2016-11-15T16:52:41-06:00 2015-12-31 381357951 PLANTE & MORAN PLLC 750 Trade Centre Way Ste 300 Portage MI 49002 990 2015-01-01 451257972 THREE RIVERS HEALTH SYSTEM INC THRE 2692781145 701 S HEALTH PARKWAY THREE RIVERS MI 49093 steve andrews CFO 2692781145 2016-11-15 1 Carol LaLonde CPA P00181637 2695674500 2015 2017-02-10 21:41:12Z THREE RIVERS HEALTH STEVE ANDREWS 701 S HEALTH PARKWAY THREE RIVERS MI 49093 56542013 0 X WWW.THREERIVERSHEALTH.ORG X 2011 MI SEE SCHEDULE O. 10 8 576 85 0 0 23710 326461 51071168 56016354 26820 2585 196005 196613 51317703 56542013 0 0 0 0 23625548 25761744 0 0 0 29151442 30432014 52776990 56193758 -1459287 348255 17020110 16925787 11571073 11128495 5449037 5797292 THREE RIVERS HEALTH IS COMMITTED TO THE SUSTAINED WELL BEING OF OUR PATIENTS, FAMILIES, AND COMMUNITIES THROUGH HIGH QUALITY, LOW COST, DYNAMIC HEALTHCARE. 0 0 45829343 56016354 GENERAL ACUTE SERVICES FOR COMMUNITY INPATIENT AND OUTPATIENT SERVICES. 45829343 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 35 0 1 576 1 0 0 0 0 0 0 0 0 0 0 X 10 8 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MI X STEVEN T ANDREWS 2692739604 701 S HEALTH PARKWAY THREE RIVERS MI 49093 LARRY CLARK BOARD CHAIR 5.00 1.00 X X 0 0 0 LAURIE HINES VICE CHAIR 3.00 X X 0 0 0 DIANA DEGRAAF SECRETARY 3.00 X X 0 0 0 RAY BENDURE TREASURER 4.00 X X 0 0 0 ANDY GOLDBERGER BOARD MEMBER 3.00 X 0 0 0 DOUG MITCHELL BOARD MEMBER 3.00 X 0 0 0 JOHN TOUSE BOARD MEMBER 3.00 X 0 0 0 JENNIFER GRABER BOARD MEMBER 3.00 X 0 0 0 GLENDORA GREEN MD BOARD MEMBER 4.00 36.00 X 0 207684 7360 LINDA EVANS MD CHIEF OF STAFF 3.00 37.00 X 0 186853 33164 WILLIAM RUSSELL PRESIDENT/CEO 40.00 4.00 X 242820 0 74555 STEVE ANDREWS CHIEF FINANCIAL OFFICER 40.00 4.00 X 178526 0 61283 HOPE BAILEY VICE PRESIDENT 40.00 3.00 X 144528 0 31786 CHAD BUSH CRNA 40.00 X 225591 0 43982 BRIAN CLARK CRNA 40.00 X 189027 0 44660 RANDALL SMITH CRNA 40.00 X 151243 0 18637 LEONARD DARLING PHARMACY MANAGER 40.00 X 136917 0 27970 DOUG ZEHNER PHARMACIST 40.00 X 121024 0 27697 1389676 394537 371094 14 0 1 0 BORGESS MEDICAL CENTER 1521 GULL ROAD KALAMAZOO MI 49048 LAB, LAUNDRY, IT SERVICES 1009765 QHR 105 CONTINENTAL PLACE BRENTWOOD TN 37027 HOSPITAL MANAGEMENT 896350 REHAB CARE GROUP PO BOX 502096 ST LOUIS MO 63150 REHAB MANAGEMENT SERVICES 707147 ATHENA HEALTH 311 ARSENAL ST WATERTOWN MA 02472 CLINIC MANAGEMENT/COLLECTIONS 546080 HEALOGICS WOUND CARE SERVICES PO BOX 551187 JACKSONVILLE FL 32256 WOUND CARE MANAGEMENT 509556 20 326461 326461 NET PATIENT REVENUE 621110 55540199 55540199 OTHER PROGRAM REVENUE 621110 476155 476155 56016354 113026 0 113026 113026 113026 2585 0 2585 2585 2585 CAFETERIA/VENDING 900099 62601 62601 MISCELLANEOUS 900099 20986 20986 83587 56542013 56016354 0 199198 X 733498 293399 440099 19244047 16479728 2764319 216768 195091 21677 4131993 3718794 413199 1435438 1291894 143544 1077591 323277 754314 274934 274934 111186 22237 88949 9217 9217 23869 23869 8886326 4450542 4435784 10591 2765 7826 103513 103513 791342 791342 171613 171613 305071 305071 2257014 2257014 362315 66774 295541 MEDICAL SUPPLIES 6057151 5913845 143306 BAD DEBT EXPENSE 4005858 4005858 PHYSICIAN FEES 3645054 3645054 EQUIP RENTAL AND MAINTE 1954779 1486586 468193 384590 384590 56193758 45829343 10364415 0 1510387 1433608 3349452 3545816 891258 1044933 804500 869941 50644151 41040861 9939391 9603290 510555 414698 14567 13501 17020110 16925787 6577274 5879562 5288948 4773971 -295149 474962 11571073 11128495 X 0 0 0 0 5449037 5797292 5449037 5797292 17020110 16925787 348255 0 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 9217 9217 0 Part II-B, Line 1: A PORTION OF MHA DUES IS ALLOCATED TO LOBBYING EXPENSE. 219500 219500 20595412 15080735 5514677 1463882 1392762 71120 28349770 24567364 3782406 15587 15587 9603290 COST REPORT SETTLEMENTS PAYABLE 474962 474962 X Part X, Line 2: THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL, TRAH PROPERTIES, AND THREE RIVERS HEALTH FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. IHS AND PHO ARE DEEMED CORPORATIONS AND FILE CORPORATE TAX RETURNS WITH NO TAX DUE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGRANIZATION AND HAS CONCLUDED THAT AS OF DECEMEBER 31, 2015 AND 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMEBER 31, 2012. 1 1 X 1 X 1 X 1 1 0 0 139285 139285 0.00270 13246782 9062045 4184737 0.08020 13386067 9062045 4324022 0.08290 133818 133818 0.00260 201481 201481 0.00390 8930590 5549649 3380941 0.06480 9265889 5549649 3716240 0.07130 22651956 14611694 8040262 0.15420 1 4005856 650000 8646036 11192599 -2546563 X 1 1 1 1 THREE RIVERS HEALTH 701 S HEALTH PARKWAY Three Rivers MI 49093 1060000006 X X X THREE RIVERS HEALTH 1 0 0 1 X X X X X X X X X X 16 1 1 1 1 X WWW.THREERIVERSHEALTH.ORG X X 1 16 1 WWW.THREERIVERSHEALTH.ORG 0 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X WWW.THREERIVERSHEALTH.ORG X WWW.THREERIVERSHEALTH.ORG X WWW.THREERIVERSHEALTH.ORG X X X X X 1 X 0 X X X X 1 X 0 1 THREE RIVERS HEALTH Part V, Section B, Line 3j: THE CHNA CONTENT INCLUDED THE PROJECT OBJECTIVES, AN OVERVIEW OF THE ASSESSMENT, AS WELL AS THE FINANCIAL OPPORTUNITY SUMMARY. THE REPORT SUMMARIZED THE APPROACH AND ITS FINDINGS. IT ALSO COMPARED HOW THE COMMUNITY COMPARED TO ITS PEERS AND SUMMARIZED KEY CONCLUSIONS AND OBSERVATIONS. FINALLY, IT RANKED THE NEEDS OF THE COMMUNITY, AND IDENTIFIED AN ACTION PLAN TO HELP IMPLEMENT THE IMPROVEMENT IN COMMUNITY HEALTH OVERALL. THREE RIVERS HEALTH Part V, Section B, Line 5: INITIALLY, WE DEPLOYED A NEEDS ASSESSMENT SURVEY WITHIN THE LOCAL POPULATION FOR ANY RESIDENT TO COMPLETE. WE RECEIVED INPUT FROM 620 AREA RESIDENTS. IT WAS AN INTERNET BASED SURVEY THAT WAS PROMOTED VIA ADVERTISING AND THROUGH LOCAL CIVIC AND HEALTH ORGANIZATIONS. PRELIMINARY CONCLUSIONS WERE THEN PRESENTED TO A LOCAL GROUP OF EXPERTS WHO WERE ASKED TO VALIDATE PRIOR ASSESSMENTS AND TO ESTABLISH PRIORITY AMONG VARIOUS IDENTIFIED HEALTH AND MEDICAL ISSUES. WHEN THE FINAL ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL GROUP OF EXPERTS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. SOME OF THE OTHER LOCAL ORGANIZATIONS THAT HELPED WITH THIS PROCESS WERE STURGIS HOSPITAL, COMMUNITY MENTAL HEALTH DEPARTMENT, BRANCH HILLSDALE- ST. JOSEPH COMMUNITY HEALTH AGENCY, AND ST. JOSEPH COUNTY COMMISSION ON AGING. THREE RIVERS HEALTH Part V, Section B, Line 6a: STURGIS HOSPITAL THREE RIVERS HEALTH Part V, Section B, Line 6b: COMMUNITY MENTAL HEALTH THREE RIVERS HEALTH Part V, Section B, Line 7d: ACCESS VIA THE WEBSITE WAS THE PRIMARY MEANS, AND BY WORD OF MOUTH REPRESENTATION FORM OUR BOARD MEMBERS. THREE RIVERS HEALTH Part V, Section B, Line 11: THE HOSPITAL'S BOARD OF DIRECTORS HAS ADOPTED THE CARVER MODEL OF GOVERNANCE WHICH HELPS THE BOARD FOCUS MORE ON OUTCOMES RATHER THAN ON DAY TO DAY OPERATIONS. THIS MODEL HAS ENABLED THE BOARD TO FOCUS ON COMMUNITY HEALTH INITIATIVES EXTENSIVELY FOR THE LAST 10 YEARS. THE CHNA ONLY FURTHER EMPHASIZES THE MISSION OF THE LOCAL HOSPITAL AND ALSO THE REASON FOR THE EXISTENCE OF THE ORGANIZATION. THREE RIVERS HEALTH Part V, Section B, Line 13b: WE USED FPL GUIDELINES, WHICH INVOLVED INCOME LEVELS. THREE RIVERS HEALTH Part V, Section B, Line 24: ONLY IF THEY DID NOT PROVIDE INFORMATION. Schedule H, Part V, Section B, line 12a SECTION 501(r)(3) APPLIES TO TAXABLE YEARS BEGINNING AFTER MARCH 23, 2012. THREE RIVERS HEALTH SYSTEM, INC. HAS A DECEMBER 31 TAX YEAR END. THE FIRST YEAR THEY WERE REQUIRED TO PREPARE AND REPORT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS 2013. HAD THE ORGANIZATION COMPLETED THE CHNA IN 2013 THE SECOND CHNA WOULD HAVE BEEN DUE IN 2016. THE HOSPITAL CONDUCTED THE CHNA IN 2012 AND UPON FURTHER REVIEW THE CHNA WAS ALSO APPROVED AND MADE WIDELY AVAILABLE IN 2012. BECAUSE OF THIS, THE NEXT CHNA WOULD HAVE NEEDED TO BE COMPLETED IN 2015 (THREE YEARS LATER). THREE RIVERS HEALTH SYSTEM PREPARED THE SECOND CHNA IN 2015. HOWEVER, BELIEVING THE SECOND CHNA WAS DUE IN 2016, IN ACCORDANCE WITH THE REGULATIONS, THE BOARD APPROVED THE CHNA AND THE REPORT WAS MADE WIDELY AVAILABLE IN 2016. THE ORGANIZATIONS ACTIONS REPRESENT REASONABLE CAUSE. THREE RIVERS HEALTH SYSTEM DID NOT REALIZE THAT THE FACT THEY ADOPTED THE REGULATIONS EARLY AND COMPLETED THE CHNA IN 2012 MEANT THAT THEY WERE REQUIRED TO COMPLETE THE SECOND CHNA IN 2015. DURING 2016 THEY APPROVED AND MADE THE SECOND CHNA REPORT WIDELY AVAILABLE ON THEIR WEBSITE. THEY ARE AWARE OF THE THREE YEAR REQUIREMENT AND MISUNDERSTOOD THE DATE THE SECOND CHNA WAS DUE SINCE THEY WERE A DECEMBER YEAR END AND COMPLIED WITH THE REGULATIONS EARLIER THEN NECESSARY. THE FACT THAT THE CHNA WAS CONDUCTED IN 2015 SHOWS THAT THE CLIENT HAD EVERY INTENTION TO MEET THE REQUIREMENTS UNDER THE 501(r) REGULATIONS. THE APPROVAL AND SUBSEQUENT COMPLETION OF THE REPORTING FOLLOWING THE 2015 TAX YEAR SUPPORTS THE FACT THAT THEY BELIEVED THE SECOND REPORT FOR A CALENDAR YEAR TAX PAYER WOULD BE DUE IN 2016 WHICH IS CORRECT IF THEY HADN'T APPROVED AND MADE THE 2012 REPORT WIDELY AVAILABLE UNTIL IT WAS NECESSARY IN 2013. THE ORGANIZATIONS BEHAVIOR CONSTITUTES REASONABLE CAUSE AND THE ERROR WAS NOT INTENTIONAL OR EGREGIOUS. THE ORGANIZATION'S COMPLIANCE OFFICER NOW UNDERSTANDS THE TIMING REQUIREMENTS AND WILL CONTINUE TO COMPLETE THE CHNA EVERY THREE YEARS ACCORDINGLY. 13 1 - THREE RIVERS HEALTH INTERNAL MEDICINE 711 S HEALTH PARKWAY THREE RIVERS MI 49093 HEALTH CLINIC - INTERNAL MEDICINE, FAMILY CARE & WOMEN'S SERV 2 - Three Rivers Health Family Care 721 6TH AVENUE STE B THREE RIVERS MI 49093 RURAL HEALTH CLINIC - THREE RIVERS 3 - Center for Wound Healing 721 S HEALTH PARKWAY THREE RIVERS MI 49093 WOUND CARE 4 - Homecare and Hospice 633 S ERIE STREET THREE RIVERS MI 49093 HOSPICE CARE 5 - Three Rivers Health Family Care 601 E CHICAGO RD WHITE PIGEON MI 49099 RURAL HEALTH CLINIC - WHITE PIGEON 6 - Three Rivers Health Surgical Services 715 S HEALTH PARKWAY THREE RIVERS MI 49093 SURGICAL SERVICES 7 - Health Trac - Wellness Pavillion 501 S HEALTH PARKWAY THREE RIVERS MI 49093 WELLNESS CENTER 8 - Three Rivers Health Orthopedics 1021 HILL STREET THREE RIVERS MI 49093 ORTHOPEDICS 9 - Three Rivers Bone and Joint 1021 HILL STREET THREE RIVERS MI 49093 BONE AND JOINT FACILITY 10 - Physical Medicine and Rehab 715 S HEALTH PARKWAY THREE RIVERS MI 49093 REHABILITATION 11 - Three Rivers Health Family Care 110 EAST MAIN MARCELLUS MI 49067 HEALTH CLINIC - MARCELLUS 12 - Three Rivers Health Endocrinology 715 S HEALTH PARKWAY THREE RIVERS MI 49093 ENDOCRINOLOGY 14 - Veera Patel MD - Internal Medicine 1021 HILL ST SUITE 300 THREE RIVERS MI 49093 INTERNAL MEDICINE Part I, Line 3c: INCOME BASED CRITERIA FOLLOWED FEDERAL POVERTY GUIDELINES. Part I, Line 7: LINES 7 A THROUGH 7C ARE REPORTED USING THE COST TO CHARGE RATIO CALCULATED USING WORKSHEET 2. LINES 7E THROUGH 7G ARE REPORTED USING DIRECT COSTS FOR CLINIC OPERATIONS. A COST ACCOUNTING SYSTEM WAS USED FOR HOSPITAL OPERATIONS. Part I, Line 7g: OTHER SUBSIDIZED HEALTH SERVICES INCLUDES GROSS CLINIC COSTS OF $7,927505. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 4,005,858. Part III, Line 2: BAD DEBT EXPENSE ARE DOLLARS THAT ARE WRITTEN OFF OR RESERVED FOR PATIENTS THAT HAVE AVAILABLE RESOURCES, BUT WOULD NOT PAY FOR SERVICES. THE EXCEPTION TO THIS RULE WOULD BE CHARITY CARE ACCOUNTS THAT ARE INCLUDED IN BAD DEBT BECAUSE A LACK OF INFORMATION PROVIDED OR THE TIMING OF THE INFORMATION BEING RECEIVED. PAYMENTS ON ACCOUNTS THAT HAVE BEEN WRITTEN OFF WOULD REDUCE THE OVERALL BAD DEBT EXPENSE. DISCOUNTS ON CHARGES ARE NOT INCLUDED IN BAD DEBT EXPENSE. Part III, Line 3: SEE ABOVE FOR METHODOLOGY. WITH REGARDS TO CHARITY CARE, THE HOSPITAL ESTIMATES THAT APPROXIMATELY $650,000 OF CHARITY CARE IS INCLUDED IN BAD DEBT EXPENSE DUE TO NOT RECEIVING INFORMATION FROM PATIENTS TO HELP DETERMINE ELIGIBILITY, OR RECEIVING NOT RECEIVING THE INFORMATION IN A TIMELY MANNER, THUS WE BELIEVE THE $650,000 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. Part III, Line 4: Accounts receivable for patients, insurance companies, and governmental agencies are based on gross charges. An allowance for contractual adjustments and interim payment advances is based on expected payment rates from payors based on current reimbursement methodologies. This amount also includes amounts received as interim payments against unpaid claims by certain payors. An allowance for uncollectible accounts is established on an aggregate basis by using historical write-off rate factors applied to unpaid accounts based on aging. Loss rate factors are based on historical loss experience and adjusted for economic conditions and other trends affecting the Organization's ability to collect outstanding amounts. Uncollectible amounts are written off against the allowance for doubtful accounts in the period they are determined to be uncollectible.For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Organization records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts in the period they are determined to be uncollectible. Part III, Line 8: MEDICARE IS OUR LARGEST PAYOR, THUS PAYMENTS FOR THIS POPULATION CREATE A FINANCIAL BURDEN ON THE HOSPITAL AS PAYMENTS DO NOT COVER COSTS. MOST OF THE MEDICARE PATIENTS LIVE ON FIXED INCOMES. WE USED THE COST TO CHARGE RATIO TO DETERMINE COST. AS MEDICARE IS OUR LARGEST PAYOR, THE SHORTFALL IS IN COVERING COSTS IS EXTREME, THUS THIS WOULD SEEM TO QUALIFY AS A BENEFIT TO OUR COMMUNITY. Part III, Line 9b: THE HOSPITALS CURRENT COLLECTION PRACTICES APPLY TO ALL PATIENTS. IF NO INSURANCE IS AVAILABLE FOR SERVICES, AND THEY DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, WE WILL MAKE THEM AWARE OF THEIR OPTIONS. DISCOUNTS ARE OFFERED WHICH ARE TIED TO COMMERICAL MANAGED CARE CONTRACTS. PAYMENT ARRANGEMENTS CAN BE MADE FOR A SPECIFIC PERIOD OF TIME, WITH NO INTEREST CHARGED. ONCE ARRANGEMENTS ARE MADE, THE ACCOUNT FOLLOWS THE STANDARD COLLECTION PROCESS OF LETTERS AND PHONE CALLS. AFTER 120 DAYS, IF NO PAYMENT HAS BEEN MADE OR IF PAYMENT ARRANGEMENTS ARE NOT KEPT, THE ACCOUNT WILL BE REFERRED TO A COLLECTION AGENCY. Part VI, Line 2: THE HOSPITAL CURRENTLY REVIEW THE HEALTH INDICATORS OF THE COUNTY, AND WILL FROM TIME TO TIME COMPLETE COMMUNITY SURVEYS. WE ASSESS WHETHER WE HAVE A SHORTAGE OF PHYSICIANS IN THE AREA ANNUALLY AS WELL. WE REVIEW TRENDS OF OUR PATIENT ACTIVITY BY SERVICE AND TYPE OF PATIENT TO SEE IF ADJUSTMENTS IN SERVICE OR RESOURCE ALLOCATION NEED TO BE MADE. WE REVIEW OUR PATIENT SATISFACTION SURVEYS PERIODICALLY TO IDENTIFY ANY POTENTIAL GAPS IN SERVICES. WE PARTNER WITH THE LOCAL SCHOOLS AND COMMUNITY MENTAL HEALTH ON SPECIFIC HEALTH INITIATIVE THROUGHOUT THE YEAR. OUR MOST RECENT NEEDS ASSESSMENT WAS COMPLETED IN 2015. WE ALSO PARTNER WITH THE OTHER HOSPITAL IN THE COUNTY - STURGIS HOSPITAL. Part VI, Line 3: UPON IDENTIFYING PATIENTS WHO HAVE NO COVERAGE, WE WILL SEND THEM TO OUR PATIENT ASSISTANCE REPRESENTATIVE. THIS PERSON WILL THEN REVIEW THE OPTIONS THAT ARE AVAILABLE FOR THIS INDIVIDUAL. IF MEDICAID IS A POSSIBILITY, WE THEN SEND THIS PERSON TO OUR MEDICAID SPECIALIST, WHO WILL HELP THEM WITH THE PROCESS AS WELL AS ANY FORMS. WE HAVE A FORMAL FINANCIAL ASSISTANCE PROGRAM THAT IS ADVERTISED HOSPITAL WIDE AND ON OUR WEBSITE. IF THEY QUALIFY FOR FINANCIAL ASSISTANCE, WE WILL EDUCATE THEM AND ASSIST THEM WITH THE PROCESS. Part VI, Line 4: THE HOSPITAL PRESENTLY SERVES ST. JOSEPH COUNTY, ALONG WITH OTHER PROVIDERS IN THE COMMUNITY. THE POPULATION OF THIS COMMUNITY IS APPROXIMATELY 62,000. THE COMMUNITY, AN AREA THAT WAS HEAVILY DEPENDENT ON THE AUTO INDUSTRY, IS PRESENTLY ECONOMICALLY DEPRESSED. WHILE THE OVERALL ECONOMY IN THE STATE HAS REBOUNDED SOMEWHAT, THE LOCAL COUNTY HAS LAGGED IN THE RECOVERY. THE UNEMPLOYMENT RATE CONTINUES TO BE HIGH, AND THE MEDICAID POPULATION IN THE COMMUNITY IS EXTREMELY HIGH. ADDITIONALLY, PEOPLE WITH COVERAGE HAS ALSO INCREASED. BECAUSE OF THIS, MANY PEOPLE USE THE ER AS THEIR PRIMARY CARE PROVIDER. WHILE THE COMMUNITY IS RURAL, IT IS CLOSE TO URBAN AREAS. MANY PEOPLE IN THE COMMUNITY DO NOT HAVE ADEQUATE TRAVEL ARRANGEMENTS, AS CAN BE EVIDENCED BY HIGH NO SHOW RATES FOR PRIMARY CARE APPOINTMENTS DUE TO TRAVEL ISSUES. Part VI, Line 5: THE HOSPITAL HAS A BOARD THAT RESIDES ENTIRELY IN THE COMMUNITY IT SERVES. THE HOSPITAL HAS EXTENDED PRIVILEGES TO ALL QUALIFIED STAFF IN THE COMMUNITY, AND AS MENTIONED ABOVE, HAS SET UP ARRANGEMENTS WITH TERTIARY HOSPITALS TO ARRANGE FOR SPECIALIST TO PROVIDE CARE IN THE COMMUNITY ON AN AS NEEDED BASIS. THIS IS CRITICAL, AS THIS MEANS THE LOCAL POPULATION DOES NOT HAVE TO TRAVEL EXTENSIVELY FOR THIS SPECIALTY CARE. IF SURPLUS FUNDS ARE AVAILABLE, THESE FUNDS ARE INVESTED BACK INTO THE COMMUNITY, BY ALLOCATING DOLLARS FOR MEDICAL EQUIPMENT REPLACEMENT, PHYSICIAN RECRUITING, AND OTHER COMMUNITY INITIATIVES. THE HOSPITAL ALSO CONTINUES TO ESTABLISH RURAL HEALTH CLINICS IN COMMUNITIES SURROUNDING ITS SERVICE AREA. THE HOSPITAL IS ALSO A MEMBER OF AN ACO, AND THE HOSPITAL HAS HIRED A CARE COORDINATOR TO HELP WITH CHRONIC CARE PATIENTS AND TO HELP PROMOTE ANNUAL WELLNESS VISTS AS WELL. Part VI, Line 7, Reports Filed With States MI X X 0 0 0 0 0 0 0 0 0 GLENDORA GREEN MD BOARD MEMBER 0 207684 0 0 0 0 0 0 0 7360 0 215044 0 0 LINDA EVANS MD CHIEF OF STAFF 0 180353 0 0 0 6500 0 18000 0 15164 0 220017 0 0 WILLIAM RUSSELL PRESIDENT/CEO 235560 0 0 0 7260 0 0 0 74555 0 317375 0 0 0 STEVE ANDREWS CHIEF FINANCIAL OFFICER 171249 0 0 0 7277 0 3780 0 57503 0 239809 0 0 0 HOPE BAILEY VICE PRESIDENT 144528 0 0 0 0 0 9161 0 22625 0 176314 0 0 0 CHAD BUSH CRNA 225591 0 0 0 0 0 14399 0 29583 0 269573 0 0 0 BRIAN CLARK CRNA 189027 0 0 0 0 0 18000 0 26660 0 233687 0 0 0 RANDALL SMITH CRNA 151243 0 0 0 0 0 0 0 18637 0 169880 0 0 0 LEONARD DARLING PHARMACY MANAGER 136917 0 0 0 0 0 5704 0 22266 0 164887 0 0 0 FORM 990, PART I, LINE 1: THE HOSPITAL'S MISSION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE TO OUR COMMUNITY. WE SERVE A COMMUNITY THAT HAS ONE OF THE HIGHEST UNEMPLOYMENT RATES IN THE STATE. WE EMPLOY 85% OF THE PHYSICIANS IN THE COMMUNITY, THUS PROVIDING ADEQUATE ACCESS TO OUR COMMUNITY, SPECIFICALLY MEDICAID ELIGIBLE PATIENTS. WE OPERATE 4 RURAL HEALTH CLINICS, AND WILL HAVE ONE MORE OPERATIONAL IN 2016, WHICH GREATLY ENHANCES ACCESS TO CARE. WE PROVIDE A FULL RANGE OF OB SERVICES TO THE COMMUNITY, OF WHICH OVER 60% IS MEDICAID. WE ALSO PROVIDE WELLNESS AND DIABETIC EDUCATION SERVICES TO THE COMMUNITY, AS WELL AS HOMECARE AND HOSPICE, ALL SERVICES THAT ARE HEAVILY SUBSIDIZED. IN ADDITION, THE HOSPITAL ALSO HAS A IP REHABILITATION UNIT ON CAMPUS , AS WELL AS A WOUND CARE CLINIC. WE HAVE STARTED AN EMPLOYEE WELLNESS PROGRAM INTERNALLY, AND PLAN TO WORK WITH LOCAL EMPLOYERS TO OFFER THIS SERVICE AS WELL. FUTURE PLANS INCLUDE OFFERING MENTAL SERVICES, AND EXPANDING ORTHOPAEDICS, AND ADDING ENT SERVICES. ADDITIONALLY, WE ARE ADDING RESOURCES TO HELP THE UNINSURED NAVIGATE THE REQUIREMENTS FOR OBTAINING INSURANCE COVERAGE FOR THEIR PROBLEMS. Form 990, Part VI, Section A, line 3 THE HOSPITAL USES A MANAGEMENT COMPANY TO MANAGE OPERATIONS. THEY ALSO EMPLOY THE CEO AND CFO. Form 990, Part VI, Section B, line 11 THE 990 IS PRESENTED AT THE BOARD MEETING, AND REVIEWED BY OFFICERS AND MEMBERS DURING THE MEETING AFTER THE RETURN IS FILED. Form 990, Part VI, Section B, line 12c THE COMPLIANCE OFFICE REQUIRES ANNUAL DISCLOSURE, AND COMMUNICATES TO BOARD PERIODICALLY. IF A CONFLICT OF INTEREST ARISES, THE INDIVIDUAL IS REQUIRED TO LEAVE THE ROOM WHEN DISCUSSIONS TAKE PLACE. Form 990, Part VI, Section B, line 15 THE HOSPITAL USES DATA FROM MHA TO DETERMINE THE SALARY STRUCTURE FOR EMPLOYEES. FOR THE CEO AND CFO, QHR IS THE PRIMARY SOURCE FOR COMPENSATION, WHICH MUST BE APPROVED BY THE BOARD. THE SALARY PLAN IS PRESENTED TO THE FINANCE COMMITTEE AS WELL. ALL DECISIONS ARE DOCUMENTED IN THE BOARD MINUTES. THIS PROCESS TOOK PLACE IN 2015 AGAIN. Form 990, Part VI, Section C, line 19 POLICIES AND STATEMENTS ARE REVIEWED AT BOARD MEETINGS. THE LOCAL PRESS ALSO RECEIVES THIS INFORMATION. IF ADDITIONAL REQUESTS ARE MADE, THIS INFORMATION IS PROVIDED AS REQUESTED. Form 990, Part IX, line 11g PURCHASED SERVICES: Program service expenses 2,563,230. Management and general expenses 4,435,784. Fundraising expenses 0. Total expenses 6,999,014. CONSULTANT FEES: Program service expenses 1,887,312. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,887,312. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. THREE RIVERS HEALTH FOUNDATION 701 S HEALTH PARKWAY THREE RIVERS MI 49093 201384776 FOUNDATION TO HOSPITAL MI 501(C)(3) 11 TYPE 1 THREE RIVERS HEALTH AUTHORITY 1 TRAH PROPERTIES INC 701 S HEALTH PARKWAY THREE RIVERS MI 49093 383366344 PROPERTY MANAGEMENT MI 501(c)(3) 11 TYPE 1 THREE RIVERS HEALTH AUTHORITY 1 THREE RIVERS HEALTH AUTHORITY 701 S HEALTH PARKWAY THREE RIVERS MI 49093 382317300 HOSPITAL MI 501(C)(3) 3 N/A 0 THREE RIVERS HEALTH NETWORK 701 S HEALTH PARKWAY THREE RIVERS MI 49093 383330974 MEDICAL DATA PROCESSING MI N/A C 1 INTEGRATED HEALTH SYSTEMS INC 701 S HEALTH PARKWAY THREE RIVERS MI 49093 383134384 PERSONNEL MANAGEMENT MI N/A C 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 TRAH PROPERTIES INC K 245277 RENT PAID INTEGRATED HEALTH SYSTEMS INC O 4009137 FMV