2015-05-11T16:03:18-05:00 2014-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2013-07-01 380997730 St Mary's of Michigan Medical Center STMA 9899078000 800 South Washington Avenue Saginaw MI 48601 Gina Butcher Chief Financial Officer 9899078000 2015-05-11 1 Alicia Janisch P00741382 5137847100 2015-05-08 2013 2016-03-07 17:11:31Z St Mary's Medical Center of Saginaw Betsy Aderholdt 800 South Washington Avenue Saginaw MI 48601 246081804 0 0928 X www.stmarysofmichigan.org X 1874 MI Provide medical services which strengthen the healing mission of the Catholic Church. 10 8 2454 263 0 0 683397 376283 238762384 226822648 12639484 10399748 3342392 8445307 255427657 246043986 1079203 1019627 0 0 121066193 116066391 0 0 0 134256096 129403867 256401492 246489885 -973835 -445899 413662767 411712212 147236357 142533389 266426410 269178823 X Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually centered, holistic care which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words. 0 0 230371434 1019627 231091126 St. Mary's of Michigan Medical Center ("SMMMC") is a 268 licensed bed nonprofit acute care hospital which provides inpatient, outpatient and emergency care services. SMMMC seeks to improve the physical, mental, social and spiritual health status of its surrounding community. SMMMC provides a substantial portion of its services to the elderly and poor. During the fiscal year, approximately 54% of the value of services rendered was to elderly patients under the Medicare program, and approximately 13% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. During the fiscal year ending June 30, 2014, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $15,282,014. 671000 671000 Towne Centre Surgery Center - Rental revenue received from the Towne Centre Surgery Center joint venture. 604459 902207 Respite Adult Day Care - The Guardian Angel Program fosters a caring atmosphere for individuals with special needs by providing them with a warm and safe haven and relief to their families enabling them to enhance their quality of life. 231646893 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 234 0 1 2454 1 0 0 0 0 0 0 0 0 0 0 0 X 10 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X Nancy Haywood 9899077596 800 South Washington Saginaw MI 48601 James Van Tifflin Chairman 1.00 0.00 X X 0 0 0 Jim Whitlock Vice-Chairman 1.00 0.00 X X 0 0 0 Paul Furlo Secretary/Treasurer 1.00 0.00 X X 0 0 0 Waheed Akbar MD Board Member 45.00 0.00 X 1003841 0 8118 Dr Anirudha Bhandiwad Board Member (start 01/14) 1.00 0.00 X 0 0 0 Brian Chermside Board Member (end 06/14) 1.00 0.00 X 0 0 0 Todd Gregory Board Member 1.00 0.00 X 0 0 0 Dr Rao Gudipati Board Member (end 01/14) 1.00 0.00 X 0 0 0 Sr Sharon Hagen Board Member 1.00 0.00 X 0 0 0 Albert Harvey Board Member 1.00 0.00 X 0 0 0 Dr Bapineedu Maganti Board Member 1.00 0.00 X 0 0 0 John Graham President & CEO 45.00 0.00 X X 1087067 0 9113 Gina Butcher Chief Financial Officer 45.00 0.00 X 194674 0 8272 Richard Ohle Chief Operating Officer 45.00 0.00 X 275108 0 12206 Bernard Jore VP - CNO 45.00 0.00 X 174710 0 7619 Michael Long VP - Hospital Admin 45.00 0.00 X 209156 0 8084 Cheri Sammis-Berman VP - Mission Integration 45.00 0.00 X 162642 0 8337 Raghuram Sarvepalli VP - Medical Affairs 45.00 0.00 X 617251 0 9880 Naman Salibi MD Physician 45.00 0.00 X 1287381 0 11406 E Malcolm Field MD Physician 45.00 0.00 X 841690 0 942 William J Pittas DO Physician 45.00 0.00 X 847578 0 7585 Pervez Yusaf MD Physician 45.00 0.00 X 614458 0 7542 Bhramaramba Sarvepalli MD Physician 45.00 0.00 X 530009 0 7573 7845565 0 106677 88 0 1 0 Michigan Cardiovascular Institute 1015 S Washington Ave Saginaw MI 48601 Physician Services 11323538 Touchpoint Support Services PO Box 102289 Atlanta GA 303682289 Environmental and Nutritional Services 8337529 HealthCare Services Inc 401 N Michigan Ave Suite 2700 Chicago IL 60611 Consulting Services 6092436 TriMedx LLC 6325 Digital Way - Suite 400 Indianapolis IN 46278 Equipment Maintenance 5524055 Hunter Partners LLC PO Box 919359 Orlando FL 328919359 Consulting Services 1644922 52 376283 376283 Net Patient Revenue 621990 224337204 224337204 Adult Day Care 623990 902207 902207 Program Related JV 621400 845086 845086 Healthsource Revenue 621400 490009 490009 248142 248142 226822648 10437566 10437566 25247 0 25247 25247 25247 37818 -37818 -37818 -37818 EMR Incentives 900099 3141685 3141685 BCBS Shared Savings 900099 2700000 2700000 Cafeteria/Vending 722210 1035619 1035619 1542756 1542756 8420060 246043986 232664333 0 13003370 X 1019627 1019627 3796078 1011959 2784119 93637916 88287756 5350160 -2273814 -2046433 -227381 14149066 13155536 993530 6757145 6296113 461032 363241 363241 303475 303475 18005 18005 55425852 53009462 2416390 525360 525360 833744 808042 25702 6400421 5950991 449430 467127 373648 93479 3608279 3354910 253369 469526 436556 32970 9064744 8428229 636515 1432809 1332199 100610 Medical Supplies 39583513 39182244 401269 Equip Rent & Maint. 7403643 7399089 4554 Service Fees 1504456 1504456 Dues & Subscriptions 495856 264149 231707 1503816 1353000 150816 246489885 231646893 14842992 0 6505189 8954765 33441172 28838895 4929061 5095627 2224251 2065397 292573898 212960450 82789031 79613448 13712659 13281717 75929 7299262 269985475 266563101 413662767 411712212 30002973 26917502 117233384 115615887 147236357 142533389 X 266426410 269178823 266426410 269178823 413662767 411712212 X -445899 16062171 -12863859 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 0 0 1 18005 18005 0 Part II-B, Line 1: Every year we pay a Michigan Health & Hospital Association (MHA) Membership Renewal Invoice. Per the invoice, 18.82% of the MHA's budgets supports lobbying activities. Therefore, 18.82% of our annual dues of $95,672 ($18,005) supports lobbying activities. St. Mary's of Michigan Medical Center does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition of) any candidate for public office. 10635764 10635764 123599117 85623497 37975620 153674906 122677485 30997421 4664111 4659468 4643 79613448 Interest in Investments held by Ascension Health Alliance 237419459 Pension Plan 11187598 Other Receivables 6653578 Construction in Progress 6204682 Ascension Health Deferred Compensation Asset 4711449 TriMedx Accounts Receivable 345963 Other Miscellaneous Assets 40372 266563101 Intercompany Payables 3093308 Third Party Payable 7812426 Valuation Allowance 1550000 AH Savings Plan Liability 1039343 Intercompany Debt with Ascension Health Alliance 102120810 115615887 X Part X, Line 2: From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of St. Mary's of Michigan Medical Center: The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2014. 1 1 X 1 X 1 X 1 1 0 1 1 5522680 5522680 0.02240 28295667 25181857 3113810 0.01260 33818347 25181857 8636490 0.03500 209990 209990 0.00090 4980679 4980679 0.00000 496987 496987 0.00200 308998 308998 0.00130 5996654 4980679 1015975 0.00420 39815001 30162536 9652465 0.03920 415686 415686 0.00170 415686 415686 0.00170 0 8541681 2539160 103271581 115547379 -12275798 X 1 1 1 1 St Mary's of Michigan Medical Center 800 South Washington Avenue Saginaw MI 48601 www.stmarysofmichigan.org 730050 X X X X X St Mary's of Michigan Medical Center 1 1 X X X X X X X X 12 1 1 1 X See Part V, Section D X X X X X X X X X X 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 St. Mary's of Michigan Medical Center Part V, Section B, Line 3: Information was gathered through focus groups, neighborhood association groups, faith-based groups, residents, and community surveys and area agencies in an attempt to acquire broad community input regarding their health concerns. In addition, public health experts including Saginaw County Public Health Officer and local public health leaders were key participants in CHNA assessment, planning, and development of action plans. Groups were facilitated by local and national public health leaders. St. Mary's of Michigan Medical Center Part V, Section B, Line 4: The other hospital facilities with which the reporting hospital facility conducted its CHNA, includes Saginaw County Department of public Health, Covenant HealthCare, Health Delivery Incorporated, Saginaw Intermediate School District, Saginaw County community Mental Health Authority, and Alignment Saginaw. St. Mary's of Michigan Medical Center Part V, Section B, Line 5d: The Community Health Needs Assessment ("CHNA") of the hospital facility can be located on the hospital's website at the following web address:http://www.stmarysofmichigan.org/documents/SMOM_Saginaw_CHNA.pdf St. Mary's of Michigan Medical Center Part V, Section B, Line 14g: The financial assistance policy is available in organization's emergency department, available online and available on request. 28 Riverfront Pulmonary Rehabilitation 1015 S Washington Avenue Saginaw MI 48601 Rehabilitation Clinic Riverfront Cardiac Rehabilitation 1015 S Washington Avenue Saginaw MI 48601 Rehabilitation Clinic St Mary's of Michigan Towne Centre 4599 Towne Centre Road Saginaw MI 48604 Emergency Room and other Outpatient Services and Diagnostic center Bay City 4040 N Euclid Avenue Bay City MI 48706 Physicians Office and Diagnostic Center Birch Run 9900 E Birch Run Road Birch Run MI 48415 Physicians Office, Rehabilitation and Diagnostic Center Chesaning 1600 W Brady Street Chesaning MI 48616 Physicians Office, Rehabilitation and Diagnostic Center Center of HOPE 723 Emerson Street Saginaw MI 48607 Neighborhood Services Frankenmuth Family Physicians 1027 West Genesee Street Frankenmuth MI 48734 Physicians Office Gratiot Family Practice 5810 Gratiot Suite B Saginaw MI 48638 Physicians Office Gratiot Rehabilitation Services 5810 Gratiot Suite A Saginaw MI 48638 Rehabilitation Clinic Guardian Angel Respite Care Davis Rd 7540 Davis Road Saginaw MI 48604 Respite Services Guardian Angel Respite Care Howard St 801 Howard Street Saginaw MI 48601 Respite Services Heritage Family Physicians 3570 Shattuck Road Saginaw MI 48603 Physicians Office Home Health Care and Hospice 716 German Street Tawas City MI 48763 Home Care and Hospice Services Orthopedics 4701 Towne Centre Road Suite 303 Saginaw MI 48604 Physicians Office Plastic Reconstructive & Hand Surgery 4705 Towne Centre Road Saginaw MI 48604 Physicians Office Pulmonary & Critical Care Associates 1015 S Washington Avenue Saginaw MI 48601 Physicians Office Riverfront Rehabilitation 1015 S Washington Avenue Saginaw MI 48601 Rehabilitation Clinic Riverfront Cardiology 1015 S Washington Avenue Saginaw MI 48601 Diagnostic Services Saginaw Valley Pediatrics 5821 Colony Drive North Saginaw MI 48638 Physicians Office Spine & Rehabilitation Center 4901 Towne Centre Road Suite 300 Saginaw MI 48604 Rehabilitation Clinic Seton Cancer Institute - Marlette 2780 Main Street Marlette MI 48453 Cancer Treatment Center Seton Cancer Institute - Tawas 200 Hemlock Street Tawas City MI 48763 Cancer Treatment Center Seton Cancer Institute - West Branch 2431 S M-30 West Branch MI 48661 Cancer Treatment Center Vassar 1212 W Saginaw Road Vassar MI 48768 Physician Office, Rehabilitation, and Diagnostic Center Womens Health Center 4040 N Euclid Avenue Suite B Bay City MI 48706 Physicians Office Wound Care & Hyperbaric Center 4599 Towne Centre Saginaw MI 48604 Rehabilitation and other Outpatient Clinic Seton Cancer Institute 800 S Washington Ave Saginaw MI 48601 Cancer Treatment Center Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a costing accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For certain categories in the table, this was a cost accounting system; in other categories, a specific cost-to-charge ratio was applied. Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services. Part II, Community Building Activities: St. Mary's of Michigan has been actively involved with community stakeholders in addressing blight reduction, including acquiring abandoned parcels and providing lawn cutting and debris clean-up, leader participation in crime reduction initiatives, lead abatement support, and economic development councils to increase workforce development, clean water initiatives including Yellow Jug Program for safe medication disposal. St. Mary's also is a partner in MIHIA Michigan Health Improvement Association and is a member of Alignment Saginaw, with leaders participating in area Community Boards. Part III, Line 4: From the consolidated audited financial statements of Ascension Health Alliance (which include the activity of St. Mary's of Michigan Medical Center):The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies.The organization's share of deduction for bad debts was $8,541,681 at charges. Part III, Line 8: St. Mary's follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. Part VI, Line 2: St. Mary's of Michigan participated in a community collaborative and as a member of the Community Health Improvement Steering Committee to engage in the community's first comprehensive community health needs assessment using MAPP Methodology with community driven strategic planning and action plans in 2010 and 2011, and completed its second CHNA assessment refresh in 2013-2014, and presented widely to community in March 2014 at a videotaped community engagement event bringing together community residents, neighborhood groups, local, state, and national service agencies, TV and newspaper media, public health officials, community foundations, and faith-based groups. Action Plan Development and Implementation Committees including community members have been ongoing each month since inception. In addition to data reviews from national, state, and local reporting agencies, surveys, focus groups, and reaching target areas of vulnerable populations including homeless, low-income, elderly, minority, and disadvantaged population groups to prioritize health needs. The CHIP Team formed in 2009 with a vision of creating a healthier Saginaw community and a mission of developing a health improvement plan that would support and maintain a healthy community. This collaborative effort provides a unique opportunity to address health related issues and ideas in a broad forum with a diverse group of partners. The planning team identified as the Community Health Improvement (CHI) Key Partners, is made up of representatives from private enterprise, faith and community based organizations, as well as educational and health and human services organizations. These groups had major participation in designing materials and activities aimed at implementing, promoting, and overseeing the success of the plan. Progress reports each year were developed and distributed to the public and key participating stakeholder agencies, and updated at Alignment Saginaw Collaborative. In this second CHNA refresh, Prioritized Health indicators were Chronic Diseases, Obesity, Infant Mortality, and Behavioral Health, with Determinants of Health of Access to Care and Utilization of Services, Neighborhood Safety, Parent Support, Transportation, and Health Prevention/Promotion.Plans and committees are in place to outline goals, strategies and activities related to these and included new development of an additional Health and Social Equity Work Group with action plans. Part VI, Line 3: It is the policy of St. Mary's of Michigan Health to ensure a socially just practice for billing for all Patients receiving care at any of our facilities. St. Mary's of Michigan provides assistance to Patients who do not have the financial resources available to pay for necessary medical service rendered. Various individuals may identify potential charity care recipients. Any Patient that may be a candidate should be referred to a financial counselor. Our billing and collection practices reflect our commitment to and reverence for human dignity and the common good; our special concern for and solidarity with poor and vulnerable persons; and our commitment to distributive justice and stewardship.St. Mary's of Michigan ensures that:A. St. Mary's of Michigan staff and agents behave in a manner that reflects the policies and values of a Catholic-sponsored facility, including treating Patients and their families with dignity, respect and compassion.B. Patients receive prompt access to charge information for any item or service.C. Patients and their families are advised of the hospital's applicable policies, including charity care and the availability of need-based financial assistance in easily understood terms.D. Patients who do not qualify for charity care, but are in need of financial assistance, are offered appropriate extended payment terms or other payment options that take into account the patient's financial status.E. Outstanding balances on patient accounts are pursued fairly and consistently, in a manner that reflects the values and commitments of a Catholic sponsored facility.F. Financial counselors are available to all patients.G. Information is posted in patient access areas including the Emergency Department regarding financial assistance and charity care policies.H. Patients are encouraged to participate in their own care by working with the financial counselor and applying for Medicaid or other public assistance programs to qualify for charity or financial assistance. Part VI, Line 4: Saginaw County population decreased from 2009 to 2012 at 198,153 with highest increases in age 65 and above of 3.4%. Population race is predominantly white at 77%, African American/Black at 20%, and Asian at 3%. Hispanic/Latino ethnicity make-up is approximately 8%. From 2009 to 2012 improvements were noted with decreased unemployment rates from 12.2% to 8.6%, median income increased from $42,244 to $43,258, with noted disparities for African Americans at $25,259. Part VI, Line 5: Expanding Awareness, Education, and Health PromotionSt. Mary's of Michigan Medical Center mission in sustaining communities by improving community health with special attention to the poor and vulnerable incoporates education and awareness of not only disease processes but promotion of positive healthy behaviors and wellness prevention lifestyle changes. St. Mary's of Michigan has invested significantly in unique, high quality health education programs and materials to reach our target community and promote health literacy. In efforts to promote healthy living, St. Mary's has made available the following community education programs: Physical Fitness Activities:- Making Strides Against Breast Cancer Walk, Footsteps for Fitness, BEE Healthy for Life Run/Walk, Children's Charity Bike Run- Lunch Connection Programs - Brain Attack - Know What to Do- Community Health Programs - Asthma Camp, Weight-Loss Surgery Information Sessions, Ask the Expert Sessions on: Get Smart About Lung Cancer, Cancer Screening Programs, Nutrition, Allergy and Asthma, Excerise, Breast Cancer, Diabetes, Healing Hearts Grief Support Programs, Fall Prevention Programs- Community Outreach - Center of HOPE (network of free clinics and charitable free community benefit pharmacy), Diabetes Expo, Pharmacy Assistance Program, Hearth Home - HIV Prevention & Education,Support Groups:MS Support Group, Support for Living - Cancer Support Group, Spinal Cord Injury Resource Group, Bariatric Support Group, Living with Diabetes support GroupAccess to Care:St. Mary's of Michigan has a rich history of helping those who are poor and most vulnerable. Our Community Advisory Board provides input to service design and CHNA action plans for person-centered health improvement and care with emphais on vulnerable populations. Physicians, nurses, therapists, technicians, administrators, and volunteers contribute untold hours of volunteer service to reach people in and around Saginaw who need us most. We minister to them in a variety of ways:- Center of HOPE (network of free clinics at area hunger feeding center and area churches, charitable free pharmacy, emergency financial assistance for utilities, Free health education programs tailored for low-literacy and low-income populations, Community Health Workers to link needed resources and enroll into eligible social service programs and Medicaid, nutrition and cooking demonstrations for healthy eating for children and families, onsite community garden, yoga and tai chi) - - Community Outreach Programs - Hearth Home - HIV prevention, education and outreach center - Cancer screening programs In furthering St. Mary's commitment to the surrounding community, financial contributions and support to local organizations and causes are made each year including Hunger Feeding Center, Community Homeless Shelters, Habitat for Humanity, Youth empowerment, temporary housing for needy patient families, American Heart Association, Cultural and Educational Enrcihment programs, Scholarship support for low income and minority families, community foundations supporting needy elderly and disabled, etc. In addition, physican staff are encouraged to become credentialied providers, and we have multiple volunteer community boards to support planning and decision-making for the best interests of our community.Medical ResearchSt. Mary's of Michigan Medical Center furthers its mission by contributing funds and personnel to support research that has helped advance medical care. Research projects include the following:- Oncology Research- Neurology ResearchMedical EducationSt. Mary's of Michigan Medical Center believes that, in order to provide the best health care to the community, its clinical personnel must receive ongoing medical education.Resident EducationSt. Mary's is affiliated with Central Michigan University (CMU), College of Medicine. CMU Medical Education Partners was established in 2009 to prepare physicians focused on improving access to high quality health care in Michigan, with an emphasis on rural and medically underserviced regions. Residents receive training as they rotate through Saginaw area member hospitals including St. Mary's. Residency programs include: - Emergency Medicine- Family Medicine- General Surgery- Internal Medicine- Obstetrics & Gynecology Part VI, Line 6: St. Mary's of Michigan Medical Center is a member of Ascension Health. Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. Ascension Health Alliance serves as the member or shareholder of various other subsidiaries. Ascension Health and its member organizations are hereafter referred to collectively as the System.Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; theCongregation of Alexian Brothers of the Immaculate Conception Province, Inc. American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province. As more fully described in the Organizational Changes note, Marian Health System, which was previously sponsored by the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province, became part of Ascension Health on April 1, 2013.Mission:The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care that sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living inpoverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.- Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs forpersons living in poverty and other vulnerable persons.- Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiencysyndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care.As a member of Ascension Health, the nation's largest Catholic healthcare system, St. Mary's of Michigan Medical Center continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of St. Mary's of Michigan Medical Center is to perpetuate the healing mission of the church. St. Mary's of Michigan Medical Center furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community, and medical research. Our concern for all human life and dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. 1 Child Abuse & Neglect Council 1311 N Michigan Ave Saginaw MI 48602 382480726 501(c)(3) 30600 General Support Saginaw Community Foundation 1 Tuscola Street Suite 100 Saginaw MI 48607 382474297 501(c)(3) 21000 General Support Hospital Hospitality House of Saginaw 1701 N Michigan Saginaw MI 48602 382480414 501(c)(3) 12000 General Support Mid-Michigan Children's Museum 315 West Genesee Ave Saginaw MI 48605 383484109 501(c)(3) 11000 General Support Catholic Diocese of Saginaw 5800 Weiss St Saginaw MI 48603 381358181 501(c)(3) 13840 General Support Mobile Medical Response Inc 834 S Washington Ave Saginaw MI 48605 383198397 501(c)(3) 10000 General Support Saginaw Chamber of Commerce 515 Washington Saginaw MI 48607 380995390 501(c)(6) 15550 General Support Field Neurosciences Institute 800 S Washington Ave Saginaw MI 48601 382790703 501(c)(3) 826372 General Support American Heart Association 460 N Lindbergh Blvd St Louis MI 63141 135613797 501(c)(3) 6500 General Support Saginaw Bay Symphony Orchestra 201 N Washington Ave Saginaw MI 48607 386082223 501(c)(3) 5625 General Support St Mary's Standish Community Hospital 805 Cedar Standish MI 48658 381671120 501(c)(3) 5625 General Support 10 1 Part I, Line 2: St. Mary's of Michigan Medical Center provides only direct contributions and other general support; therefore, no monitoring of charitable contributions is performed. 0 1 0 0 0 0 0 0 0 Waheed Akbar MD Board Member 996705 0 0 0 7136 0 7350 0 768 0 1011959 0 0 0 John Graham President & CEO 481163 0 579906 0 25998 0 7350 0 1763 0 1096180 0 0 0 Gina Butcher Chief Financial Officer 182912 0 960 0 10802 0 5570 0 2702 0 202946 0 0 0 Richard Ohle Chief Operating Officer 239925 0 30405 0 4778 0 7344 0 4862 0 287314 0 0 0 Bernard Jore VP - CNO 172993 0 960 0 757 0 5118 0 2501 0 182329 0 0 0 Michael Long VP - Hospital Admin 194580 0 8094 0 6482 0 5903 0 2181 0 217240 0 0 0 Cheri Sammis-Berman VP - Mission Integration 137120 0 22875 0 2647 0 4237 0 4100 0 170979 0 0 0 Raghuram Sarvepalli VP - Medical Affairs 563267 0 36314 0 17670 0 7350 0 2530 0 627131 0 0 0 Naman Salibi MD Physician 1085680 0 189636 0 12065 0 7350 0 4056 0 1298787 0 0 0 E Malcolm Field MD Physician 832799 0 0 0 8891 0 0 0 942 0 842632 0 0 0 William J Pittas DO Physician 609767 0 237138 0 673 0 7350 0 235 0 855163 0 0 0 Pervez Yusaf MD Physician 549823 0 57000 0 7635 0 7350 0 192 0 622000 0 0 0 Bhramaramba Sarvepalli MD Physician 289771 0 239000 0 1238 0 7350 0 223 0 537582 0 0 0 Part I, Line 3 Ascension Health, a related organization of St. Mary's of Michigan Medical Center, uses the following to establish the compensation of the organization's President & CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee. Part I, Line 4b Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid to the executive is reported as compensation on Form 990, Part II, column B in the year paid. No distributions were made from supplemental nonqualified retirement plan during calender year 2013. Form 990, Part VI, Section A, line 2 Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by St. Mary's - St. Joseph Health System related entities. Form 990, Part VI, Section A, line 6 St. Mary's Of Michigan Medical Center has a single corporate member, St. Mary's - St. Joseph Health System. Form 990, Part VI, Section A, line 7a St. Mary's of Michigan Medical Center has a single corporate member, St. Mary's - St. Joseph Health System, who has the ability to elect members to the governing body of St. Mary's of Michigan Medical Center. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to St. Mary's of Michigan Medical Center financial information or corporation as a whole are subject to approval by its sole corporate member, St. Mary's - St. Joseph Health System. Form 990, Part VI, Section B, line 11 Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Finance Committee members are provided the Form 990 and management team members are available to answer any committee member questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the Conflict of Interest Policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining the compensation of the organization's CEO, the process, performed by Ascension Health, a related organization of St. Mary's of Michigan Medical Center, included a review and approval by independent persons, comparability data and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the committee minutes. The individual was not present when his compensation was decided. The Executive Committee of the Board of Directors in conjunction with the Intermediate Sanctions Compliance Policy of the hospital is responsible for determining the compensation of other officers or key employees of the organization. The process includes a market analysis of comparable healthcare positions from other organizations of comparable size, complexity, and business activity. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part IX, line 11g Dietary: Program service expenses 3,384,791. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,384,791. Laundry: Program service expenses 933,119. Management and general expenses 0. Fundraising expenses 0. Total expenses 933,119. Other: Program service expenses 28,427,573. Management and general expenses 2,025,210. Fundraising expenses 0. Total expenses 30,452,783. Professional Fees: Program service expenses 20,263,979. Management and general expenses 391,180. Fundraising expenses 0. Total expenses 20,655,159. Form 990, Part XI, line 9: Transfers to Affiliates -14,256,875. Total Pension & Other Post-Retirement Costs 1,393,016. Ascension Health Alliance PO Box 45998 St Louis MO 631455998 453358926 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 St Mary's - St Joseph Health System 800 S Washington Ave Saginaw MI 48601 461084363 Supporting Organization MI Section 501(c)(3) Schedule A, Line 11a Ascension Health 0 Field Neurosciences Institute 800 S Washington Ave Saginaw MI 48601 382790703 Medical Research Organization MI Section 501(c)(3) Schedule A, Line 9 St Mary's of Michigan Medical Center 1 Standish Community Hospital 805 W Cedar Street Standish MI 48658 381671120 Hospital MI Section 501(c)(3) Schedule A, Line 3 St Mary's - St Joseph Health System 1 St Mary's of Michigan Foundation 800 S Washington Ave Saginaw MI 48601 382246366 Fundraising MI Section 501(c)(3) Schedule A, Line 11c St Mary's of Michigan Medical Center 1 St Joseph Health System 200 Hemlock Tawas City MI 48764 381443395 Hospital MI Section 501(c)(3) Schedule A, Line 3 Ascension Health 1 Towne Centre Surgery Center LLC 4599 Towne Centre Saginaw MI 48604 204943843 Outpatient Services MI St Mary's of Michigan Medical Center Related 503480 3643904 0 0 0.50890 St Mary's of Michigan Specialists 800 S Washington Avenue Saginaw MI 48601 205959777 Physician Practices MI St Mary's of Michigan Medical Center C 1117712 1.00000 1 St Mary's Health 800 S Washington Avenue Saginaw MI 48601 383477017 Inactive MI St Mary's of Michigan Medical Center C 1.00000 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 St Mary's of Michigan Foundation R 148645 Actual Amount Transferred Field Neurosciences Institute R 818872 Actual Amount Transferred St Mary's of Michigan Foundation C 365733 Actual Amount Transferred Standish Community Hospital O 278681 Actual Amount Transferred St Joseph Health System Q 1933270 Actual Amount Transferred Standish Community Hospital Q 4418956 Actual Amount Transferred Field Neurosciences Institute B 826372 Actual Amount Transferred Ascension Health R 17545956 Actual Amount Transferred