2015-05-11T16:03:34-05:00 2014-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2013-07-01 381671120 Standish Community Hospital STAN 9898464521 805 W Cedar Street Standish MI 48658 Anthony J Doud Controller 9898464521 2015-05-11 1 Alicia M Janisch P00741382 5137847100 2015-05-08 2013 2016-02-25 16:41:14Z St Mary's of Michigan Standish Hospital John Graham 805 W Cedar Street Standish MI 48658 23875847 0 0928 X http://www.stmarysmichigan.org/standish/ X 1960 MI Operation of a hospital, skilled nursing facility, emergency room and rural health clinic. 7 5 262 41 0 0 26146 18466 21479497 20565440 860713 830126 187366 2439103 22553722 23853135 0 0 0 0 12361810 11637740 0 0 37317 9568885 9801605 21930695 21439345 623027 2413790 31911365 34435584 9302666 7963747 22608699 26471837 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 14784159 20565440 Standish Hospital is dedicated to spiritually centered, holistic care that sustains and improves the health of individuals and communities. It furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. A substantial portion of its services are provided to the elderly and poor. During the fiscal year ending June 30, 2014, approximately 56.6% of the value of services rendered was to elderly patients under the Medicare program, and approximately 14% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's of Michigan Standish Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2014, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $21,216,017. 14784159 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 262 1 0 0 0 0 0 1 1 0 0 0 0 X 7 5 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X Nancy Haywood 9899077596 805 W Cedar Street Standish MI 48658 Curt Hillman Chairman 1.00 0.00 X X 0 0 0 Deb Morgan Secretary 1.00 0.00 X X 0 0 0 Keith Sivier Treasurer 1.00 0.00 X X 0 0 0 Lori Schumann Director 1.00 0.00 X 0 0 0 Tom Birkett Director 1.00 0.00 X 0 0 0 John Graham President/CEO - Health System 1.00 0.00 X X 0 1087067 9113 Jaya Sankarin Chief of Staff 1.00 0.00 X X 0 0 0 Gina Butcher CFO - Health System 1.00 44.00 X 0 194674 8272 Rose Goick Adm. Dir. of Operations 45.00 0.00 X 122272 0 16938 Doraisamy Venkitapathy Physician 84.00 0.00 X 618244 0 59147 Cesar Casten Physician 40.00 0.00 X 215621 0 51136 Cathy Gifford CRNA 20.00 0.00 X 111808 0 42557 Catherine McDonell CRNA 20.00 0.00 X 111116 0 39711 Rasheed Siddiqui Physician 84.00 0.00 X 615686 0 54091 1794747 1281741 280965 7 0 1 0 Touchpoint Support Services PO Box 102289 Atlanta GA 303682289 Cafeteria & Housekeeping Services 1203599 Alliance HNI LLC 7647 Collections Drive Chicago IL 606930076 Mobile MRI Services 609800 WM F Nelson Electric Inc 111 Hoyt Street Saginaw MI 48607 Electric Building Contractor 397907 TriMedx LLC PO Box 636129 Cincinnati OH 45263 Equipment Maintenance 385359 Community Hospital Services 1321 Cumberland Saginaw MI 48601 Laundry Services 133108 6 10062 5625 2779 18466 Patient Revenue 621990 20565440 20565440 20565440 830126 830126 61854 7589 54265 54265 54265 40430 10062 15123 25307 25307 EHR Incentive 900099 1853250 1853250 Blue Cross Refund 900099 221498 221498 Cafeteria Revenue 722320 46147 46147 238636 238636 2359531 23853135 20565440 0 3269229 142837 142837 8915855 7349560 1544552 21743 407081 321802 85279 1568224 1239698 328526 603743 472994 130749 39610 39610 205867 205867 714 714 2124197 419192 1705005 54116 54116 1300823 978139 307110 15574 1640005 1640005 480084 307738 172346 48097 29677 18420 122342 96713 25629 1231843 1125813 106030 108843 70095 38748 Medical Supplies 1855340 1855340 QAAP Fees 418585 418585 Permits, Taxes & Fees 137726 88705 49021 Dues and Subscriptions 19474 10108 9366 13939 13939 21439345 14784159 6617869 37317 709947 757363 543894 550965 4289061 3905432 254225 268742 131326 29983 17865766 13208035 5842689 4657731 139147 1736214 20001076 22529154 31911365 34435584 5360785 4082651 3941881 3881096 9302666 7963747 X 22523009 26393337 85690 78500 22608699 26471837 31911365 34435584 X 2413790 1394731 54617 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 714 714 0 Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Standish Community Hospital does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 500 500 5160142 4421079 739063 5397611 2763301 2634310 6085867 5537425 548442 1221646 486230 735416 4657731 Interest in Investments Held by Ascension Health Alliance 19539823 Other Current Receivables 2282731 Third Party Receivables 704195 Due from Related Organization 2405 22529154 Intercompany Debt with Ascension Health Alliance 3881096 3881096 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 Standish Community Hospital: 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. Living Legends Ball 34286 7357 26929 333 6858 500 4727 Auction 16206 2705 13501 2555 150 50492 10062 40430 333 9413 650 4727 15123 25307 1 1 X 1 X 1 X 1 1 0 1 1 162191 162191 0.00760 3338696 3406326 -67630 0.00000 3500887 3406326 94561 0.00760 3500887 3406326 94561 0.00760 0 1596469 278418 5413436 6379367 -965931 X 1 1 1 1 Standish Community Hospital 805 W Cedar Street Standish MI 48658 www.stmarysofmichigan.org/standish 060020 X X X Skilled Nursing Facility Standish Community Hospital 1 1 X X X X X X X X X 12 1 0 1 X See Part V, Section C, Line 5d X X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 Standish Community Hospital Part V, Section B, Line 3: 2010 Public Health SummitOn March 10, 2010, the Central Michigan District Health Department organized a Public Health Summit for those who live and work in Arenac, Clare, Gladwin, Isabella, Osceola, and Roscommon counties. The day-long event served to inform participants about health issues within each county and to solicit the participants' perceptions of the key health issues within their communities and methods of addressing these issues.The attendees included residents of the central Michigan health district; state, county, and local government officials; tribal nation representatives; members of the academic community and public school systems; representatives from businesses in health care, transportation, restaurant, and other types of industries; and members of nongovernmentorganizations, including community organizations.The 2010 County Health Rankings provided by University of Wisconsin Population Health Institute served as the basis for discussion of the health related issues within the six counties. Participants broke out into county-specific groups and began brainstorming sessions on health issues, identifying factors associated with the issues, determining the three most crucial issues within their county, and summarizing potential approachesand methods to address the most crucial issues using nominal group process and affinity diagrams.For Arenac County, the primary issues identified are:1. Poverty, including socioeconomic and employment issues2. Nutrition, including availability of nutritious food, education, and physical activity3. Access to care particularly for the uninsured and underinsuredThe information from the Public Health Summit is used by the Arenac County Health Improvement Planning (HIP) work group to develop objectives, measures, strategies and actions that will strengthen current efforts and respond to gaps in servicing needs.2011 Public Health SummitOn April 14, 2011, the second annual Public Health Summit convened. It brought together 120 individuals from local and state organizations involved in health care, health and social services and health services delivery, as well as stakeholders in the Central Michigan District Health Department's six county region. The Summit served as a forum to review the 2011 County Health Rankings, celebrate successes, and share insight into health improvement plans and initiatives that are underway within the counties.In 2011, a Health Issues Survey was created by the Arenac County HIP work group with the help of Veronica Romanov, Public Health Consultant. Various health statistics were used to develop the survey. It was structured on the model developed by the University of Wisconsin's Population Health Institute and the County Health Rankings. The survey asked for perceptions of severity and importance of factors within the two primary areas measured in the County Health Rankings. The health factors which directly affect health outcomes and organized into the major four topic areas of:- Health related behaviors- Health systems/clinical care- Preventative actions and wellness- Environmental factors and health outcomes (examples of poor health outcomes include premature death, disease, and ill health)Survey respondents provided their opinion on the importance of each issue (on a 5-point scale with 1 being of utmost importance to the community) and their perceptions as to the need for additional information regarding each item (using a 3-point scale with 1 indicating that additional information or research is definitely needed and 3 indicating that there is enough information available). Additionally, each respondent was given the opportunity to identify up to three direct health factors that he/she believed were of the utmost importance to the community. The survey included more than 80 direct health factor and 70 health outcome items.The Health Issues Survey was distributed via email in March 2011, with 10 returned. Of the surveys returned, the majority of the responses came from individuals that work in the public service arena or health care field. The following issues were identified as priority items for the county:- Health services- Nutrition, weight status, and physical activity- Substance abuse- Reproductive and sexual health Arenac County Resident SurveyDue to the limited amount of responses from the Health Issues Survey, the HIP work group decided to repeat the survey to a larger population, with special attention given to the poor and underserved. Paper copies of the survey were available at various locations throughout Arenac County including Michigan Works, St. Mary's of Michigan Standish Hospital, Department of Human Services, Central Michigan District Health Department, NEMSCA Early Head Start, and Sterling Area Health Center. Electronicsurveys were sent out via email to area businesses for distribution to their employees.The local newspaper, Arenac County Independent, published an article about the survey and informed the community on how to access it. It is unknown how many surveys were distributed county-wide since this was conducted via both paper and electronic formats; 222 surveys were returned.Following compilation of the results of the Arenac County Resident Survey, five general topic areas were identified. These results will be used by the HIP work group to help determine and prioritize health improvement goals and set priorities, steps and timelines for actions.- Access to Health Services- Family Life/Parenting- Nutrition & Physical Activity- Housing- Environmental IssuesThe survey results indicated that the issue of most concern to Arenac County residents was the lack of access to health services, particularly among uninsured and "underinsured" individuals, as well as the lack of access to affordable health services. Family life/parenting, as well as nutrition and lack of physical activity, were also identified as major issues of concern. Standish Community Hospital Part V, Section B, Line 5d: http://www.stmarysofmichigan.org/documents/SMOM_Standish_CHNA.pdf Standish Community Hospital Part V, Section B, Line 7: St. Mary's of Michigan Standish Hospital will not be addressing the following needs that were identified in the 2012 Community Health Needs Assessment:Housing: The Arenac County Continuum of Care is tasked with addressing the issue of housing and homelessness. While St. Mary's of Michigan Standish Hospital supports their efforts by being an active partner on the collaborative body, it was determined that the hospital does not have the resources available to directly affect change in this category.Environmental Health: The Central Michigan District Health Department's Environmental Health Services oversees the quality of land, food and water for Arenac County. They work closely with the Michigan Department of Community Health to address the community's environmental health needs. Standish Community Hospital Part V, Section B, Line 14g: A summary of financial assistance policy is posted on the hospital facility's emergency rooms or waiting rooms and admission offices. Part I, Line 6a: Community Benefit Report:This report illustrates the significant degree to which St. Mary's of Michigan Standish Hospital contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system, St. Mary's of Michigan Standish Hospital 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 Standish Hospital is to serve all persons with special attention to those who are poor and vulnerable. St. Mary's of Michigan Standish Hospital is dedicated to spiritually centered, holistic care that sustains and improves the health of individuals and communities. St. Mary's of Michigan Standish Hospital furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. 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. St. Mary's of Michigan Standish Hospital has engaged in the following activities to ensure that our mission is accomplished:Unreimbursed Services Provided to the Elderly and the Poor:St. Mary's of Michigan Standish Hospital provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2014 approximately 56.6% of the value of services rendered were to elderly patients under the Medicare program, and approximately 14.0% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's of Michigan Standish Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2014, the estimated unreimbursed charges of services provided to the elderly, uninsured, and underinsured totaled $21,216,017.Patient Services:St. Mary's of Michigan Standish Hospital provides the following in-patient and out-patient medical services to the community:- Ambulatory Care Services - Rural Health Clinic Office- Emergency Care Services- Visiting Physician Services- Cardiac Rehab Services- Rehabilitation Services- Operating Room Surgeries- Skilled Nursing Facility Some of the services listed above operate at a loss in order to ensure that all services are available to meet community health care needs. These include our Rural Health Clinic and Speech Therapy.During the fiscal year ending June 30, 2014, our hospital treated adults and children in the community for a total of 12,403 patient days of service. The medical center also provided services to 44,565 outpatients, including 46 outpatient surgery patients and 8,946 emergency visits.Community Outreach activities:St. Mary's of Michigan Standish Hospital seeks to improve the physical, mental, social and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, St. Mary's of Michigan Standish Hospital has developed the following programs to help achieve its mission:- Diabetes Education- Chronic Obstructive Disease Education- Car Seat Safety Programs- Community Thanksgiving Dinner- MIChild and Healthy Kids Enrollment Summary:St. Mary's of Michigan Standish Hospital furthers its charitable purposes by providing a broad array of services to meet the healthcare needs of patients and organizations in the community. We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those patients who are not able to pay for their own healthcare needs, provide services to other organizations that allow them to provide quality services to their patients or constituents, and present education information classes and activities to the community in order to improve its overall health status. 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 cost 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 the information in the table, a cost-to-charge ratio was calculated and 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 Standish Hospital provided the following community building activities in 2013: - Caring Bear Picnic: A health and safety day for children in the community that teaches proper hand washing, car seat safety, the importance of bicycle helmets, healthy nutrition, and the benefits of exercise.- Senior Olympics & Health Fair: An event focused on connecting Senior Citizens with health and wellness resources in the community.- Diabetes and Chronic Obstructive Pulmonary Disease (COPD) support group meetings were held on a bi-monthly basis, free of charge.- School education: St. Mary's of Michigan Standish Hospital nurses partner with the local school systems to provide education to both the teachers and students on flu prevention, proper nutrition and exercise. Part III, Line 4: From the consolidated audited financial statements of Ascension Health Alliance and subsidiaries (which include the activity of Standish Community Hospital):The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care 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. Part III, Line 8: Ascension Health and related health ministries follow 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: 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. Any patient that may be eligible for public assistance must make an application for such. A documented response from public assistance must be on file prior to final determination of charity care funds. 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 Standish Hospital (SMMSH) participates in Community Needs Assessments to gain information about the health care needs of the community. The Community Needs Assessments provides an assessment of Arenac County pertaining to demographics, health, safe and stable homes, and economic development. SMMSH uses this information to ensure that the organization is meeting the needs of the community. Part VI, Line 3: St. Mary's of Michigan Standish Hospital informs the community about their Charity Care Program, as well as other state or local government programs, through the following ways:- A Patient Financial Consultant is available Monday through Friday to discuss and assist with signup for state and local government programs, and/or the hospital's charity care program.- The Patient Financial Consultant or Case Manager meet with self-pay patients who have been admitted to the hospital to discuss financial assistance programs that are available.- Self-pay outpatients receive the hospital's financial assistance application, as well as other state and federal assistance program information (MI Child, Central Health Plan, Medicaid, and others as applicable), through the mail. Part VI, Line 4: St. Mary's of Michigan Standish Hospital's primary service area is Arenac County. Over 70 percent of its patients reside in the county.Arenac County is located at the bottom of Saginaw Bay on Lake Huron on Michigan's eastern coast. It is a popular resort area, dubbed the "sunrise side" of Michigan. A rural, largely undeveloped county, with plenty of canoeing, hunting, and fishing attracts tourists year-round. In addition to tourism, the economic base of Arenac County consists of agriculture and manufacturing. Agriculture accounts for approximately 48% of the land use. Additionally, health services provide a great deal of local employment.Standish, the county seat, is known as a supply headquarters for those traveling to Northern Michigan. It is also the location of the county's only hospital, St. Mary's of Michigan Standish Hospital. Approximately 15,649 people reside in Arenac County. They live in widely varying economic circumstances, with 17.9% of individuals identified as living below the poverty level; somewhat higher than the state rate of 15.7%.The unemployment rate is 13.2% which is slightly higher than the state average of 10.3%.There are several medical services many of which are tied to St. Mary's of Michigan Standish Hospital, but it is considered to be a health professional shortage area according to the US Health Resources and Services Administration. Accessing health care services can often be a challenge for those living in rural settings. Additional strains and stresses on these services are presented by the transient nature of some of the population (e.g. seasonal residents, tourists, and summer visitors) and general economic and demographic changes (i.e. an increasing aged population) that are occurring more generally in all of Michigan and the United States (i.e. increasing numbers of unemployed, increasing numbers of the "working poor").PopulationWith a population of roughly 15,649 inhabitants (2011 estimate), Arenac County has seen a steady decline in population since 2000 which was 17,269. The following is the population information of Arenac County from the U.S. Census Bureau.Total population - 15,899Male - 8,056Female - 7,843Under 5 years - 7545 to 9 years - 83810 to 14 years - 92915 to19 years - 1,06420 to 24 years - 72225 to 34 years - 1,53735 to 44 years - 1,73145 to 54 years - 2,66155 to 59 years - 1,24160 to 64 years - 1,19565 to 74 years - 1,89275 to 84 years - 97985 years and over - 356Race & EthnicityThe following illustrates the race and ethnicity of Arenac County residents for the year 2010.White - 15,393Black or African American - 29American Indian or Alaska Native - 190Asian - 29Hispanic or Latino - 225Native Hawaiian or Other Pacific Islander - 9Other - 44Unemployment RateThe unemployment rate of Arenac County is 13.2% which is slightly higher than the state average of 10.3%.Arenac County2000 - 5.8%2010 - 16.1%2011 - 13.2%Michigan2000 - 3.7%2010 - 12.7%2011 - 10.3%PovertyAccording to the U.S. Census Bureau, the per capita and median household income is lower in Arenac County than in Michigan. The percentage of persons below poverty is higher than the Michigan average.Arenac CountyPer Capita Income in Past 12 Months - $19,386Median Household Income - $36,281Persons below poverty level, percent - 17.9%MichiganPer Capita Income in Past 12 Months - $25,482Median Household Income - $48,669Persons below poverty level, percent - 15.7%Education RateOf the population age 25 and over, 18.9% have less than a high school diploma which is higher than the state rate of 11.6%.Arenac CountyLess than 9th Grade - 6259th to 12th Grade, no diploma - 1,602High School Graduate - 4,834Some College, no degree - 2,553Associate's Degree - 900Bachelor's Degree - 840Graduate or Professional Degree - 429MichiganLess than 9th Grade - 229,0799th to 12th Grade, no diploma - 534,231High School Graduate - 2,041,868Some College, no degree - 1,561,637Associate's Degree - 540,517Bachelor's Degree - 1,021,486Graduate or Professional Degree - 638,046Physical EnvironmentA community's health is affected by the physical environment. A safe, clean environment that provides access to healthy food and recreational opportunities is important to maintaining and improving community health.Grocery Store AccessThe following reports the number of grocery stores per 100,000 population. This indicator provides a measure of healthy food access and environmental influences on dietary behaviors.Arenac CountyTotal Population, 2010 Census - 15,899Number of Establishments - 5Establishment Rate (Per 100,000 Pop.) - 31.45MichiganTotal Population, 2010 Census - 9,883,640Number of Establishments - 2,154Establishment Rate (Per 100,000 Pop.) - 21.79United StatesTotal Population, 2010 Census - 312,471,327Number of Establishments - 67,342Establishment Rate (Per 100,000 Pop.) - 21.55Recreation and Fitness Facility AccessThe following reports the number per 100,000 population of recreation and fitness facilities. This indicator is relevant because access to recreation and fitness facilities encourages physical activity and other healthy behaviors.Arenac CountyTotal Population, 2010 Census - 15,899Number of Establishments - 1Establishment Rate (Per 100,000 Population) - 6.29MichiganTotal Population, 2010 Census - 9,883,640Number of Establishments - 894Establishment Rate (Per 100,000 Population) - 9.05United StatesTotal Population, 2010 Census - 308,745,538Number of Establishments - 29,896Establishment Rate (Per 100,000 Population) - 9.68Health BehaviorsHealth behaviors such as poor diet, a lack of exercise, and substance abuse contribute to poor health status.Physical Inactivity (Adult)The following reports the percentage of adults aged 18 and older who self-report no leisure time for activity, based on the question: "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?". Current behaviors are determinants of future health and this indicator may illustrate a cause of significant health issues, such as obesity and poor cardiovascular health.Arenac CountyTotal Population (Age 18) - 13,214Number Physically Inactive - 3,263.86Percent Physically Inactive - 24.70%MichiganTotal Population (Age 18) - 7,531,713Number Physically Inactive - 1,709,699Percent Physically Inactive - 22.70%United StatesTotal Population (Age 18) - 111,821,887Number Physically Inactive - 27,579,949Percent Physically Inactive - 24.66%Heavy Alcohol ConsumptionThe following reports the percentage of adults aged 18 and older who self-report heavy alcohol consumption (defined as more than two drinks per day for men and one drink per day for women). Current behaviors are determinants of future health and this indicator may illustrate a cause of significant health issues, such as cirrhosis, cancers, and untreated mental and behavioral health needs.Arenac CountyTotal Population (Age 18) - 13,214Number Physically Inactive - 1,572.47Percent Physically Inactive - 11.90%MichiganTotal Population (Age 18) - 7,531,713Number Physically Inactive - 1,408,430Percent Physically Inactive - 18.70% Part VI, Line 5: St. Mary's of Michigan Standish Hospital offers the following activities to focus on improving the health of the community. - Health screenings and educational materials are provided free or at a reduced cost. - Diabetes support group meetings occur on a bi-monthly basis and are available, free of charge.- Grief support group meetings are offered twice a month, free of charge.- Speakers Bureau: Associates are available to provide educational programs to civic and non-profit groups, free of charge.- Free health and safety events are hosted by the hospital. Part VI, Line 6: St. Mary's of Michigan Standish Hospital 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 healthcare facilities, or Health Ministries, located in 23 of the Unites States and the District of Columbia. Ascension serves as the member or shareholder of various subsidiaries. Ascension 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 in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, the Congregation 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, Maria 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.Standish Community Hospital's sole corporate member is St. Mary's Health. Standish Community Hospital, located in Standish, Michigan, is a nonprofit critical care access hospital. Admitting physicians are primarily practitioners in the local area. St. Mary's is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of St. Mary's are related to providing healthcare services.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 in poverty 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 for persons 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 deficiency syndrome.- 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. Part VI, Line 7, Reports Filed With States MI 0 1 0 0 0 0 0 0 0 John Graham President/CEO - Health System 0 481163 0 579906 0 25998 0 7350 0 1763 0 1096180 0 0 Gina Butcher CFO - Health System 0 182912 0 960 0 10802 0 5570 0 2702 0 202946 0 0 Doraisamy Venkitapathy Physician 615891 0 0 0 2353 0 22966 0 36181 0 677391 0 0 0 Cesar Casten Physician 213686 0 0 0 1935 0 21200 0 29936 0 266757 0 0 0 Cathy Gifford CRNA 111480 0 0 0 328 0 22658 0 19899 0 154365 0 0 0 Catherine McDonell CRNA 110902 0 0 0 214 0 17498 0 22213 0 150827 0 0 0 Rasheed Siddiqui Physician 614865 0 0 0 821 0 17534 0 36557 0 669777 0 0 0 Part I, Line 3 Ascension Health, a related organization of Standish Community Hospital, uses the following to establish the compensation of the organization's CEO: - Compensation committee - Independent compensation consultant - Compensation survey or study - 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. Benefits under the program are unfunded and non-vested. 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 under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No distributions were made from the supplemental nonqualified retirement plan during calendar 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 for Saginaw's related entities. Form 990, Part VI, Section A, line 6 Standish Community Hospital has a single corporate member, St. Mary's - St. Joseph Health System. Form 990, Part VI, Section A, line 7a Standish Community Hospital has a single corporate member, St. Mary's - St. Joseph Health System, who has the ability to elect members to the governing body of the Standish Community Hospital. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Standish Community Hospital 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 A, line 8b Line 8b is more appropriately answered as N/A since there are not any separate committees that have the authority to act on behalf of the governing body for Standish Community Hospital. 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 board 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 Standish Community Hospital, 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. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part XI, line 9: Transfer from Restricted Funds 62,386. Auxiliary -2,146. Misc. Adjustments -5,623. Ascension Health Alliance PO Box 45998 St Louis MO 63145 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 Avenue Saginaw MI 48601 461084363 Supporting Organization MI Section 501(c)(3) Schedule A, Line 11a Ascension Health 0 St Mary's of Michigan Medical Center 800 S Washington Avenue Saginaw MI 48601 380997730 Hospital MI Section 501(c)(3) Schedule A, Line 3 St Mary's - St Joseph Health System 0 St Mary's of Michigan Foundation 800 S Washington Avenue Saginaw MI 48601 382246366 Fundraising MI Section 501(c)(3) Schedule A, Line 11c St Mary's of Michigan Medical Center 0 Field Neurosciences Institute 800 S Washington Avenue Saginaw MI 48601 382790703 Medical Research Organization MI Section 501(c)(3) Schedule A, Line 9 St Mary's of Michigan Medical Center 0 Towne Centre Surgery Center LLC 4599 Towne Centre Saginaw MI 48604 204943843 Outpatient services MI N/A St Mary's of Michigan Specialists 800 S Washington Avenue Saginaw MI 48601 205959777 Physician Practices MI N/A C 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 St Mary's of Michigan Medical Center O 278681 Actual Amount Transferred St Mary's of Michigan Medical Center P 4418956 Actual Amount Transferred Ascension Health P 927220 Actual Amount Transferred