2018-05-15T08:57:31-04:00 2017-06-30 990 2016-07-01 383097861 MUNSON DIALYSIS CENTER MUNS 2319355000 1105 SIXTH STREET TRAVERSE CITY MI 49684 MARK A HEPLER CFO 2319355000 2018-05-14 2016 2022-09-23 18:48:47Z MARK S DEPONIO 2651 AERO PARK DRIVE TRAVERSE CITY MI 49684 5773509 false X N/A X 1992 MI MUNSON DIALYSIS CENTER PROVIDES RENAL DIALYSIS SERVICES TO THE RESIDENTS OF NORTHERN MICHIGAN. 6 0 59 0 0 5602325 5772081 -3147 -4576 562 220 5599740 5767725 0 0 2243157 2383248 0 0 2709236 2736335 4952393 5119583 647347 648142 3267534 3288398 473994 346716 2793540 2941682 MUNSON DIALYSIS CENTER PROVIDES RENAL DIALYSIS SERVICES TO THE RESIDENTS OF NORTHERN MICHIGAN. false false 4447473 5767167 MUNSON DIALYSIS CENTER PROVIDES RENAL DIALYSIS TREATMENTS TO PATIENTS IN THE MUNSON HEALTHCARE SERVICE AREA. IN TAX YEAR 2016, 23,162 TREATMENTS AND 87 TRAINING PROCEDURES WERE PROVIDED TO PATIENTS. 4447473 true false false false false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 6 0 true 59 true false false false false false false false false false false X 6 0 false false false false true true true true true false false true true true true true true true true false MI X NICOLE SULAK MUNSON HEALTHCARE 2319357777 4230 COPPER RIDGE DR TRAVERSE CITY MI 49684 TIMOTHY BINDER DIRECTOR 1.00 40.00 X 0 264565 43967 MARK S DEPONIO PRESIDENT/CH 2.00 40.00 X X 0 255531 34043 KEVIN ROGOLS DIRECTOR 1.00 40.00 X 0 245781 23894 PETER MARINOFF DIRECTOR 1.00 40.00 X 0 195157 37392 STEVE LEACH SEC/TREAS 2.00 40.00 X X 0 136145 28931 TIMOTHY G FRITZ DIRECTOR 1.00 40.00 X 0 128999 16782 MARK A HEPLER CFO 1.00 40.00 X 0 492007 81915 GEORGIA WILSON MDC DIRECTOR 40.00 X 121791 0 14926 121791 1718185 281850 1 false true false AHSA LLC PO BOX 945 TRAVERSE CITY MI 49685 EMPLOYMENT SERV 143622 1 MEDICARE AND MEDICAID PAYMENT 621990 4213788 4213788 RENAL DIALYSIS SERVICES 621990 1520470 1520470 RENT FROM RELATED ORGS 531120 37823 37823 5772081 558 558 650 5784 -5134 -5134 -5134 MISCELLANEOUS 621990 220 220 220 5767725 5767167 558 X 1808159 1484356 323803 184412 151388 33024 260266 213658 46608 130411 107057 23354 516095 302233 213862 23495 21473 2022 5283 5017 266 176985 176985 12830 9379 3451 675 675 162813 141439 21374 27750 24337 3413 MEDICAL SUPPLIES 1843768 1843768 COMMUNITY SUPPORT 23049 23049 MAINTENANCE AND REPAIR 20840 20840 NUTRITION COUNSELING SERV 18734 18734 -95982 -96915 933 5119583 4447473 672110 0 175 1066998 1073636 766456 859487 3459442 2271017 1267055 1188425 166850 166850 3267534 3288398 298994 268232 175000 78484 473994 346716 X 2793540 2941682 2793540 2941682 3267534 3288398 648142 -500000 X false true X true false X 166564 166564 2510207 1693097 817110 710728 557901 152827 71943 20019 51924 1188425 INVESTMENT IN EVERYGLADS DIALYSIS 166850 166850 DUE TO THIRD PARTY 78484 78484 false true false false false false false false false TIMOTHY BINDER DIRECTOR 199525 45648 19392 24016 19951 308532 MARK S DEPONIO PRESIDENT/CHAIR 193905 41420 20206 24834 9209 289574 KEVIN ROGOLS DIRECTOR 202596 42340 845 18563 5331 269675 PETER MARINOFF DIRECTOR 162901 31713 543 18294 19098 232549 STEVE LEACH SEC/TREAS 122316 13173 656 7339 21592 165076 MARK A HEPLER CFO 336845 96246 58916 56740 25175 573922 10889 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 TIMOTHY BINDER 0 13,508 0 MARK S. DEPONIO 0 13,200 0 KEVIN ROGOLS 0 12,485 0 PETER MARINOFF 0 10,046 0 MARK A. HEPLER 0 36,529 0 SCHEDULE J, PART III 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 OF MUNSON HEALTHCARE, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE RETIREMENT FUNDS ARE AVAILABLE TO THE PARTICIPANTS UPON THEIR RETIREMENT FROM MUNSON. FORM 990, PAGE 6, PART VI, LINE 6 MUNSON DIALYSIS CENTER 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 DIALYSIS CENTER TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING THE AMENDMENT OF THE ARTICLES OF INCORPORATION; AMENDMENT OF THE MISSION STATEMENT; ADOPTION OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION OR REORGANIZATION; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL TO THE PROPERTY AND ASSETS; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF MUNSON DIALYSIS CENTER; ACCEPTANCE OF THE ANNUAL BUDGET AND ANNUAL FINANCIAL STATEMENTS; INCURRENCE OF EXPENDITURES EXCEEDING BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT; INCURRENCE OF CERTAIN DEBT; CHANGE IN SCOPE OF SERVICES OR PROGRAMS PROVIDED BY MUNSON DIALYSIS CENTER; AND APPOINTMENT OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON DIALYSIS CENTER BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON DIALYSIS CENTER 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 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 IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES MUNSON DIALYSIS CENTER AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON DIALYSIS CENTER ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON DIALYSIS CENTER DOES NOT MAKE THE BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASED SERVICES 302,233 213,862 0 FORM 990, PART XI, LINE 9 INTERCOMPANY TRANSFER TO PARENT -500,000 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 HEATLH true MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE 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 HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 PARENT MI C3 12B N/A false MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI C3 10 MUNSON MED HEALTHCARE true MUNSON HEALTHCARE CADILLAC 1105 SIXTH ST TRAVERSE CITY MI 49684 471156297 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE 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 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 MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI N/A false false NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT 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 INC PO BOX 1188 TRAVERSE CITY MI 496851188 382704069 IMAGING MI N/A true false true false false false false false false false true true true true false true true true false true MUNSON HEALTHCARE M 243367 ACTUAL AMOUNT PAID MUNSON HEALTHCARE P 607659 ACTUAL AMOUNT PAID MUNSON HEALTHCARE Q 348173 ACTUAL AMOUNT PAID MUNSON HEALTHCARE B 500000 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER Q 1374120 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER P 3722853 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER O 87327 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 505371 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE M 70256 ACTUAL AMOUNT PAID PAUL OLIVER MEMORIAL HOSPITAL K 65982 LEASE CONTRACT PAYMENT SCHEDULE R MUNSON DIALYSIS CENTER 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.