2017-11-13T13:31:41-06:00 2016-12-31 990 2016-01-01 382947657 HENRY FORD MACOMB HOSPITAL CORPORATION HENR 3138768704 ONE FORD PLACE - 5F DETROIT MI 48202 ROBERT G RINEY COO 3138768704 2017-11-13 150.198.17.9 2017-11-13 13:58:49 ES P EC2F309BEAB6C8086E5B0764ED30F15AD3E8FABD E211DC56DBD7178BCD538CDAC8979EE0EC2F3682 2016 2017-02-10 21:41:12Z WRIGHT L LASSITER III ONE FORD PLACE - 5F DETROIT MI 48202 477338134 0 X WWW.HENRYFORD.COM/HOMEPAGE_MACOMB X 1990 DE TO IMPROVE PEOPLE'S LIVES THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING.VISION: TRANSFORMING LIVES AND COMMUNITIES THROUGH HEALTH AND WELLNESS-ONE PERSON AT A TIME. 19 13 3922 715 0 0 1404008 2611123 432513153 468424934 3716442 1903588 3964609 3394670 441598212 476334315 0 0 0 0 206320466 210492258 0 0 193269 234149050 253826635 440469516 464318893 1128696 12015422 317103614 331011685 224288108 226765761 92815506 104245924 X HENRY FORD MACOMB HOSPITAL (HFMH) IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM SERVING THE NORTHEASTERN METROPOLITAN DETROIT MICHIGAN COMMUNITIES. AS AN INTEGRATED COMPONENT OF ONE OF THE NATION'S LEADING COMPREHENSIVE, INTEGRATED HEALTH SYSTEMS, IT IS THE MISSION OF HFMH TO IMPROVE HUMAN LIFE THROUGH THE EXCELLENCE OF THE SCIENCE AND ART OF HEALTH CARE AND HEALING. HFMH IS COMMITTED TO PROVIDING HEALTH SERVICES AND IMPROVING THE QUALITY OF LIFE OF ALL OF THE CITIZENS OF THE COMMUNITIES IT SERVES REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. THE ORGANIZATION PROVIDES FINANCING AND HEALTH CARE DELIVERY, INCLUDING ACUTE, SPECIALTY, PRIMARY AND PREVENTATIVE CARE SERVICES BACKED BY EXCELLENCE IN RESEARCH AND EDUCATION. 0 0 228928720 233746782 HFMH IS RECOGNIZED FOR ITS EXCELLENCE IN PROVIDING INPATIENT CARE TO THE RESIDENTS OF THE MACOMB COUNTY MICHIGAN AS WELL AS ALL OF THE OTHER COMMUNITIES LOCATED NORTHEAST OF THE CITY OF DETROIT. DURING 2016 HFMH HAD 21,423 DISCHARGES, AND 104,782 PATIENT DAYS.HENRY FORD MACOMB HOSPITAL-CLINTON TOWNSHIP PROVIDES COMPREHENSIVE ACUTE AND TERTIARY CARE. SPECIALTY SERVICES INCLUDE A HEART & VASCULAR INSTITUTE, JOSEPHINE FORD CANCER CENTER, A WOMEN'S HEALTH CENTER, ALONG WITH A BIRTHING CENTER THAT FEATURES 18 LABOR, DELIVERY, RECOVERY AND POST-PARTUM SUITES. THE HOSPITAL ALSO HAS A 42-BED INPATIENT REHABILITATION PROGRAM, AN AMBULATORY AND MINIMALLY INVASIVE SURGERY CENTER AND LEADING DIAGNOSTIC IMAGING, ALONG WITH ADVANCED TRAUMA CAPABILITIES AND EMERGENCY SERVICES.HENRY FORD HOSPITAL DOCTORS TRAIN MORE THAN 600 MEDICAL SCHOOL STUDENTS, 500 RESIDENTS AND 150 FELLOWS ACROSS 46 DIFFERENT AREAS OF MEDICINE EVERY YEAR. HENRY FORD HOSPITAL RESIDENCY AND FELLOWSHIP PROGRAMS ARE NATIONALLY ACCREDITED M.D. (DOCTORATE OF MEDICINE) TRAINING PROGRAMS. HENRY FORD MACOMB HOSPITALS OFFER NATIONALLY ACCREDITED D.O. (DOCTORATE OF OSTEOPATHIC MEDICINE) AND D.P.M. (DOCTORATE OF PODIATRIC MEDICINE) TRAINING PROGRAMS, AND TRAINED OVER 100 MEDICAL RESIDENTS DURING 2016. 109461646 150606358 HFMH PROVIDES OUTPATIENT SERVICES AT MULTIPLE LOCATIONS THROUGHOUT THE NORTH EASTERN METROPOLITAN COMMUNITIES OF DETROIT. IN TOTAL THIS REPRESENTED 478,654 OUTPATIENT VISITS DURING 2016. 32758021 33068740 HFMH OPERATES A LEVEL II EMERGENCY FACILITY. EMERGENCY SERVICES REPRESENTED 68,850 PATIENT VISITS DURING 2016. 21951086 33068740 OTHER PROGRAM SERVICES INCLUDE ANCILLARY SERVICES LOCATED WITHIN THE MEDICAL FACILITIES. 21951086 33068740 393099473 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 0 1 282 19 1 3922 1 0 0 0 0 0 1 1 0 0 0 0 X 19 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X PAUL KOLPASKY 3138744867 ONE FORD PLACE DETROIT MI 48202 PAUL D ALANDT TRUSTEE 1.00 0.00 X 0 0 0 MYRA BERGMAN RSM TRUSTEE 1.00 0.00 X 0 0 0 EDWARD D CALLAGHAN PHD TRUSTEE 1.00 0.00 X 0 0 0 DAVID F GIRODAT TRUSTEE - CHAIR 2.00 0.00 X X 0 0 0 STEVEN D HARRINGTON MD PHYSICIAN/ TRUSTEE 60.00 1.00 X 800909 0 40954 CAROLANN K KINNER DO TRUSTEE 1.00 0.00 X 0 0 0 BRIAN G LODER DPM PHYSICIAN/ TRUSTEE 40.00 0.00 X 140410 40359 27837 RAYMOND C LOPE' TRUSTEE - VICE CHAIR 2.00 0.00 X X 0 0 0 ALI H SHAKIR MD TRUSTEE 1.00 5.00 X 0 6700 0 JAMES E THOMPSON DD TRUSTEE 1.00 0.00 X 0 0 0 ANTHONY J VIVIANO TRUSTEE 1.00 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RONALD LEVIN MD PHYSICIAN 60.00 0.00 X 1109269 0 48947 MARK T RYAN DO PHYSICIAN 60.00 0.00 X 744281 0 24088 6821327 4429392 809799 202 0 1 0 ALLIANCE HEALTH PROFESSIONALS PLLC 133 S MAIN ST SUITE D MT CLEMENS MI 48043 PHYSICIAN SERVICES 13600896 ALLIANCE MANAGEMENT PARTNERS LLC 133 S MAIN ST SUITE D MT CLEMENS MI 48043 MANAGEMENT SERVICES 12399929 RONCELLI INC 6471 METRO PARKWAY STERLING HEIGHTS MI 48312 CONSTRUCTION 2874974 ALLIANCE HNI LLC 7647 COLLECTION CENTER DRIVE CHICAGO IL 606930076 PHYSICIAN SERVICES 1468337 DIVISION 6 FABRICATION & INSTALLATION LL 27450 GLOEDE WARREN MI 48088 CONSTRUCTION 1399458 49 502822 2108301 513313 2611123 HOSPITAL SERVICES 900099 233746782 233746782 OUTPATIENT SERVICES 621400 150606358 150606358 EMERGENCY SERVICES 900099 44560661 44560661 MEDICAL EDUCATION-GME 900099 6442393 6442393 33068740 33068740 468424934 1029917 1029917 908578 0 908578 908578 908578 1570000 696329 873671 873671 873671 152935 502822 266489 -113554 -113554 73495 41001 32494 32494 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ORGANIZATION'S ENDOWMENTS FUNDS ARE UTILIZED BASED ON THE NATURE OF THE SPECIFIC ASSOCIATED RESTRICTION. THESE PRIMARILY RELATE TO FUNDING INITIATIVES ASSOCIATED WITH SPECIFIC DISEASE CONDITIONS AND FURTHERING MEDICAL EDUCATION AND RESEARCH INITIATIVES. PART X, LINE 2: THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2016 AND 2015. MEDALLION EVENT 325753 257309 68444 138603 SHOWTIME 151742 118990 32752 51309 2 178262 126523 51739 76577 655757 502822 152935 266489 266489 -113554 73495 41001 1 1.00000 73495 41001 41001 32494 MI 1 0 1 0 1.00000 REBECCA BLANKEN SPECIAL EVENTS DEPT ONE FORD PLACE DETROIT MI 48202 0 0 1 1 X 1 X 250.000000000000 0 1 1 1 0 1 1 3674245 3674245 0.00810 112212831 89052304 23160527 0.05110 115887076 89052304 26834772 0.05920 1978413 70888 1907525 0.00420 15039968 7946231 7093737 0.01570 13072138 10524788 2547350 0.00560 299500 299500 0.00070 263743 263743 0.00060 30653762 18541907 12111855 0.02680 146540838 107594211 38946627 0.08600 82987 82987 0.00020 173285 173285 0.00040 19439 19439 0.00000 13721 13721 0.00000 15640 15640 0.00000 247134 247134 0.00050 552206 552206 0.00110 0 11399241 2849810 163073751 156356012 6717739 X 1 1 2 1 HENRY FORD MACOMB HOSPITAL - CLINTON 15855 19 MILE ROAD CLINTON TOWNSHIP MI 48038 X X X X 2 HENRY FORD MACOMB HOSPITAL- MOUNT CLEMENS 215 NORTH AVENUE MOUNT CLEMENS MI 48043 X PSYCHIATRIC INPATIENT HENRY FORD MACOMB HOSPITAL-CLINTON TWP 1 0 0 1 X X X X X X X X X 16 1 1 0 1 X SEE LINE 10A BELOW X 1 16 1 HTTPS://WWW.HENRYFORD.COM/ABOUT/COMMUNITY-HEALTH 0 1 X 250.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/PATIENT-FINANCIAL-RESPONSIBILITY X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/PATIENT-FINANCIAL-RESPONSIBILITY X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/PATIENT-FINANCIAL-RESPONSIBILITY X X X X X X 1 X 0 1 X 0 0 HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS 2 0 0 1 X X X X X X X X X 16 1 1 0 1 X SEE LINE 10A BELOW X 1 16 1 HTTPS://WWW.HENRYFORD.COM/ABOUT/COMMUNITY-HEALTH 0 1 X 250.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/PATIENT-FINANCIAL-RESPONSIBILITY X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/PATIENT-FINANCIAL-RESPONSIBILITY X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/PATIENT-FINANCIAL-RESPONSIBILITY X X X X X X 1 X 0 1 X 0 0 HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 6A: HENRY FORD HOSPITALHENRY FORD WYANDOTTE HOSPITALHENRY FORD WEST BLOOMFIELD HOSPITALHENRY FORD MAPLEGROVE CENTERHENRY FORD KINGSWOOD HOSPITALHENRY FORD COTTAGE HOSPITAL/MEDICAL CENTER HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 11: THE CHNA WAS CONDUCTED IN 2016 IN PARTNERSHIP WITH THE MACOMB COUNTY HEALTH DEPARTMENT AND THEIR COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLAN TEAMS. SEVERAL SIGNIFICANT HEALTH NEEDS WITHIN THE SERVICE AREA OF HENRY FORD MACOMB HOSPITAL WERE IDENTIFIED. HEALTH NEEDS WERE PRIORITIZED BASED ON SEVERAL CRITERIA INCLUDING THE IMPORTANCE GIVEN TO PARTICULAR HEALTH ISSUES BY SURVEY AND FOCUS GROUP PARTICIPANTS, STATISTICAL DATA FROM THE STATE OF MICHIGAN, AS WELL AS INPUT FROM HFHS AND COMMUNITY LEADERS. HENRY FORD MACOMB'S RESOURCES AND OVERALL ALIGNMENT WITH THE HENRY FORD HEALTH SYSTEM MISSION, VISION, GOALS AND STRATEGIC PRIORITIES WERE TAKEN INTO CONSIDERATION WHEN IDENTIFYING THE TOP THREE MOST SIGNIFICANT HEALTH ISSUES TO BE ADDRESSED: HEALTHY LIFESTYLES: WEIGHT MANAGEMENT/ OBESITY/DIET AND NUTRITION, SUBSTANCE ABUSE & MENTAL HEALTH AND DIABETES HENRY FORD MACOMB WILL FOCUS ON DEVELOPING AND SUPPORTING INITIATIVES, AND MEASURE THEIR EFFECTIVENESS TO IMPROVE THESE HEALTH NEEDS. THE FOLLOWING IMPLEMENTATION STRATEGY SPECIFIES COMMUNITY HEALTH NEEDS THAT THE HOSPITAL/HEALTH SYSTEM HAS DETERMINED IT WILL ADDRESS, IN PARTNERSHIP WITH OTHER AGENCIES AND ORGANIZATIONS, CONSISTENT WITH OUR MISSION AND VISION, TO TRANSFORM LIVES AND COMMUNITIES. THE HOSPITAL RESERVES THE RIGHT TO AMEND THIS IMPLEMENTATION STRATEGY AS CIRCUMSTANCES WARRANT. IN TERMS OF SIGNIFICANT HEALTH NEEDS THAT WILL NOT BE ADDRESSED, HENRY FORD MACOMB ACKNOWLEDGES THE WIDE RANGE OF HEALTH CONCERNS THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED IT COULD MOST EFFECTIVELY FOCUS ON THOSE HEALTH NEEDS THAT WERE DETERMINED TO BE MOST URGENT AND ESSENTIAL TO THE HEALTH OF THE COMMUNITY AS WELL AS WITHIN ITS ABILITY TO INFLUENCE. WHILE MOST OF THESE ADDITIONAL HEALTH ISSUES ARE CURRENTLY BEING ADDRESSED BY EXISTING PROGRAMS AND INITIATIVES OF HFM OR A PARTNER ORGANIZATION, HFM WILL NOT TAKE NEW OR SPECIFIC, ADDITIONAL ACTIONS RELATED TO THE FOLLOWING HEALTH NEEDS:CHRONIC DISEASES - BECAUSE MANY CHRONIC DISEASES SUCH AS HIGH BLOOD PRESSURE, CARDIAC DISEASES AND CANCER ARE CLOSELY RELATED TO WEIGHT ISSUES, MANY OF THESE WILL BE ADDRESSED INDIRECTLY THROUGH STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY, AND PROMOTING WEIGHT MANAGEMENT, HEALTHY DIET AND NUTRITION. EFFORTS TO IMPROVE BEHAVIORAL HEALTH SHOULD ALSO INDIRECTLY IMPROVE CHRONIC DISEASE ISSUES INCLUDING A PERSON'S EMOTIONAL ABILITY TO MANAGE CHRONIC MEDICAL ISSUES. FOR THESE REASONS, HFM WILL NOT TAKE NEW ACTIONS TO ADDRESS CHRONIC DISEASES. HEALTH INSURANCE ENROLLMENT - HFM WILL CONTINUE TO ASSIST PATIENTS WITH INSURANCE ENROLLMENT AND ACCESS TO OTHER FINANCIAL SUPPORTS THROUGH ITS PATIENT FINANCIAL SERVICES PROGRAMS, BUT WILL NOT BE TAKING NEW OR SPECIFIC ACTIONS TO ADDRESS THIS NEED UNTIL THE FULL IMPACT OF THE AFFORDABLE CARE ACT AND ITS NEXT ITERATION CAN BE MEASURED AND SPECIFIC BARRIERS IDENTIFIED. INFANT MORTALITY - HFM WILL CONTINUE TO PARTNER WITH THE MACOMB COUNTY HEALTH DEPARTMENT TO ADDRESS INFANT MORTALITY, AS THIS AREA CONTINUES TO BE SLIGHTLY ABOVE STATE AVERAGES IN MACOMB COUNTY. HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 11: THE CHNA WAS CONDUCTED IN 2016 IN PARTNERSHIP WITH THE MACOMB COUNTY HEALTH DEPARTMENT AND THEIR COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLAN TEAMS. SEVERAL SIGNIFICANT HEALTH NEEDS WITHIN THE SERVICE AREA OF HENRY FORD MACOMB HOSPITAL WERE IDENTIFIED. HEALTH NEEDS WERE PRIORITIZED BASED ON SEVERAL CRITERIA INCLUDING THE IMPORTANCE GIVEN TO PARTICULAR HEALTH ISSUES BY SURVEY AND FOCUS GROUP PARTICIPANTS, STATISTICAL DATA FROM THE STATE OF MICHIGAN, AS WELL AS INPUT FROM HFHS AND COMMUNITY LEADERS. HENRY FORD MACOMB'S RESOURCES AND OVERALL ALIGNMENT WITH THE HENRY FORD HEALTH SYSTEM MISSION, VISION, GOALS AND STRATEGIC PRIORITIES WERE TAKEN INTO CONSIDERATION WHEN IDENTIFYING THE TOP THREE MOST SIGNIFICANT HEALTH ISSUES TO BE ADDRESSED: HEALTHY LIFESTYLES: WEIGHT MANAGEMENT/ OBESITY/DIET AND NUTRITION, SUBSTANCE ABUSE & MENTAL HEALTH AND DIABETES HENRY FORD MACOMB WILL FOCUS ON DEVELOPING AND SUPPORTING INITIATIVES, AND MEASURE THEIR EFFECTIVENESS TO IMPROVE THESE HEALTH NEEDS. THE FOLLOWING IMPLEMENTATION STRATEGY SPECIFIES COMMUNITY HEALTH NEEDS THAT THE HOSPITAL/HEALTH SYSTEM HAS DETERMINED IT WILL ADDRESS, IN PARTNERSHIP WITH OTHER AGENCIES AND ORGANIZATIONS, CONSISTENT WITH OUR MISSION AND VISION, TO TRANSFORM LIVES AND COMMUNITIES. THE HOSPITAL RESERVES THE RIGHT TO AMEND THIS IMPLEMENTATION STRATEGY AS CIRCUMSTANCES WARRANT. IN TERMS OF SIGNIFICANT HEALTH NEEDS THAT WILL NOT BE ADDRESSED, HENRY FORD MACOMB ACKNOWLEDGES THE WIDE RANGE OF HEALTH CONCERNS THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED IT COULD MOST EFFECTIVELY FOCUS ON THOSE HEALTH NEEDS THAT WERE DETERMINED TO BE MOST URGENT AND ESSENTIAL TO THE HEALTH OF THE COMMUNITY AS WELL AS WITHIN ITS ABILITY TO INFLUENCE. WHILE MOST OF THESE ADDITIONAL HEALTH ISSUES ARE CURRENTLY BEING ADDRESSED BY EXISTING PROGRAMS AND INITIATIVES OF HFM OR A PARTNER ORGANIZATION, HFM WILL NOT TAKE NEW OR SPECIFIC, ADDITIONAL ACTIONS RELATED TO THE FOLLOWING HEALTH NEEDS:CHRONIC DISEASES - BECAUSE MANY CHRONIC DISEASES SUCH AS HIGH BLOOD PRESSURE, CARDIAC DISEASES AND CANCER ARE CLOSELY RELATED TO WEIGHT ISSUES, MANY OF THESE WILL BE ADDRESSED INDIRECTLY THROUGH STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY, AND PROMOTING WEIGHT MANAGEMENT, HEALTHY DIET AND NUTRITION. EFFORTS TO IMPROVE BEHAVIORAL HEALTH SHOULD ALSO INDIRECTLY IMPROVE CHRONIC DISEASE ISSUES INCLUDING A PERSON'S EMOTIONAL ABILITY TO MANAGE CHRONIC MEDICAL ISSUES. FOR THESE REASONS, HFM WILL NOT TAKE NEW ACTIONS TO ADDRESS CHRONIC DISEASES. HEALTH INSURANCE ENROLLMENT - HFM WILL CONTINUE TO ASSIST PATIENTS WITH INSURANCE ENROLLMENT AND ACCESS TO OTHER FINANCIAL SUPPORTS THROUGH ITS PATIENT FINANCIAL SERVICES PROGRAMS, BUT WILL NOT BE TAKING NEW OR SPECIFIC ACTIONS TO ADDRESS THIS NEED UNTIL THE FULL IMPACT OF THE AFFORDABLE CARE ACT AND ITS NEXT ITERATION CAN BE MEASURED AND SPECIFIC BARRIERS IDENTIFIED. INFANT MORTALITY - HFM WILL CONTINUE TO PARTNER WITH THE MACOMB COUNTY HEALTH DEPARTMENT TO ADDRESS INFANT MORTALITY, AS THIS AREA CONTINUES TO BE SLIGHTLY ABOVE STATE AVERAGES IN MACOMB COUNTY. HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 13B: UNINSURED PATIENTS WHO DO NOT OTHERWISE QUALIFY FOR INSURANCE WITH HOUSEHOLD INCOMES AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL MAY QUALIFY FOR MEDICALLY NECESSARY SERVICES TO BE PROVIDED AT NO COST. PATIENTS REGARDLESS OF INSURANCE STATUS WITH ANNUAL MEDICAL LIABILITIES TO THE ORGANIZATION IN EXCESS OF 30% OF THEIR HOUSEHOLD INCOME MAY QUALIFY FOR DISCOUNTS ON THEIR PERSONAL OBLIGATIONS. PATIENT'S PERSONAL RESPONSIBILITIES FOR MEDICALLY NECESSARY SERVICES NOT COVERED BY INSURANCE ARE GENERALLY BASED ON THE AMOUNT GENERALLY BILLED FOR THE SERVICE, WHICH APPROXIMATES 115% OF PREVAILING MEDICARE RATES.PART V, SECTION B, LINE 22A:UNINSURED PATIENTS WHO DO NOT OTHERWISE QUALIFY FOR INSURANCE WITH HOUSEHOLD INCOMES AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL MAY QUALIFY UNDER THE PATIENT FINANCIAL ASSISTANCE POLICY (FAP) FOR MEDICALLY NECESSARY SERVICES TO BE PROVIDED AT NO COST. IN ADDITION, PATIENTS REGARDLESS OF INSURANCE STATUS WITH ANNUAL MEDICAL LIABILITIES TO HFHS IN EXCESS OF 30% OF THEIR HOUSEHOLD INCOME MAY QUALIFY FOR DISCOUNTS ON THEIR PERSONAL OBLIGATIONS. PATIENT'S PERSONAL RESPONSIBILITIES FOR MEDICALLY NECESSARY SERVICES NOT COVERED BY INSURANCE OR FAP ARE GENERALLY BASED ON THE AMOUNT GENERALLY BILLED FOR THE SERVICE, WHICH APPROXIMATES 115% OF PREVAILING MEDICARE RATES. HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 13B: UNINSURED PATIENTS WHO DO NOT OTHERWISE QUALIFY FOR INSURANCE WITH HOUSEHOLD INCOMES AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL MAY QUALIFY FOR MEDICALLY NECESSARY SERVICES TO BE PROVIDED AT NO COST. PATIENTS REGARDLESS OF INSURANCE STATUS WITH ANNUAL MEDICAL LIABILITIES TO THE ORGANIZATION IN EXCESS OF 30% OF THEIR HOUSEHOLD INCOME MAY QUALIFY FOR DISCOUNTS ON THEIR PERSONAL OBLIGATIONS. PATIENT'S PERSONAL RESPONSIBILITIES FOR MEDICALLY NECESSARY SERVICES NOT COVERED BY INSURANCE ARE GENERALLY BASED ON THE AMOUNT GENERALLY BILLED FOR THE SERVICE, WHICH APPROXIMATES 115% OF PREVAILING MEDICARE RATES.PART V, SECTION B, LINE 22A:UNINSURED PATIENTS WHO DO NOT OTHERWISE QUALIFY FOR INSURANCE WITH HOUSEHOLD INCOMES AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL MAY QUALIFY UNDER THE PATIENT FINANCIAL ASSISTANCE POLICY (FAP) FOR MEDICALLY NECESSARY SERVICES TO BE PROVIDED AT NO COST. IN ADDITION, PATIENTS REGARDLESS OF INSURANCE STATUS WITH ANNUAL MEDICAL LIABILITIES TO HFHS IN EXCESS OF 30% OF THEIR HOUSEHOLD INCOME MAY QUALIFY FOR DISCOUNTS ON THEIR PERSONAL OBLIGATIONS. PATIENT'S PERSONAL RESPONSIBILITIES FOR MEDICALLY NECESSARY SERVICES NOT COVERED BY INSURANCE OR FAP ARE GENERALLY BASED ON THE AMOUNT GENERALLY BILLED FOR THE SERVICE, WHICH APPROXIMATES 115% OF PREVAILING MEDICARE RATES. 21 1 - HENRY FORD MACOMB-BRUCE TOWNSHIP MED CTR 80650 VAN DYKE BRUCE TOWNSHIP MI 48065 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 2 - HENRY FORD MACOMB-CHESTERFIELD MED CNTR 30795 23 MILE ROAD CHESTERFIELD TOWNSHI MI 48047 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 3 - HENRY FORD MACOMB CENTER-CLINTON TWP 16151 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 4 - HENRY FORD MACOMB-FRASER HEALTH CENTER 15717 15 MILE ROAD FRASER MI 48035 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 5 - HENRY FORD MACOMB-RICHMOND MEDICAL CNTR 31505 32 MILE ROAD RICHMOND MI 48062 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 6 - HENRY FORD MACOMB-SLEEP MEDICINE 15945 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 7 - HENRY FORD MACOMB-WASHINGTON TWP MED CTR 12150 30 MILE ROAD WASHINGTON TOWNSHIP MI 48095 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 8 - HENRY FORD MACOMB MEDICAL CENTER 15520 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 9 - HENRY FORD MACOMB-CHESTERFIELD OBGYN 30795 23 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 10 - HENRY FORD MACOMB-MEDICAL CENTER 15400 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 11 - HENRY FORD MACOMB-SHELBY OBGYN 51221 SCHOENHERR SHELBY TOWNSHIP MI 48315 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 12 - HENRY FORD MACOMB-SHELBY FAMILY MED 49310 VAN DYKE SHELBY TOWNSHIP MI 48317 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 13 - HENRY FORD MACOMB-SHELBY RHEUMATOLOGY 50505 SCHOENHERR-SUITE 175 SHELBY TOWNSHIP MI 48315 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 14 - HENRY FORD MACOMB CENTER-CLINTON TWP 43401 GARFIELD ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 15 - HENRY FORD MACOMB CENTER-CLINTON TWP 43411 GARFIELD ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 16 - HENRY FORD MACOMB REHAB-STERLING HEIGHTS 44800 DELCO BLVD STERLING HEIGHTS MI 48313 REHABILITATION SERVIES 17 - HENRY FORD MACOMB REHAB-CLINTON TWP 16301 NINETEEN NIME ROAD CLINTON TOWNSHIP MI 48308 REHABILITATION SERVIES 18 - HFMH-WARREN INTERNAL MEDICINE 25531 SCHOENHERR WARREN MI 48089 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 19 - HFMH-WARREN FAMILY MEDICINE 30205 SCHOENHERR WARREN MI 48093 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 20 - HFMH-WARREN SLEEP MEDICINE 13251 E TEN MILE ROAD WARREN MI 48089 CLINICAL/DIAGNOSTIC MEDICAL SERVICES 21 - HENRY FORD MACOMB-FAMILY MEDICINE 21250 HALL ROAD CLINTON TOWNSHIP MI 48039 CLINICAL/DIAGNOSTIC MEDICAL SERVICES PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $11,399,241 PART II, COMMUNITY BUILDING ACTIVITIES: HFMH BELIEVES THAT THE STRENGTH AND VITALITY OF A COMMUNITY HAS A SIGNIFICANT IMPACT ON THE BEHAVIORS OF ITS RESIDENTS AND THAT THERE IS DIRECT CORRELATION BETWEEN THE VIABILITY OF A COMMUNITY AND THE ATTITUDE OF ITS RESIDENTS TOWARD HEALTHIER BEHAVIORS. THEREFORE, HFMH INCLUDES IN ITS COMMITTMENT TO COMMUNITY BENEFIT A FOCUS ON DIRECT INVOLVEMENT IN THE COMMUNITY TO BOTH IMPROVE THE ENVIRONMENT AND ENSURE THAT CRITICAL MESSAGES ON THE BENEFITS OF HEALTHIER BEHAVIORS ARE HEARD. HFMH LEADERS COLLABORATE WITH COMMUNITY TASK FORCES AND COALITIONS IN ADDRESSING THE NEEDS OF OUR SERVICE AREA. PART III, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE IS STATED IN THE PATIENT GROSS CHARGES. PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE ORGANIZATION RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. AT SUCH POINT IN TIME THAT A BILLED SERVICE IS BELIEVED TO BE UNCOLLECTIBLE, THE RELATED RECEIVABLE IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ESTIMATES OF RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE RECEIVED.FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE ORGANIZATION'S PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION OFFERS A DISCOUNT OFF STANDARD RATES FOR SERVICES PROVIDED THAT RESULT IN NET CHARGES THAT DO NOT EXCEED 115% OF MEDICARE RATES. PART III, LINE 9B: SHOULD A PATIENT BE DEEMED ELIGIBLE FOR ASSISTANCE ANY COLLECTION EFFORTS ASSOCIATED WITH THE QUALIFYING SERVICE ARE SUSPENDED. IF THE PATIENT IS DETERMINED TO QUALIFY UNDER THE ORGANIZATION'S CHARITY CARE POLICY PRIOR TO BILLING, NO BILL IS EVER GENERATED AND THEREFORE THE ELEMENTS OF THE COLLECTION POLICY ARE NEVER INVOKED. WHEN THE DETERMINATION IS NOT MADE PRIOR TO BILLING, THE ORGANIZATION'S COLLECTION POLICY WOULD APPLY. THIS POLICY READS IN PART:- "PATIENTS WILL BE EVALUATED FOR THE SYSTEM'S PATIENT FINANCIAL ASSISTANCE PROGRAM"- "UNINSURED PATIENTS WILL BE GIVEN A DISCOUNT"- "UNDERINSURED PATIENTS MAY QUALIFY FOR DISCOUNTED SERVICES BASED UPON THEIR AGGREGATE HOUSEHOLD INCOME"- "THE ORGANIZATION WILL REVIEW THE PATIENTS'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS REQUESTED"- "LEGAL ACTION...MAY BE TAKEN...WHEN THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS TO MEET HIS OR HER OBLIGATION"- "THE ORGANIZATION WILL NOT FORCE THE SALE OR FORECLOSURE OF ANY PATIENT OR GUARANTOR'S PRIMARY RESIDENCE TO PAY AN OUTSTANDING MEDICAL BILL"- "THE ORGANIZATION WILL NOT...REQUIRE THE PATIENT OR RESPONSIBLE PARTY TO APPEAR IN COURT"- "THE ORGANIZATION WILL DIRECT THEIR COLLECTION AGENCIES TO FOLLOW THESE GUIDELINES" PART VI, LINE 2: HENRY FORD HEALTH SYSTEM (HFHS) CONSIDERS THE ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AS AN ESSENTIAL FUNCTION. HENRY FORD MACOMB HOSPITAL WAS ENCOMPASSED IN THE HFHS COMMUNITY HEALTH NEEDS ASSESSMENT. IT PROVIDES KEY INFORMATION REGARDING THE DEMOGRAPHICS AND MAJOR NEEDS OF THE COMMUNITIES SERVED, IT SUPPORTS THE PRIORITIZATION OF THE SERVICES MADE AVAILABLE, AND IT HELPS TARGET POPULATIONS WITH THE MOST VULNERABILITY TO HEALTH NEEDS SUCH AS THE POOR, UNINSURED, AS WELL AS VARIOUS OTHER POPULATIONS THAT MAY HAVE BEEN OVERLOOKED. THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO PROVIDES VALUABLE INFORMATION REGARDING OTHER ORGANIZATIONS SUPPORTING THE NEEDS WITHIN THE COMMUNITY SO PROGRAMS CAN BE COORDINATED AND LEVERAGED TO ENSURE THAT EVERY DOLLAR IS INVESTED WISELY.THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN THREE PHASES. THE FIRST PHASE INCLUDES DATA COLLECTION FROM A VARIETY OF PUBLIC AND PROPRIETARY SOURCES THAT PROVIDED INFORMATION AROUND POPULATION DEMOGRAPHICS, SOCIOECONOMIC DATA, HEALTH STATUS INDICATORS, AS WELL AS SEVERAL OTHER DATA POINTS. SOURCES FOR THIS FIRST PHASE INCLUDED THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH (MDCH), MICHIGAN BEHAVIORAL RISK FACTOR SURVEY, CLARITAS INC. /TRUVEN HEALTH ANALYTICS, MICHIGAN STATE HOMELESS MANAGEMENT INFORMATION SYSTEM (MSHMIS), AND THE MICHIGAN INPATIENT DATABASE. THE SECOND PHASE INVOLVED DEVELOPING AND DISTRIBUTING A KEY STAKEHOLDER SURVEY TO CAPTURE THE INPUT OF OTHER COMMUNITY ORGANIZATIONS AND COALITIONS ABOUT WHAT THEY BELIEVE ARE THEMAJOR HEALTH NEEDS THAT SHOULD BE PRIORITIZED AND ADDRESSED IN THE TRI-COUNTY AREA. THE THIRD PHASE INCORPORATED THE QUANTITATIVE AND QUALITATIVE DATA THAT WAS COLLECTED IN THE FIRST TWO PHASES, AND BASED ON THIS INFORMATION IDENTIFIED PRIORITIES FOR HENRY FORD HEALTH SYSTEM TO ADDRESS WITH THE COMMUNITIES IT SERVES.THIS ASSESSMENT WAS PREPARED BY THE CORPORATE PLANNING DEPARTMENT WITHIN HENRY FORD HEALTH SYSTEM. RESULTS ARE USED AS A FOUNDATION FOR PLANNING, DEVELOPING, AND REFINING HFHS'S FUTURE COMMUNITY SERVICES IN THE TRI-COUNTY AREA. PART VI, LINE 3: HFMH HAS VARIOUS APPROACHES TO TARGET AND INFORM RESIDENTS OF ITS COMMUNITIES ABOUT THE PROGRAMS AND SERVICES IT OFFERS. PROGRAMS WHERE WE PARTNER WITH ORGANIZATIONS WITH ESTABLISHED RELATIONSHIPS WITH THE INDIVIDUALS SUCH AS THROUGH COMMUNITY HEALTH CENTERS, THE PUBLIC SCHOOLS AND FAITH-BASED ORGANIZATIONS HAVE BEEN PARTICULARLY SUCCESSFUL. HFMH FOLLOWS THE HFHS PATIENT FINANCIAL ASSISTANCE POLICY. ALL PATIENTS ARE SEEN WITHOUT REGARD TO ABILITY TO PAY. INTAKE STAFF IS TRAINED WITH REGARD TO HOW TO APPROACH AND ENGAGE AN INDIVIDUAL WHEN THERE IS AN APPARENT LACK OF ADEQUATE HEALTH COVERAGE. THIS INCLUDES INFORMING THEM OF THE PROGRAMS OFFERED BY HFMH AS WELL AS OTHER COMMUNITY, LOCAL, STATE AND FEDERAL PROGRAMS OFFERING POTENTIAL SUPPORT. HFMH HAS DEDICATED STAFF RESPONSIBLE TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR SUPPORTIVE PROGRAMS AND ASSIST THEM WITH THE ENROLLMENT PROCESS. THERE ARE MANY REASONS WHY A PATIENT IN NEED OF FINANCIAL ASSISTANCE WITH THEIR MEDICAL CARE MAY NOT HAVE BEEN IDENTIFIED AT THE TIME OF THE CARE DELIVERY. PATIENT FINANCIAL SERVICE AND COLLECTION STAFFS ARE TRAINED TO RECOGNIZE THESE INDIVIDUALS AND PROVIDE THEM WITH ADVICE REGARDING THE VARIOUS OPTIONS AVAILABLE TO SUPPORT THEIR CARE NEEDS. PART VI, LINE 4: THE TRI-COUNTY AREA INCLUDES THE CONTIGUOUS COUNTIES OF WAYNE, OAKLAND AND MACOMB, WHICH ARE LOCATED IN SOUTHEASTERN MICHIGAN AND ACCOUNT FOR 39% OF THE MICHIGAN POPULATION. WAYNE, OAKLAND, AND MACOMB (IN THAT ORDER) ARE THE MOST POPULATED COUNTIES IN MICHIGAN. OF THE NEARLY 4 MILLION RESIDENTS,APPROXIMATELY 52% OF THE POPULATION IS FEMALE. WITH REGARD TO RACE/ETHNICITY, THE TRI-COUNTY AREA IS 65% WHITE, COMPARED TO A NATIONAL AVERAGE OF 63%. OF NOTE, THE TRI-COUNTY AREA IS 25% BLACK,WHICH IS OVER TWICE THE NATIONAL PERCENTAGE OF 12%. CONVERSELY, THE HISPANIC POPULATION (4.0%) IS LESS THAN ONE QUARTER OF THE NATIONAL PERCENTAGE OF 17%.THE NUMBER OF TRI-COUNTY RESIDENTS IS EXPECTED TO DECREASE BY 1% OVER THE NEXT SEVERAL YEARS, WHICH CONTRASTS WITH THE 3% INCREASE EXPECTED NATIONWIDE. IN ADDITION, FEMALES OF CHILDBEARING AGE (15-44), WHO MAKE UP 19% OF THE TRI-COUNTY'S POPULATION, ARE EXPECTED TO DECLINE BY 4% OVER THE NEXT SEVERAL YEARS. WHEN EXAMINING AGE DISTRIBUTION, THE TRI-COUNTY AREA HAS A COMPARABLE POPULATION TO THAT OF THE COUNTRY WITH 14% OF THE POPULATION ABOVE THE AGE OF 65. OF PARTICULAR INTEREST TO HEALTHCARE PROVIDERS IS THE AGING POPULATION OF THE TRI-COUNTY AREA WITH THE 55-YEARS-OLD AND ABOVE POPULATION EXPECTED TO RISE BY 9% FROM 2013 TO 2018.WITH REGARDS TO EDUCATION, THE TRI-COUNTY AREA HAS APPROXIMATELY 12% OF RESIDENTS WHO HAVE SOME HIGH SCHOOL EDUCATION OR LESS COMPARED TO THE NATIONAL AVERAGE OF 14%. FURTHER, 28% OF RESIDENTS HAVE A BACHELOR'S DEGREE OR GREATER, WHICH IS COMPARABLE TO THE NATIONAL AVERAGE. THE TRI-COUNTY AREA IS DIVERSE IN POPULATION, RACE/ETHNICITY, ECONOMIC GROWTH AND DEVELOPMENT. THE AUTOMOTIVE INDUSTRY REMAINS THE LARGEST EMPLOYER IN THE REGION, BUT THE HEALTH CARE SECTOR IS REPRESENTED AMONG THE TOP EMPLOYERS IN THE REGION AS WELL4. THE AVERAGE HOUSEHOLD INCOME WITHIN THE TRI-COUNTY AREA ($71,262) IS LESS THAN THE NATIONAL AVERAGE ($73,487). WITHIN THE TRI-COUNTY AREA, THE AVERAGE HOUSEHOLD INCOME IN OAKLAND COUNTY ($89,683) IS SIGNIFICANTLY HIGHER THAN WAYNE COUNTY ($57,369) AND ACOMB COUNTY ($66,735). AT THE ZIP CODE LEVEL, AVERAGE HOUSEHOLD INCOMES VARY SIGNIFICANTLY.LOWER HOUSEHOLD INCOMES NEGATIVELY IMPACT PURCHASING POWER, HEALTH INSURANCE COVERAGE, AND COSTS OF BASIC NECESSITIES. AS A RESULT, THE TRI-COUNTY AREA'S SAFETY NETS, INCLUDING HEALTHCARE SYSTEMS, ARE BEING STRETCHED TO THE LIMIT. STUDIES HAVE SHOWN A SIGNIFICANT RISE IN CHILD POVERTY IN SOUTHEAST MICHIGAN, GROWING FROM 18.9% IN 2006 TO 27% IN 2012. ON A MORE POSITIVE NOTE, UNEMPLOYMENT IN MICHIGAN HAS DROPPED TO 5%6 IN SEPTEMBER 2015, WHICH IS SIMILAR TO THE NATIONAL AVERAGE7 AND A DECLINE OF 1.7% OVER THE LAST YEAR IN MICHIGAN. CONVERSELY, WITHIN THE TRI-COUNTY AREA THE UNEMPLOYMENT RATE IS SLIGHTLY HIGHER THAN THE NATIONAL AVERAGE OF 5% AT 5.6%, AND RANGES FROM 4.6% IN OAKLAND COUNTY TO 6.7% IN WAYNE COUNTY.THERE ARE KEY DEMOGRAPHIC DIFFERENCES BETWEEN THE RESIDENTS OF EACH COUNTY WITHIN THE TRI-COUNTY AREA. FOR EXAMPLE, AGE, SEX, EDUCATION, AND INCOME DISTRIBUTION DIFFER FROM COUNTY TO COUNTY. IN ORDER TO INCREASE THE UTILITY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, IT IS IMPORTANT TO ANALYZE THE PROFILE(S) OF EACH OF THESE COUNTIES AT A MORE DETAILED LEVEL, SUCH AS ZIP CODES, SO THAT CERTAIN DIFFERENCES WITHIN THE AREA BECOME EVIDENT.ONE COMMUNITY IN PARTICULAR NEED OF ATTENTION IS THE CITY OF DETROIT (FIGURE 4). WHEN EXAMINING THE CITY OF DETROIT THE AVERAGE HOUSEHOLD INCOME IS $37,887, WHICH IS SIGNIFICANTLY LESS THAN AVERAGE HOUSEHOLD INCOME OF THE OVERALL TRI-COUNTY AREA ($71,262). REGARDING EDUCATION, 22% OF RESIDENTS HAVE LESS THAN A HIGH SCHOOL EDUCATION AND ONLY 13% HAVE A BACHELOR'S DEGREE OR HIGHER. IN TERMS OF RACE/ETHNICITY, APPROXIMATELY 92% OF DETROIT IS COMPOSED OF A MINORITY POPULATION VERSUS 35% FOR THETRI-COUNTY AREA AS A WHOLE. THE DETROIT UNEMPLOYMENT RATE IS 11.5%9 (SEPT 2015), WHICH IS SIGNIFICANTLY GREATER THAN THE NATIONAL AVERAGE OF 5%, BUT 6% LESS THAN WHAT WAS REPORTED IN 2013.WHEN LOOKING OUTSIDE OF THE CITY OF DETROIT, VARIOUS ZIP CODES IN THE TRI-COUNTY AREA INDICATE SECTIONS OF THE REGION THAT HAVE LOWER INCOMES, LESS EDUCATION, AND ARE MORE RACIALLY AND ETHNICALLY DIVERSE. FIGURE 5A DISPLAYS THE ZIP CODES THAT RANK IN THE TOP TWENTY ZIP CODES FOR BOTH LOWEST AVERAGE HOUSEHOLD INCOME AND HIGHEST PROPORTION OF THE POPULATION WITHOUT A HIGH SCHOOL DIPLOMA IN THE TRI-COUNTY AREA. THE AVERAGE HOUSEHOLD INCOME OF THESE ZIP CODES IS $37,620, WHICH IS SIGNIFICANTLY LESS THAN THE AVERAGE HOUSEHOLD INCOME OF $71,262 FOR THE OVERALL TRI-COUNTY AREA. OVERALL, 21% OF RESIDENTS IN THESE ZIP CODES HAVE LESS THAN A HIGH SCHOOL EDUCATION COMPARED TO 12% FOR THE TRI-COUNTY AREA. THESE TWENTY ZIP CODES HAVE A SIMILAR PERCENTAGE OF RACIAL/ETHNIC MINORITIES AS COMPARED TO THE REST OF THE TRI-COUNTY AREA. AS A WHOLE THESE ZIP CODES ARE COMPOSED OF 34.5% MINORITIES COMPARED TO 35.2% FOR THE TRI-COUNTY AREA.AS A RESULT, THE DETROIT AREA AND ABOVE TWENTY ZIP CODES, AS WELL AS OTHER ZIP CODES WITH SIMILAR CHARACTERISTICS, ARE OF PARTICULAR INTEREST IN PLANNING COMMUNITY NEEDS INITIATIVES WITHIN THE TRI-COUNTY AREA. PART VI, LINE 5: HENRY FORD MACOMB HOSPITALS (HFMH) IS PART OF HENRY FORD HEALTH SYSTEM, ONE OF THE NATION'S LARGEST INTEGRATED HEALTH DELIVERY SYSTEMS SERVING ALL OF SOUTHEASTERN MICHIGAN. THIS TAX RETURN REFLECTS ACTIVITIES OF THE CLINTON TOWNSHIP CAMPUS OF HFMH, WHICH INCLUDES APPROXIMATELY 400 INPATIENT BEDS WITH AN OPEN MEDICAL STAFF, A BEHAVIORAL HEALTH FACILITY, AS WELL AS SEVERAL OUTPATIENT LOCATIONS SERVING THE MACOMB COUNTY AREA OF MICHIGAN. HFMH IS GOVERNED BY A DEDICATED VOLUNTEER COMMUNITY BOARD AND IT PROVIDES ITS COMMUNITIES WITH A FULL RANGE OF CLINICAL SERVICES INCLUDING GENERAL MEDICINE, SURGERY, OBSTETRICS, PEDIATRICS, CARDIAC CARE, PHYSICAL AND REHABILITATION MEDICINE, AMBULATORY SURGERY, INPATIENT AND OUTPATIENT BEHAVIORAL SERVICES, AND 24 HOUR EMERGENCY CARE. PART VI, LINE 6: THE SYSTEM DEMONSTRATES ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY BY OPERATING EMERGENCY ROOMS OPEN TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK; PROVIDING FACILITIES FOR THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS; AND MAINTAINING RESEARCH FACILITIES FOR THE STUDY OF NEW DRUGS AND MEDICAL DEVICES THAT OFFER THE PROMISE OF IMPROVING HEALTH CARE. THE SYSTEM ALSO PROVIDES COMMUNITY HEALTH SERVICES, SUCH AS COMMUNITY EDUCATION AND OUTREACH IN THE FORM OF FREE OR LOW-COST CLINICS; HEALTH EDUCATION TELEVISION PROGRAMMING; DONATIONS FOR THE COMMUNITY; MULTIPLE HEALTH PROMOTION AND WELLNESS PROGRAMS, SUCH AS HEALTH SCREENING; AND VARIOUS COMMUNITY PROJECTS AND SUPPORT GROUPS X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 STEVEN D HARRINGTON MD PHYSICIAN/ TRUSTEE 397914 0 0 0 402995 0 23155 0 17799 0 841863 0 0 0 BRIAN G LODER DPM PHYSICIAN/ TRUSTEE 140410 0 0 0 0 40359 8408 0 19429 0 168247 40359 0 0 ROBERT G RINEY TRUSTEE 0 959356 0 940329 0 235479 0 25805 0 23007 0 2183976 0 0 BARBARA W ROSSMANN PRESIDENT / TRUSTEE 501348 0 283347 0 102769 0 25805 0 27685 0 940954 0 0 0 DIANE L GEORGE DO PHYSICIAN/ TRUSTEE 0 347422 0 64271 0 7954 0 25805 0 28864 0 474316 0 0 EDITH L EISENMANN SECRETARY 0 188982 0 133008 0 23742 0 20636 0 13950 0 380318 0 0 TERRY A GOODBALIAN ASSISTANT TREASURER/CFO 0 262539 0 83142 0 8367 0 24480 0 23987 0 402515 0 0 EDWARD G CHADWICK TREASURER 0 666183 0 439612 0 21947 0 167719 0 25760 0 1321221 0 0 GARY J BEAULAC CHIEF OPERATING OFFICER 311451 0 154074 0 27775 0 24480 0 31120 0 548900 0 0 0 JOANNA R PEASE DO CHIEF MEDICAL OFFICER 341000 0 240643 0 3917 0 24480 0 16553 0 626593 0 0 0 KENNETH A SCOTT DO PHYSICIAN 646178 0 77013 0 29291 0 23155 0 21078 0 796715 0 0 0 FREMONT SCOTT DO PHYSICIAN 603354 0 20563 0 35083 0 24480 0 18155 0 701635 0 0 0 ANDREW AGOSTA MD PHYSICIAN 437972 0 84975 0 125705 0 25805 0 25164 0 699621 0 0 0 RONALD LEVIN MD PHYSICIAN 724679 0 210207 0 174383 0 24480 0 24467 0 1158216 0 0 0 MARK T RYAN DO PHYSICIAN 606893 0 118104 0 19284 0 22493 0 1595 0 768369 0 0 0 PART I, LINE 1A IT IS THE ORGANIZATION'S POLICY TO PAY OR REIMBURSE EMPLOYEES FOR BONAFIDE BUSINESS TRAVEL BASED ON THE MOST COST EFFECTIVE MEANS AVAILABLE. GENERALLY, WHEN AIR TRAVEL IS INVOLVED THIS EQUATES TO COACH CLASS AIR FARE. UNDER CERTAIN CIRCUMSTANCES, SUCH AS WHEN COACH CLASS IS NOT AVAILABLE OR THE TRIP IS OF AN EXTENSIVE DURATION, SENIOR LEADERSHIP HAS APPROVED BUSINESS CLASS, FIRST CLASS OR CHARTER TRAVEL. IN SUCH CIRCUMSTANCES, THE TRAVEL IS CONSIDERED TO BE FOR A BONAFIDE BUSINESS PURPOSE; ACCORDINGLY NO TAXABLE INCOME IS REPORTED. NO QUALIFYING INDIVIDUALS RECEIVED PAID OR REIMBURSED FIRST CLASS TRAVEL DURING 2016. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PROGRAM THAT RESULTS IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP ALSO HAVE THE OPTION TO PARTICIPATE IN NON-QUALIFIED 457 BENEFIT PROGRAMS WHICH RESULTS IN REPORTABLE TAXABLE INCOME AS BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. IT IS AN ELEMENT OF THE PLAN DESIGN TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. SEE Q. 4B FOR THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS. PART I, LINE 4B SCH J, LINE 4B, PERSONS PARTICIPATING IN NONQUALIFIED RETIREMENT PLANS SEC 457(F) - SUPPLEMENTAL HFHS EXECUTIVE RETIREMENT PLAN (SERP) TAXABLE REPORTABLE VALUE OF 2016 ACCRUAL NON-VESTED 2016 DISTRIBUTIONS W-2 AMOUNTS PARTICIPANT ROBERT G. RINEY 212,144 - - 212,144 BARBARA W. ROSSMANN 75,283 - - 75,283 EDWARD G. CHADWICK - 144,564 - - CONTRIBUTIONS TO SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2016 CONTRIBUTIONS 2016 CONTRIBUTIONS TAX GROSS-UP W-2 AMOUNTS BARBARA W. ROSSMANN 3,786 14,214 342 18,342 RONALD LEVIN, M.D. - 18,000 433 18,433 ANDREW AGOSTA, M.D. 9,464 8,536 205 18,205 GARY J. BEAULAC 14,175 3,825 92 18,092 JOANNA PEASE, M.D. - 3,825 92 3,917 ROBERT G. RINEY - 18,000 433 18,433 MARK RYAN, M.D. 7,274 10,726 258 18,258 EDITH L. EISENMANN 18,000 - - 18,000 STEVEN D. HARRINGTON 5,005 120 5,125 DIANE L. GEORGE 5,500 132 5,632 EDWARD CHADWICK 4,070 13,930 335 18,335 KENNETH A. SCOTT 9,555 230 9,785 FREMONT SCOTT 5,500 12,124 292 17,966 0 MARTIN E BEAULAC SEE BELOW 195362 SEE BELOW 0 ROSEMARY MINJEUR SEE BELOW 68637 SEE BELOW 0 RAYMOND J MINJEUR SEE BELOW 46856 SEE BELOW 0 JONATHAN E BEAULAC SEE BELOW 118487 SEE BELOW 0 ALLIANCE HEALTH PROF SEE BELOW 13600896 SEE BELOW 0 ALLIANCE MANAGEMENT SEE BELOW 12399929 SEE BELOW 0 SCHEDULE L, PART IV - BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: ALLIANCE HEALTH PROFESSIONAL PLLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: OWNER/TRUSTEE(C) AMOUNT OF TRANSACTION $ 13,600,896(D) DESCRIPTION OF TRANSACTION: PROVIDED PROFESSIONAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: ALLIANCE MANAGEMENT PARTNERS LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: OWNER/TRUSTEE(C) AMOUNT OF TRANSACTION $ 12,399,929(D) DESCRIPTION OF TRANSACTION: PROVIDED PROFESSIONAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: MARTIN E. BEAULAC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: ROSEMARY MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: RAYMOND J. MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: JONATHAN E. BEAULAC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: ACADEMIC INTERNAL MEDICINE SPECIALISTS PLLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 164,218.26(D) DESCRIPTION OF TRANSACTION: PROVIDED PROFESSIONAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: EASTPOINTE RADIOLOGISTS PC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: (C) AMOUNT OF TRANSACTION $ 103,164.05 (D) DESCRIPTION OF TRANSACTION: PROVIDED MEDICAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: KASCO INC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 1,239,813.73 (D) DESCRIPTION OF TRANSACTION: PROVIDED CONSTRUCTION SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: MEDSTAR AMBULANCE SERVICE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 452,897.74(D) DESCRIPTION OF TRANSACTION: PROVIDED AMBULANCE SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: RONCELLI INC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 2,874,974.50(D) DESCRIPTION OF TRANSACTION: PROVIDED CONSTRUCTION SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: SYENERGY ENGINEERING SERVICES(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 993,474.65(D) DESCRIPTION OF TRANSACTION: PROVIDED ENGINEERING SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: WELLINGTON HOME BUILDING LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 893,114.50(D) DESCRIPTION OF TRANSACTION: PROVIDED CONSTRUCTION SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO X 1 10491 MARKET VALUE X EVENT CONTRIBUTIONS 103 43072 FAIR MARKET VALUE X MISCELLANEOUS 1 2513 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A TAX EXEMPT STOCK CORPORATION AND HENRY FORD HEALTH SYSTEM HOLDS ALL OF THE ISSUED AND OUTSTANDING SHARES OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE STOCK HOLDER OF THE ORGANIZATION, HFHS HOLDS THE RESERVE POWER TO APPROVE OR DISAPPROVE TRUSTEE APPOINTMENTS. FORM 990, PART VI, SECTION A, LINE 7B BASED ON THE ESTABLISHED RESERVE POWERS, CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) AND THE TAX DEPARTMENT OF HFHS PREPARES THE ORGANIZATION'S FORM 990. AS PART OF THE PREPARATION AND REVIEW PROCESS PRIOR TO FILING THE RETURN, THE FOLLOWING REVIEW PROCESS IS CONDUCTED: - REVIEW OF THE ENTIRE RETURN WITH THE HFHS AND ORGANIZATION'S CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER AND CHIEF EXECUTIVE OFFICER - REVIEW OF ALL COMPENSATION MATTERS AND DISCLOSURES WITH THE COMPENSATION COMMITTEE OF THE HFHS BOARD OF TRUSTEES - REVIEW OF THE RETURN WITH THE HFHS AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES - PROVIDE A COPY OF THE RETURN TO THE ORGANIZATION'S BOARD OF TRUSTEES FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO OVERSEES THE CONFLICT OF INTEREST PROCESS WITH REGARD TO THE ORGANIZATION. HFHS HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE HFHS CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES AND EMPLOYEES. ANNUALLY, TRUSTEES, EMPLOYEES OF A MANAGEMENT LEVEL, RESEARCHERS, AS WELL AS EMPLOYEES ASSOCIATED WITH PROCUREMENT, OR IN CERTAIN OTHER PREDEFINED ROLES MUST COMPLETE AN ANNUAL DISCLOSURE DESIGNED TO IDENTIFY ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. IT IS THE RESPONSIBILITY OF THE COMMITTEE TO REVIEW THESE DISCLOSURES AND DETERMINE THE NEED FOR ANY ACTION TO MANAGE THE POTENTIAL CONFLICT. THE COMMITTEE ANNUALLY REPORTS THE RESULTS OF ITS ACTIVITIES TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE HFHS BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO HAS RESPONSIBILITY TO OVERSEE THE COMPENSATION PRACTICES OF THE ORGANIZATION. HFHS HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES CONSISTING OF ALL EXTERNAL TRUSTEES. THEY MEET PERIODICALLY THROUGHOUT THE YEAR. THEY ARE CHARGED WITH APPROVAL OF THE ORGANIZATION'S OVERALL COMPENSATION AND BENEFIT PROGRAMS AS WELL AS THE SPECIFIC REVIEW AND APPROVAL OF THE COMPENSATION OF CERTAIN EMPLOYEES INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THEY DIRECTLY ENGAGE AN INDEPENDENT COMPENSATION ADVISOR TO ASSIST WITH THIS PROCESS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE, UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS, AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTH CARE ORGANIZATIONS. THE REASONABLENESS OF COMPENSATION IS EVALUATED BASED UPON THESE AND OTHER FACTORS. THE COMMITTEE ALSO REVIEWS THE COMPENSATION DISCLOSURES TO BE MADE ON FORM 990 IN ADVANCE OF FILING. FORM 990, PART VI, SECTION C, LINE 19 IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION. AS A HOLDER OF TAX EXEMPT DEBT THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO A PUBLIC CLEARING HOUSE ON A QUARTERLY BASIS. PART IV, LINE 12 THE ORGANIZATION IS AN ELEMENT OF THE EXTERNAL AUDIT REPORT OBTAINED FOR THE CONSOLIDATED OPERATIONS OF HENRY FORD HEALTH SYSTEM. FORM 990, PART IV, LINE 24A, TAX-EXEMPT BOND ISSUE: THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM. THE ALLOCATED TAX-EXEMPT BOND LIABILITY OF THE ORGANIZATION IS REPORTED UNDER THE FORM 990, SCHEDULE K OF ITS PARENT, HENRY FORD HEALTH SYSTEM. FORM 990, PART XI, LINE 9: MINIMUM PENSION LIABILITY ADJUSTMENT -428,947. INTERCOMPANY TRANSFER 10,529. FORM 990 - PART XII - LINE 2C: HENRY FORD MACOMB HOSPITAL CORPORATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF HENRY FORD HEALTH SYSTEM. THE GOVERNING BODY OF HFHS HAS DELEGATED THE OVERSIGHT OF THE FINANCIAL STATEMENTS, INCLUDING THE CHOICE OF INDEPENDENT AUDITORS, TO ITS AUDIT COMMITTEE. FORM 5713 - INTERNATIONAL BOYCOTT ACTIVITY: A FORM 5713, INTERNATIONAL BOYCOTT REPORT, HAS BEEN FILED ON OUR BEHALF BY HENRY FORD HEALTH SYSTEM (PARENT OF OUR CONTROLLED GROUP). THE ORGANIZATION DID NOT ITSELF HAVE ANY ACTIVITIES ASSOCIATED WITH AN INTERNATIONAL BOYCOTT COUNTRY. FORM 990, PART VII: AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: MANY EXECUTIVE EMPLOYEES OF HFHS PROVIDE SERVICES TO MULTIPLE AFFILIATED ENTITIES. HENRY FORD HEALTH SYSTEM USES ESTIMATES FOR REPORTING AVERAGE HOURS PER WEEK IN ALL SECTIONS OF FORM 990. GENERALLY 60 HOURS ARE REPORTED FOR THE HOURS ASSOCIATED FOR THE ORGANIZATION THAT THE INDIVIDUAL HAS PRINCIPAL RESPONSIBILITY FOR. HOURS ASSOCIATED WITH OTHER HOSPITAL OR LARGER ORGANIZATIONS ARE REPORTED AT 5 PER WEEK AND FOR SMALLER ORGANIZATIONS 1 HOUR PER WEEK IS REPORTED. MERCY MOUNT CLEMENS REAL ESTATE LLC ONE FORD PLACE DETROIT MI 48202 382947657 REAL ESTATE MI 25000 0 N/A HENRY FORD HEALTH SYSTEM ONE FORD PLACE DETROIT MI 48202 381357020 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) 3 N/A 0 HENRY FORD WYANDOTTE HOSPITAL 2333 BIDDLE AVE WYANDOTTE MI 48192 382791823 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) 3 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM FOUNDATION ONE FORD PLACE DETROIT MI 48202 237383042 SUPPORTING ORGANIZATION MI 501(C)(3) 11A-TYPE 1 HENRY FORD HEALTH SYSTEM 1 HEALTH ALLIANCE PLAN 2850 W GRAND BLVD DETROIT MI 48202 382242827 HEALTH MAINTENANCE ORGANIZATION MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HFHS SELF FUNDED LIABILITY ONE FORD PLACE DETROIT MI 48202 386553031 MALPRACTICE INSURANCE MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HENRY FORD CONTINUING CARE ONE FORD PLACE DETROIT MI 48202 382433285 NURSING HOMES MI 501(C)(3) 9 HENRY FORD HEALTH SYSTEM 1 HFII CORPORATION ONE FORD PLACE DETROIT MI 48202 900840304 SCIENTIFIC RESEARCH MI 501(C)(3) 7 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM GOVERNMENT AFFAIRS SERVICES ONE FORD PLACE DETROIT MI 48202 464064067 ADVOCACY SERVICES FOR HFHS AND AFFILIATES MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HENRY FORD ALLEGIANCE HEALTH GROUP 205 N EAST AVENUE JACKSON MI 49201 382756428 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) 11A-TYPE II HENRY FORD HEALTH SYSTEM 1 ALLEGIANCE HEALTH FOUNDATION 205 N EAST AVENUE JACKSON MI 49201 383607833 SUPPORTING ORGANIZATION MI 501(C)(3) 11A-TYPE II HENRY FORD ALLEGIANCE HEALTH GROUP 1 NORTHWEST DETROIT DIALYSIS 30100 TELEGRAPH BINGHAM FARMS MI 48025 383232668 OPERATE DIALYSIS CLINIC MI HENRY FORD HEALTH SYSTEM N/A 0 0 MACOMB REGIONAL DIALYSIS CENTERS 16151 NINETEEN MILE RD CLINTON TOWNSHIP MI 48038 260423581 OPERATE DIALYSIS CLINICS MI HENRY FORD HEALTH SYSTEM N/A 0 0 FOOTE HEALTH CENTER ASSOCIATES 1100 E MICHIGAN AVENUE JACKSON MI 48201 383017711 LESSOR OF MEDICAL CONDOMINIUM MI HENRY FORD ALLEGIANCE HEALTH GROUP RELATED 0 0 1 FAIRLANE HEALTH SERVICES 30100 TELEGRAPH BINGHAM FARMS MI 48025 382565235 HEALTHCARE MANAGEMENT MI HENRY FORD HEALTH SYSTEM C 1 ALLIANCE HEALTH AND LIFE INSURANCE 2850 W GRAND BLVD DETROIT MI 48202 383291563 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 HAP PREFERRED INC 2850 W GRAND BLVD DETROIT MI 48202 382513504 PROVIDER NETWORK LEASING MI HEALTH ALLIANCE PLAN C 1 SHA REALTY INC ONE FORD PLACE DETROIT MI 48202 381378121 REAL ESTATE HOLDING MI HENRY FORD HEALTH SYSTEM C 1 ONIKA INSURANCE LTD FIRST CARRIBEAN HOUSE GRAND CAYMAN CJ CAPTIVE INSURANCE CJ HENRY FORD HEALTH SYSTEM C 1 HENRY FORD PHYSICIAN NETWORK ONE FORD PLACE DETROIT MI 48202 320306774 PHYSICIAN NETWORK MI HENRY FORD HEALTH SYSTEM C 1 ADMINISTRATION SYSTEMS RESEARCH CORPORATION 2850 W GRAND BLVD DETROIT MI 48202 382651185 THIRD PARTY INSURANCE ADMINISTRATOR MI HEALTH ALLIANCE PLAN C 1 HAP MIDWEST HEALTH PLAN INC 2850 W GRAND BLVD DETROIT MI 48202 383123777 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 HAP COMMUNITY ALLIANCE 2850 W GRAND BLVD DETROIT MI 48202 320306774 MANAGEMENT COMPANY MI HEALTH ALLIANCE PLAN C 1 VIKING HEALTH SYSTEM INC 205 N EAST AVENUE JACKSON MI 49201 382756161 IDLE HEALTHCARE ADMINISTRATION CORPORATION MI HENRY FORD ALLEGIANCE HEALTH GROUP C 1.00000 1 CASCADES INSURANCE COMPANY LTD 205 N EAST AVENUE JACKSON MI 49201 981132982 HOSPITAL MALPRACTICE INSURANCE MI HENRY FORD ALLEGIANCE HEALTH GROUP C 1.00000 1 0 0 0 1 1 0 0 0 0 0 0 1 1 0 0 1 0 0 0 HEALTH ALLIANCE PLAN L 35853968 CASH VALUE HEALTH ALLIANCE PLAN M 30574 CASH VALUE ALLIANCE HEALTH AND LIFE INSURANCE M 1665306 CASH VALUE ONIKA INSURANCE LTD P 1329500 CASH VALUE HEALTH ALLIANCE PLAN M 445031 CASH VALUE SCHEDULE R, PART V, LINE 1D & 1E: THE ORGANIZATION IS A MEMBER OF THE HENRY FORD HEALTH SYSTEM OBLIGATED GROUP. MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR OUTSTANDING OBLIGATIONS ISSUED UNDER THE 2016 HFHS BOND MASTER INDENTURE.