2017-05-12T11:55:50-05:00 2016-06-30 990 2015-07-01 382113393 TRINITY HEALTH - MICHIGAN TRIN 7343431000 20555 VICTOR PARKWAY LIVONIA MI 481527018 MICHAEL GUSHO TREASURER 7343431000 2017-05-12 2015 2021-01-29 14:40:06Z SEE SCHEDULE O FOR LIST ROGER SPOELMAN 20555 VICTOR PARKWAY LIVONIA MI 481527018 2517199157 0 X WWW.TRINITY-HEALTH.ORG X 1976 MI TO PROVIDE HEALTHCARE AND HOSPITAL SERVICES. 26 23 19743 1890 61537398 0 19009144 20686601 2351903603 2380634062 48523879 376188 100692847 79743546 2520129473 2481440397 2915815 4467797 0 0 1057702633 1029384691 0 0 4105870 1243786264 1269624288 2304404712 2303476776 215724761 177963621 3181338583 3202919008 1217507808 1188091246 1963830775 2014827762 X WE, TRINITY HEALTH-MICHIGAN AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. TRINITY HEALTH-MICHIGAN IS A MEMBER OF TRINITY HEALTH. 0 0 2181245457 4467797 2324096719 TRINITY HEALTH-MICHIGAN (TH-MI), A HEALTHCARE AND HOSPITAL SYSTEM, HAS BEEN A LEADER IN PATIENT CARE FOR MORE THAN 100 YEARS, COMMITTED TO THE QUALITY CARE OF PATIENTS AND THEIR FAMILIES. TH-MI OPERATES SEVEN HOSPITALS ACROSS MICHIGAN, CONTAINING 1,705 STAFFED BEDS, AS WELL AS OUTPATIENT HEALTH CENTERS, URGENT CARE FACILITIES, PHYSICIAN OFFICES AND SPECIALTY CENTERS, AND COMMUNITY OUTREACH SITES. DURING FISCAL YEAR 2016, TH-MI HOSPITALS' EMPLOYEES, PHYSICIANS AND VOLUNTEERS PROVIDED OVER 434,000 DAYS OF CARE, AND PROVIDED HEALTH CARE SERVICES FOR OVER 2.6 MILLION OUTPATIENT VISITS, OVER 349,000 EMERGENCY ROOM VISITS, AND OVER 8,600 HOME CARE VISITS.TH-MI OPERATES MERCY PRIMARY CARE CENTER IN DETROIT, PROVIDING MEDICAL SERVICES TO UNINSURED AND UNDERINSURED ADULTS, AS WELL AS SPECIAL PERSONAL ASSISTANCE SERVICES TO THE HOMELESS, INCLUDING SHOWERS AND CLEAN CLOTHING, AND ASSISTANCE IN ACCESSING EXISTING COMMUNITY PROGRAMS FOR HOUSING AND SUBSTANCE ABUSE TREATMENT.EACH YEAR TH-MI HOSPITALS PROVIDE OVER $128 MILLION DOLLARS IN UNCOMPENSATED BENEFITS TO THE COMMUNITY. TH-MI IS ACTIVELY ENGAGED IN THE COMMUNITY THROUGH BUSINESS, CIVIC AND SERVICE ORGANIZATIONS, AND THROUGH ITS FINANCIAL SUPPORT OF OTHER NOT-FOR-PROFIT ORGANIZATIONS AND SOCIAL SERVICES AGENCIES.PLEASE VISIT SCHEDULE H AND OUR WEBSITES FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.STJOESHEALTH.ORG AND WWW.MERCYHEALTHSAINTMARYS.COM 2181245457 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 0 0 1 3353 0 1 19743 1 1 1 1 CJ 0 0 0 1 1 0 0 0 0 X 26 23 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 X BETH GDOWIK 7343431000 20555 VICTOR PARKWAY LIVONIA MI 481527018 X ROBERT CASALOU PRES & CEO AS OF 1/16; SE MI REG CEO 53.00 2.00 X X 0 1010639 40911 ROGER SPOELMAN PRES & CEO THR 12/15;WEST MI REG CEO 26.00 29.00 X X 0 1161340 50263 CHARLES FRAYER DIRECTOR; CHAIR AS OF 1/16 2.00 3.00 X X 0 0 0 JAMES WOODS DIRECTOR; CHAIR THROUGH 12/15 2.00 0.00 X X 0 0 0 MARK FAZAKERLEY DIRECTOR THROUGH 12/15 2.00 3.00 X 0 0 0 RENNY ABRAHAM MD DIRECTOR 2.00 0.00 X 0 0 0 TIMOTHY CAUGHLIN DIRECTOR 2.00 0.00 X 0 0 0 MICHAEL GLUHANICH DIRECTOR 2.00 3.00 X 0 0 0 LUANN HANNASCH RSM DIRECTOR 2.00 3.00 X 0 0 0 CAMILLE JOURDEN-MARK DIRECTOR 2.00 3.00 X 0 0 0 F JOSEPH FLECK DIRECTOR 2.00 0.00 X 0 0 0 BRUCE OLSON MD DIRECTOR THROUGH 12/15 2.00 48.00 X 0 336809 39043 JULIE MILLER RIDENOUR DIRECTOR THROUGH 12/15 2.00 3.00 X 0 0 0 KENNETH SIKKEMA DIRECTOR 2.00 3.00 X 0 0 0 MAUREEN MILLER BROSNAN DIRECTOR 2.00 0.00 X 0 0 0 TERRENCE WRIGHT DIRECTOR 2.00 3.00 X 0 0 0 SR CATHERINE DECLERCQ SCH O DIRECTOR THROUGH 12/15 2.00 53.00 X 0 0 6573 SISTER RENETTA RUMPZ CSSF DIRECTOR 2.00 0.00 X 0 0 0 DAVID STEINBERGER DIRECTOR 2.00 0.00 X 0 0 0 EDD SNYDER DIRECTOR 2.00 0.00 X 0 0 0 SR MARY PERSICO IHM SCH O DIRECTOR & TH EVP MISS INT THR 6/16 2.00 48.00 X 0 0 12429 DAVID KILLIPS DIRECTOR THROUGH 7/15 2.00 0.00 X 0 0 0 JOSE INFANTE DIRECTOR AS OF 1/16 2.00 3.00 X 0 0 0 JEAN NAGELKERK PHD DIRECTOR AS OF 1/16 2.00 3.00 X 0 0 0 DALE NESBARY PHD DIRECTOR AS OF 1/16 2.00 3.00 X 0 0 0 CANETTA REID DIRECTOR AS OF 1/16 2.00 3.00 X 0 0 0 STEPHEN ZONCA MD DIRECTOR AS OF 1/16 2.00 3.00 X 0 0 0 HOWARD ZUCKERMAN DIRECTOR AS OF 1/16 2.00 0.00 X 0 0 0 JERRY NORCIA DIRECTOR AS OF 5/16 2.00 0.00 X 0 0 0 TONYA WELLS DIRECTOR AS OF 1/16 2.00 48.00 X 0 246340 38693 MICHAEL DORSEY MD DIRECTOR AS OF 1/16 2.00 0.00 X 0 0 0 SPENCER MAIDLOW DIRECTOR AS OF 1/16 2.00 0.00 X 0 0 0 CAROL TARNOWSKY SECR THR 12/15; ASST SECR AS OF 1/16 25.00 25.00 X 0 329979 20243 SALLY GUINDI ASST SECR THR 12/15; SECR AS OF 1/16 50.00 0.00 X 0 357834 48061 MICHAEL GUSHO SE MI REG CFO TREAS THR 12/15; ASST TREAS AT 1/16 53.00 2.00 X 0 444753 53789 GARY ALLORE WEST MI REG CFO ASST TREAS THR 12/15; TREAS AT 1/16 27.00 28.00 X 0 394537 34147 JACK WEINER CEO ST. JOSEPH MERCY OAKLAND 55.00 0.00 X 0 1112392 54939 DAVID SPIVEY CEO ST. MARY MERCY LIVONIA 54.00 1.00 X 0 740614 54809 BILL MANNS CEO MERCY HEALTH ST. MARY'S 53.00 2.00 X 0 685718 34761 NANCY GRAEBNER CEO ST. JOSEPH MERCY CHELSEA 55.00 0.00 X 0 530774 31003 REBEKAH SMITH CEO ST. JOSEPH MERCY PORT HURON 55.00 0.00 X 0 504071 336939 ROBIN DAMSCHRODER COO ST JOS MERCY ANN ARBOR THR 11/15 49.00 1.00 X 0 397384 167848 MIKE GRISDELA CFO/ VP FINANCE WEST MARKET 49.00 1.00 X 0 314601 32154 SHANNON STRIEBICH COO SE MI REGION, ST JOSEPH PH & OAK 50.00 0.00 X 0 310882 39983 MICHAEL SAMYN CFO ST MARY MERCY & ST JOE MERCY OAK 50.00 0.00 X 0 310615 36374 DAVID BROOKS CEO ST. JOSEPH MERCY AA AS OF 8/15 54.00 1.00 X 0 268703 51281 DANIEL GREEN VP FIN MERCY HLTH ST MARY'S AT 7/15 48.00 2.00 X 215984 0 30869 CHRISTOPHER FULKS CFO ST. JOSEPH MERCY PORT HURON 50.00 0.00 X 162580 0 26915 BRYNT ELLIS COO ST. JOSEPH MERCY THROUGH 3/16 50.00 0.00 X 159341 0 4068 ROSALIE TOCCO-BRADLEY CMO ST JOS MERCY ANN ARBOR, LIVINGS. 50.00 0.00 X 0 470848 34038 RANDALL T FORSCH CMO ST. JOSEPH MERCY CHELSEA 50.00 0.00 X 0 179829 662 PETER DEWS III CMO ST. MARY MERCY LIVONIA 50.00 0.00 X 0 382569 34368 MICHAEL K SMITH CMO ST. JOSEPH MERCY OAKLAND 50.00 0.00 X 0 397859 32216 DAVID BAUMGARTNER CMO MERCY HEALTH ST. MARY'S 25.00 25.00 X 0 392541 28964 KRISTOPHER AALDERINK ORTHOPEDIC SURGEON (SJMHS) 50.00 0.00 X 962886 0 35838 GEORGE GIBSON ORTHOPEDIC SURGEON (SJMHS) 50.00 0.00 X 907127 0 38449 TALLAL ZENI ORTHOPEDIC SURGEON (SMM LIVONIA) 50.00 0.00 X 753927 0 31278 CHARLES SCHWARTZ CARDIOTHORACIC SURGEON (OAKLAND) 50.00 0.00 X 745160 0 32915 CREG CARPENTER ORTHOPEDIC SURGEON (CHELSEA HOSP) 50.00 0.00 X 742996 0 33900 BARBARA HERTZLER FORMER KEY EMPLOYEE; EVP REG INT. 50.00 0.00 X 0 421103 40533 STEVE EAVENSON FMR KEY EMP;CFO MERCY HLTH ST. MARY'S THR 7/15 0.00 0.00 X 0 222329 21155 JAMES BOSSCHER FORMER OFFICER 0.00 0.00 X 0 113714 1137 MARIANNE CUNNINGHAM FORMER OFFICER;VP DEBT MGR/TREAS SVC 0.00 50.00 X 0 253283 37168 AGNES HAGERTY FORMER OFFICER; DEP GENERAL COUNSEL 0.00 50.00 X 0 844356 55579 BENJAMIN CARTER FORMER OFFICER; TRINITY EVP, CFO 0.00 55.00 X 0 1510330 47466 CYNTHIA CLEMENCE FMR OFFCR; SVP FIN OPS, BUDGET & CAP 0.00 50.00 X 0 593883 56444 JENNIFER BARNETT FORMER OFFICER 0.00 0.00 X 0 702011 23984 PAUL NEUMANN FMR OFFCR; TH EVP, CHIEF LEGAL OFFCR 0.00 55.00 X 0 1232000 41886 RICHARD GILFILLAN FORMER OFFICER; TH PRESIDENT & CEO 0.00 55.00 X 0 2711447 45401 KEDRICK ADKINS FORMER KEY EMPLOYEE 0.00 0.00 X 0 768621 141 J RICHARD O'CONNELL FMR KEY EMPLOYEE; TH EVP EAST GROUP 0.00 55.00 X 0 1558150 47546 CHARLES HOFFMAN FORMER KEY EMPLOYEE 0.00 0.00 X 0 243047 13205 DEBORAH ARMSTRONG FMR KEY EMP; THHS INT CFO THR 1/16 0.00 40.00 X 0 236750 10204 PHILIP MCCORKLE FORMER KEY EMPLOYEE; CONSULTANT 0.00 40.00 X 0 301478 33745 GARRY FAJA FORMER KEY EMPLOYEE; CONSULTANT 40.00 0.00 X 0 394266 17086 STEPHANIE RIEMER-MATUZAK FORMER KEY EMPLOYEE 0.00 0.00 X 0 266021 45405 CLAUDE LAUDERBACH FORMER KEY EMPLOYEE 0.00 0.00 X 0 311086 180204 MARY NEFF FORMER KEY EMPLOYEE; VP LABOR & CLIN OPS 0.00 50.00 X 0 255074 32495 JACQUELINE PRIMEAU FORMER KEY EMPLOYEE; TH VP, M&A 0.00 50.00 X 0 302267 30507 KIRSTEN KORTH-WHITE FORMER KEY EMPLOYEE 0.00 0.00 X 0 113943 20389 KATHLEEN O'CONNOR FORMER KEY EMP; DIR DECISION SUPPORT 50.00 0.00 X 30302 240201 35899 4680303 24876991 2386302 831 1 1 0 PINE REST PO BOX 1615 GRAND RAPIDS MI 49501 HEALTH CARE SERVICES 25950429 THE CHRISTMAN COMPANY 634 FRONT AVE NW 500 GRAND RAPIDS MI 49504 CONSTRUCTION SERVICES 11891786 MICHIGAN BRAIN SPINE INSTITUTE 5315 ELLIOTT DR STE 102 YPSILANTI MI 48197 HEALTH CARE SERVICES 10475553 ANN ARBOR ORTHO SPECIALISTS PC 5315 ELLIOTT DR STE 304 YPSILANTI MI 48197 HEALTH CARE SERVICES 7362127 GRANGER CONSTRUCTION COMPANY 6267 AURELIUS ROAD LANSING MI 48911 CONSTRUCTION SERVICES 6498877 244 39352 1817627 1462725 5597082 11769815 591522 20686601 NET PATIENT SERVICE REVENUE 622110 2259687004 2259687004 PHARMACY REVENUE 446110 94914147 35256020 59658127 LABORATORY REVENUE 621500 26032911 26032911 2380634062 16105625 16105625 11574794 10040437 1534357 1534357 1534357 6107548 17227307 4609678 -17227307 1497870 -15729437 -15729437 891619 1817627 1303388 -411769 -411769 23405 2293 21112 21112 4498924 2575657 1923267 1923267 CAFETERIA REVENUE 722514 12018397 12018397 PROVIDER INCENTIVE 622110 2044674 2044674 GOV'T SUBSIDY-EHR 622110 400490 400490 62213018 61964551 248467 76676579 2481440397 2324096719 61537398 75119679 4446797 4446797 21000 21000 10820530 10820530 2721962 105788 2616174 848186052 797049003 49244360 1892689 30838506 29626202 1212304 76357465 71203740 4946915 206810 60460176 56030285 4295330 134561 45669 42417 3252 1518707 1518707 8808 8808 32000 32000 1768105 1768105 219632165 209765754 8403184 1463227 9054953 8407766 644547 2640 30435235 28172006 2159690 103539 91360939 84855819 6505120 44116918 40948157 3139121 29640 2817500 2601453 199430 16617 1869038 1726407 132348 10283 29436361 29436361 140782557 130753342 10023664 5551 12958060 12035415 922645 MEDICAL SUPPLIES EXP 434862515 434862515 I/C PURCHASED SERVICES 63604979 59076053 4528821 105 HOSPITAL PROVIDER TAX 60806768 60806768 BAD DEBT EXPENSE 54044933 54044933 70468078 65227476 5000394 240208 2303476776 2181245457 118125449 4105870 19758555 31445709 1623914 574487 12166051 12285722 251709085 308036988 27721827 44838321 38182466 37219421 13020092 12247152 2655278586 1422138731 1275509933 1233139855 622353149 624490320 608412172 589841523 32056222 31954283 278825117 276845227 3181338583 3202919008 216580732 251739615 3249108 2948351 24601949 18432192 973076019 914971088 1217507808 1188091246 X 1923257437 1971100299 23701275 27106446 16872063 16621017 1963830775 2014827762 3181338583 3202919008 X 177963621 -34630173 -92336461 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 147938 1 32000 0 0 179938 0 PART II-B, LINE 1: TRINITY HEALTH - MICHIGAN (TH-MI) HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE ORGANIZATIONS HAVE PROVIDED TH-MI WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. SIMILARLY, THESE HEALTH CARE ORGANIZATIONS WILL ARRANGE CONFERENCES AND SEMINARS FOR MEMBER ORGANIZATIONS AND THEIR EXECUTIVES WHICH INVOLVE LEGISLATORS OR OTHER POLITICAL FIGURES AS GUEST SPEAKERS. TH-MI ALSO PAID A THIRD PARTY LOBBYING FIRM DURING THE YEAR TO LOBBY FOR OR AGAINST LEGISLATION DETERMINED TO BE OF INTEREST AND CONCERN TO TH-MI. OUR 2016 FEDERAL ADVOCACY GOALS INCLUDED: - SUSTAINABLE MEDICARE PAYMENT AND VALUE-BASED REIMBURSEMENT - REPEAL OF MEDICARE PHYSICIAN PAYMENT SUSTAINABLE GROWTH RATE (SGR) - REFORM OF RECOVERY AUDIT CONTRACTOR (RAC) PROGRAM - PACE FUNDING, ADAPTABILITY, AND AWARENESS -PALLIATIVE CARE EDUCATION AND FUNDING -BEHAVIORAL HEALTH ACCESS AND REIMBURSEMENT OUR 2016 STATE ADVOCACY GOALS INCLUDED: - HEALTH INSURANCE EXCHANGE ENROLLMENT - MEDICAID EXPANSION AND VALUE-BASED ENROLLMENT - WORKFORCE TRANSFORMATION - PACE ACCESS, FUNDING AND AWARENESS - BEHAVIORAL HEALTH ACCESS AND REIMBURSEMENT -INTERSTATE MEDICAL LICENSURE COMPACT -CARE ACT -STATE INNOVATION MODEL GRANT -APRN - SCOPE OF PRACTICE LOBBYING ACTIVITY PERFORMED BY TH-MI INCLUDED: - ENCOURAGEMENT OF ASSOCIATES TO WRITE LETTERS TO PUBLIC OFFICIALS - AN "ADVOCACY ACTION" WEBSITE TO ENGAGE ASSOCIATES IN FEDERAL ADVOCACY - DESIGNATE AN ADVOCACY LIAISON - ENGAGEMENT OF A LOBBYIST IN WASHINGTON, D.C. BY TRINITY HEALTH CORPORATION - LEGISLATOR VISITS - COLLABORATION WITH THE CATHOLIC HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION - ADVOCACY ACTION DAYS AT THE STATE LEVEL, ATTENDED BY TRINITY HEALTH EXECUTIVES 19561547 804151 -325670 729527 155817 19154684 17198931 2024963 336668 -229498 228513 19561547 16353319 684595 1350728 1189711 17198931 14089151 1878856 1027047 641736 16353318 15077828 -176284 -812393 14089151 0.06530 0.86770 0.06700 1 1 1 60062831 60062831 1702942363 766556863 936385500 847275210 643472650 203802560 44998182 12109218 32888964 1233139855 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 240751642 F EQUITY METHOD INVESTMENTS 204638896 C HEDGE FUNDS 144450985 F 589841523 OTHER RECEIVABLES 29210824 INTERCOMPANY ACCOUNTS RECEIVABLE 100688936 INVESTMENT IN UNCONSOLIDATED AFFILIATES 25343586 INTERCOMPANY OTHER LT ASSETS 121219927 OTHER CURRENT ASSETS 71449 OTHER LONG-TERM ASSETS 310505 276845227 INTERCOMPANY ACCOUNTS PAYABLE 70671852 DEFERRED COMPENSATION 9401612 ASSET RETIREMENT OBLIGATION (FIN 47) 2427257 ANNUITIES PAYABLE 1283665 INTERCOMPANY NOTES PAYABLE 828163851 OTHER CURRENT LIABILITIES 446589 OTHER LONG-TERM LIABILITIES 2576262 914971088 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO BE USED FOR THE FOLLOWING PURPOSES: HOSPITAL OPERATIONS SUPPORT, MEDICAL PROGRAM SUPPORT, SCHOLARSHIPS, RESEARCH, COMMUNITY SERVICE, AND VARIOUS OTHER. SCHEDULE D, PART V THE ENDOWMENTS REPORTED ON LINE 1 ARE HELD BY TH-MI. ENDOWMENTS HELD BY SAINT MARY'S FOUNDATION AND MERCY HOSPITAL CADILLAC FOUNDATION FOR THE BENEFIT OF TH-MI ARE REPORTED ON THE FORM 990 OF SAINT MARY'S FOUNDATION AND MERCY HOSPITAL CADILLAC FOUNDATION. MI HOLIDAY BALL -ANN ARBOR 1142021 769582 372439 60567 194524 15550 220060 SJMC SPRING AUCTION - CHELSEA 411798 306298 105500 20608 39385 2200 124021 5 1155427 741747 413680 32213 70618 211442 23299 288901 2709246 1817627 891619 32213 151793 445351 41049 632982 1303388 -411769 23405 1280 1013 1 1.00000 23405 1280 1013 2293 21112 MI 1 0 1 0 1.00000 KIM NIETHAMMER ST JOSEPH MERCY HE 5305 E HURON RIVER DR PO BOX 995 ANN ARBOR MI 48106 0 KIM NIETHAMMER ST JOSEPH MERCY HE 1280 FINANCIAL REPORTING, CASH DEPOSITS. X 0 1 1 X 1 X 1 X 1 1 0 1 1 2 33391 14783569 0 14783569 0.00660 2 266135 284878465 225386002 59492463 0.02640 6 3886 13353632 17397247 0 0.00000 10 303412 313015666 242783249 74276032 0.03300 25 336050 5372857 829481 4543376 0.00200 2 728 79607313 48052100 31555213 0.01400 16 107611 42409103 24636964 17772139 0.00790 5956537 3590734 2365803 0.00110 6 7140 2541057 150391 2390666 0.00110 49 451529 135886867 77259670 58627197 0.02610 59 754941 448902533 320042919 132903229 0.05910 1 0 158 158 0.00000 1 12 20449 20449 0.00000 2 12 20607 20607 1 54044933 0 557206048 560782375 -3576327 X 1 1 1 CENTER FOR DIGESTIVE CARE LLC SURGICAL CENTER 0.51000 0.49000 2 FRANCES WARDE MEDICAL LABORATORY LABORATORY SERVICES 0.66670 0.33330 3 WOODLAND IMAGING CENTER LLC DBA AVANT IMAGING IMAGING SERVICES 0.51000 0.49000 4 HEALTH PARK CENTRAL LLC MEDICAL OFFICE BUILDING 0.10550 0.82490 5 SIXTY FOURTH STREET LLC SURGICAL CENTER 0.51000 0.46770 6 MERCY PHYSICIAN COMMUNITY PHO LLC CONTRACTING AND SERVICES 0.50000 0.50000 7 NEWCO AMBULATORY SURGERY CENTER LLP DBA LAKESHORE SURGERY CENTER LLP SURGICAL CENTER 0.50000 0.50000 8 WATERFORD SURGICAL CENTER LLC SURGICAL CENTER 0.40000 0.56530 9 ADVANTAGE HEALTHSAINT MARY'S CARE NETWORK HOSPITAL/PHYSICIAN INTEGRATION 0.50000 0.50000 10 PHYSICIAN DIRECT ACCOUNTABLE CARE ORGANIZATION ACO ACTIVITY 0.25000 0.75000 11 OAKLAND HEALTH PARTNERS ACO ACTIVITY 0.50000 0.50000 7 1 ST JOSEPH MERCY ANN ARBOR 5301 MCAULEY DR YPSILANTI MI 48197 WWW.STJOESHEALTH.ORG LICENSE 1060000071 X X X X 2 MERCY HEALTH ST MARY'S 200 JEFFERSON STREET SE GRAND RAPIDS MI 49503 WWW.MERCYHEALTHSAINTMARYS.COM LICENSE 1060000030 X X X X 3 ST JOSEPH MERCY OAKLAND 44405 WOODWARD AVE PONTIAC MI 48341 WWW.STJOESOAKLAND.ORG LICENSE 1060000013 X X X X 4 ST MARY MERCY LIVONIA 36475 FIVE MILE RD LIVONIA MI 48154 WWW.STMARYMERCY.ORG LICENSE 1060000001 X X X X 5 ST JOSEPH MERCY CHELSEA 775 S MAIN CHELSEA MI 48118 WWW.STJOESCHELSEA.ORG LICENSE 1060000099 X X X 6 ST JOSEPH MERCY LIVINGSTON 620 BYRON RD HOWELL MI 48843 WWW.STJOESLIVINGSTON.ORG LICENSE 1060000033 X X X X 7 ST JOSEPH MERCY PORT HURON 2601 ELECTRIC AVE PORT HURON MI 48060 WWW.MYMERCY.US LICENSE 1060000015 X X X ST JOSEPH MERCY ANN ARBOR 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X X 1 15 1 SEE SCHEDULE H, PART V, SECTION C 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X X X X 1 X 0 X X X X X 1 X 0 0 MERCY HEALTH SAINT MARY'S 2 0 0 1 X X X X X X X X X 14 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 14 1 SEE SCHEDULE H, PART V, SECTION C 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTP://WWW.MERCYHEALTH.COM/FINANCIAL-ASSISTANCE-SM X HTTP://WWW.MERCYHEALTH.COM/FINANCIAL-ASSISTANCE-SM X HTTP://WWW.MERCYHEALTH.COM/FINANCIAL-ASSISTANCE-SM X X X X X 1 X 0 X X X X 1 X 0 0 ST JOSEPH MERCY OAKLAND 3 0 0 1 X X X X X X X X X 14 1 0 0 1 X SEE SCHEDULE H, PART V, SECTION C X 1 14 1 SEE SCHEDULE H, PART V, SECTION C 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X X X X 1 X 0 X X X 1 X 0 0 ST MARY MERCY LIVONIA 4 0 0 1 X X X X X X X X 14 1 0 0 1 X SEE SCHEDULE H, PART V, SECTION C X X 1 14 1 SEE SCHEDULE H, PART V, SECTION C 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X X X X 1 X 0 X X X 1 X 0 0 ST JOSEPH MERCY LIVINGSTON 6 0 0 1 X X X X X X X X X 14 1 0 0 1 X SEE SCHEDULE H, PART V, SECTION C X 1 14 1 SEE SCHEDULE H, PART V, SECTION C 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X X X X 1 X 0 X X X X X 1 X 0 0 ST JOSEPH MERCY CHELSEA 5 0 0 1 X X X X X X X X X 15 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X X 1 15 1 SEE SCHEDULE H, PART V, SECTION C 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X HTTP://WWW.STJOESANNARBOR.ORG/FA X X X X 1 X 0 X X X X X 1 X 0 0 ST JOSEPH MERCY PORT HURON 7 0 0 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X X X X X 1 X 0 X X X X 1 X 0 0 ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 5: IN THE SUMMER OF 2015, ST. JOSEPH MERCY ANN ARBOR (SJMAA), AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH ST. JOSEPH MERCY CHELSEA AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, CONSULTED MANY COMMUNITY ORGANIZATIONS TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH KEY STAKEHOLDER INTERVIEWS AND COMMUNITY SURVEYS, INCLUDING: FOCUS GROUPS OF RURAL OLDER ADULTS, RURAL YOUTH, URBAN OLDER ADULTS, URBAN YOUTH; KEY STAKEHOLDER INTERVIEWS WITH REPRESENTATIVES FROM WASHTENAW COUNTY COMMUNITY MENTAL HEALTH, WASHTENAW COUNTY PUBLIC HEALTH DEPARTMENT, CATHOLIC SOCIAL SERVICES, AND HAMILTON CROSSING FAMILY EMPOWERMENT PROGRAM, HURON VALLEY AMBULANCE, SALINE AREA PUBLIC SCHOOLS, AND WASHTENAW INTERMEDIATE SCHOOL DISTRICT. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 5: THE CHNA WAS VERY INCLUSIVE AND COMPREHENSIVE IN INCORPORATING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL. THE QUALITATIVE DATA IS FROM A COLLECTION OF CONSUMER SURVEYS, COMMUNITY FOCUS GROUPS AND FORUMS, AND BRIEF INTERVIEWS WITH COMMUNITY MEMBERS. MORE INFORMATION ON EACH OF THESE METHODS IS DESCRIBED IN GREATER DETAIL IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.IN THE FOCUS GROUPS, A PROFESSIONAL RESEARCHER INTERVIEWED PEOPLE IN SMALL GROUPS. THE RATIONALE FOR THE FOCUS GROUPS IS THAT GROUP DISCUSSION WILL STIMULATE DYNAMIC CONVERSATIONS AND IN-DEPTH CONVERSATIONS ABOUT A PARTICULAR TOPIC. IN THIS CASE, THE PURPOSE WAS TO GENERATE COMMUNITY INPUT FROM VARIOUS POPULATION GROUPS ABOUT HEALTH AND WELL-BEING IN KENT COUNTY. THE FOCUS GROUPS WERE RECORDED, WITH THE KNOWLEDGE OF PARTICIPANTS, AND RESEARCHERS WERE ABLE TO UTILIZE THE WORDS SPOKEN VERBATIM ABOUT A PARTICULAR HEALTH TOPIC TO SUPPORT SPECIFIC THEMES FOUND IN THE QUALITATIVE DATA COLLECTION. TWENTY-EIGHT FOCUS GROUPS WERE CONDUCTED WITH 230 COMMUNITY MEMBERS PARTICIPATING.THE INTERCEPT INTERVIEWS METHOD IS DESIGNED TO ENGAGE PARTICIPANTS WHO MAY NOT BE INCLINED TO ATTEND A FOCUS GROUP OR TOWN HALL MEETING. IT IS TYPICALLY ONE INTERVIEWER AND ONE PARTICIPANT. IT IS ALSO INTENDED TO GENERATE OPEN-ENDED FEEDBACK FROM A BROAD GROUP OF COMMUNITY MEMBERS ON THE TOPIC OF HEALTH AND WELL-BEING. SOME POPULATIONS ARE MORE COMFORTABLE BEING INTERVIEWED BY A COMMUNITY MEMBER OR TRUSTED INDIVIDUAL, THAN BY AN OUTSIDE RESEARCHER, AND INTERCEPT INTERVIEWS ARE USEFUL WITH COLLECTING INPUT FROM THOSE COMMUNITY MEMBERS. THE INTERCEPT INTERVIEWS WERE TRANSLATED INTO SPANISH FOR THE LATINO/HISPANIC COMMUNITY AND OTHER LANGUAGES SPOKEN BY THE ASIAN COMMUNITY. INTERCEPT INTERVIEWS WERE CONDUCTED BY VOLUNTEER INTERVIEWERS (TRAINED BY PROFESSIONAL CONSULTANTS) FROM THE KENT COUNTY HEALTH DEPARTMENT AND OTHER PARTNERS ENGAGED WITH THE CHNA. INTERVIEWERS WERE PROVIDED NECESSARY INTERVIEW MATERIALS, AS WELL AS TECHNICAL ASSISTANCE. COMPLETED INTERVIEWS WERE RETURNED TO PROFESSIONALLY TRAINED CONSULTANTS FOR ANALYSIS. THIRTY INTERCEPT INTERVIEWS WERE CONDUCTED IN THREE LANGUAGES BY TRAINED COMMUNITY MEMBERS. ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 5: ST. JOSEPH MERCY OAKLAND (SJMO) CONSULTED MANY COMMUNITY ORGANIZATIONS AND THEIR REPRESENTATIVES TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING REPRESENTATIVES OF:OAKLAND COMMUNITY MENTAL HEALTH, HEALTHY PONTIAC, WE CAN, OAKLAND UNIVERSITY, THE SALVATION ARMY, OAKLAND LIVINGSTON HUMAN SERVICE AGENCY, GARY BURNSTEIN COMMUNITY HEALTH CLINIC, AREA AGENCY ON AGING 1-B OAKLAND CO. CENTRAL OFFICE, RONALD L DUNLAP-LAY PASTOR, TAKEONE COMMUNITY PROGRAM, SOUTHFIELD DOMESTIC VIOLENCE GROUP, HOPE HOSPITALITY AND WARMING CENTER, OAKLAND COUNTY DEPARTMENT OF HEALTH, GLEANERS, CENTRO MULTICULTURAL LA FAMILIA INC., AND OTHERS IN THE COMMUNITY. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 5: MANY COLLABORATIVE PARTNERS WERE ENGAGED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS OF ST. MARY MERCY LIVONIA (SMML), INCLUDING THE MEMBERSHIP OF A CHNA STEERING COMMITTEE. THESE DEDICATED MEMBERS WERE INVOLVED IN THE TOOL DEVELOPMENT, SURVEY DISTRIBUTION, NEEDS IDENTIFICATION AND PRIORITIZATION AND DEVELOPMENT OF THE CHNA, DESIGN, AND IMPLEMENTATION WORKGROUPS. THESE PARTNERS INCLUDE REPRESENTATIVES FROM AUTHORITY HEALTH (FORMERLY DETROIT WAYNE COUNTY HEALTH AUTHORITY), LIVONIA AND REDFORD SCHOOLS, WAYNE HOPE CLINIC, WAYNE/WESTLAND SALVATION ARMY, MADONNA UNIVERSITY, JOY SOUTHFIELD COMMUNITY DEVELOPMENT CORPORATION, JUDSON CENTER, PLYMOUTH COMMUNITY UNITED WAY, FARMINGTON COSTICK CENTER (SENIOR CENTER), SOUTHEASTERN MICHIGAN HEALTH ASSOCIATION, REDFORD INTERFAITH RELIEF, WESTLAND YOUTH ASSISTANCE, WAYNE COUNTY HEALTH AND HUMAN SERVICES, AND LIVONIA YMCA.THE SMML COMMUNITY HEALTH NEEDS SURVEY WAS BRANDED WITH THE BANNER "MAKE A DIFFERENCE IN THE HEALTH OF OUR COMMUNITY". A PAPER AND ON-LINE SURVEY, COMPOSED OF 30 QUESTIONS ABOUT ACCESS TO CARE, PERSONAL HEALTH BEHAVIORS, PERCEIVED COMMUNITY HEALTH NEEDS AND PARTICIPANT DEMOGRAPHICS, WAS PROMOTED AT MANY COMMUNITY EVENTS THROUGH VARIOUS COMMUNITY PARTNERS. OF THE 1,578 RESPONSES, 666 WERE PAPER SURVEYS COMPLETED BY VULNERABLE POPULATIONS AT THE REDFORD INTERFAITH FOOD PANTRY, WAYNE/WESTLAND SALVATION ARMY FOOD PANTRY AND WAYNE HOPE CLINIC. A COMMUNITY FORUM WAS HELD AT THURSTON HIGH SCHOOL IN REDFORD, MICHIGAN TO SHARE THE SURVEY RESULTS, GAIN SOME ADDITIONAL INFORMATION ABOUT 10 OF THE SURVEY QUESTIONS AND ENGAGE COMMUNITY MEMBERS IN DISCUSSION ABOUT PROGRAMS FOR CHANGING BEHAVIORS FOR HEALTHY EATING, INCREASED PHYSICAL ACTIVITY, ACCESS TO CARE, AND MENTAL HEALTH/SUBSTANCE ABUSE PREVENTION AND TREATMENT. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 5: ST. JOSEPH MERCY LIVINGSTON (SJML) CONSULTED OTHER COMMUNITY ORGANIZATIONS, INCLUDING THE LIVINGSTON COUNTY DEPARTMENT OF HEALTH, COMMUNITY MENTAL HEALTH SERVICES OF LIVINGSTON COUNTY, OAKLAND LIVINGSTON HUMAN SERVICE AGENCY, AND LIVINGSTON COUNTY CATHOLIC CHARITIES IN CONDUCTING THE MOST RECENT CHNA. ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 5: IN THE SUMMER OF 2015, ST. JOSEPH MERCY CHELSEA (SJMC), AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH SJMAA AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, CONSULTED MANY COMMUNITY ORGANIZATIONS TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH KEY STAKEHOLDER INTERVIEWS AND COMMUNITY SURVEYS, INCLUDING: FOCUS GROUPS OF RURAL OLDER ADULTS, RURAL YOUTH, URBAN OLDER ADULTS, URBAN YOUTH; AND KEY STAKEHOLDER INTERVIEWS WITH REPRESENTATIVES FROM WASHTENAW COUNTY COMMUNITY MENTAL HEALTH, WASHTENAW COUNTY PUBLIC HEALTH DEPARTMENT, CATHOLIC SOCIAL SERVICES, HAMILTON CROSSING FAMILY EMPOWERMENT PROGRAM, HURON VALLEY AMBULANCE, SALINE AREA PUBLIC SCHOOLS, AND WASHTENAW INTERMEDIATE SCHOOL DISTRICT. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 6A: SJMC AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 6A: METRO HEALTH HOSPITAL AND SPECTRUM HEALTH ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 6A: SJMAA AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 6B: WASHTENAW COUNTY PUBLIC HEALTH MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 6B: GRAND RAPIDS AFRICAN AMERICAN HEALTH INSTITUTE (GRAAHI), PINE REST CHRISTIAN MENTAL HEALTH SERVICES, MARY FREE BED REHABILITATION HOSPITAL, YMCA, AND KENT COUNTY PUBLIC HEALTH. ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 6B: WASHTENAW COUNTY PUBLIC HEALTH ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 7D: ANNUALLY, SJMAA PRODUCES A COMMUNITY BENEFIT REPORT INCLUDING FINANCIAL INFORMATION AND STORIES ABOUT THE HOSPITAL'S PROGRAMS. THE REPORT DESCRIBES THE COMMUNITY HEALTH NEEDS ASSESSMENT, AND SJMAA PLANS TO MAKE IT AVAILABLE TO OUR EMPLOYEES AND COMMUNITY MEMBERS IN KIOSKS THROUGHOUT THE HOSPITAL. ADDITIONALLY, AS A UNITE GROUP, SJMAA WILL ASSESS THE MOST FEASIBLE WAY TO INFORM COMMUNITY MEMBERS OF OUR PROGRESS.LINE 7A:HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A:HTTP://WWW.STJOESANNARBOR.ORG/CBM MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 7D: LINE 7A:HTTP://WWW.MERCYHEALTHSAINTMARYS.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTLINE 10A: HTTP://WWW.MERCYHEALTHSAINTMARYS.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 7D: LINE 7A: HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A: HTTP://WWW.STJOESANNARBOR.ORG/CBM ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 7D: ANNUALLY, SMML PRODUCES A COMMUNITY BENEFIT REPORT INCLUDING FINANCIAL INFORMATION AND STORIES ABOUT THE HOSPITAL'S PROGRAMS. THE REPORT DESCRIBES THE COMMUNITY HEALTH NEEDS ASSESSMENT AND WAS INSERTED IN LOCAL NEWSPAPERS THAT REACHED 58,000 HOUSEHOLDS AND WAS AVAILABLE TO OUR EMPLOYEES AND COMMUNITY MEMBERS IN KIOSKS THROUGHOUT THE HOSPITAL.LINE 7A: HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A: HTTP://WWW.STJOESANNARBOR.ORG/CBM ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 7D: LINE 7A: HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A: HTTP://WWW.STJOESANNARBOR.ORG/CBM ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 7D: ANNUALLY, SJMC PRODUCES A COMMUNITY BENEFIT REPORT INCLUDING FINANCIAL INFORMATION AND STORIES ABOUT THE HOSPITAL'S PROGRAMS. THE REPORT DESCRIBES THE COMMUNITY HEALTH NEEDS ASSESSMENT, AND SJMC PLANS TO MAKE IT AVAILABLE TO OUR EMPLOYEES AND COMMUNITY MEMBERS IN KIOSKS THROUGHOUT THE HOSPITAL. ADDITIONALLY, AS A UNITE GROUP, SJMC WILL ASSESS THE MOST FEASIBLE WAY TO INFORM COMMUNITY MEMBERS OF OUR PROGRESS.LINE 7A: HTTP://WWW.STJOESANNARBOR.ORG/CBMLINE 10A: HTTP://WWW.STJOESANNARBOR.ORG/CBM ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 2: (ALSO APPLIES TO PART V, SECTION B, LINE 12A)THE ST. JOSEPH MERCY PORT HURON (SJMPH) HOSPITAL FACILITY WAS OPERATED BY TRINITY HEALTH-MICHIGAN UNTIL AUGUST 31, 2015. EFFECTIVE SEPTEMBER 1, 2015, TRINITY HEALTH-MICHIGAN SOLD THE SJMPH HOSPITAL FACILITY TO PRIME HEALTHCARE.IN ACCORDANCE WITH REG. 1.501(R)-3(D)(4), SJMPH WAS NOT REQUIRED TO MEET THE CHNA REQUIREMENTS BECAUSE TRINITY HEALTH-MICHIGAN TRANSFERRED ALL OWNERSHIP OF THE HOSPITAL FACILITY TO ANOTHER ORGANIZATION (PRIME HEALTHCARE) BEFORE THE END OF THE TAX YEAR. THEREFORE, THE EXCISE TAX UNDER SECTION 4959 WAS NOT INCURRED. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 11: AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH SJMC AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, COMMUNITY HEALTH NEEDS PRIORITIZED ARE OBESITY, BEHAVIORAL HEALTH, AND PRECONCEPTUAL/PERINATAL HEALTH. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR EACH SIGNIFICANT HEALTH NEED:OBESITY - SJMAA WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY. SJMAA SUPPORTS THE COMMUNITY THROUGH:- EFFORTS SEEKING TO INCREASE ACCESS TO NUTRITIOUS FOODS THROUGH THE AVAILABILITY OF AFFORDABLE, LOCALLY SOURCED OPTIONS, COUPLED WITH NUTRITION EDUCATION TO ENCOURAGE LONG-TERM BEHAVIOR CHANGE, - OPPORTUNITIES FOR PHYSICAL ACTIVITY THROUGH SUPPORTING POLICY AND ENVIRONMENTAL CHANGE BUILT AROUND ENVIRONMENT STRATEGIES, AND- ENGAGEMENT OF SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND FOOD INSECURITY THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND NUTRITION AND HUNGER RELIEF.BEHAVIORAL HEALTH - SJMAA WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY BY:- CONTRIBUTING TOWARD IMPROVING ACCESS TO AND INTEGRATION OF BEHAVIORAL HEALTH SERVICES ACROSS THE LIFESPAN, SUBSTANCE USE DISORDER TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE,- ADDRESSING ACCESS TO CARE BARRIERS FOR THOSE MOST VULNERABLE IN THE COMMUNITY WE SERVE,- PROVIDING EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS UTILIZING BEST PRACTICE FRAMEWORKS, AND- ENGAGING SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND MENTAL HEALTH AND SUBSTANCE USE DISORDER THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND BEHAVIORAL HEALTH SERVICES.PRECONCEPTUAL/PERINATAL HEALTH THIS HEALTH NEED IS NEWLY PRIORITIZED IN THE 2016 CHNA. STRATEGIES TO ADDRESS THIS COMMUNITY HEALTH NEED ARE IN DEVELOPMENT. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 11: OVER THE NEXT THREE FISCAL YEARS, MERCY HEALTH SAINT MARY'S (MHSM) WILL DIRECTLY ADDRESS ALL FOUR OF THE HIGH PRIORITY COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA. THESE HIGH PRIORITY NEEDS INCLUDE: MENTAL HEALTH, NUTRITION AND OBESITY, SUBSTANCE USE, AND SAFETY AND VIOLENCE.MENTAL HEALTH - AT THE COMMUNITY HEALTH CENTERS, A SBIRT (SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT) IS CONDUCTED FOR EVERY PATIENT. THROUGH A HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) GRANT IN THE AMOUNT OF $350,000, MHSM HIRED BEHAVIORAL HEALTH COUNSELORS. ADDITIONALLY, DEPRESSION SCREENINGS ARE CONDUCTED AT EACH PRIMARY CARE AND SPECIALTY OFFICE VISIT USING THE PHQ-2/9 TOOL FOR ALL PATIENTS 12 YEARS OF AGE AND OLDER. ELIGIBLE PATIENTS ARE THEN ENROLLED IN MHSM'S PHARMACEUTICAL ACCESS PROGRAM TO ENSURE POVERTY IS NOT A BARRIER FOR PATIENTS TO SEEK MENTAL HEALTH MEDICATIONS. LASTLY, THE COMPLEX CARE PROGRAM HAS EXPANDED TO INCLUDE PATIENTS WITH COMPLEX MEDICAL AND PSYCHO/SOCIAL BEHAVIOR CHALLENGES, THOSE UNENGAGED WITH CARE MANAGEMENT OR A MEDICAL HOME, WHO HAVE FREQUENT EMERGENCY DEPARTMENT UTILIZATION, AND WHO HAVE SIGNIFICANT SAFETY ISSUES, INCLUDING THOSE AT RISK FOR SUICIDE OR WHO PORTRAY VIOLENT, THREATENING BEHAVIOR.NUTRITION AND OBESITY - AT EACH PRIMARY CARE VISIT, BMI MEASUREMENTS ARE TAKEN AND EDUCATION AND/OR APPROPRIATE REFERRAL TO TREATMENT ARE PROVIDED TO PATIENTS WITH A BMI OUTSIDE OF NORMAL PARAMETERS (SEE BELOW). CHILDREN WHO STRUGGLE WITH OBESITY ARE REFERRED TO FITKIDS, A COMMUNITY PROGRAM THAT SPECIALIZES IN FIGHTING CHILDHOOD OBESITY AT THE HELEN DEVOS CHILDREN'S HOSPITAL, AND ANY CHILD UNDER THE AGE OF 5 IS REFERRED TO WIC FOR NUTRITION COUNSELING. ADDITIONALLY, MHSM IS A KEY COMMUNITY PARTNER AT THE KENT COUNTY HEALTH DEPARTMENT OBESITY AND POOR NUTRITION COALITION, WHOSE PRIMARY GOAL IS TO INCREASE THE NUMBER OF KENT COUNTY RESIDENTS WHO ARE AT A HEALTHY WEIGHT (DEFINED BY A BMI BETWEEN 18.5 AND 24.9) BY 2018. AS PART OF THE COMMUNITY HEALTH PROGRAMS, SEVERAL COMMUNITY HEALTH WORKERS (CHWS) HAVE BECOME FACILITATORS FOR DIABETES PATH, A SIX-WEEK WORKSHOP TO IMPROVE DIABETES MANAGEMENT THROUGH EXERCISE AND EDUCATION ABOUT HEALTH AND NUTRITION.IN ADDITION, MHSM OFFERED WELLNESS OPPORTUNITIES TO THE COMMUNITY INCLUDING FIT FIRST FRIDAY WHICH PROVIDES INBODY 520 TESTING AND A BRIEF CONSULTATION REGARDING PERSONALIZED FITNESS GOALS AND INDIVIDUAL BODY COMPOSITION; HOLD IT THROUGH THE HOLIDAYS, WHICH IS A WEIGHT MAINTENANCE CHALLENGE DURING THE HOLIDAY SEASON; MICHIGAN FIRE FIGHTERS CAMPAIGN, WHICH PROVIDES EDUCATION AND SUPPORT TO FIRE FIGHTERS TO ENHANCE EATING AND WELLNESS PRACTICES AT FIRE STATIONS; AND ONSITE EXERCISE CLASSES INCLUDING YOGA, ZUMBA, AND TAI-CHI THAT ARE OPEN TO THE PUBLIC FOR FREE OR FOR A NOMINAL FEE. MHSM ALSO SPONSORS AND PARTICIPATES IN SEVERAL COMMUNITY HEALTH AND WELLNESS EVENTS SUCH AS THE FIFTH THIRD BANK RUN, GRAND RAPIDS TRIATHLON, NANA'S RUN, BRIDGE RUN, GRAND RAPIDS HEART WALK, AND GRAND RAPIDS TOUR DE RAPIDS, AMONG OTHERS. THE HOSPITAL CAFETERIA PARTICIPATED IN "FRESH FROM THE FARM TUESDAY", WHICH PARTNERED WITH LOCAL FARMERS TO OBTAIN FRESH, SEASONAL FOOD TO PURCHASE. UTILIZING THE MATTER OF BALANCE CURRICULUM AS A MODEL FOR EXERCISE TO INCREASE STRENGTH AND BALANCE FOR OLDER ADULTS, MHSM CONDUCTED THREE EIGHT-WEEK, TWO-HOUR SESSIONS AT SPARTA HEALTH CENTER. TEN PARTICIPANTS ATTENDED THESE CLASSES ON A REGULAR BASIS TO IMPROVE THEIR FALL RISK AND TO SET GOALS TO INCREASE THEIR ACTIVITY LEVELS, STRENGTH AND BALANCE.SUBSTANCE USE - IN ADDITION TO THE SBIRT TREATMENT AND THE BEHAVIORAL HEALTH COUNSELORS AT EACH COMMUNITY HEALTH CENTER, ONE OF THE COMMUNITY HEALTH CENTERS (HEARTSIDE HEALTH CENTER) HAS IMPLEMENTED A NON-NARCOTIC PAIN PROGRAM, WHICH FOCUSES ON PHYSICAL THERAPY, OCCUPATIONAL THERAPY, PAIN PSYCHOLOGY AND CASE MANAGEMENT. THIS PROGRAM IS AN ALTERNATIVE PROGRAM FOR PATIENTS WITH CHRONIC PAIN AND WHO ARE ADDICTED OR AT RISK FOR ADDICTION TO NARCOTIC PAIN MEDICATION. MHSM IS ALSO A KEY COMMUNITY PARTNER AT THE KENT COUNTY HEALTH DEPARTMENT SUBSTANCE USE COALITION WHOSE PRIMARY GOALS ARE TO INCREASE EDUCATION OF SUBSTANCE USE, EXPAND MEDICATION DROP-OFF SITES AND EVENTS, PROVIDE MEDICATION TREATMENT FOR OPIOID ADDICTION, REDUCE ADULT AND YOUTH TOBACCO/ELECTRONIC CIGARETTE USE, REDUCE ADULT BINGE DRINKING, INCREASE PERCEPTION OF HARM WITH MARIJUANA USE, AND REDUCE THE NONMEDICAL USE OF PAIN RELIEVERS FOR 18-25 YEAR OLDS. MHSM HAS ALSO BEGUN PURSUIT OF AN ADDICTION SPECIALIST TO JOIN THE HEALTH SYSTEM TO ADDRESS BOTH THE SUBSTANCE ABUSE AND THE MENTAL HEALTH CHNA NEEDS. PLANS TO INCORPORATE THEIR SERVICES TO PATIENTS IN THE NEAR FUTURE ARE IN DEVELOPMENT.SAFETY AND VIOLENCE - IN ADDITION TO THE SBIRT TREATMENT AND THE BEHAVIORAL HEALTH COUNSELORS AT EACH COMMUNITY HEALTH CENTER, SCREENING AND TREATMENT FOR DEPRESSION, BULLYING, AND DOMESTIC VIOLENCE, AMONG OTHER ISSUES, IS PROVIDED. MHSM HAS BUILT A STRONG RELATIONSHIP WITH THE KENT COUNTY HEALTH DEPARTMENT, WHO WILL RECEIVE AND RESETTLE 700 REFUGEE FAMILIES THIS YEAR, FOR 400 OF WHICH MHSM WILL PROVIDE MEDICAL TREATMENT AND BECOME THEIR PRIMARY CARE PROVIDERS AS THEY SEEK SAFETY FROM DRUGS AND VIOLENCE IN THEIR HOME COUNTRY. CLINICA SANTA MARIA PROVIDES PRIMARY CARE FOR CHILDREN WHO ARE ABANDONED OR SEPARATED FROM THEIR PARENTS WHILE IMMIGRATING TO THE U.S. FROM MEXICO. LASTLY, THE INJURY PREVENTION COORDINATOR AT MHSM PROVIDES A PROGRAM TITLED "DRIVEN TO DISTRACTION", A TWO-HOUR, MULTI-DISCIPLINARY, STUDENT DRIVEN PROGRAM TO IDENTIFY RISK FACTORS AND BEHAVIORS THAT CONTRIBUTE TO DISTRACTED DRIVING AND POTENTIAL CONSEQUENCES. THE GOAL OF THIS PROGRAM IS INJURY PREVENTION THROUGH EDUCATION AND HIGH IMPACT DEMONSTRATIONS, INCLUDING A SIMULATED ACCIDENT, AN INVESTIGATION, A FUNERAL, A COURT HEARING, AND AN EDUCATIONAL DISCUSSION REGARDING BEHAVIOR MODIFICATION. IN FISCAL YEAR 16, THE INJURY PREVENTION COORDINATOR CONDUCTED ONE EVENT AT NORTHVIEW HIGH SCHOOL FOR 300 HIGH SCHOOL STUDENTS. ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 11: THE FOUR COMMUNITY HEALTH NEEDS PRIORITIZED BY SJMO ARE OBESITY, FINANCIAL ACCESS TO CARE, DENTAL CARE, AND BEHAVIORAL HEALTH. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS:OBESITY - SJMO IS WORKING TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES TO ADDRESS RISING OBESITY RATES IN OUR COMMUNITY. SJMO SUPPORTS AREA SCHOOLS WITH EDUCATION & PREVENTION STRATEGIES, SUCH AS A "BOOT CAMP" FOR MIDDLE SCHOOL GIRLS AND SUMMER CAMP CAMPERSHIPS FOR HIGH RISK CHILDREN IDENTIFIED BY THE SCHOOL DISTRICT. ALL PONTIAC PUBLIC SCHOOL TEACHERS WERE PROVIDED A FREE MEMBERSHIP TO THE HOSPITAL'S WELLNESS CENTER AND OVER 500 AREA SENIORS PARTICIPATED IN "SENIOR FIT" FREE EXERCISE CLASSES AT TEN LOCATIONS AROUND THE COMMUNITY. WE SEEK TO INCREASE COMMUNITY ACCESS TO NUTRITIOUS FOODS, OPPORTUNITIES FOR PHYSICAL ACTIVITY, AND EDUCATION ON HEALTHY LIVING IN VARIOUS COMMUNITY VENUES. AS A CERTIFIED "BABY FRIENDLY" HOSPITAL, SJMO PROVIDES EDUCATION, SUPPORT AND ENCOURAGEMENT TO MOTHERS WHO CHOOSE TO BREASTFEED THEIR BABIES. ACCESS TO CARE - SJMO CONTINUES TO PROVIDE ENROLLMENT SERVICES TO ASSIST THOSE ELIGIBLE FOR INSURANCE PLANS AND ALTERNATIVE PAYMENT SOURCES, WHILE STILL PROVIDING NEEDED CARE TO THOSE WITHOUT ACCESS TO INSURANCE. ADDITIONALLY, A KEY PARTNERSHIP WITH "FREEDOM ROAD" WILL ASSIST PATIENTS AND COMMUNITY MEMBERS IN GETTING TO MEDICAL APPOINTMENTS AND OTHER NEEDED SERVICES IN A COMMUNITY WITH A SEVERELY INADEQUATE MASS TRANSIT SYSTEM. DENTAL CARE - SJMO HAS RAISED THE NEEDED CAPITAL FUNDING TO EXPAND ITS IN-HOSPITAL DENTAL CLINIC FOR LOW-INCOME AND MEDICALLY COMPLEX INDIVIDUALS AND ANTICIPATES CONSTRUCTION TO BEGIN SOON. FURTHER, SJMO IS WORKING TO IMPROVE COORDINATION AND ACCESS TO NECESSARY FOLLOW UP CARE AFTER DENTAL TREATMENT. SJMO CONTINUES TO SUPPORT DENTAL HYGIENE EDUCATION IN THE COMMUNITY.BEHAVIORAL HEALTH - SJMO IS WORKING TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY AND TO MEET THE NEEDS OF THESE INDIVIDUALS. THE HOSPITAL PUT TOGETHER A WELL-ATTENDED COMMUNITY SUICIDE PREVENTION EDUCATION SESSION AND FORUM AND HAVE CREATED A MONTHLY SUPPORT GROUP FOR FAMILIES OF THOSE DIAGNOSED WITH A MENTAL ILLNESS. SJMO IS A FOUNDING PARTNER IN THE HOPE RECUPERATIVE CENTER WHICH PROVIDES A SAFE PLACE FOR HEALING AND RECOVERY FOR HOMELESS PERSONS RECENTLY DISCHARGED FROM THE HOSPITAL. SJMO CONTINUES TO CONTRIBUTE TOWARD IMPROVING ACCESS TO SUBSTANCE ABUSE TREATMENT AND SUPPORT FOR PATIENT COMPLIANCE. A NEWLY LAUNCHED PARTNERSHIP WITH THE LOCAL TIMEBANK IS AN INITIATIVE WHICH THE HOSPITAL ANTICIPATES MAY HELP TO ADDRESS ISSUES OF ISOLATION AND LONELINESS IN OUR COMMUNITY, ESPECIALLY AMONG THE ELDERLY. SJMO WILL ADDRESS ACCESS TO CARE BARRIERS AND WILL PROVIDE EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 11: LISTED IN ORDER OF PRIORITY, SMML FOCUSED ON DEVELOPING AND/OR SUPPORTING INITIATIVES AND MEASURING THEIR EFFECTIVENESS, TO IMPROVE THE FOLLOWING HEALTH NEEDS: OBESITY - IN PARTNERSHIP WITH MEIJER (LOCAL RETAILER), MADONNA UNIVERSITY DIETETICS PROGRAM AND SOUTH REDFORD SCHOOLS, ACTIVITIES ENCOURAGING INCREASED FRUIT AND VEGETABLE INTAKE WERE CARRIED OUT DURING THE SCHOOL YEAR AT A TARGETED SCHOOL WITH THE GOAL OF REDUCING OBESITY THROUGH IMPROVED EATING HABITS. TWO "ALL SCHOOL TASTING DAYS", GROCERY STORE TOUR AND STUDENT ASSEMBLIES WERE HELD WITH POSITIVE IMPACT. WITH THE GOAL OF INCREASED PHYSICAL ACTIVITY AND IMPROVED NUTRITION, ESPECIALLY IN CHILDREN AGES K-12, EDUCATIONAL PROGRAMS AND ACTIVITIES FOR CHILDREN AND FAMILIES IN THE LIVONIA PUBLIC SCHOOLS WERE THE FOCUS OF A "HEALTHY FAMILIES" NIGHT.ACCESS TO CARE AND TRANSPORTATION - ACCESS TO PRIMARY CARE PROVIDERS AND HEALTHCARE SERVICES WAS IMPROVED BY EXPANDING TRANSPORTATION SERVICES FOR HEALTHCARE APPOINTMENTS AND THROUGH EDUCATION/PROMOTION OF RIGHT CARE/RIGHT TIME TO INCREASE THE NUMBER OF ADULTS RECEIVING PRIMARY CARE AND WELLNESS CHECKS. IN PARTNERSHIP WITH A FAITH-BASED CHARITABLE NON-PROFIT COMMUNITY HEALTH CENTER, EFFORTS ARE BEING DIRECTED TO OPENING A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) THAT WILL OFFER INTEGRATED MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE TO WESTLAND RESIDENTS.MENTAL HEALTH/SUBSTANCE ABUSE - THROUGH A PARTNERSHIP WITH LIVONIA SAVE OUR YOUTH (LSOY) AND GROWTH WORKS, AN ONGOING (10 MONTHS/YEAR) PROGRAM FOR TEENS, FAMILIES AND THE COMMUNITY-AT-LARGE WAS IMPLEMENTED TO ADDRESS DRUG/ALCOHOL EDUCATION IN A NEUTRAL LOCATION. THE INTENT WAS TO INCREASE INFORMATION AND REDUCE THE STIGMA OF TALKING ABOUT SUBSTANCE USE/ABUSE LEADING TO INTERVENTIONS AND DECREASING AT-RISK BEHAVIORS. ADDRESSING THE IDENTIFIED NEED TO REDUCE TEEN SUICIDE, SMML PARTNERED WITH SOUTH REDFORD SCHOOLS, OAKLAND SCHOOLS, WAYNE RESA, REDFORD COMMISSION ON YOUTH AND FAMILIES, GROWTH WORKS, AND DETROIT WAYNE MENTAL HEALTH AUTHORITY TO PROVIDE A FORUM TO BRING TOGETHER SCHOOL COUNSELORS AND SOCIAL WORKERS TO START THE CONVERSATION ON SUICIDE PREVENTION AND MENTAL HEALTH AWARENESS. FOR THE FIRST TIME EVER, SEVEN SCHOOL DISTRICTS MET TO START THE CONVERSATION TO ADDRESS PREVENTION AND AWARENESS AND TO IDENTIFY GAPS IN THE COMMUNITY AND OUR SCHOOLS TO ASSIST IN SUICIDE PREVENTION. SMML ACKNOWLEDGED THE WIDE-RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. SMML WILL NOT TAKE ANY NEW OR ADDITIONAL ACTIONS ON THE FOLLOWING HEALTH NEEDS: PHYSICAL ACTIVITY AND NUTRITION FOR ADULTS - ALTHOUGH ADULT PHYSICAL ACTIVITY AND NUTRITION WILL NOT BE ADDRESSED IN THIS PLAN, THE HOSPITAL WILL CONTINUE TO SPONSOR COMMUNITY FUN RUNS, COOKING DEMONSTRATIONS, AND OTHER COMMUNITY EVENTS THAT PROMOTE PHYSICAL ACTIVITY AND HEALTHY EATING. CANCER- CANCER WILL BE ADDRESSED INDIRECTLY THROUGH THE STRATEGY FOR ACCESS TO CARE AND IN THE HOSPITAL'S COMMUNITY BENEFIT PROGRAMS FOR EDUCATIONAL SEMINARS, PREVENTION SCREENINGS AND SUPPORT GROUPS. HEART DISEASE- HEART DISEASE WILL BE ADDRESSED INDIRECTLY THROUGH THE STRATEGIES FOR ACCESS TO CARE AND OBESITY.DIABETES- DIABETES DID NOT RANK AMONG THE TOP PRIORITIZED HEALTH NEEDS, DESPITE STUDIES SHOWING ONE-THIRD OF THE PEOPLE IN THE UNITED STATES UNKNOWINGLY HAVE DIABETES. SMML WILL CONTINUE TO OFFER DIABETES PREVENTION SEMINARS AND PROGRAMS, OUTPATIENT DIABETES EDUCATION AND A SUPPORT GROUP. MANY OF THE STRATEGIES TO INCREASE PHYSICAL ACTIVITY AND IMPROVE NUTRITION WILL ALSO IMPROVE THE QUALITY OF LIFE FOR DIABETIC PATIENTS. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 11: THE TWO SIGNIFICANT COMMUNITY HEALTH NEEDS PRIORITIZED BY SJML ARE OBESITY & BEHAVIORAL HEALTH. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR BOTH SIGNIFICANT HEALTH NEEDS:OBESITY- SJML:- WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY, AND- SUPPORTS EFFORTS SEEKING TO INCREASE ACCESS TO NUTRITIOUS FOODS THROUGH THE AVAILABILITY OF AFFORDABLE, LOCALLY SOURCED OPTIONS COUPLED WITH NUTRITION EDUCATION TO ENCOURAGE LONG-TERM BEHAVIOR CHANGE.BEHAVIORAL HEALTH - SJML:- CONTRIBUTES TOWARD IMPROVING ACCESS TO AND INTEGRATION OF BEHAVIORAL HEALTH SERVICES ACROSS THE LIFESPAN, SUBSTANCE USE DISORDER TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE,- ADDRESSES ACCESS TO CARE BARRIERS FOR THOSE MOST VULNERABLE IN THE COMMUNITY WE SERVE, INCLUDING THE DONATION OF FUNDS SUPPORTING THE DEVELOPMENT OF AN ENGAGEMENT CENTER TO SUPPORT THOSE EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE DISORDER CRISES, AND- PROVIDES EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS UTILIZING BEST PRACTICE FRAMEWORKS. ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 11: AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH SJMAA AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, COMMUNITY HEALTH NEEDS PRIORITIZED ARE OBESITY, BEHAVIORAL HEALTH, AND PRECONCEPTUAL/PERINATAL HEALTH. OUR IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR EACH SIGNIFICANT HEALTH NEED:OBESITY - SJMC WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY. SJMC SUPPORTS THE COMMUNITY THROUGH:- EFFORTS SEEKING TO INCREASE ACCESS TO NUTRITIOUS FOODS THROUGH THE AVAILABILITY OF AFFORDABLE, LOCALLY SOURCED OPTIONS COUPLED WITH NUTRITION EDUCATION TO ENCOURAGE LONG-TERM BEHAVIOR CHANGE, - OPPORTUNITIES FOR PHYSICAL ACTIVITY THROUGH SUPPORTING POLICY AND ENVIRONMENTAL CHANGE BUILT AROUND ENVIRONMENT STRATEGIES, AND- ENGAGEMENT OF SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND FOOD INSECURITY THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND NUTRITION AND HUNGER RELIEF.BEHAVIORAL HEALTH - SJMC WORKS TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY BY:- CONTRIBUTING TOWARD IMPROVING ACCESS TO AND INTEGRATION OF BEHAVIORAL HEALTH SERVICES ACROSS THE LIFESPAN, SUBSTANCE USE DISORDER TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE,- ADDRESSING ACCESS TO CARE BARRIERS FOR THOSE MOST VULNERABLE IN THE COMMUNITY WE SERVE,- PROVIDING EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS UTILIZING BEST PRACTICE FRAMEWORKS, AND- ENGAGING SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND MENTAL HEALTH AND SUBSTANCE USE DISORDER THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND BEHAVIORAL HEALTH SERVICES.PRECONCEPTUAL/PERINATAL HEALTH - THIS HEALTH NEED IS NEWLY PRIORITIZED IN THE 2016 CHNA. STRATEGIES TO ADDRESS THIS COMMUNITY HEALTH NEED ARE IN DEVELOPMENT. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 20E: OFFERED INFORMATION FOR OTHER VARIETIES OF PAYMENT PLAN OPTIONS; USED AUTOMATED PRESUMPTIVE CHARITY FOR SELF PAY ACCOUNTS ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 20E: OFFERED INFORMATION FOR OTHER VARIETIES OF PAYMENT PLAN OPTIONS; USED AUTOMATED PRESUMPTIVE CHARITY FOR SELF PAY ACCOUNTS ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 20E: OFFERED INFORMATION FOR OTHER VARIETIES OF PAYMENT PLAN OPTIONS; USED AUTOMATED PRESUMPTIVE CHARITY FOR SELF PAY ACCOUNTS ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. ST. JOSEPH MERCY ANN ARBOR - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. ST. JOSEPH MERCY CHELSEA - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. 104 1 - (ANN ARBOR) MICHIGAN HEART & VASCULAR IN 5325 ELLIOTT DR YPSILANTI MI 48197 CARDIOVASCULAR CARE 2 - (AA) ST JOSEPH MERCY BRIGHTON 7575 GRAND RIVER RD BRIGHTON MI 48114 LAB, IMAGING, THERAPY, AMBULATORY SURG., EMPLOYED PHYS, ONCOLOGY, 24 HR EMER 3 - (AA) ST JOSEPH MERCY CANTON HEALTH CTR 1600 CANTON CENTER RD CANTON MI 48188 LAB, IMAGING, THERAPY, ONCOLOGY, AMBULATORY SURGERY, URGENT CARE 4 - (AA) REICHERT HEALTH CENTER 5333 MCAULEY DR YPSILANTI MI 48197 LAB, IMAGING, AMBULATORY SURG., EMPLOYED PHYSICIANS 5 - (AA) CHELSEA PROFESSIONAL OFFICE BLDG 14650 OLD US 12 CHELSEA MI 48118 PHARMACY, ONCOLOGY, EMPLOYED PHYSICIANS 6 - (AA) MICHIGAN ORTHOPEDIC CENTER 5315 ELLIOTT DR YPSILANTI MI 48197 ORTHOPEDIC CARE 7 - (AA) ST JOSEPH MERCY SALINE 400 W RUSSELL ST SALINE MI 48176 LAB, IMAGING, URGENT CARE 8 - (AA) ELLEN THOMPSON WOMEN'S CENTER 5320 ELLIOTT DR YPSILANTI MI 48197 WOMEN'S HEALTH 9 - (AA) CHELSEA HEALTH & WELLNESS CTR 20800 OLD US 12 CHELSEA MI 48118 REHAB 10 - (AA) MICHIGAN HEART BUILDING 1548 W MAUMEE ST ADRIAN MI 49221 EMPLOYED PHYSICIANS 11 - (AA) SLEEP DISORDERS CENTER 5305 ELLIOTT DR YPSILANTI MI 48197 SLEEP CLINIC 12 - (AA) HURON OAKS 5401 MCAULEY DR YPSILANTI MI 48197 BEHAVIORAL MEDICINE 13 - (AA) ST JOSEPH MERCY MAPLE HEALTH 501 N MAPLE RD ANN ARBOR MI 48103 URGENT CARE 14 - (AA) ST JOSEPH MERCY ARBOR HEALTH 990 W ANN ARBOR TRAIL PLYMOUTH MI 48170 LAB 15 - (AA) ARBOR PARK CENTRE 4972 CLARK RD YPSILANTI MI 48197 LAB 16 - (AA) LIVINGSTON OBGYN ASSOCIATES 524 BYRON RD HOWELL MI 48843 EMPLOYED PHYSICIANS 17 - (AA) MICHIGAN HEART MILAN 870 E ARKONA RD MILAN MI 48160 EMPLOYED PHYSICIANS, LAB 18 - (AA) SJMHS OUTPATIENT CLINIC 2310 E STADIUM BLVD ANN ARBOR MI 48104 REHAB 19 - (AA) CHERRY HILL LAB 49650 CHERRY HILL RD CANTON MI 48187 LAB 20 - (AA) MARIAN PROFESSIONAL BUILDING 14555 LEVAN RD LIVONIA MI 48154 RADIATION ONCOLOGY, REHAB, MRI, EMPLOYED PHYSICIANS 21 - (AA) GENOA MEDICAL CENTER 2305 GENOA BUSINESS PARK DR BRIGHTON MI 48114 LAB 22 - (AA) HAAB HEALTH BUILDING 111 N HURON ST YPSILANTI MI 48197 EMPLOYED PHYSICIANS 23 - (AA) MONUMENT PARK BUILDING 8031 MAIN ST DEXTER MI 48130 EMPLOYED PHYSICIANS 24 - (AA) ARBOR SCIO PROFESSIONAL BLDG 6360 JACKSON RD ANN ARBOR MI 48103 LAB 25 - (AA) ST JOS MERCY CHEMICAL DEPENDENT 2008 HOGBACK RD ANN ARBOR MI 48105 BEHAVIORAL MEDICINE 26 - (AA) PARKWAY MEDICAL CENTER 2345 S HURON PKWY ANN ARBOR MI 48104 LAB 27 - (AA) SALINE PROFESSIONAL OFFICE BLDG 420 W RUSSELL ST SALINE MI 48176 REHAB 28 - (AA) MICHIGAN HEART BUILDING 200 ARNET ST YPSILANTI MI 48198 EMPLOYED PHYSICIANS 29 - (AA) HURON PROFESSIONAL BUILDING 704 W HURON ST ANN ARBOR MI 48103 LAB 30 - (AA) SUMMERWOOD CENTER 10299 E GRAND RIVER BRIGHTON MI 48116 BEHAVIORAL MEDICINE 31 - (AA) DIAGNOSTIC SERVICES CENTER 202 E VAN RIPER RD FOWLERVILLE MI 48836 LAB, IMAGING 32 - (AA) FAMILY MEDICINE OF STOCKBRIDGE 4525 S M-52 STOCKBRIDGE MI 49285 EMPLOYED PHYSICIANS 33 - (AA) ST JOSEPH MERCY BEHAVIORAL SVCS 2200 CANTON CENTER RD CANTON MI 48188 BEHAVIORAL MEDICINE 34 - (AA) SALINE ADULT & PEDIATRIC MED 182 S INDUSTRIAL DR SALINE MI 48176 EMPLOYED PHYSICIANS 35 - (AA) CENTER FOR DIGESTIVE CARE 5300 ELLIOTT DR YPSILANTI MI 48197 DIGESTIVE CARE 36 - (AA) TOWSLEY HEALTH BUILDING 5361 MCAULEY DR YPSILANTI MI 48197 NURSING HOME, EMPLOYED PHYS. 37 - (AA) SAMARITAN CENTER 5555 CONNER DETROIT MI 48213 INDIGENT CARE 38 - (OTHER) FRANCES WARDE MEDICAL LAB 300 W TEXTILE RD ANN ARBOR MI 48104 LAB 39 - (GRAND RAPIDS) WEGE BUILDING 300 LAFAYETTE GRAND RAPIDS MI 49503 LAB, FAMILY PRACTICE, INTERNAL MEDICINE PRACTICE 40 - (GR) SAINT MARY'S SOUTHWEST 2373 64TH STREET SW BYRON CENTER MI 49315 AMBULATORY SURGICAL CTR, REHAB, LAB, IMAGING, FAMILY PRACTICE, CARDIO AND ER 41 - (GR) ADVANTAGE HEALTH BUILDING 1471 EAST BELTLINE GRAND RAPIDS MI 49525 LAB, IMAGING, REHAB, EMPLOYED PHYS., URGENT CARE, OB 42 - (GR) CLINICA SANTA MARIA 730 GRANDVILLE AVE SW GRAND RAPIDS MI 49503 INDIGENT PRIMARY CARE CENTER 43 - (GR) PINE REST 300 68TH STREET SE GRAND RAPIDS MI 49548 MENTAL HEALTH 44 - (GR) SPARTA FAMILY HEALTH CENTER 475 S STATE ST SPARTA MI 49345 FAMILY PRACTICE CENTER 45 - (GR) BROWNING CLAYTOR HEALTH CENTER 1246 MADISON SE GRAND RAPIDS MI 49507 FAMILY PRACTICE CENTER 46 - (GR) HEARTSIDE HEALTH CLINIC 359 S DIVISION GRAND RAPIDS MI 49503 INDIGENT PRIMARY CARE CENTER 47 - (GR) RIVERTOWN BUILDING 3380 44TH STREET SW GRANDVILLE MI 49418 LAB, IMAGING, REHAB, FAMILY PRACTICE 48 - (GR) STANDALE BUILDING 1175 WILSON AVE NW WALKER MI 49534 LAB, IMAGING, REHAB, FAMILY PRACTICE 49 - (GR) 310 LAFAYETTE BUILDING 310 LAFAYETTE SE GRAND RAPIDS MI 49503 IMMUNOLOGY, VASCULAR, INFECTIOUS DISEASE, AND PULMONOLOGY 50 - (GR) ADVANTAGE HEALTH BUILDING 10047 CROSS ROADS COURT CALEDONIA MI 49316 LAB, IMAGING, REHAB, FAMILY PRACTICE 51 - (GR) ADVENT REHAB 1375 W GREEN ST HASTINGS MI 49058 REHAB 52 - (GR) ADVENT REHAB 1915 GEORGETOWN CENTER DR JENISON MI 49428 REHAB 53 - (GR) CHERRY BUILDING 245 CHERRY ST GRAND RAPIDS MI 48503 PEDIATRIC CLINIC, FAMILY MEDICINE, OB, NEUROSCIENCES, AND SLEEP 54 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 933 THREE MILE NW GRAND RAPIDS MI 49504 LAB, REHAB, FAMILY PRACTICE 55 - (GR) ADVANTAGE HEALTH BUILDING 7782 20TH AVENUE JENISON MI 49428 FAMILY PRACTICE CENTER 56 - (GR) SOUTHEAST ADVANTAGE HEALTH BLDG 2080 44TH ST SE KENTWOOD MI 49508 REHAB, LAB, FAMILY PRACTICE 57 - (GR) ADVANTAGE HEALTH BUILDING 6050 NORTHLAND DR NE ROCKFORD MI 49341 FAMILY PRACTICE CENTER, URGENT CARE, LAB, IMAGING, WOMEN'S HEALTH, REHAB 58 - (GR) WYOMING FAMILY PRACTICE 950 36TH STREET SW WOMING MI 49509 FAMILY PRACTICE CENTER 59 - (GR) ADVENT REHAB 7575 EAST FULTON ADA MI 49355 REHAB 60 - (GR) ADVENT REHAB 1000 EAST PARIS ST 222 GRAND RAPIDS MI 49546 REHAB 61 - (GR) ADVENT REHAB 150 JEFFERSON SE ST 100 GRAND RAPIDS MI 49503 REHAB 62 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 771 KENNMORE SE GRAND RAPIDS MI 49547 FAMILY PRACTICE 63 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 2093 HEALTH DRIVE SUITE 300 WYOMING MI 49519 VASCULAR 64 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 2144 EAST PARIS SE GRAND RAPIDS MI 49546 INTERNAL MEDICINE 65 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 1000 EAST PARIS STE 222 GRAND RAPIDS MI 49546 CARDIOVASCULAR 66 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 260 JEFFERSON SE STE 115 GRAND RAPIDS MI 49503 CONCIERGE MEDICINE 67 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 3290 NORTH WELLNESS DRIVE HOLLAND MI 49424 FAMILY PRACTICE 68 - (GR) MERCY HEALTH DENTAL CLINIC 781 36TH STREET SE GRAND RAPIDS MI 49548 DENTAL CLINIC 69 - (OAKLAND)SJMO MEDICAL OFFICE BUIDING 44555 WOODWARD AVE PONTIAC MI 48341 COLORECTAL SURGERY, NEUROLOGY, LAB, NEUROSURGERY, RADIOLOGY, OTHER SURGERY 70 - (OA) BALD MOUNTAIN REGIONAL MEDICAL 1375 S LAPEER RD LAKE ORION MI 48360 URGENT CARE, LAB, RADIOLOGY, INTERNAL MED/PEDS 71 - (OA) WOODWARD PROFESSIONAL BUILDING 44428 WOODWARD AVE PONTIAC MI 48341 REHAB, OB/GYN CLINIC, PARTIAL PSYCH HOSPITAL 72 - (OA) MERCY MEDICAL GROUP-OAKLAND PHYSICI 5210 HIGHLAND RD WATERFORD MI 48327 INTERNAL MEDICINE, URGENT CARE, LAB, RADIOLOGY 73 - (OA) INDEPENDENCE POINTE 7210 ORTONVILLE RD CLARKSTON MI 48346 LAB 74 - (OA) KAROTECH BUILDING 2630 UNION LAKE RD COMMERCE TOWNSHIP MI 48382 LAB, PEDIATRICS 75 - (OA) SLEEP DISORDERS CLINIC 3100 CROSS CREEK PKWY AUBURN HILLS MI 48341 SLEEP CLINIC 76 - (OA) WHITE LAKE 320 TOWN CENTER BLVD WHITE LAKE TWP MI 48386 URGENT CARE, LAB, RADIOLOGY, REHAB 77 - (OA) SHORES III PROFESSIONAL BLDG 2300 HAGGERTY RD WEST BLOOMFIELD MI 48323 RADIOLOGY 78 - (OA) WATERFORD LAB 5800 HIGHLAND RD WATERFORD MI 48327 LAB 79 - (OA) MERCY MEDICAL GROUP-ROCHESTER 1854 W AUBURN RD ROCHESTER HILLS MI 48309 INTERNAL MEDICINE/PEDS, OB/GYN, ENDOCRINOLOGY 80 - (OA) WATERFORD SURGICAL CENTER 5220 HIGHLAND RD WATERFORD MI 48327 SURGICAL CENTER 81 - (OA) CLARKSTON 6770 DIXIE HWY CLARKSTON MI 48346 OB/GYN, FAMILY MED 82 - (OA) BLOOMFIELD LAB 42557 WOODWARD AVE BLOOMFIELD HILLS MI 48304 LAB 83 - (OA) LEXUS PROFESSIONAL BUILDING 44200 WOODWARD AVE PONTIAC MI 48341 LAB, OB/GYN 84 - (OA) MERCY MEDICAL GROUP-BLOOMFIELD HILL 1750 TELEGRAPH RD BLOOMFIELD HILLS MI 48302 OB/GYN 85 - (OA) AFFINITY PEDIATRICS & INTERNAL MEDI 5820 HIGHLAND ROAD WATERFORD MI 48328 INTERNAL MEDICINE/PEDIATRICS 86 - (OA) AUBURN HILLS DIAGNOSTICS 719 S OPDYKE ROAD AUBURN HILLS MI 48326 CARDIOLOGY, RADIOLOGY, LAB 87 - (OA) DAVISBURG FAMILY MEDICINE 10740 DIXIE HIGHWAY DAVISBURG MI 48350 FAMILY MEDICINE, LAB 88 - (OA) BLOOMFIELD HILLS IM 2520 S TELEGRAPH RD BLOOMFIELD HILLS MI 48302 INTERNAL MEDICINE 89 - (OA) MERCY PLACE 55 CLINTON ST PONTIAC MI 48342 OUTPATIENT CLINIC 90 - (OA) NORTH HILLS MEDICAL BUILDING 44038 WOODWARD AVE BLOOMFIELD HILLS MI 48302 TRAUMA, ORTHOPEDICS 91 - (OA) OAKLAND MEDICAL GROUP 3950 S ROCHESTER ROAD ROCHESTER HILLS MI 48307 OB/GYN 92 - (OA) OAKLAND MEDICAL GROUP 27301 DEQUINDRE ROAD MADISON HEIGHTS MI 48071 OB/GYN 93 - (OA) NEUROSURGERY CLARKSTON 7650 DIXIE HIGHWAY CLARKSTON MI 48346 NEUROSURGERY 94 - (OA) NEUROSURGERY BLOOMFIELD HILLS 799 DENISON CT BLOOMFIELD HILLS MI 48302 NEUROSURGERY 95 - (PORT HURON) MERCY HEALTH CENTER 4190 24TH AVE FORT GRATIOT MI 48059 LAB, IMAGING, URGENT CARE 96 - (PH) FITRAC - MARYSVILLE 782 HURON BLVD MARYSVILLE MI 48040 PHYSICAL THERAPY 97 - (PH) DR MOREY'S MERCY SURGERY CARE 2609 ELECTRIC AVE STE B PORT HURON MI 48060 EMPLOYED SURGEON 98 - (PH) PEOPLES' CLINIC FOR BETTER HEALTH 3110 GOULDEN ST PORT HURON MI 48060 OUTPATIENT CLINIC 99 - (PH) GEORGE CARLEY ASSOCIATES 1943 HOLLAND PORT HURON MI 48060 LAB 100 - (PH) DR JERRY 600 FORT STREET PORT HURON MI 48060 LAB 101 - (PH) DR JARAD 2540 16TH STREET PORT HURON MI 48060 LAB 102 - (PH) NORTH BUILDING 2306 ELECTRIC AVE PORT HURON MI 48060 LAB 103 - (PH) DR LAL 2605 ELECTRIC AVE PORT HURON MI 48060 LAB 104 - (PH) DR KHALIL 1201 STONE ST SUITE 3 PORT HURON MI 48060 DRAW STATION PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: TRINITY HEALTH - MICHIGAN (TH-MI) REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG. IN ADDITION, THE HOSPITAL DIVISIONS OF TH-MI INCLUDE A COPY OF THEIR MOST RECENT SCHEDULE H ON THEIR RESPECTIVE WEBSITES. TRINITY HEALTH ALSO INCLUDES TH-MI'S MOST RECENTLY FILED SCHEDULE H ON ITS WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITALS' COST ACCOUNTING SYSTEMS. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $54,044,933, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITALS IN TH-MI SERVE ON COMMUNITY TASK FORCES AND COALITIONS TO HELP ADDRESS THE NEEDS OF THE SERVICE AREA. THE HOSPITALS PARTICIPATE IN DIVERSITY COUNCILS, MINISTRY ASSOCIATIONS, HEALTH COALITIONS, AND HEALTH IMPROVEMENT COUNCILS.ST. MARY MERCY LIVONIATO ASSIST IN ADDRESSING THE EDUCATIONAL DISPARITIES IN DETROIT, SMML HAS BEEN ONE OF THE CORPORATE SPONSORS OF THE DETROIT CHRISTO REY SCHOOL SINCE IT OPENED. CHRISTO REY IS A COLLEGE PREP CATHOLIC HIGH SCHOOL, ONE OF OVER 30 AROUND THE COUNTRY, FOR LOW-INCOME KIDS WHO OTHERWISE WOULD NOT BE ABLE TO AFFORD PRIVATE SCHOOL. THE VAST MAJORITY OF STUDENTS ARE EITHER HISPANIC OR BLACK, AND MOST OF THEM WILL BE THE FIRST IN THEIR FAMILY TO GO TO COLLEGE. THIS UNIQUE EDUCATIONAL MODEL PREPARES STUDENTS FOR COLLEGE AND FOR WORK. ONE DAY A WEEK, BEGINNING FRESHMAN YEAR, THE STUDENTS GO TO WORK FOR A PROFESSIONAL COMPANY. THE COMPANY, IN TURN, AGREES TO PAY 60% OF THE STUDENT'S SCHOOL TUITION. THERE HAVE BEEN THREE GRADUATING CLASSES SINCE CRISTO REY OPENED IN DETROIT. STUDENTS INTERESTED IN HEALTH CARE ALSO TRADE THEIR SCHOOL UNIFORMS FOR HOSPITAL SCRUBS AS THEY TRAVEL ONCE PER WEEK TO SMML FOR THEIR WORK-EXPERIENCE IN THE MIRACLE OF LIFE BIRTHING CENTER. BESIDES THE WORK EXPERIENCE, THEY ARE MENTORED AND GUIDED BY THE SIXTY EMPLOYEES WORKING IN THIS DEPARTMENT. IN ADDITION TO THE BEHAVIORAL HEALTH SERVICES PROVIDED BY SMML, THE HOSPITAL IS INVOLVED IN THE LIVONIA SAVE OUR YOUTH (LSOY) WHICH IS A COALITION WITH A MISSION TO EDUCATE AND EMPOWER THE COMMUNITY REGARDING THE HEALTH AND SAFETY OF OUR YOUNG PEOPLE WITH A FOCUS ON ALCOHOL AND OTHER DRUGS. THE COALITION INCLUDES PARENTS, TEENS, EDUCATORS, HEALTH CARE WORKERS, LAW ENFORCEMENT, THE FAITH COMMUNITY, AND SUBSTANCE ABUSE PROFESSIONALS. THE GROUP PARTNERS BROADLY WITH COMMUNITY MEMBERS AND GROUPS TO PREVENT SUBSTANCE ABUSE AND BRING AWARENESS OF DRUG ISSUES TO THE COMMUNITY AND PROVIDES RESOURCE GUIDES, EDUCATION, AND AN ANNUAL RUN 2 SAVE OUR YOUTH WHICH IS A FAMILY EXPO EVENT TO RAISE AWARENESS AND FUNDS. SMML SUPPORTED THIS EVENT AND THE COALITION ACTIVITIES. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: TH-MI USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, TH-MI IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, TH-MI IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: TH-MI IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 15 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: TH-MI DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITALS' COLLECTION POLICIES CONTAIN PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN EACH ORGANIZATION'S COLLECTION POLICY. THE HOSPITALS HAVE IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - THE HOSPITALS IN TH-MI ASSESS THE HEALTH STATUS OF THEIR COMMUNITIES, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THEIR OVERALL COMMUNITIES. IN THE ASSESSMENT OF THEIR COMMUNITIES, THE HOSPITALS MAY USE PATIENT DATA, PUBLIC HEALTH DATA, COMMITTEE MEETINGS WITH MEDICAL STAFF (PHYSICIANS) AND DEPARTMENT STAFF, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - TH-MI IS COMMITTED TO:-PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES-CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES-ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE -BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, TH-MI HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: -PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS-MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS-OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS-IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER-IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSTH-MI COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. TH-MI OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH AND SEVERAL OTHER LANGUAGES, REFLECTING OTHER LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITALS. TH-MI HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. TH-MI MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - ST. JOSEPH MERCY HEALTH SYSTEM (ANN ARBOR):SAINT JOSEPH MERCY HEALTH SYSTEM (SJMHS) IS A SUBURBAN HEALTH CARE NETWORK SERVING WASHTENAW, LIVINGSTON, EASTERN JACKSON, LENAWEE, MONROE, WESTERN WAYNE AND SOUTHWESTERN OAKLAND COUNTIES. THE SJMHS HEALTH CARE NETWORK INCLUDES FIVE HOSPITALS: ST. JOSEPH MERCY ANN ARBOR, ST. MARY MERCY HOSPITAL IN LIVONIA, ST. JOSEPH MERCY CHELSEA, ST. JOSEPH MERCY OAKLAND IN PONTIAC AND SAINT JOSEPH MERCY LIVINGSTON IN HOWELL. COMBINED, THESE HOSPITALS ARE LICENSED FOR 1,726 INPATIENT BEDS. THE SJMAA SERVICE AREA IS DEFINED AS THE POPULATION OF WASHTENAW COUNTY. WASHTENAW COUNTY IS ESTIMATED TO HAVE A POPULATION OF 358,081 AS OF DECEMBER 2014 (SEMCOG). THE POPULATION UNDER AGE 18 HAS CONSISTENTLY DECLINED OVER THE PAST FOUR YEARS WHILE THE OVER-65 POPULATION HAS GROWN. IN 2014, 12% OF THE POPULATION WAS 65 AND OLDER. WASHTENAW COUNTY'S POPULATION IS RACIALLY DIVERSE WITH 76.2% WHITE, 13.9% BLACK, 9.4% ASIAN, AND 0.6% NATIVE AMERICAN IN JULY 2014. INCOME AND POVERTY ARE SIGNIFICANT INDICATORS OF HEALTH AND LIFE EXPECTANCY. EDUCATION LEVEL IS ALSO SIGNIFICANTLY CONNECTED WITH INCOME LEVEL AND POVERTY. IN WASHTENAW COUNTY, THE MEDIAN HOUSEHOLD INCOME IS $60,805. THIS IS SIGNIFICANTLY HIGHER THAN THE MEDIAN INCOME OF MICHIGAN IN GENERAL, WHICH IS $49,087. IT IS ALSO HIGHER THAN THE U.S. MEDIAN INCOME OF $52,482. HOWEVER, OBSERVING THE PERCENTAGE OF THOSE LIVING IN POVERTY BASED ON GEOGRAPHICAL LOCATION DEMONSTRATES THAT THERE ARE SPECIFIC AREAS OF WASHTENAW COUNTY THAT ARE EXPERIENCING HIGHER RATES OF POVERTY COMPARED TO THE REST OF THE COUNTY AND THE STATE.MERCY HEALTH SAINT MARY'S GRAND RAPIDS:KENT COUNTY IS CONSIDERED THE PRIMARY MARKET AREA OF MHSM. KENT COUNTY IS LOCATED IN WESTERN MICHIGAN AND IS THE FOURTH LARGEST POPULOUS COUNTY IN THE STATE. THE COUNTY IS COMPOSED OF 21 TOWNSHIPS, FIVE VILLAGES, AND NINE CITIES COVERING 864 SQUARE MILES. GRAND RAPIDS IS THE COUNTY SEAT AND IS 30 MILES FROM LAKE MICHIGAN. THE HEALTHCARE RESOURCES IN KENT COUNTY INCLUDE MHSM, METROPOLITAN HEALTH, SPECTRUM HEALTH-BUTTERWORTH CAMPUS, SPECTRUM HEALTH-BLODGETT CAMPUS, PINE REST, AND MARY FREE BED REHABILITATION HOSPITAL. IN ADDITION, THE HEALTH DEPARTMENT OPERATES SIX PUBLIC HEALTH CLINICS THROUGHOUT THE COUNTY THAT OFFER PERSONAL HEALTH SERVICES. THERE ARE AN ESTIMATED 636,369 PEOPLE RESIDING IN KENT COUNTY AS OF JULY 1, 2015. THE MEDIAN HOUSEHOLD INCOME FOR KENT COUNTY IS $52,716. TWENTY-FIVE PERCENT (25%) OF THE POPULATION IS BELOW THE AGE OF 18 AND 13% IS 65 YEARS OF AGE AND OLDER. EIGHTY-THREE PERCENT (83%) OF THE POPULATION IS WHITE, 10.5% BLACK, AND 10.3% LATINO. EIGHTY-NINE PERCENT (89%) ARE HIGH SCHOOL GRADUATES AND 33% HAVE A BACHELOR'S DEGREE. THE CURRENT UNEMPLOYMENT RATE IS 3.3%.ST. JOSEPH MERCY OAKLAND (PONTIAC):SJMO IS A PART OF SJMHS, A SUBURBAN HEALTH CARE NETWORK SERVING WASHTENAW, LIVINGSTON, EASTERN JACKSON, LENAWEE, MONROE, WESTERN WAYNE AND SOUTHWESTERN OAKLAND COUNTIES. SJMO IS LICENSED FOR 443 INPATIENT BEDS. THE SJMO SERVICE AREA IS DEFINED AS THE ENTIRE POPULATION OF OAKLAND COUNTY. OAKLAND COUNTY IS ESTIMATED TO HAVE A POPULATION OF 1,231,640 AS OF 2013 (MICHIGAN DEPARTMENT OF COMMUNITY HEALTH). THE POPULATION OF OAKLAND COUNTY IS GROWING AT A STEADY RATE. THIS ESTIMATE INDICATES POPULATION GROWTH OF NEARLY 2.4% BETWEEN 2010 AND 2013 AND 4.4% BETWEEN 2000 AND 2013.THE POPULATION OF OAKLAND COUNTY IS GRADUALLY AGING. THE POPULATION UNDER AGE 18 HAS CONSISTENTLY DECLINED OVER THE PAST FOUR YEARS WHILE THE OVER-65 POPULATION HAS GROWN AS A PERCENTAGE OF THE WHOLE. WHILE OAKLAND COUNTY'S POPULATION OVERALL IS RACIALLY DIVERSE WITH A 77.9% WHITE, 15.0% BLACK, 6.6% ASIAN, AND 0.4% NATIVE AMERICAN IN 2013, THE RACIAL MAKEUP OF THE CITY OF PONTIAC IS 34% WHITE, 51% BLACK AND 15% LATINO. OAKLAND COUNTY'S POVERTY RATE HAS CONSISTENTLY BEEN LOWER THAN THAT OF ALL MICHIGAN; HOWEVER, THE COMMUNITY OF PONTIAC, IN WHICH THE HOSPITAL RESIDES, HAS ONE OF THE HIGHEST POVERTY LEVELS IN THE STATE WITH APPROXIMATELY 38% OF PONTIAC RESIDENTS AND OVER 50% OF PONTIAC CHILDREN LIVING IN POVERTY. IN 2013, APPROXIMATELY 7.3% OF ALL OAKLAND COUNTY HOUSEHOLDS LIVED IN POVERTY. THIS PERCENTAGE HAS DECLINED SINCE 2011 BUT IS NOT AS LOW AS IT WAS IN 2010.OAKLAND COUNTY HAS A HIGH PROPORTION OF PEOPLE WITH A 4-YEAR DEGREE OR HIGHER. HOWEVER, IT ALSO HAS GEOGRAPHIC POCKETS WHERE MORE THAN 20% OF THE POPULATION HAS LESS THAN A HIGH SCHOOL DIPLOMA.ST. MARY MERCY LIVONIA:SMML'S SERVICE AREA INCLUDES CANTON, LIVONIA, NORTHVILLE CITY AND TOWNSHIP, PLYMOUTH CITY AND TOWNSHIP, REDFORD, FARMINGTON CITY AND FARMINGTON HILLS, AND WESTLAND WITH ABOUT 500,000 PEOPLE IN THESE COMMUNITIES. THE MEDIAN HOUSEHOLD INCOME RANGES FROM $44,000 IN WESTLAND TO $119,000 IN NORTHVILLE. THE HIGHEST POVERTY LEVEL CAN BE FOUND IN WESTLAND AT 15.7%, FOLLOWED BY REDFORD AT 13.8%. UNEMPLOYMENT IS THE HIGHEST IN REDFORD AT 8% AND THE LOWEST AT 2.4% IN FARMINGTON HILLS. CANTON HAS A SIGNIFICANT NUMBER OF YOUTH (26%) AND LIVONIA HAS THE HIGHEST NUMBER OF PEOPLE 65 OR OLDER (20%). THE HOSPITAL'S COMMUNITY IS PREDOMINANTLY CAUCASIAN WITH SOME AFRICAN AMERICANS, HISPANICS AND ASIANS. ST. JOSEPH MERCY CHELSEA:THE SJMC SERVICE AREA IS DEFINED AS THE GEOGRAPHIC AREA ENCOMPASSING THE ZIP CODES OF CHELSEA, DEXTER, GRASS LAKE, GREGORY, MANCHESTER, MUNITH AND STOCKBRIDGE, MICHIGAN. THIS INCLUDES SECTIONS OF FOUR COUNTIES (WESTERN WASHTENAW, SOUTHEASTERN INGHAM, SOUTHWESTERN LIVINGSTON AND EASTERN JACKSON) AND ALL OR PART OF THE FOLLOWING CITIES, VILLAGES, AND TOWNSHIPS: BRIDGEWATER, CHELSEA, DEXTER, DEXTER TOWNSHIP, FREEDOM, GRASS LAKE, HENRIETTA, LIMA, LYNDON, MANCHESTER, SCIO, SHARON, STOCKBRIDGE, SYLVAN, UNADILLA, WATERLOO, WEBSTER, VILLAGE OF GRASS LAKE, VILLAGE OF MANCHESTER, AND VILLAGE OF STOCKBRIDGE. ACCORDING TO THE HOSPITAL'S PLANNING DEPARTMENT, THE SJMC SERVICE AREA WAS DETERMINED BY THE GEOGRAPHIC PROXIMITY OF THESE COMMUNITIES TO THE HOSPITAL IN CHELSEA, MI. THE TOTAL POPULATION OF THE SIX ZIP CODES INCLUDED IN THE SJMC SERVICE AREA IS 56,023 ACCORDING TO THE 2010 CENSUS. THE AVERAGE RACE DISTRIBUTION FOR THE SERVICE AREA IS 95% CAUCASIAN, 2.1% HISPANIC, AND LESS THAN ONE PERCENT EACH OF OTHER RACES. THE AVERAGE AGE FOR THE SERVICE AREA IS 42.5.BECAUSE GREGORY AND MUNITH DO NOT HAVE THEIR OWN SCHOOL DISTRICTS (YOUTH THERE ATTEND SCHOOL IN A NEIGHBORING COMMUNITY), THE SJMC SERVICE AREA IS COMMONLY REFERRED TO AS THE FIVE COMMUNITIES OF CHELSEA, DEXTER, GRASS LAKE, MANCHESTER AND STOCKBRIDGE. WE USE THE DEMOGRAPHIC DATA OUTLINED ABOVE, BUT OTHERWISE REFER TO THESE FIVE TOWNS AS THE SJMC SERVICE AREA. ST. JOSEPH MERCY LIVINGSTON:THE SJML SERVICE AREA FOR PURPOSES OF THE NEEDS ASSESSMENT IS DEFINED AS THE POPULATION OF LIVINGSTON COUNTY. LIVINGSTON COUNTY IS ESTIMATED TO HAVE A POPULATION OF 186,234 AS OF DECEMBER 2014 (SEMCOG). THE POPULATION OF LIVINGSTON COUNTY IS GROWING; IT WAS SE MICHIGAN'S FASTEST GROWING COUNTY BY PERCENTAGE IN THE FIRST DECADE OF 2000 AT NEARLY 15.3%. HOWEVER, THE POPULATION OF LIVINGSTON COUNTY IS AGING. THE PERCENT OF AND ACTUAL NUMBER OF PEOPLE UNDER AGE 18 HAS CONSISTENTLY DECLINED OVER THE PAST FOUR YEARS WHILE THE OVER-65 POPULATION HAS GROWN. LIVINGSTON COUNTY'S POPULATION IS RACIALLY HOMOGENOUS WITH NEARLY 98% OF ITS RESIDENTS WHITE. THIS COMPARES WITH MICHIGAN'S POPULATION COMPOSITION WHICH IS ABOUT 79% WHITE AND 14.2% BLACK.A JANUARY 2015 REPORT ON 247WALLST.COM FOUND LIVINGSTON COUNTY HAS THE HIGHEST MEDIAN INCOME OF ALL MICHIGAN COUNTIES, AT $72,359 PER HOUSEHOLD BASED ON THE MOST RECENT AMERICAN COMMUNITY SURVEY DATA. APPROXIMATELY 5.9% OF LIVINGSTON INDIVIDUALS LIVED IN POVERTY IN 2013; LIVINGSTON HAS THE LOWEST POVERTY RATE OF ALL MICHIGAN COUNTIES.LIVINGSTON COUNTY HAS A HIGH PROPORTION OF PEOPLE WITH A 4-YEAR DEGREE OR HIGHER. HOWEVER, LIVINGSTON COUNTY DOES HAVE GEOGRAPHIC POCKETS IN WHICH 11-16% OF THE POPULATION HAVE LESS THAN A HIGH SCHOOL DIPLOMA.ST. JOSEPH MERCY PORT HURON:SJMPH IS LOCATED IN ST. CLAIR COUNTY IN SOUTHEASTERN MICHIGAN. SHARING A BORDER WITH CANADA, THE COUNTY IS HOME TO THE BLUE WATER BRIDGE. DUE TO ITS PROXIMITY TO CANADA AND THE HIGH CONCENTRATION OF MANUFACTURING ON BOTH SIDES OF THE BRIDGE, ST. CLAIR COUNTY HAS BEEN IDENTIFIED BY THE FEDERAL GOVERNMENT AS A HIGH-RISK AREA FOR BOTH NATURAL AND MANMADE DISASTERS.BASED ON 2010 U.S. CENSUS BUREAU DATA, ST. CLAIR COUNTY HAS ABOUT 163,000 RESIDENTS AND IS EXPECTED TO SLOWLY DECLINE. OF THAT POPULATION, 94.5% ARE CAUCASIAN, 2.6% BLACK OR AFRICAN AMERICAN AND 2.9% HISPANIC OR LATINO. IN 2011, 15% OF AREA RESIDENTS WERE SENIORS AGE 65 AND OLDER, WHICH IS THE ONLY DEMOGRAPHIC EXPECTED TO GROW IN THE NEXT DECADE. THE COUNTY IS 721 SQUARE MILES, ENCOMPASSING 33 COMMUNITIES. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: TH-MI HOSPITALS COLLABORATE WITH OTHERS IN THE COMMUNITY TO ACHIEVE IMPROVEMENTS IN HEALTH AND ACCESS TO HEALTHCARE.SAINT JOSEPH MERCY HEALTH SYSTEM (ANN ARBOR AND CHELSEA):THE WASHTENAW HEALTH PLAN (WHP) REPRESENTS A PARTNERSHIP BETWEEN WASHTENAW COUNTY, THE UNIVERSITY OF MICHIGAN AND SJMHS TO PROVIDE PRIMARY MEDICAL CARE SERVICES FOR THE MOST VULNERABLE AND DISENFRANCHISED IN THE COMMUNITY. SJMHS SUPPORTS THIS PROGRAM BY PROVIDING STAFF SUPPORT TO HELP PATIENTS GAIN ACCESS TO A MEDICAL HOME. THE HOSPITALS ALSO PROVIDE THIS POPULATION WITH FREE OR REDUCED-FEE CLINICAL SERVICES.SJMAA WAS THE LEAD AGENCY IN THE ORIGINATION OF THE WASHTENAW HOUSING ALLIANCE (WHA), A COALITION OF NINE SOCIAL SERVICE AGENCIES DEALING WITH HOUSING OF VARIOUS TYPES, WHOSE MISSION IS TO END HOMELESSNESS IN WASHTENAW COUNTY. IN ADDITION, SJMHS AND ITS BOARD MEMBERS WERE KEY IN BUILDING THE DELONIS CENTER IN DOWNTOWN ANN ARBOR. THIS CENTER PROVIDES NEEDED ACCOMMODATIONS FOR THE HOMELESS, AS WELL AS SOCIAL AND HEALTH SUPPORT SERVICES. IN 2015, SJMAA BECAME A PART OF THE WASHTENAW COUNTY COORDINATED FUNDERS, A PUBLIC-PRIVATE COLLABORATIVE FUNDING PARTNERSHIP WORKING TO FUND SOCIAL SERVICES AGENCIES ACROSS COMMUNITY-LEVEL OUTCOMES IN THE AGING, SAFETY NET HEALTH, CRADLE TO CAREER, NUTRITION, AND HOUSING AND HOMELESSNESS SECTOR. SJMAA ALSO SUPPORTS AVALON HOUSING'S FUSE PROGRAM, WHICH PROVIDES CARE AND RESOURCES TO HOMELESS INDIVIDUALS EXPERIENCING MENTAL HEALTH, SUBSTANCE USE DISORDER, AND CHRONIC ILLNESSES, BY SECURING HOUSING AND NECESSARY SOCIAL SERVICE SUPPORTS THROUGH A PERMANENT SUPPORTIVE HOUSING MODEL.SJMHS OPERATES TWO CLINICS THAT SUPPLY FREE OR REDUCED-FEE HEALTH CARE SERVICES TO AT-RISK POPULATIONS. THE NEIGHBORHOOD HEALTH CLINIC IS LOCATED IN DOWNTOWN YPSILANTI, WHILE THE ACADEMIC OB/GYN CLINIC IS LOCATED ON THE ANN ARBOR HOSPITAL CAMPUS.IN FY16, SJMAA BECAME A PARTNER IN THE COLLABORATIVE FUNDING MODEL, WASHTENAW COORDINATED FUNDING. THE MODEL CONSISTS OF SEVEN PARTNERS MEETING THE NEEDS OF OUR COMMUNITY'S MOST VULNERABLE IN FOUR PRIORITY AREAS THROUGH THREE FUNDING COMPONENTS INTENDED TO: SUPPORT HUMAN SERVICES PROGRAMMING; BUILD NONPROFIT CAPACITY; AND FOSTER COMMUNITY COLLABORATION AND SYSTEMS-LEVEL CHANGE. THE THREE DISTINCT COMPONENTS WITHIN THE MODEL (SECTOR LEADERS (FORMERLY PLANNING & COORDINATING ENTITIES), PROGRAM OPERATIONS FUNDING & CAPACITY BUILDING GRANTS) ARE DESIGNED TO PREVENT GAPS AND AVOID REDUNDANCIES IN SERVICES, WHILE STREAMLINING APPLICATION AND REPORTING PROCEDURES FOR GRANTEES. SJMAA IS CONTRIBUTING FUNDING TO THE MODEL AND DEDICATED STAFF TIME AND OTHER RESOURCES DURING FY16. ALL FUNDING DISTRIBUTED THROUGH THIS MODEL IS ALIGNED WITH SJMAA'S PRIORITY HEALTH AREAS OF BEHAVIORAL HEALTH AND OBESITY.MERCY HEALTH SAINT MARY'S GRAND RAPIDS:MHSM IMPLEMENTS AND PARTICIPATES IN DOZENS OF PROGRAMS EACH YEAR, OFTEN PARTNERING WITH OTHER ORGANIZATIONS IN THE COMMUNITY. MHSM IS A ONE-THIRD PARTNER WITH THE MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE AND MARY FREE BED REHABILITATION HOSPITAL, IN THE COMMUNITY'S ONLY CERTIFIED ALS (AMYOTROPHIC LATERAL SCLEROSIS) TREATMENT CENTER FOR LOU GEHRIG'S DISEASE. THE WEGE INSTITUTE FOR HEALTH AND LEARNING IS HOME TO THE WEGE RESIDENCY PROGRAM, THROUGH WHICH PARTICIPANTS WORK WITH THE UNINSURED, REFUGEE POPULATION AND THOSE EXPERIENCING HOMELESSNESS.IN APRIL 2016, MHSM OPENED A CONCIERGE MEDICINE DEPARTMENT WHICH PROVIDES 24/7 ACCESS TO A PRIMARY CARE PHYSICIAN. TO ALIGN WITH MHSM'S MISSION STATEMENT TO PROVIDE CARE FOR THE POOR AND UNDERSERVED, 10% OF THE REVENUE FROM THE CONCIERGE MEDICINE DEPARTMENT WILL BE REALLOCATED TO FUND PROGRAMS THAT SUPPORT THE POOR AND UNDERSERVED MEMBERS OF THE COMMUNITY. IT IS ESTIMATED THIS AMOUNT WILL RANGE FROM $75,000-$125,000 ANNUALLY.MHSM IS A PARTNER WITH KENT COUNTY HEALTH DEPARTMENT SUBSTANCE USE DISORDER COMMUNITY HEALTH IMPROVEMENT PLAN WORK GROUP. IN FY16, THE WORK GROUP ADDED TOBACCO 21, A NATIONAL INITIATIVE THAT ADVOCATES INCREASING THE LEGAL AGE TO PURCHASE TOBACCO FROM 18 TO 21, TO THE STRATEGIC PLAN, WITH THE GOAL TO REDUCE REPORTED TOBACCO USE WITHIN THE PAST 30 DAYS AMONG HIGH SCHOOL AGED YOUTH FROM 12% TO 11% BY FY18. ST. JOSEPH MERCY OAKLAND (PONTIAC):SJMO WORKED IN PARTNERSHIP WITH THE OAKLAND SCHOOLS MICHIGAN WORKS JOBLINKS PROGRAM (A PROGRAM IN WHICH PARTICIPATION IS BASED ON FINANCIAL NEED) TO DEVELOP OUR HEALTH CARE CO-OP PROGRAM FOR PONTIAC AREA HIGH SCHOOL STUDENTS. THE STUDENTS WORKED APPROXIMATELY 15 HOURS/WEEK AFTER SCHOOL DURING THE SCHOOL YEAR AND 40 HOURS/WEEK DURING THEIR SUMMER BREAK. STUDENTS WERE PAID FOR THEIR HOURS WORKED BY THE MICHIGAN WORKS PROGRAM. THE PROGRAM PROVIDED OPPORTUNITIES FOR PERSONAL AND PROFESSIONAL DEVELOPMENT FOR STUDENTS AS WELL AS FINANCIAL STABILITY FOR THEIR FAMILIES. THE HOSPITAL ALSO CONTINUES TO STRENGTHEN OUR SENIOR FIT PROGRAM, EXPANDING TO SERVE MORE THAN 500 SENIORS IN NINE LOCATIONS ACROSS THE COUNTY, PROVIDING BASIC PRE AND POST HEALTH SCREENING, AND A TWICE WEEKLY EXERCISE PROGRAM FOR SENIORS. THIS PROGRAM SUPPORTS BOTH THEIR PHYSICAL AND EMOTIONAL HEALTH. THROUGH THE MERCY SUPPORT PROGRAM, 5,662 LOW-INCOME AND AT-RISK PERSONS WERE SERVED, WHILE AN ADDITIONAL 2,925 WERE SERVED THROUGH THE INDIGENT PROCUREMENTS AND MERCY SUPPORT PRESCRIPTION PROGRAMS. AS A KEY PARTNER WITH THE OAKLAND COUNTY HEALTH DEPARTMENT, OAKLAND UNIVERSITY, AND PONTIAC ELECTED OFFICIALS, SJMO IS PART OF THE FIVE MEMBER "INVEST HEALTH" GRANT TEAM, FUNDED THROUGH THE REINVESTMENT FUND AND ROBERT WOOD JOHNSON FOUNDATION TO ADDRESS SOCIAL DETERMINATES OF HEALTH IN 50 MID-SIZED CITIES ACROSS AMERICA. STILL IN ITS FIRST YEAR, THIS TEAM IS FOCUSED ON BUILDING COMMUNITY COLLABORATIONS AND HELPING TO LEVERAGE RESOURCES TO IDENTIFY AND ADDRESS BARRIERS TO THE HEALTH OF PONTIAC RESIDENTS.ST. MARY MERCY LIVONIA:RESPONDING TO THE COMMUNITY NEED FOR MENTAL HEALTH AND SUBSTANCE ABUSE CARE, SMML OFFERS A ROBUST INPATIENT BEHAVIORAL MEDICINE SERVICE. TO IMPROVE THE ER EXPERIENCE FOR THESE PATIENTS AND THEIR FAMILIES AND FRIENDS, A BEHAVIORAL MEDICINE SECTION WAS CREATED IN THE HOSPITAL'S ER. PSYCHIATRIC SOCIAL WORKERS ASSIST PATIENTS AND THEIR FAMILIES IN THE AUTHORIZATION PROCESS FOR INPATIENT ADMISSION OR CONNECTING THEM WITH OUTPATIENT SERVICES AVAILABLE IN THE COMMUNITY.WITH LIMITED ACCESS TO HEALTHCARE FOR THE UNINSURED, SMML HAS PARTNERED WITH WAYNE HOPE CLINICS TO PROVIDE LAB SERVICES. THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE TO THE MAPI CHARITABLE CLINIC IN LATHRUP VILLAGE, MI. ADDITIONAL FINANCIAL ASSISTANCE WAS PROVIDED TO THE WAYNE HOPE CLINICS TO INCREASE DIABETES PREVENTION AND MANAGEMENT PROGRAMMING ON THEIR SITE. FURTHERMORE, ASSISTANCE WAS PROVIDED TO THE CABRINI CLINIC IN SUPPORT OF STAFFING A COMMUNITY HEALTH WORKER. ADDRESSING THE NEED FOR SPECIALIST CARE FOR THE UNINSURED INDIVIDUALS WHO ARE CARED FOR IN THE ER, AN INTERNAL SPECIALIST CARE PROGRAM, THROUGH THE MEDICAL STAFF OFFICE, CONTINUED. THIS PROGRAM HAS REDUCED THE RATE OF RETURN ER VISITS FOR FOLLOW-UP CARE AND HAS IMPROVED THE PATIENT'S QUALITY OF LIFE; AND WITHOUT THIS PROGRAM MANY OF THESE INDIVIDUALS WOULD NOT HAVE RECEIVED THIS NEEDED CARE.ST. JOSEPH MERCY LIVINGSTON:SJML ACTIVELY SUPPORTS COMMUNITY ENTITIES INCLUDING LIVINGSTON COUNTY PUBLIC HEALTH, LIVINGSTON COUNTY CATHOLIC CHARITIES, WHICH HOUSES THE LIVINGSTON COUNTY SUBSTANCE ABUSE PREVENTION COALITION, LIVINGSTON COUNTY COMMUNITY MENTAL HEALTH, AND THE LOCAL HUMAN SERVICES COLLABORATIVE BODY. SUPPORT OF THESE ORGANIZATIONS INCLUDES BUT IS NOT LIMITED TO: SEATS ON VARIOUS BOARDS, SJML STAFF MEMBERS' PRESENCE AT WORKGROUPS WITHIN COLLABORATIONS SUPPORTING THE WORK OF THESE AGENCIES, AND MONETARY OR IN-KIND STAFF TIME AT EVENTS PROMOTING HEALTH TO THE GENERAL PUBLIC. SJML ALSO SUPPORTS THE LOCAL FOOD BANK THROUGH DONATIONS. ADDITIONALLY, THE SJML COMMUNITY SAW AN OPPORTUNITY TO INCREASE ACCESS FOR THOSE WITH DENTAL ISSUES. SJML DONATED A BUILDING AND FUNDS TO RENOVATE THE SPACE TO ACCOMMODATE A DENTAL CLINIC, WHICH PROVIDES DENTAL CARE FOR MEDICAID RECIPIENTS AND THOSE WITHOUT DENTAL INSURANCE.ST. JOSEPH MERCY PORT HURON:SINCE 1990, SJMPH HAS SPONSORED THE PEOPLES' CLINIC FOR BETTER HEALTH. THIS FREE CLINIC, LOCATED WITHIN THE GUADALUPE MISSION IN PORT HURON, HAS BEEN THE CORNERSTONE OF SJMPH'S COMMUNITY INITIATIVES FOR THE POOR AND UNDERSERVED. THE CLINIC IS OPERATED IN COLLABORATION WITH THE UNITED WAY AND THE ST. CLAIR COUNTY MEDICAL SOCIETY, WHICH PROVIDES VOLUNTEER PHYSICIANS. PRIMARY MEDICAL CARE AND PRESCRIPTION MEDICATIONS ARE PROVIDED FREE OF CHARGE EACH YEAR TO OVER 3,500 18 TO 65 YEAR-OLDS WHO LACK INSURANCE OR ARE UNDERINSURED. THE CLINIC INCLUDES A SWEET TOUCH PROGRAM DESIGNED TO MONITOR AND MANAGE THE CHRONIC DISEASE OF DIABETES TO THE POOR AND UNINSURED POPULATION. PART VI, LINE 6: TH-MI IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2016, GOALS INCLUDED 1) PARTNERING WITH COMMUNITY ORGANIZATIONS IN INSURANCE ENROLLMENT ACTIVITIES TARGETED AT UNINSURED INDIVIDUALS TO IMPROVE ACCESS TO HEALTHCARE, 2) PARTICIPATING IN LOCAL ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, AND 3) DEVELOPING A STRATEGY WITH MULTI-DISCIPLINARY TEAMS TO OPTIMIZE CARE FOR VULNERABLE PERSONS, WITH PARTICULAR FOCUS ON THOSE WHO ARE DUALLY ENROLLED IN MEDICAID AND MEDICARE. TRINITY HEALTH APPRECIATES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED PROGRAMS FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED AREAS OF NEED AND THAT WILL REDUCE OBESITY AND TOBACCO USE.AS A SYSTEM, TRINITY HEALTH SUPPORTED PROGRAMS AND ORGANIZATIONS WHO ADDRESS THESE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE GRANTING SEVEN DACA "DREAMERS" LOW INTEREST LOANS, ENABLING RECIPIENTS TO ATTEND MEDICAL SCHOOL AT STRITCH SCHOOL OF MEDICINE, AND PROVIDING A GRANT TO THE U.S. SOCCER FOUNDATION TO FUND ITS SOCCER FOR SUCCESS PROGRAM IN NINE COMMUNITIES, OFFERING STUDENTS IN UNDERSERVED AREAS THE OPPORTUNITY TO SAFELY AND COST-EFFECTIVELY ENGAGE IN A HEALTHY AND ACTIVE LIFESTYLE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS NEARLY $1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. 1 AMERICAN HEART ASSOCIATION PO BOX 50035 PRESCOTT AZ 86304 135613797 501(C)(3) 101500 SPONSOR GALA ANN ARBOR MI ANN ARBOR AREA COMMUNITY FOUNDATION 301 N MAIN ST STE 300 ANN ARBOR MI 48104 386087967 501(C)(3) 200000 SUPPORT SISTER YVONNE GELLISE FUND FOR PERMANENT SUPPORTIVE HOUSING SERVICES ANN ARBOR SPARK 201 S DIVISION ST ANN ARBOR MI 48104 382436899 501(C)(6) 30000 SPARK WASHTENAW COUNTY AVALON HOUSING 1327 JONES DR STE 102 ANN ARBOR MI 48105 383086920 501(C)(3) 150000 FUSE/HSS/ASHLEY HOUSE CANCER SUPPORT COMMUNITY OF GREATER ANN ARBOR 2010 HOGBACK STE 3 ANN ARBOR MI 48105 050597871 501(C)(3) 15000 PSYCHOSOCIAL SUPPORT PROGRAMS CENTER FOR HEALTHCARE RESEARCH 2929 PLYMOUTH RD STE 245 ANN ARBOR MI 48105 271017827 501(C)(3) 120000 WASHTENAW HEALTH INITIATIVE CITY OF YPSILANTI ONE SOUTH HURON ST YPSILANTI MI 48197 CITY GOVERNMENT 50000 BORDER TO BORDER TRAIL BETWEEN RIVERSIDE PARK AND MICHIGAN AVENUE DETROIT REGIONAL CHAMBER OF COMMERCE PO BOX 77359 DETROIT MI 48277 380477570 501(C)(6) 35000 2016 MACKINAC POLICY CONFERENCE SPONSOR EASTERN MARKET CORPORATION 2934 RUSSELL ST DETROIT MI 48154 320030432 501(C)(3) 50000 FOOD ACCESS; FARM STAND FOOD GATHERERS 1 CARROT WAY ANN ARBOR MI 48105 382853858 501(C)(3) 10000 LOCAL FOOD BANKS GLEANERS COMMUNITY FOOD BANK 5924 STERLING DR HOWELL MI 48843 382156255 501(C)(3) 10000 LOCAL FOOD BANKS GREATER BRIGHTON AREA CHAMBER OF COMMERCE 218 E GRAND RIVER BRIGHTON MI 48116 382016858 501(C)(6) 10000 CHAMBER SPONSOR GROWING HOPE INC 922 W MICHIGAN AVE YPSILANTI MI 48197 743091845 501(C)(3) 20000 FARMERS MARKET GUEST HOUSE 1601 JOSLYN RD LAKE ORION MI 48360 381557146 501(C)(3) 15000 57TH ANNUAL DETROIT BISHOP'S DINNER SPONSORSHIP MAKE A WISH MICHIGAN 7600 GRAND RIVER AVE STE 175 BRIGHTON MI 48114 382505812 501(C)(3) 25000 WAM SPONSORSHIP WASHTENAW HEALTH PLAN 555 TOWNER ST YPSILANTI MI 48198 020585175 501(C)(3) 107000 BRIDGE FUNDING TO HELP SERVE ADULTS CONSUMERS WITH SEVERE MENTAL ILLNESS WASHTENAW COUNTY-COUNTY OF THE SHERIFF PO BOX 8645 ANN ARBOR MI 48107 COUNTY GOVERNMENT 40000 OUTREACH TEAM HEALTH LEADERS WASHTENAW COUNTY PUBLIC HEALTH DEPARTMENT 555 TOWNER ST STE 1 YPSILANTI MI 48198 COUNTY GOVERNMENT 152590 HAAB SIGNAGE FUNDING CHELSEA SCHOOL DISTRICT 500 WASHINGTON ST CHELSEA MI 48118 501(C)(3) 20000 SRSLY COALITION CONTRIBUTION CHELSEA SENIOR CENTER 512 WASHINGTON ST CHELSEA MI 48118 912187162 501(C)(3) 11500 GRASS LAKE SENIOR CTR TRANSPORTATION ASSISTANCE COMMUNITY RESOURCE CENTER 410 CITY RD MANCHESTER MI 48158 382792399 501(C)(3) 40000 ASSISTANCE FOR FAMILIES IN NEED DEXTER SENIOR CENTER 7720 ANN ARBOR ST DEXTER MI 48130 237144195 501(C)(3) 5750 DEXTER SENIOR CENTER TRANSPORTATION ASSISTANCE FAITH IN ACTION 603 S MAIN ST CHELSEA MI 48118 382463646 501(C)(3) 35000 COMMUNITY SUPPORT GRASS LAKE MINISTERIAL ASSOC 4520 WOLF LAKE RD GRASS LAKE MI 49240 501(C)(3) 15000 TO SUPPORT BASIC NEED-HOUSING AND ACCESS TO MENTAL HEALTH SERVICES. LEGACY LAND CONSERVANCY 1100 N MAIN ST STE 203 ANN ARBOR MI 48104 382899980 501(C)(3) 45000 HURON WATERLOO PATHWAYS INITIATIVE MANCHESTER COMMUNITY SCHOOLS 410 CITY RD MANCHESTER MI 48158 501(C)(3) 15000 SUPPORT CAPACITY BUILDING ST LOUIS CENTER 16195 W OLD US HIGHWAY 12 CHELSEA MI 48118 386038121 501(C)(3) 110000 SUPPORT FITNESS AND HEALTH PROGRAMS; TAKE ROOT GARDENING; INNER RHYTHM MUSIC THERAPY STOCKBRIDGE COMMUNITY OUTREACH ASSOC 360 CHERRY ST PO BOX 682 STOCKBRIDGE MI 49285 382609279 501(C)(3) 50000 ASSISTANCE FOR FAMILIES IN NEED AMERICAN CANCER SOCIETY INC 129 JEFFERSON SE GRAND RAPIDS MI 49503 131788491 501(C)(3) 23500 SPONSORSHIP AMERICAN DIABETES ASSOCIATION 1550 E BELTLINE SE SUITE 250 GRAND RAPIDS MI 49506 131623888 501(C)(3) 7000 SPONSORSHIP MARCH OF DIMES 3351 CLAYSTONE SE SUITE G20 GRAND RAPIDS MI 49546 131846366 501(C)(3) 5000 SPONSORSHIP PINE REST FOUNDATION PO BOX 165 GRAND RAPIDS MI 49501 381676540 501(C)(3) 5000 SPONSORSHIP UNIVERSITY OF MICHIGAN 1415 WASHINGTON HEIGHTS ANN ARBOR MI 48109 386006309 501(C)(3) 27500 SPONSORSHIP GRAND VALLEY STATE UNIVERSITY 401 WEST FULTON ST GRAND RAPIDS MI 49504 381684280 501(C)(3) 11000 SPONSORSHIP HOSPICE OF MICHIGAN 989 SPAULDING SE ADA MI 49301 382255529 501(C)(3) 5000 SPONSORSHIP ALIVE ON THE LAKESHORE 2735 E APPLE MUSKEGON MI 49442 383605723 501(C)(3) 5000 SPONSORSHIP MUSKEGON RESCUE MISSION 1715 PECK STREET MUSKEGON MI 49441 383525239 501(C)(3) 5500 SPONSORSHIP WEST MICHIGAN SYMPHONY 360 W WESTERN AVE STE 200 MUSKEGON MI 49440 386092131 501(C)(3) 10000 SPONSORSHIP GRAND RAPIDS SYMPHONY 300 OTTAWA NW GRAND RAPIDS MI 49503 386005447 501(C)(3) 12000 SPONSORSHIP NATIONAL MULTIPLE SCLEROSIS 21311 CIVIC CENTER DR SOUTHFIELD MI 48076 381410476 501(C)(3) 7500 SPONSORSHIP DIOCESE OF GRAND RAPIDS 360 DIVISION AVE S GRAND RAPIDS MI 49503 381368746 501(C)(3) 10000 SPONSORSHIP MARY FREE BED FOUNDATION 235 WEALTHY SE GRAND RAPIDS MI 49503 461164285 501(C)(3) 5000 SPONSORSHIP MUSKEGON LAKESHORE CHAMBER OF COMMERCE FOUNDATION 380 WESTERN SUITE 202 MUSKEGON MI 49440 383634571 501(C)(3) 20000 SPONSORSHIP GRAND RAPIDS AFRICAN AMERICAN HEALTH INSTITUTE 301 MICHIGAN ST NE GRAND RAPIDS MI 49503 061658200 501(C)(3) 5000 SPONSORSHIP GRAND RAPIDS URBAN LEAGUE 745 EASTERM SE GRAND RAPIDS MI 49503 381359259 501(C)(3) 5000 SPONSORSHIP HEALTHY HOMES COALITION OF WEST MI 1545 BUCHANAN AVE GRAND RAPIDS MI 49507 205326650 501(C)(3) 340265 SPONSORSHIP FOREST HILLS PUBLIC SCHOOLS 660 FOREST HILLS AVE SE GRAND RAPIDS MI 49546 382568754 501(C)(3) 5000 SPONSORSHIP WEST MICHIGAN HISPANIC CHAMBER OF COMMERCE 1167 MADISON AVE SE GRAND RAPIDS MI 49507 201483629 501(C)(6) 5000 SPONSORSHIP NATIONAL KIDNEY FOUNDATION 260 LEONARD ST NW GRAND RAPIDS MI 49504 381559941 501(C)(3) 25000 SPONSORSHIP OSTOEPATHIC FOUNDATION OF WEST MICHIGAN 800 E ELLIS ROAD NORTON SHORES MI 49441 382841014 501(C)(3) 10000 SPONSORSHIP PINK TIE GUYS 18068 WOODLAND TRAIL SPRING LAKE MI 49456 452627971 501(C)(3) 5000 SPONSORSHIP SAN JUAN DIEGO ACADEMY 1650 GODREY SW WYOMING MI 49509 501(C)(3) 10000 SPONSORSHIP WV FOUNDATION PO BOX 33 GRAND HAVEN MI 49417 453697006 501(C)(3) 10000 SPONSORSHIP MUSKEGON YMCA PO BOX 1667 MUSKEGON MI 49440 382000172 501(C)(3) 25000 SPONSORSHIP GRAND RAPIDS RED PROJECT 343 ATLAS SE GRAND RAPIDS MI 49506 383414580 501(C)(3) 5000 SPONSORSHIP WEST MICHIGAN ASIAN AMERICAN ASSO PO BOX 230432 GRAND RAPIDS MI 49523 861091018 501(C)(3) 5000 SPONSORSHIP SUSAN G KOMEN PO BOX 4368 LANSING MI 48826 752844631 501(C)(3) 12500 SPONSORSHIP MUSKEGON HEIGHTS FESTIVAL IN THE PARK PO BOX 4503 MUSKEGON HEIGHTS MI 49444 911932918 501(C)(3) 5000 SPONSORSHIP NY UNIV OF NURSING DBA NURSES IMPROVING CARE FOR ELDERS (NICHE) 250 PARK AVENUE SOUTH NEW YORK NY 10003 135562308 501(C)(3) 5000 SPONSORSHIP KENT COUNTY MEDICAL SOCIETY ALLIANCE FOUNDATION 5534 ALHAMBRA DR SE GRAND RAPIDS MI 49503 383336422 501(C)(3) 5000 SPONSORSHIP LOWELL AREA SCHOOLS 300 HIGH STREET LOWELL MI 49331 383251960 501(C)(3) 6000 SPONSORSHIP GRAND RAPIDS COMMUNITY COLLEGE 143 BOSTWICK SE GRAND RAPIDS MI 49503 386100380 501(C)(3) 5050 SPONSORSHIP WEST MICHIGAN CENTER FOR ARTS & TECH 98 E FULTON SUITE 02 GRAND RAPIDS MI 49503 743120354 501(C)(3) 6000 SUPPORT FOR THE NEEDY MEL TROTTER MINISTRIES 225 COMMERCE AVE SW GRAND RAPIDS MI 49503 381410467 501(C)(3) 100000 SPONSORSHIP FELICIAN SISTERS OF NORTH AMERICA 871 MERCER ROAD BEAVER FALLS PA 15010 501(C)(3) 5000 WORLD YOUTH DAY SCOLARSHIP SPONSORSHIP TRINITY COMM SVCS & EDU FND DBA ST FRANICS CABRINI CLINIC 1234 PORTER ST DETROIT MI 48226 383129349 501(C)(3) 30000 SUPPORT HOPE CLINIC 33608 PALMER RD WESTLAND MI 48186 382469007 501(C)(3) 15000 HOPE ON THE HORIZON - HEALTHY YOU LIFE CLASSES LIVONIA PUBLIC SCHOOLS EDUCATION FOUNDATION 15125 FARMINGTON ROAD LIVONIA MI 48154 201085968 501(C)(3) 7500 2016 BACK TO SCHOOL PARTY AND ANNUAL FALL LUNCHEON OAKLAND UNIVERSITY 2200 NORTH SQUIRREL ROAD ROCHESTER MI 48309 381714400 501(C)(3) 6160 SPONSORSHIP WELLNESS PLAN 7700 SECOND AVE DETROIT MI 48202 382008890 501(C)(3) 199617 COMMUNITY BENEFIT GRANT THE BLIGHT AUTHORITY 1 N SAGINAW ST PONTIAC MI 48342 461898090 501(C)(3) 30000 SPONSORSHIP CAMP CAVELL CONSERVANCY 3335 LAKESHORE LEXINGTON MI 48450 462336793 501(C)(3) 5000 SPONSORSHIP THE COMMUNITY HOUSE 380 SOUTH BATES BIRMINGHAM MI 48009 381256004 501(C)(3) 10000 SPONSORSHIP ENCORE CENTER FOR THE PERFORMING ARTS 79 OAKLAND AVENUE PONTIAC MI 48342 464811446 501(C)(3) 25000 SPONSORSHIP FREEDOM ROAD TRANSPORTATION 2633 S LAPEER ROAD ORION MI 48360 352212929 501(C)(3) 50000 COMMUNITY BENEFIT GRANT HOPE 249 BALDWIN AVENUE PONTIAC MI 48342 383571989 501(C)(3) 60000 SPONSORSHIP COMMON GROUND 1410 SOUTH TELEGRAPH RD BLOOMFIELD HILLS MI 48302 381997712 501(C)(3) 60000 COMMUNITY BENEFIT GRANT 73 4 HELEN V BURG COMMITMENT TO NURSING SCHOLARSHIP 6 6000 FAIR MARKET VALUE SCHOLARSHIPS JULIE MACDONALD NURSING SCHOLARSHIP 1 2000 FAIR MARKET VALUE SCHOLARSHIPS TUOMY NURSING SCHOLARSHIP AWARD 3 3000 FAIR MARKET VALUE SCHOLARSHIPS WILL JOHNSON SCHOLARSHIP 4 10000 FAIR MARKET VALUE SCHOLARSHIPS PART I, LINE 2: DONATIONS MADE BY TRINITY HEALTH - MICHIGAN TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 1 1 0 0 0 0 0 0 0 ROBERT CASALOU PRES & CEO AS OF 1/16; SE MI REG CEO 0 574601 0 263752 0 172286 0 11925 0 28986 0 1051550 0 25287 ROGER SPOELMAN PRES & CEO THR 12/15;WEST MI REG CEO 0 581891 0 258109 0 321340 0 24988 0 25275 0 1211603 0 152962 BRUCE OLSON MD DIRECTOR THROUGH 12/15 0 332373 0 0 0 4436 0 20891 0 18152 0 375852 0 0 TONYA WELLS DIRECTOR AS OF 1/16 0 190449 0 54947 0 944 0 14776 0 23917 0 285033 0 0 CAROL TARNOWSKY SECR THR 12/15; ASST SECR AS OF 1/16 0 256666 0 71415 0 1898 0 15900 0 4343 0 350222 0 0 SALLY GUINDI ASST SECR THR 12/15; SECR AS OF 1/16 0 276528 0 79181 0 2125 0 22981 0 25080 0 405895 0 0 MICHAEL GUSHO SE MI REG CFO TREAS THR 12/15; ASST TREAS AT 1/16 0 352100 0 91799 0 854 0 31929 0 21860 0 498542 0 0 GARY ALLORE WEST MI REG CFO ASST TREAS THR 12/15; TREAS AT 1/16 0 310898 0 82897 0 742 0 11925 0 22222 0 428684 0 0 JACK WEINER CEO ST. JOSEPH MERCY OAKLAND 0 456259 0 211739 0 444394 0 15900 0 39039 0 1167331 0 0 DAVID SPIVEY CEO ST. MARY MERCY LIVONIA 0 407000 0 188573 0 145041 0 29275 0 25534 0 795423 0 28860 BILL MANNS CEO MERCY HEALTH ST. MARY'S 0 392987 0 182017 0 110714 0 8145 0 26616 0 720479 0 0 NANCY GRAEBNER CEO ST. JOSEPH MERCY CHELSEA 0 299962 0 137637 0 93175 0 16937 0 14066 0 561777 0 0 REBEKAH SMITH CEO ST. JOSEPH MERCY PORT HURON 0 182417 0 170195 0 151459 0 333298 0 3641 0 841010 0 0 ROBIN DAMSCHRODER COO ST JOS MERCY ANN ARBOR THR 11/15 0 283376 0 82876 0 31132 0 147360 0 20488 0 565232 0 0 MIKE GRISDELA CFO/ VP FINANCE WEST MARKET 0 257218 0 56786 0 597 0 8950 0 23204 0 346755 0 0 SHANNON STRIEBICH COO SE MI REGION, ST JOSEPH PH & OAK 0 245113 0 65525 0 244 0 15900 0 24083 0 350865 0 0 MICHAEL SAMYN CFO ST MARY MERCY & ST JOE MERCY OAK 0 245846 0 64214 0 555 0 15900 0 20474 0 346989 0 0 DAVID BROOKS CEO ST. JOSEPH MERCY AA AS OF 8/15 0 213660 0 50000 0 5043 0 43085 0 8196 0 319984 0 0 DANIEL GREEN VP FIN MERCY HLTH ST MARY'S AT 7/15 195500 0 20000 0 484 0 12748 0 18121 0 246853 0 0 0 CHRISTOPHER FULKS CFO ST. JOSEPH MERCY PORT HURON 162580 0 0 0 0 0 4871 0 22044 0 189495 0 0 0 BRYNT ELLIS COO ST. JOSEPH MERCY THROUGH 3/16 136943 0 22333 0 65 0 0 0 4068 0 163409 0 0 0 ROSALIE TOCCO-BRADLEY CMO ST JOS MERCY ANN ARBOR, LIVINGS. 0 408954 0 59800 0 2094 0 11925 0 22113 0 504886 0 0 RANDALL T FORSCH CMO ST. JOSEPH MERCY CHELSEA 0 139834 0 39513 0 482 0 0 0 662 0 180491 0 0 PETER DEWS III CMO ST. MARY MERCY LIVONIA 0 302848 0 78366 0 1355 0 11925 0 22443 0 416937 0 0 MICHAEL K SMITH CMO ST. JOSEPH MERCY OAKLAND 0 317209 0 78457 0 2193 0 11925 0 20291 0 430075 0 0 DAVID BAUMGARTNER CMO MERCY HEALTH ST. MARY'S 0 369846 0 17511 0 5184 0 21422 0 7542 0 421505 0 0 KRISTOPHER AALDERINK ORTHOPEDIC SURGEON (SJMHS) 821346 0 140698 0 842 0 11653 0 24185 0 998724 0 0 0 GEORGE GIBSON ORTHOPEDIC SURGEON (SJMHS) 804242 0 102049 0 836 0 11925 0 26524 0 945576 0 0 0 TALLAL ZENI ORTHOPEDIC SURGEON (SMM LIVONIA) 569207 0 184188 0 532 0 11925 0 19353 0 785205 0 0 0 CHARLES SCHWARTZ CARDIOTHORACIC SURGEON (OAKLAND) 743898 0 0 0 1262 0 11925 0 20990 0 778075 0 0 0 CREG CARPENTER ORTHOPEDIC SURGEON (CHELSEA HOSP) 650897 0 88075 0 4024 0 15900 0 18000 0 776896 0 0 0 BARBARA HERTZLER FORMER KEY EMPLOYEE; EVP REG INT. 0 328940 0 87799 0 4364 0 19875 0 20658 0 461636 0 0 STEVE EAVENSON FMR KEY EMP;CFO MERCY HLTH ST. MARY' 0 159794 0 60615 0 1920 0 10038 0 11117 0 243484 0 0 JAMES BOSSCHER FORMER OFFICER 0 0 0 37892 0 75822 0 1137 0 0 0 114851 0 0 MARIANNE CUNNINGHAM FORMER OFFICER;VP DEBT MGR/TREAS SVC 0 195820 0 55857 0 1606 0 15010 0 22158 0 290451 0 0 AGNES HAGERTY FORMER OFFICER; DEP GENERAL COUNSEL 0 405473 0 159574 0 279309 0 34306 0 21273 0 899935 0 0 BENJAMIN CARTER FORMER OFFICER; TRINITY EVP, CFO 0 798221 0 356711 0 355398 0 11925 0 35541 0 1557796 0 129972 CYNTHIA CLEMENCE FMR OFFCR; SVP FIN OPS, BUDGET & CAP 0 368917 0 145900 0 79066 0 30801 0 25643 0 650327 0 0 JENNIFER BARNETT FORMER OFFICER 0 0 0 0 0 702011 0 7800 0 16184 0 725995 0 565943 PAUL NEUMANN FMR OFFCR; TH EVP, CHIEF LEGAL OFFCR 0 608088 0 268674 0 355238 0 11925 0 29961 0 1273886 0 128891 RICHARD GILFILLAN FORMER OFFICER; TH PRESIDENT & CEO 0 1428965 0 877072 0 405410 0 11925 0 33476 0 2756848 0 0 KEDRICK ADKINS FORMER KEY EMPLOYEE 0 0 0 0 0 768621 0 0 0 141 0 768762 0 767689 J RICHARD O'CONNELL FMR KEY EMPLOYEE; TH EVP EAST GROUP 0 859386 0 383634 0 315130 0 11925 0 35621 0 1605696 0 39142 CHARLES HOFFMAN FORMER KEY EMPLOYEE 0 0 0 0 0 243047 0 0 0 13205 0 256252 0 248832 DEBORAH ARMSTRONG FMR KEY EMP; THHS INT CFO THR 1/16 0 236750 0 0 0 0 0 10204 0 0 0 246954 0 0 PHILIP MCCORKLE FORMER KEY EMPLOYEE; CONSULTANT 0 295298 0 0 0 6180 0 15900 0 17845 0 335223 0 0 GARRY FAJA FORMER KEY EMPLOYEE; CONSULTANT 0 101141 0 139047 0 154078 0 16525 0 561 0 411352 0 0 STEPHANIE RIEMER-MATUZAK FORMER KEY EMPLOYEE 0 124019 0 58419 0 83583 0 31892 0 13513 0 311426 0 18392 CLAUDE LAUDERBACH FORMER KEY EMPLOYEE 0 129105 0 62947 0 119034 0 172252 0 7952 0 491290 0 0 MARY NEFF FORMER KEY EMPLOYEE; VP LABOR & CLIN 0 203838 0 39454 0 11782 0 23006 0 9489 0 287569 0 0 JACQUELINE PRIMEAU FORMER KEY EMPLOYEE; TH VP, M&A 0 301121 0 0 0 1146 0 21398 0 9109 0 332774 0 0 KIRSTEN KORTH-WHITE FORMER KEY EMPLOYEE 0 89465 0 24401 0 77 0 7108 0 13281 0 134332 0 0 KATHLEEN O'CONNOR FORMER KEY EMP; DIR DECISION SUPPORT 30105 230117 0 8565 197 1519 0 20321 1694 13884 31996 274406 0 0 PART I, LINE 3 TRINITY HEALTH - MICHIGAN (TH-MI) IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. TH-MI'S HOSPITAL CEO'S ARE PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF TH-MI'S CEO'S: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2015. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $532,835 JENNIFER BARNETT - $565,943 ROBIN DAMSCHRODER - $30,665 CHARLES HOFFMAN - $248,832 CLAUDE LAUDERBACH - $117,518 REBEKAH SMITH - $79,618 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNTS, WHICH WERE UNPAID AS OF 12/31/15: ROBIN DAMSCHRODER - $135,435 (PAID IN 2016) CLAUDE LAUDERBACH - $132,805 (PAID IN 2016) REBEKAH SMITH - $313,438 ($262,038 PAID IN 2016 AND $51,400 TO BE PAID IN 2017) THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2015, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2015. THE FOLLOWING PAYOUTS FOR 2015 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $234,854 JENNIFER BARNETT - $135,880 JAMES BOSSCHER - $75,822 BENJAMIN CARTER - $194,694 ROBERT CASALOU - $127,880 CYNTHIA CLEMENCE - $49,296 GARRY FAJA - $151,893 RICHARD GILFILLAN, MD - $358,530 NANCY GRAEBNER - $76,892 AGNES HAGERTY - $97,266 BILL MANNS - $95,620 PAUL NEUMANN - $143,799 J. RICHARD O'CONNELL - $207,673 STEPHANIE RIEMER-MATUZAK - $57,336 REBEKAH SMITH - $59,933 DAVID SPIVEY - $99,623 ROGER SPOELMAN - $140,561 JACK WEINER - $102,313 THE FOLLOWING ACCRUAL FOR 2015 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: DAVID BROOKS - $40,833 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION OR RETENTION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($265,000 FOR 2015). THE FOLLOWING PAYOUTS FOR 2015 FOR THESE PLANS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: BENJAMIN CARTER - $135,796 ROBERT CASALOU - $25,287 CYNTHIA CLEMENCE - $14,249 PAUL NEUMANN - $136,786 J. RICHARD O'CONNELL - $39,142 STEPHANIE RIEMER-MATUZAK - $18,392 DAVID SPIVEY - $28,860 ROGER SPOELMAN - $158,434 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. KATHRYN TUNE FAMILY MEMBER OF BARBARA HERTZLER, KEY EMPLOYEE 48247 EMPLOYMENT ARRANGEMENT 0 RYAN SMITH FAMILY MEMBER OF REBEKAH SMITH, KEY EMPLOYEE 45615 EMPLOYMENT ARRANGEMENT 0 JANEL CARTER FAMILY MEMBER OF BENJAMIN CARTER, FORMER OFFICER 11926 EMPLOYMENT ARRANGEMENT 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 690338 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 637310 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 3436618 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 192081 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 458805 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 216985 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 947249 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 114617 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 145302 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 6498877 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2737366 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 106776 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 720792 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 111491 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 111068 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 588180 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 955997 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 646388 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 311026 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 564529 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 770913 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 1456214 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 727300 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 251712 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 1715545 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 141375 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 598633 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2783432 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 512433 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 257955 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 188011 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 964190 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 575777 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 112967 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 203881 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 199479 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 139600 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 856800 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 X 7 144779 DONOR PROVIDED VALUE X 705 DONOR PROVIDED VALUE X 8066 DONOR PROVIDED VALUE X 7 282568 MEDIAN VALUE - TSFR DATE X 24 8650 DONOR PROVIDED VALUE X 26 6573 DONOR PROVIDED VALUE X 3 8700 DONOR PROVIDED VALUE X MISCELLANEOUS 258 131481 DONOR PROVIDED VALUE 0 0 1 1 PART I, LINE 32B: SPECIAL EVENT COMMITTEE VOLUNTEERS SOLICIT NON-CASH CONTRIBUTIONS FROM LOCAL BUSINESSES. THEY SOLICIT ITEMS TO BE USED DURING THE SPECIAL EVENT, SUCH AS FOOD, PLUS ITEMS TO BE SOLD AT THE EVENT AUCTION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF TH-MI IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF TH-MI. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF TH-MI. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR TH-MI IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS ARE REVIEWED BY THE EXECUTIVE COMMITTE OF THE REGIONAL BOARDS OF TH-MI. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C TH-MI HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF TH-MI, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF TH-MI AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF TH-MI (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO TH-MI OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF TH-MI (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF TH-MI. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF TH-MI IS ESTABLISHED AND PAID BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND CFO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO'S AND CFO'S OF TH-MI ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 TH-MI IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, TH-MI INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. TH-MI'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A: SR. CATHERINE DECLERCQ IS A MEMBER OF THE ORDER OF ADRIAN DOMINICAN SISTERS. HAVING TAKEN A VOW OF POVERTY, SR. CATHERINE DECLERCQ DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED TO TH-MI EXCEPT FOR INSURANCE BENEFITS OF $6,573. INSTEAD, A TOTAL OF $613,798 WAS PAID BY TH-MI DIRECTLY TO THE ORDER OF ADRIAN DOMINICAN SISTERS FOR SR. CATHERINE DECLERCQ'S SERVICES. FORM 990, PART VII, SECTION A: SR. MARY PERSICO, IHM IS A MEMBER OF THE SISTERS, SERVANTS OF THE IMMACULATE HEART OF MARY. HAVING TAKEN A VOW OF POVERTY, SR. MARY DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED AS EXECUTIVE VICE PRESIDENT MISSION INTEGRATION TO TRINITY HEALTH, EXCEPT FOR INSURANCE BENEFITS OF $12,429. INSTEAD, A TOTAL OF $948,956 WAS PAID BY TRINITY HEALTH DIRECTLY TO THE CONGREGATION OF THE SISTERS, SERVANTS OF THE IMMACULATE HEART OF MARY. FOR SR. MARY'S SERVICES. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO AFFILIATES -80,771,683. CHANGE IN DEFERRED RETIREMENT COSTS -2,364,933. LOSS ON DISPOSAL OF DISCONTINUED OPERATIONS -9,984,111. OTHER TRANSACTIONS -2,441,559. PARTNERSHIP EQUITY ACTIVITY 141,193. NET ASSETS RELEASED FROM RESTRICTIONS 205,208. EQUITY GAIN IN UNCONSOLIDATED AFFILIATES 2,879,424. FORM 990, PART XII, LINE 2: TH-MI'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY16 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, DOING BUSINESS AS NAMES: MERCY HEALTH PHARMACY SOLUTIONS, SAINT MARY'S LTC PHARMACY, CHELSEA PROFESSIONAL SERVICES, SJMO ROCHESTER HILLS OB/GYN, SAINT JOSEPH MERCY HEALTH SYSTEM CENTER FOR BEHAVORIAL MEDICINE, ST. MARY MERCY OUTPATIENT PSYCHIATRIC SERVICES, ST. MARY MERCY ONCOLOGY PRACTICE, SPARTA FAMILY HEALTH CENTER, SAINT MARY'S ADVANCED SPECIALTY CARE, HEARTSIDE HEALTH CLINIC, ADVANCED LAPAROSCOPIC SURGICAL ASSOCIATES (ASLA), MICHIGAN BARIATRIC INSTITUTE (MBI), MICHIGAN HEART, MICHIGAN STROKE NETWORK, MICHIGAN STROKE NETWORK REGISTRY, MERCY HEALTH SERVICES, ST. MARY MERCY HOSPITAL, MERCY ADVANTAGE, MICHIGAN CANCER INSTITUTE, SAINT MARY'S FAMILY PHARMACY - ECS, ST. MARY MERCY WOUND CARE CENTER, MERCY MEDICAL CENTER - NOVI, MERCY PRIMARY CARE CENTER - DETROIT PHARMACY, SAINT MARY'S MERCY WOUND CARE CENTER, MERCY PRIMARY CARE CENTER - DETROIT, MERCY NORTH OUTPATIENT PHARMACY, THE SHOPPE AT SAINT MARY'S, ST. JOE'S MEDICAL GROUP, ST. JOSEPH MERCY HOSPITAL - SMHC, SRSLY, CHELSEA COMMUNITY HOSPITAL CHILDREN'S CENTER, MERCY OUTPATIENT PHARMACY, MERCY HOSPITAL OUTPATIENT PHARMACY, CHELSEA COMMUNITY HOSPITAL, CHELSEA COMMUNITY HOSPITAL, A MEMBER OF THE SAINT JOSEPH MERCYHEALTH SYSTEM, WOMEN'S HEALTH CENTER, WHITE OAK INN, CHELSEACARE PHARMACY, DEXTER INTERNAL MEDICINE AND PEDIATRICS, CONFIDENTIAL ASSISTANCE AND REFERRAL FOR EMPLOYEES, CARE (CONFIDENTIAL ASSISTANCE AND REFERRAL FOR EMPLOYEES), FAMILY MEDICINE OF STOCKBRIDGE, CHELSEACARE, SPORTX, CHELSEACARE HOME HEALTH, CHELSEA ORTHOPEDIC SPECIALISTS, ANN ARBOR HOME INFUSION PHARMACY, ST. JOSEPH MERCY OAKLAND URGENT CARE-BIRMINGHAM, MERCY SURGERY CARE NETWORK, MERCY PATHOLOGY, ST. JOSEPH MERCY - BRIGHTON, SJMHS LIVINGSTON ORTHOPEDIC SURGICAL GROUP, SJMHS SPECIALTY PHYSICIANS, MERCY SURGICAL CARE, SAINT MARY'S HEALTH CARE, PROFESSIONAL FINANCIAL SERVICES, SAINT MARY'S HEALTH CARE, SJMHS ORTHOPEDIC SERVICES, SAINT MARY'S FAMILY PHARMACY-CATHEDRAL SQUARE, SAINT MARY'S FAMILY PHARMACY-WEGE CENTER, SAINT MARY'S FAMILY PHARMACY-SOUTHWEST, SAINT MARY'S MERCY MEDICAL CENTER, SAINT MARY'S MERCY HOSPITAL, SAINT MARY'S MERCY WEGE CENTER, HEALTH EXPLORATION STATION, MUSKEGON GENERAL HOSPITAL SAINT MARYS'S FAMILY PHARMACY WEGE CENTER FOR HEALTH AND LEARNING, SAINT JOSEPH MERCY HEALTH NETWORK, SAINT JOSEPH MERCY HEALTH SYSTEM , CLINICA SANTA MARIA, SISTERS OF MERCY HEALTH CORPORATION, WEST MICHIGAN REGIONAL HEART AND VASCULAR INSTITUTE, MERCY MEDICAL GROUP, WESTSHORE FAMILY MEDICINE, SAINT MARY'S FAMILY PHARMACY - LTC, MERCY HEALTH SERVICES NORTH, EVANGELICAL DEACONESS HOSPITAL, ST. MARY'S HOSPITAL, GRAND RAPIDS, ST. JOSEPH MERCY HOSPITAL, PONTIAC, SJMH MEDICAL PRACTICE, SJMH URGENT CARES, ST. JOSEPHMERCY OAKLAND - IMAGE ENHANCEMENT CENTER, THE BOUTIQUE AT MERCY HEALTH, LACKS CANCER CENTER, THE BOUTIQUE AT MERCY HEALTH, MERCY HEALTH PHARMACY-ROCKFORD , MERCY HEALTH DENTAL CLINIC , ST. JOSEPH MERCY PORT HURTON, MERCY ENDOCRINOLOGY, CLINXUS, MERCY HEALTH CLINXUS, ST. MARY MERCY - CANCER CENTER, ST. JOSEPH MERCY OAKLAND-CANCER CENTER, ST. JOSEPH MERCY ANN ARBOR-CANCER CENTER, ST. JOSEPH MERCY LIVINGSTON-CANCER CENTER, ST. JOSEPH MERCY BRIGHTON-CANCER CENTER, ST. JOSEPH MERCY CHELSEA-CANCER CENTER, ST. JOSEPH MERCY CANTON-CANCER CENTER, ST. JOSEPH MERCY PORT HURON - CANCER CENTER, ST. JOSEPH MERCY CHELSEA, MERCY FAMILY CARE, MERCY SURGERY CARE, MERCY SPECIALTY CARE , MERCY HEALTH-MUSKEGON CMH PHARMACY, ST. MARY MERCY OUTPATIENT PHARMACY, MERCY PHYSICIAN PARTNERS, ST. MARY MERCY PHYSICIAN PRACTICES, ST. MARY MERCY HOSPITAL PROFESSIONAL, MERCY HOSPITAL GRAYLING D/B/A MERCY HEALTH CANCER CENTER, MERCY CADILLAC ANESTHESIA, ST. JOSEPH MERCY SALINE HEALTH CENTER, ST. JOSEPH MERCY ANN ARBOR, ST. JOSEPH MERCY CANTON, ST. JOSEPH MERCY LIVINGSTON, ST. JOSEPH MERCY SALINE, ST. MARY MERCY LIVONIA, MERCY HEALTH - GRAND RAPIDS, MERCY HEALTH PHARMACY - SOUTHWEST, MERCY HEALTH PHARMACY - HOME INFUSION, MERCY HEALTH PHARMACY - LONG TERM CARE, MERCY HEALTH PHARMACY - CATHEDRAL SQUARE, MERCY HEALTH SAINT MARY'S, MERCY HEALTH PHARMACY - WEGE CENTER, MERCY HEALTH ROCKFORD CAMPUS, MERCY HEALTH SOUTHWEST CAMPUS, INSPIRIT CANCER SUPPORT SERVICES, MERCY CADILLAC PHYSICIAN NETWORK, MERCY PHYSICIAN NETWORK CADILLAC, MERCY PHYSICIAN NETWORK, MERCY CANCER CENTER, MERCY CADILLAC CANCER CENTER, ST. JOSEPH MERCY PORT HURON, MERCY PROFESSIONAL SERVCES, HEALTHFIRST MEDICAL CENTER, BALD MOUNTAIN DIAGNOSTIC IMAGING, MERCY OB/GYN PARTNERS, CADILLAC OCCUPATIONAL MEDICINE, MCAULEY HEALTH CENTER, PROFESSIONAL FINANCIAL SERVICES, RICHARD J. LACKS CANCER CENTER, BROWNING CLAYTOR HEALTH CENTER, SOPHIA'S HOUSE, WESTSIDE OBSTETRICS AND GYNECOLOGY, SAINT JOSEPH MERCY CENTER FOR ADVANCED MEDICINE AND SURGERY, SAINT JOSEPH MERCY CANTON HEALTH CENTER, CANTON HEALTH CENTER, CANTON CENTER FOR ADVANCED MEDICINE AND SURGERY, SAINT JOSEPH MERCY PHARMACY - HOWELL, SAINT JOSEPH MERCY PHARMACY - TOWERS, SAINT JOSEPH MERCY PHARMACY - REICHERT, SAINT JOSEPH MERCY PHARMACY - SALINE, ST. JOSEPH MERCY OAKLAND, SALINE COMMUNITY HOSPITAL, SAINT MARY'S HEALTH SERVICES, GRAND RAPIDS, LIVINGSTON COMMUNITY HOSPICE, MERCY HOSPITAL, MERCY HOSPITAL, CADILLAC, MERCY HOSPITAL, GRAYLING, MERCY HOSPITAL, MUSKEGON , MERCY HOSPITAL, PORT HURON, ST JOSEPH MERCY HOSPITAL, PONTIAC, SAMARITAN HEALTH CENTER, DETROIT, MERCY GENERAL HEALTH PARTNERS, SAINT JOSEPH MERCY LIVINGSTON HOME CARE, SAINT JOSEPH MERCY LIVINGSTON HOSPITAL, ST. JOSEPH MERCY HOSPITAL, ANN ARBOR, SAINT JOSEPH MERCY SALINE HOSPITAL, TRINITY INFORMATION SERVICES. 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