2026-01-21T13:33:16-06:00 2024-12-31 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-01-01 386108110 COMMUNITY HEALTH CENTER OF BRANCH COUNTY COMM 5172795400 274 EAST CHICAGO ST COLDWATER MI 49036 ATIF BAWAHAB PRESIDENT/DIRECTOR 5172795400 2026-01-20 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2026-01-20 2024 2025-03-06 01:10:19Z INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER ATIF BAWAHAB 274 EAST CHICAGO ST COLDWATER MI 49036 85977006 0 X WWW.INSIGHTCOLDWATER.ORG X 2018 MI COMMUNITY HEALTH CENTER OF BRANCH COUNTY IS AN ACUTE CARE HOSPITAL THAT STRIVES TO BE THE DESIRED DESTINATION FOR HEALTHCARE SERVICES FOR EVERYONE, EVERY TIME IN BRANCH COUNTY. 7 3 553 39 0 0 1356237 22420 79122028 85890014 18984 56327 35561 8245 80532810 85977006 0 0 0 0 38363552 37024158 0 0 22832 48133180 51071795 86496732 88095953 -5963922 -2118947 31517240 41722239 27143505 38722893 4373735 2999346 X COMMUNITY HEALTH CENTER OF BRANCH COUNTY PROVIDES A HIGH-QUALITY, PERSONALIZED EXPERIENCE TO SERVE THE HEALTHCARE NEEDS OF OUR COMMUNITIES. 0 0 75517812 0 85890014 COMMUNITY HEALTH CENTER OF BRANCH COUNTY (D/B/A INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER) (CRH) IS A MISSION-BASED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY.INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER (CRH) IS AN 87-BED, CRITICAL ACCESS, GENERAL ACUTE CARE HOSPITAL IN COLDWATER, MICHIGAN. THE 290,000-SQUARE-FOOT FACILITY PROVIDES HEALTHCARE SERVICES TO RESIDENTS IN THE MICHIGAN COUNTIES OF BRANCH AND HILLSDALE. IN DECEMBER 2024, CRH HAD A NEW MEMBER (FIRDAUS FOUNDATION). CRH OFFERS A BROAD RANGE OF SERVICES TO MEET THE COMMUNITY'S IDENTIFIED HEALTHCARE NEEDS, INCLUDING A 17-BED EMERGENCY CENTER, SURGICAL SERVICES, INPATIENT BEHAVIORAL HEALTH CARE, A FULL SPECTRUM OF ORTHOPEDIC SURGICAL SERVICES, AND CANCER SERVICES CONNECTED TO THE PROMEDICA CANCER INSTITUTE, THE REGION'S CANCER TREATMENT LEADER. IN 2021, CRH BEGAN OFFERING PAIN MANAGEMENT SERVICES AS WELL AS ORTHOPEDIC SURGERY.WOMEN'S HEALTH SERVICES INCLUDE DIAGNOSTIC BREAST MAMMOGRAPHY AND ULTRASOUND, DEXA BONE DENSITY SCREENING, BREAST MRI, AND PRIVATE BIRTHING SUITES THAT PROVIDE A FAMILY-FOCUSED BIRTHING EXPERIENCE. CRH ALSO ADDED A NEW GENIUS 3D MAMMOGRAPHY TECHNOLOGY FOR IMPROVED CLINICAL ACCURACY AND HIGH-RESOLUTION 3D IMAGES.MEDICAL OFFICE BUILDINGS ON THE HOSPITAL CAMPUS INCLUDE OFFICES FOR FAMILY PRACTICE AND INTERNAL MEDICINE PHYSICIAN GROUPS AS WELL AS CARDIOLOGY AND UROLOGY PRACTICES, AN ALLERGY AND ASTHMA CLINIC, GENERAL SURGERY OFFICES, HEMATOLOGY AND ONCOLOGY, AND ENT. OTHER SERVICES INCLUDE EMERGENCY MEDICINE, CARDIAC AND PULMONARY REHAB, VASCULAR CARE, PHYSICAL AND OCCUPATIONAL THERAPY, AND PODIATRY.CRH IS ACCREDITED BY THE JOINT COMMISSION, AND THE HOSPITAL'S WOUND CARE CENTER IS A CENTER OF DISTINCTION AWARD WINNER. IN THE SPRING OF 2024, CRH RECEIVED AN "A" HOSPITAL SAFETY GRADE FROM THE LEAPFROG GROUP IN THE SPRING AND A "C" IN THE FALL OF 2024, A NATIONAL NONPROFIT UPHOLDING THE STANDARD OF PATIENT SAFETY IN HOSPITALS AND AMBULATORY SURGERY CENTERS. CRH ALSO EARNED A FIVE-STAR RATING FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) AS PART OF ITS UPDATED OVERALL HOSPITAL QUALITY STAR RATING.IN 2024, THE HOSPITAL SERVED 2,275 INPATIENTS AND 97,678 OUTPATIENTS. ADDITIONALLY, 19,004 PEOPLE SOUGHT CARE THROUGH CRH'S EMERGENCY CENTER IN 2024. THE HOSPITAL CONTRIBUTED TO THE COMMUNITY THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE, AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE.AS A COMMUNITY-BASED HOSPITAL, CRH HOSTED VARIOUS SUPPORT GROUPS AND COMMUNITY OUTREACH ACTIVITIES. IN 2024, THIS INCLUDED EMPLOYEE DONATIONS OF MORE THAN 250 POUNDS OF FOOD TO THE BRANCH COUNTY FOOD PANTRY. CANCER CENTER SUPPORT GROUPS HELD VIRTUALLY, INCLUDING LOOK GOOD, FEEL BETTER AND THE SURVIVORS SUPPORT GROUP, COMMUNITY SPONSORSHIPS, CPR AND PALS CLASSES, COMMUNITY BLOOD DRIVES, AND THE BRANCH COUNTY UNITED WAY ANNUAL UNITED WE READ DAY. CRH ALSO PROVIDED FINANCIAL ASSISTANCE TO THE COMMUNITY THROUGHOUT 2024, OF WHICH $3,300,980 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT OF PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. COLDWATER HOSPITAL'S COST OF BAD DEBT FOR 2024 WAS $3,888,745.IN SUMMARY, COLDWATER HOSPITAL DEMONSTRATES INSIGHT'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES, RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY, PROVIDE APPROPRIATE FINANCIAL ASSISTANCE, OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS, AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS, AND OTHER OUTREACH ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. 75517812 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 553 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 3 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 X NADIR IJAZ 5868802427 21230 DEQUINDRE RD WARREN MI 48091 ATIF BAWAHAB PRESIDENT/DIRECTOR 1.00 X X 0 0 0 BASEER TAJUDDIN SECRETARY 1.00 X X 0 0 0 ATIQ NAKRAWALA TREASURER 1.00 X X 0 0 0 HARRIS AHMED DIRECTOR 1.00 X 0 0 0 RIAZULA HUDA DIRECTOR 1.00 X 0 0 0 JAWAD SHAH DIRECTOR 1.00 X 0 0 0 ABDULLAH WAHEED DIRECTOR 1.00 X 0 0 0 DARRIN ARQUETTE PRESIDENT MONROE REGIONAL HOSPITAL 1.00 40.00 X X 0 640902 10194 KATHLEEN MERRILL CHAIR/CHIEF MARKETING OFFICER (THRU 12.1.24) 1.00 40.00 X X 0 528138 12669 TERRY METZGER TREASURER (THRU 12.1.24) 1.00 X X 0 0 0 STEVE SADOWSKI SECRETARY (THRU 12.1.24) 1.00 X X 0 0 0 MIKE BECKWITH TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 LAURA CAYWOOD TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 HILLARY ELEY TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 JOSEPH HUGHES TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 CINDY LONGSTREET TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 DEBORAH LOUNDS-BOWERS TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 JANINCE J GRABOWSKI TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 KENDRA DANIELSEN TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 EVAN FREDERICK DDS TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 TIMOTHY MILLER DO TRUSTEE/EMT (THRU 12.1.24) 1.00 X 0 62942 2014 CHARLES F WHITAKER IV MD TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 CATHERINE C HABERL TRUSTEE (THRU 12.1.24) 1.00 X 0 0 0 DANIEL SCHWANKE PRESIDENT 40.00 X 190680 0 0 ARTURO POLIZZI PRESIDENT AND CEO PROMEDICA HEALTH SYSTEM (THRU 12 1.00 40.00 X 0 3119320 14012 TERRENCE METZGER CHIEF FINANCIAL OFFICER (THRU 12.1.24) 1.00 40.00 X 0 1209318 6610 STEPHEN SADOWSKI CHIEF LEGAL OFFICER (THRU 12.1.24) 1.00 40.00 X 0 1180376 6038 ONDREA WILLIAMS CHIEF NURSING OFFICER PROVIDER (THRU 12.1.24) 1.00 40.00 X 0 626139 5257 DASA DZIERWA CP AVP NON CLINICAL (THRU 12.1.24) 1.00 40.00 X 0 182969 0 BARBARA MCGRATH ONCOLOGIST 40.00 X 813296 0 0 CHRISTOPHER HOGG ORTHOPEDIC SURGEON 40.00 X 625061 0 0 EDWARD JANKOWSKI OTOLARYNGOLOGIST 40.00 X 435090 0 0 KANWAR RANA PSYCHIATRIST 40.00 X 417837 0 0 NOLAN HERRINGTON PSYCHIATRIST 40.00 X 357144 0 0 2839108 7550104 56794 45 0 1 0 AYA HEALTHCARE INC 5930 CORNERSTONE COURT WEST SAN DIEGO CA 92121 TEMPORARY AGENCY 3357489 CLINICAL COLLEAGUES INC 1765 E NINE MILE ROAD PENSACOLA FL 32514 ANESTHESIA SERVICES 2435542 EPMG OF MICHIGAN PC 2000 GREEN ROAD ANN ARBOR MI 48105 PROVIDER SERVICES 866679 KALAMAZOO FOOT AND ANKLE SPECIALISTS PLC 7971 MOORSBRIDGE ROAD PORTAGE MI 49024 PROVIDER SERVICES 574670 PAIN MANAGEMENT GROUP LLC 229 WEST MAIN CROSS STREET FINDLAY OH 45840 PROFESSIONAL SERVICES 365442 17 22420 22420 NET PATIENT SERVICES 622110 85890014 85890014 85890014 56327 56327 8245 0 8245 8245 8245 85977006 85890014 0 64572 X 29438851 24754474 4671944 12433 867826 729735 137724 367 4690965 3944528 744456 1981 2026516 1704052 321608 856 1143172 1143172 109108 109108 8120 8120 13687236 10721504 2965732 154478 34736 119742 558187 125510 432677 19090 12821 6269 1076583 1044301 32282 29585 6708 22877 11394 11394 5089827 4575464 514363 775408 775408 MEDICAL SUPPLIES 12412982 12412982 CORPORATE ALLOCATION 5415836 5415836 PROVIDER ASSESSMENT TAX 4537531 4537531 BAD DEBT EXPENSE 4179932 4179932 1863326 1306304 549827 7195 88095953 75517812 12555309 22832 6020246 2562440 10572875 8830410 1563773 1970693 274836 1457970 40949577 23228926 6916451 17720651 824530 0 5344529 9180075 31517240 41722239 3411422 7682170 0 30418 0 10394702 23732083 20615603 27143505 38722893 X -85311 -1453000 4459046 4452346 4373735 2999346 31517240 41722239 X -2118947 -1288747 2033305 X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 8120 8120 0 PART II-B, LINE 1: COMMUNITY HEALTH CENTER OF BRANCH COUNTY PAYS DUES TO THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATION. 947500 947500 22675470 9045907 13629563 1273729 890168 383561 15923250 13292851 2630399 129628 129628 17720651 RIGHT OF USE ASSETS 542906 3RD PARTY SETTLEMENT RESERVE 4184823 BENEFICIAL INTEREST FOR FOUNDATION 4452346 9180075 FIXED ASSET CLEARING 15712692 PROVIDER TAXES PAYABLE 4320589 FINANCE LEASE OBLIGATION 564922 DUE TO AFFILIATES 17400 20615603 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 0 1058110 0 1058110 0.01260 18970987 14218827 4752160 0.05660 20029097 14218827 5810270 0.06920 20029097 14218827 5810270 0.06920 1 4179932 3300981 9843836 11512124 -1668288 X 1 1 1 1 COMMUNITY HEALTH CENTER OF BRANCH COUNTY 274 EAST CHICAGO ST COLDWATER MI 49036 WWW.INSIGHTCOLDWATER.ORG 1060000011 X X X COMMUNITY HEALTH CENTER OF BRANCH COUNTY 1 0 1 1 X X X X X X X X X 22 1 0 1 1 X SEE SUPPLEMENTAL INFORMATION X 1 22 1 HTTPS://WWW.PROMEDICA.ORG/ABOUT-PROMEDICA/COMMUNITY 0 1 X 200.000000000000 600.000000000000 X X X 1 1 X X X 1 X HTTPS:///WWW.PROMEDICA.ORG/PAY-MY-BILL/FINANCIAL-ASSISTANCE X HTTPS:///WWW.PROMEDICA.ORG/PAY-MY-BILL/FINANCIAL-ASSISTANCE X HTTPS:///WWW.PROMEDICA.ORG/PAY-MY-BILL/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 8 1 - PROMEDICA HOUGHTON FAMILY PHYSICAL THERA 320 E CHICAGO ST COLDWATER MI 49036 TOTAL REHAB 2 - PROMEDICA PEDIATRIC & ADOLESCENT CLINIC 358 E CHICAGO ST STE 202 COLDWATER MI 49036 RHC PEDS 3 - PROMEDICA COLDWATER REGIONAL HOSPITAL PA 360 E CHICAGO ST COLDWATER MI 49036 PAIN CLINIC 4 - PROMEDICA COLDWATER FAMILY MEDICINE CLIN 370 E CHICAGO ST STE 200 COLDWATER MI 49036 RHC COLDWATER FM 5 - PROMEDICA COLDWATER WOUND HEALING CENTER 370 E CHICAGO ST STE 700 COLDWATER MI 49036 WOUND CARE CLINIC 6 - PROMEDICA COLDWATER REGIONAL CANCER CENT 370 E CHICAGO ST STE 100 COLDWATER MI 49036 ONCOLOGY 7 - MAPLE LAWN 50 SANDERSON LANE COLDWATER MI 49036 LAB 8 - PROMEDICA UNION CITY MEDICAL CENTER 624 M 60 UNION CITY MI 49094 RHC UNION CITY FM PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 7: COMMUNITY HEALTH CENTER OF BRANCH COUNTY CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2: RATIO OF PATIENT CARE COST TO CHARGES. OTHER BENEFIT AMOUNTS REPORTED ON LINE 7 WERE RECALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED UNDER OTHER BENEFITS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4,179,932. PART III, LINE 2: COMMUNITY HEALTH CENTER OF BRANCH COUNTY'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD. THIS METHOD UTILIZES HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS AS WELL AS PATIENT PAYMENTS SUCH AS COPAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY. PART III, LINE 3: COMMUNITY HEALTH CENTER OF BRANCH COUNTY ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION. THESE WERE CASES IN WHICH THE APPLICATION WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, AND THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT. PART III, LINE 4: PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 16 AND 17 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION. PART III, LINE 8: COMMUNITY HEALTH CENTER OF BRANCH COUNTY USED THE MEDICARE ALLOWABLE COSTS PER ITS 2024 FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE RECALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE-GENERATING UNITS WITHIN THE HOSPITAL. IT IS IMPORTANT TO NOTE THAT THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. PART III, LINE 9B: FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE ESTABLISHED CRITERIA. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED TO ENSURE REIMBURSEMENT CAN BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION DEMONSTRATING THAT THEY MEET THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE ELIGIBILITY IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS WITH A SELF-PAY BALANCE INCLUDING THOSE WHO MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION MAY BE MADE USING PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, AND OTHER RELEVANT INDICATORS TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED ACCORDING TO POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY MATERIALS NECESSARY TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, ALONG WITH ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT. PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE, BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED THE HOSPITAL REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, HAS NOT SUBMITTED A FINANCIAL ASSISTANCE APPLICATION, HAS NOT RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR IF THE HOSPITAL IS UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION THAT THE EXTERNAL COLLECTION AGENCY, AS THEY WORK THE ACCOUNTS, WILL OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE. FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION, THE AGENCY WILL FORWARD APPLICATIONS TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING. PART VI, LINE 2: INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER DEMONSTRATE A COMMITMENT TO THE COMMUNITIES THEY SERVE AND, THEREFORE, BELIEVE IT IS CRITICAL TO UNDERSTAND THE HEALTHCARE NEEDS OF THEIR PRIMARY SERVICE AREAS. TO THAT END, INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER CONDUCT NEEDS ASSESSMENTS IN THEIR PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTHCARE DATA, IDENTIFY GAPS IN HEALTHCARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF GENERAL COMMUNITY HEALTH.ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER COMMUNITY ASSESSMENTS ARE ALL METHODS USED TO DEVELOP RECOMMENDATIONS FOR INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS. THIS INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ENSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY.PUBLISHED COUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS.INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER COMMUNITY GOALS ARE SET BASED ON THIS DATA. OVERALL, INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER COMMUNITY HEALTH PLAN PLACES EMPHASIS ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBER OF INDIVIDUALS AFFECTED BY THESE CONDITIONS. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES RELATES TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY, AS WELL AS IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS.INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER IS ALSO COMMITTED TO WORKING BEYOND ITS FOUR WALLS, ADDRESSING THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL-FETAL MEDICINE. PART VI, LINE 3: THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENT AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE. THIS OUTREACH IS INTENDED TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION, AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT THE TIME OF ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE.C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. THESE ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY, ASSIST WITH APPLICATIONS FOR GOVERNMENT ASSISTANCE PROGRAMS, EXPLAIN PATIENT LIABILITY FOR CHARGES, PROVIDE ESTIMATES OF CHARGES WHEN FEASIBLE, EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE INCLUDING THE CRITERIA AND APPLICATION METHOD, AND DISCUSS PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON PATIENT BILLING STATEMENTS TO NOTIFY UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. THE MESSAGE EXPLAINS THE ELIGIBILITY CRITERIA AND DESCRIBES THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENTS, AVAILABLE VIA THE INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER WEBSITE, AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTIONS DEPARTMENTS. PART VI, LINE 4: INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER, LOCATED IN COLDWATER, MICHIGAN, SERVES AN AREA PRIMARILY CENTERED AROUND BRANCH COUNTY. APPROXIMATELY 19% OF THE SERVICE AREA POPULATION IS AGE 65 OR OLDER, WHILE 58% FALLS BETWEEN THE AGES OF 18 AND 64. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $60,000, AND 89% OF THE ADULT POPULATION AGED 25 AND OLDER HAS A HIGH SCHOOL DEGREE OR LOWER.BRANCH COUNTY HAS A POPULATION OF APPROXIMATELY 45,000, WITH AROUND 18% OF FAMILIES LIVING BELOW THE POVERTY LEVEL. ABOUT 9% OF THE COUNTY'S POPULATION IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR BRANCH COUNTY IN 2023 WAS 5.0%.THE LEADING CAUSES OF DEATH IN BRANCH COUNTY, BASED ON AGE-ADJUSTED MORTALITY RATES, INCLUDE HEART DISEASE, CANCER, COVID-19, UNINTENTIONAL INJURIES/ACCIDENTS, STROKE, LUNG DISEASE, ALZHEIMER'S DISEASE, AND DIABETES.ACCORDING TO THE 2023 COUNTY HEALTH RANKINGS, BRANCH COUNTY RANKED 57TH OUT OF 83 COUNTIES FOR HEALTH OUTCOMES AND 51ST OUT OF 83 FOR HEALTH FACTORS.THERE ARE FIVE HOSPITALS WITHIN A 30-MILE RADIUS OF COLDWATER REGIONAL HOSPITAL: STURGIS HOSPITAL, CAMERON MEMORIAL COMMUNITY HOSPITAL IN ANGOLA, HILLSDALE HOSPITAL, CAMERON HOSPITAL IN FREMONT, AND OAKLAWN HOSPITAL. PART VI, LINE 5: INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER IS AN INTEGRAL PART OF INSIGHT HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM.INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS AT ITS METRO TOLEDO AND REGIONAL HOSPITALS. WHILE QUALIFICATIONS MAY VARY BY HOSPITAL, ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES UPON REQUEST.AS PART OF INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED TWO SYSTEM-WIDE UPGRADES TO THE EPIC PLATFORM. THESE UPGRADES ENABLED T INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER TO TAKE ADVANTAGE OF ENHANCEMENTS MADE TO EPIC'S SOFTWARE BASED ON USER INPUT.INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS RELATED TO SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS ABOUT EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND EXPOSURE TO VIOLENCE. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THESE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER SENIOR CARE SKILLED NURSING FACILITIES, ALONG WITH ITS HOME HEALTH AND HOSPICE AGENCIES, PROVIDE UNIQUE SERVICES TO VETERANS, HOLIDAY SUPPORT, SUPPORT GROUPS, AND WORKSHOPS FOR ANYONE IN THE COMMUNITY NEEDING HELP COPING WITH THE LOSS OF A LOVED ONE. PATIENTS AND RESIDENTS' WISHES ARE GRANTED THROUGH THE ORGANIZATION'S HEART'S DESIRE PROGRAM. THROUGH GRANTS FROM THE HOSPICE MEMORIAL FUND, GRIEF CAMPS FOR CHILDREN AND ADULTS ARE OFFERED, ALONG WITH EDUCATIONAL SESSIONS AND LIFE CELEBRATION EVENTS. THE FUND ALSO PROVIDES STABILIZING RESOURCES FOR HOSPICE PATIENTS AND FAMILIES EXPERIENCING FINANCIAL DISTRESS DUE TO THE LOSS OR REDUCTION OF INCOME FROM TERMINAL ILLNESS OR DISEASE.INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER CONTINUE TO EXPAND ITS OPTIONS FOR HOSPITAL-LEVEL CARE IN THE COMFORT OF A PATIENT'S HOME. INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER ACUTE CARE AT HOME COMBINES THE ORGANIZATION'S EXTENSIVE NETWORK OF IN-HOME CARE PROVIDERS WITH A SOPHISTICATED TECHNOLOGY PLATFORM TO DELIVER SEAMLESS AND EFFECTIVE CARE AT HOME FOR PATIENTS WITH SELECT CHRONIC CONDITIONS OR DIAGNOSES SUCH AS HEART FAILURE, PNEUMONIA, OR COPD. RECENTLY, INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER ACUTE CARE AT HOME EXPANDED ITS SERVICES TO INCLUDE CARE FOR SELECT ONCOLOGY PATIENTS BY COLLABORATING WITH THE INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER CANCER CENTER. THE CARE TEAM CONSISTS OF PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, AND MAY INCLUDE OTHER HEALTHCARE PROFESSIONALS SUCH AS PHYSICAL OR OCCUPATIONAL THERAPISTS, AS NEEDED. PART VI, LINE 6: INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER IS A MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN FLINT, MICHIGAN. DURING THE FIRST 11 MONTHS OF THE YEAR, THE ORGANIZATION WAS A PART OF THE PROMEDICA HEALTH SYSTEM AND MUCH OF THE ACTIVITY INCLUDED ON THIS ENTIRE SCHEDULE H REFLECTS THE POLICIES IN PLACE IN STEP WITH THAT HEALTH SYSTEM. AS AN INTEGRATED DELIVERY SYSTEM, INSIGHT HOSPITAL AND MEDICAL CENTER COLDWATER PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING, WHILE ALSO PROVIDING COST-EFFICIENT SERVICES. 0 1 0 0 0 0 0 0 0 ARTURO POLIZZI PRESIDENT AND CEO PROMEDICA HEALTH S 0 1585940 0 1530880 0 2500 0 0 0 14012 0 3133332 0 0 TERRENCE METZGER CHIEF FINANCIAL OFFICER (THRU 12.1.2 0 771258 0 438060 0 0 0 0 0 6610 0 1215928 0 0 STEPHEN SADOWSKI CHIEF LEGAL OFFICER (THRU 12.1.24) 0 618697 0 561679 0 0 0 0 0 6038 0 1186414 0 0 BARBARA MCGRATH ONCOLOGIST 813296 0 0 0 0 0 0 0 0 0 813296 0 0 0 DARRIN ARQUETTE PRESIDENT MONROE REGIONAL HOSPITAL 0 329393 0 308712 0 2797 0 0 0 10194 0 651096 0 0 ONDREA WILLIAMS CHIEF NURSING OFFICER PROVIDER (THRU 0 434521 0 188788 0 2830 0 0 0 5257 0 631396 0 0 CHRISTOPHER HOGG ORTHOPEDIC SURGEON 625061 0 0 0 0 0 0 0 0 0 625061 0 0 0 KATHLEEN MERRILL CHAIR/CHIEF MARKETING OFFICER (THRU 0 285891 0 239700 0 2547 0 0 0 12669 0 540807 0 0 EDWARD JANKOWSKI OTOLARYNGOLOGIST 435090 0 0 0 0 0 0 0 0 0 435090 0 0 0 KANWAR RANA PSYCHIATRIST 417837 0 0 0 0 0 0 0 0 0 417837 0 0 0 NOLAN HERRINGTON PSYCHIATRIST 357144 0 0 0 0 0 0 0 0 0 357144 0 0 0 DANIEL SCHWANKE PRESIDENT 190680 0 0 0 0 0 0 0 0 0 190680 0 0 0 DASA DZIERWA CP AVP NON CLINICAL (THRU 12.1.24) 0 155252 0 27417 0 300 0 0 0 0 0 182969 0 0 PART I, LINE 3: AS OF 12.1.24 THERE WAS A MEMBER SUBSTATION AGREEMENT IN WHICH PROMEDICA HEALTH SYSTEM, INC. IS NO LONGER THE MEMBER. INDIVIDUALS LISTED THRU 12.1.24 RECEIVED COMPENSATION FROM PROMEDICA HEALTH SYSTEMS, INC. AND RELATED ENTITIES. THE ORGANIZATION DETERMINES TOP MANAGEMENT COMPENSATION THROUGH A COMPENSATION COMMITTEE, AN INDEPENDENT CONSULTANT, SURVEYS OR STUDIES, OR BOARD/COMMITTEE APPROVAL. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER: ATIF BAWAHAB, BASEER TAJUDDIN, ATIQ NAKRAWALA, AND JAWAD SHAH. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE DECEMBER 1, 2024, A MEMBER SUBSTITUTION OCCURRED. FIRDAUS FOUNDATION IS THE NEW MEMBER. FORM 990, PART VI, SECTION A, LINE 6 AS A MICHIGAN NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROMEDICA HEALTH SYSTEM POLICY: WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS, INCLUDING ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, EXPENDITURES FOR ITEMS INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS THAT EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, INCURRENCE, ASSUMPTION, OR GUARANTEE OF ANY INDEBTEDNESS, SALE, LEASE, OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION, OR LIQUIDATION. FORM 990, PART VI, SECTION A, LINE 7B PROMEDICA HEALTH SYSTEM POLICY: WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NONBUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS REVIEWED BY MANAGEMENT BEFORE BEING PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN, IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, AND MORE OFTEN, AS APPROPRIATE TO KEEP THE INFORMATION CURRENT, ALL PERSONNEL MUST INDIVIDUALLY ATTEST TO THE ACCURACY OF THE MOST RECENT CONFLICTS OF INTEREST ATTESTATION ON FILE. EACH NEW MEMBER OF THE BOARD AND PERSONNEL MUST REVIEW THIS POLICY AND COMPLETE, SIGN AND DATE THE CONFLICTS OF INTEREST ATTESTATION ATTACHED HERETO WITHIN SIXTY (60) DAYS OF HIS OR HER APPOINTMENT, EMPLOYMENT OR ENGAGEMENT. IN THE EVENT THAT IN THE PERIOD BETWEEN EXECUTING THE LAST ANNUAL CONFLICTS OF INTEREST ATTESTATION AND EXECUTING THE NEXT ANNUAL ATTESTATION, AN INDIVIDUAL'S CONFLICTS OF INTEREST ATTESTATION CEASES TO BE ACCURATE OR COMPLETE, THE AFFECTED PERSONNEL OR MEMBER OF THE BOARD MUST IMMEDIATELY COMPLETE, SIGN AND DATE A NEW ATTESTATION. IT IS THE RESPONSIBILITY OF SUCH PERSONNEL OR THE BOARD TO ENSURE THAT THE ATTESTATION IS PROMPTLY UPDATED. ALL ATTESTATIONS INDICATING A POTENTIAL CONFLICT MUST BE PROMPTLY PROVIDED TO THE CHIEF COMPLIANCE OFFICER (CCO) WHO WILL REVIEW THE ATTESTATIONS AND MAINTAIN THE RECORDS IN COMPLIANCE WITH THE HOSPITAL'S DOCUMENT RETENTION POLICIES. THE CCO WILL REVIEW ALL CONFLICTS OF INTEREST DISCLOSURES IN WHICH A POTENTIAL CONFLICT IS IDENTIFIED (WHETHER IN THE FORM OF THE ATTESTATION OR OTHERWISE) AND, WITH THE ASSISTANCE OF THE OFFICE OF THE GENERAL COUNSEL, AS APPROPRIATE, DETERMINE WHETHER THE AFFECTED INDIVIDUAL MUST RECUSE HIMSELF OR HERSELF FROM THE MATTER OR DECISION OR TAKE SOME OTHER ACTION IN THE BEST INTERESTS OF THE ORGANIZATION. THE CCO SHALL PROVIDE DAY-TO-DAY GUIDANCE WITH RESPECT TO MATTERS FALLING UNDER THIS POLICY. THE FAILURE TO FULLY, ACCURATELY AND PROMPTLY DISCLOSE ACTUAL, POTENTIAL OR PERCEIVED CONFLICTS OF INTEREST MAY RESULT IN CORRECTIVE ACTION, INCLUDING, WITHOUT LIMITATION, DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. AS SET FORTH ABOVE, ALL CONFLICTS OF INTEREST ATTESTATIONS, AS WELL AS ALL OTHER DISCLOSURES OR DOCUMENTS RELATING TO CONFLICTS OF INTEREST AND THEIR RESOLUTION SHALL BE MAINTAINED IN THE PERSONNEL FILES IN COMPLIANCE WITH INSIGHT'S DOCUMENT RETENTION POLICIES. COMPLIANCE WITH THIS POLICY SHALL BE MONITORED AND AUDITED IN COMPLIANCE WITH INSIGHT'S MONITORING AND AUDITING POLICIES. SUCH MONITORING AND AUDITING SHALL BE DOCUMENTED IN THE COMPLIANCE PROGRAM FILES AND MAINTAINED IN COMPLIANCE WITH INSIGHT'S DOCUMENT RETENTION POLICIES. FORM 990, PART VI, SECTION B, LINE 15 PROMEDICA HEALTH SYSTEM POLICY: COMMUNITY HEALTH CENTER OF BRANCH COUNTY'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS FOR THESE INDIVIDUALS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR, INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED ON MARKET DATA. THIS DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE, AND OTHER FORMS OF COMPENSATION ARE APPROVED BASED ON PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 COMMUNITY HEALTH CENTER OF BRANCH COUNTY PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,173,837. MANAGEMENT AND GENERAL EXPENSES 325,590. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,499,427. SERVICE CONTRACT FEES: PROGRAM SERVICE EXPENSES 3,545,011. MANAGEMENT AND GENERAL EXPENSES 983,289. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,528,300. OTHER FEES: PROGRAM SERVICE EXPENSES 6,002,656. MANAGEMENT AND GENERAL EXPENSES 1,656,853. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,659,509. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS MEMBER SUBSTITUTION 2,033,305. 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THE LATE FILING OF FORM 990 FOR THE YEAR ENDED DECEMBER 31, 2024, WAS AN ISOLATED IRREGULARITY.FOR TAX YEAR 2024, THE ORGANIZATION EXPERIENCED A TRANSITION IN MEMBERSHIP BETWEEN TWO MEMBER ORGANIZATIONS. THE PRIOR MEMBER ORGANIZATION SERVED FOR THE MAJORITY OF THE YEAR. THIS LED TO CONFUSION REGARDING RESPONSIBILITY FOR THE EXTENSION AND FILING. ONCE THE NEW MEMBER ORGANIZATION UNDERSTOOD THAT THE FILING OBLIGATION RESTED WITH THEM, THEY PROMPTLY ENGAGED A CPA FIRM TO PREPARE THE RETURN.TO ENSURE A COMPLETE AND ACCURATE RETURN, THE ORGANIZATION RELIED ON CERTAIN INFORMATION FROM THE PRIOR MEMBER ORGANIZATION, INCLUDING COMPENSATION DETAILS. THERE WERE DELAYS IN RECEIVING THIS INFORMATION, WHICH FURTHER IMPACTED THE TIMELINE. THE ORGANIZATION PRIORITIZED ACCURACY AND COMPLETENESS OVER SPEED, RESULTING IN THE RETURN BEING FILED AFTER THE ORIGINAL DUE DATE BUT WITHIN THE TYPICAL EXTENDED DUE DATE PERIOD.BASED ON THE ORGANIZATION'S HISTORY OF ROUTINE COMPLIANCE AND THE CIRCUMSTANCES DESCRIBED, WE RESPECTFULLY REQUEST THAT ANY PROPOSED INTEREST AND PENALTIES BE ABATED AND THAT THE IRS RECOGNIZE REASONABLE CAUSE IN THIS MATTER.