGRAPHIC INFORMATION INDICATING MICHIGAN RESIDENCY ARE AUTOMATICALLY ADJUSTED OFF TO CHARITY CARE WITHOUT A FORMAL APPLICATION PROCESS. ALL OF THESE EFFORTS ARE MADE PRIOR TO INITIATING ANY COLLECTION ACTIONS. FACILITY 2 -- OAKWOOD SOUTHSHORE MEDICAL CENTER PART V, SECTION B, LINE 20D: A DISCOUNT OF 45 PERCENT WAS DERIVED BY CALCULATING AN AVERAGE OF OUR COMMERCIAL DISCOUNTS. FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 1J: CHNA REGULATION REQUIRES EACH HOSPITAL TO DEFINE THEIR "COMMUNITY SERVED" FOR THE PURPOSES OF THE ASSESSMENT. THE OAKWOOD HEALTHCARE HOSPITAL COMMUNITIES ARE DEFINED AS ZIP CODES THAT COMPRISE 80% OF INPATIENT DISCHARGES AND ARE CONTIGUOUS. THE OVERALL OAKWOOD HEALTHCARE COMMUNITY IS THE AGGREGATE OF EACH HOSPITAL'S COMMUNITY. IT IS IMPORTANT TO NOTE THAT INDIVIDUAL HOSPITAL COMMUNITIES OVERLAP. OAKWOOD HEALTHCARE HOSPITALS ARE LOCATED IN WAYNE COUNTY, MICHIGAN, AND THE COMMUNITY THEY SERVE CONSISTS OF ZIP CODES IN WAYNE COUNTY WITH SOME OVERLAP INTO NORTHEASTERN MONROE COUNTY, MICHIGAN. OAKWOOD HEALTHCARE APPROACHED THE CHNA PROCESS AS A COLLABORATIVE EFFORT BETWEEN THEIR HOSPITALS BUT ALSO INCLUDED INFORMATION SPECIFIC TO EACH HOSPITAL COMMUNITY WHERE THE DATA COLLECTION WAS ABLE TO PROVIDE HOSPITAL COMMUNITY SPECIFIC INFORMATION. TO ASSESS HEALTH NEEDS OF THE OAKWOOD HEALTHCARE COMMUNITIES, A QUANTITATIVE AND QUALITATIVE APPROACH WAS USED. IN ADDITION TO COLLECTING DATA FROM A NUMBER OF PUBLIC SOURCES AND TRUVEN HEALTH PROPRIETARY SOURCES, INTERVIEWS (BOTH IN-PERSON AND TELEPHONE) AND FOCUS GROUPS WERE CONDUCTED WITH INDIVIDUALS REPRESENTING COMMUNITY LEADERS/GROUPS, PUBLIC ORGANIZATIONS, PATIENTS, PROVIDERS, AND OAKWOOD HEALTHCARE REPRESENTATIVES FROM THE HOSPITAL AND CORPORATE LEVELS. IN ADDITION TO THE QUALITATIVE FEEDBACK, QUANTITATIVE HEALTH INDICATORS WERE COLLECTED AND ANALYZED TO ASSESS COMMUNITY HEALTH NEEDS. ONE HUNDRED-SIX INDICATORS WERE EVALUATED FOR EACH OF THE COUNTIES OR TOWNS (DEPENDING ON LEVEL OF DATA AVAILABLE) IN THE OAKWOOD HEALTHCARE COMMUNITY SERVED. SUPPLEMENTED HEALTH INDICATOR DATA WITH ZIP CODE ESTIMATES (COMMUNITY NEEDS INDEX) WERE USED TO IDENTIFY SPECIFIC POPULATIONS WITHIN A COMMUNITY WHERE HEALTH NEEDS MAY BE GREATER. FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 3: TO TAKE INTO ACCOUNT THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, TRUVEN HEALTH CONDUCTED INTERVIEWS (BOTH ONE-ON-ONE AND IN SMALL GROUPS) AS WELL AS FOCUS GROUPS IN FEBRUARY 2013. THE INTERVIEW QUESTIONNAIRE WAS DESIGNED TO UNDERSTAND HOW PARTICIPANTS FEEL ABOUT THE GENERAL HEALTH STATUS OF THE COMMUNITY AND THE VARIOUS DRIVERS CONTRIBUTING TO HEALTH ISSUES. FORTY-SIX INTERVIEWS WERE COMPLETED FOR THE CHNA PROCESS FOR OAKWOOD HEALTHCARE, INC. INDIVIDUALS WERE GROUPED INTO THE FOLLOWING CATEGORIES TO ENSURE BROAD PARTICIPATION: COMMUNITY LEADERS/GROUPS, PUBLIC HEALTH AND OTHER HEALTH-CARE ORGANIZATIONS, OTHER PROVIDERS (INCLUDING PHYSICIANS), AND OAKWOOD HEALTHCARE REPRESENTATIVES (CORPORATE AND HOSPITAL). FIVE FOCUS GROUPS WERE ALSO CONDUCTED TO SOLICIT FEEDBACK FROM COMMUNITY MEMBERS. FOCUS GROUPS WERE DESIGNED TO FAMILIARIZE COMMUNITY MEMBERS WITH THE CHNA PROCESS AND GAIN A BETTER UNDERSTANDING OF THE COMMUNITY'S PERSPECTIVE OF SIGNIFICANT HEALTH NEEDS. FOCUS GROUPS WERE FORMATTED FOR INDIVIDUAL AS WELL AS SMALL-GROUP FEEDBACK; THESE FOCUS GROUPS ALSO HELPED IDENTIFY OTHER COMMUNITY ORGANIZATIONS ALREADY ADDRESSING HEALTH NEEDS IN THE COMMUNITY. FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 4: OAKWOOD ANNAPOLIS HOSPITAL'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:- OAKWOOD HOSPITAL & MEDICAL CENTER (OHMC)- OAKWOOD HERITAGE HOSPITAL (OHH)- OAKWOOD SOUTHSHORE MEDICAL CENTER (OSMC) FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 5D: IN ADDITION TO THE POSTING OF THE CHNA ON THE OAKWOOD WEBSITE, THE CHNA REPORT WAS SENT TO ALL OF THE ORGANIZATIONS THAT PARTICIPATED IN THE INTERVIEWS AND FOCUS GROUPS. THE CHNA WAS ALSO SHARED THROUGH COMMUNITY PRESENTATIONS AND WITH COMMUNITY PARTNERS. FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 7: THE HOSPITALS PRIORITIZED THE SIGNIFICANT HEALTH CARE NEEDS BASED ON THE FOLLOWING CRITERIA WITH AN UNDERLYING FOUNDATIONAL PURPOSE OF SERVING VULNERABLE POPULATIONS: MAGNITUDE OF THE NEED, SEVERITY OF THE NEED, ALIGNMENT OF THE PROBLEM WITH ORGANIZATIONAL STRENGTHS, EXISTING RESOURCES, AND ABILITY TO MEASURE CHANGE. THE FOLLOWING WERE DETERMINED NOT TO BE INCLUDED IN THE IMPLEMENTATION PLAN BASED ON THE ABOVE CRITERIA: MENTAL HEALTH, MATERNAL HEALTH, ENVIRONMENTAL ISSUES AND SOCIOECONOMIC ISSUES. WHILE EACH OF THESE NEEDS ARE IMPORTANT, OAKWOOD WILL CONTINUE TO ADDRESS THESE NEEDS IN EXISTING PROGRAMS OR WITH OAKWOOD PARTNER ORGANIZATIONS. FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 12I: ALL SELF-PAY PATIENTS ARE BILLED FULL CHARGES AND THEN THE CHARGES ARE REDUCED PER OUR FINANCIAL ASSISTANCE POLICY. ALL SELF-PAY, UNINSURED PATIENTS RECEIVE, AT A MINIMUM, A 45% DISCOUNT OFF OF FULL CHARGES WITHOUT HAVING TO SUBMIT A FORMAL APPLICATION FOR OR INQUIRE ABOUT FINANCIAL ASSISTANCE. THE MINIMUM DISCOUNT PERCENTAGE IS UPDATED ANNUALLY BASED ON AVERAGE PAYMENT RATES FROM COMMERCIAL PAYORS. OAKWOOD ATTEMPTS TO SCREEN ALL SELF-PAY PATIENTS UPON SCHEDULING THROUGH CENTRAL SCHEDULING, WHILE ACCESSING CARE THROUGH OUR EMERGENCY DEPARTMENTS, AND UPON INPATIENT ADMISSION INTO OUR HOSPITALS. OAKASSIST FINANCIAL COUNSELORS GATHER INFORMATION ON THE PATIENT'S OVERALL FINANCIAL SITUATION. PATIENTS APPLYING FOR AN ADDITIONAL LEVEL OF DISCOUNT OR APPLYING FOR A CATASTROPHIC MEDICAL DEBT DISCOUNT NEED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION FORM OR REQUEST A DETERMINATION AS TO WHETHER OR NOT A THEY QUALIFY FOR FREE OR DISCOUNTED CARE. SELF-PAY DISCOUNTS ARE BASED UPON THE FOLLOWING:1) FEDERAL POVERTY GUIDELINES/INCOME LEVEL2) EARNING CAPACITY3) EMPLOYMENT STATUS 4) ASSETS5) INSURANCE STATUS AND THE POSSIBILITY OF QUALIFYING FOR SOME FORM OF GOVERNMENT ASSISTANCE OR SOURCE OF COVERAGE FOR UNINSURED PATIENT6) THE LEVEL OF SELF PAY DISCOUNTING CURRENTLY BEING OFFERED THROUGH THE FINANCIAL ASSISTANCE POLICY. FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 14G: THE ORGANIZATION'S WEBSITE DIRECTS PATIENTS TO CONTACT OUR OAKASSIST FINANCIAL COUNSELORS FOR ASSISTANCE AND PROVIDES SUMMARY LEVEL INFORMATION ON THE TYPES AND ELIGIBILITY REQUIREMENTS OF FINANCIAL ASSISTANCE AVAILABLE. FINANCIAL ASSISTANCE INFORMATION IS INCLUDED IN OUR ADMISSION PACKETS AND IS MADE AVAILABLE TO ALL HOSPITAL INPATIENTS THAT CONTAIN THE TELEPHONE NUMBER DIRECTLY TO OAKWOOD'S FINANCIAL COUNSELORS. OUR PATIENT STATEMENTS INCLUDE A BOLD STATEMENT INDICATING "FINANCIAL ASSISTANCE AVAILABLE" AND THERE IS A NOTICE TO PATIENTS, ON THE STATEMENT, AS FOLLOWS: "IF YOU CANNOT PAY THIS BALANCE IN FULL, PLEASE CALL A CUSTOMER SERVICE REPRESENTATIVE AS SOON AS POSSIBLE AT THE NUMBERS LISTED BELOW TO DISCUSS OTHER OPTIONS. MONTHLY PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE TO THOSE WHO QUALIFY." THE TELEPHONE NUMBER FOR CUSTOMER SERVICE IS LISTED AND OAKWOOD'S WEBSITE ADDRESS. THERE ARE POSTINGS NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND THE CONTACT INFORMATION TO OBTAIN FINANCIAL ASSISTANCE IS POSTED IN OUR EMERGENCY DEPARTMENTS AND HOSPITAL REGISTRATION/PATIENT ACCESS AREAS. THE POLICY WAS MADE AVAILABLE TO PATIENTS UPON REQUEST. FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 18E: THE HOSPITAL ROUTES ALL SELF PAY INPATIENTS AND EMERGENCY PATIENTS TO OUR OAKASSIST FINANCIAL COUNSELORS WHO ASSESS THE PATIENTS FOR ELIGIBILITY UNDER OUR FINANCIAL ASSISTANCE POLICY. IN ADDITION, SELF PAY PATIENTS, SCHEDULED THROUGH OUR CENTRAL SCHEDULING DEPARTMENT, ARE ALSO ROUTED THROUGH OUR FINANCIAL CLEARANCE CENTER AND, IF DEEMED ELIGIBLE OR A DETERMINATION CANNOT BE MADE, THE PATIENT IS ROUTED TO OUR OAKASSIST FINANCIAL COUNSELORS FOR FURTHER SCREENING. PATIENTS ARE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING THEIR INPATIENT STAY THROUGH A SECTION OF THE ADMISSION PACKET WHERE PATIENTS WHO ARE CONCERNED ABOUT THEIR FINANCIAL RESPONSIBILITY CAN SPEAK TO FINANCIAL COUNSELORS FOR OPTIONS TO ASSIST THEM WITH PAYMENTS. THERE ARE POSTINGS IN THE EMERGENCY DEPARTMENTS AND MAIN REGISTRATION/PATIENT ACCESS AREAS INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE. PATIENTS ARE ALSO PROVIDED INFORMATION ABOUT HOW TO ACCESS OAKWOOD PROGRAMS AND HOW TO CONTACT OUR FINANCIAL COUNSELORS FOR MORE INFORMATION AND ASSISTANCE. PATIENTS ARE ALSO NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ON THE MONTHLY PATIENT STATEMENTS WHICH INCLUDES WEBSITE AND TELEPHONE CONTACT INFORMATION. IN ADDITION, THE UNINSURED ARE PROVIDED A SELF-PAY DISCOUNT BASED ON AVERAGE COMMERCIAL PAYMENT RATES WITHOUT A FORMAL REQUEST FOR FINANCIAL ASSISTANCE. INFORMATION ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IS AVAILABLE ON OUR WEBSITE AND TELEPHONE CONTACT DATA REGARDING FINANCIAL ASSISTANCE OPTIONS IS LISTED ON OUR WEBSITE. PRIOR TO SENDING PATIENT PAY ACCOUNTS TO OUR EXTERNAL COLLECTION AGENCY, OUR EXTERNAL CUSTOMER SERVICE VENDOR PROCESSES THE ACCOUNTS THROUGH THEIR PROPRIETARY "PROPENSITY TO PAY" MODEL AND ASSIGNS A "PROPENSITY TO PAY SCORE" ON EACH ACCOUNT. PER OAKWOOD POLICY, THOSE PATIENT ACCOUNTS SCORED AT 650 OR LESS, WITH NO INSURANCE INFORMATION ATTACHED, AN OUTSTANDING BALANCE OF $100.00 OR MORE, AND CONTAINING DEMOGRAPHIC INFORMATION INDICATING MICHIGAN RESIDENCY ARE AUTOMATICALLY ADJUSTED OFF TO CHARITY CARE WITHOUT A FORMAL APPLICATION PROCESS. ALL OF THESE EFFORTS ARE MADE PRIOR TO INITIATING ANY COLLECTION ACTIONS. FACILITY 3 -- OAKWOOD ANNAPOLIS HOSPITAL PART V, SECTION B, LINE 20D: A DISCOUNT OF 45 PERCENT WAS DERIVED BY CALCULATING AN AVERAGE OF OUR COMMERCIAL DISCOUNTS. FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 1J: CHNA REGULATION REQUIRES EACH HOSPITAL TO DEFINE THEIR "COMMUNITY SERVED" FOR THE PURPOSES OF THE ASSESSMENT. THE OAKWOOD HEALTHCARE HOSPITAL COMMUNITIES ARE DEFINED AS ZIP CODES THAT COMPRISE 80% OF INPATIENT DISCHARGES AND ARE CONTIGUOUS. THE OVERALL OAKWOOD HEALTHCARE COMMUNITY IS THE AGGREGATE OF EACH HOSPITAL'S COMMUNITY. IT IS IMPORTANT TO NOTE THAT INDIVIDUAL HOSPITAL COMMUNITIES OVERLAP. OAKWOOD HEALTHCARE HOSPITALS ARE LOCATED IN WAYNE COUNTY, MICHIGAN, AND THE COMMUNITY THEY SERVE CONSISTS OF ZIP CODES IN WAYNE COUNTY WITH SOME OVERLAP INTO NORTHEASTERN MONROE COUNTY, MICHIGAN. OAKWOOD HEALTHCARE APPROACHED THE CHNA PROCESS AS A COLLABORATIVE EFFORT BETWEEN THEIR HOSPITALS BUT ALSO INCLUDED INFORMATION SPECIFIC TO EACH HOSPITAL COMMUNITY WHERE THE DATA COLLECTION WAS ABLE TO PROVIDE HOSPITAL COMMUNITY SPECIFIC INFORMATION. TO ASSESS HEALTH NEEDS OF THE OAKWOOD HEALTHCARE COMMUNITIES, A QUANTITATIVE AND QUALITATIVE APPROACH WAS USED. IN ADDITION TO COLLECTING DATA FROM A NUMBER OF PUBLIC SOURCES AND TRUVEN HEALTH PROPRIETARY SOURCES, INTERVIEWS (BOTH IN-PERSON AND TELEPHONE) AND FOCUS GROUPS WERE CONDUCTED WITH INDIVIDUALS REPRESENTING COMMUNITY LEADERS/GROUPS, PUBLIC ORGANIZATIONS, PATIENTS, PROVIDERS, AND OAKWOOD HEALTHCARE REPRESENTATIVES FROM THE HOSPITAL AND CORPORATE LEVELS. IN ADDITION TO THE QUALITATIVE FEEDBACK, QUANTITATIVE HEALTH INDICATORS WERE COLLECTED AND ANALYZED TO ASSESS COMMUNITY HEALTH NEEDS. ONE HUNDRED-SIX INDICATORS WERE EVALUATED FOR EACH OF THE COUNTIES OR TOWNS (DEPENDING ON LEVEL OF DATA AVAILABLE) IN THE OAKWOOD HEALTHCARE COMMUNITY SERVED. SUPPLEMENTED HEALTH INDICATOR DATA WITH ZIP CODE ESTIMATES (COMMUNITY NEEDS INDEX) WERE USED TO IDENTIFY SPECIFIC POPULATIONS WITHIN A COMMUNITY WHERE HEALTH NEEDS MAY BE GREATER. FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 3: TO TAKE INTO ACCOUNT THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, TRUVEN HEALTH CONDUCTED INTERVIEWS (BOTH ONE-ON-ONE AND IN SMALL GROUPS) AS WELL AS FOCUS GROUPS IN FEBRUARY 2013. THE INTERVIEW QUESTIONNAIRE WAS DESIGNED TO UNDERSTAND HOW PARTICIPANTS FEEL ABOUT THE GENERAL HEALTH STATUS OF THE COMMUNITY AND THE VARIOUS DRIVERS CONTRIBUTING TO HEALTH ISSUES. FORTY-SIX INTERVIEWS WERE COMPLETED FOR THE CHNA PROCESS FOR OAKWOOD HEALTHCARE, INC. INDIVIDUALS WERE GROUPED INTO THE FOLLOWING CATEGORIES TO ENSURE BROAD PARTICIPATION: COMMUNITY LEADERS/GROUPS, PUBLIC HEALTH AND OTHER HEALTH-CARE ORGANIZATIONS, OTHER PROVIDERS (INCLUDING PHYSICIANS), AND OAKWOOD HEALTHCARE REPRESENTATIVES (CORPORATE AND HOSPITAL). FIVE FOCUS GROUPS WERE ALSO CONDUCTED TO SOLICIT FEEDBACK FROM COMMUNITY MEMBERS. FOCUS GROUPS WERE DESIGNED TO FAMILIARIZE COMMUNITY MEMBERS WITH THE CHNA PROCESS AND GAIN A BETTER UNDERSTANDING OF THE COMMUNITY'S PERSPECTIVE OF SIGNIFICANT HEALTH NEEDS. FOCUS GROUPS WERE FORMATTED FOR INDIVIDUAL AS WELL AS SMALL-GROUP FEEDBACK; THESE FOCUS GROUPS ALSO HELPED IDENTIFY OTHER COMMUNITY ORGANIZATIONS ALREADY ADDRESSING HEALTH NEEDS IN THE COMMUNITY. FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 4: OAKWOOD HERITAGE HOSPITAL'S CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:- OAKWOOD ANNAPOLIS HOSPITAL (OAH)- OAKWOOD HOSPITAL & MEDICAL CENTER (OHMC)- OAKWOOD SOUTHSHORE MEDICAL CENTER (OSMC) FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 5D: IN ADDITION TO THE POSTING OF THE CHNA ON THE OAKWOOD WEBSITE, THE CHNA REPORT WAS SENT TO ALL OF THE ORGANIZATIONS THAT PARTICIPATED IN THE INTERVIEWS AND FOCUS GROUPS. THE CHNA WAS ALSO SHARED THROUGH COMMUNITY PRESENTATIONS AND WITH COMMUNITY PARTNERS. FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 7: THE HOSPITALS PRIORITIZED THE SIGNIFICANT HEALTH CARE NEEDS BASED ON THE FOLLOWING CRITERIA WITH AN UNDERLYING FOUNDATIONAL PURPOSE OF SERVING VULNERABLE POPULATIONS: MAGNITUDE OF THE NEED, SEVERITY OF THE NEED, ALIGNMENT OF THE PROBLEM WITH ORGANIZATIONAL STRENGTHS, EXISTING RESOURCES, AND ABILITY TO MEASURE CHANGE. THE FOLLOWING WERE DETERMINED NOT TO BE INCLUDED IN THE IMPLEMENTATION PLAN BASED ON THE ABOVE CRITERIA: MENTAL HEALTH, MATERNAL HEALTH, ENVIRONMENTAL ISSUES AND SOCIOECONOMIC ISSUES. WHILE EACH OF THESE NEEDS ARE IMPORTANT, OAKWOOD WILL CONTINUE TO ADDRESS THESE NEEDS IN EXISTING PROGRAMS OR WITH OAKWOOD PARTNER ORGANIZATIONS. FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 12I: ALL SELF-PAY PATIENTS ARE BILLED FULL CHARGES AND THEN THE CHARGES ARE REDUCED PER OUR FINANCIAL ASSISTANCE POLICY. ALL SELF-PAY, UNINSURED PATIENTS RECEIVE, AT A MINIMUM, A 45% DISCOUNT OFF OF FULL CHARGES WITHOUT HAVING TO SUBMIT A FORMAL APPLICATION FOR OR INQUIRE ABOUT FINANCIAL ASSISTANCE. THE MINIMUM DISCOUNT PERCENTAGE IS UPDATED ANNUALLY BASED ON AVERAGE PAYMENT RATES FROM COMMERCIAL PAYORS. OAKWOOD ATTEMPTS TO SCREEN ALL SELF-PAY PATIENTS UPON SCHEDULING THROUGH CENTRAL SCHEDULING, WHILE ACCESSING CARE THROUGH OUR EMERGENCY DEPARTMENTS, AND UPON INPATIENT ADMISSION INTO OUR HOSPITALS. OAKASSIST FINANCIAL COUNSELORS GATHER INFORMATION ON THE PATIENT'S OVERALL FINANCIAL SITUATION. PATIENTS APPLYING FOR AN ADDITIONAL LEVEL OF DISCOUNT OR APPLYING FOR A CATASTROPHIC MEDICAL DEBT DISCOUNT NEED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION FORM OR REQUEST A DETERMINATION AS TO WHETHER OR NOT A THEY QUALIFY FOR FREE OR DISCOUNTED CARE. SELF-PAY DISCOUNTS ARE BASED UPON THE FOLLOWING:1) FEDERAL POVERTY GUIDELINES/INCOME LEVEL2) EARNING CAPACITY3) EMPLOYMENT STATUS 4) ASSETS5) INSURANCE STATUS AND THE POSSIBILITY OF QUALIFYING FOR SOME FORM OF GOVERNMENT ASSISTANCE OR SOURCE OF COVERAGE FOR UNINSURED PATIENT6) THE LEVEL OF SELF PAY DISCOUNTING CURRENTLY BEING OFFERED THROUGH THE FINANCIAL ASSISTANCE POLICY. FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 14G: THE ORGANIZATION'S WEBSITE DIRECTS PATIENTS TO CONTACT OUR OAKASSIST FINANCIAL COUNSELORS FOR ASSISTANCE AND PROVIDES SUMMARY LEVEL INFORMATION ON THE TYPES AND ELIGIBILITY REQUIREMENTS OF FINANCIAL ASSISTANCE AVAILABLE. FINANCIAL ASSISTANCE INFORMATION IS INCLUDED IN OUR ADMISSION PACKETS AND IS MADE AVAILABLE TO ALL HOSPITAL INPATIENTS THAT CONTAIN THE TELEPHONE NUMBER DIRECTLY TO OAKWOOD'S FINANCIAL COUNSELORS. OUR PATIENT STATEMENTS INCLUDE A BOLD STATEMENT INDICATING "FINANCIAL ASSISTANCE AVAILABLE" AND THERE IS A NOTICE TO PATIENTS, ON THE STATEMENT, AS FOLLOWS: "IF YOU CANNOT PAY THIS BALANCE IN FULL, PLEASE CALL A CUSTOMER SERVICE REPRESENTATIVE AS SOON AS POSSIBLE AT THE NUMBERS LISTED BELOW TO DISCUSS OTHER OPTIONS. MONTHLY PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE TO THOSE WHO QUALIFY." THE TELEPHONE NUMBER FOR CUSTOMER SERVICE IS LISTED AND OAKWOOD'S WEBSITE ADDRESS. THERE ARE POSTINGS NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND THE CONTACT INFORMATION TO OBTAIN FINANCIAL ASSISTANCE IS POSTED IN OUR EMERGENCY DEPARTMENTS AND HOSPITAL REGISTRATION/PATIENT ACCESS AREAS. THE POLICY WAS MADE AVAILABLE TO PATIENTS UPON REQUEST. FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 18E: THE HOSPITAL ROUTES ALL SELF PAY INPATIENTS AND EMERGENCY PATIENTS TO OUR OAKASSIST FINANCIAL COUNSELORS WHO ASSESS THE PATIENTS FOR ELIGIBILITY UNDER OUR FINANCIAL ASSISTANCE POLICY. IN ADDITION, SELF PAY PATIENTS, SCHEDULED THROUGH OUR CENTRAL SCHEDULING DEPARTMENT, ARE ALSO ROUTED THROUGH OUR FINANCIAL CLEARANCE CENTER AND, IF DEEMED ELIGIBLE OR A DETERMINATION CANNOT BE MADE, THE PATIENT IS ROUTED TO OUR OAKASSIST FINANCIAL COUNSELORS FOR FURTHER SCREENING. PATIENTS ARE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING THEIR INPATIENT STAY THROUGH A SECTION OF THE ADMISSION PACKET WHERE PATIENTS WHO ARE CONCERNED ABOUT THEIR FINANCIAL RESPONSIBILITY CAN SPEAK TO FINANCIAL COUNSELORS FOR OPTIONS TO ASSIST THEM WITH PAYMENTS. THERE ARE POSTINGS IN THE EMERGENCY DEPARTMENTS AND MAIN REGISTRATION/PATIENT ACCESS AREAS INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE. PATIENTS ARE ALSO PROVIDED INFORMATION ABOUT HOW TO ACCESS OAKWOOD PROGRAMS AND HOW TO CONTACT OUR FINANCIAL COUNSELORS FOR MORE INFORMATION AND ASSISTANCE. PATIENTS ARE ALSO NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ON THE MONTHLY PATIENT STATEMENTS WHICH INCLUDES WEBSITE AND TELEPHONE CONTACT INFORMATION. IN ADDITION, THE UNINSURED ARE PROVIDED A SELF-PAY DISCOUNT BASED ON AVERAGE COMMERCIAL PAYMENT RATES WITHOUT A FORMAL REQUEST FOR FINANCIAL ASSISTANCE. INFORMATION ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IS AVAILABLE ON OUR WEBSITE AND TELEPHONE CONTACT DATA REGARDING FINANCIAL ASSISTANCE OPTIONS IS LISTED ON OUR WEBSITE. PRIOR TO SENDING PATIENT PAY ACCOUNTS TO OUR EXTERNAL COLLECTION AGENCY, OUR EXTERNAL CUSTOMER SERVICE VENDOR PROCESSES THE ACCOUNTS THROUGH THEIR PROPRIETARY "PROPENSITY TO PAY" MODEL AND ASSIGNS A "PROPENSITY TO PAY SCORE" ON EACH ACCOUNT. PER OAKWOOD POLICY, THOSE PATIENT ACCOUNTS SCORED AT 650 OR LESS, WITH NO INSURANCE INFORMATION ATTACHED, AN OUTSTANDING BALANCE OF $100.00 OR MORE, AND CONTAINING DEMOGRAPHIC INFORMATION INDICATING MICHIGAN RESIDENCY ARE AUTOMATICALLY ADJUSTED OFF TO CHARITY CARE WITHOUT A FORMAL APPLICATION PROCESS. ALL OF THESE EFFORTS ARE MADE PRIOR TO INITIATING ANY COLLECTION ACTIONS. FACILITY 4 -- OAKWOOD HERITAGE HOSPITAL PART V, SECTION B, LINE 20D: A DISCOUNT OF 45 PERCENT WAS DERIVED BY CALCULATING AN AVERAGE OF OUR COMMERCIAL DISCOUNTS. 69 OAKWOOD DEARBORN MEDICAL PARK 18100 OAKWOOD BLVD DEARBORN MI 48124 O/P PHYS/CARDIAC CLINICS, BREAST CARE/DIALYSIS CTR,O/P IMAGING,LAB DRAW SITE OAKWOOD SOUTHSHORE SURGERY CENTER 5452 FORT STREET TRENTON MI 48183 O/P SURGICAL SERVICES, REHAB. CLINIC (PT & OT), ORTHOPEDIC CTR OF EXCELLENCE OAKWOOD HEALTH CARE CTR - CANTON 7300 CANTON CENTER ROAD CANTON MI 48187 EMERGENCY ROOM, RADIOLOGY, OUTPATIENT IMAGING, LAB DRAW SITE OAKWOOD MEDICAL OFFICES - DEARBORN 18181 OAKWOOD BLVD DEARBORN MI 48124 OUTPATIENT PHYSICIAN CLINIC, LAB DRAW SITE OAKWOOD HEALTH CARE CTR - SOUTHGATE 15777 NORTHLINE ROAD SOUTHGATE MI 48195 O/P CLINIC, CANCER CTR, URGENT CARE, RADIOLOGY, REHAB - PT, LAB DRAW SITE OAKWOOD MIDWEST MEDICAL CENTER 4700 SCHAEFFER ROAD DEARBORN MI 48126 O/P PHYS CLINIC, O/P SURG SERVICES, O/P IMAGING OAKWOOD HERITAGE HOSPITAL REHAB SCVS 9870 TELEGRAPH TAYLOR MI 48180 REHAB. CLINIC - PT OAKDALE MEDICAL VILLAGE 25045 FORD ROAD DEARBORN MI 48128 OUTPATIENT IMAGING, LAB DRAW SITE HAGGERTY MEDICAL BLDG - CANTON 2050 NORTH HAGGERTY RD CANTON MI 48188 OUTPATIENT PHYSICIAN CLINIC, OUTPATIENT IMAGING OAKWOOD BREAST CARE CTR 4491 VENOY RD WAYNE MI 48184 BREAST CARE CENTER OAKWOOD SOUTHSHORE PHYS MED REHAB 2707 W JEFFERSON TRENTON MI 48183 REHAB. CLINIC-PT, OT AND ST OAKWOOD MEDICAL OFFICES - WAYNE 33000 ANNAPOLIS AVENUE WAYNE MI 48184 OUTPATIENT PHYSICIAN CLINIC, REHAB. CLINIC-PT, OT AND ST OAKWOOD TRAINING & DEVELOPMENT CTR 18501 ROTUNDA DRIVE DEARBORN MI 48124 OUTPATIENT PHYSICIAN CLINIC, REHAB. CLINIC OAKWOOD HEALTH CARE CTR - MERCURY DR 4900 MERCURY DRIVE DEARBORN MI 48126 OUTPATIENT PHYSICIAN CLINIC OAKWOOD MEDICAL OFFICE BLDG - CANTON 7330 CANTON CENTER ROAD CANTON MI 48187 OUTPATIENT PHYSICIAN CLINIC OAKWOOD SPORTS MEDICINE - DEARBORN 2552 MONROE DEARBORN MI 48124 REHAB. CLINIC-PT OAKWOOD REHAB THERAPY SVCS-W DEARBORN 22731 NEWMAN ROAD DEARBORN MI 48124 REHAB. CLINIC - PT OAKWOOD OUTPATIENT IMAGING 1676 FORT STREET TRENTON MI 48183 OUTPATIENT IMAGING OAKWOOD HEALTH CARE CTR - WESTLAND 2001 SOUTH MERRIMAN WESTLAND MI 48186 OUTPATIENT PHYSICIAN CLINIC, LAB DRAW SITE INTERNAL MEDICINE WYANDOTTE 1700 BIDDLE AVE WYANDOTTE MI 48192 OUTPATIENT PHYSICIAN CLINIC, LAB DRAW SITE OAKWOOD HEALTH CARE CTR - BELLEVILLE 201 THIRD STREET BELLEVILLE MI 48111 OUTPATIENT PHYSICIAN CLINIC, REHAB. CLINIC - PT OAKWOOD HEALTH CARE CTR - ALLEN PARK 15915 SOUTHFIELD ALLEN PARK MI 48101 OUTPATIENT PHYSICIAN CLINIC, REHAB. CLINIC - PT OAKWOOD PHYSICAL THERAPY CENTER 4111 S CANTON CENTER ROAD CANTON MI 48188 REHAB. CLINIC - PT OAKLANE MEDICAL SUITES 17000 HUBBARD DEARBORN MI 48126 OUTPATIENT PHYSICIAN CLINIC, REHAB. CLINIC - PT OAKWOOD MEDICAL OFFICES - TRENTON 5400 FORT STREET TRENTON MI 48183 OUTPATIENT PHYSICIAN CLINIC, CARDIAC REHAB. CLINIC, LAB DRAW SITE OAKWOOD CARDIAC CENTER 22060 BEECH ROAD DEARBORN MI 48124 CARDIAC CENTER OAKWOOD VENOY PATIENT SERVICE CENTER 4020 VENOY SUITE 200A WAYNE MI 48184 OUTPATIENT PHYSICIAN CLINIC, LAB DRAW SITE OAKWOOD MEDICAL OFF BLDG-GARDEN CITY 29150 FORD ROAD GARDEN CITY MI 48135 OUTPATIENT PHYSICIAN CLINIC, URGENT CARE OAKWOOD IMAGING CENTER TAYLOR 8850 S TELEGRAPH RD TAYLOR MI 48180 OUTPATIENT IMAGING OAKWOOD HEALTH CARE CTR - TB CLINIC 2001 SOUTH MERRIMAN WESTLAND MI 48186 OUTPATIENT PHYSICIAN CLINIC (TB CLINIC) OAKWOOD TAYLOR TEEN CENTER 26650 EUREKA ROAD SUITE B TAYLOR MI 48180 OUTPATIENT PHYSICIAN CLINIC OAKWOOD BLANZY CLINIC 14319 DIX TOLEDO ROAD SOUTHGATE MI 48195 OUTPATIENT PHYSICIAN CLINIC ONCOLOGY DOWNRIVER 19725 ALLEN ROAD SUITE 101 BROWNSTOWN MI 48183 OUTPATIENT PHYSICIAN CLINIC, ONCOLOGY, O/P IMAGING, LAB DRAW SITE ATHENS CLINIC 15100 S PLAZA DRIVE TAYLOR MI 48180 OUTPATIENT PHYSICIAN CLINIC EVERINGHAM FAMILY MEDICINE 12100 HURON RIVER DRIVE ROMULUS MI 48174 OUTPATIENT PHYSICIAN CLINIC TAYLOR CLINIC 9340 S TELEGRAPH TAYLOR MI 48180 OUTPATIENT PHYSICIAN CLINIC NAJAR OBGYN 2142 MONROE STREET SUITE A DEARBORN MI 48124 OUTPATIENT PHYSICIAN CLINIC OAKWOOD INTERNAL MEDICINE-ALLEN PARK 7804 ALLEN ROAD ALLEN PARK MI 48101 OUTPATIENT PHYSICIAN CLINIC OAKWOOD HEALTHCARE CTR - NEWPORT 3132 NEWPORT RD NEWPORT MI 48166 OUTPATIENT PHYSICIAN CLINIC HENRY FORD VILLAGE GERIATRICS 15101 FORD ROAD 1ST FLOOR DEARBORN MI 48126 OUTPATIENT PHYSICIAN CLINIC OAKMAN MEDICAL GROUP 15120 MICHIGAN AVE DEARBORN MI 48126 OUTPATIENT PHYSICIAN CLINIC, LAB DRAW SITE ADULT MEDICAL CARE PLCC 35330 NANKIN BLVD SUITE 701 WESTLAND MI 48185 OUTPATIENT PHYSICIAN CLINIC ALLEN PARK CARDIOLOGY 6742 PARK AVE ALLEN PARK MI 48101 CARDIAC REHAB. OAKWOOD PT & WELLNESS CENTER 17101 ROTUNDA BLVD DEARBORN MI 48124 REHAB. CLINIC - PT OAKWOOD INFUSION SERVICES 1633 FAIRLANE CIRCLE SUITE 165 ALLEN PARK MI 48101 OUTPATIENT INFUSION SERVICES PRECISION ORTHOPEDICS 25755 TELEGRAPH RD BROWNSTOWN MI 48134 OUTPATIENT PHYSICIAN CLINIC OAKWOOD URGENT CARE WYANDOTTE 211 EUREKA ROAD WYANDOTTE MI 48192 URGENT CARE LINCOLN-ADAMS CHILDADOLESCENT HC CTR 33475 PALMER WESTLAND MI 48186 OUTPATIENT PHYSICIAN CLINIC ALLIED MEDICAL GROUP 35180 NANKIN BLVD WESTLAND MI 48185 OUTPATIENT PHYSICIAN CLINIC SOUTH CANTON INTERNAL MEDICINE 42287 CHEERY HILL RD SUITE D CANTON MI 48188 OUTPATIENT PHYSICIAN CLINIC TRENTON OBGYN 3290 WEST ROAD TRENTON MI 48183 OUTPATIENT PHYSICIAN CLINIC LAB AT WOODHAVEN 25000 HALL ROAD WOODHAVEN MI 48183 LAB DRAW SITE CHASE MEDICAL CLINIC 6211 CHASE ROAD DEARBORN MI 48126 OUTPATIENT PHYSICIAN CLINIC INKSTER TEEN HEALTH CENTER 3250 MIDDLEBELT INKSTER MI 48141 OUTPATIENT PHYSICIAN CLINIC OAKWOOD HEALTHCARE FLAT ROCK 29100 GATEWAY BLVD FLAT ROCK MI 48134 OUTPATIENT PHYSICIAN CLINIC GENERAL SURGICAL SERVICES 3851 WEST ROAD SUITE 3 TRENTON MI 48183 OUTPATIENT PHYSICIAN CLINIC TRUMAN HIGH SCHOOL 11211 BEECH DALY RD TAYLOR MI 48180 OUTPATIENT PHYSICIAN CLINIC OAKWOOD WYANDOTTE SPECIALTY 1848 BIDDLE WYANDOTTE MI 48192 OUTPATIENT PHYSICIAN CLINIC INKSTER TEEN HEALTH CTR 25912 ANNAPOLIS STREET INKSTER MI 48141 OUTPATIENT PHYSICIAN CLINIC DEARBORN FAMILY CLINIC 3133 SOUTH TELEGRAPH DEARBORN MI 48124 OUTPATIENT PHYSICIAN CLINIC LAB AT FAMILY HEALTH RIVERVIEW CENTER 19020 FORT STREET RIVERVIEW MI 48192 LAB DRAW SITE OAKWOOD HEALTH CARE CTR - BROWNSTOWN 17000 KING ROAD BROWNSTOWN MI 48183 OUTPATIENT PHYSICIAN CLINIC OAKWOOD LABORATORY - HAMLET BLDG 1331 MONROE STREET DEARBORN MI 48124 LAB DRAW SITE, RESPIRATORY CARE OAKWOOD HOME MEDICAL EQUIP 1633 FAIRLANE CIRCLE DEARBORN MI 48124 DURABLE MEDICAL EQUIPMENT OAKWOOD ADULT & CHILD CARE SVCS 3601 PELHAM DEARBORN MI 48124 ADULT AND CHILD CARE CENTER LAB AT DEARBORN FAMILY PRACTICE 23870 MICHIGAN AVE DEARBORN MI 48124 LAB DRAW SITE INTERNAL MEDICINE MONROE STREET 1611 MONROE STREET DEARBORN MI 48124 OUTPATIENT PHYSICIAN CLINIC INTERNAL MEDICINE DETROIT 18300 W MCNICHOLS RD DETROIT MI 48219 OUTPATIENT PHYSICIAN CLINIC OAKWOOD YMCA SOUTHGATE PT 16777 NORTHLINE ROAD SOUTHGATE MI 48195 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: OAKASSIST FINANCIAL COUNSELORS GATHER INFORMATION ON THE PATIENT'S OVERALL FINANCIAL SITUATION. DETERMINATION AS TO WHETHER OR NOT A PATIENT QUALIFIES FOR FREE OR DISCOUNTED CARE, ABOVE THE 45% SELF PAY DISCOUNT FOR THE UNINSURED, AND THE AMOUNT OF THE DISCOUNT TO BE PROVIDED ARE BASED UPON:1) FEDERAL POVERTY GUIDELINES/INCOME LEVEL2) EARNING CAPACITY3) EMPLOYMENT STATUS 4) ASSETS5) INSURANCE STATUS AND THE POSSIBILITY OF QUALIFYING FOR SOME FORM OF GOVERNMENT ASSISTANCE OR SOURCE OF COVERAGE FOR UNINSURED PATIENT6) THE LEVEL OF SELF PAY DISCOUNTING CURRENTLY BEING OFFERED THROUGH THE FINANCIAL ASSISTANCE POLICYTHE DISCOUNT OF 45 PERCENT WAS DERIVED BY CALCULATING AN AVERAGE OF OUR COMMERCIAL DISCOUNTS. PART I, LINE 7: CHARITY CARE (LINE A) USED A COST TO CHARGE RATIO SPECIFIC TO EACH ACUTE CARE BUSINESS UNIT. MEDICAID (LINE B) ALSO USED A BUSINESS UNIT-SPECIFIC COST TO CHARGE RATIO. HEALTH PROFESSIONS EDUCATION (LINE F) USED A COMBINATION OF EXPENSES REPORTED IN THE GENERAL LEDGER AND ALLOCATIONS FOR SPECIFIC EXPENSES FROM OTHER COST CENTERS TO THE MEDICAL EDUCATION PROGRAM. SUBSIDIZED HEALTH SERVICES (LINE G) USED A COST ACCOUNTING SYSTEM THAT INCLUDES ALL ACUTE CARE FACILITY ACTIVITY. PART I, LN 7 COL(F): BAD DEBT IN THE AMOUNT OF $574,482 WAS NOT COUNTED AS EXPENSE IN THE MEDICAL RESIDENT EDUCATION PORTION OF HEALTH PROFESSIONS EDUCATION. BAD DEBT EXPENSE OF $92,485,028 WAS EXCLUDED FROM TOTAL EXPENSES WHEN COMPUTING THE COMMUNITY BENEFIT PERCENTAGES. A FULL COPY OF THE COMMUNITY BENEFIT REPORT CAN BE FOUND AT:HTTP://WWW.OAKWOOD.ORG/REPORT-TO-OUR-COMMUNITY PART II, COMMUNITY BUILDING ACTIVITIES: OAKWOOD HEALTHCARE SYSTEM HAS A STRONG CONNECTION TO THE COMMUNITIES IT SERVES. WE EXEMPLIFY THAT WITH WIDE AND EXTENSIVE PARTICIPATION FROM OUR EMPLOYEES AS BOARD MEMBERS AND VOLUNTEERS OF VARIOUS NON-PROFIT AND PROFESSIONAL ORGANIZATIONS. WHAT IS REPORTED IN THE SECTION REGARDING COMMUNITY BUILDING ACTIVITIES ARE THOSE WHERE A DIRECT OUTLAY OF CASH OR STAFF/FACILITY RESOURCES WERE EXPENDED. ACTIVITIES THAT ARE COVERED IN THIS SECTION INCLUDE DUES TO VARIOUS CHAMBERS OF COMMERCE INCLUDING: GREATER DETROIT CHAMBER OF COMMERCE; SOUTHERN WAYNE COUNTY CHAMBER OF COMMERCE; CANTON AND DEARBORN CHAMBERS OF COMMERCE; AND THE AMERICAN ARAB CHAMBER OF COMMERCE. ADDITIONAL ACTIVITIES INCLUDE EFFORTS IN SUPPORT OF THE MICHIGAN FITNESS FOUNDATION, AND THE GOVERNOR'S COUNCIL ON PHYSICAL FITNESS, HEALTH AND SPORTS TO FOSTER HEALTH AND HEALTHY LIFESTYLES OF MICHIGAN CITIZENS. ALSO INCLUDED ARE COSTS RELATED TO THE COORDINATION AND OFFERING OF COMMUNITY BLOOD DONOR DRIVES (DONE IN PARTNERSHIP WITH THE AMERICAN RED CROSS) AND ORGAN DONOR DRIVES (DONE IN PARTNERSHIP WITH GIFT OF LIFE OF MICHIGAN) AT OUR LOCATIONS AND COMMUNITY LOCATIONS THAT TARGET OUR EMPLOYEES AND MEMBERS OF THE PUBLIC. OAKWOOD IS ACTIVELY ENGAGED IN BUILDING "HEALTHY COMMUNITIES" WITH THE COMMUNITIES IT SERVES. THIS ENTAILS WORKING WITH THE CITIES, SCHOOLS, NONPROFIT PARTNERS AND COMMUNITY MEMBERS TO IMPROVE HEALTH IN EACH COMMUNITY WITH THE SUPPORT OF COALITIONS IN EACH COMMUNITY. PART III, LINE 2: THE ESTIMATED BAD DEBT FOR THE ORGANIZATION IS CALCULATED BY USING GROSS CHARGES MULTIPLIED BY THE COST TO CHARGE RATIO. PART III, LINE 3: THE PORTION OF BAD DEBT THAT IS CONSIDERED TO BE A COMMUNITY BENEFIT IS DETERMINED BY THE BAD DEBTS UNDER $100 FOR PATIENTS WITHOUT INSURANCE THAT WOULD HAVE BEEN ELIGIBLE FOR CHARITY CARE. THE ORGANIZATION CONSIDERS BAD DEBT EXPENSE TO BE A COMMUNITY BENEFIT SINCE THE COSTS OF PROVIDING UNCOMPENSATED SERVICES TO PATIENTS IMPEDES THE ORGANIZATION'S ABILITY TO PROVIDE OTHER CHARITY CARE AND COMMUNITY BENEFIT SERVICES. ALSO, THE PROVISION OF UNCOMPENSATED CARE TO PATIENTS WITHOUT INSURANCE POSITIVELY IMPACTS THE HEALTH OF THE SOUTHEASTERN MICHIGAN COMMUNITIES IN WHICH WE SERVE. PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE COMPANY ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE PROVISION FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES IN EVALUATING THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY HEALTH CARE COVERAGE, THE COMPANY ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. EFFECTIVE JANUARY 1, 2012, ALL CHARGES FOR PATIENTS WITHOUT INSURANCE ARE DISCOUNTED TO AN AMOUNT THAT APPROXIMATES THE COMPANY'S LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES. FOR ACCOUNTS RECEIVABLE ASSOCIATED WITH SELF-PAY ACCOUNTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE COMPANY RECORDS A SIGNIFICANT PROVISION FOR DOUBTFUL ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST COLLECTION 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 DOUBTFUL ACCOUNTS. THE PROVISION FOR DOUBTFUL ACCOUNTS HAS BEEN REPORTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. PART III, LINE 8: THE COST OF MEDICARE SERVICES WAS DETERMINED USING A COST ACCOUNTING SYSTEM THAT INCLUDED ALL ACUTE CARE FACILITY ACTIVITY. THE COST ACCOUNTING SYSTEM ASSIGNS DIRECT AND INDIRECT COST AT A CHARGE CODE LEVEL BASED ON RELATIVE VALUE UNITS AND OTHER ALLOCATION METHODOLOGIES. NET REVENUE AT A PATIENT ACCOUNT LEVEL IS BASED ON ACTUAL PAYMENTS WHERE AVAILABLE, AND MODELED REVENUE WHERE PAYMENT HAS YET TO BE RECEIVED. PATIENTS ARE THEN GROUPED BY PAYOR TO ARRIVE AT SUMMARIZED REVENUE AND COSTS.THE ORGANIZATION CONSIDERS THE MEDICARE SHORTFALL TO BE A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: 1) SINCE THERE IS AN EXCESS OF EXPENSES OVER MEDICARE REIMBURSEMENT, OHI MUST COVER THE SHORTFALL. AS A RESULT, THE AMOUNT NEEDED TO COVER THE SHORTFALL IS NOT AVAILABLE FOR OTHER CHARITY CARE AND COMMUNITY BENEFIT SERVICES, 2) A SIGNIFICANT PORTION OF SERVICES PROVIDED TO MEDICARE BENEFICIARIES WOULD LIKELY QUALIFY FOR CHARITY CARE ABSENT INSURANCE COVERAGE UNDER THE MEDICARE PROGRAM, AND 3) THE PROVISION OF UNDER-COMPENSATED PATIENT CARE TO MEDICARE BENEFICIARIES POSITIVELY IMPACTS THE HEALTH OF THE SOUTHEASTERN MICHIGAN COMMUNITIES IN WHICH WE SERVE. PART III, LINE 9B: HOSPITAL PATIENTS PRESENTING OR SCHEDULING FOR SERVICES WITHOUT INSURANCE ARE IDENTIFIED AS "SELF-PAY" PATIENTS. THESE PATIENTS ARE ASSESSED BY FINANCIAL COUNSELING STAFF, WITHIN THE ORGANIZATION'S "OAKASSIST PROGRAM" TO: A) DETERMINE IF SOME TYPE OF INSURANCE COVERAGE MAY EXIST, B) ASSESS ELIGIBILITY FOR A GOVERNMENT SPONSORED INSURANCE PROGRAM, OR C) ASSESS ELIGIBILITY FOR A FULL OR PARTIAL CHARITY CARE, CATASTROPHIC MEDICAL EXPENSE OR SELF-PAY DISCOUNT. THIS PROCESS IS INITIATED AT THE TIME OF SCHEDULING OR AS CLOSE TO THE DATE OF SERVICE AS POSSIBLE. IF THE DETERMINATION OF DISCOUNTING OR OTHER COVERAGE IS NOT FOUND, THE PATIENT WILL RECEIVE A BILLING STATEMENT WITH DIRECTION TO CONTACT AN OAKWOOD CUSTOMER SERVICE REPRESENTATIVE OR OAKASSIST FINANCIAL COUNSELOR FOR FINANCIAL ASSISTANCE OR IF EXTENDED PAYMENT ARRANGEMENTS ARE NEEDED TO HELP SATISFY THE DEBT. THE PATIENT RECEIVES A MINIMUM OF FOUR (4) STATEMENTS NOTIFYING THEM OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PRIOR TO FORWARDING ACCOUNTS TO A THIRD-PARTY COLLECTION AGENCY. IN ADDITION, PRIOR TO FORWARDING ACCOUNTS TO A COLLECTION AGENCY, THE ACCOUNTS ARE SCORED TO DETERMINE THE PATIENT'S ABILITY TO PAY AND DEEMED EITHER CHARITY OR BAD DEBT. ACCOUNTS ELIGIBLE FOR CHARITY CARE, PURSUANT TO THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, ARE WRITTEN-OFF TO A CHARITY CARE CODE AND NO FURTHER COLLECTION ACTIVITY IS PURSUED. IN CASES WHERE THE ORGANIZATION EXPECTS PAYMENT BUT IS UNABLE TO COLLECT, THE ACCOUNTS ARE CLASSIFIED AS BAD DEBT AND FORWARDED FOR FURTHER COLLECTION ACTIVITY. PART VI, LINE 2: IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT, OAKWOOD CONDUCTS AN ANNUAL ENVIRONMENTAL SCAN OF THE COMMUNITIES SERVED EACH YEAR AS PART OF THE STRATEGIC PLANNING PROCESS WHICH INCLUDES KEY INFORMATION FROM THE COMMUNITIES SERVED INCLUDING ACCESS TO CARE, DEMOGRAPHICS, HEALTH NEEDS, INTERNAL HOSPITAL DATA, AND IDENTIFYING GAPS IN SERVICES. THE COMMUNITY OUTREACH DEPARTMENT DIRECTS SERVICES AND PROGRAMS TARGETING VULNERABLE POPULATIONS AND SERVICES TO IMPROVE THE GENERAL HEALTH OF THE COMMUNITIES SERVED. NUMEROUS PHYSICIANS AND EMPLOYEES OF OAKWOOD SERVE ON LOCAL COMMITTEES, TASK FORCES, COALITIONS, AND BOARDS THAT ARE RELATED TO HEALTH AND HEALTH NEEDS. THIS INFORMATION IS USED TO ASSIST IN THE DEVELOPMENT OF PROGRAMS AND SERVICES IN THE COMMUNITIES, COLLABORATE ON HEALTH NEEDS AND REDUCE ANY DUPLICATION OF SERVICES TO MAXIMIZE RESOURCES. NUMEROUS DATA SOURCES ARE UTILIZED TO ASSESS HEALTH NEEDS OF THE COMMUNITIES INCLUDING MDCH, TRUVEN HEALTH DATA, CDC DATA SETS, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, CENSUS DATA, PUBLIC HEALTH DATA FOR WAYNE COUNTY, ETC. PART VI, LINE 3: OUR FINANCIAL ADVISORY TEAM, OAKASSIST, PROVIDES PRE-SERVICE AND POST-SERVICE SUPPORT TO OUR PATIENTS AND THEIR FAMILIES IN DETERMINING ELIGIBILITY OPTIONS FOR HEALTH CARE COVERAGE. PATIENTS IDENTIFIED WITHOUT INSURANCE COVERAGE ARE ASSESSED AT ALL ACCESS POINTS, INCLUDING THE EMERGENCY DEPARTMENT AND OUTPATIENT DIAGNOSTIC SCHEDULING, PRIOR TO ELECTIVE PROCEDURES, AND PHYSICIAN OFFICE REFERRALS. PATIENTS ARE PROVIDED INFORMATION OR ASSISTANCE IN REGARD TO ELIGIBILITY WITH THE ORGANIZATION'S CHARITY CARE POLICY OR OTHER FORMS OF FINANCIAL ASSISTANCE AVAILABLE (MEDICAID, ADULT BENEFIT WAIVER, COBRA COVERAGE, VICTIMS OF CRIME, ETC.). POSTERS IDENTIFYING THE FINANCIAL ADVISORY TEAM, OAKASSIST, AND THE AVAILABILITY OF CHARITY CARE ARE VISIBLE IN HIGH TRAFFIC AREAS, SUCH AS THE EMERGENCY DEPARTMENT, OUTPATIENT REGISTRATION AREAS, AND ON THE OAKWOOD.ORG WEBSITE. DOCUMENTATION IS ALSO PRINTED ON THE PATIENT BILLING STATEMENT INCLUDING CONTACT INFORMATION SHOULD A PATIENT REQUIRE ASSISTANCE POST SERVICE. PART VI, LINE 4: LOCATED IN SOUTHEAST MICHIGAN, OAKWOOD HEALTHCARE SYSTEM (OHS) SERVES MORE THAN 940,000 RESIDENTS IN 36 COMMUNITIES STRETCHING ACROSS A 500 SQUARE MILE AREA OF WESTERN WAYNE COUNTY. THIS AREA IS RICHLY VARIED BY RACE AND ETHNICITY (AFRICAN AMERICAN 16.6%, HISPANIC 9.5%, ASIAN 2.9%, MULTI-RACIAL 2.4%, WHITE 68.1%, AND OTHER .4%). IN THE CITY OF DEARBORN, 41.7% OF THE POPULATION IS ARABIC. ONE OF THE MOST CULTURALLY DIVERSE AREAS IN MICHIGAN, OVER 12.4% OF RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH WITH SOME COMMUNITIES FAR EXCEEDING THE NATIONAL AVERAGE: DEARBORN (43.9%), SOUTHWEST DETROIT (59%), AND MELVINDALE (21.2%). IN THE OHS SERVICE AREA, 88% ARE UNDER THE AGE OF 65, WITH 63% BETWEEN THE AGES OF 18 AND 64 AND 25% UNDER THE AGE OF 18. ONE OF THE REGIONS HARDEST HIT BY THE RECESSION, SOUTHEASTERN MICHIGAN RESIDENTS CONTINUE TO STRUGGLE WITH HIGH RATES OF POVERTY (23.8%) AND UNEMPLOYMENT (8.9%). FOR MANY IN MICHIGAN, RACIAL AND ETHNIC DISPARITIES, POVERTY AND LACK OF INSURANCE HAVE LED TO LIMITED ACCESS TO PROVIDERS AND PREVENTIVE CARE. WAYNE COUNTY WAS RANKED HIGHEST IN MICHIGAN FOR MORTALITY AND MORBIDITY BY THE ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS. PART VI, LINE 5: OAKWOOD HEALTHCARE SYSTEM AND ITS EMPLOYEES, BOARD MEMBERS, PHYSICIANS AND VOLUNTEERS ARE PROUD TO BE INVOLVED IN MAKING OUR COMMUNITY A HEALTHIER PLACE TO LIVE, WORK, AND PLAY.OUR GOVERNING BOARDS ARE COMPRISED OF BUSINESS, CIVIC AND COMMUNITY LEADERS WHO WORK AND/OR LIVE IN THE AREA, AND HAVE A STAKE IN COMMUNITY HEALTH IMPROVEMENT. BOARD MEMBERS ARE ACTIVELY ENGAGED IN OAKWOOD'S MISSION TO PROVIDE EXCELLENCE IN CARE, HEALING AND HEALTH TO THE INDIVIDUALS AND COMMUNITIES WE SERVE. A GOVERNING BOARD STRATEGIC PLANNING COMMITTEE AND MEDICAL STAFF STRATEGIC PLANNING COMMITTEE INTEGRATE THEIR PERSPECTIVES INTO BOTH SHORT AND LONG TERM VISIONING AND PLANNING GEARED TOWARD FULFILLING OUR MISSION.EACH OF OUR FOUR ACUTE CARE SITES FEATURES AN OPEN MEDICAL STAFF, WITH ELECTED LEADERSHIP AND ACTIVE COMMITTEE STRUCTURE. TO PROMOTE HEALTH IN THE COMMUNITIES, OAKWOOD PROVIDES AFTERSCHOOL NUTRITION AND PHYSICAL EDUCATION IN 17 AREA SCHOOLS, OPERATES A WELLNESS PROGRAM IN TAYLOR, MI., OPERATES A SCHOOL-BASED HEALTH CLINIC IN WAYNE, AND OPERATES ADOLESCENT HEALTH CENTERS IN THE CITIES OF TAYLOR AND INKSTER. COMMUNITY BENEFIT PROGRAMS SUCH AS CAR SEAT SAFETY, INFANT SAFE SLEEP, COMMUNITY SCREENING AND HEALTH EDUCATION INCLUDING BLOOD PRESSURE, CHOLESTEROL (TOTAL AND HDL) AND GLUCOSE TESTING. NUTRITIONAL SEMINARS ARE OFFERED FOR ALL AGE GROUPS IN THE COMMUNITY. A SMOKING CESSATION HOTLINE AND INFORMATION ARE PROVIDED TO ASSIST COMMUNITY MEMBERS IN THEIR EFFORTS TO STOP SMOKING. OAKWOOD ALSO OPERATES A HIV/AIDS PROGRAM AND TB CLINIC FOR THOSE IN NEED OF THESE SPECIALIZED SERVICES.A SIGNIFICANT PORTION OF THE OAKWOOD HEALTHCARE SYSTEM SERVICE AREA CONSISTS OF FEDERALLY MEDICALLY UNDERSERVED AREAS AS DESIGNATED BY HRSA (HEALTH RESOURCES AND SERVICES ADMINISTRATION). MULTI-LEVEL PARTNERSHIPS AND COLLABORATIONS WITH FEDERALLY QUALIFIED HEALTH CENTERS AND OTHER COMMUNITY BASED CLINICS ARE IN PLACE. DURING THE MID-2000'S, OAKWOOD WAS THE DRIVING FORCE BEHIND THE FIRST SUCCESSFUL FQHC (FEDERALLY QUALIFIED HEALTH CENTER) APPLICATION IN OUT-WAYNE COUNTY. OAKWOOD HAS MAINTAINED A STRONG COLLABORATIVE RELATIONSHIP WITH THE FGHC AGENCY, WHICH NOW HAS TWO LOCATIONS TO BETTER MEET THE PRIMARY CARE NEEDS OF OUR UNINSURED AND UNDERINSURED COMMUNITY MEMBERS. WE ALSO ACTIVELY PARTICIPATE IN WORKGROUPS, COMMITTEES AND BOARDS ASSOCIATED WITH COMMUNITY PROGRAMS SUCH AS THE DETROIT WAYNE COUNTY HEALTH AUTHORITY AND THE VOICES OF DETROIT INITIATIVE-BOTH DEDICATED TO COLLABORATIVE, COMMUNITY BASED SOLUTIONS TO THE CHALLENGES OF THE UNINSURED. INITIATIVES ADDRESS THE NEED FOR ACCESS TO PRIMARY HEALTH CARE AS WELL AS DEVELOPMENT OF A BROAD BASED RESPONSE TO THE NEED FOR EMERGENCY DEPARTMENT DIVERSION FOR PATIENTS IDEALLY SERVED IN A PRIMARY CARE SETTING.IN ADDITION TO THE MANY COMMUNITY HEALTH IMPROVEMENT ACTIVITIES PRESENTED BY ITS COMMUNITY HEALTH, MEDICAL EDUCATION, SCHOOL BASED/SCHOOL LINKED HEALTH CENTERS AND OTHER DEPARTMENTS, OAKWOOD PRESENTS A RADIO PROGRAM FEATURING INFORMATION ABOUT PERSONAL AND FAMILY HEALTH PROMOTION. "CHAMPIONS OF CARE" IS BROADCAST EACH WEEK TO ALL COMMUNITIES WE SERVE ON WJR, AN AM RADIO STATION WITH A STRONG GEOGRAPHIC SIGNAL THAT COVERS NOT ONLY OUR IMMEDIATE AREA, BUT ALSO A LARGE PORTION OF THE STATE AND EVEN PARTS OF THE MIDWESTERN REGION.MANY OF OUR EXECUTIVES, MANAGERS AND OTHER EMPLOYEES SERVE AS LEAD VOLUNTEERS OR BOARD DIRECTORS AND OFFICERS FOR KEY NON-PROFIT AGENCIES AND GOVERNMENT COMMISSIONS IN THE REGION. THESE INCLUDE ORGANIZATIONS AND AUTHORITIES ASSOCIATED WITH HEALTH CARE, SOCIAL SERVICES, EDUCATION, MUNICIPAL GOVERNANCE, INDUSTRY AND TRADE GROUPS AS WELL AS SERVICE ORGANIZATIONS AND CHAMBERS OF COMMERCE. MANY OAKWOOD EMPLOYEES ALSO OFFER AD-HOC CONSULTING ADVICE.OAKWOOD HAS ALSO MAINTAINED LONG STANDING, DEMONSTRATED PARTNERSHIPS WITH VITAL COMMUNITY AGENCIES SUCH AS ACCESS (SERVING THE ARAB AMERICAN COMMUNITY AND OTHERS WITH HEALTH AND SOCIAL SERVICES AS WELL AS EMPLOYMENT PROGRAMS); SOUTHWEST SOLUTIONS (SOCIAL SERVICES AND HOUSING AGENCY); STARFISH FAMILY SERVICES (SOCIAL SERVICES); CABRINI, MAPI AND HOPE CLINICS (FREE MEDICAL CLINICS); FIRST STEP (DOMESTIC VIOLENCE AND SEXUAL ASSAULT RESPONSE AGENCY); AND WESTERN WAYNE FAMILY HEALTH CENTER (FQHC). WE OFFER THESE AGENCIES PROGRAMS AND SERVICES, IN KIND OR DISCOUNTED FEES FOR LAB SERVICES, AND COLLABORATE IN VARIOUS GRANT APPLICATIONS AND COLLABORATIVE PROGRAMS. PARTNERSHIPS ARE ALSO IN PLACE FOR REGIONAL WORKFORCE DEVELOPMENT AND HEALTH INFORMATION TECHNOLOGY. OAKWOOD STAFF ASSISTS IN COMMUNITY JOB FAIRS, GIVING JOB ADVICE, REVIEWING RESUMES, AND CONDUCTING MOCK INTERVIEWS ALONG WITH PROVIDING INTERNSHIPS FOR STUDENTS ATTENDING MANY COLLEGES AND UNIVERSITIES.OTHER EXAMPLES INCLUDE OUR FOCUSED WORK AND COOPERATION WITH GIFT OF LIFE-MICHIGAN TO SUPPORT ORGAN DONATION AND A WELL-DEVELOPED AND EXTENSIVE SPEAKER'S BUREAU THAT OFFERS VOLUNTEER OAKWOOD SPEAKERS TO TALK TO COMMUNITY AND OTHER GROUPS ABOUT A BROAD RANGE OF TOPICS. OUR ARTS FOR THE SPIRIT PROGRAM PROVIDES AN ENVIRONMENT OPEN TO THE PUBLIC TO PROMOTE HEALTH AND HEALING. WE HAVE A STRONG TRADITION OF BEING A PART OF OUR COMMUNITY, WITH SHARED VISION OF CREATING HEALTH AND WELLNESS FOR ALL AND CONTINUE TO EXPAND THAT OUTREACH WITH EVERY PASSING YEAR. PART VI, LINE 6: OAKWOOD HEALTHCARE SYSTEM ACTIVELY SUPPORTS THE HEALTH OF THE COMMUNITIES THROUGH SPECIFIC INITIATIVES OF EACH HOSPITAL SITE FOR THE COMMUNITIES SERVED IN ADDITION TO THE COMMUNITY OUTREACH DEPARTMENT THAT PROVIDES SERVICES AND PROGRAMS FOR THE ENTIRE SYSTEM. PROGRAMS INCLUDE CHILD AND ADOLESCENT HEALTH CENTERS IN TAYLOR, INKSTER AND WESTLAND; AN INFECTIOUS DISEASE CLINIC OFFERING CARE FOR BOTH HIV AND TB; THE CENTER FOR EXCEPTIONAL FAMILIES (SERVING CHILDREN WITH SPECIAL NEEDS) FREE COMMUNITY HEALTH SCREENINGS, A SPEAKERS BUREAU THAT PROVIDES EDUCATION AND HEALTH INFORMATION, FREE CHRONIC ILLNESS SUPPORT AND PREVENTION CLASSES AND PROGRAMS, HEALTHY COOKING AND EATING CLASSES AND AFTERSCHOOL NUTRITION AND ACTIVITY PROGRAMS IN 17 SCHOOLS. HEALTHCARE NAVIGATORS ASSIST COMMUNITY MEMBERS IN ENROLLING IN THE HEALTH INSURANCE MARKETPLACE AND MEDICAID. OAKWOOD HEALTHCARE SYSTEM HAS A PROACTIVE APPROACH AND PLAN TO ASSIST WITH COMMUNITY CONCERNS RELATED TO COMPREHENSIVE DISASTER PLANNING AND PROTOCOLS FOR SUPPORTING THE COMMUNITY IN A TIME OF NEED. IN ADDITION, TRAUMA PROGRAMS AT EACH HOSPITAL REACH OUT TO THEIR SURROUNDING COMMUNITIES TO REDUCE INJURIES AND POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY.OAKWOOD HEALTHCARE SYSTEM PARTICIPATES IN NUMEROUS CIVIC ORGANIZATIONS. SENIOR LEADERS PROMOTE EMPLOYEE PARTICIPATION IN COMMUNITY-BASED ORGANIZATIONS THROUGH STRATEGIES SUCH AS THE CLINICAL ADVANCEMENT PROGRAM, PARISH NURSING, AND THE BRAVO! RECOGNITION PROGRAM. CURRENT COMMUNITY SUPPORT ACTIVITIES INCLUDE: A FINANCIAL COMMITMENT TO CHARITY CARE, COMMUNITY HEALTH, THE OAKWOOD HEALTHCARE FOUNDATION, PROGRAMS CONDUCTED BY OAKWOOD HEALTHCARE SYSTEM, AND LEADERSHIP AND STAFF PARTICIPATION ON OVER 100 LOCAL, REGIONAL, AND NATIONAL BOARDS AND COMMITTEES.TO TRACK COMMUNITY SUPPORT ACTIVITIES, OAKWOOD HEALTHCARE SYSTEM MAINTAINS A COMMUNITY BENEFITS REPORTING SYSTEM THAT DELINEATES THE PROJECTS IT SUPPORTS, BOTH FROM A VOLUNTEER AND FINANCIAL STANDPOINT. CONTRIBUTIONS TO COMMUNITY HEALTH PROVIDED BY OAKWOOD HEALTHCARE SYSTEM'S COMMUNITY HEALTH DEPARTMENT ARE TRACKED THROUGH A COMPREHENSIVE DATABASE THAT RECORDS HOW MANY UNITS OF SERVICE ARE DELIVERED TO THE COMMUNITY THROUGH VARIOUS OAKWOOD HEALTHCARE SYSTEM PROGRAMS.OAKWOOD HEALTHCARE INC. IS PRIMARILY COMPRISED OF OAKWOOD HEALTHCARE SYSTEM. THE AFFILIATED HEALTHCARE SYSTEM ALSO INCLUDES THE FOLLOWING COMPANIES:OAKWOOD HEALTH PROMOTIONS, INC. - PROVIDES FOUR DIFFERENT LEVELS OF ELDER CARE: INDEPENDENT LIVING, ASSISTED LIVING, ALZHEIMER CARE, AND SKILLED NURSING CARE. OAKWOOD HEALTH PROMOTIONS ALSO PROVIDES ADULT DAY CARE SERVICES.OAKWOOD HOME CARE SERVICES - DELIVERS HIGH QUALITY HOME HEALTH CARE SERVICES TO THOUSANDS TO RESIDENTS THROUGHOUT SOUTHEAST MICHIGAN. IN 2013, OAKWOOD HOME CARE SERVICES PROVIDED MEDICAL CARE TO 6,464 HOME-BOUND PATIENTS, WHICH INCLUDED PROFESSIONAL PATIENT CARE VISITS IN EXCESS OF 79,000. ITS DEDICATED STAFF INCLUDES REGISTERED NURSES, PHYSICAL AND OCCUPATIONAL THERAPISTS, SPEECH PATHOLOGISTS, MEDICAL SOCIAL WORKERS, NUTRITIONISTS, AND HOME HEALTH AIDES.OAKWOOD UNITED HOSPITALS, INC. - PROVIDES HEALTH CARE FACILITIES FOR OAKWOOD HEALTHCARE, INC.OAKWOOD HEALTHCARE FOUNDATION - PROVIDES SUPPORT TO ENTITIES THAT COMPRISE OAKWOOD HEALTHCARE, INC.'S HEALTH CARE SYSTEM. THE OAKWOOD HEALTHCARE FOUNDATION OPERATES EXCLUSIVELY FOR EDUCATIONAL, SCIENTIFIC, AND CHARITABLE PURPOSES IN SUPPORT OF THE MISSION OF OAKWOOD HEALTHCARE SYSTEM, THE HEALTHCARE DELIVERY SYSTEM OF OAKWOOD HEALTHCARE, INC. OAKWOOD HEALTHCARE FOUNDATION'S PURPOSE IS TO PROMOTE PHILANTHROPIC INVESTMENT OF TIME, TALENT AND TREASURE IN SUPPORT OF OAKWOOD'S NOT-FOR-PROFIT MISSION TO PROVIDE EXCELLENCE IN CARE, HEALING AND HEALTH TO THE INDIVIDUALS AND COMMUNITIES WE SERVE. DURING 2013, OAKWOOD HEALTHCARE FOUNDATION HAD A TOTAL OF 6,694 DONORS AND RAISED TOTAL FUNDS OF $12,325,645. OAKWOOD HEALTHCARE FOUNDATION MADE MORE THAN $4.4 MILLION IN DISBURSEMENTS IN 2013 TO SUPPORT MULTIPLE PROGRAMS AND INITIATIVES.OAKWOOD ENTERPRISES, INC. - OWNS AND MANAGES REAL ESTATE IN SOUTHEAST MICHIGAN, PRIMARILY MEDICAL OFFICE BUILDINGS. ALSO, OPERATES OAKWOOD CARE CONNECTIONS WHICH PROVIDES PRIVATE DUTY NURSING SERVICES, AND INVESTS IN VARIOUS HEALTHCARE RELATED JOINT VENTURES.MIDWEST MEDICAL CENTER - OWNS AND OPERATES SIX PHYSICIAN PRACTICE FACILITIES CONVENIENTLY LOCATED IN SOUTHEASTERN MICHIGAN. MIDWEST HAS OVER 65 PHYSICIANS SPECIALIZING IN 19 DIFFERENT SPECIALTIES. IT ALSO OWNS AND OPERATES A CAP CERTIFIED LABORATORY. IN ADDITION TO CORE PHYSICIAN SERVICES, CENTERS ALSO INCLUDE RADIOLOGY AND REHABILITATION SERVICES.OAKWOOD INFUSION SERVICES - PROVIDES HOME INFUSION SERVICES. OAKWOOD INFUSION CENTERS OFFER ROUTINE OUTPATIENT SERVICES FOR PATIENTS SEEKING TREATMENT FOR CANCER, RHEUMATOID ARTHRITIS, CROHN'S DISEASE, MULTIPLE SCLEROSIS AND OTHER DIAGNOSES PROVIDING SERVICES SUCH AS, IV MEDICATION THERAPY, CHEMOTHERAPY INFUSIONS, REFILL AND MAINTENANCE OF PORT PUMPS, ANTIBIOTIC THERAPY, INTRAMUSCULARLY AND SUBCUTANEOUS INJECTIONS, IV FLUID HYDRATION, VENOUS ACCESS DEVICE IRRIGATION, IMPLANTED VENOUS ACCESS DEVICE DECLOTTING, THERAPEUTIC PHLEBOTOMY AND BLOOD TRANSFUSION.OAKWOOD HEALTHCARE SYSTEM IS A REGIONAL HEALTH CARE NETWORK AND IS ONE OF THE MOST COMPREHENSIVE HEALTH CARE DELIVERY SYSTEMS IN SOUTHEASTERN MICHIGAN, SERVING SOUTHEAST MICHIGAN FOR MORE THAN 60 YEARS. OAKWOOD HEALTHCARE SYSTEM IS A RECOGNIZED LEADER IN CLINICAL QUALITY, SERVICE AND VALUE. OUR EMPLOYEES, PHYSICIANS AND VOLUNTEERS ARE COMMITTED TO PROVIDING EXCELLENT CLINICAL QUALITY AND WORLD-CLASS CUSTOMER SERVICE TO OUR PATIENTS AND THEIR FAMILIES. PART VI, LINE 7, REPORTS FILED WITH STATES MI SCHEDULE H, PART VI, OTHER COMMUNITY BENEFIT INFORMATION: THE OAKWOOD CHNA STEERING COMMITTEE SELECTED CRITERIA BY WHICH TO PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITIES. THE CRITERIA SELECTED INCLUDED MAGNITUDE, SEVERITY, ALIGNMENT, EXISTING RESOURCES, AND ABILITY TO MEASURE CHANGE. IN ADDITION TO THE FIVE CRITERIA, THE COMMITTEE EMPHASIZED THE UNDERLYING FOUNDATION OF THE PRIORITIZATION PROCESS SHOULD BE A FOCUS ON SERVING VULNERABLE POPULATIONS. THE FOLLOWING HEALTH CARE NEEDS WERE IDENTIFIED IN THE CHNA AS A PRIORITY FOR OAKWOOD HEALTHCARE, INC.; HEART/CARDIOVASCULAR DISEASE, DIABETES, OBESITY AND ACCESS TO CARE.THE OAKWOOD HEALTHCARE FOUNDATION PROVIDES SIGNIFICANT ASSISTANCE TO STRENGTHEN OAKWOOD'S COMMUNITY BENEFIT PROGRAMS AND SERVICES. IN ADDITION TO PROVIDING THE FUNDS FOR MANY COMMUNITY BENEFIT PROGRAMS, SUCH AS ADOLESCENT HEALTH CENTERS, THE CENTER FOR EXCEPTIONAL FAMILIES, NEEDY PATIENT PROGRAMS, ETC., IT EXPENDED OVER $800,000 IN 2013 TO COVER THE COSTS OF FUNDRAISING AND GRANT WRITING THAT IS DIRECTLY ASSOCIATED WITH COMMUNITY BENEFIT PROGRAMMING. TWO LARGE EVENTS WERE HELD IN 2013 THAT WERE SPECIFICALLY PRESENTED TO RAISE FUNDS TO OPERATE THE CENTER FOR EXCEPTIONAL FAMILIES, A MULTIDISCIPLINARY CLINIC FOR CHILDREN WITH PHYSICAL AND COGNITIVE IMPAIRMENTS. MANY OF THE SERVICES PROVIDED BY THE CENTER ARE NOT COVERED BY INSURANCE BUT ARE INTEGRAL TO CARE, WITH OTHER FINANCIAL SUPPORT RAISED FOR OPERATION OF THEIR PHYSICAL LOCATION. NUMEROUS GRANTS TO FEDERAL AND STATE FUNDING SOURCES SUCH AS HRSA AND MICHIGAN DEPARTMENT OF COMMUNITY HEALTH AND OTHER PRIVATE FUNDING SOURCES WERE PREPARED, COMPLETED AND SUBMITTED BY THE FOUNDATION ON BEHALF OF PROGRAMS SUCH AS OAKWOOD'S SCHOOL BASED/SCHOOL LINKED HEALTH CENTERS, PREVENTION PROGRAMS, RYAN WHITE CLINIC FOR HIV CARE, THE CENTER FOR EXCEPTIONAL FAMILIES, NUTRITION EDUCATION AND OTHER PROGRAMS THAT BENEFIT OUR COMMUNITY. 1 AUTISM ALLIANCE OF MICHIGAN 26500 AMERICAN DR SOUTHFIELD MI 48034 270472137 501(C)(3) 9280 COMMUNITY SUPPORT DEARBORN COMMUNITY FUND 15801 MICHIGAN AVE DEARBORN MI 48126 383507205 501(C)(3) 18000 COMMUNITY SUPPORT DETROIT ECONOMIC CLUB 211 WEST FORT ST SUITE 505 DETROIT MI 482263286 380508823 501(C)(3) 8796 COMMUNITY SUPPORT EDSEL & ELEANOR FORD HOUSE 1100 LAKE SHORE RD GROSSE POINTE SHORES MI 48236 382218274 501(C)(3) 16250 COMMUNITY SUPPORT HENRY FORD ESTATE 1100 LAKE SHORE RD GROSSE POINTE SHORES MI 48236 274877171 501(C)(3) 6800 COMMUNITY SUPPORT HENRY FORD HEALTH SYSTEM 1 FORD PLACE 5A OFFICE OF PHILANTHR PY DETROIT MI 482023450 381357020 501(C)(3) 10000 COMMUNITY SUPPORT NAMI MICHIGAN 921 N WASHINGTON LANSING MI 48906 382643038 501(C)(3) 7032 COMMUNITY SUPPORT OAKLAND UNIVERSITY SCHOOL OF NURSING 2200 N SQUIRREL ROAD ROCHESTER MI 483094497 382434916 501(C)(3) 7240 COMMUNITY SUPPORT WSU SCHOOL OF MEDICINE - DEVELOPMENT AND ALUMNI AFFAIRS 4201 ST ANTOINE MAILBOX 253-UHC 6-FG DETROIT MI 48201 753235212 501(C)(3) 9010 COMMUNITY SUPPORT OAKWOOD HEATLHCARE FOUNDATION 15500 LUNDY PARKWAY DEARBORN MI 48126 383432073 501(C)(3) 3036312 SUPPORT THE MISSION AND OPERATION OF OAKWOOD HEALTH SYSTEM 10 0 HELPING HANDS - NEEDY EMPLOYEE ASSISTANCE 34 64337 0 EMPLOYEE SCHOLARSHIPS 87 120239 0 MEDICAL RESIDENTS STIPENDS 254 12918498 0 PART I, LINE 2: THE OAKWOOD HEALTHCARE SYSTEM MAKES CONTRIBUTIONS PRIMARILY TO ORGANIZATIONS THAT HAVE BEEN RECOGNIZED BY THE IRS AS TAX-EXEMPT CHARITABLE ORGANIZATIONS UNDER IRC SECTION 501(C)(3). GOVERNMENT GRANTS RECEIVED BY THE OAKWOOD HEALTHCARE SYSTEM ARE MONITORED BY THE RESPECTIVE DEPARTMENTS. OAKWOOD HEALTHCARE INC. FOLLOWS THE GUIDELINES AND IS SUBJECT TO AN A133 AUDIT ANNUALLY UPON MEETING THE EXPENDITURE THRESHOLD. THE OAKWOOD HEALTHCARE SYSTEM AWARDS SCHOLARSHIPS ANNUALLY TO EMPLOYEES, FAMILY MEMBERS AND STUDENT VOLUNTEERS. THE EMPLOYEES APPLY AND APPLICATIONS ARE REVIEWED BY AN IMPARTIAL SELECTION COMMITTEE. THE COMMITTEE IS COMPRISED OF REPRESENTATIVES FROM HUMAN RESOURCES, NURSING/ALLIED HEALTH, VOLUNTEER SERVICES, FINANCE AND THE FOUNDATION. APPLICANTS ARE SCORED USING SEVERAL KEY CRITERIA, THEN RANKED ACCORDINGLY. THE OAKWOOD HEALTHCARE SYSTEM ALSO PROVIDES GRANTS TO EMPLOYEES IN THEIR GREATEST TIME OF NEED AS A RESULT OF PERSONAL CRISIS OR CATASTROPHIC EVENT THROUGH THE HELPING HANDS FUND. THE HELPING HANDS FUND IS ADMINISTERED THROUGH HUMAN RESOURCES AND A COMMITTEE HAS BEEN ESTABLISHED TO REVIEW REQUESTS AND MAKE RECOMMENDATIONS. ELIGIBILITY CRITERIA HAS BEEN ESTABLISHED WITH A MAXIMUM PAYMENT. IN CONJUNCTION WITH THE ORGANIZATION'S GRADUATE MEDICAL EDUCATION PROGRAM SUMMARIZED IN PROGRAM SERVICE ACCOMPLISHMENTS, OAKWOOD HEALTHCARE, INC. PAID MEDICAL RESIDENT STIPENDS IN THE AMOUNT OF $12,918,498 DURING 2013. OAKWOOD HEALTHCARE SYSTEM MONITORS USE OF GRANT FUNDS THROUGH ITS PAYROLL AND HUMAN RESOURCES DEPARTMENTS AS THESE GRANTS ARE GENERALLY MADE IN CONNECTION WITH THE EMPLOYEE'S COMPENSATION. X X X X 1 1 X X X X X 0 1 0 1 1 0 0 0 0 CONNOLLY BRIAN PRESIDENT & CEO 784220 0 627687 0 549139 0 294521 0 42371 0 2297938 0 303369 0 HENOCH MALCOLM MD SVP & CMO 353518 0 186214 0 45866 0 70115 0 30109 0 685822 0 93670 0 LLOYD SETH SECRETARY, SVP/CORPORATE COUNSEL 283186 0 76381 0 32793 0 7236 0 11027 0 410623 0 0 0 KEUTEN JOHN SVP & CFO 322798 0 169285 0 72934 0 61293 0 20840 0 647150 0 46880 0 CAMPBELL DAVID EVP OPS. SYS. STRAT. & GROWTH 324727 0 76381 0 69160 0 67277 0 21008 0 558553 0 0 0 CONWAY PAUL SVP HUMAN RESOURCES 194751 0 122150 0 53288 0 45080 0 24068 0 439337 0 61458 0 D'AGOSTINO MAUREEN SVP ORGANIZ. EXCELLENCE 196371 0 71875 0 21940 0 42886 0 30063 0 363135 0 19984 0 GEHEB MICHAEL EVP PHYS. PLAN & OPS. 398379 0 266363 0 76273 0 102764 0 19281 0 863060 0 114945 0 HUGHES EDITH SITE PRESIDENT 237402 0 85683 0 49732 0 29680 0 20359 0 422856 0 0 0 ISENSTEIN BILL SVP MANAGED CARE 284363 0 116472 0 43613 0 18126 0 22916 0 485490 0 0 0 MEDVEC BARBARA SVP, CHIEF NURSING OFFICER 204424 0 114715 0 55131 0 53011 0 4584 0 431865 0 60258 0 ODOM LEE ANN SITE PRESIDENT 161386 0 41226 0 26148 0 19418 0 3195 0 251373 0 0 0 O'MALLEY CARLA EXECUTIVE DIRECTOR FOUNDATION 188867 0 114069 0 61974 0 77236 0 22317 0 464463 0 47939 0 SMITH KELLY SVP & SITE PRESIDENT 257687 0 58699 0 50756 0 62835 0 4312 0 434289 0 0 0 SMITH PAULA SVP & CHIEF INFORMATION OFFICER 214921 0 209969 0 52507 0 77095 0 23178 0 577670 0 63157 0 WELDAY DOUGLAS EVP 449048 0 253835 0 140696 0 138171 0 39874 0 1021624 0 115071 0 WIDNER ERIC SITE PRESIDENT 235335 0 53773 0 34053 0 22554 0 20398 0 366113 0 0 0 ZATINA MARY SVP GOVERNMENT RELATIONS 176141 0 113238 0 61110 0 41158 0 22789 0 414436 0 57177 0 DABIR REZA R STAFF PHYSICIAN 621044 0 0 0 54989 0 11856 0 8723 0 696612 0 0 0 FATH JOHN JOSEPH STAFF PHYSICIAN 569100 0 90000 0 30524 0 18479 0 14102 0 722205 0 0 0 JUNN FREDRICK SONG CHUN STAFF PHYSICIAN 1238285 0 147643 0 80199 0 21755 0 18005 0 1505887 0 0 0 PANNU TEJPAUL SINGH STAFF PHYSICIAN 702327 0 92010 0 28255 0 16649 0 22946 0 862187 0 0 0 SPRAGUE KEVIN JOSEPH STAFF PHYSICIAN 194498 0 555571 0 43826 0 20196 0 1056 0 815147 0 0 0 DIEDERICH JOSEPH FORMER OFFICER 0 0 136389 0 2007 0 0 0 0 0 138396 0 0 0 PART I, LINE 1A OAKWOOD HEALTHCARE, INC. HAS A FORMAL EXPENSE REIMBURSEMENT POLICY, WHICH APPLIES TO ALL TYPES OF REIMBURSEMENT. OAKWOOD HEALTHCARE, INC. DOES NOT HAVE A SPECIFIC POLICY REGARDING THE PROVISION OF TAX GROSS-UP PAYMENTS. HOWEVER, CERTAIN CORPORATE POLICIES (E.G. "EMPLOYEE RECOGNITION AWARDS") PROVIDE FOR TAX GROSS-UP PAYMENTS. ALSO, EXECUTIVE EMPLOYMENT AGREEMENTS PROVIDE FOR TAX GROSS-UP PAYMENTS AND DISCRETIONARY CHARITABLE SPENDING ACCOUNTS IN LIMITED INSTANCES. THE ORGANIZATION'S PAYROLL DEPARTMENT DETERMINED TAX GROSS-UP PAYMENTS WERE APPROPRIATE IN LIMITED INSTANCES WHERE AN INDIVIDUAL DID NOT HAVE A NET PAYMENT DUE TO THEM (E.G. TAXABLE VALUE OF GUEST TRAVEL) IN THE TAX YEAR AND THE FINANCIAL IMPACT WAS MINOR. THE FOLLOWING BENEFITS WERE PROVIDED TO CERTAIN OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES LISTED IN FORM 990, PART VII: TRAVEL FOR COMPANIONS, TAX INDEMNIFICATION AND GROSS-UP PAYMENTS, DISCRETIONARY SPENDING, AND HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES. TRAVEL FOR COMPANIONS - DURING 2013, 3 OFFICERS, 3 TRUSTEES, AND 13 KEY EMPLOYEES RECEIVED PAYMENTS FOR COMPANION TRAVEL. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE ONLY PAID TO INDIVIDUALS IN LIMITED CIRCUMSTANCES, AND MUST BE APPROVED IN ACCORDANCE WITH OAKWOOD HEALTHCARE, INC. POLICIES GOVERNING THESE TYPES OF PAYMENTS. AT LEAST ANNUALLY, THE EXPENSES INCURRED BY ALL EMPLOYEES ARE REVIEWED TO ENSURE APPROPRIATE TAXATION AND REPORTING. DURING 2013, 1 FORMER OFFICER RECEIVED TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. DISCRETIONARY SPENDING ACCOUNT - DURING 2013, 1 OFFICER AND 2 KEY EMPLOYEES RECEIVED PAYMENTS FOR DISCRETIONARY SPENDING. HEALTH AND SOCIAL CLUB DUES OR INITIATION FEES - DURING 2013, 1 OFFICER, 1 TRUSTEE, AND 5 KEY EMPLOYEES RECEIVED PAYMENTS FOR HEALTH AND SOCIAL CLUB DUES OR INITIATION FEES. ALL PAYMENTS FOR THE ABOVE BENEFITS WERE TREATED AS TAXABLE TO ALL PERSONS RECEIVING SUCH BENEFITS. PART I, LINE 4B OAKWOOD HEALTHCARE, INC. HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) THAT IS LIMITED TO THE FOLLOWING PARTICIPANTS: BRIAN CONNOLLY, PRESIDENT AND CEO; DOUGLAS WELDAY, EVP OPERATIONS & DIVISION PRESIDENT; AND MICHAEL GEHEB, EVP PHYSICIAN PLAN & OPERATIONS. DURING 2013, MR. CONNOLLY RECEIVED A PAYMENT OF $470,196 AND MR. WELDAY RECEIVED A PAYMENT OF $81,926 PURSUANT TO THE PLAN PROVISIONS. PART I, LINE 5A: OAKWOOD HEALTHCARE, INC. HAS SHORT-TERM AND LONG-TERM INCENTIVE PLANS FOR EXECUTIVES. INCENTIVE AWARDS ARE CALCULATED BASED ON THE ACHIEVEMENT OF MULTIPLE TARGETS, INCLUDING THE ATTAINMENT OF OPERATING REVENUE TARGETS. PART I, LINE 5B: OAKWOOD HEALTHCARE, INC.'S OPERATING REVENUE TARGETS, USED FOR PURPOSES OF DETERMINING SHORT-TERM AND LONG-TERM INCENTIVE AWARDS FOR EXECUTIVES, INCLUDE THE REVENUES OF OAKWOOD HEALTHCARE, INC. AND ITS AFFILIATE ORGANIZATIONS. A MICHIGAN STATE HOSPITAL FINANCE AUTHORITY 382889417 59465HGA8 2007-04-24 110209925 FIN. HOSPITAL/PARTIAL REF OF BONDS ISSUED 1/27/1994 AND 6/6/1995 0 0 0 B MICHIGAN FINANCE AUTHORITY 800596186 59447PLJ8 2012-05-01 161691656 FIN. HOSP/PARTIAL REF OF BONDS ISSUED 4/7/1998, 12/10/2002, & 11/13/2003 0 0 0 C MICHIGAN FINANCE AUTHORITY 800596186 59447PUT6 2013-04-25 53999789 REFUNDING OF BONDS ISSUED 4/7/1998 0 0 0 A 21365000 110640578 8075529 901276 25436310 76601313 2008 1 0 1 1 B 2025000 161691771 3 1687398 25289885 134714488 2013 1 1 0 1 C 53999789 667921 53331869 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 A 0 B 0 C 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MICHIGAN STATE HOSPITAL FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/15/2007 PART II, LINE 4: THE AMOUNTS SHOWN HERE CONSIST OF AMOUNTS IN BOTH DEBT SERVICE RESERVE FUNDS AND DEBT SERVICE FUND DEPOSITS. FOR COLUMNS A, B, AND C RESPECTIVELY, THE AMOUNTS IN DEBT SERVICE RESERVE FUNDS ARE $7,889,099; ZERO; AND ZERO. THE AMOUNTS OF DEBT SERVICE FUND DEPOSITS ARE $186,430; $3; AND ZERO RESPECTIVELY. FORM 990, SCHEDULE K, PART III: DIFFERENCES BETWEEN THE ISSUE PRICE (PART I, COLUMN (E)) AND TOTAL PROCEEDS OF ISSUE (PART II, LINE 3 (B)) ARE DUE TO INVESTMENT EARNINGS. PART IV, LINE 6, COLUMN B: THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS. SEE PART V SEE PART V 23536 SEE PART V 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: SURENDRA KUMAR, M.D.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SURENDRA KUMAR, M.D. IS A FAMILY MEMBER OF NEELAM KUMAR, M.D. (TRUSTEE).(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT FORM 990, PART VI, SECTION A, LINE 3 OAKWOOD HEALTHCARE, INC. HAS OUTSOURCED THE MANAGEMENT DUTIES OF DIETARY SERVICES, CLINICAL ENGINEERING, FACILITY SERVICES, ENVIRONMENTAL SERVICES, LAUNDRY SERVICES AND NON-CLINICAL SERVICES WITHIN THE COMPANY'S PHYSICIAN PRACTICE DIVISION. ALL COMPANIES ENGAGED TO PROVIDE MANAGERIAL SERVICES FOR THE ORGANIZATION REPORT DIRECTLY TO SITE ADMINISTRATORS AND/OR CORPORATE DIRECTORS EMPLOYED BY OAKWOOD HEALTHCARE, INC. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S PROCESS FOR PREPARATION AND REVIEW OF FORM 990 INCLUDES PREPARATION BY AN OUTSIDE ACCOUNTING FIRM AND REVIEW BY LEADERSHIP WITHIN THE FINANCE DEPARTMENT. ADDITIONALLY, THE FORM 990 WAS REVIEWED AT A REGULARLY SCHEDULED MEETING OF THE ORGANIZATION'S BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C OAKWOOD HEALTHCARE, INC. ANNUALLY REQUIRES ITS BOARD MEMBERS, EXECUTIVE LEADERSHIP (INCLUDING OFFICERS AND KEY EMPLOYEES) AND CERTAIN INDEPENDENT CONTRACTORS TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. CONFLICTS EDUCATION IS PROVIDED ANNUALLY TO BOARD MEMBERS AND OTHER PERSONS WHO ATTEND THE BOARD MEETING WHERE SUCH EDUCATION IS PROVIDED. BOARD MEMBERS, EXECUTIVE LEADERS AND KEY INDEPENDENT CONTRACTORS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS BY COMPLETING A WRITTEN QUESTIONNAIRE. OAKWOOD HEALTHCARE, INC.'S DIRECTOR OF BOARD RELATIONS IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH THE DISCLOSURE PROCESS AND ANY POTENTIAL CONFLICT IS CLEARED BY THE DIRECTOR OF BOARD RELATIONS PURSUANT TO THE CONFLICT OF INTEREST POLICY. FAILURE TO COMPLY WITH THE REQUEST FOR DISCLOSURE COULD RESULT IN REMOVAL FROM THE BOARD. ANNUAL CONFLICT DISCLOSURE STATEMENTS, INCLUDING RESPONSES REQUIRED FOR FORM 990 DISCLOSURE PURPOSES, ARE REVIEWED BY THE OAKWOOD HEALTHCARE, INC. BUSINESS PRACTICES OFFICER (COMPLIANCE OFFICER), THE DIRECTOR OF BOARD RELATIONS, THE SR VP OF ORGANIZATIONAL EXCELLENCE, ACCREDITATION & COMPLIANCE, THE PRESIDENT & CEO, THE BOARD CHAIRPERSONS AND GENERAL COUNSEL. PERSONS REVIEWING THE DISCLOSURES ADDRESS ANY QUESTIONS TO THE RESPONDENT TO ENSURE COMPLETENESS OF RESPONSE. BOARD MEMBERS, EXECUTIVES, OTHER EMPLOYEES AND PARTIES INVOLVED IN TRANSACTIONS WITH THE REPORTING ORGANIZATION ARE REQUIRED TO DECLARE POTENTIAL CONFLICTS VIA THE WRITTEN RESPONSE. IF A POTENTIAL CONFLICT ARISES AFTER SUBMISSION OF THE WRITTEN RESPONSE, THE PARTY MUST AFFIRMATIVELY DISCLOSE SUCH POTENTIAL AS OUTLINED IN THE CONFLICTS STATEMENT. THIS POLICY IS OUTLINED IN THE COVER LETTER THAT IS SENT WITH THE REQUEST FOR WRITTEN RESPONSE TO THE CONFLICT OF INTEREST POLICY. THE RECIPIENT IS DIRECTED TO REPORT A CONFLICT THAT ARISES AT ANY TIME IMMEDIATELY TO THE PRESIDENT AND CEO OR DIRECTOR OF BOARD RELATIONS. IN THE EVENT A POTENTIAL CONFLICT IS RAISED IN THE WRITTEN RESPONSE AND THE INDIVIDUAL HAS NOT PREVIOUSLY RAISED THE POTENTIAL CONFLICT WITH APPROPRIATE PERSONS, THE POTENTIAL CONFLICT WILL BE RAISED EITHER BY THE BOARD CHAIR, GENERAL COUNSEL, THE DIRECTOR OF BOARD RELATIONS OR ANY OTHER MEMBER OR MEETING PARTICIPANT. IN THE EVENT IT IS DETERMINED THAT A CONFLICT IN FACT EXISTS, THE CONFLICTED PARTY IS RESTRICTED TO COMMUNICATING FACTUAL INFORMATION REGARDING THE TRANSACTION OR DECISION AND IS NOT PERMITTED TO PARTICIPATE IN BOARD DELIBERATIONS OR VOTING ON THAT MATTER. POTENTIAL AND ACTUAL CONFLICTS THAT ARE REPORTED AS PART OF THE ANNUAL WRITTEN STATEMENT OR OTHERWISE BROUGHT TO THE BOARD'S ATTENTION ARE RECORDED IN THE BOARD MINUTES, ALONG WITH THE BOARD'S ACTION TAKEN IN RESPONSE TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 OAKWOOD HEALTHCARE, INC., AS THE EMPLOYER, DETERMINES OR APPROVES THE COMPENSATION OF ALL OFFICERS, TRUSTEES, KEY EMPLOYEES AND HIGHEST PAID EMPLOYEES. ON AN ANNUAL BASIS, AN INDEPENDENT CONSULTANT IS ENGAGED BY THE EXECUTIVE COMMITTEE OF THE BOARD AND EVALUATES THE COMPENSATION PACKAGES OF THE PRESIDENT, CEO AND OTHER SENIOR EXECUTIVES. THE CONSULTANT REVIEWS THE COMPETITIVENESS OF THESE EXECUTIVES' COMPENSATION RELATIVE TO MARKET COMPENSATION LEVELS AND ENSURES THAT SHORT- AND LONG-TERM INCENTIVE PLAN PAYMENTS ARE COMMENSURATE WITH ACTUAL BUSINESS PERFORMANCE. IN ITS ANNUAL REVIEWS, THE CONSULTANT UTILIZES MULTIPLE PUBLISHED COMPENSATION SURVEYS TO COMPARE THE BASE SALARY LEVELS AND SHORT- AND LONG-TERM INCENTIVE AWARD OPPORTUNITIES OF THE PRESIDENT AND CEO AND OTHER SENIOR EXECUTIVES RELATIVE TO COMPARABLE EXECUTIVE POSITIONS AT OTHER HEALTHCARE ORGANIZATIONS ACROSS THE COUNTRY WITH APPROXIMATELY $1.0B IN ANNUAL NET REVENUE. THE ANNUAL REVIEW MEETS THE REQUIREMENTS FOR OBTAINING AN INDEPENDENT COMPENSATION STUDY FOR PURPOSES OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR EXECUTIVE COMPENSATION. IN GATHERING RELEVANT MARKET COMPENSATION DATA FOR ITS EVALUATION, THE CONSULTANT FOLLOWS ITS STANDARD AND GENERALLY ACCEPTED METHODOLOGY FOR STUDIES OF EXECUTIVE COMPENSATION IN TAX EXEMPT ORGANIZATIONS, INCLUDING THE FOLLOWING STEPS: A) RESEARCHING THE FACTS AND CIRCUMSTANCES SPECIFIC TO OAKWOOD HEALTHCARE, INC. AND SUBSIDIARIES (I.E., ORGANIZATIONAL STRUCTURE, BUSINESS GOALS, FINANCIAL PERFORMANCE, AND OTHER RELEVANT FACTORS ABOUT THE ORGANIZATION); B) UNDERSTANDING THE DUTIES AND SCOPE OF RESPONSIBILITIES OF THE EXECUTIVE POSITIONS IN ORDER TO MATCH THE POSITIONS TO SIMILAR POSITIONS USING RELEVANT SURVEY SOURCES; AND C) ANALYZING MARKET DATA TO DERIVE AN ASSESSMENT OF THE COMPETITIVE RANGE OF MARKET PRACTICE FOR TOTAL COMPENSATION FOR EACH EXECUTIVE POSITION. FOLLOWING THE COMPLETION OF ITS ANNUAL COMPENSATION EVALUATIONS, THE CONSULTANT CONSULTS WITH THE PRESIDENT AND CEO REGARDING THE COMPENSATION OF OTHER SENIOR EXECUTIVES. SIMILARLY, THE CONSULTANT CONSULTS DIRECTLY WITH OAKWOOD HEALTHCARE, INC.'S EXECUTIVE COMMITTEE OF THE BOARD TO DEVELOP RECOMMENDATIONS REGARDING THE COMPENSATION OF THE PRESIDENT AND CEO, ABSENT THE PRESENCE OF THE PRESIDENT AND CEO FOR THESE DISCUSSIONS. IN SUMMARY, OAKWOOD HEALTHCARE, INC. AND THE CONSULTANT FOLLOWS THESE GUIDELINES IN REVIEWING AND FINALIZING THE PAY OF SENIOR EXECUTIVES: A) THE COMPENSATION ARRANGEMENTS ARE APPROVED BY THE INDEPENDENT MEMBERS OF THE BOARD EXECUTIVE COMMITTEE; B) THE EXECUTIVE COMMITTEE OBTAINS AND RELIES UPON APPROPRIATE DATA AS TO COMPARABILITY (I.E., COMPENSATION PAID BY SIMILARLY-SITUATED ORGANIZATIONS FOR POSITIONS WITH SIMILAR SCOPES OF RESPONSIBILITY); AND C) THE COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS (I.E., THE RECORDS INCLUDE THE ELEMENTS OF COMPENSATION CONSIDERED, THE DECISIONS MADE, AND THE RATIONALE FOR THE DECISIONS). FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 4,620,794. MANAGEMENT AND GENERAL EXPENSES 254,081. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,874,875. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 24,134,950. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,134,950. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 51,303,859. MANAGEMENT AND GENERAL EXPENSES 32,772,014. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,075,873. INTRAOPERATIVE MONITORING SVCS: PROGRAM SERVICE EXPENSES 481,439. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 481,439. CONTRACTED MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 492,453. MANAGEMENT AND GENERAL EXPENSES 3,900,718. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,393,171. LANGUAGE SERVICES: PROGRAM SERVICE EXPENSES 243,961. MANAGEMENT AND GENERAL EXPENSES 12,863. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 256,824. FORM 990, PART XI, LINE 9: PENSION & POST RETIREMENT LIAB ADJ. 60,500,456. WRITE-OFF OF INTERCOMPANY TRANSFERS 33,007. 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