2015-11-16T13:28:08-06:00 2014-12-31 381357951 PLANTE & MORAN PLLC 750 TRADE CENTRE WAY STE 300 PORTAGE MI 49002 990 2014-01-01 451257972 THREE RIVERS HEALTH SYSTEM INC THRE 2692781145 701 S HEALTH PARKWAY THREE RIVERS MI 49093 STEVE ANDREWS CFO 2692781145 2015-11-16 1 CAROL LALONDE CPA P00181637 2695674500 2014 2016-02-25 16:41:14Z THREE RIVERS HEALTH STEVE ANDREWS 701 S HEALTH PARKWAY THREE RIVERS MI 49093 51317703 0 X WWW.THREERIVERSHEALTH.ORG X 2011 MI SEE SCHEDULE O. 10 10 549 130 0 0 581 23710 41855486 51071168 -9259 26820 -77228 196005 41769580 51317703 0 0 0 0 18516711 23625548 0 0 0 25877430 29151442 44394141 52776990 -2624561 -1459287 19329742 17020110 12421418 11571073 6908324 5449037 THREE RIVERS HEALTH IS COMMITTED TO THE SUSTAINED WELL BEING OF OUR PATIENTS, FAMILIES, AND COMMUNITIES THROUGH HIGH QUALITY, LOW COST, DYNAMIC HEALTHCARE. 0 0 45830231 51071168 GENERAL ACUTE SERVICES FOR COMMUNITY INPATIENT AND OUTPATIENT SERVICES. 45830231 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 32 0 1 549 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MI X STEVEN T ANDREWS 2692739604 701 S HEALTH PARKWAY THREE RIVERS MI 49093 LARRY CLARK BOARD CHAIR 4.00 1.00 X X 0 0 0 LAURIE HINES VICE CHAIR 3.00 0.00 X X 0 0 0 DIANA DEGRAAF SECRETARY 3.00 0.00 X X 0 0 0 RAY BENDURE TREASURER 4.00 0.00 X X 0 0 0 ANDY GOLDBERGER BOARD MEMBER 3.00 0.00 X 0 0 0 DOUG MITCHELL BOARD MEMBER 3.00 0.00 X 0 0 0 JOHN TOUSE BOARD MEMBER 3.00 0.00 X 0 0 0 JACKIE BOWEN BOARD MEMBER 3.00 0.00 X 0 0 0 HENRI'ETTA TOLBERT BOARD MEMBER 3.00 0.00 X 0 0 0 JENNIFER GRABER BOARD MEMBER 3.00 0.00 X 0 0 0 SUE POTTS BOARD MEMBER - PART-YEAR 3.00 0.00 X 0 0 0 PAT HENDERSON BOARD MEMBER - PART-YEAR 3.00 1.00 X 0 0 0 GARRETT HALL BOARD MEMBER - PART-YEAR 3.00 0.00 X 0 0 0 WILLIAM RUSSELL PRESIDENT/CEO 40.00 4.00 X 232319 0 71645 STEVE ANDREWS CHIEF FINANCIAL OFFICER 40.00 4.00 X 174575 0 58964 HOPE BAILEY VICE PRESIDENT 40.00 3.00 X 143688 0 31159 MIKE PULFORD CRNA 40.00 0.00 X 202654 0 45997 LEONARD DARLING PHARMACY MANAGER 40.00 0.00 X 137816 0 23636 DOUG ZEHNER PHARMACIST 40.00 0.00 X 123893 0 28266 DAVE PARKS IT MANAGER 40.00 0.00 X 107189 0 25996 KATHARINE GAJ OP PT MANAGER 40.00 0.00 X 105512 0 30166 1227646 0 315829 9 0 1 0 QHR 105 CONTINENTAL PLACE BRENTWOOD TN 37027 MANAGEMENT SERVICES, SALARIES 940431 BORGESS MEDICAL CENTER 1521 GULL ROAD KALAMAZOO MI 49048 LAB, LAUNDRY, IT SERVICES 780200 REHAB CARE GROUP PO BOX 502096 ST LOUIS MO 63150 REHAB MANAGEMENT SERVICES 751795 HEALOGICS WOUND CARE SERVICES 5220 BELFORT RD STE 130 JACKSONVILLE FL 32256 WOUND CARE MANAGEMENT 467418 LABORATORY CORPORATION PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 207670 10 23710 23710 NET PATIENT REVENUE 621110 50603147 50603147 OTHER PROGRAM REVENUE 621110 468021 468021 51071168 14177 14177 103432 0 103432 103432 103432 12643 0 12643 12643 12643 CAFETERIA/VENDING 900099 52579 52579 MISCELLANEOUS 900099 39994 39994 92573 51317703 51071168 0 222825 X 174847 69939 104908 17918497 14998611 2919886 181330 167478 13852 4068343 3672808 395535 1282531 1154278 128253 1221234 366370 854864 82737 82737 100764 20153 80611 8113 8113 12091 12091 7480692 6580175 900517 7913 296 7617 101649 101649 815083 815083 194206 194206 302890 302890 2554892 2554892 837637 63676 773961 MEDICAL SUPPLIES 5457970 5356009 101961 PHYSICIAN FEES 4006992 4006992 BAD DEBT EXPENSE 3969512 3969512 EQUIP RENTAL AND MAINTE 1648369 1176074 472295 348698 348698 52776990 45830231 6946759 0 781794 1510387 5674266 3349452 1099853 891258 1028661 804500 48724305 38784914 10130044 9939391 481865 510555 117626 0 15633 14567 19329742 17020110 6861393 6577274 4791422 5288948 768603 -295149 12421418 11571073 X 0 0 0 0 6908324 5449037 6908324 5449037 19329742 17020110 -1459287 0 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 8113 8113 0 PART II-B, LINE 1: A PORTION OF MHA DUES IS ALLOCATED TO LOBBYING EXPENSE. 219500 219500 20055292 14402636 5652656 1449702 1357028 92674 26928811 23025250 3903561 71000 71000 9939391 COST REPORT SETTLEMENTS PAYABLE -295149 -295149 X PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL, TRAH PROPERTIES, AND THREE RIVERS HEALTH FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. IHS AND PHO ARE DEEMED CORPORATIONS AND FILE CORPORATE TAX RETURNS WITH NO TAX DUE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGRANIZATION AND HAS CONCLUDED THAT AS OF DECEMEBER 31, 2014 AND 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMEBER 31, 2011. 1 1 X 1 X 1 X 1 1 0 0 969342 969342 0.01990 12460757 8068527 4392230 0.09000 13430099 8068527 5361572 0.10990 120790 120790 0.00250 149582 149582 0.00310 270372 270372 0.00560 13700471 8068527 5631944 0.11550 1 3969512 515000 10629996 11070939 -440943 X 1 1 1 1 THREE RIVERS HEALTH 701 S HEALTH PARKWAY THREE RIVERS MI 49093 1060000006 X X X THREE RIVERS HEALTH 1 0 0 1 X X X X X X X X X 12 1 1 0 1 X HTTP://WWW.TRHEALTH.ORG/ X 1 13 0 1 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X X 1 X X X X X X X X 1 X 0 X X X X 1 X 0 0 THREE RIVERS HEALTH PART V, SECTION B, LINE 3J: THE CHNA CONTENT INCLUDED THE PROJECT OBJECTIVES, AN OVERVIEW OF THE ASSESSMENT, AS WELL AS THE FINANCIAL OPPORTUNITY SUMMARY. THE REPORT SUMMARIZED THE APPROACH, AND ITS FINDINGS. IT ALSO COMPARED HOW THE COMMUNITY COMPARED TO ITS PEERS, AND SUMMARIZED KEY CONCLUSIONS AND OBSERVATIONS. FINALLY, IT RANKED THE NEEDS OF THE COMMUNITY, AND IDENTIFIED AN ACTION PLAN TO HELP IMPLEMENT THE IMPROVEMENT IN COMMUNITY HEALTH OVERALL. THREE RIVERS HEALTH PART V, SECTION B, LINE 5: INITIALLY, WE DEPLOYED A NEEDS ASSESSMENT SURVEY WITHIN THE LOCAL POPULATION FOR ANY RESIDENT TO COMPLETE. WE RECEIVED INPUT FROM 620 AREA RESIDENTS. IT WAS AN INTERNET BASED SURVEY THAT WAS PROMOTED VIA ADVERTISING, AND THROUGH LOCAL CIVIC AND HEALTH ORGANIZATIONS. PRELIMINARY CONCLUSIONS WERE THEN PRESENTED TO A LOCAL GROUP OF EXPERTS, WHO WERE ASKED TO VALIDATE PRIOR ASSESSMENTS, AND TO ESTABLISH PRIORITY AMONG VARIOUS IDENTIFIED HEALTH AND MEDICAL ISSUES. WHEN THE FINAL ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL GROUP OF EXPERTS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. SOME OF THE OTHER LOCAL ORGANIZATIONS THAT HELPED WITH THIS PROCESS WAS STURGIS HOSPITAL, COMMUNITY MENTAL HEALTH DEPARTMENT, BRANCH HILLSDALE- ST. JOSEPH COMMUNITY HEALTH AGENCY, AND ST. JOSEPH COUNTY COMMISSION ON AGING. THREE RIVERS HEALTH PART V, SECTION B, LINE 6A: STURGIS HOSPITAL THREE RIVERS HEALTH PART V, SECTION B, LINE 7D: ACCESS VIA THE WEBSITE WAS THE PRIMARY MEANS, AND BY WORD OF MOUTH REPRESENTATION FORM OUR BOARD MEMBERS. THREE RIVERS HEALTH PART V, SECTION B, LINE 11: THE HOSPITAL'S BOARD OF DIRECTORS HAS ADOPTED THE CARVER MODEL OF GOVERNANCE, WHICH HELPS THE BOARD FOCUS MORE ON OUTCOMES, RATHER THAN ON DAY TO DAY OPERATIONS. THIS MODEL HAS ENABLED THE BOARD TO FOCUS ON COMMUNITY HEALTH INITIATIVES EXTENSIVELY FOR THE LAST 10 YEARS. THE CHNA ONLY FURTHER EMPHASIZES THE MISSION OF THE LOCAL HOSPITAL, AND ALSO THE REASON FOR THE EXISTENCE OF THE ORGANIZATION. THE SURVEY IDENTIFIED 23 AREAS THAT WERE PROBLEMS. THESE WERE RANKED ACCORDING TO PRIORITY, AND IMPLEMENTATION STRATEGY. THERE WERE 7 CATEGORIES THAT RANKED AS A LOW PRIORITY, AND LOW IMPLEMENTATION RESPONSIBILITY. THE FOLLOWING SEVEN AREAS WERE: PALLIATIVE CARE, DRINKING, MOTOR VEHICLE DEATHS, PREMATURE DEATHS, SELF DESCRIBES HEALTH STATUS, PHYSICAL ENVIRONMENT FACTORS, AND UNINTENTIONAL INJURY. THE OTHER 16 AREAS WILL BE ADDRESSED FIRST, WHILE THESE SEVEN AREAS WILL NOT BE ADDRESSED INITIALLY. THREE RIVERS HEALTH PART V, SECTION B, LINE 15E: THE HOSPITAL WORKS WITH A COMPANY THAT ASSISTS THE STATE EMPLOYEE IN THE HOSPITAL WITH COVERAGE OPTIONS. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY THREE RIVERS HEALTH PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.TRHEALTH.ORG/ABOUTUS/CHARITY_CARE THREE RIVERS HEALTH PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.TRHEALTH.ORG/ABOUTUS/CHARITY_CARE THREE RIVERS HEALTH PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.TRHEALTH.ORG/ABOUTUS/CHARITY_CARE 14 THREE RIVERS HEALTH INTERNAL MEDICINE 711 S HEALTH PARKWAY THREE RIVERS MI 49093 HEALTH CLINIC - INTERNAL MEDICINE, FAMILY CARE & WOMEN'S SERV THREE RIVERS HEALTH FAMILY CARE 721 6TH AVENUE STE B THREE RIVERS MI 49093 RURAL HEALTH CLINIC - THREE RIVERS CENTER FOR WOUND HEALING 721 S HEALTH PARKWAY THREE RIVERS MI 49093 WOUND CARE HOMECARE AND HOSPICE 633 S ERIE STREET THREE RIVERS MI 49093 HOSPICE CARE THREE RIVERS HEALTH FAMILY CARE 601 E CHICAGO RD WHITE PIGEON MI 49099 RURAL HEALTH CLINIC - WHITE PIGEON THREE RIVERS HEALTH SURGICAL SERVICES 715 S HEALTH PARKWAY THREE RIVERS MI 49093 SURGICAL SERVICES HEALTH TRAC - WELLNESS PAVILLION 501 S HEALTH PARKWAY THREE RIVERS MI 49093 WELLNESS CENTER THREE RIVERS HEALTH ORTHOPEDICS 1021 HILL STREET THREE RIVERS MI 49093 ORTHOPEDICS THREE RIVERS BONE AND JOINT 1021 HILL STREET THREE RIVERS MI 49093 BONE AND JOINT FACILITY PHYSICAL MEDICINE AND REHAB 715 S HEALTH PARKWAY THREE RIVERS MI 49093 REHABILITATION THREE RIVERS HEALTH FAMILY CARE 110 EAST MAIN MARCELLUS MI 49067 HEALTH CLINIC - MARCELLUS THREE RIVERS HEALTH ENDOCRINOLOGY 715 S HEALTH PARKWAY THREE RIVERS MI 49093 ENDOCRINOLOGY THREE RIVERS HEALTH FAMILY CARE 677 EAST MAIN CENTREVILLE MI 49032 RURAL HEALTH CLINIC - CENTERVILLE VEERA PATEL MD - INTERNAL MEDICINE 1021 HILL ST SUITE 300 THREE RIVERS MI 49093 INTERNAL MEDICINE PART I, LINE 7: COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS INSTRUCTIONS. PART I, LINE 7G: OTHER SUBSIDIZED HEALTH SERVICES INCLUDES GROSS CLINIC COSTS OF $7,099,444. PART I, LN 7 COL(F): BAD DEBT EXPENSE ARE DOLLARS THAT ARE WRITTEN OFF OR RESERVED FOR PATIENTS THAT HAVE AVAILABLE RESOURCES, BUT WOULD NOT PAY FOR SERVICES. THE EXCEPTION TO THIS RULE WOULD BE CHARITY CARE ACCOUNTS THAT ARE INCLUDED IN BAD DEBT BECAUSE A LACK OF INFORMATION PROVIDED, OR THE TIMING OF THE INFORMATION BEING RECEIVED. PAYMENTS ON ACCOUNTS THAT HAVE BEEN WRITTEN OFF WOULD REDUCE THE OVERALL BAD DEBT EXPENSE. DISCOUNTS ON CHARGES ARE NOT INCLUDED IN BAD DEBT EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL PRESENTLY INVESTS RESOURCES EVERY YEAR TO RECRUIT AN ADEQUATE NUMBER OF PHYSICIANS TO SERVE ITS COMMUNITY. MOST OF THESE PROVIDERS ARE EMPLOYEES OF THE HOSPITAL, AND THE HOSPITALS PROVIDE HEAVY SUBSIDIES TO THESE PRACTICES. THE HOSPITAL CONTINUES TO HAVE ANNUAL HEALTH FAIRS, AND HAS SPECIFIC SCHOLARSHIP FUNDS FOR SELECT SERVICES SUCH AS DIABETES AND CARDIAC REHAB. THE HOSPITAL ALSO PARTNERS WITH TERTIARY HOSPITALS IN KALAMAZOO TO PROMOTE HEALTHY LIVING, AND ALSO PROVIDES ACCESS TO SPECIALISTS FROM URBAN AREAS ON OUR CAMPUS. THE HOSPITAL ADDITIONALLY THROUGH ITS WELLNESS FACILITY OFFERS WELLNESS PROGRAMS TO THE COMMUNITY. PART III, LINE 4: THE HOSPITAL HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZED AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED(OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. EFFECTIVE APRIL 1, 2014, THE STATE OF MICHIGAN EXTENDED MEDICAID TO MOVE LOW-INCOME PATIENTS, WHICH RESULTED IN PATIENTS PREVIOUSLY CLASSIFIED AS SELF-PAY TO BE ELIGIBLE FOR MEDICAID. THE PROVISION FOR BAD DEBT RECORDED IN 2014 WAS SIGNIFICANTLY IMPACTED BY THIS PROGRAM. PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS (BUT BEFORE PROVISION FOR BAD DEBTS), RECOGNIZED IN THE PERIOD FROM THESE MAJOR PAYOR SOURCES IN TOTAL WAS $50,603,147 DURING 2014. THIS AMOUNT IS MADE UP OF AMOUNTS FROM THIRD-PARTY PAYORS OF $46,968,700 AND AMOUNTS FROM SELF-PAY PAYORS OF $3,634,447. RETROACTIVELY CALCULATED ADJUSTMENTS ARISING UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARY PAYORS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED.LAWS AND REGULATIONS GOVERNING THE MEDICARE AND MEDICAID PROGRAMS ARE COMPLEX AND SUBJECT TO INTERPRETATION. MANAGEMENT BELIEVES THAT IT IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. FINAL DETERMINATION OF COMPLIANCE OF SUCH LAWS AND REGULATIONS IS SUBJECT TO FUTURE GOVERNMENT REVIEW AND INTERPRETATION. VIOLATIONS MAY RESULT IN SIGNIFICANT REGULATORY ACTION INCLUDING FINES, PENALTIES, AND EXCLUSION FROM THE MEDICARE AND MEDICAID PROGRAMS.BAD DEBT EXPENSES CONSISTS OF DOLLARS THAT ARE WRITTEN OFF OR RESERVED FOR THAT PERTAINS TO PATIENTS THAT HAD AVILABLE RESOURCES, BUT WOULD NOT PAY FOR THEIR SERVICES. THE EXCEPTION TO THIS RULE APPLIES TO CHARITY CARE ACCOUNTS THAT ACTUALLY ARE INCLUDED IN BAD DEBT BECAUSE OF LACK OF INFORMATION PROVIDED, OR BECAUSE OF THE TIMING OF DETERMINATION FOR CHARITY CARE. WE ESTIMATE THAT AT THE END OF 2014, APPROXIMATELY $515,000 INCLUDED IN BAD DEBT SHOULD ACTUALLY CONSIDERED CHARITY CARE. BECAUSE OF THIS WE BELIEVE THIS SHOULD ALSO BE INCLUDED IN OUR COMMUNITY BENEFIT CALCULATION. PART III, LINE 8: MEDICARE IS OUR LARGEST PAYOR, THUS PAYMENTS FOR THIS POPULATION CREATE A FINANCIAL BURDEN ON THE HOSPITAL, AS PAYMENTS DO NOT COVER COSTS. MOST OF THE MEDICARE PATIENTS LIVE ON FIXED INCOMES. WE USED THE COST TO CHARGE RATIO TO DETERMINE COST. AS MEDICARE IS OUR LARGEST PAYOR, THE SHORTFALL IS IN COVERING COSTS IS EXTREME, THUS THIS WOULD SEEM TO QUALIFY AS A BENEFIT TO OUR COMMUNITY. PART III, LINE 9B: THE HOSPITALS CURRENT COLLECTION PRACTICES APPLY TO ALL PATIENTS. IF NO INSURANCE IS AVAILABLE FOR SERVICES, AND THEY DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, WE WILL MAKE THEM AWARE OF THEIR OPTIONS. DISCOUNTS ARE OFFERED WHICH ARE TIED TO COMMERICAL MANAGED CARE CONTRACTS. PAYMENT ARRANGEMENTS CAN BE MADE FOR A SPECIFIC PERIOD OF TIME, WITH NO INTEREST CHARGED. ONCE ARRANGEMENTS ARE MADE, THE ACCOUNT FOLLOWS THE STANDARD COLLECTION PROCESS OF LETTERS AND PHONE CALLS. AFTER 120 DAYS, IF NO PAYMENT HAS BEEN MADE OR IF PAYMENT ARRANGEMENTS ARE NOT KEPT, THE ACCOUNT WILL BE REFERRED TO A COLLECTION AGENCY. PART VI, LINE 2: THE HOSPITAL CURRENTLY REVIEWS THE HEALTH INDICATORS OF THE COUNTY, AND WILL FROM TIME TO TIME COMPLETE COMMUNITY SURVEYS. WE ASSESS WHETHER WE HAVE A SHORTAGE OF PHYSICIANS IN THE AREA ANNUALLY AS WELL. WE REVIEW TRENDS OF OUR PATIENT ACTIVITY BY SERVICE AND TYPE OF PATIENT TO SEE IF ADJUSTMENTS IN SERVICE OR RESOURCE ALLOCATION NEED TO BE MADE. WE RVIEW OUR PATIENT SATISFACTION SURVEYS PERIODICALLY TO IDENTIFY AND POTENTIAL GAPS IN SERVICES. WE PARTNER WITH THE LOCAL SCHOOLS AND COMMUNITY MENTAL HEALTH ON SPECIFIC HEALTH INITIATIVE THROUGHOUT THE YEAR. OUR MOST RECENT NEEDS ASSESSMENT WAS COMPLETED IN 2012. WE ARE IN THE PROCESS OF PLANNING FOR ANOTHER ASSESSMENT TO BE COMPLETED IN 2015. PART VI, LINE 3: UPON IDENTIFYING A PATIENT WHO HAS NO COVERAGE, WE WILL SEND THEM TO OUR PATIENT ASSISTANCE REPRESENTATIVE. THIS REPRESENTATIVE WILL THEN REVIEW THE OPTIONS THAT ARE AVAILABLE FOR THAT INDIVIDUAL. IF MEDICAID IS A POSSIBILITY, WE THEN SEND THE INDIVIDUAL TO OUR MEDICAID SPECIALIST, WHO WILL HELP THEM WITH THE PROCESS, AS WELL AS ANY FORMS. WE HAVE A FORMAL FINANCIAL ASSISTANCE PROGRAM THAT IS ADVERTISED HOSPITAL WIDE, AND ON OUR WEBSITE. IF THEY QUALIFY FOR FINANCIAL ASSTSTANCE, WE WILL EDUCATE THEM AND ASSEST THEM WITH THE PROCESS. PART VI, LINE 4: THE HOSPITAL PRESENTLY SERVES ST. JOSEPH COUNTY, ALONG WITH OTHER PROVIDERS IN THE COMMUNITY. THE POPULATION OF THIS COMMUNITY IS APPROXIMATELY 62,000. THE COMMUNITY, AN AREA THAT WAS HEAVILY DEPENDENT ON THE AUTO INDUSTRY, IS PRESENTLY ECONOMICALLY DEPRESSED. WHILE THE OVERALL ECONOMY IN THE STATE HAS REBOUNDED SOMEWHAT, THE LOCAL COUNTY HAS LAGGED IN THE RECOVERY. THE UNEMPLOYMENT RATE CONTINUES TO BE HIGH, AND THE MEDICAID POPULATION IN THE COMMUNITY IS EXTREMELY HIGH. ADDITIONALLY, PEOPLE WITH COVERAGE HAS ALSO INCREASED. BECAUSE OF THIS, MANY PEOPLE USE THE ER AS THEIR PRIMARY CARE PROVIDER. WHILE THE COMMUNITY IS RURAL, IT IS CLOSE TO URBAN AREAS. MANY PEOPLE IN THE COMMUNITY DO NOT HAVE ADEQUATE TRAVEL ARRANGEMENTS, AS CAN BE EVIDENCED BY HGIH NO SHOW RATES FOR PRIMARY CARE APPOINTMENTS DUE TO TRAVEL ISSUES. PART VI, LINE 5: THE HOSPITAL HAS A BOARD THAT RESIDES ENTIRELY IN THE COMMUNITY IT SERVES. THE HOSPITAL HAS EXTENDED PRIVELEGES TO ALL QUALIFIED STAFF IN THE COMMUNITY, AND AS MENTIONED ABOVE, HAS SET UP ARRANGEMENTS WITH TERTIARY HOSPITALS TO ARRANGE FOR SPECIALISTS TO PROVIDE CARE IN THE COMMUNITY ON AN AS NEEDED BASIS. THIS IS CRITICAL AS THIS MEANS THAT LOCAL POPULATION DOES NOT HAVE TO TRAVEL EXTENSIVELY FOR THIS SPECIALTY CARE. IF SURPLUS FUNDS ARE AVAILABLE, THESES FUNDS ARE INVESTED BACK INTO THE COMMUNITY BY ALLOCATING DOLLARS FOR MEDICAL EQUIPMENT REPLACEMENT, PHYSICIAN RECRUITING, AND OTHER COMMUNITY INITIATIVES. THE HOSPITAL ALSO CONTINUES TO ESTABLISH RURAL HEALTH CLINICS IN COMMUNITIES SURROUNDING ITS SERVICE AREA. PART VI, LINE 7, REPORTS FILED WITH STATES MI X X 0 0 0 0 0 0 0 0 0 WILLIAM RUSSELL PRESIDENT/CEO 225059 0 0 0 7260 0 0 0 71645 0 303964 0 0 0 STEVE ANDREWS CHIEF FINANCIAL OFFICER 170462 0 0 0 4113 0 3480 0 55484 0 233539 0 0 0 HOPE BAILEY VICE PRESIDENT 143688 0 0 0 0 0 8561 0 22598 0 174847 0 0 0 MIKE PULFORD CRNA 202654 0 0 0 0 0 22571 0 23426 0 248651 0 0 0 LEONARD DARLING PHARMACY MANAGER 137816 0 0 0 0 0 2684 0 20952 0 161452 0 0 0 DOUG ZEHNER PHARMACIST 123893 0 0 0 0 0 9911 0 18355 0 152159 0 0 0 FORM 990, PART I, LINE 1: THE HOSPITAL'S MISSION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE TO OUR COMMUNITY. WE SERVE A COMMUNITY THAT HAS ONE OF THE HIGHEST UNEMPLOYMENT RATES IN THE STATE. WE EMPLOY 85% OF THE PHYSICIANS IN THE COMMUNITY, THUS PROVIDING ADEQUATE ACCESS TO OUR COMMUNITY, SPECIFICALLY MEDICAID ELIGIBLE PATIENTS. WE OPERATE 4 RURAL HEALTH CLINICS, AND WILL HAVE ONE MORE OPERATIONAL IN 2016, WHICH GREATLY ENHANCES ACCESS TO CARE. WE PROVIDE A FULL RANGE OF OB SERVICES TO THE COMMUNITY, OF WHICH OVER 60% IS MEDICAID. WE ALSO PROVIDE WELLNESS AND DIABETIC EDUCATION SERVICES TO THE COMMUNITY, AS WELL AS HOMECARE AND HOSPICE, ALL SERVICES THAT ARE HEAVILY SUBSIDIZED. IN ADDITION, THE HOSPITAL ALSO HAS A IP REHABILITATION UNIT ON CAMPUS , AS WELL AS A WOUND CARE CLINIC. WE HAVE STARTED AN EMPLOYEE WELLNESS PROGRAM INTERNALLY, AND PLAN TO WORK WITH LOCAL EMPLOYERS TO OFFER THIS SERVICE AS WELL. FUTURE PLANS INCLUDE OFFERING MENTAL SERVICES, AND EXPANDING ORTHOPAEDICS, AND ADDING ENT SERVICES. ADDITIONALLY, WE ARE ADDING RESOURCES TO HELP THE UNINSURED NAVIGATE THE REQUIREMENTS FOR OBTAINING INSURANCE COVERAGE FOR THEIR PROBLEMS. FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL USES A MANAGEMENT COMPANY TO MANAGE OPERATIONS. THEY ALSO EMPLOY THE CEO AND CFO. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PRESENTED AT THE BOARD MEETING, AND REVIEWED BY OFFICERS AND MEMBERS DURING THE MEETING AFTER THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE COMPLIANCE OFFICE REQUIRES ANNUAL DISCLOSURE, AND COMMUNICATES TO BOARD PERIODICALLY. IF A CONFLICT OF INTEREST ARISES, THE INDIVIDUAL IS REQUIRED TO LEAVE THE ROOM WHEN DISCUSSIONS TAKE PLACE. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL USES DATA FROM MHA TO DETERMINE THE SALARY STRUCTURE FOR EMPLOYEES. FOR THE CEO AND CFO, QHR IS THE PRIMARY SOURCE FOR COMPENSATION, WHICH MUST BE APPROVED BY THE BOARD. THE SALARY PLAN IS PRESENTED TO THE FINANCE COMMITTEE AS WELL. ALL DECISIONS ARE DOCUMENTED IN THE BOARD MINUTES. THIS PROCESS TOOK PLACE IN 2014 AGAIN. FORM 990, PART VI, SECTION C, LINE 19 POLICIES AND STATEMENTS ARE REVIEWED AT BOARD MEETINGS. THE LOCAL PRESS ALSO RECEIVES THIS INFORMATION. IF ADDITIONAL REQUESTS ARE MADE, THIS INFORMATION IS PROVIDED AS REQUESTED. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,629,713. MANAGEMENT AND GENERAL EXPENSES 900,517. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,530,230. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 1,950,462. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,950,462. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. THREE RIVERS HEALTH FOUNDATION 701 S HEALTH PARKWAY THREE RIVERS MI 49093 201384776 FOUNDATION TO HOSPITAL MI 501(C)(3) 11 TYPE 1 THREE RIVERS HEALTH AUTHORITY 1 TRAH PROPERTIES INC 701 S HEALTH PARKWAY THREE RIVERS MI 49093 383366344 PROPERTY MANAGEMENT MI 501(C)(3) 11 TYPE 1 THREE RIVERS HEALTH AUTHORITY 1 THREE RIVERS HEALTH AUTHORITY 701 S HEALTH PARKWAY THREE RIVERS MI 49093 382317300 HOSPITAL MI 501(C)(3) 3 N/A 0 THREE RIVERS HEALTH NETWORK 701 S HEALTH PARKWAY THREE RIVERS MI 49093 383330974 MEDICAL DATA PROCESSING MI THREE RIVERS HEALTH AUTHORITY C 13582 1.00000 1 INTEGRATED HEALTH SYSTEMS INC 701 S HEALTH PARKWAY THREE RIVERS MI 49093 383134384 PERSONNEL MANAGEMENT MI N/A C 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 TRAH PROPERTIES INC K 245277 RENT PAID INTEGRATED HEALTH SYSTEMS INC P 4404051 FMV