2021-11-11T13:37:11-06:00 2020-12-31 990 2020-01-01 382947657 HENRY FORD MACOMB HOSPITAL CORPORATION HENR 3138768704 ONE FORD PLACE - 5F DETROIT MI 48202 ROBIN DAMSCHRODER EVP FINANCE/CFO 3138745446 2021-11-11 ROBIN DAMSCHRODER 999009999 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROBIN DAMSCHRODER ONE FORD PLACE - 5F DETROIT MI 48202 606647200 0 X WWW.HENRYFORD.COM/HOMEPAGE_MACOMB X 1990 DE WE IMPROVE PEOPLE'S LIVES THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING.VISION: WE WILL BE THE TRUSTED PARTNER IN HEALTH, LEADING THE NATION IN SUPERIOR CARE AND VALUE-ONE PERSON AT A TIME. 14 12 4115 347 0 0 2194753 41867309 570711195 553047047 11462756 9479437 4130696 2111591 588499400 606505384 187455 45133 0 0 235113564 244348112 0 0 187983 320648560 324710277 555949579 569103522 32549821 37401862 410349956 541025510 259838841 351702397 150511115 189323113 X HENRY FORD MACOMB HOSPITAL (HFMH) IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM SERVING THE NORTHEASTERN METROPOLITAN DETROIT MICHIGAN COMMUNITIES. AS AN INTEGRATED COMPONENT OF ONE OF THE NATION'S LEADING COMPREHENSIVE, INTEGRATED HEALTH SYSTEMS, IT IS THE MISSION OF HFMH TO IMPROVE HUMAN LIFE THROUGH THE EXCELLENCE OF THE SCIENCE AND ART OF HEALTH CARE AND HEALING. HFMH IS COMMITTED TO PROVIDING HEALTH SERVICES AND IMPROVING THE QUALITY OF LIFE OF THE CITIZENS OF THE COMMUNITIES IT SERVES REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. THE ORGANIZATION PROVIDES FINANCING AND HEALTH CARE DELIVERY, INCLUDING ACUTE, SPECIALTY, PRIMARY AND PREVENTATIVE CARE SERVICES BACKED BY EXCELLENCE IN RESEARCH AND EDUCATION. 0 0 345642340 45133 432608051 HENRY FORD MACOMB HOSPITAL-CLINTON TOWNSHIP (HFMH) IS RECOGNIZED FOR ITS EXCELLENCE IN PROVIDING INPATIENT CARE TO THE RESIDENTS OF MACOMB COUNTY MICHIGAN AS WELL AS OTHER COMMUNITIES LOCATED NORTHEAST OF THE CITY OF DETROIT. DURING 2020, HFMH HAD 21,588 DISCHARGES.HFMH PROVIDES COMPREHENSIVE ACUTE AND TERTIARY CARE. SPECIALTY SERVICES INCLUDE A HEART & VASCULAR INSTITUTE, HENRY FORD CANCER INSTITUTE, A WOMEN'S HEALTH CENTER, ALONG WITH A BIRTHING CENTER THAT FEATURES 17 LABOR, DELIVERY, RECOVERY AND POST-PARTUM SUITES. THE HOSPITAL ALSO HAS A 36-BED INPATIENT REHABILITATION PROGRAM, AN AMBULATORY AND MINIMALLY INVASIVE SURGERY CENTER AND LEADING DIAGNOSTIC IMAGING, ALONG WITH ADVANCED TRAUMA CAPABILITIES AND EMERGENCY SERVICES.HFMH AND AFFILIATES INCLUDING HENRY FORD HEALTH SYSTEM ("SYSTEM") RESPONSE TO COVID-19 ANTICIPATING THE RISK AHEAD, THE SYSTEM INITIATED PLANS TO ADDRESS COVID 19 IN EARLY FEBRUARY 2020, WITH TARGETED TRAINING AND EDUCATION FOR HEALTH CARE TEAMS, EXPANDING TO THE TOTAL WORKFORCE, CONTINUING TO THIS DAY AS INFORMATION CONTINUES TO EVOLVE. THE SYSTEM ACTIVATED ITS SYSTEM INCIDENT COMMAND (SIC) LED BY THE CHIEF QUALITY OFFICER DURING THE FIRST WEEK OF MARCH 2020, WHICH SERVES TO CONNECT FEDERAL AND STATE INFORMATION AND GUIDELINES TO OUR OPERATING UNITS AND SERVES AS A POINT OF COORDINATED COMMUNICATIONS ACROSS THE SYSTEM, WITH LOCAL AGENCIES, AND TO THE COMMUNITIES WE SERVE.THE SYSTEM ADMITTED ITS FIRST COVID 19 PATIENT ON MARCH 11, 2020. ALIGNING WITH THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) AND STATE RECOMMENDATIONS, IN THE THIRD WEEK OF MARCH 2020, THE SYSTEM BEGAN CANCELING ALL NON-TIME SENSITIVE VISITS AND CLOSING AND CONSOLIDATING ITS MEDICAL CENTERS AND CLINICS. THE SYSTEM'S PLAN INCLUDED RAPID CYCLE EXPANSION OF VIRTUAL VISITS, CREATION OF A COVID 19 HOTLINE, CONVERSION, OR REDEPLOYMENT OF ALL NONESSENTIAL WORKERS TO REMOTE WORK ARRANGEMENTS, AND CANCELING NONESSENTIAL BUSINESS TRAVEL AND SYSTEM EVENTS.IN MARCH 2020, THE SYSTEM LAUNCHED PUBLIC SERVICE MESSAGING TO SUPPORT SAFE SOCIAL PRACTICES, CREATED OUTREACH PROGRAMS WITH KEY SOCIAL SERVICES ORGANIZATIONS, AND PARTNERED WITH LOCAL GOVERNMENTS. THIS INCLUDED WORKING WITH THE CITY OF DETROIT TO ESTABLISH THE REGION'S LARGEST DRIVE THROUGH COVID 19 TESTING FACILITY AND PARTNERING WITH THE STATE TO CONVERT THE REGION'S LARGEST CONVENTION CENTER INTO A FEDERAL EMERGENCY MANAGEMENT ASSOCIATION SURGE FACILITY. IN ADDITION, THE SYSTEM PROVIDED ON SITE TESTING AT SKILLED NURSING FACILITIES AND SENIOR CENTERS.ON MAY 29, 2020, IN ALIGNMENT WITH THE MICHIGAN GOVERNOR'S EXECUTIVE ORDERS, THE SYSTEM BEGAN A STRUCTURED REOPENING OF ITS MEDICAL CENTERS AND CLINICS WITH AN INITIAL FOCUS ON THE PREVIOUSLY POSTPONED PROCEDURES. AS OF THE END OF 2020, PATIENT SERVICE VOLUME IS NEAR THE PRE COVID 19 BASELINE, WITH ALL FORMS OF VIRTUAL VISITS EXCEEDING 9,800 PER WEEK AND ALMOST ALL OF THE PREVIOUSLY FURLOUGHED WORKERS HAVE BEEN CALLED BACK. COVID 19 INPATIENT VOLUMES, WHICH WERE 861 AT THEIR PEAK IN EARLY APRIL, REACHED A LOW OF 27 IN EARLY JULY AND INCREASED IN EARLY DECEMBER TO 526. RECOGNIZING THE POTENTIAL IMPLICATIONS OF THIS INCREASE, SIC WAS REACTIVATED IN EARLY OCTOBER 2020. CONSISTENT WITH PATTERNS ACROSS THE STATE, THE SYSTEM'S COVID 19 VOLUME DECREASED TO 118 ADMITTED PATIENTS BY MARCH 14, 2021.WHILE THE ONGOING PATTERN OF COVID 19 CANNOT BE PREDICTED, THE SYSTEM BELIEVES THAT THE KNOWLEDGE GAINED DURING 2020 REGARDING EFFECTIVE CLINICAL PRACTICES AND TREATMENT PROTOCOLS, THE OPTIMAL APPROACH TO PROTECTING STAFF AND PATIENTS FROM VIRUS TRANSMISSION, AND HOW TO SANITIZE PHYSICAL ENVIRONMENTS HAS POSITIONED THE SYSTEM WELL TO MAINTAIN FULL SCOPE OF OPERATIONS.THE SYSTEM'S RESPONSE INCLUDED EFFORTS TO REPRIORITIZE THE WORK OF THE ENTIRE EXECUTIVE TEAM, REDIRECT RESOURCES TO THE FRONTLINE CLINICAL AREAS SUPPORTING COVID, INVESTMENT IN TEMPORARY FACILITIES, EXPANDING CARE CAPACITY, ACQUISITION OF EQUIPMENT TO SUPPORT PATIENT CARE AND COVID TESTING, AS WELL AS ACQUISITION OF PERSONAL PROTECTIVE EQUIPMENT TO HELP PROTECT OUR PATIENTS, OUR TEAM MEMBERS, AND OUR COMMUNITIES. THE EFFORTS TO MEASURE THE COST OF RESPONDING TO THE PANDEMIC ARE ONGOING. NOT CONSIDERING THE COST OF ALL REDEPLOYED ASSETS AND TEAM MEMBERS, THE DIRECT INCREMENTAL COSTS OF RESPONDING TO THE PANDEMIC IN 2020 ALONE IS NOW ESTIMATED TO EXCEED $80 MILLION. MEDICAL EDUCATION:HENRY FORD HOSPITAL DOCTORS TRAIN APPROXIMATELY 900 MEDICAL SCHOOL STUDENTS, 675 RESIDENTS AND FELLOWS ACROSS 50 DIFFERENT AREAS OF MEDICINE EVERY YEAR. HENRY FORD HOSPITAL RESIDENCY AND FELLOWSHIP PROGRAMS ARE NATIONALLY ACCREDITED M.D. (DOCTORATE OF MEDICINE) TRAINING PROGRAMS.HENRY FORD MACOMB HOSPITALS TRAIN APPROXIMATELY 130 RESIDENTS IN 8 ACCREDITED TRAINING PROGRAMS, SEVEN BY THE ACGME AND ONE BY CPME. 136460111 73299521 HFMH PROVIDES OUTPATIENT SERVICES AT MULTIPLE LOCATIONS THROUGHOUT THE NORTH EASTERN METROPOLITAN COMMUNITIES OF DETROIT. IN TOTAL THIS REPRESENTED 733,733 TOTAL OUTPATIENT FACILITY VISITS DURING 2020. 25101446 16330245 HFMH OPERATES A LEVEL II EMERGENCY FACILITY. EMERGENCY SERVICES REPRESENTED 55,203 PATIENT VISITS DURING 2020. 46047163 32298051 OTHER PROGRAM SERVICES INCLUDE ANCILLARY SERVICES LOCATED WITHIN THE MEDICAL FACILITIES. 46047163 32298051 553251060 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 0 1 0 1 369 0 1 4115 1 0 0 0 0 0 0 0 0 0 0 X 14 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ROBIN DAMSCHRODER 3138768714 ONE FORD PLACE DETROIT MI 48202 WRIGHT L LASSITER III DIRECTOR-PRESIDENT 2.00 63.00 X X 0 3857524 56246 KATHLEEN L YAREMCHUK MD DIRECTOR/PHYSICIAN 1.00 61.00 X 0 925896 55019 LYNN FORD ALANDT DIRECTOR 1.00 3.00 X 0 0 0 BARRY G PORTER DIRECTOR 1.00 2.00 X 0 0 0 STEPHANIE W BERGERON DIRECTOR 1.00 3.00 X 0 0 0 DAVID J BREEN DIRECTOR-CHAIR 2.00 4.00 X X 0 0 0 SHARI L BURGESS DIRECTOR 1.00 2.00 X 0 0 0 DAVID M HEMPSTEAD DIRECTOR 1.00 3.00 X 0 0 0 MICHAEL S RAFFERTY DIRECTOR 1.00 2.00 X 0 0 0 CHARLES G MCCLURE JR DIRECTOR 1.00 3.00 X 0 0 0 LAWRENCE H SCHULTZ DIRECTOR 1.00 2.00 X 0 0 0 SANDRA E PIERCE DIRECTOR 1.00 3.00 X 0 0 0 JOSEPH J RICHARDSON JR DIRECTOR 1.00 3.00 X 0 0 0 EDGAR L VANN II DIRECTOR 1.00 3.00 X 0 0 0 ROBIN S DAMSCHRODER TREASURER 2.00 63.00 X 0 1276437 253972 MICHELLE JOHNSON TIDJANI ESQ SECRETARY 2.00 63.00 X 0 1012041 184055 MARJORIE A STATEN JD ASSISTANT SECRETARY 2.00 58.00 X 0 205420 12672 BARBARA W ROSSMANN CEO MACOMB HOSPITAL 60.00 1.00 X 1070414 0 50977 DENISE BROOKS-WILLIAMS CEO NORTH MARKET 30.00 30.00 X 0 959404 54057 TERRY A GOODBALIAN CFO NORTH MARKET 60.00 0.00 X 0 382003 56523 CHRISTOPHER MILBACK MD CMO 60.00 0.00 X 442054 0 37683 KENNETH A SCOTT DO PHYSICIAN 60.00 0.00 X 83906 968031 53939 MARK T RYAN DO PHYSICIAN 60.00 0.00 X 819048 117052 36027 RONALD LEVIN MD PHYSICIAN 60.00 0.00 X 282986 715101 51299 EDDIE EL-YUSSIF DO PHYSICIAN 60.00 0.00 X 79866 867328 55154 VINAY PAMPATI DO PHYSICIAN 60.00 0.00 X 50930 650336 50535 WILLIAM A CONWAY MD FORMER DIRECTOR/PHYSICIAN 0.00 60.00 X 0 945156 50205 2829204 12881729 1058363 238 1 1 0 ALLIANCE HEALTH PROFESSIONALS PLLC 133 S MAIN ST SUITE D MT CLEMENS MI 48043 PHYSICIAN SERVICES 18633664 ALLIANCE MANAGEMENT PARTNERS LLC 133 S MAIN ST SUITE D MT CLEMENS MI 48043 MANAGEMENT SERVICES 14762460 RONCELLI INC 6471 METRO PARKWAY STERLING HEIGHTS MI 48312 CONSTRUCTION 2040073 SELECT SPECIALTY HOSPITAL- MACOMB COUNTY 4714 OLD GETTYSBURG RD MECHANICSBURG PA 17055 DIETARY & HOUSEKEEPING SERVICES 1728404 PINNACLE CONTRACTING INC 111 GROVE PARK MT CLEMENS MI 48043 CONSTRUCTION 877568 55 312806 41337776 216727 41867309 HOSPITAL SERVICES 900099 431119230 431119230 OUTPATIENT SERVICES 621400 73299521 73299521 EMERGENCY SERVICES 900099 16330245 16330245 MEDICAL EDUCATION-GME 900099 9886313 9886313 22411738 22411738 553047047 9314271 9314271 793559 0 793559 793559 793559 174400 9234 165166 165166 165166 60862 312806 110054 -49192 -49192 66097 22528 43569 43569 CAFETERIA 900099 774445 774445 GIFT SHOP 453220 290874 290874 258336 258336 1323655 606505384 554535868 0 10102207 45133 45133 2123526 1058382 958968 106176 684455 684455 201217951 194541265 6676686 3883722 3736353 145348 2021 22606897 21749070 846061 11766 13831561 13306718 517645 7198 260997 22139 238858 48427992 47202703 1225116 173 164600 28712 135888 9041818 8638888 402929 1 524670 523497 1173 4496594 3788822 707772 61419 55326 6093 482015 462542 19473 5448738 5396596 51613 529 19599769 18453857 1145391 521 14338929 14338929 MEDICAL SUPPLIES 106676011 106676011 CORPORATE ALLOCATION 61195381 61157013 30912 7456 UNCOMPENSATED SERVICES 12720051 12720051 QAAP TAX 11400501 11400501 29870792 27264097 2554553 52142 569103522 553251060 15664479 187983 7214 6020 52042307 195643608 210220 229658 63181499 39849501 32500 0 11047073 13983237 2727322 2698136 399705462 211631230 190830176 188074232 67133687 75644038 136827 3 3 23137955 24760250 410349956 541025510 50488778 130661313 137371956 130970783 71978107 90070301 259838841 351702397 X 143251749 182416835 7259366 6906278 150511115 189323113 410349956 541025510 X 37401862 1410136 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7259366 523910 8829 885826 6906279 5616528 2160100 49690 566952 7259366 10403458 1427858 41385 6256173 5616528 9443231 1250290 47392 337455 10403458 7262962 2530063 85125 434919 9443231 0.34220 0.65780 0 0 11743199 11743199 248987965 111126680 137861285 1702894 1174050 528844 129729395 99330500 30398895 7542009 7542009 188074232 MALPRACTICE LIABILITY 27232379 CORPORATE RESERVE 7842235 WORKERS COMP LIABILITY 1549148 DEFERRED COMPENSATION 9005117 POST RETIREMENT BENEFITS 23388553 CURR OPERATING LEASE LIABILITY 3267345 OTHER NOTES PAYABLE 4936395 CURR FINANCE LEASE LIABILITY 345016 LT FINANCE LEASE LIABILITY 5418185 LT OPERATING LEASE LIABILITY 6487093 OPERATING LEASE A/P PAYMENT CLEARING 598835 90070301 X PART V, LINE 4: EARNINGS FROM THE ORGANIZATION'S ENDOWMENTS FUNDS ARE UTILIZED BASED ON THE NATURE OF THE SPECIFIC ASSOCIATED RESTRICTION. THESE PRIMARILY RELATE TO FUNDING INITIATIVES ASSOCIATED WITH SPECIFIC DISEASE CONDITIONS AND FURTHERING MEDICAL EDUCATION AND RESEARCH INITIATIVES. PART X, LINE 2: THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2020 AND 2019. MEDALLION EVENT 301968 244121 57847 102819 SHOWTIME 71700 68685 3015 7235 0 373668 312806 60862 110054 110054 -49192 66097 22528 1 1.00000 66097 22528 22528 43569 MI 1 0 1 0 1.00000 BARBARA BROWN SPECIAL EVENTS DEPT ONE FORD PLACE DETROIT MI 48202 0 0 1 1 X 1 X 250.000000000000 0 1 1 1 0 1 1 4162723 4162723 0.00730 111887815 78175172 33712643 0.05920 116050538 78175172 37875366 0.06650 1025066 46197 978869 0.00170 21056417 9886313 11170104 0.01960 14471536 13037841 1433695 0.00250 281144 281144 0.00050 162357 162357 0.00030 36996520 22970351 14026169 0.02460 153047058 101145523 51901535 0.09110 38181 38181 0.00010 114247 114247 0.00020 2109 2109 0.00000 17435 17435 0.00000 132 132 0.00000 172104 172104 0.00030 0 12720051 3180013 234208835 244400385 -10191550 X 1 1 2 1 HENRY FORD MACOMB HOSPITAL - CLINTON 15855 19 MILE ROAD CLINTON TOWNSHIP MI 48038 X X X X 2 HENRY FORD MACOMB HOSPITAL- MOUNT CLEMENS 215 NORTH AVENUE MOUNT CLEMENS MI 48043 X PSYCHIATRIC INPATIENT HENRY FORD MACOMB HOSPITAL-CLINTON TWP 1 0 0 1 X X X X X X X X X 19 1 1 0 1 X SEE LINE 10A BELOW X 1 19 1 HTTPS://WWW.HENRYFORD.COM/ABOUT/COMMUNITY-HEALTH/NEEDS-ASSESSMENT 0 1 X 250.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X 1 X 0 0 HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS 2 0 0 1 X X X X X X X X X 19 1 1 0 1 X SEE LINE 10A BELOW X 1 19 1 HTTPS://WWW.HENRYFORD.COM/ABOUT/COMMUNITY-HEALTH/NEEDS-ASSESSMENT 0 1 X 250.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X 1 X 0 0 HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 5: OUR METHODOLOGY FOR DATA COLLECTION INVOLVED REACHING OUT TO COMMUNITY EXPERTS AND OTHER MEMBERS OF COMMUNITY AGENCIES IN MACOMB COUNTY USING FOCUS GROUPS WHICH WERE CONDUCTED MARCH AND APRIL 2019. FOCUS GROUP PARTICIPANTS INCLUDED LEADERS FROM AGENCIES SUCH AS CARE OF SOUTHEASTERN MICHIGAN, MACOMB COUNTY OFFICE OF SUBSTANCE ABUSE, MACOMB COUNTY HEALTH DEPARTMENT, EASTERSEALS MICHIGAN AND MANY OTHERS. PARTICIPANTS HAD A WIDE RANGE OF EXPERTISE. FROM THEIR SURVEY RESPONSES WE GAINED INSIGHT INTO THE KINDS OF HEALTH ISSUES FACING OUR COMMUNITIES.OUR METHODOLOGY ALSO INCLUDED A WIDE VARIETY OF SECONDARY DATA SOURCES IN ADDITION TO RESULTS OBTAINED FROM SURVEY PARTICIPANTS IN WAYNE, OAKLAND, AND JACKSON COUNTIES. ADDITIONALLY, WE LOCATED STATE HEALTH NEEDS DATA FOR HFHS USING THE MICHIGAN BEHAVIORAL RISK FACTOR SURVEY AND MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES PROFILES AMONG OTHER SOURCES. DATA FROM THESE SOURCES CAN BE FOUND IN THE APPENDIX. HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 5: OUR METHODOLOGY FOR DATA COLLECTION INVOLVED REACHING OUT TO COMMUNITY EXPERTS AND OTHER MEMBERS OF COMMUNITY AGENCIES IN MACOMB COUNTY USING FOCUS GROUPS WHICH WERE CONDUCTED MARCH AND APRIL 2019. FOCUS GROUP PARTICIPANTS INCLUDED LEADERS FROM AGENCIES SUCH AS CARE OF SOUTHEASTERN MICHIGAN, MACOMB COUNTY OFFICE OF SUBSTANCE ABUSE, MACOMB COUNTY HEALTH DEPARTMENT, EASTERSEALS MICHIGAN AND MANY OTHERS. PARTICIPANTS HAD A WIDE RANGE OF EXPERTISE. FROM THEIR SURVEY RESPONSES WE GAINED INSIGHT INTO THE KINDS OF HEALTH ISSUES FACING OUR COMMUNITIES.OUR METHODOLOGY ALSO INCLUDED A WIDE VARIETY OF SECONDARY DATA SOURCES IN ADDITION TO RESULTS OBTAINED FROM SURVEY PARTICIPANTS IN WAYNE, OAKLAND, AND JACKSON COUNTIES. ADDITIONALLY, WE LOCATED STATE HEALTH NEEDS DATA FOR HFHS USING THE MICHIGAN BEHAVIORAL RISK FACTOR SURVEY AND MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES PROFILES, AMONG OTHER SOURCES. DATA FROM THESE SOURCES CAN BE FOUND IN THE APPENDIX. HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 6A: HENRY FORD HOSPITALHENRY FORD WYANDOTTE HOSPITALHENRY FORD WEST BLOOMFIELD HOSPITALHENRY FORD KINGSWOOD HOSPITALHENRY FORD ALLEGIANCE HEALTHHENRY FORD ALLEGIANCE SPECIALTY HOSPITALHENRY FORD COTTAGE HOSPITAL/MEDICAL CENTER HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 11: THE CHNA WAS CONDUCTED IN 2019 IN PARTNERSHIP WITH THE MACOMB COUNTY HEALTH DEPARTMENT AND THEIR COMMUNITY HEALTH IMPROVEMENT PLAN WORKGROUPS. SEVERAL SIGNIFICANT HEALTH NEEDS WITHIN THE SERVICE AREA OF HENRY FORD MACOMB HOSPITAL(HFMH) WERE IDENTIFIED. HEALTH NEEDS WERE PRIORITIZED BASED ON SEVERAL CRITERIA INCLUDING IMPORTANCE GIVEN TO HEALTH ISSUES BY FOCUS GROUP AND SURVEY PARTICIPANTS, STATISTICAL DATA FROM THE STATE OF MICHIGAN, AS WELL AS INPUT FROM HFHS AND COMMUNITY LEADERS. HENRY FORD MACOMB'S RESOURCES AND OVERALL ALIGNMENT WITH THE HENRY FORD HEALTH SYSTEM MISSION, VISION, GOALS AND STRATEGIC PRIORITIES WERE TAKEN INTO CONSIDERATION WHEN IDENTIFYING THE TOP THREE MOST SIGNIFICANT HEALTH ISSUES TO BE ADDRESSED: HEALTHY LIFESTYLES & DIABETES, SUBSTANCE ABUSE & MENTAL HEALTH AND HEART DISEASE. HENRY FORD MACOMB WILL FOCUS ON DEVELOPING AND SUPPORTING INITIATIVES AND MEASURE THEIR EFFECTIVENESS TO IMPROVE THESE HEALTH NEEDS. IN TERMS OF SIGNIFICANT HEALTH NEEDS THAT WILL NOT BE ADDRESSED, HENRY FORD MACOMB ACKNOWLEDGES THE WIDE RANGE OF HEALTH CONCERNS THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED IT COULD MOST EFFECTIVELY FOCUS ON THOSE HEALTH NEEDS THAT WERE DETERMINED TO BE MOST URGENT AND ESSENTIAL TO THE HEALTH OF THE COMMUNITY AS WELL AS WITHIN ITS ABILITY TO INFLUENCE. WHILE MOST OF THESE ADDITIONAL HEALTH ISSUES ARE CURRENTLY BEING ADDRESSED BY EXISTING PROGRAMS AND INITIATIVES OF HFM OR A PARTNER ORGANIZATION, HFM WILL NOT TAKE NEW OR SPECIFIC, ADDITIONAL ACTIONS RELATED TO THE FOLLOWING HEALTH NEEDS: KIDNEY DISEASE, FAMILY PLANNING, ASTHMA AND ALZHEIMER'S DISEASE. HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 11: THE CHNA WAS CONDUCTED IN 2019 IN PARTNERSHIP WITH THE MACOMB COUNTY HEALTH DEPARTMENT AND THEIR COMMUNITY HEALTH IMPROVEMENT PLAN WORKGROUPS. SEVERAL SIGNIFICANT HEALTH NEEDS WITHIN THE SERVICE AREA OF HENRY FORD MACOMB HOSPITAL (HFMH) WERE IDENTIFIED. HEALTH NEEDS WERE PRIORITIZED BASED ON SEVERAL CRITERIA INCLUDING IMPORTANCE GIVEN TO HEALTH ISSUES BY FOCUS GROUP AND SURVEY PARTICIPANTS, STATISTICAL DATA FROM THE STATE OF MICHIGAN, AS WELL AS INPUT FROM HFHS AND COMMUNITY LEADERS. HENRY FORD MACOMB'S RESOURCES AND OVERALL ALIGNMENT WITH THE HENRY FORD HEALTH SYSTEM MISSION, VISION, GOALS AND STRATEGIC PRIORITIES WERE TAKEN INTO CONSIDERATION WHEN IDENTIFYING THE TOP THREE MOST SIGNIFICANT HEALTH ISSUES TO BE ADDRESSED: HEALTHY LIFESTYLES & DIABETES, SUBSTANCE ABUSE & MENTAL HEALTH AND HEART DISEASE. HENRY FORD MACOMB WILL FOCUS ON DEVELOPING AND SUPPORTING INITIATIVES AND MEASURE THEIR EFFECTIVENESS TO IMPROVE THESE HEALTH NEEDS. IN TERMS OF SIGNIFICANT HEALTH NEEDS THAT WILL NOT BE ADDRESSED, HENRY FORD MACOMB ACKNOWLEDGES THE WIDE RANGE OF HEALTH CONCERNS THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED IT COULD MOST EFFECTIVELY FOCUS ON THOSE HEALTH NEEDS THAT WERE DETERMINED TO BE MOST URGENT AND ESSENTIAL TO THE HEALTH OF THE COMMUNITY AS WELL AS WITHIN ITS ABILITY TO INFLUENCE. WHILE MOST OF THESE ADDITIONAL HEALTH ISSUES ARE CURRENTLY BEING ADDRESSED BY EXISTING PROGRAMS AND INITIATIVES OF HFM OR A PARTNER ORGANIZATION, HFM WILL NOT TAKE NEW OR SPECIFIC, ADDITIONAL ACTIONS RELATED TO THE FOLLOWING HEALTH NEEDS: KIDNEY DISEASE, FAMILY PLANNING, ASTHMA AND ALZHEIMER'S DISEASE. HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 13B: HENRY FORD MACOMB HOSPITAL-CLINTON TOWNSHIP ADMINISTERS A PATIENT FINANCIAL ASSISTANCE POLICY DESIGNED TO PROVIDE FINANCIAL ASSISTANCE FOR UNINSURED PATIENTS AS WELL AS FOR INSURED PATIENTS WITH LIMITED RESOURCES. FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE SYSTEM OFFERS A DISCOUNTED RATE THAT DOES NOT EXCEED 138% OF MEDICARE PAYMENT RATES. INSURED PATIENTS WITH LIMITED FINANCIAL RESOURCES MAY QUALIFY FOR A DISCOUNT ON SELF-PAY BALANCES.PART V, SECTION B, LINE 22A:HENRY FORD MACOMB HOSPITAL-CLINTON TOWNSHIP ADMINISTERS A PATIENT FINANCIAL ASSISTANCE POLICY DESIGNED TO PROVIDE FINANCIAL ASSISTANCE FOR UNINSURED PATIENTS AS WELL AS FOR INSURED PATIENTS WITH LIMITED RESOURCES. FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE SYSTEM OFFERS A DISCOUNTED RATE THAT DOES NOT EXCEED 138% OF MEDICARE PAYMENT RATES. INSURED PATIENTS WITH LIMITED FINANCIAL RESOURCES MAY QUALIFY FOR A DISCOUNT ON SELF-PAY BALANCES. HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 13B: HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS ADMINISTERS A PATIENT FINANCIAL ASSISTANCE POLICY DESIGNED TO PROVIDE FINANCIAL ASSISTANCE FOR UNINSURED PATIENTS AS WELL AS FOR INSURED PATIENTS WITH LIMITED RESOURCES. FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE SYSTEM OFFERS A DISCOUNTED RATE THAT DOES NOT EXCEED 138% OF MEDICARE PAYMENT RATES. INSURED PATIENTS WITH LIMITED FINANCIAL RESOURCES MAY QUALIFY FOR A DISCOUNT ON SELF-PAY BALANCES. PART V, SECTION B, LINE 22A:HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS ADMINISTERS A PATIENT FINANCIAL ASSISTANCE POLICY DESIGNED TO PROVIDE FINANCIAL ASSISTANCE FOR UNINSURED PATIENTS AS WELL AS FOR INSURED PATIENTS WITH LIMITED RESOURCES. FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE SYSTEM OFFERS A DISCOUNTED RATE THAT DOES NOT EXCEED 138% OF MEDICARE PAYMENT RATES. INSURED PATIENTS WITH LIMITED FINANCIAL RESOURCES MAY QUALIFY FOR A DISCOUNT ON SELF-PAY BALANCES. 19 1 - HF MACOMB HEALTH CENTER-BRUCE TWP 80650 VAN DYKE BRUCE TOWNSHIP MI 48065 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 2 - HF MACOMB HLTH CENTER-CHESTERFIELD 30795 23 MILE ROAD CHESTERFIELD TOWNSHI MI 48047 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 3 - HF MACOMB HOSPITAL MEDICAL PAVILION 16151 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 4 - HF MACOMB HEALTH CENTER-FRASER 15717 15 MILE ROAD FRASER MI 48035 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 5 - HF MACOMB HEALTH CENTER-RICHMOND 67267 MAIN STREET RICHMOND MI 48062 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 6 - HF MACOMB SLEEP MEDICINE CENTER 43650 GARFIELD ROAD UNIT 103 CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 7 - HF MACOMB HEALTH CENTER-WASH TWP 12150 30 MILE ROAD WASHINGTON TOWNSHIP MI 48095 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 8 - HF MACOMB MEDICAL CENTER 15520 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 9 - HF MACOMB-CHESTERFIELD OBGYN 30795 23 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 10 - HF MACOMB MEDICAL CENTER 15400 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 11 - HF MACOMB-SHELBY OBGYN 51221 SCHOENHERR SHELBY TOWNSHIP MI 48315 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 12 - HF MACOMB-SHELBY FAMILY MED 49310 VAN DYKE SHELBY TOWNSHIP MI 48317 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 13 - HF MACOMB-SHELBY RHEUMATOLOGY 50505 SCHOENHERR-SUITE 175 SHELBY TOWNSHIP MI 48315 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 14 - HF MACOMB CENTER-CLINTON TWP 43411 GARFIELD ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 15 - HENRY FORD FAMILY MEDICINE-HALL ROAD 21250 HALL ROAD- SUITE 200 CLINTON TOWNSHIP MI 48039 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 16 - HFMH-PC CENTER FOR WOMENS HEALTH 17941 HALL ROAD MACOMB MI 48044 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 17 - HENRY FORD REHABILITATION-CLINTON TWP 16301 NINETEEN MILE ROAD CLINTON TOWNSHIP MI 48308 REHABILITATION SERVIES 18 - HENRY FORD REHABILITATION-WARREN 13251 E TEN MILE ROAD STE 400 WARREN MI 48089 REHABILITATION SERVIES 19 - HENRY FORD REHAB & SPORTS MED-FRASER 15595 15 MILE ROAD CLINTON TOWNSHIP MI 48035 REHABILITATION SERVIES PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $12,962,635 PART II, COMMUNITY BUILDING ACTIVITIES: HFMH BELIEVES THAT THE STRENGTH AND VITALITY OF A COMMUNITY HAS A SIGNIFICANT IMPACT ON THE BEHAVIORS OF ITS RESIDENTS AND THAT THERE IS DIRECT CORRELATION BETWEEN THE VIABILITY OF A COMMUNITY AND THE ATTITUDE OF ITS RESIDENTS TOWARD HEALTHIER BEHAVIORS. THEREFORE, HFMH INCLUDES IN ITS COMMITMENT TO COMMUNITY BENEFIT A FOCUS ON DIRECT INVOLVEMENT IN THE COMMUNITY TO BOTH IMPROVE THE ENVIRONMENT AND ENSURE THAT CRITICAL MESSAGES ON THE BENEFITS OF HEALTHIER BEHAVIORS ARE HEARD. HFMH LEADERS COLLABORATE WITH COMMUNITY TASK FORCES AND COALITIONS IN ADDRESSING THE NEEDS OF OUR SERVICE AREA. PART III, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE IS STATED BASE UPON GROSS CHARGES. PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE ORGANIZATION RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. AT SUCH POINT IN TIME THAT A BILLED SERVICE IS BELIEVED TO BE UNCOLLECTIBLE, THE RELATED RECEIVABLE IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ESTIMATES OF RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE RECEIVED.FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE ORGANIZATION'S PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION OFFERS A DISCOUNT OFF STANDARD RATES FOR SERVICES PROVIDED THAT RESULT IN NET CHARGES THAT DO NOT EXCEED 138% OF MEDICARE RATES. PART III, LINE 9B: SHOULD A PATIENT BE DEEMED ELIGIBLE FOR ASSISTANCE ANY COLLECTION EFFORTS ASSOCIATED WITH THE QUALIFYING SERVICE ARE SUSPENDED. IF THE PATIENT IS DETERMINED TO QUALIFY UNDER THE ORGANIZATION'S CHARITY CARE POLICY PRIOR TO BILLING, NO BILL IS EVER GENERATED AND THEREFORE THE ELEMENTS OF THE COLLECTION POLICY ARE NEVER INVOKED. WHEN THE DETERMINATION IS NOT MADE PRIOR TO BILLING, THE ORGANIZATION'S COLLECTION POLICY WOULD APPLY. THIS POLICY READS IN PART:- "PATIENTS WILL BE EVALUATED FOR THE SYSTEM'S PATIENT FINANCIAL ASSISTANCE PROGRAM"- "UNINSURED PATIENTS WILL BE GIVEN A DISCOUNT"- "UNDERINSURED PATIENTS MAY QUALIFY FOR DISCOUNTED SERVICES BASED UPON THEIR AGGREGATE HOUSEHOLD INCOME"- "THE ORGANIZATION WILL REVIEW THE PATIENTS'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS REQUESTED"- "LEGAL ACTION...MAY BE TAKEN...WHEN THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS TO MEET HIS OR HER OBLIGATION"- "THE ORGANIZATION WILL NOT FORCE THE SALE OR FORECLOSURE OF ANY PATIENT OR GUARANTOR'S PRIMARY RESIDENCE TO PAY AN OUTSTANDING MEDICAL BILL"- "THE ORGANIZATION WILL NOT...REQUIRE THE PATIENT OR RESPONSIBLE PARTY TO APPEAR IN COURT"- "THE ORGANIZATION WILL DIRECT THEIR COLLECTION AGENCIES TO FOLLOW THESE GUIDELINES" PART VI, LINE 2: HENRY FORD HEALTH SYSTEM (HFHS) CONSIDERS THE ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AS AN ESSENTIAL FUNCTION. HENRY FORD MACOMB HOSPITAL WAS ENCOMPASSED IN THE HFHS COMMUNITY HEALTH NEEDS ASSESSMENT. IT PROVIDES KEY INFORMATION REGARDING THE DEMOGRAPHICS AND MAJOR NEEDS OF THE COMMUNITIES SERVED, IT SUPPORTS THE PRIORITIZATION OF THE SERVICES MADE AVAILABLE, AND IT HELPS TARGET POPULATIONS WITH THE MOST VULNERABILITY TO HEALTH NEEDS SUCH AS THE POOR, UNINSURED, AS WELL AS VARIOUS OTHER POPULATIONS THAT MAY HAVE BEEN OVERLOOKED. THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO PROVIDES VALUABLE INFORMATION REGARDING OTHER ORGANIZATIONS SUPPORTING THE NEEDS WITHIN THE COMMUNITY SO PROGRAMS CAN BE COORDINATED AND LEVERAGED TO ENSURE THAT EVERY DOLLAR IS INVESTED WISELY.INTERNALLY THE COMMUNITY HEALTH ANCHOR COUNCIL ENTERPRISE (CHANCE) PROVIDES EXECUTIVE OVERSIGHT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR HENRY FORD HEALTH SYSTEM. THE CHNA WAS COMPLETED IN SEVERAL PHASES. THE FIRST PHASE INCLUDED DATA COLLECTION FROM A VARIETY OF PUBLIC AND PROPRIETARY SOURCES THAT PROVIDED INFORMATION AROUND POPULATION DEMOGRAPHICS, SOCIOECONOMIC DATA, HEALTH STATUS INDICATORS AS WELL AS SEVERAL OTHER DATA ELEMENTS. THE SECOND PHASE INVOLVED DEVELOPING AND DISTRIBUTING A KEY STAKEHOLDER SURVEY TO CAPTURE COMMUNITY ORGANIZATION AND COALITION INPUT AS TO MAJOR HEALTH NEEDS THEY BELIEVE SHOULD BE PRIORITIZED AND ADDRESSED IN THE FOUR-COUNTY AREA. THE THIRD PHASE INCORPORATED QUANTITATIVE AND QUALITATIVE DATA COLLECTED IN THE FIRST TWO PHASES AND BASED ON THIS INFORMATION IDENTIFIED PRIORITIES FOR HENRY FORD HEALTH SYSTEM TO ADDRESS WITHIN THE COMMUNITIES IT SERVES. THIS ASSESSMENT WAS PREPARED JOINTLY BY THE HFHS BUSINESS INTEGRITY SERVICES AND CORPORATE STRATEGIC PLANNING DEPARTMENTS, ALONG WITH THE OFFICE OF COMMUNITY HEALTH, EQUITY AND WELLNESS. RESULTS ARE BEING USED AS A FOUNDATION FOR PLANNING, DEVELOPING, AND REFINING HFHS'S FUTURE COMMUNITY SERVICES IN THE FOUR-COUNTY AREAS. RESULTS OF THIS ASSESSMENT HAVE BEEN REVIEWED WITH SEVERAL HENRY FORD HEALTH SYSTEM LEADERS, LEADING TO STRATEGIC AND IMPLEMENTATION PLAN MODIFICATIONS TO ALIGN STRATEGY WITH IDENTIFIED NEEDS PART VI, LINE 3: HFMH HAS VARIOUS APPROACHES TO TARGET AND INFORM RESIDENTS OF ITS COMMUNITIES ABOUT THE PROGRAMS AND SERVICES IT OFFERS. PROGRAMS WHERE WE PARTNER WITH ORGANIZATIONS WITH ESTABLISHED RELATIONSHIPS WITH THE INDIVIDUALS SUCH AS THROUGH COMMUNITY HEALTH CENTERS, THE PUBLIC SCHOOLS AND FAITH-BASED ORGANIZATIONS HAVE BEEN PARTICULARLY SUCCESSFUL. HFMH FOLLOWS THE HFHS PATIENT FINANCIAL ASSISTANCE POLICY. HFHS HAS A SINGULAR PATIENT FINANCIAL ASSISTANCE POLICY (PFAP). INDIVIDUALS WITHOUT ADEQUATE HEALTH INSURANCE COVERAGE MOST FREQUENTLY APPEAR IN OUR EMERGENCY ROOM FOR SERVICES, ALL PATIENTS ARE SEEN WITHOUT REGARD TO ABILITY TO PAY. INTAKE STAFF IS TRAINED WITH REGARD TO HOW TO APPROACH AND ENGAGE AN INDIVIDUAL WHEN THERE IS AN APPARENT LACK OF ADEQUATE HEALTH COVERAGE. THIS INCLUDES INFORMING THEM OF THE PROGRAMS OFFERED BY HFMH AS WELL AS OTHER COMMUNITY, LOCAL, STATE AND FEDERAL PROGRAMS OFFERING POTENTIAL SUPPORT. HFMH HAS DEDICATED STAFF RESPONSIBLE TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR SUPPORTIVE PROGRAMS AND ASSIST THEM WITH THE ENROLLMENT PROCESS. THERE ARE MANY REASONS WHY A PATIENT IN NEED OF FINANCIAL ASSISTANCE WITH THEIR MEDICAL CARE MAY NOT HAVE BEEN IDENTIFIED AT THE TIME OF THE CARE DELIVERY. PATIENT FINANCIAL SERVICE AND COLLECTION STAFFS ARE TRAINED TO RECOGNIZE THESE INDIVIDUALS AND PROVIDE THEM WITH ADVICE REGARDING THE VARIOUS OPTIONS AVAILABLE TO SUPPORT THEIR CARE NEEDS. PART VI, LINE 4: THE FOUR-COUNTY AREA INCLUDES THE COUNTIES OF WAYNE, OAKLAND, MACOMB, AND JACKSON WHICH ARE LOCATED IN SOUTHEASTERN AND SOUTHCENTRAL MICHIGAN AND ACCOUNT FOR 41% OF THE MICHIGAN POPULATION. WAYNE, OAKLAND, AND MACOMB (IN THAT ORDER) ARE THE MOST POPULATED COUNTIES IN MICHIGAN. JACKSON COUNTY IS MUCH SMALLER. OF THE NEARLY 4 MILLION RESIDENTS, APPROXIMATELY 51% OF THE POPULATION IS FEMALE. WITH REGARD TO RACE/ETHNICITY, THE FOUR-COUNTY AREA IS 64% WHITE, COMPARED TO A NATIONAL AVERAGE OF 60%. OF NOTE, THE FOUR-COUNTY AREA IS 24% BLACK, WHICH IS TWICE THE NATIONAL PERCENTAGE OF 12%. CONVERSELY, THE HISPANIC POPULATION (5.0%) IS A LITTLE UNDER ONE THIRD THE NATIONAL PERCENTAGE OF 18%.THE NUMBER OF FOUR-COUNTY RESIDENTS IS EXPECTED TO REMAIN FLAT OVER THE NEXT SEVERAL YEARS. WHEN EXAMINING AGE DISTRIBUTION, THE FOUR-COUNTY AREA HAS A COMPARABLE POPULATION TO THAT OF THE COUNTRY WITH 17% OF THE POPULATION ABOVE THE AGE OF 65. OF PARTICULAR INTEREST TO HEALTHCARE PROVIDERS IS THE AGING POPULATION OF THE FOUR-COUNTY AREA WITH THE 65-YEARS-OLD AND ABOVE POPULATION EXPECTED TO RISE BY 15% FROM 2019 TO 2024.WITH REGARDS TO EDUCATION, THE FOUR-COUNTY AREA HAS APPROXIMATELY 11% OF RESIDENTS WHO HAVE SOME HIGH SCHOOL EDUCATION OR LESS COMPARED TO THE NATIONAL AVERAGE OF 13%. FURTHER, 29% OF RESIDENTS HAVE A BACHELOR'S DEGREE OR GREATER, WHICH IS COMPARABLE TO THE NATIONAL AVERAGE. THE FOUR-COUNTY AREA IS DIVERSE IN POPULATION, RACE/ETHNICITY, ECONOMIC GROWTH AND DEVELOPMENT. THE AUTOMOTIVE INDUSTRY REMAINS THE LARGEST EMPLOYER IN THE REGION, BUT THE HEALTH CARE SECTOR IS REPRESENTED AMONG THE TOP EMPLOYERS IN THE REGION AS WELL. THE AVERAGE MEDIAN HOUSEHOLD INCOME WITHIN THE FOUR-COUNTY AREA ($56,240) IS SLIGHTLY LESS THAN THE NATIONAL AVERAGE ($57,652). WITHIN THE FOUR-COUNTY AREA, THE MEDIAN HOUSEHOLD INCOME IN OAKLAND COUNTY ($73,369) IS SIGNIFICANTLY HIGHER THAN WAYNE COUNTY ($43,702), JACKSON COUNTY ($49,715) AND MACOMB COUNTY ($58,175). AT THE ZIP CODE LEVEL, AVERAGE HOUSEHOLD INCOMES VARY SIGNIFICANTLY.LOWER HOUSEHOLD INCOMES NEGATIVELY IMPACT PURCHASING POWER, HEALTH INSURANCE COVERAGE, AND COSTS OF BASIC NECESSITIES. AS A RESULT, THE FOUR-COUNTY AREA'S SAFETY NETS, INCLUDING HEALTHCARE SYSTEMS, ARE BEING STRETCHED TO THE LIMIT. MICHIGAN RANKS 33RD IN THE COUNTRY FOR CHILDREN UNDER 18 IN FAMILIES BELOW THE POVERTY LEVEL, AT 19.3%, A 3% IMPROVEMENT FROM 2016. UNEMPLOYMENT IN MICHIGAN HAS DROPPED TO 4.6% IN 2018, WHICH IS SIMILAR TO THE NATIONAL AVERAGE AND A DECLINE OF 0.8% SINCE 2016 IN MICHIGAN. CONVERSELY, WITHIN THE FOUR-COUNTY AREA THE UNEMPLOYMENT RATE MATCHES THE NATIONAL AVERAGE OF 4% AND RANGES FROM 3.2% IN OAKLAND COUNTY TO 5.0% IN WAYNE COUNTY.THERE ARE KEY DEMOGRAPHIC DIFFERENCES BETWEEN THE RESIDENTS OF EACH COUNTY WITHIN THE FOUR-COUNTY AREA. FOR EXAMPLE, AGE, SEX, EDUCATION, AND INCOME DISTRIBUTION DIFFER FROM COUNTY TO COUNTY. IN ORDER TO INCREASE THE UTILITY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, IT IS IMPORTANT TO ANALYZE THE PROFILE(S) OF EACH OF THESE COUNTIES AT A MORE DETAILED LEVEL, SUCH AS ZIP CODES, SO THAT CERTAIN DIFFERENCES WITHIN THE AREA BECOME EVIDENT.ONE COMMUNITY IN PARTICULAR NEED OF ATTENTION IS THE CITY OF DETROIT. WHEN EXAMINING THE CITY OF DETROIT THE AVERAGE HOUSEHOLD INCOME IS $40,314, WHICH IS SIGNIFICANTLY LESS THAN AVERAGE HOUSEHOLD INCOME OF THE OVERALL FOUR-COUNTY AREA ($68,064). REGARDING EDUCATION, 23% OF RESIDENTS HAVE LESS THAN A HIGH SCHOOL EDUCATION AND ONLY 14% HAVE A BACHELOR'S DEGREE OR HIGHER. IN TERMS OF RACE/ETHNICITY, APPROXIMATELY 91% OF DETROIT IS COMPOSED OF A MINORITY POPULATION VERSUS 37% FOR THE FOUR-COUNTY AREA AS A WHOLE. THE DETROIT UNEMPLOYMENT RATE IS 7.9% (NOVEMBER 2018), DOWN FROM 11.5% IN SEPTEMBER 2015.WHEN LOOKING OUTSIDE OF THE CITY OF DETROIT, VARIOUS OTHER ZIP CODES IN THE FOUR-COUNTY AREA INDICATE SECTIONS OF THE REGION THAT HAVE LOWER INCOMES, LESS EDUCATION, AND ARE MORE RACIALLY AND ETHNICALLY DIVERSE. THE AVERAGE HOUSEHOLD INCOME OF THESE ZIP CODES RANGES FROM $29,486-$54,251, LOWER THAN THE FOUR-COUNTY SERVICE AREA. OVERALL, 17% OF RESIDENTS IN THESE ZIP CODES HAVE LESS THAN A HIGH SCHOOL EDUCATION COMPARED TO 11% FOR THE FOUR-COUNTY AREA. THESE TWENTY ZIP CODES HAVE A SLIGHTLY DIFFERENT PERCENTAGE OF RACIAL/ETHNIC MINORITIES AS COMPARED TO THE REST OF THE FOUR-COUNTY AREA. AS A WHOLE THESE ZIP CODES ARE COMPOSED OF 40% MINORITIES COMPARED TO 36% FOR THE FOUR-COUNTY AREA.AS A RESULT, THE CITY OF DETROIT AND ABOVE TWENTY ZIP CODES ARE OF PARTICULAR INTEREST IN PLANNING COMMUNITY NEEDS INITIATIVES WITHIN THE FOUR-COUNTY AREA. PART VI, LINE 5: HENRY FORD MACOMB HOSPITALS (HFMH) ARE PART OF HENRY FORD HEALTH SYSTEM, ONE OF THE NATION'S LARGEST INTEGRATED HEALTH DELIVERY SYSTEMS SERVING ALL OF SOUTHEASTERN MICHIGAN. THIS TAX RETURN REFLECTS ACTIVITIES OF THE CLINTON TOWNSHIP CAMPUS OF HFMH, WHICH INCLUDES APPROXIMATELY 400 INPATIENT BEDS WITH AN OPEN MEDICAL STAFF, A BEHAVIORAL HEALTH FACILITY, AS WELL AS SEVERAL OUTPATIENT LOCATIONS SERVING THE MACOMB COUNTY AREA OF MICHIGAN. HFMH IS GOVERNED BY A DEDICATED VOLUNTEER COMMUNITY BOARD AND IT PROVIDES ITS COMMUNITIES WITH A FULL RANGE OF CLINICAL SERVICES INCLUDING GENERAL MEDICINE, SURGERY, OBSTETRICS, PEDIATRICS, CARDIAC CARE, PHYSICAL AND REHABILITATION MEDICINE, AMBULATORY SURGERY, INPATIENT AND OUTPATIENT BEHAVIORAL SERVICES, AND 24 HOUR EMERGENCY CARE. PART VI, LINE 6: THE SYSTEM DEMONSTRATES ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY BY OPERATING EMERGENCY ROOMS OPEN TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK; PROVIDING FACILITIES FOR THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS; AND MAINTAINING RESEARCH FACILITIES FOR THE STUDY OF NEW DRUGS AND MEDICAL DEVICES THAT OFFER THE PROMISE OF IMPROVING HEALTH CARE. THE SYSTEM ALSO PROVIDES COMMUNITY HEALTH SERVICES, SUCH AS COMMUNITY EDUCATION AND OUTREACH IN THE FORM OF FREE OR LOW-COST CLINICS; HEALTH EDUCATION TELEVISION PROGRAMMING; DONATIONS FOR THE COMMUNITY; MULTIPLE HEALTH PROMOTION AND WELLNESS PROGRAMS, SUCH AS HEALTH SCREENING; AND VARIOUS COMMUNITY PROJECTS AND SUPPORT GROUPS. 0 CARE OF SOUTHEASTERN MICHIGAN 31900 UTICA ROAD FRASER MI 48026 382175274 501(C)(3) 6000 ORGANIZATIONAL SUPPORT MACOMB COUNTY PLANNING & ECONOMIC DEVELOPMENT 1 SOUTH MAIN STREET 7TH FLOOR MOUNT CLEMENS MI 48043 115 GOVERMENT 5000 ORGANIZATIONAL SUPPORT SOUTHEASTERN MICHIGAN HEALTH ASSOCIATION 3011 W GRAND BOULEVARD SUITE 200 DETROIT MI 48202 381671500 501(C)(3) 5000 ORGANIZATIONAL SUPPORT LEADERSHIP MACOMB INC 14460 LAKESIDE CIRCLE STE 220 STERLING HEIGHTS MI 48313 383551700 501(C)(3) 11000 ORGANIZATIONAL SUPPORT MACOMB COUNTY CHAMBER OF COMMERCE 28 FIRST STREET SUITE B MOUNT CLEMENS MI 48043 380855880 501(C)(6) 7800 ORGANIZATIONAL SUPPORT ADVANCING MACOMB FOUNDATION 25 NORTH MAIN STREET MOUNT CLEMENS MI 48043 462433176 501(C)(3) 5000 ORGANIZATIONAL SUPPORT CHALDEAN AMERICAN CHAMBER OF COMMERCE 30095 NORTHWESTERN HWY NO 101 FARMINGTON HILLS MI 48334 161657532 501(C)(6) 5333 ORGANIZATIONAL SUPPORT 4 3 X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 WRIGHT L LASSITER III DIRECTOR-PRESIDENT 0 1754642 0 1441274 0 661608 0 24441 0 31805 0 3913770 0 0 ROBIN S DAMSCHRODER TREASURER 0 830349 0 425346 0 20742 0 221611 0 32361 0 1530409 0 0 MICHELLE JOHNSON TIDJANI ESQ SECRETARY 0 705834 0 293497 0 12710 0 152227 0 31828 0 1196096 0 0 BARBARA W ROSSMANN CEO MACOMB HOSPITAL 560722 0 390690 0 119002 0 27291 0 23686 0 1121391 0 0 0 KENNETH A SCOTT DO PHYSICIAN 71050 838750 -25000 73568 37856 55713 5036 22630 2117 24156 91059 1014817 0 0 RONALD LEVIN MD PHYSICIAN 136805 523982 114281 31770 31900 159349 9529 16853 5891 19026 298406 750980 0 0 DENISE BROOKS-WILLIAMS CEO NORTH MARKET 0 574982 0 259375 0 125047 0 24441 0 29616 0 1013461 0 0 EDDIE EL-YUSSIF DO PHYSICIAN 66800 788085 -25000 23438 38066 55805 9851 15005 2475 27823 92192 910156 0 0 WILLIAM A CONWAY MD FORMER DIRECTOR/PHYSICIAN 0 454167 0 391846 0 99143 0 27291 0 22914 0 995361 0 0 KATHLEEN L YAREMCHUK MD DIRECTOR/PHYSICIAN 0 778560 0 127367 0 19969 0 27291 0 27728 0 980915 0 0 MARK T RYAN DO PHYSICIAN 778512 104005 33259 0 7277 13047 19454 4988 10339 1246 848841 123286 0 0 VINAY PAMPATI DO PHYSICIAN 50865 580912 0 19265 65 50159 7369 18554 2450 22162 60749 691052 0 0 CHRISTOPHER MILBACK MD CMO 356014 0 65408 0 20632 0 4275 0 33408 0 479737 0 0 0 TERRY A GOODBALIAN CFO NORTH MARKET 0 288542 0 80638 0 12823 0 25866 0 30657 0 438526 0 0 MARJORIE A STATEN JD ASSISTANT SECRETARY 0 167759 0 36162 0 1499 0 2978 0 9694 0 218092 0 0 PART I, LINE 1A IT IS THE ORGANIZATION'S POLICY TO PAY OR REIMBURSE EMPLOYEES FOR BONAFIDE BUSINESS TRAVEL BASED ON THE MOST COST EFFECTIVE MEANS AVAILABLE. GENERALLY, WHEN AIR TRAVEL IS INVOLVED THIS EQUATES TO COACH CLASS AIR FARE. UNDER CERTAIN CIRCUMSTANCES, SUCH AS WHEN COACH CLASS IS NOT AVAILABLE OR THE TRIP IS OF AN EXTENSIVE DURATION, SENIOR LEADERSHIP HAS APPROVED BUSINESS CLASS, FIRST CLASS OR CHARTER TRAVEL. IN SUCH CIRCUMSTANCES, THE TRAVEL IS CONSIDERED TO BE FOR A BONAFIDE BUSINESS PURPOSE; ACCORDINGLY NO TAXABLE INCOME IS REPORTED. NO QUALIFYING INDIVIDUALS RECEIVED PAID OR REIMBURSED FIRST CLASS TRAVEL DURING 2020. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PROGRAM THAT RESULTS IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP ALSO HAVE THE OPTION TO PARTICIPATE IN NON-QUALIFIED 457 BENEFIT PROGRAMS WHICH RESULTS IN REPORTABLE TAXABLE INCOME AS BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. IT IS AN ELEMENT OF THE PLAN DESIGN TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. SEE Q. 4B FOR THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS. PART I, LINE 4B SCH J, LINE 4B, PERSONS PARTICIPATING IN NONQUALIFIED RETIREMENT PLANS SEC 457(F) - SUPPLEMENTAL HFHS EXECUTIVE RETIREMENT PLAN (SERP) TAXABLE REPORTABLE VALUE OF 2020 ACCRUAL NON-VESTED 2020 DISTRIBUTIONS W-2 AMOUNTS PARTICIPANT BARBARA W. ROSSMANN 115,845 - - 115,845 MICHELLE JOHNSON TIDJANI - 128,499 - - WILLIAM A. CONWAY,M.D. 99,143 - - 99,143 WRIGHT L. LASSITER III 637,206 - - 637,206 DENISE BROOKS-WILLIAMS 105,525 - - 105,525 ROBIN DAMSCHRODER - 197,170 - - CONTRIBUTIONS TO SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2020 CONTRIBUTIONS 2020 CONTRIBUTIONS TAX GROSS-UP W-2 AMOUNTS BARBARA W. ROSSMANN 3,157 - - 3,157 RONALD LEVIN, M.D. - 19,500 469 19,969 MARK RYAN, M.D. 7,687 11,813 284 19,784 KENNETH A. SCOTT - 19,500 469 19,969 TERRY A. GOODBALIAN - 1,350 32 1,382 EDDIE EL-YUSSIF 1,594 17,906 431 19,931 WRIGHT L. LASSITER III 19,500 - - 19,500 VINAY PAMPATI, D.O. - 14,100 339 14,439 ROBIN S. DAMSCHRODER 19,500 - - 19,500 DENISE BROOKS-WILLIAMS 16,900 - - 16,900 MICHELLE JOHNSON TIDJANI 11,000 - - 11,000 KATHLEEN YAREMCHUK, M.D. - 19,500 469 19,969 CHRISTOPHER MILBACK, M.D. - 2,147 52 2,199 MARTIN E BEAULAC SEE BELOW 218894 SEE BELOW 0 ROSEMARY MINJEUR SEE BELOW 76654 SEE BELOW 0 RAYMOND J MINJEUR SEE BELOW 14928 SEE BELOW 0 JONATHAN E BEAULAC SEE BELOW 311003 SEE BELOW 0 KIRCO SEE BELOW 2939969 SEE BELOW 0 SCHEDULE L, PART IV - BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: MARTIN E. BEAULAC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/FORMER KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: ROSEMARY MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/FORMER KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: RAYMOND J. MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/FORMER KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: MARTIN E. BEAULAC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/FORMER KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: ROSEMARY MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/FORMER KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: RAYMOND J. MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/FORMER KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: JONATHAN E. BEAULAC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/FORMER KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: KIRCO(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER/BOARD MEMBER(C) AMOUNT OF TRANSACTION $ 2,939,969(D) DESCRIPTION OF TRANSACTION: CONSTRUCTION SERVICES PAID BY THE ORGANIZATION(A) NAME OF PERSON: ACADEMIC INTERNAL MEDICINE SPECIALISTS PLLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 480,349(D) DESCRIPTION OF TRANSACTION: PROVIDED PROFESSIONAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO(A) NAME OF PERSON: ALLIANCE HEALTH PROFESSIONALS, PLLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 18,112,664(D) DESCRIPTION OF TRANSACTION: PROVIDED PROFESSIONAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO(A) NAME OF PERSON: CARDIOVASCULAR CONSULTANTS P.C.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 102,317(D) DESCRIPTION OF TRANSACTION: PROVIDED CARDIOVASCULAR SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO(A) NAME OF PERSON: FERNDALE ELECTRIC CO., INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 110,992(D) DESCRIPTION OF TRANSACTION: PROVIDED ELECTRICAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NOA) NAME OF PERSON: PROFESSIONAL EMERGENCY CARE, PC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 286,466(D) DESCRIPTION OF TRANSACTION: PROVIDED PROFESSIONAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO(A) NAME OF PERSON: RONCELLI INC,(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 7,586,986(D) DESCRIPTION OF TRANSACTION: PROVIDED CONSTRUCTION SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO FORM 990, PART VI, SECTION A, LINE 2 DIRECTOR TO DIRECTOR BUSINESS RELATIONSHIP: MICHAEL RAFFERY AND SANDRA PIERCE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A TAX EXEMPT STOCK CORPORATION AND HENRY FORD HEALTH SYSTEM HOLDS ALL OF THE ISSUED AND OUTSTANDING SHARES OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE STOCK HOLDER OF THE ORGANIZATION, HFHS HOLDS THE RESERVE POWER TO APPROVE OR DISAPPROVE TRUSTEE APPOINTMENTS. FORM 990, PART VI, SECTION A, LINE 7B BASED ON THE ESTABLISHED RESERVE POWERS, CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) AND THE TAX DEPARTMENT OF HFHS PREPARES THE ORGANIZATION'S FORM 990. AS PART OF THE PREPARATION AND REVIEW PROCESS PRIOR TO FILING THE RETURN, THE FOLLOWING REVIEW PROCESS IS CONDUCTED: - REVIEW OF THE ENTIRE RETURN WITH THE HFHS AND ORGANIZATION'S SENIOR VICE PRESIDENT FINANCIAL OPERATIONS AND CHIEF FINANCIAL OFFICER, - REVIEW OF ALL COMPENSATION MATTERS AND DISCLOSURES WITH THE COMPENSATION COMMITTEE OF THE HFHS BOARD OF DIRECTORS - REVIEW OF THE RETURN WITH THE HFHS AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS, INCLUDING THE CEO AND COO - PROVIDE A COPY OF THE RETURN TO THE ORGANIZATION'S BOARD OF DIRECTORS FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO OVERSEES THE CONFLICT OF INTEREST PROCESS WITH REGARD TO THE ORGANIZATION. HFHS HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE HFHS CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS AND EMPLOYEES. ANNUALLY, DIRECTORS, EMPLOYEES OF A MANAGEMENT LEVEL, RESEARCHERS, AS WELL AS EMPLOYEES ASSOCIATED WITH PROCUREMENT, OR IN CERTAIN OTHER PREDEFINED ROLES MUST COMPLETE AN ANNUAL DISCLOSURE DESIGNED TO IDENTIFY ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. IT IS THE RESPONSIBILITY OF THE COMMITTEE TO REVIEW THESE DISCLOSURES AND DETERMINE THE NEED FOR ANY ACTION TO MANAGE THE POTENTIAL CONFLICT. THE COMMITTEE ANNUALLY REPORTS THE RESULTS OF ITS ACTIVITIES TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE HFHS BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO HAS RESPONSIBILITY TO OVERSEE THE COMPENSATION PRACTICES OF THE ORGANIZATION. HFHS HAS A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS CONSISTING OF ALL EXTERNAL DIRECTORS. THEY MEET PERIODICALLY THROUGHOUT THE YEAR. THEY ARE CHARGED WITH APPROVAL OF THE ORGANIZATION'S OVERALL COMPENSATION AND BENEFIT PROGRAMS AS WELL AS THE SPECIFIC REVIEW AND APPROVAL OF THE COMPENSATION OF CERTAIN EMPLOYEES INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THEY DIRECTLY ENGAGE AN INDEPENDENT COMPENSATION ADVISOR TO ASSIST WITH THIS PROCESS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE, UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS, AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTH CARE ORGANIZATIONS. THE REASONABLENESS OF COMPENSATION IS EVALUATED BASED UPON THESE AND OTHER FACTORS. THE COMMITTEE ALSO REVIEWS THE COMPENSATION DISCLOSURES TO BE MADE ON FORM 990 IN ADVANCE OF FILING. FORM 990, PART VI, SECTION C, LINE 19 IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION. AS A HOLDER OF TAX EXEMPT DEBT THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO A PUBLIC CLEARING HOUSE ON A QUARTERLY BASIS. PART IV, LINE 12 THE ORGANIZATION IS AN ELEMENT OF THE EXTERNAL AUDIT REPORT OBTAINED FOR THE CONSOLIDATED OPERATIONS OF HENRY FORD HEALTH SYSTEM. FORM 990, PART IV, LINE 24A, TAX-EXEMPT BOND ISSUE: THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM. THE ALLOCATED TAX-EXEMPT BOND LIABILITY OF THE ORGANIZATION IS REPORTED UNDER THE FORM 990, SCHEDULE K OF ITS PARENT, HENRY FORD HEALTH SYSTEM. SCHEDULE R, PART II, IDENTIFICATION OF OTHER RELATED ORGANIZATIONS THE ORGANIZATION HAS THE FOLLOWING OPERATING DIVISION THAT IS NOT A SEPARATE LEGAL ENTITY BUT HAS THEIR OWN UNIQUE ASSIGNED EIN. FINANCIAL INFORMATION RELATING TO THIS DIVISION IS INCLUDED IN THIS RETURN. -HENRY FORD MACOMB ANCILLARY SERVICES (47-3293378) SCHEDULE R, PART V, LINE 2, COLUMN C ALL TRANSACTIONS REPORTED ARE BASED ON CASH VALUE FORM 990, PART XI, LINE 9: MINIMUM PENSION LIABILITY ADJUSTMENT 1,410,136. INTERCOMPANY TRANSFER FORM 990 - PART XII - LINE 2C: HENRY FORD MACOMB HOSPITAL CORPORATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF HENRY FORD HEALTH SYSTEM. THE GOVERNING BODY OF HFHS HAS DELEGATED THE OVERSIGHT OF THE FINANCIAL STATEMENTS, INCLUDING THE CHOICE OF INDEPENDENT AUDITORS, TO ITS AUDIT COMMITTEE. FORM 5713 - INTERNATIONAL BOYCOTT ACTIVITY: A FORM 5713, INTERNATIONAL BOYCOTT REPORT, HAS BEEN FILED ON OUR BEHALF BY HENRY FORD HEALTH SYSTEM (PARENT OF OUR CONTROLLED GROUP). THE ORGANIZATION DID NOT ITSELF HAVE ANY ACTIVITIES ASSOCIATED WITH AN INTERNATIONAL BOYCOTT COUNTRY. FORM 990, PART VII: AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: MANY EXECUTIVE EMPLOYEES OF HFHS PROVIDE SERVICES TO MULTIPLE AFFILIATED ENTITIES. HENRY FORD HEALTH SYSTEM USES ESTIMATES FOR REPORTING AVERAGE HOURS PER WEEK IN ALL SECTIONS OF FORM 990. GENERALLY 60 HOURS ARE REPORTED FOR THE HOURS ASSOCIATED FOR THE ORGANIZATION THAT THE INDIVIDUAL HAS PRINCIPAL RESPONSIBILITY FOR. HOURS ASSOCIATED WITH OTHER HOSPITAL OR LARGER ORGANIZATIONS ARE REPORTED AT 5 PER WEEK AND FOR SMALLER ORGANIZATIONS 1 HOUR PER WEEK IS REPORTED. MERCY MOUNT CLEMENS REAL ESTATE LLC ONE FORD PLACE DETROIT MI 48202 382947657 REAL ESTATE MI 0 0 N/A HENRY FORD HEALTH SYSTEM ONE FORD PLACE DETROIT MI 48202 381357020 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 N/A 0 HENRY FORD WYANDOTTE HOSPITAL 2333 BIDDLE AVE WYANDOTTE MI 48192 382791823 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM FOUNDATION ONE FORD PLACE DETROIT MI 48202 237383042 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I HENRY FORD HEALTH SYSTEM 1 HEALTH ALLIANCE PLAN 2850 W GRAND BLVD DETROIT MI 48202 382242827 HEALTH MAINTENANCE ORGANIZATION MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HFII CORPORATION ONE FORD PLACE DETROIT MI 48202 900840304 SCIENTIFIC RESEARCH MI 501(C)(3) LINE 7 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM GOVERNMENT AFFAIRS SERVICES ONE FORD PLACE DETROIT MI 48202 464064067 ADVOCACY SERVICES FOR HFHS AND AFFILIATES MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HENRY FORD ALLEGIANCE HEALTH GROUP 205 N EAST AVENUE JACKSON MI 49201 382756428 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 12B, II HENRY FORD HEALTH SYSTEM 1 ALLEGIANCE HEALTH FOUNDATION 205 N EAST AVENUE JACKSON MI 49201 383607833 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I HENRY FORD ALLEGIANCE HEALTH GROUP 1 HOSPICE OF JACKSON DBA ALLEGIANCE HOSPICE 205 N EAST AVENUE JACKSON MI 49201 382336367 HOSPICE CARE MI 501(C)(3) LINE 7 HEALTHLINK 1 HEALTHLINK 205 N EAST AVENUE JACKSON MI 49201 382756425 HOME HEALTH CARE MI 501(C)(3) LINE 12A, I HENRY FORD ALLEGIANCE HEALTH GROUP 1 CARELINK OF JACKSON 110 NORTH ELM AVENUE JACKSON MI 49202 381218485 LONG TERM ACUTE CARE HOSPITAL MI 501(C)(3) LINE 3 HENRY FORD ALLEGIANCE HEALTH GROUP 1 WA FOOTE MEMORIAL HOSPITAL 205 N EAST AVENUE JACKSON MI 49201 382027689 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 HENRY FORD ALLEGIANCE HEALTH GROUP 1 THE CLARENCE S LIVINGOOD LECTURESHIP AND EDUCATION FUND 3031 WEST GRAND BOULEVARD NO 800 DETROIT MI 48202 382682321 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12B, II HENRY FORD HEALTH SYSTEM 1 NORTHWEST DETROIT DIALYSIS 30100 TELEGRAPH BINGHAM FARMS MI 48025 383232668 OPERATE DIALYSIS CLINIC MI HENRY FORD HEALTH SYSTEM N/A 0 0 MACOMB REGIONAL DIALYSIS CENTERS 16151 NINETEEN MILE RD CLINTON TOWNSHIP MI 48038 260423581 OPERATE DIALYSIS CLINICS MI HENRY FORD HEALTH SYSTEM N/A 0 0 FOOTE HEALTH CENTER ASSOCIATES 1100 E MICHIGAN AVENUE JACKSON MI 49201 383017711 LESSOR OF MEDICAL CONDOMINIUM MI HENRY FORD ALLEGIANCE HEALTH GROUP RELATED 0 0 HENRY FORD ELIJAH MCCOY CONDOMINIUM ASSOCIATION 1150 ELIJAH MCCOY DR DETROIT MI 48202 852144748 CONDOMINIUM ASSOCIATION MI HENRY FORD HEALTH SYSTEM C 1 FAIRLANE HEALTH SERVICES 30100 TELEGRAPH BINGHAM FARMS MI 48025 382565235 HEALTHCARE MANAGEMENT MI HENRY FORD HEALTH SYSTEM C 1 ALLIANCE HEALTH AND LIFE INSURANCE 2850 W GRAND BLVD DETROIT MI 48202 383291563 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 HAP PREFERRED INC 2850 W GRAND BLVD DETROIT MI 48202 382513504 PROVIDER NETWORK LEASING MI HEALTH ALLIANCE PLAN C 1 SHA REALTY INC ONE FORD PLACE DETROIT MI 48202 381378121 REAL ESTATE HOLDING MI HENRY FORD HEALTH SYSTEM FOUNDATION C 1 ONIKA INSURANCE LTD FIRST CARRIBEAN HOUSE GRAND CAYMAN CJ CAPTIVE INSURANCE CJ HENRY FORD HEALTH SYSTEM C 1 HENRY FORD PHYSICIAN NETWORK ONE FORD PLACE DETROIT MI 48202 320306774 PHYSICIAN NETWORK MI HENRY FORD HEALTH SYSTEM C 1 ADMINISTRATION SYSTEMS RESEARCH CORPORATION 2850 W GRAND BLVD DETROIT MI 48202 382651185 THIRD PARTY INSURANCE ADMINISTRATOR MI HEALTH ALLIANCE PLAN C 1 HAP EMPOWERED HEALTH PLAN INC 2850 W GRAND BLVD DETROIT MI 48202 383123777 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 HENRY FORD ALLEGIANCE PHARMACY 205 N EAST AVENUE JACKSON MI 49201 383370242 PHARMACY MI HENRY FORD ALLEGIANCE HEALTH GROUP C 1 0 0 0 1 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0 HEALTH ALLIANCE PLAN L 31218997 CASH VALUE HEALTH ALLIANCE PLAN M 27040 CASH VALUE ALLIANCE HEALTH AND LIFE INSURANCE M 1792433 CASH VALUE ONIKA INSURANCE LTD P 1687076 CASH VALUE ONIKA INSURANCE LTD Q 250142 CASH VALUE ALLIANCE HEALTH AND LIFE INSURANCE P 1792433 CASH VALUE HENRY FORD PHYSICIANS ACCOUNTABLE CARE ORG S 176370 CASH VALUE SCHEDULE R, PART V, LINE 1D & 1E: THE ORGANIZATION IS A MEMBER OF THE HENRY FORD HEALTH SYSTEM OBLIGATED GROUP. MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR OUTSTANDING OBLIGATIONS ISSUED UNDER THE 2016 HFHS BOND MASTER INDENTURE.