2015-07-31T14:41:30-05:00 2014-09-30 381357951 PLANTE & MORAN PLLC 511 RENAISSANCE DRIVE ST JOSEPH MI 49085 990 2013-10-01 382156872 LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC LAKE 2699838166 1234 NAPIER AVE ST JOSEPH MI 49085 TIMOTHY CALHOUN VP - FINANCE & CFO 2699838166 2015-07-27 1 KENLEY PENNER CPA P00740260 2699828000 2013 2016-02-25 16:41:14Z LAKELAND HEALTHCARE LOREN HAMEL MD 1234 NAPIER AVE ST JOSEPH MI 49085 864691247 0 X LAKELANDHEALTH.ORG X 1985 MI LAKELAND HOSPITAL IS A 339 BED ACUTE CARE HOSPITAL AND PROVIDES A FULL CONTINIUM OF HEALTHCARE SERVICES TO IT'S TRI-COUNTY AREA. LAKELAND REGIONAL HEALTH SYSTEM IS THE PARENT COMPANY FOR LAKELAND HOSPITALS, NURSING HOMES, AND OTHER HEALTH-RELATED SERVICE CORPORATIONS SERVING THE TRI-COUNTY AREA. 22 18 3350 700 3429236 -107642 732354 486766 345819417 359118438 23328992 27624813 261324 305184 370142087 387535201 5496269 8963634 0 0 147885738 157518640 0 0 0 174772695 180186919 328154702 346669193 41987385 40866008 687998273 718710006 181774267 182753010 506224006 535956996 TO ENHANCE HEALTH AND SERVE OUR COMMUNITY 0 0 259533919 8963634 355689202 HOSPITAL SERVICES PROVIDED TO 16,063 INPATIENTS AND 323,415 OUTPATIENTS. 259533919 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 131 0 1 3350 1 1 1 0 0 0 0 0 0 0 0 0 X 22 18 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X TIMOTHY J CALHOUN 2699838166 1234 NAPIER AVENUE ST JOSEPH MI 49085 DANIEL HOPP CHAIRMAN 8.00 10.00 X X 0 0 0 JEFF EDMUNDS VICE CHAIRMAN & TREASURER 4.00 4.00 X X 0 0 0 TERRENCE ALLEN SECRETARY 4.00 4.00 X X 0 0 0 LOREN B HAMEL MD PRESIDENT 15.00 40.00 X X 751087 0 52460 NIELS-ERIK ANDREASEN DIRECTOR 2.00 2.00 X 0 0 0 LENORE BECKER DIRECTOR 2.00 2.00 X 0 0 0 DAVID BINKLEY DIRECTOR 2.00 2.00 X 0 0 0 LAURIANNE DAVIS DIRECTOR 2.00 2.00 X 0 0 0 BETH DODGE DIRECTOR 2.00 3.00 X 0 0 0 JOHN FROGGATT MD DIRECTOR 2.00 42.00 X 279173 0 20209 LYNN GRAY MD DIRECTOR 2.00 42.00 X 24000 0 0 PATRICIA HALL DIRECTOR 2.00 2.00 X 0 0 0 GEORGE HEENAN MD DIRECTOR 2.00 2.00 X 0 0 0 J DOUGLAS HUGGETT DO DIRECTOR 2.00 2.00 X 0 0 0 MICHAEL MORTIMORE DIRECTOR 2.00 4.00 X 0 0 0 KENNETH O'NEILL MD DIRECTOR 2.00 42.00 X 249154 0 12741 JEFFREY SCHMIDT DDS DIRECTOR 2.00 2.00 X 0 0 0 LINDA STANLEY MD DIRECTOR 2.00 2.00 X 0 0 0 WESLEY STEPHENS DIRECTOR 2.00 2.00 X 0 0 0 CHRISTINE VANLANDINGHAM DIRECTOR 2.00 2.00 X 0 0 0 THOMAS YEAGER DIRECTOR 2.00 2.00 X 0 0 0 JUDITH ZACHA DIRECTOR 2.00 2.00 X 0 0 0 JOSEPH BARRETT PART YEAR DIRECTOR 2.00 2.00 X 0 0 0 MARCUS ROBINSON PART YEAR DIRECTOR 2.00 2.00 X 0 0 0 TIMOTHY CALHOUN VP - FINANCE & CFO 15.00 35.00 X 382993 0 37904 LINDA BEUSHAUSEN VP - LIFE TRANSITIONS 1.00 50.00 X 145810 0 17609 RAY CRUSE VP - STRATEGIC INITIATIVE 15.00 35.00 X 266725 0 24664 LAURIE FLEMING VP - OUTPATIENT & DIAGNOST 30.00 20.00 X 223201 0 25550 LOWELL HAMEL MD VP - MEDICAL AFFAIRS & CMO 20.00 10.00 X 241627 0 24456 MARY ANN PATER VP - LEGAL & RISK MANAGEME 30.00 20.00 X 176427 0 21564 NORMA TIRADO-KELLENBERGER VP - IT & HR SERVICES 20.00 30.00 X 323062 0 27582 WARREN WHITE VP - MEDICAL PRACTICES 10.00 40.00 X 282991 0 26976 EILEEN WILLITS VP - NURSING & CNO 20.00 30.00 X 289549 0 30253 DAVID BURGHART FOUNDATION PRESIDENT 5.00 40.00 X 166751 0 15533 JAMES SCHLAMAN EXECUTIVE DIRECTOR - REHAB AND LONG 1.00 40.00 X 153783 0 11615 THOMAS FOLEY PHARMACIST 40.00 0.00 X 149731 0 13347 NEIL JOHNSON PHARMACY MANAGER 40.00 0.00 X 140937 0 14827 MICHELINO MANCINI PROGRAM DIRECTOR - EMERGENCY MEDICINE 40.00 0.00 X 150000 0 0 MARK SMALLEY PROGRAM DIRECTOR - INTERNAL MEDICINE 40.00 0.00 X 151440 0 0 JANN TOTZKE EXECUTIVE DIRECTOR - ONCOLOGY SERVICES 40.00 0.00 X 140138 0 11520 4688579 0 388810 73 0 1 0 LAKELAND MEDICAL PRACTICE 122 GRANT STREET NILES MI 49210 PHYSICIAN SERVICES 9311642 SUNSET COAST ANESTHESIA ASSOCIATES 1234 NAPIER AVE ST JOSEPH MI 49085 ANESTHESIA SERVICES 2510841 EPMG OF MICHIGAN PC 2000 GREEN ROAD SUITE 300 ANN ARBOR MI 481051571 ER SERVICES 1935310 ALLIANCE - HNI PETCT SERVICES PO BOX 402209 ATLANTA GA 303842209 PET SCAN RADIOLOGY SERVICES 1180505 SOUTH BEND MEDICAL FOUNDATION INC PO BOX 2030 MISHAWAKA IN 465462030 LAB SERVICES 911405 38 434451 52315 486766 PATIENT SERVICE REVENUE (57% MEDI 541380 355132643 351868355 3264288 OTHER OPERATING REVENUE 541380 3985795 3820847 164948 359118438 7711900 7711900 305184 0 305184 305184 305184 497068959 477115559 40487 19953400 -40487 19912913 19912913 387535201 355689202 3429236 27929997 8963634 8963634 4397432 3210125 1187307 115805388 84537933 31267455 4269031 3116393 1152638 24273700 17719802 6553898 8773089 6404355 2368734 219235 219235 269315 269315 1800001 1800001 7512836 5484370 2028466 769500 561735 207765 146292 106793 39499 6555316 4785381 1769935 6100557 4453407 1647150 718712 524660 194052 4067214 2969066 1098148 21726537 15860372 5866165 1624268 1185716 438552 SUPPLIES & DRUGS 63451492 46319589 17131903 PROVISION FOR BAD DEBTS 19848991 19848991 PHYSICIAN RELATIONS 17472887 12755208 4717679 QAAP ASSESSMENTS 9050571 9050571 18853195 11675818 7177377 346669193 259533919 87135274 0 71673159 62631625 24196622 29947694 6769927 8260078 3948228 4182455 472137979 245823756 228252497 226314223 330920248 356723590 22237592 30650341 687998273 718710006 28859489 29662029 107540927 104317028 45373851 48773953 181774267 182753010 X 504647007 534755608 1576999 1201388 506224006 535956996 687998273 718710006 X 40866008 3114400 -14247418 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 PART II-B, LINE 1: A PORTION OF THE HOSPITAL'S MHHA DUES ARE ALLOCATED TO LOBBYING ACTIVITIES. 5215020 5215020 186409733 68256485 118153248 4389087 2913658 1475429 273124167 174653613 98470554 2999972 2999972 226314223 PROVISION FOR MEDICAL MALPRACTICE 21000000 PROVISION FOR DEFERRED COMPENSATION 4855028 PROVISION FOR POSTRETIREMENT BENEFIT 4040425 INTEREST RATE SWAP AGREEMENTS 16050677 DUE TO RELATED PARTIES 2827823 48773953 X 357092810 3114400 -31438607 -28324207 385417017 1800001 318183 2118184 387535201 316056567 0 316056567 1800001 28812625 30612626 346669193 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL 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 HOSPITAL AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2011. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF SWAP AGREEMENTS -2,245,881. PROVISION FOR BAD DEBTS -19,848,991. CHANGE IN INTEREST OF NET ASSETS OF CHARITABLE FOUNDATIONS -380,101. GRANT TO LAKELAND HEALTH FOUNDATION, BENTON HARBOR/ST. JOSEPH -8,963,634. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION FROM LAKELAND HEALTH FOUNDATION, BENTON HARBOR/ST. JOSEPH 318,183. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO LAKELAND HEALTH FOUNDATION, BENTON HARBOR/ST. JOSEPH 8,963,634. PROVISION FOR BAD DEBTS 19,848,991. 1 1 X 1 X 1 X 225.000000000000 1 1 1 0 1 1 1 9439 4907612 0 4907612 0.01420 1 63526 61332738 47439488 13893250 0.04010 2 72965 66240350 47439488 18800862 0.05430 699 176965 3103366 6678 3096688 0.00890 111 1212 3967354 0 3967354 0.01140 1 436 38360 0 38360 0.00010 110 5302 245671 0 245671 0.00070 921 183915 7354751 6678 7348073 0.02110 923 256880 73595101 47446166 26148935 0.07540 24 578 5812 0 5812 0.00000 2 45 283 0 283 0.00000 1 3 660 0 660 0.00000 3 360 1045 0 1045 0.00000 13 0 2762 0 2762 0.00000 43 986 10562 10562 1 19848991 8439473 118492884 130665560 -12172676 X 1 0 2 1 LAKELAND HOSPITALS AT ST JOSEPH 1234 NAPIER AVENUE ST JOSEPH MI 49085 X X X A 2 LAKELAND HOSPITALS AT NILES 31 N SAINT JOSEPH AVENUE NILES MI 49120 X X X A FACILITY REPORTING GROUP - A 1 X X X X X X X X 12 1 0 1 X HTTP://WWW.LAKELANDHEALTH.ORG/HEALTH-WELL X X X X X X X X X 0 0 1 1 150.000000000000 1 225.000000000000 1 X X X X 1 1 X X 1 0 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 2: LAKELAND HOSPITALS AT NILES, - FACILITY 1: LAKELAND HOSPITALS AT ST. JOSEPH FACILITY 2 -- LAKELAND HOSPITALS AT NILES PART V, SECTION B, LINE 3: THE CHNA INCLUDED INPUT AND DATA COLLECTED FROM PEOPLE AND ORGANIZATIONS THROUGHOUT THE COUNTY REPRESENTING THE BROAD INTERESTS OF BERRIEN COUNTY-PUBLIC HEALTH, GOVERNMENT, COMMUNITY LEADERS, MEDICALLY UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS. PARTICIPATING ORGANIZATIONS INCLUDED:- BERRIEN COUNTY HEALTH DEPARTMENT- BERRIEN COUNTY DEPARTMENT OF HUMAN SERVICES- BERRIEN HEALTH PLAN- HEAL HEALTH EQUITY ALLIANCE- HEALTHY COMMUNITY PARTNERSHIP- BERRIEN COUNTY INTERMEDIATE SCHOOL DISTRICT- UNITED WAY OF SOUTHWEST MICHIGAN- AREA AGENCY ON AGING REGION 4- SOUTHWEST MICHIGAN PLANNING COMMISSION- BENTON HARBOR ST. JOSEPH YMCA- PUBLICLY AVAILABLE DATA FROM THE CENTER FOR DISEASE CONTROL AND PREVENTION(CDC), MICHIGAN DEPARTMENT OF COMMUNITY HEALTH(MDCH), US CENSUS, AMERICAN COMMUNITY SURVEY, MICHIGAN HOSPITAL ASSOCIATION(MHA) AND COUNTY HEALTH RANKINGS(UNIVERSITY OF WISCONSIN) FACILITY 2 -- LAKELAND HOSPITALS AT NILES PART V, SECTION B, LINE 5D: THE CHNA WILL BE MADE AVAILABLE TO THE PUBLIC BY A NUMBER OF MARKETING TACTICS: NEWS RELEASES TO BERRIEN COUNTY NEWSPAPERS, COMMUNITY EMAIL BLAST TO OVER 1,000 SUBSCRIBERS, MYLAKELAND INTRANET POSTING TO OVER 4,500 LAKELAND ASSOCIATES, VOLUNTEERS AND PHYSICIANS, DISTRIBUTED AT COMMUNITY EDUCATION EVENTS, PHYSICIAN SPEAKER SERIES AND MANY OTHER COMMUNITY HEALTH/WELLNESS PROGRAMS. PAPER COPIES ARE AVAILABLE UPON REQUEST USING THE 800 LAKELAND PHONE NUMBER.AN ONLINE COPY OF THE ASSESSMENT IS AVAILABLE AT WWW.LAKELANDHEALTH.ORG/CHNA FACILITY 2 -- LAKELAND HOSPITALS AT NILES PART V, SECTION B, LINE 7: THE HOSPITAL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENT NEEDS ASSESSMENT BECAUSE THE NEED TO REDUCE EXCESSIVE DRINKING, MOTOR VEHICLE CRASH DEATHS, AND SEXUALLY TRANSMITTED INFECTIONS ARE SPECIFIC HEALTH BEHAVIORS THAT ARE ADDRESSED BY THE BERRIEN COUNTY HEALTH DEPARTMENT. FACILITY 2 -- LAKELAND HOSPITALS AT NILES PART V, SECTION B, LINE 14G: FINANCIAL ASSISTANCE AVAILABILITY IS REFERENCED ON OUR BILLING STATEMENT AND IN BROCHURES LOCATED IN: EMERGENCY DEPARTMENT, ADMISSION OFFICE, PATIENT WAITING AREAS, AND IN PATIENT DISCHARGE PACKET. FACILITY 2 -- LAKELAND HOSPITALS AT NILES PART V, SECTION B, LINE 20D: BASED ON FPL LEVEL, BALANCES WERE DISCOUNTED AS % OF CHARGES. FPL LEVELS: 0-150, 151-175, 176-200, 201-225. FACILITY 1 -- LAKELAND HOSPITALS AT ST. JOSEPH PART V, SECTION B, LINE 3: THE CHNA INCLUDED INPUT AND DATA COLLECTED FROM PEOPLE AND ORGANIZATIONS THROUGHOUT THE COUNTY REPRESENTING THE BROAD INTERESTS OF BERRIEN COUNTY-PUBLIC HEALTH, GOVERNMENT, COMMUNITY LEADERS, MEDICALLY UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS. PARTICIPATING ORGANIZATIONS INCLUDED:- BERRIEN COUNTY HEALTH DEPARTMENT- BERRIEN COUNTY DEPARTMENT OF HUMAN SERVICES- BERRIEN HEALTH PLAN- HEAL HEALTH EQUITY ALLIANCE- HEALTHY COMMUNITY PARTNERSHIP- BERRIEN COUNTY INTERMEDIATE SCHOOL DISTRICT- UNITED WAY OF SOUTHWEST MICHIGAN- AREA AGENCY ON AGING REGION 4- SOUTHWEST MICHIGAN PLANNING COMMISSION- BENTON HARBOR ST. JOSEPH YMCA- PUBLICLY AVAILABLE DATA FROM THE CENTER FOR DISEASE CONTROL AND PREVENTION(CDC), MICHIGAN DEPARTMENT OF COMMUNITY HEALTH(MDCH), US CENSUS, AMERICAN COMMUNITY SURVEY, MICHIGAN HOSPITAL ASSOCIATION(MHA) AND COUNTY HEALTH RANKINGS(UNIVERSITY OF WISCONSIN) FACILITY 1 -- LAKELAND HOSPITALS AT ST. JOSEPH PART V, SECTION B, LINE 5D: THE CHNA WILL BE MADE AVAILABLE TO THE PUBLIC BY A NUMBER OF MARKETING TACTICS: NEWS RELEASES TO BERRIEN COUNTY NEWSPAPERS, COMMUNITY EMAIL BLAST TO OVER 1,000 SUBSCRIBERS, MYLAKELAND INTRANET POSTING TO OVER 4,500 LAKELAND ASSOCIATES, VOLUNTEERS AND PHYSICIANS, DISTRIBUTED AT COMMUNITY EDUCATION EVENTS, PHYSICIAN SPEAKER SERIES AND MANY OTHER COMMUNITY HEALTH/WELLNESS PROGRAMS. PAPER COPIES ARE AVAILABLE UPON REQUEST USING THE 800 LAKELAND PHONE NUMBER.AN ONLINE COPY OF THE ASSESSMENT IS AVAILABLE AT HTTP://WWW.LAKELANDHEALTH.ORG/HEALTH-WELLNESS/COMMUNITY-HEALTH-AND-WELLNESS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1 -- LAKELAND HOSPITALS AT ST. JOSEPH PART V, SECTION B, LINE 7: THE HOSPITAL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENT NEEDS ASSESSMENT BECAUSE THE NEED TO REDUCE EXCESSIVE DRINKING, MOTOR VEHICLE CRASH DEATHS, AND SEXUALLY TRANSMITTED INFECTIONS ARE SPECIFIC HEALTH BEHAVIORS THAT ARE ADDRESSED BY THE BERRIEN COUNTY HEALTH DEPARTMENT. FACILITY 1 -- LAKELAND HOSPITALS AT ST. JOSEPH PART V, SECTION B, LINE 14G: FINANCIAL ASSISTANCE AVAILABILITY IS REFERENCED ON OUR BILLING STATEMENT AND IN BROCHURES LOCATED IN: EMERGENCY DEPARTMENT, ADMISSION OFFICE, PATIENT WAITING AREAS, AND IN PATIENT DISCHARGE PACKET. FACILITY 1 -- LAKELAND HOSPITALS AT ST. JOSEPH PART V, SECTION B, LINE 20D: BASED ON FPL LEVEL, BALANCES WERE DISCOUNTED AS % OF CHARGES. FPL LEVELS: 0-150, 151-175, 176-200, 201-225. PART I, LINE 7: THE COST TO CHARGE RATIO USED WAS BASED ON THE COST REPORT. 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 $19,848,991. PART I, LINES 7F AND 7I: HEALTH PROFESSIONS EDUCATION - INCLUDES PROVIDING A CLINICAL SETTING FOR UNDERGRADUATE AND GRADUATE STUDENTS, VOCATIONAL TRAINING, AND THE PROFESSIONAL HEALTH CAREERS ACADEMY FOR ELEVENTH AND TWELFTH GRADE STUDENTS.CASH & IN-KIND DONATIONS TO COMMUNITY GROUPS - REPRESENTS LAKELAND'S FINANCIAL AND IN-KIND CONTRIBUTIONS TO SOCIAL SERVICES OR COMMUNITY AGENCIES FOR HEALTHCARE RELATED ACTIVITIES, DONATION OF MEDICAL SUPPLIES, UNITED WAY LEADERSHIP, GIRLS ON THE RUN, AND MEMBERSHIP ON COMMUNITY BOARDS. FINANCIAL ASSISTANCE - COVERS THE FREE OR DISCOUNTED CARE THAT LAKELAND OFFERS TO THOSE WHO CANNOT AFFORD TO PAY OR ARE NOT ELIGIBLE FOR PUBLIC PROGRAMS.FINANCIAL ASSISTANCE DOES NOT INCLUDE THE BAD DEBT COST, WHICH TOTALED $19,848,991 IN FY 2014 OR THE SURPLUS OF MEDICARE, WHICH TOTALED $-12,172,676. UNREIMBURSED MEDICAID- REPRESENTS THE COST OF CARING FOR PEOPLE COVERED BY MEDICAID MINUS THE AMOUNT LAKELAND RECEIVES FROM THOSE PROGRAMS. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES INCLUDE HOSTS MENTORING PROGRAM FOR YOUNG CHILDREN, HEALTH CAREER PRESENTATIONS TO AREA STUDENTS, DISASTER READINESS, AND YOUNG ENTREPRENEURS DAY FOR AREA HIGH SCHOOL STUDENTS. PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL 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 HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.PATIENT CHARGES WRITTEN OFF PURSUANT TO FINANCIAL ASSISTANCE POLICIES ARE TRACKED AND ARE DETERMINED TO BE COMMUNITY BENEFIT. PART VI, LINE 2: THE ORGANIZATION USES NEEDS ASSESSMENT PREPARED BY THE COUNTY HEALTH DEPARTMENT AND PARTICIPATES IN A REGIONAL HEALTHY BERRIEN COMMUNITY COMMITTEE TO ADDRESS HEALTH NEEDS. PART VI, LINE 3: THE ORGANIZATION EMPLOYS MORE THAN 12 FINANCIAL COUNSELORS WHO ASSIST PATIENTS WITH ELIGIBILITY. PART VI, LINE 4: THE SYSTEM SERVES APPROXIMATELY 160,000 RESIDENTS IN BERRIEN COUNTY AND SURROUNDING AREAS. APPROXIMATELY 12% OF FAMILIES AND 17% OF INDIVIDUALS ARE BELOW POVERTY LEVEL. PART VI, LINE 5: COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS - REPRESENTS ACTIVITIES THAT HELP IMPROVE THE HEALTH AND QUALITY OF LIFE FOR PEOPLE IN THE COMMUNITY. HEALTH PRESENTATIONS INCLUDE: ACT IN TIME TO HEART ATTACK AND STROKE, EXPECTANT PARENT, SMOKE FREE LIFE, TEEN PREGNANCY PREVENTION - BABY THINK IT OVER AND POSTPONING SEXUAL INVOLVEMENT - ADVANCED DIRECTIVES, SENIOR-EXPO, PRE-DIABETES, FALLS PREVENTION, MEDICATION SAFETY, HEARTSAFE AND HEART LESSONS. CANCER SCREENINGS INCLUDE PROSTATE, BREAST AND COLORECTAL, CANCER SUPPORT PROGRAMS SUCH AS: LOOK GOOD, FEEL BETTER, THE ANNUAL CARE FAIR, AND BREAST HEALTH AWARENESS. LAKELAND SUPPORTS TWO HEALTH RESOURCE LIBRARIES AT ST. JOSEPH AND NILES, PARISH AND SENIOR CENTER NURSES, AND NUMEROUS HEALTH SCREENINGS ARE SOME EXAMPLES. PART VI, LINE 6: THE ORGANIZATION IS PART OF LAKELAND REGIONAL HEALTH SYSTEM WHICH SERVES THE SAME GEOGRAPHIC AREA FOR HEALTHCARE RELATED SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES MI 1 LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH 1234 NAPIER AVENUE ST JOSEPH MI 49085 382539929 501(C)(3) 8963634 DONATION FOR HOSPICE RESIDENCE 1 0 PART I, LINE 2: THE ORGANIZATION DISBURSES FUNDS TO RELATED ORGANIZATIONS AND MONITORS FUNDS THROUGH COMMON MANAGEMENT. X X X X 0 1 0 0 0 0 0 0 0 LOREN B HAMEL MD PRESIDENT 548588 0 160650 0 41849 0 48749 0 3711 0 803547 0 0 0 JOHN FROGGATT MD DIRECTOR 246816 0 0 0 32357 0 15543 0 4666 0 299382 0 0 0 KENNETH O'NEILL MD DIRECTOR 202428 0 10255 0 36471 0 11441 0 1300 0 261895 0 0 0 TIMOTHY CALHOUN VP - FINANCE & CFO 296996 0 58791 0 27206 0 34036 0 3868 0 420897 0 0 0 LINDA BEUSHAUSEN VP - LIFE TRANSITIONS 123944 0 11093 0 10773 0 14345 0 3264 0 163419 0 0 0 RAY CRUSE VP - STRATEGIC INITIATIVE 219991 0 36444 0 10290 0 22744 0 1920 0 291389 0 0 0 LAURIE FLEMING VP - OUTPATIENT & DIAGNOST 181410 0 27166 0 14625 0 23189 0 2361 0 248751 0 0 0 LOWELL HAMEL MD VP - MEDICAL AFFAIRS & CMO 198891 0 38214 0 4522 0 22742 0 1714 0 266083 0 0 0 MARY ANN PATER VP - LEGAL & RISK MANAGEME 150620 0 14857 0 10950 0 19135 0 2429 0 197991 0 0 0 NORMA TIRADO-KELLENBERGER VP - IT & HR SERVICES 255641 0 50980 0 16441 0 25828 0 1754 0 350644 0 0 0 WARREN WHITE VP - MEDICAL PRACTICES 226472 0 41911 0 14608 0 26440 0 536 0 309967 0 0 0 EILEEN WILLITS VP - NURSING & CNO 227789 0 45420 0 16340 0 27679 0 2574 0 319802 0 0 0 DAVID BURGHART FOUNDATION PRESIDENT 162064 0 1440 0 3247 0 13977 0 1556 0 182284 0 0 0 JAMES SCHLAMAN EXECUTIVE DIRECTOR - REHAB AND LONG 149704 0 1440 0 2639 0 9052 0 2563 0 165398 0 0 0 THOMAS FOLEY PHARMACIST 146824 0 162 0 2745 0 8595 0 4752 0 163078 0 0 0 NEIL JOHNSON PHARMACY MANAGER 134376 0 1200 0 5361 0 8467 0 6360 0 155764 0 0 0 MARK SMALLEY PROGRAM DIRECTOR - INTERNAL MEDICINE 150000 0 1440 0 0 0 0 0 0 0 151440 0 0 0 JANN TOTZKE EXECUTIVE DIRECTOR - ONCOLOGY SERVIC 138276 0 1440 0 422 0 8415 0 3105 0 151658 0 0 0 PART I, LINE 4B LAKELAND MAINTAINS A 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. THE INDIVIDUALS LISTED IN PART VII WHO PARTICIPATED IN THE PLAN ARE: LOREN HAMEL, MD; TIMOTHY CALHOUN; LINDA BEUSHAUSEN; DAVID BURGHART; RAY CRUSE; LAURIE FLEMING; LOWELL HAMEL, MD; MARY ANN PATER; NORMA TIRADO-KELLENBERGER; WARREN WHITE; EILEEN WILLITS A HOSPITAL AUTHORITY OF THE CITY OF ST JOSEPH (MICHIGAN) 383151499 790678CC8 2003-12-17 41525000 REFUND BONDS ISSUED 1/13/94 AND FACILITY CONSTRUCTION AND IMPROVEMENTS 0 0 0 B HOSPITAL AUTHORITY OF THE CITY OF ST JOSEPH (MICHIGAN) 383151499 790678CD6 2006-01-26 50000000 FACILITY CONSTRUCTION AND IMPROVEMENTS 0 0 0 A 41643043 193091 31392506 10057446 2004 1 0 1 1 B 52613405 467500 1012738 51133167 2007 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 1 1 UBS AG 28.000000000000 0 0 0 0 0 B 1 1 1 UBS AG 28.900000000000 0 0 1 CITIGROUP GLOBAL MARKETS 2.700000000000 1 0 0 A 0 B 0 FORM 990, PART VI, SECTION A, LINE 2 LOREN HAMEL, MD AND LOWELL HAMEL, MD HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 990 HAS BEEN POSTED ON THE BOARD PORTAL FOR REVIEW PRIOR TO FILING. THE BOARD PORTAL IS AVAILABLE TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT, THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES, AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE ASKED TO RESIGN. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT FIRM IS HIRED BY THE BOARD TO DETERMINE COMPENSATION PACKAGES FOR THE CEO AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. THE FIRM PRESENTS COMPARATIVE PAY RANGES AND COMPENSATION RECOMMENDATIONS TO THE GOVERNANCE (COMPENSATION) COMMITTEE FOR THEIR APPROVAL. FOR SENIOR MANAGEMENT, THE CEO CAN PROVIDE INPUT AND RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. FOR THE CEO'S COMPENSATION, THE GOVERNANCE COMMITTEE PRESENTS THE COMPENSATION PACKAGE TO THE FULL BOARD FOR APPROVAL. WRITTEN CONTRACTS FOR THE CEO ARE APPROVED BY THE FULL BOARD OF DIRECTORS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2014. FORM 990, PART VI, SECTION C, LINE 18 THE HOSPITAL'S FORM 990 IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SWAP AGREEMENTS -2,245,880. CHANGE IN INTEREST OF NET ASSETS OF CHARITABLE FOUNDATIONS -380,101. CHANGE OF INTEREST IN PARTNERSHIP -3,969. ALLOCATION OF EXPENSES TO RELATED PARTIES -581,978. CAPITAL CONTRIBUTION TO LAKELAND REGIONAL HEALTH SYSTEM -8,047,612. CAPITAL CONTRIBUTION TO LAKELAND HEALTH FOUNDATION, BENTON HARBOR -2,987,878. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE IN THE AUDIT OVERSIGHT PROCESS FROM THE PRIOR YEAR. LAKELAND REGIONAL HEALTH SYSTEM INC 1234 NAPIER AVE ST JOSEPH MI 49085 382609624 PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY MI 501(C)(3) LINE 11B, II N/A 0 LAKELAND SPECIALITY HOSPITAL AT BERRIEN CENTER 1234 NAPIER AVE ST JOSEPH MI 49085 383452303 LONGTERM HEALTHCARE/HEALING SERVICES MI 501(C)(3) LINE 3 LAKELAND REGIONAL HEALTH SYSTEM INC 1 LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH 1234 NAPIER AVE ST JOSEPH MI 49085 382539929 PROMOTE AND ASSIST IN PROVIDING HEALTH CARE MI 501(C)(3) LINE 7 LAKELAND REGIONAL HEALTH SYSTEM INC 1 LAKELAND HEALTH FOUNDATION NILES 1234 NAPIER AVE ST JOSEPH MI 49085 383130558 PROMOTE/ASSIST IN PROVIDING HEALTH CARE SERVICES IN SOUTHWESTERN MICHIGAN MI 501(C)(3) LINE 7 LAKELAND REGIONAL HEALTH SYSTEM INC 1 MERCY MEMORIAL HEALTH SERVICES INC 3425 LAKESHORE DRIVE ST JOSEPH MI 49085 382748035 PROVIDE HOMECARE AND LONG-TERM HEALTHCARE TO PATIENTS IN SOUTHWEST MICHIGAN MI 501(C)(3) LINE 9 LAKELAND REGIONAL HEALTH SYSTEM INC 1 LAKELAND COMMUNITY HOSPITAL - WATERVLIET 400 MEDICAL PARK DRIVE WATERVLIET MI 49098 381368745 TO PROVIDE GENERAL HEALTH OF THE COMMUNITY THROUGH EDUCATION AND HEALTHCARE MI 501(C)(3) LINE 9 LAKELAND REGIONAL HEALTH SYSTEM INC 1 HOSPICE AT HOME INC 4025 HEALTH PARK LANE ST JOSEPH MI 49085 382416086 TO PROVIDE HOSPICE AND PALLIATIVE CARE TO THE TERMINALLY ILL MI 501(C)(3) LINE 7 LAKELAND REGIONAL HEALTH SYSTEM INC 1 VAN'S MEDICAL EQUIPMENT OF LAKELAND LLC 1234 NAPIER AVE ST JOSEPH MI 49085 261497708 MEDICAL EQUIPMENT MI N/A CLIFFSIDE COMPANY LLC 910 S WASHINGTON AVENUE ROYAL OAK MI 48067 383306320 ASSISTED LIVING MI N/A LAKELINE ASSOCIATES LLC 910 S WASHINGTON AVENUE ROYAL OAK MI 48067 383306318 PROPERTY MANAGEMENT/RENTAL MI N/A LIBERTY DIALYSIS LAKELAND LLC 7650 SE 27TH STREET SUITE 200 MERCER ISLAND WA 98040 272099855 MEDICAL SERVICES WA N/A LDBH LLC 7650 SE 27TH STREET SUITE 200 MERCER ISLAND WA 98040 451745643 MEDICAL SERVICES WA N/A LAKELAND HEALTH ENTERPRISES INC 31 NORTH ST JOSEPH AVENUE NILES MI 49120 382669798 ACCOUNTING AND BILLING MI LAKELAND REGIONAL HEALTH SYSTEM C 1 PHARMACY SHOPPE INC DBA LAKELAND PHARMACY SHOPPE INC 1234 NAPIER AVE ST JOSEPH MI 49085 382929090 PHARMACEUTICALS MI LAKELAND HEALTH ENTERPRISES C 1 LAKELAND MEDICAL PRACTICES 1234 NAPIER AVE ST JOSEPH MI 49085 270381199 MEDICAL ADMINISTRATIVE SERVICES MI LAKELAND HEALTH ENTERPRISES C 1 SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC 1234 NAPIER AVE ST JOSEPH MI 49085 272589359 PHYSICIAN OFFICE MI LAKELAND HEALTH ENTERPRISES C 1 FOUR FLAGS PROPERTIES INC 122 GRANT STREET NILES MI 49120 364501639 PROPERTY MANAGEMENT/RENTAL MI LAKELAND HEALTH ENTERPRISES C 1 LAKELAND HEALTH VENTURES INC 1234 NAPIER AVE ST JOSEPH MI 49085 272313790 HOLDING COMPANY MI LAKELAND HEALTH ENTERPRISES C 1 LAKELAND PHYSICIAN CARE NETWORK 1234 NAPIER AVE ST JOSEPH MI 49085 208513031 MEDICAL SERVICES MI LAKELAND HEALTH ENTERPRISES C 1 LAKELAND PERSONAL CARE SERVICES INC 1234 NAPIER AVE ST JOSEPH MI 49085 272990797 HEALTH CARE SERVICES MI LAKELAND HEALTH ENTERPRISES C 1 LAKELAND CARE INC 1234 NAPIER AVE ST JOSEPH MI 49085 383225306 CONTRACT NEGOTIATION MI C 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH C 486766 ACTUAL AMOUNT OF GRANT LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH O 250250 ALLOCATION OF EXPENSE LAKELAND HEALTH FOUNDATION NILES O 116395 ALLOCATION OF EXPENSE LAKELAND COMMUNITY HOSPITAL - WATERVLIET O 58198 ALLOCATION OF EXPENSE HOSPICE AT HOME INC O 157134 ALLOCATION OF EXPENSE LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH B 8963634 ACTUAL AMOUNT OF GRANT FOUR FLAGS PROPERTIES K 738251 ACTUAL AMOUNT OF RENT LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH R 2987878 ACTUAL AMOUNT OF TRANSFER LAKELAND REGIONAL HEALTH SYSTEM R 8047612 ACTUAL AMOUNT OF TRANSFER