2018-11-15T14:24:54-06:00 2017-12-31 381357951 PLANTE & MORAN PLLC 750 TRADE CENTRE WAY SUITE 300 PORTAGE MI 49002 990 2017-01-01 381359180 ALLEGAN GENERAL HOSPITAL ALLE 2696864280 555 LINN STREET ALLEGAN MI 49010 SHELLY WOODY WHITE III INTERIM CFO 2696864280 2018-11-15 1 CAROL LALONDE CPA P00181637 2695674500 2018-11-15 67.59.56.31 2018-11-15 14:21:22 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 58F74DC53CB874483B207ADF23CD6921384352E9 2017 2019-02-21 02:37:17Z SHIRLEY WOODY WHITE III 555 LINN STREET ALLEGAN MI 49010 46788057 0 X WWW.AGHOSP.ORG X 1944 MI THE HOSPITAL IS A SHORT-TERM, ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. 11 10 366 34 5402 0 399908 12915 36445653 34346237 9434 9058 7518988 8939304 44373983 43307514 0 0 0 0 20609469 20432620 0 0 0 23887646 26008351 44497115 46440971 -123132 -3133457 29009592 23618696 25357945 27300441 3651647 -3681745 TO PROVIDE EXCEPTIONAL, COMPASSIONATE, PERSONALIZED HEALTHCARE TO OUR COMMUNITY. 0 0 31542829 34346237 ANCILLARY MEDICAL SERVICES. 5479271 7957875 ROUTINE MEDICAL SERVICES; CHARITY CARE PROVIDED IN 2017 WAS APPROXIMATELY $119,304. 37022100 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 22 0 1 366 1 1 1 0 0 0 0 0 0 0 0 0 X 11 10 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X SHIRLEY WOODY WHITE III 2696864284 555 LINN STREET ALLEGAN MI 49010 STEVE MCKOWN CHAIRMAN 0.50 0.50 X X 0 0 0 JOHN WALSTRUM VICE CHAIR 0.50 40.00 X X 0 183847 46784 JAMES MUENZER TREASURER 0.50 1.00 X X 0 0 0 JIM CONNELL SECRETARY 0.50 1.00 X X 0 0 0 MATTHEW ANTKOVIAK BOARD MEMBER 0.50 0.00 X 0 0 0 JASON BURCHARDT BOARD MEMBER 0.50 0.00 X 0 0 0 KEVIN HARNESS BOARD MEMBER 0.50 0.00 X 0 0 0 CHRISTINE HASSING BOARD MEMBER 0.50 0.00 X 0 0 0 PAUL ANTON HODGE BOARD MEMBER 0.50 0.00 X 0 0 0 KIMBERLY SHRIVER BOARD MEMBER 0.50 0.00 X 0 0 0 JANNA TIBBITTS CPA BOARD MEMBER 0.50 0.00 X 0 0 0 GERALD BARBINI CEO-COMPENSATED BY QUORUM 39.00 1.00 X 281254 0 72563 RICHARD HARNING CHIEF FINANCIAL OFFICER 39.00 1.00 X 196993 0 39024 DAVID FEDERINKO CHIEF INFORMATION OFFICER 39.00 1.00 X 129020 0 40347 KATHY CHAPMAN CHIEF CLINICAL OFFICER 39.00 1.00 X 129482 0 27188 MARK WARNER ORTHOPEDIC SURGEON 40.00 0.00 X 785368 0 46337 MATTHEW RALPH GENERAL SURGEON 40.00 0.00 X 314676 0 46707 TIMOTHY FULLER CRNA 40.00 0.00 X 209912 0 53355 AURORA ANDREWS PSYCHIATRIST 40.00 0.00 X 253478 0 12337 TYLER WILHELM CRNA 40.00 0.00 X 235143 0 53431 2535326 183847 438073 16 0 1 1 WEST MICHIGAN REHABILITATION 576 LINN STREET ALLEGAN MI 49010 THERAPY SERVICES 1493175 EPMG 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 ER PHYSICIAN SERVICES 799772 ALLIANCE HNI 7647 COLLECTION CENTER DRIVE CHICAGO IL 60693 MRI SERVICES 587206 HEALOGICS WOUND CARE 28525 NETWORK PLACE CHICAGO IL 60673 WOUND CARE STAFF 543713 WEST MICHIGAN CANCER CENTER 200 N PARK STREET KALAMAZOO MI 49007 INFUSION STAFF 444181 17 12915 12915 PATIENT SERVICE 621110 34346237 34346237 34346237 9058 9058 474278 290351 183927 183927 183927 11148067 3190192 7957875 7957875 OTHER SERVICES 900099 636407 636407 CAFETERIA 722100 152938 5402 147536 GIFT SHOP 900099 8157 8157 797502 43307514 42304112 5402 985085 X 886974 886974 14049476 10729218 3320258 554134 476974 77160 3867519 3183609 683910 1074517 705500 369017 108098 108098 176525 176525 814 814 9206117 7461217 1744900 491419 394880 96539 469947 469947 3152306 2533034 619272 331881 266683 65198 SUPPLIES 6020506 5370995 649511 BAD DEBT EXPENSE 2987987 2987987 REPAIRS & MAINTENANCE 1696306 1363031 333275 1366445 1079025 287420 46440971 37022100 9418871 0 21430 113181 2958616 880213 4369254 4022459 1700184 1260709 308021 325008 54951188 40230433 16520209 14720755 311770 0 202648 0 2617460 2296371 29009592 23618696 5079650 5031014 19069331 20752995 1208964 1516432 25357945 27300441 X 3651647 -3681745 3651647 -3681745 29009592 23618696 X -3133457 -4199935 X X 1 X 1 X 1 0 X 0 0 0 0 0 0 0 0 1 814 814 0 PART II-B, LINE 1: A PORTION OF AHA DUES IS ALLOCATED TO LOBBYING ACTIVITIES. 70556 70556 27155361 17127257 10028104 27648143 23103176 4544967 77128 77128 14720755 OTHER ASSETS 139843 OTHER RECEIVABLES 1406528 NOTES FROM AFFILIATES 750000 2296371 COST REPORT SETTLEMENT 1516432 1516432 43834338 -2663368 -2663368 46497706 -3190192 -3190192 43307514 47206359 765388 765388 46440971 0 46440971 PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -2,987,987. ALLEGAN GENERAL PAIN MANAGEMENT REVENUE 704,702. CHANGE IN ALLEGAN GENERAL PAIN MANAGEMENT CONTROLLING INTEREST -177,435. IMPAIRMENT OF GOODWILL -202,648. PART XI, LINE 4B - OTHER ADJUSTMENTS: COST OF GOODS SOLD -3,190,192. PART XII, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -2,987,987. ALLEGAN GENERAL PAIN MANAGEMENT EXPENSES 563,183. COST OF GOODS SOLD 3,190,192. 1 1 X 1 X 250.000000000000 1 1 1 1 0 1 1 55601 0 55601 0.00130 8521107 5500559 3020548 0.06950 8576708 5500559 3076149 0.07080 110709 0 110709 0.00250 424971 0 424971 0.00980 17914 0 17914 0.00040 553594 553594 0.01270 9130302 5500559 3629743 0.08350 2 2882 0 2882 0.00010 56 7140 0 7140 0.00020 11 594 0 594 0.00000 6 2035 0 2035 0.00000 115779 0 115779 0.00270 75 128430 128430 0.00300 1 2987987 2240990 12879144 13436233 -557089 X 1 1 1 1 ALLEGAN GENERAL HOSPITAL 555 LINN STREET ALLEGAN MI 49010 M393862 X X X X ALLEGAN GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 0 1 1 X FULL WEBSITE LISTED IN "OTHER" X X 1 16 1 HTTPS://WWW.AGHOSP.ORG/SITES/WWW/UPLOADS/FILES/DOWNLOADS/COMMUNITY%20HEALTH 0 1 X 250.000000000000 0.000000000000 X X X X X 1 1 X X X X 1 X WWW.AGHOSP.ORG X WWW.AGHOSP.ORG X WWW.AGHOSP.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 ALLEGAN GENERAL HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, MOST DATA USED IN THE ANALYSIS WAS AVAILABLE FROM PUBLIC INTERNET SOURCES AND QUORUM PROPRIETARY DATA FROM TRUVEN. DATA SOURCES INCLUDE:1) WWW.COUNTYHEALTHRANKINGS.ORG - ASSESSMENT OF HEALTH NEEDS OF ALLEGAN COUNTY COMPARED TO ALL STATE COUNTIES 2) WWW.COMMUNITYHEALTH.HHS.GOV - ASSESSMENT OF HEALTH NEEDS OF ALLEGAN COUNTY COMPARED TO ITS NATIONAL SET OF "PEER COUNTIES"3) TRUVEN (FORMERLY KNOWN AS THOMPSON) MARKET PLANNER - ASSESS CHARACTERISTICS OF THE HOSPITAL'S PRIMARY SERVICE AREA, AT A ZIP CODE LEVEL, BASED ON CLASSIFYING THE POPULATION INTO VARIOUS SOCIO-ECONOMIC GROUPS, DETERMINING THE HEALTH AND MEDICAL TENDENCIES OF EACH GROUP AND CREATING AN AGGREGATE COMPOSITION OF THE SERVICE AREA ACCORDING TO THE POPULATION OF EACH GROUP IN THE ENTIRE AREA; AND, TO ACCESS POPULATION SIZE, TRENDS AND SOCIO-ECONOMIC CHARACTERISTICS4) WWW.CAPC.ORG AND WWW.GETPALLIATIVECARE.ORG - TO IDENTIFY THE AVAILABILITY OF PALLIATIVE CARE PROGRAMS AND SERVICES IN THE AREA5) WWW.CARINGINFO.ORG AND IWEB.NHPCO.ORG - TO IDENTIFY THE AVAILABILITY OF HOSPICE PROGRAMS IN THE COUNTY6) WWW.HEALTHMETRICSANDEVALUATION.ORG - TO EXAMINE THE PREVALENCE OF DIABETIC CONDITIONS AND CHANGE IN LIFE EXPECTANCY7) WWW.CDC.GOV - TO EXAMINE AREA TRENDS FOR HEART DISEASE AND STROKE8) HTTP://SVI.CDC.GOV - TO IDENTIFY THE SOCIAL VULNERABILITY INDEX VALUE9) WWW.CHNA.ORG - TO IDENTIFY POTENTIAL NEEDS FROM A VARIETY OF RESOURCES AND HEALTH NEEDS METRICS10) WWW.DATAWAREHOUSE.HRSA.GOV - TO IDENTIFY APPLICABLE MANPOWER SHORTAGE DESIGNATIONS11) WWW.WORLDLIFEEXPECTANCY.COM/USA-HEALTH-RANKINGS - TO DETERMINE RELATIVE IMPORTANCE AMONG 15 TOP CAUSES OF DEATHIN ADDITION TO GATHERING DATA FROM THE ABOVE SOURCES, QUORUM DEVELOPED A STANDARD PROCESS OF GATHERING COMMUNITY INPUT:1) WE DEPLOYED A CHNA "ROUND 1" SURVEY TO OUR LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITALS DESIRE TO REPRESENT THE REGION'S GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. WE RECEIVED COMMUNITY INPUT FROM 22 LOCAL EXPERT ADVISORS. SURVEY RESPONSES STARTED FEBRUARY 12, 2016 AND ENDED WITH THE LAST RESPONSE ON FEBRUARY 28, 2016.2) INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW ALLEGAN COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. RESPONDENTS COMMENTED ON WHETHER THEY BELIEVE CERTAIN POPULATION GROUPS ("PRIORITY POPULATIONS") NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT TO IMPROVE THE CONDITIONS OF THESE GROUPS. 3) LOCAL OPINIONS OF THE NEEDS OF PRIORITY POPULATIONS, WHILE PRESENTED IN ITS ENTIRETY IN THE APPENDIX, WAS ABSTRACTED IN THE FOLLOWING "TAKE-AWAY" BULLETED COMMENTS A) PRIORITY POPULATIONS HAVE A BARRIER TO ADEQUATE TRANSPORTATION B) OBESITY IS A MAJOR PROBLEM IN THE COMMUNITY C) MENTAL HEALTH SERVICES NEED TO BE EXPANDED WHEN THE ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL EXPERT ADVISORS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. THEY WERE FREE TO AUGMENT POTENTIAL CONCLUSIONS WITH ADDITIONAL COMMENTS OF NEED, AND NEW NEEDS DID EMERGE FROM THIS EXCHANGE. CONSULTATION WITH 21 LOCAL EXPERTS OCCURRED AGAIN VIA AN INTERNET-BASED SURVEY (EXPLAINED BELOW) BEGINNING MARCH 21, 2016 AND ENDING APRIL 25, 2016. HAVING TAKEN STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A "WISDOM OF CROWDS" METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS. IN THE AGH PROCESS, EACH LOCAL EXPERT HAD THE OPPORTUNITY TO INTRODUCE NEEDS PREVIOUSLY UNIDENTIFIED AND TO CHALLENGE CONCLUSIONS DEVELOPED FROM THE DATA ANALYSIS. WHILE THERE WERE A FEW OPINIONS OF THE DATA CONCLUSIONS NOT BEING COMPLETELY ACCURATE, THE VAST MAJORITY OF COMMENTS AGREED WITH OUR FINDINGS. WE DEVELOPED A SUMMARY OF ALL NEEDS IDENTIFIED BY ANY OF THE ANALYZED DATA SETS. THE LOCAL EXPERTS THEN ALLOCATED 100 POINTS AMONG THE POTENTIAL SIGNIFICANT NEED CANDIDATES, INCLUDING THE OPPORTUNITY TO AGAIN PRESENT ADDITIONAL NEEDS THAT WERE NOT IDENTIFIED FROM THE DATA. A RANK ORDER OF PRIORITIES EMERGED, WITH SOME NEEDS RECEIVING NONE OR VIRTUALLY NO SUPPORT, AND OTHER NEEDS RECEIVING IDENTICAL POINT ALLOCATIONS. ALLEGAN GENERAL HOSPITAL PART V, SECTION B, LINE 6B: QUORUM HEALTH RESOURCES ALLEGAN GENERAL HOSPITAL PART V, SECTION B, LINE 7D: FROM LINE 7A: HTTPS://WWW.AGHOSP.ORG/SITES/WWW/UPLOADS/FILES/DOWNLOADS/COMMUNITY%20HEALTH%20NEEDS%20ASSESSMENT%20FINAL-%208%204%202016%20ALLEGAN.PDF ALLEGAN GENERAL HOSPITAL PART V, SECTION B, LINE 11: WHILE THE CHNA IDENTIFIED OTHER HEALTH NEEDS, THEY WERE SEEN TO BE BEYOND THE SCOPE OF OUR SERVICES OR WE COULD NOT MAKE A SIGNIFICANT IMPACT UPON THEM DUE TO LIMITED PERSONNEL AND/OR FINANCIAL RESOURCES. ALLEGAN GENERAL HOSPITAL PART V, SECTION B, LINE 13B: THE HOSPITAL USES INCOME LEVELS, NUMBER OF DEPENDENTS, AND PATIENTS GUARANTORS AS FACTORS. PART I, LINE 7: THE COST TO CHARGE RATIO IS USED TO CALCULATE COMMUNITY BENEFIT. 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 $ 2,987,987. PART II, COMMUNITY BUILDING ACTIVITIES: WELLNESS PROGRAMS AND SPIRIT OF WOMEN OUTREACH PROGRAMS PART III, LINE 2: BAD DEBT EXPENSE IS CALCULATED USING THE COST TO CHARGE METHODOLOGY FROM THE INTERNAL FINANCIAL STATEMENTS. PART III, LINE 3: BASED ON PRIOR EXPERIENCE, ALLEGAN GENERAL HOSPITAL HAS DETERMINED THAT ROUGHLY 75% OF THE BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (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). 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 FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS 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. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. PART III, LINE 8: THE ESTIMATED MEDICARE SHORTFALL IS BASED ON THE COST TO CHARGE METHODOLOGY OF THE UNREIMBURSED COST OF CARE. ALL OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT AS MOST OF THESE PATIENTS ARE LIVING ON FIXED INCOMES AND DO NOT HAVE THE ABILITY TO HELP COVER THE COST OF THEIR MEDICAL CARE. THE MEDICAL FACILITY HAS TO ABSORB THESE COSTS AND IT IS DONE SO AS A BENEFIT TO THE COMMUNITY. PART III, LINE 9B: WHEN FINANCIAL ASSISTANCE PATIENTS ARE IDENTIFIED, COLLECTION ACTIVITY IS STOPPED AND THEIR ACCOUNTS ARE PLACED ON HOLD PENDING COMPLETION AND RETURN OF ALL REQUIRED DOCUMENTS. THE IDENTIFICATION CAN OCCUR AT PRE-REGISTRATION, DURING AN ADMISSION OR AFTER A PATIENT HAS RECEIVED A BALANCE OWING STATEMENT. THE APPROPRIATE PERCENTAGE OF DISCOUNT IS DETERMINED ONCE ALL INFORMATION IS RECEIVED BY THE HOSPITAL. THE ACCOUNTS INVOLVED WITH THE FINANCIAL ASSISTANCE ARE THEN REVIEWED, APPROVED, AND CREDIT ADJUSTMENTS POSTED TO THE ACCOUNTS. ANY ACCOUNTS THAT MAY HAVE A REMAINING BALANCE AFTER DISCOUNTING ARE RELEASED FROM HOLD AND THE PATIENT IS BILLED. PART VI, LINE 2: THE ORGANIZATION USES VARIOUS SURVEYS TO OBTAIN INFORMATION REGARDING THE NEEDS OF THE COMMUNITY. PART VI, LINE 3: OUR IN-HOUSE FINANCIAL COUNSELOR EDUCATES AND WORKS WITH PATIENTS TO GET FEDERAL ASSISTANCE OR TO APPLY FOR MEDICAID PART VI, LINE 4: ALLEGAN GENERAL HOSPITAL IS LOCATED IN ALLEGAN, MICHIGAN, THE COUNTY SEAT OF ALLEGAN COUNTY. ALLEGAN COUNTY IS APPROXIMATELY 40 MILES SOUTH OF GRAND RAPIDS, 80 MILES WEST OF LANSING AND 70 MILES NORTH OF SOUTH BEND, INDIANA. IN ADDITION TO THE HOSPITAL, OTHER MAJOR EMPLOYERS INCLUDE: PERRIGO COMPANY (3,200 EMPLOYEES), HAWORTH INC. (3,000 EMPLOYEES), PARKER HANNIFIN CORP. (700 EMPLOYEES), S 2 YACHTS INC. (600 EMPLOYEES), AND VENTUREDYNE CORP. (500 EMPLOYEES). ALLEGAN COUNTY HAS A TOTAL POPULATION OF APPROXIMATELY 100,000. APPROXIMATELY 30% OF THIS POPULATION IS OVER THE AGE OF 55, WITH 16% OVER THE AGE OF 65, WHICH IS IN LINE WITH THE STATE OF MICHIGAN AVERAGES OF 30% AND 16% RESPECTIVELY. ALLEGAN COUNTY'S POPULATION IS RELATIVELY YOUNG. AS THE POPULATION AGES, THE HOSPITAL SHOULD SEE AN OVERALL INCREASE IN PATIENT CARE DEMAND. ALLEGAN COUNTY'S MEDIAN HOUSEHOLD INCOME IN 2016 WAS $57,818, WHICH IS HIGHER THAN THE STATE AVERAGE OF $50,415 AND THE NATIONAL AVERAGE OF $55,072. PART VI, LINE 5: THE HOSPITAL'S MISSION IS TO PROVIDE EXCEPTIONAL, COMPASSIONATE, PERSONALIZED HEALTHCARE TO OUR COMMUNITY. THE HOSPITAL'S VISION IS TO BE THE TRUSTED HEALTHCARE PROVIDER OF CHOICE BY DEMONSTRATING CLINICAL AND OPERATIONAL EXCELLENCE, OUTSTANDING CUSTOMER SERVICE AND AN UNWAVERING COMMITMENT TO THE HEALTH OF OUR COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES MI X X X 0 0 0 0 0 0 0 0 0 JOHN WALSTRUM VICE CHAIR 0 183847 0 0 0 0 0 28129 0 18655 0 230631 0 0 GERALD BARBINI CEO-COMPENSATED BY QUORUM 281254 0 0 0 0 0 0 0 72563 0 353817 0 0 0 RICHARD HARNING CHIEF FINANCIAL OFFICER 196993 0 0 0 0 0 15541 0 23483 0 236017 0 0 0 DAVID FEDERINKO CHIEF INFORMATION OFFICER 129020 0 0 0 0 0 21874 0 18473 0 169367 0 0 0 KATHY CHAPMAN CHIEF CLINICAL OFFICER 129482 0 0 0 0 0 24514 0 2674 0 156670 0 0 0 MARK WARNER ORTHOPEDIC SURGEON 785368 0 0 0 0 0 22200 0 24137 0 831705 0 0 0 MATTHEW RALPH GENERAL SURGEON 314676 0 0 0 0 0 22835 0 23872 0 361383 0 0 0 TIMOTHY FULLER CRNA 209912 0 0 0 0 0 35511 0 17844 0 263267 0 0 0 AURORA ANDREWS PSYCHIATRIST 253478 0 0 0 0 0 5094 0 7243 0 265815 0 0 0 TYLER WILHELM CRNA 235143 0 0 0 0 0 29752 0 23679 0 288574 0 0 0 FORM 990, PART VII, LINE 1A: GERALD BARBINI IS COMPENSATED BY QUORUM, AN UNRELATED ORGANIZATION, AS CEO OF ALLEGAN GENERAL HOSPITAL. HIS TOTAL REPORTABLE COMPENSATION WAS $281,254. FORM 990, PART VI, SECTION A, LINE 3 THE CEO IS CONTRACTED OUT FROM A PROFESSIONAL STAFFING FIRM. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY THE CFO. ANY REPORTABLE INFORMATION IS SHARED WITH THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST PROCESS IS THAT BOARD MEMBERS AND THE LEADERSHIP TEAM ARE EXPECTED TO COMPLETE THE DISCLOSURE STATEMENTS ANNUALLY. THESE ARE REVIEWED BY THE COMPLIANCE OFFICER FOR ANY POTENTIAL ISSUES AND DISCUSSED WITH INDIVIDUAL BOARD MEMBERS AS NECESSARY. IF A MATERIAL CONFLICT IS IDENTIFIED, MEASURES ARE TAKEN TO MITIGATE THE CONFLICT. IF NECESSARY, EXTERNAL LEGAL COUNSEL WILL BE CONSULTED. FORM 990, PART VI, SECTION B, LINE 15 A REVIEW IS PERFORMED COMPARING CURRENT COMPENSATION TO EXTERNAL WAGE SURVEYS ON MARKET RATES. ADDITIONALLY, AN INDEPENDENT COMPENSATION CONSULTANT IS USED AND THE BOARD CONDUCTS A STUDY TO DETERMINE COMPENSATION. ALL DECISIONS ARE DOCUMENTED IN WRITTEN CONTRACTS AND THE BOARD MINUTES. THIS PROCESS IS PERFORMED ANNUALLY. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS 2017. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,766,875. MANAGEMENT AND GENERAL EXPENSES 352,757. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,119,632. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,376,215. MANAGEMENT AND GENERAL EXPENSES 1,314,368. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,690,583. OTHER FEES: PROGRAM SERVICE EXPENSES 318,127. MANAGEMENT AND GENERAL EXPENSES 77,775. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 395,902. FORM 990, PART XI, LINE 9: TRANSFER TO APHS -3,997,287. IMPAIRMENT OF GOODWILL -202,648. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGES IN PROCESS FROM PRIOR YEAR. ALLEGAN HEALTHCARE GROUP 555 LINN STREET ALLEGAN MI 49010 382802463 HOSPITAL MI 501(C)(3) LINE 12B, II N/A 0 ALLEGAN PROFESSIONAL HEALTH SERVICES 555 LINN STREET ALLEGAN MI 49010 205800012 HEALTHCARE MI 501(C)(3) LINE 3 ALLEGAN HEALTHCARE GROUP 1 ALLEGAN GENERAL HOSPITAL PAIN ADMINISTRATION SERVICES LLC 555 LINN STREET ALLEGAN MI 49010 473706652 PAIN MGMT SERVICES MI ALLEGAN GENERAL HOSPITAL INVESTMENT 72175 62200 0 0 0.51000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 ALLEGAN PROFESSIONAL HEALTH SERVICES R 3997287 CASH