2024-02-27T09:15:16-06:00 2023-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-07-01 381507302 MARLETTE REGIONAL HOSPITAL MARL 9896354230 2770 MAIN STREET PO BOX 307 MARLETTE MI 48453 ANGELA MCCONNACHIE CEO 9896354230 2024-02-13 1 ANGELA MCCONNACHIE XXX-XX-XXXX 0 MICHAEL J PETERSON CPA P01833529 2187224705 2024-02-12 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ANGELA MCCONNACHIE 2770 MAIN STREET PO BOX 307 MARLETTE MI 48453 40475724 0 X WWW.MARLETTEREGIONALHOSPTIAL.ORG X 1951 MI TO CONTINUOUSLY IMPROVE THE QUALITY OF HEALTH IN THE COMMUNITIES WE SERVE 12 11 462 54 0 0 1876991 1804435 36663398 37216879 23958 363266 429188 668778 38993535 40053358 34482 23418 0 0 22892141 23297878 0 0 0 14391599 15768234 37318222 39089530 1675313 963828 35817565 34270756 5501462 2699936 30316103 31570820 X THE MISSION OF MARLETTE REGIONAL HOSPITAL IS TO CONTINUOUSLY IMPROVE THE QUALITY OF HEALTH IN THE COMMUNITIES WE SERVE. 0 0 33188917 23418 37380102 DURING FISCAL YEAR 2022-2023 MARLETTE REGIONAL HOSPITAL SERVED 343 ACUTE AND 328 SWING BED INPATIENT DAYS, PROVIDED CARE TO 44,562 OUTPATIENT VISITS, 9,736 EMERGENCY DEPARTMENT VISITS, AND SERVED 30,084 VISITS IN ITS FAMILY HEALTH PRACTICES.RECOGNIZING ITS MISSION TO THE COMMUNITY, THE HOSPITAL PARTICIPATES IN THE FEDERAL GOVERNMENT'S MEDICARE PROGRAM AND NUMEROUS MEDICAID HEALTH PLANS, OFTEN PROVIDING CHARITY CARE OR SERVICE AT RATES OF REIMBURSEMENT THAT ARE BELOW THE HOSPITAL'S ACTUAL COST. IN THE LAST FISCAL YEAR, THE HOSPITAL HAD CHARITY CARE EXPENSES OF $56,859. ADDITIONALLY, THE HOSPITAL'S ALLOWANCE FOR UNCOLLECTABLE BAD DEBTS ARE ESTIMATED BY THE USE OF THE ALLOWANCE METHOD. BAD DEBTS FOR THE YEARS ENDING JUNE 30, 2023, AND 2022 AMOUNTED TO $1,046,034 AND $1,072,075, RESPECTIVELY. OTHER COMMUNITY BENEFITS ARE PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED ON ACTIVITIES AND SERVICES THAT MRH BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. A SAMPLING OF THESE COMMUNITY BENEFITS IS PROVIDED BELOW: EDUCATIONAL SERVICES/PROGRAMS:-CAREER GUIDANCE FOR AREA SCHOOL STUDENTS-DISEASE/CONDITION-SPECIFIC EDUCATION, E.G., DIABETES-EDUCATION/COUNSELING FOR FAMILIES OF PATIENTS-EDUCATION/COUNSELING FOR PATIENTS-EDUCATIONAL PROGRAMS FOR EMPLOYEES (ADULT EDUCATION)-SUPPORT GROUPS FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY-TRAINING OF PUBLIC HEALTH AND SAFETY PERSONNELCOMMUNITY WELLNESS CAMPAIGNS/PROGRAMS:-SENIOR FOCUSED EXERCISE CLASSES-HEALTH PROMOTION AND PREVENTIONS ACTIVITIES-BLOOD PRESSURE CLINICS-DISCHARGE PLANNING WITH FOLLOW-UP SUPPORT PROGRAMS-HEALTH PROMOTION/WELLNESS PROGRAMS FOR STAFF AND THE COMMUNITY-HEALTH SCREENING/HEALTH FAIRS-NUTRITION AND WEIGHT CONTROL-RURAL HEALTH OUTREACH SERVICES-STRESS MANAGEMENT-WORK SITE HEALTH PROMOTION SERVICE-KNOW YOUR NUMBERS LOW-COST SCREENING ON THE FIRST MONDAY OF EVERY MONTH (EXCEPT FOR HOLIDAYS), MARLETTE REGIONAL HOSPITAL OFFERS REDUCED RATE HEALTH SCREENINGS INCLUDING ACHILLES BONE DENSITY, BASIC METABOLIC PANEL, COMPLETE BLOOD COUNT, GLUCOSE, HBA1C, LIPID PROFILE, LIVER PANEL, POTASSIUM, PROSTATE-SPECIFIC ANTIGEN (PSA), MICROALBUMIN, SPIROMETRY, THYROID-STIMULATING HORMONE (TSH), AND VITAMIN D. LAB RATES RANGE FROM $8 TO $40. -BCUPS (THE BREAST CANCER UNDERSTANDING PREVENTION AND SCREENING (B.C.U.P.S.) PROGRAM IS IN PLACE TO FINANCIALLY ASSIST PATIENTS IN ACQUIRING IMPORTANT SCREENING MAMMOGRAMS AND DIAGNOSTIC TESTING SERVICES.)-MARLETTE REGIONAL HOSPITAL OFFERS $10 SPORTS PHYSICALS IN JUNE, JULY & AUGUST. MARLETTE REGIONAL HOSPITAL'S FAMILY HEALTHCARE OFFICES WILL OFFER REDUCED-PRICE SPORTS PHYSICALS TO AREA ATHLETES FOR A COST OF TEN DOLLARS IN THE MONTHS OF JUNE, JULY AND AUGUST, AND HALF OF THE PROCEEDS WILL BE DONATED BACK TO LOCAL SCHOOLS' ATHLETIC PROGRAMS.-MARLETTE ARC BLOOD DRIVE WE PROVIDE FOOD FOR THE BLOOD DRIVE. BARB PICKS UP THE FOOD FROM THE HOSPITAL AND DROPS IT OFF MONTHLY. WE ALSO HELP COORDINATE THE VOLUNTEERS.MRH SERVICES/PROGRAMS:-EMERGENCY SERVICES DEPARTMENT-ADVANCED LIFE SUPPORT AMBULANCE SERVICE-FIRE AND POLICE ASSISTANCE-HELICOPTER TRANSFER ASSISTANCE-CLINICAL SERVICES-CERTIFIED RURAL HEALTH CLINICS-CHILDHOOD & ADULT IMMUNIZATIONS-TELE-STROKE VIRTUAL MEDICINE-PRIMARY CARE SERVICES-ACUTE MEDICAL AND SURGICAL SERVICES-RESIDENTIAL AND HOME-BASED HOSPICE SERVICES-UNIQUELY-ACCREDITED HOSPITAL, LABORATORY, CARDIOPULMONARY, HOSPICE AND LONG-TERM CARE SERVICES-MOBILE PET AND BONE DENSITY TESTING TECHNOLOGY-COORDINATION OF PATIENT CARE SERVICES IN HOSPITAL-FREE OR LOW-COST SERVICES TO LOW-INCOME FAMILIES-GENERAL HEALTH SCREENING CLINICS-RESPIRATORY/PULMONARY DISEASE SERVICES-SCHOOL SPORTS PHYSICALS-SKILLED NURSING SERVICES/INTERMEDIATE CARE FACILITY-WOUND CARE CLINIC-PEDIATRIC SERVICES-CRTN CANCER CENTER SERVICES -NON-CLINICAL HOSPITAL SERVICES-ADVOCACY ON BEHALF OF SPECIFIC PATIENTS NEEDING INTERVENTION WITH PUBLIC AGENCIES (SOCIAL SERVICES)-FREE MEETING ROOMS FOR COMMUNITY GROUPS-GUIDANCE AND REFERRAL TO COMMUNITY SERVICES AND PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICAID-MEALS FOR FAMILY MEMBERS-TRANSLATION OR INTERPRETER SERVICES FOR NON-ENGLISH-SPEAKING PATIENTS-SUPPORT FOR OTHER HEALTH CARE PROVIDERS-VISITING MEDICAL AND SURGICAL SPECIALISTS TO COMPLEMENT PRIMARY CARE-BEREAVEMENT GROUP MEETS AT EAST CAMPUS MONTHLY IN THE FOUNDATION CONFERENCE ROOM.-TRANSITIONS PROGRAM THIS IS A FREE SERVICE RAN THROUGH HOSPICE.- PHYSICIANS' CARE- WORK IN PARTNERSHIP CARING HEART HEALTH CLINIC-SUPPORT FOR BLOOD DRIVES-PHYSICIAN REFERRAL SERVICES-PARTNER IN REGIONAL RURAL HEALTH NETWORKS-WORKING RELATIONSHIPS WITH OTHERS-CIVIC ORGANIZATIONS SUCH AS LIONS CLUB, TOYS FOR TOTS, AMERICAN CANCER SOCIETY RESEARCH PROGRAM-AMERICAN ASSOCIATION OF RETIRED PERSONS-COMMUNITY-BASED BUSINESS GROUPS SUCH AS CHAMBERS OF COMMERCE-ECONOMIC DEVELOPMENT AGENCIES-HOME HEALTH AGENCIES-HOSPICES-LOCAL SCHOOLS AND COLLEGES-NURSING HOMES-SENIOR CITIZENS - FREE MATTER OF BALANCE PROGRAM-STATE AND LOCAL AGENCIES AND ORGANIZATIONS-CENTRAL MICHIGAN UNIVERSITY COLLEGE OF MEDICINE-COVENANT REGIONAL THUMB NETWORK (CRTN)-DECKERVILLE COMMUNITY HOSPITAL- THE HEARTLANDS, INDEPENDENT LIVING, MEMORY CARE AND ASSISTED LIVING -MICHIGAN CENTER FOR RURAL HEALTH-SANILAC COUNTY HEALTH DEPARTMENT-THUMB COMMUNITY HEALTH PARTNERSHIP (TCHP)-THUMB OPIOID RESPONSE CONSORTIUM (TORC)MARLETTE REGIONAL HOSPITAL IS COMMITTED TO SERVING OUR PATIENTS IN WAYS THAT RESPECT THE ORIGINAL VALUES OF OUR COMMUNITY - A COMPASSION FOR OUR NEIGHBORS AND A SENSE OF DUTY TO SERVE THOSE IN NEED. IN RESPECTING THESE VALUES, MARLETTE REGIONAL HOSPITAL ACKNOWLEDGES ITS OBLIGATION TO OFFER SERVICES TO PATIENTS THAT MAY NOT BE ABLE TO FULLY AFFORD THE CARE THEY NEED, WHILE ALSO SERVING THE HEALTH IMPROVEMENT NEEDS OF OUR LARGER COMMUNITY. TO THAT END, THE HOSPITAL HAS ADOPTED POLICIES THAT DESCRIBE HOW. 33188917 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 73 0 462 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X KIM GENTNER CFO 9896354230 2770 MAIN STREET MARLETTE MI 48453 DANIEL BABCOCK CEO (THRU DEC 2022) 36.00 4.00 X X 203316 0 26806 ANGELA MCCONNACHIE COO/CEO 36.00 4.00 X X 0 111026 7537 GAIL DENTON CHARIMAN 1.00 1.00 X X 0 0 0 JUSTIN FABER VICE CHAIRMAN 1.00 1.00 X X 0 0 0 VICTORIA MEIBURG SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 CHRISTOPHER CLARK DIRECTOR (THRU MAY 2023) 1.00 1.00 X 0 0 0 SUE COOK DIRECTOR 1.00 1.00 X 0 0 0 STEVE ELLIS DIRECTOR 1.00 1.00 X 0 0 0 IRENE COLE DIRECTOR 1.00 1.00 X 0 0 0 CURTIS LANDRITH DIRECTOR 1.00 1.00 X 0 0 0 ALEXANDER MESSING DIRECTOR 1.00 1.00 X 0 0 0 DAVID MESSING DIRECTOR 1.00 1.00 X 0 0 0 SCOTT ORR DIRECTOR 1.00 1.00 X 0 0 0 PAUL ROHLING DIRECTOR 1.00 1.00 X 0 0 0 DAVID WEST DIRECTOR (THRU MAY 2023) 1.00 1.00 X 0 0 0 KIM GENTNER CFO 36.00 4.00 X 0 103570 0 DR CHRISTOPHER HANCZARUK DOCTOR 40.00 X 299121 0 15639 DR SARAH ALBERS DOCTOR 40.00 X 383211 0 5360 DR DANIEL KULICK DOCTOR 40.00 X 339962 0 30481 DR MICHAEL KITTO DOCTOR 40.00 X 313514 0 231 DR ANJANETTE KEMP DOCTOR 40.00 X 300908 0 18304 1840032 214596 104358 27 0 1 0 SODEXO INC PO BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICE 1032161 RESTORIX HEALTH PO BOX 71849 CHICAGO IL 606941849 WOUND CARE TREATMENTS 394000 CERNER CORP PO BOX 959159 ST LOUIS MO 63195 IT SERVICES 391857 MICHIGAN SURGICAL SPECIALISTS PC 5510 HOSNER RD METAMORA MI 48455 SURGICAL SERVICES 244000 THUMB COOLING & HEATING 8430 VAN DYKE RD CASS CITY MI 48726 MAINTENANCE 236145 14 1468986 335449 1804435 NET I/O PATIENT SERVICE REVENUE 621500 27147261 27147261 CLINIC SERVICE REVENUE 621110 5832129 5832129 NURSING FACILITY REVENUE 623000 3908980 3908980 340 B PROGRAM 456110 143000 143000 185509 185509 37216879 386204 386204 694314 199428 494886 494886 494886 200000 222938 -22938 -22938 -22938 173892 163223 10669 173892 40053358 37380102 0 868821 X 23418 23418 265458 265458 19054979 17359934 1695045 247129 247129 2395706 1991420 404286 1334606 1201707 132899 65485 65485 90313 90313 405 405 95731 95731 6011997 4474034 1537963 89369 9609 79760 64103 9966 54137 125014 102705 22309 8358 6891 1467 1428603 1346501 82102 489150 117588 371562 SUPPLILES 3769288 3696575 72713 LAB EXPENSES 940208 940208 BAD DEBT 925968 925968 TAXES & LICENSES 509697 92192 417505 1154545 890201 264344 39089530 33188917 5900613 0 577026 76731 15057257 11088581 73809 4113585 4667286 334205 275470 613724 342824 53515488 40315923 13503698 13199565 1618070 4546490 35817565 34270756 1614886 2039538 90 442 169608 90335 3716878 569621 5501462 2699936 X 29482589 30567287 833514 1003533 30316103 31570820 35817565 34270756 X 963828 290889 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 405 405 0 PART II-B, LINE 1: THE ORGANIZATION PAYS ANNUAL DUES TO AMERICAN HEALTH CARE ASSOCIATION (AHCA), HEALTH CARE ASSOCIATION OF MICHIGAN (HCAM), MICHIGAN HEALTH AND HOSPITAL ASSOCIATION (MHA) AND A PORTION OF THOSE DUES GOES TOWARD LOBBYING. THE MHA WORKS WITH ITS MEMBER HOSPITAL AND HEALTH SYSTEMS TO INFORM DECISION-MAKERS ABOUT THE IMPACT OF HOSPITALS ON LOCAL HEALTH AND HEALTHCARE DELIVERY, AND ON CREATING THRIVING COMMUNITIES. THEY SPEND TIME IN MICHIGAN AND WASHINGTON DC TO ADVOCATE ON BEHALF OF THE INTERESTS OF ITS MEMBERS. 15405 15405 26703027 17934449 8768578 26025555 21814787 4210768 771501 566687 204814 13199565 RELATED PARTY RECEIVABLE 3049413 INVESTMENT IN UNCONSOLIDATED AFFILIATE 1119944 BUILDING HELD FOR SALE 377133 4546490 HHS PROVIDER RELIEF FUND REFUNDABLE ADVANCES 42300 ESTIMATED THIRD-PARTY PAYOR LIABILITY 471134 FINANCE LEASE OBILGATION 56187 569621 39146663 -180155 -180155 39326818 726540 726540 40053358 38362990 0 38362990 726540 726540 39089530 PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INVESTMENT IN UNCONSOLIDATED AFFILIATES -180,155. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 925,968. RENT EXPENSES -199,428. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 925,968. RENTAL EXPENSES -199,428. 1 1 X 1 X 1 X 1 1 0 1 1 56859 56859 0.00150 1 7660420 2366070 5294350 0.13870 1 7717279 2366070 5351209 0.14020 111 1530 131010 38250 92760 0.00240 45 45 23600 23600 0.00060 6 5025205 3595924 1429281 0.03750 30 550 25448 2160 23288 0.00060 192 2125 5205263 3636334 1568929 0.04110 193 2125 12922542 6002404 6920138 0.18130 1 8 551 551 0.00000 12 1200 563 563 0.00000 13 1208 1114 1114 0.00000 0 564388 0 4228933 4144180 84753 X 1 1 1 1 MARLETTE REGIONAL HOSPITAL 2770 MAIN ST PO BOX 307 MARLETTE MI 48453 HTTPS://MARLETTEREGIONALHOSPITAL.ORG/ 1060000165 X X X RHC(S) MARLETTE REGIONAL HOSPITAL 0 0 1 X X X X X X X X X 21 1 0 1 1 X SEE PART V, SECTION C, LINE 7D X X 1 21 1 SEE PART V, SECTION C, LINE 7D 0 1 X 100.000000000000 250.000000000000 X X X 1 1 X X X X 1 X HTTPS://MARLETTEREGIONALHOSPITAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ X HTTPS://MARLETTEREGIONALHOSPITAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ X HTTPS://MARLETTEREGIONALHOSPITAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ X X X X 1 X 0 X X X X 1 X 0 0 MARLETTE REGIONAL HOSPITAL PART V, SECTION B, LINE 5: A SURVEY WAS SENT OUT TO THE COMMUNITY TO ENSURE COLLECTION OF ADEQUATE HEALTH INDICATORS AND INPUT OF STAKEHOLDERS AND VULNERABLE POPULATIONS. WE CONDUCTED A FOUR-COUNTY REGIONAL ASSESSMENT PROCESS IN PARTNERSHIP WITH THE THUMB COMMUNITY HEALTH PARTNERSHIP ALONG WITH A STAKEHOLDER MEETING. THE SURVEY AND PARTNERSHIP CONSISTED OF HOSPITALS, LOCAL PUBLIC HEALTH DEPARTMENTS, MENTAL HEALTH AGENCIES, COMMUNITY MEMBERS AND OTHER HUMAN SERVICE PROVIDERS IN HURON, LAPEER, SANILAC, AND TUSCOLA COUNTIES. ADDITIONALLY, SOCIAL SERVICE ORGANIZATIONS THAT SERVE VULNERABLE POPULATIONS WERE PROVIDED SURVEYS. AGENCIES INCLUDED HUMAN DEVELOPMENT COMMISSION, MENTAL HEALTH AGENCIES, THE PUBLIC HEALTH AND SOCIAL SERVICES DIVISION OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, SOCIAL WORKERS, INTERMEDIATE SCHOOL DISTRICTS, STAFF FROM HEALTH CARE SECTOR WITH FREE OR LOW-COST HEALTH CLINICS, EARLY CHILDHOOD SERVICE PROVIDERS, AND LAW ENFORCEMENT. MARLETTE REGIONAL HOSPITAL PART V, SECTION B, LINE 6B: MARLETTE REGIONAL HOSPITAL WORKS IN PARTNERSHIP WITH A WIDE VARIETY OF HEALTH AND COMMUNITY ORGANIZATIONS TO MEET THE NEEDS OF THE COMMUNITY. THE CHNA PROCESS WAS CONDUCTED WITH THE SAME PRINCIPLES OF COLLABORATION. SPECIFICALLY, MRH UTILIZED ITS MEMBERSHIP IN THE THUMB COMMUNITY HEALTH PARTNERSHIP. THIS PARTNERSHIP ALLOWED US TO SURVEY A GREATER NUMBER OF PEOPLE IN OUR COMMUNITY. THE MOST IMPORTANT PARTNER IN MEETING HEALTH NEEDS OF OUR COMMUNITY IS THE RESIDENTS WE SERVE. MARLETTE REGIONAL HOSPITAL PART V, SECTION B, LINE 7D: PART V, SECTION B, LINES 7A & 10A:HTTPS://MARLETTEREGIONALHOSPITAL.ORG/ACCREDITATIONS-DESIGNATIONS-ASSESSMENT MARLETTE REGIONAL HOSPITAL PART V, SECTION B, LINE 11: A LEAD PERSON HAS BEEN IDENTIFIED RELATED TO EACH SIGNIFICANT NEED THAT WAS MOST RECENTLY ADDRESSED IN THE CHNA. ACCESS TO HEALTH INSURANCE: WE ARE FOCUSING ON EXPANDING THE HEALTH INSURANCES WE OFFER TO PROVIDE CARE TO A GREATER NUMBER OF PEOPLE. WE ARE ALSO MAKING THIS INFORMATION EASILY ACCESSIBLE FOR PATIENTS AND STAFF. WE ARE FOCUSED ON ADVERTISING INFORMATION ON FREE OR REDUCED HEALTHCARE SERVICES FOR UNINSURED OR UNDER-INSURED PATIENTS. IN ADDITION TO PROVIDING AWARENESS WE ALSO SUPPORT AND MANAGE PROGRAMS THAT ALLOW UNINSURED OR UNDER-UNINSURED PATIENTS TO RECEIVE THE CARE THEY NEED.1. SUPPORT CARING HEART HEALTH CLINIC2. KNOW YOUR NUMBERS LOW-COST SCREENING 3. OFFER BCUPS PROGRAM4. SUPPORT PCUPS PROGRAM5. HOST ANNUAL HEALTH FAIR AWARENESS OF SERVICES:COMMUNITY INVOLVEMENT THROUGH - MARLETTE CHAMBER OF COMMERCE, SENIOR FAIR PARTICIPATION AND COMMUNITY WIDE EVENTS HAVE PROVIDED SERVICE AWARENESS. WE HAVE ALSO ADDRESSED THIS NEED THROUGH MARKETING ADVERTISEMENTS. LASTLY, WE PROVIDE EDUCATION TO MRH HEALTH CARE OFFICE PROVIDERS AND MANAGERS DURING QUARTERLY MEETINGS AND WEEKLY COMMUNICATIONS. THIS ALLOWS US TO COMMUNICATE THE SERVICES WE OFFER WITH SURROUNDING COMMUNITIES THROUGH WORD OF MOUTH AND PRINT MATERIALS. HEART DISEASE: - ADVERTISE MRH CURRENT EFFORTS LIKE EXERCISE CLASSES IN OTHER MEDIA OUTLETS. - IN 2023 WE OFFERED 2, 4-WEEK EXERCISE CLASSES (MATTER OF BALANCE) TO THE SENIOR POPULATION. - DIABETIC EDUCATION VIDEOS AND MEET AND GREATS WERE OFFERED FOR CAREGIVERS AND PREVENTION. - WELLNESS CHALLENGES (2023 WALKING PROGRAM, HEALTHY EATING HABITS, AND WELLNESS EDUCATION IS PROVIDED MONTHLY.)TOBACCO USEUSE OF VAPING PRODUCTS: - PRESENTATIONS AT LOCAL SCHOOLS ABOUT DANGERS OF SMOKING AND/OR VAPING. - SOCIAL MEDIA CAMPAIGNSCANCER - CONTINUE TO ADVERTISE THE BCUPS PROGRAM TO OUR COMMUNITIES. - CONTINUE TO OFFER FINANCIAL ASSISTANCE FOR DIAGNOSTIC MAMMOGRAMS AND ULTRASOUNDS FOR THOSE WHO QUALIFY THROUGH THE BCUPS PROGRAM. - EXPLORE CREATIVE EVENTS AND PROMOTIONS TO EDUCATE AND SCREEN. - TECHNOLOGY UPGRADES.BEHAVIORAL HEALTH (INCLUDES MENTAL HEALTH AND SUBSTANCE USE DISORDERS): - HAVE DEPARTMENT LEADERS AND STAFF THAT ARE CERTIFIED PROVIDE EDUCATION AT SCHOOLS. THIS IS BEING CONDUCTED THROUGH A SPORTS SUMMIT INVITING COACHES AND ATHLETIC DIRECTORS IN 4 COUNTIES TO ATTEND. - SOCIAL MEDIA CAMPAIGNS FOR ANTI-DRUG AND ALCOHOL USE. PART I, LINE 7: THE ORGANIZATION USES THE COST TO CHARGE RATIO RECOMMENDED BY WORKSHEET 2 OF THE IRS FORM 990, SCHEDULE H INSTRUCTIONS. PART I, LINE 7G: THE ORGANIZATION IS REPORTING THE FOLLOWING SERVICE LINES FROM THEIR CLINICS UNDER THE SUBSIDIZED HEALTH SERVICES. 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 $ 925,968. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION WILL SEND REPRESENTATIVES TO LOCAL CHAMBER OF COMMERCE MEETINGS TO IDENTIFY OTHER AREAS OF NEED WITHIN THE COMMUNITY. THAT REPRESENTATIVE WILL ALSO ASSIST IN COMMUNITY EVENTS FROM TIME TO TIME AND DEVOTES 1-2 HOURS PER MONTH SUPPORTING THE CHAMBER/COMMUNITY. PART III, LINE 2: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. PART III, LINE 4: THE ORGANIZATION DOES NOT HAVE A SPECIFIC BAD DEBT FOOTNOTE IN THEIR FINANCIAL STATEMENTS. ACCOUNTS RECEIVABLE AND CREDIT POLICY:ACCOUNTS RECEIVABLE ARE REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE HOSPITAL EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS, WHICH REFLECT MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. THE HOSPITAL DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE AMOUNT OF MEDICARE ALLOWABLE COST WAS TAKEN DIRECTLY FROM THE MEDICARE COST REPORT. WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES TO MEDICARE BENEFICIARIES, THESE PATIENTS, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.THE TOTAL MEDICARE REVENUE SHOWN ON SCHEDULE H IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY THE CHARGES FROM MEDICARE PROGRAM BENEFICIARIES THAT ARE REPORTED ON THE HOSPITAL'S MEDICARE COST REPORT. THE AMOUNT LISTED FOR MEDICARE REVENUE DOES NOT INCLUDE PHYSICIAN SERVICES PROVIDED AT THE HOSPITAL, OUTLYING CLINIC LOCATIONS. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARE FOR PATIENTS. PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AN ADDITIONAL COMMUNITY BENEFIT THE HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE COST METHOD USED ABOVE FOR IRS 990 COMPLIANCES REPORTING IS BASED ON THE OVERALL AVERAGE COST TO CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE DIVIDED BY THE HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES, WHICH ARE REIMBURSED BASED ON MEDICARE REGULATIONS. INCLUDING THE FEE SCHEDULE ITEMS, SUCH AS PHYSICIAN SERVICES, WOULD PRODUCE A LOSS OR SHORTFALL ON THESE SERVICES TO BE REPORTED ON THE FORM 990 IN ANY GIVEN YEAR. PART III, LINE 9B: DURING THE UP FRONT COLLECTION PROCESS PATIENTS ARE SCREENED FOR PRESUMPTIVE ELIGIBILITY OF FINANCIAL ASSISTANCE IF THEY ARE UNABLE TO PAY FOR THE REQUIRED DEPOSIT AMOUNT FOR OUTPATIENT TESTING. THE STAFF MEMBERS THAT ESTIMATE THE ELIGIBILITY OF FINANCIAL ASSISTANCE EXTEND THE APPLICATION AND PLAIN LANGUAGE SUMMARY TO THE PATIENT IF THEY ARE SCREEN AS PRESUMPTIVELY ELIGIBLE PRIOR TO THE OUTPATIENT SERVICES BEING RENDERED TO THE PATIENTS. ALL UNINSURED PATIENTS THAT PRESENT TO THE ER ARE CALLED BY THE BUSINESS OFFICE TO EXTEND FINANCIAL ASSISTANCE ELIGIBILITY INFORMATION OR ACQUIRE INSURANCE INFORMATION. ALL PATIENT STATEMENTS CONTAIN WORDING REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE PRE-COLLECT AGENCY IS AWARE OF THE FINANCIAL ASSISTANCE AVAILABILITY WHEN THEY ARE PERFORMING OUTREACH ACTION TO PATIENTS PRIOR TO EXTRAORDINARY COLLECTION ACTION. PART VI, LINE 2: THE HOSPITAL HAS PARTNERED WITH PRESS GANEY WHICH IS A COMPANY THAT HELPS US DO SURVEYS FOR PATIENT SATISFACTION. WE USE FEEDBACK FROM THOSE SURVEYS TO BETTER UNDERSTAND THE NEEDS OF OUR PATIENTS. ALSO, WITH WORKING CLOSELY WITH DCH WE GAIN A BETTER UNDERSTANDING OF THE NEEDS OF OUR PATIENTS IN OUR COUNTY BY ANALYZING DATA AT BOTH FACILITIES FOR POTENTIAL NEEDS. THE HOSPITAL ALSO UTILIZES THE RELATIONSHIP WITH THE CRTN GROUP TO GATHER INFORMATION ON WHAT SERVICES WE MAY NEED IN OUR COMMUNITIES. PART VI, LINE 3: FOR INPATIENT SERVICES WE SEEK ANY INFORMATION REGARDING INSURANCE COVERAGE. IF NO COVERAGE IS AVAILABLE, WE REFER THE PATIENT TO OUR SOCIAL WORKER WHO HELPS THE PATIENT APPLY FOR GOVERNMENT ASSISTANCE IF APPLICABLE AND AVAILABLE, AND IF IT IS NOT, THEN WE HELP THEM COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. FOR OUTPATIENT SERVICES THE REGISTRATION STAFF OFFER FINANCIAL ASSISTANCE APPLICATIONS TO PATIENTS WHO CANNOT PAY THEIR UPFRONT COLLECTIONS. THE BILLING DEPARTMENT ALSO ASSISTS THE PATIENT IN APPLYING FOR GOVERNMENTAL ASSISTANCE. IF NOT APPLICABLE OR AVAILABLE, THE PATIENT IS ASSISTED IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION AND APPLICATIONS TO SPECIAL ORGANIZATIONS THAT MIGHT OFFER ASSISTANCE AS WELL. NOTICES OF AVAILABILITY OF FINANCIAL ASSISTANCE ARE ALSO POSTED IN THE HOSPITAL LOBBY. PART VI, LINE 4: MARLETTE REGIONAL HOSPITAL SERVES RURAL COMMUNITIES IN SANILAC COUNTY AND PORTIONS OF LAPEER AND TUSCOLA COUNTIES. THE HOSPITAL'S SERVICE AREA INCLUDES NUMEROUS MUNICIPALITIES: BROWN CITY, DECKER, DEFORD, MARLETTE, MELVIN, PECK, SANDUSKY, SNOVER, FOSTORIA, KINGSTON, MAYVILLE, NORTH BRANCH, CLIFFORD, YALE, AND SILVERWOOD. BASED ON CENSUS DATA FOR MUNICIPALITIES, APPROXIMATELY 47,157 PEOPLE LIVE IN THE SERVICE AREA. THE HOSPITAL PROVIDES SERVICE TO COMMUNITIES IN WHICH THERE ARE A WIDE RANGE OF NEEDS (CENSUS-AMERICAN COMMUNITY SURVEY 5 YEAR AVERAGE (2020). EIGHTEEN AND ONE HALF PERCENT OF THE POPULATION IS OVER THE AGE OF 65 AND ONLY 23% ARE UNDER AGE 18. THE POPULATION HAS LIMITED RACIAL DIVERSITY WITH 98.5% OF THE POPULATION WHITE. THE SERVICE AREA HAS A COLLEGE DEGREE RATE OF 11.2% COMPARED TO MICHIGAN'S 30.5% AND UNITED STATES 32.9%. AVERAGE HOUSEHOLD INCOME IN THE SERVICE AREA IS $67,887 AS COMPARED TO MICHIGAN'S AVERAGE INCOME OF $80,803 AND THE UNITED STATES AVERAGE INCOME OF $91,547. UNEMPLOYMENT IN THE SERVICE AREA RANGED FROM 3.9 TO 13.4% COMPARED TO MICHIGAN AT 6% AND THE U.S. AT 5.4%. OF THE CIVILIAN NONINSTITUTIONALIZED POPULATION 8.5% HAVE NO HEALTH INSURANCE COVERAGE COMPARED TO MICHIGAN AT 5.4% AND THE U.S. AT 8.7%. THE PERCENTAGE OF PEOPLE WHO HAD INCOMES BELOW POVERTY IN PAST 12 MONTHS WAS 14.88% BUT RANGED BY MUNICIPALITY FROM 7.8% TO 28.4%. PART VI, LINE 5: THE HOSPITAL IS GOVERNED BY A COMMUNITY BOARD AND HAS AN OPEN MEDICAL STAFF. IT ALSO PARTICIPATES IN FREE OR REDUCED HEALTH SCREENINGS AND FAIRS THAT ARE AVAILABLE TO THE GENERAL PUBLIC. AT THE END OF FY2022 THE HOSPITAL PARTIALLY OPENED UP ITS SENIOR LIVING COMMUNITY, THE HEARTLANDS, WHICH ENCOMPASSES 20 INDEPENDENT VILLAS, 20 ASSISTED LIVING, AND 12 MEMORY CARE ROOMS AND A COMMUNITY CENTER. WE HAD A HANDFUL OF INDEPENDENT VILLA RESIDENTS MOVE IN AT THE END OF THE FISCAL YEAR AND AT THE END OF FY2023 WE HAD OUR ASSISTED LIVING AND MEMORY CARE ROOMS AVAILABLE AS WELL AS OUR COMMUNITY CENTER. AT THE COMMUNITY CENTER A COMMUNITY MEMBER HOSTS FREE WORKOUT CLASSES FOR THE RESIDENTS. IN FY23 WE BECAME OFFICIAL PARTNERS WITH THE CRTN CANCER CENTER TO OFFER CANCER TREATMENTS LOCALLY. DURING THE END OF FY23 WE BEGAN WORKING TO OPEN A QUICK CARE FOR OUR PATIENTS WHICH WILL OPEN IN FY24. PART VI, LINE 6: THE ORGANIZATION IS WORKING WITH DECKERVILLE COMMUNITY HOSPITAL, THUMB MRI, AND THE COVENANT REGIONAL THUMB NETWORK TO BETTER SERVE THE NEEDS OF THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES MI 0 PATIENT SUPPORT - SUPPORT FOR WOMEN UNDERGOING BREAST CANCER TREATMENT 45 23418 X X X 0 0 0 0 0 0 0 0 0 DR SARAH ALBERS DOCTOR 339103 0 4658 0 39450 0 2735 0 2625 0 388571 0 0 0 DR DANIEL KULICK DOCTOR 320168 0 6706 0 13088 0 4607 0 25874 0 370443 0 0 0 DR ANJANETTE KEMP DOCTOR 279699 0 4714 0 16495 0 4517 0 13787 0 319212 0 0 0 DR CHRISTOPHER HANCZARUK DOCTOR 287485 0 4726 0 6910 0 5966 0 9673 0 314760 0 0 0 DR MICHAEL KITTO DOCTOR 302582 0 4714 0 6218 0 105 0 126 0 313745 0 0 0 DANIEL BABCOCK CEO (THRU DEC 2022) 191441 0 5329 0 6546 0 4090 0 22716 0 230122 0 0 0 FORM 990, PART VI, SECTION A, LINE 7A THE HOSPITAL HAS ONLY 1 MEMBER, WHICH IS BLUEWATER HEALTHCARE NETWORK WHICH MAY APPOINT ONE OR MORE OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE SINGLE MEMBER HAS THE RIGHT TO APPOINT AN OFFICER OR DIRECTOR OR ANYONE ELSE TO ACT ON ITS BEHALF IN THE CAPACITY OF THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED AND APPROVED BY THE BOARD PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL'S CONFLICT OF INTEREST POLICY COVERS THE BOARD OF DIRECTORS, MEDICAL STAFF, MANAGERS AND EMPLOYEES OF THE HOSPITAL. THE POLICY DEFINES A CONFLICT OF INTEREST AND THE PROCEDURE TO FOLLOW IN ANY CIRCUMSTANCE WHERE A REAL OR PERCEIVED CONFLICT EXISTS. BOARD OF DIRECTORS - PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS OF INTEREST SHALL FILE FORMAL STATEMENTS DISCLOSING ACTUAL OR POTENTIAL CONFLICTS WHENEVER AN ACTUAL OR POTENTIAL CONFLICT ARISES; BEFORE ANY TRANSACTIONS CONSTITUTING A CONFLICT OR POTENTIAL CONFLICT IS CONSUMMATED; AND ONCE EACH CALENDAR YEAR SO LONG AS THE CONFLICT OR POTENTIAL CONFLICT CONTINUES TO EXIST. THE DISCLOSURE STATEMENT SHALL INCLUDE A DESCRIPTION OF THE RELATIONSHIP OR INTEREST CAUSING THE CONFLICT OR POTENTIAL CONFLICT, THE ROLE IN THE RELATIONSHIP OR TRANSACTION PLAYED BY THE PERSON HAVING THE CONFLICT, AND THE BENEFITS AND DETERMENTS ACCRUING TO THE HOSPITAL AND TO THE PERSON HAVING THE CONFLICT AS A RESULT OF THE CONTRACT, TRANSACTION, OR RELATIONSHIP. ANY MEMBER OF THE BOARD OF DIRECTORS HAVING AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER CONSTITUTING A CONFLICT. THE INTERESTED DIRECTOR MAY, HOWEVER, BE COUNTED FOR THE PURPOSE OF DETERMINING WHETHER A QUORUM OF THE BOARD, OR OF A COMMITTEE OF THE BOARD, EXISTS. THE MATTER CONSTITUTING THE CONFLICT SHALL BE APPROVED IF IT IS APPROVED BY A MAJORITY OF DISINTERESTED DIRECTORS VOTING ON THE MATTER. THE CONFLICT OF INTEREST POLICY SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF THE BOARD OF DIRECTORS AND THAT ANY NEW MEMBERS OF THE SAID BOARD OF DIRECTORS BE ADVISED OF THE POLICY UPON ENTERING ON THE DUTIES OF HIS/HER OFFICE. IN ADDITION TO THE BOARD OF DIRECTORS BEING HELD TO THE CONFLICT OF INTEREST POLICY, COPIES OF THE POLICY ARE AVAILABLE TO ALL MANAGEMENT EMPLOYEES. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED ANNUALLY BY ALL DIRECTORS, OFFICERS, MANAGING EMPLOYEES, AND EMPLOYED MEDICAL STAFF. THE COMPLETED FORMS ARE KEPT ON FILE BY THE HOSPITAL'S COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL IS BASED UPON APPLICABLE STATEWIDE COMPENSATION SURVEYS. IN ADDITION, THE COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. THE COMPENSATION OF OTHER TOP OFFICIALS ARE BASED UPON APPLICABLE STATEWIDE COMPENSATION SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND OTHER ORGANIZING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES AND CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 4,474,034. MANAGEMENT AND GENERAL EXPENSES 1,537,963. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,011,997. FORM 990, PART XI, LINE 9: TRANSFER FROM UNITED HEALTHCARE PARTNERS 471,044. CHANGE IN INVESTMENT IN UNCONSOLIDATED AFFILIATES -180,155. BLUEWATER HEALTHCARE NETWORK 2770 MAIN STREET MARLETTE MI 48453 465444203 PARENT MI 501(C)(3) LINE 12B, II N/A 0 DECKERVILLE COMMUNITY HOSPITAL 3559 PINE ST DECKERVILLE MI 48427 381415390 HOSPITAL MI 501(C)(3) LINE 3 BLUEWATER HEALTHCARE NETWORK 1 MARLETTE SENIOR LIVING 6305 BLUEWATER COURT MARLETTE MI 48453 843210271 SENIOR LIVING MI 501(C)(3) LINE 10 BLUEWATER HEALTHCARE NETWORK 1 THUMB MRI LLC 6320 VAN DYKE RD CASS CITY MI 48726 364107673 IMAGING MI RELATED -2439 171271 0 1 0.33330 THUMB MRI PROPERTY HOLDING CO LLC 6320 VAN DYKE RD CASS CITY MI 48726 270668404 RENTAL MI RELATED 0 1 0.33330 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 DECKERVILLE COMMUNITY HOSPITAL E 543849 COST DECKERVILLE COMMUNITY HOSPITAL O 347173 COST DECKERVILLE COMMUNITY HOSPITAL Q 54539 COST