2019-11-08T10:39:25-06:00 2018-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2018-01-01 381359218 BRONSON LAKEVIEW HOSPITAL BRON 2693416000 601 JOHN STREET KALAMAZOO MI 49007 REBECCA EAST SENIOR VP/CFO 2693416000 2019-10-30 1 DAVID LOWENTHAL P00378651 3122071040 2019-10-30 67.59.56.30 2019-10-30 13:11:47 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 23D9C3BAD3C11415BCA5E3AEE50D281DF37E870F 2018 2020-03-31 21:24:44Z FRANK SARDONE 301 JOHN STREET KALAMAZOO MI 49007 55220520 0 X BRONSONHEALTH.COM X 2007 MI OPERATION OF A GENERAL ACUTE CARE HOSPITAL 21 14 441 28 0 0 5849 21501 55837743 54878935 36558 10021 248047 310063 56128197 55220520 1250000 5615933 0 0 31523046 31777426 0 0 0 18746223 19954693 51519269 57348052 4608928 -2127532 24227991 22288276 4025683 4213500 20202308 18074776 TOGETHER, WE ADVANCE THE HEALTH OF OUR COMMUNITIES 0 0 36663990 5615933 46099551 BRONSON LAKEVIEW HOSPITAL (BLH)IS A 35-BED CRITICAL ACCESS HOSPITAL, INCLUDING 25 CRITICAL ACCESS AND 10-BED GERIATRIC PSYCHIATRIC UNIT. BLH OFFERS A FULL RANGE OF ACUTE CARE FOR INPATIENTS AND IS A WELL-ESTABLISHED DESTINATION FOR SURGERY, GERIATRIC PSYCHIATRY AND EMERGENCY CARE. BLH OPERATES A FULL-SERVICE, 24/7 EMERGENCY DEPARTMENT THAT TREATS OVER 18,000 PATIENT VISITS ANNUALLY, REGARDLESS OF THEIR ABILITY TO PAY. OUTPATIENT SERVICES ARE PROVIDED AT THE HOSPITAL, AS WELL AS AT RURAL HEALTH CLINICS IN PAW PAW, DECATUR, AND MATTAWAN. IN 2018, IN FURTHERANCE OF ITS MISSION, BLH INCURRED NET COMMUNITY BENEFIT EXPENSE OF $3,842,470. 12117687 9039845 IN 2018, BLH'S MEDICAID COST WAS $12,117,687 AND MEDICAID NET REVENUE WAS $9,039,845. 3715891 IN 2018, IN FURTHERANCE OF ITS MISSION, BLH INCURRED $3,715,891 IN BAD DEBT TO PROVIDE CARE TO ITS PATIENTS. 52497568 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 43 0 1 441 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X REBECCA EAST SENIOR VPCFO 2693416000 301 JOHN STREET KALAMAZOO MI 49007 X PARFET DONALD R CHAIRPERSON 1.00 8.00 X X 0 1291 0 EBERTS RANDALL W VICE CHAIRPERSON 1.00 8.00 X X 0 2422 0 KARRE NELSON VICE CHAIRPERSON 1.00 8.00 X X 0 0 0 JAMES BARBARA L TREASURER 1.00 8.00 X X 0 1849 0 NYBERG NEIL SECRETARY 1.00 8.00 X X 0 1389 0 ALLEN RICHARD J DIRECTOR 1.00 8.00 X 0 96514 4998 ATKINSON MARK B DIRECTOR 1.00 8.00 X 0 1913 0 DAVIDSON SCOTT B BMH CHIEF OF STAFF 1.00 8.00 X 0 0 0 FINK KATY DIRECTOR 1.00 8.00 X 0 0 0 GIBSON SCOTT C DIRECTOR 1.00 8.00 X 0 6400 0 GONZALEZ JORGE G DIRECTOR 1.00 8.00 X 0 942 0 GREENE JAMES E DIRECTOR 1.00 8.00 X 0 1910 0 HUNT BRENDA L DIRECTOR 1.00 8.00 X 0 0 0 JOHNSTON WILLIAM D DIRECTOR 1.00 8.00 X 0 0 0 KARAMCHANDANI MAHESH C DIRECTOR 1.00 8.00 X 0 674083 27587 LANE-DAVIES AARON DIRECTOR (THRU 6-2018) 1.00 8.00 X 0 317402 36841 LAWLOR JOHN R DIRECTOR 1.00 8.00 X 0 391208 26279 LIGGINS JAMES L DIRECTOR 1.00 8.00 X 0 2281 0 LINS STEVEN J DIRECTOR 1.00 8.00 X 0 900 0 MONTGOMERY TABRON LA JUNE DIRECTOR 1.00 8.00 X 0 0 0 ODAR MICHAEL F DIRECTOR 1.00 8.00 X 0 723 0 ZELLER CHARLES DIRECTOR (THRU 9-2018) 1.00 8.00 X 0 1178 0 SARDONE FRANK J PRESIDENT AND CEO 3.00 37.00 X X 0 1772072 382180 EAST REBECCA L SR VP CFO BHG 3.00 37.00 X 0 662571 167522 FALAHEE JAMES SR VP LEGAL & LEG. AFFAIRS 3.00 37.00 X 0 706813 172795 HARRELSON KATHLEEN M SR VP CLINICAL OPERATIONS 3.00 37.00 X 0 700836 156393 HAYDEN JOHN VP & CHIEF HR OFFICER 3.00 37.00 X 0 582819 128798 JONES JR JOHN L SR VP REG. & PHYS. SVS. 3.00 37.00 X 0 647426 169725 LARSON SCOTT SR VP MEDICAL AFFAIRS/CMO 3.00 37.00 X 0 793665 177944 RICHARDSON KIRK VP COO BLH 32.00 8.00 X 0 301630 81444 SANGALLI-DAVIS CHRISTINE VP CHIEF COMPLIANCE OFFICER 3.00 37.00 X 0 226802 63714 TRELLA REBECCA VP POST ACUTE CARE 3.00 37.00 X 0 319318 66155 WAY MICHAEL S VP MAT. MGT. & FACILITY SV 3.00 37.00 X 0 310517 92345 DOMMER MATTHEW PHYSICIAN - VP MEDICAL AFFAIRS 40.00 0.00 X 375713 0 71375 MIRZA NADEEM M PSYCHIATRIST 40.00 0.00 X 368678 0 36890 LEKOVIC MIRSEN PHYSICIAN - FAMILY MEDICINE 40.00 0.00 X 339707 0 22996 DUPUIS PEARCE PHYSICIAN - FAMILY MEDICINE 40.00 0.00 X 249902 0 24754 FOSSITT DEXTER PHYSICIAN - INTERNAL MEDICINE 40.00 0.00 X 243225 0 31376 1577225 8526874 1942111 26 0 1 0 SW MI EMERGENCY SERVICES PC 125 S KALAMAZOO MALL SUITE 204 KALAMAZOO MI 49007 MEDICAL SERVICES 487650 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICE 331678 2 21501 21501 NET PATIENT REVENUE 621110 54329098 54329098 PGIP REVENUE 900099 446330 446330 MEANINGFUL USE REVENUE 900099 102000 102000 RENTAL REVENUE FROM AFFILIATED OR 532000 1507 1507 54878935 2422 2422 7599 0 7599 7599 7599 CAFETERIA EMPLOYEE REVENUE 722310 185283 185283 OUTSIDE SERVICE REVENUE 900099 67755 67755 GAIN/LOSS ON SUBS OR JOINT VENTUR 900099 49602 49602 7423 7423 310063 55220520 55139396 0 59623 5615933 5615933 25856098 22385910 3470188 4461776 4283305 178471 1459552 1427096 32456 2201618 2120411 81207 7117 6642 475 1845017 1799502 45515 2554912 2491725 63187 61617 61405 212 47576 47388 188 2289942 2236077 53865 278429 174436 103993 MEDICAL SUPPLIES 4251349 4251461 -112 BAD DEBT EXPENSE 3715891 3715891 ALLOCATION EXPENSE 2208302 1383501 824801 EQUIPMENT MAINT/REPAIR 577751 577494 257 -84828 -80609 -4219 57348052 52497568 4850484 0 730625 495550 1845742 -9839 7256147 5116587 595585 890902 140868 1595503 55350305 42480934 13659024 12869371 0 1330202 24227991 22288276 2171374 2541048 1854309 1672452 4025683 4213500 X 20202308 18074776 20202308 18074776 24227991 22288276 -2127532 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 818892 818892 28478404 21073125 7405279 21245733 18253511 2992222 4807276 3154298 1652978 12869371 INVESTMENT IN HOSPITAL NETWORK INCORPORATED ASSETS 1330202 1330202 COST REPORT SETTLEMENTS 1672452 1672452 1 1 X 1 X 1 X 1 1 0 1 1 506260 506260 0.00940 17448 12117687 9039845 3077842 0.05740 17448 12623947 9039845 3584102 0.06680 23 124 131606 131606 0.00250 12 47 107571 107571 0.00200 17 19191 19191 0.00040 52 171 258368 258368 0.00490 52 17619 12882315 9039845 3842470 0.07170 1 232 232 0.00000 1 1129 1129 0.00000 2 538 538 0.00000 4 1899 1899 0.00000 1 3715891 86226 9877509 11010854 -1133345 X 1 1 1 1 BRONSON LAKEVIEW HOSPITAL 408 HAZEN STREET PAW PAW MI 49079 BRONSONHEALTH.COM X X X X BRONSON LAKEVIEW HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 1 0 1 X SEE PART V, PAGE 8 X 1 16 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 350.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://WWW.BRONSONHEALTH.COM/MEDICAL-FINANCIAL-ASSISTANCE-POLICY/ X BRONSONHEALTH.COM/MEDICAL-FINANCIAL-ASSISTANCE/FINANCIAL-ASSIST X BRONSONHEALTH.COM/MEDICAL-FINANCIAL-ASSISTANCE/PLAIN-LANGUAGE-P X X X X X X 1 X 0 X 1 X 0 0 BRONSON LAKEVIEW HOSPITAL PART V, SECTION B, LINE 5: BRONSON LAKEVIEW TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENTED THE COMMUNITY USING THREE METHODS; RESIDENT SURVEYS, KEY INFORMANT SURVEYS AND KEY INFORMANT INTERVIEWS. A PAPER-BASED SURVEY SEEKING INPUT FROM COUNTY RESIDENTS PERTAINING TO HEALTH NEEDS AND BARRIERS WAS DISTRIBUTED AT COMMUNITY AGENCIES AND VAN BUREN COMMUNITY MENTAL HEALTH. 3190 COMPLETED SURVEYS WERE COLLECTED AND ANALYZED. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS BASED ON THEIR EXTENSIVE KNOWLEDGE AND EXPERTISE ON PUBLIC HEALTH ISSUES, EXPERIENCE WITH VULNERABLE POPULATIONS OR STAKEHOLDER PERCEPTIONS OF THE COUNTY'S HEALTH STATUS AND UNMET NEEDS. THESE KEY INFORMANTS INCLUDED PERSONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY AND KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH. KEY INFORMANTS INCLUDED:-DOUG CULTRA, ADMINISTRATOR VAN BUREN COUNTY-KIRK RICHARDSON, VICE PRESIDENT BRONSON LAKEVIEW HOSPITAL-JOESEPH GOEPFRICH, DIRECTOR CHILD & FAMILY SERVICES OF SOUTHWEST MICHIGAN INC.-VERA TANIER, CEO VAN BUREN COUNTY UNITED WAY-CHRISTINE VANLANDINGHAM, DIRECTOR AREA AGENCY ON AGING -DEBRA HESS, CEO VAN BUREN COMMUNITY MENTAL HEALTH -MARK POMPEY, LEADER POKAGON TRIBAL SOCIAL SERVICES-VELMA HENDERSHOTT, DIRECTOR INTERCAREFOCUS GROUPS WITH VULNERABLE POPULATIONS WERE ALSO CONDUCTED BY AN INDEPENDENT CONSULTANT, AND WERE HELD AT THE FOLLOWING LOCATIONS:-FIRST CONGREGATIONAL CHURCH-VAN BUREN COMMUNITY MENTAL HEALTH HOPE CENTER-BANGOR HEALTH CLINIC BRONSON LAKEVIEW HOSPITAL PART V, SECTION B, LINE 6A: BRONSON METHODIST HOSPITALBRONSON BATTLE CREEK HOSPITAL BRONSON LAKEVIEW HOSPITAL PART V, SECTION B, LINE 11: THE CHNA PROCESS INCLUDED A PRIORITIZATION OF HEALTH NEEDS BASED UPON CONSENSUS CRITERIA, INCLUDING: MAGNITUDE OF NEED, MEASURABLE OUTCOMES, BRONSON CAPABILITIES, EVIDENCE FOR EFFECTIVE INTERVENTIONS, COMMUNITY COMMITMENT, AND CONSISTENCY WITH BRONSON STRATEGY. AT THE CONCLUSION OF THIS PRIORITIZATION PROCESS, IMPROVING ACCESS TO CARE WAS SELECTED AS THE FOCUS FOR COMMUNITY HEALTH ACTIVITIES IN 2016-2019. THIS FOCUSED EFFORT WILL REQUIRE SUBSTANTIAL FINANCIAL AND STAFFING RESOURCES AS WELL AS SIGNIFICANT COLLABORATIONS WITH COMMUNITY ORGANIZATIONS. GIVEN THE EXTRAORDINARY CHALLENGE OF SUBSTANTIALLY AND MEASURABLY IMPROVING ACCESS TO CARE IN AN ENVIRONMENT OF LIMITED RESOURCES, BRONSON LEADERS AND COMMUNITY HEALTH BOARD COMMITTEE MEMBERS HAVE CHOSEN TO LIMIT OUR INITIAL FOCUS TO THIS TOP PRIORITY HEALTH NEED. OTHER NEEDS IDENTIFIED INCLUDE OBESITY, LACK OF MENTAL HEALTH SUPPORT, CHRONIC DISEASE MANAGEMENT, ADDICTION PREVENTION, SAFETY, SOCIAL HEALTH, AND SEXUAL HEALTH. WHILE THESE HEALTH NEEDS WERE NOT THE PRIORITY AREA, BRONSON CONTINUES TO COLLABORATE AND PARTNER WITH THOSE AGENCIES BETTER SUITED TO HAVE AN IMPACT IN THESE AREAS AND BRONSON ANTICIPATES THAT IMPROVING ACCESS TO QUALITY CARE WILL IMPACT AND IMPROVE OUTCOMES FOR MANY OF THE OTHER NEEDS IDENTIFIED IN THE CHNA. THE ACCESS OF CARE PLAN IS ATTACHED TO THE 990 FOR REFERENCE OF AREAS NOT BEING ADDRESSED AT THIS TIME. BRONSON LAKEVIEW HOSPITAL PART V, SECTION B, LINE 20E: THE HOSPITAL ACKNOWLEDGES THAT ALL INDIVIDUALS ARE NOT EQUALLY CAPABLE OF PAYING FOR HEALTHCARE SERVICES, EITHER BY THEMSELVES OR THROUGH A THIRD PARTY INSURANCE CARRIER. THE HOSPITAL RECOGNIZES ITS RESPONSIBILITY TO OFFER CARE FOR PERSONS IN NEED, AND THEREFORE PROVIDES AND PROMOTES ACCESS TO EMERGENCY OR MEDICALLY NECESSARY SERVICES WITHOUT REGARD TO ABILITY TO PAY.THE HOSPITAL HAS SIGNS AT ENTRANCES TO THE EMERGENCY DEPARTMENT THAT INFORM PATIENTS OF THE FINANCIAL ASSISTANCE POLICY AS WELL AS THE ADMITTING AND FINANCIAL COUNSELING DEPARTMENTS. THE POLICY IS ALSO ON THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). THE PLAIN LANGUAGE SUMMARY IS INCLUDED ON ALL PATIENT STATEMENTS.PATIENTS MAY REQUEST AN APPLICATION TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE BY CALLING A PATIENT FINANCIAL COUNSELOR OR BRONSON'S BILLING DEPARTMENT. THE APPLICATION IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). PART V, SECTION B, LINE 7A, CHNA: WWW.BRONSONHEALTH.COM/APP/FILES/PUBLIC/2304/BLH-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-REPORT.PDF PART V, SECTION B, LINE 10A, IMPLEMENTATION STRATEGY: WWW.BRONSONHEALTH.COM/APP/FILES/PUBLIC/5041/BLH-ACCESS-TO-CARE-IMPLEMENTATION-2017-.PDF PART I, LINE 3C: THE ORGANIZATION USES THE FOLLOWING FPG TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS:200% OR BELOW OF FPL IS ENTITLED TO A 100% REDUCTION250% OF FPL IS ENTITLED TO A 90% REDUCTION300% OF FPL IS ENTITLED TO A 80% REDUCTION350% OF FPL IS ENTITLED TO A 70% REDUCTION PART I, LINE 7: (A-C) COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS INSTRUCTIONS FOR LINES A-C. (E-I) COSTING METHODOLOGY IS ACTUAL COSTS PER THE HOSPITAL ACCOUNTING SYSTEM FOR LINES E-I.(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 $3,715,891. PART II, COMMUNITY BUILDING ACTIVITIES: BRONSON LAKEVIEW HOSPITAL (BLH) IS LOCATED IN THE COUNTY SEAT AND GENERATES EMPLOYMENT FOR OVER 430 EMPLOYEES. THE EMPLOYEES ARE ENCOURAGED TO BE INVOLVED IN VOLUNTEERISM WITHIN THE COMMUNITIES AND MOST NON PROFIT AGENCIES HAVE A BLH REPRESENTATIVE WORKING WITH THEM IN SOME CAPACITY. BRONSON HAS A VOLUNTEER TIME OFF PROGRAM WHERE EACH EMPLOYEE CAN GET UP TO FOUR HOURS OF PAID VOLUNTEER TIME TO SUPPORT COMMUNITY NONPROFITS. LOCATED ON MAPLE LAKE, THE ORGANIZATION MAKES ALL DECISIONS WITH THE ENVIRONMENT IN MIND AND UTILIZES GREEN TECHNOLOGY WHENEVER POSSIBLE.COMMUNITY HEALTH STAFF ARE INVOLVED WITH SEVERAL KEY COUNCILS INCLUDING THE HEALTH AND HUMAN SERVICES COUNCIL, GREAT START COLLABORATIVE AND OFFENDER SUCCESS TASK FORCE.BRONSON LAKEVIEW HOSPITAL (AND THE OTHER HOSPITALS THAT ARE PART OF THE BRONSON HEALTHCARE GROUP) CONDUCTED AN EXTENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2016. PLEASE REFER TO SCHEDULE H, PART V, SECTION B, COMMUNITY HEALTH NEEDS ASSESSMENT, ALONG WITH SCHEDULE H, PART V, SECTION C SUPPLEMENTAL INFORMATION, FOR A FULL DESCRIPTION OF THE CHNA. THE CHNA PROCESS INCLUDED A PRIORITIZATION OF HEALTH NEEDS BASED UPON CONSENSUS CRITERIA, INCLUDING: MAGNITUDE OF NEED, MEASURABLE OUTCOMES, BRONSON CAPABILITIES, EVIDENCE FOR EFFECTIVE INTERVENTIONS, COMMUNITY COMMITMENT, AND CONSISTENCY WITH BRONSON STRATEGY. AT THE CONCLUSION OF THIS PRIORITIZATION PROCESS, IMPROVING ACCESS TO CARE WAS SELECTED AS THE FOCUS FOR COMMUNITY HEALTH ACTIVITIES IN 2016-2019. PART III, LINE 2: UNCOLLECTIBLE AMOUNTS ARE WRITEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. BAD DEBT EXPENSE IS DISCLOSED BASED ON GROSS CHARGES. PART III, LINE 3: BAD DEBT WRITEOFFS SUPPORT THE COMMUNITY BY PROVIDING A PORTION OF SERVICES WITHOUT PAYMENT. THE AMOUNT OF BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS ESTIMATED BY REVIEWING THE BAD DEBT DETAIL FOR A SPECIFIC WRITE-OFF CODE. PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE GROUP'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS OR PART OF THE BILL), THE GROUP RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THIS INFORMATION CAN BE FOUND IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER NOTE 2, SIGNIFICANT ACCOUNTING POLICIES FOR ACCOUNTS RECEIVABLE. PART III, LINE 8: WE UTILIZED THE ALLOWABLE COST AMOUNT FROM THE MEDICARE COST REPORT SCHEDULE D-1, PART II FOR INPATIENT AND SCHEDULE E, PART B FOR OUTPATIENT AND SCHEDULE M-SERIES. ALLOWABLE COST REPORT COST IS DETERMINED BASED ON THE PROVIDER REIMBURSEMENT MANUAL (PUBLICATION 15-1) AS ESTABLISHED BY CENTER FOR MEDICARE AND MEDICAID SERVICES. BRONSON LAKEVIEW HOSPITAL IS A CRITICAL ACCESS HOSPITAL THAT HAS AN INPATIENT PSYCHIATRIC FACILITY AS WELL AS THREE RURAL HEALTH CLINICS. THE INPATIENT PSYCHIATRIC FACILITY HAD A MEDICARE SHORTFALL OF $752,985, AND THE RURAL HEALTH CLINICS HAD A MEDICARE SHORTFALL OF $341,775. THE REMAINING SHORTFALL OF $38,585 IS DUE TO SEQUESTRATION REDUCING INPATIENT AND OUTPATIENT PAYMENTS. THE SHORTFALL IS COUNTED TOWARDS THE COMMUNITY BENEFIT.PART III, LINE 7: BRONSON LAKEVIEW HOSPITAL EXPERIENCE ADDITIONAL COMMUNITY BENEFIT EXPENSE OF $7,231,173 AND DIRECT OFFSETTING REVENUE OF $5,656,517 FOR A NET COMMUNITY BENEFIT OF $1,574,656 RELATED TO SERVICES PROVIDED TO MEDICARE ADVANTAGE INSUREDS. PART III, LINE 9B: THE POLICY REQUIRES THE COLLECTION AGENCY BE NOTIFIED AND ACTIVITY SUSPENDED WHEN A REQUEST FOR FINANCIAL ASSISTANCE IS MADE AND A PATIENT SUBMITS AN APPLICATION ON PREVIOUSLY LISTED ACCOUNTS. IF A PATIENT QUALIFIES FOR FULL FINANCIAL ASSISTANCE, THE ACCOUNT IS RETURNED TO BRONSON FROM THE AGENCY AND ANY INITIATED ECA IS REVERSED. IF THE PATIENT QUALIFIES FOR PARTIAL FINANCIAL ASSISTANCE, A DETERMINATION IS SENT TO THE AGENCY INDICATING THE NEW BALANCE AND ANY INITIATED ECA IS REVERSED. IF THE PATIENT DOES NOT PROVIDE COMPLETE APPLICATION INFORMATION OR IS DETERMINED TO BE INELIGIBLE, A DENIAL LETTER IS ISSUED AND THE AGENCY RESUMES COLLECTION ACTIVITY. PART VI, LINE 2: BRONSON LAKEVIEW HOSPITAL (BLH) WORKS WITH VAN BUREN COUNTY HEALTH DEPARTMENT, THE MICHIGAN OFFICE OF RURAL HEALTH, AND MANY LOCAL SOCIAL SERVICE AGENCIES IN RESPONDING TO THE HEALTHCARE NEEDS OF ITS RESIDENTS. THE AREAS IDENTIFIED ARE INCORPORATED INTO STRATEGIC PLANNING. AS A PART OF THE ANNUAL BUDGETING PROCESS, TRENDS IN SERVICE UTILIZATION ARE UTILIZED FOR RESOURCE PLANNING. PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE EMERGENCY ROOM, THE ADMITTING DEPARTMENT, THE PATIENT FINANCIAL COUNSELING OFFICE, AND THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). THE PLAIN LANGUAGE SUMMARY IS ALSO INCLUDED IN THE PATIENT'S DISCHARGE DOCUMENTS, ON PATIENT STATEMENTS AND THE HOSPITAL'S WEBSITE. BOTH THE POLICY AND THE PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST. PART VI, LINE 4: BRONSON LAKEVIEW HOSPITAL (BLH) SERVES VAN BUREN COUNTY WHICH IS APPROXIMATELY 75,000 RESIDENTS. THE COUNTY IS AGRICULTURAL AND HAS HIGHER THAN STATE AVERAGE UNEMPLOYMENT. FIVE PROVIDER BASED HEALTH CLINICS ARE STRATEGICALLY PLACED THROUGHOUT EASTERN VAN BUREN COUNTY TO PROVIDE ACCESS TO CARE. THE CLINICS ACCEPT PATIENTS REGARDLESS OF ABILITY TO PAY AND HAVE CHARITY CARE PROCESSES IN PLACE. PART VI, LINE 5: BRONSON LAKEVIEW HOSPITAL (BLH) HAS AN OPEN MEDICAL STAFF AND HAS MANY SPECIALISTS FROM NEIGHBORING KALAMAZOO THAT HAVE HOSPITAL BASED CLINICS TO PROVIDE EASY ACCESS TO RESIDENTS. THE EMPLOYEES HOLD FOOD DRIVES FOR THE LOCAL FOOD PANTRIES AND ADOPT SEVERAL IN NEED FAMILIES EACH HOLIDAY SEASON. EMPLOYEES ARE ABLE TO PROVIDE MEDICAL SUPPORT TO MANY COMMUNITY ACTIVITIES AS PART OF THEIR SCHEDULED WORK TIME. BRONSON LAKEVIEW HOSPITAL IS THE ONLY HOSPITAL IN THE BRONSON SYSTEM THAT HAS CRITICAL ACCESS HOSPITAL (CAH) DESIGNATION. BLH PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A HOST OF EDUCATIONAL PROGRAMS AND ACTIVITIES, INCLUDING CPR CLASSES, BLOOD PRESSURE SCREENINGS, MAMMOGRAPHY SCREENINGS AND SUPPORT GROUPS FOR THOSE WHO ARE ALZHEIMERS CAREGIVERS. BLH AND ITS EMPLOYEES ACTIVELY PARTICIPATE IN AND PROVIDE SUPPORT TO MANY COMMUNITY ORGANIZATIONS INCLUDING: AREA AGENCY ON AGING, UNITED WAY, KIWANIS LEADERSHIP, LAKEVIEW FOUNDATION, PAW PAW CORPORATE COLLABORATIONS AND VAN BUREN COUNTY COLLABORATION. THE HOSPITAL ALSO WORKS WITH LOCAL SCHOOL SYSTEMS TO PROVIDE CAREER DAY PROGRAMS AND VOCATIONAL TECH SCHOOL-TO-WORK INITIATIVES AND DOES AN INSURANCE ENROLLMENT OUTREACH. PART VI, LINE 6: BRONSON LAKEVIEW HOSPITAL (BLH) IS PART OF AN AFFILIATED SYSTEM THAT INCLUDES THREE OTHER HOSPITALS, BRONSON METHODIST HOSPITAL, BRONSON SOUTH HAVEN HOSPITAL AND BRONSON BATTLE CREEK HOSPITAL. THE HOSPITALS ARE CONTROLLED BY BRONSON HEALTHCARE GROUP, WHICH IS COMMUNITY-OWNED AND GOVERNED NOT-FOR-PROFIT HOLDING COMPANY. THE BRONSON HEALTHCARE GROUP (BHG) BOARD IS COMPRISED OF 22 MEMBERS OF THE COMMUNITY. THE FOUR HOSPITALS IN THE BRONSON SYSTEM COLLABORATE TO PROMOTE THE HEALTH OF THE COLLECTIVE COMMUNITIES WE SERVE.IN ADDITION TO THE FOUR HOSPITALS, THE BHG SYSTEM INCLUDES SEVERAL SMALLER ENTITIES WHOSE EFFECTS SUPPORT THE HOSPITALS AND THEIR MISSION OF TOGETHER, WE ADVANCE THE HEALTH OF THE COMMUNITY. THESE ENTITIES INCLUDE: BRONSON HEALTHCARE GROUP, BRONSON COMMONS, BRONSON LIFESTYLE IMPROVEMENT & RESEARCH CENTER, BRONSON HEALTH FOUNDATION, BRONSON AT HOME, VBEMS, AND BRONSON PROPERTIES CORPORATION. PART VI, LINE 7, REPORTS FILED WITH STATES MI 1 BRONSON HEALTHCARE GROUP 601 JOHN STREET KALAMAZOO MI 49007 382418383 501(C)(3) 5615933 GENERAL SUPPORT 1 0 PART I, LINE 2: THERE IS NO FORMAL PROCEDURE. GENERALLY GRANTS ARE UNRESTRICTED. THE GRANTS ARE MADE BY THE ORGANIZATION ON A DISCRETIONARY BASIS FOR PURPOSES CONSISTENT WITH THE ORGANIZATIONS'S MISSION. X X 1 1 0 1 0 0 0 0 0 0 0 KARAMCHANDANI MAHESH C DIRECTOR 0 598141 0 51086 0 24856 0 13650 0 13937 0 701670 0 0 LANE-DAVIES AARON DIRECTOR (THRU 6-2018) 0 300092 0 14741 0 2569 0 17700 0 19141 0 354243 0 0 LAWLOR JOHN R DIRECTOR 0 336127 0 34433 0 20648 0 13650 0 12629 0 417487 0 0 SARDONE FRANK J PRESIDENT AND CEO 0 887624 0 376175 0 508273 0 368078 0 14102 0 2154252 0 635164 EAST REBECCA L SR VP CFO BHG 0 430410 0 133314 0 98847 0 154140 0 13382 0 830093 0 133314 FALAHEE JAMES SR VP LEGAL & LEG. AFFAIRS 0 415769 0 123037 0 168007 0 153072 0 19723 0 879608 0 211118 HARRELSON KATHLEEN M SR VP CLINICAL OPERATIONS 0 455422 0 140116 0 105298 0 144944 0 11449 0 857229 0 140116 HAYDEN JOHN VP & CHIEF HR OFFICER 0 346826 0 114987 0 121006 0 119901 0 8897 0 711617 0 166237 JONES JR JOHN L SR VP REG. & PHYS. SVS. 0 407545 0 143082 0 96799 0 149976 0 19749 0 817151 0 143082 LARSON SCOTT SR VP MEDICAL AFFAIRS/CMO 0 471827 0 128687 0 193151 0 164560 0 13384 0 971609 0 229755 RICHARDSON KIRK VP COO BLH 0 239046 0 43500 0 19084 0 62220 0 19224 0 383074 0 43500 SANGALLI-DAVIS CHRISTINE VP CHIEF COMPLIANCE OFFICER 0 194068 0 31582 0 1152 0 56247 0 7467 0 290516 0 31582 TRELLA REBECCA VP POST ACUTE CARE 0 273913 0 44241 0 1164 0 57755 0 8400 0 385473 0 44241 WAY MICHAEL S VP MAT. MGT. & FACILITY SV 0 220930 0 67771 0 21816 0 79630 0 12715 0 402862 0 37771 DOMMER MATTHEW PHYSICIAN - VP MEDICAL AFFAIRS 308515 0 48195 0 19003 0 65738 0 5637 0 447088 0 48195 0 MIRZA NADEEM M PSYCHIATRIST 334658 0 13159 0 20861 0 17700 0 19190 0 405568 0 0 0 LEKOVIC MIRSEN PHYSICIAN - FAMILY MEDICINE 339390 0 0 0 317 0 10548 0 12448 0 362703 0 0 0 DUPUIS PEARCE PHYSICIAN - FAMILY MEDICINE 231803 0 17950 0 149 0 12270 0 12484 0 274656 0 0 0 FOSSITT DEXTER PHYSICIAN - INTERNAL MEDICINE 242291 0 750 0 184 0 12109 0 19267 0 274601 0 0 0 PART I, LINE 1A THE BOARD OF DIRECTORS IS NOT DIRECTLY COMPENSATED. SPOUSAL TRAVEL AND HEALTH CLUB DUES ARE AVAILABLE FOR THE BOARD OF DIRECTORS. THOSE WHO PARTICIPATE RECEIVE A 1099 AND THE DUES ARE TREATED AS A TAXABLE FRINGE BENEFIT. PART I, LINE 3 BRONSON HEALTHCARE GROUP, A RELATED ORGANIZATION, USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY AND/OR STUDY AND APPROVAL BY BOARD AND/OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED PAYMENT FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN FROM RELATED ENTITY BRONSON HEALTHCARE GROUP: SARDONE, FRANK J $260,526 SERP DISTRIBUTION SARDONE, FRANK J $206,295 SERP CONTRIBUTION FALAHEE JR., JAMES B $88,081 SERP DISTRIBUTION FALAHEE JR., JAMES B $74,246 SERP CONTRIBUTION HAYDEN, JOHN T $51,250 SERP DISTRIBUTION HAYDEN, JOHN T $64,075 SERP CONTRIBUTION JONES JR., JOHN $74,987 SERP CONTRIBUTION HARRELSON, KATHLEEN $83,164 SERP CONTRIBUTION EAST, REBECCA $79,612 SERP CONTRIBUTION LARSON, SCOTT D $101,068 SERP DISTRIBUTION LARSON, SCOTT D $82,174 SERP CONTRIBUTION PART II, COLUMN (B) (III) AND (F): INCLUDED IN PART II, COLUMN (B) (III) AND (F) ARE AMOUNTS THAT WERE PAID TO THE EXECUTIVES UNDER THE BRONSON HEALTHCARE GROUP, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THESE AMOUNTS WERE CREDITED TO AN ACCOUNT FOR THE EXECUTIVE IN PRIOR YEARS AND WERE PREVIOUSLY REPORTED IN COLUMN C IN THE PRIOR YEAR, BUT THE EXECUTIVE WAS REQUIRED TO REMAIN EMPLOYED UNTIL THE YEAR FOR WHICH THIS FORM IS BEING FILED IN ORDER TO BECOME VESTED IN HIS OR HER ACCOUNT. AMOUNTS HAVE BEEN CREDITED TO THESE EXECUTIVES' ACCOUNTS EACH YEAR SINCE THE SERP WAS ADOPTED IN 1994, AND THE ACCOUNTS HAVE ALSO BEEN ADJUSTED FOR GAINS AND LOSSES SINCE THAT TIME. THEREFORE, THESE AMOUNTS SHOULD BE VIEWED AS HAVING BEEN EARNED OVER THE EXECUTIVE'S ENTIRE PERIOD OF EMPLOYMENT AS AN EXECUTIVE OF BRONSON. THE AMOUNT CREDITED TO EACH EXECUTIVE'S ACCOUNT IN THE SERP EACH YEAR AND EACH EXECUTIVES TOTAL COMPENSATION PACKAGE WAS APPROVED BY AN INDEPENDENT CONSULTANT TO ENSURE THAT THESE AMOUNTS ARE COMPARABLE TO OR LESS THAN THE AMOUNTS AWARDED TO EXECUTIVES OF COMPARABLE HEALTH CARE ORGANIZATIONS. KIMBERLY JAMES DAUGHTER OF BOARD MEMBER BARBARA JAMES 93714 TOTAL COMPENSATION FOR BEING AN EMPLOYEE OF BRONSON METHODIST HOSPITAL 0 MARLA ATKINSON SPOUSE OF BOARD MEMBER MARK ATKINSON 150551 TOTAL COMPENSATION FOR BEING AN EMPLOYEE OF BRONSON METHODIST HOSPITAL 0 JAIDEEP KARAMCHANDANI SON OF BOARD MEMBER MAHESH KARAMCHANDANI 66259 TOTAL COMPENSATION FOR BEING AN EMPLOYEE OF BRONSON METHODIST HOSPITAL 0 FORM 990, PART VI, SECTION A, LINE 2 FRANK SARDONE, STEVEN J. LINS, M.D. AND SCOTT C. GIBSON, M.D. HAVE A BUSINESS RELATIONSHIP. ALL BOARD MEMBERS HAVE A BUSINESS RELATIONSHIP WITH ALL BRONSON SUBSIDIARIES DUE TO BEING ON BRONSON HEALTHCARE GROUP BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 BRONSON HEALTHCARE GROUP IS THE SOLE MEMBER OF BRONSON LAKEVIEW HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A BRONSON HEALTHCARE GROUP (BHG) IS THE SOLE MEMBER OF BRONSON LAKEVIEW HOSPITAL (BLH) AND AS SUCH MEMBER IT ELECTS 10-15 OF THE TOTAL 20-24 MEMBERS OF THE BLH BOARD. COMMUNITY PARTNERS SHALL, AFTER CONSULTING WITH AND SEEKING INPUT FROM THE NOMINATING COMMITTEE OF BHG, APPOINT 6 MEMBERS TO THE BOARD. THE REMAINING 3 MEMBERS OF THE BOARD SHOULD BE EX OFFICIO, WITH VOTE, AND SHALL CONSIST OF THE PRESIDENT, THE CHIEF OF STAFF, AND IMMEDIATE PAST CHIEF OF THE MEDICAL STAFF OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B BRONSON HEALTHCARE GROUP (BHG) IS THE SOLE MEMBER OF BRONSON LAKEVIEW HOSPITAL (BLH) AND HAS CERTAIN RESERVED POWERS OVER THE ACTIONS OF BLH. THE BOARD OF DIRECTORS HAS THE POWER TO: -AMENDMENT, RESTATEMENT, OR REPEAL OF THE HOSPITALS ARTICLES OF INCORPORATION OR BYLAWS. -ADOPTION, EXECUTION, REVOCATION, OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, REORGANIZATION, OR OTHER MAJOR CHANGE IN CORPORATE STRUCTURE INVOLVING THE HOSPITAL. -SALE, LEASE EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE HOSPITALS PROPERTY AND ASSETS. -ACQUISITION OF ANY OTHER ENTITY OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE. -ADOPTION OF ALL OPERATING AND CAPITAL EXPENDITURE BUDGETS. -INCUR OPERATING OR CAPITAL EXPENDITURES WHICH CAUSE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES AND/OR THE DOLLAR AMOUNT SPECIFIED BY BHG. -SECURE BORROWINGS, WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS A PART OF A BUDGET. -CHANGE THE MISSION STATEMENT, PURPOSES, OR STRATEGIC GOALS OF THE HOSPITAL. -ANY SIGNIFICANT CHANGE IN THE SCOPE OF SERVICES OR PROGRAMS. -APPOINTMENT, REMOVAL OR COMPENSATION OF THE PRESIDENT OR ANY DIRECTOR OR OFFICER. FORM 990, PART VI, SECTION B, LINE 11B THE SR VP/CFO & CONTROLLER REVIEWS THE 990S. THE SR VP/CFO MET WITH THE FINANCE COMMITTEE CHAIRPERSON ON OCTOBER 15, 2019 TO REVIEW THE PREPARED FORM 990 AND SCHEDULES. THE FINANCE COMMITTEE OF THE BOARD REVIEWED THE PREPARED FORM 990S AT ITS REGULARLY SCHEDULED MEETING ON OCTOBER 21, 2019. THE REVIEW WAS LED BY THE SR VP/CFO AND PLANTE MORAN. THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY WERE PROVIDED THE PREPARED FORM 990 FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE CONFLICT OF INTEREST POLICY AND ITS ACCOMPANYING QUESTIONNAIRE ARE REVIEWED, AND REVISED, IF NECESSARY, ON AN ANNUAL BASIS BY THE ORGANIZATION'S GENERAL COUNSEL/CORPORATE COMPLIANCE OFFICER AND THE BOARD'S EXECUTIVE COMMITTEE. ALL BOARD MEMBERS AND ALL EMPLOYEES HOLDING THE TITLE OF VICE PRESIDENT AND ABOVE ARE COVERED BY THE CONFLICT OF INTEREST POLICY AND ANNUALLY COMPLETE THE CONFLICT OF INTEREST QUESTIONNAIRE. ALL COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE ORGANIZATION'S GENERAL COUNSEL/CORPORATE COMPLIANCE OFFICER AND THE EXECUTIVE COMMITTEE. DETERMINATIONS AS TO WHETHER A CONFLICT EXISTS ARE MADE BY THE GENERAL COUNSEL/CORPORATE COMPLIANCE OFFICER AND THE EXECUTIVE COMMITTEE. ACTUAL CONFLICTS ARE REVIEWED BY THE GENERAL COUNSEL/CORPORATE COMPLIANCE OFFICER AND THE EXECUTIVE COMMITTEE. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS ON THE TRANSACTION IN QUESTION. FORM 990, PART VI, SECTION B, LINE 15 FOR THE CEO, OFFICERS AND OTHER KEY EMPLOYEES, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH FUNCTIONS AS THE COMPENSATION COMMITTEE FOR BRONSON HEALTHCARE GROUP, RETAINS THE SERVICES OF AN EXTERNAL EXECUTIVE COMPENSATION CONSULTANT (SULLIVAN, COTTER AND ASSOCIATES) WHO CONDUCTS A THOROUGH COMPENSATION AND BENEFIT SURVEY PROCESS THAT IS USED TO DETERMINE THE APPROPRIATE ADJUSTMENT IN CASH COMPENSATION AND BENEFITS PROVIDED. THIS PROCESS IS DONE ANNUALLY AND WAS UNDER TAKEN IN 2018. THE CONSULTANT USES THREE TO FIVE NATIONAL HEALTHCARE-BASED SURVEYS FOR COMPARABILITY DATA, EACH ONE OF LIKE REVENUE SIZED HEALTHCARE SYSTEMS TO THE BRONSON HEALTHCARE GROUP. THE CONSULTANT PREPARES A DETAILED REPORT WITH RECOMMENDATIONS FOR PAY AND/OR BENEFIT ADJUSTMENTS, AND PRESENTS THE INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS (WHEN THE CEOS SURVEY DATA AND RECOMMENDATIONS ARE PRESENTED, THE CEO AND STAFF ARE EXCUSED FROM THE DELIBERATIONS). AFTER ALL QUESTIONS OF THE BOARD MEMBERS ARE ANSWERED, FORMAL MOTIONS ARE PROPOSED, SECONDED AND VOTED ON (FOR ANY PAY ADJUSTMENTS AND FOR RECEIPT OF THE CONSULTANT'S REPORT). AT THE SUBSEQUENT MEETING OF THE FULL BOARD OF DIRECTORS, THE CHAIR DISCLOSES THE RESULTS AND APPROVED MOTIONS OF THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC BY POSTING THEM ON THE ORGANIZATION'S WEBSITE AND PROVIDING COPIES ON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS, OTHER THAN THE FORM 990, ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII SECTION A, LINE 1A: THE BOARD OF DIRECTORS IS NOT DIRECTLY COMPENSATED. SPOUSAL TRAVEL AND HEALTH CLUB DUES ARE AVAILABLE FOR THE BOARD OF DIRECTORS. THOSE WHO PARTICIPATE RECEIVE A 1099 AND THE DUES ARE TREATED AS A TAXABLE FRINGE BENEFIT. BRONSON HEALTHCARE GROUP 601 JOHN STREET KALAMAZOO MI 49007 382418383 PROVIDE SUPPORT SERVICES MI 501(C)(3) LINE 12C, III-FI N/A 0 BRONSON METHODIST HOSPITAL 601 JOHN STREET KALAMAZOO MI 49007 381359087 HOSPITAL MI 501(C)(3) LINE 3 BRONSON HEALTHCARE GROUP 0 BRONSON HEALTH FOUNDATION 601 JOHN STREET KALAMAZOO MI 49007 382415081 SUPPORTS HEALTHCARE ORGANIZATION MI 501(C)(3) LINE 11 BRONSON HEALTHCARE GROUP 0 BRONSON COMMONS 23332 RED ARROW HWY MATTAWAN MI 49071 382842451 SKILLED NURSING MI 501(C)(3) LINE 10 BRONSON HEALTHCARE GROUP 0 VBEMS 39338 W RED ARROW HWY PAW PAW MI 49079 382745910 AMBULANCE SERVICES MI 501(C)(3) LINE 10 BRONSON HEALTHCARE GROUP 0 BRONSON PROPERTIES CORPORATION 601 JOHN STREET KALAMAZOO MI 49007 386052573 PROVIDE SUPPORT SERVICES MI 501(C)(3) LINE 12B, II BRONSON HEALTHCARE GROUP 0 BRONSON BATTLE CREEK HOSPITAL 300 NORTH AVE BATTLE CREEK MI 49016 382776791 HOSPITAL MI 501(C)(3) LINE 3 BRONSON HEALTHCARE GROUP 0 BRONSON AT HOME 601 JOHN STREET KALAMAZOO MI 49007 383298476 NURSING, HOSPICE, & EQUIP SALES MI 501(C)(3) LINE 10 BRONSON HEALTHCARE GROUP 0 BRONSON SOUTH HAVEN HOSPITAL 955 S BAILEY AVE SOUTH HAVEN MI 49090 381676780 HOSPITAL MI 501(C)(3) LINE 3 BRONSON HEALTHCARE GROUP 0 HOSPITAL NETWORK INC LEASING 6212 AMERICAN AVE PORTAGE MI 49002 383638430 SUPPORT SERVICES MI N/A HOSPITAL NETWORK VENTURES LLC 6212 AMERICAN AVE PORTAGE MI 49002 383302979 SUPPORT SERVICES MI N/A BRONSON MANAGEMENT SERVICES CORPORATION 601 JOHN STREET KALAMAZOO MI 49007 382415032 OTHER MEDICAL SERVICES MI N/A C 0 BRONSON LIFESTYLE AND IMPROVEMENT RESEARCH CENTER 601 JOHN STREET KALAMAZOO MI 49007 383552556 REHABILITATION SERVICES MI N/A C 0 WESTLEY DEVELOPMENT COMPANY 301 JOHN STREET KALAMAZOO MI 49007 383619232 REAL ESTATE OWNERSHIP MI N/A C 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 0 BRONSON BATTLE CREEK HOSPITAL O 60737 METHOD BASED ON ACTUAL COST BRONSON HEALTHCARE GROUP L 1811583 METHOD BASED ON ACTUAL COST BRONSON HEALTHCARE GROUP M 6939887 METHOD BASED ON ACTUAL COST BRONSON HEALTHCARE GROUP O 4212820 METHOD BASED ON ACTUAL COST BRONSON HEALTHCARE GROUP B 5615933 CASH TRANSFER BRONSON METHODIST HOSPITAL L 1016708 METHOD BASED ON ACTUAL COST BRONSON METHODIST HOSPITAL O 273046 METHOD BASED ON ACTUAL COST BRONSON METHODIST HOSPITAL M 1075718 METHOD BASED ON ACTUAL COST BRONSON PROPERTIES CORP M 2398079 METHOD BASED ON ACTUAL COST BRONSON PROPERTIES CORP L 63156 METHOD BASED ON ACTUAL COST BRONSON SOUTH HAVEN O 71967 METHOD BASED ON ACTUAL COST BRONSON SOUTH HAVEN M 507957 METHOD BASED ON ACTUAL COST BRONSON PROPERTIES CORP O 46389 METHOD BASED ON ACTUAL COST BRONSON NETWORK LLC M 78807 METHOD BASED ON ACTUAL COST BRONSON NETWORK LLC L 257455 METHOD BASED ON ACTUAL COST