2018-05-15T08:57:31-04:00 2017-06-30 990 2016-07-01 471156297 MUNSON HEALTHCARE CADILLAC MUNS 2319355000 1105 SIXTH STREET TRAVERSE CITY MI 49684 MARK HEPLER CFO 2319355000 2018-05-14 2016 2022-09-23 18:48:47Z TONYA SMITH 400 HOBART ST CADILLAC MI 49601 88437651 false X WWW.MUNSONHEALTHCARE.ORG X 2014 MI COMMUNITY HOSPITAL AND HEALTH-RELATED SERVICES 14 11 836 127 0 1461419 1890208 82421857 85208206 2164 -6448 986466 1335037 84871906 88427003 134935 153865 0 40628676 42377115 0 135719 42713282 44792154 83476893 87323134 1395013 1103869 40119857 43560744 25823994 28161012 14295863 15399732 NONE. false false 73595870 153865 85197558 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF CADILLAC, MICHIGAN AND THE SURROUNDING AREA WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. 73595870 true true false true false false false false false true true false false false true false false true false false false false false false false false true 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ROGERS CHAIR 2.00 X X 0 0 0 JEREMY WINKLE DIRECTOR 1.00 X 0 0 0 MARK HEPLER CFO 1.00 40.00 X 0 492007 81915 MIKE ZDRODOWSKI CHIEF OPERAT 40.00 X 192277 0 40160 KENT C BOWDEN PHYSICIAN 40.00 X 771232 0 39711 TIMOTHY ISERI PHYSICIAN 40.00 X 483105 0 27254 SARAH S HELM PHYSICIAN 40.00 X 339205 0 36702 CHARLES URSE PHYSICIAN 40.00 X 332443 0 40594 NELSON POU PHYSICIAN 40.00 X 325398 0 20120 2443660 1740409 506782 35 false true false INDIGO HOSPITAL MEDICINE CADILLAC PL 10850 E TRAVERSE HWY STE 4400 TRAVERSE CITY MI 49684 MEDICAL SERVICE 2018713 AGILITY HEALTH-GRAND RAPIDS PO BOX 5509 CAROL STREAM IL 601975509 MEDICAL SERVICE 1287286 SODEXO INC AND AFFILIATES 10 EARHART DRIVE WILLIAMSVILLE NY 14221 FOOD SERVICE 835303 AHSA LLC PO BOX 945 TRAVERSE CITY MI 49685 STAFFING 550721 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 554809146 LABORATORY SERV 421513 14 1707171 174277 8760 1890208 MEDICARE AND MEDICAID PMTS 621990 46644815 46644815 PATIENT SERVICE REVENUE 621990 37977404 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0.00230 209681 15000 194681 0.00230 true 2616365 854848 22732418 25876539 -3144121 X true true 1 1 MUNSON HEALTHCARE CADILLAC 400 HOBART ST CADILLAC MI 49601 WWW.MUNSONHEALTHCARE.ORG 1060000041 X X X MUNSON HEALTHCARE CADILLAC 1 false false true X X X X X X X X 15 true false true true X HTTP://WWW.MUNSONHEALTHCARE.ORG/UPLOAD X true 15 true HTTPS://WWW.MUNSONHEALTHCARE.ORG/UPLOA false true X 200.000000000000 400.000000000000 X X X true true X X X true X HTTP://WWW.MUNSONHEALTHCARE.ORG/UPLOAD X HTTP://WWW.MUNSONHEALTHCARE.ORG/UPLOAD X HTTP://WWW.MUNSONHEALTHCARE.ORG/FINANC X X X X X X X true X false X X X X X true X false false FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 5 MUNSON HEALTHCARE CADILLAC HOSPITAL COMPLETED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN TAX YEAR 2015. THE PROCESS WAS INCLUSIVE AND TRANSPARENT, INVOLVING LEADERSHIP FROM MUNSON HEALTHCARE COMMUNITY HEALTH COMMITTEE OF THE BOARD, DISTRICT HEALTH DEPARTMENT 10, ALONG WITH REPRESENTATION FROM MULTIPLE WEXFORD/MISSAUKEE HUMAN SERVICE ORGANIZATIONS, AND VARIOUS KEY STAKEHOLDER GROUPS LISTED BELOW. NO WRITTEN COMMENTS WERE RECEIVED ON THE CHNA OR IMPLEMENTATION STRATEGY. MUNSON HEALTHCARE CADILLAC HOSPITAL PARTNERED WITH DISTRICT HEALTH DEPARTMENT 10, TO CONDUCT TWO COMMUNITY CONVERSATIONS DESIGNED TO SOLICIT FEEDBACK FROM THE BROAD COMMUNITY. THE TECHNOLOGY OF PARTICIPATION (TOP) CONSENSUS WORKSHOP APPROACH WAS USED TO ALLOW A HIGHLY STRUCTURED YET PARTICIPATORY APPROACH TO COLLECTING, ORGANIZING AND REPORTING INPUT. IT IS BASED ON A FOCUS QUESTION, SUCH AS "WHAT ARE THE BARRIERS TO ACHIEVING THE GOAL OF HEALTHY PEOPLE IN HEALTHY COMMUNITIES HERE IN WEXFORD AND MISSAUKEE COUNTIES?" THE DATES AND LOCATIONS OF THESE CONVERSATIONS ARE: CADILLAC AREA HEALTH COALITION, JANUARY 12, 2016, CADILLAC, MICH., HUMAN SERVICES LEADERSHIP COLLABORATIVE, JANUARY 26, 2016, CADILLAC, MICH. ADDITIONALLY, TWO SEPARATE SURVEYS WERE DISTRIBUTED TO BOTH COMMUNITY MEMBERS "WHAT MATTERS TO YOU?" SURVEY AND HEALTHCARE PROVIDERS "HEALTH CARE PROVIDER" SURVEY TO COLLECT COMMUNITY DATA. WEXFORD AND MISSAUKEE COUNTIES COMPLETED THE "WHAT MATTERS TO YOU?" SURVEY FROM DECEMBER 9, 2015 - JANUARY 22, 2016. PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS COMPLETED A "HEALTH CARE PROVIDER" SURVEY FOR WEXFORD AND MISSAUKEE COUNTIES FROM NOVEMBER 5 - NOVEMBER 11, 2015. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 6B FACILITY 1, PART V, LINE 6B MUNSON HEALTHCARE CADILLAC HOSPITAL PARTNERED WITH DISTRICT HEALTH DEPARTMENT 10, ALONG WITH REPRESENTATION FROM THE CADILLAC AREA HEALTH COALITION AND HUMAN SERVICES LEADERSHIP COLLABORATIVE COMPRISED OF HOSPITAL LEADERS AND PUBLIC HEALTH OFFICIALS, AS LISTED IN APPENDIX A OF THE CHNA. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, SECTION B, LINE 7: 7A. FULL URL TO THE CHNA: HTTP://WWW.MUNSONHEALTHCARE.ORG/UPLOAD/DOCS/CHNA/2016%20MMC%20CHNA.PDF FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, SECTION B, LINE 10: 10A. FULL URL TO THE IMPLEMENTATION STRATEGY HTTPS://WWW.MUNSONHEALTHCARE.ORG/UPLOAD/DOCS/CHNA/2016%20MMC%20CHNA %20IMPLEMENTATION%20STRATEGY%20-%20MMC%20(11.03.16).PDF FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 11 WITH THE SUPPORT OF THE MUNSON HEALTHCARE BOARD'S COMMUNITY HEALTH COMMITTEE, MUNSON HEALTHCARE CADILLAC PARTICIPATES IN THE CONTINUAL EVALUATION OF THE HEALTH PROGRAMS DESIGNED TO MEET THE NEEDS OF THE COMMUNITIES IN CADILLAC HOSPITAL'S SERVICE AREA. AS OUTLINED IN THE COMMUNITY HEALTH IMPLEMENTATION STRATEGY, THE CONTINUATION OF SUCCESSFUL PROGRAMS, COMBINED WITH OPPORTUNITIES TO INITIATE NEW PROGRAMS AT THE HOSPITAL OR AS A PARTNER IN MORE BROAD-BASED EFFORTS, FORM THE STRATEGIC BASIS TO IMPROVE ISSUES SURROUNDING HEALTH AND HEALTHCARE DELIVERY. OTHER SIGNIFICANT NEEDS THAT HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT INCLUDE: HEALTH DISPARITIES AND SOCIAL DETERMINANTS OF HEALTH, SUBSTANCE ABUSE, TOBACCO USE AND MENTAL HEALTH. ALTHOUGH MUNSON HEALTHCARE CADILLAC HOSPITAL FEELS THESE ARE IMPORTANT HEALTH NEEDS, THE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS IDENTIFIED IN THE CHNA AS PART OF THIS IMPLEMENTATION PLAN DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES TO THE THREE PRIORITY HEALTH NEEDS IDENTIFIED. MUNSON HEALTHCARE CADILLAC HOSPITAL WILL CONTINUE TO EVALUATE OPPORTUNITIES TO COLLABORATE WITH COMMUNITY PARTNERS TO COMMIT TO IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 13H PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, AT THE SOLE DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE CADILLAC - QUESTION V, SECTION B, LINE 16: 16A. FULL URL TO FINANCIAL ASSISTANCE POLICY: HTTP://WWW.MUNSONHEALTHCARE.ORG/UPLOAD/DOCS/PATIENTS%20AND %20VISITORS/FINANCIAL%20ASSISTANCE/FINANCIAL-ASSISTANCE-POLICY-10.16-17.PDF 16B. FULL URL TO FINANCIAL ASSISTANCE POLICY APPLICATION: HTTP://WWW.MUNSONHEALTHCARE.ORG/UPLOAD/DOCS/MUNSON%20HEALTHCARE/FINANCIAL %20ASSISTANCE/MUNSON%20MEDICAL%202.18.PDF 16C. FULL URL TO PLAIN LANGUAGE SUMMARY: HTTP://WWW.MUNSONHEALTHCARE.ORG/FINANCIALHELP FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 16J IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE. FACILITY 1, MUNSON HEALTHCARE CADILLAC - PART V, LINE 20E MUNSON HEALTHCARE CADILLAC REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. MUNSON WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2.DOCUMENTING THAT MUNSON HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH MHC DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. MUNSON WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS. 4 MUNSON HEALTHCARE CADILLAC REHABILI 704 OAK ST CADILLAC MI 49601 REHABILITAITON SERVICE MUNSON HEALTHCARE CADILLAC OBGYN 7985 MACKINAW TRAIL CADILLAC MI 49601 PHYSICIAN PRACTICE - WOMEN'S HEALTH CADILLAC SURGICAL CARE 927 S CARMEL ST CADILLAC MI 49601 PHYSICIAN PRACTICE - SURGICAL SERVICES WOMEN'S HEALTH SPECIALISTS 7800 US 131 STE C CADILLAC MI 49601 PHYSICIAN PRACTICE - WOMEN'S HEALTH PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE INCOME UP TO 200% OF THE FPG = 100% DISCOUNT ON CHARGES INCOME BETWEEN 201% AND 300% FPG = 75% DISCOUNT ON CHARGES INCOME BETWEEN 301% AND 400% FPG = 65% DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE, OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS. FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG: EARNINGS, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES; CASH, CHECKING AND SAVINGS BALANCES, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, IRAS TRUSTS, INHERITANCES, ANNUITIES, SAVINGS BONDS, STOCKS, MUTUAL FUNDS, AND/OR CASH VALUE OF LIFE INSURANCE. PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 6,046,959. THESE COSTS ARE OFFSET BY RELATED REVENUES IN COMPUTING THE NET COMMUNITY BENEFIT. PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 87,323,134. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 2,616,365. THE NET EXPENSE OF 84,706,769 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO. PART II - COMMUNITY BUILDING ACTIVITIES MUNSON HEALTHCARE CADILLAC PROVIDED 194,681 OF COMMUNITY-BUILDING ACTIVITIES DURING THE 2017 FISCAL YEAR. CADILLAC HOSPITAL BELIEVES THESE ACTIVITIES PROMOTE HEALTH BY SUPPORTING THE UNDERLYING SUPPORT STRUCTURE OF COMMUNITY HEALTH. THE MAJORITY OF COMMUNITY BUILDING FUNDS WERE DESIGNATED FOR WORKFORCE DEVELOPMENT. SPECIFICALLY, SINCE WEXFORD AND MISSAUKEE COUNTIES ARE DESIGNATED AS A MEDICALLY UNDERSERVED AREA, CADILLAC HOSPITAL INVESTS DOLLARS INTO THE RECRUITMENT OF CRITICALLY NEEDED PHYSICIANS TO THE AREA TO PROMOTE PATIENT ACCESS TO CARE. A SHORTAGE OF PRIMARY CARE PHYSICIANS IN THE AREA REPRESENTS A BARRIER FOR MANY PEOPLE MANAGING THEIR HEALTH. PHYSICIANS FROM WEXFORD COUNTY SERVE MANY MISSAUKEE, OSCEOLA, AND LAKE COUNTY RESIDENTS DUE TO MINIMAL PROVIDERS IN THESE COUNTIES. INVESTMENT IN PHYSICIAN RECRUITMENT AND DEVELOPMENT ATTRACTS AND RETAINS PHYSICIANS WHO WILL HAVE A DEGREE OF LONGEVITY IN THE SERVICE AREA WHICH BENEFITS THE COMMUNITY FOR THE LONG TERM. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY DIRECT WRITE-OFF FROM UNPAID ACCOUNTS WHICH ARE DEEMED NO LONGER COLLECTIBLE ARE RECORDED AGAINST THE ALLOWANCE FOR BAD DEBT. AN ESTIMATE OF BAD DEBT EXPENSE IS RECORDED BASED ON 1) AN ANALYSIS OF THE DIRECT WRITE- OFFS AND 2) AN ESTIMATE OF THE AMOUNT OF BAD DEBT, NET OF DISCOUNTS, IN THE ACCOUNTS RECEIVABLE BALANCE, CONSIDERING THE PAST EXPERIENCE AND CURRENT TRENDS OF PAYMENTS ON PATIENT ACCOUNTS FOR EACH OF THE MAJOR PAYOR SOURCES OF REVENUE. PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE THE METHODOLOGY USED TO DETERMINE THE ESTIMATED AMOUNT OF CHARITY IN BAD DEBT IS AS FOLLOWS. WE DETERMINED THE APPROVAL RATE OF FINANCIAL COUNSELING BY TAKING THE VALUE OF THE ACCOUNTS THAT SUCCESSFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT WERE DENIED. THEN WE APPLIED THAT PERCENTAGE TO THE VALUE OF ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS THE ACCOUNTS RECEIVABLE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF MUNSON HEALTHCARE AND SUBSIDIARIES OF THE ATTACHED STATEMENTS STATES: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING AND HISTORICAL WRITE- OFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER AMOUNTS DUE FROM THIRD-PARTY PAYORS ARE SATISFIED AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES. PART III, LINE 8 - MEDICARE EXPLANATION MUNSON HEALTHCARE CADILLAC CONSIDERS THE ENTIRE MEDICARE SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION MUNSON HEALTHCARE'S INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684. PART VI, LINE 2 - NEEDS ASSESSMENT THE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE (CHC) TO SERVE THE MUNSON HEALTHCARE SYSTEM. THE CHC CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM MUNSON HEALTHCARE HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON HEALTHCARE BOARD CHAIRPERSON. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MHC RESPONSE TO ANY EMERGING HEALTH TRENDS AS IDENTIFIED BY COMMUNITY HEALTH NEEDS ASSESSMENT, AND REVIEW ANY NEW COMMUNITY HEALTH BASED COLLABORATION OR PROGRAM. THE CHC IS RESPONSIBLE FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MHC COMMUNITY BENEFIT PROGRAMS AND SERVICES. THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT EMPLOYEES OF THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE SYSTEM ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN MUNSON HEALTHCARE'S EXTENSIVE GEOGRAPHICAL AREA. COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED, AS WELL AS WHERE PROGRESS HAS BEEN MADE. THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITY-WIDE. THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM PARTICIPATE IN A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. THE ASSESSMENT IS ACCOMPLISHED THROUGH COLLABORATION WITH MANY OF THE HUMAN SERVICE ORGANIZATIONS IN THE COMMUNITY. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS: BROCHURES THAT DESCRIBE MUNSON HEALTHCARE'S FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES. THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR. STATEMENT ON BILLS: STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL. SIGNS IN THE ER REGISTRATION AREA: ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY. THE MUNSON HEALTHCARE INTERNET HAS THE FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, THE PLAIN LANGUAGE SUMMARY AND THE BILLING AND COLLECTIONS POLICY AVAILABLE TO REVIEW AND PRINT. REFERRAL BY REGISTRATION STAFF: AT THE TIME OF REGISTRATION, SELF-PAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF. MUNSON HEALTHCARE FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS. THE COUNSELOR VISIT ALL INPATIENTS THAT ARE DEEMED SELF-PAY, TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP. IF THE PATIENT WOULD LIKE HELP, THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID. GENERALLY, THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR. ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR, THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS. THE COUNSELORS ALSO IDENTIFY ALL SELF-PAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS, ONLY BY PHONE. THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION, BUT WHEN THAT IS NOT POSSIBLE, THE CALL IS MADE SOON AFTER DISCHARGE. AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: MEDICAID (AND ALL OF ITS SUBSETS), SOCIAL SECURITY DISABILITY, TRAVERSE HEALTH CLINIC, MUNSON HEALTHCARE FINANCIAL ASSISTANCE, AND MUNSON MEDICAL CENTER MEDS PROGRAM. MUNSON HEALTHCARE MAKES A PHONE CALL TO ALL PRIVATE-PAY PATIENTS PRIOR TO TRANSFERRING THEIR ACCOUNT TO A COLLECTION AGENCY TO INFORM THEM OF OUR FINANCIAL ASSISTANCE POLICY. PART VI, LINE 4 - COMMUNITY INFORMATION DESCRIPTION MUNSON HEALTHCARE CADILLAC HOSPITAL IS LOCATED IN CADILLAC, MICHIGAN AND SITUATED IN WEXFORD COUNTY. THE HOSPITAL SERVES MORE THAN 63,000 PEOPLE IN WEXFORD AND MISSAUKEE COUNTIES, AS WELL AS PORTIONS OF NORTHERN OSCEOLA AND LAKE COUNTIES. WEXFORD AND MISSAUKEE COUNTIES ARE CONSIDERED OUR COMMUNITY BECAUSE A MAJORITY OF THE MUNSON HEALTHCARE CADILLAC HOSPITAL INPATIENT POPULATION RESIDES WITHIN THIS AREA. THE SERVICE AREA OF MUNSON HEALTHCARE CADILLAC HOSPITAL IS ENCOMPASSED BY DISTRICT HEALTH DEPARTMENT 10, IN ADDITION TO THE COUNTIES OF MECOSTA, NEWAYGO, OCEANA, MASON, MANISTEE, KALKASKA, AND CRAWFORD. HOSPITAL SERVICES CADILLAC PROVIDES 24-HOUR EMERGENCY CARE, ACUTE CARE, OUTPATIENT SURGICAL SERVICES, AND RESPITE CARE. SPECIALISTS FROM MUNSON MEDICAL CENTER, ALSO IN THE MUNSON SYSTEM, REGULARLY HOLD CLINICS AT CADILLAC, MAKING IT EASY TO RECEIVE SPECIALIZED CARE. IN THE CADILLAC MAIN SERVICE AREA OF WEXFORD COUNTY: 2010 CENSUS FOR WEXFORD COUNTY IS 32,735 (2017 POPULATION ESTIMATE IS 33,276) 15.8% OF THE 2010 POPULATION IS 65 YEARS OR OLDER (18.3% OF THE 2016 ESTIMATED POPULATION) UNEMPLOYMENT IS 6.7% (2018) 7.7% ESTIMATE UNINSURED (UNDER 65 YEARS OF AGE) (2016) 17.8% ESTIMATE LIVE BELOW THE FEDERAL POVERTY LEVEL (2016) QUALITY RECOGNIZED THREE TIMES AS ONE OF THE NATION'S 100 TOP HOSPITALS BY TRUVEN HEALTH ANALYTICS IN 2008, 2011, AND 2012 RECOGNIZED FOUR TIMES AS ONE OF HEALTH CARE'S MOST WIRED HOSPITALS BY THE AMERICAN HOSPITAL ASSOCIATION HOSPITALS & HEALTH NETWORKS MAGAZINE IN 2010, 2011, 2014, 2015 AND 2017 RECEIVED THE MICHIGAN GOVERNOR'S AWARD OF EXCELLENCE FOR IMPROVING PATIENT SAFETY AND QUALITY OF CARE IN THE HOSPITAL SETTING IN 2003, 2004, 2005, 2006, AND 2007. TWO-TIME WINNER OF THE MHA LUDWIG COMMUNITY BENEFIT AWARD FROM THE MICHIGAN HOSPITAL ASSOCIATION FOR THE CADILLAC COMMUNITY HEALTH CLINIC IN 2003 AND THE PARISH NURSE PROGRAM IN 1996 HOSPITAL SERVICES. HONORED FOR QUALITY BY THE NATIONAL ORGANIZATION OF STATE OFFICES OF RURAL HEALTH AND IVANTAGE HEALTH ANALYTICS 2016 RECEIVED FIVE-STAR QUALITY RATING FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) 2017 PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE CADILLAC HOSPITAL BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, THE MAJORITY OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, FUNDRAISING, AND GENERAL STEWARDSHIP. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS. CADILLAC HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA. EXAMPLES OF HOW CADILLAC HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PROGRAMS INCLUDE: HEALTHY FUTURES- A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS, HEALTH DEPARTMENTS AND MUNSON HEALTHCARE CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UNDER AGE 2. THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMES-BASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY, ACCESS TO HEALTH CARE AND IMMUNIZATIONS. SUPPORT GROUPS SUCH AS: BARIATRIC, CANCER, NORTHERNER'S BLIND SUPPORT AND DEPRESSION SUPPORT. NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- NORTHERN MICHIGAN DIABETES INITIATIVE (NMDI)- A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 11 COUNTY SERVICE AREA, WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES. NMDI IS COMMITTED TO PROVIDING LOCAL, REGIONAL, AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES. WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES, NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS: THE GENERAL COMMUNITY; THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION; AND RURAL PRIMARY CARE PROVIDERS (PCP) CARING FOR DIABETIC PATIENTS. SENIOR FIT - IN COLLABORATION WITH THE CADILLAC AREA YMCA, IS AN EVIDENCE-BASED MODEL IS DESIGNED TO IMPROVE THE OVERALL HEALTH OF SENIORS WHILE PROVIDING AN UNDERSTANDING OF HOW TO EXERCISE IN A SAFE AND EFFECTIVE MANNER. THIS PROGRAM HAS HAD POSITIVE CLINICAL OUTCOMES AND CONTINUES TO ENJOY MUCH SUCCESS WITH THE AVERAGE CLASS SIZE OF SEVENTY SENIORS PARTICIPATING TWICE A WEEK. COMMUNITY HEALTH PRACTITIONER - MUNSON HEALTHCARE CADILLAC HOSPITAL CONTINUES TO PARTNER WITH CATHOLIC HUMAN SERVICES TO SUBSIDIZE A COMMUNITY HEALTH PRACTITIONER (CHP) TO DELIVER CASE MANAGEMENT SERVICES FOR THOSE PRESENTING TO MUNSON HEALTHCARE CADILLAC HOSPITAL HAVING A SUBSTANCE ABUSE AND/OR MENTAL HEALTH CONDITION. THE PRACTITIONER INVITES THE PATIENT INTO A CARE COORDINATION RELATIONSHIP, TO PROVIDE ANSWERS TO QUESTIONS, ADDRESS CONTINUING NEEDS, GOALS AND PRIORITIES. ASSISTANCE IS PROVIDED WITH ACCESS TO RESOURCES, INCLUDING MEDICATION, TRANSPORTATION, PRIMARY CARE, MENTAL HEALTH AND SUBSTANCE ABUSE SUPPORT. UNITED WAY 2-1-1 - MUNSON HEALTHCARE CADILLAC HOSPITAL CONTINUES TO PROVIDE A VOICE OF SUPPORT FOR THE 2-1-1- INITIATIVE AND RECEIVES RECOGNITION AS A LEADER COMMITTED TO THE HEALTH AND WELFARE ACROSS OUR TWO COUNTIES. STEHOUWER FREE CLINIC - MUNSON CADILLAC HOSPITAL IS AN IMPORTANT FUNDING SOURCE FOR THE CLINIC AND IS COMMITTED TO SERVING THOSE IN THE COMMUNITY THAT HAVE LIMITED OR NO ACCESS TO CARE OTHERWISE. IN ADDITION TO AN ANNUAL DONATION, THE HOSPITAL PROVIDES IN-KIND SUPPORT TO THE CLINIC IN THE WAY OF IMAGING AND LAB SERVICES AND SELECT MEDICATIONS AT NO CHARGE. MUNSON CADILLAC HOSPITAL PARTNERS WITH THE MEDICATION ACCESS PROGRAM (MAP) PROVIDING PRESCRIPTION MEDICATIONS TO THOSE WHO ARE UNINSURED OR UNDERINSURED. MUNSON HEALTHCARE CADILLAC HOSPITAL PARTNERS WITH DISTRICT HEALTH DEPARTMENT 10 TO REDUCE THE RATE OF TOBACCO USE IN THE COMMUNITY WITH REFERRALS TO THE STATE OF MICHIGAN QUIT LINE ALONG WITH PROVIDING SMOKING CESSATION RESOURCES TO PREGNANT WOMEN. MUNSON HEALTHCARE CADILLAC HOSPITAL PARTNERS WITH MSU EXTENSION TO OFFER COOKING MATTERS FOR FAMILIES ONSITE. A NUTRITION PROGRAM WHERE PARTICIPANTS LEARN HOW TO EAT HEALTHY, COOK AND GROCERY SHOP ON A LIMITED BUDGET. THROUGH VARIOUS FUNDRAISING EVENTS AND ACTIVITIES, MUNSON HEALTHCARE CADILLAC HOSPITAL OFFERS REDUCED-COST MAMMOGRAPHY AND OTHER BREAST CANCER DIAGNOSTIC SERVICES TO PATIENTS THROUGHOUT THE COMMUNITY WHO ARE UNDERINSURED. WEXFORD-MISSAUKEE ISD TIME SHARE - MUNSON HEALTHCARE CADILLAC HOSPITAL HAS PARTNERED WITH THE WEXFORD-MISSAUKEE CAREER & TECHNICAL CENTER TO OFFER REAL WORLD MEDICAL EXPERIENCES TO OUR SECOND YEAR HEALTH SCIENCE CAREERS STUDENTS. TODAY, STUDENTS HAVE A STATE OF THE ART FACILITY TO PRACTICE THEIR SKILLS, LEARN FIRSTHAND WHAT GOES ON IN A HOSPITAL, FIGURE OUT WHAT AREA OF MEDICINE/HEALTH CARE THEY ARE MOST INTERESTED IN, ALL WHILE GAINING VALUABLE EXPERIENCE WORKING DIRECTLY ON THE FLOOR WITH THE CADILLAC HOSPITAL STAFF EVERY DAY. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM MUNSON HEALTHCARE CADILLAC'S SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM WHICH INCLUDE MUNSON MEDICAL CENTER, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL AND MUNSON HEALTHCARE MANISTEE HOSPITAL PROVIDED 53.6 MILLION OF COMMUNITY BENEFIT IN THE 2016 TAX YEAR. ADDITIONALLY, MMC WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA. THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON CAMPUS. COMMUNITY BENEFIT, IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR. NORTH FLIGHT, INC. IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM. WITH ITS FIXED WING AND HELICOPTER AIR SERVICES, IN COMBINATION WITH GROUND TRANSPORT, PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE. NORTH FLIGHT, INC. PROVIDED APPROXIMATELY 631,000 IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR. MUNSON MEDICAL GROUP, THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM, PROVIDED APPROXIMATELY 910,000 IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2016. MMC PERFORMS THE NEEDS ASSESSMENTS FOR MUNSON HEALTHCARE. UTILIZING THIS NEEDS ASSESSMENT, MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING, DEVELOPING, IMPLEMENTING, EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS. IN TOTAL, THE MUNSON HEALTHCARE SYSTEM PROVIDED 64.8 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS, INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS, OUTREACH PROGRAMS, BAD DEBT, AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN. true STEHOUWER FREE CLINIC 201 N MITCHELL ST STE L-1 CADILLAC MI 49601 611401888 501(C) 82250 MEDICALLY UNDERSERVE CADILLAC AREA YMCA 9845 CAMPUS DRIVE CADILLAC MI 49601 300013507 501(C) 36410 SENIOR/YOUTH FIT PRO CATHOLIC HUMAN SERVICES INC 1000 HASTINGS STREET TRAVERSE CITY MI 49686 383198322 501(C) 30000 COMMUNITY HEALTH UNITED WAY OF WEXFORD-MISSAUKEE PO BOX 177 CADILLAC MI 49601 237112549 501(C) 5205 COMMUNITY HEALTH 4 SCHEDULE I, PAGE 1, PART I, LINE 2 MUNSON HEALTHCARE CADILLAC MAY AWARD A GRANT OR CONTRIBUTION TO ANOTHER TAX EXEMPT ORGANIZATION BASED ON AN EVALUATION OF THE USE OF THE FUNDS FOR THE PROMOTION OF HEALTH IN THE COMMUNITY. THE ONGOING RELATIONSHIP OF MUNSON HEALTHCARE CADILLAC WITH ITS PARTNERS IN THE COMMUNITY FOR THE PROMOTION OF HEALTH ALLOWS FOR THE MONITORING OF THE GRANT AWARD. false true false false false false false false false EDWIN A NESS DIRECTOR 675627 261450 3790 146937 24643 1112447 TONYA SMITH PRESIDENT 260103 34438 494 28589 20157 343781 MARK HEPLER CFO 336845 96246 58916 56740 25175 573922 10889 MIKE ZDRODOWSKI CHIEF OPERATING OFFI 155813 35386 1078 17876 22284 232437 KENT C BOWDEN PHYSICIAN 752376 18856 12677 27034 810943 TIMOTHY ISERI PHYSICIAN 472409 10000 696 7350 19904 510359 SARAH S HELM PHYSICIAN 338391 814 12677 24025 375907 CHARLES URSE PHYSICIAN 328561 3882 12677 27917 373037 NELSON POU PHYSICIAN 299791 25033 574 8219 11901 345518 SCHEDULE J, PAGE 1, PART I, LINE 3 THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 134,260 0 TONYA SMITH 0 15,912 0 MARK HEPLER 0 36,529 0 MIKE ZDRODOWSKI 0 9,903 0 SCHEDULE J, PART III EXECUTIVE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON HEALTHCARE'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON HEALTHCARE. A CNTY GRD TRAV HOSP FIN AUTH 2014C 386004832 386523EH3 2014-12-17 16210267 PURCHASE THE ASSETS OF CADILLAC HOSPITAL false false false A 16210333 208029 16002304 2015 false false false true A false true false false false false true A false false true false false false false false true A true SCHEDULE K - DIFFERENCES IN ISSUE PRICE EXPLANATION CNTY GRD TRAV HOSP FIN AUTH 2014C INVESTMENT INCOME EARNED SCHEDULE K - ADDITIONAL INFORMATION CNTY GRD TRAV HOSP FIN AUTH 2014C MUNSON HEALTHCARE CADILLAC MAINTAINS POLICIES AND PROCEDURES TO REVIEW AND MONITOR ALL CONTRACTS, INCLUDING LEASES, MANAGEMENT, SERVICE AND RESEARCH CONTRACTS. THE MONITORING PROCESS INCLUDES A REVIEW BY THE CORPORATE INTERNAL LEGAL DEPARTMENT. OUTSIDE COUNSEL MAY BE CONSULTED, AS NECESSARY. OUTSIDE COUNSEL IS RETAINED FOR ALL NEW EXEMPT BOND OFFERINGS, DURING WHICH A THOROUGH DUE DILIGENCE PROCESS REVIEWS APPLICABLE CONTACTS. SINCE NEW BONDS WERE ISSUED IN 2014, OUTSIDE COUNSEL WAS ENGAGED DURING THAT TAX YEAR. OBLIGATED GROUP ISSUE RECORDED ON RELATED ORGANIZATIONS ON DECEMBER 17, 2014, THE MUNSON HEALTHCARE OBLIGATED GROUP ISSUED COUNTY OF GRAND TRAVERSE HOSPITAL FINANCE AUTHORITY REVENUE BONDS (MUNSON HEALTHCARE OBLIGATED GROUP) SERIES 2014A, 2014B AND 2014C, AT A PREMIUM. THE 2014 SERIES A BONDS ARE RECORDED ON MUNSON MEDICAL CENTER'S BOOKS AND RECORDS AT A PAR VALUE OF 27,620,000. THE 2014 SERIES B BONDS ARE RECORDED ON MUNSON HEALTHCARE GRAYLING'S BOOKS AND RECORDS AT A PAR VALUE OF 13,805,000. THE 2014 SERIES C BONDS ARE RECORDED ON MUNSON HEALTHCARE CADILLAC'S BOOKS AND RECORDS AT A PAR VALUE OF 15,870,000. THE RELATED BOND PREMIUM WAS RECORDED ON THE RESPECTIVE ENTITIES' BOOKS AND RECORDS. JENNIFER PIWOWARSKI FAMILY OF TRUST 199771 RELATED FAMILY COMP false FORM 990, PAGE 6, PART VI, LINE 6 MUNSON HEALTHCARE CADILLAC IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE DIRECTORS FOR SUBSIDIARY ENTITIES. NOMINATIONS TO MUNSON HEALTHCARE FOR SUBSIDIARY DIRECTORS ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON HEALTHCARE CADILLAC (CAD) TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF CAD; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF CAD; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF CAD; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR CAD; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY CAD WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF CAD WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF CAD; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY CAD; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE CADILLAC HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE CADILLAC HOSPITAL BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF EXECUTIVE COMPENSATION AND FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES OF MUNSON HEALTHCARE CADILLAC AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE CADILLAC ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE CADILLAC DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. FORM 990, PART IX, LINE 11G PURCHASED SERVICES 5,753,437 7,744,725 135,719 PROFESSIONAL FEES 3,370,995 520,831 0 TOTAL 9,124,432 8,265,556 135,719 MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUSNON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 HEALTHCARE MI C3 12B N/A false MUNSON HEALTHCARE FOUNDATIONS 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE true MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true MUNSON HOME HEALTH 1105 SIXTH ST TRAVERSE CITY MI 49684 383335362 HOME HEALT MI C3 12B MUNSON HC MUNSON HEALTHCARE true MUNSON HOME SERVICES 1105 SIXTH ST TRAVERSE CITY MI 49684 382543463 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 12B MUNSON HC MUNSON HEALTHCARE true PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI C3 10 MUNSON MED MUNSON MEDICAL CENTER true MUNSON HEALTHCARE GRAYLING 1105 SIXTH ST TRAVERSE CITY MI 49684 471161992 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CADILLAC FOUNDATI 1105 SIXTH ST TRAVERSE CITY MI 49684 472857600 RAISE FUND MI C3 7 MHC CADILL MUNSON HEALTHCARE CADILLAC true MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CHARLEVOIX HOSPIT 1105 SIXTH ST TRAVERSE CITY MI 49684 381459366 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE CHARLEVOIX HOSPITAL FOUNDATION 1105 SIXTH ST TRAVERSE CITY MI 49684 753078034 RAISE FUND MI C3 12A MHC CHARLE HOSPITAL true MUNSON HEALTHCARE MANISTEE HOSPITAL 1465 E PARKDALE AVE MANISTEE MI 496609709 380350304 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE MANISTEE HOSPITAL FOUNDATION 1465 E PARKDALE AVE MANISTEE MI 496609709 383565083 RAISE FUND MI C3 12A MHC MANIST HOSPITAL true NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI N/A false false MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true MUNSON SUPPORT SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A true SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true MEDICAL OFFICE CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true MUNSON MOBILE IMAGING PO BOX 1188 TRAVERSE CITY MI 496851188 382704069 IMAGING MI N/A true false false true false false false false false false false false true true false true true true true true MUNSON HEALTHCARE L 149938 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE M 7499827 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE Q 5641054 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE P 8767064 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE O 114312 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC FOUNDATI C 1707171 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE GRAYLING O 380020 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE GRAYLING P 262166 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE GRAYLING Q 484893 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE GRAYLING L 52178 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER L 123150 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER M 900225 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER O 110739 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER P 27940060 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER S 182693 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER Q 941922 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP M 282774 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP O 208564 ACTUAL AMOUNTS PAID MUNSON SUPPORT SERVICES M 281107 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE M 917311 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE O 320764 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE Q 65448 ACTUAL AMOUNTS PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 4002637 ACTUAL AMOUNTS PAID PAUL OLIVER MEMORIAL HOSPITAL P 186675 ACTUAL AMOUNTS PAID SCHEDULE R MUNSON HEALTHCARE CADILLAC USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.