2022-05-16T11:27:42-05:00 2021-06-30 990 2020-07-01 471156297 MUNSON HEALTHCARE CADILLAC MUNS 2319355000 1105 SIXTH STREET TRAVERSE CITY MI 49684 ALICIA M MAITLAND CFO 2319355000 2022-05-13 ALICIA M MAITLAND 999009999 2020 2022-09-23 18:48:47Z PETER MARINOFF 1105 SIXTH STREET TRAVERSE CITY MI 49684 128597466 false X WWW.MUNSONHEALTHCARE.ORG X 2014 MI MUNSON HEALTHCARE CADILLAC AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. 14 11 791 56 48000 7768665 2476469 103148380 121278846 32743 92976 512308 53075 111462096 123901366 86062 73292 0 43284694 47420796 0 88639 58228870 62554803 101599626 110048891 9862470 13852475 96622371 113351457 45072880 46875945 51549491 66475512 MUNSON HEALTHCARE CADILLAC AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. false false 96522508 73292 120901798 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF CADILLAC, MICHIGAN AND THE SURROUNDING AREA WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE CADILLAC HAD 2,917 INPATIENT ADMISSIONS IN FISCAL YEAR 2021 AND OVER 145,000 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 4,800 SURGICAL CASES, 343 OBSTETRICAL BIRTHS, AND OVER 21,300 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE CADILLAC ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS 330 PROVIDERS AND 45 VOLUNTEERS. INCLUDED IN PROGRAM SERVICE EXPENSES ARE 1.1 MILLION OF EXPENSES RELATED TO THE COMPREHENSIVE CARE OF COVID-19 PATIENTS. 96522508 true true false true false false false false false false true true false false true false false true false false false false false false false false true true true false true true false false false false false false false false true true false false false false false true false false false true 39 0 true 791 true true true false false false false false false false false false false false X 14 11 false false false false true true true true true false false true true true true true true true true false X NICOLE SULAK MUNSON HEALTHCARE 2319357777 4230 COPPER RIDGE DR TRAVERSE CITY MI 49684 EDWIN A NESS DIRECTOR 1.00 40.00 X 0 915969 209738 KENT BOWDEN DO PHYSICIAN 40.00 X 751802 0 44902 DAVID HOBBS MD PHYSICIAN 40.00 X 722080 0 39012 MARK HEPLER CFO 2.00 40.00 X 0 522987 84099 LYNNE MCCORMICK DO PHYSICIAN 36.00 4.00 X 485125 46029 29856 TIMOTHY ISERI MD PHYSICIAN 40.00 X 463774 0 58376 LAURA GLENN PRESIDENT AM 2.00 40.00 X 0 439683 79501 LOUIS TEGTMEYER DO PHYSICIAN 40.00 X 485304 0 26223 TONYA SMITH PRESIDENT PT 40.00 1.00 X X 0 377457 80762 ALICIA MAITLAND CORPORATE CO 2.00 40.00 X 0 217978 45202 PETER MARINOFF PRESIDENT PT 40.00 X X 0 192730 51561 KATHRYN BANDFIELD-KEOUGH VP PATIENT C 34.00 6.00 X 149697 56463 36264 NANCY BOWMAN DIRECTOR 1.00 X 0 0 0 JULIE COON DIRECTOR 1.00 X 0 0 0 DEAN DEKRYGER TREAS/SEC 2.00 X X 0 0 0 MICHAEL HAMNER VICE CHAIR 2.00 X X 0 0 0 CRAIG HEWETT DIRECTOR 1.00 X 0 0 0 CHRIS HUCKLE DIRECTOR 1.00 X 0 0 0 DANIEL KLOTZ DIRECTOR 1.00 X 0 0 0 ELIZABETH RZEPKA-ALTO MD DIRECTOR 1.00 X 0 0 0 TANIA LEBARON MD DIRECTOR 1.00 X 0 0 0 NATHAN PIWOWARSKI DIRECTOR 1.00 X 0 0 0 OWEN ROBERTS CHAIR 2.00 X X 0 0 0 JEREMY WINKLE DIRECTOR 1.00 X 0 0 0 3057782 2769296 785496 51 false true false SOUND INPATIENT PHYSICIANS PO BOX 742936 LOS ANGELES CA 900742936 MEDICAL 1834464 ALLIANCE PHYSICAL THERAPY GROUP PO BOX 5509 CAROL STREAM IL 601975509 MEDICAL 1226394 EPMG OF MI PC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 MEDICAL 842524 GREAT LAKES ORTHOPAEDIC CENTER 4045 WEST ROYAL DRIVE TRAVERSE CITY MI 49684 MEDICAL 669991 MAYO CLINIC LABORATORIES PO BOX 9146 MINNEAPOLIS MN 554809146 LABORATORY 641313 13 2397009 79460 2476469 MEDICARE AND MEDICAID PMTS 621990 63926063 63926063 PATIENT SERVICE REVENUE 621990 53942457 53942457 340B PRESCRIPTION REVENUE 621990 3175758 3175758 QUALITY INCENTIVE PAYMENTS 621990 177535 177535 RENT FROM CHILDREN'S CENTER 621990 48000 48000 9033 9033 121278846 113334 113334 74659 74659 74659 74659 4674171 1571 4695489 611 -21318 960 -20358 -20358 CAFETERIA SALES 722210 234771 234771 MISCELLANEOUS INCOME 621990 52335 52335 COVID-19 GRANT REVENUE 446199 -308690 -308690 -21584 123901366 120901798 48000 475099 X 73292 73292 209531 209531 38215947 36514843 1701104 1521627 1453244 68383 5503658 5259026 244632 1970033 1882732 87301 17620 17620 4553 4553 24446041 14039091 10318311 88639 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DUES ALLOCATED TO LOBBYING. 1040000 1040000 22402235 4455172 17947063 63816 21626 42190 19054345 12314535 6739810 2733205 295075 2438130 28207193 INVESTMENT IN MUNSON HEALTHCARE FOUN 15588154 F 15588154 ESTIMATED THIRD PARTY SETTLEMENTS 12054107 MEDICARE ACCELERATED PAYMENTS 3194000 RESERVE FOR THIRD PARTY SETTLEMENTS 2668501 LT OPERATING LEASE LIABILITY 2032847 LT DEFERRED TAX LIABILITY 619968 ST OPERATING LEASE LIABILITY 315113 CAPITAL LEASE 148315 21032851 true true X true X true X true true false false 348427 348427 0.00330 17922515 17653776 268739 0.00250 18270942 17653776 617166 0.00580 208265 208265 0.00200 29317 29317 0.00030 11984606 9232757 2751849 0.02590 43947 43947 0.00040 12266135 9232757 3033378 0.02860 30537077 26886533 3650544 0.03440 1924 1924 7361 7361 0.00010 4811 4811 100000 100000 0.00090 114096 114096 0.00110 true 3786475 1529400 25695991 21452794 4243197 X true true 1 1 MUNSON HEALTHCARE CADILLAC 400 HOBART ST CADILLAC MI 49601 WWW.MUNSONHEALTHCARE.ORG 1060000041 X X X MUNSON HEALTHCARE CADILLAC 1 false false true X X X X X X X X X X 18 true true true true X HTTPS://TINYURL.COM/YC368MRZ X true 19 true HTTPS://TINYURL.COM/YD48TGWQ false true X 200.000000000000 400.000000000000 X X X true true X X X true X HTTPS://TINYURL.COM/4HVNZX67 X HTTPS://TINYURL.COM/YB5NV3K3 X HTTPS://TINYURL.COM/49JBJKMU X X X X X X X true X false X X X X X true X false false FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 3E YES, THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND WERE IDENTIFIED THROUGH THE CHNA. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 5 COMMUNITY HEALTH NEEDS ASSESSMENT METHODS WE USED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) FRAMEWORK TO GUIDE THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. MAPP, DEVELOPED BY THE NATIONAL ASSOCIATION FOR COUNTY & CITY HEALTH OFFICIALS AND THE US CENTERS FOR DISEASE CONTROL AND PREVENTION, IS CONSIDERED THE GOLD STANDARD FOR COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLANNING. MAPP IS A COMMUNITY-DRIVEN PLANNING TOOL THAT APPLIES STRATEGIC THINKING TO PRIORITY ISSUES AND IDENTIFIES RESOURCES TO ADDRESS THEM. THE COMMUNITY HEALTH ASSESSMENT PORTION OF THE MAPP PROCESS INCLUDES FOUR PHASES. PHASE ONE: ORGANIZE FOR SUCCESS IN SPRING 2018, WE BEGAN THE PROCESS OF BRINGING PARTNERS TOGETHER TO LAY THE FOUNDATIONS OF THE MITHRIVE PROJECT. WE ORGANIZED A STEERING COMMITTEE WITH REPRESENTATION FROM LOCAL HOSPITALS, LOCAL HEALTH DEPARTMENTS, FEDERALLY-QUALIFIED HEALTH CENTERS, COMMUNITY MENTAL HEALTH, AND THE AREA AGENCY ON AGING. FROM THE BEGINNING, WE LAID PLANS FOR REACHING OUT TO NEW PARTNERS IN OTHER SECTORS TO JOIN MITHRIVE. PHASE TWO: VISIONING THE STEERING COMMITTEE TOGETHER SET THE VISION OF THE PROJECT FOR THE COMMUNITY: A VIBRANT, DIVERSE, AND CARING COMMUNITY IN WHICH REGIONAL COLLABORATION ALLOWS ALL PEOPLE THE ABILITY TO ACHIEVE OPTIMUM PHYSICAL, MENTAL, CULTURAL, SOCIAL, SPIRITUAL, AND ECONOMIC HEALTH AND WELL-BEING. PHASE THREE: THE ASSESSMENTS COMMUNITY THEMES AND STRENGTHS ASSESSMENT THIS ASSESSMENT GATHERED INPUT (MOSTLY QUALITATIVE) FROM COMMUNITY MEMBERS TO FIND OUT HOW THEY PERCEIVE THEIR QUALITY OF LIFE, SEE ASSETS AND PROBLEMS IN THEIR COMMUNITIES, AND DEFINE WHAT IS IMPORTANT TO THEM. COMMUNITY INPUT BOARDS THE PURPOSE OF THE COMMUNITY INPUT BOARDS WAS TO GATHER FEEDBACK FROM THE GENERAL PUBLIC ON HOW THEIR COMMUNITY CONTEXT IMPACTS HEALTH. AT LARGE COMMUNITY EVENTS, COMMUNITY MEMBERS ANSWERED TWO QUESTIONS BY WRITING THEIR ANSWER ON A STICKY NOTE AND STICKING IT TO THE QUESTION BOARD. THESE ARE THE QUESTIONS WE ASKED: 1. WHAT IN YOUR COMMUNITY HELPS YOU LIVE A HEALTHY LIFE? 2. WHAT CAN BE DONE IN YOUR COMMUNITY TO IMPROVE HEALTH AND QUALITY OF LIFE? WE COLLECTED DATA USING COMMUNITY INPUT BOARDS FROM JULY-OCTOBER 2018. MINI CLIENT INTERVIEWS THE PURPOSE OF THE MINI CLIENT INTERVIEWS WAS TO GATHER INPUT FROM SPECIFIC VULNERABLE POPULATIONS BY PARTNERING WITH ORGANIZATIONS THAT SPECIALIZE IN WORKING WITH THESE POPULATIONS. OUR QUESTIONS FOCUSED ON BARRIERS TO ACCESSING HEALTH CARE: 1. IN THE PAST YEAR, WHAT CHALLENGES HAVE YOU OR YOUR FAMILY HAD TRYING TO GET HEALTH CARE YOU NEEDED? 2. WHAT KIND OF HEALTH CARE DID YOU HAVE TROUBLE GETTING? 3. WHAT WOULD MAKE IT EASIER TO GET CARE? COMMUNITY HEALTH STATUS ASSESSMENT THE PURPOSE OF THIS ASSESSMENT WAS TO COLLECT QUANTITATIVE, SECONDARY DATA ABOUT THE HEALTH, WELLNESS, AND SOCIAL DETERMINANTS OF HEALTH OF ALL RESIDENTS IN OUR COUNTIES. THIS INVOLVED GATHERING STATISTICS FROM SOURCES LIKE THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE CENTER FOR MEDICARE AND MEDICAID SERVICES, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, THE CENSUS BUREAU, AND OTHER ESTABLISHED SOURCES. LOCAL COMMUNITY HEALTH SYSTEM ASSESSMENT THE PURPOSE OF THIS ASSESSMENT WAS TO GATHER INPUT FROM ORGANIZATIONS SERVING THE COMMUNITY, AND GET A SYSTEM PERSPECTIVE ON WORK BEING DONE IN THE COMMUNITY. FACILITATORS GUIDED DISCUSSIONS AT HUMAN SERVICES COORDINATING BODIES AND OTHER GROUPS. DISCUSSIONS FOCUSED ON DIFFERENT ASPECTS OF HOW ALL COMMUNITY ORGANIZATIONS AND ENTITIES WORK TOGETHER AS A UNIFIED SYSTEM TO SERVE THE COMMUNITIES. WE ORGANIZED NOTES BY LOOKING AT SYSTEM OPPORTUNITIES, SYSTEM WEAKNESSES, AND SYSTEM STRENGTHS. FORCES OF CHANGE ASSESSMENT THE PURPOSE OF THIS ASSESSMENT WAS TO IDENTIFY FORCES TRENDS, FACTORS, AND EVENTS THAT ARE INFLUENCING OR LIKELY WILL INFLUENCE THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITY OR THAT IMPACT THE WORK OF THE LOCAL COMMUNITY HEALTH SYSTEM IN NORTHERN MICHIGAN. THIS ASSESSMENT PROVIDES CRITICAL INFORMATION ABOUT THE LARGER CONTEXT INFLUENCING THE POTENTIAL SUCCESS OF THE STRATEGIES WE DEVELOP. THIS ASSESSMENT WAS DONE THROUGH FOUR CROSS-SECTOR EVENTS, IN TRAVERSE CITY (2), WEST BRANCH, AND BIG RAPIDS. THE DISCUSSION FOCUSED ON SEVEN TYPES OF FORCES AFFECTING THE COMMUNITY: ECONOMIC, ENVIRONMENTAL, ETHICAL, SOCIAL/CULTURAL, TECH/SCIENCE/EDUCATION, POLITICAL/LEGISLATIVE, AND SCIENTIFIC. AFTER IDENTIFYING FORCES AT WORK, WE LOOKED AT THREATS AND OPPORTUNITIES PRESENTED BY THESE FORCES. THE FIRST THREE FORCES OF CHANGE EVENTS FOCUSED BROADLY ON ANY ISSUES AFFECTING THE COMMUNITY. AFTER AGING POPULATION WAS IDENTIFIED AT ALL THREE EVENTS AS ONE OF THE MOST POWERFUL FORCES IN OUR NORTHERN MICHIGAN COMMUNITIES, WE ADDED A FOURTH EVENT FOCUSED SPECIFICALLY ON HOW THESE SEVEN TYPES OF FORCES INTERSECT WITH ISSUES AROUND A GROWING AGING POPULATION. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 6A MUNSON MEDICAL CENTER, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL, AND KALKASKA MEMORIAL HEALTH CENTER ALL WORKED TOGETHER ON REGIONAL CHNA EFFORTS AS PART OF THE MITHRIVE REGIONAL CHNA INITIATIVE. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 6B BENZIE-LEELANAU DISTRICT HEALTH DEPT, CENTRAL MICHIGAN DISTRICT HEALTH BENZIE-LEELANAU DISTRICT HEALTH DEPT, CENTRAL MICHIGAN DISTRICT HEALTH DEPT. HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, NORTHEAST MICHIGAN COMMUNITY SERVICE AGENCY, NORTH COUNTRY COMMUNITY MENTAL HEALTH, NORTHERN MICHIGAN COMMUNITY HEALTH INNOVATION REGION, TRAVERSE HEALTH CLINIC. OUR CONTINUED COMMITMENT TO OUR MISSION OF WORKING TOGETHER WITH OUR PARTNERS TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH IS REFLECTED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AS WELL AS IN THE WORK WE DO EACH DAY TO BETTER UNDERSTAND AND ADDRESS THE HEALTH NEEDS OF OUR COMMUNITY. FOR THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, THIS COMMITMENT IS EVIDENT IN OUR PARTICIPATION IN MITHRIVE, A REGIONAL, COLLABORATIVE PROJECT DESIGNED TO BRING TOGETHER DOZENS OF ORGANIZATIONS ACROSS 31 COUNTIES OF NORTHERN MICHIGAN TO IDENTIFY LOCAL NEEDS AND WORK TOGETHER TO IMPROVE OUR COMMUNITIES. WHERE WE LIVE, LEARN, WORK, AND PLAY POWERFULLY INFLUENCES OUR HEALTH. IMPROVING COMMUNITY HEALTH REQUIRES A BROAD FOCUS AND COORDINATION AMONG DIVERSE AGENCIES AND STAKEHOLDERS. THE GOAL IS TO CONTINUE TO BUILD NEW PARTNERSHIPS AND GATHER INPUT FROM MORE ORGANIZATIONS AND RESIDENTS. OUR CHNA REPRESENTS A COLLABORATIVE, COMMUNITY-BASED APPROACH TO IDENTIFY, ASSESS, AND PRIORITIZE THE MOST IMPORTANT HEALTH ISSUES AFFECTING OUR COMMUNITY, GIVING SPECIAL ATTENTION TO THE POOR AND UNDERSERVED IN OUR SERVICE AREA. THE PROCESS IS ALSO THE FOUNDATION THAT WE WILL USE TO COLLABORATIVELY PLAN, DEVELOP, AND FOSTER PROGRAMS TO EFFECTIVELY ADDRESS THOSE NEEDS IN OUR COMMUNITY. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/4987%20CADILLAC%20CHNA %20REPORT%202019.PDF FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/4987%20CADILLAC%20CHNA %20IMPLEMENTATION%20STRATEGY%202019.PDF FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 11 WE IDENTIFIED STRATEGIC ISSUES AS PART OF THE MITHRIVE COLLABORATIVE. STRATEGIC ISSUES ARE BROADER THAN INDIVIDUAL HEALTH CONDITIONS, AND REPRESENT UNDERLYING CHALLENGES THAT NEED TO BE ADDRESSED, WHICH WOULD LEAD TO IMPROVEMENT IN HEALTH CONDITIONS. EACH STRATEGIC ISSUE SHOULD IMPACT MORE THAN ONE HEALTH CONDITION. EACH STRATEGIC ISSUE WAS PRIORITIZED USING THE FOLLOWING CRITERIA: 1. MAGNITUDE: HOW MANY PEOPLE ARE IMPACTED BY THIS ISSUE? 2. SEVERITY: HOW URGENT IS THIS ISSUE AND WHAT ARE THE CONSEQUENCES OF NOT ADDRESSING IT NOW? 3. VALUES: DOES THE COMMUNITY CARE ABOUT THIS ISSUE? WHICH ISSUE IS MOST IMPORTANT TO THE COMMUNITY? 4. IMPACT: HOW MUCH IMPACT WOULD IMPROVING OR FOCUSING ON THIS ISSUE HAVE ON HEALTH, HEALTH EQUITY, AND QUALITY OF LIFE? 5. SUSTAINABILITY AND ACHIEVABILITY: IS THE ISSUE WITHIN OUR SPHERE OF CONTROL? WILL WE HAVE THE EXPERTISE NECESSARY TO ADDRESS IT? THROUGH THIS PROCESS THESE PRIORITY ISSUES WERE IDENTIFIED: THE TWO TOP PRIORITY ISSUES TO BE ADDRESSED: HOW DO WE ENSURE A COMMUNITY THAT PROVIDES PREVENTIVE AND ACCESSIBLE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES? ACTION PLAN ON PAGE 5 HOW DO WE ADDRESS BASIC NEEDS OF LIVING TO CREATE RESILIENCY AND PROMOTE EQUITY? ACTION PLAN ON PAGE 7 ADDITIONAL STRATEGIC ISSUES IDENTIFIED: HOW DO WE IMPROVE ACCESS TO COMPREHENSIVE HEALTH CARE FOR ALL? HOW DO WE FOSTER A SENSE OF COMMUNITY THAT PROMOTES TRUST, SOCIAL SUPPORT, AND INCLUSIVENESS? HOW DO WE IMPROVE PREVENTION AND REDUCE HEALTH RISKS FOR LEADING CAUSES OF DEATH? STRATEGIC ISSUES THAT WILL NOT BE TARGETED AND WHY CADILLAC HOSPITAL ACKNOWLEDGES THE WIDE RANGE OF ISSUES THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED THAT WITH THE BROAD NATURE OF THE STRATEGIC ISSUES WE COULD EFFECTIVELY FOCUS ON ONLY THOSE ISSUES THAT WERE PRIORITIZED THE HIGHEST BY OUR COMMUNITY. DUE TO THE LOWER PRIORITIZATION, CADILLAC HOSPITAL WILL NOT TARGET THE FOLLOWING IDENTIFIED STRATEGIC ISSUES: HOW DO WE IMPROVE ACCESS TO COMPREHENSIVE HEALTH CARE FOR ALL? HOW DO WE FOSTER A SENSE OF COMMUNITY THAT PROMOTES TRUST, SOCIAL SUPPORT, AND INCLUSIVENESS? HOW DO WE IMPROVE PREVENTION AND REDUCE HEALTH RISKS FOR LEADING CAUSES OF DEATH? WHILE WE ARE NOT TARGETING THESE STRATEGIC ISSUES IN THIS IMPLEMENTATION STRATEGY, WE STILL COMMIT TO CONTINUING OUR EFFORTS TO IMPROVE THESE ISSUES AS WELL. RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE ISSUES WE PLAN TO COMMIT THE RESOURCES BELOW IN ORDER TO FACILITATE THE EXECUTION OF OUR IMPLEMENTATION STRATEGY. THESE RESOURCES INCLUDE: STAFF TIME NEEDED FOR PROGRAMMING, PARTICIPATION IN COLLABORATIVE PROJECTS, BOARDS, AND SUPPORT FOR OTHER COMMUNITY IMPROVEMENT PROJECTS RELATED TO OUR PRIORITY STRATEGIC ISSUES. SUPPORT (IN-KIND AND/OR FINANCIAL) FOR PROGRAMS, COMMUNITY COLLABORATIONS, AND ORGANIZATIONS WHO HAVE DEMONSTRATED A NEED FOR ASSISTANCE IN ADDRESSING THE PRIORITY STRATEGIC ISSUES. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 13H PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, AT THE SOLE DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/FINANCIAL_ASSISTANCE_POLICY.PDF FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/CADILLAC%20HOSPITAL%20- %20FINANCIAL%20ASSISTANCE.PDF FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/MEDIA/FILE/PLAIN%20LANGUAGE%20SUMMARY.PDF FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 16J IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 20E MUNSON HEALTHCARE CADILLAC (CADILLAC) REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. CADILLAC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY CADILLAC; 2.DOCUMENTING THAT CADILLAC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH CADILLAC'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH CADILLAC DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. CADILLAC WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS. 3 CADILLAC SURGICAL CARE 927 S CARMEL ST CADILLAC MI 49601 PHYSICIAN PRACTICE - SURGICAL SERVICES MUNSON HEALTHCARE CADILLAC REHABILI 704 OAK ST CADILLAC MI 49601 REHABILITAITON SERVICE MUNSON HEALTHCARE URGENT CARE 302 HOBART ST CADILLAC MI 49601 URGENT CARE SCHEDULE H, PART I, LINE 3C INCOME UP TO 200% OF THE FPG = 100% DISCOUNT ON CHARGES INCOME BETWEEN 201% AND 300% FPG = 75% DISCOUNT ON CHARGES INCOME BETWEEN 301% AND 400% FPG = 65% DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE, OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS. FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG: EARNINGS, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES; CASH, CHECKING AND SAVINGS BALANCES, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, IRAS TRUSTS, INHERITANCES, ANNUITIES, SAVINGS BONDS, STOCKS, MUTUAL FUNDS, AND/OR CASH VALUE OF LIFE INSURANCE. SCHEDULE H, PART I, LINE 7G THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 6,684,925. THESE COSTS ARE OFFSET BY RELATED REVENUES IN COMPUTING THE NET COMMUNITY BENEFIT. SCHEDULE H, PART I, LINE 7, COLUMN (F) TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 110,048,894. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 3,786,475. THE NET EXPENSE OF 106,262,419 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). SCHEDULE H, PART I, LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO. SCHEDULE H, PART II MUNSON HEALTHCARE CADILLAC HOSPITAL PROVIDED 114,096 OF COMMUNITY BUILDING ACTIVITIES DURING THE 2021 FISCAL YEAR. CADILLAC HOSPITAL BELIEVES COMMUNITY BUILDING ACTIVITIES PROMOTE HEALTH BY SUPPORTING THE UNDERLYING SUPPORT STRUCTURE OF COMMUNITY HEALTH. A SIGNIFICANT PORTION OF THE CADILLAC HOSPITAL COMMUNITY-BUILDING ACTIVITIES INVESTMENT IS DEDICATED TO RECRUITMENT OF PHYSICIANS IN NEEDED SPECIALTIES FOR DESIGNATED MEDICALLY UNDERSERVED AREAS. ADDITIONAL ACTIVITIES INCLUDED COMMUNITY SUPPORT, COMMUNITY HEALTH IMPROVEMENT ADVOCACY, ECONOMIC DEVELOPMENT, WORKFORCE DEVELOPMENT, AFFORDABLE HOUSING AND OTHER COLLABORATIVE EFFORTS. THESE EFFORTS WERE SOMEWHAT REDUCED DURING FY21 TAX YEAR DUE TO COVID-19 CHALLENGES AND ORGANIZATIONAL GATHERING POLICIES RELATED TO KEEPING OUR EMPLOYEES AND COMMUNITIES SAFE FROM COVID-19. SCHEDULE H, PART III, LINE 2 DIRECT WRITE-OFF FROM UNPAID ACCOUNTS WHICH ARE DEEMED NO LONGER COLLECTIBLE ARE RECORDED AGAINST THE ALLOWANCE FOR BAD DEBT. AN ESTIMATE OF BAD DEBT EXPENSE IS RECORDED BASED ON 1) AN ANALYSIS OF THE DIRECT WRITE- OFFS AND 2) AN ESTIMATE OF THE AMOUNT OF BAD DEBT, NET OF DISCOUNTS, IN THE ACCOUNTS RECEIVABLE BALANCE, CONSIDERING THE PAST EXPERIENCE AND CURRENT TRENDS OF PAYMENTS ON PATIENT ACCOUNTS FOR EACH OF THE MAJOR PAYOR SOURCES OF REVENUE. SCHEDULE H, PART III, LINE 3 THE METHODOLOGY USED TO DETERMINE THE ESTIMATED AMOUNT OF CHARITY IN BAD DEBT IS AS FOLLOWS. WE DETERMINED THE APPROVAL RATE OF FINANCIAL COUNSELING BY TAKING THE VALUE OF THE ACCOUNTS THAT SUCCESSFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT WERE DENIED. THEN WE APPLIED THAT PERCENTAGE TO THE VALUE OF ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING. SCHEDULE H, PART III, LINE 4 SEE NOTE 2 ON PAGE 8 OF ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 9B MUNSON HEALTHCARE'S INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684. SCHEDULE H, PART VI, LINE 2 THE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE (CHC) TO SERVE THE MUNSON HEALTHCARE SYSTEM. THE CHC CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM MUNSON HEALTHCARE HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON HEALTHCARE BOARD CHAIRPERSON. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MHC RESPONSE TO ANY EMERGING HEALTH TRENDS AS IDENTIFIED BY COMMUNITY HEALTH NEEDS ASSESSMENT, AND REVIEW ANY NEW COMMUNITY HEALTH BASED COLLABORATION OR PROGRAM. THE CHC IS RESPONSIBLE FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MHC COMMUNITY BENEFIT PROGRAMS AND SERVICES. THIS COMMITTEE IS SUPPORTED BY COMMUNITY HEALTH DEPARTMENT EMPLOYEES OF THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE SYSTEM ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN MUNSON HEALTHCARE'S EXTENSIVE GEOGRAPHICAL AREA. COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED, AS WELL AS WHERE PROGRESS HAS BEEN MADE. THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITY-WIDE. THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM PARTICIPATE IN A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. THE ASSESSMENT IS ACCOMPLISHED THROUGH COLLABORATION WITH MANY OF THE HUMAN SERVICE ORGANIZATIONS IN THE COMMUNITY. SCHEDULE H, PART VI, LINE 3 IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS: BROCHURES THAT DESCRIBE MUNSON HEALTHCARE'S FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES. THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR. STATEMENT ON BILLS: STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL. SIGNS IN THE ER REGISTRATION AREA: ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY. THE MUNSON HEALTHCARE INTERNET HAS THE FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, THE PLAIN LANGUAGE SUMMARY AND THE BILLING AND COLLECTIONS POLICY AVAILABLE TO REVIEW AND PRINT. REFERRAL BY REGISTRATION STAFF: AT THE TIME OF REGISTRATION, SELF-PAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF. MUNSON HEALTHCARE FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS. THE COUNSELOR VISIT ALL INPATIENTS THAT ARE DEEMED SELF-PAY, TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP. IF THE PATIENT WOULD LIKE HELP, THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID. GENERALLY, THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR. ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR, THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS. THE COUNSELORS ALSO IDENTIFY ALL SELF-PAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS, ONLY BY PHONE. THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION, BUT WHEN THAT IS NOT POSSIBLE, THE CALL IS MADE SOON AFTER DISCHARGE. AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: MEDICAID (AND ALL OF ITS SUBSETS), SOCIAL SECURITY DISABILITY, TRAVERSE HEALTH CLINIC, MUNSON HEALTHCARE FINANCIAL ASSISTANCE, AND MUNSON MEDICAL CENTER MEDS PROGRAM. MUNSON HEALTHCARE MAKES A PHONE CALL TO ALL PRIVATE-PAY PATIENTS PRIOR TO TRANSFERRING THEIR ACCOUNT TO A COLLECTION AGENCY TO INFORM THEM OF OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART VI, LINE 4 DESCRIPTION MUNSON HEALTHCARE CADILLAC (CADILLAC HOSPITAL) HAS SERVED THE GREATER WEXFORD COUNTY REGION SINCE 1908, WITH A LONG HISTORY AND HERITAGE OF KEEPING PATIENTS AT THE CENTER OF ALL WE DO. LOCATED WITHIN THE CITY OF CADILLAC WITH A POPULATION OF 10,500 PEOPLE, IT IS THE ONLY CITY IN THE NATION WITH TWO LOVELY LAKES WITHIN ITS CITY LIMITS LAKE MITCHELL AND LAKE CADILLAC. SHIFTING WINDS ACROSS NEARBY LAKE MICHIGAN KEEP CADILLAC WINTERS SNOW COVERED AND THE SUMMERS COMFORTABLE. LOCATED 50 MILES SOUTH OF TRAVERSE CITY, CADILLAC HOSPITAL IS ONE OF NINE COMMUNITY HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM, NORTHERN MICHIGANS LEADING AND LARGEST HEALTH CARE PROVIDER. OUR SERVICE AREA COVERING LAKE, MISSAUKEE, OSCEOLA, AND WEXFORD COUNTIES COVERS A TOTAL OF ABOUT 2,300 SQUARE MILES OF LAND. THE REGION IS CLASSIFIED AS RURAL BY THE US CENSUS BUREAU. IN GENERAL, RURAL LOCATIONS EXPERIENCE SIGNIFICANT HEALTH DISPARITIES, SUCH AS HIGHER INCIDENCE OF DISEASE AND DISABILITY, INCREASED MORTALITY RATES AND LOWER LIFE EXPECTANCY. RURAL RESIDENTS ARE MORE LIKELY TO HAVE A NUMBER OF CHRONIC CONDITIONS AND ARE LESS LIKELY TO RECEIVE RECOMMENDED PREVENTIVE SERVICES, IN PART DUE TO LACK OF ACCESS TO PHYSICIANS AND HEALTH CARE DELIVERY SITES AND/OR ADEQUATE TRANSPORTATION OPTIONS. CADILLAC HOSPITAL IS PROUD TO OFFER HIGH QUALITY HEALTHCARE SERVICES AND COMMUNITY HEALTH INTERVENTIONS AIMED AT REDUCING THESE DISPARITIES. HOSPITAL SERVICES CADILLAC HOSPITAL HAS AN ACTIVE MEDICAL STAFF OF 330 PROVIDERS AND 45 VOLUNTEERS. WITH APPROXIMATELY 800 EMPLOYEES, CADILLAC HOSPITAL IS ONE OF THE LARGEST EMPLOYERS IN THE SURROUNDING AREA. THIS 49-BED HOSPITAL OFFERS A WIDE RANGE OF SERVICES INCLUDING: COMPREHENSIVE RADIOLOGY SERVICES WITH CT, MRI, CT, ULTRASOUND, MAMMOGRAPHY, AND X-RAY OUTPATIENT LABORATORY SERVICES COMPREHENSIVE REHABILITATION SERVICES, INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH AND HEARING, AND WOUND THERAPY PROGRAMS 24-HOUR EMERGENCY CARE, ACUTE CARE, URGENT CARE AND WALK-IN SERVICES WOMENS HEALTH SLEEP DISORDERS SPECIALTIES, INCLUDING ORTHOPEDICS, UROLOGY, OPHTHALMOLOGY, EAR NOSE AND THROAT, CARDIOLOGY, CANCER SERVICES AND MORE CARDIAC AND PULMONARY REHABILITATION PRIMARY CARE LONG-TERM CARE AND SKILLED REHABILITATION DIALYSIS MATERNITY CARE GENERAL, ORTHOPEDIC, OUTPATIENT AND HAND SURGERY THE HOSPITAL SERVED MORE THAN 4,800 SURGICAL CASES, OVER 145,000 OUTPATIENT VISITS, 2,917 INPATIENT ADMISSIONS, AND OVER 21,300 EMERGENCY ROOM VISITS IN FISCAL YEAR 2021. POPULATION SERVED CADILLAC HOSPITAL IS LOCATED IN CADILLAC, MICHIGAN AND SITUATED IN WEXFORD COUNTY. WEXFORD, MISSAUKEE, LAKE, AND OSCEOLA COUNTIES ARE CONSIDERED OUR COMMUNITY BECAUSE A MORE THAN 67 PERCENT OF THE CADILLAC HOSPITAL INPATIENT POPULATION RESIDES WITHIN THIS AREA. OF THE 84,000 PEOPLE WHO LIVE IN THE FOUR-COUNTY REGION, 95% ARE WHITE. THE LARGEST MINORITIES ARE AFRICAN AMERICAN (2%), HISPANIC/LATINO (2%) AND NATIVE AMERICAN (1%). THE PROPORTION OF ADULTS OVER 65 YEARS OLD IS LARGER IN THE REGION (20%) THAN THE STATE (16%). IN ADDITION, THE PROPORTION OF OLDER ADULTS IS EXPECTED TO CONTINUE INCREASING ACROSS NORTHERN MICHIGAN AT A MUCH FASTER RATE THAN THE STATE AVERAGE. EDUCATION, EMPLOYMENT, AND HEALTH ARE INTRICATELY LINKED. WITHOUT A GOOD EDUCATION, PROSPECTS FOR A STABLE AND REWARDING JOB WITH GOOD EARNINGS DECREASE. EDUCATION IS ASSOCIATED WITH LIVING LONGER, EXPERIENCING BETTER HEALTH, PRACTICING HEALTH PROMOTING BEHAVIORS SUCH AS EXERCISING REGULARLY, REFRAINING FROM SMOKING, AND OBTAINING TIMELY HEALTH CHECKUPS AND SCREENINGS. A LARGER PERCENTAGE OF THE POPULATION OF MICHIGAN HAVE A COLLEGE DEGREE (29%) THAN IN IN THE FOUR-COUNTY REGION, WHERE COLLEGE ATTAINMENT IS BETWEEN 14% (OSCEOLA) AND 18% (WEXFORD). HOWEVER, THE PROPORTION OF THE POPULATION WITH A HIGH SCHOOL DIPLOMA IS ABOUT THE SAME IN THESE FOUR COUNTIES AS IT IS FOR MICHIGAN OVERALL: AROUND 90%. AMONG THESE FOUR COUNTIES, MEDIAN HOUSEHOLD INCOME IS HIGHEST IN WEXFORD COUNTY AT 36,734 THIS IS STILL WELL BELOW MEDIAN INCOME IN MICHIGAN (59,583). QUALITY DURING FY21, CADILLAC HOSPITAL WAS RECOGNIZED BY THE MICHIGAN ALLIANCE FOR INNOVATION IN MATERNAL HEALTH (MI AIM) FOR HOSPITAL EFFORTS TO PROMOTE QUALITY CARE FOR MOMS TO BE. CADILLAC RECEIVED A PLATINUM RECOGNITION FOR THEIR QUALITY WORK TO REDUCE MATERNAL DEATHS, HYPERTENSION DURING PREGNANCY, AND OBSTETRIC BLEEDING. THE HOSPITAL WAS ALSO NAMED A 2021 TOP 100 RURAL & COMMUNITY HOSPITALS BY THE CHARTIS CENTER FOR RURAL HEALTH. REGARDED AS ONE OF THE INDUSTRYS MOST SIGNIFICANT DESIGNATIONS OF PERFORMANCE EXCELLENCE, THE ANNUAL TOP 100 RURAL & COMMUNITY HOSPITALS AWARD IS BASED UPON THE RESULTS OF THE HOSPITAL STRENGTH INDEX FROM IVANTAGE HEALTH ANALYTICS. THE HOSPITAL STRENGTH INDEX IS THE INDUSTRY'S MOST COMPREHENSIVE AND OBJECTIVE ASSESSMENT OF RURAL HOSPITAL PERFORMANCE IN THE UNITED STATES. RURAL HOSPITALS ARE CHOSEN BASED ON SCORES OF PERFORMANCE IN 50 RURAL-RELEVANT INDICATORS. ADDITIONAL, RECENT PAST RECOGNITIONS INCLUDE: CADILLAC HOSPITAL IS KNOWN FOR HIGH QUALITY CARE BASED ON RATINGS FROM OUTSIDE AGENCIES, INCLUDING AN A PATIENT SAFETY RATING FROM THE LEAPFROG GROUP. CADILLAC HOSPITAL HAS RECEIVED A 5-STAR CMS RATING FOR OVERALL HOSPITAL QUALITY ONE OF JUST 10 HOSPITALS IN MICHIGAN TO RECEIVE THE TOP RATING BASED ON QUALITY MEASURES. CADILLAC HOSPITAL ALSO HAS BEEN DESIGNATED BY BLUE CROSS BLUE SHIELD OF MICHIGAN AS A BLUE DISTINCTION CENTER+ FOR MATERNITY CARE AND KNEE AND HIP REPLACEMENT. SCHEDULE H, PART VI, LINE 5 THE CADILLAC HOSPITAL BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, THE MAJORITY OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, FUNDRAISING, AND GENERAL STEWARDSHIP. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS. CADILLAC HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA. EXAMPLES OF HOW CADILLAC HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PROGRAMS INCLUDE: HEALTHY FUTURES- A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS, HEALTH DEPARTMENTS AND MUNSON HEALTHCARE CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UNDER AGE 2. THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMES-BASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY, ACCESS TO HEALTH CARE AND IMMUNIZATIONS. NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 11 COUNTY SERVICE AREA, WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES. NMDI IS COMMITTED TO PROVIDING LOCAL, REGIONAL, AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES. WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES, NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS: THE GENERAL COMMUNITY; THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION; AND RURAL PRIMARY CARE PROVIDERS (PCP) CARING FOR DIABETIC PATIENTS. SENIOR FIT - IN COLLABORATION WITH THE CADILLAC AREA YMCA, IS AN EVIDENCE-BASED MODEL IS DESIGNED TO IMPROVE THE OVERALL HEALTH OF SENIORS WHILE PROVIDING AN UNDERSTANDING OF HOW TO EXERCISE IN A SAFE AND EFFECTIVE MANNER. THIS PROGRAM HAS HAD POSITIVE CLINICAL OUTCOMES AND CONTINUES TO ENJOY MUCH SUCCESS WITH THE AVERAGE CLASS SIZE OF 70-80 PARTICIPANTS PARTICIPATING IN FOUR CLASSES TWICE A WEEK. CLASSES AND SCHEDULE WERE ADJUSTED DURING THE FY21 AND COVID-19 PANDEMIC TO PROTECT THE HEALTH AND SAFETY OF PARTICIPATING SENIORS. STEHOUWER FREE CLINIC - MUNSON CADILLAC HOSPITAL IS AN IMPORTANT FUNDING SOURCE FOR THE CLINIC AND IS COMMITTED TO SERVING THOSE IN THE COMMUNITY THAT HAVE LIMITED OR NO ACCESS TO CARE OTHERWISE. IN ADDITION TO AN ANNUAL DONATION, THE HOSPITAL PROVIDES IN-KIND SUPPORT TO THE CLINIC IN THE WAY OF IMAGING AND LAB SERVICES AND SELECT MEDICATIONS AT NO CHARGE. MUNSON CADILLAC HOSPITAL MAKES SIGNIFICANT ANNUAL INVESTMENTS IN THE MEDICATION ACCESS PROGRAM (MAP) PROVIDING PRESCRIPTION MEDICATIONS TO THOSE WHO ARE UNINSURED OR UNDERINSURED. MUNSON HEALTHCARE CADILLAC HOSPITAL PARTNERS WITH MSU EXTENSION AND DHD10 TO OFFER THE PRESCRIPTION FOR HEALTH PROGRAM OFFERING REFERRED PARTICIPANTS FREE NUTRITION EDUCATION AND VOUCHERS TO PURCHASE FREE FRUITS AND VEGETABLES. VACCINATION CLINICS: THE HOSPITAL HOSTED FREE, COMMUNITY DRIVE-THROUGH COVID-19 VACCINATION CLINICS AND PROVIDED HUNDREDS OF HOURS OF FREE STAFFING SUPPORT TO AREA HEALTH DEPARTMENTS TO SUPPORT VACCINATION CLINICS DURING FY21. THE MUNSON HEALTHCARE SYSTEM DEVELOPED AND OFFERED A VIRTUAL SMOKING CESSATION COURSE, AVAILABLE TO POMH PATIENTS WITH POSITIVE RESULTS IN FY21. THE HOSPITAL OFFERS A FREE MEDSAFE RETURN BIN TO COLLECT UNUSED MEDICATIONS, REDUCING THE POSSIBILITY OF AN ACCIDENTAL OVERDOSE OR ENVIRONMENTAL CONTAMINATION. SCHEDULE H, PART VI, LINE 6 MUNSON HEALTHCARE CADILLAC'S SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM WHICH INCLUDE MUNSON MEDICAL CENTER, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL AND MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL PROVIDED 72.7 MILLION OF COMMUNITY BENEFIT IN THE 2020 TAX YEAR. ADDITIONALLY, MMC WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA. THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON CAMPUS. COMMUNITY BENEFIT, IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR. NORTH FLIGHT, INC. IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM. WITH ITS GROUND MEDICAL TRANSPORTATION SERVICES, PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE. NORTH FLIGHT, INC. PROVIDED 208,000 IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR. MUNSON MEDICAL GROUP, THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM, PROVIDED 1.4 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2020. MMC PERFORMS THE NEEDS ASSESSMENTS FOR MUNSON HEALTHCARE. UTILIZING THIS NEEDS ASSESSMENT, MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING, DEVELOPING, IMPLEMENTING, EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS. IN TOTAL, THE MUNSON HEALTHCARE SYSTEM PROVIDED 80.9 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS, INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS, OUTREACH PROGRAMS, BAD DEBT, AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN. SCHEDULE H, PART VI, LINE 7 MICHIGAN true STEHOUWER FREE CLINIC 201 N MITCHELL ST STE L-1 CADILLAC MI 49601 611401888 501(C) 20000 MEDICALLY UNDERSERVE CADILLAC AREA YMCA 9845 CAMPUS DRIVE CADILLAC MI 49601 300013507 501(C) 17292 SENIOR/YOUTH FIT PRO WEXFORD PHO 117 N MITCHELL STREET SUITE 6 CADILLAC MI 49601 383100681 36000 MEDICATION ACCESS PR 2 1 SCHEDULE I, PAGE 1, PART I, LINE 2 MUNSON HEALTHCARE CADILLAC MAY AWARD A GRANT OR CONTRIBUTION TO ANOTHER TAX EXEMPT ORGANIZATION BASED ON AN EVALUATION OF THE USE OF THE FUNDS FOR THE PROMOTION OF HEALTH IN THE COMMUNITY. THE ONGOING RELATIONSHIP OF MUNSON HEALTHCARE CADILLAC WITH ITS PARTNERS IN THE COMMUNITY FOR THE PROMOTION OF HEALTH ALLOWS FOR THE MONITORING OF THE GRANT AWARD. X true true false true false false false false false false false EDWIN A NESS DIRECTOR 877571 700 37698 177479 32259 1125707 KENT BOWDEN DO PHYSICIAN 551429 179819 20554 14279 30623 796704 DAVID HOBBS MD PHYSICIAN 518118 183412 20550 13483 25529 761092 MARK HEPLER CFO 451179 700 71108 69989 14110 607086 14141 LYNNE MCCORMICK DO PHYSICIAN 481546 46029 700 2879 8550 19546 1760 513221 47789 TIMOTHY ISERI MD PHYSICIAN 425063 36818 1893 33984 24392 522150 LAURA GLENN PRESIDENT AMB SERVIC 423775 700 15208 56998 22503 519184 LOUIS TEGTMEYER DO PHYSICIAN 391401 72758 21145 14279 11944 511527 TONYA SMITH PRESIDENT PT-YR 352563 23393 1501 54279 26483 458219 ALICIA MAITLAND CORPORATE CONTROLLER 209588 692 7698 23559 21643 263180 PETER MARINOFF PRESIDENT PT-YR 191081 692 957 29482 22079 244291 KATHRYN BANDFIELD-KEOUGH VP PATIENT CARE SERV 143234 23876 756 30429 5707 2158 14737 1174 14681 5672 179115 63309 SCHEDULE J, PAGE 1, PART I, LINE 1A MUNSON HEALTHCARE MAINTAINS A SOCIAL MEMBERSHIP AT THE TRAVERSE CITY COUNTRY CLUB. A REQUIREMENT OF THE COUNTRY CLUB IS THAT A MEMBERSHIP BE IN AN INDIVIDUAL NAME AND NOT A CORPORATE NAME, SO EDWIN NESS IS LISTED AS THE INDIVIDUAL FOR THE MEMBERSHIP. MUNSON HEALTHCARE USES THE SOCIAL MEMBERSHIP TO CONDUCT OFF-SITE MEETINGS AND RETREATS. SCHEDULE J, PAGE 1, PART I, LINE 3 THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 163,201 0 MARK HEPLER 0 47,430 0 LAURA GLENN 0 42,800 0 TONYA SMITH 0 40,000 0 ALICIA MAITLAND 0 12,816 0 PETER MARINOFF 0 19,640 0 KATHRYN BANDFIELD-KEOUGH 0 13,200 0 SCHEDULE J, PART III SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON HEALTHCARE'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON HEALTHCARE. A CNTY GRD TRAV HOSP FIN AUTH 2014C 386004832 386523EH3 2014-12-17 16210267 PURCHASE THE ASSETS OF CADILLAC HOSPITAL false false false A 16210461 208029 16002432 2015 false false true true A false true true false false 0.00780 0.00780 false false true A false false true false false false false false true A true DIFFERENCES IN ISSUE PRICE EXPLANATION CNTY GRD TRAV HOSP FIN AUTH 2014C INVESTMENT INCOME EARNED PURPOSE OF ISSUE DESCRIPTION CNTY GRD TRAV HOSP FIN AUTH 2014C PURCHASE THE ASSETS OF CADILLAC HOSPITAL ADDITIONAL INFORMATION CNTY GRD TRAV HOSP FIN AUTH 2014C OBLIGATED GROUP ISSUE RECORDED ON RELATED ORGANIZATIONS ON DECEMBER 17, 2014, THE MUNSON HEALTHCARE OBLIGATED GROUP ISSUED COUNTY OF GRAND TRAVERSE HOSPITAL FINANCE AUTHORITY REVENUE BONDS (MUNSON THE 2014 SERIES A BONDS WERE RECORDED ON MUNSON MEDICAL CENTER'S BOOKS AND RECORDS AT A PAR VALUE OF 27,620,000. THE 2014 SERIES B BONDS WERE RECORDED ON MUNSON HEALTHCARE GRAYLING'S BOOKS AND RECORDS AT A PAR VALUE OF 13,805,000. THE 2014 SERIES C BONDS WERE RECORDED ON MUNSON HEALTHCARE CADILLAC'S BOOKS AND RECORDS AT A PAR VALUE OF 15,870,000. THE RELATED BOND PREMIUM WAS RECORDED ON THE RESPECTIVE ENTITIES' BOOKS AND RECORDS. PART III, QUESTION 3B AND D MUNSON HEALTHCARE CADILLAC MAINTAINS POLICIES AND PROCEDURES TO REVIEW AND MONITOR ALL CONTRACTS, INCLUDING LEASES, MANAGEMENT, SERVICE AND RESEARCH CONTRACTS. THE MONITORING PROCESS INCLUDES A REVIEW BY THE CORPORATE INTERNAL LEGAL DEPARTMENT. OUTSIDE COUNSEL MAY BE CONSULTED, AS NECESSARY. OUTSIDE COUNSEL IS RETAINED FOR ALL NEW EXEMPT BOND OFFERINGS, DURING WHICH A THOROUGH DUE DILIGENCE PROCESS REVIEWS APPLICABLE CONTACTS. SINCE NEW BONDS WERE ISSUED IN THE MUNSON HEALTHCARE SYSTEM IN 2019, OUTSIDE COUNSEL WAS ENGAGED DURING THAT TAX YEAR. JENNIFER PIWOWARSKI SEE PART V 250063 COMPENSATION PAID false SCHEDULE L, PART V PART IV, LINE 1 JENNIFER PIWOWARSKI IS A FAMILY MEMBER OF BOARD MEMBER NATHAN PIWOWARSKI. FORM 990, PAGE 6, PART VI, LINE 6 MUNSON HEALTHCARE CADILLAC IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE DIRECTORS FOR SUBSIDIARY ENTITIES. NOMINATIONS TO MUNSON HEALTHCARE FOR SUBSIDIARY DIRECTORS ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON HEALTHCARE CADILLAC (CAD) TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF CAD; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF CAD; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF CAD; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR CAD; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY CAD WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF CAD WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF CAD; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY CAD; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE CADILLAC HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE CADILLAC HOSPITAL BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF EXECUTIVE COMPENSATION AND FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. MINUTES ARE PREPARED FOR MEETINGS OF THE COMMITTEE. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON EXECUTIVES IS DETERMINED IN PART BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES OF MUNSON HEALTHCARE CADILLAC AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE CADILLAC ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE CADILLAC DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. FORM 990, PART IX, LINE 11G PURCHASED SERVICES 10,165,911 9,879,940 88,639 PROFESSIONAL FEES 3,873,180 438,371 0 TOTAL 14,039,091 10,318,311 88,639 FORM 990, PART XI, LINE 9 CHANGE IN INVESTEMENT IN MUNSON HEALTHCARE FOUNDAT 1,153,520 MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 HEALTHCARE MI C3 12B N/A false MUNSON HEALTHCARE FOUNDATIONS 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE true MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true MUNSON HOME HEALTH 1105 SIXTH ST TRAVERSE CITY MI 49684 383335362 HOME HEALT MI C3 12B MUNSON HC MUNSON HEALTHCARE true MUNSON HOME SERVICES 1105 SIXTH ST TRAVERSE CITY MI 49684 382543463 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 12B MUNSON HC MUNSON HEALTHCARE true PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI C3 10 MUNSON MED MUNSON MEDICAL CENTER true MUNSON HEALTHCARE GRAYLING 1105 SIXTH ST TRAVERSE CITY MI 49684 471161992 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CHARLEVOIX HOSPIT 1105 SIXTH ST TRAVERSE CITY MI 49684 381459366 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE MANISTEE HOSPITAL 1465 E PARKDALE AVE MANISTEE MI 496609709 380350304 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE OTSEGO MEMORIAL H 825 N CENTER AVE GAYLORD MI 497351592 381303843 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true MUNSON SUPPORT SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A true SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true MEDICAL OFFICE CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true false false true false false false false false false false true true true false true true true true true MUNSON HEALTHCARE M 9166340 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE Q 1032956 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE O 2475778 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE P 9121887 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS C 2397009 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS M 88639 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE GRAYLING P 54506 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE GRAYLING Q 68678 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE MANISTEE HOSPITAL M 64248 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE MANISTEE HOSPITAL O 298944 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE MANISTEE HOSPITAL R 54763 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER M 3085690 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER P 4485437 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER Q 2826095 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER O 29670320 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER S 738080 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER R 1325074 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP M 494734 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP O 402501 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP P 55546 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP S 170399 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP R 134118 ACTUAL AMOUNTS PAID MUNSON SUPPORT SERVICES M 189322 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE M 912818 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 3240215 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE R 237117 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE S 265315 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H Q 193317 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H P 554011 ACTUAL AMOUNTS PAID SCHEDULE R MUNSON HEALTHCARE CADILLAC USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.