2019-05-14T18:04:57-05:00 2018-06-30 990 2017-07-01 381360526 ASCENSION BORGESS HOSPITAL (FKA BORGESS MEDICAL CENTER) ASCE 3147338000 1521 Gull Road Kalamazoo MI 49048 Tonya Mershon Tax Officer 2019-05-14 2017 2020-01-14 16:20:31Z Kathy Young 1521 Gull Road Kalamazoo MI 49048 503401830 false 0928 X https://healthcare.ascension.org/Locations/Michigan/MIKAL/Kalamazoo-Ascension-Borgess-Hospital X 1927 MI To improve the health and well-being of all people in the communities we serve. 10 9 3660 200 2632404 0 183288 1324843 466674179 494069000 595944 636750 4726352 7212034 472179763 503242627 307774 0 0 190133750 190369642 0 0 219305779 264021088 409747303 454390730 62432460 48851897 268587367 246153799 330814039 256631771 -62226672 -10477972 Ascension Borgess Hospital (f/k/a Borgess Medical Center) provides necessary and vital health care services to an area which includes all of S.W. Michigan. This care is given regardless of any individuals' race, color, religion, gender, age, national origin or ability to pay. Ascension Borgess Hospital (f/k/a Borgess Medical Center) is committed to cooperating with patients and families in providing holistic treatment by integrating within the healing process the physical, emotional and spiritual needs of each patient. Services include inpatient routine, inpatient and outpatient ancillary care in support of our stated mission. false false 355049299 0 495957554 Ascension Borgess Hospital (f/k/a Borgess Medical Center) is a 361-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, Borgess Medical Center treated 18,048 adults and children for a total of 87,117 patient days of service. The hospital also provided services for 392,665 outpatient visits, which included 6,968 outpatient surgeries and 58,994 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. 355049299 true true false true false false false false false true false true true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 288 0 true 3660 true true true false false false false false true false false false X 10 9 false false false false true true true true true false false false true true true true true false true true true X SARA OBRIEN 3147338070 11775 BORMAN DRIVE MARYLAND HEIGHTS MO 63146 JERRY LOVE CHAIR 1.0 3.0 X X 0 0 0 JONI KNAPPER VICE CHAIR 1.0 3.0 X X 0 0 0 BETH BRUTSCHE SECRETARY 1.0 3.0 X X 0 0 0 CHARLES BURLING DDS TREASURER 1.0 3.0 X X 0 0 0 THOMAS STOVER MD INTERIM PRESIDENT & CEO (START 6/2018) 45.0 5.0 X X 0 0 0 KATHY A YOUNG PRESIDENT & CEO (END 6/2018) 45.0 5.0 X X 0 1124139 38400 MARK A SHAMAN MD TRUSTEE 1.0 4.0 X 0 0 0 KATHY GEORGE TRUSTEE 1.0 3.0 X 0 0 0 RASHMI KOTHARI MD TRUSTEE (START 1/2018) 1.0 3.0 X 0 0 0 MARY SLATER MD TRUSTEE 1.0 3.0 X 0 0 0 RICHARD L FELBINGER CFO (END 8/2017) 15.0 37.0 X 0 624090 32035 DAMON D SORENSEN CFO (START 9/2017) 10.0 41.0 X 0 73249 9509 J PATRICK DYSON CSO 15.0 37.0 X 0 805207 30482 ANTHONY F MCDONNELL CHIEF DEVELOPMENT OFFICER 25.0 25.0 X 0 232551 31844 ROBERT HILL MD CMO 10.0 40.0 X 0 432420 45969 LORI J BROWN RN CNO 20.0 30.0 X 337963 0 30839 JOHN RYDER COO 10.0 40.0 X 0 226586 33342 GEORGE R DREW MD PHYSICIAN 50.0 0 X 455346 0 33711 CHRISTIAN ERTL MD PHYSICIAN 50.0 0 X 454035 0 46342 JESSICA D WILLIAMS MD PHYSICIAN 50.0 0 X 441284 0 44483 BRIAN T BOWDITCH MD PHYSICIAN 50.0 0 X 407404 0 43797 2096033 3518242 420752 130 true true false PREMIER MEDICAL CARE PC po box 249 goodlettsville TN 37070 MEDICAL SERVICES 4836387 KALAMAZOO EMERGENCY ASSOC PLC 1535 gull road kalamazoo MI 49048 MEDICAL SERVICES 2223368 SOUTHWEST MI IMAGING LLC 1700 gull road kalamazoo MI 49048 IMAGING SERVICES 2122574 CCS PERFUSION ASSOCIATES LLC 31330 schoolcraft road suite 200 livonia MI 48150 MEDICAL SERVICES 2076277 AHSA LLC PO BOX 945 TRAVERSE CITY MI 49685 STAFFING SERVICES 1106904 29 X 0 0 0 1324843 0 0 1324843 Net Patient Service Revenue 621990 446107510 446107510 Services to Affiliates 561000 35522924 35522924 Pharmacy Revenue 446110 9322095 9322095 Management Fees 561000 1499377 1499377 Income from Joint Ventures 621990 1071963 1071963 545131 7560 537571 0 494069000 63277 63277 0 0 0 0 623710 0 0 623710 0 623710 623710 0 574602 1128 0 573474 573473 573473 0 0 0 0 356628 158075 198553 198553 Cafeteria/Vending Revenue 722514 1490401 1490401 Community Services 900099 91775 91775 Laundry Revenue 900099 3578182 1483349 2094833 1229413 851001 0 378412 6389771 503242627 495957554 2632404 3327826 368802 319383 49419 138202809 119731504 18471305 5154066 4465205 688861 36499201 31620927 4878274 10144764 8788871 1355893 1089421 1007324 82097 21964 21964 6000 6000 11049724 9200850 1848874 0 16877 16390 487 1458379 477720 980659 1280885 335685 945200 12484878 6168822 6316056 248745 184370 64375 366763 235647 131116 5654231 5654231 18937833 7363119 11574714 3491215 3491215 Purchased Services 71259646 30748528 40511118 Medical Supplies 84659524 84067492 592032 Physician Fees to Affiliates 34948510 34948510 Laundry 5255712 5255712 11790781 10113240 1677541 0 454390730 355049299 99341431 0 2881848 17280 149368 9496250 0 0 64554100 50408990 0 0 0 0 0 0 6838044 6832478 3087500 1578310 315408242 177948422 140784319 137459820 0 0 0 17034554 19042574 8824485 5076378 24433149 16241719 268587367 246153799 29634254 34884064 0 0 11264 11266 0 0 0 0 0 0 0 0 0 0 301168521 221736441 330814039 256631771 X -62376040 -10622582 149368 144610 0 0 -62226672 -10477972 268587367 246153799 X 48851897 2896803 X false true X true false X false false false false false false false false true 6000 6000 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidates for public office. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidates for public office. 4270624 4270624 214034455 114817388 99217067 1576809 1518709 58100 86836535 60950864 25885671 8689819 661461 8028358 137459820 Investment in Portfolio Companies 569100 F Equity Investment in Kalamazoo Center Med Studies 3853866 F Equity Investment in West Michigan Air Care 1513640 F Equity Investment in West Michigan Cancer Center 13078499 F Equity Investment in Kalamazoo Cty Med Control 27469 F Equity Investment in. 19042574 Deferred Tax Asset Other Assets -2017 Unidentified Remittances -96933 Due from Affiliates 4790082 Other Receivables 1021771 Deferred Compensation/Retirement/Pension Asset 1491087 Security Deposit 9533 Estimated 3rd Party Payor Settlements 9028196 16241719 Deferred Sales Lease Back Liability 1407460 Fin 48 Liability Asset Retirement Obligation 121285 Valuation Allowance 967271 Due to Affiliates 46443598 Deferred Compensation/Retirement/Pension Liability 9170122 Liability Sold with Recourse 490760 Savings Plan Liability Estimated 3rd Party Payor Settlement 5779059 Recovery Tail Liability 2240064 Debt with Ascension Health Alliance 155116822 221736441 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return, The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2018. true true X true X true X true true true false false 8961632 0 8961632 0.0197 72387182 61757951 10629231 0.0234 0 0.0 0 0 81348814 61757951 19590863 0.0431 21 793214 403555 0 403555 0.0009 3 346 15678123 0 15678123 0.0345 2 9 3467 0 3467 0.0000 1 0 1993146 0 1993146 0.0044 4 161 285175 0 285175 0.0006 31 793730 18363466 0 18363466 0.0404 31 793730 99712280 61757951 37954329 0.0835 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 0 572 0 572 0.0000 1 0 1353 0 1353 0.0000 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 50 19146 0 19146 0.0000 2 0 2811 0 2811 0.0000 0 0 0 0 0 0.0 5 50 23882 0 23882 0.0001 false 1289610 429553 226297516 250682905 -24385389 X true true 2 1 Ascension Borgess Hospital 1521 Gull Road Kalamazoo MI 49048 https://healthcare.ascension.org/Locations/Michigan/MIKAL/Kalamazoo-Ascension-Borgess-Hospital L424370 X X X X X A 2 Ascension Borgess PIPP Hospital 411 Naomi Street Plainwell MI 49080 https://healthcare.ascension.org/Locations/Michigan/MIKAL/Plainwell-Ascension-BorgessPipp-Hospital L431681 X Long-Term Acute Care A A false false true X X X X X X X X X 15 true true true true X https://healthcare.ascension.org/Locations/Michigan/MIKAL/Kalamazoo-Ascension-Borgess-Hospital/Commu true 15 true https://healthcare.ascension.org/Locations/Michigan/MIKAL/Kalamazoo-Ascension-Borgess-Hospital/Commu false true X 200.0 350.0 X X X true true X X X true X https://healthcare.ascension.org/Financial-Assistance/Michigan X https://healthcare.ascension.org/Financial-Assistance/Michigan X https://healthcare.ascension.org/Financial-Assistance/Michigan X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E To better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed. Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER). In 2015, Borgess Health re-established the Community Benefit Advisory Committee (CBAC). The CBAC represents nine (9) community agency leaders throughout Kalamazoo County and is intended to represent a wide range of expertise and services that impact our community's health status. Each committee member also holds numerous board and community committee positions in Kalamazoo and is adequately positioned to represent the community needs. The CBAC represented a large cross section of community agencies. The committee members' expertise involves public health, not-for-profit agencies, school/educational programs, elderly support services, family health centers, chronic disease specialty clinics, Borgess Health representatives involved in community work, and a local government official. All agencies and their representatives on the committee are involved with providing services to the medically underserved, low income and minority populations. The following list represents the Community Benefit Advisory Committee participating members and data sources: Family Health Center Catholic Charities Comstock Community Center Western Michigan University Borgess Health Borgess-Pipp Hospital Borgess Diabetes Center Kalamazoo County Health & Community Services Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER). The CHNA was conducted with the following hospital facility(s): -Ascension Borgess Lee Hospital -Ascension Borgess PIPP Hospital Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER). The CHNA was conducted with the following non-hospital facility(s): -Family Health Center -Kalamazoo County Health and Community Services Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) - Part 1. ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) is addressing the need identified in its most recent CHNA in the following ways: Prioritized Need #1 - Access to Care - Goal: Improve Access to Care Strategy 1: Reduce the racial disparity and improve birth outcomes among high risk women in Kalamazoo by increasing their access to prenatal care ** Women & Infant Supportive Help (WISH) Program ** The YWCA of Kalamazoo was the contracted agency for providing perinatal services to women in the Kalamazoo community who are at highest risk, "falling through the cracks" as many of them have been released or discharged from other home visiting and case management programs due to non-compliance or an inability to maintain effective contact with service agencies. Many programs do not have the resources to continue to follow these high-risk, complex cases. The WISH program is designed to be a safety net for this client population. What makes the WISH program unique is that there are no eligibility requirements other than being a perinatal Kalamazoo area resident. Additionally, the women served through this program are those at highest risk for poor birth outcomes, and through this program are receiving comprehensive and intensive case management throughout the perinatal period. The WISH program, which ended in July 2018 but continues as a YWCA program, reached capacity (average monthly caseload was over 50 women) and served the maximum number of women projected to participate at program end through Ascension/Borgess funding. Monthly narrative program reports highlighted coordination of resources among providers including provision of transportation to prenatal, well child, and WIC appointments for clients, assisting with procurement of car seat vouchers from Safe Kids Kalamazoo, and coordination with the local YWCA of Kalamazoo to assist clients in receiving necessary household items. The program made it a priority to help clients minimize or eliminate the barriers they are facing which make it difficult to access the healthcare they need to ensure a safe Although funding for this program ended in July of 2018, the program will continue to operate (with technical assistance and programmatic guidance from Borgess and Cradle Kalamazoo) with United Way funding. A Year 2 program evaluation was conducted in May 2018 for program quality assurance purposes. Results of the evaluation were reported to appropriate stakeholders. ** Cradle Kalamazoo** - Borgess is a voting partner of the Cradle Kalamazoo Steering Committee. Cradle Kalamazoo, is a multi-agency community initiative led by YWCA Kalamazoo. This initiative is based on the work of many community members and organizations, including Dr. Arthur James who brought attention to and began working on the racial disparities in infant mortality in 1992. By bringing together community leaders and organizations to implement evidence-based and holistic interventions, the initiative's goal is to reduce infant death and promote respect for families, women and their children. Borgess leaders and associates attend bi-monthly steering committee meetings, and additionally attend the cultural competence sub-committee meetings. ** MDHHS Health Equity Grant Project ** - Borgess is a grantee of a Michigan Department of Health and Human Services grant to provide cultural competency assessment, training, strategy and operational policy change for women and infant health services. Borgess associates from IT, women's health, care management, community benefit and clinical informatics, as well as administration and HR, have been meeting with a national birth equity consultant and a Western Michigan University School of Medicine (WMed) professor for over a year to conduct grant programming. Over 50 Borgess associates have received training in 2017 and 2018 related to health equity, racial disparities and cultural competence. This work will continue indefinitely. ** Fetal Infant Mortality Review (FIMR)** - Borgess has a strong presence on the Kalamazoo FIMR committee. Representatives from the Birthing Center, Community Benefit, Care Management, and Women's Health attend monthly meetings along with numerous additional community agencies and healthcare organizations. FIMR is a process used to look at fetal and infant deaths. Findings are then given to a community action team to come up with creative ideas to help improve birth outcomes for women, and to reduce infant mortality in our community. FIMR can provide information about our health care system, and how it affects families when the attempt to get services. FIMR can also inform healthcare providers about what some mothers go through during their pregnancies and how it impacts the birth of their babies. A group of community individuals volunteer their time to look at why babies are dying. This group of people is called a Community Review Team (CRT). The team is made up of people like you and me who care about the death of an infant. Members include doctors, nurses, social workers, and others. Every month the CRT comes together to review cases about infants that died in the previous year. Each case is a summary of everything that can be found about the pregnancy and the infant. All names of babies, mothers, medical staff and facilities are removed to keep the information confidential. Strategy 2: Design, develop & deliver a Medical Mission at Home in downtown Kalamazoo. A Medical Mission at Home will be tabled until 2019 with a goal of planning this event at that time. Borgess is awaiting further direction from Ascension with regards to a national program. Prioritized Need #2 - Diabetes Prevention - Goal: Improve the health of those at-risk or living with diabetes Strategy 1: Provide diabetes screenings and education through community groups and local churches. Borgess Health has provided ** biometric screenings** in the community which includes height, weight, BMI, blood pressure, total and HDL cholesterol level as well as a random glucose reading to 289 individuals at 8 community locations. Approximately 45 individuals have been referred to their physician for prediabetes and we have an 80% referral completion rate. First year medical students through WMed have assisted at these screening on numerous occasions in 2018. They conduct blood pressures and provide counseling and education. In addition, Borgess has conducted awareness activities at 10 locations, assisting individuals with completion of the CDC Prediabetes Screening Test, which provides the participant with a score for determining their risk for prediabetes. 176 screening tests have been completed and these individuals also receive counseling and education about diabetes prevention. Diabetes presentations have been provided in the community to large groups of community residents at 3 locations, with 226 individuals in attendance. Borgess staff is working closely with the Borgess Diabetes & Endocrine Center to ensure consistent education and screening tools are utilized for each screening event. Monthly internal workgroup meetings have been held for Borgess Health staff involved in diabetes prevention activities including staff responsible for the CDC Diabetes Prevention Program (DPP) application for certification planning process (see Strategy 2.) Strategy 2: Design, develop, and distribute an online pre-diabetes program based on the CDC recognized Diabetes Prevention Lifestyle change program. While national Ascension priorities encourage participation in the CDC Diabetes Prevention Program (DPP), the Borgess Diabetes & Endocrine Center has taken the lead in application to the CDC to receive certification for a Diabetes Prevention Recognition Program (DPP.) Monthly in-person meetings are held with Borgess staff directly responsible for the DPP program implementation and monthly meetings are held with the Borgess diabetes management and prevention team. Application was made to the CDC as of March 2017. Several Borgess associates from the Diabetes Center, Borgess Health & Fitness Center, CorpFit, and additional departments have been trained as diabetes lifestyle coaches to lead the DPP program cohort classes. The first cohort DPP class began June 1, 2017 and will end in June of 2018. A second cohort began in August of 2017 and is nearing completion of the program (one year.) A third cohort began in April 2018 and will continue for one year. The CDC DPP program is complex and requires a year of proving successful outcomes in terms of participant retention as well as health goal outcomes. Although Borgess will not receive CDC recognition in FY 2018, the DPP committee will continue to conduct this important program, as the outcomes reported are significant. Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) - Part 2. Prioritized Need #3 - Infant Mortality Goal: Reduce racial disparities and improve birth outcomes among high-risk women in Kalamazoo by increasing their access to prenatal care. Strategy 1: Reduce the incidence of infant mortality in Kalamazoo ** Women & Infant Supportive Help (WISH) Program ** (See Prioritized Need 1, Access to Care, Strategy 1 report.) Community needs not addressed: Identified needs that will not be addressed were determined by availability of services in the community. Chronic diseases with substantial support in the community such as cancer, lung disease and heart disease are supported by strong Borgess health programs with a variety of available resources in addition to the support of the American Cancer Society, American Lung Association and the American Heart Association. Mental health and lack of providers is certainly a health priority, however, other agencies in the Kalamazoo area have greater resources to address this need. Injury prevention scored moderately high, but will not be addressed in the CHNA implementation strategy and action plans. 0 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self-pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part II Community Building Activities Research shows that social determinants of health and quality of life play a major role in the health status of individuals and communities. Community Building activities, which focus on improving the quality of life within a community, ultimately influence and improve health status. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2018 was $4,605,751 at charges, ($1,289,610 at cost). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 21. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The organization has a written debt collection policy and collection procedures will only pertain to patients that do net qualify for charity or financial assistance and who are not complying with payment arrangements that have been agreed to by the hospital and the patient. Schedule H, Part V, Section B, Line 16a FAP website A - Ascension Borgess Hospital: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/Michigan; Schedule H, Part V, Section B, Line 16b FAP Application website A - Ascension Borgess Hospital: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance/Michigan; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - Ascension Borgess Hospital: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance/Michigan; Schedule H, Part VI, Line 2 Needs assessment ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) reviews numerous reports and statistics, including epidemiological reports published by the Kalamazoo County Health and Human Services Department, admission and emergency room data to determine where the specific needs of the community are and where we can focus our efforts to offer assistance. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Information regarding financial assistance is posted in the admitting, and registration departments in addition to the emergency department. ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) has staff dedicated to assisting uninsured patients complete a means test and complete applications for public assistance. Patients are provided with contact numbers on their medical bills to contact the billing office if assistance is needed to pay their bill. We leave it up to the patient to contact us then we direct them through the Charity Care process or applying for other government assistance programs. Schedule H, Part VI, Line 4 Community information Kalamazoo is a two-hospital market with the consumers believing that there are two very good, equal healthcare facilities. However, because it's a newer facility with all private rooms, Bronson's reputation is partially based on facility amenities. Many consumers choose a hospital based on specific service needs and/or physician recommendations and preferences. Outside of Kalamazoo, the Borgess Health service area includes several small rural hospitals and two secondary service level hospitals. Description of Community: Assessment of Kalamazoo County and Borgess Health's Primary Service Areas The City of Kalamazoo is located within county and represents approximately 30% of the total population. The average annual income of a Kalamazoo county resident is $46,019 annually with 18.6% of the population falling below the poverty level. The current unemployment rate is 8.8%. Southwest Michigan Population Demographics and Trends Southwest Michigan is comprised of a nine-county region that borders Indiana. Kalamazoo County is at the heart of southwest Michigan and is the most densely populated of the nine counties. Together, the neighboring cities of Kalamazoo and Portage within the county represent the largest metropolitan area in the region. For the purpose of the Community Health Needs Assessment, we will define our focus on Kalamazoo County, which includes the cities Kalamazoo and Portage. In 2013 County Health Rankings were released on March 21, 2013 by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Kalamazoo County places in the middle of the 82 Michigan counties at the 46th rank. According to estimates by the U.S. Census, the City of Kalamazoo's population increased 0.64 percent from 74,262 to 74,743 between 2010 and 2011. During the same timeframe, the population of the City of Portage increased 0.71 percent from 46,292 to 46,624. Population Living in Poverty 2008-2010 estimates projected that 19.2% of the Kalamazoo County population or 46,091 people lived below the poverty level. The proportions of people living below the poverty level in Michigan (15.7%) as well as the proportion in the United States (14.4%) were lower than the proportion in Kalamazoo County. Within Kalamazoo County, the proportion of the population living below the poverty level varied by city and township. In 2008-2010, the City of Kalamazoo had the highest poverty rate with 36.0% of residents living below the poverty level. Poverty estimates for all cities and townships in Kalamazoo County are available from the American Community Survey as an average rate between 2006 and 2010. The highest rate was in the City of Kalamazoo; lowest rates were in Texas Township, Cooper Township, Climax Township, Ross Township, and Prairie Ronde Township. Schedule H, Part VI, Line 5 Promotion of community health ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) provides a number of services to the community at no or a very low cost to the general community and to uninsured patients in our comprehensive Diabetes Uninsured Clinic, Wellness Project offered to adults in Allegan County, pharmaceutical assistance program, and in-home nursing programs. We also provide health screenings e.g., colorectal, immunizations, mammograms and school physicals. Borgess has a history steeped in the tradition of serving the poor and underserved. Borgess leadership including the Board of Trustees are educated on the organization's mission and values and challenge themselves on how to serve the poor and underserved members of our community. Schedule H, Part VI, Line 6 Affiliated health care system ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) is a wholly owned subsidiary of Borgess Health Alliance, Inc. which is a member of Ascension Health. Ascension Health Alliance, D/B/A Ascension, is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic National health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities or health ministries, located in 23 states and the District of Columbia. Ascension and its member organizations are hereafter referred to collectively as the System. Ascension is sponsored by Ascension Sponsor, a public juridic person. The participating entities of Ascension Sponsor are the Daughters of Charity of St. Vincent De Paul, St. Louise Province; the Congregation of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. Ascension Borgess Hospital, located in Kalamazoo, Michigan, is a nonprofit acute care hospital. The Medical Center provides inpatient, outpatient, and emergency care services for the residents of Kalamazoo, Michigan. Admitting physicians are primarily practitioners in the local area. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services. The System directs its governance and management activities toward a strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each health ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: - Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured. - Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. - Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. - Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ration of each entity's total operation expenses to the entity's billed charges for patient care. true true false false false false false false false KATHY A YOUNG PRESIDENT & CEO (END 6/2018) 0 480392 0 553977 0 89770 0 17550 0 20850 0 1162539 0 0 RICHARD L FELBINGER CFO (END 8/2017) 0 236518 0 135698 0 251873 0 15444 0 16591 0 656125 0 0 J PATRICK DYSON CSO 0 381448 0 372111 0 51648 0 16491 0 13990 0 835689 0 0 ANTHONY F MCDONNELL CHIEF DEVELOPMENT OFFICER 0 171287 0 49432 0 11832 0 11818 0 20025 0 264394 0 0 ROBERT HILL MD CMO 0 317357 0 90390 0 24673 0 13500 0 32469 0 478389 0 0 LORI J BROWN RN CNO 244763 0 67875 0 25325 0 9769 0 21070 0 368802 0 0 0 JOHN RYDER COO 0 176486 0 39527 0 10573 0 12076 0 21266 0 259928 0 0 GEORGE R DREW MD PHYSICIAN 451220 0 0 0 4126 0 12150 0 21561 0 489056 0 0 0 CHRISTIAN ERTL MD PHYSICIAN 389533 0 49267 0 15235 0 14850 0 31492 0 500377 0 0 0 JESSICA D WILLIAMS MD PHYSICIAN 377560 0 62419 0 1305 0 14850 0 29633 0 485767 0 0 0 BRIAN T BOWDITCH MD PHYSICIAN 404819 0 0 0 2585 0 12150 0 31647 0 451202 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Ascension Health, a related organization of ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER uses the following methods to establish the compensation of the organization's CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization for calendar year 2017: RICHARD L FELBINGER - $98,490 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No payments were made to listed persons in Part VII under the non-qualified retirement plan during the year. Form 990, Part IV, Line 20b Audited FInancial Statements The activity of Ascension Borgess Hospital (f/k/a Borgess Medical Center) is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Ascension Borgess Hospital (f/k/a Borgess Medical Center) is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of Ascension Borgess Hospital (f/k/a Borgess Medical Center). Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO, THE PROCESS PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF Ascension Borgess Hospital (f/k/a Borgess Medical Center). INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE PRESIDENT & CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. Form 990, Part VI, Line 6 Classes of members or stockholders ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) has a single corporate member, Ascension Michigan, who has the ability to elect members of the governing body of the ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER). Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER) has a single corporate member, Ascension Michigan who has the ability to elect members to the governing body of the ASCENSION BORGESS HOSPITAL (F/K/A BORGESS MEDICAL CENTER). Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the Conflict of Interest Policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 15b Process to establish compensation of other employees IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 19 Required documents available to the public The organization will provide any documents open to public inspection upon request. Form 990, Part VIII, Line 2f Other Program Service Revenue Miscellaneous Program Revenue - Total Revenue: 3010, Related or Exempt Function Revenue: 3010, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Contracted Services Revenue - Total Revenue: 4550, Related or Exempt Function Revenue: 4550, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Lab Services - Total Revenue: 537571, Related or Exempt Function Revenue: , Unrelated Business Revenue: 537571, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Escheatment Revenue - Total Revenue: 3915, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 3915; Medical Records Fees - Total Revenue: 8937, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 8937; Miscellaneous Revenue - Total Revenue: 1109860, Related or Exempt Function Revenue: 838488, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 271372; Retail Sales - Total Revenue: 12513, Related or Exempt Function Revenue: 12513, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Medical Staff Dues - Total Revenue: 94188, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 94188; Form 990, Part XI, Line 9 Other changes in net assets or fund balances FAS 158 Pension Adjustment - 208093; Transfers to/from Alpha Fund - 2565863; Transfers to/from Affiliates - 122847; Form 990, Part XII, Line 2c Audit Committee Ascension Borgess Hospital (f/k/a Borgess Medical Center) is included in the consolidated financial statements of Ascension. The Finance and Audit committee of Ascension's Board assumes responsibility for the consolidated organization as a whole. 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