2018-05-12T11:02:50-05:00 2017-06-30 990 2016-07-01 381490190 Lee Memorial Hospital Corporation LEEM 3147338000 420 W High Street Dowagiac MI 49047 Tonya Mershon Tax Officer 2018-05-12 2016 2021-01-29 14:40:06Z Borgess Lee Memorial Hospital John Ryder 420 W High Street Dowagiac MI 49047 27860735 false 0928 X www.healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee X 1954 MI To promote the health and well-being of the communities we serve. 11 9 247 47 0 0 70164 25189 28277696 27449951 1490 -947 144835 364322 28494185 27838515 0 0 0 14293426 15205485 0 0 0 10580322 10698770 24873748 25904255 3620437 1934260 14610010 13275510 14085244 11334946 524766 1940564 Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false false 21718658 27449951 LEE MEMORIAL HOSPITAL CORPORATION PROVIDES INPATIENT, SWING BED, AND OUTPATIENT SERVICES TO ALL RESIDENTS IN THE CASS COUNTY AREA REGARDLESS OF THEIR ABILITY TO PAY FOR THOSE SERVICES. 21718658 true true false false false false false false false false true false false 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 35 0 true 247 true false false false false false false false false false false X 11 9 false false false false true true true true true false false false true true true true true false false false X John Ryder 2697828681 420 W High Street Dowagiac MI 49047 KATHY A YOUNG PRESIDENT/CEO 1.0 39.0 X X 0 1155633 37924 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/TREASURER 1.0 3.0 X X 0 0 0 THOMAS J ROHS JR MD TRUSTEE 1.0 39.0 X 0 567805 43974 CHARLES BURLING DDS TRUSTEE 1.0 3.0 X 0 0 0 SANJAY DALAL MD TRUSTEE 1.0 3.0 X 0 0 0 GARY DRUSKOVICH MD TRUSTEE 1.0 3.0 X 0 0 0 MARY ELLEN GONDECK CSJ TRUSTEE 1.0 3.0 X 0 0 0 JAMES F HETTINGER TRUSTEE 1.0 3.0 X 0 0 0 MARY SLATER MD TRUSTEE 1.0 3.0 X 0 0 0 ROBERT HILL MD VP MEDICAL STAFF AFFAIRS 5.0 35.0 X 0 467372 40851 ASAD KIZILBASH MD CHIEF OF STAFF 40.0 0 X 0 0 0 JOHN RYDER COO 18.0 22.0 X 0 262583 40553 CHRISTOPHER FISH MD PHYSICIAN 40.0 0 X 388260 0 24911 ABBAS R SYED MD PHYSICIAN 40.0 0 X 319979 0 41329 AFTAB ANSARI MD PHYSICIAN 40.0 0 X 303738 0 17688 EREM E BOBRAKOV MD PHYSICIAN 40.0 0 X 301155 0 11586 GIASUDDIN AHMED MD PHYSICIAN 40.0 0 X 276485 0 32493 1589617 2453393 291309 23 false true false SOUTHWEST MI IMAGING 1700 Gull Road Kalamazoo MI 49048 CT & MRI Services 513715 PREMIER MEDICAL CARE 1535 Gull Road Kalamazoo MI 49048 Radiology Serivces 362765 AHSA LLC PO BOX 945 TRAVERSE CITY MI 49685 SUPPLEMENTAL STAFFING SERVICES 147944 WEST MICHIGAN CANCER CENTER 200 N PARK ST KALAMAZOO MI 49007 MEDICAL SERVICES 118150 4 14798 8760 1631 0 25189 Net Patient Revenue 621990 27371683 27371683 Government INcentives 900099 78268 78268 0 0 0 0 27449951 3115 3115 4803 4803 0 4803 4803 4062 0 -4062 -4062 -4062 35268 18158 17110 17110 Escheat Revenue 900099 12317 12317 Other Miscellaneous Revenue 900099 330092 330092 0 0 0 0 342409 27838515 27449951 0 363375 11536541 10561439 975102 158943 145509 13434 2754809 2521964 232845 755192 691361 63831 2530049 2518372 11677 0 14323 927 13396 81658 35718 45940 743 743 758108 312833 445275 45199 40655 4544 27571 24872 2699 819231 35522 783709 94317 94317 Medical Supplies 2730241 2730241 Purchased Services 2520258 1162458 1357800 Contract Labor 385259 385259 Equipment Rental 357372 357372 334441 193413 141028 0 25904255 21718658 4185597 0 1206 85960 354754 358359 5565335 3639268 0 0 0 358064 438414 0 167 18022011 10768831 6440195 7253180 0 0 808719 606539 1081737 893623 14610010 13275510 1673557 1525667 0 12411687 9809279 14085244 11334946 X 524766 1940564 524766 1940564 14610010 13275510 X 1934260 -518462 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 105071 105071 12134633 6814679 5319954 4249185 3776712 472473 1533122 177440 1355682 7253180 Estimated Third Party Payor Settlements 605000 Due from Affiliates 269569 Rent Receivable 19054 893623 Self Insurance Liability Pension & Other Post Retirement Liability 4171305 Due to Affiliates 4036798 Estimated Third Party Payor Settlements 1350340 AH Savings Plan Liability 137900 Other Noncurrent Liabilities 100000 Recovery Tail Liability 12936 9809279 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, 2017. true true X true X true X true true true false true true 1736404 1043859 692545 0.0267 7088370 5408031 1680339 0.0649 0 0 0 0.0 0 0 8824774 6451890 2372884 0.0916 1194 30914 30914 0.0012 139 232885 232885 0.0090 2 1327 265 1062 0.0000 0 0.0 2922 86812 86812 0.0034 0 4257 351938 265 351673 0.0136 0 4257 9176712 6452155 2724557 0.1052 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 611 9382 9382 0.0004 0 0.0 0 611 9382 0 9382 0.0004 false 985651 101378 4891488 4939919 -48431 X true true 1 1 Borgess Lee Memorial Hospital 420 West High Street Dowagiac MI 49047 http://www.borgess.com/about-us/community-health 1060000082 X X X X Borgess Lee Memorial Hospital 1 false false true X X X X X X X X 15 true false false true X https://healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee/Community-Benefit-Reports X true 15 true https://healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee/Community-Benefit-Reports false true X 200.0 350.0 X X X X true true X X X true X https://healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee/Financial-Assistance X https://healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee/Financial-Assistance X https://healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee/Financial-Assistance X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Borgess Lee Memorial Hospital. THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM HOSPITAL LEADERSHIP, REPRESENTATIVES FROM GOVERNMENTAL HEALTH ORGANIZATIONS, AND COMMUNITY AGENCY PEOPLE WHO ARE DIRECTLY INVOLVED IN PROVIDING SERVICES TO THE MEDICALLY UNDERSERVED, MINORITY, AND LOW INCOME POPULATIONS. THE FOLLOWING IS A LIST OF THE CHNA COMMITTEE MEMBERS AND THE ORGANIZATIONS THEY REPRESENT: 1- Jan Troeger - LEE MEMORIAL HOSPITAL 2- JOHN RYDER - LEE MEMORIAL HOSPITAL 3-Samantha Kreitner- LEE MEMORIAL HOSPITAL 4- BOB COCHRANE - CASS COUNTY COUNCIL ON AGING 5- MARY MIDDLETON - CASS FAMILY CLINIC 6- Kathy Valdes- DEPARTMENT OF HUMAN SERVICES 7- Ann Crabb, Delano Clinic 8- Matt Clay- POKAGON HEALTH CENTER 9- JEFF ELLIOT - VAN BUREN/CASS COUNTY DISTRICT HEALTH DEPARTMENT 10- KATHY EMANS - WOODLANDS BEHAVIORAL HEALTHCARE NETWORK 11- Jodi Bolyard - Borgess Medical Group 12- Danielle Persky - Van Buren Cass Health Department 13- Jodee Rolfe Community Benefits Manager Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Borgess Lee Memorial Hospital. During the most recently conducting CHNA, the following needs were identified: Access to Care - Expand Access to Mental Health Services -Create an FTE Position to add additional provider for expansion of Tele-Psychiatric Services -Offer One Mental Health First Aid Class in the Community -Explore implementing a pilot program of an integrated primary care and behavioral health Clinic Diabetes - improve the health of those at-risk or living with diabetes -Provide Diabetes Screenings and education through community groups and local churches -design, develop and distribute an online pre-diabetes program based on the CDC recognized diabetes prevention lifestyle change program Community Health Education - increase the quality, availability, and effectiveness of educational and community baed programs designed to prevent disease and injury, imporve health and enhance the quality of life. -increase the proportion of elementary, middle and senior high schools that receive health education with classes related to health promotion, disease prevention and mental health 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 Heath 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. The Cass /Van Buren District Health Department provide a number of community services. There is a mental health provider in Cass County, The Woodlands Behavioral Health Care. They provide services to those with mental health needs but there are far more needs in the community than they can provide. Because the demographics of the Cass County is rural coupled with high amount of poverty, there are significant community needs. However, resources are limited as well in this area. BLMH has chosen areas to address where they think they will make the most impact with the resources allotted . 0 Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. 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 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 2017 was $2,471,300 at charges, ($985,651 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 19. 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 not 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 - Borgess Lee Memorial Hospital: Line 16a URL: https://healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee/Financial-Assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - Borgess Lee Memorial Hospital: Line 16b URL: https://healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee/Financial-Assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Borgess Lee Memorial Hospital: Line 16c URL: https://healthcare.ascension.org/Locations/Michigan/Dowagiac-Borgess-Lee/Financial-Assistance; Schedule H, Part VI, Line 2 Needs assessment The CHNA Committee met six times over the course of twelve months. Members brought data to these meetings which was reviewed. Discussions and presentations helped committee members identify key community health priorities and resources available to meet them. This process provided a significant amount of data collection that covered multiple categories which related to health needs of Cass County. This data was synthesized to develop a Community Needs Scorecard, the frame work of the CHNA. -Discussion of community goals -Ability to make impact. What can community and Borgess-Lee do to improve goals? -Consider alignment with other systems in the county -Align with Healthy People 2020 Current programs and plans Effectiveness Duplication of services Resources - money and human need Implementation Plan FY2017 - 2019 -Mental Health Services -Explore collaboration with school system for integrated child and adolescent behavioral health program -Explore education within school system -FQHC provides assistance at Cass Schools for students with behavioral health issues. Practitioner completes education with students. -Work with Cass Clinic and implementation -Implement Tobacco cessation program -Diabetes Education -Improve DSME program -Review on-line diabetes program which is available at Borgess Medical Center -Community Collaborative -Assist high utilizers of services -Assist with transportation -Evaluate why utilization is high Schedule H, Part VI, Line 3 Patient education of eligibility for assistance As part of the intake process, the organization provides a copy of the policy and financial assistance contact information to patients. Also, available is a staff person to discuss with the patient the availability of various government benefits, such as Medicaid or state and local programs and assist the patient with qualification for such programs, where applicable. Schedule H, Part VI, Line 4 Community information Cass County is located in southwest Michigan and borders the State of Indiana. It covers about 491 square miles with a total population of 52,242. The area was originally inhabited by three bands of Potawatomi Indians. And during the Civil War, Cass County played a major role in the Underground Railroad which resulted in the settling of many Black families in the area. Both of these factors have contributed to the unique cultural diversity of the county. According to 2010 US Census Data Cass County has 20, 101 households. The current unemployment rate is about 8.1 %, below the state-wide average. The median household income is $45,432. The per capita income is $23,045. Both are below the Michigan average. The percentage of persons with Bachelor's degrees is 16. 7%, much lower than the Michigan average of 25%. About 90% of the full-time residents are white, 5.4% are African-American, 3% are Hispanic and 1% is Native American. About 13.3% of the residents fall below the poverty level, which is better than the state-wide average. The overall population tends to skew slightly older and is declining somewhat. Three characteristics combine to make Cass County somewhat unique, especially as it relates to serving health needs. The first is the county's rather large, rural/agriculture base. About 60% of Cass County is farm land ranking it 15th out of Michigan's 83 counties. Much of the farm land is used for growing seasonal fruits and vegetables which require migrant farm laborers to harvest. This results in a heavy influx of mostly Hispanic families which in turn impacts the need and delivery of health care services. The second characteristic relates to the significant recreational opportunities that abound in Cass County. It has over 250 lakes and the county's close proximity to major population centers in Indiana and Illinois makes a regional recreational "Mecca". During the summer, the population around the lakes grows significantly. Both the summer and full-time lake residents tend to be very affluent. While most of the health care needs of the summer residents are served by out-of-state providers, these people do impact the area's health care service delivery, especially emergency room and fast track primary care services. The third characteristic is the large blue-collar population in the county's two largest population centers-Dowagiac and Cassopolis. The City of Dowagiac is the county's largest city. It has about 2,400 households with a total population of 5,879. Median household income is $31,329 and per capita income is $17,739. Both are well below the county and state averages. Also, about 20% of the residents fall below the poverty rate. The Village of Cassopolis, the County Seat, ranks even lower. It has about 700 households with a total population of 1,774. Median household income is $24,781 and per capita income is $15,114. Almost 30% of the Cassopolis residents fall below the poverty level. Schedule H, Part VI, Line 5 Promotion of community health The organizations governing body is mostly comprised of persons who reside in Cass County and are neither employees nor contractors of the organization. The organization is a Critical Access Hospital and provides medical services to all people in the community without regard to the patient's race, creed, national origin, economic status or ability to pay, In addition the organization participates in Medicare Medicaid, CHAMPUS and other government sponsored health care programs, The organization provides education and materials for nutrition/weight loss management, PSA and Flu Shot Clinics. Schedule H, Part VI, Line 6 Affiliated health care system Lee Memorial Hospital Corporation is a wholly owned subsidiary Ascension Health. Ascension Health Alliance, d/b/a Ascension (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 of the Unites States and the District of Columbia. Ascension served as the member or shareholder of various subsidiaries. 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; the Congregation of the Sisters 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. The Hospital, located in Dowagiac, Michigan, is a nonprofit critical access hospital. The Hospital provides inpatient, outpatient, and emergency care services for the residents of Dowagiac, 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 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 of persons living in poverty and other community benefit programs is estimated by reducing charges foregone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care. Schedule H, Part VI, Line 7 State filing of community benefit report MI false true false false false false false false false KATHY A YOUNG PRESIDENT/CEO 0 481004 0 498252 0 176377 0 17225 0 20699 0 1193557 0 0 THOMAS J ROHS JR MD TRUSTEE 0 522521 0 42350 0 2934 0 13250 0 30724 0 611779 0 0 ROBERT HILL MD VP MEDICAL STAFF AFFAIRS 0 325743 0 121153 0 20476 0 11925 0 28926 0 508223 0 0 JOHN RYDER COO 0 175084 0 53001 0 34498 0 13153 0 27400 0 303136 0 0 CHRISTOPHER FISH MD PHYSICIAN 357075 0 28858 0 2327 0 6625 0 18286 0 413171 0 0 0 ABBAS R SYED MD PHYSICIAN 302878 0 8000 0 9101 0 11925 0 29404 0 361308 0 0 0 AFTAB ANSARI MD PHYSICIAN 295426 0 0 0 8312 0 5300 0 12388 0 321426 0 0 0 EREM E BOBRAKOV MD PHYSICIAN 277174 0 21128 0 2853 0 3481 0 8105 0 312741 0 0 0 GIASUDDIN AHMED MD PHYSICIAN 237223 0 32348 0 6914 0 6625 0 25868 0 308978 0 0 0 Schedule J, Part II Officer Compensation Asad Kizilbash, MD was paid by Apogee Medical Management for services provided to Lee Memorial Hospital Corporation. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH, A RELATED ORGANIZATION OF LEE MEMORIAL HOSPITAL CORPORATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE, - INDEPENDENT COMPENSATION CONSULTANT, - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. 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 individuals received current year distributions. 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 LEE MEMORIAL HOSPITAL CORPORATION 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 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE PROCESS PERFORMED BY BORGESS MEDICAL CENTER, A RELATED ORGANIZATION OF LEE MEMORIAL HOSPITAL CORPORATION, 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 6 Classes of members or stockholders Lee Memorial Hospital Corporation has a single corporate member, Ascension Michigan. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Lee Memorial Hospital Corporation has a single corporate member, Ascension Michigan, who has the ability to elect members to the governing body of Lee Memorial Hospital Corporation. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Lee Memorial Hospital Corporation financial information or corporation as a whole are subject to approval by its single corporate member, Ascension Michigan. 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 committee with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee 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 19 Required documents available to the public The organization will provide any documents open to public inspection upon request. Form 990, Part XI, Line 9 Other changes in net assets or fund balances FAS 158 Pension Adjustment - 86609; Transfers with Alpha Fund - -605071; Form 990, Part XII, Line 2b Audited Financial Statements The activity of Lee Memorial Hospital Corporation is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Lee Memorial Hospital Corporation is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of Lee Memorial Hospital Corporation. Form 990, Part XII, Line 2c Audit Committee Lee Memorial Hospital Corporation 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. ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I ASCENSION HEALTH ALLIANCE false ASCENSION MICHIGAN 28000 DEQUINDRE ROAD WARREN MI 48092 382631907 HEALTH CARE MI 501(c)(3) 10 ASCENSION HEALTH false BORGESS HEALTH ALLIANCE INC 1521 GULL ROAD KALAMAZOO MI 49048 382335286 HEALTH SYSTEM PARENT MI 501(c)(3) Type III-FI ASCENSION MICHIGAN true BORGESS MEDICAL CENTER 1521 GULL ROAD KALAMAZOO MI 49048 381360526 HEALTHCARE SERVICES MI 501(c)(3) 3 ASCENSION MICHIGAN true BRIGHTON CENTER FOR RECOVERY 12851 GRAND RIVER BRIGHTON MI 48116 381576680 HOSPITAL MI 501(c)(3) 3 ASCENSION MICHIGAN true GENESYS HEALTH SYSTEM ONE GENESYS PARKWAY GRAND BLANC MI 484398065 383339703 HEALTH SYSTEM PARENT MI 501(c)(3) Type II ASCENSION MICHIGAN true GENESYS REGIONAL MEDICAL CENTER ONE GENESYS PARKWAY GRAND BLANC MI 484398065 382377821 HOSPITAL MI 501(c)(3) 3 ASCENSION MICHIGAN true PROVIDENCE-PROVIDENCE PARK HOSPITAL 16001 WEST NINE MILE ROAD SOUTHFIELD MI 48037 381358212 HOSPITAL MI 501(c)(3) 3 ASCENSION MICHIGAN true ST JOHN HOSPITAL & MEDICAL CENTER 28000 DEQUINDRE ROAD WARREN MI 48092 381359063 HEALTH CARE MI 501(c)(3) 3 ASCENSION MICHIGAN true ST JOHN MACOMB-OAKLAND HOSPITAL 28000 DEQUINDRE ROAD WARREN MI 48092 383322109 HOSPITAL MI 501(c)(3) 3 ASCENSION MICHIGAN true ST JOHN PROVIDENCE 28000 DEQUINDRE ROAD WARREN MI 48092 382244034 PARENT MI 501(c)(3) Type III-FI ASCENSION MICHIGAN true ST JOHN RIVER DISTRICT HOSPITAL 4100 RIVER ROAD EAST CHINA MI 48054 383160564 HOSPITAL MI 501(c)(3) 3 ASCENSION MICHIGAN true ST JOSEPH HEALTH SYSTEM 200 HEMLOCK ROAD TAWAS CITY MI 48763 381443395 HEALTH CARE MI 501(c)(3) 3 ASCENSION MICHIGAN true ST MARY'S - ST JOSEPH HEALTH SYSTEM 800 S WASHINGTON AVENUE SAGINAW MI 48601 461084363 SUPPORTING ORGANIZATION MI 501(c)(3) Type III-FI ASCENSION MICHIGAN true ST MARY'S OF MICHIGAN MEDICAL CENTER 800 S WASHINGTON AVENUE SAGINAW MI 48601 380997730 HOSPITAL MI 501(c)(3) 3 ASCENSION MICHIGAN true STANDISH COMMUNITY HOSPITAL 805 WEST CEDEAR STREET STANDISH MI 48658 381671120 HOSPITAL MI 501(c)(3) 3 ASCENSION MICHIGAN true BORGESS AMBULATORY CARE CORPORATION 1521 GULL ROAD KALAMAZOO MI 49048 382468823 HOLDING COMPANY MI 501(c)(3) 3 BORGESS HEALTH ALLIANCE INC true BORGESS FOUNDATION 1521 GULL ROAD KALAMAZOO MI 49048 237222558 FUNDRAISING MI 501(c)(3) Type III-FI BORGESS HEALTH ALLIANCE INC true PROMED HEALTHCARE 1521 GULL ROAD KALAMAZOO MI 49048 383193801 HEALTHCARE SERVICES MI 501(c)(3) 10 BORGESS HEALTH ALLIANCE INC true CENTER FOR GERONTOLOGY 5455 ALI DRIVE DEPT200 GRAND BLANC MI 484395195 382514708 ADULT DAY CARE MI 501(c)(3) Type I GENESYS AMBULATORY HEALTH SERVICES true GENESYS CONVALESCENT CENTER 8481 HOLLY ROAD GRAND BLANC MI 484391812 382317364 CONVALESCENT CENTER MI 501(c)(3) 3 GENESYS AMBULATORY HEALTH SERVICES true GENESYS AMBULATORY HEALTH SERVICES 5455 ALI DR DEPT 200 GRAND BLANC MI 484395195 382371754 HEALTH SRVCS/STAFFING/PROP MNGT MI 501(c)(3) Type II GENESYS HEALTH SYSTEM true GENESYS HEALTH FOUNDATION ONE GENESYS PARKWAY GRAND BLANC MI 484398065 383591148 FOUNDATION MI 501(c)(3) Type I GENESYS HEALTH SYSTEM true HEALTH SOURCE GROUP 5455 ALI DR DEPT 200 GRAND BLANC MI 484395195 382427678 PRG RELATED INVESTMENTS MI 501(c)(3) Type I GENESYS HEALTH SYSTEM true LEE MEMORIAL FOUNDATION 420 W HIGH STREET DOWAGIAC MI 49047 382860459 FUNDRAISING MI 501(c)(3) Type III-FI LEE MEMORIAL HOSPITAL CORPORATION true EASTWOOD COMMUNITY CLINICS 28000 DEQUINDRE ROAD WARREN MI 48092 381958763 HEALTH CARE MI 501(c)(3) 10 ST JOHN PROVIDENCE true ASCENSION MEDICAL GROUP MICHIGAN FKA MEDICAL RESOURCES GROUP 43800 GARFIELD CLINTON TOWNSHIP MI 48038 383494637 HEALTH CARE MI 501(c)(3) 10 ST JOHN PROVIDENCE true PROVIDENCE HEALTH FOUNDATION 22101 MOROSS DETROIT MI 48236 383526629 FUNDRAISING MI 501(c)(3) Type III-FI ST JOHN PROVIDENCE true SETON HEALTH CORP OF SE MICHIGAN 28000 DEQUINDRE WARREN MI 48092 382820107 HEALTH CARE MI 501(c)(3) 10 ST JOHN PROVIDENCE true ST JOHN COMMUNITY HEALTH INVESTMENT CORP 28000 DEQUINDRE ROAD WARREN MI 48092 382262856 HEALTH CARE MI 501(c)(3) 3 ST JOHN PROVIDENCE true ST JOHN HOSPITAL FOUNDATION 22101 MOROSS DETROIT MI 48236 202961579 FUNDRAISING MI 501(c)(3) 7 ST JOHN PROVIDENCE true ST JOHN PROVIDENCE PHYSICIANS CMG 28000 DEQUINDRE ROAD WARREN MI 48092 382601348 HEALTH CARE MI 501(c)(3) 10 ST JOHN PROVIDENCE true ST JOSEPH HEALTH SYSTEM FOUNDATION 200 HEMLOCK ROAD TAWAS CITY MI 48763 010790428 FUNDRAISING MI 501(c)(3) Type I ST JOSEPH HEALTH SYSTEM true FIELD NEUROSCIENCES INSTITUTE 800 S WASHINGTON AVENUE SAGINAW MI 48601 382790703 MEDICAL RESEARCH ORGANIZATION MI 501(c)(3) 10 STMARY'S OF MICHIGAN MEDICAL CENTER true ST MARY'S MEDICAL CENTER FOUNDATION SAGINAW MICHIGAN 800 S WASHINGTON AVENUE SAGINAW MI 48601 382246366 FUNDRAISING MI 501(c)(3) Type II STMARY'S OF MICHIGAN MEDICAL CENTER true CRITTENTON HOSPITAL MEDICAL CENTER 1101 W UNIVERSITY DR ROCHESTER MI 48307 381359247 GENERAL HOSPITAL MI 501(c)(3) 3 ASCENSION MICHIGAN true CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION 1101 WEST UNIVERSITY DR ROCHESTER MI 48307 382627336 SUPPORTING MI 501(c)(3) Type I CRITTENTON HOSPITAL MEDICAL CENTER true CRITTENTON CANCER CENTER 1101 WEST UNIVERSITY DR ROCHESTER MI 48307 383239057 CANCER TREATMENT MI 501(c)(3) 10 CRITTENTON HOSPITAL MEDICAL CENTER true ADVENT PARTNERS LP 28000 DEQUINDRE WARREN MI 48092 383544539 RENTAL REAL ESTATE MI NA N/A TOWNE CENTRE SURGERY CENETER 4599 TOWNE CENTRE SAGINAW MI 48604 204943843 OUTPATIENT SERVICES MI NA N/A ST JOSEPH HEALTH ENTERPRISES 200 HEMLOCK ROAD TAWAS CITY MI 48764 382686747 OTHER MEDICAL MI NA C Corporation true GENESYS PRACTICE PARTNERS 5445 ALI DRIVE DEPT 200 GRAND BLANC MI 48439 030516871 EMPLOYED PHY PRACTICE MI NA C Corporation true BEECHER BALLENGER SERVICES ONE GENESYS PARKWAY GRAND BLANC MI 484398065 382497922 HOLDING COMPANY MI NA C Corporation true ADVENT INC 28000 DEQUINDRE WARREN MI 48092 382971743 RENTAL REAL ESTATE MI NA C Corporation true AFFILIATED HEALTH SERVICES INC 28000 DEQUINDRE WARREN MI 48092 382292922 MEDICAL SERVICES MI NA C Corporation true St Mary's Health 800 S Washington Avenue Saginaw MI 48601 383477017 Dormant MI NA C Corporation true TEXTILE SYSTEMS INC 817 WALBRIDGE KALAMAZOO MI 49007 382705047 LAUNDRY SERVICES MI NA C Corporation true CRITTENTON DEVELOPMENT CORPORATION 2251 N SQUIRREL RD STE 310 AUBURN HILLS MI 48326 382594115 REAL ESTATE MI NA C Corporation true CRITTENTON MEDICAL PHARMACY 1101 W UNIVERSITY DR ROCHESTER MI 48307 203773341 PHARMACY SALES MI NA C Corporation true false false true false false false false false false false false true false false true true true true true BORGESS HEALTH ALLIANCE INC Q 101820 FAIR MARKET VALUE BORGESS HEALTH ALLIANCE INC P 1217100 FAIR MARKET VALUE BORGESS HEALTH ALLIANCE INC S 6476386 FAIR MARKET VALUE BORGESS MEDICAL CENTER L 251042 FAIR MARKET VALUE BORGESS MEDICAL CENTER Q 478087 FAIR MARKET VALUE BORGESS MEDICAL CENTER P 576437 FAIR MARKET VALUE BORGESS MEDICAL CENTER S 122517 FAIR MARKET VALUE Schedule R, Part II ProMed Healthcare, Inc. Due to a corporate reorganization during FY 2017, the sole corporate member of ProMed Healthcare, Inc. changed from Borgess Health Alliance, Inc. to Ascension Medical Group, a disregarded entity of Ascension Health, EIN 31-1662309. At that time, ProMed Healthcare, Inc. ceased to be a member of the Ascension Michigan group. Schedule R, Part II Medical Resources Group Due to a corporate reorganization during FY 2017, Medical Resources Group changed its name to Ascension Medical Group Michigan. The sole corporate member of Ascension Medical Group Michigan (f/k/a Medical Resources Group) changed from St. John Providence, Inc. to Ascension Medical Group, a disregarded entity of Ascension Health, EIN 31-1662309. At that time, Ascension Medical Group Michigan (f/k/a Medical Resources Group) ceased to be a member of the Ascension Michigan group.