2020-07-08T15:38:47-05:00 2019-06-30 381357951 PLANTE & MORAN PLLC 600 E FRONT ST STE 300 TRAVERSE CITY MI 49686 990 2018-07-01 464088182 MIDMICHIGAN MEDICAL CENTER-WEST BRANCH MIDM 9893453660 2463 S M-30 WEST BRANCH MI 48661 KATHARINE KOHR CFO 9893453660 2020-06-22 1 DAVID LOWENTHAL P00378651 2319477800 2020-06-22 73.161.36.242 2020-06-22 12:38:38 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EBB51160BF2136090E0706D858221EDFD566B897 2018 2020-11-06 18:47:13Z RAY STOVER 2463 S M-30 WEST BRANCH MI 48661 52681740 0 X MIDMICHIGAN.ORG X 2013 MI THE MISSION OF MIDMICHIGAN MEDICAL CENTER-WEST BRANCH IS TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. 15 12 435 45 191541 182734 260 324057 11777833 51287839 84026 390102 156600 652988 12018719 52654986 3774 9670 0 0 4790247 21872741 0 0 0 7518415 34015357 12312436 55897768 -293717 -3242782 52202850 54613510 37828108 38446591 14374742 16166919 THE MISSION OF MIDMICHIGAN MEDICAL CENTER-WEST BRANCH IS TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. 0 0 43939908 9670 51287839 PROVIDED NURSING AND PROFESSIONAL SERVICES FOR ACUTE INPATIENTS, EMERGENCY, AND OUTPATIENTS IN A RURAL AREA DURING THE FISCAL YEAR ENDING JUNE 30, 2019. INPATIENT SERVICES WERE PROVIDED TO 2,236 PATIENTS TOTALING 7,729 DAYS OF CARE. 63,167 PATIENTS RECEIVED OUTPATIENT SERVICES, AND EMERGENCY ROOM VISITS TOTALED 14,738. 43939908 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 30 0 1 435 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 1 0 X KATHARINE KOHR 9893433228 2463 S M-30 WEST BRANCH MI 48661 J DANIEL STONEBACK CHAIRPERSON 10.00 2.00 X X 950 0 0 E ARNOLD ENGSTER SECRETARY 5.00 0.00 X X 700 0 0 JACQUIE KATTERMAN TREASURER 5.00 0.00 X X 350 0 0 JEFFREY GODFREY VICE-CHAIRPERSON 5.00 0.00 X X 550 0 0 ROBERT MCGRAIL PRESIDENT 40.00 10.00 X X 370281 0 38888 MARK WEBER MD TRUSTEE 2.00 0.00 X 0 0 0 ELIZABETH PESZKO TRUSTEE 2.00 0.00 X 400 0 0 EDWARD NAPIERALA TRUSTEE 2.00 0.00 X 300 0 0 KEVIN ELLIOTT TRUSTEE 2.00 0.00 X 450 0 0 ALAN BRUDER TRUSTEE 2.00 0.00 X 450 0 0 RICHARD BACHELDER TRUSTEE 2.00 0.00 X 550 0 0 PATSY HARDAWAY TRUSTEE 2.00 0.00 X 450 0 0 THOMAS KISH TRUSTEE 2.00 0.00 X 500 0 0 DIANE POSTLET-SLATTERY TRUSTEE 2.00 50.00 X 0 1005371 196197 GREGORY ROGERS TRUSTEE 2.00 50.00 X 0 668805 265423 FRANCINE PADGETT SECRETARY/TREASURER 2.00 50.00 X 0 560770 188336 KATHARINE KOHR CHIEF FINANCIAL OFFICER 40.00 10.00 X 244385 0 15231 NICOLE GILLETTE CHIEF NURSING OFFICER 40.00 2.00 X 183562 0 27077 JILL JENNINGS MD PHYSICIAN 40.00 0.00 X 137822 0 0 KENT ALLEN DIRECTOR HUMAN RESOURCES 40.00 0.00 X 141405 0 12153 LISA WARACK PHYSICIAN ASSISTANT 40.00 0.00 X 112179 0 7429 PETER WHYTE DIRECTOR INFORMATION TECHNOLOGY 40.00 0.00 X 114395 0 14494 THOMAS OESCH DIRECTOR IMAGING 40.00 0.00 X 102287 0 22406 1411966 2234946 787634 8 0 1 0 THREE RIVERS CORPORATION 3069 E VANTAGE POINT DR MIDLAND MI 48642 CONSTRUCTION 2296953 GREATER MIDLAND EMERGENCY PHYSICIANS PO BOX 2579 MIDLAND MI 48641 E.R. PHYSICIANS 1735880 PHARMACY SYSTEMS INC 5050 BRADENTON AVE DUBLIN OH 43017 PHARMACY STAFFING/MANAGEMENT 949213 PSI REHAB SERVICES 5050 BRADENTON AVE DUBLIN OH 43017 PHYS, OCC & SPEECH THERAPY 820024 COMPUTER PROGRAMS AND SYSTEMS INC 6600 WALL ST MOBILE AL 36695 SOFTWARE/HARDWARE MAINTENANCE 812029 20 324057 324057 PATIENT SERVICE REVENUE 621110 51132380 51132380 OTHER RELATED REVENUE 621110 155459 155459 51287839 405620 191541 214079 445440 0 445440 445440 445440 10273 963 0 26754 10273 -25791 -15518 -15518 CAFETERIA REVENUE 722210 207548 207548 207548 52654986 51287839 191541 851549 X 9670 9670 699143 699143 15616523 11646738 3969785 4372062 3496370 875692 1185013 950114 234899 68650 68650 9237233 8240025 997208 10460 10460 854405 685041 169364 46123 20121 26002 379346 379346 2993827 2405663 588164 154972 19174 135798 SUPPLIES 13833399 13240402 592997 REPAIRS & MAINTENANCE 2094626 1194765 899861 PROVISION FOR BAD DEBTS 1952791 1952791 QAAP PROVIDER TAXES 1390855 1390855 998670 79034 919636 55897768 43939908 11957860 0 1010733 2202619 9938434 10498019 3395017 3851960 602731 309031 2475408 402100 40803849 4418109 32146895 36385740 397819 1160685 640250 272128 323791 803000 0 52202850 54613510 3679683 4406876 2782367 2623234 12053256 11388589 19312802 20027892 37828108 38446591 X 14374742 16166919 14374742 16166919 52202850 54613510 X -3242782 431539 4603420 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1189302 16899 1206201 1192529 7573 10800 1189302 1173327 30402 11200 1192529 1166036 7440 29831 16950 13030 1173327 1134772 109518 27205 3000 102459 1166036 0.00000 0.00000 0.00000 0 0 1290000 1290000 22876294 1577908 21298386 320304 64999 255305 8448932 2109332 6339600 7868319 665870 7202449 36385740 COST REPORT SETTLEMENT PAYABLE 2592311 ACCRUED POST-RETIREMENT BENEFIT 8756380 PENSION OBLIGATION 6654035 ASBESTOS RETIREMENT OBLIGATION 665871 OTHER LONG TERM LIABILITIES 1359295 20027892 X PART X, LINE 2: MIDMICHIGAN HEALTH AND ALL SUBSIDIARIES, EXCEPT MHDA, MCCO, AND MIDMICHIGAN HEALTH PAIN MANAGEMENT, HAVE BEEN RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAXES UNDER PROVISIONS OF THE INTERNAL REVENUE CODE (IRC) SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN IRC SECTION 501(C)(3). ALL OF THESE EXEMPT ORGANIZATIONS ARE CLASSIFIED AS PUBLIC CHARITIES. MHDA IS EXEMPT FROM FEDERAL INCOME TAXES UNDER PROVISIONS OF IRC SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(2). MCCO IS A SINGLE-MEMBER LIMITED LIABILITY COMPANY, AND THE MAJORITY OF ITS ACTIVITY IS CONSIDERED EXEMPT FROM TAX SINCE IT IS CONDUCTED BY MIDMICHIGAN HEALTH. MIDMICHIGAN HEALTH PAIN MANAGEMENT IS A TWO-MEMBER FOR-PROFIT LIMITED LIABILITY COMPANY, IN WHICH MIDMICHIGAN HEALTH HOLDS A 51% MAJORITY INTEREST. MIDMICHIGAN HEALTH'S SHARE OF THIS INCOME IS CONSIDERED EXEMPT FROM TAX. MIDMICHIGAN HEALTH DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2019 AND 2018. 1 1 X 1 X 1 X 1 1 1 0 0 148526 148526 0.00280 9187643 6271268 2916375 0.05410 9336169 6271268 3064901 0.05690 25370 25370 0.00050 18850 18850 0.00030 3170 3170 0.00010 47390 47390 0.00090 9383559 6271268 3112291 0.05780 26 280 6373 6373 0.00010 1 464 464 0.00000 19 90 27166 27166 0.00050 2 20 6655 6655 0.00010 1 6960 6960 0.00010 1 435 435 0.00000 50 390 48053 48053 0.00080 0 1952791 330022 24743170 25966316 -1223146 X 1 1 1 1 MIDMICHIGAN MEDICAL CENTER-WEST BRANCH 2463 S M-30 WEST BRANCH MI 48661 MIDMICHIGAN.ORG 1060000046 X X X MIDMICHIGAN MEDICAL CENTER-WEST BRANCH 1 0 0 1 X X X X X X X X X 17 1 0 1 1 X HTTPS://TINYURL.COM/Y7Q22LQC X 1 17 1 HTTPS://TINYURL.COM/Y7Q22LQC 0 1 X 200.000000000000 250.000000000000 X X X X 1 1 X X X 1 X HTTPS://TINYURL.COM/YCE9OKRM X HTTPS://TINYURL.COM/YCE9OKRM X HTTPS://TINYURL.COM/YCE9OKRM X X X X X X 1 X 0 X X X X 1 X 0 0 MIDMICHIGAN MEDICAL CENTER-WEST BRANCH PART V, SECTION B, LINE 5: IN MAY 2016, MICHIGAN CENTER FOR RURAL HEALTH, WEST BRANCH REGIONAL MEDICAL CENTER AND DISTRICT HEALTH DEPARTMENT NO. 2 COLLABORATED TO DEVELOP AND DISTRIBUTE THE COMMUNITY HEALTH NEEDS ASSESSMENT. A PROCESS WAS DEVELOPED FOR THE AREA THAT PROVIDED CONSISTENT DATA COLLECTION, WHICH WOULD PROVIDE COUNTY AND REGIONAL AGGREGATION OF DATA. IN ADDITION TO THE LOCAL HOSPITAL PLANS AND ACTIVITIES, THIS PROCESS WOULD AFFORD GREATER IMPACT OF COUNTYWIDE AND REGIONAL PROJECTS AND INITIATIVES.DISTRIBUTION OF SURVEYS WAS INTENTIONALLY PLANNED TO INCLUDE INDIVIDUALS FROM VULNERABLE POPULATION GROUPS: SENIOR CITIZENS, UNDERRESOURCED FAMILIES, VETERANS, YOUTH AND WOMEN. DATA ANALYSIS INCLUDED CROSS TABULATION OF RESULTS FOR VULNERABLE POPULATIONS. HOSPITALS INVITED A VARIETY OF INDIVIDUALS THAT REPRESENTED MULTIPLE SECTORS OF INDUSTRY, AGE AND HEALTH CONDITIONS FOR THE FOCUS GROUP.SAMPLE/TARGET POPULATION: THE WEST BRANCH REGIONAL MEDICAL CENTER AND DISTRICT HEALTH DEPARTMENT NO 2 CHNA COLLABORATION MEMBERS DECIDED TO USE NON-PROBABILITY SAMPLING, COMBINING CONVENIENCE SAMPLING WITH PURPOSIVE (JUDGMENTAL) SAMPLING. IN A CONVENIENCE SAMPLE, RESPONDENTS CAN BE ANYONE WHO COMES INTO CONTACT WITH THE RESEARCHER OR HAS ACCESS TO THE SURVEY. THIS COULD RANGE FROM PEOPLE ON A STREET CORNER, IN A MALL OR THOSE WHO CAME ACROSS THE SURVEY ONLINE. SINCE EACH HOSPITAL USED THE SAME SURVEY METHODOLOGY, THE RESULTS CAN BE ANALYZED AND COMPARE. ALTHOUGH THE FINDINGS CANNOT BE GENERALIZED, THEY CAN POINT OUT COMMON NEEDS AND SOLUTIONS.FOCUS GROUPS WERE CONDUCTED IN A STANDARD FORMAT ACROSS THE TWO COUNTIES. THE FACILITATOR FOLLOWED A SCRIPT (SEE APPENDIX E) AND ENGAGED THE GROUP IN SEVERAL PROCEDURES, INCLUDING ASKING PARTICIPANTS TO REVIEW AND COMMENT ON A LIST OF POTENTIAL HEALTH CONCERNS THAT MAY AFFECT THE COMMUNITY AS A WHOLE, USING STICKY NOTES ON AN EASEL PAD OR WALL AND GROUP DISCUSSION/BRAINSTORMING. FOCUS GROUP NOTES WERE RECORDED AND CODED BY THE MICHIGAN CENTER FOR RURAL HEALTH (MCRH) WITH SUMMARIES PROVIDED FOR ANALYSIS. MIDMICHIGAN MEDICAL CENTER-WEST BRANCH PART V, SECTION B, LINE 6B: MICHIGAN CENTER FOR RURAL HEALTH AND DISTRICT HEALTH DEPARTMENT NO. 2 MIDMICHIGAN MEDICAL CENTER-WEST BRANCH PART V, SECTION B, LINE 11: A CHNA HELPS DIRECT RESOURCES TO THE ISSUES THAT HAVE THE GREATEST POTENTIAL FOR IMPROVING THE HEALTH OF THE COMMUNITY. SUCCESSFULLY ADDRESSING PRIORITY ISSUES INCREASES LIFE EXPECTANCY, IMPROVES QUALITY OF LIFE AND RESULTS IN A SAVINGS TO THE HEALTHCARE SYSTEM.WEST BRANCH REGIONAL MEDICAL CENTER BEGAN THE PRIORITIZATION PROCESS BY REVIEWING THE DATA DESCRIBED IN THE FINDINGS SECTION OF THE REPORT. THE IMPLEMENTATION MEETING INCLUDED APPROXIMATELY 30 PARTICIPANTS, WITH MEMBERS FROM THE FIRST FOCUS GROUP AND HOSPITAL EMPLOYEES (DEPARTMENT MANAGERS AND HOSPITAL LEADERSHIP). THE MEETING PARTICIPANTS ALSO REVIEWED THE LIST OF CONCERNS REVEALED IN FOCUS GROUPS. THE MEETING PARTICIPANTS USED A PRIORITIZATION PROCESS THAT INCLUDED ANALYSIS OF ISSUES LOCATED IN MULTIPLE DATA SOURCES. THE COMMUNITY HEALTH TEAM, MIDMICHIGAN HEALTH LEADERSHIP, POPULATION HEALTH TEAM, AND RESPECTIVE COMMUNITY GROUPS USED MICHIGAN STATE BENCHMARKS TO COMPARE THE DATA FOUND. WHEN UNACCEPTABLE HEALTH SURFACED FROM ANALYSIS OF QUALITATIVE DATA, AND/OR POOR PERFORMANCE OF QUANTITATIVE DATA THROUGH COMPARING LOCAL DATA AGAINST MICHIGAN STATE BENCHMARKS, AN AREA OF HEALTH CONCERN WAS DETERMINED.PRIORITY ISSUES FOR THE POPULATIONS SERVED BY MIDMICHIGAN MEDICAL CENTER - WEST BRANCH UNFOLDED IN THE CHNA REPORT. THE PRIORITY AREAS BASED UPON THE PRIORITIZED NEEDS IDENTIFIED IN THE CHNA AND REVIEWED BY THE MIDMICHIGAN MEDICAL CENTER - WEST BRANCH BOARD ON OCTOBER 22, 2018 FOLLOWS:1. SUBSTANCE USE. PROJECTS THAT ALIGN WITH REDUCING SUBSTANCE USE IN THE COMMUNITY.A. COLLABORATION WITH THE DRUG FREE COALITION TO DISSEMINATE SUBSTANCE USE MESSAGESB. THE LAUNCHING OF PROJECT ASSERT WITHIN THE MEDICAL CENTER'S EMERGENCY DEPARTMENT.C. PARTNERING WITH SCHOOLS TO EDUCATE ON THE DANGERS OF DRUG USE AND VAPING.D. IMPLEMENT PAIN MANAGEMENT GROUP TO WEST BRANCH THAT GUIDE ALTERNATIVES TO OPIOIDS.E. EDUCATION SESSIONS WITH LOCAL ORGANIZATIONS AND EMPLOYEES2. ACTIVE/HEALTHY LIFESTYLES: A. GO OUTSIDE! INITIATIVE TO LOWER OBESITY RATES IN CHILDREN THROUGH EDUCATION AND COLLABORATION WITH COMMUNITY PARTNERS TO INCREASE ACCESS OF FRUITS AND VEGETABLES AND IMPROVE PHYSICAL ACTIVITY.B. ACTIVITY PROGRAMS FOR COMMUNITY TO INITIATE REGULAR PHYSICAL ACTIVITY.C. HEALTHY LIFESTYLE INFORMATION DISSEMINATION THROUGH PROVIDER OFFICES.D. PARTNERSHIP WITH LOCAL SCHOOLS FOR PROGRAM AND EDUCATION IMPLEMENTATION.E. EDUCATION SESSIONS WITH LOCAL ORGANIZATIONS AND EMPLOYEES3. ACCESS TO CARE: A. INCREASE SERVICES AND HEALTH CARE PROVIDER RECRUITMENT EFFORTS. B. PROMOTE PUBLIC TRANSPORTATION WHILE COLLABORATING TO OFFER 24 HOUR TRANSPORTATION SERVICE.C. IMPLEMENTATION OF TELEMEDICINE IN THE SURROUNDING COMMUNITIES.A STRATEGIC PLAN WAS DEVELOPED FOR THE ABOVE PROJECTS AS WELL AS OTHERS THAT EACH CONTAIN GOALS AND OUTCOME MEASURES UPON WHICH WE WILL EVALUATE PROGRAMS TOWARD GOAL COMPLETION. . THE COMPLETED CHNA AND IMPLEMENTATION PLAN CAN BE ACCESSED BY THE PUBLIC ON THE MIDMICHIGAN HEALTH WEBSITE AT: HTTPS://WWW.MIDMICHIGAN.ORG/APP/FILES/PUBLIC/31449/CHNA-WEST-BRANCH.PDF.THE UNDERLYING PREMISE FOR EACH MIDMICHIGAN HEALTH SUBSIDIARY IS SHARED OWNERSHIP FOR COMMUNITY HEALTH. THE PLAN REFLECTS INPUT FROM DESIGNATED INDIVIDUALS IN EACH COMMUNITY INCLUSIVE OF, BUT NOT LIMITED TO, PUBLIC HEALTH EXPERTS, REPRESENTATIVES OF LOW-INCOME AND MEDICALLY UNDERSERVED POPULATIONS AND THOSE SUFFERING FROM CHRONIC DISEASE. THE BROADENED SCOPE FROM WHICH WE FUNCTION IS INHERENT IN THE STRATEGIES WHICH INCLUDE INTERNAL HEALTH IMPROVEMENT INITIATIVES OF MIDMICHIGAN MEDICAL CENTER - MIDLAND AND MIDMICHIGAN HEALTH, AS WELL AS COLLABORATIVE EFFORTS OF THE HOSPITAL WITH PUBLIC HEALTH, THE UNIVERSITY OF MICHIGAN AND OUR COMMUNITY PARTNERS.THE HOSPITAL DID NOT ADDRESS ALL NEEDS IDENTIFIED IN THE CHNA DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES TO THE PRIORITY NEEDS IDENTIFIED IN THE IMPLEMENTATION PLAN. PART V, SECTION B, LINES 16A, 16B, AND 16C: HTTPS://WWW.MIDMICHIGAN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/PATIENT-NOTICE-OF-FINANCIAL-AID/ PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,952,791. PART II, COMMUNITY BUILDING ACTIVITIES: MIDMICHIGAN MEDICAL CENTER-WEST BRANCH EMPLOYEES CONTRIBUTED MANY HOURS AS MEMBERS OF COMMUNITY BOARDS, CIVIC ORGANIZATIONS, ADVISORY COMMITTEES, COALITIONS AND WORK GROUPS. EXAMPLES INCLUDE PARTICIPATING IN STRATEGIC INITIATIVES FOR NON-PROFIT ORGANIZATIONS AND COALITIONS SUCH AS THE GREAT START COLLABORATIVE, OGEMAW COUNTY COUNCIL ON AGING, NORTHERN MICHIGAN VETERANS COALITION, COALITION OF HOPE, OGEMAW COUNTY TRUST AND ROSCOMMON COUNTY TRUST. FINANCIAL SUPPORT WAS PROVIDED FOR COMMUNITY SUPPORT ACTIVITIES THROUGH THE WEST BRANCH CHAMBER OF COMMERCE AND BOARD PARTICIPATION ON THE ECONOMIC DEVELOPMENT COMMITTEE IN WEST BRANCH. ENVIRONMENTAL IMPROVEMENTS WERE PROVIDED THROUGH THE BIOFEST PROGRAM, AND WORKING ALONGSIDE THE OPTIMIST CLUB, KIWANAS, OGEMAW COUNTY HABITAT FOR HUMANITY, AND WITHIN THE SCHOOLS FOR EDUCATION AND LEADERSHIP DEVELOPMENT. PHYSICAL IMPROVEMENTS AND HOUSING THROUGH VARIOUS JOB FAIRS, WEST BRANCH BUSINESS EXPO, TOLFREE WELLNESS PARK UPGRADES SUCH AS THE PARTNERSHIP WITH SAGINAW VALLEY STATE UNIVERSITY IN THE CONSTRUCTION AND UPKEEP OF THE COMMUNITY TEACHING GARDENS, COMMUNITY DOG PARK AND COMMUNITY/GROUP GARDENS WITHIN THE CITY OF WEST BRANCH. WORKFORCE DEVELOPMENT THROUGH WEST BRANCH-ROSE CITY SCHOOLS HEALTHCARE JOB SHADOWING PROGRAM, BIOFEST EDUCATION FOR ENGINEERING AND DESIGN CAREERS RELATING TO HEALTHCARE AND CLINICAL INSTRUCTION. MIDMICHIGAN MEDICAL CENTER WEST BRANCH IS A KEY PARTNER WITH THE UNITED WAY OF OGEMAW COUNTY, WHICH SUPPORTS THE WORK OF MANY NON-PROFIT AGENCIES IN OGEMAW COUNTY, INCLUDING 211 FIRST CALL FOR HELP, LOCAL YOUTH ORGANIZATIONS SUCH AS OPTIMIST AND KIWANAS, NEXT STEP PROGRAMS AND DISASTER RELIEF WITHIN OGEMAW COUNTY. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX. PART III, LINE 3: THE AMOUNT OF BAD DEBT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY WAS AS ESTIMATE. THIS AMOUNT WAS CALCULATED BY MULTIPLYING THE BAD DEBT EXPENSE BY 16.9%. THIS ESTIMATE IS BASED ON THE AREA POVERTY RATE AS REPORTED IN THE 2018 CENSUS STATISTICS. PART III, LINE 4: PATIENT ACCOOUNTS RECEIVABLEPATIENT ACCOUTNS RECEIVABLE ARE STATED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHER INSURERS TO WHICH MIDMICHIGAN HEALTH EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. MANAGEMENT PERIODICALLY REVIEWS THE ADEQUACY OF THE IMPLICIT PRICE CONCESSIONS (DURING 2019) OR THE ALLOWANCE FOR DOUBTFUL ACCOUNTS (DURING 2018) BASED ON HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, MIDMICHIGAN HEALTH ANALYZES CONTRACTUALLY DUE AMOUNTS AND IMPLICIT PRICE CONCESSIONS (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY) TO RECORD RECEIVABLES AT THEIR ESTIMATED NET REALIZABLE VALUE. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENT WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL). MIDMICHIGAN HEALTH RECORDS SIGNIFICANT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTORICAL EXPERIENCE.PATIENT FINANCIAL ASSISTANCEMIDMICHIGAN HEALTH ADMINISTERS A PATIENT FINANCIAL ASSISTNANT 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 MIDMICHIGAN HEALTH'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 FULL FINANCIAL ASSISTANCE, MIDMICHIGAN HEALTH OFFERS AN EXPLICIT PRICE CONCESSION OFF STANDARD RATES FOR SERVICES PROVIDED THAT RESULT IN NET CHARGES THAT DO NOT EXCEED TRADITIONAL MEDICARE PAYMENT RATES. MIDMICHIGAN HEALTH OFFERS A 40% DISCOUNT FOR ALL UNINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. THE DISCOUNT IS OFFERED REGARDLESS OF THE PATIENT'S ABILITY TO PAY. INSURED PATIENTS WITH LIMITED FINANCIAL RESOURCES MAY QUALIFY FOR FINANCIAL ASSISTANCE WITH DEDUCTIBLES, COINSURANCES, AND CO-PAYS. THE ACCOUNTS RECEIVABLE FROM PATIENT BALANCES REPRESENTED 46.5% AND 46.7% OF TOTAL ACCOUNTS RECEIVABLE AT JUNE 30, 2019 AND 2018 RESPECTIVELY. PART III, LINE 8: THE FOLLOWING COSTING METHOD OF COST TO CHARGE RATE IS USED: MEDICARE COSTS DIVIDED BY MEDICARE CHARGES. ANY SHORTFALLS CALCULATED ARE CONSIDERED TO BE COMMUNITY BENEFIT. PART III, LINE 9B: ANY PATIENT THAT IS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE RECEIVES PERSONAL ASSISTANCE AND SUPPORT IN OBTAINING THE INFORMATION NEEDED TO QUALIFY THEM FOR FULL OR PARTIAL DISCOUNTS DEPENDING ON THEIR INCOME LEVEL. IT IS, HOWEVER, THE PATIENT'S RESPONSIBILITY TO CONTACT THE PATIENT FINANCIAL COUNSELOR TO REQUEST AN APPLICATION FOR FINANCIAL ASSISTANCE. ATTEMPTS ARE ALSO MADE BY FINANCIAL ASSISTANCE PERSONNEL TO CONTACT ANY SELF PAY PATIENT IDENTIFIED TO DISCUSS PAYMENT OPTIONS AND DETERMINE IF THERE IS A NEED TO SEND THEM A FINANCIAL ASSISTANCE APPLICATION. BROCHURES ARE ALSO LOCATED THROUGHOUT THE HOSPITAL FOR THE PATIENT'S BENEFIT WHICH EXPLAIN THE FINANCIAL ASSISTANCE PROGRAM AND HOW TO APPLY. APPLICATIONS MAY ALSO BE DOWNLOADED FROM THE HOSPITAL'S WEBSITE. EVERY POSSIBLE ATTEMPT IS MADE TO HELP THE PATIENT RESOLVE THEIR ACCOUNT; HOWEVER, IF THE PATIENT DOES NOT FOLLOW THROUGH WITH THE APPLICATION PROCESS OR IS DENIED FINANCIAL ASSISTANCE, OR FAILS TO MAKE PAYMENT ON THEIR ACCOUNT, THE ACCOUNT WILL GO THROUGH THE SAME COLLECTION PROCESS AS ALL OTHER ACCOUNTS. PART VI, LINE 2: IN FY 19 MIDMICHIGAN HEALTH'S FOCUS ON IMPROVING THE HEALTH OF OUR COMMUNITIES WAS REFLECTED IN OUR MISSION, VALUES, AND VISION. WE PARTNERED WITH SCHOOLS, BUSINESSES AND HEALTH CARE AGENCIES TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITIES SERVED. OUR HOSPITAL BOARDS ARE COMPRISED OF COMMUNITY MEMBERS WHO PROVIDE INPUT INTO THE COMMUNITY ENDEAVORS WE INSTITUTE. ADDITIONALLY, WE PARTICIPATE IN COMMUNITY COLLABORATIVE PARTNERSHIPS FOR AREA NON-PROFITS WITH A FOCUS ON HEALTH LIKE SETON CANCER INSTITUTE, THE WEST BRANCH AREA COUNCIL ON AGING, COALITION OF HOPE, OGEMAW AND ROSCOMMON COUNTY TRUST, NORTHERN MICHIGAN CHILDREN'S ASSESSMENT CENTER, NORTHER MICHIGAN VETERANS COALITION AND THE TEN 16 RECOVERY NETWORK. WE ALSO PARTNER WITH THE MICHIGAN HEALTH INFORMATION ALLIANCE, INC., OR MIHIA, A DIVERSE GROUP OF STAKEHOLDERS COLLABORATING TOGETHER AS A NON-PROFIT ORGANIZATION TO IMPROVE HEALTH AND HEALTH DELIVERY IN CENTRAL MICHIGAN THROUGH PARTICIPATION IN A REGIONAL POPULATION HEALTH TEAM. THESE COMMUNITY COLLABORATIONS HELP TO BUILD A HEALTH CARE SYSTEM WHERE CONSUMERS, PROVIDERS AND PAYERS MAKE DECISIONS FOR BEST PRACTICE IN THE AREA SERVED. ADDITIONALLY, WE PARTNER ON NEEDED HEALTH INITIATIVES, WORKING WITH LOCAL PUBLIC HEALTH DEPARTMENTS AND HEALTH AND HUMAN SERVICE AGENCIES TO UNDERSTAND THE UNIQUE HEALTH NEEDS OF EACH OF OUR COMMUNITIES. THE COMMUNITY HEALTH SPECIALIST FOR MIDMICHIGAN MEDICAL CENTER WEST BRANCH IS AN ACTIVE MEMBER OF THE 2018-2021 MITHRIVE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT AND THE NORTHERN MICHIGAN CHILDREN'S ASSESSMENT CENTER. PART VI, LINE 3: IN FISCAL YEAR 2019, MIDMICHIGAN MEDICAL CENTER-WEST BRANCH PROVIDED FINANCIAL ASSISTANCE TO PATIENTS THAT MET ESTABLISHED INCOME, ASSET AND NEEDS CRITERIA. PATIENTS THAT FAILED TO SATISFY ESTABLISHED FINANCIAL ASSISTANCE CRITERIA WERE GIVEN AID IN OBTAINING FREE/LOW-COST HEALTH INSURANCE AND/OR HELP WITH ARRANGING A PAYMENT PLAN. MIDMICHIGAN HEALTH COMMUNITY HEALTH STAFF MADE A CONCENTRATED EFFORT THIS FISCAL YEAR TO CONNECT PEOPLE TO PHYSICIANS AND NEEDED HEALTH SERVICES. CONTACT INFORMATION FOR SERVICES WERE TAKEN TO EACH SCREENING AND COMMUNITY OUTREACH EVENT AND PROVIDED AT THE TIME OF PHYSICIAN APPOINTMENTS; WHEN SCHEDULING APPOINTMENTS OR INQUIRING ABOUT AN APPOINTMENT AT A COMMUNITY EVENT. THE PUBLIC IS MADE AWARE OF OUR FINANCIAL ASSISTANCE POLICY: - THROUGH BROCHURES AVAILABLE AT ALL MIDMICHIGAN MEDICAL CENTER-WEST BRANCH AND MIDMICHIGAN PHYSICIAN GROUP OFFICES, AS WELL AS THE EMERGENCY ROOM. - BY PATIENT ACCOUNTING COUNSELORS AND SOCIAL WORKERS, AND - ON THE PATIENT AND FINANCIAL ASSISTANCE PROGRAM WEBPAGE ON OUR WEBSITE (HTTPS://WWW.MIDMICHIGAN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/PATIENT-NOTICE-OF-FINANCIAL-AID/). PART VI, LINE 4: MIDMICHIGAN HEALTH IS A NON-PROFIT HEALTH SYSTEM, HEADQUARTERED IN MIDLAND, MICHIGAN, AFFILIATED WITH MICHIGAN MEDICINE, THE HEALTH CARE DIVISION OF THE UNIVERSITY OF MICHIGAN. MIDMICHIGAN HEALTH COVERS A 23-COUNTY REGION WITH MEDICAL CENTERS IN ALPENA, ALMA, CLARE, GLADWIN, MIDLAND, MT. PLEASANT AND WEST BRANCH. IN ADDITION TO ITS MEDICAL CENTERS, MIDMICHIGAN HEALTH ALSO OFFERS BOTH HOME HEALTH CARE AND PHYSICIAN SERVICES, AND HAS A STRONG COMMITMENT TO MEDICAL EDUCATION. MIDMICHIGAN PHYSICIANS GROUP PROVIDES URGENT CARE AND MEDICAL OFFICES IN MORE THAN 30 SPECIALTIES AND SUBSPECIALTIES INCLUDING CARDIOLOGY, HEMATOLOGY/ONCOLOGY, ORTHOPEDICS, VASCULAR SURGERY, FAMILY MEDICINE AND MORE. THE MIDMICHIGAN HEALTH FOUNDATION SUPPORTS PATIENTS AND FAMILIES SERVED BY MIDMICHIGAN HEALTH BY RAISING FUNDS FOR EQUIPMENT, SERVICES AND PROGRAMS. CURRENTLY, MIDMICHIGAN HAS MORE THAN 7,400 EMPLOYEES, VOLUNTEERS AND PHYSICIANS.MIDMICHIGAN MEDICAL CENTER - WEST BRANCH IS AN 88 LICENSED-BED ACUTE CARE FACILITY LOCATED ON 44 ACRES OF ROLLING COUNTRYSIDE IN NORTHEAST MICHIGAN. IT HAS THREE OPERATING SUITES, A 24-HOUR EMERGENCY DEPARTMENT AND A STATE-OF-THE-ART IMAGING DEPARTMENT. THE MEDICAL CENTER SERVES A BROAD REGION, WITH 30 ZIP CODES IN OGEMAW, OSCODA, ROSCOMMON, ARENAC AND IOSCO COUNTIES. MIDMICHIGAN MEDICAL CENTER WEST BRANCH HAS APPROXIMATELY 350 EMPLOYEES, 58 VOLUNTEERS, 25 ACTIVE STAFF PHYSICIANS, AS WELL AS 12 ASSOCIATE STAFF PHYSICIANS, 53 CONSULTING STAFF PHYSICIANS, 23 ALLIED HEALTH PROFESSIONALS AND 17 TELEMEDICINE PHYSICIANS.DEFINITION OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY: MIDMICHIGAN MEDICAL CENTER-WEST BRANCH IS LOCATED WITHIN WEST BRANCH, MICHIGAN. AS RURAL COMMUNITY HOSPITAL, MIDMICHIGAN MEDICAL CENTER-WEST BRANCH PROVIDES MEDICAL CARE TO OGEMAW, ARENAC, ROSCOMMON, IOSCO AND OSCODA COUNTIES; COMPRISED OF THE FOLLOWING 30 ZIP CODES: 48635 (LUPTON), 48654 (ROSE CITY), 48661 (WEST BRANCH), 48756 (PRESCOTT), 48761 (SOUTH BRANCH), 48610 (ALGER), 48658 (STANDISH), 48659 (STERLING), 48703 (AU GRES), 48749 (OMER), 48765 (TURNER) 48766 (TWINING), 48627 (HIGGINS LAKE), 48629 (HOUGHTON LAKE), 46830 (HOUGHTON LAKE HEIGHTS), 48651 (PRUDENVILLE), 48653 (ROSCOMMON), 48656 (SAINT HELEN), 48730 (EAST TAWAS), 48739 (HALE), 48743 (LONG LAKE) 48748 (NATIONAL CITY), 48750 (OSCODA), 48763 (TAWAS CITY), 48764 (TAWAS CITY), 48770 (WHITTEMORE), 48619 (COMINS), 48621 (FAIRVIEW), 48636 (LUZERNE) AND 48647 (MIO)COMMUNITY CHARACTERISTICS AND DEMOGRAPHICS AVERAGE TOTALS ACROSS ALL COMMUNITIES: TOTAL POPULATION - 93,234GEOGRAPHIC SERVICE AREA - RURAL AGE DEMOGRAPHICSPERSONS UNDER 5 YEARS - 4.6%PERSONS UNDER 18 YEARS - 17.5%PERSONS 65 YEARS & OLDER - 28%ETHNICITY & RACE DEMOGRAPHICSWHITE - 96.2% BLACK - 0.5%NATIVE AMERICAN - 1.0%ASIAN - 0.6%NATIVE HAWAIIAN/PACIFIC ISLANDER - 0.1%TWO OR MORE RACES - 1.6%HISPANIC/ LATINO - 2.1%SOCIOECONOMIC DEMOGRAPHICSMEDIAN HOUSEHOLD INCOME - $37,237PERSONS IN POVERTY - 16.9%CHILDREN IN POVERTY - 35%PEOPLE 65+ LIVING BELOW POVERTY - 7.9%ACCESS TO CARE DEMOGRAPHICSUNINSURED ADULTS - 15%UNINSURED CHILDREN - 5.6%% OF MEDICAID RECIPIENTS - 22.4%% OF MEDICARE RECIPIENTS - 37.8%MEDICALLY UNDERSERVED DESIGNATION - YES# OF NON-MIDMICHIGAN HEALTH HOSPITAL SERVING THE COMMUNITY - 2NOTE: THE SOURCES FOR EACH METRIC MENTIONED IN THE CHART ABOVE CAN BE FOUND IN MIDMICHIGAN MEDICAL CENTER-WEST BRANCH'S 2018 COMMUNITY HEALTH NEEDS ASSESSMENT AVAILABLE AT: HTTPS://WWW.MIDMICHIGAN.ORG/APP/FILES/PUBLIC/31449/CHNA-WEST-BRANCH.PDF PART VI, LINE 5: EACH MIDMICHIGAN HEALTH SUBSIDIARY ADDRESSES HEALTH AND WELLBEING WITHIN THE COMMUNITIES SERVED. FOUR PORTFOLIOS OF POPULATION HEALTH ARE ADDRESSED: PHYSICAL AND BEHAVIORAL HEALTH; SOCIAL AND SPIRITUAL WELL-BEING; COMMUNITY HEALTH AND WELL-BEING AND COMMUNITIES OF SOLUTIONS. PORTFOLIO ONE AIMS AT IMPROVING THE PHYSICAL AND OR MENTAL HEALTH OF INDIVIDUALS SERVED THROUGH QUALITY MEASUREMENT AND PERFORMANCE IMPROVEMENT INITIATIVES, AS WELL AS THE USE OF PATIENT CARE NAVIGATORS AND CARE MANAGERS IN PRIMARY CARE OFFICES AND INITIATIVES TO IMPROVE ACCESS TO CARE, LIKE INCREASED OPPORTUNITIES FOR TELEMEDICINE. PORTFOLIO TWO ADDRESSES SOCIAL AND SPIRITUAL DRIVERS OF HEALTH AND WELL-BEING, MANY OF WHICH ARE IDENTIFIED THROUGH SYSTEMATIC EVALUATION OF SOCIAL DETERMINANTS OF HEALTH COMPLETED AT SEVERAL POINTS OF CONTACT INCLUDING: NEW PATIENTS, EMERGENCY DEPARTMENT PATIENTS, ANNUAL PHYSICALS, POST HOSPITAL DISCHARGES, REFERRALS TO CARE MANAGERS AND PATIENTS WHO CONSISTENTLY DO NOT SHOW UP FOR APPOINTMENTS TO DETERMINE WHAT BARRIERS THEY MAY BE ENCOUNTERING. PORTFOLIO THREE ACTIVITIES AIM TO IMPROVE COMMUNITY HEALTH AND WELL-BEING BY COMMUNITY PARTNERS WORKING TOGETHER TO ASSESS DATA, DETERMINE FOCUS AREAS OF HEALTH AND POOL STAFF AND RESOURCES TO IMPLEMENT HEALTH IMPROVEMENT PROJECTS LIKE INCREASING PHYSICAL ACTIVITY, ACCESS TO HEALTHY FOODS AND REDUCING OPIOID USAGE. PORTFOLIO FOUR ADDRESSES OUR ROLE AS AN ANCHOR INSTITUTION. WE ARE THE MAJOR EMPLOYER IN EACH COMMUNITY WE SERVE AND AS SUCH, WE PROMOTE HEALTH AND WELL-BEING BY CAPITALIZING ON COMMUNITY ASSETS AND ACTIVE ENGAGEMENT WITH REGIONAL INITIATIVES. A TOTAL OF $67,631.15 IN COMMUNITY BENEFITS WAS PROVIDED BY MIDMICHIGAN MEDICAL CENTER WEST BRANCH IN 2019 THROUGH COMMUNITY EDUCATION PROGRAMS, SCREENINGS, SPECIAL EVENTS AND HEALTH EXPERTISE, INCLUDING INSURANCE UNDER-REIMBURSEMENTS AND SERVICES FOR THOSE WHO COULD NOT PAY. OVER $90 MILLION COMMUNITY BENEFITS WERE PROVIDED BY MIDMICHIGAN HEALTH TO THE COMMUNITIES IT SERVES.IN FY 2019, 70 PERSONS WERE REACHED WITH GENERAL COMMUNITY EDUCATION TOPICS LIKE DIABETES EDUCATION AND NUTRITION/WEIGHT MANAGEMENT. 120 INDIVIDUALS WERE REACHED IN DIABETES SUPPORT GROUPS OFFERED BY MIDMICHIGAN MEDICAL CENTER-WEST BRANCH. THERE WERE 75 INDIVIDUALS WHO PARTICIPATED IN MENTAL HEALTH/DEPRESSION EDUCATION OFFERINGS. MORE THAN 1,035 INDIVIDUALS PARTICIPATED IN OUR GO OUTSIDE! PROGRAM THAT OFFERS SCREENINGS FOR HEART RISK, OVERWEIGHT AND OBESITY AND ALSO OFFERS GROUP AND ONE-ON-ONE EDUCATION SESSIONS THE REDUCE CHILDHOOD OBESITY.176 INDIVIDUALS PARTICIPATED IN MIDMICHIGAN MEDICAL CENTER-WEST BRANCH'S FREE SPORTS PHYSICAL DAY THAT PROVIDED SCREENING FROM SEVERAL PROVIDERS AND TESTED FOR POTENTIALLY SERIOUS HEALTH CONCERNS SUCH CVD RISK FACTORS, SCOLIOSIS, VISION, HEARING, HERNIA AND BALANCE TESTS.MIDMICHIGAN MEDICAL CENTER-WEST BRANCH EMPLOYEES VOLUNTEERED FOR HEALTH FAIRS TO ENCOURAGE AND TEACH CHILDREN ABOUT REGULAR EXERCISE, GOOD NUTRITION AND MAINTAINING A HEALTHY WEIGHT. MIDMICHIGAN HEALTH COLLABORATED WITH SCHOOLS WITH MANY OF THESE PROGRAMS. 1 MICHIGAN HEALTH FOUNDATION 400 WELLNESS DRIVE MIDLAND MI 48670 812813405 501(C)(3) 7807 DONATION - MATCHING EMPLOYEE CONTRIBUTIONS 1 0 PART I, LINE 2: THE MICHIGAH HEALTH FOUNDATION USES FUNDS ONLY IN SUPPORT OF OTHER MIDMICHIGAN HEALTH ENTITES IN ACCORDANCE WITH THEIR CHARITABLE MISSION AS A 501(C)(3). X X 0 0 0 0 0 0 0 0 0 ROBERT MCGRAIL PRESIDENT 251519 0 0 0 118762 0 23998 0 14890 0 409169 0 0 0 DIANE POSTLET-SLATTERY TRUSTEE 0 780909 0 219617 0 4845 0 175750 0 20447 0 1201568 0 0 GREGORY ROGERS TRUSTEE 0 515014 0 124421 0 29370 0 240380 0 25043 0 934228 0 0 FRANCINE PADGETT SECRETARY/TREASURER 0 446928 0 89748 0 24094 0 173907 0 14429 0 749106 0 0 KATHARINE KOHR CHIEF FINANCIAL OFFICER 196829 0 0 0 47556 0 8890 0 6341 0 259616 0 0 0 NICOLE GILLETTE CHIEF NURSING OFFICER 152740 0 0 0 30822 0 8607 0 18470 0 210639 0 0 0 KENT ALLEN DIRECTOR HUMAN RESOURCES 114284 0 0 0 27121 0 5812 0 6341 0 153558 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 MIDMICHIGAN HEALTH IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE MIDMICHIGAN HEALTH BOARD SHALL ELECT INDIVIDUALS TO FILL EACH OPEN SEAT ON THE SUBSIDIARY BOARD CREATED BY THE EXPIRATION OF AN AT LARGE DIRECTOR'S TERM. FORM 990, PART VI, SECTION A, LINE 7B THE MIDMICHIGAN HEALTH BOARD SHALL HAVE THE RIGHT TO VOTE ON ALL MATTERS REQUIRED TO BE SUBMITTED TO A VOTE OF THE MEMBER(S) OF A MICHIGAN NONPROFIT CORPORATION UNDER APPLICABLE LAW. IN ADDITION, THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE EXCLUSIVELY RESERVED TO THE MIDMICHIGAN HEALTH BOARD: A. APPROVE ANY CHANGE IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; B. APPROVE ANY SALE, CONVEYANCES, ASSIGNMENTS, TRANSFERS, ALIENATIONS, PLEDGES OR OTHER ENCUMBRANCES OF ANY CORPORATION'S ASSETS, EXCEPT FOR SUCH TRANSACTION OR TRANSACTIONS OCCURRING IN THE ORDINARY COURSE OF BUSINESS VALUED, EITHER INDIVIDUALLY OR IN THE AGGREGATE, AT LESS THAN $100,000 OR WHICH HAVE BEEN APPROVED AS PART OF THE CORPORATION'S CAPITAL PLAN; C. APPROVE THE ANNUAL BUDGET AND ANY UNBUDGETED CAPITAL EXPENDITURES IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE MIDMICHIGAN HEALTH BOARD FOR SOLE MEMBER'S OTHER HOSPITALS, (THE CURRENT THRESHOLDS ARE AS FOLLOWS: ANNUAL UNBUDGETED OPERATING EXPENSES IN EXCESS OF $500,000 REQUIRE THE SOLE MEMBER'S CEO'S OR HIS OR HER DESIGNEE'S APPROVAL; CAPITAL EXPENDITURES GREATER THAN $1,000,000 REQUIRE APPROVAL OF THE CORPORATION BOARD AND THE SOLE MEMBER CORPORATE FINANCE COMMITTEE, AND CAPITAL EXPENDITURES GREATER THAN $5,000,000 REQUIRE APPROVAL BY THE MIDMICHIGAN HEALTH BOARD IN ADDITION TO RECEIVING APPROVAL OF THE CORPORATION BOARD AND THE SOLE MEMBER CORPORATE FINANCE COMMITTEE); D. GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; E. THE INCURRENCE BY THE CORPORATION OF ANY BORROWED MONEY; F. ANY LEASE OBLIGATION THAT IS OUTSIDE OF THE ORDINARY COURSE OF BUSINESS OR THAT IS IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY SOLE MEMBER FOR ITS OTHER HOSPITAL (WHICH AMOUNT AS OF FEBRUARY 2018, IS $500,000 IN AGGREGATE FOR THE ENTIRE LEASE TERM); AND G. ANY CORPORATE REORGANIZATION, MERGER, CONSOLIDATION, JOINT VENTURE, AFFILIATION, PARTNERSHIP, OR RISK-BASED OR COST-SHARING ARRANGEMENTS. FORM 990, PART VI, SECTION B, LINE 11B AFTER PREPARATION OF THE RETURN BY A THIRD PARTY, IT WILL BE REVIEWED BY THE CEO, CFO, AND THE CORPORATE TAX DEPARTMENT. THE BOARD WILL BE NOTIFIED THAT A COPY OF THE FORM 990 IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST FORM IS COMPLETED ANNUALLY AND MONITORED FOR COMPLIANCE BY ADMINISTRATION AND THE CHAIRMAN OF THE BOARD. WHEN A CONFLICT EXISTS, THE BOARD MEMBER WITH THE CONFLICT IS ALLOWED TO DISCUSS THE MATTER AT HAND, BUT IS NOT ALLOWED TO VOTE ON ANY CONFLICTED ITEM. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS SET AT MARKET VALUE, BASED ON MARKET STUDIES DONE BY A COMMITTEE OF THE BOARD OF DIRECTORS. THIS PROCESS WAS LAST UNDERTAKEN IN JULY 2017. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 8,240,025. MANAGEMENT AND GENERAL EXPENSES 997,208. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,237,233. FORM 990, PART XI, LINE 9: ADJUSTMENT DUE TO AFFILIATION -1,235,995. PENSION-RELATED CHANGES -2,004,678. OPEB-RELATED CHANGES -1,282,907. EQUITY TRANSFER 9,127,000. MIDMICHIGAN HEALTH 4000 WELLNESS DR MIDLAND MI 48670 382459948 SUPPORT MI 501(C)(3) LINE 12A, I N/A 0 MIDMICHIGAN MEDICAL CENTER - GRATIOT 300 E WARWICK DR ALMA MI 48801 381437919 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 MIDMICHIGAN MEDICAL CENTER - CLARE 703 N MCEWAN ST CLARE MI 48617 381518643 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 MIDMICHIGAN MEDICAL CENTER - GLADWIN 515 QUARTER ST GLADWIN MI 48624 386020434 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 MIDMICHIGAN MEDICAL CENTER - ALPENA 1501 W CHISHOLM ST ALPENA MI 49707 386000029 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 MIDMICHIGAN VNA DBA MIDMICHIGAN HOME CARE 3007 N SAGINAW RD MIDLAND MI 48640 381459397 HOME CARE MI 501(C)(3) LINE 10 MIDMICHIGAN HEALTH 1 MIDMICHIGAN PHYSICIANS GROUP 2620 W SUGNET RD MIDLAND MI 48640 383317788 MEDICAL OFFICE MI 501(C)(3) LINE 12A, I MIDMICHIGAN HEALTH 1 MIDMICHIGAN HEALTH DEVELOPMENT ASSOCIATES 4000 WELLNESS DR MIDLAND MI 48670 382459947 OPERATIONS MI 501(C)(2) MIDMICHIGAN HEALTH 1 MIDMICHIGAN HEALTH FOUNDATION 4000 WELLNESS DR MIDLAND MI 48670 812813405 FOUNDATION MI 501(C)(3) LINE 12A, I MIDMICHIGAN HEALTH 1 MIDMICHIGAN MEDICAL CENTER - MIDLAND 4000 WELLNESS DR MIDLAND MI 48670 380833014 HOSPITAL MI 501(C)(3) LINE 3 MIDMICHIGAN HEALTH 1 TOLFREE FOUNDATION 335 E HOUGHTON AVE WEST BRANCH MI 48661 383067917 FUNDRAISING MI 501(C)(3) LINE 10 MIDMICHIGAN HEALTH 1 HOSPICE OF HELPING HANDS INC 322 W HOUGHTON AVE WEST BRANCH MI 48661 382424475 HOSPICE CARE MI 501(C)(3) LINE 10 MIDMICHIGAN HEALTH 1 MIDMICHIGAN HEALTH PAIN MANAGEMENT 2463 SOUTH M-30 WEST BRANCH MI 48661 834186622 HEALTHCARE PAIN MANAGEMENT MI MIDMICHIGAN MEDICAL CENTER-WEST BRANCH RELATED -26754 96951 0 0 0.51000 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 MIDMICHIGAN HEALTH S 9127000 FMV TOLFREE FOUNDATION Q 470662 FMV HOSPICE OF HELPING HANDS INC C 182239 FMV