2017-05-10T19:02:32-05:00 2016-06-30 990 2015-07-01 380997730 St Mary's of Michigan STMA 9899078000 800 South Washington Avenue Saginaw MI 48601 Nancy Haywood Chief Financial officer 2017-05-10 2015 2021-01-29 14:40:06Z St Mary's Medical Center of Saginaw Christopher Palazzolo 800 South Washington Avenue Saginaw MI 48601 267887742 false 0928 X www.stmarysofmichigan.org X 1874 MI Provide medical services which strengthen the healing mission of the Catholic Church. 10 9 2302 170 0 0 1035675 819886 232395739 260838138 6930603 900616 6030337 5329102 246392354 267887742 1221332 113100 0 112313845 118097130 0 0 146419343 141206568 259954520 259416798 -13562166 8470944 379384438 351102956 147543357 145089689 231841081 206013267 Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. false false 238896360 113100 263617873 ST. MARY'S OF MICHIGAN MEDICAL CENTER ("SMMMC") IS A 268 LICENSED BED NONPROFIT ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES. SMMMC SEEKS TO IMPROVE THE PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL HEALTH STATUS OF ITS SURROUNDING COMMUNITY. SMMMC PROVIDES A SUBSTANTIAL PORTION OF ITS SERVICES TO THE ELDERLY AND POOR. DURING THE FISCAL YEAR, APPROXIMATELY 53% OF THE VALUE OF SERVICES RENDERED WAS TO ELDERLY PATIENTS UNDER THE MEDICARE PROGRAM, AND APPROXIMATELY 16% OF THE SERVICES WERE PROVIDED TO PATIENTS WHO WERE DEEMED INDIGENT UNDER STATE, COUNTY, OR MEDICAL CENTER GUIDELINES. DURING THE FISCAL YEAR ENDING JUNE 30, 2016, THE ESTIMATED UNREIMBURSED COST OF SERVICES PROVIDED TO THE ELDERLY, UNINSURED, AND UNDERINSURED TOTALED $12,176,155. 784778 929251 RESPITE ADULT DAY CARE - THE GUARDIAN ANGEL PROGRAM FOSTERS A CARING ATMOSPHERE FOR INDIVIDUALS WITH SPECIAL NEEDS BY PROVIDING THEM WITH A WARM AND SAFE HAVEN AND RELIEF TO THEIR FAMILIES ENABLING THEM TO ENHANCE THEIR QUALITY OF LIFE. 616216 616216 TOWNE CENTRE SURGERY CENTER - The joint venture furthers the hospital's mission by providing a broad range of health care services to the residents geographically located on the other side of the city; aiding us in our journey to provide services to all, especially to the elderly, uninsured, and underinsured. 240297354 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 206 0 true 2302 true false false false false false false false false false false X 10 9 false false false false true true true true true false false true true true true true true false false true true X Nancy Haywood 9899077596 800 South Washington Avenue Saginaw MI 48601 MUHAMMAD ABOUDAN MD TREASURER 1.0 3.1 X X 0 0 0 ELIZABETH ADERHOLDT PRESIDENT & CEO 43.0 17.0 X X 460156 1235771 33068 JOHN FREEL CHAIRMAN 1.0 3.1 X X 0 0 0 JAMES HRESKO VICE CHAIR 1.0 3.1 X X 0 0 0 BAPINEEDU MAGANTI MD SECRETARY 1.0 3.1 X X 0 0 0 JAMES BOLES TRUSTEE 1.0 3.1 X 0 0 0 PAUL FURLO TRUSTEE 1.0 5.7 X 0 0 0 TODD GREGORY TRUSTEE 1.0 3.1 X 0 0 0 RICHARD HEINRICH TRUSTEE 1.0 5.1 X 0 0 0 DEBORAH MORGAN TRUSTEE 1.0 3.1 X 0 0 0 MARK PIPER TRUSTEE 1.0 3.1 X 0 0 0 JO STUDLEY-MAY MD TRUSTEE 1.0 62.1 X 0 271154 46665 ALBERT SARGE HARVEY BOARD MEMBER 1.0 7.1 X 0 0 0 NANCY HAYWOOD CHIEF FINANCIAL OFFICER 30.0 30.0 X 186758 232500 45146 CHARLES HUSSON DO CHIEF MEDICAL OFFICER 12.0 42.0 X 74801 362598 21407 CHERYL GUELDENZOPF CHIEF ADMINISTRATIVE OFFICER 45.0 0 X 127508 0 22612 BERNARD JORE VP- CNO 45.0 0 X 200375 0 31355 SHARON LEAMAN-CASE VP-PROF & SUPP 45.0 0 X 187808 0 16990 MICHAEL LONG PRESIDENT-PHYS ENT. (ENDS 8/2015) 45.0 0 X 160737 0 18046 RAGHURAM SARVEPALLI VP -MEDICAL AFFAIRS 45.0 0 X 661861 0 47609 JOSEPH ADEL MD PHYSICIAN 45.0 1.0 X 1108359 0 39815 WAHEED AKBAR MD PHYSICIAN 45.0 2.0 X 810828 0 29489 WILLIAM J PITTAS DO PHYSICIAN 45.0 0 X 618100 0 23544 NAMAN SALIBI MD PHYSICIAN 45.0 2.0 X 2147881 0 47487 TAREK A TAHA MD PHYSICIAN 45.0 0 X 845341 0 32526 GINA BUTCHER CHIEF FINANCIAL OFFICER (END 1/29/15) 0.0 0.0 X 269195 0 12419 JOHN GRAHAM PRESIDENT & CEO (END DATE 12/31/14) 0.0 0.0 X 510112 0 11853 8369820 2102023 480031 118 true true false CMU MEDICAL EDUCATION PARTNERS 1000 haughton ave sagnaw MI 48602 medical services 5366586 CYBERKNIFE OF SAGINAW LLC 4677 TOWNE CENTRE ROAD STE 301 saginaw MI 48604 medical services 1288320 GLBR MEDICAL RESOURCES LLC 912 s washington ste 1 saginaw MI 48601 medical recruitment/staffing 1235911 COMMUNITY HOSPITAL SERVICES 1321 Cumberland St saginaw MI 48601 transport services 940994 towne center surgery center llc 4599 TOWNE CENTRE ROAD saginaw MI 48604 medical services 769415 27 X 525108 90500 204278 819886 NET PATIENT REVENUE 621990 255743356 255743356 PROGRAM RELATED JV 623990 3010457 3010457 RESPITE 621400 929251 929251 TOWNE CENTER 621400 616216 616216 HEALTHSOURCE REVENUE 621400 452753 452753 86105 86105 0 0 260838138 900091 900091 54903 54903 0 54903 54903 525 0 525 525 525 CAFETERIA/VENDING 722514 948997 948997 OTHER REVENUE 900099 4325202 4325202 0 0 0 0 5274199 267887742 265163340 0 1904516 X 113100 113100 7610590 2028832 5581758 284226 75769 208457 93608516 87511476 6097040 -2101502 -1891352 -210150 12169566 11438572 730994 6525734 6133750 391984 581634 581634 630486 630486 17047 17047 49246946 47566520 1680426 0 762804 762804 6485172 6427193 57979 15454825 15454825 6553153 6159522 393631 528926 497155 31771 3887618 3654099 233519 9073425 8528408 545017 1978854 1859989 118865 MEDICAL SUPPLIES 42136255 42150865 -14610 Dues & Subscriptions 249198 75551 173647 Symphony Service Fees 1803177 1803177 Other Miscellaneous 1817048 1733229 83819 0 0 0 0 259416798 240297354 19119444 0 0 0 2359502 3100811 0 28336079 34438204 0 0 5611297 5480210 3706048 2118472 264721439 189299873 73082826 75421566 0 0 15395132 15780654 5908714 14322313 244984840 200440726 379384438 351102956 28734040 23726071 118809317 121363618 147543357 145089689 231841081 206013267 231841081 206013267 379384438 351102956 X 8470944 -7387592 -26911166 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 17047 17047 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Part of St. Mary's annual dues paid to Michigan Health & Hospital Association (MHA) are used for lobbying activities, per prior communication from MHA. St. Mary's of Michigan Medical Center does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition of) any candidate for public office. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Part of St. Mary's annual dues paid to Michigan Health & Hospital Association (MHA) are used for lobbying activities, per prior communication from MHA. St. Mary's of Michigan Medical Center does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition of) any candidate for public office. 9261190 9261190 114609924 84545778 30064146 0 0 0 119325893 94402861 24923032 21524432 10351234 11173198 75421566 INTEREST IN INVESTMENTS HELD BY ASCENSION HEALTH ALLIANCE 186115448 CONSTRUCTION IN PROGRESS ASCENSION HEALTH DEFERRED COMPENSATION ASSET 5188280 OTHER RECEIVABLES 2487201 PENSION PLANS INTERCOMPANY ACCOUNTS RECEIVABLE 2548025 ADVANCES TO AFFILIATES OTHER DEPOSITS 15522 ESTIMATED SETTLEMENTS FROM 3RD PARTY PAYOR 3115952 ASSETS HELD FOR SALE, NET 970298 200440726 INTERCOMPANY DEBT WITH ASCENSION HEALTH ALLIANCE 100818408 THIRD PARTY PAYABLE 7870314 VALUATION ALLOWANCE INTERCOMPANY PAYABLES 3361855 CURRENT PORTION L/T DEBT AH SAVINGS PLAN LIABILITIY 1332357 CAPITAL LEASE OBLIGATIONS 1626666 PHYSICIAN GUARANTEE LIABILITY 64888 PENSION PLAN LIABILITY 6289130 121363618 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of St. Mary's of Michigan Medical Center: 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, 2016. true true X true X true X true true false true true 706996 0 706996 0.0027 46734310 33764864 12969446 0.0500 0 0 0 0.0 0 0 47441306 33764864 13676442 0.0527 624397 0 624397 0.0024 5113908 5113908 0 0.0 0 0 0 0.0 240704 0 240704 0.0009 222483 0 222483 0.0009 0 0 6201492 5113908 1087584 0.0042 0 0 53642798 38878772 14764026 0.0569 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 10534379 1057096 102858726 113760209 -10901483 X true true 1 1 STMARY'S OF MICHIGAN MEDICAL CENTER 800 SOUTH WASHINGTON AVENUE SAGINAW MI 48601 http://www.stmarysofmichigan.org/ 730050 X X X X X STMARY'S OF MICHIGAN MEDICAL CENTER 1 false false true X X X X X X X X 15 true true true true X http://www.stmarysofmichigan.org/community-health X true 15 true http://www.stmarysofmichigan.org/community-health false false true X 200.0 300.0 X X X X true true X X X true X https://www.stmarysofmichigan.org/financial-assistance X https://www.stmarysofmichigan.org/financial-assistance X https://www.stmarysofmichigan.org/financial-assistance 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 - ST.MARY'S OF MICHIGAN MEDICAL CENTER. INFORMATION WAS GATHERED THROUGH FOCUS GROUPS, NEIGHBORHOOD ASSOCIATION GROUPS, FAITH-BASED GROUPS, RESIDENTS, AND COMMUNITY SURVEYS AND AREA AGENCIES IN AN ATTEMPT TO ACQUIRE BROAD COMMUNITY INPUT REGARDING THEIR HEALTH CONCERNS. IN ADDITION, PUBLIC HEALTH EXPERTS INCLUDING SAGINAW COUNTY PUBLIC HEALTH OFFICER AND LOCAL PUBLIC HEALTH LEADERS WERE KEY PARTICIPANTS IN CHNA ASSESSMENT PLANNING, AND DEVELOPMENT OF ACTION PLANS. GROUPS WERE FACILITATED BY LOCAL AND NATIONAL PUBLIC HEALTH LEADERS. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - ST.MARY'S OF MICHIGAN MEDICAL CENTER. ST. MARY'S OF MICHIGAN MEDICAL CENTER COLLABORATED WITH THE FOLLOWING HOSPITAL ORGANIZATIONS IN CONDUCTING ITS MOST RECENT CHNA: - COVENANT HEALTHCARE Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - ST.MARY'S OF MICHIGAN MEDICAL CENTER. ST. MARY'S OF MICHIGAN MEDICAL CENTER COLLABORATED WITH THE FOLLOWING ORGANIZATIONS IN CONDUCTING ITS MOST RECENT CHNA: - SAGINAW COUNTY DEPARTMENT OF PUBLIC HEALTH - SAGINAW COUNTY COMMUNITY MENTAL HEALTH AUTHORITY - HEALTH DELIVERY INC. - FEDERALLY QUALIFIED HEALTH CENTERS - SAGINAW INTERMEDIATE SCHOOL DISTRICT - ALIGNMENT SAGINAW Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ST.MARY'S OF MICHIGAN MEDICAL CENTER (SMOM). i) How the CHNA needs were met in FY 2016 for the old/previous CHNA that covered fiscal year 2014-2016 Prioritized Need 1: Chronic Disease - ST.MARY'S OF MICHIGAN MEDICAL CENTER (SMOM) recognizes the critical need to address diabetes in our community. SMOM's goal is to reach both SMOM patients, as well as those who are poor and vulnerable. SMOM has focused on diabetes nutrition and education through the DSME (Diabetes Self-Management Education) and diabetes PATH (Personal Action Towards Health) programs. SMOM has also leveraged the strengths of Ascension Mid-Michigan's current diabetes and nutrition programs to improve and grow the diabetes programming. SMOM has implemented and sustained the CDC recognized DPP (Diabetes Prevention Program) for patients who have been identified as pre-diabetics. The program aims to address access barriers for patients with pre-diabetes to participate and achieve improved, positive, measurable behavioral and clinical changes to their health. SMOM has also offered the Healthy Lifestyle Your Way program for patients with chronic diseases such as diabetes, hypertension and obesity. The program provides 1:1 lifestyle change coaching to patients. SMOM has strategically placed community health workers in the local provider offices and clinics to educate patients and gain referrals to the appropriate program/s. SMOM participated in the Million Hearts Learning Collaborative Project, a national initiative to prevent 1 million heart attacks and strokes by 2017. The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services co-lead the initiative on behalf of the U.S. Department of Health and Human Services. The focus was on identifying individuals with undiagnosed hypertension and improving control of their blood pressure within both the undiagnosed and diagnoses population by 5% within Saginaw County. Prioritized Need 2: Obesity - SMOM has made it a priority to serve as a vital presence in the community to support physical activity and programing that meets community health needs and supports population health delivery. The SMOM Center of HOPE (off-site community center strategically placed in a neighborhood to meet people where they are) offers yoga, hustle-robotics, walking classes, Cooking Matters classes, and a robust youth education program. In partnership with MSU Extension, YMCA, and Beacon of Hope Church, the Center of HOPE offered the Summer Feeding youth education program. This offers kids within the community a safe and educational place to learn/practice healthy eating, physical activity, and life skills. Prioritized Need 3: Health Care/Insurance Access and Utilization of Services - SMOM offers 3 Free Medical Clinics (Naseau Clinic, Cathedral Clinic, Family Life Community Clinic) that bridge the uninsured to basic health care and provide medications and education until the patient receives health insurance and a primary care provider. SMOM Center of HOPE also operates a Community Benefit Pharmacy, providing medications for under/uninsured. Prioritized Need 4: Behavioral Health - St. Mary's COH has partnered with SCCMHA (Saginaw County Community Mental Health Authority) to provide Chronic Disease PATH classes for their severely mental ill participants. The Stanford Chronic Disease Self-Management Program (PATH) was developed and studied by Stanford University to help people learn to better manage their chronic disease(s). The class is a six-week workshop for 2 1/2 hour sessions each week. ii) List the programs from the new CHNA that the hospital will be addressing for fiscal year 2017-2019 SMOM will address the following priority health needs identified within the 2017 CHNA: 1. Health Conditions - Chronic Disease, Obesity 2. Social, Emotional, Behavioral Health - Nutrition and Healthy Eating 3. Access to Healthcare and Services/Accessibility Disparities - Outreach and awareness, Service Delivery, End of Life Care 4. Health Determinants - Health Insurance Enrollment Other: Human Trafficking, Access to Care (Veterans) iii) List the programs from the new CHNA that the hospital will NOT be addressing for fiscal year 2017-2019 and why: SMOM will not directly address the following priority health needs identified within the 2017 CHNA: 1. Health Conditions - Dental Health, HIV/AIDS, Infant, Child, Maternal Health 2. Social, Emotional, Behavioral Health - Substance Abuse/Misuse, Tobacco Use/Misuse, Mental Health, Gun Violence, Teen Pregnancy 3. Access to Healthcare and Services/Accessibility Disparities - Affordability, Professional Development 4. Health Determinants - Race/Place/Income, Transportation, Poverty, Air/Environment hazards While critically important to overall community health, these specific priorities did not meet internally determined criteria that prioritized addressing needs by either continuing or expanding current programs, services and initiatives to steward resources and achieve the greatest community impact. For the areas listed that were not chosen, there are other service providers in the community better resourced to address these priorities, SMOM will work collaboratively with these organizations as appropriate to ensure optimal service coordination and utilization. SMOM will also participate on various committees to aid in coordination, provide support and remain informed on all plans to address identified health needs. 27 RIVERFRONT PULMONARY REHABILITATION 1015 S WASHINGTON AVENUE SAGINAW MI 48601 REHABILITATION CLINIC NEUROSURGERY ASSOCIATES 4677 TOWNE CENTRE SAGINAW MI 48604 PHYSICIANS OFFICE PINCONNING FAMILY MEDICINE 204 W THIRD ST PINCONNING MI 48650 PHYSICIANS OFFICE PRIMARY HEALTH CARE 1320 N MICHIGAN AVE SAGINAW MI 48602 PHYSICIANS OFFICE RIVERFRONT CARDIAC REHABILITATION 1015 S WASHINGTON AVENUE SAGINAW MI 48601 REHABILITATION CLINIC STMARY'S OF MICHIGAN TOWNE CENTRE 4599 TOWNE CENTRE ROAD SAGINAW MI 48604 EMERGENCY ROOM AND OTHER OUTPATIENT SERVICES AND DIAGNOSTIC CENTER BIRCH RUN 9900 E BIRCH RUN ROAD BIRCH RUN MI 48415 PHYSICIANS OFFICE, REHABILITATION AND DIAGNOSTIC CENTER CHESANING 1600 W BRADY STREET CHESANING MI 48616 PHYSICIANS OFFICE, REHABILITATION AND DIAGNOSTIC CENTER CENTER OF HOPE 723 EMERSON STREET SAGINAW MI 48607 NEIGHBORHOOD SERVICES FRANKENMUTH FAMILY PHYSICIANS 1027 WEST GENESEE STREET FRANKENMUTH MI 48734 PHYSICIANS OFFICE GRATIOT REHABILITATION SERVICES 5810 GRATIOT SUITE A SAGINAW MI 48638 REHABILITATION CLINIC GUARDIAN ANGEL RESPITE CARE DAVIS RD 7540 DAVIS ROAD SAGINAW MI 48604 RESPITE SERVICES GUARDIAN ANGEL RESPITE CARE HOWARD ST 801 HOWARD STREET SAGINAW MI 48601 RESPITE SERVICES HERITAGE FAMILY PHYSICIANS 3570 SHATTUCK ROAD SAGINAW MI 48603 PHYSICIANS OFFICE ORTHOPEDICS 4701 TOWNE CENTRE ROAD SUITE 303 SAGINAW MI 48604 PHYSICIANS OFFICE PLASTIC RECONSTRUCTIVE & HAND SURGERY 4705 TOWN CENTRE ROAD SAGINAW MI 48604 PHYSICIANS OFFICE PULMONARY & CRITICAL CARE ASSOCIATES 1015 S WASHINGTON AVENUE SAGINAW MI 48601 PHYSICIANS OFFICE RIVERFRONT CARDIOLOGY 1015 S WASHINGTON AVENUE SAGINAW MI 48601 DIAGNOSTIC SERVICES SAGINAW VALLEY PEDIATRICS 5821 COLONY DRIVE NORTH SAGINAW MI 48638 PHYSICIANS OFFICE SPINE & REHABILITATION CENTER 4901 TOWNE CENTRE ROAD SUITE 300 SAGINAW MI 48604 REHABILITATION CLINIC SETON CANCER INSTITUTE - MARLETTE 2780 MAIN STREET MARLETTE MI 48453 CANCER TREATMENT CENTER SETON CANCER INSTITUTE - TAWAS 200 HEMLOCK STREET TAWAS CITY MI 48763 CANCER TREATMENT CENTER SETON CANCER INSTITUTE - WEST BRANCH 2431 S M-30 WEST BRANCH MI 48661 CANCER TREATMENT CENTER VASSAR 1212 W SAGINAW ROAD VASSAR MI 48768 PHYSICIAN OFFICE, REHABILITATION, AND DIAGNOSTIC CENTER WOMANS HEALTH CENTER 4040 N EUCLID AVENUE SUITE B BAY CITY MI 48706 PHYSICIANS OFFICE WOUND CARE & HYPERBARIC CENTER 4599 TOWNE CENTRE SAGINAW MI 48604 REHABILITATION AND OTHER OUTPATIENT CLINIC SETON CANCER INSTITUTE 800 S WASHINGTON AVE SAGINAW MI 48601 CANCER TREATMENT CENTER Schedule H, Part I, Line 6a Community benefit report prepared by related organization Saginaw County Department of Public Health Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a costing 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 certain categories in the table this was a cost accounting system; in other categories, a specific cost-to-charge ratio was applied. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad debt is estimated based on aging of patient accounts receivable. Contractual adjustment and bad debt write off percentages are calculated using a 12 month historical look back period. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Bad debt is estimated based on aging of patient accounts receivable. Contractual adjustment and bad debt write off percentages are calculated using a 12 month historical look back period. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote From the consolidated audited financial statements of Ascension Health Alliance (which include the activity of St. Mary's of Michigan Medical Center): The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, 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. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted the Health Ministry follows established guidelines for placing certain past-due patient balances with 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 Health Ministry's policies. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs St. Mary's follows 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 that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. Schedule H, Part V, Section B, Line 16a FAP website - ST.MARY'S OF MICHIGAN MEDICAL CENTER: Line 16a URL: https://www.stmarysofmichigan.org/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - ST.MARY'S OF MICHIGAN MEDICAL CENTER: Line 16b URL: https://www.stmarysofmichigan.org/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST.MARY'S OF MICHIGAN MEDICAL CENTER: Line 16c URL: https://www.stmarysofmichigan.org/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment St. Mary's of Michigan participated in a community collaborative and as a member of the Community Health Improvement Steering Committee to engage in the community's first comprehensive Community health needs assessment using MAPP Methodology with community driven strategic planning and action plans in 2010 and 2011 and completed its second CHNA assessment refresh in 2013-2014 for the years 2014 - 2016, and presented the CHNA assessment widely to community in March 2014 at a videotaped community engagement event bringing together community residents, neighborhood groups, local, STATE, and national service agencies, TV and newspaper media, public health officials, community foundations, and faith-based groups. Action Plan Development and Implementation Committees including community members have been ongoing each month since inception. In addition to data reviews from national state and local reporting agencies, surveys, focus groups, and reaching target areas of vulnerable populations including homeless, low-income elderly, minority, and disadvantaged population groups to prioritize health needs. The CHIP Team formed in 2009 with a vision of creating a healthier Saginaw community and a mission of developing a health improvement plan that would support and maintain a healthy community. This collaborative effort provides a unique opportunity to address health related issues and ideas in a broad forum with a diverse group of partners. The planning team identified as the Community Health Improvement (CHI) Key Partners is made up of representatives from private enterprise, faith and community based organizations, as well as educational and health and human services organizations. These groups had major participation in designing materials and activities aimed at implementing, promoting, and overseeing the success of the plan. Progress reports each year were developed and distributed to the public and key participating stakeholder agencies, and updated at Alignment Saginaw Collaborative. In this second CHNA refresh Prioritized Health indicators were Chronic Diseases Obesity, Infant Mortality, and Behavioral Health, with Determinants of Health of Access to Care and Utilization of Services, Neighborhood Safety, Parent Support, Transportation, and Health Prevention/Promotion. Plans and committees are in place to outline goals, strategies and activities related to these and included new development of an additional Health and Social Equity Work Group with action plans. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance It is the policy of St. Mary's of Michigan Health to ensure a socially just practice for billing for all Patients receiving care at any of our facilities. St. Mary's of Michigan provides assistance to Patients who do not have the financial resources available to pay for necessary medical service rendered. Various individuals may identify potential charity care recipients. Any Patient that may be a candidate should be referred to a financial counselor. Our billing and collection practices reflect our commitment to and reverence for human dignity and the common good; our special concern for and solidarity with poor and vulnerable persons; and our commitment to distributive justice and stewardship. St. Mary's of Michigan ensures that: A. St. Mary's of Michigan staff and agents behave in a manner that reflects the policies and values of a Catholic-sponsored facility, including treating Patients and their families with dignity, respect and compassion. B. Patients receive prompt access to charge information for any item or service. C. Patients and their families are advised of the hospital's applicable policies, including charity care and the availability of need-based financial assistance in easily understood terms. D. Patients who do not qualify for charity care, but are in need of financial assistance, are offered appropriate extended payment terms or other payment options that take into account the patient's financial status. E. Outstanding balances on patient accounts are pursued fairly and consistently, in a manner that reflects the values and commitments of a Catholic sponsored facility. F. Financial counselors are available to all patients. G. Information is posted in patient access areas including the Emergency Department regarding financial assistance and charity care policies. H. Patients are encouraged to participate in their own care by working with the financial counselor and applying for Medicaid or other public assistance programs to qualify for charity or financial assistance. Schedule H, Part VI, Line 4 Community information Saginaw County population was 193,307 in 2015. Population race was predominantly white at 76.5%, African American/Black at 19.4%, and Asian at 1.4%. Hispanic/Latino ethnicity make-up of approximately 8.2%. In 2015 the poverty rate for the County was at 18.6% of all residents with income below the poverty level. Schedule H, Part VI, Line 5 Promotion of community health Expanding Awareness, Education, and Health Promotion St. Mary's of Michigan Medical Center's mission in sustaining communities by improving community health with special attention to the poor and vulnerable incorporates education and awareness of not only disease processes, but promotion of positive, healthy behaviors and wellness prevention lifestyle changes. St. Mary's of Michigan has invested significantly in unique, high quality health education programs and materials to reach our target community and promote health literacy. In efforts to promote healthy living, St. Mary's has made available the following community education programs: Physical Fitness Activities: - Making Strides Against Breast Cancer Walk, Footsteps for Fitness, BEE Healthy for Life Run/Walk, Children's Charity Bike Run - Lunch Connection Programs - Brain Attack - Know What to Do - Community Health Programs - Asthma Camp, Weight-Loss Surgery Information Sessions, Ask the Expert Sessions on: Get Smart About Lung Cancer, Cancer Screening Programs, Nutrition, Allergy and Asthma Exercise Breast Cancer, Diabetes, Healing Hearts Grief Support Programs, Fall Prevention Programs Community Outreach - Center of HOPE (network of free clinics and charitable free community benefit pharmacy), Diabetes Expo, Pharmacy Assistance Program, Hearth Home - HIV Prevention & Education, Support Groups: MS Support Group, Support for Living - Cancer Support Group, Spinal Cord Injury Resource Group, Bariatric Support Group, Living with Diabetes support Group. Access to Care: St. Mary's of Michigan has a rich history of helping those who are poor and the most vulnerable. Our Community Advisory Board provides input to service design and CHNA action plans for person-centered health improvement and care with emphasis on vulnerable populations. Physicians, nurses, therapists, technicians, administrators and volunteers contribute untold hours of volunteer service to reach people in and around Saginaw who need us most. We minister to them in a variety of ways: - Center of HOPE (network of free clinics at area hunger feeding center and area churches, charitable free pharmacy, emergency financial assistance for utilities Free health education programs tailored for low-literacy and low-income populations, Community Health Workers to link needed resources and enroll into eligible social service programs and Medicaid, nutrition and cooking demonstrations for healthy eating for children and families, onsite community garden, yoga and tai chi) - Community Outreach Programs - Hearth Home - HIV prevention, education and outreach center - Cancer screening programs In furthering St. Mary's commitment to the surrounding community, financial contributions and support to local organizations and causes are made each year including Hunger Feeding Center, Community Homeless Shelters Habitat for Humanity, Youth empowerment, temporary housing for needy patient families American Heart Association, Cultural and Educational Enrichment programs, Scholarship support for low income and minority families, community foundations supporting needy elderly and disabled, etc. In addition, physician staff are encouraged to become credentialed providers, and we have multiple volunteer community boards to support planning and decision-making for the best interests of our community. Medical Research St. Mary's of Michigan Medical Center furthers its mission by contributing funds and personnel to support research that has helped advance medical care. Research projects include the following: - Oncology Research - Neurology Research Medical Education St. Mary's of Michigan Medical Center believes that in order to provide the best health care to the community, its clinical personnel must receive ongoing medical education. Resident Education St. Mary's is affiliated with Central Michigan University (CMU), College of Medicine. CMU Medical Education Partners was established in 2009 to prepare physicians focused on improving access to high quality health care in Michigan, with an emphasis on rural and medically underserviced regions. Residents receive training as they rotate through Saginaw area member hospitals including St. Mary's. Residency programs include: - Emergency Medicine - Family Medicine - General Surgery - Internal Medicine - Obstetrics & Gynecology. Schedule H, Part VI, Line 6 Affiliated health care system St. Mary's of Michigan Medical Center is a member of Ascension Health ALLIANCE ("THE SYSTEM"). 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 health care facilities, or Health Ministries, located in 23 states and the District of Columbia. Ascension Health and its member organizations are hereafter referred to collectively as the System. SPONSORSHIP: 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. Mission: 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 that 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 health care 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 themeans to pay. Discounts provided to those patients who did not qualify forassistance 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 to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care. true American Heart Association 460 N Lindbergh Blvd St Louis MO 63141 135613797 501(c)(3) 7500 General Support Hospital Hospitality House of Saginaw 1701 N Michigan Ave Saginaw MI 48602 382480414 501(c)(3) 12000 General Support Saginaw Community Foundation 1 Tuscola Street Suite 100 Saginaw MI 48607 382474297 501(c)(3) 15000 General Support Saginaw Future 515 N Washington Ave Saginaw MI 48601 383021995 501(c)3 35100 General Support Tall Ship Celebration Bay City PO Box 820 Bay City MI 48707 352184140 501(c)(3) 25000 General Support Mobile Medical Response Inc 834 S Washington Ave Saginaw MI 48601 383198397 501(c)(3) 10000 General Support Pulse 3 Foundation 1015 S Washington Ave Saginaw MI 48601 383146518 501(c)(3) 8500 General Support 7 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. St. Mary's of Michigan Medical Center provides only direct contributions and other general support; therefore, no monitoring of charitable contributions is performed true true false false false false false false false ELIZABETH ADERHOLDT PRESIDENT & CEO 460156 125075 0 934663 0 176033 0 18606 0 14462 460156 1268839 0 96493 JO STUDLEY-MAY MD TRUSTEE 0 270962 0 0 0 192 0 43609 0 3056 0 317819 0 0 GINA BUTCHER CHIEF FINANCIAL OFFICER (END 1/29/15) 23481 0 0 0 245714 0 792 0 11627 0 281614 0 0 0 JOHN GRAHAM PRESIDENT & CEO (END DATE 12/31/14) 10720 0 0 0 499392 0 0 0 11853 0 521965 0 0 0 NANCY HAYWOOD CHIEF FINANCIAL OFFICER 186758 173998 0 23333 0 35169 0 19448 0 25698 186758 277646 0 0 CHARLES HUSSON DO CHIEF MEDICAL OFFICER 74801 289116 0 23600 0 49882 0 18368 0 3039 74801 384005 0 0 CHERYL GUELDENZOPF CHIEF ADMINISTRATIVE OFFICER 125923 0 0 0 1585 0 8208 0 14404 0 150121 0 0 0 BERNARD JORE VP- CNO 188781 0 0 0 11594 0 12299 0 19056 0 231730 0 0 0 SHARON LEAMAN-CASE VP-PROF & SUPP 161401 0 0 0 26407 0 10370 0 6620 0 204798 0 0 0 MICHAEL LONG PRESIDENT-PHYS ENT. (ENDS 8/2015) 150930 0 0 0 9807 0 4195 0 13851 0 178783 0 0 0 RAGHURAM SARVEPALLI VP -MEDICAL AFFAIRS 582905 0 0 0 78956 0 17225 0 30384 0 709470 0 0 0 JOSEPH ADEL MD PHYSICIAN 1107619 0 0 0 740 0 13250 0 26565 0 1148174 0 0 0 WAHEED AKBAR MD PHYSICIAN 805459 0 0 0 5369 0 14575 0 14914 0 840318 0 0 0 WILLIAM J PITTAS DO PHYSICIAN 592376 0 24140 0 1584 0 14575 0 8969 0 641643 0 0 0 NAMAN SALIBI MD PHYSICIAN 2073883 0 58639 0 15358 0 13250 0 34237 0 2195367 0 0 0 TAREK A TAHA MD PHYSICIAN 844833 0 0 0 508 0 13250 0 19276 0 877867 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Ascension Health, a related organization of St. Mary's of Michigan Medical Center, uses the following to establish the compensation of the organization's President & CEO: -Compensation Committee, -Independent Compensation Consultant, -Compensation Survey or Study, and -Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4a Severance or change-of-control payment Eligible executives receive severance payment contingent solely upon the person's severance from service in specified circumstances, such as upon an involuntary separation from service or under a separation or termination agreement voluntarily entered into by the parties. Severance payments made in calendar year 2015 were paid to: Michael Long - $8,160 Gina Butcher - $245,180 John Graham - $499,392 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. 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 to the executive is reported as compensation on Form 990, Schedule J, Part II, column B in the year paid. Form 990, Part IV, Line 20b Explanation of Financial Statements The activity of ST. MARY'S OF MICHIGAN MEDICAL CENTER is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of ST. MARY'S OF MICHIGAN MEDICAL CENTER is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of ST. MARY'S OF MICHIGAN MEDICAL CENTER. Form 990, Part VI, Line 6 Classes of members or stockholders St. Mary's Of Michigan Medical Center has a single corporate member, St. Mary's - St. Joseph Health System. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body St. Mary's of Michigan Medical Center has a single corporate member, St. Mary's - St. Joseph Health System, who has the ability to elect members to the governing body of St. Mary's of Michigan Medical Center. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to St. Mary's of Michigan Medical Center financial information or corporation as a whole are subject to approval by its sole corporate member, St. Mary's - St. Joseph Health System. Form 990, Part VI, Line 11b Review of form 990 by governing body Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form 990 to a designated committee of the Board to review and answer any questions. Prior to filing the returns, all Board members are provided the Form 990 and management team members are available to answer any Board member questions. 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 committees 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 conflicts 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 VIII, Line 2f Other Program Service Revenue Billing Arrangements - Total Revenue: 20812, Related or Exempt Function Revenue: 20812, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Intercompany Rent - Total Revenue: 65293, Related or Exempt Function Revenue: 65293, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees DIETARY - Total Expense: 3565204, Program Service Expense: 3565204, Management and General Expenses: , Fundraising Expenses: ; LAUNDRY - Total Expense: 904321, Program Service Expense: 904321, Management and General Expenses: , Fundraising Expenses: ; OTHER PROFESSIONAL SERVICES - Total Expense: 5755807, Program Service Expense: 5410071, Management and General Expenses: 345736, Fundraising Expenses: ; MEDICAL CONTRACTORS - Total Expense: 16396603, Program Service Expense: 16396603, Management and General Expenses: , Fundraising Expenses: ; Reference lab - Total Expense: 338249, Program Service Expense: 338249, Management and General Expenses: , Fundraising Expenses: ; Medical Transportation - Total Expense: 66879, Program Service Expense: 66879, Management and General Expenses: , Fundraising Expenses: ; OTHER CONTRACT SERVICES - Total Expense: 22219883, Program Service Expense: 20885193, Management and General Expenses: 1334690, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfers to affiliates - -9727361; Pension and Post Retirement Costs Ascension Admin - -17183805; DOING BUSINESS AS St. Mary's of Michigan Primary Healthcare Pinconning Family Medicine St. Mary's Wound Care St. Mary's Medical Oncology St. Mary's Emergency Room Physician Group St. Mary's of Michigan - Neurosurgery St. Mary's Emergency Physicians St. Mary's of Michigan Hospital St. Mary's of Michigan Medical Center St. Mary's Riverfront Cardiology St. Mary's Orthopedics St. Mary's of Michigan Coumadin Clinic St. Mary's Pulmonary & Critical Care Associates St. Mary's of Michigan Specialty Rehabilitation Center St. Mary's Plastic, Reconstructive, Cosmetic and Hand Surgery St. Mary's Pathology St. Mary's Trauma St. Mary's of Michigan Community Pharmacy Assistance Program EMS of Saginaw Emergency Medical Services of Saginaw, Inc. Saint Mary's Flightcare St. Mary's of Michigan Flightcare St. Mary's of Michigan Gratiot Family Practice St. Mary's of Michigan Physical Rehabilitation Center St. Mary's of Michigan Women;s Health Center St. Mary's of Michigan Vassar St. Mary's of Michigan - Dr. Ruth Licht St. Mary's of Michigan Birch Run St. Mary's of Michigan Chesaning St. Mary's of Michigan Frankenmuth St. Mary's of Michigan Guardian Angel Respite & Adult Day Services St. Mary's of Michigan Medical Imaging St. Mary's of Michigan Rehab- Towne Centre St. Mary's of Michigan Respite Care St. Mary's of Michigan Saginaw Valley Pediatrics St. Mary's of Michigan Seton Cancer Institute St. Mary's of Michigan Spine and Rehabilitation Services St. Mary's of Michigan Heritage Family Physicians St. Mary's Medical Center of Saginaw St. Mary's St. Mary's Ambulatory Care Center Michigan Spine and Rehab Center St. Mary's of Michigan Walk-In Clinic Saint Mary's of Michigan Flightcare ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 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