2015-05-13T14:15:32-05:00 2014-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2013-07-01 381360526 Borgess Medical Center BORG 2692268301 1521 Gull Road Kalamazoo MI 49048 Richard Felbinger Health System - CFO 2692268301 2015-05-13 1 Alicia M Janisch P00741382 5137847100 2015-05-08 2013 2016-02-25 16:41:14Z Paul A Spaude 1521 Gull Road Kalamazoo MI 49048 449778343 0 0928 X www.borgess.com X 1927 MI Provide inpatient & outpatient routine & ancillary care to the community. 14 12 3365 434 3966658 0 0 0 418594569 417089067 5293253 4802885 36385719 27406114 460273541 449298066 320070 290333 0 0 173599881 162998582 0 0 0 226582443 221710807 400502394 384999722 59771147 64298344 409815584 402691664 296055343 286405536 113760241 116286128 X Borgess Medical Center provides necessary and vital health care services to an area which includes all of S.W. Michigan. This care is given regardless of any individuals' race, color, religion, gender, age, national origin or ability to pay. Borgess Medical Center is committed to cooperating with patients and families in providing holistic treatment by integrating within the healing process the physical, emotional and spiritual needs of each patient. Services include inpatient routine, inpatient and outpatient ancillary care in support of our stated mission. 0 0 337181341 290333 439625482 In furtherance of its mission, Borgess Medical Center provides quality medical services regardless of race, creed, sex, national origin, handicap or ability to pay. Additionally, the Medical Center participates in state and federal programs designed for the indigent and elderly where reimbursements are less than cost. These estimates do not include community health promotions and outreach programs performed to assist those in need and provided without charge (See Schedule H for the Community Benefit Report). 337181341 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 352 0 1 3365 1 1 1 0 0 0 0 0 0 0 0 0 X 14 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 X Jeff Simpson 2692267000 1521 Gull Road Kalamazoo MI 49048 X Daniel E Stewart MD Chair 1.00 3.00 X X 0 0 0 James Devlin Vice Chair 1.00 3.00 X X 0 0 0 William M Harrison Secretary 1.00 3.00 X X 0 0 0 Joni L Knapper Secretary (end 7/13) 1.00 3.00 X X 0 0 0 Susan Pozo PhD Treasurer 1.00 3.00 X X 0 0 0 Sanjay Dalal MD Trustee 1.00 3.00 X 0 0 0 S Tim Derrington Trustee 1.00 3.00 X 0 0 0 Gary Druskovich MD Trustee 1.00 3.00 X 0 0 0 Mary Ellen Gondeck CSJ Trustee 1.00 3.00 X 0 0 0 James F Hettinger Trustee 1.00 3.00 X 0 0 0 Kevin Holleman MD Trustee 1.00 3.00 X 0 0 0 Albert Little Trustee 1.00 3.00 X 0 0 0 Larry D Lueth Trustee 1.00 3.00 X 0 0 0 Mark Noffsinger MD Sch O Trustee (end 1/14) 1.00 3.00 X 809080 0 68147 Mirjana Stancic MD Sch O Trustee (start 1/14) 1.00 3.00 X 244920 0 40568 Paul A Spaude CEO - Health System 32.00 8.00 X X 1294457 0 49093 Richard Felbinger CFO - Health System 32.00 8.00 X 354519 0 112908 Robert Hill MD Chief Medical Officer 35.00 5.00 X 270493 0 57821 Mark Anthony COO - Health System 35.00 5.00 X 306499 0 80534 J Patrick Dyson Executive VP 35.00 5.00 X 590086 0 175764 John Ryder COO - Lee & PIPP 20.00 20.00 X 185318 0 81490 Sreenivas Kamath MD Physician 40.00 0.00 X 1021485 0 53734 John Gustafson MD Physician 40.00 0.00 X 990541 0 51309 David Martin MD Physician 40.00 0.00 X 852088 0 62437 Thomas Ryan MD Physician 40.00 0.00 X 841149 0 63300 Vishal Gupta MD Physician 40.00 0.00 X 767710 0 39357 Anthony F Olivia Former Chief Medical Officer 0.00 0.00 X 109938 0 13762 8638283 0 950224 173 1 1 0 LHRET Ascension SW Michigan LLC 6004 Payshere Circle Chicago IL 60674 Software Services 6755726 Trimedx LLC 15091 Bake Parkway Irvine CA 92618 Medical Equipment 6469866 Premier Radiology 1535 Gull Road Kalamazoo MI 49048 Radiology Services 2243111 Deloitte & Touche LLP 250 East Fifth Street Cincinnati OH 45202 Consulting 2132527 CCS-PA LLC 31330 Schoolcraft Road Livonia MI 48150 Consulting 1898953 232 Net Patient Services 621990 403489233 403489233 Pharmacy 621990 10902309 10902309 Joint Ventures Income 900099 1337222 924039 413183 Reference Lab 541380 885927 686399 199528 Affiliated Rental Inc. 532000 474376 474376 417089067 4810363 4810363 912887 67326 845561 845561 845561 7478 -7478 -7478 -7478 462953 405473 57480 57480 Affiliate Income 621990 11624664 11624664 Laundry Revenue 812300 5055242 1701295 3353947 Research Dept. Revenue 541700 858714 858714 8964453 8964453 26503073 449298066 439625482 3966658 5705926 290333 290333 3291959 1306384 1985575 123700 123700 128019808 111860160 16159648 9662138 8695924 966214 12494532 11245079 1249453 9406445 9406445 14185307 14185307 55210 55210 164086 164086 594761 594761 71011 71011 1066454 959809 106645 18417291 16575562 1841729 310931 279838 31093 4877741 4877741 16793245 15113920 1679325 2215775 2215775 Medical Supplies 80118701 73023458 7095243 Contract Services 70626504 63563854 7062650 Physician Fees 5284735 5284735 Lease Expense 2325770 2325770 4603285 2993752 1609533 384999722 337181341 47818381 0 16203986 20556438 50077774 55777829 7625812 7435366 2766254 5145464 318055771 156503625 142986467 161552146 278356 276223 13276992 13652716 1286814 1534648 175313129 136760834 409815584 402691664 36847033 38844447 1673606 1604236 257534704 245956853 296055343 286405536 X 113481885 116009905 278356 276223 113760241 116286128 409815584 402691664 X 64298344 8347170 -70119627 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 4118 4118 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. Borgess Medical Center 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 candidates for public office. 4189957 4189957 202502154 89733001 112769153 1576809 1293031 283778 94025870 64897510 29128360 15760981 580083 15180898 161552146 Interest in Investments Held by Ascension Health Alliance 100367620 Deferred Compensation Annuities 12627518 Intercompany Receivables 12333807 Third Party Settlements 8152434 Other Receivables 3279455 136760834 Intercompany Debt with Ascension Health Alliance 163620963 Pension Payable 44543494 Third Party Settlements 16909372 Deferred Compensation 12627518 Self Insurance Liability 4380408 Other Liabilities 3875098 245956853 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 Borgess Medical Center: The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2014. 1 1 X 1 X 1 X 1 1 1 0 1 1 9291319 9291319 0.02410 46869793 29864273 17005520 0.04420 203564644 214313535 -10748891 0.00000 259725756 244177808 15547948 0.06830 486273 1910 484363 0.00130 8310314 8310314 0.02160 37002 2554 34448 0.00010 1242853 1242853 0.00320 450845 450845 0.00120 10527287 4464 10522823 0.02740 270253043 244182272 26070771 0.09570 0 2039043 1432941 214313535 203423474 10890061 X 1 1 2 1 Borgess Medical Center 1521 Gull Road Kalamazoo MI 49048 www.borgess.com L424370 X X X X X A 2 Borgess PIPP Hospital 411 Naomi Street Plainwell MI 49080 www.borgess.com L431681 X Long-Term Acute Care A Facility Reporting Group A 1 X X X X X X X X X 12 1 1 1 X See Part V, Section C, Supplemental Info. X X X X X X X X X 0 0 1 1 200.000000000000 1 350.000000000000 1 X X X X X X 1 1 X 1 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Borgess Medical Center, - Facility 2: Borgess PIPP Hospital Facility 1 -- Borgess Medical Center Part V, Section B, line 3: In 2012, Borgess Health re-established the Community Benefit Advisory Committee. This committee represents sixteen (16) community agency leaders throughout Kalamazoo County and is intended to represent a wide range of expertise and services that impact our community's health status. Each committee member also holds numerous board and community committee positions in Kalamazoo and is adequately positioned to represent the community needs.The Community Benefit Advisory Committee represented a large cross section of community agencies. The committee members' expertise involves public health, not-for-profit agencies, school/educational programs, elderly support services, family health centers, chronic disease specialty clinics, Borgess Health representatives involved in community work, and a local government official.All agencies and their representatives on the committee are involved with providing services to the medically underserved, low income and minority populations. The following list represents the Community Benefit Advisory Committee participating members and data sources: Community Benefit Advisory Committee Members:- Denise Crawford- Fran Denny- Van R. Dickerson- Patrick Dyson- Mary Gustas- Bobby J. Hopewell- Gregory Miller- Bill Mayer, M.D.- Margaret Patton- Susan Pozo- Linda Root- John Ryder- Diane Schrock- Cheryl Tenenbaum- Linda Vail Facility 1 -- Borgess Medical Center Part V, Section B, line 4: The other hospital facility with which the reporting hospital facility conducted its CHNA includes Bronson Hospital. Facility 1 -- Borgess Medical Center Part V, Section B, line 5d: The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address:http://www.borgess.com/files/chna/CHNA_Borgess_Health.pdf Facility 1 -- Borgess Medical Center Part V, Section B, line 14g: A summary of the financial assistance policy is posted on the hospital facility's emergency rooms or waiting rooms, admission offices and available upon request. Facility 2 -- Borgess PIPP Hospital Part V, Section B, line 3: In 2012, Borgess Health re-established the Community Benefit Advisory Committee. This committee represents sixteen (16) community agency leaders throughout Kalamazoo County and is intended to represent a wide range of expertise and services that impact our community's health status. Each committee member also holds numerous board and community committee positions in Kalamazoo and is adequately positioned to represent the community needs.The Community Benefit Advisory Committee represented a large cross section of community agencies. The committee members' expertise involves public health, not-for-profit agencies, school/educational programs, elderly support services, family health centers, chronic disease specialty clinics, Borgess Health representatives involved in community work, and a local government official.All agencies and their representatives on the committee are involved with providing services to the medically underserved, low income and minority populations. The following list represents the Community Benefit Advisory Committee participating members and data sources: Community Benefit Advisory Committee Members:- Denise Crawford- Fran Denny- Van R. Dickerson- Patrick Dyson- Mary Gustas- Bobby J. Hopewell- Gregory Miller- Bill Mayer, M.D.- Margaret Patton- Susan Pozo- Linda Root- John Ryder- Diane Schrock- Cheryl Tenenbaum- Linda Vail Facility 2 -- Borgess PIPP Hospital Part V, Section B, line 4: The other hospital facility with which the reporting hospital facility conducted its CHNA includes Bronson Hospital. Facility 2 -- Borgess PIPP Hospital Part V, Section B, line 5d: The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address:http://www.borgess.com/files/chna/CHNA_Borgess_Health.pdf Facility 2 -- Borgess PIPP Hospital Part V, Section B, line 7: All of the community needs have been addressed within the implementation plan. The implementation plan is still in its roll out stage. Facility 2 -- Borgess PIPP Hospital Part V, Section B, line 14g: A summary of the financial assistance policy is posted on the hospital facility's emergency rooms or waiting rooms, admission offices and available upon request. 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 were calculated and applied. Part I, Line 6: Community Benefit Report:This report illustrates the significant degree to which Borgess Medical Center contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system, Borges Medical Center continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of Borgess Medical Center is to perpetuate the healing mission of the church. Borgess Medical Center furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community, and medical research. Our concern for all human life and dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. Borgess Medical Center has engaged in the following activities to ensure that our mission is accomplished:Unreimbursed Services Provided to the Elderly and the PoorBorgess Medical Center provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2014, approximately 51.6% of the value of services rendered were to elderly patients under the Medicare program, and approximately 11.9% 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, Borgess Medical Center 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 $38.5 million.Patient ServicesIn addition to offering nationally recognized, cardiac, neuro and orthopedic care, Borgess Medical Center serves southern Michigan and the greater Kalamazoo region with more than 40 inpatient and outpatient specialties -- including emergency and trauma, heart health, advanced cancer care, vascular services and women's health -- provided by a medical staff of more than 500 physicians. The following represent some of the services provided: -Behavioral Medicine-Birthing Center-Breast Care Centers-Cancer Care-Cardiac Services (Heart Care)-Clinical Trials (Research)-CorpFit (Occupational Health) -Diabetes Education-Emergency Services-Fitness-Health Promotion (For Instructor Use)-Home Health Care & Hospice-Integrative Medicine-Laboratory Services-Level I Trauma Center-Neuro Sciences (Head, neck and spine)-Nutritional Counseling-Orthopedic Services / Joint Replacement Center-Osteoporosis Centers-Radiology Services-Rehabilitation Services-Sleep Disorders Center-Surgical Services-Vascular Services-West Michigan Spine-Women's HealthSome services operate at a loss in order to ensure that all services are available to meet community health care needs. Some of the larger examples include Obstetrics, Neonatal, Behavioral, and General Medicine.During the fiscal year ending June 30, 2014, our Medical Center treated adults and children in the community for a total of 88,746 patient days of service. The Medical Center also provided services for 508,483 outpatient visits, including 7,090 outpatient surgeries, and 62,965 emergency and minor care visits. Community Outreach ActivitiesBorgess Medical Center 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, Borgess Medical Center has developed the following programs to help achieve its mission:Expanding Awareness, Education, and Health PromotionBorgess Medical Center believes that it is essential to educate people regarding the types of behavior that improve their chances of living a healthy life. Borgess Medical Center has invested significantly in unique, top quality health education and materials to accomplish its goals. Below are some of the topics of program offerings to the community:-Cardiac Rehabilitation-Loss and Bereavement-Healthy Heart Education-Food Preparation for Cardiac Patients-Hip and Knee Pain-Joint Replacement Pre-op Education-Diabetes Education-Family and Sibling Education-Cardio Pulmonary Seminars-Lamaze-Lamaze for Spanish speaking population-Birth Education-Better Breathers Club-Breast Education-End of Life IssuesBorgess Medical Center provides the following information on its website:1. Listings of Health and Wellness classes, including a description of the class, cost, and location.2. Drug Reference information on thousands of Brand and Generic drugs.3. Adult and Pediatric Disease and Condition Index, that provides information on various disease processes and health conditions for adults and children.While our health ministry does not have formal public health clinic, it does provide a variety of specialized clinics at various sites in the community independently and in conjunction with other organizations. These include:-Public Flu Clinic-Diabetes Screenings-Congestive Heart failure-Fitness and Exercise-Cholesterol -Stroke-Cardiac Health-Wellness Clinics offered by Parish Nurse Program-Blood Pressure Screenings-Prevention and Safety Health Fairs offered by Visiting Nurse and Hospice Program-Senior Wellness Program-Joint community health fairs:1. African American Health Fair2. Cover the Uninsured Week health screenings3. Senior Expo4. Women's Festival5. Kalamazoo County Health FairIn fulfillment of its corporate responsibility to address compelling community and social needs through philanthropy, Borgess Medical Center has established a policy to direct monetary contributions to not-for-profit organizations that work to improve the quality of life in its service area. Priority is given to those organizations whose mission is most closely aligned with the mission and values of Borgess.Borgess played a leadership role in the establishment of the Kalamazoo County Health Plan, whose mission is to improve coverage and access for the uninsured in Kalamazoo County. Additionally Borgess executive staff sit on a number of governance Boards of non-profit organizations in our community that serve disfranchised groups; such as the American Red Cross, Greater Kalamazoo United Way, Family Health Center and Ministry with Community to name a few. Borgess also has representation on public and private organizations including the Kalamazoo Chamber of Commerce and the Kalamazoo Valley Community College Foundation.Medical ResearchBorgess Medical Center furthers its mission by contributing funds and personnel to support research that has helped advance medical care. Borgess Research Institute conducts sponsored clinical device and drug trials in the following areas:- Cardiovascular Research: high cholesterol, high blood pressure, heart failure, acute myocardial infaction, patients with acute coronary syndrome undergoing coronary stent placement, carotid stenting, and coronary artery bypass graphs.- Neuroscience Research: Parkinson's Disease, Alzheimer's Disease, Back pain, Spine Surgery, Mild Cognitive Impairment, Peripheral Neuropathy, Migraines, Sleep Disorders, Acute Stroke, Stroke Prevention and Insonomia.Acute Care and Trauma Research: Sepsis, Acute Respitory Distress Syndrome, and Pneumonia.- Other: Erosive Gerd, Chron's Disease, and Infectious Disease. Basic and Molecular Science research is conducted in trauma research looking at ischemia and reperfusion animal models. Cardiovascular basic science research is also conducted at Borgess. Borgess Medical Center utilizes its website to recruit patients for clinical trials. Furthermore, advertising is done on Centerwatch and other research recruiting websites. Medical EducationBorgess Medical Center believes that, in order to provide the best health care to the community, its clinical personnel must receive ongoing medical education. Classes, seminars, and materials are provided to medical residents and staff. Additionally, symposiums such as for Cardiac and Neurology are offered. Summary: Borgess Medical Center 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 II, Community Building Activities: We have a Community Benefit Advisory Committee that includes community leaders from health and human service organizations, the Borgess Health Board of Trustees and leadership that discusses and collaborates on community building activities. Borgess Health is positioned through its membership on 58 local regional and state health, economic and community service boards and advisory committees to help shape the discussion on health issues in the communities we serve. To that end, Borgess has representation on the Boards and/or advisory committees of Southwest Michigan First, Western Michigan University (WMU) School of Medicine, Kalamazoo Valley Community College and WMU Schools of Nursing, Greater Kalamazoo United Way, Blue Cross/ Blue Shield and Priority Health to name a few. Our participation on the Family Health Center (our local FQHC), Kalamazoo County Health Plan and financial support of Michigan State University/Kalamazoo Center for Medical Studies residency program and the Southwest Michigan Cancer Center insure access to care for vulnerable patients. Part III, Line 4: From the consolidated audited financial statements of Ascension Health Alliance and its member entities ("The System") which includes the activity of Borgess Medical Center:The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System 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 the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System'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: The organization has a written debt collection policy and collection procedures will only pertain to patients that do not qualify for charity or financial assistance and who are not complying with payment arrangements that have been agreed to by the hospital and the patient. Part VI, Line 2: Borgess reviews numerous reports and statistics, including epidemiological reports published by the Kalamazoo County Health and Human Services Department, admission and emergency room data to determine where the specific needs of the community are and where we can focus our efforts to offer assistance. Part VI, Line 3: Information regarding financial assistance is posted in the admitting, and registration departments in addition to the emergency department. Borgess has staff dedicated to assisting uninsured patients complete a means test and complete applications for public assistance. Patients are provided with contact numbers on their medical bills to contact the billing office if assistance is needed to pay their bill. We leave it up to the patient to contact us then we direct them through the Charity Care process or applying for other government assistance programs. Part VI, Line 4: Kalamazoo is a two-hospital market with the consumers believing that there are two very good, equal healthcare facilities. However, because it's a newer facility with all private rooms, Bronson's reputation is partially based on facility amenities. Many consumers choose a hospital based on specific service needs and/or physician recommendations and preferences. Outside of Kalamazoo, the Borgess Health service area includes several small rural hospitals and two secondary service level hospitals. Description of Community:Assessment of Kalamazoo County and Borgess Health's Primary Service AreasThe City of Kalamazoo is located within county and represents approximately 30% of the total population. The average annual income of a Kalamazoo county resident is $46,019 annually with 18.6% of the population falling below the poverty level. The current unemployment rate is 8.8%. Southwest Michigan Population Demographics and Trends Southwest Michigan is comprised of a nine-county region that borders Indiana. Kalamazoo County is at the heart of southwest Michigan and is the most densely populated of the nine counties. Together, the neighboring cities of Kalamazoo and Portage within the county represent the largest metropolitan area in the region. For the purpose of the Community Health Needs Assessment, we will define our focus on Kalamazoo County, which includes the cities Kalamazoo and Portage. In 2013 County Health Rankings were released on March 21, 2013 by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Kalamazoo County places in the middle of the 82 Michigan counties at the 46th rank. According to estimates by the U.S. Census, the City of Kalamazoo's population increased 0.64 percent from 74,262 to 74,743 between 2010 and 2011. During the same timeframe, the population of the City of Portage increased 0.71 percent from 46,292 to 46,624. Population Living in Poverty 2008-2010 estimates projected that 19.2% of the Kalamazoo County population or 46,091 people lived below the poverty level. The proportions of people living below the poverty level in Michigan (15.7%) as well as the proportion in the United States (14.4%) were lower than the proportion in Kalamazoo County. Within Kalamazoo County, the proportion of the population living below the poverty level varied by city and township. In 2008-2010, the City of Kalamazoo had the highest poverty rate with 36.0% of residents living below the poverty level. "Poverty estimates for all cities and townships in Kalamazoo County are available from the American Community Survey as an average rate between 2006 and 2010. The highest rate was in the City of Kalamazoo; lowest rates were in Texas Township, Cooper Township, Climax Township, Ross Township, and Prairie Ronde Township." Part VI, Line 5: Borgess provides a number of services to the community at no or a very low cost to the general community and to uninsured patients in our comprehensive Diabetes Uninsured Clinic, Wellness Project offered to adults in Allegan County, pharmaceutical assistance program, and in-home nursing programs. We also provide health screenings e.g., colorectal, immunizations, mammograms and school physicals. Borgess has a history steeped in the tradition of serving the poor and underserved. Borgess leadership including the Board of Trustees are educated on the organization's mission and values and challenge themselves on how to serve the poor and underserved members of our community. Part VI, Line 6: Borgess Medical Center is a wholly owned subsidiary of Borgess Health Alliance, Inc. which 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 served 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, 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. Marian Health System, which was previously sponsored by the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province, became part of Ascension Health on April 1, 2013.The Medical Center, located in Kalamazoo, Michigan, is a nonprofit acute care hospital. The Medical Center provides inpatient, outpatient, and emergency care services for the residents of Kalamazoo, Michigan. Admitting physicians are primarily practitioners in the local area. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.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 which 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 healthcare 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 community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated by reducing charges foregone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care. 1 Southwest Michigan First Corporation 3940 Peninsular Drive SE 180 Grand Rapids MI 49007 382853785 Section 501(c)(3) 106750 General Assistance Greater Kalamazoo United Way 709 South Westnedge Kalamazoo MI 49007 381359193 Section 501(c)(3) 95000 General Assistance Hospital Hospitality House of Kalamazoo Inc 527 West South Street Kalamazoo MI 49007 382540700 Section 501(c)(3) 28000 General Assistance Communities in Schools PO Box 50372 Kalamazoo MI 49007 382873188 Section 501(c)(3) 10000 General Assistance Bishops Annual Appeal 215 North Westnedge Kalamazoo MI 49007 381961750 Section 501(c)(3) 10000 General Assistance 5 0 Part I, Line 2: If grant is for a specific event we usually have a representative attend the function. If it is for non-function activities we usually receive a letter detailing our contribution and what it was used for. X 1 1 0 1 0 0 0 0 0 0 0 Mark Noffsinger MD Sch O Trustee (end 1/14) 767208 0 20000 0 21872 0 45104 0 23043 0 877227 0 0 0 Mirjana Stancic MD Sch O Trustee (start 1/14) 231986 0 12490 0 444 0 31745 0 8823 0 285488 0 0 0 Paul A Spaude CEO - Health System 500635 0 615162 0 178660 0 31771 0 17322 0 1343550 0 132809 0 Richard Felbinger CFO - Health System 279667 0 0 0 74852 0 90527 0 22381 0 467427 0 35129 0 Robert Hill MD Chief Medical Officer 252061 0 0 0 18432 0 36289 0 21532 0 328314 0 0 0 Mark Anthony COO - Health System 277222 0 0 0 29277 0 68887 0 11647 0 387033 0 0 0 J Patrick Dyson Executive VP 326285 0 0 0 263801 0 164606 0 11158 0 765850 0 231894 0 John Ryder COO - Lee & PIPP 161749 0 0 0 23569 0 60471 0 21019 0 266808 0 13285 0 Sreenivas Kamath MD Physician 577692 0 421490 0 22303 0 31292 0 22442 0 1075219 0 0 0 John Gustafson MD Physician 492100 0 480093 0 18348 0 30665 0 20644 0 1041850 0 0 0 David Martin MD Physician 780270 0 50000 0 21818 0 41793 0 20644 0 914525 0 0 0 Thomas Ryan MD Physician 685732 0 133982 0 21435 0 43178 0 20122 0 904449 0 0 0 Vishal Gupta MD Physician 416445 0 272380 0 78885 0 27033 0 12324 0 807067 0 60000 0 Anthony F Olivia Former Chief Medical Officer 107399 0 0 0 2539 0 8500 0 5262 0 123700 0 0 0 Part I, Line 1a An officer is allowed to bring a companion on two travel occasions that the company will pay for and include the cost of that travel in the officer's W-2. Part I, Line 3 Ascension Health, a related organization of Borgess Medical Center uses the following methods to establish the compensation of the organization's CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee. Part I, Line 4b Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. 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 executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year paid. The following individual received payout from Ascension Health's nonqualified retirement plan in the amount as noted: Paul A. Spaude - $132,809 Richard Felbinger - $35,129 J. Patrick Dyson - $231,894 John Ryder - $13,285 Vishal Gupta, M.D. - $60,000 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 sitting on related Borgess Health Alliance, Inc. entity boards. Form 990, Part VI, Section A, line 6 Borgess Medical Center has a single corporate member, Borgess Health Alliance, Inc. Form 990, Part VI, Section A, line 7a Borgess Medical Center has a single corporate member, Borgess Health Alliance, Inc., who has the ability to elect members to the governing body of the Borgess Medical Center. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Borgess Medical Center's financial information or corporation as a whole are subject to approval by its sole corporate member, Borgess Health Alliance, Inc. 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 Board Members' 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 meeting 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 15b In determining the compensation of the organization's CEO, the process, performed by Ascension Health, a related organization of Borgess Medical Center, included a review and approval by independent persons, comparability data and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the committee minutes. The individual was not present when his compensation was decided. In determining the compensation of other officers and key employees of the organization, the process, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive/Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers and key employees were 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 board minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part VII, Section A: Explanation of Compensation Paid to Mark Noffsinger, M.D.: The compensation paid to Mark Noffsinger, M.D. reflects payments for his services as Physician, not remuneration for his participation on the Board of Trustees. Form 990, Part VII, Section A: Explanation of Compensation Paid to Mirjana Stancic, M.D.: The compensation paid to Mirjana Stancic, M.D. reflects payments for her services as Physician, not remuneration for her participation on the Board of Trustees. Form 990, Part XI, line 9: Amortization of Gain on Sale of Buildings 164,608. Transfer to Ascension Health -15,793,376. Deferred Pension Costs -93,505. Transfers to Affiliates -54,397,354. Ascension Health Alliance PO Box 45998 St Louis MO 631455998 453358926 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 63134 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Borgess Health Alliance Inc 1521 Gull Road Kalamazoo MI 49048 382335286 Health System Parent MI Section 501(c)(3) Schedule A, Line 11c Ascension Health 0 Borgess Ambulatory Care Corporation 1521 Gull Road Kalamazoo MI 49048 382468823 Holding Company MI Section 501(c)(3) Schedule A, Line 3 Borgess Health Alliance Inc 1 Borgess Foundation 1521 Gull Road Kalamazoo MI 49048 237222558 Fundraising MI Section 501(c)(3) Schedule A, Line 11c Borgess Health Alliance Inc 1 Borgess Nursing Home 3057 Gull Road Kalamazoo MI 490481281 382555589 Residential Care MI Section 501(c)(3) Schedule A, Line 3 Borgess Health Alliance Inc 1 Lee Memorial Hospital Corporation 420 West High Street Dowagiac MI 49047 381490190 Healthcare Services MI Section 501(c)(3) Schedule A, Line 3 Borgess Health Alliance Inc 1 Lee Memorial Foundation 420 West High Street Dowagiac MI 49047 382860459 Fundraising MI Section 501(c)(3) Schedule A, Line 11c Borgess Health Alliance Inc 1 ProMed Healthcare 1521 Gull Road Kalamazoo MI 49048 383193801 Healthcare Services MI Section 501(c)(3) Schedule A, Line 9 Borgess Health Alliance Inc 1 Visiting Nurses Home Care DBA Borgess VNA Home Care 348 North Burdick Kalamazoo MI 49007 382717691 Home Healthcare Services MI Section 501(c)(3) Schedule A, Line 9 Borgess Health Alliance Inc 1 Textile Systems Inc 817 Walbridge Kalamazoo MI 49007 382705047 Laundry Services MI Borgess Medical Center C 2597556 993079 1.00000 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 ProMed Healthcare I 112167 Actual Amount Transferred ProMed Healthcare O 50739926 Actual Amount Transferred Borgess Ambulatory Care Corporation P 25692447 Actual Amount Transferred Borgess Health Alliance Inc P 45090064 Actual Amount Transferred Borgess Foundation P 745553 Actual Amount Transferred ProMed Healthcare P 12493912 Actual Amount Transferred Borgess Ambulatory Care Corporation Q 26624233 Actual Amount Transferred Borgess Nursing Home Q 12614899 Actual Amount Transferred ProMed Healthcare Q 31372329 Actual Amount Transferred Lee Memorial Hospital Corporation Q 18432166 Actual Amount Transferred Borgess Ambulatory Care Corporation R 931787 Actual Amount Transferred Ascension Health R 15793376 Actual Amount Transferred Borgess Nursing Home S 13266971 Actual Amount Transferred Visiting Nurses Home Care S 1298441 Actual Amount Transferred Borgess Foundation S 724403 Actual Amount Transferred ProMed Healthcare S 776531 Actual Amount Transferred Lee Memorial Hospital Corporation S 23172390 Actual Amount Transferred