2014-04-03T08:43:04-05:00 2013-09-30 381357951 PLANTE & MORAN PLLC 600 E FRONT ST SUITE 300 TRAVERSE CITY MI 49686 990 2012-10-01 381359266 MEMORIAL MEDICAL CENTER OF WEST MICHIGAN MEMO 2318432591 ONE ATKINSON DRIVE LUDINGTON MI 49431 KERRI L NELSON 2318432591 2014-03-31 1 CAROL LALONDE CPA P00181637 2319477800 2012 2015-11-30 17:44:51Z SEE SCHEDULE O MARK VIPPERMAN ONE ATKINSON DRIVE LUDINGTON MI 49431 62440371 0 X WWW.MMCWM.COM X 1906 MI TO ENHANCE LIFE THROUGH EXCEPTIONAL HEALTHCARE. 13 11 644 130 0 0 456694 163273 62631084 60434941 449549 303145 1202172 1169757 64739499 62071116 23473 21348 0 0 29443214 29472119 0 0 160663 31757471 37109822 61224158 66603289 3515341 -4532173 82326477 80154373 50328084 42768569 31998393 37385804 X TO ENHANCE LIFE THROUGH EXCEPTIONAL HEALTHCARE. 0 0 12623681 14595484 OPERATING ROOM (7,302 VISITS) - SEE LINE 4D "OTHER PROGRAM SERVICES" FOR ADDITIONAL DESCRIPTION. 7770693 8984465 LAB (338,790 TESTS) - SEE LINE 4D "OTHER PROGRAM SERVICES" FOR ADDITIONAL DESCRIPTION. 4244476 4907457 PHARMACY (788,734 UNITS) - SEE LINE 4D "OTHER PROGRAM SERVICES" FOR ADDITIONAL DESCRIPTION. 28501126 21348 32952967 MEMORIAL MEDICAL CENTER (38-1359266) PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY.REALIZING THAT REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE ONGOING OPERATION AND STABILITY OF MEMORIAL MEDICAL, WE STILL RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER RECOGNIZE THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH OUR COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY: A. FREE CARE AND/OR SUBSIDIZED CARE, B. CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT BELOW COST, C. HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S ABILITY TO PAY CO-EXISTS. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.MEMORIAL MEDICAL CENTER SERVED 2,534 INPATIENTS WITH 10,260 DAYS OF CARE, AND PROVIDED NEARLY 95,000 OUTPATIENT SERVICES DURING FISCAL YEAR 2013.OUR HOSPITAL PROVIDES CARE TO PEOPLE COVERED BY GOVERNMENTAL PROGRAMS AT LESS THAN WHAT WE MUST GENERATE IN ORDER TO MAINTAIN STABILITY OF OPERATIONS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS IS $111,835,476. IN ADDITION, FOR PATIENTS NOT COVERED BY A GOVERNMENTAL PROGRAM AND ALSO UNABLE TO PAY FOR SERVICES, WE RECOGNIZED $1,132,344 IN CHARITY CARE.OUR SCOPE OF COMMUNITY CARE WENT BEYOND THE AFOREMENTIONED RESPONSIBILITIES. IN ADDITION TO COMMUNITY BENEFIT EXPENDITURES, MANY REDUCED PRICE SERVICES AND FREE PROGRAMS ARE OFFERED THROUGHOUT THE YEAR, BASED UPON ACTIVITIES AND SERVICES WHICH MEMORIAL MEDICAL BELIEVES WILL SERVE COMMUNITY HEALTH NEEDS. THESE ARE DETAILED AS FOLLOWS: SCREENING PROGRAMS:- MONTHLY BLOOD PRESSURE AND BLOOD SUGAR TESTING AT 3 COMMUNITY LOCATIONS- PARTICIPATION IN TISSUE/ORGAN DONATION PROGRAM IN CONJUNCTION WITH GIFT OF LIFE- WORKSITE WELLNESS SCREENING AT AREA MANUFACTURING ORGANIZATIONCOMMUNITY EDUCATION ONGOING PROGRAMS:- PRENATAL AND MATERNAL CLASSES- NUTRITION PROGRAMS, MONTHLY PROGRAMS TAUGHT BY REGISTERED DIETITIANS FOR VARIOUS ORGANIZATIONS IN LUDINGTON AND HART.- OUTPATIENT DIABETIC SELF MANAGEMENT PROGRAM- FAMILY FAIR (HEALTH FAIR) WITH AREA SCHOOLSCOMMUNITY EDUCATIONAL PROGRAMS ON VARIOUS DISEASES & HEALTH TOPICS:- DONE FOR VARIOUS SERVICE ORGANIZATIONS, SCHOOLS, COMMUNITY GROUPS TOPICS INCLUDE: STRESS MANAGEMENT, HEALTHY EATING, UNDERSTANDING CHOLESTEROL, DIABETES, EYE DISEASES, INFECTION CONTROL, BACK SAFETY.- ANNUAL HEALTH FAIR AT LONGFELLOW TOWERS, PROGRAMS DONE BY HOME CARE AND DIETITIANS.- TEDDY BEAR CLINICS FOR PRE-SCHOOL CLASSES- GRADE SCHOOL TOURS AND CAREER FOCUS DAY- HIGH SCHOOL HEALTH CLASS TOURS WITH WELLNESS FOCUSSUPPORT GROUPS & OTHER SPONSORSHIPS:- TYPE 1 DIABETES GROUP - TYPE 2 DIABETES GROUP CLINICAL EXPERIENCE FOR STUDENT PROGRAMS:- WEST SHORE COMMUNITY COLLEGE = LPN & RN PROGRAMS, PRE-PHYSICIAN THERAPY- WEST SHORE COMMUNITY COLLEGE/LIFE EMS = EMS PROGRAMS- MID MICHIGAN COLLEGE = RADIOLOGY TECHNICIAN STUDENTS- BAKER COLLEGE, MUSKEGON = SURGICAL SCRUB TECHNICIAN PROGRAM, MEDICAL RECORDS PROGRAM, EMS, PHLEBOTOMY PROGRAM, PHARMACY PROGRAM, STERILE PROCESSING PROGRAM, PHYSICAL AND OCCUPATIONAL THERAPY ASSISTANT- BAKER COLLEGE, CADILLAC = SURGICAL SCRUB TECHNICIAN PROGRAM, EKG/PULMONARY PROGRAMS, SOCIAL WORK, EMS- MUSKEGON COMMUNITY COLLEGE = PHLEBOTOMY PROGRAM, RESPIRATORY THERAPY- WESTERN UNIVERSITY OF HEALTH SCIENCE (CALIFORNIA) = NURSE PRACTITIONER- CENTRAL MICHIGAN UNIVERSITY = PHYSICAL THERAPY PROGRAM, FOOD SERVICES ADMINISTRATION, PHYSICIAN ASSISTANT PROGRAM- GRAND VALLEY STATE UNIVERSITY = PRE-PHYSICAL THERAPY/PHYSICAL THERAPY, OCCUPATIONAL THERAPY, LABORATORY TECHNICIAN, NURSING, SOCIAL WORK- LUDINGTON AND MASON COUNTY AREA SCHOOLS = CAREERS IN HEALTHCARE PROGRAM- ROSS MEDICAL STUDENT TRAINING PROGRAM = MEDICAL ASSISTANT PROGRAM- MASON-LAKE ISD = ALLIED HEALTH PROGRAMS- WESTERN MICHIGAN UNIVERSITY = PHYSICIAN ASSISTANT PROGRAM- WEST SHORE COMMUNITY COLLEGE = ACCOUNTING- MICHIGAN STATE UNIVERSITY = SOCIAL WORK, NURSE PRACTITIONER- FERRIS STATE UNIVERSITY = HEALTHCARE ADMINISTRATION, ALLIED HEALTH, MEDICAL TRANSCRIPTION, MEDICAL CODING, NURSING, NUCLEAR MEDICINE, ULTRASOUND, PHARMACY, PHLEBOTOMY, HEALTH INFORMATION- CHATHAM UNIVERSITY = PHYSICIANS ASSISTANT- DAVENPORT UNIVERSITY = ALLIED HEALTH/HEALTH INFORMATION MANAGEMENT- KETTERING COLLEGE = PHYSICIAN'S ASSISTANT- NUMEROUS JOB SHADOWING EXPERIENCES = FOR HIGH SCHOOL THROUGH COLLEGE LEVEL STUDENTS THROUGHOUT THE HOSPITAL- NORTHWESTERN MICHIGAN COLLEGE = ABNORMAL PSYCHOLOGY- WALDEN UNIVERSITY = MSNSPEAKERS BUREAU:- TOPICS AND SPEAKERS LISTING AVAILABLE UPON REQUEST- LECTURES FOR AREA AGENCIES DONE ON HEALTH RELATED SUBJECTS ON A REQUEST BASIS BY HOME CARE, EDUCATION, DIETITIAN, CARDIAC REHAB, MEDICAL/SURGICAL, AND E.R. STAFF. 28501126 21348 32952967 53139976 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 47 0 1 644 1 0 0 0 0 0 1 1 0 0 0 0 X 13 11 0 0 1 0 0 0 0 1 1 0 0 1 1 0 1 1 0 1 1 0 X KERRI L NELSON VICE PRESIDENT OF FINANCE 2318452251 ONE ATKINSON DRIVE LUDINGTON MI 49431 JEANNE OAKES 0.50 0.00 X 0 0 0 ALLEN DEERING 2.00 0.00 X X 0 0 0 CHARLES DILLON 1.00 0.00 X X 0 0 0 KENNETH ROCCO 0.50 0.00 X X 0 0 0 CONNIE KRUSNIAK 0.50 0.00 X 0 0 0 ANTHONY FABAZ DO 0.50 0.00 X 0 0 0 JDEAN GUSTAFSON 0.50 0.00 X 0 0 0 MARC LENZ 0.50 0.00 X X 0 0 0 ANTHONY MONTON 0.50 0.00 X 0 0 0 ALLAN NELSON MD 0.50 0.00 X 11850 0 0 MARGARET GUSTAFSON MD 0.50 0.00 X 0 0 0 JAMES SCATENA 0.50 0.00 X 0 0 0 STEVEN STRBICH DO 0.50 0.00 X 0 0 0 TIMOTHY HEINRICH 40.00 0.00 X 255163 0 52604 KERRI NELSON 40.00 0.00 X 186954 0 22503 MARK VIPPERMAN 40.00 0.00 X 384940 0 40302 HELEN JOHNSON 40.00 0.00 X 184108 0 17000 DAVID KLINGER 40.00 0.00 X 171317 0 15929 JOHN P COONEY DO 40.00 0.00 X 206273 0 14643 TAMARA BUCKLESMD 40.00 0.00 X 218791 0 13104 EDDIE MAKOWICKI 40.00 0.00 X 174434 0 21973 AMANDA OVERMYERMD 40.00 0.00 X 150123 0 13104 ROBERT JOHNSON 40.00 0.00 X 159941 0 50303 2103894 0 261465 27 0 1 0 QUEST DIAGNOSTICS 13138 COLLECTIONS CTR DRIVE CHICAGO IL 60693 LAB SERVICES 802764 ANESTHESIOLOGY ASSOCIATES OF WEST MICHIG ONE ATKINSON DRIVE LUDINGTON MI 49431 ANESTHESIA SERVICES 530559 JACKSON & COKER PO BOX 2776 ATLANTA GA 30384 PHYSICIAN SERVICES 250438 COMPHEALTH PO BOX 9726 DALLAS TX 75397 PHYSICIAN SERVICES 198295 BARTON ASSOCIATES INC 10 DEARBORN PEABODY MA 01960 PHYSICIAN SERVICES 137395 6 162911 362 5070 163273 PROGRAM SERVICE REVENUE 622110 60138531 60138531 MEANINGFUL USE REVENUE 622110 296410 296410 60434941 386420 386420 312610 226504 86106 86106 86106 10000 93275 -83275 -83275 -83275 22430 162911 49476 -27046 -27046 OTHER RELATED REVENUE 900099 919326 919326 CAFETERIA SALES 722210 191371 191371 1110697 62071116 61440373 0 467470 X 21348 21348 1241180 206864 1034316 22002281 18990764 2864161 147356 1018290 764227 254063 3522850 2740877 781973 1687518 1266484 421034 626752 626752 99492 99492 11262532 7509188 3751918 1426 528295 464 527831 1549567 940849 607148 1570 1119589 49304 1070285 291396 194209 96514 673 159677 119838 39839 3090042 2319079 770963 881144 778782 102362 MEDICAL SUPPLIES & DRUG 11017966 10803000 214966 PROVISION FOR BAD DEBTS 4793163 4793163 QUALITY ASSURANCE TAXES 1325091 1325091 DSH EXPENSES 285601 285601 79515 30844 39033 9638 66603289 53139976 13302650 160663 13553862 4135613 12504879 6855599 673797 491315 6558131 6294780 1364616 1582351 1020260 1017777 73214225 37255823 24422006 35958402 9541033 10880955 12687893 12937581 82326477 80154373 5849018 7021179 10000000 10000000 8505000 8505000 25974066 17242390 50328084 42768569 X 31998393 37385804 31998393 37385804 82326477 80154373 X -4532173 964079 8955505 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4809 4809 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A PORTION OF ANNUAL DUES TO THE MICHIGAN HEALTH & HOSPITAL ASSOCIATION ARE USED TOWARD LOBBYING ACTIVITIES. 3340111 3340111 30068803 11095274 18973529 3145164 877861 2267303 35595361 25282688 10312673 1064786 1064786 35958402 PREPAID PENSION 12345535 COST REPORT SETTLEMENTS RECEIVABLE 592046 12937581 ACCRUED INSURANCE 635276 ACCRUED POST-RETIREMENT BENEFIT 16172052 COST REPORT SETTLEMENTS PAYABLE 435062 17242390 X 63311175 964079 964079 62347096 -275980 -275980 62071116 66879269 275980 275980 66603289 0 66603289 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CENTER IS A NOT-FOR-PROFIT, TAX-EXEMPT ORGANIZATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2009. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL INCOME EXPENSES NETTED WITH REVENUE -226,504. SPECIAL EVENT EXPENSES NETTED WITH REVENUE -49,476. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES NETTED WITH REVENUE 49,476. RENTAL INCOME EXPENSES NETTED WITH REVENUE 226,504. BENEFIT BALL 2012 140385 120785 19600 279 42104 TEAM SPIRIT WEEK 2012 37837 37837 500 3310 1 7119 4289 2830 169 3114 185341 162911 22430 948 48528 49476 -27046 1 1 X 1 X 1 X 1 1 1 0 1 1 711500 821642 -110142 0.00000 8560454 5771965 2788489 0.04510 9271954 6593607 2678347 0.04510 1718368 1549492 168876 0.00270 21348 21348 0.00030 1739716 1549492 190224 0.00300 11011670 8143099 2868571 0.04810 242720 242720 0.00390 242720 242720 0.00390 1 4793163 479316 20375981 19162393 1213588 X 1 0 1 1 MEMORIAL MEDICAL CENTER OF WEST MICHIGAN

ONE ATKINSON DRIVE LUDINGTON MI 49431

X X X MEMORIAL MEDICAL CENTER OF WEST MICHIGAN 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X X X X X 0 0 1 1 150.000000000000 1 200.000000000000 1 X X X X X 1 1 X 1 0 X X 1 X 0 0 1 MEMORIAL FAMILY CARE CENTER

2481 N 72 AVE HART MI 49420

PHYSICIAN OFFICE PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM WORKSHEET 2, IS USED FOR LINES 7A AND 7B. ACTUAL COSTS ARE USED FOR LINES 7E AND 7I. COST-TO-CHARGE RATIOS DERIVED FROM THE COST REPORT ARE USED FOR LINE 7G. PART I, LINE 7G: A PORTION OF THE REPORTED SUBSIDIZED HEALTH SERVICES INCLUDES THE FAMILY CARE CLINIC AND TWO PHYSICIAN PRACTIVES. THE TOTAL COMMUNITY BENEFIT EXPENSE RELATED TO THESE PHYSICIAN CLINICS IS $1,049,540, AND THE NET COMMUNITY BENEFIT EXPENSE IS $34,789. PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE IS $4,793,163. PART II: MEMORIAL MEDICAL CENTER PARTICIPATES IN A MULTITUDE OF COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNNITY SUCH AS SEVERAL HEALTH FAIRS, BLOOD DRIVES, PRENATAL AND CHILDBIRTH EDUCATION, NUTRITION EDUCATION WITH LOCAL SCHOOLS AND SPORTS GROUPS, EDUCATIONAL PRESENTATIONS RELATED TO MEDICATIONS AND MEDICAL CONDITIONS, STRONG PART IN DEVELOPMENT AND ADMINISTRATION OF HEALTHY COMMUNITIES COMMITTEE, DISTRIBUTES COMMUNITY HEALTH NEWSLETTERS, PROVIDES DIABETES TESTING AND COMMUNITY EVENTS, AND ASSIST WITH MANY DIFFERENT SUPPORT GROUPS, ALONG WITH SUPPORT THE LOCAL WIN WITH WELLNESS INITIATIVE. PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECIEVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOY PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOY PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACUTALLY COLLECTED AFTER ALL REASONABLE COLLECTIONS EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTABLE. THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES.THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $479,316. THIS WAS CALCULATED BASED ON AN ESTIMATE OF 10 PERCENT OF BAD DEBT EXPENSE DETERMINED BY THE DIRECTOR OF THE HOSPITAL'S BUSINESS OFFICE. PART III, LINE 8: THE AMOUNTS REPORTED FOR MEDICARE ARE FROM THE MEDICARE COST REPORT, WHICH DO NOT SHOW A SHORTFALL. THIS IS BASED ON THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT. PART III, LINE 9B: PATIENTS AT THE 150 PERCENT FEDERAL POVERTY LIMIT QUALIFY FOR FREE CARE AND THEREFORE WILL NOT OWE ANYTHING OR BE SUBJECTED TO COLLECTION ACTIVITIES.ALL PATIENTS/GUARANTORS WITH A BALANCE FOR CARE PROVIDED ARE SENT A LETTER REGARDING THE BALANCE. A STATEMENT IS THEN SENT AFTER 30 DAYS. A SECOND STATEMENT IS SENT IF THERE IS A REMAINING BALANCE. IF NO PAYMENT IS RECEIVED AFTER THE THIRD NOTIFICATION THE ACCOUNT IS SENT TO PRE-COLLECTION STATUS. A FINAL LETTER IS SENT TO THE PATIENT/GUARANTOR IF NOTHING HAS BEEN RECEIVED. IF THERE IS NO RESPONSE THEN THE ACCOUNT IS SENT TO COLLECTIONS. IF A PAYMENT IS RECEIVED AT ANY TIME DURING THIS PROCESS THE PROCESS IS REPEATED UNTIL THE ACCOUNT IS PAID IN FULL OR IT IS SENT TO A COLLECTION AGENCY. MEMORIAL MEDICAL CENTER OF WEST MICHIGAN PART V, SECTION B, LINE 3: THE BELOW IS AN EXCERPT FROM THE HOSPITALS CHNA, WHICH CAN BE FOUND ON THEIR WEBSITE AT WWW.MMCWM.COM.THE RESEARCH INVOLVED THE COLLECTION OF PRIMARY AND SECONDARY DATA. THE TABLE BELOW SHOWS THE BREAKDOWN OF PRIMARY DATA COLLECTED WITH THE TARGET AUDIENCE, METHOD OF DATA COLLECTION, AND NUMBER OF COMPLETES.+ KEY STAKEHOLDERS - IN-DEPTH TELEPHONE INTERVIEWS - HOSPITAL AND CLINIC DIRECTORS - 7 COMPLETES+ KEY INFORMANTS - ONLINE SURVEY - PHYSICIANS, NURSES, DENTISTS - 36 COMPLETES+ COMMUNITY RESIDENTS - TELEPHONE SURVEY - MASON COUNTY, NORTHERN OCEANA COUNTY ADULTS - 1,043 COMPLETESSECONDARY DATA WAS DERIVED FROM LOCAL HOSPITAL UTILIZATION DATA AND VARIOUS GOVERNMENT AND HEALTH SOURCES SUCH AS THE US CENSUS, MICHIGAN DEPARTMENT OF COMMUNITY HEALTH, COUNTY HEALTH RANKINGS.KEY STAKEHOLDER INTERVIEWS INCLUDED:1. ADMINISTRATOR AT OCEANA COUNTY MEDICAL CARE FACILITY2. DIRECTOR OF COMMUNITY MENTAL HEALTH3. DIRECTOR OF DEPARTMENT OF HUMAN SERVICES4. EXECUTIVE DIRECTOR OF UNITED WAY IN MASON COUNTY5. HEALTH OFFICER AT MASON COUNTY HEALTH DEPARTMENT6. INTERIM DIRECTOR OF NURSING AND ALLIED HEALTH AT WEST SHORE COMMUNITY COLLEGE7. PRESIDENT AND CEO OF MEMORIAL MEDICAL CENTERKEY INFORMANT SURVEYS INCLUDED:1. 4H PROGRAM SECRETARY, OCEANA COUNTY EXTENSION OFFICE2. 4H PROGRAM SUPERVISOR, MASON COUNTY EXTENSION OFFICE3. 4H PROGRAM SUPERVISOR, OCEANA COUNTY EXTENSION OFFICE4. ADMINISTER, OAKVIEW MEDICAL CARE FACILITY5. CAPTAIN, SALVATION ARMY6. CHAIRPERSON, WEST MICHIGAN HUMAN SERVICES7. DEPUTY HEALTH OFFICER, DISTRICT 10 PUBLIC HEALTH8. DIRECTOR, HADLEY CENTER, MEMORIAL MEDICAL CENTER OF WEST MICHIGAN9. DIRECTOR, LUDINGTON SENIOR CENTER10. DIRECTOR, OB/CLINICAL, MEMORIAL MEDICAL CENTER OF WEST MICHIGAN11. DIRECTOR OF HOME CARE, MEMORIAL MEDICAL CENTER OF WEST MICHIGAN12. DIRECTOR OF INFECTION CONTROL, MEMORIAL MEDICAL CENTER OF WEST MICHIGAN13. DIRECTOR OF STUDENT SERVICES, MASON COUNTY CENTRAL14. DISCHARGE PLANNER, MEMORIAL MEDICAL CENTER OF WEST MICHIGAN15. DISCHARGE PLANNER, MEMORIAL MEDICAL CENTER OF WEST MICHIGAN16. DISTRICT MANAGER, SOCIAL SECURITY ADMINISTRATOR17. EXECUTIVE DIRECTOR, STAIRCASE18. EXECUTIVE DIRECTOR, WEST MICHIGAN COMMUNITY MENTAL HEALTH19. EXECUTIVE DIRECTOR, WEST SHORE PREGNANCY CARE CENTER20. GUIDANCE COUNSELOR, MASON COUNTY CENTRAL21. HEALTH EDUCATOR, DISTRICT 10 HEALTH DEPARTMENT22. HEALTH EDUCATOR, DISTRICT 10 HEALTH DEPARTMENT23. MANAGER, SHEPHERD'S STAFF AND SERVICES24. MSU EXTENSION OFFICE MANAGER, OCEANA COUNTY EXTENSION OFFICE25. OCCUPATIONAL THERAPIST, MASON-LAKE ISD26. PEDIATRICIAN, LUDINGTON, MICHIGAN27. PEDIATRICIAN, LUDINGTON, MICHIGAN28. PRINCIPAL, HART ELEMENTARY SCHOOL29. REFERRAL MANAGER, TENDERCARE OF LUDINGTON30. REGISTERED NURSE, OCEANA COUNTY COUNCIL ON AGING31. SECRETARY, CATHOLIC CHARITIES OF WEST MICHIGAN32. SECRETARY, MASON COUNTY EASTERN33. SOCIAL WORKER, MASON COUNTY CENTRAL34. SOCIAL WORKER, OAKVIEW MEDICAL CARE FACILITY35. SUPERVISOR, WEST MICHIGAN COMMUNITY MENTAL HEALTH36. SUPERVISOR, MASON-LAKE ISD37. VILLAGE PRESIDENT, PENTWATER, MICHIGAN MEMORIAL MEDICAL CENTER OF WEST MICHIGAN PART V, SECTION B, LINE 5C: IN ADDITION TO PUBLISHING THE COMMUNITY HEALTH NEEDS ASSESSMENT ON THE MEMORIAL MEDICAL CENTER WEBSITE (WWW.MMCWM.COM) AND PROVIDING COPIES AVAILABLE UPON REQUEST, A COPY WAS GIVEN TO THE LOCAL NEWSPAPER WHO COMPLETED AN ARTICLE ABOUT THE PROCESS AND CITED HIGHLIGHTS OF THE RESULTS. COPIES WERE GIVEN TO EACH MEMBER REPRESENTATIVE ON THE COMMUNITY HEALTH AND WELLNESS ADVISORY COUNCIL, WITH INSTRUCTIONS TO SHARE BROADLY WITHIN THEIR MEMBERSHIPS. MEMORIAL MEDICAL CENTER OF WEST MICHIGAN PART V, SECTION B, LINE 6I: MEMORIAL MEDICAL CENTER OF WEST MICHIGAN ALSO DEVELOPED A COMMUNITY HEALTH AND WELLNESS ADVISORY COUNCIL MADE UP OF A BROAD RANGE OF COMMUNITY ORGANIZATIONS DEDICATED TO SERVING RESIDENTS IN VARIOUS CAPACITIES. MEMORIAL MEDICAL CENTER OF WEST MICHIGAN PART V, SECTION B, LINE 7: THE BELOW IS AN EXCERPT FROM THE HOSPITALS IMPLEMENTATION PLAN, WHICH CAN BE FOUND ON THEIR WEBSITE AT WWW.MMCWM.COM.EACH OF THE HEALTH NEEDS LISTED BELOW IS IMPORTANT AND IS BEING ADDRESSED BY NUMEROUS PROGRAMS AND INITIATIVES OPERATED BY THE HOSPITAL AND OTHER COMMUNITY PARTNERS OF THE HOSPITAL. HOWEVER, THE HOSPITAL WILL NOT SPECIFICALLY ADDRESS THE FOLLOWING PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE CHNA AS PART OF THIS IMPLEMENTATION PLAN DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES ON THE TWO PRIORITY HEALTH NEEDS IDENTIFIED. SOME OF THESE HEALTH NEEDS WILL BE INDIRECTLY IMPACTED BY FOCUSING ON THE TWO PRIORITY HEALTH NEEDS IDENTIFIED.THE TOP THREE PRIORITIES THAT WILL NOT BE ADDRESSED ARE: 1. ARTHRITIS-RELATED CONDITIONS ARE BY FAR THE MOST PREVALENT CHRONIC CONDITIONS REPORTED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE CHRONIC CONDITIONS CLASSIFIED AS "ARTHRITIS" ARE MANAGED BY INTERNAL MEDICINE AND FAMILY PRACTICE PHYSICIANS. THERE WILL BE ON-GOING EVALUATION REGARDING THE CREATION OF LOCAL ACCESS TO THE RHEUMATOLOGY SUB-SPECIALTY.2. REDUCE SUBSTANCE ABUSE CURRENTLY BEING ADDRESSED BY NORTHERN MICHIGAN SUBSTANCE ABUSE SERVICES, THE DEPARTMENT OF COMMUNITY MENTAL HEALTH AND OTHERS. THESE PROGRAMS ADDRESS THE ALCOHOL/DRUG USE, SMOKING, SECONDHAND SMOKE, PRESCRIPTION DRUG ABUSE AND SUBSTANCE ABUSE TREATMENT ISSUES IDENTIFIED IN THE NEEDS ASSESSMENT.3. ADDRESS MENTAL HEALTH CURRENTLY BEING ADDRESSED BY THE MICHIGAN DEPARTMENT OF COMMUNITY MENTAL HEALTH. THESE PROGRAMS ADDRESS THE MENTAL HEALTH AND SUICIDE ISSUES IDENTIFIED IN THE NEEDS ASSESSMENT. AS WELL, MMC HAS EMPLOYED TWO PSYCHIATRISTS WHO WERE PREVIOUSLY IN PRIVATE PRACTICE TO EXPAND THEIR AVAILABILITY FOR OUTPATIENT SERVICES. MMC'S INPATIENT PSYCHIATRIC SERVICE LINE IS BEING EVALUATED BASED UPON FUTURE NEED. THE FOLLOWING ISSUES WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, BUT DETERMINED TO BE NOT AS HIGH OF A PRIORITY AS THE ABOVE MENTIONED ISSUES: 1. THESE ISSUES CAN BE BEST ADDRESSED THROUGH GOVERNMENT COUNCILS OR DEPARTMENTS. THE LOCAL HEALTH CARE ORGANIZATION DOES NOT HAVE THE RESOURCES TO ADDRESS THESE ISSUES EFFECTIVELY.- HIGH UNEMPLOYMENT RATE AND HIGH POVERTY RATES, ESPECIALLY FOR SINGLE-FEMALE HOUSEHOLDS WITH CHILDREN- LARGE PROPORTION OF CHILDREN LIVING IN POVERTY- CHILD ABUSE/NEGLECT CASES ON PAR WITH STATE AND HIGHER THAN U.S. LAKE COUNTY MUCH HIGHER - FEWER COLLEGE EDUCATED RESIDENTS THAN MICH. OR U.S. LOWER PROPORTIONS OF OCEANA AND LAKE COUNTY MEN AND WOMAN HAVE NOT GRADUATED FROM HIGH SCHOOL IN COMPARISON TO MICHIGAN OR U.S. AVERAGE. - LACK OF SPANISH-SPEAKING HEALTH CARE PROFESSIONALS- PEOPLE NOT GETTING ENOUGH SLEEP (AT LEAST EIGHT HOURS)- HIGHER DISABILITY RATES THAN THE MICH. AVERAGE- TRANSPORTATION (PUBLIC/PERSONAL)- HOUSING (AFFORDABLE/AVAILABLE)- HEALTHY FOODS (AVAILABILITY)1. THE REMAINING ISSUES WILL BE ADDRESSED BY THE FOLLOWING:- DENTAL CARE IS BEING ADDRESSED BY FAMILY HEALTH CARE IN LAKE COUNTY AND MICHIGAN COMMUNITY DENTAL CLINICS IN MANISTEE COUNTY. BOTH ORGANIZATIONS HAVE SERVICE AREAS THAT EXTEND THROUGH MASON AND OCEANA COUNTIES.- CANCER IN 2013, MMC EXPANDED ITS CANCER SERVICES TO ACCOMMODATE INCREASED DEMAND CAUSED BY THE CLOSING OF THE CANCER AND BLOOD CENTER IN FREE SOIL, MI. MMC WILL CONTINUE TO PROVIDE MEDICAL ONCOLOGY SERVICES AT THE HOSPITAL AND SEEKS TO EXPAND THE AVAILABILITY OF PROVIDERS IN THE COMMUNITY. HOSPITAL WILL CONTINUE TO PROMOTE CANCER AWARENESS AND THE IMPORTANCE OF OBTAINING RECOMMENDED SCREENING, AS IT DID IN ITS CANCER SYMPOSIUM IN SEPTEMBER OF 2013.- NURSING HOME CARE (ACCESS) TENDERCARE AND OAKVIEW MEDICAL CARE FACILITY PARTICIPATE IN THE MMC'S HEALTH AND WELLNESS ADVISORY COUNCIL AND ISSUES RELATED TO ACCESS WILL BE ADDRESSED THERE.- DIABETES MMC HAS A ROBUST DIABETES EDUCATION AND SELF-MANAGEMENT PROGRAM. OUR FOCUS ON OBESITY AND TARGETING YOUNGER POPULATIONS WILL POSITIVELY IMPACT DIABETES FREQUENCY AND SEVERITY IN THE LONG TERM.- HEART DISEASE MMC CONTINUES TO PROVIDE COMMUNITY EDUCATION ON HEART DISEASE THROUGH ITS WIN WITH WELLNESS PROGRAMMING. THE HOSPITAL WILL CONTINUE TO PROMOTE HEART HEALTH THROUGH ITS COMMUNITY HEALTH AND WELLNESS COUNCIL IN PARTNERSHIP WITH COMMUNITY AND BUSINESS GROUPS. MEMORIAL MEDICAL CENTER OF WEST MICHIGAN PART V, SECTION B, LINE 20D: WE FIRST ATTEMPT TO QUALIFY THE PATIENT FOR FAP OR OTHER COMMUNITY RESOURCES FOR COVERAGE. PATIENT IS THEN OFFERED A DISCOUNT UP TO 30% OF CHARGES. THE 30% IS ARRIVED AT BY ADDING THE SELF-PAY DISCOUNT OF 20% PLUS THE PROMPT PAY DISCOUNT OF 10%. THE 30% ALIGNS WITH THE DISCOUNT THE HOSPITAL ACCEPTS FROM OTHER PAYERS.PATIENTS AT THE 150 PERCENT FEDERAL POVERTY LIMIT QUALIFY FOR FREE CARE AND THEREFORE WILL NOT OWE ANYTHING OR BE SUBJECTED TO COLLECTION ACTIVITIES. MEMORIAL MEDICAL CENTER OF WEST MICHIGAN PART V, SECTION B, LINE 22: THE HOSPITAL FACILITY MAKES EVERY REASONABLE ATTEMPT TO HELP ITS PATIENTS RECEIVE SOME SORT OF ASSISTANCE OR DISCOUNT. IF THE PATIENT DOES NOT REPLY OR CORRESPOND TO HOSPITAL'S ATTEMPTS THEN A BILL COULD BE GENERATED USING GROSS CHARGES. PART VI, LINE 2: IN THE PAST THE MASON COUNTY HEALTH DEPARTMENT CONDUCTED A HEALTH NEEDS ASSESSMENT OF THE COMMUNITY. MEMORIAL MEDICAL CENTER THEN WORKED ALONG SIDE THE HEALTH DEPARTMENT TO ANALYZE THOSE NEEDS TO ENSURE THAT THOSE NEEDS WERE BEING MET. MEMORIAL MEDICAL CENTER ISSUED THEIR OWN COMMUNITY HEALTH NEEDS ASSESSMENT IN SEPTEMBER 2013. PART VI, LINE 3: MEMORIAL MEDICAL CENTER PATIENTS HAVE A HOSPITAL FINANCIAL COUNSELOR THAT THEY MEET WITH. DURING THAT MEETING THE PATIENTS ARE INTERVIEWED TO ASSESS THEIR FINANCIAL ABILITY OR ASSISTANCE NEEDS. THEY ARE INFORMED AT THAT TIME IF THEY MAY BE POSSIBLE CANDIDATES FOR FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR THE HOPITAL'S CHARITY CARE PROGRAM. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS ATTACHED TO BILLING INVOICES, IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY, WAITING ROOMS AND ADMISSIONS OFFICES, AND IT IS ALSO MADE AVAILABLE UPON REQUEST. PART VI, LINE 4: MEMORIAL MEDICAL CENTER SERVES A RURAL COMMUNITY THAT IS LOCATED ON THE COAST OF LAKE MICHIGAN. BECAUSE THE LOCATION IS A SEASONAL TOURIST ATTRACTION THE POPULATION OF THE COMMUNITY SIGNIFICANTLY CHANGES WITH THE SEASONS. ALSO SEASONALLY DRIVEN, BECAUSE OF THE AGRICULTURAL EMPLOYMENT OPPORTUNITIES, IS A MIGRANT POPULATION. A LARGE PART OF THE HOSPITAL PATIENTS ARE COVERED BY EITHER MEDICARE OR MEDICAID. PART VI, LINE 5: MEMORIAL MEDICAL CENTER IS A SOLE COMMUNITY HOSPITAL WITH A COMMUNITY BOARD MADE UP OF VOLUNTEER MEMBERS. THE MEDICAL STAFF CONSISTS MOSTLY OF INDIVIDUAL PHYSICIANS PRACTICING WITHIN THE SERVICE AREA OF THE HOSPITAL. THE HOSPITAL HELPS PROVIDE ACCESS TO CARE BY SUPPORTING RECRUITING EFFORTS FOR NECESSARY PHYSICIANS AS WELL AS ASSURING THE COMMUNITY HAS THE MOST RECENT TECHNOLOGY AND ACCESS TO EMERGENCY CARE WHEN NEEDED. PART VI, LINE 6: N/A - NOT AFFILIATED. REPORTS FILED WITH STATES PART VI, LINE 7 MI 1 LUDINGTON SCOTTVILLE CHAMBER OF COMMERCE 5827 W US 10 LUDINGTON MI 49431 380775025 501(C)(3) 5095 N/A N/A SPONSORSHIP OF ICE OPEN, SUMMERFEST, VISION LEVEL, GUS MACKER BASKETBALL TOURNAMENT 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: WHEN GRANTS ARE GIVEN TO PUBLIC CHARITIES, THE HOSPITAL REVIEWS EACH ORGANIZATION TO ENSURE THAT THEY ARE EXEMPT. X X 1 1 X X X X 0 0 0 0 0 0 0 0 0 TIMOTHY HEINRICH 255163 0 0 0 0 0 39500 0 13104 0 307767 0 0 0 KERRI NELSON 186954 0 0 0 0 0 9399 0 13104 0 209457 0 0 0 MARK VIPPERMAN 384940 0 0 0 0 0 29500 0 10802 0 425242 0 0 0 HELEN JOHNSON 184108 0 0 0 0 0 17000 0 0 0 201108 0 0 0 DAVID KLINGER 171317 0 0 0 0 0 5127 0 10802 0 187246 0 0 0 JOHN P COONEY DO 206273 0 0 0 0 0 14643 0 0 0 220916 0 0 0 TAMARA BUCKLESMD 218791 0 0 0 0 0 0 0 13104 0 231895 0 0 0 EDDIE MAKOWICKI 174434 0 0 0 0 0 8869 0 13104 0 196407 0 0 0 AMANDA OVERMYERMD 150123 0 0 0 0 0 0 0 13104 0 163227 0 0 0 ROBERT JOHNSON 159941 0 0 0 0 0 39500 0 10803 0 210244 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS: MARK VIPPERMAN, ALLOWED FOR IN HIS EMPLOYEMENT CONTRACT. TREATED AS TAXABLE COMPENSATION. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: MARK VIPPERMAN, LINCOLN HILLS DUES. SOCIAL CLUB DUES ARE NOT TREATED AS TAXABLE COMPENSATION. THE ONLY REASON THE STAFF MEMBERS OBTAIN A MEMBERSHIP TO THE LOCAL SOCIAL CLUBS, IS SO MEMORIAL MEDICAL CENTER CAN USE THE SOCIAL CLUB FACILITIES FOR HOSPITAL SPONSORED EVENTS SUCH AS THE BENEFIT HALL, EMPLOYEE SERVICE AWARDS DINNER, ETC. THE MEMBERSHIP WAS NOT UTILIZED FOR PERSONAL BENEFIT. MEMORIAL MEDICAL CENTER DOES NOT PAY FOR HEALTH CLUB DUES. A MASON COUNTY HOSPITAL FINANCE AUTHORITY 386004870 2012-06-15 10000000 REFINANCING AND CONSTRUCTION 0 0 0 A 10000000 193251 4355207 5451542 2013 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 0 A 0 SCHEDULE K, PART II, LINE 11: THE AMOUNT OF OTHER SPENT PROCEEDS REPRESENTS THE PORTION OF THE $10,000,000 BOND THAT WAS USED TO PAY OFF THE NOTE PAYABLE TO THE MICHIGAN STATE HOSPITAL FINANCE AUTHORITY. PERE MARQUETTE EMERGENCY PHYSICIAN PLC BOARD MEMBER STEVEN STRIBICH IS OWNER OF THIS PHYSICIAN PRACTICE 102042 HOSPITAL PAID RENT AND OVERHEAD COSTS OF HOSPITAL-EMPLOYED PHYSICIAN LOCATED IN THE BOARD MEMBERS PRACTICE. 0 FORM 990, PART VI, SECTION A, LINE 4 THE BOARD OF DIRECTORS AMENDED THE BYLAWS ON APRIL 2, 2013. THE AMENDED BYLAWS INCLUDE A REVISED SECTION ON COMPENSATION STATING "DIRECTORS ON THE BOARD OR ANY BOARD COMMITTEE, AS SUCH, SHALL NOT RECEIVE SALARIES FOR THEIR SERVICES AS A MEMBER OF THE BOARD. THE BOARD BY AN ACTION MAY DETERMINE THAT THE DIRECTORS ON THE BOARD OR ANY BOARD COMMITTEE MAY RECEIVE REASONABLE REIMBURSMENT FOR EXPENSES INCURRED IN ATTENDING TO THEIR AUTHORIZED DUTIES. THIS SECTION 8 SHALL NOT BE CONSTRUED TO PRECLUDE ANY MEMBER OF THE BOARD FROM SERVING THE CORPORATION IN ANY OTHER CAPACITY AND RECEIVING COMPENSATION THEREFORE. THE FOREGOING SHALL ALSO NOT PREVENT THE BOARD FROM REIMBURSING ANY DIRECTOR FOR EXPENSES ACTUALLY AND NECESSARILY INCURRED BY HIM OR HER IN THE PERFORMANCE OF HIS OR HER DUTIES AS DIRECTOR, OR FROM ENTERING INTO A CONTRACT DIRECTLY OR INDIRECTLY WITH A DIRECTOR FOR THE PROVIDING OF GOODS AND OR SERVICES TO THE CORPORATION, IF SUCH CONTRACT IS IN THE BEST INTEREST OF THE CORPORATION AND ON FAIR AND REASONABLE TERMS." THE AMENDED BYLAWS CLARIFY THE DISTRIBUTION OF THE ASSETS UPON DISSOLUTION OF THE CORPORATION, BY STATING THAT AFTER PAYING OR MAKING PROVISION FOR THE PAYMENT OF ALL LIABILITIES AND OBLIGATIONS OF THE CORPORATION, THE REMAINING ASSETS SHALL BE DISTRIBUTED TO MEMORIAL MEDICAL CENTER FOUNDATION IF IN EXISTANCE, AND MASON COUNTY, MICHIGAN IF THE FOUNDATION IS NOT IN EXISTANCE. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PLACED ON THE AGENDA FOR THE BOARD MEETING AND EACH BOARD MEMBER HAS A CHANCE TO REVIEW THE 990 AND THEN ASK QUESTIONS REGARDING DATA WITHIN THE FORM BEFORE IT IS FILED. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL HAS THE OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS SIGN A DOCUMENT DISCLOSING THEIR CONFLICTS OF INTEREST. THE DOCUMENTS ARE REVIEWED ONCE A YEAR BY THE BOARD MEMBERS AND THEY WOULD DETERMINE WHETHER A CONFLICT EXISTS. ANY PERSON WHO IS DEEMED TO HAVE A CONFLICT OF INTEREST WOULD BE PROHIBITED FROM PARTICIPATING IN ANY DELIBERATION AND DECISIONS REGARDING THE RELATED TRANSACTION. RESPONDED NO FOR PART VI, LINE 12B AS THE CONFLICT OF INTEREST FORMS WERE NOT COMPLETED BY KEY EMPLOYEES DURING FISCAL YEAR 2013. FORM 990, PART VI, SECTION B, LINE 15 ONCE A YEAR THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE REVIEWS THE CEO'S EMPLOYMENT PERFORMANCE AND RECOMMENDS TO THE FULL BOARD A CONTINUATION OF EMPLOYMENT AND ANY COMPENSATION INCREASES OR CHANGES. MEMORIAL MEDICAL CENTER'S HUMAN RESOURCES MANAGER COMPILES COMPARABILITY DATA FROM A NUMBER OF DIFFERENT COMPENSATION SURVEYS, THE BOARD COMPLETES AN EVALUATION FORM ON THE CEO'S PERFORMANCE, HUMAN RESOURCES COMPILES ALL OF THE DATA FROM THE SURVEYS AND PROVIDES THAT DATA - ALONG WITH THE COMPENSATION COMPARABILITY DATA TO THE BOARD. ONCE A YEAR THE PRESIDENT/CEO REVIEWS THE ANNUAL LEADERSHIP APPRAISAL FOR THE VICE PRESIDENT AND OTHER MANAGEMENT EMPLOYEES UNDER HIS/HER DIRECT SUPERVISION AND RECOMMENDS ANY COMPENSATION ADJUSTMENTS TO THE FULL BOARD OF DIRECTORS FOR APPROVAL. THE LAST REVIEW OF COMPENSATION COMPARABILITY DATA TO DETERMINE THE FISCAL YEAR'S OFFICER COMPENSATION WAS PERFORMED AT THE 11/27/12 BOARD MEETING. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,160,315. MANAGEMENT AND GENERAL EXPENSES 2,726,234. FUNDRAISING EXPENSES 1,426. TOTAL EXPENSES 5,887,975. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 3,547,443. MANAGEMENT AND GENERAL EXPENSES 7,438. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,554,881. COLLECTION FEES: PROGRAM SERVICE EXPENSES 1,831. MANAGEMENT AND GENERAL EXPENSES 325,033. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 326,864. MAINTENANCE AGREEMENTS: PROGRAM SERVICE EXPENSES 799,599. MANAGEMENT AND GENERAL EXPENSES 693,213. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,492,812. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT 8,955,505. FORM 990, PART XII, LINE 2C: NO CHANGES FROM PRIOR YEAR FORM 990, PAGE 1, C: THE HOSPITAL HAS THE FOLLOWING DBA'S ON RECORD: - MEMORIAL FAMILY CARE - MEMORIAL MEDICAL HOME CARE FORM 990, PART X: FOR TAX RETURN PURPOSES, PREPAID PENSION HAS BEEN CLASSIFIED AS AN ASSET VERSUS NETTING AGAINST THE PENSION LIABILITY. DUE TO THIS, BALANCE SHEET ASSETS AND LIABILITIES ON THE 990 ARE HIGHER THAN THE AUDITED FINANCIAL STATEMENTS BY $12,345,535 AND $10,678,523 AS OF SEPTEMBER 30, 2013 AND 2012, RESPECTIVELY.