2016-05-13T09:51:23-05:00 2015-06-30 990 2014-07-01 382113393 TRINITY HEALTH - MICHIGAN TRIN 7343431000 20555 VICTOR PARKWAY LIVONIA MI 481527018 MICHAEL GUSHO ASSISTANT TREASURER 7343431000 2016-05-13 2014 2016-08-17 19:52:53Z SEE SCHEDULE O FOR LIST ROBERT CASALOU 20555 VICTOR PARKWAY LIVONIA MI 481527018 2540070301 0 X WWW.TRINITY-HEALTH.ORG X 1976 MI TO PROVIDE HEALTHCARE AND HOSPITAL SERVICES. 23 18 17166 2129 52110199 -752413 20956370 19009144 2306424306 2351903603 47592189 48523879 99951854 100692847 2474924719 2520129473 2017633 2915815 0 0 1064013822 1057702633 17681 0 4096760 1306060933 1243786264 2372110069 2304404712 102814650 215724761 3119780142 3181338583 1284221498 1217507808 1835558644 1963830775 X WE, TRINITY HEALTH-MICHIGAN AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMIN HEALING PRESENCE WITHIN OUR COMMUNITIES. TRINITY HEALTH-MICHIGAN IS A MEMBER OF TRINITY HEALTH. 0 0 2174877321 2915815 2347001088 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 1,688 STAFFED BEDS, AS WELL AS OUTPATIENT HEALTH CENTERS, URGENT CARE FACILITIES, PHYSICIAN OFFICES AND SPECIALTY CENTERS, AND COMMUNITY OUTREACH SITES. DURING FISCAL YEAR 2015, TH-MI HOSPITALS' EMPLOYEES, PHYSICIANS AND VOLUNTEERS PROVIDED OVER 445,000 DAYS OF CARE, AND PROVIDED HEALTH CARE SERVICES FOR OVER 2.5 MILLION OUTPATIENT VISITS, OVER 338,000 EMERGENCY ROOM VISITS, AND 10,715 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 $140 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 2174877321 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 0 1 1 1 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 0 0 1 3267 1 1 17166 1 1 1 1 CJ 0 0 0 1 1 0 0 0 0 X 23 18 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 ROGER SPOELMAN PRES & CEO; WEST MI REG CEO 26.00 29.00 X X 0 958333 49378 JAMES WOOD DIRECTOR; CHAIRMAN 2.00 0.00 X X 0 0 0 MARK FAZAKERLEY DIRECTOR 2.00 2.00 X 0 0 0 RENNY ABRAHAM MD DIRECTOR 2.00 0.00 X 0 0 0 CHARLES FRAYER DIRECTOR 2.00 2.00 X 0 0 0 TIMOTHY CAUGHLIN DIRECTOR 2.00 0.00 X 0 0 0 ROBERT CASALOU DIRECTOR;SE MI REG CEO 1/15;CEO ST JO 53.00 2.00 X 0 904315 39120 MICHAEL GLUHANICH DIRECTOR 2.00 2.00 X 0 0 0 ROSSANA DEGROOD MD DIRECTOR THROUGH 12/14 2.00 48.00 X 0 173334 22835 LUANN HANNASCH RSM DIRECTOR 2.00 0.00 X 0 0 0 GARRY FAJA DIRECTOR AND SE MI REG CEO THR 12/14 53.00 2.00 X 0 1006593 40470 CAMILLE JOURDEN-MARK DIRECTOR 2.00 2.00 X 0 0 0 F JOSEPH FLECK DIRECTOR 2.00 0.00 X 0 0 0 BRUCE OLSON MD DIRECTOR 2.00 48.00 X 0 369982 35951 JOHN I JARAD MD DIRECTOR THROUGH 12/14 2.00 0.00 X 0 0 0 JULIE MILLER RIDENOUR DIRECTOR 2.00 0.00 X 0 0 0 KENNETH SIKKEMA DIRECTOR 2.00 2.00 X 0 0 0 MAUREEN MILLER BROSNAN DIRECTOR 2.00 0.00 X 0 0 0 TERRENCE WRIGHT DIRECTOR 2.00 2.00 X 0 0 0 SUSAN ROSIAK DIRECTOR THROUGH 9/2014 2.00 0.00 X 0 0 0 SR CATHERINE DECLERCQ SCH O DIRECTOR AS OF 7/2014 2.00 0.00 X 0 0 6531 SISTER RENETTA RUMPZ CSSF DIRECTOR 2.00 0.00 X 0 0 0 JEFFERY SMITH DIRECTOR 2.00 0.00 X 0 0 0 KEVIN SEXTON DIRECTOR THR 7/14;PRES& CEO MARYLAND 2.00 48.00 X 0 1006858 57406 DAVID STEINBERGER DIRECTOR 2.00 0.00 X 0 0 0 EDD SNYDER DIRECTOR 2.00 0.00 X 0 0 0 MARY PERSICO IHM SCH O DIRECTOR; TH EVP MISSION INTERGRATION 2.00 48.00 X 0 0 25865 DAVID KILLIPS DIRECTOR 2.00 0.00 X 0 0 0 CAROL TARNOWSKY SECRETARY 26.00 24.00 X 0 264592 15998 SALLY GUINDI ASSISTANT SECRETARY 50.00 0.00 X 0 280017 47883 MICHAEL GUSHO TREASURER; SE MI REGIONAL CFO 53.00 2.00 X 0 425259 49010 GARY ALLORE ASSISTANT TREASURER; WEST MI REG CFO 17.00 38.00 X 0 384091 33873 JACK WEINER CEO ST. JOSEPH MERCY OAKLAND 50.00 0.00 X 0 699922 55806 DAVID SPIVEY CEO ST. MARY MERCY LIVONIA 49.00 1.00 X 0 654177 43008 BILL MANNS CEO MERCY HEALTH ST. MARY'S 48.00 2.00 X 0 618106 37930 NANCY GRAEBNER CEO ST. JOSEPH MERCY CHELSEA 50.00 0.00 X 0 499734 33424 STEPHANIE RIEMER-MATUZAK CEO MERCY HOSPITAL GRAYLING 50.00 0.00 X 0 370302 57457 JOHN MACLEOD CEO MERCY HOSPITAL CADILLAC THR 9/14 50.00 0.00 X 0 416511 39001 RANDALL WAGNER COO MERCY HLTH ST. MARY'S THR 4/15 48.00 2.00 X 0 406538 38597 REBEKAH SMITH CEO ST. JOSEPH MERCY PORT HURON 49.00 1.00 X 0 394085 30692 BARBARA HERTZLER COO ST JOSEPH MERCY OAKLAND THR 7/14 50.00 0.00 X 0 383993 62847 STEVE EAVENSON VP FINANCE MERCY HEALTH SAINT MARY'S 48.00 2.00 X 0 372868 35378 ROBIN DAMSCHRODER COO ST JOE MERCY ANN ARBOR AT 10/13 50.00 0.00 X 0 356540 33118 KATHLEEN O'CONNOR VP FIN ST JOE MRCY ANN ARBOR THR8/14 50.00 0.00 X 318672 0 46820 CLAUDE LAUDERBACH COO ST. MARY MERCY LIVONIA THR 7/14 50.00 0.00 X 0 316323 50620 MICHAEL SAMYN CFO ST MARY MCY& ST JOE MCY OAK 9/14 50.00 0.00 X 0 272987 30916 MARY NEFF CADILLAC INTERIM CEO AT 9/14; COO 50.00 0.00 X 0 236153 39638 JACKIE PRIMEAU INTERM VP FIN ST JOSEPH OAK THR 8/14 50.00 0.00 X 0 225615 29470 SHANNON STRIEBICH COO SE MI REGION, ST JOSEPH PH & OAK 50.00 0.00 X 0 223531 23254 KIRSTEN KORTH-WHITE COO MERCY HOSPITAL GRAYLING 50.00 0.00 X 0 176113 26680 GEORGE GIBSON ORTHOPEDIC SURGEON (SJMHS) 50.00 0.00 X 903437 0 32709 CHARLES SCHWARTZ CARDIOTHORACIC SURGEON (OAKLAND) 50.00 0.00 X 862886 0 34396 KRISTOPHER AALDERINK ORTHOPEDIC SURGEON (SJMHS) 50.00 0.00 X 861898 0 28638 CREG CARPENTER ORTHOPEDIC SURGEON (CHELSEA HOSP) 50.00 0.00 X 764661 0 35359 TALLAL ZENI ORTHOPEDIC SURGEON (SMM LIVONIA) 50.00 0.00 X 742939 0 31842 DANIEL HALE FORMER OFFICER 0.00 55.00 X 0 1049660 42477 JAMES BOSSCHER FORMER OFFICER 0.00 50.00 X 0 762947 39620 MARIANNE CUNNINGHAM FORMER OFFICER 0.00 50.00 X 0 226089 37539 AGNES HAGERTY FORMER OFFICER 1.00 49.00 X 0 676227 49611 BENJAMIN CARTER FORMER OFFICER 2.00 53.00 X 0 1337975 45858 CYNTHIA CLEMENCE FORMER OFFICER 2.00 48.00 X 0 529532 51495 JENNIFER BARNETT FORMER OFFICER 0.00 0.00 X 0 1334875 1014807 PAUL NEUMANN FORMER OFFICER 2.00 53.00 X 0 995662 41564 RICHARD GILFILLAN FORMER OFFICER 1.00 54.00 X 0 1986485 44075 KEDRICK ADKINS FORMER KEY EMPLOYEE 0.00 0.00 X 0 1069394 1656 J RICHARD O'CONNELL FORMER KEY EMPLOYEE 1.00 54.00 X 0 1748402 54577 CHARLES HOFFMAN FORMER KEY EMPLOYEE 40.00 0.00 X 0 509150 289090 DEBORAH ARMSTRONG FORMER KEY EMPLOYEE 40.00 0.00 X 0 244156 12208 PHILIP MCCORKLE FORMER KEY EMPLOYEE 49.00 1.00 X 0 302917 35035 4454493 25170343 3061532 808 1 1 0 PINE REST PO BOX 1615 GRAND RAPIDS MI 49501 HEALTH CARE SERVICES 26434317 BARTON MALOW CO 26500 AMERICAN DR SOUTHFIELD MI 48034 CONSTRUCTION SERVICES 22645006 GRANGER CONSTRUCTION COMPANY 6267 AURELIUS ROAD LANSING MI 48911 CONSTRUCTION SERVICES 15274941 ELZINGA VOLKERS CONSTRUCTION 86 EAST SIXTH STREET HOLLAND MI 49423 CONSTRUCTION SERVICES 10421494 THE CHRISTMAN COMPANY 634 FRONT AVE NW 500 GRAND RAPIDS MI 49504 CONSTRUCTION SERVICES 7600080 261 93967 1118185 3575968 4662419 9558605 718134 19009144 NET PATIENT SVC REV 622110 2259120649 2259120649 PHARMACY REVENUE 446110 72246365 31534828 40711537 LABORATORY REVENUE 621500 20536589 20536589 2351903603 24810317 24810317 11655470 12349566 -694096 -694096 -694096 22694534 5234208 0 4215180 22694534 1019028 23713562 23713562 845111 1118185 1055932 -210821 -210821 14084 9644 4440 4440 4126995 2310506 1816489 1816489 CAFETERIA REVENUE 722514 11857614 11857614 PROVIDER INCENTIVE 622110 2075314 2075314 GOV'T SUBSIDY-EHR 622110 1276591 1276591 84567316 84528534 38782 99776835 2520129473 2347001088 52110199 102009042 2915815 2915815 11135592 11135592 1292445 148721 1143724 877236988 821454916 53998807 1783265 28075945 26526132 1549813 77958023 72466257 5301644 190122 62003640 57324580 4553705 125355 658460 610003 48457 2051991 2051991 46333 46333 104852 104852 1755616 1755616 216256328 206733274 8115036 1408018 9137290 8458248 671900 7142 27777615 25623741 2035479 118395 98997988 91712206 7285362 420 44110596 40844987 3244612 20997 2568288 2360560 187516 20212 2066837 1903953 151245 11639 32899220 32899220 146370431 135592450 10771086 6895 16099788 14914983 1184805 MEDICAL SUPPLIES EXP 406793443 406774477 0 18966 I/C PURCHASED SERVICES 56746075 52475516 4168509 102050 HOSPITAL PROVIDER TAX 53205012 53205012 0 0 BAD DEBT EXPENSE 45352889 45352889 0 0 80787212 74579381 5924547 283284 2304404712 2174877321 125430631 4096760 27946136 19758555 2607737 1623914 12999728 12166051 256719013 251709085 26642634 27721827 38494918 38182466 17893955 13020092 2733742046 1458232113 1283198645 1275509933 601729077 622353149 519812650 608412172 31901916 32056222 299833733 278825117 3119780142 3181338583 202618953 216580732 2481789 3249108 24482269 24601949 1054638487 973076019 1284221498 1217507808 X 1783839954 1923257437 37438030 23701275 14280660 16872063 1835558644 1963830775 3119780142 3181338583 X 215724761 -28719557 -58733073 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 105853 1 104852 0 0 210705 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 2015 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 2015 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 TRINITY HEALTH - MICHIGAN 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 17198931 2024963 336668 -229498 228513 19561547 16353319 684595 1350728 1189711 17198931 14089151 1878856 1027047 641736 16353318 15077828 -176284 -812393 14089151 14367389 223954 486485 15077828 0.06390 0.86250 0.07360 1 1 1 67263942 67263942 1720986673 759836820 961149853 900621798 686870830 213750968 44869633 11524463 33345170 1275509933 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 170355408 F EQUITY METHOD INVESTMENTS 231196625 C HEDGE FUNDS 206860139 F 608412172 OTHER RECEIVABLES 27633976 INTERCOMPANY ACCOUNTS RECEIVABLE 108865858 INVESTMENT IN UNCONSOLIDATED AFFILIATES 24963016 INTERCOMPANY OTHER LT ASSETS 116884997 OTHER CURRENT ASSETS 19114 OTHER LONG-TERM ASSETS 458156 278825117 INTERCOMPANY ACCOUNTS PAYABLE 79772889 DEFERRED COMPENSATION 10779344 ASSET RETIREMENT OBLIGATION (FIN 47) 2844916 ANNUITIES PAYABLE 1507027 INTERCOMPANY NOTES PAYABLE 875157455 LEASE OBLIGATION 39657 OTHER CURRENT LIABILITIES 1060398 OTHER LONG-TERM LIABILITIES 1914333 973076019 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 TRINITY HEALTH - MICHIGAN. ENDOWMENTS HELD BY SAINT MARY'S FOUNDATION AND MERCY HOSPITAL CADILLAC FOUNDATION FOR THE BENEFIT OF TRINITY HEALTH - MICHIGAN ARE REPORTED ON THE FORM 990 OF SAINT MARY'S FOUNDATION AND MERCY HOSPITAL CADILLAC FOUNDATION. MI HOLIDAY BALL -ANN ARBOR 761484 386466 375018 57671 169453 10775 203882 SJMC SPRING AUCTION - CHELSEA 312979 219855 93124 3150 10277 2200 111156 11 888833 511864 376969 7052 44937 173284 26500 235595 1963296 1118185 845111 7052 105758 353014 39475 550633 1055932 -210821 1 1 X 1 X 1 X 1 1 0 1 1 2 38769 21769620 877565 20892055 0.00920 2 366201 254395563 190309352 64086211 0.02840 7 5951 12605607 15178890 -2573283 0.00000 11 410921 288770790 206365807 82404983 0.03760 42 184328 4465446 723202 3742244 0.00170 16 1994 81308529 47019471 34289058 0.01520 19 133457 41891370 21884251 20007119 0.00890 1 13 5713894 3268939 2444955 0.00110 30 8993 1664818 83962 1580856 0.00070 108 328785 135044057 72979825 62064232 0.02760 119 739706 423814847 279345632 144469215 0.06520 1 17 124 124 0.00000 1 40 526 526 0.00000 2 2 4602 4602 0.00000 4 4 128037 128037 0.00010 8 63 133289 133289 0.00010 0 45352889 0 581911850 547089537 34822313 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 0.54120 9 CRAWFORD MERCY PHO CONTRACTING SERVICES 0.50000 0.50000 10 WEXFORD MERCY PHO CONTRACTING SERVICES 0.50000 0.50000 11 ADVANTAGE HEALTHSAINT MARY'S CARE NETWORK HOSPITAL/PHYSICIAN INTEGRATION 0.50000 0.50000 9 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 8 MERCY HOSPITAL GRAYLING 1100 EAST MICHIGAN AVE GRAYLING MI 49738 WWW.MERCYHEALTHGRAYLING.COM LICENSE 1060000029 X X X 9 MERCY HOSPITAL CADILLAC 400 HOBART STREET CADILLAC MI 49601 WWW.MERCYHEALTHCADILLAC.COM LICENSE 1060000041 X X X ST JOSEPH MERCY ANN ARBOR 1 0 0 1 X X X X X X X X X 14 1 1 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 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JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 5: ST. JOSEPH MERCY ANN ARBOR 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: THE WASHTENAW COUNTY DEPARTMENT OF HEALTH, THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM, THE HOPE CLINIC, SAFEHOUSE, CASA LATINA, FOOD GATHERERS, PHYSICIAN PRACTICES AND HEALTH SYSTEM EMPLOYEES. 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 OF 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 WELLBEING 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 PARTICIPATINGTHE 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 WELLBEING. 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 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; NO ONE DIES ALONE; 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 THE DETROIT WAYNE COUNTY HEALTH DEPARTMENT, LIVONIA AND REDFORD SCHOOLS, WAYNE HOPE CLINIC, WESTLAND SALVATION ARMY, MADONNA UNIVERSITY, JOY SOUTHFIELD COMMUNITY DEVELOPMENT CORPORATION, JUDSON CENTER, PLYMOUTH COMMUNITY UNITED WAY, FARMINGTON COSTICK CENTER, SOUTH EASTERN 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, 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 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: ST. JOSEPH MERCY CHELSEA (SJMC) TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY THROUGH PARTICIPATION IN VARIOUS COMMUNITY COALITIONS AND BY CONDUCTING INTERVIEWS. SJMC IS A MEMBER OF THE WASHTENAW COUNTY HEALTH IMPROVEMENT PLAN (HIP), A COLLABORATIVE EFFORT OF PUBLIC AND PRIVATE ORGANIZATIONS AIMED AT IMPROVING HEALTH. HIP INCLUDES REPRESENTATIVES FROM WASHTENAW COUNTY PUBLIC HEALTH, ST. JOSEPH MERCY ANN ARBOR, THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM, THE WASHTENAW INTERMEDIA SCHOOL DISTRICT, AND OTHER ORGANIZATIONS.EACH OF THE FIVE COMMUNITIES IN THE SJMC SERVICE AREA HAS A WELLNESS COALITION WITH VOLUNTEER MEMBERS FROM KEY COMMUNITY SECTORS AND ORGANIZATIONS, SUCH AS SJMC HOSPITAL STAFF, LOCAL GOVERNMENT, SCHOOLS, LIBRARIES, BUSINESSES, SENIOR CENTERS, COMMUNITY GARDENS, CHURCHES, FOOD BANKS AND RESOURCE CENTERS, YOUTH SUBSTANCE ABUSE PREVENTION ORGANIZATIONS, HOSPITALS AND OTHER HEALTHCARE PROVIDERS, AND LOCAL CITIZENS. THE 5 HEALTHY TOWNS FOUNDATION, OR 5HF (FORMERLY CHELSEA-AREA WELLNESS FOUNDATION), WHICH SERVES THE SAME FIVE TOWNS AS SJMC, INITIATED THE ORGANIZATION OF THESE COALITIONS IN 2010. EACH COALITION COMPLETED A CIVIC ASSESSMENT AND NEEDS ASSESSMENT IN 2010, AND THE FIRST QUARTER OF 2011, AND PRESENTED THEM TO THE 5HF BOARD. THEY HAVE ALSO BEEN TASKED TO DEVELOP A COMPREHENSIVE WELLNESS PLAN FOR THEIR COMMUNITY, BASED ON LOCAL DATA DEMONSTRATING NEED, AND RESOURCES AVAILABLE TO ADDRESS THOSE NEEDS. TO ASSESS THE COMMUNITIES' NEEDS, EACH COALITION REVIEWED AVAILABLE SURVEY DATA, INCLUDING HIP (WHICH PROVIDED COMMUNITY-LEVEL DATA IN STOCKBRIDGE AND GRASS LAKE, AND REGIONAL-LEVEL DATA FOR CHELSEA, DEXTER AND MANCHESTER), AND MIPHY (WHICH PROVIDED COMMUNITY-LEVEL DATA FOR ALL FIVE TOWNS), AS WELL AS THE PROMOTING ACTIVE COMMUNITIES, AND NUTRITION ENVIRONMENTAL ASSESSMENT TOOL SURVEYS. DURING THE MOST RECENT CHNA, HOSPITAL STAFF PRESENTED DATA TO THE FIVE WELLNESS COALITIONS, AND ASKED FOR THEIR INPUT IN IDENTIFYING AND PRIORITIZING NEEDS THEY SEE IN THEIR COMMUNITIES. THIS PROCESS TOOK PLACE IN THE FALL OF 2014.IN ORDER TO GAIN INPUT ON THE NEEDS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS IN THE COMMUNITY, LEADERS FROM SJMC CONDUCTED KEY STAKEHOLDER INTERVIEWS IN OCTOBER 2014 THROUGH JANUARY 2015. MEMBERS OF THE COMMUNITY HEALTH IMPROVEMENT COUNCIL GENERATED A LIST OF COMMUNITY AGENCIES AND ORGANIZATIONS THAT SERVE THESE POPULATIONS, AND QUESTIONS TO ASK EACH ABOUT THE NEEDS OF THEIR CLIENTS OR MEMBERS. THESE INTERVIEWS WERE CONDUCTED IN PERSON IF POSSIBLE, AND BY PHONE, OR BY EMAIL IF NECESSARY. ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 5: A SURVEY THAT WAS CREATED BY THE CHNA STEERING COMMITTEE AT ST. JOSEPH MERCY PORT HURON WAS GIVEN TO SEVERAL COMMUNITY ADVISOR MEMBERS INCLUDING: THE VISITING NURSE ASSOCIATION, ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH, DOWNRIVER COMMUNITY SERVICES, COUNCIL ON AGING, CATHOLIC SOCIAL SERVICES, BLUE WATER TRANSIT, DEPARTMENT OF HUMAN SERVICES, MERCY HOME CARE, AND VARIOUS OTHER COMMUNITY BUSINESS LEADERS. PATIENTS AND STAFF AT MEDICAL CLINICS AND SENIOR FACILITIES WERE ALSO GIVEN THE SURVEY IN ORDER TO GAIN INPUT FROM THE COMMUNITY. MERCY HOSPITAL CADILLAC PART V, SECTION B, LINE 5: MERCY HOSPITAL COMMUNITY BENEFIT DEPARTMENT COMPLETED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FROM AUGUST 2013 TO OCTOBER 2014. THIS PROCESS WAS INCLUSIVE AND TRANSPARENT, INVOLVING LEADERSHIP FROM MERCY HOSPITAL COMMUNITY BENEFIT MINISTRY, DISTRICT HEALTH DEPT. #10, MSU EXTENSION, ADOLESCENT WELLNESS CENTERS, WEXFORD-MISSAUKEE INTERMEDIATE SCHOOL DISTRICT, CADILLAC AREA PUBLIC SCHOOLS, STEHOUWER FREE CLINIC, GREAT LAKES FAMILY CARE, CADILLAC WEXFORD TRANSIT AUTHORITY, WEXFORD-MISSAUKEE PHYSICIAN HEALTH ORGANIZATION, UNITED WAY OF WEXFORD/MISSAUKEE COUNTIES, LIFE RESOURCES OF NORTHERN MICHIGAN, NORTHERN LAKES COMMUNITY MENTAL HEALTH, CADILLAC AREA YMCA, LOVE INC OF WEXFORD COUNTY, WEXFORD-MISSAUKEE CHILD PROTECTION COUNCIL, NORTHWEST MI COMMUNITY ACTION AGENCY, WEXFORD MISSAUKEE DEPARTMENT OF HUMAN SERVICES, NORTHWEST MICHIGAN WORKS, BAKER COLLEGE OF CADILLAC, AND NEW HOPE SHELTERS.A PROVIDER SURVEY WAS DISTRIBUTED TO PARTICIPANTS DURING THE ANNUAL MEDICAL SYMPOSIUM TITLED "IMPROVING HEALTHCARE DELIVERY IN THE COMMUNITY" WHICH WAS HELD ON MAY 2, 2014. A TOTAL OF 15 PROVIDERS PRACTICING IN WEXFORD (10), MISSAUKEE (2), CRAWFORD (2) AND GRAND TRAVERSE (1) COUNTIES GAVE FEEDBACK. THIS INCLUDED FAMILY PRACTICE PHYSICIANS, NURSE PRACTITIONERS AND NURSES.INFORMAL INTERVIEWS WERE CONDUCTED WITH LEADERS FROM THE FOLLOWING ORGANIZATIONS: CHIEF MEDICAL OFFICER MERCY HOSPITAL, GREAT LAKES FAMILY CARE, NORTHERN LAKES COMMUNITY MENTAL HEALTH, STEHOUWER FREE CLINIC MEDICATION ACCESS PROGRAM, AND THE STEHOUWER FREE CLINIC.AN ONLINE SURVEY WAS DISTRIBUTED FROM FEBRUARY 26 TO MARCH 17, 2014 TO MEMBERS OF THE COMMUNITY HEALTH COALITION, THE POVERTY REDUCTION COALITION, THE SENIOR NETWORK ADVOCACY GROUP, AND THE MINISTERIAL ASSOCIATION. THIS INCLUDED COMMUNITY LEADERS AND REPRESENTATIVES FROM HEALTH ORGANIZATIONS ACROSS WEXFORD AND MISSAUKEE COUNTIES AS LISTED BELOW. MANY REPRESENTATIVES WORK FOR ORGANIZATIONS THAT ASSIST UNDERSERVED AND VULNERABLE POPULATIONS. IT INCLUDED QUESTIONS ABOUT THEIR PERCEPTION OF NEEDS IN THE COMMUNITY WITH A FOCUS ON VULNERABLE AND UNDERSERVED POPULATIONS. REPRESENTATION INCLUDED: ACT NOW, ALEX HARRISON MEMORIAL FOUNDATION; BAKER COLLEGE AND BAKER COLLEGE CADILLAC; BELLE OAKES, LIVING CENTER; CADILLAC LEADERSHIP CLASS; CADILLAC MICHIGAN WORKS!; CAPS; DISTRICT HEALTH DEPT. #10; DISTRICT HEALTH DEPT. #10 ADOLESCENT WELLNESS CENTERS; GREAT LAKES FAMILY CARE; GREAT START COLLABORATIVE WEXFORD/MISSAUKEE/MANISTEE COUNTIES; HARBOR VIEW APARTMENTS; HOPE NETWORK; HUMAN SERVICES LEADERSHIP COUNCIL; INTERGOVERNMENTAL COOPERATION COMMITTEE; LAKE CITY SCHOOLS; LOVE IN THE NAME OF CHRIST; NMCAA; STEHOUWER FREE CLINIC; WEXFORD COA; WEXFORD COA/CADILLAC SENIOR CENTER; AND WEXFORD PHO AT MERCY HEALTH PHYSICIAN PARTNERS.A HEALTH BARRIERS CAMPAIGN, WHICH RAN FROM MAY 13 TO JUNE 1, 2014, WAS A COMPONENT OF THE COMMUNITY INPUT PROCESS THAT IDENTIFIED HEALTH BARRIERS IN THE COMMUNITY. THE PRIMARY OUTREACH METHOD WAS "COMMUNITY BOARDS" PLACED AT STRATEGIC LOCATIONS THROUGHOUT THE COMMUNITY FOR 3 TO 14 DAYS. BOARD LOCATIONS INCLUDED, CADILLAC SENIOR CENTER, CADILLAC YMCA, DISTRICT HEALTH DEPARTMENT #10, FRIENDS MINISTRY (LAKE CITY), GREAT LAKES FAMILY CARE, MERCY HOSPITAL, NORTHERN LAKES COMMUNITY MENTAL HEALTH, SHEPHERD'S TABLE- SITE OF FREE COMMUNITY MEALS, STEHOUWER FREE CLINIC, AND THE TUSTIN LIBRARY. THIS POSTER BOARD INCLUDED A PROMPT, "WHAT DO YOU THINK IS THE BIGGEST BARRIER TO HEALTH IN YOUR COMMUNITY?" IT ALSO INCLUDED INFORMATION TO FIND OUR COMMUNITY HEALTH PERSPECTIVES FACEBOOK PAGE AND TWITTER ACCOUNT.THE MICHIGAN AGING AND DISABILITY NEEDS ASSESSMENT (MADNA) SURVEY WAS DISTRIBUTED TO AREA SENIORS BY THE SENIOR NETWORK ADVOCACY GROUP (SNAG) IN 2012 AND A TOTAL OF 328 RESPONSES WERE COLLECTED. THE SURVEY WAS CONDUCTED BY PARTNERS FROM MICHIGAN AGING AND DISABILITY ORGANIZATIONS THROUGH FUNDING FROM A FEDERAL GRANT. MICHIGAN RESIDENTS OVER 50 AND ADULTS OVER 18 WITH DISABILITIES WERE SURVEYED ABOUT TOPICS INCLUDING HEALTHCARE, HOUSING, SERVICES, TRANSPORTATION, SOCIAL SUPPORT AND LEGAL SERVICES.THE MICHIGAN PROFILE FOR HEALTHY YOUTH (MIPHY) IS AN ONLINE, ANONYMOUS STUDENT SURVEY DEVELOPED BY THE MICHIGAN DEPARTMENT OF EDUCATION (MDE) IN COLLABORATION WITH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH (MDCH). THE MIPHY IS AVAILABLE TO ALL MICHIGAN SCHOOLS TO ASSESS RISK BEHAVIORS, RISK FACTORS, AND PROTECTIVE FACTORS ASSOCIATED WITH ALCOHOL, TOBACCO, AND OTHER DRUG USE, VIOLENCE, SEXUAL BEHAVIOR, PHYSICAL ACTIVITY, AND NUTRITION IN GRADE 7, 9, AND 11. THE 2013-2014 DATA REPORTED IS FROM 250 7TH GRADERS AND 290 9TH AND 11TH GRADERS IN WEXFORD COUNTY AND 160 7TH AND 248 9TH AND 11TH GRADERS IN MISSAUKEE COUNTY. (GENERAL MIPHY FAQ 2010 MICHIGAN DEPARTMENT OF EDUCATION) ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 6A: ST. JOSEPH MERCY LIVINGSTON MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 6A: METRO HEALTH HOSPITAL AND SPECTRUM HEALTH ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 6A: ST. JOSEPH MERCY ANN ARBOR 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 ANN ARBOR PART V, SECTION B, LINE 7D: LINE 7A:HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS/SJMAA-CHNA-2015.PDFLINE 10A:HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS/SJMAA-IMPLEMENTATION-PLAN-2015.PDF MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 7D: LINE 7A:HTTP://WWW.MERCYHEALTHSAINTMARYS.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTLINE 10A: HTTP://MERCYHEALTHSAINTMARYS.COM/DOCUMENTS/GRANDRAPIDS/MHSMIMPLEMENTATIONSTRATEGY2016-2018.PDF ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 7D: LINE 7A: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS5/SJMO-CHNA-2015.PDFLINE 10A: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS5/SJMO-IMPLEMENTATION-PLAN-2015.PDF ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 7D: ANNUALLY WE PRODUCE A COMMUNITY BENEFIT REPORT INCLUDING FINANCIAL INFORMATION AND STORIES ABOUT OUR 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.STMARYMERCY.ORG/DOCUMENTS4/CHNA-2015-REPORT.PDFLINE 10A: HTTP://WWW.STMARYMERCY.ORG/DOCUMENTS4/CHNA-IMPLEMENTATION-STRATEGY.PDF ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 7D: LINE 7A: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS1/SJML-CHNA-2015.PDFLINE 10A: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS1/SJML-IMPLEMENTATION-PLAN-2015.PDF ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 7D: LINE 7A: HTTP://WWW.STJOESCHELSEA.ORG/DOCUMENTS3/SJMC2015COMMUNITYHEALTNEEDSASSESSMENT.PDFLINE 10A: HTTP://WWW.STJOESCHELSEA.ORG/DOCUMENTS3/SJMC2015CHNAIMPLEMENTATIONSTRATEGY.PDF ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 7D: LINE 7A:HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS6/SJMPH-CHNA.PDFLINE 10A: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS6/SJMPH-CHNA.PDF MERCY HOSPITAL CADILLAC PART V, SECTION B, LINE 7D: LINE 7A: HTTP://WWW.MUNSONHEALTHCARE.ORG/UPLOAD/DOCS/CADILLAC/FINALCHNA2014.PDFLINE 10A:HTTP://WWW.MUNSONHEALTHCARE.ORG/UPLOAD/DOCS/CADILLAC/FINALMERCYCHNAIMPLEMENTATIONSTRAGETY2015-2017.PDF MERCY HOSPITAL GRAYLING PART V, SECTION B, LINE 2: (ALSO APPLIES TO PART V, SECTION B, LINE 12A) THE MERCY HOSPITAL GRAYLING HOSPITAL FACILITY WAS OPERATED BY TRINITY HEALTH-MICHIGAN FROM JULY 1, 2014 TO JANUARY 31, 2015. EFFECTIVE FEBRUARY 1, 2015, TRINITY HEALTH-MICHIGAN TRANSFERRED ITS OWNERSHIP OF MERCY HOSPITAL GRAYLING TO MUNSON HEALTHCARE, A SECTION 501(C)(3) HOSPITAL SYSTEM IN NORTHERN MICHIGAN.IN ACCORDANCE WITH REG. 1.501(R)-3(D)(4), MERCY HOSPITAL GRAYLING WAS NOT REQUIRED TO MEET THE CHNA REQUIREMENTS BECAUSE TRINITY HEALTH-MICHIGAN TRANSFERRED ALL OWNERSHIP OF THE HOSPITAL FACILITY TO ANOTHER ORGANIZATION (MUNSON HEALTHCARE) BEFORE THE END OF THE TAXABLE YEAR. THEREFORE, THE EXCISE TAX UNDER SECTION 4959 WAS NOT INCURRED. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 11: THE TWO COMMUNITY HEALTH NEEDS PRIORITIZED BY ST. JOSEPH MERCY ANN ARBOR (SJMAA) ARE OBESITY & BEHAVIORAL HEALTH. OUR IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS:OBESITY - SJMAA WILL WORK TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY. SJMAA WILL SUPPORT AREA SCHOOLS WITH EDUCATION & PREVENTION STRATEGIES, NUTRITION EDUCATION, PHYSICAL ACTIVITY AND BEHAVIORAL HEALTH. WE SEEK TO INCREASE COMMUNITY ACCESS TO NUTRITIOUS FOODS, OPPORTUNITIES FOR PHYSICAL ACTIVITY AND EDUCATION ON HEALTHY LIVING IN VARIOUS COMMUNITY VENUES.BEHAVIORAL HEALTH - SJMAA WILL WORK TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY. SJMAA WILL CONTRIBUTE TOWARD IMPROVING ACCESS TO ADOLESCENT BEHAVIORAL HEALTH, SUBSTANCE ABUSE TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE. SJMAA WILL ADDRESS ACCESS TO CARE BARRIERS AND WILL PROVIDE EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS.THERE WERE NEEDS IDENTIFIED THAT ST. JOSEPH MERCY HOSPITAL (SJMH) CHOSE NOT TO ADDRESS. THESE NEEDS, WHILE IMPORTANT TO THE HEALTH SYSTEM AND THE COMMUNITY, WERE NOT CHOSEN BASED ON OUR PRIORITIZATION PROCESS. THIS PROCESS INCLUDED THE FOLLOWING QUESTIONS: 1) THE NUMBER OF PEOPLE AFFECTED, 2) THE SEVERITY OF THE PROBLEM, 3) THE HEALTH SYSTEM'S ABILITY TO IMPACT AND 4) THE EXTENT TO WHICH OTHER ORGANIZATIONS WERE MEETING THE NEED. THE NEEDS THAT WERE NOT CHOSEN ARE AS FOLLOWS:BREAST CANCER - SJMAA CURRENTLY OFFERS AND WILL CONTINUE TO OFFER FREE AND LOW-COST PROGRAMS AIMED AT BREAST CANCER PREVENTION AND EARLY DETECTION. WASHTENAW COUNTY HAS HISTORICALLY HAD A HIGHER BREAST CANCER MORTALITY RATE THAN MICHIGAN BUT THE TREND IS FAVORABLE AND WASHTENAW'S BREAST CANCER AGE-ADJUSTED DEATH RATE WAS LOWER THAN MICHIGAN IN 2012 (THE MOST RECENT YEAR AVAILABLE). BECAUSE CANCER RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS, SJMAA BELIEVES IT IS APPROPRIATE TO MAINTAIN ITS CURRENT BREAST CANCER-FOCUSED INITIATIVES AND TO MONITOR CHANGES IN INCIDENCE AND DEATH RATES IN ITS SERVICE AREA AS NEWER DATA BECOME AVAILABLE. CHRONIC DISEASES - BECAUSE MANY CHRONIC DISEASES SUCH AS DIABETES AND HIGH BLOOD PRESSURE ARE CLOSELY RELATED TO WEIGHT ISSUES, MANY CHRONIC DISEASES WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY. EFFORTS TO IMPROVE BEHAVIORAL HEALTH SHOULD ALSO INDIRECTLY IMPROVE CHRONIC DISEASE ISSUES SUCH AS LIVER DISEASE AND PATIENTS' EMOTIONAL ABILITY TO MANAGE CHRONIC MEDICAL ISSUES. FOR THESE REASONS, SJMAA WILL NOT TAKE NEW OR SPECIFIC ACTIONS TO ADDRESS CHRONIC DISEASES. ASTHMA - THE ONE CONDITION FOR WHICH WASHTENAW COUNTY'S HOSPITALIZATION RATE WAS HIGHER THAN MICHIGAN WAS FOR ASTHMA IN CHILDREN LESS THAN 18 YEARS. THE EQUIVALENT ASTHMA HOSPITALIZATION RATE FOR WASHTENAW ADULTS WAS LOWER THAN MICHIGAN. BECAUSE THE DATA FOR THIS METRIC WERE DATED AND CAUSAL EVIDENCE WAS ANECDOTAL AT BEST, SJMAA WILL CONTINUE TO MONITOR PUBLIC DATA AND INTERNAL EXPERIENCE TO DETERMINE IF CHILDHOOD ASTHMA SHOULD BE MADE A PRIORITY. ALCOHOL ABUSE - BECAUSE BEHAVIORAL HEALTH WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, AND BECAUSE IT INCLUDES ALCOHOL ABUSE, THIS WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT ADDRESSING BEHAVIORAL HEALTH. IMMUNIZATIONS - IMMUNIZATIONS RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS. SJMAA BELIEVES THAT NEW RULES REGARDING MICHIGAN CHILDHOOD IMMUNIZATION WAIVERS WILL IMPROVE CHILDHOOD IMMUNIZATION RATES. ADDITIONALLY, SJMAA BELIEVES THE TREND TOWARD POPULATION HEALTH MANAGEMENT, MEDICAL HOMES AND ACCOUNTABLE CARE WILL CREATE PROVIDER INCENTIVES NECESSARY TO ELEVATE ALL ADULT IMMUNIZATION RATES. IMMUNIZATION RATES FOR ADULTS ARE BETTER IN WASHTENAW THAN MICHIGAN OVERALL AND THE NUMBER OF HOSPITALIZATIONS AND DEATHS IN WASHTENAW IS LOWER THAN MICHIGAN FOR RELATED CONDITIONS. FOR THESE REASONS, SJMAA WILL NOT TAKE NEW OR SPECIFIC ADDITIONAL ACTIONS TO ADDRESS IMMUNIZATIONS. NUTRITION AND HEALTHFUL EATING - BECAUSE OBESITY WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, NUTRITION AND HEALTHFUL EATING WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY. HOSPITAL-BASED CARE - DATA DERIVED FROM THE COMMUNITY SURVEY AND INTERVIEW PROCESS REGARDING THE NEED FOR HOSPITAL-BASED CARE WERE LIMITED, BUT APPEARED TO BE PRIMARILY RELATED TO FINANCIAL ACCESS TO CARE. SJMAA WILL CONTINUE TO ASSIST PATIENTS WITH INSURANCE ENROLLMENT AND ACCESS TO OTHER FINANCIAL SUPPORT THROUGH ITS PATIENT FINANCIAL SERVICES PROGRAMS, BUT WILL NOT BE TAKING NEW OR SPECIFIC ACTIONS TO ADDRESS ACCESS THIS NEED UNTIL THE FULL IMPACT OF THE AFFORDABLE CARE ACT CAN BE MEASURED AND SPECIFIC BARRIERS ARE IDENTIFIED. DENTAL HEALTH - THE NEED FOR DENTAL HEALTH WAS SPECIFIC TO ACCESS FOR LOW INCOME INDIVIDUALS AS IDENTIFIED THROUGH THE COMMUNITY SURVEYS AND INTERVIEWS. SPECIFIC, QUANTITATIVE DATA REGARDING DENTAL HEALTH AND ACCESS TO DENTAL CARE WERE NOT READILY AVAILABLE. IN FEBRUARY 2015, SJMAA BEGAN A PARTNERSHIP WITH THE WASHTENAW COUNTY HEALTH DEPARTMENT TO OPEN A DENTAL HEALTH CLINIC IN YPSILANTI. AS SUCH, SJMAA IS NOT PRIORITIZING DENTAL HEALTH AS PART OF THIS CHNA PROCESS, BUT WILL REVIEW DATA AGAIN IN 2018.SPECIALIST PHYSICIANS - THE NEED FOR IMPROVED ACCESS TO SPECIALIST CARE WAS IDENTIFIED BY SOME COMMUNITY SURVEYS AND INTERVIEW PARTICIPANTS. HOWEVER, ACCESS TO SPECIALIST PHYSICIANS RANKED LOW AMONG COMMUNITY HEALTH NEEDS AND FEW OF THE MORTALITY OR HOSPITALIZATION RATES POINTED TO SPECIFIC, ACTIONABLE BARRIERS. FOR THESE REASONS, SJMAA WILL NOT TAKE NEW OR SPECIFIC ACTIONS TO ADDRESS ACCESS TO SPECIALIST PHYSICIANS. END OF LIFE CARE - ANECDOTAL DATA THROUGH LOCAL SURVEYS INDICATED THAT END-OF-LIFE CARE IS A COMMUNITY NEED. HOWEVER, AVAILABLE DATA REGARDING ACCESS TO NURSING HOMES DOES NOT INDICATE AN UNMET NEED (APPROXIMATELY 78% OCCUPANCY) AND OTHER SUPPORTING METRICS WERE NOT RELIABLY AVAILABLE. SJMAA WILL CONTINUE TO SUPPORT THE AREA AGENCY ON AGING, ITS HOME CARE, HOSPICE AND REGIONAL NURSING HOME PARTNERS TO ENSURE SPECIFIC END-OF-LIFE NEEDS ARE ADDRESSED AS THEY ARE IDENTIFIED. HEALTH EDUCATION AND AWARENESS - HEALTH EDUCATION AND AWARENESS ARE ESSENTIAL FOR INDIVIDUALS TO PREVENT, SEEK CARE AND MANAGE HEALTH CONDITIONS. INITIATIVES FOR THE TWO COMMUNITY HEALTH NEEDS THAT SJMAA HAS RESOLVED TO ADDRESS WILL EACH INCLUDE ESSENTIAL ELEMENTS FOR HEALTH EDUCATION AND AWARENESS SUCH AS EDUCATION REGARDING HEALTHY LIFESTYLES AND EATING, AND SUBSTANCE ABUSE PREVENTION EDUCATION. TRANSPORTATION - THIS NEED AFFECTS ACCESS TO CARE, PARTICULARLY AMONG LOW-INCOME AND MEDICALLY UNDERSERVED INDIVIDUALS. HOWEVER, TRANSPORTATION RANKED LOW AMONG OTHER RISK FACTORS. SJMAA WILL CONTINUE TO MONITOR THIS NEED AND INCREMENTALLY ADD INITIATIVES TO ADDRESS IT AS APPROPRIATE. HEALTH INSURANCE ENROLLMENT - SJMAA WILL CONTINUE TO ASSIST PATIENTS WITH INSURANCE ENROLLMENT AND ACCESS TO OTHER FINANCIAL SUPPORT THROUGH ITS PATIENT FINANCIAL SERVICES PROGRAMS, BUT WILL NOT BE TAKING NEW OR SPECIFIC ACTIONS TO ADDRESS ACCESS THIS NEED UNTIL THE FULL IMPACT OF THE AFFORDABLE CARE ACT CAN BE MEASURED AND SPECIFIC BARRIERS ARE IDENTIFIED. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 11: FOUR HIGH PRIORITY CHNA IDENTIFIED NEEDS THAT MERCY HEALTH SAINT MARY'S (MHSM) WILL DIRECTLY ADDRESS OVER THE NEXT THREE FISCAL YEARS INCLUDE: MENTAL HEALTH, NUTRITION AND OBESITY, SUBSTANCE USE, AND SAFETY AND VIOLENCE.MENTAL HEALTH - AT EACH OF 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, ELIGIBLE PATIENTS ARE ENROLLED IN MHSM'S PHARMACEUTICAL ACCESS PROGRAM TO ENSURE POVERTY IS NOT A BARRIER FOR PATIENTS TO SEEK MENTAL HEALTH MEDICATIONS. MHSM ALSO HAS ACCESS TO THE UNIVERSITY OF MICHIGAN CHILD COLLABORATIVE CARE (MC3) PROGRAM, WHICH PROVIDES PHONE CONSULTS WITH THEIR PSYCHIATRISTS REGARDLESS OF WHETHER A PATIENT HAS AN ESTABLISHED MENTAL HEALTH PROVIDER OR NOT. LASTLY, MHSM IS IMPLEMENTING PAIN PSYCHOLOGISTS TO AID PATIENTS WITH PAIN MANAGEMENT.IN COLLABORATION WITH A CENTER FOR HOMELESS TEENS, ONE COMMUNITY HEALTH WORKER (CHW) WAS LOCATED ON SITE AT THE CENTER. THE CHW CONNECTS TEENS WITH COMMUNITY RESOURCES, ENROLLMENT IN HEALTH CARE COVERAGE, AND PROVIDING PRIMARY CARE PHYSICIAN OPTIONS AT HEARTSIDE HEALTH CENTER. IN COLLABORATION WITH MAKING CHOICES MICHIGAN, MHSM PROVIDED TWO ADVANCE CARE PLANNING SEMINARS ON APRIL 16, 2015, WHICH 30 INDIVIDUALS ATTENDED. ONE EVENT WAS HELD AT MHSM, THE OTHER AT MERCY HEALTH SOUTHWEST CAMPUS.NUTRITION AND OBESITY - AT EACH PRIMARY CARE VISIT, SCREENING AND EDUCATION IS PROVIDED TO PATIENTS WHO INDICATE OBESITY IS A FACTOR. CHILDREN WHO STRUGGLE WITH OBESITY ARE REFERRED TO A COMMUNITY PROGRAM THAT SPECIALIZES IN FIGHTING CHILDHOOD OBESITY, 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 CHW'S HAVE BECOME FACILITATORS FOR DIABETES PATH, A SIX-WEEK WORKSHOP TO IMPROVE DIABETES MANAGEMENT THROUGH EDUCATION ABOUT NUTRITION, EXERCISE AND HEALTH EDUCATION. MHSM PROVIDERS ALSO REFER TO THE FITKIDS PROGRAM AT THE HELEN DEVOS CHILDREN'S HOSPITAL. IN ADDITION, 264 BLOOD PRESSURE SCREENINGS WERE CONDUCTED WITHIN THE YEAR IN VARIOUS COMMUNITIES WITHIN KENT COUNTY, AT OUTREACH EVENTS AND AT HEALTH FAIRS. ALL PATIENTS WHO WERE SCREENED RECEIVED INFORMATION RELATED TO SIGNS AND SYMPTOMS OF A STROKE. UTILIZING THE MATTER OF BALANCE CURRICULUM AS A MODEL FOR EXERCISE TO INCREASE STRENGTH AND BALANCE FOR OLDER ADULTS, MHSM CONDUCTED AN EIGHT-WEEK, TWO-HOUR SESSION 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 ALREADY OBTAINED THE INTEREST OF AN ADDICTION SPECIALIST TO JOIN OUR 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 PROCESS.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, ARE PROVIDED. IN ADDITION, 14 STAFF MEMBERS ARE CERTIFIED APPLICATION COUNSELORS-8 WHO CONDUCT EXTENSIVE OUTREACH IN THE COMMUNITY NAVIGATING AND EDUCATING UNINSURED INDIVIDUALS ABOUT THEIR HEALTH INSURANCE OPTIONS, SPECIFICALLY VICTIMS OF DOMESTIC VIOLENCE AND HUMAN TRAFFICKING WHO MAY BE ELIGIBLE TO ENROLL IN HEALTH COVERAGE, AND UNDOCUMENTED INDIVIDUALS WHO MAY QUALIFY FOR A T-1 VISA. 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. 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. LAST FISCAL YEAR, THE INJURY PREVENTION COORDINATOR CONDUCTED TWO EVENTS AT COMSTOCK PARK AND NORTHVIEW HIGH SCHOOL. THE EVENTS WERE PRESENTED TO APPROXIMATELY 600 HIGH SCHOOL STUDENTS.THE FOLLOWING DESCRIBES THE TOP CHNA IDENTIFIED NEEDS THAT MERCY HEALTH SAINT MARY'S (MHSM) WILL NOT DIRECTLY ADDRESS OVER THE NEXT THREE FISCAL YEARS, WITH A SUMMARY EXPLANATION OF WHY WE HAVE DETERMINED THAT THIS ORGANIZATION WILL NOT MAKE THESE A PRIORITY. PUBLIC TRANSPORTATION - MHSM CANNOT REALISTICALLY RESOLVE THIS NEED, HOWEVER MHSM HAS SET ASIDE FUNDS FOR CAB VOUCHERS AND BUS PASSES FOR INDIVIDUALS AND FAMILIES IN NEED OF TRANSPORTATION. IN ADDITION, KENT COUNTY'S LOCAL BUS TRANSPORTATION SYSTEM DONATES 350 BUS PASSES TO LOCAL NONPROFITS (MHSM INCLUDED) ANNUALLY TO DISTRIBUTE TO INDIVIDUALS AND FAMILIES WITH TRANSPORTATION BARRIERS. INCREASE COMMUNITY'S KNOWLEDGE ABOUT RESOURCES AVAILABLE IN THE COMMUNITY - RATHER THAN A SEPARATE STRATEGIC GOAL, MHSM WILL INCORPORATE COMMUNITY RESOURCE INFORMATION IN ALL OF COMMUNITY HEALTH CENTERS. AS PATIENTS MEET WITH THE COMMUNITY HEALTH WORKERS STATIONED IN THE CBM MEDICAL HOMES, COMMUNITY RESOURCES ARE IDENTIFIED AND REFERRALS ARE MADE TO REDUCE BARRIERS AND SOCIAL DETERMINANTS OF HEALTH.POOR HOUSING QUALITY - COMMUNITY GROUPS ARE ALREADY ADDRESSING THIS ISSUE (E.G., TRUE NORTH, SALVATION ARMY, DEPARTMENT OF HEALTH AND HUMAN SERVICES, OUR BROTHER'S KEEPERS, HABITAT FOR HUMANITY, AND THE MEL TROTTER MISSION). THEREFORE, MHSM RESOURCES ARE BETTER ALLOCATED TOWARD OTHER NEEDS. LACK OF HEALTH EDUCATION - RATHER THAN A SEPARATE STRATEGIC GOAL, MHSM WILL INCORPORATE HEALTH EDUCATION AS PART OF THE COMMUNITY HEALTH PROGRAM, WHICH INCLUDES COMMUNITY HEALTH WORKERS TRAINED AS DIABETES PATH FACILITATORS AND MATTER OF BALANCE FACILITATORS, AND HEALTH EDUCATION CONDUCTED AT COMMUNITY OUTREACH EVENTS AND HEALTH FAIRS. HEALTH EDUCATION IS ALSO PROVIDED AT SPECIFIC OUTREACH EVENTS HELD AT THE COMMUNITY HEALTH CENTERS SERVING MORE VULNERABLE POPULATIONS (I.E., HISPANIC, HOMELESS, ETC.). CASE MANAGERS HAVE ALSO BEEN HIRED TO PROVIDE HEALTH EDUCATION AT THE COMMUNITY HEALTH CENTERS OF THE UNINSURED. HOME VISITS TO PATIENTS AND PROVIDER REPRESENTATION AT LOCAL COMMUNITY OUTREACH EVENTS ALSO OCCUR ROUTINELY. ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 11: THE FOUR COMMUNITY HEALTH NEEDS PRIORITIZED BY ST. JOSEPH MERCY OAKLAND (SJM0) ARE OBESITY, FINANCIAL ACCESS TO CARE, DENTAL CARE, AND BEHAVIORAL HEALTH. OUR IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS:OBESITY - SJMO WILL WORK TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY. SJMO WILL SUPPORT AREA SCHOOLS WITH EDUCATION & PREVENTION STRATEGIES, NUTRITION EDUCATION, PHYSICAL ACTIVITY AND BEHAVIORAL HEALTH. WE SEEK TO INCREASE COMMUNITY ACCESS TO NUTRITIOUS FOODS, OPPORTUNITIES FOR PHYSICAL ACTIVITY, AND EDUCATION ON HEALTHY LIVING IN VARIOUS COMMUNITY VENUES. FINANCIAL ACCESS TO CARE - SJMO WILL PROVIDE ENROLLMENT SERVICES TO ASSIST THOSE ELIGIBLE FOR INSURANCE PLANS AND ALTERNATIVE PAYMENT SOURCES.DENTAL CARE - SJMO WILL EXPAND ACCESS TO DENTAL CARE FOR LOW INCOME AND MEDICALLY COMPLEX INDIVIDUALS. FURTHER, SJMO WILL WORK TO IMPROVE COORDINATION AND ACCESS TO NECESSARY FOLLOW UP CARE AFTER DENTAL TREATMENT. SJMO WILL SUPPORT DENTAL HYGIENE EDUCATION IN THE COMMUNITY.BEHAVIORAL HEALTH - SJMO WILL WORK TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY. SJMO WILL CONTRIBUTE TOWARD IMPROVING ACCESS TO ADOLESCENT BEHAVIORAL HEALTH, SUBSTANCE ABUSE TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE. SJMO WILL ADDRESS ACCESS TO CARE BARRIERS AND WILL PROVIDE EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS.SJMO WILL NOT TAKE NEW OR SPECIFIC ADDITIONAL ACTIONS ON THE FOLLOWING HEALTH NEEDS:CANCER - SJMO CURRENTLY OFFERS AND WILL CONTINUE TO OFFER SEVERAL FREE AND LOW-COST PROGRAMS AIMED AT CANCER PREVENTION AND EARLY DETECTION, INCLUDING SMOKING CESSATION AND BREAST CANCER SCREENING. BECAUSE CANCER RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS, SJMO BELIEVES IT IS APPROPRIATE TO MAINTAIN ITS CURRENT CANCER-FOCUSED INITIATIVES AND TO MONITOR CHANGES IN CANCER INCIDENCE AND DEATH RATES IN ITS SERVICE AREA. CHRONIC DISEASES - BECAUSE MANY CHRONIC DISEASES SUCH AS HIGH BLOOD PRESSURE, STROKE AND DIABETES ARE CLOSELY RELATED TO WEIGHT ISSUES, MANY CHRONIC DISEASES WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY. OTHER EFFORTS REGARDING BEHAVIORAL HEALTH AND FINANCIAL ACCESS TO CARE SHOULD ALSO DIRECTLY IMPROVE ISSUES SUCH AS CHRONIC LIVER DISEASE AND MEDICATION AFFORDABILITY. SUICIDE - BECAUSE BEHAVIORAL HEALTH WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, SUICIDE WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT ADDRESSING BEHAVIORAL HEALTH. ALCOHOL ABUSE - BECAUSE BEHAVIORAL HEALTH WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, AND BECAUSE IT INCLUDES ALCOHOL ABUSE, THIS WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT ADDRESSING BEHAVIORAL HEALTH. HEALTHFUL EATING - BECAUSE OBESITY WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, NUTRITION WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY. IMMUNIZATIONS - IMMUNIZATIONS RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS. SJMO BELIEVES THAT NEW RULES REGARDING MICHIGAN CHILDHOOD IMMUNIZATION WAIVERS WILL IMPROVE CHILDHOOD IMMUNIZATION RATES. EXERCISE - WHILE OVERWEIGHT AND OBESITY WERE RANKED AS MOST IMPORTANT HEALTH NEEDS, EXERCISE WILL BE INCLUDED AS ONE OF THE MANY STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY. HOSPITAL-BASED CARE - BECAUSE FINANCIAL ACCESS TO CARE WAS RANKED AS THE MOST IMPORTANT HEALTH NEED AND SOME OF THE NEED FOR HOSPITAL BASED CARE WAS RELATED TO FINANCIAL ACCESS, THIS NEED WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT IMPROVING FINANCIAL ACCESS. SPECIALIST PHYSICIANS - BECAUSE FINANCIAL ACCESS TO CARE WAS RANKED AS THE MOST IMPORTANT HEALTH NEED AND THE NEED FOR IMPROVED ACCESS TO SPECIALIST CARE WAS PRIMARILY RELATED TO FINANCIAL ACCESS, THIS NEED WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT IMPROVING FINANCIAL ACCESS. END OF LIFE CARE - ANECDOTAL DATA THROUGH LOCAL SURVEYS INDICATED THAT END-OF-LIFE CARE IS A COMMUNITY NEED. HOWEVER, AVAILABLE DATA REGARDING ACCESS TO NURSING HOMES DOES NOT INDICATE AN UNMET NEED (78% OCCUPANCY) AND OTHER SUPPORTING METRICS WERE NOT RELIABLY AVAILABLE. SJMO WILL CONTINUE TO PROVIDE END OF LIFE/PALLIATIVE CARE SERVICES AND WILL SUPPORT THE AREA AGENCY ON AGING AND ITS HOME CARE, HOSPICE AND REGIONAL NURSING HOME PARTNERS TO ENSURE SPECIFIC END-OF-LIFE NEEDS ARE ADDRESSED ACROSS THE CONTINUUM OF CARE. PHARMACEUTICALS - BECAUSE FINANCIAL ACCESS TO CARE WAS RANKED AS THE MOST IMPORTANT HEALTH NEED AND SOME OF THE NEED FOR IMPROVED ACCESS TO PHARMACEUTICALS CARE WAS RELATED TO FINANCIAL ACCESS, THIS NEED WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT IMPROVING FINANCIAL ACCESS. PRIMARY CARE - PRIMARY CARE RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS. SJMO CURRENTLY OFFERS, AND WILL CONTINUE TO OFFER, NO COST AND LOW COST PRIMARY CARE THROUGH MERCY PLACE, MERCY MEDICINE AND MERCY WOMEN'S HEALTH. MATERNAL HEALTH EDUCATION - MATERNAL HEALTH EDUCATION CARE RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS AND INFANT MORTALITY RATES IN THE SERVICE AREA HAVE SHOWN IMPROVEMENT. SJMO WILL CONTINUE TO OFFER MATERNAL HEALTH EDUCATION THROUGH ITS MERCY WOMEN'S HEALTH CLINIC, AS WELL AS MERCY PLACE AS NEEDED. TRANSPORTATION - THIS NEED AFFECTS ACCESS TO CARE, PARTICULARLY AMONG LOW-INCOME AND MEDICALLY UNDERSERVED INDIVIDUALS. HOWEVER, TRANSPORTATION RANKED LOW AMONG OTHER RISK FACTORS GIVEN THE AVAILABILITY OF PUBLIC TRANSIT WITHIN THE IMMEDIATE PONTIAC AREA AND SUBSIDIZED TRANSPORTATION SERVICES CURRENTLY AVAILABLE IN THE AREA. HEALTH LITERACY - HEALTH LITERACY IS ESSENTIAL FOR INDIVIDUALS TO PREVENT, SEEK CARE FOR, AND MANAGE HEALTH CONDITIONS. HEALTH LITERACY ALSO INCLUDES AWARENESS OF BENEFITS AVAILABLE THROUGH INSURANCE AND WHERE TO RECEIVE CARE. FOR THIS REASON, INITIATIVES FOR THE FOUR COMMUNITY HEALTH NEEDS THAT SJMO HAS RESOLVED TO ADDRESS WILL EACH INCLUDE ESSENTIAL ELEMENTS FOR HEALTH LITERACY SUCH AS HEALTH EDUCATION AND CONNECTIVITY WITH COMMUNITY RESOURCES. NAVIGATION OF HEALTHCARE RESOURCES - LIKE HEALTH LITERACY, THIS NEED GREATLY AFFECTS ACCESS TO CARE. MANY COMMUNITY MEMBERS HAVE DIFFICULTY UNDERSTANDING HOW AND WHERE TO ACCESS CARE, PARTICULARLY IF THEY FACE OTHER BARRIERS SUCH AS ABILITY TO PAY. INITIATIVES FOR THE FIVE COMMUNITY HEALTH NEEDS THAT SJMO HAS RESOLVED TO ADDRESS WILL EACH INCLUDE ESSENTIAL ELEMENTS FOR NAVIGATION OF HEALTHCARE RESOURCES, SUCH AS HEALTH EDUCATION AND CONNECTIVITY WITH COMMUNITY RESOURCES. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 11: LISTED IN ORDER OF IMPORTANCE, ST. MARY MERCY LIVONIA (SMML) WILL FOCUS ON DEVELOPING AND/OR SUPPORTING INITIATIVES AND MEASURING THEIR EFFECTIVENESS, TO IMPROVE THE FOLLOWING HEALTH NEEDS: OBESITY - INCREASE PHYSICAL ACTIVITY AND IMPROVED NUTRITION ESPECIALLY IN CHILDREN AGES K-12 THROUGH EDUCATIONAL PROGRAMS AND ACTIVITIES TO ENCOURAGE INCREASED STEPS/PHYSICAL ACTIVITY FOR CHILDREN AND FAMILIES IN THE LIVONIA PUBLIC SCHOOLS, IMPLEMENTATION OF AN "ALL SCHOOL TASTING DAY" AT A TARGET SCHOOL IN THE SOUTH REDFORD SCHOOL DISTRICT, AND A GROCERY STORE TOUR AND STUDENT ASSEMBLY IN PARTNERSHIP WITH MEIJER TO INCREASE FRUIT AND VEGETABLE INTAKE.ACCESS TO CARE - IMPROVE ACCESS TO PRIMARY CARE PROVIDERS AND SPECIALISTS AND TRANSPORTATION FOR HEALTHCARE APPOINTMENTS THROUGH EDUCATION/PROMOTION OF WELLNESS CHECKS, RIGHT CARE/RIGHT TIME AND PREVENTION SERVICES TO THE COMMUNITY IN CONJUNCTION WITH SOUTH REDFORD SCHOOL DISTRICT, EXPANSION OF CURRENT SCHOOL-BASED LOCATIONS IN SOUTH REDFORD SCHOOL DISTRICT AND/OR OTHER LOCATIONS, EXPANSION OF POINT-OF-CARE LOCATIONS IN THE COMMUNITY, INCREASE THE NUMBER OF ADULTS RECEIVING TRANSPORTATION ASSISTANCE TO HEALTH CARE APPOINTMENT, EXPANSION OF THE INFRASTRUCTURE FOR SPECIALIST CARE IN THE COMMUNITY, AND IMPLEMENTATION/EXPANSION OF NAVIGATORS/COMMUNITY HEALTH WORKERS TO ASSIST WITH FOLLOW-UP HEALTH CARE APPOINTMENTS AND MANAGEMENT OF CHRONIC DISEASES. MENTAL HEALTH/SUBSTANCE ABUSE - PREVENT SUICIDE, IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICE AND REDUCE EXCESSIVE USE OF ALCOHOL THROUGH PARTNERSHIPS WITH LOCAL CLINICS, PHYSICIANS, BEHAVIORAL HEALTH AND SENIOR CARE AGENCIES TO EDUCATE/TRAIN/SUPPORT THE PROVISION OF SUICIDAL RISK SCREENINGS BY HEALTHCARE PROVIDERS, INCLUDING NEW AND VARIOUS LOCATIONS (ASSISTED LIVING). THROUGH THESE PARTNERSHIPS, SMML WILL INCREASE THE NUMBER OF DEPRESSION SCREENINGS FOR ALL TEENS SEEN IN THE EMERGENCY ROOM, ESTABLISH SUPPORT/EDUCATION FOR DEPRESSION SCREENING AS ROUTINE CARE AT PRIMARY CARE VISITS WITHIN THE ST. MARY MERCY MEDICAL GROUP, SUPPORT/EXPAND (SITES, SESSIONS FUNDING, LINKAGES) THE NUMBER OF PEOPLE TRAINED TO BE A MENTAL HEALTH FIRST AID RESPONDER YEARLY, CREATE A BEHAVIORAL HEALTH TRANSITIONS OF CARE TEAM USING THE STARFORM MODEL, AND PARTNER WITH LOCAL ORGANIZATIONS TO PROVIDE A DRUG/ALCOHOL EDUCATIONAL PROGRAM FOR TEENS, FAMILIES AND THE COMMUNITY-AT-LARGE AT A NEUTRAL VENUE. ST. MARY MERCY LIVONIA ACKNOWLEDGES 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- ADULT PHYSICAL ACTIVITY AND NUTRITION WILL NOT BE ADDRESSED IN THIS PLAN BUT THE HOSPITAL WILL CONTINUE TO SPONSOR COMMUNITY FUN RUNS AND THE OTHER COMMUNITY EVENTS THAT PROMOTE PHYSICAL ACTIVITY AND COOKING DEMONSTRATIONS FOR HEALTHIER EATING. CANCER- CANCER WILL BE ADDRESSED IN THE STRATEGIES 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 IN THE STRATEGIES FOR ACCESS TO CARE AND OBESITY.DIABETES- DIABETES DID NOT RANK AMONG THE TOP HEALTH NEEDS ALTHOUGH ONE-THIRD OF THE PEOPLE IN THE UNITED STATES HAVE DIABETES BUT DO NOT KNOW IT. ST. MARY MERCY LIVONIA 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 COMMUNITY HEALTH NEEDS PRIORITIZED BY ST. JOSEPH MERCY LIVINGSTON (SJML) ARE OBESITY & BEHAVIORAL HEALTH. OUR IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS:OBESITY- SJML WILL WORK TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY. SJML WILL SUPPORT AREA SCHOOLS WITH EDUCATION & PREVENTION STRATEGIES, NUTRITION EDUCATION, PHYSICAL ACTIVITY AND BEHAVIORAL HEALTH. WE SEEK TO INCREASE COMMUNITY ACCESS TO NUTRITIOUS FOODS, OPPORTUNITIES FOR PHYSICAL ACTIVITY, AND EDUCATION ON HEALTHY LIVING IN VARIOUS COMMUNITY VENUES.BEHAVIORAL HEALTH - SJML WILL WORK TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY. SJML WILL CONTRIBUTE TOWARD IMPROVING ACCESS TO ADOLESCENT BEHAVIORAL HEALTH, SUBSTANCE ABUSE TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE. SJML WILL ADDRESS ACCESS TO CARE BARRIERS AND WILL PROVIDE EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS.THERE WERE NEEDS IDENTIFIED THAT ST. JOSEPH MERCY LIVINGSTON (SJML) CHOSE NOT TO ADDRESS. THESE NEEDS, WHILE IMPORTANT TO THE HEALTH SYSTEM AND THE COMMUNITY, WERE NOT CHOSEN BASED ON OUR PRIORITIZATION PROCESS. THIS PROCESS INCLUDED THE FOLLOWING QUESTIONS: 1) THE NUMBER OF PEOPLE AFFECTED, 2) THE SEVERITY OF THE PROBLEM, 3) THE HEALTH SYSTEM'S ABILITY TO IMPACT, AND 4) THE EXTENT TO WHICH OTHER ORGANIZATIONS WERE MEETING THE NEED. THE NEEDS THAT WERE NOT CHOSEN ARE AS FOLLOWS:BREAST CANCER - SJML CURRENTLY OFFERS AND WILL CONTINUE TO OFFER FREE AND LOW-COST PROGRAMS AIMED AT BREAST CANCER PREVENTION AND EARLY DETECTION. THE PERCENTAGE OF LIVINGSTON COUNTY WOMEN HAVING A MAMMOGRAM WAS LOWER THAN THAT OTHER MICHIGAN WOMEN BUT THE DATA HAVE NOT BEEN UPDATED SINCE 2010. LIVINGSTON'S MORTALITY RATE ATTRIBUTED TO INVASIVE BREAST CANCER HAS BEEN WORSE THAN MICHIGAN IN 4 OF THE LAST 5 YEARS. BECAUSE CANCER RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS, SJML BELIEVES IT IS APPROPRIATE TO MAINTAIN ITS CURRENT BREAST CANCER-FOCUSED INITIATIVES AND TO MONITOR CHANGES IN INCIDENCE AND DEATH RATES IN ITS SERVICE AREA AS NEWER DATA BECOME AVAILABLE. CHRONIC DISEASES - BECAUSE MANY CHRONIC DISEASES SUCH AS DIABETES AND HIGH BLOOD PRESSURE ARE CLOSELY RELATED TO WEIGHT ISSUES, MANY CHRONIC DISEASES WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY. EFFORTS TO IMPROVE BEHAVIORAL HEALTH SHOULD ALSO INDIRECTLY IMPROVE CHRONIC DISEASE ISSUES SUCH AS LIVER DISEASE AND PATIENTS' EMOTIONAL ABILITY TO MANAGE CHRONIC MEDICAL ISSUES. FOR THESE REASONS, SJML WILL NOT TAKE NEW OR SPECIFIC ACTIONS TO ADDRESS CHRONIC DISEASES. SUICIDE - BECAUSE BEHAVIORAL HEALTH WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, AND BECAUSE SUICIDE IS OFTEN A REFLECTION OF UNMET MENTAL HEALTH NEEDS OR SUBSTANCE ABUSE ISSUES, SJML ANTICIPATES SUICIDE WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF ITS STRATEGIES AND ACTIVITIES AIMED AT ADDRESSING BEHAVIORAL HEALTH. COLON CANCER - THE PERCENT OF LIVINGSTON COUNTY ADULTS HAVING AN APPROPRIATELY-TIMED COLONOSCOPY IS LOWER THAN THAT OF MICHIGAN ADULTS, AND LIVINGSTON'S MORTALITY RATE ATTRIBUTED TO INVASIVE COLORECTAL CANCER HAS BEEN CONSISTENTLY WORSE THAN MICHIGAN FOR EACH OF THE LAST FIVE YEARS MEASURED. HOWEVER, COLON CANCER RANKED LOW AMONG OTHER NEEDS. SJML WILL CONTINUE TO MONITOR THIS NEED AND INCREMENTALLY ADD INITIATIVES TO ADDRESS IT AS APPROPRIATE. TOBACCO USE - TOBACCO USE RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS. SMJL ANTICIPATES THAT THROUGH ITS EFFORTS TO ADDRESS BEHAVIORAL HEALTH NEEDS, AND SPECIFICALLY EDUCATION REGARDING SUBSTANCE USES AND THEIR IMPACTS, TOBACCO USE MAY DECLINE AS AN INDIRECT RESULT OF ITS STRATEGIES AND ACTIVITIES AIMED AT ADDRESSING OTHER ASPECTS OF BEHAVIORAL HEALTH. DRUG ABUSE - BECAUSE BEHAVIORAL HEALTH WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, AND BECAUSE IT INCLUDES DRUG ABUSE, THIS WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT ADDRESSING BEHAVIORAL HEALTH. ALCOHOL ABUSE - BECAUSE BEHAVIORAL HEALTH WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, AND BECAUSE IT INCLUDES ALCOHOL ABUSE, THIS WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT ADDRESSING BEHAVIORAL HEALTH. IMMUNIZATIONS - IMMUNIZATIONS RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS. SJML BELIEVES THAT NEW RULES REGARDING MICHIGAN CHILDHOOD IMMUNIZATION WAIVERS WILL IMPROVE CHILDHOOD IMMUNIZATION RATES. ADDITIONALLY, SJML BELIEVES THE TREND TOWARD POPULATION HEALTH MANAGEMENT, MEDICAL HOMES AND ACCOUNTABLE CARE WILL CREATE PROVIDER INCENTIVES NECESSARY TO ELEVATE ALL ADULT IMMUNIZATION RATES. FOR THESE REASONS, SJML WILL NOT TAKE NEW OR SPECIFIC ADDITIONAL ACTIONS TO ADDRESS IMMUNIZATIONS BUT WILL CONTINUE TO MONITOR THE DATA. NUTRITION AND HEALTHFUL EATING - BECAUSE OBESITY WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, NUTRITION AND HEALTHFUL EATING WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY. HOSPITAL-BASED CARE - DATA DERIVED FROM THE COMMUNITY SURVEY AND INTERVIEW PROCESS REGARDING THE NEED FOR HOSPITAL BASED CARE WERE LIMITED, BUT APPEARED TO BE PRIMARILY RELATED TO FINANCIAL ACCESS TO CARE. SJML WILL CONTINUE TO ASSIST PATIENTS WITH INSURANCE ENROLLMENT AND ACCESS TO OTHER FINANCIAL SUPPORTS THROUGH ITS PATIENT FINANCIAL SERVICES PROGRAMS, BUT WILL NOT BE TAKING NEW OR SPECIFIC ACTIONS TO ADDRESS THIS NEED UNTIL THE FULL IMPACT OF THE AFFORDABLE CARE ACT CAN BE MEASURED AND SPECIFIC BARRIERS ARE IDENTIFIED. DENTAL HEALTH - THE NEED FOR DENTAL HEALTH WAS SPECIFIC TO ACCESS FOR LOW INCOME INDIVIDUALS AS IDENTIFIED THROUGH THE COMMUNITY SURVEYS AND INTERVIEWS. SJML HAS BEEN AND WILL CONTINUE TO EVALUATE OPTIONS FOR ESTABLISHING A DENTAL HEALTH CLINIC AT THE HOSPITAL, BUT IS UNSURE THESE PLANS WILL BE OPERATIONALIZED BEFORE 2018. PRIMARY CARE - INCREASED ACCESS TO PRIMARY CARE WAS IDENTIFIED AS A NEED BY SOME COMMUNITY SURVEYS AND INTERVIEWS. HOWEVER, LIVINGSTON COUNTY METRICS SUCH AS THE PERCENT OF RESIDENTS REPORTING TO HAVE A PRIMARY CARE PHYSICIAN, AND HOSPITALIZATIONS FOR AMBULATORY-SENSITIVE CONDITIONS DID NOT SUPPORT THE FINDING. BECAUSE OF THIS, AND BECAUSE PRIMARY CARE RANKED LOW COMPARED WITH OTHER COMMUNITY NEEDS, PRIMARY CARE WILL NOT BE ADDRESSED BY SJML. ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 11: AFTER REVIEWING THIS DATA, AND MAPPING EXISTING RESOURCES, THE COMMUNITY HEALTH IMPROVEMENT COUNCIL DEVELOPED AN IMPLEMENTATION STRATEGY WITH EVIDENCE-BASED INTERVENTIONS. THE ST. JOSEPH MERCY CHELSEA (SJMC) BOARD OF TRUSTEES APPROVED THE IMPLEMENTATION STRATEGY ON MARCH 24, 2015. THE PRIORITY NEEDS - OBESITY, MENTAL HEALTH, SUBSTANCE ABUSE, AND ACCESS TO CARE - WERE IDENTIFIED BASED ON SIZE, SEVERITY, AVAILABLE DATA, AND THE HOSPITAL'S ABILITY TO HAVE AN IMPACT. IN ORDER TO ADDRESS PRIORITY NEEDS, SJMC WILL ENGAGE KEY COMMUNITY PARTNERS IN IMPLEMENTING EVIDENCE-BASED STRATEGIES ACROSS THE SERVICE AREA. THESE STRATEGIES TO ADDRESS THE PRIORITY NEEDS LISTED PREVIOUSLY INCLUDE MODIFYING POLICES, PROVIDING SUPPORT, ENHANCING ACCESS, CHANGING CONSEQUENCES AND INCENTIVES, PROVIDING INFORMATION, AND ENHANCING SKILLS.SJMC ACKNOWLEDGES THE WIDE RANGE OF SIGNIFICANT 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. SJMC WILL NOT TAKE NEW OR ADDITIONAL ACTIONS ON THE FOLLOWING HEALTH NEEDS:DENTAL HEALTH - ACCESS TO AFFORDABLE DENTAL CARE WAS IDENTIFIED AS A MAJOR NEED AMONG THE LOW-INCOME AND MEDICALLY UNDERSERVED POPULATIONS. A REGIONAL COALITION CALLED THE WASHTENAW HEALTH INITIATIVE (WHI) IS WORKING TO ADDRESS THIS NEED IN WASHTENAW COUNTY, INCLUDING CHELSEA, DEXTER AND MANCHESTER. RESIDENTS OF GRASS LAKE HAVE ACCESS TO THE CENTER FOR FAMILY HEALTH IN JACKSON, WHICH PROVIDES FREE AND LOW COST MEDICAL AND DENTAL CARE TO ADULTS AND YOUTH THROUGH THEIR DOWNTOWN CLINIC, AS WELL AS SCHOOL-BASED CLINICS. BESIDES THE RESOURCES IN ANN ARBOR AND JACKSON, STOCKBRIDGE RESIDENTS CAN ALSO ACCESS THE ADULT DENTAL CENTER IN LANSING. SJMC SUPPORTS THE WHI IN THEIR EFFORTS TO EXPAND ACCESS TO DENTAL CARE.DIABETES - DIABETES WAS NOT PRIORITIZED BECAUSE ITS PREVALENCE IN WESTERN WASHTENAW COUNTY DROPPED SIGNIFICANTLY FROM 2005 TO 2010. ALSO, OBESITY WAS RANKED AS THE MOST IMPORTANT HEALTH NEED AND WILL INDIRECTLY ADDRESS DIABETES THROUGH MANY OF THE SAME STRATEGIES AND ACTIVITIES. SJMC WILL CONTINUE TO OFFER OUTPATIENT DIABETES EDUCATION AND DIETICIAN SERVICES TO PATIENTS WITH DIABETES OR PRE-DIABETES THROUGH CLASSES, INDIVIDUAL APPOINTMENTS, AND THE DIABETES SHARE GROUP. FAMILY AND COMMUNITY INVOLVEMENT - THESE ARE PROTECTIVE FACTORS FOR YOUTH AGAINST SUBSTANCE ABUSE. THE SRSLY COALITIONS ARE WORKING TO STRENGTHEN THESE FACTORS THROUGH PARENT EDUCATION CLASSES AND YOUTH-LED INITIATIVES. SJMC WOULD ASSIST IN REPLICATING SRSLY, IF OTHER COMMUNITIES IN THE SERVICE AREA ARE INTERESTED IN MAKING SRSLY CENTRAL TO THEIR STRATEGIC PLANS. SJMC WILL NOT INITIATE NEW INTERVENTIONS TO STRENGTHEN FAMILY AND COMMUNITY INVOLVEMENT FOR YOUTH OUTSIDE OF SRSLY. HEART DISEASE - OBESITY AND SUBSTANCE ABUSE WERE RANKED AS HIGH PRIORITY HEALTH NEEDS AND HEART DISEASE WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE SAME STRATEGIES AND ACTIVITIES.NUTRITION - OBESITY WAS RANKED AS THE MOST IMPORTANT HEALTH NEED AND NUTRITION WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE SAME STRATEGIES AND ACTIVITIES.PHYSICAL ACTIVITY - OBESITY WAS RANKED AS THE MOST IMPORTANT HEALTH NEED AND PHYSICAL ACTIVITY WILL BE ADDRESSED INDIRECTLY THROUGH MANY OF THE SAME STRATEGIES AND ACTIVITIES. PHYSICAL ENVIRONMENT -WALK-ABILITY AND EASY ACCESS TO GROCERY STORES CAN BE MAJOR BARRIERS TO REGULARLY PARTICIPATING IN PHYSICAL ACTIVITY AND ACCESSING FRESH FRUITS AND VEGETABLES. SJMC IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITIES, AND FULLY SUPPORTS LOCAL GOVERNMENTS AND WELLNESS COALITIONS IN THEIR EFFORTS TO IMPACT THESE ISSUES.SOCIAL SUPPORT - THIS INDICATOR IS IMPORTANT TO MENTAL HEALTH FOR YOUTH AND ADULTS. THE FIVE AREA WELLNESS COALITIONS ARE EACH ADDRESSING THIS ISSUE AT THE COMMUNITY LEVEL THROUGH INITIATIVES TO SUPPORT "CONNECTING WITH OTHERS IN HEALTHY WAYS." SJMC WILL CONTINUE TO PARTICIPATE IN THESE COALITIONS AND SUPPORT PLANNING AND IMPLEMENTATION OF ACTIVITIES TO PROMOTE SOCIAL SUPPORT AS MUCH AS POSSIBLE. TRANSPORTATION - THIS AFFECTS ACCESS TO CARE, PARTICULARLY AMONG THE LOW-INCOME AND MEDICALLY UNDERSERVED. HOWEVER, TRANSPORTATION RANKED LOW AMONG OTHER RISK FACTORS DUE TO THE LOW NUMBER OF PEOPLE THAT ARE AFFECTED. IN ADDITION, OTHER LOCAL ORGANIZATIONS LIKE SENIOR CENTERS AND THE WESTERN WASHTENAW AREA VALUE EXPRESS (WAVE) BUS ARE ALREADY WORKING TO ADDRESS TRANSPORTATION NEEDS IN THE AREA. SJMC WILL CONTINUE TO HAVE A REPRESENTATIVE ON THE WAVE BOARD OF DIRECTORS IN ORDER TO SUPPORT THIS RESOURCE. ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 11: THERE ARE 5 NEEDS THAT ST. JOSEPH MERCY PORT HURON (SJMPH) WILL FOCUS ON DEVELOPING AND /OR SUPPORTING INITIATIVES AND MEASURING THEIR EFFECTIVENESS TO IMPROVE THE FOLLOWING HEALTH NEEDS:OBESITY:1. CONTINUE EXISTING BARIATRICS CLINICS AND SURGERY PROGRAMS.2. BARIATRICS TEAM WILL FURTHER DEVELOP MEDICAL WEIGHT LOSS PROGRAM.3. BARIATRICS TEAM WILL FURTHER DEVELOP BARIATRICS EXERCISE PROGRAM.4. BEGIN PROCESS TO BECOME BARIATRIC CENTER OF EXCELLENCE.5. NUTRITION SERVICES AND BARIATRICS WILL EXPLORE CHILDHOOD OBESITY INITIATIVES.6. SUPPORT COMMUNITY OUTREACH AND EDUCATION AS IT RELATES TO NUTRITION AND OBESITY.ACCESS TO CARE:1. CONTINUE SUPPORTING PEOPLE'S CLINIC FOR BETTER HEALTH (FREE CLINIC).2. START A MEDICAID CLINIC TO WORK PARALLEL WITH THE PEOPLES CLINIC.3. PROVIDE $4 PRESCRIPTIONS FOR COMMONLY PRESCRIBED DRUGS.4. SUPPORT HEALTHY MICHIGAN MEDICAID ENROLLMENT INITIATIVE.5. CONTINUE TO PROVIDE CHARITY CARE FOR THE POOR.DIABETES:1. PROVIDE ACCESS TO DIABETES MANAGEMENT.2. BEGIN PROCESS TO BECOME DIABETES CENTER OF EXCELLENCE.3. PROVIDE COMMUNITY OUTREACH AND EDUCATION.4. PROVIDE CARE COORDINATION SERVICES TO PRIMARY CARE PHYSICIANS AND DIABETES PATIENTS.5. SUPPORT COMMUNITY WELLNESS PROGRAMS.SENIOR SERVICES:1. HOLD COMMUNITY PROGRAMS RELATED TO SENIOR HEALTHCARE NEEDS.2. PROVIDE ON-SITE SERVICES GEARED TOWARDS SENIORS: SPECIAL PARKING, SENIOR ED, NICHE TRAINING, ETC.3. SPONSOR SUPPORT GROUP FOR SENIORS: SOLO CLUB, CAREGIVER GROUP, STROKE/HEAD INJURY, BBC.MENTAL HEALTH1. PARTNER WITH ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH TO PROVIDE ACCESS AND COORDINATED CARE INCLUDING SUPPORTING HEALTHY MICHIGAN MEDICAID ENROLLMENT.2. PARTNER WITH THE ST. CLAIR COUNTY INTERVENTION CENTER (JAIL) TO PROVIDE ACCESS AND COORDINATED CARE.3. IMPROVE COORDINATION AND TRANSITION OF CARE WITH COMMUNITY PARTNERS AND PROVIDERS.ST. JOSEPH MERCY PORT HURON ACKNOWLEDGES 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. SJMPH WILL NOT TAKE ACTION ON THE FOLLOWING HEALTH NEEDS: CANCER - SJMPH HAS A COMPREHENSIVE CANCER PROGRAM THAT INCLUDES ONCOLOGY AND RADIATION THERAPY. BY BEING PART OF THE MERCY CANCER NETWORK AND AFFILIATED WITH THE UNIVERSITY OF MICHIGAN CANCER PROGRAM, OUR COMMUNITY HAS ACCESS TO THE BEST CARE AS WELL AS CLINIC TRIALS FOR BOTH ONCOLOGY AND RADIATION THERAPY. ADDITIONALLY, MCLAREN PH HAS ANNOUNCED THEY WILL BE ADDING RADIATION THERAPY TO THEIR CANCER PROGRAM. CARDIAC/HEART DISEASE - SJMPH LACKS THE VOLUMES TO ACQUIRE A CON FOR OPEN HEART CARDIAC SERVICES. WE WILL CONTINUE TO PROVIDE TOP NOTCH OUTPATIENT SERVICES INCLUDING CARDIAC CATH LAB AND CARDIAC REHAB. WE ARE PARTNERING WITH OTHER ST. JOSEPH MERCY HEALTH SYSTEM HOSPITALS TO PROVIDE HIGH QUALITY IP SERVICES. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. DENTAL - SJMPH DOES NOT PROVIDE DENTAL SERVICES AND FEELS THAT THIS PRIORITY FALLS TO OTHER COMMUNITY SERVICE ORGANIZATIONS IN THE COMMUNITY. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION.SMOKING - SJMPH OPERATES A SMOKE FREE CAMPUS AND SUPPORTS SMOKING CESSATION PROGRAMS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. MERCY HOSPITAL CADILLAC PART V, SECTION B, LINE 11: ALL THREE OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED BY MERCY HOSPITAL CADILLAC (MERCY) ARE BEING ADDRESSED IN THE IMPLEMENTATION STRATEGY. THESE NEEDS INCLUDE: BARRIERS TO HEALTHCARE ACCESS, CHRONIC DISEASE MANAGEMENT, AND MENTAL HEALTH/SUBSTANCE ABUSE.BARRIERS TO HEALTHCARE ACCESS- THE COMMUNITY FACE CHALLENGES TO HEALTHCARE ACCESSIBILITY INCLUDING ECONOMIC FACTORS AND PROVIDER SHORTAGES. THE PERCENTAGE OF UNINSURED ADULTS IN WEXFORD HAS INCREASED SLIGHTLY BUT IT HAS DECREASED IN MISSAUKEE SINCE THE 2011 CHNA. ACCESS TO PRIMARY CARE PROVIDERS/ SPECIALISTS CONTINUES TO BE A CHALLENGE IN THE COMMUNITY. MERCY IMPLEMENTATION PLANS INCLUDE OBJECTIVES TO SUPPORT THE FQHC, ADOLESCENT WELLNESS CENTERS, STEHOUWER FREE CLINIC, AND WEXFORD MISSAUKEE PHO TO IMPROVE KNOWLEDGE OF CHRONIC DISEASE MANAGEMENT IN VULNERABLE POPULATIONS. THE STEHOUWER FREE CLINIC PROVIDES MEDICAL SERVICES WITH THE MEDICATION ACCESS PROGRAM (MAP) PROVIDING PRESCRIPTION MEDICATIONS TO THOSE WHO ARE UNINSURED OR UNDERINSURED. BOTH PROGRAMS RECEIVE FINANCIAL SUPPORT AND IN-KIND DONATIONS FROM MERCY HOSPITAL CADILLAC COMMUNITY BENEFITS. CHRONIC DISEASE MANAGEMENT- HIGH RATES OF OBESITY, TOBACCO USE, AND CARDIOVASCULAR DISEASE CONTRIBUTED TO THE PRIORITIZATION OF CHRONIC DISEASE MANAGEMENT. THE HIGH PREVALENCE AND HIGH MORTALITY RATES OF DIABETES RELATED CONDITIONS IN THE AREA ARE A SIGNIFICANT PUBLIC HEALTH CONCERN. LIKE MICHIGAN, CARDIOVASCULAR DISEASE IS THE LEADING CAUSE OF DEATH IN THE WEXFORD/MISSAUKEE. BETTER CHRONIC DISEASE MANAGEMENT CAN IMPROVE MORTALITY RATES. CHRONIC LOWER RESPIRATORY DISEASE IS THE THIRD LEADING CAUSE OF DEATH IN THE WEXFORD/MISSAUKEE AREA AND ENCOMPASSES ASTHMA, EMPHYSEMA, AND COPD. A SIGNIFICANT CONTRIBUTORY FACTOR IS THE HIGH SMOKING RATES IN THE AREA.MERCY IMPLEMENTATION PLANS OUTLINE EFFORTS TO SUPPORT EXERCISE PROGRAMS SUCH AS SENIOR FIT, AND IN COLLABORATION WITH THE CADILLAC AREA YMCA, HEALTHY KIDS/HEALTHY MICHIGAN, AND CONTINUED COLLABORATION WITH THE NORTHERN MICHIGAN DIABETES INITIATIVE, TO PROVIDE EDUCATIONAL OUTREACH PROGRAMS TO THE COMMUNITY.CARDIAC REHAB SERVICES INCLUDE SUPERVISED EXERCISE AND EDUCATION FOR THOSE WHO HAVE HAD CARDIAC EVENTS, ARE AT RISK FOR CARDIAC EVENTS, OR WHO WERE INTERESTED IN PARTICIPATING IN A SUPERVISED EXERCISE PROGRAM.PULMONARY REHABILITATION IS A MULTI-PHASE, PROGRESSIVE EXERCISE PROGRAM FOR INDIVIDUALS WHO HAVE LUNG DISEASE SUCH AS COPD, LUNG CANCER, PULMONARY FIBROSIS, ETC. A COMBINATION OF EDUCATION WITH INDIVIDUALIZED EXERCISE PROGRAMS MINIMIZE RISK FACTORS AND PROMOTE THE REHABILITATION PROCESS. THIS PROGRAM IS ALSO SUPPORTED BY MERCY HOSPITAL CADILLAC COMMUNITY BENEFITS.MENTAL HEALTH/SUBSTANCE ABUSE- MENTAL HEALTH HAS ALSO BEEN STRONGLY LINKED TO SOCIOECONOMIC FACTORS WHICH ARE RELEVANT TO THE WEXFORD/MISSAUKEE COMMUNITY. SHORTAGES OF MENTAL HEALTHCARE WORKERS AS WELL AS FRAGMENTED TREATMENT OPTIONS ARE LIMITATIONS IN ADDRESSING MENTAL HEALTH IN THE COMMUNITY. SUBSTANCE ABUSE IS A FREQUENT CO-MORBIDITY OF MENTAL ILLNESS AND IS IDENTIFIED AS AN AREA FOR IMPROVEMENT. MERCY IMPLEMENTATION PLANS INCLUDE OBJECTIVES THAT ADDRESS MENTAL HEALTH AND SUBSTANCE ABUSE WITHIN OUR COMMUNITY. WE CONTINUE TO FOCUS ON PREVENTION ACTIVITIES, EXPLORING DELIVERY SYSTEMS FOR THE ONGOING MANAGEMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE. IN COLLABORATION WITH THE WEXFORD/MISSAUKEE PHO, PRESCRIBER PRACTICES AND PRESCRIPTION DRUG DIVERSION COMMUNITY ROUND TABLE IS ANNUALLY HELD IN RESPONSE TO THE GROWING PROBLEM OF PRESCRIPTION DRUG ABUSE AND DIVERSION IN OUR COMMUNITY. EDUCATIONAL OPPORTUNITIES AND INFORMATION TO INCREASE AWARENESS AND IMPLEMENT STEPS TO DECREASE THIS PROBLEM ARE PROVIDED. THIS ROUNDTABLE IS HELD ON A YEARLY BASIS WITH ATTENDANCE FROM AREA PHYSICIANS, DENTISTS, PHARMACISTS, MID-LEVEL PROVIDERS, LAW ENFORCEMENT AND REPRESENTATIVES FROM DEPARTMENT OF HUMAN SERVICES. MERCY HOSPITAL CONTINUES TO PROVIDE CONTINUING EDUCATION CREDITS TO ATTENDEES OF THIS ROUNDTABLE. MERCY HOSPITAL CONTINUES TO PARTNER WITH CATHOLIC HUMAN SERVICES TO SUBSIDIZE A MENTAL HEALTH/SUBSTANCE ABUSE CASE MANAGER TO DELIVER CASE MANAGEMENT SERVICES FOR THOSE PRESENTING WITH SUBSTANCE ABUSE AND/OR A MENTAL HEALTH CONDITION. THE PRACTITIONER INVITES THE PATIENT INTO A CARE COORDINATION RELATIONSHIP TO ANSWER QUESTIONS AND TO ADDRESS CONTINUING NEEDS, GOALS AND PRIORITIES. ACCESS TO RESOURCES, INCLUDING MEDICATION, TRANSPORTATION, PRIMARY CARE, MENTAL HEALTH AND SUBSTANCE ABUSE SUPPORT IS PROVIDED. 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. MERCY HOSPITAL GRAYLING 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 HOSPITAL CADILLAC 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. MERCY HOSPITAL GRAYLING 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 HOSPITAL CADILLAC 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. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.STJOESANNARBOR.ORG/DOCUMENTS/PFS/FINANCIALPOLICY.PDF ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 16B WEBSITE: WWW.STJOESHEALTH.ORG/DOCUMENTS/PFS/FINANCIAL-QUESTIONNAIRE-APPLICATION.PDF ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS/PFS/FINANCIAL-APP-INSTRUCTIONS.PDF MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.MERCYHEALTH.COM/FINANCIAL-ASSISTANCE-SM MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.MERCYHEALTH.COM/FINANCIAL-ASSISTANCE-SM MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.MERCYHEALTH.COM/FINANCIAL-ASSISTANCE-SM ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.STJOESOAKLAND.ORG/DOCUMENTS/PFS/FINANCIALPOLICY.PDF ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 16B WEBSITE: WWW.STJOESHEALTH.ORG/DOCUMENTS/PFS/FINANCIAL-QUESTIONNAIRE-APPLICATION.PDF ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 16C WEBSITE: STJOESOAKLAND.ORG ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.STMARYMERCY.ORG/DOCUMENTS4/FORMS/CHARITYAPPLICATION.PDF ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.STJOESANNARBOR.ORG/DOCUMENTS/PFS/FINANCIALPOLICY.PDF ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 16B WEBSITE: WWW.STJOESHEALTH.ORG/DOCUMENTS/PFS/FINANCIAL-QUESTIONNAIRE-APPLICATION.PDF ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS/PFS/FINANCIAL-APP-INSTRUCTIONS.PDF ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.STJOESCHELSEA.ORG/DOCUMENTS/PFS/FINANCIALPOLICY.PDF ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 16B WEBSITE: WWW.STJOESHEALTH.ORG/DOCUMENTS/PFS/FINANCIAL-QUESTIONNAIRE-APPLICATION.PDF ST. JOSEPH MERCY CHELSEA PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS/PFS/FINANCIAL-APP-INSTRUCTIONS.PDF 107 (ANN ARBOR) MICHIGAN HEART & VASCULAR IN 5325 ELLIOTT DR YPSILANTI MI 48197 CARDIOVASCULAR CARE (AA) ST JOSEPH MERCY BRIGHTON 7575 GRAND RIVER RD BRIGHTON MI 48114 LAB, IMAGING, THERAPY, AMBULATORY SURG., EMPLOYED PHYS, ONCOLOGY, 24 HR EMER (AA) ST JOSEPH MERCY CANTON HEALTH CTR 1600 CANTON CENTER RD CANTON MI 48188 LAB, IMAGING, THERAPY, ONCOLOGY, AMBULATORY SURGERY, URGENT CARE (AA) REICHERT HEALTH CENTER 5333 MCAULEY DR YPSILANTI MI 48197 LAB, IMAGING, AMBULATORY SURG., EMPLOYED PHYSICIANS (AA) CHELSEA PROFESSIONAL OFFICE BLDG 14650 OLD US 12 CHELSEA MI 48118 PHARMACY, ONCOLOGY, EMPLOYED PHYSICIANS (AA) MICHIGAN ORTHOPEDIC CENTER 5315 ELLIOTT DR YPSILANTI MI 48197 ORTHOPEDIC CARE (AA) ST JOSEPH MERCY SALINE 400 W RUSSELL ST SALINE MI 48176 LAB, IMAGING, URGENT CARE (AA) ELLEN THOMPSON WOMEN'S CENTER 5320 ELLIOTT DR YPSILANTI MI 48197 WOMEN'S HEALTH (AA) CHELSEA HEALTH & WELLNESS CENTER 20800 OLD US 12 CHELSEA MI 48118 REHAB (AA) MICHIGAN HEART BUILDING 1548 W MAUMEE ST ADRIAN MI 49221 EMPLOYED PHYSICIANS (AA) SLEEP DISORDERS CENTER 5305 ELLIOTT DR YPSILANTI MI 48197 SLEEP CLINIC (AA) HURON OAKS 5401 MCAULEY DR YPSILANTI MI 48197 BEHAVIORAL MEDICINE (AA) ST JOSEPH MERCY MAPLE HEALTH BLDG 501 N MAPLE RD ANN ARBOR MI 48103 URGENT CARE (AA) ST JOSEPH MERCY ARBOR HEALTH CTR 990 W ANN ARBOR TRAIL PLYMOUTH MI 48170 LAB (AA) ARBOR PARK CENTRE 4972 CLARK RD YPSILANTI MI 48197 LAB (AA) LIVINGSTON OBGYN ASSOCIATES 524 BYRON RD HOWELL MI 48843 EMPLOYED PHYSICIANS (AA) MICHIGAN HEART MILAN 870 E ARKONA RD MILAN MI 48160 EMPLOYED PHYSICIANS, LAB (AA) SJMHS OUTPATIENT CLINIC 2310 E STADIUM BLVD ANN ARBOR MI 48104 REHAB (AA) CHERRY HILL LAB 49650 CHERRY HILL RD CANTON MI 48187 LAB (AA) MARIAN PROFESSIONAL BUILDING 14555 LEVAN RD LIVONIA MI 48154 RADIATION ONCOLOGY, REHAB, MRI, EMPLOYED PHYSICIANS (AA) GENOA MEDICAL CENTER 2305 GENOA BUSINESS PARK DR BRIGHTON MI 48114 LAB (AA) HAAB HEALTH BUILDING 111 N HURON ST YPSILANTI MI 48197 EMPLOYED PHYSICIANS (AA) MONUMENT PARK BUILDING 8031 MAIN ST DEXTER MI 48130 EMPLOYED PHYSICIANS (AA) ARBOR SCIO PROFESSIONAL BUILDING 6360 JACKSON RD ANN ARBOR MI 48103 LAB (AA) ST JOSEPH MERCY CHEMICAL DEPENDENT 2008 HOGBACK RD ANN ARBOR MI 48105 BEHAVIORAL MEDICINE (AA) PARKWAY MEDICAL CENTER 2345 S HURON PKWY ANN ARBOR MI 48104 LAB (AA) SALINE PROFESSIONAL OFFICE BLDG 420 W RUSSELL ST SALINE MI 48176 REHAB (AA) MICHIGAN HEART BUILDING 200 ARNET ST YPSILANTI MI 48198 EMPLOYED PHYSICIANS (AA) HURON PROFESSIONAL BUILDING 704 W HURON ST ANN ARBOR MI 48103 LAB (AA) SUMMERWOOD CENTER 10299 E GRAND RIVER BRIGHTON MI 48116 BEHAVIORAL MEDICINE (AA) DIAGNOSTIC SERVICES CENTER 202 E VAN RIPER RD FOWLERVILLE MI 48836 LAB, IMAGING (AA) FAMILY MEDICINE OF STOCKBRIDGE 4525 S M-52 STOCKBRIDGE MI 49285 EMPLOYED PHYSICIANS (AA) ST JOSEPH MERCY BEHAVIORAL SVCS 2200 CANTON CENTER RD CANTON MI 48188 BEHAVIORAL MEDICINE (AA) SALINE ADULT & PEDIATRIC MEDICINE 182 S INDUSTRIAL DR SALINE MI 48176 EMPLOYED PHYSICIANS (AA) CENTER FOR DIGESTIVE CARE 5300 ELLIOTT DR YPSILANTI MI 48197 DIGESTIVE CARE (AA) TOWSLEY HEALTH BUILDING 5361 MCAULEY DR YPSILANTI MI 48197 NURSING HOME, EMPLOYED PHYS. (AA) SAMARITAN CENTER 5555 CONNER DETROIT MI 48213 INDIGENT CARE (OTHER) FRANCES WARDE MEDICAL LABORATORY 300 W TEXTILE RD ANN ARBOR MI 48104 LAB (CADILLAC) CADILLAC SURGICAL CARE 927 SOUTH CARMEL STREET CADILLAC MI 49601 EMPLOYED PHYSICIANS (CAD) MERCY OBGYN PARTNERS 7985 MACKINAW TRAIL CADILLAC MI 49601 EMPLOYED PHYSICIANS (CAD)MERCY HEALTH PHYSICIAN PARTNERS 7985 MACKINAW TRAIL CADILLAC MI 49601 EMPLOYED PHYSICIANS (CAD)MERCY HEALTH PHYSICIAN PARTNERS 100 NORTH ROLAND MCBAIN MI 49657 EMPLOYED PHYSICIANS (GRAND RAPIDS) WEGE BUILDING 300 LAFAYETTE GRAND RAPIDS MI 49503 LAB, FAMILY PRACTICE, INTERNAL MEDICINE PRACTICE (GR) SAINT MARY'S SOUTHWEST 2373 64TH STREET SW BYRON CENTER MI 49315 AMBULATORY SURGICAL CTR, REHAB, LAB, IMAGING, FAMILY PRACTICE, CARDIO AND ER (GR) ADVANTAGE HEALTH BUILDING 1471 EAST BELTLINE GRAND RAPIDS MI 49525 LAB, IMAGING, REHAB, EMPLOYED PHYS., URGENT CARE, OB (GR) CLINICA SANTA MARIA 730 GRANDVILLE AVE SW GRAND RAPIDS MI 49503 INDIGENT PRIMARY CARE CENTER (GR) PINE REST 300 68TH STREET SE GRAND RAPIDS MI 49548 MENTAL HEALTH (GR) SPARTA FAMILY HEALTH CENTER 475 S STATE ST SPARTA MI 49345 FAMILY PRACTICE CENTER (GR) BROWNING CLAYTOR HEALTH CENTER 1246 MADISON SE GRAND RAPIDS MI 49507 FAMILY PRACTICE CENTER (GR) HEARTSIDE HEALTH CLINIC 359 S DIVISION GRAND RAPIDS MI 49503 INDIGENT PRIMARY CARE CENTER (GR) RIVERTOWN BUILDING 3380 44TH STREET SW GRANDVILLE MI 49418 LAB, IMAGING, REHAB, FAMILY PRACTICE (GR) STANDALE BUILDING 1175 WILSON AVE NW WALKER MI 49534 LAB, IMAGING, REHAB, FAMILY PRACTICE (GR) 310 LAFAYETTE BUILDING 310 LAFAYETTE SE GRAND RAPIDS MI 49503 IMMUNOLOGY, VASCULAR, AND PULMONOLOGY (GR) ADVANTAGE HEALTH BUILDING 10047 CROSS ROADS COURT CALEDONIA MI 49316 LAB, IMAGING, REHAB, FAMILY PRACTICE (GR) GREEN STREET BUILDING 1375 W GREEN ST HASTINGS MI 49058 REHAB (GR) GEORGETOWN BUILDING 1915 GEORGETOWN CENTER DR JENISON MI 49428 REHAB (GR) CHERRY BUILDING 245 CHERRY ST GRAND RAPIDS MI 48503 PEDIATRIC CLINIC, FAMILY MEDICINE, OB AND SLEEP (GR) SAINT MARY'S LAB NORTHWEST 933 THREE MILE NW GRAND RAPIDS MI 49504 LAB, REHAB, FAMILY PRACTICE (GR) ADVANTAGE HEALTH BUILDING 7782 20TH AVENUE JENISON MI 49428 FAMILY PRACTICE CENTER (GR) SOUTHEAST ADVANTAGE HEALTH BUILDING 2080 44TH ST SE KENTWOOD MI 49508 REHAB, LAB, FAMILY PRACTICE (GR) ADVANTAGE HEALTH BUILDING 6050 NORTHLAND DR NE ROCKFORD MI 49341 FAMILY PRACTICE CENTER, URGENT CARE, LAB, IMAGING, WOMEN'S HEALTH (GR) WYOMING FAMILY PRACTICE 950 36TH STREET SW WOMING MI 49509 FAMILY PRACTICE CENTER (GR) ADVENT REHAB 7575 EAST FULTON ADA MI 49355 REHAB (GR) ADVENT REHAB 1000 EAST PARIS ST 222 ADA MI 49546 CARDIO (GR) ADVENT REHAB 150 JEFFERSON SE ST 100 GRAND RAPIDS MI 49503 REHAB (GR) MERCY HEALTH PHYSICIAN PARTNERS 771 KENNMORE SE GRAND RAPIDS MI 49547 FAMILY PRACTICE (GR) MERCY HEALTH PHYSICIAN PARTNERS 2093 HEALTH DRIVE SUITE 300 WYOMING MI 49519 VASCULAR (GRAYLING) MERCY MANOR 1200 EAST MICHIGAN AVE GRAYLING MI 49738 LONG TERM CARE (GRAY) MERCY FAMILY CARE GRAYLING 1250 EAST MICHIGAN AVE GRAYLING MI 49738 EMPLOYED PHYSICIANS (GRAY) MERCY FAMILY CARE ROSCOMMON 234 LAKE STREET ROSCOMMON MI 48653 EMPLOYED PHYSICIANS (GRAY) MERCY COMMUNITY HEALTH CENTER 2585 WEST HOUGHTON LAKE DRIVE PRUDENVILLE MI 48651 REHAB, IMAGING, LAB, EMPLOYED PHYSICIANS (GRAY) AUSABLE UROLOGY 809 MICHIGAN AVE GRAYLING MI 49738 EMPLOYED PHYSICIANS (GRAY) MILTOWN CLINIC 1200 W NORTH DOWN RIVER RD GRAYLING MI 49738 EMPLOYED PHYSICIANS (OAKLAND)SJMO MEDICAL OFFICE BUIDING 44555 WOODWARD AVE PONTIAC MI 48341 COLORECTAL SURGERY, TRAUMA ORTHOPEDICS, LAB, RADIOLOGY,OTHER SURG SPECIALTIS (OA) BALD MOUNTAIN REGIONAL MEDICAL 1375 S LAPEER RD LAKE ORION MI 48360 URGENT CARE, LAB, RADIOLOGY, INTERNAL MED/PEDS (OA) WOODWARD PROFESSIONAL BUILDING 44428 WOODWARD AVE PONTIAC MI 48341 REHAB, OB/GYN CLINIC, PARTIAL PSYCH HOSPITAL (OA) MERCY MEDICAL GROUP-OAKLAND PHYSICI 5210 HIGHLAND RD WATERFORD MI 48327 INTERNAL MEDICINE, URGENT CARE, LAB, RADIOLOGY (OA) INDEPENDENCE POINTE 7210 ORTONVILLE RD CLARKSTON MI 48346 LAB (OA) KAROTECH BUILDING 2630 UNION LAKE RD COMMERCE TOWNSHIP MI 48382 PEDS, LAB (OA) SLEEP DISORDERS CLINIC 3100 CROSS CREEK PKWY AUBURN HILLS MI 48341 SLEEP CLINIC (OA) WHITE LAKE 320 TOWN CENTER BLVD WHITE LAKE TWP MI 48386 URGENT CARE, LAB, RADIOLOGY, REHAB (OA) SHORES III PROFESSIONAL BUILDING 2300 HAGGERTY RD WEST BLOOMFIELD MI 48323 RADIOLOGY (OA) WATERFORD LAB 5800 HIGHLAND RD WATERFORD MI 48327 LAB (OA) MERCY MEDICAL GROUP-ROCHESTER 1854 W AUBURN RD ROCHESTER HILLS MI 48309 INTERNAL MEDICINE/PEDS, OB/GYN, ENDOCRINOLOGY (OA) WATERFORD SURGICAL CENTER 5220 HIGHLAND RD WATERFORD MI 48327 SURGICAL CENTER (OA) CLARKSTON 6770 DIXIE HWY CLARKSTON MI 48346 OB/GYN, FAMILY MED (OA) BLOOMFIELD LAB 42557 WOODWARD AVE BLOOMFIELD HILLS MI 48304 LAB (OA) LEXUS PROFESSIONAL BUILDING 44200 WOODWARD AVE PONTIAC MI 48341 LAB (OA) MERCY MEDICAL GROUP-BLOOMFIELD HILL 1750 TELEGRAPH RD BLOOMFIELD HILLS MI 48302 OB/GYN (OA) AFFINITY PEDIATRICS & INTERNAL MEDI 5820 HIGHLAND ROAD WATERFORD MI 48328 INTERNAL MEDICINE/PEDIATRICS (OA) BLOOMFIELD HILLS IM 2520 S TELEGRAPH RD BLOOMFIELD HILLS MI 48302 INTERNAL MEDICINE (OA) MERCY PLACE 55 CLINTON ST PONTIAC MI 48342 OUTPATIENT CLINIC (OA) BERKLEY MEDICAL CENTER 1695 W 12 MILE RD BERKLEY MI 48072 INTERNAL MEDICINE, RADIOLOGY, LAB (OA) OAKLAND MEDICAL GROUP 3950 S ROCHESTER ROAD ROCHESTER HILLS MI 48307 OB/GYN (OA) OAKLAND MEDICAL GROUP 27301 DEQUINDRE ROAD MADISON HEIGHTS MI 48071 OB/GYN (OA) NEUROSURGERY CLARKSTON 7650 DIXIE HIGHWAY CLARKSTON MI 48346 NEUROSURGERY (OA) NEUROSURGERY BLOOMFIELD HILLS 799 DENISON CT BLOOMFIELD HILLS MI 48302 NEUROSURGERY (PORT HURON) MERCY HEALTH CENTER 4190 24TH AVE FORT GRATIOT MI 48059 LAB, IMAGING, URGENT CARE (PH) FITRAC - MARYSVILLE 782 HURON BLVD MARYSVILLE MI 48040 PHYSICAL THERAPY (PH) DR MOREY'S MERCY SURGERY CARE 2609 ELECTRIC AVE STE B PORT HURON MI 48060 EMPLOYED SURGEON (PH) PEOPLES' CLINIC FOR BETTER HEALTH 3110 GOULDEN ST PORT HURON MI 48060 OUTPATIENT CLINIC (PH) GEORGE CARLEY ASSOCIATES 1943 HOLLAND PORT HURON MI 48060 LAB (PH) DR JERRY 600 FORT STREET PORT HURON MI 48060 LAB (PH) DR JARAD 2540 16TH STREET PORT HURON MI 48060 LAB (PH) NORTH BUILDING 2306 ELECTRIC AVE PORT HURON MI 48060 LAB (PH) DR LAL 2605 ELECTRIC AVE PORT HURON MI 48060 LAB (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 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 TRINITY HEALTH - MICHIGAN INCLUDE A COPY OF THEIR MOST RECENT SCHEDULE H ON THEIR RESPECTIVE WEBSITES. TRINITY HEALTH ALSO INCLUDES TRINITY HEALTH - MICHIGAN'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, $45,352,889, 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 TRINITY HEALTH-MICHIGAN 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 LIVONIAST. MARY MERCY LIVONIA IS THE LEADER OF THE CARE TRANSITION IMPROVEMENT COALITION, WHICH IS COMPRISED OF MEMBERS FROM HOSPITALS, LONG TERM CARE, ASSISTED LIVING, SOCIAL SERVICE AGENCIES, SENIOR ALLIANCE AND PRIVATE DUTY NURSING AGENCIES. THEIR MISSION IS TO BUILD COOPERATIVE RELATIONSHIPS AND COORDINATED PROCESSES BETWEEN SETTINGS OF CARE, PROMOTING IMPROVED QUALITY OF LIFE, COST EFFECTIVENESS, AND PERSON-CENTERED CARE. WORKING TOGETHER TO IMPROVE THE COMMUNITY'S EXPERIENCE AND OUTCOMES WITH CARE TRANSITIONS, THEIR WORK FOCUSES ON REDUCTION OF THE 30-DAY HOSPITAL READMISSION RATES IN THE TARGETED POPULATION AND THE IMPROVMENT OF PATIENT AND CAREGIVER FAMILY SATISFACTION WITH CARE TRANSITION INTERVENTIONS AND OVERALL EXPERIENCE. TO HELP ADDRESS THE EDUCATIONAL DISPARITIES IN DETROIT, ST. MARY MERCY LIVONIA HAS BEEN ONE OF THE CORPORATE SPONSORS SINCE THE DETROIT CHRISTO REY SCHOOL OPENED. CHRISTO REY IS A COLLEGE PREP CATHOLIC HIGH SCHOOL, ONE OF 25 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 WHITE-COLLAR 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. ONE DAY A WEEK, THE FOUR STUDENTS TRADE THEIR SCHOOL UNIFORMS FOR HOSPITAL SCRUBS AS THEY TRAVEL TO ST. MARY MERCY LIVONIA FOR THEIR WORK-EXPERIENCE IN THE MIRACLE OF LIFE BIRTHING CENTER. BESIDE THE WORK EXPERIENCE, THEY ARE MENTORED, GUIDED, AND MOTHERED BY THE SIXTY FEMALE STAFF WORKING IN THIS DEPARTMENT. ST. JOSEPH MERCY PORT HURON:ST. JOSEPH MERCY PORT HURON (SJMPH) LEADERSHIP IS ACTIVELY INVOLVED IN COMMUNITY ACTIVITIES THROUGH REPRESENTATION ON VARIOUS COMMUNITY BOARDS. THIS INCLUDES COLLABORATIVE PARTNERSHIPS WITH COMMUNITY GROUPS/WORKSHOPS TO IMPROVE OVERALL COMMUNITY HEALTH. COMMUNITY BOARD INVOLVEMENT INCLUDES LOCAL ORGANIZATIONS SUCH AS: EDA EXECUTIVE COMMITTEE, TOBACCO COALITION, VNA PROFESSIONAL ADVISORY COMMITTEE, UNITED WAY BOARD, ST. CLAIR COMMUNITY COLLEGE CENTER FOUNDATION COMMITTEE, SCC COMMUNITY SERVICES COORDINATING BODY, BAKER COLLEGE BOARD OF REGENTS, COMMUNITY ACTION AGENCY OF ST. CLAIR COUNTY, AND UNITED WAY BOARD.YMCA BOARD - THIS BOARD GOVERNS THE LOCAL YMCA AND PROVIDES SERVICES TO THE BROADER COMMUNITY, INCLUDING LOW INCOME, SENIORS, AND MENTALLY CHALLENGED INDIVIDUALS. BY SERVING ON THE BOARD, WE CAN BETTER IDENTIFY PROGRAMS AND SERVICES FOR THIS POPULATION. THE PROGRAMS OF YMCA REACH A LARGE AUDIENCE OF DISADVANTAGED INDIVIDUALS IN OUR COUNTY. THE COMMUNITY REACHES OUT TO YMCA BY PROVIDING SUPPORT AND UTILIZATION OF SERVICES. EMPLOYERS (INCLUDING SJMPH) ASSIST WITH FUNDING, WORK TRAINING, AND HEALTH PROGRAMS FOR THIS POPULATION. PORT HURON CHAMBER OF COMMERCE BOARD - OUR HOSPITAL SUPPLIES A BOARD MEMBER AND ALSO FINANCIAL SUPPORT TO THE LOCAL CHAMBER. THIS ORGANIZATION PROMOTES BUSINESS IN OUR COMMUNITY AND WE HAVE BEEN AN ACTIVE MEMBER FOR MANY YEARS. PARTNERS AT HEART ADVISORY COMMITTEE - THIS BODY COORDINATES THE AREA'S PARTNERS AT HEART PROGRAM WHICH PROVIDES CARDIAC SERVICES TO THE BROADER COMMUNITY, INCLUDING LOW INCOME INDIVIDUALS AND ESPECIALLY SENIORS. ACCESS TO CARDIOVASCULAR SERVICES OFFERED UNDER "PARTNERS AT HEART" IS ONE ROLE SERVED BY THE ADVISORY COMMITTEE. IT CAN BETTER IDENTIFY SERVICES FOR THIS POPULATION AND LOOK FOR WAYS TO PROACTIVELY IMPROVE THE HEALTH OF OUR COMMUNITY. THE SERVICES OF PARTNERS AT HEART REACH A LARGE PORTION OF OUR SENIOR POPULATION (INCLUDING THE LOW INCOME POPULATION). THE COMMUNITY REACHES OUT TO PARTNERS AT HEART THROUGH UTILIZATION OF THE SERVICES OFFERED. THE LOCAL HOSPITALS AND MEDICAL PROVIDERS SUPPORT THE PROGRAMS WITH THEIR TIME, MONEY, AND EXPERTISE IN THIS FIELD. OUR COMMUNITY IS ABLE TO RECEIVE LOCAL HEART CARE WHICH BETTER REACHES OUT TO THE BROADER COMMUNITY AND THOSE IN LOWER INCOME GROUPS.MERCY HOSPITAL GRAYLING:TWO DISTINCT COMMUNITY-BUILDING ACTIVITIES CONDUCTED BY MERCY HOSPITAL GRAYLING ARE SIGNIFICANT IN IMPROVING THE GENERAL HEALTH OF THE COMMUNITY.DESPITE LARGE FINANCIAL LOSSES IN PHYSICIAN PRACTICES, MERCY GRAYLING ACTIVELY WORKS TO SECURE NEEDED PHYSICIAN SPECIALTIES FOR THE SERVICE AREA INCLUDING PRIMARY CARE, OBSTETRICS, PEDIATRICS AND SURGERY. MERCY HAS SUCCESSFULLY ADDED A PRIMARY CARE PHYSICIAN ASSISTANT TO ITS PHYSICIAN NETWORK. THE ADDITION OF THIS PROVIDER EXPANDS SERVICES TO THE COMMUNITY IN AN AREA OF GREATEST NEED.MERCY HOSPITAL GRAYLING ALSO SUPPORTS VARIOUS TRINITY HEALTH NATIONAL AND STATE EFFORTS TO ADVOCATE FOR THE HEALTH NEEDS OF THE VULNERABLE AND UNDERSERVED.MERCY HOSPITAL CADILLACCOMMUNITY-BUILDING ACTIVITIES ARE VERY SIGNIFICANT IN IMPROVING THE GENERAL HEALTH OF OUR COMMUNITY. MERCY HOSPITAL CADILLAC IS LOCATED IN AN UNDERSERVED AREA, AS REFLECTED THROUGH THE 2009 DEVELOPMENT OF A FEDERALLY QUALIFIED HEALTH CENTER.THROUGH THE COMMUNITY HEALTH IMPROVEMENT ADVOCACY INITIATIVE, STATE AND FEDERAL REPRESENTATIVES ARE CONTACTED TO SUPPORT NEEDED RURAL HEALTH DELIVERY AT THE POINT OF NEED. THE STATE AND FEDERAL REPRESENTATIVES ADVOCATE IN CONGRESS AND AT THE STATE LEVEL FOR IMPROVED HEALTHCARE POLICIES, WHILE ADMINISTRATION AT MERCY HOSPITAL CADILLAC AND TRINITY HEALTH USE RESOURCES TO INFORM ASSOCIATES OF NATIONAL HEALTHCARE ISSUES. THE PHYSICIAN RECRUITMENT AND DEVELOPMENT INITIATIVES ATTRACT AND RETAIN PHYSICIANS WHO WILL HAVE A DEGREE OF LONGEVITY IN OUR SERVICE AREA FOR THE GOOD OF THE COMMUNITY.COALITION BUILDING IS ALSO OF GREAT IMPORTANCE IN OUR COMMUNITY. HOSPITAL LEADERS ARE MEMBERS OF HUMAN SERVICES LEADERSHIP COLLABORATIVE, CADILLAC CHAMBER OF COMMERCE, CADILLAC COMMUNITY HEALTH COALITION, AND OTHER COMMUNITY GROUPS.MERCY HOSPITAL CADILLAC'S COMMUNITY OUTREACH DEPARTMENT'S PRIMARY FOCUS IS TO IMPROVE THE HEALTH OF THE COMMUNITY. THIS IS ACCOMPLISHED THROUGH COLLABORATION WITH MANY OF THE HUMAN SERVICE ORGANIZATIONS IN THE COMMUNITY, INCLUDING CADILLAC AREA HEALTH COALITION (CAHC). CAHC IS COMPRISED OF AREA ORGANIZATIONS THAT PROVIDE LEADERSHIP AND RESOURCES TO ACCOMPLISH THE GOALS OUTLINED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). 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: TRINITY HEALTH - MICHIGAN 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, TRINITY HEALTH - MICHIGAN IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, TRINITY HEALTH - MICHIGAN IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: TRINITY HEALTH - MICHIGAN 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 MINISTIRES 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 8: TRINITY HEALTH - MICHIGAN 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 TRINITY HEALTH - MICHIGAN ASSESS THE HEALTH STATUS OF THEIR COMMUNITIES BOTH IN 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. ST. JOSEPH MERCY PORT HURON ALSO ASSESSED THE COMMUNITY'S HEALTH CARE NEEDS AS FOLLOWS:ST. JOSEPH MERCY PORT HURON CONTINUALLY OFFERS EDUCATION SEMINARS ON A BROAD ARRAY OF TOPICS, SUCH AS SENIOR LIVING, BARIATRICS, DIABETES, PULMONARY REHAB, BRAIN INJURIES, AND PROSTATE HEALTH AND STROKE EDUCATION. DURING THESE INFORMATIONAL SESSIONS, INSTRUCTORS HAVE THE OPPORTUNITY TO INTERACT WITH RESIDENTS AND FUTURE PATIENTS TO DETERMINE WHAT HEALTH-SPECIFIC NEEDS ARE NOT BEING MET.ST. JOSEPH MERCY PORT HURON ALSO CONTINUES TO OPERATE THE PEOPLES' CLINIC FOR BETTER HEALTH, WHICH PROVIDES FREE/SUBSIDIZED SERVICES TO UNDER/UNINSURED INDIVIDUALS IN OUR COMMUNITY. HEALTH ASSESSMENTS ARE MADE REGULARLY FOR THOSE INDIVIDUALS WHO ARE SEEN AT THE CLINIC. INFORMATION GLEANED FROM INDIVIDUALS RECEIVING CARE AT THE PEOPLES' CLINIC SUPPLEMENTED OTHER RESEARCH AND DATA. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - TRINITY HEALTH - MICHIGAN 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, TRINITY HEALTH - MICHIGAN 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 OBLIGATIONSTRINITY HEALTH - MICHIGAN 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. TRINITY HEALTH - MICHIGAN 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, REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITALS. TRINITY HEALTH - MICHIGAN HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. TRINITY HEALTH - MICHIGAN 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. SJMHS SPECIALIZES IN CANCER, CARDIOVASCULAR, ORTHOPEDICS, NEUROSCIENCES, AND WOMEN AND CHILDREN'S HEALTH. IT ALSO OFFERS TREATMENT AND CARE IN EMERGENCY SERVICES, SURGERY, ENDOSCOPY, RADIOLOGY, AND HOME CARE/HOSPICE. 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 ST. JOSEPH MERCY HOSPITAL ANN ARBOR (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 OF WASHTENAW COUNTY IS GROWING. THIS MOST RECENT ESTIMATE SHOWS POPULATION GROWTH OF NEARLY 2.6% BETWEEN 2010 AND 2013. THE POPULATION UNDER AGE 18 HAS CONSISTENTLY DECLINED OVER THE PAST FOUR YEARS WHILE THE OVER-65 POPULATION HAS GROWN. WASHTENAW COUNTY'S POPULATION IS RACIALLY DIVERSE WITH 76.5% WHITE, 13.9% BLACK, 9.1% ASIAN, AND 4% NATIVE AMERICAN IN 2013.IN 2013, APPROXIMATELY 16.7% OF WASHTENAW HOUSEHOLDS LIVED IN POVERTY, AND 15.5% OF CHILDREN UNDER THE AGE OF 18 ARE LIVING IN POVERTY. THIS NUMBER HAS BEEN RELATIVELY STABLE SINCE 2011. SINCE 2010, WASHTENAW COUNTY'S UNEMPLOYMENT HAS BEEN LOWER THAN UNEMPLOYMENT RATES IN MICHIGAN DURING THIS TIME PERIOD.WASHTENAW COUNTY HAS A HIGH PROPORTION OF PEOPLE WITH A 4-YEAR DEGREE OR HIGHER. HOWEVER, WASHTENAW COUNTY ALSO HAS GEOGRAPHIC POCKETS WHERE MORE THAN 20% OF THE POPULATION HAS LESS THAN A HIGH SCHOOL DIPLOMA.MERCY HEALTH ST. MARY'S (GRAND RAPIDS):KENT COUNTY IS CONSIDERED THE PRIMARY MARKET AREA OF MERCY HEALTH SAINT MARY'S (MHSM). KENT COUNTY IS LOCATED IN WESTERN MICHIGAN AND IS THE FOURTH LARGEST POPULATION CENTER IN THE STATE. THE COUNTY IS COMPOSED OF 21 TOWNSHIPS, 5 VILLAGES, AND 9 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 609,000 PEOPLE RESIDING IN KENT COUNTY. THE MEDIAN HOUSEHOLD INCOME FOR KENT COUNTY IS $51,667. TWENTY-FIVE PERCENT (25%) OF THE POPULATION IS BELOW THE AGE OF 18 AND 11% IS 65 YEARS OF AGE AND OLDER. EIGHTY-TWO PERCENT OF THE POPULATION IS WHITE, 9.6% BLACK, AND 9.8% LATINO. EIGHTY-NINE PERCENT (89%) ARE HIGH SCHOOL GRADUATES AND 32% HAVE A BACHELOR'S DEGREE. THE CURRENT UNEMPLOYMENT RATE IS 4.4%.ST. JOSEPH MERCY OAKLAND (PONTIAC):ST. JOSEPH MERCY OAKLAND IS A PART OF SAINT JOSEPH MERCY HEALTH SYSTEM (SJMHS), A SUBURBAN HEALTH CARE NETWORK SERVING WASHTENAW, LIVINGSTON, EASTERN JACKSON, LENAWEE, MONROE, WESTERN WAYNE AND SOUTHWESTERN OAKLAND COUNTIES. ST. JOSEPH MERCY OAKLAND IS LICENSED FOR 443 INPATIENT BEDS. THE ST. JOSEPH MERCY OAKLAND (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. OAKLAND COUNTY'S POPULATION IS RACIALLY DIVERSE WITH 77.9% WHITE, 15.0% BLACK, 6.6% ASIAN, AND 0.4% NATIVE AMERICAN IN 2013. OAKLAND COUNTY'S POVERTY RATE HAS CONSISTENTLY BEEN LOWER THAN THAT OF ALL MICHIGAN. IN 2013, APPROXIMATELY 7.3% OF 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:ST. MARY MERCY LIVONIA'S SERVICE AREA INCLUDES CANTON, LIVONIA, NORTHVILLE CITY AND TOWNSHIP, PLYMOUTH CITY AND TOWNSHIP, REDFORD, FARMINGTON CITY AND FARMINGTON HILLS AND WESTLAND WITH 510,806 PEOPLE IN THESE COMMUNITIES. THE MEDIAN HOUSEHOLD INCOME RANGES FROM $45,496 IN WESTLAND TO $101,943 IN NORTHVILLE. THE HIGHEST POVERTY LEVEL CAN BE FOUND IN WESTLAND AT 14%, FOLLOWED BY FARMINGTON HILLS AT 7%. UNEMPLOYMENT IS THE HIGHEST IN WESTLAND AND NORTHVILLE AT 6% AND THE LOWEST AT 3% IN FARMINGTON HILLS, FARMINGTON, PLYMOUTH TOWNSHIP AND NORTHVILLE TOWNSHIP. CANTON HAS THE HIGHEST NUMBER OF YOUTH (54%) AND LIVONIA HAS THE HIGHEST NUMBER OF SENIORS (18%). OUR COMMUNITY IS PREDOMINANTLY WHITE, CAUCASIAN WITH SOME AFRICAN AMERICANS, HISPANICS AND ASIANS. ST. JOSEPH MERCY CHELSEATHE ST. JOSEPH MERCY CHELSEA (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 TOWNSHIP, CITY OF CHELSEA, CITY OF DEXTER, DEXTER TOWNSHIP, FREEDOM TOWNSHIP, GRASS LAKE TOWNSHIP, HENRIETTA TOWNSHIP, LIMA TOWNSHIP, LYNDON TOWNSHIP, MANCHESTER TOWNSHIP, SCIO TOWNSHIP, SHARON TOWNSHIP, STOCKBRIDGE TOWNSHIP, SYLVAN TOWNSHIP, UNADILLA TOWNSHIP, WATERLOO TOWNSHIP, WEBSTER TOWNSHIP, VILLAGE OF GRASS LAKE, VILLAGE OF MANCHESTER, AND THE 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, WHICH IS LOCATED AT 775 S. MAIN ST, CHELSEA, MICHIGAN. THE TOTAL POPULATION OF THE SIX ZIP CODES LISTED ABOVE 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. THESE COMMUNITIES EACH HAVE A SCHOOL DISTRICT, WHICH UNIFIES CITIES AND VILLAGES WITH THE OUTLYING TOWNSHIPS, AND GIVES EACH A SENSE OF IDENTITY. WE USE THE DEMOGRAPHIC DATA OUTLINED ABOVE, BUT OTHERWISE REFER TO THESE FIVE TOWNS AS THE SJMC SERVICE AREA. ST. JOSEPH MERCY LIVINGSTON:THE ST. JOSEPH MERCY LIVINGSTON (SJML) SERVICE AREA FOR PURPOSES OF THIS 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; LIVINGSTON COUNTY 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, INCLUDING IN HOWELL, FOWLERVILLE, BRIGHTON AND IN PUTNAM TOWNSHIP WHICH INCLUDES THE VILLAGE OF PINCKNEY.ST. JOSEPH MERCY PORT HURON:ST. JOSEPH MERCY PORT HURON IS LOCATED IN ST. CLAIR COUNTY IN SOUTHEASTERN MICHIGAN. SHARING A BORDER WITH CANADA, THE COUNTY IS HOME TO THE BLUE WATER BRIDGE, ONE OF THE BUSIEST INTERNATIONAL BORDER CROSSINGS IN NORTH AMERICA. 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 DISASTER.BASED ON 2010 U.S. CENSUS BU PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: TRINITY HEALTH-MICHIGAN 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.ST. JOSEPH MERCY ANN ARBOR 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. 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.MERCY HEALTH ST. MARY'S (GRAND RAPIDS):MERCY HEALTH SAINT MARY'S WORKS WITH DOZENS OF PROGRAMS AND ORGANIZATIONS EACH YEAR, OFTEN PARTNERING WITH OTHER ORGANIZATIONS IN THE COMMUNITY. MERCY HEALTH SAINT MARY'S 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. MERCY HEALTH SAINT MARY'S ALSO PARTICIPATES IN CANCER, NEUROSCIENCE, AND HIV/AIDS RESEARCH, BOTH INDEPENDENTLY AND IN COLLABORATION WITH NATIONAL AND LOCAL ORGANIZATIONS.THE WEGE INSTITUTE FOR HEALTH AND LEARNING IS HOME TO THE WEGE RESIDENCY PROGRAM, THROUGH WHICH PARTICIPANTS WORK WITH THE UNINSURED AND THE HOMELESS. IN ADDITION, A NUMBER OF MERCY HEALTH SAINT MARY'S FAMILY PRACTICE AND PEDIATRIC OFFICES PARTICIPATE IN THE REACH OUT AND READ PROGRAM, WHICH TARGETS AT-RISK CHILDREN IN LOW-INCOME HOMES BY FOCUSING ON READING READINESS. ST. JOSEPH MERCY OAKLAND (PONTIAC):ST. JOSEPH MERCY OAKLAND 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 EXPERIENCE WAS SUCCESSFUL FOR BOTH THE STUDENTS AND HOSPITAL. IT PROVIDED OPPORTUNITIES FOR PERSONAL AND PROFESSIONAL DEVELOPMENT FOR STUDENTS AS WELL AS FINANCIAL STABILITY FOR THEIR FAMILIES. THE HOSPITAL ALSO STRENGTHENED OUR SENIOR FIT PROGRAM, SERVING NEARLY 400 SENIORS IN NINE LOCATIONS ACROSS THE COUNTY, PROVIDING BASIC PRE AND POST HEALTH SCREENING, AND A WEEKLY EXERCISE PROGRAM FOR SENIORS. THIS PROGRAM SUPPORTED BOTH THEIR PHYSICAL AND EMOTIONAL HEALTH. A WEEKLY BREASTFEEDING SUPPORT GROUP WAS ALSO OFFERED, SERVING 200+ MOTHERS OVER THE COURSE OF THE YEAR. THE GROUP OFFERED SUPPORT AND ENCOURAGEMENT TO MOTHERS IN THE COMMUNITY WHO MADE THE CHOICE TO BREASTFEED. THE GROUP CONTINUES TO GROW AND IS WELL RECEIVED.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. ST. MARY MERCY LIVONIA:RESPONDING TO THE COMMUNITY NEED FOR MENTAL HEALTH AND SUBSTANCE ABUSE CARE, ST. MARY MERCY LIVONIA 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 OUR 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 FOR HEALTHCARE FOR THE UNINSURED, ST. MARY MERCY LIVONIA HAS PARTNERED WITH WAYNE HOPE CLINICS TO PROVIDE LAB SERVICES. THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE TO THE MAPI CHARITABLE CLINIC IN LATHRUP VILLAGE, MI. TO ADDRESS THE NEED FOR SPECIALIST CARE FOR THE UNINSURED INDIVIDUALS CARED FOR IN OUR EMERGENCY ROOM, AN INTERNAL SPECIALIST CARE PROGRAM, THROUGH THE MEDICAL STAFF OFFICE, CONTINUED IN FISCAL YEAR 2015. THIS PROGRAM HAS REDUCED RETURN ER VISITS FOR FOLLOW-UP CARE AND HAS IMPROVED THE PATIENT'S QUALITY OF LIFE. WITHOUT THIS PROGRAM MANY OF THESE INDIVIDUALS WOULD NOT HAVE RECEIVED THIS NEEDED CARE. ST. JOSEPH MERCY LIVINGSTON: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. ST. JOSEPH MERCY PORT HURON:SINCE 1990, ST. JOSEPH MERCY PORT HURON (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 ST. JOSEPH MERCY'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. THROUGH VARIOUS FUNDRAISING EVENTS AND ACTIVITIES, ST. JOSEPH MERCY PORT HURON OFFERS REDUCED-COST MAMMOGRAPHY AND OTHER BREAST CANCER DIAGNOSTIC SERVICES TO PATIENTS THROUGHOUT THE COMMUNITY WITH NO INSURANCE OR RESOURCES TO PAY FOR THEIR CARE. SJMPH IS A MEMBER OF THE MICHIGAN STROKE NETWORK, WHICH BRINGS HIGHLY TRAINED NEURO-ENDOVASCULAR SPECIALISTS FROM A CERTIFIED STROKE CENTER DIRECTLY INTO OUR EMERGENCY DEPARTMENT VIA A TELE-MEDICINE STROKE ROBOT.SJMPH ALSO OFFERS THE ONLY COMPREHENSIVE ARRAY OF CANCER TREATMENT SERVICES TO THE COMMUNITY THROUGH ITS MERCY REGIONAL CANCER CENTER. LED BY THE MERCY CANCER COMMITTEE, THE CENTER NOT ONLY PROVIDES INNOVATIVE TECHNOLOGY SUCH AS THE MOST ADVANCED DIGITAL MAMMOGRAPHY IN PORT HURON, BUT ACCESS TO AN ONCOLOGY NURSE NAVIGATOR AS WELL AS THE MOST EXTENSIVE ARRAY OF CLINICAL CANCER RESEARCH TRIALS AVAILABLE THROUGH M.D. ANDERSON AND THE MAYO CLINIC. MERCY HOSPITAL GRAYLING:MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE SERVICE AREA FOR ALL APPROPRIATE DEPARTMENTS. THE HOSPITAL OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY, PARTICIPATES IN EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS, AND PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH PROGRAMS. MEDICARE AND MEDICAID ARE THE PRIMARY PAYERS FOR THE HOSPITAL AND THE OUTPATIENT CLINICS. THE ORGANIZATION IS THE SOLE COMMUNITY PROVIDER OF HEALTHCARE SERVICES FOR MUCH OF THE REGION. MERCY HOSPITAL GRAYLING IS AN ACTIVE PARTICIPANT IN AND SUPPORTER OF THE AUSABLE FREE CLINIC WHICH PROVIDES MEDICAL SERVICES TO THOSE WHO ARE UNINSURED OR UNDERINSURED. COALITION BUILDING IS ALSO OF GREAT IMPORTANCE IN OUR COMMUNITY. HOSPITAL LEADERS ARE MEMBERS OF THE CRAWFORD COUNTY COLLABORATIVE BODY, THE ROSCOMMON COUNTY HUMAN SERVICES COLLABORATIVE BODY, THE OSCODA COUNTY HUMAN SERVICES COORDINATING COUNCIL, THE NORTHERN MICHIGAN PERINATAL INTEGRATION PLANNING GROUP, MICHIGAN HOME VISITING INITIATIVE, BREAST FEEDING COALITION, GRAYLING REGIONAL CHAMBER OF COMMERCE, AND OTHER COMMUNITY GROUPS.IN ADDITION TO COALITION BUILDING, MERCY HOSPITAL GRAYLING OFFERS NUMEROUS PROGRAMS TO ASSIST PATIENTS IN THE MANAGEMENT OF CHRONIC DISEASE. FREE EDUCATIONAL CLASSES AND SEMINARS ARE ALSO OFFERED WITHIN THE COMMUNITY BY STAFF AND PROVIDERS. MERCY HOSPITAL CADILLACMEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE SERVICE AREA FOR ALL APPROPRIATE DEPARTMENTS. THE ORGANIZATION IS THE SOLE COMMUNITY PROVIDER, AND OFFERS VOLUNTEER OPPORTUNITIES TO MEMBERS OF THE COMMUNITY. MERCY HOSPITAL CADILLAC COMMUNITY BENEFITS IS A SUPPORTER OF THE STEHOUWER FREE CLINIC, WHICH PROVIDES MEDICAL SERVICES AND PRESCRIPTION MEDICATIONS PART VI, LINE 6: TRINITY HEALTH-MICHIGAN IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL REGIONAL HEALTH MINISTRIES DEFINE - AND ACHIEVE - COMMUNITY BENEFIT GOALS THAT INCLUDE IMPLEMENTING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY 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 MORE THAN $800 MILLION 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 EACH COMMUNITY'S SPECIFIC NEEDS. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. 1 AMERICAN CANCER SOCIETY (NATIONAL HOME OFFICE) 250 WILLIAMS STREET NW ATLANTA GA 30303 131788491 501(C)(3) 7500 RFL AND COLON ACTIVITY AMERICAN HEART ASSOCIATION 40 OAK HOLLOW STE 220 SOUTHFIELD MI 48033 135613797 501(C)(3) 40000 WASHTENAW CTY HEART BALL SPONSOR AND HEART WALK SPONSOR ANN ARBOR REGIONAL CHAMBER OF COMMERCE 115 W HURON ST 3RD FL ANN ARBOR MI 48104 380303680 501(C)(6) 10000 STRATEGIC ALLIANCE PARTNERS-PLATINUM LEVEL 2015 ANN ARBOR COMMUNITY FOUNDATION 301 N MAIN ST ANN ARBOR MI 48104 386087967 501(C)(3) 205000 ENDING HOMELESSNESS IN ANN ARBOR AND CHERYL W ELLIOTT TRIBUTE FUND ANN ARBOR SPARK 201 S DIVISION ST ANN ARBOR MI 48104 382436899 501(C)(6) 35000 2015 CONTRIBUTION CANCER SUPPORT COMMUNITY OF GREATER ANN ARBOR 2010 HOGBACK RD STE C3 ANN ARBOR MI 48105 050597871 501(C)(3) 15000 CANCER SUPPORT GRANT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION 2929 PLYMOUTH RD STE 245 ANN ARBOR MI 48105 271017827 501(C)(3) 180000 WASHTENAW HEALTH INITIATIVE SUPPORT AND FUSE/HSS/ASHLEY HOUSE FUNDING DETROIT REGIONAL CHAMBER OF COMMERCE PO BOX 33840 ANN ARBOR MI 48106 380477570 501(C)(6) 10000 2015 MACKINAC POLICY CONFERENCE-NICKEL SPONSOR EASTERN MARKET CORPORATION 2934 RUSSELL ST DETROIT MI 48207 320030432 501(C)(3) 50000 FOOD ACCESS PROGRAMMING GRANT FOOD GATHERS PO BOX 131037 ANN ARBOR MI 48113 382853858 501(C)(3) 15000 SUPPORT TO FEED THE NEEDY FRIENDS OF HENNE FIELD 199 W MICHIGAN AVE SALINE MI 48176 261434434 501(C)(3) 5000 LIGHTING PATH AROUND PERIMETER OF HENNE FIELD GLEANERS COMMUNITY FOOD BANK 5924 STERLING DR HOWELL MI 48843 382156255 501(C)(3) 10000 SUPPORT TO FEED THE NEEDY LIVINGSTON COUNTY ECONOMIC DEVELOPMENT 218 E GRAND RIVER BRIGHTON MI 48116 382488748 501(C)(3) 5000 2015 PARTNERSHIP MAKE A WISH FOUNDATION 7600 GRAND RIVER AVE STE 175 BRIGHTON MI 48114 382505812 501(C)(3) 25000 WAM 2015 GOLD SPONSORSHIP MILAN AREA SCHOOLS 100 BIG RED DR MILAN MI 48160 471128995 501(C)(3) 5000 REACHING HIGHER TEEN COURSE FUNDING AND SENSORY GARDEN FUNDING UNITED WAY PO BOX 995 ANN ARBOR MI 48106 941312348 501(C)(3) 10613 LEADERSHIP RECEPTION SPONSORSHIP WASHTENAW COUNTY PUBLIC HEALTH 555 TOWNER I ROOM 226 YPSILANTI MI 48197 020585175 501(C)(3) 36783 HEALTH IMPROVEMENT PLAN BRFSS SURVEY 2015 FUNDING LIVONIA PUBLIC SCHOOLS EDUCATION FOUNDATION 15125 FARMINGTON ROAD LIVONIA MI 48154 281085968 501(C)(3) 15000 2ND AND 3RD INSTALLMENT, BACK-TO-SCHOOL PROGRAM FOUNDATION OF MICHIGAN ASSOCIATION OF PHYSICIANS OF INDIAN ORIGIN 28235 SOUTHFIELD RD LATHRUP VILLAGE MI 48076 383032459 501(C)(3) 10000 MAPI FREE CLINIC PLATINUM SPONSOR OAKLAND UNIVERSITY 2200 NORTH SQUIRREL ROAD ROCHESTER MI 48309 381714400 501(C)(3) 15000 SPONSORSHIPS WELLNESS PLAN 7700 SECOND AVE DETROIT MI 48202 382008890 501(C)(3) 445016 COMMUNITY BENEFIT GRANT THE BLIGHT AUTHORITY 1 N SAGINAW ST PONTIAC MI 48342 461898090 501(C)(3) 30000 SPONSORSHIP SAINT MARY'S FOUNDATION 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 381779602 501(C)(3) 640470 PROGRAM SUPPORT 19 3 HELEN V BURG COMMITMENT TO NURSING SCHOLARSHIP 5 20000 FAIR MARKET VALUE SCHOLARSHIPS JULIE MACDONALD NURSING SCHOLARSHIP 2 6000 FAIR MARKET VALUE SCHOLARSHIPS TUOMY NURSING SCHOLARSHIP AWARD 1 2000 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 ROGER SPOELMAN PRES & CEO; WEST MI REG CEO 0 548702 0 240525 0 169106 0 24800 0 24578 0 1007711 0 30605 ROBERT CASALOU DIRECTOR;SE MI REG CEO 1/15;CEO ST J 0 497485 0 217796 0 189034 0 13000 0 26120 0 943435 0 84582 ROSSANA DEGROOD MD DIRECTOR THROUGH 12/14 0 88768 0 82963 0 1603 0 6412 0 16423 0 196169 0 0 GARRY FAJA DIRECTOR AND SE MI REG CEO THR 12/14 0 591613 0 261704 0 153276 0 18200 0 22270 0 1047063 0 0 BRUCE OLSON MD DIRECTOR 0 365040 0 0 0 4942 0 18947 0 17004 0 405933 0 0 KEVIN SEXTON DIRECTOR THR 7/14;PRES& CEO MARYLAND 0 507763 0 180447 0 318648 0 18200 0 39206 0 1064264 0 167375 CAROL TARNOWSKY SECRETARY 0 262299 0 0 0 2293 0 12660 0 3338 0 280590 0 0 SALLY GUINDI ASSISTANT SECRETARY 0 277419 0 0 0 2598 0 26297 0 21586 0 327900 0 0 MICHAEL GUSHO TREASURER; SE MI REGIONAL CFO 0 337536 0 85972 0 1751 0 27651 0 21359 0 474269 0 0 GARY ALLORE ASSISTANT TREASURER; WEST MI REG CFO 0 305233 0 77272 0 1586 0 13000 0 20873 0 417964 0 0 JACK WEINER CEO ST. JOSEPH MERCY OAKLAND 0 446378 0 123050 0 130494 0 18200 0 37606 0 755728 0 0 DAVID SPIVEY CEO ST. MARY MERCY LIVONIA 0 399118 0 158185 0 96874 0 25046 0 17962 0 697185 0 17911 BILL MANNS CEO MERCY HEALTH ST. MARY'S 0 380044 0 149600 0 88462 0 13188 0 24742 0 656036 0 0 NANCY GRAEBNER CEO ST. JOSEPH MERCY CHELSEA 0 291967 0 139344 0 68423 0 19200 0 14224 0 533158 0 6790 STEPHANIE RIEMER-MATUZAK CEO MERCY HOSPITAL GRAYLING 0 231167 0 83420 0 55715 0 32376 0 25081 0 427759 0 3548 JOHN MACLEOD CEO MERCY HOSPITAL CADILLAC THR 9/14 0 195785 0 88826 0 131900 0 19669 0 19332 0 455512 0 73784 RANDALL WAGNER COO MERCY HLTH ST. MARY'S THR 4/15 0 321546 0 80111 0 4881 0 18200 0 20397 0 445135 0 0 REBEKAH SMITH CEO ST. JOSEPH MERCY PORT HURON 0 255219 0 80459 0 58407 0 24472 0 6220 0 424777 0 3613 BARBARA HERTZLER COO ST JOSEPH MERCY OAKLAND THR 7/14 0 323651 0 51035 0 9307 0 42073 0 20774 0 446840 0 0 STEVE EAVENSON VP FINANCE MERCY HEALTH SAINT MARY'S 0 292996 0 71584 0 8288 0 18200 0 17178 0 408246 0 0 ROBIN DAMSCHRODER COO ST JOE MERCY ANN ARBOR AT 10/13 0 304106 0 51401 0 1033 0 13000 0 20118 0 389658 0 0 KATHLEEN O'CONNOR VP FIN ST JOE MRCY ANN ARBOR THR8/14 259156 0 57039 0 2477 0 31516 0 15304 0 365492 0 0 0 CLAUDE LAUDERBACH COO ST. MARY MERCY LIVONIA THR 7/14 0 243139 0 54894 0 18290 0 40872 0 9748 0 366943 0 0 MICHAEL SAMYN CFO ST MARY MCY& ST JOE MCY OAK 9/14 0 223386 0 48545 0 1056 0 13000 0 17916 0 303903 0 0 MARY NEFF CADILLAC INTERIM CEO AT 9/14; COO 0 197524 0 35878 0 2751 0 30538 0 9100 0 275791 0 0 JACKIE PRIMEAU INTERM VP FIN ST JOSEPH OAK THR 8/14 0 223782 0 0 0 1833 0 19704 0 9766 0 255085 0 0 SHANNON STRIEBICH COO SE MI REGION, ST JOSEPH PH & OAK 0 196734 0 26375 0 422 0 11387 0 11867 0 246785 0 0 KIRSTEN KORTH-WHITE COO MERCY HOSPITAL GRAYLING 0 147385 0 28431 0 297 0 9088 0 17592 0 202793 0 0 GEORGE GIBSON ORTHOPEDIC SURGEON (SJMHS) 799236 0 102468 0 1733 0 7800 0 24909 0 936146 0 0 0 CHARLES SCHWARTZ CARDIOTHORACIC SURGEON (OAKLAND) 724200 0 137500 0 1186 0 13000 0 21396 0 897282 0 0 0 KRISTOPHER AALDERINK ORTHOPEDIC SURGEON (SJMHS) 828906 0 31426 0 1566 0 7800 0 20838 0 890536 0 0 0 CREG CARPENTER ORTHOPEDIC SURGEON (CHELSEA HOSP) 655260 0 107223 0 2178 0 13000 0 22359 0 800020 0 0 0 TALLAL ZENI ORTHOPEDIC SURGEON (SMM LIVONIA) 561542 0 180284 0 1113 0 13000 0 18842 0 774781 0 0 0 DANIEL HALE FORMER OFFICER 0 517806 0 398302 0 133552 0 25344 0 17133 0 1092137 0 0 JAMES BOSSCHER FORMER OFFICER 0 309997 0 244874 0 208076 0 22225 0 17395 0 802567 0 127972 MARIANNE CUNNINGHAM FORMER OFFICER 0 197732 0 25222 0 3135 0 15539 0 22000 0 263628 0 0 AGNES HAGERTY FORMER OFFICER 0 417495 0 199166 0 59566 0 28149 0 21462 0 725838 0 0 BENJAMIN CARTER FORMER OFFICER 0 728468 0 490338 0 119169 0 13000 0 32858 0 1383833 0 0 CYNTHIA CLEMENCE FORMER OFFICER 0 375388 0 142707 0 11437 0 25735 0 25760 0 581027 0 0 JENNIFER BARNETT FORMER OFFICER 0 513036 0 480323 0 341516 0 991064 0 23743 0 2349682 0 0 PAUL NEUMANN FORMER OFFICER 0 535916 0 304901 0 154845 0 13000 0 28564 0 1037226 0 0 RICHARD GILFILLAN FORMER OFFICER 0 1430763 0 475771 0 79951 0 13000 0 31075 0 2030560 0 0 KEDRICK ADKINS FORMER KEY EMPLOYEE 0 0 0 0 0 1069394 0 0 0 1656 0 1071050 0 1056681 J RICHARD O'CONNELL FORMER KEY EMPLOYEE 0 791024 0 532372 0 425006 0 18200 0 36377 0 1802979 0 174337 CHARLES HOFFMAN FORMER KEY EMPLOYEE 0 244770 0 102375 0 162005 0 273159 0 15931 0 798240 0 0 DEBORAH ARMSTRONG FORMER KEY EMPLOYEE 0 244156 0 0 0 0 0 12208 0 0 0 256364 0 0 PHILIP MCCORKLE FORMER KEY EMPLOYEE 0 294535 0 0 0 8382 0 18200 0 16835 0 337952 0 0 PART I, LINE 3 TRINITY HEALTH - MICHIGAN IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH - MICHIGAN'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 TRINITY HEALTH - MICHIGAN'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 2014. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III): KEDRICK ADKINS - $814,924 JENNIFER BARNETT - $160,173 CHARLES HOFFMAN - $158,063 CLAUDE LAUDERBACH - $15,000 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 12/31/14: JENNIFER BARNETT - $971,714 ($565,943 PAID IN 2015 AND $405,771 TO BE PAID IN 2016) CHARLES HOFFMAN - $248,832 (PAID IN 2015) THE FOLLOWING IS A PARTICIPANT IN AN INDIVIDUAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). HE DID NOT RECEIVE A SERP PAYOUT IN 2014. KEDRICK ADKINS THE FOLLOWING ARE PARTICIPANTS IN THE NEW TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) EFFECTIVE JANUARY 1, 2014. THE PLAN WILL PROVIDE RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. THERE WERE NO PAYOUTS IN 2014. JENNIFER BARNETT -0- JAMES BOSSCHER -0- BENJAMIN CARTER -0- ROBERT CASALOU -0- CYNTHIA CLEMENCE -0- CATHERINE DECLERCQ -0- GARRY FAJA -0- RICHARD GILFILLAN -0- NANCY GRAEBNER -0- AGNES HAGERTY -0- DANIEL HALE -0- JOHN MACLEOD -0- BILL MANNS -0- PAUL NEUMANN -0- J. RICHARD O'CONNELL -0- STEPHANIE RIEMER-MATUZAK -0- KEVIN SEXTON -0- REBEKAH SMITH -0- DAVID SPIVEY -0- ROGER SPOELMAN -0- JACK WEINER -0- THE FOLLOWING ARE PARTICIPANTS IN THE NEW TRINITY HEALTH RESTORATION PLAN, EFFECTIVE JANUARY 1, 2014. THE PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($260,000 FOR 2014). THERE WERE NO PAYOUTS IN 2014. CYNTHIA CLEMENCE -0- MARIANNE CUNNINGHAM -0- DAVID SPIVEY -0- THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH CASH BALANCE RESTORATION AND RETENTION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETENTION BENEFITS PLUS RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($260,000 FOR 2014). THE PLAN WAS FROZEN DECEMBER 31, 2013. THE FOLLOWING PAYOUTS FOR 2014 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $242,986 JAMES BOSSCHER - $128,622 ROBERT CASALOU - $92,801 NANCY GRAEBNER - $6,825 JOHN MACLEOD - $75,704 J. RICHARD O'CONNELL - $185,824 STEPHANIE RIEMER-MATUZAK - $3,566 KEVIN SEXTON - $168,226 REBEKAH SMITH - $3,631 DAVID SPIVEY - $18,002 ROGER SPOELMAN - $30,760 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING INDIVIDUALS ARE VESTED IN THE CATHOLIC HEALTH EAST SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), A NONQUALIFED PLAN. THE PLAN WAS FROZEN DECEMBER 31, 2013. THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: JENNIFER BARNETT - $145,235 KATHRYN TUNE FAMILY MEMBER OF BARBARA HERTZLER, KEY EMPLOYEE 85736 EMPLOYMENT ARRANGEMENT 0 RYAN SMITH FAMILY MEMBER OF REBEKAH SMITH, KEY EMPLOYEE 45541 EMPLOYMENT ARRANGEMENT 0 JAMIE WEINER FAMILY MEMBER OF JACK WEINER, KEY EMPLOYEE 17444 EMPLOYMENT ARRANGEMENT 0 DONOR #1 DONOR #1 IS A SUBSTANTIAL CONTRIBUTOR 1312747 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #6 DONOR #6 IS A SUBSTANTIAL CONTRIBUTOR 5481579 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #7 DONOR #7 IS A SUBSTANTIAL CONTRIBUTOR 481465 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #19 DONOR #19 IS A SUBSTANTIAL CONTRIBUTOR 884367 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #30 DONOR #30 IS A SUBSTANTIAL CONTRIBUTOR 530760 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #32 DONOR #32 IS A SUBSTANTIAL CONTRIBUTOR 534228 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #54 DONOR #54 IS A SUBSTANTIAL CONTRIBUTOR 533431 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #56 DONOR #56 IS A SUBSTANTIAL CONTRIBUTOR 634713 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #152 DONOR #152 IS A SUBSTANTIAL CONTRIBUTOR 320789 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #171 DONOR #171 IS A SUBSTANTIAL CONTRIBUTOR 115792 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #175 DONOR #175 IS A SUBSTANTIAL CONTRIBUTOR 238878 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #182 DONOR #182 IS A SUBSTANTIAL CONTRIBUTOR 351339 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #184 DONOR #184 IS A SUBSTANTIAL CONTRIBUTOR 15274941 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #186 DONOR #186 IS A SUBSTANTIAL CONTRIBUTOR 1660050 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #187 DONOR #187 IS A SUBSTANTIAL CONTRIBUTOR 292620 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #189 DONOR #189 IS A SUBSTANTIAL CONTRIBUTOR 2963107 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #192 DONOR #192 IS A SUBSTANTIAL CONTRIBUTOR 257787 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #205 DONOR #205 IS A SUBSTANTIAL CONTRIBUTOR 145798 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #217 DONOR #217 IS A SUBSTANTIAL CONTRIBUTOR 1108538 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #228 DONOR #228 IS A SUBSTANTIAL CONTRIBUTOR 342666 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #238 DONOR #238 IS A SUBSTANTIAL CONTRIBUTOR 122300 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #246 DONOR #246 IS A SUBSTANTIAL CONTRIBUTOR 737794 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #274 DONOR #274 IS A SUBSTANTIAL CONTRIBUTOR 2272283 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #275 DONOR #275 IS A SUBSTANTIAL CONTRIBUTOR 2467470 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #278 DONOR #278 IS A SUBSTANTIAL CONTRIBUTOR 231198 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #280 DONOR #280 IS A SUBSTANTIAL CONTRIBUTOR 215218 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 DONOR #281 DONOR #281 IS A SUBSTANTIAL CONTRIBUTOR 969528 DONOR PROVIDED GOODS/SERVICES TO TH-MI 0 X 8 7545 FAIR MARKET VALUE X 350 FAIR MARKET VALUE X 10349 FAIR MARKET VALUE X 18 504791 MEDIAN VALUE ON TRANSFER X 35 15390 FAIR MARKET VALUE X 46 6211 FAIR MARKET VALUE X 2 2199 FAIR MARKET VALUE X MISCELLANEOUS 322 171299 FAIR MARKET 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 TRINITY HEALTH - MICHIGAN 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 TRINITY HEALTH - MICHIGAN. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF TRINITY HEALTH - MICHIGAN. 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 TRINITY HEALTH - MICHIGAN IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS ARE REVIEWED BY THE EXECUTIVE COMMITTE OF THE REGIONAL BOARDS OF TRINITY HEALTH-MICHIGAN. 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 TRINITY HEALTH - MICHIGAN 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 TRINITY HEALTH - MICHIGAN, 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 TRINITY HEALTH - MICHIGAN 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 TRINITY HEALTH - MICHIGAN (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO TRINITY HEALTH - MICHIGAN OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF TRINITY HEALTH - MICHIGAN (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 TRINITY HEALTH - MICHIGAN. 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 TRINITY HEALTH - MICHIGAN 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 TRINITY HEALTH - MICHIGAN 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 TRINITY HEALTH - MICHIGAN 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, TRINITY HEALTH - MICHIGAN INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. TRINITY HEALTH - MICHIGAN'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 TRINITY HEALTH-MICHIGAN EXCEPT FOR INSURANCE BENEFITS OF $6,531. INSTEAD, A TOTAL OF $576,286 WAS PAID BY TRINITY HEALTH-MICHIGAN 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 $13,865 AND A CAR ALLOWANCE OF $12,000. INSTEAD, A TOTAL OF $847,360 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 -52,289,183. CHANGE IN DEFERRED RETIREMENT COSTS -1,421,421. LOSS ON DISPOSAL OF DISCONTINUED OPERATIONS -5,080,782. OTHER TRANSACTIONS 4,033,656. INDIGENT CARE AGREEMENT REVENUE 4,645,373. INDIGENT CARE AGREEMENT CONTRIBUTIONS -4,427,384. EQUITY EARNINGS -49,099. ASSET IMPAIRMENT -4,144,233. FORM 990, PART XII, LINE 2: TRINITY HEALTH - MICHIGAN'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY15 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, DOING BUSINESS AS NAMES: ADVANCED LAPAROSCOPIC SURGICAL ASSOCIATES (ASLA), ANN ARBOR HOME INFUSION PHARMACY, BALD MOUNTAIN DIAGNOSTIC IMAGING, BROWNING CLAYTOR HEALTH CENTER, CADILLAC OCCUPATIONAL MEDICINE, CANTON CENTER FOR ADVANCED MEDICINE AND SURGERY, CANTON HEALTH CENTER, CARE (CONFIDENTIAL ASSISTANCE AND REFERRAL FOR EMPLOYEES), CHELSEA COMMUNITY HOSPITAL, CHELSEA COMMUNITY HOSPITAL CHILDREN'S CENTER, CHELSEA COMMUNITY HOSPITAL, A MEMBER OF THE SAINT JOSEPH MERCY HEALTH SYSTEM, CHELSEA COMMUNITY HOSPITAL, A MEMBER OF THE SAINT JOSEPH MERCYHEALTH SYSTEM, CHELSEA ORTHOPEDIC SPECIALISTS, CHELSEACARE, CHELSEACARE HOME HEALTH, CHELSEACARE PHARMACY, CLINICA SANTA MARIA, CLINXUS, CONFIDENTIAL ASSISTANCE AND REFERRAL FOR EMPLOYEES, DEXTER INTERNAL MEDICINE AND PEDIATRICS, EVANGELICAL DEACONESS HOSPITAL, FAMILY MEDICINE OF STOCKBRIDGE, HEALTH EXPLORATION STATION, HEALTHFIRST MEDICAL CENTER, HEARTSIDE HEALTH CLINIC, INSPIRIT CANCER SUPPORT SERVICES, LIVINGSTON COMMUNITY HOSPICE, MCAULEY HEALTH CENTER, MERCY ADVANTAGE, MERCY CADILLAC ANESTHESIA, MERCY CADILLAC CANCER CENTER, MERCY CADILLAC PHYSICIAN NETWORK, MERCY CANCER CENTER, MERCY ENDOCRINOLOGY, MERCY FAMILY CARE, MERCY GENERAL HEALTH PARTNERS, MERCY HEALTH - GRAND RAPIDS, MERCY HEALTH CLINXUS, MERCY HEALTH DENTAL CLINIC, MERCY HEALTH PHARMACY - CATHEDRAL SQUARE, MERCY HEALTH PHARMACY - HOME INFUSION, MERCY HEALTH PHARMACY - LONG TERM CARE, MERCY HEALTH PHARMACY - SOUTHWEST, MERCY HEALTH PHARMACY - WEGE CENTER, MERCY HEALTH PHARMACY-ROCKFORD, MERCY HEALTH ROCKFORD CAMPUS, MERCY HEALTH SAINT MARY'S, MERCY HEALTH SERVICES, MERCY HEALTH SERVICES NORTH, MERCY HEALTH SOUTHWEST CAMPUS, MERCY HEALTH-MUSKEGON CMH PHARMACY, MERCY HOSPITAL, MERCY HOSPITAL GRAYLING D/B/A MERCY HEALTH CANCER CENTER, MERCY HOSPITAL OUTPATIENT PHARMACY, MERCY HOSPITAL, CADILLAC, MERCY HOSPITAL, GRAYLING, MERCY HOSPITAL, MUSKEGON, MERCY HOSPITAL, PORT HURON, MERCY MEDICAL CENTER - NOVI, MERCY MEDICAL GROUP, MERCY NORTH OUTPATIENT PHARMACY, MERCY OB/GYN PARTNERS, MERCY OUTPATIENT PHARMACY, MERCY PATHOLOGY, MERCY PHYSICIAN NETWORK, MERCY PHYSICIAN NETWORK CADILLAC, MERCY PHYSICIAN PARTNERS, MERCY PRIMARY CARE CENTER - DETROIT, MERCY PRIMARY CARE CENTER - DETROIT PHARMACY, MERCY PROFESSIONAL SERVCES, MERCY SPECIALTY CARE, MERCY SURGERY CARE, MERCY SURGERY CARE NETWORK, MERCY SURGICAL CARE, MICHIGAN BARIATRIC INSTITUTE (MBI), MICHIGAN CANCER INSTITUTE, MICHIGAN HEART, MICHIGAN STROKE NETWORK, MICHIGAN STROKE NETWORK REGISTRY, MUSKEGON GENERAL HOSPITAL, PARTNERS AT HEART, PROFESSIONAL FINANCIAL SERVICES, RICHARD J. LACKS CANCER CENTER, SAINT JOSEPH MERCY CANTON HEALTH CENTER, SAINT JOSEPH MERCY CENTER FOR ADVANCED MEDICINE AND SURGERY, SAINT JOSEPH MERCY HEALTH NETWORK, SAINT JOSEPH MERCY HEALTH SYSTEM, SAINT JOSEPH MERCY HEALTH SYSTEM CENTER FOR BEHAVORIAL MEDICINE, SAINT JOSEPH MERCY LIVINGSTON HOME CARE, SAINT JOSEPH MERCY LIVINGSTON HOSPITAL, SAINT JOSEPH MERCY PHARMACY - HOWELL, SAINT JOSEPH MERCY PHARMACY - REICHERT, SAINT JOSEPH MERCY PHARMACY - SALINE, SAINT JOSEPH MERCY PHARMACY - TOWERS, SAINT JOSEPH MERCY SALINE HOSPITAL, SAINT MARY'S ADVANCED SPECIALTY CARE, SAINT MARY'S FAMILY PHARMACY - ECS, SAINT MARY'S FAMILY PHARMACY - LTC, SAINT MARY'S FAMILY PHARMACY-CATHEDRAL SQUARE, SAINT MARY'S FAMILY PHARMACY-SOUTHWEST, SAINT MARY'S FAMILY PHARMACY-WEGE CENTER, SAINT MARY'S HEALTH CARE, SAINT MARY'S HEALTH CARE, PROFESSIONAL FINANCIAL SERVICES, SAINT MARY'S HEALTH SERVICES, GRAND RAPIDS, SAINT MARY'S MERCY HOSPITAL, SAINT MARY'S MERCY MEDICAL CENTER, SAINT MARY'S MERCY WEGE CENTER, SAINT MARY'S MERCY WOUND CARE CENTER, SAINT MARYS'S FAMILY PHARMACY WEGE CENTER FOR HEALTH AND LEARNING, SALINE COMMUNITY HOSPITAL, SAMARITAN HEALTH CENTER, DETROIT, SISTERS OF MERCY HEALTH CORPORATION, SJMH MEDICAL PRACTICE, SJMH URGENT CARES, SJMHS LIVINGSTON ORTHOPEDIC SURGICAL GROUP, SJMHS ORTHOPEDIC SERVICES, SJMHS SPECIALTY PHYSICIANS, SJMO ROCHESTER HILLS OB/GYN, SOPHIA'S HOUSE, SPARTA FAMILY HEALTH CENTER, SPORTX, SRSLY, ST JOSEPH MERCY HOSPITAL, PONTIAC, ST. JOE'S MEDICAL GROUP, ST. JOSEPH MERCY - BRIGHTON, ST. JOSEPH MERCY ANN ARBOR, ST. JOSEPH MERCY ANN ARBOR-CANCER CENTER, ST. JOSEPH MERCY BRIGHTON-CANCER CENTER, ST. JOSEPH MERCY CANTON, ST. JOSEPH MERCY CANTON-CANCER CENTER, ST. JOSEPH MERCY CHELSEA, ST. JOSEPH MERCY CHELSEA-CANCER CENTER, ST. JOSEPH MERCY HOSPITAL - SMHC, ST. JOSEPH MERCY HOSPITAL, ANN ARBOR, ST. JOSEPH MERCY HOSPITAL, PONTIAC, ST. JOSEPH MERCY LIVINGSTON, ST. JOSEPH MERCY LIVINGSTON-CANCER CENTER, ST. JOSEPH MERCY OAKLAND, ST. JOSEPH MERCY OAKLAND - IMAGE ENHANCEMENT CENTER, ST. JOSEPH MERCY OAKLAND URGENT CARE-BIRMINGHAM, ST. JOSEPH MERCY OAKLAND-CANCER CENTER, ST. JOSEPH MERCY PORT HURON, ST. JOSEPH MERCY PORT HURON - CANCER CENTER, ST. JOSEPH MERCY PORT HURTON, ST. JOSEPH MERCY SALINE, ST. JOSEPH MERCY SALINE HEALTH CENTER, ST. MARY MERCY - CANCER CENTER, ST. MARY MERCY HOSPITAL, ST. MARY MERCY HOSPITAL PROFESSIONAL, ST. MARY MERCY LIVONIA, ST. MARY MERCY ONCOLOGY PRACTICE, ST. MARY MERCY OUTPATIENT PHARMACY, ST. MARY MERCY OUTPATIENT PSYCHIATRIC SERVICES, ST. MARY MERCY PHYSICIAN PRACTICES, ST. MARY MERCY WOUND CARE CENTER, ST. MARY'S HOSPITAL, GRAND RAPIDS, THE BOUTIQUE AT MERCY HEALTH, THE BOUTIQUE AT MERCY HEALTH, LACKS CANCER CENTER, THE SHOPPE AT SAINT MARY'S, TRINITY INFORMATION SERVICES, WEST MICHIGAN REGIONAL HEART AND VASCULAR INSTITUTE, WESTSHORE FAMILY MEDICINE, WESTSIDE OBSTETRICS AND GYNECOLOGY, WHITE OAK INN, WOMEN'S HEALTH CENTER. CLR INVESTMENTS LLC 120 W HARRIS ST CADILLAC MI 49601 320008631 REAL ESTATE RENTAL & DEVELOPMENT MI 0 TRINITY HEALTH-MICHIGAN CONNECTED CARE LLC 2601 ELECTRIC AVE PORT HURON MI 48060 465671411 ACCOUNTABLE CARE ORGANIZATION MI 0 0 TRINITY HEALTH-MICHIGAN SAINT MARY'S PHARMACY LLC 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 383404443 PHARMACY MI 0 0 TRINITY HEALTH-MICHIGAN THE SAINT JOSEPH MERCY HLTH PTNRS CLINICALLY INTEGRATED NTWK PO BOX 995 ANN ARBOR MI 48106 471340852 ACCOUNTABLE CARE ORGANIZATION MI 0 0 TRINITY HEALTH-MICHIGAN TRINITY HEALTH-WARDE LAB LLC 20555 VICTOR PARKWAY LIVONIA MI 48152 272681908 REAL ESTATE RENTAL DE 1064557 8394593 TRINITY HEALTH-MICHIGAN WESTERN CARE ALLIANCE LLC 36475 FIVE MILE ROAD LIVONIA MI 48154 465620128 ACCOUNTABLE CARE ORGANIZATION MI 0 0 TRINITY HEALTH-MICHIGAN THE CARE ALLIANCE 36475 FIVE MILE ROAD LIVONIA MI 48154 465648536 ACCOUNTABLE CARE ORGANIZATION MI 131419 207585 TRINITY HEALTH-MICHIGAN ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE 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