2015-11-13T11:36:00-06:00 2014-12-31 990 2014-01-01 382947657 HENRY FORD MACOMB HOSPITAL CORPORATION HENR 3138768714 ONE FORD PLACE - 5F DETROIT MI 48202 EDWARD G CHADWICK TREASURER 3138768714 2015-11-13 2014 2016-03-07 17:11:31Z EDWARD G CHADWICK ONE FORD PLACE - 5F DETROIT MI 48202 428157782 0 X WWW.HENRYFORD.COM/HOMEPAGE_MACOMB X 1990 DE TO IMPROVE PEOPLE'S LIVES THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING.VISION: TRANSFORMING LIVES AND COMMUNITIES THROUGH HEALTH AND WELLNESS-ONE PERSON AT A TIME. 20 14 4068 800 0 0 805484 976756 424214179 419973018 692896 891715 5374017 4252845 431086576 426094334 0 0 0 0 207702973 195127421 0 0 159792 222065449 211680819 429768422 406808240 1318154 19286094 318636179 329892691 228509694 234765989 90126485 95126702 X HENRY FORD MACOMB HOSPITAL (HFMH) IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM SERVING THE NORTHEASTERN METROPOLITAN DETROIT MICHIGAN COMMUNITIES. AS AN INTEGRATED COMPONENT OF ONE OF THE NATION'S LEADING COMPREHENSIVE, INTEGRATED HEALTH SYSTEMS, IT IS THE MISSION OF HFMH TO IMPROVE HUMAN LIFE THROUGH THE EXCELLENCE OF THE SCIENCE AND ART OF HEALTH CARE AND HEALING. HFMH IS COMMITTED TO PROVIDING HEALTH SERVICES AND IMPROVING THE QUALITY OF LIFE OF ALL OF THE CITIZENS OF THE COMMUNITIES IT SERVES REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. THE ORGANIZATION PROVIDES FINANCING AND HEALTH CARE DELIVERY, INCLUDING ACUTE, SPECIALTY, PRIMARY AND PREVENTATIVE CARE SERVICES BACKED BY EXCELLENCE IN RESEARCH AND EDUCATION. 0 0 246164680 309465106 HFMH IS RECOGNIZED FOR ITS EXCELLENCE IN PROVIDING INPATIENT CARE TO THE RESIDENTS OF THE MACOMB COUNTY MICHIGAN AS WELL AS ALL OF THE OTHER COMMUNITIES LOCATED NORTHEAST OF THE CITY OF DETROIT. DURING 2014 HFMH HAD 21,321 DISCHARGES, AND 106,195 PATIENT DAYS.HENRY FORD MACOMB HOSPITAL-CLINTON TOWNSHIP PROVIDES COMPREHENSIVE ACUTE AND TERTIARY CARE. SPECIALTY SERVICES INCLUDE A HEART & VASCULAR INSTITUTE, JOSEPHINE FORD CANCER CENTER, A WOMEN'S HEALTH CENTER, ALONG WITH A BIRTHING CENTER THAT FEATURES 18 LABOR, DELIVERY, RECOVERY AND POST-PARTUM SUITES. THE HOSPITAL ALSO HAS A 42-BED INPATIENT REHABILITATION PROGRAM, AN AMBULATORY AND MINIMALLY INVASIVE SURGERY CENTER AND LEADING DIAGNOSTIC IMAGING, ALONG WITH ADVANCED TRAUMA CAPABILITIES AND EMERGENCY SERVICES.HENRY FORD HOSPITAL DOCTORS TRAIN MORE THAN 600 MEDICAL SCHOOL STUDENTS, 500 RESIDENTS AND 150 FELLOWS ACROSS 46 DIFFERENT AREAS OF MEDICINE EVERY YEAR. HENRY FORD HOSPITAL RESIDENCY AND FELLOWSHIP PROGRAMS ARE NATIONALLY ACCREDITED M.D. (DOCTORATE OF MEDICINE) TRAINING PROGRAMS. HENRY FORD MACOMB HOSPITALS OFFER NATIONALLY ACCREDITED D.O. (DOCTORATE OF OSTEOPATHIC MEDICINE) AND D.P.M. (DOCTORATE OF PODIATRIC MEDICINE) TRAINING PROGRAMS, AND TRAINED 103 MEDICAL RESIDENTS DURING 2014. 67809316 67330394 HFMH PROVIDES OUTPATIENT SERVICES AT MULTIPLE LOCATIONS THROUGHOUT THE NORTH EASTERN METROPOLITAN COMMUNITIES OF DETROIT. IN TOTAL THIS REPRESENTED 429,898 OUTPATIENT VISITS DURING 2014. 28339586 34686436 HFMH OPERATES A LEVEL II EMERGENCY FACILITY. EMERGENCY SERVICES REPRESENTED 66,509 PATIENT VISITS DURING 2014. 4335626 10967532 OTHER PROGRAM SERVICES INCLUDE ANCILLARY SERVICES LOCATED WITHIN THE MEDICAL FACILITIES. 4335626 10967532 346649208 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 0 1 256 22 1 4068 1 0 0 0 0 0 1 1 0 0 0 0 X 20 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X EDWARD G CHADWICK 3138768714 ONE FORD PLACE DETROIT MI 48202 PAUL D ALANDT TRUSTEE 1.00 0.00 X 0 0 0 MYRA BERGMAN RSM TRUSTEE 1.00 0.00 X 0 0 0 EDWARD D CALLAGHAN PHD TRUSTEE 1.00 4.00 X 0 0 0 DAVID F GIRODAT TRUSTEE - CHAIR 1.00 0.00 X X 0 0 0 STEVEN D HARRINGTON MD TRUSTEE 1.00 1.00 X 0 0 0 CAROLANN K KINNER DO TRUSTEE 1.00 0.00 X 0 0 0 BRIAN G LODER DPM TRUSTEE 40.00 0.00 X 157227 0 24972 RAYMOND C LOPE' TRUSTEE - VICE CHAIR 1.00 0.00 X X 0 0 0 ALI H SHAKIR MD TRUSTEE 1.00 0.00 X 0 0 0 JAMES E THOMPSON DD TRUSTEE 1.00 0.00 X 0 0 0 ANTHONY J VIVIANO TRUSTEE 1.00 1.00 X 0 0 0 ANDREA L WULF TRUSTEE 2.00 0.00 X 0 0 0 ALBERT L LORENZO PHD TRUSTEE 2.00 0.00 X 0 0 0 THOMAS B MELDRUM TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM A MORELLI SR TRUSTEE 1.00 0.00 X 0 0 0 RHONDA M POWELL TRUSTEE 1.00 0.00 X 0 0 0 ROSS C RICHARDSON TRUSTEE 1.00 0.00 X 0 0 0 ROBERT G RINEY TRUSTEE 1.00 63.00 X 0 1623807 48083 BARBARA W ROSSMANN PRESIDENT / TRUSTEE 60.00 0.00 X X 755022 0 110645 DIANE L GEORGE DO TRUSTEE 1.00 0.00 X 0 339940 46966 JAMES M CONNELLY TREASURER - PART YEAR 1.00 62.00 X 0 1328462 46784 EDITH L EISENMANN SECRETARY 1.00 62.00 X 0 237876 33113 TERRY A GOODBALIAN ASSISTANT TREASURER/CFO 40.00 20.00 X 269084 0 50156 EDWARD G CHADWICK TREASURER - PART YEAR 1.00 65.00 X 0 197253 7336 GARY J BEAULAC CHIEF OPERATING OFFICER 60.00 0.00 X 366678 0 45733 MICHAEL M CERVENAK VP-ORG STRATEGY - PART YEAR 1.00 0.00 X 150453 0 18174 JOANNA R PEASE DO CHIEF MEDICAL OFFICER 60.00 0.00 X 379555 0 37775 ANDREW AGOSTA MD PHYSICIAN 60.00 0.00 X 463794 0 107199 FREMONT L SCOTT DO PHYSICIAN 60.00 0.00 X 524289 0 48343 RONALD LEVIN MD PHYSICIAN 60.00 0.00 X 1011227 0 54039 MARK T RYAN MD PHYSICIAN 60.00 0.00 X 686007 0 23630 EDDIE EL-YUSSIF PHYSICIAN 60.00 0.00 X 544210 0 39594 5307546 3727338 742542 183 0 1 0 RONCELLI INC 6471 METRO PARKWAY STERLING HEIGHTS MI 48312 CONSTRUCTION 5063783 WELLINGTON HOME BUILDING LLC PO BOX 54 TRENTON MI 48183 CONSTRUCTION 1457035 DEMARIA BUILDING COMPANY INC 45500 GRAND RIVER AVE PO BOX 8018 NOVI MI 48376 CONSTRUCTION 1226873 JOHN E GREEN COMPANY 220 VICTOR AVENUE HIGHLAND PARK MI 48203 CONSTRUCTION 851475 TRINITY INFORMATION SERVICES 20555 VICTOR PARKWAY LIVONIA MI 48152 IT SERVICES 791461 54 549107 427649 121282 976756 HOSPITAL SERVICES 900099 301030706 301030706 OUTPATIENT SERVICES 621400 67330394 67330394 EMERGENCY SERVICES 900099 34686436 34686436 MEDICAL EDUCATION-GME 900099 8434400 8434400 8491082 8491082 419973018 843988 843988 885120 0 885120 885120 885120 1761796 1714069 47727 47727 47727 204557 549107 284276 -79719 -79719 76158 65103 11055 11055 CAFETERIA 900099 1007666 1007666 JOINT VENTURES 900099 1001573 1001573 GIFT SHOP 453220 748988 748988 678162 678162 3436389 426094334 422449468 0 2668110 2315025 755286 1471442 88297 394130 394130 158373557 152336608 6036949 7378956 7030963 343948 4045 15779085 15034941 735495 8649 10886668 10373251 507450 5967 70814 11555 59259 111625 111625 16493771 15398136 1095420 215 2181177 8560 2172617 9081067 8067380 1009697 3990 813717 779398 34319 11195562 10193450 962698 39414 412714 300617 106704 5393 449225 408295 40930 7738823 7738823 33981142 33981142 15403316 14161189 1240522 1605 4282023 3829246 452777 MEDICAL SUPPLIES 70063257 69682752 380505 BAD DEBT EXPENSE 11424273 11424273 QUAAP TAX 9485811 9485811 REPAIRS & MAINTENANCE 8848157 8444953 403204 9644345 8528414 1113714 2217 406808240 346649208 59999240 159792 8117 6020 71078382 76780711 424268 38519 30185973 34572963 7069416 6160736 3945500 1873343 330791138 167929049 159706820 162862089 29559204 30798333 963296 1036122 98590 98590 15596613 15665265 318636179 329892691 32376445 31716412 155162999 148905000 40970250 54144577 228509694 234765989 X 84484240 88843868 3279705 3919620 2362540 2363214 90126485 95126702 318636179 329892691 X 19286094 -74937 -14210940 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5642245 908092 16735 284238 6282834 7809597 766354 80354 3014060 5642245 9503430 1301075 104796 3099704 7809597 7906493 3249213 -11640 1640636 9503430 7002141 1150549 41284 861779 -574298 7906493 0.37610 0.62390 0 0 839257 11743198 12582455 254284 185537595 70502674 115289205 1610589 575471 1035118 119002112 96850904 22151208 11804103 11804103 162862089 MALPRACTICE LIABILITY 21674134 CORPORATE RESERVE 3560543 WORKERS COMP LIABILITY 1473726 DEFERRED COMPENSATION 5444806 POST RETIREMENT BENEFITS 21443770 OTHER LONG TERM LIABILITIES 547598 54144577 X PART V, LINE 4: EARNINGS FROM THE ORGANIZATION'S ENDOWMENTS FUNDS ARE UTILIZED BASED ON THE NATURE OF THE SPECIFIC ASSOCIATED RESTRICTION. THESE PRIMARILY RELATE TO FUNDING INITIATIVES ASSOCIATED WITH SPECIFIC DISEASE CONDITIONS AND FURTHERING MEDICAL EDUCATION AND RESEARCH INITIATIVES. PART X, LINE 2: THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2014 AND 2013. MEDALLION EVENT 357227 267026 90201 120378 AMBASSADOR CLUB 172670 135677 36993 77460 2 223767 146404 77363 86438 753664 549107 204557 284276 284276 -79719 76158 65103 1 1.00000 76158 65103 65103 11055 MI 1 0 1 0 1.00000 REBECCA BLANKEN SPECIAL EVENTS DEPT ONE FORD PLACE DETROIT MI 48202 0 0 1 1 X 1 X 250.000000000000 0 1 1 1 0 1 1 5216116 5216116 0.01320 85221462 72440225 12781237 0.03230 90437578 72440225 17997353 0.04550 2477037 43077 2433960 0.00620 13660751 8434400 5226351 0.01320 14023400 11173990 2849410 0.00720 485182 485182 0.00120 344485 344485 0.00090 30990855 19651467 11339388 0.02870 121428433 92091692 29336741 0.07420 52778 52778 0.00010 133647 133647 0.00030 11598 11598 0.00010 7000 7000 0.00000 11756 11756 0.00010 204478 204478 0.00050 421257 421257 0.00110 0 14270265 3567566 108217605 106854330 1363275 X 1 1 2 1 HENRY FORD MACOMB HOSPITAL - CLINTON 15855 19 MILE ROAD CLINTON TOWNSHIP MI 48038 X X X X 2 HENRY FORD MACOMB HOSPITAL- MOUNT CLEMENS 215 NORTH AVENUE MOUNT CLEMENS MI 48043 X PSYCHIATRIC INPATIENT HENRY FORD MACOMB HOSPITAL-CLINTON TWP 1 0 0 1 X X X X X X X 13 1 1 0 1 X WWW.HENRYFORD.COM X 1 13 0 1 0 1 X 250.000000000000 X X X X X X 1 1 X X X X 1 X X X 1 X 0 X X 1 X 0 0 HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS 2 0 0 1 X X X X X X X X 13 1 1 0 1 X WWW.HENRYFORD.COM X 1 13 0 1 0 1 X 250.000000000000 X X X X X X 1 1 X X X X 1 X X X 1 X 0 X X 1 X 0 0 HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 5: AS PART OF THE CHNA PROCESS, A COMMUNITY STAKEHOLDER SURVEY WAS DEVELOPED AND CONDUCTED BY HENRY FORD HEALTH SYSTEM, INCLUSIVE OF HENRY FORD WYANDOTTE AND HENRY FORD MACOMB HOSPITALS. THE SURVEY WAS DESIGNED TO GATHER INPUT FROM MAJOR COMMUNITY STAKEHOLDERS IN THE TRI-COUNTY AREA AND BE USED TO COMPLEMENT AND VALIDATE THE TRENDS IN DEMOGRAPHIC AND COMMUNITY HEALTH DATA IDENTIFIED WITHIN THE CHNA. THE SURVEY ALSO ASSISTED IN ACHIEVING COMPLIANCE WITH THE IRS REQUIREMENTS OF GATHERING COMMUNITY INPUT. AREAS OF SPECIFIC FOCUS IN THE SURVEY INCLUDED: PROMOTING HEALTHY BEHAVIORS, MANAGING CHRONIC DISEASE, PUBLIC HEALTH INFRASTRUCTURE/ENVIRONMENTAL HAZARDS AND ADDITIONAL OPEN ENDED QUESTIONS. KEY COMMUNITY STAKEHOLDERS THROUGHOUT THE WAYNE, MACOMB AND OAKLAND TRI-COUNTY AREA WERE INVITED TO PARTICIPATE IN THE SURVEY VIA A LINK TO THE ELECTRONIC SURVEY FROM NOVEMBER, 2011 TO DECEMBER, 2012. SEE APPENDIX 2 OF THE CHNA TO VIEW THE STAKEHOLDER SURVEY TEMPLATE. APPENDIX 3 DETAILS THE COMMUNITY STAKEHOLDERS INVITED TO PARTICIPATE AS WELL AS THE STAKEHOLDERS THAT COMPLETED THE SURVEY. HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 5: AS PART OF THE CHNA PROCESS, A COMMUNITY STAKEHOLDER SURVEY WAS DEVELOPED AND CONDUCTED BY HENRY FORD HEALTH SYSTEM, INCLUSIVE OF HENRY FORD WYANDOTTE AND HENRY FORD MACOMB HOSPITALS. THE SURVEY WAS DESIGNED TO GATHER INPUT FROM MAJOR COMMUNITY STAKEHOLDERS IN THE TRI-COUNTY AREA AND BE USED TO COMPLEMENT AND VALIDATE THE TRENDS IN DEMOGRAPHIC AND COMMUNITY HEALTH DATA IDENTIFIED WITHIN THE CHNA. THE SURVEY ALSO ASSISTED IN ACHIEVING COMPLIANCE WITH THE IRS REQUIREMENTS OF GATHERING COMMUNITY INPUT. AREAS OF SPECIFIC FOCUS IN THE SURVEY INCLUDED: PROMOTING HEALTHY BEHAVIORS, MANAGING CHRONIC DISEASE, PUBLIC HEALTH INFRASTRUCTURE/ENVIRONMENTAL HAZARDS AND ADDITIONAL OPEN ENDED QUESTIONS. KEY COMMUNITY STAKEHOLDERS THROUGHOUT THE WAYNE, MACOMB AND OAKLAND TRI-COUNTY AREA WERE INVITED TO PARTICIPATE IN THE SURVEY VIA A LINK TO THE ELECTRONIC SURVEY FROM NOVEMBER, 2011 TO DECEMBER, 2012. SEE APPENDIX 2 OF THE CHNA TO VIEW THE STAKEHOLDER SURVEY TEMPLATE. APPENDIX 3 DETAILS THE COMMUNITY STAKEHOLDERS INVITED TO PARTICIPATE AS WELL AS THE STAKEHOLDERS THAT COMPLETED THE SURVEY. HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 6A: HENRY FORD HOSPITALHENRY FORD MACOMB HOSPITALSHENRY FORD WYANDOTTE HOSPITALHENRY FORD WEST BLOOMFIELD HOSPITALHENRY FORD MAPLEGROVE CENTERHENRY FORD KINGSWOOD HOSPITALHENRY FORD COTTAGE HOSPITAL/MEDICAL CENTER HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 11: THE CHNA IMPLEMENTATION PLAN (SEE ATTACHED) FOCUSES ON THE PROGRAMS IDENTIFIED WHICH WERE DEEMED TO BE THE AREAS OF MOST CRITICAL NEED, AND WITH THE GREATEST POTENTIAL FOR ACHIEVING A MEASURABLE IMPROVEMENT. THE CHNA HAS THREE BROAD AREAS OF FOCUS WITH TARGETED FOCUSES WITHIN EACH. THIS INCLUDES AT RISK POPULATIONS; WITH A FOCUS ON ACCESS FOR UN AND UNDER INSURED POPULATIONS, MINORITY HEALTH DISPARITIES IN THE CITY OF DETROIT, IMPROVING HEALTH STATUS WITH FOCUSES ON PHYSICAL ACTIVITY AND NUTRITION AND CHRONIC DISEASE MANAGEMENT WITH A FOCUS ON CHRONIC HEART DISEASE AND DIABETES. HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 11: THE CHNA IMPLEMENTATION PLAN (SEE ATTACHED) FOCUSES ON THE PROGRAMS IDENTIFIED WHICH WERE DEEMED TO BE THE AREAS OF MOST CRITICAL NEED, AND WITH THE GREATEST POTENTIAL FOR ACHIEVING A MEASURABLE IMPROVEMENT. THE CHNA HAS THREE BROAD AREAS OF FOCUS WITH TARGETED FOCUSES WITHIN EACH. THIS INCLUDES AT RISK POPULATIONS; WITH A FOCUS ON ACCESS FOR UN AND UNDER INSURED POPULATIONS, MINORITY HEALTH DISPARITIES IN THE CITY OF DETROIT, IMPROVING HEALTH STATUS WITH FOCUSES ON PHYSICAL ACTIVITY AND NUTRITION AND CHRONIC DISEASE MANAGEMENT WITH A FOCUS ON CHRONIC HEART DISEASE AND DIABETES. HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 22D: UNINSURED PATIENTS WHO DO NOT OTHERWISE QUALIFY FOR INSURANCE WITH HOUSEHOLD INCOMES AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL MAY QUALIFY FOR MEDICALLY NECESSARY SERVICES TO BE PROVIDED AT NO COST. PATIENTS REGARDLESS OF INSURANCE STATUS WITH ANNUAL MEDICAL LIABILITIES TO THE ORGANIZATION IN EXCESS OF 30% OF THEIR HOUSEHOLD INCOME MAY QUALIFY FOR DISCOUNTS ON THEIR PERSONAL OBLIGATIONS. PATIENT'S PERSONAL RESPONSIBILITIES FOR MEDICALLY NECESSARY SERVICES NOT COVERED BY INSURANCE ARE GENERALLY BASED ON THE AMOUNT GENERALLY BILLED FOR THE SERVICE, WHICH APPROXIMATES 115% OF PREVAILING MEDICARE RATES.CHARGES RELATED TO MEDICALLY NECESSARY SERVICES TO PRIVATE PAY PATIENTS ARE BASED ON 115% OF PREVAILING MEDICARE RATES. HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 22D: UNINSURED PATIENTS WHO DO NOT OTHERWISE QUALIFY FOR INSURANCE WITH HOUSEHOLD INCOMES AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL MAY QUALIFY FOR MEDICALLY NECESSARY SERVICES TO BE PROVIDED AT NO COST. PATIENTS REGARDLESS OF INSURANCE STATUS WITH ANNUAL MEDICAL LIABILITIES TO THE ORGANIZATION IN EXCESS OF 30% OF THEIR HOUSEHOLD INCOME MAY QUALIFY FOR DISCOUNTS ON THEIR PERSONAL OBLIGATIONS. PATIENT'S PERSONAL RESPONSIBILITIES FOR MEDICALLY NECESSARY SERVICES NOT COVERED BY INSURANCE ARE GENERALLY BASED ON THE AMOUNT GENERALLY BILLED FOR THE SERVICE, WHICH APPROXIMATES 115% OF PREVAILING MEDICARE RATES. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.HENRYFORD.COM HENRY FORD MACOMB HOSPITAL-MOUNT CLEMENS PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.HENRYFORD.COM 30 HENRY FORD MACOMB-BRUCE TOWNSHIP MED CTR 80650 VAN DYKE BRUCE TOWNSHIP MI 48065 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-CHESTERFIELD MED CNTR 30795 23 MILE ROAD CHESTERFIELD TOWNSHI MI 48047 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB CENTER-CLINTON TWP 16151 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-FRASER HEALTH CENTER 15717 15 MILE ROAD FRASER MI 48035 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-RICHMOND MEDICAL CNTR 31505 32 MILE ROAD RICHMOND MI 48062 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SLEEP MEDICINE 15945 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SHELBY OBGYN 49050 SCHOENHERR SHELBY TOWNSHIP MI 48316 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-WASHINGTON TWP MED CTR 12150 30 MILE ROAD WASHINGTON TOWNSHIP MI 48095 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB MEDICAL CENTER 15520 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-CHESTERFIELD OBGYN 51086 FAIRCHILD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-MEDICAL CENTER 15400 19 MILE ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-PARK PLACE PEDIATRICS 20373 HALL ROAD MACOMB MI 48044 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SHELBY OBGYN 51221 SCHOENHERR SHELBY TOWNSHIP MI 48315 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SHELBY FAMILY MED 49310 VAN DYKE SHELBY TOWNSHIP MI 48317 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-HARPER FAMILY MEDICINE 36539 HARPER AVENUE CLINTON TOWNSHIP MI 48035 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-MACOMB FAMILY MED 48924 HAYES ROAD MACOMB MI 48044 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SHELBY RHEUMATOLOGY 50505 SCHOENHERR-SUITE 175 SHELBY TOWNSHIP MI 48315 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-CNTR FOR HEALTH MGMT 42850 GARFIELD ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB CENTER-CLINTON TWP 43401 GARFIELD ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB CENTER-CLINTON TWP 43411 GARFIELD ROAD CLINTON TOWNSHIP MI 48038 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB REHAB-STERLING HEIGHTS 44800 DELCO BLVD STERLING HEIGHTS MI 48313 REHABILITATION SERVIES HENRY FORD MACOMB REHAB-WARREN 3601 E ELEVEN MILE ROAD WARREN MI 48092 REHABILITATION SERVIES HENRY FORD MACOMB REHAB-CLINTON TWP 16301 NINETEEN NIME ROAD CLINTON TOWNSHIP MI 48308 REHABILITATION SERVIES HFMH-WARREN INTERNAL MEDICINE 25531 SCHOENHERR WARREN MI 48089 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN MEDICAL CENTER 25625 SCHOENHERR WARREN MI 48089 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN MARTIN MEDICAL CENTER 28001 SCHOENHERR WARREN MI 48088 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN FAMILY MEDICINE 30205 SCHOENHERR WARREN MI 48093 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN SLEEP MEDICINE 13251 E TEN MILE ROAD WARREN MI 48089 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN VASCULAR SURGERY 27500 HOOVER WARREN MI 48093 CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-FAMILY MEDICINE 21250 HALL ROAD CLINTON TOWNSHIP MI 48039 CLINICAL/DIAGNOSTIC MEDICAL SERVICES PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 11,424,273. PART II, COMMUNITY BUILDING ACTIVITIES: HFMH BELIEVES THAT THE STRENGTH AND VITALITY OF A COMMUNITY HAS A SIGNIFICANT IMPACT ON THE BEHAVIORS OF ITS RESIDENTS AND THAT THERE IS DIRECT CORRELATION BETWEEN THE VIABILITY OF A COMMUNITY AND THE ATTITUDE OF ITS RESIDENTS TOWARD HEALTHIER BEHAVIORS. THEREFORE, HFMH INCLUDES IN ITS COMMITTMENT TO COMMUNITY BENEFIT A FOCUS ON DIRECT INVOLVEMENT IN THE COMMUNITY TO BOTH IMPROVE THE ENVIRONMENT AND ENSURE THAT CRITICAL MESSAGES ON THE BENEFITS OF HEALTHIER BEHAVIORS ARE HEARD. HFMH LEADERS COLLABORATE WITH COMMUNITY TASK FORCES AND COALITIONS IN ADDRESSING THE NEEDS OF OUR SERVICE AREA. PART III, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE IS STATED IN PATIENT GROSS CHARGES PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE ORGANIZATION RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. AT SUCH POINT IN TIME THAT A BILLED SERVICE IS BELIEVED TO BE UNCOLLECTIBLE, THE RELATED RECEIVABLE IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ESTIMATES OF RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE RECEIVED.FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE ORGANIZATION'S PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION OFFERS A DISCOUNT OFF STANDARD RATES FOR SERVICES PROVIDED THAT RESULT IN NET CHARGES THAT DO NOT EXCEED 115% OF MEDICARE RATES. PART III, LINE 9B: SHOULD A PATIENT BE DEEMED ELIGIBLE FOR ASSISTANCE ANY COLLECTION EFFORTS ASSOCIATED WITH THE QUALIFYING SERVICE ARE SUSPENDED. IF THE PATIENT IS DETERMINED TO QUALIFY UNDER THE ORGANIZATION'S CHARITY CARE POLICY PRIOR TO BILLING, NO BILL IS EVER GENERATED AND THEREFORE THE ELEMENTS OF THE COLLECTION POLICY ARE NEVER INVOKED. WHEN THE DETERMINATION IS NOT MADE PRIOR TO BILLING, THE ORGANIZATION'S COLLECTION POLICY WOULD APPLY. THIS POLICY READS IN PART:- "PATIENTS WILL BE EVALUATED FOR THE SYSTEM'S PATIENT FINANCIAL ASSISTANCE PROGRAM"- "UNINSURED PATIENTS WILL BE GIVEN A DISCOUNT"- "UNDERINSURED PATIENTS MAY QUALIFY FOR DISCOUNTED SERVICES BASED UPON THEIR AGGREGATE HOUSEHOLD INCOME"- "THE ORGANIZATION WILL REVIEW THE PATIENTS'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS REQUESTED"- "LEGAL ACTION...MAY BE TAKEN...WHEN THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS TO MEET HIS OR HER OBLIGATION"- "THE ORGANIZATION WILL NOT FORCE THE SALE OR FORECLOSURE OF ANY PATIENT OR GUARANTOR'S PRIMARY RESIDENCE TO PAY AN OUTSTANDING MEDICAL BILL"- "THE ORGANIZATION WILL NOT...REQUIRE THE PATIENT OR RESPONSIBLE PARTY TO APPEAR IN COURT"- "THE ORGANIZATION WILL DIRECT THEIR COLLECTION AGENCIES TO FOLLOW THESE GUIDELINES" PART VI, LINE 2: HENRY FORD HEALTH SYSTEM (HFHS) CONSIDERS THE ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AS AN ESSENTIAL FUNCTION. HENRY FORD MACOMB HOSPITAL WAS ENCOMPASSED IN THE HFHS COMMUNITY HEALTH NEEDS ASSESSMENT. IT PROVIDES KEY INFORMATION REGARDING THE DEMOGRAPHICS AND MAJOR NEEDS OF THE COMMUNITIES SERVED, IT SUPPORTS THE PRIORITIZATION OF THE SERVICES MADE AVAILABLE, AND IT HELPS TARGET POPULATIONS WITH THE MOST VULNERABILITY TO HEALTH NEEDS SUCH AS THE POOR, UNINSURED, AS WELL AS VARIOUS OTHER POPULATIONS THAT MAY HAVE BEEN OVERLOOKED. THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO PROVIDES VALUABLE INFORMATION REGARDING OTHER ORGANIZATIONS SUPPORTING THE NEEDS WITHIN THE COMMUNITY SO PROGRAMS CAN BE COORDINATED AND LEVERAGED TO ENSURE THAT EVERY DOLLAR IS INVESTED WISELY.THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN THREE PHASES. THE FIRST PHASE INCLUDES DATA COLLECTION FROM A VARIETY OF PUBLIC AND PROPRIETARY SOURCES THAT PROVIDED INFORMATION AROUND POPULATION DEMOGRAPHICS, SOCIOECONOMIC DATA, HEALTH STATUS INDICATORS, AS WELL AS SEVERAL OTHER DATA POINTS. SOURCES FOR THIS FIRST PHASE INCLUDED THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH (MDCH), MICHIGAN BEHAVIORAL RISK FACTOR SURVEY, CLARITAS INC. /TRUVEN HEALTH ANALYTICS, MICHIGAN STATE HOMELESS MANAGEMENT INFORMATION SYSTEM (MSHMIS), AND THE MICHIGAN INPATIENT DATABASE. THE SECOND PHASE INVOLVED DEVELOPING AND DISTRIBUTING A KEY STAKEHOLDER SURVEY TO CAPTURE THE INPUT OF OTHER COMMUNITY ORGANIZATIONS AND COALITIONS ABOUT WHAT THEY BELIEVE ARE THEMAJOR HEALTH NEEDS THAT SHOULD BE PRIORITIZED AND ADDRESSED IN THE TRI-COUNTY AREA. THE THIRD PHASE INCORPORATED THE QUANTITATIVE AND QUALITATIVE DATA THAT WAS COLLECTED IN THE FIRST TWO PHASES, AND BASED ON THIS INFORMATION IDENTIFIED PRIORITIES FOR HENRY FORD HEALTH SYSTEM TO ADDRESS WITH THE COMMUNITIES IT SERVES.THIS ASSESSMENT WAS PREPARED BY THE CORPORATE PLANNING DEPARTMENT WITHIN HENRY FORD HEALTH SYSTEM. RESULTS ARE USED AS A FOUNDATION FOR PLANNING, DEVELOPING, AND REFINING HFHS'S FUTURE COMMUNITY SERVICES IN THE TRI-COUNTY AREA. PART VI, LINE 3: HFMH HAS VARIOUS APPROACHES TO TARGET AND INFORM RESIDENTS OF ITS COMMUNITIES ABOUT THE PROGRAMS AND SERVICES IT OFFERS. PROGRAMS WHERE WE PARTNER WITH ORGANIZATIONS WITH ESTABLISHED RELATIONSHIPS WITH THE INDIVIDUALS SUCH AS THROUGH COMMUNITY HEALTH CENTERS, THE PUBLIC SCHOOLS AND FAITH-BASED ORGANIZATIONS HAVE BEEN PARTICULARLY SUCCESSFUL. HFMH FOLLOWS THE HFHS PATIENT FINANCIAL ASSISTANCE POLICY. ALL PATIENTS ARE SEEN WITHOUT REGARD TO ABILITY TO PAY. INTAKE STAFF IS TRAINED WITH REGARD TO HOW TO APPROACH AND ENGAGE AN INDIVIDUAL WHEN THERE IS AN APPARENT LACK OF ADEQUATE HEALTH COVERAGE. THIS INCLUDES INFORMING THEM OF THE PROGRAMS OFFERED BY HFMH AS WELL AS OTHER COMMUNITY, LOCAL, STATE AND FEDERAL PROGRAMS OFFERING POTENTIAL SUPPORT. HFMH HAS DEDICATED STAFF RESPONSIBLE TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR SUPPORTIVE PROGRAMS AND ASSIST THEM WITH THE ENROLLMENT PROCESS. THERE ARE MANY REASONS WHY A PATIENT IN NEED OF FINANCIAL ASSISTANCE WITH THEIR MEDICAL CARE MAY NOT HAVE BEEN IDENTIFIED AT THE TIME OF THE CARE DELIVERY. PATIENT FINANCIAL SERVICE AND COLLECTION STAFFS ARE TRAINED TO RECOGNIZE THESE INDIVIDUALS AND PROVIDE THEM WITH ADVICE REGARDING THE VARIOUS OPTIONS AVAILABLE TO SUPPORT THEIR CARE NEEDS. PART VI, LINE 4: ALTHOUGH HFHS AND ITS AFFILIATES PROVIDE SERVICES TO INDIVIDUALS RESIDING THROUGHOUT THE STATE OF MICHIGAN AND IN SOME CASES FROM AROUND THE WORLD, IT DEFINES ITS COMMUNITIES SERVED BASED ON THE AREAS GENERATING THE HIGHEST INPATIENT VOLUMES. MORE THAN 94% OF THIS VOLUME FOR HFHS ORIGINATES IN THE TRI-COUNTY AREA, INCLUDING THE CITY OF DETROIT. THE TRI-COUNTY AREA INCLUDES THE CONTIGUOUS COUNTIES OF WAYNE, OAKLAND AND MACOMB, WHICH ARE LOCATED IN SOUTHEASTERN MICHIGAN AND ACCOUNT FOR 39% OF THE MICHIGAN POPULATION. WAYNE, OAKLAND, AND MACOMB (IN THAT ORDER) ARE THE MOST POPULATED COUNTIES IN MICHIGAN. OF THE NEARLY 4 MILLION RESIDENTS, APPROXIMATELY 52% OF THE POPULATION IS FEMALE. WITH REGARD TO RACE/ETHNICITY, THE TRI-COUNTY AREA IS 65% WHITE, COMPARED TO A NATIONAL AVERAGE OF 62%. OF NOTE, THE TRI-COUNTY AREA IS 25% BLACK, WHICH IS OVER TWICE THE NATIONAL PERCENTAGE OF 12%. CONVERSELY, THE HISPANIC POPULATION (4.0%) IS LESS THAN ONE QUARTER OF THE NATIONAL PERCENTAGE OF 17%. THE NUMBER OF TRI-COUNTY RESIDENTS IS EXPECTED TO DECREASE BY 1% OVER THE NEXT SEVERAL YEARS,WHICH CONTRASTS WITH THE 3% INCREASE EXPECTED NATIONWIDE. IN ADDITION, FEMALES OF CHILD BEARING AGE (15-44), WHO MAKE UP 19% OF THE TRI-COUNTY'S POPULATION, ARE EXPECTED TO DECLINE BY 4% OVER THE NEXT SEVERAL YEARS. WHEN EXAMINING AGE DISTRIBUTION, THE TRI-COUNTY HAS A COMPARABLE POPULATION TO THAT OF THE COUNTRY AND 14% OF THE POPULATION IS ABOVE THE AGE OF 65. OF PARTICULAR INTEREST TO HEALTHCARE PROVIDERS IS THE AGING POPULATION OF THE TRI-COUNTY AREA WITH THE 55 YEARS OLD AND ABOVE POPULATION EXPECTED TO RISE BY 9% FROM 2013 TO 2018. WITH REGARDS TO EDUCATION, THE TRI-COUNTY HAS APPROXIMATELY 12% OF RESIDENTS WHO HAVE SOME HIGH SCHOOL EDUCATION OR LESS COMPARED TO THE NATIONAL AVERAGE OF 15%. FURTHER, 28% OF RESIDENTS HAVE A BACHELOR'S DEGREE OR GREATER, WHICH IS COMPARABLE TO THE NATIONAL AVERAGE.THE TRI-COUNTY AREA IS DIVERSE IN REGARDS TO POPULATION, RACIAL/ETHNIC COMPOSITION, ECONOMIC GROWTH AND DEVELOPMENT. THE AUTOMOTIVE INDUSTRY REMAINS THE LARGEST EMPLOYER IN THE REGION, BUT THE HEALTH CARE SECTOR IS ALSO REPRESENTED AMONG THE TOP EMPLOYERS IN THE REGION AS WELL (CRAIN'S DETROIT 2012 LISTINGS OF MAJOR EMPLOYERS). THE AVERAGE HOUSEHOLD INCOME WITHIN THE TRI-COUNTY AREA ($63,344) IS LESS THAN THE NATIONAL AVERAGE ($69,637). WITHIN THE TRI-COUNTY AREA, THE AVERAGE HOUSEHOLD INCOME IN OAKLAND COUNTY ($80,157) IS SIGNIFICANTLY HIGHER THAN WAYNE COUNTY ($53,355) AND MACOMB COUNTY ($58,589). AT THE ZIP CODE LEVEL, AVERAGE HOUSEHOLD INCOMES VARY SIGNIFICANTLY,RANGING FROM $25,145 TO $163,374. LOWER HOUSEHOLD INCOMES NEGATIVELY IMPACT PURCHASING POWER, HEALTH INSURANCE COVERAGE, AND COSTS OF BASIC NECESSITIES. AS A RESULT, THE TRI-COUNTY AREA'S SAFETY NETS, INCLUDING HEALTHCARE SYSTEMS, ARE BEING STRETCHED TO THE LIMIT (UNITED WAY RESEARCH INCOME DOWN ACROSS STATE: POVERTY INCREASING AND SPREADING THROUGHOUT THE TRICOUNTY 2006, HTTP://WWW.UWSEM.ORG). IN ADDITION, WITHIN THE TRI-COUNTY AREA THE UNEMPLOYMENT RATE IS SLIGHTLY HIGHER THAN THE NATIONAL AVERAGE OF 7.6% AND RANGES FROM 8.3% IN OAKLAND COUNTY TO 11% IN WAYNE COUNTY (LOCAL AREA UNEMPLOYMENT STATISTIC UPDATE MARCH 2013, OAKLAND COUNTY MICHIGAN).AS STATED PREVIOUSLY, THE TRI-COUNTY AREA IS RATHER DIVERSE THROUGHOUT ITS THREE COUNTIES. FOR EXAMPLE, AGE, SEX, EDUCATION, AND INCOME DISTRIBUTION DIFFER FROM COUNTY TO COUNTY. IN ORDER TO INCREASE THE UTILITY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, IT IS IMPORTANT TO ANALYZE THE PROFILE(S) OF EACH OF THESE COUNTIES AT A MORE DETAILED LEVEL, SUCH AS ZIP CODES, SO THAT CERTAIN DIFFERENCES WITHIN THE AREA BECOME EVIDENT.ONE COMMUNITY IN PARTICULAR NEED OF ATTENTION IS THE CITY OF DETROIT.WHEN EXAMINING THE CITY OF DETROIT THE AVERAGE HOUSEHOLD INCOME IS $36,186, WHICH IS SIGNIFICANTLY LESS THAN AVERAGE HOUSEHOLD INCOME OF THE OVERALL TRI-COUNTY AREA ($63,344). REGARDING EDUCATION, 22% OF RESIDENTS HAVE LESS THAN A HIGH SCHOOL EDUCATION AND ONLY 12% OF HAVE A BACHELOR'S DEGREE OR HIGHER. IN TERMS OF RACIAL/ETHNIC DIVERSITY, APPROXIMATELY 93% OF DETROIT IS COMPOSED OF A MINORITY POPULATION VERSUS 36% FOR THE TRI-COUNTY AREA AS A WHOLE. THE DETROIT UNEMPLOYMENT RATE IS 17.5%, WHICH IS SIGNIFICANTLY GREATER THAN THE NATIONAL AVERAGE OF 7.6% (LOCAL AREA UNEMPLOYMENT STATISTIC UPDATE MARCH 2013, OAKLAND COUNTY MICHIGAN).WHEN LOOKING OUTSIDE OF THE CITY OF DETROIT, VARIOUS ZIP CODES IN THE TRI-COUNTY AREA REPRESENT SECTIONS OF THE REGION THAT HAVE LOWER INCOMES, LESS EDUCATION, AND ARE MORE RACIALLY AND ETHNICALLY DIVERSE. OF THE ZIP CODES THAT RANK IN THE TOP 20 ZIP CODES FOR BOTH LOWEST AVERAGE HOUSEHOLD INCOME AND HIGHEST PROPORTION OF THE POPULATION WITHOUT A HIGH SCHOOL DIPLOMA IN THE TRI-COUNTY AREA, THE AVERAGE HOUSEHOLD INCOME IS $41,724, WHICH IS SIGNIFICANTLY LESS THAN THE AVERAGE HOUSEHOLD INCOME OF $63,344 FOR THE OVERALL TRI-COUNTY AREA. OVERALL, 21% OF RESIDENTS IN THESE ZIP CODES HAVE LESS THAN A HIGH SCHOOL EDUCATION COMPARED TO 12% FOR THE TRI-COUNTY AREA. THESE 20 ZIP CODES HAVE A SLIGHTLY HIGHER PERCENTAGE OF RACIAL/ETHNIC MINORITIES AS COMPARED TO THE REST OF THE TRI-COUNTY AREA. AS A WHOLE THESE ZIP CODES ARE COMPRISED OF 42% MINORITIES COMPARED TO 36% FOR THE TRI-COUNTY AREA.AS A RESULT, THE DETROIT AREA AND ABOVE 20 ZIP CODES, AS WELL AS OTHER ZIP CODES WITH SIMILAR CHARACTERISTICS, SHOULD BE OF PARTICULAR INTEREST WHEN PLANNING COMMUNITY NEEDS INITIATIVES WITHIN THE TRI-COUNTY AREA.PLEASE SEE THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR FURTHER DETAILS. PART VI, LINE 5: HENRY FORD MACOMB HOSPITALS (HFMH) IS PART OF HENRY FORD HEALTH SYSTEM, ONE OF THE NATION'S LARGEST INTEGRATED HEALTH DELIVERY SYSTEMS SERVING ALL OF SOUTHEASTERN MICHIGAN. THIS TAX RETURN REFLECTS ACTIVITIES OF THE CLINTON TOWNSHIP CAMPUS OF HFMH, WHICH INCLUDES APPROXIMATELY 400 INPATIENT BEDS WITH AN OPEN MEDICAL STAFF, A BEHAVIORAL HEALTH FACILITY, AS WELL AS SEVERAL OUTPATIENT LOCATIONS SERVING THE MACOMB COUNTY AREA OF MICHIGAN. HFMH IS GOVERNED BY A DEDICATED VOLUNTEER COMMUNITY BOARD AND IT PROVIDES ITS COMMUNITIES WITH A FULL RANGE OF CLINICAL SERVICES INCLUDING GENERAL MEDICINE, SURGERY, OBSTETRICS, PEDIATRICS, CARDIAC CARE, PHYSICAL AND REHABILITATION MEDICINE, AMBULATORY SURGERY, INPATIENT AND OUTPATIENT BEHAVIORAL SERVICES, AND 24 HOUR EMERGENCY CARE. PART VI, LINE 6: THE SYSTEM DEMONSTRATES ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY BY OPERATING EMERGENCY ROOMS OPEN TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK; PROVIDING FACILITIES FOR THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS; AND MAINTAINING RESEARCH FACILITIES FOR THE STUDY OF NEW DRUGS AND MEDICAL DEVICES THAT OFFER THE PROMISE OF IMPROVING HEALTH CARE. THE SYSTEM ALSO PROVIDES COMMUNITY HEALTH SERVICES, SUCH AS COMMUNITY EDUCATION AND OUTREACH IN THE FORM OF FREE OR LOW-COST CLINICS; HEALTH EDUCATION TELEVISION PROGRAMMING; DONATIONS FOR THE COMMUNITY; MULTIPLE HEALTH PROMOTION AND WELLNESS PROGRAMS, SUCH AS HEALTH SCREENING; AND VARIOUS COMMUNITY PROJECTS AND SUPPORT GROUPS X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 BRIAN G LODER DPM TRUSTEE 106137 0 0 0 51090 0 7298 0 17674 0 182199 0 0 0 ROBERT G RINEY TRUSTEE 0 929492 0 493802 0 200513 0 25285 0 22798 0 1671890 0 0 BARBARA W ROSSMANN PRESIDENT / TRUSTEE 477836 0 200745 0 76441 0 84468 0 26177 0 865667 0 0 0 DIANE L GEORGE DO TRUSTEE 0 296834 0 38420 0 4686 0 25285 0 21681 0 386906 0 0 JAMES M CONNELLY TREASURER - PART YEAR 0 750607 0 357346 0 220509 0 29308 0 17476 0 1375246 0 0 EDITH L EISENMANN SECRETARY 0 183017 0 34357 0 20502 0 19904 0 13209 0 270989 0 0 TERRY A GOODBALIAN ASSISTANT TREASURER/CFO 222566 0 35110 0 11408 0 23141 0 27015 0 319240 0 0 0 EDWARD G CHADWICK TREASURER - PART YEAR 0 147253 0 50000 0 0 0 3375 0 3961 0 204589 0 0 GARY J BEAULAC CHIEF OPERATING OFFICER 284152 0 55092 0 27434 0 22635 0 23098 0 412411 0 0 0 MICHAEL M CERVENAK VP-ORG STRATEGY - PART YEAR 97947 0 36782 0 15724 0 8470 0 9704 0 168627 0 0 0 JOANNA R PEASE DO CHIEF MEDICAL OFFICER 313966 0 58202 0 7387 0 22685 0 15090 0 417330 0 0 0 ANDREW AGOSTA MD PHYSICIAN 366783 0 79325 0 17686 0 82589 0 24610 0 570993 0 0 0 FREMONT L SCOTT DO PHYSICIAN 498862 0 447 0 24980 0 23985 0 24358 0 572632 0 0 0 RONALD LEVIN MD PHYSICIAN 675921 0 129309 0 205997 0 36589 0 17450 0 1065266 0 0 0 MARK T RYAN MD PHYSICIAN 593347 0 74802 0 17858 0 22035 0 1595 0 709637 0 0 0 EDDIE EL-YUSSIF PHYSICIAN 391194 0 113244 0 39772 0 22035 0 17559 0 583804 0 0 0 PART I, LINE 1A IT IS THE ORGANIZATION'S POLICY TO PAY OR REIMBURSE EMPLOYEES FOR BONAFIDE BUSINESS TRAVEL BASED ON THE MOST COST EFFECTIVE MEANS AVAILABLE. GENERALLY, WHEN AIR TRAVEL IS INVOLVED THIS EQUATES TO COACH CLASS AIR FARE. UNDER CERTAIN CIRCUMSTANCES, SUCH AS WHEN COACH CLASS IS NOT AVAILABLE OR THE TRIP IS OF AN EXTENSIVE DURATION, SENIOR LEADERSHIP HAS APPROVED BUSINESS CLASS, FIRST CLASS OR CHARTER TRAVEL. IN SUCH CIRCUMSTANCES, THE TRAVEL IS CONSIDERED TO BE FOR A BONAFIDE BUSINESS PURPOSE; ACCORDINGLY NO TAXABLE INCOME IS REPORTED. NO QUALIFYING INDIVIDUALS RECEIVED PAID OR REIMBURSED FIRST CLASS TRAVEL DURING 2014. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PROGRAM THAT RESULTS IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP ALSO HAVE THE OPTION TO PARTICIPATE IN NON-QUALIFIED 457 BENEFIT PROGRAMS WHICH RESULTS IN REPORTABLE TAXABLE INCOME AS BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. IT IS AN ELEMENT OF THE PLAN DESIGN TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. SEE Q. 4B FOR THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS. PART I, LINE 4B SCH J, LINE 4B, PERSONS PARTICIPATING IN NONQUALIFIED RETIREMENT PLANS SEC 457(F) - SUPPLEMENTAL HFHS EXECUTIVE RETIREMENT PLAN (SERP) TAXABLE REPORTABLE VALUE OF 2014 ACCRUAL 2014 DISTRIBUTIONS W-2 AMOUNTS PARTICIPANT JAMES M. CONNELLY 177,104 - 177,104 ROBERT G. RINEY 177,690 - 177,690 BARBARA W. ROSSMANN 49,462 - 49,462 CONTRIBUTIONS TO SEC 457(F)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2014 CONTRIBUTIONS 2014 CONTRIBUTIONS TAX GROSS-UP W-2 AMOUNTS BARBARA W. ROSSMANN 3,575 13,925 335 17,835 RONALD LEVIN, M.D. - 17,500 421 17,921 ANDREW AGOSTA, M.D. 9,810 7,689 186 17,686 JAMES M. CONNELLY - 17,500 421 17,921 STEVEN J. HATHAWAY - 1,514 36 1,550 FREMONT L. SCOTT, D.O. - 12,350 297 12,647 GARY J. BEAULAC 15,274 2,225 54 17,553 JOANNA PEASE, M.D. - 2,145 52 2,197 ROBERT G. RINEY - 17,500 421 17,921 MARK RYAN, M.D. 6,624 10,875 262 17,761 EDITH L. EISENMANN 17,500 - - 17,500 SEE BELOW 0 ADVANCED CARDIO PLLC SEE BELOW 332583 SEE BELOW 0 0 MARTIN E BEAULAC SEE BELOW 166762 SEE BELOW 0 ROSEMARY MINJEUR SEE BELOW 79098 SEE BELOW 0 RAYMOND J MINJEUR SEE BELOW 56805 SEE BELOW 0 JONATHAN E BEAULAC SEE BELOW 73076 SEE BELOW 0 COLLEEN M HARRINGTON SEE BELOW 18388 SEE BELOW 0 SCHEDULE L, PART IV - BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: ADVANCED CARDIOTHORACIC SURGEONS, PLLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: OWNER/TRUSTEE(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR MEDICAL SERVICES(A) NAME OF PERSON: MARTIN E. BEAULAC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: ROSEMARY MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: RAYMOND J. MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: JONATHAN E. BEAULAC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: COLLEEN M. HARRINGTON: (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/TRUSTEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: DIVISION 6 FABRICATION & INSTALLATION LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B C) AMOUNT OF TRANSACTION $ 705,950.43 (D) DESCRIPTION OF TRANSACTION: PROVIDED TRANSPORTATION SERVICES (E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: EASTPOINTE RADIOLOGISTS PC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 103,723.39 (D) DESCRIPTION OF TRANSACTION: PROVIDED MEDICAL SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: KASCO INC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 1,285,021.98 (D) DESCRIPTION OF TRANSACTION: PROVIDED CONSTRUCTION SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: MEDSTAR AMBULANCE SERVICE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 689,074(D) DESCRIPTION OF TRANSACTION: PROVIDED AMBULANCE SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: RED PINE PROPERTY VENTURE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 187,441.91(D) DESCRIPTION OF TRANSACTION: PROVIDED REAL ESTATE SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: RONCELLI INC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 5,063,782.70(D) DESCRIPTION OF TRANSACTION: PROVIDED CONSTRUCTION SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: T G PRIEHS PAVING CO(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 499,120.00(D) DESCRIPTION OF TRANSACTION: PROVIDED CONSTRUCTION SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: TOMS LAWN AND SNOW INC(B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 763,176.39(D) DESCRIPTION OF TRANSACTION: PROVIDED LANDSCAPING SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: WELLINGTON HOME BUILDING LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 1,457,034.57(D) DESCRIPTION OF TRANSACTION: PROVIDED CONSTRUCTION SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO (A) NAME OF PERSON: WRIGHT & FILIPPIS INC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 162,415.89(D) DESCRIPTION OF TRANSACTION: PROVIDED MEDICAL EQUIPMENT SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO X 1 10115 MARKET VALUE X EVENT CONTRIBUTIONS 100 89794 FAIR MARKET VALUE X MISCELLANEOUS 5 21373 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A TAX EXEMPT STOCK CORPORATION AND HENRY FORD HEALTH SYSTEM HOLDS ALL OF THE ISSUED AND OUTSTANDING SHARES OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE STOCK HOLDER OF THE ORGANIZATION, HFHS HOLDS THE RESERVE POWER TO APPROVE OR DISAPPROVE TRUSTEE APPOINTMENTS. FORM 990, PART VI, SECTION A, LINE 7B BASED ON THE ESTABLISHED RESERVE POWERS, CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) AND THE TAX DEPARTMENT OF HFHS PREPARES THE ORGANIZATION'S FORM 990. AS PART OF THE PREPARATION AND REVIEW PROCESS PRIOR TO FILING THE RETURN, THE FOLLOWING REVIEW PROCESS IS CONDUCTED: - REVIEW OF THE ENTIRE RETURN WITH THE HFHS AND ORGANIZATION'S CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER AND CHIEF EXECUTIVE OFFICER - REVIEW OF ALL COMPENSATION MATTERS AND DISCLOSURES WITH THE COMPENSATION COMMITTEE OF THE HFHS BOARD OF TRUSTEES - REVIEW OF THE RETURN WITH THE HFHS AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES - PROVIDE A COPY OF THE RETURN TO THE ORGANIZATION'S BOARD OF TRUSTEES FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO OVERSEES THE CONFLICT OF INTEREST PROCESS WITH REGARD TO THE ORGANIZATION. HFHS HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE HFHS CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES AND EMPLOYEES. ANNUALLY, TRUSTEES, EMPLOYEES OF A MANAGEMENT LEVEL, RESEARCHERS, AS WELL AS EMPLOYEES ASSOCIATED WITH PROCUREMENT, OR IN CERTAIN OTHER PREDEFINED ROLES MUST COMPLETE AN ANNUAL DISCLOSURE DESIGNED TO IDENTIFY ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. IT IS THE RESPONSIBILITY OF THE COMMITTEE TO REVIEW THESE DISCLOSURES AND DETERMINE THE NEED FOR ANY ACTION TO MANAGE THE POTENTIAL CONFLICT. THE COMMITTEE ANNUALLY REPORTS THE RESULTS OF ITS ACTIVITIES TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE HFHS BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO HAS RESPONSIBILITY TO OVERSEE THE COMPENSATION PRACTICES OF THE ORGANIZATION. HFHS HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES CONSISTING OF ALL EXTERNAL TRUSTEES. THEY MEET PERIODICALLY THROUGHOUT THE YEAR. THEY ARE CHARGED WITH APPROVAL OF THE ORGANIZATION'S OVERALL COMPENSATION AND BENEFIT PROGRAMS AS WELL AS THE SPECIFIC REVIEW AND APPROVAL OF THE COMPENSATION OF CERTAIN EMPLOYEES INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THEY DIRECTLY ENGAGE AN INDEPENDENT COMPENSATION ADVISOR TO ASSIST WITH THIS PROCESS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE, UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS, AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTH CARE ORGANIZATIONS. THE REASONABLENESS OF COMPENSATION IS EVALUATED BASED UPON THESE AND OTHER FACTORS. THE COMMITTEE ALSO REVIEWS THE COMPENSATION DISCLOSURES TO BE MADE ON FORM 990 IN ADVANCE OF FILING. FORM 990, PART VI, SECTION C, LINE 19 IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION. AS A HOLDER OF TAX EXEMPT DEBT THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO A PUBLIC CLEARING HOUSE ON A QUARTERLY BASIS. PART IV, LINE 12 THE ORGANIZATION IS AN ELEMENT OF THE EXTERNAL AUDIT REPORT OBTAINED FOR THE CONSOLIDATED OPERATIONS OF HENRY FORD HEALTH SYSTEM. FORM 990, PART IV, LINE 24A, TAX-EXEMPT BOND ISSUE: THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM. THE ALLOCATED TAX-EXEMPT BOND LIABILITY OF THE ORGANIZATION IS REPORTED UNDER THE FORM 990, SCHEDULE K OF ITS PARENT, HENRY FORD HEALTH SYSTEM. FORM 990, PART XI, LINE 9: MINIMUM PENSION LIABILITY ADJUSTMENT -27,520,101. INTERCOMPANY TRANSFER 13,309,161. FORM 990, PART VII: AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: MANY EXECUTIVE EMPLOYEES OF HFHS PROVIDE SERVICES TO MULTIPLE AFFILIATED ENTITIES. HENRY FORD HEALTH SYSTEM USES ESTIMATES FOR REPORTING AVERAGE HOURS PER WEEK IN ALL SECTIONS OF FORM 990. GENERALLY 60 HOURS ARE REPORTED FOR THE HOURS ASSOCIATED FOR THE ORGANIZATION THAT THE INDIVIDUAL HAS PRINCIPAL RESPONSIBILITY FOR. HOURS ASSOCIATED WITH OTHER HOSPITAL OR LARGER ORGANIZATIONS ARE REPORTED AT 5 PER WEEK AND FOR SMALLER ORGANIZATIONS 1 HOUR PER WEEK IS REPORTED FORM 990 - PART XII - LINE 2C: HENRY FORD MACOMB HOSPITAL CORPORATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF HENRY FORD HEALTH SYSTEM. THE GOVERNING BODY OF HFHS HAS DELEGATED THE OVERSIGHT OF THE FINANCIAL STATEMENTS, INCLUDING THE CHOICE OF INDEPENDENT AUDITORS, TO ITS AUDIT COMMITTEE. FORM 5713 - INTERNATIONAL BOYCOTT ACTIVITY: A FORM 5713, INTERNATIONAL BOYCOTT REPORT, HAS BEEN FILED ON OUR BEHALF BY HENRY FORD HEALTH SYSTEM (PARENT OF OUR CONTROLLED GROUP). THE ORGANIZATION DID NOT ITSELF HAVE ANY ACTIVITIES ASSOCIATED WITH AN INTERNATIONAL BOYCOTT COUNTRY. MERCY MOUNT CLEMENS REAL ESTATE LLC ONE FORD PLACE DETROIT MI 48202 382947657 REAL ESTATE MI 25000 0 N/A HENRY FORD HEALTH SYSTEM ONE FORD PLACE DETROIT MI 48202 381357020 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) 3 N/A 0 HENRY FORD WYANDOTTE HOSPITAL 2333 BIDDLE AVE WYANDOTTE MI 48192 382791823 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) 3 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM FOUNDATION ONE FORD PLACE DETROIT MI 48202 237383042 SUPPORTING ORGANIZATION MI 501(C)(3) 11A-TYPE 1 HENRY FORD HEALTH SYSTEM 1 HEALTH ALLIANCE PLAN 2850 W GRAND BLVD DETROIT MI 48202 382242827 HEALTH MAINTENANCE ORGANIZATION MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HFHS SELF FUNDED LIABILITY ONE FORD PLACE DETROIT MI 48202 386553031 MALPRACTICE INSURANCE MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 DOWNRIVER CENTER FOR ONCOLOGY ONE FORD PLACE DETROIT MI 48202 383193008 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) 3 HENRY FORD HEALTH SYSTEM 1 HENRY FORD CONTINUING CARE ONE FORD PLACE DETROIT MI 48202 382433285 NURSING HOMES MI 501(C)(3) 9 HENRY FORD HEALTH SYSTEM 1 HFII CORPORATION ONE FORD PLACE DETROIT MI 48202 900840304 SCIENTIFIC RESEARCH MI 501(C)(3) 7 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM GOVERNMENT AFFAIRS SERVICES ONE FORD PLACE DETROIT MI 48202 464064067 SUPPORTING ORGANIZATION MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 NORTHWEST DETROIT DIALYSIS 30100 TELEGRAPH BINGHAM FARMS MI 48025 383232668 OPERATE DIALYSIS CLINIC MI HENRY FORD HEALTH SYSTEM N/A 0 0 DIALYSIS PARTNERS OF NW OHIO 30100 TELEGRAPH BINGHAM FARMS MI 48025 341877956 OPERATE DIALYSIS CLINIC OH HENRY FORD HEALTH SYSTEM N/A 0 0 MACOMB REGIONAL DIALYSIS CENTERS 16151 NINETEEN MILE RD CLINTON TOWNSHIP MI 48038 260423581 OPERATE DIALYSIS CLINICS MI HENRY FORD HEALTH SYSTEM N/A 0 0 HORIZON PROPERTIES INC ONE FORD PLACE DETROIT MI 48202 382679527 REAL ESTATE - LESSOR BUILDINGS MI N/A C 313665 945910 1.00000 1 FAIRLANE HEALTH SERVICES 30100 TELEGRAPH BINGHAM FARMS MI 48025 382565235 HEALTHCARE MANAGEMENT MI HENRY FORD HEALTH SYSTEM C 1 ALLIANCE HEALTH AND LIFE INSURANCE 2850 W GRAND BLVD DETROIT MI 48202 383291563 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 HAP PREFERRED INC 2850 W GRAND BLVD DETROIT MI 48202 382513504 PROVIDER NETWORK LEASING MI HEALTH ALLIANCE PLAN C 1 SHA REALTY INC ONE FORD PLACE DETROIT MI 48202 381378121 REAL ESTATE HOLDING MI HENRY FORD HEALTH SYSTEM C 1 ONIKA INSURANCE LTD FIRST CARRIBEAN HOUSE GRAND CAYMAN CJ CAPTIVE INSURANCE CJ HENRY FORD HEALTH SYSTEM C 1 HENRY FORD PHYSICIAN NETWORK ONE FORD PLACE DETROIT MI 48202 320306774 PHYSICIAN NETWORK MI HENRY FORD HEALTH SYSTEM C 1 ADMINISTRATION SYSTEMS RESEARCH CORPORATION 2850 W GRAND BLVD DETROIT MI 48202 382651185 THIRD PARTY INSURANCE ADMINISTRATOR MI HEALTH ALLIANCE PLAN C 1 MIDWEST HEALTH PLAN 4700 SHAEFER ROAD SUITE 340 DEARBORN MI 48126 383123777 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 HAP COMMUNITY ALLIANCE 2850 W GRAND BLVD DETROIT MI 48202 270449055 HEALTH MAINTENANCE ORGANIZATION MI HEALTH ALLIANCE PLAN C 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 HEALTH ALLIANCE PLAN L 36539404 CASH VALUE HEALTH ALLIANCE PLAN M 9740170 CASH VALUE HFHS SELF FUNDED LIABILITY M 806480 CASH VALUE