2014-10-06T15:39:50-05:00 2013-12-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2013-01-01 383236977 NORTHSTAR HEALTH SYSTEM NORT 9062656121 1400 W ICE LAKE RD IRON RIVER MI 49935 GLENN DOBSON CFO 9062656121 2014-09-30 1 TERRI REXRODE CPA MST P00096513 9206620016 2014-09-30 2013 2015-11-30 17:44:51Z GLENN DOBSON 1400 W ICE LAKE RD IRON RIVER MI 49935 41139676 0 X WWW.NORTHSTARHS.ORG X 1995 MI OUR ORGANIZATION CONTINUES TO STRIVE TO MEET THE EVOLVING NEEDS OF OUR SERVICE AREA WITH THE CONTINUATION AND EXPANSION OF SERVICES TO A LARGER DEMOGRAPHIC AREA. WE PROVIDE AMBULANCE SERVICE ALONG WITH CONTINUING TO BRING IN ADDITIONAL PHYSICIANS AND SERVICES, ESPECIALLY STABILIZING OUR PHYSICIAN CLINIC PRACTICE. OUR FOCUS IN 2013 WAS TO IDENTIFY THE NEEDS OF THE AREA AND INCREASE MARKET SHARE BY OFFERING THE SERVICES IDENTIFIED THROUGH SURVEYS TO BE NEEDED AND IN DEMAND BY THE POPULATION ALLOWING FOR FISCAL RESPONSIBILITIES. 9 7 333 45 0 0 75546 100931 39701678 36977877 277383 497727 0 0 40054607 37576535 8968 15171 0 0 20588991 19905738 0 0 0 20196698 19755542 40794657 39676451 -740050 -2099916 35383689 35210928 27831836 29687965 7551853 5522963 X NORTHSTAR HEALTH SYSTEM IS A COMMUNITY-OWNED, NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR THE PHYSICAL AND EMOTIONAL HEALTH OF PEOPLE LIVING IN SOUTH CENTRAL UPPER PENINSULA OF MICHIGAN AND NORTHERN WISCONSIN. DIRECTLY, AND IN GENERAL PARTNERSHIP WITH COMMUNITIES, EMPLOYERS, SCHOOLS, AND GOVERNMENT OFFICIALS, AS WELL AS SELECT PARTNERSHIPS WITH OTHER HEALTH CARE PROVIDERS, WE GUIDE INDIVIDUALS AND FAMILIES IN THEIR LIFELONG JOURNEY TOWARDS OPTIMAL HEALTH. WE ARE COMMITTED TO PROVIDING HIGH QUALITY, RELIABLE, COST-EFFECTIVE, TOTAL HEALTH SOLUTIONS WITH RESPECT AND COMPASSION. OUR INNOVATIVE EFFORTS WILL POSITIVELY IMPACT HEALTH CARE DELIVERY IN OUR SERVICE AREA. 0 0 34455356 15171 36870213 -EMERGENCY DEPARTMENT: NORTHSTAR HEALTH SYSTEM OPERATES AN EMERGENCY DEPARTMENT 365 DAYS A YEAR, 24 HOURS A DAY. A PHYSICIAN IS ON-SITE AT ALL TIME, DEDICATED TO ONLY THE EMERGENCY DEPARTMENT. IN 2013, 8993 VISITS WERE MADE TO THIS DEPARTMENT. 85% OF ALL INPATIENT ADMISSION TO NORTHSTAR HEALTH SYSTEM IP COMES FROM THE EMERGENCY DEPARTMENT. ALSO, ON MONDAY-FRIDAY, 4PM-8PM, WE OPERATE AN EXPRESS CARE CLINIC FOR THE NOT-CRITICALLY ILL PATIENTS THAT CANNOT GET INTO THEIR OWN PHYSICIAN'S OFFICE THAT DAY. THE TOTAL VISITS LISTED ABOVE INCLUDE THE COUNTS FOR THE EXPRESS CARE. MANY OF THESE TIMES, A MID-LEVEL PROVIDER IS ADDED TO HELP COVER FOR THESE PATIENTS, RELIEVING THE PHYSICIAN TO MANAGE THE CRITICALLY ILL AND PROVIDING EXPRESS (FASTER) FLOW THROUGH FOR PATIENTS. GROSS REVENUE IS $5,055,016 AND DOES NOT ACCOUNT FOR CONTRACTUAL WRITE-OFFS.-HOME HEALTH - NORTHSTAR HEALTH SYSTEM OPERATED A HOME HEALTH AGENCY BASED AWAY FROM THE MAIN CAMPUS BUT STILL IN IRON RIVER, MI. HOME HEALTH VISITS TOTALED 7,950 IN 2013 WHICH HAS REMAINED STRONG OVER THE YEARS. HOME HEALTH ALLOWS PATIENTS TO LEAVE THE IP SETTING SOONER, HELPING SOLIDIFY THE TRANSITION FROM HOSPITAL TO HOME CARE. HOME CARE PROVIDES RN, NURSE AIDE, PHYSICAL AND OCCUPATIONAL THERAPY, ETC. FOR THE HOME BOUND PATIENT.-DIALYSIS - NORTHSTAR HEALTH SYSTEM CONTINUES THE DIALYSIS PROGRAM IN CRYSTAL FALLS MI WHICH IS 15 MILES TO THE WEST OF THE MAIN HOSPITAL CAMPUS. THIS IS ONE OF ONLY A COUPLE PROGRAMS IN OUR GEOGRAPHICAL AREA OF 90 SQUARE MILES, AND IT PROVIDES A DEMONSTRATED COMMUNITY NEED. PATIENT VISITS IN 2013 TOTALED 2,400 WHICH INCLUDES TRANSIENT, SUMMER VACATIONING PATIENTS. 34455356 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 83 0 1 333 1 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X GLENN DOBSON 9062656121 1400 W ICE LAKE ROAD IRON RIVER MI 499359594 MARK TOUSIGNANT CHAIRMAN 1.00 0.50 X X 3600 0 0 WILLIAM MAYER VICE CHAIRMAN 1.00 0.80 X X 3600 0 0 JIM GIBULA TREASURER 1.00 0.50 X X 3600 0 0 SANDRA BATTYE SECRETARY 1.00 0.50 X X 3600 0 0 DIANE ROSTAGNO BOARD MEMBER 1.00 0.50 X 0 0 0 RANDY JACOBS BOARD MEMBER 1.00 0.50 X 1650 0 0 RICK KENT BOARD MEMBER 1.00 0.50 X 1650 0 0 KIM MAHLER MD EX-OFFICIO MEMBER 40.00 0.50 X 263550 0 29307 CONNIE KUOTOUZOS BOARD MEMBER/CEO 40.00 0.50 X X 206217 0 16000 GLENN E DOBSON CHIEF FINANCIAL OFFICER 40.00 0.50 X 136699 0 30900 MARTIES ANSAY MD PHYSICIAN 40.00 X 232004 0 16495 HAROLD CLINE MD PHYSICIAN 40.00 X 602559 0 41899 NASSEEM RIZKALLA MD PHYSICIAN 40.00 X 414715 0 39330 KATALIN SZLOBODA PHYSICIAN 40.00 X 245050 0 27260 GREGORY PEYER MD PHYSICIAN 40.00 X 385116 0 31871 2503610 0 233062 11 0 1 0 MARQUETTE GENERAL HEALTH SYSTEMS 580 W COLLEGE AVE MARQUETTE MI 49855 EMERGENCY ROOM DOCTORS 2710689 ARAMARK UNIFORM COMPANY 5330 INDUSTRIAL BLVD SUITE 616 FRIDLEY MN 55412 LAUNDRY SERVICES 536689 ANESTHESIA ASSOCIATES 788 PENTOGA TRAIL CRYSTAL FALLS MI 49920 ANESTHESIA 305928 DR MAEKAKA 15730 CR 28 GOSHEN IN 46528 RADIOLOGIST 296700 UP HEALTH CARE NETWORK 228 W WASHINGTON AVE MARQUETTE MI 49855 MRI MOBILE 257405 10 80017 20914 100931 NET PATIENT SERVICE REVENUE 900099 36870213 36870213 CAFETERIA MEALS 900099 107664 107664 36977877 114951 114951 3945917 3552832 10309 393085 -10309 382776 382776 37576535 36870213 0 605391 X 15171 15171 700373 292857 407516 14550644 12957276 1593368 532356 471952 60404 3130474 2756321 374153 991891 860811 131080 65624 65624 94660 94660 4401494 3443341 958153 93467 93467 1061762 782300 279462 597594 444800 152794 188607 132455 56152 1453362 1081763 371599 1764524 1764524 210116 33549 176567 MEDICAL SUPPLIES 4877891 4877891 REPAIRS AND MAINTENANCE 2432890 2251249 181641 PROVISION FOR BAD DEBTS 2217832 2217832 DUES & SUBSCRIPTION 159873 71264 88609 135846 135846 39676451 34455356 5221095 0 1568917 568835 1939140 1135839 4521232 6483105 17529 3333 509334 457486 242874 225741 34947454 14659136 20300421 20288318 5229491 4484418 1054751 1563853 35383689 35210928 5898060 5808748 665253 21719322 21426618 178923 987824 35531 799522 27831836 29687965 X 7551853 5522963 7551853 5522963 35383689 35210928 X -2099916 58336 12690 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 235876 235876 25339017 8081886 17257131 491150 352251 138899 8881411 6224999 2656412 20288318 DUE TO THIRD PARTY PAYORS 799522 799522 X 35429458 58336 -2205413 -2147077 37576535 0 37576535 37458348 0 37458348 2218103 2218103 39676451 PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CORPORATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS IN 2013 OR 2012. FEDERAL INCOME TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2010, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -2,217,832. SCHOOL GRANT EXPENSES -271. TRANSFER OF NET ASSETS TO FOUNDATION -22,841. CHANGE IN PENSION OBLIGATION 35,531. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,217,832. SCHOOL GRANT EXPENSES 271. 1 1 1 X 250.000000000000 1 X 1 1 1 0 1 1 236960 236960 0.00630 3006542 992200 2014342 0.05380 3243502 992200 2251302 0.06010 36900 36900 0.00100 12000 12000 0.00030 3245684 2327600 918084 0.02450 19335 19335 0.00050 3313919 2327600 986319 0.02630 6557421 3319800 3237621 0.08640 1 2217832 15219243 15957773 -738530 X 1 0 1 1 NORTHSTAR HEALTH SYSTEM 1400 W ICE LAKE ROAD IRON RIVER MI 49935 X X X X NORTHSTAR HEALTH SYSTEM 1 1 X X X X X X 13 1 0 1 X HTTP://NORTHSTARHS.ORG X X X X X X X 0 0 1 1 250.000000000000 1 300.000000000000 1 X X X 1 1 X X X X 1 X 1 X X X 1 X 0 0 NORTHSTAR HEALTH SYSTEM PART V, SECTION B, LINE 3: PRIMARY DATA WAS GATHERED THROUGH A COMMUNITY ONLINE SURVEY MADE AVAILABLE TO ALL IRON AND DICKINSON COUNTY COMMUNITY MEMBERS. A SECONDARY SOURCE OF DATA COLLECTION INCLUDED A SERIES OF FOCUS GROUP MEETINGS LED BY NORTHSTAR'S DIRECTORY OF COMMUNITY SERVICES. THE GROUPS RANGED IN SIZE FROM 8 TO 12 PEOPLE AND KEY INDIVIDUALS IN THE COMMUNITY WERE IDENTIFIED TO PARTICIPATE TO ASSURE THAT APPROPRIATE CONSTITUENCIES WERE REPRESENTED. ETHNICITIES, RACE AND OTHER DIVERSITY FACTORS WERE INCLUDED IN THE SELECTION OF THESE FOCUS GROUPS. THESE FOCUS GROUPS HAD A FACILITATOR ASSIGNED WHO WAS SKILLED AT CREATING AND MAINTAINING AN ENVIRONMENT WHERE EVERY PARTICIPANT'S VOICE WAS HEARD AND WHERE A SINGLE INDIVIDUAL OR TOPIC DID NOT DOMINATE. NORTHSTAR HEALTH SYSTEM PART V, SECTION B, LINE 7: SOME OF THE ITEMS IDENTIFIED ON THE SURVEY WHICH FELL BELOW THE 15 PERCENTILE WERE NOT FOLLOWED UP WITH A STRATEGIC INITIATIVE BY NORTHSTAR HEALTH SYSTEM. MOST OF THESE ITEMS (CHILD ABUSE/NEGLECT, DOMESTIC VIOLENCE, FIREARM RELATED INJURIES, MOTOR VEHICLE CRASH/INJURY, RAPE/SEXUAL ASSAULT) WERE DESIGNATED FOR MORE APPROPRIATE FOLLOW UP WITH LOCAL LAW ENFORCEMENT AGENCIES AND/OR FAMILY SERVICE AGENCIES. NORTHSTAR HEALTH SYSTEM PART V, SECTION B, LINE 20D: PER OUR POLICY ON HOW CHARGES ARE CALCULATED. APPLICATION FOR CHARITY CARE IS REQUIRED. IF INDIGENT - NO BALANCE IS DUE FROM THE PATIENT. OTHERWISE A SLIDING FEE SCALE IS USED AS DETERMINED UPON 100% OF THE CURRENT POVERTY LEVEL. 7 NORTHSTAR HOME CARE AND HOSPICE 927 RIVERSIDE AVENUE IRON RIVER MI 49935 HOME HEALTH AGENCY NORTHSTAR HEALTH SYSTEM - ERSD 1328 US HWY 2 CRYSTAL FALLS MI 49920 DIALYSIS/FAMILY PRACTICE GENESEE CLINIC 229 W GENESEE ST IRON RIVER MI 49935 ORTHOPEDICS/REHAB NORTHSTAR ICE LAKE 1300 WEST ICE LAKE IRON RIVER MI 49935 FAMILY PRACTICE NORTHSTAR RIVERSIDE PLAZA 927 RIVERSIDE AVENUE IRON RIVER MI 49935 FAMILY PRACTICE MARENISCO CLINIC 236 MAIN STREET MARENISCO MI 49947 FAMILY PRACTICE NORTHSTAR SURGERY 1500 WEST ICE LAKE RD IRON RIVER MI 49935 SURGERY PART I, LINE 7: THE COSTING METHODOLOGY USED WAS A COST-TO-CHARGE RATIO. PART I, LINE 7G: THE ORGANIZATION DID NOT INCLUDE ANY PHYSICIAN CLINICS IN CALCULATING SUBSIDIZED HEALTH SERVICE COSTS. PART I, LN 7 COL(F): IN CALCULATING THE PERCENTAGES IN PART 1, LINE 7 BAD DEBT EXPENSE OF $2,217,832 WAS EXCLUDED FROM THE DENOMINATOR. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES CONSISTED OF MISCELLANEOUS COMMUNITY SUPPORT. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE FOR THE PURPOSE OF ESTIMATING THE APPROPRIATE AMOUNTS OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE PROVISION FOR BAD DEBTS. DATA IN EACH MAJOR PAYOR SOURCE ARE REGULARLY REVIEWED TO EVALUATE THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES RELATING TO SERVICES PROVIDED TO PATIENTS HAVING THIRD-PARTY COVERAGE, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A CORRESPONDING PROVISION FOR BAD DEBTS ARE ESTABLISHED BASED ON HISTORICAL WRITE-OFF PERCENTAGES; FOR RECEIVABLES RELATING TO SELF-PAY PATIENTS, A PROVISION FOR BAD DEBTS IS MADE IN THE PERIOD SERVICES ARE RENDERED BASED ON EXPERIENCE INDICATING THE INABILITY OR UNWILLINGNESS OF PATIENTS TO PAY AMOUNTS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 4: THE COSTING METHODOLOGY USED IN DETERMINING AMOUNTS REPORTED ABOVE IS THE COST TO CHARGE RATIO. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE ALLOWABLE COSTS REPORTED ABOVE IS THE COST TO CHARGE RATIO. PART III, LINE 9B: IF THE PATIENT QUALIFIES FOR CHARITY CARE AND A 100% WRITE-OFF IS NOT QUALIFIED FOR, THE PATIENT MUST MAKE MONTHLY PAYMENT ACCORDING TO FACILITY PAYMENT POLICY. IF PATIENT DOES NOT MAKE MONTHLY PAYMENTS AND CANNOT BE REACHED BY TELEPHONE, THE FORMAL COLLECTION PROCESS WOULD BEGIN. PART VI, LINE 2: THE ORGANIZATION ASSESSES THE NEEDS OF THE COMMUNITY THROUGH A NEEDS ASSESSMENT SURVEY, THROUGH DOCUMENTATION OF REQUESTS FROM OUTLYING AGENCIES OR COMMUNITY GROUPS, AND FROM EVALUATION OF THE REPEAT DIAGNOSIS OF PATIENTS SERVED WITHIN THE SERVICE AREA. PART VI, LINE 3: THE ORGANIZATION HAS A DEPARTMENT DEVOTED TO SELF PAY ACCOUNTS RECEIVABLE WITH THEIR MAIN FOCUS ON MAKING PATIENT CONTACT WITH THOSE PATIENTS THAT EITHER HAVE NO INSURANCE OR ARE UNDER INSURED BASED UPON INFORMATION COLLECTED AT THE TIME OF SERVICE. THIS STAFF IS EDUCATED ON WHAT PROGRAMS ARE AVAILABLE WITHIN THE COMMUNITY AND CAN ASSIST THE PATIENT IN MAKING CONTACT WITH THESE AGENCIES AND CAN ASSIST IN APPLICATION COMPLETION FOR OUTSIDE PROGRAMS. THE CHARITY CARE PROGRAM IS ALSO COMMUNICATED THE SAME WAY. PART VI, LINE 4: THE COMMUNITY SERVED IS RELATIVELY OLDER IN AGE WITH A HIGH UTILIZATION OF MEDICARE. THERE IS LITTLE INDUSTRY, NO AIRPORT, AND THE NEAREST TRAUMA CENTER IS 90 MILES AWAY. THE NEXT CLOSEST HOSPITALS ARE 45 TO 55 MILES AWAY. THE GEOGRAPHIC AREA, BY COUNTY, IS VERY LARGE BUT VERY LITTLE POPULATED. THE AREA SUPPORTS SEVERAL RURAL HEALTH CLINICS AND THIS FACILITY SURVIVES BECAUSE OF THE CRITICAL ACCESS HOSPITAL DESIGNATION ONLY. PART VI, LINE 5: OUR BOARD IS MADE UP OF VOLUNTEER INDIVIDUALS FROM WITHIN THE DIRECT COMMUNITY. MEDICAL STAFF PRIVILEGES TO ALL PROVIDERS WITHIN THE COMMUNITY AND SURROUDING AREA/COUNTIES AS THE TRAVEL TIME TO OTHER HOSPITALS IS OVER 1 HR TO THE NEAREST. SURPLUS FUNDS HAVE BEEN PUT INTO AN $18 MILLION EXPANSION COMPLETED IN 2009 INCLUDING THE EXPANSION OF ED SERVICES AND IP ROOMS/ETC. PART VI, LINE 7, REPORTS FILED WITH STATES MI 1 PART I, LINE 2: THE ORGANIZATION PROVIDES VARIOUS GRANTS TO EXEMPT ORGANIZATIONS IN THE LOCAL AREA AND MONITORS THE FUNDS TO ENSURE THAT THEY ARE USED FOR THE PURPOSE SPECIFIED IN THE GRANT REQUEST. X X X X X 0 0 0 0 0 0 0 0 0 KIM MAHLER MD EX-OFFICIO MEMBER 263550 0 0 0 0 0 7907 0 21400 0 292857 0 0 0 CONNIE KUOTOUZOS BOARD MEMBER/CEO 206217 0 0 0 0 0 6242 0 9758 0 222217 0 0 0 GLENN E DOBSON CHIEF FINANCIAL OFFICER 136699 0 0 0 0 0 4275 0 26625 0 167599 0 0 0 MARTIES ANSAY MD PHYSICIAN 232004 0 0 0 0 0 7014 0 9481 0 248499 0 0 0 HAROLD CLINE MD PHYSICIAN 602559 0 0 0 0 0 16063 0 25836 0 644458 0 0 0 NASSEEM RIZKALLA MD PHYSICIAN 414715 0 0 0 0 0 12601 0 26729 0 454045 0 0 0 KATALIN SZLOBODA PHYSICIAN 245050 0 0 0 0 0 5921 0 21339 0 272310 0 0 0 GREGORY PEYER MD PHYSICIAN 385116 0 0 0 0 0 10786 0 21085 0 416987 0 0 0 A CITY OF IRON RIVER HOSPITAL FINANCE AUTHORITY 383527449 463003AA1 2008-05-15 22721540 HOSPITAL FACILITY IMPROVEMENTS 0 0 0 A 1330000 22721540 1713975 5667697 422278 14917591 15339968 2010 0 1 1 1 A 0 0 1 1 0 0 0 1 A 0 1 0 0 0 0 0 0 0 A 0 SCHEDULE K SUPPLENTAL INFORMATION THIS BOND ISSUE WAS COMPRISED OF THREE BONDS THAT WERE ALL ISSUED ON 5/15/2008. THE CUSIP NUMBERS INCLUDED IN THIS ONE ISSUANCE WERE ARE FOLLOWS: 463003AA1 463003AL7 463003AT0 HAROLD CLINE MD HIGHLY COMPENSATED EMPLOYEE SIGN ON BONUS FORGIVEN OVER LIFE OF CONTRACT X 24238 3333 0 1 1 3333 FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS E-MAILED TO ALL BOARD MEMBERS PRIOR TO MAILING/SUBMITTING THE FORM. MEMBERS OF THE BOARD ARE ALLOWED TO SUBMIT FEEDBACK AND APPROPRIATE REQUESTED CHANGES ARE INCORPORATED, IF WARRANTED, INTO THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE WRITTEN CONFLICT OF INTEREST POLICY COVERS DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWER. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE ABOVE INDIVIDUALS MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTIONS OR ARRANGEMENT, OR IF A MEMBER OF ADMINISTRATION, TO THE CHIEF EXECUTIVE OFFICER. AFTER DISCLOSURE OF THE FINANCIAL INTEREST, TO THE BOARD OR COMMITTEE, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND EACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL SIGN AN ANNUAL DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S KEY EMPLOYEES AND HIGHEST PAID EMPLOYEES HAVE EMPLOYMENT CONTRACTS THAT GOVERN THEIR COMPENSATION. COMPENSATION LEVELS ARE REVIEWED BY THE APPLICABLE LEVEL OF MANAGEMENT AND/OR THE BOARD OF DIRECTORS. FOR GUIDANCE RELATED TO COMPENSATION LEVELS, MANAGEMENT GATHERS MARKET DATA AND COMPENSATION STUDIES TO ARRIVE AT AMOUNTS THAT ARE COMPETITIVE WITHIN THEIR MARKET AREA. THE COMPENSATION IS APPROVED BY INDIVIDUALS WITHOUT A CONFLICT OF INTEREST AND THEN DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 A COPY OF THE FILED FORM 990 IS AVAILABLE TO THE PUBLIC THROUGH A REQUEST FROM ANY MEMBER OF THE PUBLIC. FORM 990, PART IX, LINE 11G CONTRACTED PHYSICIANS: PROGRAM SERVICE EXPENSES 1,683,306. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,683,306. LAB SERVICES: PROGRAM SERVICE EXPENSES 311,364. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 311,364. LEASES: PROGRAM SERVICE EXPENSES 226,638. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 226,638. PROFESSIONAL CONTRACTED STAFF: PROGRAM SERVICE EXPENSES 218,144. MANAGEMENT AND GENERAL EXPENSES 31,095. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 249,239. LAUNDRY: PROGRAM SERVICE EXPENSES 540,769. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 540,769. CONSULTING: PROGRAM SERVICE EXPENSES 195,173. MANAGEMENT AND GENERAL EXPENSES 547,528. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 742,701. MOBILE MRI SERVICES: PROGRAM SERVICE EXPENSES 259,850. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 259,850. MAINTENANCE: PROGRAM SERVICE EXPENSES 8,097. MANAGEMENT AND GENERAL EXPENSES 210,483. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 218,580. BILLING OFFICE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 169,047. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 169,047. FORM 990, PART XI, LINE 9: CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE 35,531. NET ASSET TRANSFER TO FOUNDATION -22,841. FORM 990, PART XII, LINE 2C AUDIT FIRM IS APPROVED BY THE FINANCE COMMITTEE. THE AUDIT FIRM PRESENTS THE AUDIT RESULTS TO THE FINANCE COMMITTEE. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. GREATER IRON COUNTY EMS INC 1400 WEST ICE LAKE ROAD IRON RIVER MI 49935 383491283 EMERGENCY MEDICAL SERVICES MI 501(C)3 LINE 11A, I NORTHSTAR HEALTH SYSTEM 1 NORTHSTAR HEALTH SYSTEM FOUNDATION 1400 WEST ICE LAKE ROAD IRON RIVER MI 49935 383762132 RAISE FUNDS FOR NORTHSTAR HEALTH SYSTEM MI 501(C)3 LINE 11A, I NORTHSTAR HEALTH SYSTEM 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 1 GREATER IRON COUNTY EMS INC S 685000 BANK TRANSFERS GREATER IRON COUNTY EMS INC O 413949 PAYROLL REPORTS GREATER IRON COUNTY EMS INC Q 79554 DIRECT INVOICES/REPORTS NORTHSTAR HEALTH SYSTEM FOUNDATION C 80017 CASH PAID