2014-05-13T10:10:17-05:00 2013-06-30 990 2012-07-01 382113393 TRINITY HEALTH - MICHIGAN TRIN 7343431000 20555 VICTOR PARKWAY LIVONIA MI 481527018 BENJAMIN CARTER 7343431000 2014-05-10 2012 2015-11-30 17:44:51Z SEE SCHEDULE O FOR LIST RICHARD GILFILLAN MD 20555 VICTOR PARKWAY LIVONIA MI 481527018 2494530645 0 X WWW.TRINITY-HEALTH.ORG X 1976 MI HEALTH CARE SERVICES 5 4 20122 2420 44284775 -518541 20715254 17760337 2295921306 2321925909 21215855 46159381 76992243 89948230 2414844658 2475793857 1478755 1573554 0 0 1032442355 1057257330 165614 28876 4371226 1253065422 1278102676 2287152146 2336962436 127692512 138831421 3446109503 3000851139 1213866974 1301210075 2232242529 1699641064 HEALTH CARE SERVICES - SEE SCHEDULE H FOR MORE INFORMATION 0 0 2166572274 1573554 2320122401 TRINITY HEALTH - MICHIGAN OPERATED HOSPITALS IN 7 AREAS OF MICHIGAN THAT PROVIDED 502,648 DAYS OF HEALTHCARE SERVICES TO THEIR COMMUNITIES.THE MISSION STATEMENT OF TRINITY HEALTH - MICHIGAN IS AS FOLLOWS:WE, CHE TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. 2166572274 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 1 0 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 0 0 1 3229 2 1 20122 1 1 1 1 CJ 0 0 0 1 1 0 0 0 0 X 5 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X BETH GDOWIK 7343431000 20555 VICTOR PARKWAY LIVONIA MI 481527018 X JOSEPH SWEDISH 1.00 54.00 X X 0 3233500 601476 LARRY WARREN 5.00 50.00 X X 0 25000 0 JUDITH PERSICHILLI 1.00 54.00 X X 0 3890553 17510 MARY MOLLISON CSA 2.00 14.00 X X 0 0 0 MELANIE DREHER PHD RN 2.00 14.00 X X 0 25000 0 BARBARA WHEELEY RSM 1.00 7.00 X X 0 0 0 SUZANNE BRENNAN CSC 1.00 7.00 X 0 0 0 JOSE SANTILLAN 1.00 7.00 X 0 22750 0 STANLEY URBAN 1.00 7.00 X 0 0 0 PAUL NEUMANN 2.00 48.00 X 0 812881 106329 AGNES HAGERTY 2.00 48.00 X 0 368657 54774 JENNIFER BARNETT 1.00 49.00 X 0 927285 22601 BENJAMIN CARTER 5.00 45.00 X 0 799303 112810 JAMES BOSSCHER 1.00 49.00 X 0 586570 91437 KEDRICK ADKINS 1.00 54.00 X 0 1821619 126167 RICHARD O'CONNELL 1.00 54.00 X 0 1036410 130423 GARRY FAJA 49.40 0.60 X 0 969031 84796 PHILIP MCCORKLE 47.50 2.50 X 0 653026 57962 JACK WEINER 50.00 0.00 X 0 637507 136477 ROBERT CASALOU 49.00 1.00 X 0 619307 97325 DAVID SPIVEY 49.00 1.00 X 0 528816 97710 CHARLES HOFFMAN SJMHS CFO THR 812 48.40 1.60 X 0 510320 53956 NANCY GRAEBNER 50.00 0.00 X 0 405132 50086 BARBARA HERTZLER 50.00 0.00 X 0 404465 63279 RANDALL WAGNER 50.00 0.00 X 0 367660 42797 JOHN MACLEOD 49.00 1.00 X 0 350474 74435 ROBERT SMYTHE 50.00 0.00 X 0 345864 35056 STEPHANIE RIEMER-MATUZAK 50.00 0.00 X 0 330437 85728 MICHAEL GUSHO 50.00 0.00 X 0 329828 61518 CLAUDE LAUDERBACH 50.00 0.00 X 0 275454 60877 DEBORAH ARMSTRONG 50.00 0.00 X 0 260000 19850 REBEKAH SMITH 49.00 1.00 X 0 245685 52990 MICHAEL SAMYN 50.00 0.00 X 0 243268 37110 KATHLEEN O'CONNOR 50.00 0.00 X 276459 0 59752 KRISTOPHER AALDERINK 50.00 0.00 X 959499 0 26978 CREG CARPENTER 50.00 0.00 X 747211 0 30925 GEORGE GIBSON 50.00 0.00 X 720682 0 20024 TALLAL ZENI 50.00 0.00 X 718204 0 39328 MARK KELLEY 50.00 0.00 X 713255 0 37159 DANIEL HALE 0.00 50.00 X 0 856049 63490 MARIANNE CUNNINGHAM 0.00 45.00 X 0 165279 32527 STEPHEN PIROG 10.00 0.00 X 0 236406 53138 PETER KARADJOFF 0.00 0.00 X 0 117000 18595 PAUL BROWNE 0.00 0.00 X 0 480030 41852 DEBRA CANALES 0.00 50.00 X 0 852044 102033 PAUL CONLON 0.00 50.00 X 0 488655 114364 LOUIS FIERENS 0.00 50.00 X 0 518640 68929 PRESTON GEE 0.00 50.00 X 0 468475 79749 MICHAEL HOLPER 0.00 50.00 X 0 450005 94299 TERRENCE O'ROURKE 0.00 50.00 X 0 964005 56964 MARIA SZYMANSKI 0.00 50.00 X 0 624384 76589 ROGER SPOELMAN 0.00 50.00 X 0 724012 125216 GREGORY LOOMIS 0.00 50.00 X 0 368881 52203 GARY ALLORE 0.00 50.00 X 0 334125 39015 MICHAEL MURPHY 0.00 0.00 X 0 180882 16630 4135310 28854674 3625238 861 1 1 0 BARTON MALOW COMPANY 26500 AMERICAN DRIVE SOUTHFIELD MI 48034 CONSTRUCTION SERVICES 35054504 THE CHRISTMAN COMPANY 208 N CAPITOL AVENUE LANSING MI 48933 CONSTRUCTION SERVICES 31549161 GRANGER CONSTRUCTION COMPANY 6267 AURELIUS RD LANSING MI 48911 CONSTRUCTION SERVICES 28800315 PINE REST CHRISTIAN HOSPITAL 300 68TH ST GRAND RAPIDS MI 49548 HEALTH CARE SERVICES 23492934 MICHIGAN MULTISPECIALTY PHYSICIANS 2350 GREEN RD STE 170 ANN ARBOR MI 48105 HEALTH CARE SERVICES 8313142 251 108672 1722515 231716 3376996 12320438 526514 17760337 NET PATIENT SVC REV 900099 2240339007 2240339007 PHARMACY REVENUE 446110 60542066 22791800 37750266 LABORATORY REVENUE 621500 21044836 21044836 2321925909 31486504 31486504 11361185 14061708 -2700523 -2700523 -2700523 13818107 2430944 0 1576174 13818107 854770 14672877 14672877 759871 1722515 1222392 -462521 -462521 40978 17626 23352 23352 3515954 1858888 1657066 1657066 MEDICARE/MEDICAID HIT 900099 16931642 16931642 CAFETERIA REVENUE 900099 11199323 11199323 PROVIDER INCENTIVE 900099 3798385 3798385 59501506 59053367 448139 91430856 2475793857 2320122401 44284775 93626344 1524082 1524082 49472 49472 9834919 9834919 381346 168110 213236 845263936 767161222 76188166 1914548 55092992 50159869 4933123 86896204 78208923 8352569 334712 59787933 53685169 5965019 137745 927664 834898 92766 1746109 1746109 18844 18844 32000 32000 28876 28876 207298050 185402692 20600299 1295059 9000175 8013147 890350 96678 35087388 33122529 1743291 221568 92071064 82863958 9207106 43046434 40875089 2151320 20025 2599090 2452504 129079 17507 1882470 1686832 187426 8212 33353584 33331633 21951 138059427 131153521 6902816 3090 15004395 14254175 750220 MEDICAL SUPPLIES 371455954 371434648 21306 BAD DEBT 106795067 106795067 INTERCO. PURCHASED SVCS 81493272 73285269 8142808 65195 HOSPITAL PROVIDER TAX 54153373 54153373 84078316 75956092 7937470 184754 2336962436 2166572274 166018936 4371226 11754754 13476573 2569346 2068643 11601508 10804980 279854428 251580301 7029712 24190179 34246486 37335081 9873081 15230738 2680669640 1426603454 1155447596 1254066186 369836717 563314428 588998271 529193813 32123701 31939271 942773903 267650946 3446109503 3000851139 209014224 239435280 623801 1735530 22795354 23531943 981433595 1036507322 1213866974 1301210075 X 2207268592 1670489813 12288809 15883496 12685128 13267755 2232242529 1699641064 3446109503 3000851139 X 138831421 20621737 -692054623 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 117990 1 109440 0 0 227430 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: TRINITY HEALTH - MICHIGAN (TH-MI) HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS. THESE ORGANIZATIONS HAVE PROVIDED TH-MI WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. SIMILARLY, THESE HEALTH CARE ORGANIZATIONS WILL ARRANGE CONFERENCES AND SEMINARS FOR MEMBER ORGANIZATIONS AND THEIR EXECUTIVES WHICH INVOLVE LEGISLATORS OR OTHER POLITICAL FIGURES AS GUEST SPEAKERS. TH-MI ALSO PAID A THIRD PARTY LOBBYING FIRM DURING THE YEAR TO LOBBY FOR OR AGAINST LEGISLATION DETERMINED TO BE OF INTEREST AND CONCERN TO TH-MI. FEDERAL AND STATE ADVOCACY PRIORITIES FOR FY13 INCLUDED: - ENSURING MAXIMUM COVERAGE AND ACCESS, INCLUDING SUPPORTING EXCHANGE IMPLEMENTATION AND MEDICAID EXPANSION - DRIVING QUALITY AND EFFICIENCY ACROSS THE CONTINUUM OF CARE WITH VALUE-BASED, SUSTAINABLE PAYMENT MODELS LOBBYING ACTIVITY PERFORMED BY TRINITY HEALTH - MICHIGAN INCLUDED: - ENCOURAGEMENT OF ASSOCIATES TO WRITE LETTERS TO PUBLIC OFFICIALS - AN "ADVOCACY ACTION" WEBSITE TO ENGAGE ASSOCIATES IN FEDERAL ADVOCACY - DESIGNATE AN ADVOCACY LIAISON - ENGAGEMENT OF A LOBBYIST IN WASHINGTON, D.C. BY TRINITY HEALTH CORPORATION - LEGISLATOR VISITS - COLLABORATION WITH THE CATHOLIC HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION - ADVOCACY ACTION DAYS AT THE FEDERAL LEVEL, ATTENDED BY TRINITY HEALTH - MICHIGAN EXECUTIVES 14089151 197316 1027047 641736 14671778 15077828 -176284 -812393 14089151 14367389 223954 486485 15077828 13827175 203571 336643 14367389 13890593 378849 -442267 13827175 0.08520 0.90430 0.01050 0 1 1 68152219 68152219 1570704400 758900127 811804273 853547265 656466554 197080711 188265756 11236773 177028983 1254066186 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 161998106 F EQUITY METHOD INVESTMENTS 194397727 C HEDGE FUNDS 172797980 F 529193813 OTHER RECEIVABLES 20905334 INTERCOMPANY ACCOUNTS RECEIVABLE 104176703 INVESTMENT IN UNCONSOLIDATED AFFILIATES 28761743 INTERCOMPANY OTHER LT ASSETS 113145738 OTHER ASSETS 661428 267650946 INTERCOMPANY ACCOUNTS PAYABLE 73191310 DEFERRED COMPENSATION 9684408 ASSET RETIREMENT OBLIGATION (FIN 47) 2607527 OTHER LIABILITIES 2896518 ANNUITIES PAYABLE 1755085 INTERCOMPANY NOTES PAYABLE 946124744 LEASE OBLIGATION 247730 1036507322 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO BE USED FOR THE FOLLOWING PURPOSES: HOSPITAL OPERATIONS SUPPORT, MEDICAL PROGRAM SUPPORT, SCHOLARSHIPS, RESEARCH, COMMUNITY SERVICE, AND VARIOUS OTHER. X X 1 HARRIS CONNECT LLC 1400-A CROSSWAYS BLVD CHESAPEAKE VA 23320 EXPLORATORY AND TIER II PHONE CALLS 0 0 28876 -28876 28876 -28876 MI HOLIDAY BALL -ANN ARBOR 765127 605711 159416 60678 201827 11200 193612 SPRING AUCTION -CHELSEA 309719 241096 68623 1450 7818 93544 29 1407540 875708 531832 2324 57198 223139 24175 345427 2482386 1722515 759871 2324 119326 432784 35375 632583 1222392 -462521 40978 3594 13332 700 1 1.00000 40978 3594 13332 700 17626 23352 MI 1 0 1 0 1.00000 BRANDY MARINO ST JOSEPH MERCY HEALTH SYSTEM 5305 E HURON RIVER DR PO BOX 995 ANN ARBOR MI 48106 0 BRANDY MARINO ST JOSEPH MERCY HEA 1144 FINANCIAL REPORTING, CASH DEPOSITS. X 0 EXPLANATION OF FUNDRAISING PAYMENTS SCHEDULE G, PART I, LINE 2B, COLUMN (V) TRINITY HEALTH - MICHIGAN PAID HARRIS CONNECT, LLC $276 IN REIMBURSEMENT OF EXPENSES. THE AGREEMENT SPECIFIES THAT ALL ITEMIZED EXPENSES FOR FUNDRAISING MATERIALS AND SUPPLIES WILL BE FULLY REIMBURSED AND THE FEE FOR FUNDRAISING WILL BE BASED ON THE MONTHLY CONTRACTED FEE. 1 1 X 1 X 1 X 1 1 0 1 1 9 82489 56375109 11782539 44592570 0.02000 9 245728 223402438 170845306 52557132 0.02360 11 72386 20967713 11710156 9257557 0.00420 29 400603 300745260 194338001 106407259 0.04780 143 499534 10260792 3112133 7148659 0.00320 23 1198 71052263 41218904 29833359 0.01340 29 108412 51966619 31024406 20942213 0.00940 2 23 5211070 0 5211070 0.00230 48 13191 963540 95132 868408 0.00040 245 622358 139454284 75450575 64003709 0.02870 274 1022961 440199544 269788576 170410968 0.07650 1 326 326 0.00000 2 56 2037 2037 0.00000 5 1013 21879 21879 0.00000 3 2145 21883 21883 0.00000 6 112 237494 237494 0.00010 17 3326 283619 283619 0.00010 0 37177672 12022566 621471061 591383086 30087975 X 1 1 1 CENTER FOR DIGESTIVE CARE LLC SURGICAL CENTER 0.51000 0.49000 2 FRANCES WARDE MEDICAL LABORATORY LABORATORY SERVICES 0.66670 0.33330 3 WOODLAND IMAGING CENTER LLC DBA AVANT IMAGING IMAGING SERVICES 0.51000 0.49000 4 HEALTH PARK CENTRAL LLC MEDICAL OFFICE BUILDING 0.10550 0.82490 5 SIXTY FOURTH STREET LLC SURGICAL CENTER 0.51000 0.46770 6 MERCY PHYSICIAN COMMUNITY PHO LLC CONTRACTING AND SERVICES 0.50000 0.50000 7 NEWCO AMBULATORY SURGERY CENTER LLP DBA LAKESHORE SURGERY CENTER LLP SURGICAL CENTER 0.50000 0.50000 8 WATERFORD SURGICAL CENTER LLC SURGICAL CENTER 0.40000 0.57580 9 CRAWFORD MERCY PHO CONTRACTING SERVICES 0.50000 0.50000 10 WEXFORD MERCY PHO CONTRACTING SERVICES 0.50000 0.50000 11 ADVANTAGE HEALTHSAINT MARY'S CARE NETWORK HOSPITAL/PHYSICIAN INTEGRATION 0.50000 0.50000 9 1 ST JOSEPH MERCY ANN ARBOR

5301 MCAULEY DR YPSILANTI MI 48197

WWW.STJOESHEALTH.ORG X X X X 2 MERCY HEALTH ST MARY'S

200 JEFFERSON STREET SE GRAND RAPIDS MI 49503

WWW.MERCYHEALTHSAINTMARYS.COM X X X X 3 ST JOSEPH MERCY OAKLAND

44405 WOODWARD AVE PONTIAC MI 48341

WWW.STJOESOAKLAND.ORG X X X X 4 ST MARY MERCY LIVONIA

36475 FIVE MILE RD LIVONIA MI 48154

WWW.STMARYMERCY.ORG X X X X 5 CHELSEA COMMUNITY HOSPITAL

775 S MAIN CHELSEA MI 48118

WWW.CCH.ORG X X X 6 ST JOSEPH MERCY LIVINGSTON

620 BYRON RD HOWELL MI 48843

WWW.STJOESLIVINGSTON.ORG X X X X 7 ST JOSEPH MERCY PORT HURON

2601 ELECTRIC AVE PORT HURON MI 48060

WWW.MYMERCY.US X X X 8 MERCY HOSPITAL GRAYLING

1100 EAST MICHIGAN AVE GRAYLING MI 49738

WWW.MERCYHEALTHGRAYLING.COM X X X 9 MERCY HOSPITAL CADILLAC

400 HOBART STREET CADILLAC MI 49601

WWW.MERCYHEALTHCADILLAC.COM X X X ST JOSEPH MERCY ANN ARBOR 1 1 X X X X X X X X 11 1 1 1 X X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X 1 0 X X X X 1 X 0 0 MERCY HEALTH SAINT MARY'S 2 1 X X X X X X X X X 11 1 1 1 X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X 1 0 X X X X 1 X 0 0 ST JOSEPH MERCY OAKLAND 3 1 X X X X X X X X X 11 1 0 1 X X X X X X X 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X 1 0 X X X X 1 X 0 0 ST MARY MERCY LIVONIA 4 1 X X X X X X X X X 11 1 0 1 X X X X X X X X X 0 0 1 1 100.000000000000 1 400.000000000000 1 X X X X X X 1 1 X 1 0 X X X X 1 X 0 0 ST JOSEPH MERCY LIVINGSTON 6 1 X X X X X X X X 11 1 1 1 X X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X 1 0 X X X X 1 X 0 0 CHELSEA COMMUNITY HOSPITAL 5 1 X X X X X X X X X 11 1 0 1 X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X 1 0 X X X X 1 X 0 0 ST JOSEPH MERCY PORT HURON 7 1 X X X X X X X X 12 1 0 1 X X X X X X X 1 0 1 1 150.000000000000 1 400.000000000000 1 X X X X X X 1 1 X 1 0 X X X X 1 X 0 0 MERCY HOSPITAL GRAYLING 8 1 X X X X X X X X X 11 1 0 1 X X X X X X X X X 0 0 1 1 100.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 MERCY HOSPITAL CADILLAC 9 1 X X X X X X X X X 11 1 0 1 X X X X X X X X X X 1 0 1 1 100.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 105 (ANN ARBOR) MICHIGAN HEART & VASCULAR IN

5325 ELLIOTT DR YPSILANTI MI 48197

CARDIOVASCULAR CARE (AA) ST JOSEPH MERCY BRIGHTON

7575 GRAND RIVER RD BRIGHTON MI 48114

LAB, IMAGING, THERAPY, AMBULATORY SURG., EMPLOYED PHYS, ONCOLOGY, 24 HR EMER (AA) REICHERT HEALTH CENTER

5333 MCAULEY DR YPSILANTI MI 48197

LAB, IMAGING, AMBULATORY SURG., EMPLOYED PHYSICIANS (AA) ST JOSEPH MERCY CANTON HEALTH CTR

1600 CANTON CENTER RD CANTON MI 48188

LAB, IMAGING, EMERGENCY SERVICES, THERAPY, ONCOLOGY, AMBULATORY SURG. (AA) MICHIGAN ORTHOPEDIC CENTER

5315 ELLIOTT DR YPSILANTI MI 48197

ORTHOPEDIC CARE (AA) ST JOSEPH MERCY SALINE

400 W RUSSELL ST SALINE MI 48176

LAB, IMAGING, EMERGENCY SERVICES (AA) ELLEN THOMPSON WOMEN'S CENTER

5320 ELLIOTT DR YPSILANTI MI 48197

WOMEN'S HEALTH (AA) CHELSEA PROFESSIONAL OFFICE BLDG

14650 OLD US 12 CHELSEA MI 48118

PHARMACY, ONCOLOGY, EMPLOYED PHYSICIANS (AA) MARIAN PROFESSIONAL BUILDING

14555 LEVAN RD LIVONIA MI 48154

RADIATION ONCOLOGY, REHAB, MRI, EMPLOYED PHYSICIANS (AA) SLEEP DISORDERS CENTER

5305 ELLIOTT DR YPSILANTI MI 48197

SLEEP CLINIC (AA) MICHIGAN HEART BUILDING

309 PAGE AVE JACKSON MI 49201

EMPLOYED PHYSICIANS (AA) CHELSEA HEALTH & WELLNESS CENTER

20800 OLD US 12 CHELSEA MI 48118

REHAB (AA) ST JOSEPH MERCY MAPLE HEALTH BLDG

501 N MAPLE RD ANN ARBOR MI 48103

URGENT CARE (AA) HURON OAKS

5401 MCAULEY DR YPSILANTI MI 48197

BEHAVIORAL MEDICINE (AA) LIVINGSTON OBGYN ASSOCIATES

524 BYRON RD HOWELL MI 48843

EMPLOYED PHYSICIANS (AA) SJMHS OUTPATIENT CLINIC

2310 E STADIUM BLVD ANN ARBOR MI 48104

REHAB (AA) HAAB HEALTH BUILDING

111 N HURON ST YPSILANTI MI 48197

EMPLOYED PHYSICIANS (AA) SALINE PROFESSIONAL OFFICE BLDG

420 W RUSSELL ST SALINE MI 48176

REHAB (AA) CENTER FOR DIGESTIVE CARE

5300 ELLIOTT DR YPSILANTI MI 48197

DIGESTIVE CARE (AA) SALINE ADULT & PEDIATRIC MEDICINE

182 S INDUSTRIAL DR SALINE MI 48176

EMPLOYED PHYSICIANS (AA) MICHIGAN HEART MILAN

870 E ARKONA RD MILAN MI 48160

EMPLOYED PHYSICIANS (AA) MICHIGAN HEART BUILDING

1548 W MAUMEE ST ADRIAN MI 49221

EMPLOYED PHYSICIANS (AA) MONUMENT PARK BUILDING

8031 MAIN ST DEXTER MI 48130

EMPLOYED PHYSICIANS (AA) ST JOSEPH MERCY ARBOR HEALTH CTR

990 W ANN ARBOR TRAIL PLYMOUTH MI 48170

LAB (AA) SUMMERWOOD CENTER

10299 E GRAND RIVER BRIGHTON MI 48116

BEHAVIORAL MEDICINE (AA) ARBOR PARK CENTRE

4972 CLARK RD YPSILANTI MI 48197

LAB (AA) CHERRY HILL LAB

49650 CHERRY HILL RD CANTON MI 48187

LAB (AA) ST JOSEPH MERCY BEHAVIORAL SVCS

2200 CANTON CENTER RD CANTON MI 48188

BEHAVIORAL MEDICINE (AA) ST JOSEPH MERCY CHEMICAL DEPENDENT

2008 HOGBACK RD ANN ARBOR MI 48105

BEHAVIORAL MEDICINE (AA) GENOA MEDICAL CENTER

2305 GENOA BUSINESS PARK DR BRIGHTON MI 48114

LAB (AA) FAMILY MEDICINE OF STOCKBRIDGE

4525 S M-52 STOCKBRIDGE MI 49285

EMPLOYED PHYSICIANS (AA) ARBOR SCIO PROFESSIONAL BUILDING

6360 JACKSON RD ANN ARBOR MI 48103

LAB (AA) PARKWAY MEDICAL CENTER

2345 S HURON PKWY ANN ARBOR MI 48104

LAB (AA) TOWSLEY HEALTH BUILDING

5361 MCAULEY DR YPSILANTI MI 48197

NURSING HOME, EMPLOYED PHYS. (AA) SAMARITAN CENTER

5555 CONNER DETROIT MI 48213

INDIGENT CARE (AA) HURON PROFESSIONAL BUILDING

704 W HURON ST ANN ARBOR MI 48103

LAB (AA) DIAGNOSTIC SERVICES CENTER

202 E VAN RIPER RD FOWLERVILLE MI 48836

LAB, IMAGING (AA) MICHIGAN HEART BUILDING

200 ARNET ST YPSILANTI MI 48198

EMPLOYED PHYSICIANS (CADILLAC) CADILLAC SURGICAL CARE

927 SOUTH CARMEL STREET CADILLAC MI 49601

EMPLOYED PHYSICIANS (CAD) MERCY OBGYN PARTNERS

7985 MACKINAW TRAIL CADILLAC MI 49601

EMPLOYED PHYSICIANS (CAD)MERCY HEALTH PHYSICIAN PARTNERS

7985 MACKINAW TRAIL CADILLAC MI 49601

EMPLOYED PHYSICIANS (CAD)MERCY HEALTH PHYSICIAN PARTNERS

100 NORTH ROLAND MCBAIN MI 49657

EMPLOYED PHYSICIANS (GRAND RAPIDS) WEGE BUILDING

300 LAFAYETTE GRAND RAPIDS MI 49503

LAB, FAMILY PRACTICE, INTERNAL MEDICINE PRACTICE (GR) SAINT MARY'S SOUTHWEST

2373 64TH STREET SW BYRON CENTER MI 49315

AMBULATORY SURGICAL CTR, URGENT CARE CTR, REHAB, LAB, IMAGING, EMPLOYED PHYS (GR) ADVANTAGE HEALTH BUILDING

1471 EAST BELTLINE GRAND RAPIDS MI 49525

LAB, IMAGING, REHAB, EMPLOYED PHYS., URGENT CARE, OB (GR) CLINICA SANTA MARIA

730 GRANDVILLE AVE SW GRAND RAPIDS MI 49503

INDIGENT PRIMARY CARE CENTER (GR) PINE REST

300 68TH STREET SE GRAND RAPIDS MI 49548

MENTAL HEALTH (GR) SPARTA FAMILY HEALTH CENTER

475 S STATE ST SPARTA MI 49345

FAMILY PRACTICE CENTER (GR) BROWNING CLAYTOR HEALTH CENTER

1246 MADISON SE GRAND RAPIDS MI 49507

FAMILY PRACTICE CENTER (GR) HEARTSIDE HEALTH CLINIC

359 S DIVISION GRAND RAPIDS MI 49503

INDIGENT PRIMARY CARE CENTER (GR) RIVERTOWN BUILDING

3380 44TH STREET SW GRANDVILLE MI 49418

LAB, IMAGING, REHAB, FAMILY PRACTICE (GR) STANDALE BUILDING

1175 WILSON AVE NW WALKER MI 49534

LAB, IMAGING, REHAB, FAMILY PRACTICE (GR) 310 LAFAYETTE BUILDING

310 LAFAYETTE SE GRAND RAPIDS MI 49503

IMMUNOLOGY (GR) ADVANTAGE HEALTH BUILDING

10047 CROSS ROADS COURT CALEDONIA MI 49316

LAB, IMAGING, REHAB, FAMILY PRACTICE (GR) GRSPORTS CENTER

1640 E PARIS AVE SE GRAND RAPIDS MI 49546

REHAB (GR) MICHIGAN ATHLETIC CLUB

2500 BURTON SE GRAND RAPIDS MI 49546

REHAB (GR) GREEN STREET BUILDING

1375 W GREEN ST HASTINGS MI 49058

REHAB (GR) GEORGETOWN BUILDING

1915 GEORGETOWN CENTER DR JENISON MI 49428

REHAB (GR) DAVID D HUNTING YMCA

475 LAKE MICHIGAN DR NW GRAND RAPIDS MI 49504

REHAB (GR) CHERRY BUILDING

245 CHERRY ST GRAND RAPIDS MI 48503

REHAB, PEDIATRIC CLINIC, FAMILY MEDICINE AND OB (GR) ADVANTAGE HEALTH BUILDING

5171 PLAINFIELD NE GRAND RAPIDS MI 49525

FAMILY PRACTICE CENTER (GR) SAINT MARY'S LAB NORTHWEST

933 THREE MILE NW GRAND RAPIDS MI 49504

LAB, REHAB, FAMILY PRACTICE (GR) ADVANTAGE HEALTH BUILDING

7782 20TH AVENUE JENISON MI 49428

FAMILY PRACTICE CENTER (GR) SOUTHEAST ADVANTAGE HEALTH BUILDING

2080 44TH ST SE KENTWOOD MI 49508

REHAB, LAB, FAMILY PRACTICE (GR) ADVANTAGE HEALTH BUILDING

6050 NORTHLAND DR NE ROCKFORD MI 49341

FAMILY PRACTICE CENTER (GR) JEFFERSON BUILDING

260 JEFFERSON SE GRAND RAPIDS MI 49503

LAB (GRAYLING) MERCY MANOR

1200 EAST MICHIGAN AVE GRAYLING MI 49738

LONG TERM CARE (GRAY) MERCY FAMILY CARE GRAYLING

1250 EAST MICHIGAN AVE GRAYLING MI 49738

EMPLOYED PHYSICIANS (GRAY) MERCY FAMILY CARE ROSCOMMON

234 LAKE STREET ROSCOMMON MI 48653

EMPLOYED PHYSICIANS (GRAY) MERCY COMMUNITY HEALTH CENTER

2585 WEST HOUGHTON LAKE DRIVE PRUDENVILLE MI 48651

REHAB, IMAGING, LAB, EMPLOYED PHYSICIANS (GRAY) AUSABLE UROLOGY

809 MICHIGAN AVE GRAYLING MI 49738

EMPLOYED PHYSICIANS (GRAY) MILTOWN CLINIC

1200 W NORTH DOWN RIVER RD GRAYLING MI 49738

EMPLOYED PHYSICIANS (OAKLAND)SJMO MEDICAL OFFICE BUIDING

44555 WOODWARD AVE PONTIAC MI 48341

LAB, IMAGING, VASCULAR SURGERY, GENERAL SURGERY, CARDIOTHORACIC SURGERY, BAR (OA) BALD MOUNTAIN REGIONAL MEDICAL

1375 S LAPEER RD LAKE ORION MI 48360

URGENT CARE, LAB, IMAGING, INTERNAL MED/PEDS (OA) WOODWARD PROFESSIONAL BUILDING

44428 WOODWARD AVE PONTIAC MI 48341

REHAB, OB/GYN CLINIC, PARTIAL PSYCH HOSPITAL (OA) MERCY MEDICAL GROUP-OAKLAND PHYSICI

5210 HIGHLAND RD WATERFORD MI 48327

INTERNAL MEDICINE, URGENT CARE, LAB, IMAGING (OA) BERKLEY MEDICAL CENTER

1695 W 12 MILE RD BERKLEY MI 48072

INTERNAL MEDICINE, IMAGING, LAB (OA) SLEEP DISORDERS CLINIC

3100 CROSS CREEK PKWY AUBURN HILLS MI 48341

SLEEP CLINIC (OA) INDEPENDENCE POINTE

7210 ORTONVILLE RD CLARKSTON MI 48346

LAB (OA) KAROTECH BUILDING

2630 UNION LAKE RD COMMERCE TOWNSHIP MI 48382

PEDS, LAB (OA) BLOOMFIELD LAB

42557 WOODWARD AVE BLOOMFIELD HILLS MI 48304

LAB (OA) WHITE LAKE

320 TOWN CENTER BLVD WHITE LAKE TWP MI 48386

URGENT CARE, LAB, IMAGING, REHAB (OA) SHORES III PROFESSIONAL BUILDING

2300 HAGGERTY RD WEST BLOOMFIELD MI 48323

IMAGING (OA) WATERFORD SURGICAL CENTER

5220 HIGHLAND RD WATERFORD MI 48327

SURGICAL CENTER (OA) MERCY MEDICAL GROUP-ROCHESTER

1854 W AUBURN RD ROCHESTER HILLS MI 48309

INTERNAL MEDICINE/PEDS, OB/GYN (OA) CLARKSTON

6770 DIXIE HWY CLARKSTON MI 48346

OB/GYN, FAMILY MED (OA) LEXUS PROFESSIONAL BUILDING

44200 WOODWARD AVE PONTIAC MI 48341

LAB (OA) SAINT JOSEPH MERCY OAKLAND BIRMINGH

2110 E MAPLE RD BIRMINGHAM MI 48009

URGENT CARE, LAB, IMAGING (OA) MERCY MEDICAL GROUP-BLOOMFIELD HILL

1750 TELEGRAPH RD BLOOMFIELD HILLS MI 48302

OB/GYN (OA) LAKE ORION REHABILITATION CENTER

3800 BALDWIN RD ORION TOWNSHIP MI 48359

REHAB (OA) BLOOMFIELD HILLS IM

2520 S TELEGRAPH RD BLOOMFIELD HILLS MI 48302

INTERNAL MEDICINE (OA) PONTIAC OBGYN

989 UNIVERSITY DR PONTIAC MI 48342

OB/GYN (OA) OAKLAND MEDICAL GROUP

3950 S ROCHESTER ROAD ROCHESTER HILLS MI 48307

OB/GYN (OA) OAKLAND MEDICAL GROUP

27301 DEQUINDRE ROAD MADISON HEIGHTS MI 48071

OB/GYN (OA) CLINICA SANTA TERESA MERCY PLACE

55 CLINTON ST PONTIAC MI 48342

OUTPATIENT CLINIC (PORT HURON) MERCY HEALTH CENTER

4190 24TH AVE FORT GRATIOT MI 48059

LAB, IMAGING, URGENT CARE (PH) MERCY FITRAC

2615 ELECTRIC AVE PORT HURON MI 48060

PHYSICAL THERAPY (PH) FITRAC - MARYSVILLE

782 HURON BLVD MARYSVILLE MI 48040

PHYSICAL THERAPY (PH) DR MOREY'S MERCY SURGERY CARE

2609 ELECTRIC AVE STE B PORT HURON MI 48060

EMPLOYED SURGEON (PH) PEOPLES' CLINIC FOR BETTER HEALTH

3110 GOULDEN ST PORT HURON MI 48060

OUTPATIENT CLINIC (PH) GEORGE CARLEY ASSOCIATES

1943 HOLLAND PORT HURON MI 48060

LAB (PH) DR JERRY

600 FORT STREET PORT HURON MI 48060

LAB (PH) DR JARAD

2540 16TH STREET PORT HURON MI 48060

LAB (PH) NORTH BUILDING

2306 ELECTRIC AVE PORT HURON MI 48060

LAB (OTHER) FRANCES WARDE MEDICAL LABORATORY

300 W TEXTILE RD ANN ARBOR MI 48104

LAB PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: TRINITY HEALTH - MICHIGAN REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG. IN ADDITION, THE HOSPITAL DIVISIONS OF TRINITY HEALTH - MICHIGAN INCLUDE A COPY OF THEIR MOST RECENT SCHEDULE H ON THEIR RESPECTIVE WEBSITES. TRINITY HEALTH ALSO INCLUDES TRINITY HEALTH - MICHIGAN'S MOST RECENTLY FILED SCHEDULE H ON ITS WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITALS' COST ACCOUNTING SYSTEMS. PART I, L7 COL(F): THE FOLLOWING NUMBER, $106,795,067, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II: COMMUNITY BUILDING ACTIVITIES-SAINT JOSEPH MERCY HEALTH SYSTEMIN GENERAL, SAINT JOSEPH MERCY HEALTH SYSTEM (SJMHS) SERVES ON COMMUNITY TASK FORCES AND COALITIONS TO HELP ADDRESS THE NEEDS OF THE SERVICE AREA. SJMHS PARTICIPATES IN DIVERSITY COUNCILS, MINISTRY ASSOCIATIONS, HEALTH COALITIONS, AND HEALTH IMPROVEMENT COUNCILS. THE HOSPITAL ALSO PROVIDES AN ARENA FOR YOUNG PEOPLE TO JOB SHADOW PROFESSIONALS IN A VARIETY OF HEALTH CAREERS.ST. MARY MERCY LIVONIAST. MARY MERCY LIVONIA SERVES ON THE LIVONIA YMCA BOARD, SERVING AS THE HOSTING SITE AND CHAIR OF THE MONTHLY HEALTHY PARTNERS CIRCLE OF CARE COALITION MEETINGS. THEY ALSO PROVIDE AN INSIDE VIEW OF ST. MARY MERCY CLINICAL SERVICES THROUGH THE HEALTHCARE PARTNERSHIP PROGRAM AND PROVIDE A VENUE FOR NETWORKING WITH COMMUNITY LEADERS AND PARTNERS TO IMPROVE THE HEALTH OF OUR COMMUNITIES. IN ADDITION, ST. MARY MERCY LIVONIA SERVES MANY NEEDS IN THE CITY OF DETROIT. IN DETROIT, ONLY ONE-QUARTER TO ONE-HALF OF HIGH SCHOOL STUDENTS GRADUATE, AND NEARLY HALF OF THE ADULT POPULATION ARE CONSIDERED FUNCTIONALLY ILLITERATE. IN SOUTHWEST DETROIT, 24 PERCENT OF ADULTS DO NOT HAVE A 9TH GRADE EDUCATION, AND MORE THAN HALF DID NOT FINISH HIGH SCHOOL. TO ADDRESS THIS NEED FOR EDUCATION, ST. MARY MERCY IS A CORPORATE SPONSOR FOR THE CRISTO REY SCHOOL AND MERCY EDUCATION PROGRAM. CRISTO REY STUDENTS SPEND FOUR DAYS EACH WEEK IN THE CLASSROOM, STRIVING FOR ACADEMIC EXCELLENCE AND ARE INVOLVED IN SERVICE ACTIVITIES IN THEIR COMMUNITY. ONE DAY A WEEK THEY HAVE A REAL-LIFE EXPERIENCE WORKING AT THE ST. MARY MERCY HOSPITAL MIRACLE OF LIFE BIRTHING CENTER. SEEING THE BIRTH OF A CHILD AND WATCHING MOTHERS ACCEPT THE RESPONSIBILITY OF CARING FOR THE INFANT, HAS PROFOUNDLY AFFECTED THE STUDENTS WHO HAVE BEEN WORKING IN THE BIRTHING CENTER.THE MERCY EDUCATION PROJECT (MEP) PROVIDES A CARING, SUPPORTIVE LEARNING ENVIRONMENT FOR LOW-INCOME WOMEN AND GIRLS WHO HAVE EXPERIENCED EDUCATIONAL FAILURE. THE RESULTS-DRIVEN EDUCATIONAL PROGRAMS IMPROVE ACADEMIC OUTCOMES AND HELP GIRLS AND WOMEN BECOME STRONG, CONFIDENT, MORE HOPEFUL AND BETTER EQUIPPED FOR SUCCESS IN SCHOOL AND IN LIFE. ONE OF THE MANY PROGRAMS OFFERED THROUGH MEP IS THE GIRLS' TUTORING PROGRAM WHICH PROVIDES ONE-TO-ONE REMEDIAL TUTORING IN READING AND MATH TO IMPROVE ACADEMIC OUTCOMES FOR GIRLS IN 1ST THROUGH 8TH GRADES. ST. MARY MERCY HOSPITAL'S SPONSORSHIP HELPED FUND THE PARTICIPATION OF THE 175 GIRLS/WOMEN WHO ARE ENROLLED IN THE MEP.ST. JOSEPH MERCY PORT HURONST. JOSEPH MERCY PORT HURON LEADERSHIP IS ACTIVELY INVOLVED IN COMMUNITY ACTIVITIES THROUGH REPRESENTATION ON VARIOUS COMMUNITY BOARDS. THIS INCLUDES COLLABORATIVE PARTNERSHIPS WITH COMMUNITY GROUPS/WORKSHOPS TO IMPROVE OVERALL COMMUNITY HEALTH. COMMUNITY BOARD INVOLVEMENT INCLUDES LOCAL ORGANIZATIONS SUCH AS:YMCA BOARD - THIS BOARD GOVERNS THE LOCAL YMCA AND PROVIDES SERVICES TO THE BROADER COMMUNITY, INCLUDING LOW INCOME, SENIORS, AND MENTALLY CHALLENGED INDIVIDUALS. BY SERVING ON THE BOARD, WE CAN BETTER IDENTIFY PROGRAMS AND SERVICES FOR THIS POPULATION. THE PROGRAMS OF YMCA REACH A LARGE AUDIENCE OF DISADVANTAGED INDIVIDUALS IN OUR COUNTY. THE COMMUNITY REACHES OUT TO YMCA BY PROVIDING SUPPORT AND UTILIZATION OF SERVICES. EMPLOYERS (INCLUDING SJMPH) ASSIST WITH FUNDING, WORK TRAINING, AND HEALTH PROGRAMS FOR THIS POPULATION. PORT HURON CHAMBER OF COMMERCE BOARD - OUR HOSPITAL SUPPLIES A BOARD MEMBER AND ALSO FINANCIAL SUPPORT TO THE LOCAL CHAMBER. THIS ORGANIZATION PROMOTES BUSINESS IN OUR COMMUNITY AND WE HAVE BEEN AN ACTIVE MEMBER FOR MANY YEARS. PARTNERS AT HEART ADVISORY COMMITTEE - THIS BODY COORDINATES THE AREA'S PARTNERS AT HEART PROGRAM WHICH PROVIDES CARDIAC SERVICES TO THE BROADER COMMUNITY, INCLUDING LOW INCOME INDIVIDUALS AND ESPECIALLY SENIORS. ACCESS TO CARDIOVASCULAR SERVICES OFFERED UNDER "PARTNERS AT HEART" IS ONE ROLE SERVED BY THE ADVISORY COMMITTEE. IT CAN BETTER IDENTIFY SERVICES FOR THIS POPULATION AND LOOK FOR WAYS TO PROACTIVELY IMPROVE THE HEALTH OF OUR COMMUNITY. THE SERVICES OF PARTNERS AT HEART REACH A LARGE PORTION OF OUR SENIOR POPULATION (INCLUDING THE LOW INCOME POPULATION). THE COMMUNITY REACHES OUT TO PARTNERS AT HEART THROUGH UTILIZATION OF THE SERVICES OFFERED. THE LOCAL HOSPITALS AND MEDICAL PROVIDERS SUPPORT THE PROGRAMS WITH THEIR TIME, MONEY, AND EXPERTISE IN THIS FIELD. OUR COMMUNITY IS ABLE TO RECEIVE LOCAL HEART CARE WHICH BETTER REACHES OUT TO THE BROADER COMMUNITY AND THOSE IN LOWER INCOME GROUPS.MERCY HOSPITAL GRAYLINGTWO DISTINCT COMMUNITY-BUILDING ACTIVITIES CONDUCTED BY MERCY HOSPITAL GRAYLING ARE SIGNIFICANT IN IMPROVING THE GENERAL HEALTH OF THE COMMUNITY.DESPITE LARGE FINANCIAL LOSSES IN PHYSICIAN PRACTICES, MERCY GRAYLING ACTIVELY WORKS TO SECURE NEEDED PHYSICIAN SPECIALTIES FOR THE SERVICE AREA INCLUDING PRIMARY CARE, OBSTETRICS, PEDIATRICS AND SURGERY. MERCY HAS SUCCESSFULLY ADDED AN UROLOGIST, AN ORTHOPEDIC SURGEON, AN INTERNIST AND TWO FAMILY PRACTICE DOCTORS TO ITS PHYSICIAN NETWORK. THE ADDITION OF THESE PROVIDERS EXPANDS SERVICES TO THE COMMUNITY IN AREAS OF GREATEST NEED.MERCY HOSPITAL GRAYLING SUPPORTS VARIOUS CHE TRINITY HEALTH NATIONAL AND STATE EFFORTS TO ADVOCATE FOR THE HEALTH NEEDS OF THE VULNERABLE AND UNDERSERVED.MERCY HOSPITAL CADILLACCOMMUNITY-BUILDING ACTIVITIES ARE VERY SIGNIFICANT IN IMPROVING THE GENERAL HEALTH OF OUR COMMUNITY. MERCY HOSPITAL CADILLAC IS LOCATED IN AN UNDERSERVED AREA, AS REFLECTED THROUGH THE 2009 DEVELOPMENT OF A FEDERALLY QUALIFIED HEALTH CENTER.THROUGH THE COMMUNITY HEALTH IMPROVEMENT ADVOCACY INITIATIVE, STATE AND FEDERAL REPRESENTATIVES ARE CONTACTED TO SUPPORT NEEDED RURAL HEALTH DELIVERY AT THE POINT OF NEED. THE STATE AND FEDERAL REPRESENTATIVES ADVOCATE IN CONGRESS AND AT THE STATE LEVEL FOR IMPROVED HEALTHCARE POLICIES, WHILE ADMINISTRATION AT MERCY HOSPITAL CADILLAC AND CHE TRINITY HEALTH USE RESOURCES TO INFORM ASSOCIATES OF NATIONAL HEALTHCARE ISSUES. THE PHYSICIAN RECRUITMENT AND DEVELOPMENT ATTRACTS AND RETAINS PHYSICIANS WHO WILL HAVE A DEGREE OF LONGEVITY IN OUR SERVICE AREA FOR THE GOOD OF THE COMMUNITY.COALITION BUILDING IS ALSO OF GREAT IMPORTANCE IN OUR COMMUNITY. HOSPITAL LEADERS ARE MEMBERS OF HUMAN SERVICES LEADERSHIP COLLABORATIVE, CADILLAC CHAMBER OF COMMERCE, CADILLAC COMMUNITY HEALTH COALITION, NORTHERN MICHIGAN SUBSTANCE ABUSE COORDINATING AGENCY, POVERTY REDUCTION COALITION, SUICIDE COALITION AND OTHER COMMUNITY GROUPS.MERCY HOSPITAL CADILLAC'S COMMUNITY OUTREACH DEPARTMENT'S PRIMARY FOCUS IS TO IMPROVE THE HEALTH OF THE COMMUNITY. THIS IS ACCOMPLISHED THROUGH COLLABORATION WITH MANY OF THE HUMAN SERVICE ORGANIZATIONS IN THE COMMUNITY, INCLUDING CADILLAC AREA HEALTH COALITION (CAHC). CAHC IS COMPRISED OF AREA ORGANIZATIONS THAT PROVIDE LEADERSHIP AND RESOURCES TO ACCOMPLISH THE GOALS OUTLINED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). PART III, LINE 4: TRINITY HEALTH - MICHIGAN IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 17 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY MINISTRY ORGANIZATION AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - BAD DEBT EXPENSE REPORTED ON LINE 2 IS SHOWN AT COST AND WAS CALCULATED USING A COST TO CHARGE RATIO METHODOLOGY.ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.PART III, LINE 3 - TRINITY HEALTH - MICHIGAN USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FY13 WAS THE FIRST YEAR TRINITY HEALTH - MICHIGAN UTILIZED THE PREDICTIVE MODEL WITH RESULTS USED FOR ANALYSIS ONLY. STARTING IN FY14, TRINITY HEALTH - MICHIGAN IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL.MERCY HOSPITAL GRAYLING AND MERCY HOSPITAL CADILLAC ARE NOT CURRENTLY USING THE PREDICTIVE MODEL DESCRIBED ABOVE. INSTEAD, THEIR PORTION OF THE AMOUNT IN LINE 3 REPRESENTS THE PATIENTS THAT WERE SENT TO BAD DEBT WHO WOULD QUALIFY FOR A FORM OF MEDICAID HMO. THESE PATIENTS HAVE BEEN MEANS TESTED BY THE INSURANCE COMPANY AND HAVE SHOWN TO HAVE MET THEIR GUIDELINES FOR LOW INCOME ASSISTANCE. THEREFORE, THEY WOULD MEET THE REQUIREMENTS FOR THE HOSPITAL'S CHARITY GUIDELINES BUT DID NOT FILL OUT A CHARITY APPLICATION. PART III, LINE 8: TRINITY HEALTH - MICHIGAN DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITALS' COLLECTION POLICIES CONTAIN PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN EACH ORGANIZATION'S COLLECTION POLICY. THE HOSPITALS HAVE IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 3: SJMHS CONSULTED MANY COMMUNITY ORGANIZATIONS TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING: THE WASHTENAW COUNTY HEALTH DEPARTMENT, THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM, THE PACKARD CLINIC, THE HOPE CLINIC, WASHTENAW COUNTY COUNCIL MEMBERS, THE WASHTENAW HEALTH INITIATIVE, PHYSICIAN PRACTICES AND HEALTH SYSTEM EMPLOYEES. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 3: THE CHNA WAS VERY INCLUSIVE AND COMPREHENSIVE IN INCORPORATING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL. THIS QUALITATIVE DATA COLLECTION INVOLVED CONDUCTING FOCUS GROUPS, BRIEF INTERCEPT INTERVIEWS, AND COMMUNITY INPUT WALLS WITH COMMUNITY MEMBERS. EACH OF THESE METHODS IS DESCRIBED ALONG WITH THE ACTUAL QUESTIONS USED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.FOCUS GROUPSIN THE FOCUS GROUPS, A PROFESSIONAL RESEARCHER INTERVIEWED PEOPLE IN SMALL GROUPS. THE RATIONALE FOR THE FOCUS GROUPS IS THAT GROUP DISCUSSION WILL STIMULATE DYNAMIC CONVERSATIONS AND IN-DEPTH CONVERSATIONS ABOUT A PARTICULAR TOPIC. IN THIS CASE, THE PURPOSE WAS TO GENERATE COMMUNITY INPUT FROM VARIOUS POPULATION GROUPS ABOUT HEALTH AND WELLBEING IN KENT COUNTY. BECAUSE THE FOCUS GROUPS WERE TAPE RECORDED WITH THE KNOWLEDGE OF PARTICIPANTS, RESEARCHERS WERE ABLE TO UTILIZE THE WORDS SPOKEN VERBATIM ABOUT A PARTICULAR HEALTH TOPIC TO SUPPORT SPECIFIC THEMES FOUND IN THE QUALITATIVE DATA COLLECTION.- 12 FOCUS GROUPS WERE CONDUCTED WITH 119 COMMUNITY MEMBERS PARTICIPATINGINTERCEPT INTERVIEWS METHODTHIS METHOD IS DESIGNED TO ENGAGE PARTICIPANTS WHO MAY NOT BE INCLINED TO ATTEND A FOCUS GROUP OR TOWN HALL MEETING. IT IS TYPICALLY ONE INTERVIEWER AND ONE PARTICIPANT. IT IS ALSO INTENDED TO GENERATE OPEN ENDED FEEDBACK FROM A BROAD GROUP OF COMMUNITY MEMBERS ON THE TOPIC OF HEALTH AND WELLBEING. SOME POPULATIONS ARE MORE COMFORTABLE BEING INTERVIEWED BY A COMMUNITY MEMBER OR TRUSTED INDIVIDUAL THAN BY AN OUTSIDE RESEARCHER AND INTERCEPT INTERVIEWS ARE USEFUL TO COLLECT INPUT FROM THOSE COMMUNITY MEMBERS. THE INTERCEPT INTERVIEWS WERE TRANSLATED INTO SPANISH FOR THE LATINO/HISPANIC COMMUNITY AND OTHER LANGUAGES SPOKEN BY THE ASIAN COMMUNITY. INTERCEPT INTERVIEWS WERE CONDUCTED BY VOLUNTEER INTERVIEWERS (TRAINED BY PROFESSIONAL CONSULTANTS) FROM THE KENT COUNTY HEALTH DEPARTMENT AND OTHER PARTNERS ENGAGED WITH THE CHNA. INTERVIEWERS WERE PROVIDED THE NECESSARY INTERVIEW MATERIALS NEEDED, AS WELL AS TECHNICAL ASSISTANCE. COMPLETED INTERVIEWS WERE RETURNED TO PROFESSIONALLY TRAINED CONSULTANTS FOR ANALYSIS. - 395 INTERCEPT INTERVIEWS WERE CONDUCTED IN THREE LANGUAGES BY TRAINED COMMUNITY MEMBERSCOMMUNITY INPUT WALLSTHIS STRATEGY INVOLVES GATHERING INPUT FROM COMMUNITY MEMBERS DIRECTLY BY POSTING LARGE SHEETS OF PAPER IN A PUBLIC SPACE AND ASKING COMMUNITY MEMBERS TO ANSWER QUESTIONS ABOUT COMMUNITY HEALTH BY WRITING THEIR THOUGHTS ON THE WALL.- 4 COMMUNITY INPUT WALLS ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 3: WE FULLY INCORPORATED COMMUNITY PARTNERS IN THE PLANNING PROCESS, FROM SERVICE ON THE STEERING COMMITTEE TO THE COLLECTION AND ANALYSIS OF DATA. OUR STEERING COMMITTEE INCLUDED REPRESENTATION FROM: TRINITY HEALTH AND SJMO PERSONNEL, OAKLAND LIVINGSTON HUMAN SERVICE AGENCY, CATHOLIC SOCIAL SERVICES OF OAKLAND COUNTY, THE SOCIAL SERVICES AGENCY OF THE ARCHDIOCESE OF DETROIT, THE OAKLAND COUNTY WORKFORCE DEVELOPMENT DIVISION, CENTRO MULTICULTURAL LA FAMILIA, INC., THE ARCHDIOCESE OF DETROIT.THE COMMITTEE HAD INPUT INTO THE PLANNING OF OUR PROCESSES FOR COLLECTING DATA, AND GAVE GUIDANCE IN REVISING THE CHNA QUESTIONNAIRES. THEY THEN PARTICIPATED IN FINAL EDITING OF THE REPORT AND IN SUGGESTING FUTURE COMMUNITY BENEFIT SERVICES AT SJMO. ONE PARTICULARLY EFFECTIVE APPROACH TO COMMUNITY INVOLVEMENT WAS THE METHOD WE USED FOR ADMINISTERING THE SURVEYS TO VARIOUS CONSTITUENT GROUPS. BECAUSE OF THE STRONG TIES TO THE COMMUNITY, AND THE WELL-ESTABLISHED PRESENCE SJMO HAS DEVELOPED IN THE PAST FOUR YEARS, WE WERE ABLE TO PRESENT OUR CHNA "CAMPAIGN" AND ADMINISTER SURVEYS DURING THE MEETING AGENDAS OF SEVERAL COMMUNITY ORGANIZATIONS OF WHICH WE ARE A PART. THIS SAVED TIME IN THE DATA COLLECTION PROCESS, SINCE WE DID NOT HAVE TO SCHEDULE AND FACILITATE SEPARATE MEETINGS, AND ALLOWED US TO HAVE MAXIMUM PARTICIPATION AND EXPOSURE. SIMILARLY, OUR STRONG COLLABORATION WITH ANOTHER GROUP, THE PONTIAC SCHOOL DISTRICT (PSD) AFFORDED US THE RARE OPPORTUNITY TO MEET WITH COMMUNITY-LEVEL DISTRICT REPRESENTATIVES (I.E., PARENTS) DURING THE FINAL DAYS OF THE SCHOOL YEAR. WE BROUGHT THIS GEOGRAPHICALLY DISPARATE GROUP TO SJMO, IN ORDER TO DISCUSS THE CHNA, COMPLETE THE SURVEYS, AND BEGIN PLANNING STRATEGICALLY FOR SJMO/PSD COLLABORATION DURING THE 2011-2012 SCHOOL YEAR. WE REGULARLY USE THIS STRATEGY OF BRINGING COMMUNITY PARTNERS IN HOUSE, IN ORDER TO BALANCE OUR COMMUNITY PRESENCE AND TO FOSTER A LASTING NON-CLINICAL RELATIONSHIP WITH THE COMMUNITY AS WELL. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 3: THE HEALTHY PARTNERS CIRCLE OF CARE COALITION CONSISTS OF REPRESENTATIVES FROM VARIOUS SOCIAL SERVICE AGENCIES, SCHOOLS, CHURCHES AND COMMUNITY MEMBERS IN WESTERN WAYNE COUNTY. THEY PROVIDED INPUT AT SEVERAL POINTS DURING OUR CHNA. WE ALSO RECEIVED INPUT FROM THE 800 RESPONSES TO OUR ONLINE SURVEY AND THREE FOCUS GROUPS. IN ADDITION, THE DETROIT WAYNE COUNTY HEALTH AUTHORITY BOARD REVIEWED AND SUPPORTED OUR CHNA STRATEGIES. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 3: ST. JOSEPH MERCY LIVINGSTON CONSULTED OTHER COMMUNITY ORGANIZATIONS, INCLUDING THE LIVINGSTON COUNTY PUBLIC HEALTH DEPARTMENT AND THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM, IN CONDUCTING THE MOST RECENT CHNA. CHELSEA COMMUNITY HOSPITAL PART V, SECTION B, LINE 3: CHELSEA COMMUNITY HOSPITAL (CCH) TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY THROUGH PARTICIPATION IN VARIOUS COMMUNITY COALITIONS AND BY CONDUCTING INTERVIEWS. CCH IS A MEMBER OF THE WASHTENAW COUNTY HEALTH IMPROVEMENT PLAN (HIP), A COLLABORATIVE EFFORT OF PUBLIC AND PRIVATE ORGANIZATIONS AIMED AT IMPROVING HEALTH. HIP INCLUDES REPRESENTATIVES FROM WASHTENAW COUNTY PUBLIC HEALTH, ST. JOSEPH MERCY ANN ARBOR, THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM, THOMPSON REUTERS, AND OTHER ORGANIZATIONS.EACH OF THE FIVE COMMUNITIES IN THE CCH SERVICE AREA HAS A WELLNESS COALITION WITH VOLUNTEER MEMBERS FROM KEY COMMUNITY SECTORS AND ORGANIZATIONS, SUCH AS CCH HOSPITAL STAFF, LOCAL GOVERNMENT, SCHOOLS, LIBRARIES, BUSINESSES, SENIOR CENTERS, COMMUNITY GARDENS, CHURCHES, FOOD BANKS AND RESOURCE CENTERS, YOUTH SUBSTANCE ABUSE PREVENTION ORGANIZATIONS, HOSPITAL AND OTHER HEALTHCARE PROVIDERS, AND LOCAL CITIZENS. CHELSEA-AREA WELLNESS FOUNDATION (CWF), WHICH SERVES THE SAME FIVE TOWNS AS CCH, INITIATED THE ORGANIZATION OF THESE COALITIONS IN 2010. EACH COALITION COMPLETED A CIVIC ASSESSMENT AND NEEDS ASSESSMENT IN 2010, AND THE FIRST QUARTER OF 2011, AND PRESENTED THEM TO THE CWF BOARD. THEY HAVE ALSO BEEN TASKED TO DEVELOP A COMPREHENSIVE WELLNESS PLAN FOR THEIR COMMUNITY, BASED ON LOCAL DATA DEMONSTRATING NEED, AND RESOURCES AVAILABLE TO ADDRESS THOSE NEEDS. TO ASSESS THE COMMUNITIES' NEEDS, EACH COALITION REVIEWED AVAILABLE SURVEY DATA, INCLUDING HIP (WHICH PROVIDED COMMUNITY-LEVEL DATA IN STOCKBRIDGE AND GRASS LAKE, AND REGIONAL-LEVEL DATA FOR CHELSEA, DEXTER AND MANCHESTER), AND MIPHY (WHICH PROVIDED COMMUNITY-LEVEL DATA FOR ALL FIVE TOWNS), AS WELL AS THE PROMOTING ACTIVE COMMUNITIES, AND NUTRITION ENVIRONMENTAL ASSESSMENT TOOL SURVEYS.IN ORDER TO GAIN INPUT ON THE NEEDS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS IN THE COMMUNITY, LEADERS FROM CCH CONDUCTED KEY STAKEHOLDER INTERVIEWS IN MARCH 2012. MEMBERS OF THE COMMUNITY HEALTH IMPROVEMENT COUNCIL GENERATED A LIST OF COMMUNITY AGENCIES AND ORGANIZATIONS THAT SERVE THESE POPULATIONS, AND QUESTIONS TO ASK EACH ABOUT THE NEEDS OF THEIR CLIENTS OR MEMBERS. THESE INTERVIEWS WERE CONDUCTED IN PERSON IF POSSIBLE, AND BY PHONE, OR BY EMAIL IF NECESSARY. ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 3: A SURVEY THAT WAS CREATED BY THE CHNA STEERING COMMITTEE AT ST. JOSEPH MERCY PORT HURON WAS GIVEN TO SEVERAL COMMUNITY ADVISOR MEMBERS INCLUDING: THE VISITING NURSE ASSOCIATION, ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH, DOWNRIVER COMMUNITY SERVICES, COUNCIL ON AGING, CATHOLIC SOCIAL SERVICES, BLUE WATER TRANSIT, DEPARTMENT OF HUMAN SERVICES, MERCY HOME CARE, AND VARIOUS OTHER COMMUNITY BUSINESS LEADERS. PATIENTS AND STAFF AT MEDICAL CLINICS AND SENIOR FACILITIES WERE ALSO GIVEN THE SURVEY, IN ORDER TO GAIN INPUT FROM THE COMMUNITY. MERCY HOSPITAL GRAYLING PART V, SECTION B, LINE 3: DATA WAS COLLECTED FROM A VARIETY OF CURRENT SOURCES TO PROVIDE A FOUNDATION FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. SOURCES UTILIZED INCLUDE BOTH PRIMARY AND SECONDARY SOURCES: U.S. CENSUS BUREAU, MICHIGAN DEPARTMENT OF COMMUNITY HEALTH, MICHIGAN LEAGUE FOR HUMAN SERVICES, MIPHY (MICHIGAN PROFILE FOR HEALTHY YOUTH), DISTRICT HEALTH DEPARTMENT, #10 DISTRICT HEALTH DEPARTMENT, #2 CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, MICHIGAN LABOR, MARKET BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM, COUNTY HEALTH RANKINGS, ROSCOMMON COUNTY RESIDENT SURVEY, MERCY HOSPITAL PHYSICIAN FEEDBACK.IN ADDITION TO THE QUANTITATIVE ANALYSIS OF THE SURVEYS AND SECONDARY DATA, PRIMARY DATA WERE OBTAINED THROUGH A SERIES OF GROUP DISCUSSIONS FACILITATED AT ALL THREE COMMUNITY COLLABORATIVE BODIES, THE ROSCOMMON HEALTH IMPROVEMENT PLANNING COMMITTEE, THE (6 COUNTY) GREAT START COLLABORATIVE BODIES AND A PHYSICIAN STEERING GROUP. THE COMMUNITY COLLABORATIVE GROUPS HAVE MEMBERSHIP THAT INCLUDES BUSINESS, HEALTH CARE, ACADEMICS, SOCIAL SERVICE DEPARTMENTS, AND AREA RESIDENTS. MERCY HOSPITAL CADILLAC PART V, SECTION B, LINE 3: THE CHNA WAS CONDUCTED WITH AN OVERSIGHT COMMITTEE COMPOSED OF THE DEPARTMENT OF HUMAN SERVICES, NORTHERN LAKES COMMUNITY MENTAL HEALTH AND DISTRICT HEALTH DEPARTMENT #10. MEMBERS OF THE CADILLAC AREA HEALTH COALITION PROVIDED ADDITIONAL FEEDBACK TO THE OVERSIGHT GROUP AND ITS CONSULTANTS ON A MONTHLY BASIS UNTIL ITS COMPLETION IN NOVEMBER 2011.A PRESENTATION WAS DEVELOPED, INCLUDING ALL THE AVAILABLE HEALTH RELATED DATA FOR WEXFORD AND MISSAUKEE COUNTIES. THIS WAS PRESENTED TO THE CADILLAC AREA HEALTH COALITION, OFFERING REPRESENTATION FROM THE YMCA, DISTRICT HEALTH DEPARTMENT #10, BAKER COLLEGE, MERCY HOSPITAL PHO, CADILLAC PUBLIC SCHOOLS, WEXFORD-MISSAUKEE INTERMEDIATE SCHOOL DISTRICT, VARIOUS COMMUNITY ORGANIZATIONS, HUMAN SERVICES, AND COALITION WORKGROUPS. THE COALITION COLLECTIVELY DETERMINED THE HIGHEST PRIORITY ISSUES AFFECTING THE HEALTH NEEDS OF THE COMMUNITY. THE COALITION WILL FOCUS ON THESE NEEDS DURING THE UPCOMING YEARS.CONSUMER HEALTH SURVEYS: POVERTY SURVEY - A SURVEY WAS DISTRIBUTED FROM LATE OCTOBER THROUGH MID-DECEMBER (2009) BY MORE THAN TWO DOZEN HUMAN SERVICE ORGANIZATIONS THROUGHOUT THE WEXFORD/MISSAUKEE COUNTIES. A TOTAL OF 965 ANONYMOUS SURVEYS WERE COLLECTED FROM INDIVIDUALS USING THOSE SERVICES AND UTILIZED IN IDENTIFYING THE FINDINGS OF THIS REPORT. TWO-THIRDS (69%) OF THE SURVEY RESPONDENTS LIVE IN WEXFORD COUNTY, 26% IN MISSAUKEE COUNTY AND 5% WERE IDENTIFIED AS RESIDENTS OF OSCEOLA COUNTY. PUBLIC FORUMS: AFFINITY FOCUS GROUPS - A PRESENTATION OF THE DATA WAS GIVEN TO THE HUMAN SERVICES LEADERSHIP COLLABORATIVE (HSLC). INPUT WAS RECEIVED FROM HUMAN SERVICE PROVIDERS, YMCA, BAKER COLLEGE, CADILLAC AREA PUBLIC SCHOOLS, WEXFORD MISSAUKEE INTERMEDIATE SCHOOL DISTRICT, SCHOOL SUPERINTENDENT, AND COMMUNITY HEALTH CARE ORGANIZATION REPRESENTATIVES. ACTION PLANNING AND ONGOING STATUS UPDATES WILL BE EVALUATED AND REPORTED ON PERIODICALLY.YOUTH ADVISORY SURVEY - THE YOUTH ADVISORY COMMITTEE OF THE CADILLAC AREA COMMUNITY FOUNDATION CONDUCTS A YOUTH SURVEY EVERY THREE YEARS. THE 2010 SURVEY WAS A RANDOM SAMPLING OF 242 STUDENTS IN GRADES 6-12. THE SURVEY FOCUSED ON ISSUES AND ACTIVITIES. THE TOP THREE ISSUES IDENTIFIED BY STUDENTS ARE SMOKING, DRUG ABUSE AND ALCOHOL ABUSE. STUDENTS ARE MOST INTERESTED IN MORE SOCIAL AND SPORTS ACTIVITIES. TRANSPORTATION TO ACTIVITIES REMAINS AN ISSUE TO BE ADDRESSED. THE DATA CORRESPONDS WELL WITH THE 09/10 MICHIGAN PROFILE FOR HEALTHY YOUTH (MIPHY) RESULTS. SUMMARY OBSERVATIONS FROM PHYSICIAN INPUT - THE PHYSICIAN HOSPITAL ORGANIZATION AND OTHER PHYSICIAN SERVICE GROUPS HAVE SUGGESTED GAPS IN SERVICES AND HEALTH PRIORITIES FOR THE COMMUNITY. PHYSICIANS HAVE AGREED THAT THE COMMUNITY MUST FOCUS ON CHRONIC DISEASE PREVENTION AND MANAGEMENT, INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE DISORDERS. THEY STRESS THE NEED FOR MENTAL HEALTH SERVICES FOR CHILDREN, RECRUITMENT OF PRIMARY CARE PROVIDERS, INCLUDING ADVANCED CARE PRACTITIONERS, AND PROMOTION OF SELF-MANAGEMENT OF HEALTH. FURTHER, THEY STRESS ADVANTAGES FOR THE CONSUMER AND THE COMMUNITY FOR PROVIDERS THAT ARE A PATIENT CENTERED MEDICAL HOME. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 4: UNIVERSITY OF MICHIGAN HEALTH SYSTEM. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 4: -MARY FREE BED REHABILITATION HOSPITAL-METRO HEALTH HOSPITAL-PINE REST CHRISTIAN MENTAL HEALTH SERVICES-SPECTRUM HEALTH ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 4: UNIVERSITY OF MICHIGAN HEALTH SYSTEM. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 5C: LINE 5A:HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS/SJMAA_CHNA.PDF MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 5C: THE CHNA REPORT IS ALSO AVAILABLE ON THE WEBSITE OF THE KENT COUNTY HEALTH DEPARTMENT. LINE 5A:HTTP://MERCYHEALTHSAINTMARYS.COM/DOCUMENTS/GRANDRAPIDS/KENTCOCHNA_FINAL (WEBSITE).PDF ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 5C: LINE 5A: HTTP://WWW.STJOESOAKLAND.ORG/DOCUMENTS5/2012CHNAFINAL2.PDF ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 5C: LINE 5A: HTTP://WWW.STMARYMERCY.ORG/DOCUMENTS4/SMML_CHNA.PDFLINE 5C:WE PROVIDED A SUMMARY OF OUR CHNA ON THE FRONT PAGE OF THE 2012 CBM REPORT TO THE COMMUNITY. THE ANNUAL REPORT WAS INSERTED IN LOCAL NEWSPAPERS THAT REACHED 160,000 HOUSEHOLDS AND WAS AVAILABLE TO OUR EMPLOYEES AND COMMUNITY MEMBERS IN KIOSKS THROUGHOUT THE HOSPITAL. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 5C: LINE 5A: HTTP://WWW.STJOESHEALTH.ORG/DOCUMENTS1/SJML_CHNA.PDF CHELSEA COMMUNITY HOSPITAL PART V, SECTION B, LINE 5C: LINE 5A: HTTP://WWW.CCH.ORG/DOCUMENTS3/2012%20CHNA.PDF ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 5C: LINE 5A:HTTP://WWW.MYMERCY.US/DOCUMENTS6/SJMPH-CHNA.PDF MERCY HOSPITAL GRAYLING PART V, SECTION B, LINE 5C: LINE 5A: HTTP://WWW.MERCYHEALTHGRAYLING.COM/DOCUMENTS/GRAYLING/MERCY%20HOSPITAL%20GRAYLING%20CHNA.PDF MERCY HOSPITAL CADILLAC PART V, SECTION B, LINE 5C: LINE 5A: HTTP://WWW.MERCYHEALTHCADILLAC.COM/DOCUMENTS/CADILLAC/MERCY-HOSPITAL-NEEDS-ASSESSMENT-SEPTEMBER-2011.PDF ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 7: THERE WERE NEEDS IDENTIFIED THAT ST. JOSEPH MERCY HOSPITAL (SJMH) CHOSE NOT TO ADDRESS. THESE NEEDS WHILE IMPORTANT TO THE HEALTH SYSTEM AND THE COMMUNITY WERE NOT CHOSEN BASED ON OUR PRIORITIZATION PROCESS. THIS PROCESS INCLUDED THE FOLLOWING QUESTIONS: 1) THE NUMBER OF PEOPLE AFFECTED, 2) THE SEVERITY OF THE PROBLEM, 3) THE HEALTH SYSTEM'S ABILITY TO IMPACT AND 4) THE EXTENT TO WHICH OTHER ORGANIZATIONS WERE MEETING THE NEED. THE NEEDS THAT WERE NOT CHOSEN ARE AS FOLLOWS:ASTHMA - ST. JOSEPH MERCY HOSPITAL HAS BEEN ACTIVELY INVOLVED IN WASHTENAW COUNTY'S ASTHMA COALITION AND CONTINUES TO DO SO. THIS ENTITY HAS WORKED TO PROVIDE COMMUNITY AND PROVIDER EDUCATION AS WELL AS HELPING TO IDENTIFY BEST PRACTICES. IN THE RECENT PAST, ASTHMA WAS ALSO A MAJOR COMMUNITY BENEFIT INITIATIVE BY SJMH THAT LED TO SIGNIFICANT COLLABORATIVE EFFORTS WITH SCHOOLS AND HOSPITAL BASED SERVICES (CASE MANAGEMENT AND PEDIATRIC EMERGENCY CASE MANAGEMENT). CURRENTLY, A HOME CARE BASED STRATEGY IS IN PLACE. BECAUSE OF THESE ONGOING EFFORTS, AND BECAUSE OTHER UNMET NEEDS HAVE GREATER PRIORITY, NO FURTHER ASTHMA PROGRAMS WILL BE NEWLY INITIATED AT THIS TIME. NUTRITION AND PHYSICAL ACTIVITY - NUTRITION AND LACK OF PHYSICAL ACTIVITY WERE BOTH IDENTIFIED AS UNMET NEEDS. WHILE GOOD NUTRITION AND PHYSICAL ACTIVITY ARE NECESSARY TO PREVENT DISEASES AND CONDITIONS INCLUDING OBESITY, WE HAVE NOT CHOSEN TO DIRECTLY ADDRESS THESE NEEDS. INSTEAD, WE HAVE CHOSEN OBESITY AS A PRIORITY AREA, WHICH WE FEEL WILL ADDRESS BOTH PHYSICAL ACTIVITY AND NUTRITION RISK FACTORS. IN ADDITION, SJMH SUPPORTS AND COLLABORATES WITH OTHER ORGANIZATIONS DEDICATED TO INCREASING FOOD SECURITY FOR THE POPULATION SUCH AS FOOD GATHERERS. SJMH ALSO REGULARLY RESPONDS TO COMMUNITY REQUESTS FOR SPEAKERS ON NUTRITION TOPICS, HAVE OFFERED COOKING CLASSES TO TEACH HEALTHY COOKING AND NUTRITION, AND CONTINUE TO PROVIDE INDIVIDUAL AND GROUP SERVICES RELATED TO CONDITION SPECIFIC NEEDS, E.G. DIABETES, GLUTEN FREE, LOW FAT, CHOLESTEROL MANAGEMENT AND NUMEROUS OTHERS. SJMH CONTINUES TO WORK CLOSELY WITH PHYSICIAN NETWORK TO PROVIDE MORE OF THESE NUTRITION SERVICES AT POINT OF CARE, AND NOT EXCLUSIVELY ON OUR CAMPUS, THUS IMPROVING NUTRITION ACCESS.PERINATAL HEALTH - SJMHS HAS A MAJOR OBSTETRICAL PROGRAM AND MAJOR NETWORK OF PRIVATE PRACTICE PRACTITIONERS INCLUDING OB/GYN DOCTORS, NURSE PRACTITIONERS AND MIDWIVES PROVIDING PERINATAL HEALTH SERVICES. IN ADDITION, OUR ACADEMIC OB/GYN AND NEIGHBORHOOD FAMILY HEALTH CENTER PROVIDE SIMILAR SERVICES TO LOW INCOME, UNINSURED OR UNDERINSURED WOMEN. TO SUPPORT THIS EFFORT, NUMEROUS HEALTHY LIVING EDUCATIONAL OPPORTUNITIES, AS WELL AS A PLETHORA OF PRE-NATAL CLASSES FOR PREGNANT WOMEN ARE OFFERED TO OUR COMMUNITY. SJMH IS ALSO A MEMBER OF THE WASHTENAW COUNTY INFANT MORTALITY COALITION WHICH CURRENTLY HAS SEVERAL EFFORTS UNDERWAY. THE 3 X MORE LIKELY CAMPAIGN TARGETS YOUNG AFRICAN AMERICAN WOMEN IN OUR COMMUNITY TO PROVIDE THEM WITH HEALTHY LIVING GUIDANCE PRIOR TO CONCEIVING, ALSO ADDRESSING PRENATAL HEALTH, IF ALREADY PREGNANT. PLEASE VISIT THE WWW.3XMORELIKELY.COM WEBSITE FOR MORE DETAILS. IN LIGHT OF ALL THESE MAJOR EFFORTS THAT WE CONTINUE TO BE ACTIVELY COMMITTED TO, WE HAVE PRIORITIZED OTHER NEEDS. SEXUALLY TRANSMITTED DISEASE - WASHTENAW COUNTY HAS MANY ORGANIZATIONS WORKING TO REDUCE THE PREVALENCE OF STDS IN THE COUNTY. AMONG THESE ARE THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM, THE CORNER HEALTH CENTER FOR ADOLESCENTS, PRIMARY CARE PHYSICIAN OFFICES, AND OTHERS. AT THIS TIME SJMH DID NOT FEEL IT COULD PROVIDE THE MOST EFFECTIVE PROGRAMS TO REDUCE STDS PREVALENCE AND INSTEAD, SUPPORTS THE WORK OF THOSE ORGANIZATIONS THAT DO. SJMH HAS BEEN INVOLVED IN THE COMMUNITY EDUCATION EFFORTS AROUND THE HPV VIRUS AND HAVE PROVIDED PHYSICIAN SPEAKERS.SOCIAL SUPPORT - SOCIAL SUPPORT IS IMPORTANT TO MENTAL HEALTH FOR BOTH YOUTH AND ADULTS. ST. JOSEPH MERCY HOSPITAL CURRENTLY HAS SEVERAL SUPPORT GROUPS THAT MEET ON CAMPUS AND PROVIDES SPACE FOR GROUPS TO MEET FOR SOCIAL GATHERINGS, AND OTHER ACTIVITIES. SJMH ALSO PARTICIPATES IN SEVERAL HEALTH COALITIONS THAT SUPPORT THESE TYPES OF ACTIVITIES. SJMH WILL CONTINUE TO PARTICIPATE IN THESE COALITIONS AND WILL SUPPORT THE PLANNING AND IMPLEMENTATION OF ACTIVITIES TO PROMOTE SOCIAL SUPPORT, BUT WILL NOT IMPLEMENT NEW PROGRAMS TO ENHANCE SOCIAL SUPPORT.PHYSICAL ENVIRONMENT - WALK-ABILITY AND EASY ACCESS TO GROCERY STORES CAN BE MAJOR BARRIERS TO REGULARLY PARTICIPATING IN PHYSICAL ACTIVITY, AND ACCESSING FRESH FRUITS AND VEGETABLES. SJMH IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITIES, AND FULLY SUPPORTS LOCAL GOVERNMENTS AND WELLNESS COALITIONS IN THEIR EFFORTS TO IMPACT THESE ISSUES. AS A COMMUNITY NEIGHBOR, WE DID EXTEND THE BORDER TO BORDER TRAILS THAT CONNECT YPSILANTI WITH THE ANN ARBOR COMMUNITIES THROUGH OUR CAMPUS. HOWEVER, THE PHYSICAL ENVIRONMENT WILL NOT BE ADDRESSED DIRECTLY BY SJMH. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 7: PRIMARY NEEDS IDENTIFIED IN THE CHNA NOT BEING ADDRESSED:THE FOLLOWING DESCRIBES THE TOP CHNA IDENTIFIED NEEDS THAT MERCY HEALTH SAINT MARY'S (MHSM) WILL NOT DIRECTLY ADDRESS OVER THE NEXT THREE FISCAL YEARS; WITH A SUMMARY EXPLANATION OF WHY WE HAVE DETERMINED THAT THIS ORGANIZATION WILL NOT MAKE THESE A PRIORITY.CHNA IDENTIFIED NEED NOT BEING ADDRESSED: INCREASE HEALTHY EATING BY ENSURING ACCESS TO HEALTHY FOODS TO PROMOTE AN ENVIRONMENT THAT SUPPORTS HEALTHY LIVING FOR ALL REASON: COMMUNITY GROUPS ADDRESSING THIS ISSUE: E.G., CHILDREN'S FOOD BASKET, COMMUNITY TRANSFORMATION GRANT, LOCAL FARMER'S MARKET (MHSM IS PARTICIPATING IN A FARMER'S MARKET COLLABORATIVE ALREADY)CHNA IDENTIFIED NEED NOT BEING ADDRESSED: REDUCE DISPARITY IN HEALTH RISK FACTORS AND PROTECTIVE FACTORS AMONG YOUTH REASON: COMMUNITY GROUPS ADDRESSING THIS ISSUE: KENT COUNTY PREVENTION COALITION, YOUTH DEVELOPMENT NETWORK, LIFE GUIDANCE, ARBOR CIRCLECHNA IDENTIFIED NEED NOT BEING ADDRESSED: ACCESS TO DENTAL CARE AND MENTAL HEALTH SERVICES REASON: MERCY HEALTH SAINT MARY'S (MHSM) IS ALREADY ADDRESSING THESE NEEDS THROUGH COMMUNITY PARTNERSHIPS; E.G., CHERRY STREET HEALTH SERVICES, MEL TROTTER, ARBOR CIRCLE, CATHOLIC CHARITIES WEST MICHIGANCHNA IDENTIFIED NEED NOT BEING ADDRESSED: INCREASE COMMUNITY'S KNOWLEDGE ABOUT RESOURCES AVAILABLE IN THE COMMUNITY REASON: RATHER THAN A SEPARATE STRATEGIC GOAL, MHSM WILL INCORPORATE COMMUNITY RESOURCE INFORMATION IN ALL OF HEALTHLINK'S MEDICAL HOME RESOURCES. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 7: THREE NEEDS SURFACED- AFFORDABLE HEALTHCARE, DENTAL CARE, AND SMOKING CESSATION- THAT WERE NOT ADDRESSED IN THE ST. MARY MERCY LIVONIA CHNA IMPLEMENTATION PLAN. AFFORDABLE HEALTHCARE IS BEING ADDRESSED ON A STATE AND NATIONAL BASIS AND WE DO EVERYTHING THAT WE CAN TO ENROLL PEOPLE IN PUBLIC ASSISTANCE PROGRAMS AND TO ASSIST THEM WITH PAYMENT PLANS TO PAY FOR NEEDED SERVICES. WE ALSO ARE INVOLVED IN THE TRINITY HEALTH AND MHA ADVOCACY EFFORTS FOR AFFORDABLE HEALTHCARE. DENTAL SERVICES ARE NOT AVAILABLE AT THE HOSPITAL. INDIVIDUALS PRESENTING IN OUR EMERGENCY ROOM WITH DENTAL PROBLEMS ARE REFERRED TO THE U OF D MERCY SCHOOL OF DENTISTRY AND LOCAL DENTISTS. SMOKING CESSATION EDUCATION IS INCLUDED IN THE DISCHARGE PROCESS FOR INPATIENTS. IN THE PAST WE HAVE OFFERED SMOKING CESSATION CLASSES TO THE COMMUNITY AND NO ONE ENROLLED IN THE CLASS. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 7: THERE WERE NEEDS IDENTIFIED THAT ST. JOSEPH MERCY LIVINGSTON (SJML) CHOSE NOT TO ADDRESS. THESE NEEDS WHILE IMPORTANT TO THE HEALTH SYSTEM AND THE COMMUNITY WERE NOT CHOSEN BASED ON OUR PRIORITIZATION PROCESS. THIS PROCESS INCLUDED THE FOLLOWING QUESTIONS: 1) THE NUMBER OF PEOPLE AFFECTED, 2) THE SEVERITY OF THE PROBLEM, 3) THE HEALTH SYSTEM'S ABILITY TO IMPACT AND 4) THE EXTENT TO WHICH OTHER ORGANIZATIONS WERE MEETING THE NEED. THE NEEDS THAT WERE NOT CHOSEN ARE AS FOLLOWS:NUTRITION AND PHYSICAL ACTIVITY - NUTRITION AND LACK OF PHYSICAL ACTIVITY WERE BOTH IDENTIFIED AS UNMET NEEDS. WHILE GOOD NUTRITION AND PHYSICAL ACTIVITY ARE NECESSARY TO PREVENT DISEASES AND CONDITIONS INCLUDING OBESITY, WE HAVE NOT CHOSEN TO DIRECTLY ADDRESS THESE NEEDS. INSTEAD, WE HAVE CHOSEN OBESITY AS A PRIORITY AREA, WHICH WE FEEL WILL ADDRESS BOTH PHYSICAL ACTIVITY AND NUTRITION RISK FACTORS. IN ADDITION, SJML SUPPORTS AND COLLABORATES WITH OTHER ORGANIZATIONS DEDICATED TO INCREASING FOOD SECURITY FOR THE POPULATION SUCH AS GLEANERS. ST. JOSEPH MERCY LIVINGSTON HAS REPRESENTATION AT THE LIVINGSTON COUNTY HUNGER COUNCIL NUTRITION EDUCATION SUBCOMMITTEE. HEART DISEASE - ST. JOSEPH MERCY LIVINGSTON CURRENTLY HAS SEVERAL PROGRAMS IN PLACE TO REDUCE THE AMOUNT OF HEART DISEASE IN THE COMMUNITY. THE HEALTH SYSTEM EMPLOYS A LARGE GROUP OF CARDIOLOGISTS THAT TREAT PATIENTS WITH THIS DISEASE. BY FOCUSING ON OBESITY, THE HOSPITAL FELT SEVERAL OF THE TACTICS TO ENCOURAGE EXERCISE AND HEALTH NUTRITION WOULD ALSO REDUCE THE AMOUNT OF HEART DISEASE. IN ADDITION, BY CHOOSING TO IMPLEMENT INITIATIVES TO INCREASE THE ACCESS THAT THE POPULATION HAD TO HEALTH PROVIDERS, THE HOSPITAL COULD BETTER PREVENT AND TREAT HEART DISEASE. SO WHILE THE HOSPITAL IS NOT IMPLEMENTING A NEW PROGRAM AIMED ONLY AT HEART DISEASE, WE EXPECT AN OUTCOME OF THE NEW PROGRAMS TO REDUCE OBESITY AND INCREASE ACCESS WILL ALSO REDUCE HEART DISEASE. SUBSTANCE ABUSE - AT THIS TIME SJML IS NOT IMPLEMENTING ANY NEW PROGRAMS TO REDUCE SUBSTANCE ABUSE IN THE COUNTY. SJML CURRENTLY PROVIDES MENTAL HEALTH AND DETOX SERVICES THOUGH THE SAINT JOSEPH MERCY HEALTH SYSTEM AND COLLABORATES THROUGH OUR MEMBERSHIP IN COALITIONS SUCH AS THE LIVINGSTON/WASHTENAW SUBSTANCE ABUSE COORDINATING AGENCY. THE HEALTH SYSTEM ALSO HOLDS COMMUNITY MEETINGS AND EDUCATION SESSIONS SUCH AS DRUGS 101 FOR PARENTS OF TEENS. IN ADDITION, THERE IS ALREADY A HOSPITAL IN THE COUNTY DEDICATED TO SUBSTANCE ABUSE AND IT PLAYS A MAJOR ROLE IN THIS CAPACITY. CHELSEA COMMUNITY HOSPITAL PART V, SECTION B, LINE 7: THE PHYSICAL ENVIRONMENT WILL NOT BE ADDRESSED DIRECTLY BY CHELSEA COMMUNITY HOSPITAL (CCH) HOSPITAL-LED INITIATIVES. THE HOSPITAL IS NOT IN A POSITION TO DIRECTLY IMPACT THE RURAL NATURE AND WALKABILITY OF THE COMMUNITIES. HOWEVER, CCH IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITIES, AND FULLY SUPPORTS LOCAL GOVERNMENTS AND WELLNESS COALITIONS IN THEIR EFFORTS TO IMPACT PHYSICAL ENVIRONMENT ISSUES.CCH WILL NOT DIRECTLY ADDRESS TRANSPORTATION WITH ANY NEW INITIATIVES BECAUSE THE NEED RANKED LOW AMONG OTHER RISK FACTORS DUE TO THE LOW NUMBER OF PEOPLE THAT ARE AFFECTED. IN ADDITION, OTHER LOCAL ORGANIZATIONS LIKE SENIOR CENTERS AND THE WESTERN WASHTENAW AREA VALUE EXPRESS (WAVE) BUS ARE ALREADY WORKING TO ADDRESS TRANSPORTATION NEEDS IN THE AREA. CCH WILL CONTINUE TO HAVE A REPRESENTATIVE ON THE WAVE BOARD OF DIRECTORS, IN ORDER TO SUPPORT THIS EXISTING RESOURCE. CCH IS NOT IN A POSITION AT THIS TIME TO DIRECTLY IMPACT ACCESS TO DENTAL CARE. THERE ARE SOME RESOURCES AVAILABLE IN THE SERVICE AREA, AND A REGIONAL COALITION CALLED THE WASHTENAW HEALTH INITIATIVE (WHI) IS WORKING TO ADDRESS THIS ISSUE IN WASHTENAW COUNTY, INCLUDING CHELSEA, DEXTER AND MANCHESTER. RESIDENTS OF GRASS LAKE HAVE ACCESS TO THE CENTER FOR FAMILY HEALTH IN JACKSON, WHICH PROVIDES FREE AND LOW COST MEDICAL AND DENTAL CARE TO ADULTS AND YOUTH THROUGH THEIR DOWNTOWN CLINIC AS WELL AS SCHOOL-BASED CLINICS. ADULTS IN STOCKBRIDGE HAVE THE FARTHEST TO TRAVEL FOR FREE OR REDUCED COST DENTAL CARE. BESIDES THE RESOURCES IN ANN ARBOR AND JACKSON, STOCKBRIDGE RESIDENTS CAN ALSO ACCESS THE ADULT DENTAL CENTER IN LANSING. CCH WILL CONTINUE TO SUPPORT THE WHI IN THEIR EFFORTS TO EXPAND ACCESS.DIABETES DID NOT RANK AMONG THE TOP HEALTH NEEDS BECAUSE PREVALENCE DROPPED SIGNIFICANTLY IN WESTERN WASHTENAW FROM 2005 TO 2010. ALSO, BECAUSE OBESITY WAS RANKED AS THE MOST IMPORTANT HEALTH NEED, CCH COMMUNITY HEALTH IMPROVEMENT COUNCIL MEMBERS FELT DIABETES WOULD ALSO BE ADDRESSED THROUGH MANY OF THE STRATEGIES AND ACTIVITIES AIMED AT REDUCING OBESITY. CCH WILL CONTINUE TO OFFER OUTPATIENT DIABETES EDUCATION AND OUTPATIENT DIETICIAN SERVICES TO PATIENTS WITH DIABETES OR PRE-DIABETES THROUGH CLASSES, INDIVIDUAL APPOINTMENTS, AND THE DIABETES SHARE GROUP. CCH WILL NOT INITIATE NEW INTERVENTIONS TO STRENGTHEN FAMILY AND COMMUNITY INVOLVEMENT, BECAUSE OF LACK OF RESOURCES AND THE PRESENCE OF COMMUNITY RESOURCES. THE SRSLY COALITION IN CHELSEA IS WORKING TO STRENGTHEN THESE FACTORS THROUGH PARENT EDUCATION CLASSES AND YOUTH-LED COMMUNITY IMPROVEMENT INITIATIVES, AND CCH WILL CONTINUE TO SUPPORT THIS EFFORT. BEYOND WHAT CCH IS ALREADY DOING (SENIOR SUPPER CLUB, DIABETES SHARE GROUP, STROKE GROUP, ETC), THE HOSPITAL WILL NOT IMPLEMENT NEW STRATEGIES TO PROMOTE SOCIAL SUPPORT. THE FIVE AREA WELLNESS COALITIONS ARE EACH ADDRESSING THIS ISSUE AT THE COMMUNITY LEVEL THROUGH INITIATIVES TO SUPPORT "CONNECTING WITH OTHERS IN HEALTHY WAYS." CCH WILL CONTINUE TO PARTICIPATE IN THESE COALITIONS AND SUPPORT PLANNING AND IMPLEMENTATION OF ACTIVITIES TO PROMOTE SOCIAL SUPPORT AS MUCH AS POSSIBLE. MERCY HOSPITAL GRAYLING PART V, SECTION B, LINE 7: THE HOSPITAL DID NOT ADDRESS ADVOCACY RELATED TO SUBSTANCE ABUSE SERVICES AND MENTAL HEALTH SERVICES, ORAL HEALTH, 2-1-1, SUICIDE PREVENTION, TRANSPORTATION, HOMELESSNESS, DOMESTIC VIOLENCE, BULLYING PREVENTION AND PRISONER RE-ENTRY. MERCY GRAYLING DOES NOT HAVE THE RESOURCES AND/OR EXPERTISE TO ADDRESS THESE ISSUES EFFECTIVELY. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 12H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 12H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 12H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 12H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 12H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. CHELSEA COMMUNITY HOSPITAL PART V, SECTION B, LINE 12H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 12H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 14G: 1. SIGNAGE IS POSTED AND BROCHURES ARE DISPLAYED IN THE EMERGENCY DEPARTMENT, PATIENT ACCESS AREAS AND WAITING ROOMS. 2. BROCHURES WITH A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (FAP) ARE DISPLAYED IN THE EMERGENCY ROOM, PATIENT ACCESS AREAS, WAITING ROOMS, INPATIENT ROOMS, AND EMPLOYED PHYSICIAN OFFICES. APPLICATIONS ARE AVAILABLE IN THE EMERGENCY ROOM AND FINANCIAL COUNSELING OFFICE.3. INFORMATION ON FINANCIAL ASSISTANCE IS INCLUDED ON BILLING STATEMENTS OR PROVIDED UPON REQUEST FROM THE CUSTOMER SERVICE, PATIENT ACCESS AREAS AND FINANCIAL COUNSELING DEPARTMENTS.4. A SUMMARY OF THE FAP POLICY AND FULL APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE HTTPS://WWW.STJOESANNARBOR.ORG/FINANCIAL-ASSISTANCE-PROGRAMS MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 14G: DUE TO THE COMPLEXITY OF THE POLICY, COPIES OF THE FULL POLICY ARE ONLY PROVIDED ON REQUEST. STATEMENTS PROVIDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THE NUMBER(S) TO CALL ARE PROVIDED TO PATIENTS AT PRE-REGISTRATION, REGISTRATION, ON THE HOSPITAL WEBSITE, POSTINGS IN REGISTRATION AREAS AND ADMISSIONS OFFICES, AND INCLUDED ON ALL BILLING STATEMENTS SENT TO THE PATIENT/GUARANTOR. ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 14G: 1. SIGNAGE IS POSTED AND BROCHURES ARE DISPLAYED IN THE EMERGENCY DEPARTMENT, PATIENT ACCESS AREAS AND WAITING ROOMS. 2. BROCHURES WITH A SUMMARY OF THE FAP ARE DISPLAYED IN THE EMERGENCY ROOM, PATIENT ACCESS AREAS, WAITING ROOMS AND EMPLOYED PHYSICIAN OFFICES. APPLICATIONS ARE AVAILABLE IN THE EMERGENCY ROOM AND FINANCIAL COUNSELING OFFICE.3. INFORMATION ON FINANCIAL ASSISTANCE IS INCLUDED ON BILLING STATEMENTS OR PROVIDED UPON REQUEST FROM THE CUSTOMER SERVICE, PATIENT ACCESS AREAS AND FINANCIAL COUNSELING DEPARTMENTS.4. A SUMMARY OF THE FAP POLICY AND FULL APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE HTTPS://WWW.STJOESOAKLAND.ORG/FINANCIAL-ASSISTANCE-PROGRAMS ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 14G: 1. SIGNAGE IS POSTED AND BROCHURES ARE DISPLAYED IN THE EMERGENCY DEPARTMENT, PATIENT ACCESS AREAS AND WAITING ROOMS. 2. BROCHURES WITH A SUMMARY OF THE FAP ARE DISPLAYED IN THE EMERGENCY ROOM, PATIENT ACCESS AREAS, WAITING ROOMS AND EMPLOYED PHYSICIAN OFFICES. APPLICATIONS ARE AVAILABLE IN THE EMERGENCY ROOM AND FINANCIAL COUNSELING OFFICE.3. INFORMATION ON FINANCIAL ASSISTANCE IS INCLUDED ON BILLING STATEMENTS OR PROVIDED UPON REQUEST FROM THE CUSTOMER SERVICE, PATIENT ACCESS AREAS AND FINANCIAL COUNSELING DEPARTMENTS.4. A SUMMARY OF THE FAP POLICY AND FULL APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE HTTPS://WWW.STMARYMERCY.ORG/SMML-PFS ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 14G: 1. SIGNAGE IS POSTED AND BROCHURES ARE DISPLAYED IN THE EMERGENCY DEPARTMENT, PATIENT ACCESS AREAS AND WAITING ROOMS. 2. BROCHURES WITH A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED IN THE EMERGENCY ROOM, PATIENT ACCESS AREAS, WAITING ROOMS, INPATIENT ROOMS, AND EMPLOYED PHYSICIAN OFFICES. APPLICATIONS ARE AVAILABLE IN THE EMERGENCY ROOM AND FINANCIAL COUNSELING OFFICE.3. INFORMATION ON FINANCIAL ASSISTANCE IS INCLUDED ON BILLING STATEMENTS OR PROVIDED UPON REQUEST FROM THE CUSTOMER SERVICE, PATIENT ACCESS AREAS AND FINANCIAL COUNSELING DEPARTMENTS.4. A SUMMARY OF THE FAP POLICY AND FULL APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE HTTPS://WWW.STJOESANNARBOR.ORG/FINANCIAL-ASSISTANCE-PROGRAMS CHELSEA COMMUNITY HOSPITAL PART V, SECTION B, LINE 14G: 1. SIGNAGE IS POSTED AND BROCHURES ARE DISPLAYED IN THE EMERGENCY DEPARTMENT, PATIENT ACCESS AREAS AND WAITING ROOMS. 2. BROCHURES WITH A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED IN THE EMERGENCY ROOM, PATIENT ACCESS AREAS, WAITING ROOMS, INPATIENT ROOMS, AND EMPLOYED PHYSICIAN OFFICES. APPLICATIONS ARE AVAILABLE IN THE EMERGENCY ROOM AND FINANCIAL COUNSELING OFFICE.3. INFORMATION ON FINANCIAL ASSISTANCE IS INCLUDED ON BILLING STATEMENTS OR PROVIDED UPON REQUEST FROM THE CUSTOMER SERVICE, PATIENT ACCESS AREAS AND FINANCIAL COUNSELING DEPARTMENTS.4. A SUMMARY OF THE FAP POLICY AND FULL APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE HTTPS://WWW.STJOESANNARBOR.ORG/FINANCIAL-ASSISTANCE-PROGRAMS ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 14G: 1. SIGNAGE IS POSTED AND BROCHURES ARE DISPLAYED IN THE EMERGENCY DEPARTMENT, PATIENT ACCESS AREAS AND WAITING ROOMS. 2. BROCHURES WITH A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (FAP) ARE DISPLAYED IN THE EMERGENCY ROOM, PATIENT ACCESS AREAS AND WAITING ROOMS. APPLICATIONS ARE AVAILABLE IN THE EMERGENCY ROOM AND FINANCIAL COUNSELING OFFICE.3. INFORMATION ON FINANCIAL ASSISTANCE IS INCLUDED ON BILLING STATEMENTS OR PROVIDED UPON REQUEST FROM THE CUSTOMER SERVICE, PATIENT ACCESS AREAS AND FINANCIAL COUNSELING DEPARTMENTS.4. A SUMMARY OF THE FAP POLICY AND FULL APPLICATION ARE POSTED ON THE HOSPITAL WEBSITE HTTPS://WWW.MYMERCY.US/SJMPH-PFS MERCY HOSPITAL GRAYLING PART V, SECTION B, LINE 14G: THE HOSPITAL PROVIDED A SUMMARY OF THE POLICY ON THE BILLING STATEMENTS, THERE WERE BROCHURES AVAILABLE IN THE ADMISSIONS AREAS, THE EMERGENCY DEPARTMENT, PATIENT ACCOUNTS AND IN THE LOBBY. A PATIENT THAT WANTED A COPY OF THE POLICY, OR AN APPLICATION COULD GET ONE IN ADMISSIONS, FINANCIAL ASSISTANCE OFFICES, MEDICAID COORDINATOR'S OFFICE, DISABILITY COORDINATORS' OFFICES, PATIENT ACCOUNTS, OR BY ASKING A NURSE OR SOCIAL WORKER. ALL PATIENTS ARE PROVIDED WITH FINANCIAL ASSISTANCE INFORMATION AT ADMISSIONS, ON THE PATIENT'S BILLING STATEMENT, OR BY REQUEST. THE WEB ADDRESS FOR MERCY HOSPITAL GRAYLING'S FINANCIAL ASSISTANCE INFORMATION IS WWW.MERCYHEALTHGRAYLING.COM/FINANCIAL-ASSISTANCE-GRAYLING MERCY HOSPITAL CADILLAC PART V, SECTION B, LINE 14G: THE HOSPITAL PROVIDED A SUMMARY OF THE POLICY ON THE BILLING STATEMENTS, THERE WERE BROCHURES AVAILABLE IN THE ADMISSIONS AREAS, THE EMERGENCY DEPARTMENT, PATIENT ACCOUNTS AND IN THE LOBBY. A PATIENT THAT WANTED A COPY OF THE POLICY, OR AN APPLICATION COULD OBTAIN ONE IN ADMISSIONS, FINANCIAL ASSISTANCE OFFICES, MEDICAID COORDINATOR'S OFFICE, DISABILITY COORDINATORS' OFFICES, PATIENT ACCOUNTS, OR BY ASKING A NURSE OR SOCIAL WORKER. ALL PATIENTS ARE PROVIDED WITH FINANCIAL ASSISTANCE INFORMATION AT ADMISSIONS, ON THE PATIENT'S BILLING STATEMENT, OR BY REQUEST. THE WEB ADDRESS FOR MERCY HOSPITAL CADILLAC'S FINANCIAL ASSISTANCE INFORMATION IS WWW.MERCYHEALTHCADILLAC.COM/FINANCIAL-ASSISTANCE ST. JOSEPH MERCY ANN ARBOR PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 201% AND 300% OF THE FPG RECEIVE A WRITE OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE COMMERCIAL CONTRACTUAL ADJUSTMENT FOR ALL COMMERCIAL PAYERS. MERCY HEALTH SAINT MARY'S PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 201% AND 300% OF THE FPG RECEIVE A WRITE OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE COMMERCIAL CONTRACTUAL ADJUSTMENT FOR ALL COMMERCIAL PAYERS. ST. JOSEPH MERCY OAKLAND PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 201% AND 300% OF THE FPG RECEIVE A FIXED PERCENTAGE DISCOUNT OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES. ST. MARY MERCY LIVONIA PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 101% AND 400% OF THE FPG RECEIVE A PERCENTAGE DISCOUNT OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES, BASED UPON A SLIDING SCALE. ST. JOSEPH MERCY LIVINGSTON PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 201% AND 300% OF THE FPG RECEIVE A WRITE OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE COMMERCIAL CONTRACTUAL ADJUSTMENT FOR ALL COMMERCIAL PAYERS. CHELSEA COMMUNITY HOSPITAL PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 201% AND 300% OF THE FPG RECEIVE A WRITE OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE COMMERCIAL CONTRACTUAL ADJUSTMENT FOR ALL COMMERCIAL PAYERS. ST. JOSEPH MERCY PORT HURON PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 150% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 151% AND 400% OF THE FPG RECEIVE A PERCENTAGE DISCOUNT OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES, BASED UPON A SLIDING SCALE. MERCY HOSPITAL GRAYLING PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 101% AND 300% OF THE FPG, RECEIVE A PERCENTAGE DISCOUNT OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES, BASED UPON A SLIDING SCALE. MERCY HOSPITAL CADILLAC PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 101% AND 300% OF THE FPG RECEIVE A PERCENTAGE DISCOUNT OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES, BASED UPON A SLIDING SCALE. PART VI, LINE 2: NEEDS ASSESSMENT - THE HOSPITALS IN TRINITY HEALTH - MICHIGAN ASSESS THE HEALTH STATUS OF THEIR COMMUNITIES BOTH IN THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THEIR OVERALL COMMUNITIES. THE HOSPITALS MAY USE PATIENT DATA, PUBLIC HEALTH DATA, COMMITTEE MEETINGS WITH MEDICAL STAFF (PHYSICIANS) AND DEPARTMENT STAFF, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED, IN THE ASSESSMENT OF THEIR COMMUNITIES.TWO OF THE MEMBER HOSPITALS ALSO PERFORMED ADDITIONAL PROCEDURES, WHICH ARE DETAILED BELOW:ST. JOSEPH MERCY OAKLANDST. JOSEPH MERCY OAKLAND (SJMO) USED A NUMBER OF METHODS TO SECURE INFORMATION ON HEALTH STATUS (BOTH SUBJECTIVE AND OBJECTIVE), SERVICE AND PROGRAMMATIC NEEDS, AND GAPS IN SERVICE TO ENSURE THE MOST COMPREHENSIVE AND USEFUL COMMUNITY HEALTH NEEDS DATA. THESE GAPS INCLUDED COMPLETELY UNMET NEEDS, INADEQUATELY ADDRESSED NEEDS, AND THE OVER- OR UNDER-UTILIZATION OF FACILITIES, SERVICES, AND PROGRAMS. WE EMPLOYED HISTORICAL DATA REVIEW, LITERATURE REVIEW, META-ANALYSIS, DATA MINING, INTERPRETIVE OBSERVATION, CONTENT ANALYSIS, AND QUESTIONNAIRES. HISTORICAL DATA REVIEW THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WORK TEAM REVIEWED DATA CULLED DURING PREVIOUS COLLECTION PERIODS IN ORDER TO: 1)CONFIRM THAT OUR CURRENT DATA COLLECTION WAS COMPREHENSIVE AND HISTORICALLY SOUND AND 2)BEGIN TO PREPARE HYPOTHESES ABOUT OUR CURRENT PROCESS OUTCOMES.LITERATURE REVIEW SJMO'S STRONGEST COLLABORATIVE RELATIONSHIP IS WITH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH, WHICH AFFORDS US ACCESS TO A NUMBER OF DATABASES AND REPORTS, SUCH AS THE "MICHIGAN'S HEALTH PROFILE CHARTBOOK," AND THE "HEALTH PROFILE CHARTBOOK: REGION 2N." FOR THE PURPOSES OF THIS PROCESS, WE REVIEWED THESE AND A NUMBER OF OTHER REPORTS (E.G., THE "2009-2010 OAKLAND COUNTY COMMUNITY ASSESSMENT" OF THE OAKLAND LIVINGSTON HUMAN SERVICE AGENCY'S CHILD AND FAMILY SERVICES DIVISION HEAD START PROGRAM) TO FRAME OUR CONVERSATIONS, AND TO FURTHER UNDERSTAND THE HEALTH NEEDS OF OUR COMMUNITY AGAINST OTHERS THROUGHOUT THE STATE OF MICHIGAN.IN ADDITION, DATA WAS COLLECTED FROM THE U.S. CENSUS BUREAU, AREA CHAMBERS OF COMMERCE, THE MICHIGAN STATE GOVERNMENT, THINK TANKS SUCH AS THE ECONOMIC POLICY INSTITUTE AND TRUST FOR AMERICA'S HEALTH, NEWSPAPER ARTICLES, AND NUMEROUS DATABASES, SUCH AS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, THE USDA FOOD CONSUMPTION ATLAS, AND HEALTH RELATED QUALITY OF LIFE AND HEALTH DATA INTERACTIVE, BOTH FROM THE U.S. CENTER FOR DISEASE CONTROL. A COMPLETE LIST OF DATABASES IS FOUND IN THE APPENDIX OF THE CHNA.META-ANALYSIS IN 2010, SJMO LED A CAPACITY-BUILDING EFFORT AMONG COMMUNITY HEALTH STAKEHOLDERS IN THE PONTIAC AREA. THAT EFFORT INCLUDED A SURVEY OF A SMALL GROUP (175 PARTICIPANTS) ON ISSUES OF HEALTHCARE AND SOCIAL SERVICE NEEDS. WE REVIEWED AND CONSIDERED THE RESULTANT DATA AS WE DEVELOPED OUR CHNA SURVEY TOOL, AND AS WE ANALYZED THE DATA FROM THIS ASSESSMENT EXPERIENCE.DATA MINING SJMO CREATED A SURVEY TOOL (THE CHNA QUESTIONNAIRE) TO EXTRACT SIMILAR DATA, BUT FROM VARYING STAKEHOLDER PERSPECTIVES. THE QUESTIONNAIRE WAS CUSTOMIZED FOR INDIVIDUALS, BUSINESS OWNERS, PHYSICIANS, AND COMMUNITY SERVICE VOLUNTEERS AND EMPLOYEES. ITS ADMINISTRATION WAS A LARGE PART OF OUR DATA COLLECTION EFFORT. RATHER LENGTHY, AT 35 48 QUESTIONS (DEPENDING ON THE STAKEHOLDER GROUP SURVEYED), THE QUESTIONNAIRES PROVIDED DEMOGRAPHIC DATA, A WEALTH OF INFORMATION ON HEALTH STATUS NEEDS (BOTH PERCEIVED AND DIAGNOSED), RESPONDENTS' AWARENESS OF PROGRAMS AND SERVICES, AND THEIR PERSONAL HYPOTHESES ABOUT WHAT IS NEEDED TO IMPROVE COMMUNITY HEALTH. THE SURVEY WAS ADMINISTERED EITHER BY A CHNA WORK TEAM MEMBER OR A TRAINED REPRESENTATIVE OF A COMMUNITY PARTNER. OUR MINING TASK CONCLUDED WITH A SUMMARIZATION OF THESE VARYING DATA POINTS INTO USEFUL INFORMATION THAT WE WILL USE TO ASSESS CURRENT PROGRAM DESIGN, COSTS, AND OUTCOMES, AND TO ENVISION AND IMPLEMENT NEW PROGRAMS TO BETTER MEET THE NEEDS IDENTIFIED BY OUR VARIOUS STAKEHOLDER GROUPS. INTERPRETIVE OBSERVATION THE CHNA WORK TEAM HAD SOME UNIQUE OPPORTUNITIES TO INTERACT WITH MEMBERS OF OUR COMMUNITY IN THE PLACES THEY FREQUENT TO RECEIVE VARIOUS HEALTHCARE SERVICES: MERCY PLACE, THE BALDWIN CENTER, THE BOWEN CENTER, AND NEW MT. MORIAH CHURCH. WHILE THE DATA COLLECTED IN THIS MANNER IS BY DEFINITION SUBJECTIVE, IT DID PROVIDE USEFUL INSIGHT INTO THE LIVES OF OUR COMMUNITY MEMBERS.ST. JOSEPH MERCY PORT HURONST. JOSEPH MERCY PORT HURON CONTINUALLY OFFERS EDUCATION SEMINARS ON A BROAD ARRAY OF TOPICS, SUCH AS SENIOR LIVING, BARIATRICS, DIABETES, PULMONARY REHAB, BRAIN INJURIES, AND PROSTATE HEALTH AND STROKE EDUCATION. DURING THESE INFORMATIONAL SESSIONS, INSTRUCTORS HAVE THE OPPORTUNITY TO INTERACT WITH RESIDENTS AND FUTURE PATIENTS TO DETERMINE WHAT HEALTH-SPECIFIC NEEDS ARE NOT BEING MET.ST. JOSEPH MERCY PORT HURON ALSO CONTINUES TO OPERATE THE PEOPLES' CLINIC FOR BETTER HEALTH, WHICH PROVIDES FREE/SUBSIDIZED SERVICES TO UNDER/UNINSURED INDIVIDUALS IN OUR COMMUNITY. HEALTH ASSESSMENTS ARE MADE REGULARLY FOR THOSE INDIVIDUALS WHO ARE SEEN AT THE CLINIC. INFORMATION GLEANED FROM INDIVIDUALS RECEIVING CARE AT THE PEOPLES' CLINIC SUPPLEMENTED OTHER RESEARCH AND DATA. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - TRINITY HEALTH-MICHIGAN IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, TRINITY HEALTH-MICHIGAN HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSTRINITY HEALTH-MICHIGAN COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE. TRINITY HEALTH-MICHIGAN OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL PATIENT ACCOUNTING DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES AND IN ADMISSION PACKAGES DURING INTAKE. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH IN SEVERAL COMMUNITIES, REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITALS. TRINITY HEALTH-MICHIGAN'S HOSPITALS HAVE ESTABLISHED WRITTEN POLICIES FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. TRINITY HEALTH-MICHIGAN MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. OUR HOSPITALS EDUCATE STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. PART VI, LINE 4: COMMUNITY INFORMATION - ST. JOSEPH MERCY OAKLAND (PONTIAC):ST. JOSEPH MERCY OAKLAND SERVES ALL OF OAKLAND COUNTY NORTH OF EIGHT MILE ROAD, ALTHOUGH MOST COMMUNITY BENEFIT INITIATIVES FOCUS ON PONTIAC. THE 2013 RACIAL BREAKDOWN FOR OAKLAND COUNTY IS: WHITE NOT HISPANIC 77%; AFRICAN AMERICAN 13%; AMERICAN INDIAN AND ALASKAN NATIVE <1%; ASIAN 5%; PERSONS REPORTING TWO OR MORE RACES 2%; AND HISPANIC OR LATINO 3%. ESTIMATES FOR THE CITY OF PONTIAC ARE: WHITE NOT HISPANIC 34%; AFRICAN AMERICAN 52%; AMERICAN INDIAN AND ALASKA NATIVE <1%; ASIAN 2%; PERSONS REPORTING TWO OR MORE RACES 4%; HISPANIC OR LATINO 16%. THE HISPANIC OR LATINO POPULATION HAS INCREASED SIGNIFICANTLY. PONTIAC'S UNEMPLOYMENT RATE WAS AT 17.5% IN DECEMBER OF 2013, DOWN FROM A HIGH OF 31.1% IN OCTOBER 2009. THESE FIGURES ARE HIGHER THAN BOTH OAKLAND COUNTY AND THE STATE OF MICHIGAN. WHILE SHOWING IMPROVEMENT, THE RECENT DATA SHOWED, AT ITS WORST, A SIGNIFICANT RISE IN UNEMPLOYMENT COMPARED TO THE PRE-RECESSION YEAR OF 2007-PONTIAC, UP 60.9%; MICHIGAN UP 43.5%; AND OAKLAND COUNTY UP 72.1%. DESPITE THE FACT THAT THE RISE IN UNEMPLOYMENT FOR THE ENTIRE UNITED STATES HAS BEEN MUCH HIGHER, AT 89.6%, IT SHOULD BE REMEMBERED THAT MICHIGAN, AND ESPECIALLY PONTIAC, BEGAN THEIR RECESSIONS BETWEEN 10 AND 30 YEARS AGO, SO RECENT INCREASES ADD INSULT TO GREATER EXISTING INJURY, AND THUS APPEAR LESS SIGNIFICANT.MERCY HEALTH SAINT MARY'S (GRAND RAPIDS):KENT COUNTY IS CONSIDERED THE PRIMARY MARKET AREA OF MERCY HEALTH SAINT MARY'S (MHSM). KENT COUNTY IS LOCATED IN WESTERN MICHIGAN AND IS THE FOURTH LARGEST POPULATION CENTER IN THE STATE. THE COUNTY IS COMPOSED OF TWENTY-ONE TOWNSHIPS, FIVE VILLAGES, AND NINE CITIES COVERING 864 SQUARE MILES. GRAND RAPIDS IS THE COUNTY SEAT AND IS 30 MILES FROM LAKE MICHIGAN. THE HEALTH CARE RESOURCES IN KENT COUNTY INCLUDE MHSM, METROPOLITAN HEALTH, SPECTRUM HEALTH-BUTTERWORTH CAMPUS, SPECTRUM HEALTH-BLODGETT CAMPUS, PINE REST, AND MARY FREE BED REHABILITATION HOSPITAL. IN ADDITION, THE HEALTH DEPARTMENT OPERATES SIX PUBLIC HEALTH CLINICS THROUGHOUT THE COUNTY THAT OFFER PERSONAL HEALTH SERVICES. IN 2012, THERE WERE 614,462 PEOPLE LIVING IN KENT COUNTY WHICH IS 6.1 PERCENT OF MICHIGAN'S POPULATION. THE MEDIAN HOUSEHOLD INCOME FOR KENT COUNTY IS $50,801. TWENTY-SIX PERCENT OF THE POPULATION IS BELOW THE AGE OF 18 AND ELEVEN PERCENT IS 65 YEARS OF AGE AND OLDER. EIGHTY-THREE PERCENT OF THE POPULATION IS WHITE, 10.3% BLACK, AND 9.9% LATINO. EIGHTY-EIGHT PERCENT ARE HIGH SCHOOL GRADUATES AND 30% HAVE A BACHELOR'S DEGREE. THE CURRENT UNEMPLOYMENT RATE IS 8.5%.MERCY HOSPITAL CADILLAC:MERCY HOSPITAL CADILLAC SERVES A RURAL REGION IN CENTRAL NORTHERN MICHIGAN COMPRISED OF ALL OF MISSAUKEE AND WEXFORD COUNTIES (WHERE THE HOSPITAL IS LOCATED), ALONG WITH PORTIONS OF OSCEOLA, KALKASKA, MANISTEE AND LAKE COUNTIES. THE SERVICE REGION ENCOMPASSES THE COMMUNITIES OF CADILLAC, LAKE CITY, MANTON, MESICK AND MCBAIN. MERCY HOSPITAL CADILLAC IS THE ONLY IN-PATIENT AND EMERGENCY SERVICE PROVIDER FOR THIS SERVICE REGION. IT IS DESIGNATED A SOLE COMMUNITY PROVIDER. THE U.S. CENSUS DATA FROM 2010 HAVE NOTED THAT AN INCREASING SEGMENT OF THE POPULATION IS ELDERLY. WITH ADVANCED AGE USUALLY COMES AN INCREASED RATE OF CHRONIC DISEASE. MERCY HOSPITAL GRAYLING:MERCY HOSPITAL GRAYLING SERVES A SPARSELY POPULATED, RURAL REGION IN CENTRAL NORTHERN MICHIGAN COMPRISED OF ALL OF CRAWFORD COUNTY (WHERE THE HOSPITAL IS LOCATED) AND MOST OF ROSCOMMON COUNTY, AS WELL AS MUCH OF OSCODA COUNTY AND SMALL PORTIONS OF MONTMORENCY AND OTSEGO COUNTIES. MERCY HOSPITAL GRAYLING IS THE ONLY INPATIENT AND EMERGENCY SERVICE PROVIDER FOR THIS REGION. THERE ARE NEARLY 50,000 PEOPLE LIVING IN MERCY GRAYLING'S THREE COUNTY SERVICE AREAS. FROM 2000-2010, THE POPULATION IN CRAWFORD, OSCODA AND ROSCOMMON COUNTIES HAS DECREASED, WITH THE LARGEST DECREASE OCCURRING IN OSCODA COUNTY. THE PERCENTAGE OF PERSONS BELOW POVERTY CONTINUES TO BE HIGHER IN ALL THREE COUNTIES THAN IN ALL OF MICHIGAN WITH ROSCOMMON HAVING THE HIGHEST RATE AT 22.2% COMPARED TO MICHIGAN'S RATE OF 14.8%.THE CONCERN FOR SINGLE PARENT STATUS SURFACES AS AN ONGOING ISSUE FOR OUR COMMUNITY FAMILIES TODAY. CHILDREN THAT ARE LIVING IN SINGLE PARENT HOUSEHOLDS ARE HIGHER THAN MICHIGAN IN BOTH CRAWFORD (38%) AND ROSCOMMON (45%), WITH OSCODA BEING SLIGHTLY LOWER AT 26%. MICHIGAN'S OVERALL RATE IS 32%.ST. JOSEPH MERCY PORT HURON:ST. JOSEPH MERCY PORT HURON IS LOCATED IN ST. CLAIR COUNTY IN SOUTHEASTERN MICHIGAN. SHARING A BORDER WITH CANADA, THE COUNTY IS HOME TO THE BLUE WATER BRIDGE, ONE OF THE BUSIEST INTERNATIONAL BORDER CROSSINGS IN NORTH AMERICA. DUE TO ITS PROXIMITY TO CANADA AND THE HIGH CONCENTRATION OF MANUFACTURING ON BOTH SIDES OF THE BRIDGE, ST. CLAIR COUNTY HAS BEEN IDENTIFIED BY THE FEDERAL GOVERNMENT AS A HIGH-RISK AREA FOR BOTH NATURAL AND MANMADE DISASTER.BASED ON 2010 U.S. CENSUS BUREAU DATA, ST. CLAIR COUNTY HAS ABOUT 163,000 RESIDENTS AND IS EXPECTED TO SLOWLY DECLINE. OF THAT POPULATION 94.5% ARE CAUCASIAN, 2.6% BLACK OR AFRICAN AMERICAN AND 2.9% HISPANIC OR LATINO. IN 2011 15% OF AREA RESIDENTS WERE SENIORS AGE 65 AND OLDER, WHICH IS THE ONLY DEMOGRAPHIC EXPECTED TO GROW IN THE NEXT DECADE. THE COUNTY IS 721 SQUARE MILES, ENCOMPASSING 33 COMMUNITIES. THE COUNTY SEAT IS LOCATED IN PORT HURON AND THE COUNTY IS GOVERNED BY A SEVEN MEMBER BOARD OF COMMISSIONERS. THE LARGEST GROWTH SECTOR IN TERMS OF JOBS FOR THE COUNTY IS CONSIDERED PRIVATE EDUCATION/HEALTHCARE, FOLLOWED BY RETAIL TRADE AND KNOWLEDGE-BASED SERVICES. ITS TOP FOUR LARGEST EMPLOYERS INCLUDE SERVICE INDUSTRY PROVIDERS SUCH AS HEALTH CARE, EDUCATION, GOVERNMENT AND A UTILITY. ST. JOSEPH MERCY HOSPITAL IS THE FIFTH LARGEST EMPLOYER IN THE COUNTY. SAINT MARY MERCY LIVONIA:ST MARY MERCY LIVONIA'S PRIMARY SERVICE AREA INCLUDES CANTON, LIVONIA, NORTHVILLE, NOVI, PLYMOUTH, REDFORD AND WESTLAND. MANY OF THE RESIDENTS HAVE BEEN AFFECTED BY THE ECONOMIC CHALLENGES THAT HAVE AFFECTED OUR NATION AND CITY. HOME FORECLOSURES, DEBT DUE TO MEDICAL BILLS, UNEMPLOYMENT AND INCREASED COST OF LIVING WITH NO WAGE INCREASES HAVE CAUSED MANY PEOPLE TO MAKE DIFFICULT CHOICES ABOUT THEIR HEALTH CARE. BASED UPON THE 2010 CENSUS DATA, MEDIAN INCOME RANGES FROM $46,308 IN WESTLAND TO $81,541 IN NORTHVILLE, WHICH IS CONSIDERABLY LESS THAN THE 2000 CENSUS DATA. THE NUMBER OF PERSONS LIVING IN POVERTY IN WESTLAND, 6.7%, IS ABOUT THE SAME AS IN 2000, WHILE IN NORTHVILLE THE NUMBER IS 2.5%, HIGHER THAN THE 2000 CENSUS. THE 65+ AGE GROUP POPULATION RANGES FROM 17.7% IN LIVONIA TO 8.9% IN CANTON. SAINT JOSEPH MERCY HEALTH SYSTEM (ANN ARBOR):SAINT JOSEPH MERCY HEALTH SYSTEM (SJMHS) IS A SUBURBAN HEALTH CARE NETWORK SERVING WASHTENAW, LIVINGSTON, EASTERN JACKSON, LENAWEE, MONROE, WESTERN WAYNE AND SOUTHWESTERN OAKLAND COUNTIES. SJMHS SPECIALIZES IN CANCER, CARDIOVASCULAR, ORTHOPEDICS, NEUROSCIENCES, AND WOMEN AND CHILDREN'S HEALTH. IT ALSO OFFERS TREATMENT AND CARE IN EMERGENCY SERVICES, SURGERY, ENDOSCOPY, RADIOLOGY, AND HOME CARE/HOSPICE. THE SJMHS HEALTH CARE NETWORK INCLUDES FOUR HOSPITALS: ST. JOSEPH MERCY ANN ARBOR, ST. MARY MERCY HOSPITAL IN LIVONIA, CHELSEA COMMUNITY HOSPITAL, AND SAINT JOSEPH MERCY LIVINGSTON IN HOWELL. COMBINED, THESE HOSPITALS ARE LICENSED FOR 1,090 INPATIENT BEDS. BASED ON 2011 DATA, THE AVERAGE HOUSEHOLD INCOME IN THE SJMHS SERVICES AREA IS $74,533 COMPARED TO THE AVERAGE FOR THE UNITED STATES OF $69,376. THIRTEEN PERCENT OF THE SERVICE AREA'S POPULATION IS BELOW FEDERAL POVERTY GUIDELINES. ABOUT 10% OF THE SERVICE AREA POPULATION RECEIVES MEDICAID OR OTHER ASSISTANCE, WHILE 13% ARE UNINSURED OR UNDERINSURED. THE NON-ENGLISH SPEAKING POPULATION COMPRISES 8.4% OF THE TOTAL.THE LARGEST SEGMENT OF THE SERVICE AREA POPULATION, 29.6% IS BETWEEN 35 AND 54 YEARS OF AGE, COMPARED TO THE NATIONAL AVERAGE OF 27.6%. CHILDREN 0-14 YEARS MAKE UP 18.5% OF THE TOTAL POPULATION, COMPARED TO THE NATIONAL AVERAGE OF 20.2%. THE OVER-55 POPULATION ACCOUNTS FOR 25.2% OF THE TOTAL, COMPARED TO THE NATIONAL AVERAGE OF 25%. ONLY 8.9% OF THE SERVICE AREA POPULATION DOES NOT HAVE A HIGH SCHOOL EDUCATION, COMPARED TO THE NATIONAL AVERAGE OF 15.1%. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: MERCY HEALTH SAINT MARY'SMERCY HEALTH SAINT MARY'S WORKS WITH DOZENS OF PROGRAMS AND ORGANIZATIONS EACH YEAR, OFTEN PARTNERING WITH OTHER ORGANIZATIONS IN THE COMMUNITY. MERCY HEALTH SAINT MARY'S IS A ONE-THIRD PARTNER, WITH THE MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE AND MARY FREE BED REHABILITATION HOSPITAL, IN THE COMMUNITY'S ONLY CERTIFIED ALS (AMYOTROPHIC LATERAL SCLEROSIS) TREATMENT CENTER FOR LOU GEHRIG'S DISEASE. MERCY HEALTH SAINT MARY'S ALSO PARTICIPATES IN NUMEROUS CANCER, NEUROSCIENCE, AND HIV/AIDS RESEARCH BOTH INDEPENDENTLY AND IN COLLABORATION WITH NATIONAL AND LOCAL ORGANIZATIONS.THE WEGE INSTITUTE FOR HEALTH AND LEARNING IS HOME TO THE WEGE RESIDENCY PROGRAM, THROUGH WHICH PARTICIPANTS WORK WITH THE UNINSURED AND THE HOMELESS. IN ADDITION, A NUMBER OF MERCY HEALTH SAINT MARY'S FAMILY PRACTICE AND PEDIATRIC OFFICES PARTICIPATE IN THE REACH OUT AND READ PROGRAM, WHICH TARGETS AT-RISK CHILDREN IN LOW INCOME HOMES BY FOCUSING ON READING READINESS. MERCY HOSPITAL CADILLAC MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE SERVICE AREA FOR ALL APPROPRIATE DEPARTMENTS. THE ORGANIZATION IS THE SOLE COMMUNITY PROVIDER, AND OFFERS VOLUNTEER OPPORTUNITIES TO MEMBERS OF THE COMMUNITY.MERCY HOSPITAL GRAYLINGMEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE SERVICE AREA FOR ALL APPROPRIATE DEPARTMENTS. THE HOSPITAL OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY, PARTICIPATES IN EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS, AND PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH PROGRAMS. MEDICARE AND MEDICAID ARE THE PRIMARY PAYERS FOR THE HOSPITAL AND THE OUTPATIENT CLINICS. THE ORGANIZATION IS THE SOLE COMMUNITY PROVIDER OF HEALTHCARE SERVICES FOR MUCH OF THE REGION. MERCY HOSPITAL GRAYLING IS AN ACTIVE PARTICIPANT IN AND SUPPORTER OF THE AUSABLE FREE CLINIC WHICH PROVIDES MEDICAL SERVICES TO THOSE WHO ARE UNINSURED OR UNDERINSURED. IN ADDITION TO COALITION BUILDING, MERCY HOSPITAL GRAYLING OFFERS NUMEROUS PROGRAMS TO ASSIST PATIENTS IN THE MANAGEMENT OF CHRONIC DISEASE, SUCH AS DIABETES PROGRAMS THAT ARE OFTEN FREE OF CHARGE. A WELLNESS COACH IS ALSO EMPLOYED TO PROVIDE SERVICES TO PATIENTS WITH HIGH BLOOD PRESSURE, HIGH CHOLESTEROL AND OTHER CHRONIC CONDITIONS. IN ADDITION, FREE EDUCATIONAL CLASSES AND SEMINARS ARE OFFERED WITHIN THE COMMUNITY BY STAFF AND PROVIDERS.SAINT JOSEPH MERCY HEALTH SYSTEM SAINT JOSEPH MERCY HEALTH SYSTEM (SJMHS) COLLABORATES WITH OTHERS IN THE COMMUNITY TO ACHIEVE IMPROVEMENTS IN HEALTH AND ACCESS TO HEALTHCARE. THE WASHTENAW HEALTH PLAN (WHP) REPRESENTS A PARTNERSHIP BETWEEN WASHTENAW COUNTY, THE UNIVERSITY OF MICHIGAN AND SJMHS TO PROVIDE PRIMARY MEDICAL CARE SERVICES FOR THE MOST VULNERABLE AND DISENFRANCHISED IN THE COMMUNITY. SJMHS SUPPORTS THIS PROGRAM BY PROVIDING STAFF SUPPORT TO HELP PATIENTS GAIN ACCESS TO A MEDICAL HOME. THE HOSPITALS ALSO PROVIDE THIS POPULATION WITH FREE OR REDUCED-FEE CLINICAL SERVICES.ST. JOSEPH MERCY ANN ARBOR WAS THE LEAD AGENCY IN THE ORIGINATION OF THE WASHTENAW HOUSING ALLIANCE (WHA), A COALITION OF NINE SOCIAL SERVICE AGENCIES DEALING WITH HOUSING OF VARIOUS TYPES, WHOSE MISSION IS TO END HOMELESSNESS IN WASHTENAW COUNTY. IN ADDITION, SJMHS AND ITS BOARD MEMBERS WERE KEY IN BUILDING THE DELONIS CENTER IN DOWNTOWN ANN ARBOR. THIS CENTER PROVIDES NEEDED ACCOMMODATIONS FOR THE HOMELESS, AS WELL AS SOCIAL AND HEALTH SUPPORT SERVICES. SJMHS OPERATES TWO CLINICS THAT SUPPLY FREE OR REDUCED-FEE HEALTH CARE SERVICES TO AT-RISK POPULATIONS. THE NEIGHBORHOOD HEALTH CLINIC IS LOCATED IN DOWNTOWN YPSILANTI, WHILE THE ACADEMIC OB/GYN CLINIC IS LOCATED ON THE ANN ARBOR HOSPITAL CAMPUS.ST. JOSEPH MERCY OAKLANDST. JOSEPH MERCY OAKLAND (SJMO) PARTNERED WITH "THE CORNER", A PONTIAC COMMITTEE THAT CREATED CELEBRATORY EVENTS TO COMMEMORATE PONTIAC'S SESQUICENTENNIAL AND TO CELEBRATE THE LIVES OF THE FIRST GROUP OF AFRICAN AMERICAN PHYSICIANS WHO DEDICATED THEIR LIVES IN SERVICE TO THE CITY. ADDITIONALLY, THEY WANTED TO PIQUE AN INTEREST IN HEALTH CARE CAREERS FOR THE CHILDREN OF PONTIAC AS WELL AS INCREASE THEIR POTENTIAL FOR INCREASING THE FUTURE FINANCIAL STABILITY (AND ULTIMATE PHYSICAL HEALTH) OF THEIR FAMILIES BY EXPOSING THE CHILDREN TO NEW CAREER PATHS AND POTENTIALITIES. THE CORNER ASKED SJMO TO CREATE A HEALTH CARE CO-OP PROGRAM THAT PROVIDED EXPERIENTIAL LEARNING OPPORTUNITIES FOR THESE SAME CHILDREN. IN RESPONSE, SJMO WORKED IN PARTNERSHIP WITH THE OAKLAND SCHOOLS MICHIGAN WORKS: JOBLINKS PROGRAM (A PROGRAM IN WHICH PARTICIPATION IS BASED ON FINANCIAL NEED) TO DEVELOP OUR HEALTH CARE CO-OP PROGRAM FOR PONTIAC AREA HIGH SCHOOL STUDENTS. THE STUDENTS WORK 15 HOURS/WEEK AFTER SCHOOL DURING THE SCHOOL YEAR AND 40 HOURS/WEEK DURING THEIR SUMMER BREAK. STUDENTS ARE PAID FOR THEIR HOURS WORKED BY THE MICHIGAN WORKS PROGRAM.OUR FIRST COHORT OF 21 STUDENTS BEGAN JANUARY OF 2013. THE EXPERIENCE WAS PHENOMENALLY SUCCESSFUL FOR BOTH THE STUDENTS AND HOSPITAL. IT PROVIDED TREMENDOUS OPPORTUNITIES FOR PERSONAL AND PROFESSIONAL DEVELOPMENT FOR STUDENTS AS WELL AS FINANCIAL STABILITY FOR THEIR FAMILIES. ALL OF THE STUDENTS WHO COMPLETED THE PROGRAM (16) MATRICULATED ONTO COLLEGE.BASED ON THE SUCCESS OF OUR FIRST COHORT, WE ARE CURRENTLY HOSTING OUR SECOND COHORT OF 15 STUDENTS WHICH BEGAN JANUARY 2014. OTHER EFFORTS INCLUDE 44 COMMUNITY HEALTH FAIR EVENTS WITH A TOTAL ATTENDANCE OF 3,298 COMMUNITY MEMBERS. OUR COMMUNITY HEALTH NAVIGATORS PROVIDED 1,053 SCREENINGS AND 679 FOLLOW-UPS. THEIR HEALTH SCREENING INCLUDED BLOOD SUGAR, BLOOD PRESSURE AND CHOLESTEROL. MERCY PLACE, OUR FREE OUTPATIENT CLINIC IN DOWNTOWN PONTIAC, PROVIDES COMPREHENSIVE HEALTH CARE, TREATMENT AND PREVENTION TO UNINSURED PEOPLE WHO DO NOT QUALIFY FOR OTHER HEALTH CARE ALTERNATIVES. ST. JOSEPH MERCY PORT HURONSINCE 1990, ST. JOSEPH MERCY PORT HURON (SJMPH) HAS SPONSORED THE PEOPLES' CLINIC FOR BETTER HEALTH. THIS FREE CLINIC, LOCATED WITHIN THE GUADALUPE MISSION IN PORT HURON, HAS BEEN THE CORNERSTONE OF ST. JOSEPH MERCY'S COMMUNITY INITIATIVES FOR THE POOR AND UNDERSERVED. THE CLINIC IS OPERATED IN COLLABORATION WITH THE UNITED WAY AND THE ST. CLAIR COUNTY MEDICAL SOCIETY, WHICH PROVIDES VOLUNTEER PHYSICIANS. PRIMARY MEDICAL CARE AND PRESCRIPTION MEDICATIONS ARE PROVIDED FREE OF CHARGE EACH YEAR TO OVER 3,500 18 TO 65 YEAR-OLDS WHO LACK INSURANCE OR ARE UNDERINSURED. THE CLINIC INCLUDES A SWEET TOUCH PROGRAM DESIGNED TO MONITOR AND MANAGE THE CHRONIC DISEASE OF DIABETES TO THE POOR AND UNINSURED POPULATION. THROUGH VARIOUS FUNDRAISING EVENTS AND ACTIVITIES, ST. JOSEPH MERCY PORT HURON OFFERS REDUCED-COST MAMMOGRAPHY AND OTHER BREAST CANCER DIAGNOSTIC SERVICES TO PATIENTS THROUGHOUT THE COMMUNITY WITH NO INSURANCE OR RESOURCES TO PAY FOR THEIR CARE. SJMPH IS A MEMBER OF THE MICHIGAN STROKE NETWORK, WHICH BRINGS HIGHLY TRAINED NEURO-ENDOVASCULAR SPECIALISTS FROM A CERTIFIED STROKE CENTER DIRECTLY INTO OUR EMERGENCY DEPARTMENT VIA A TELE-MEDICINE STROKE ROBOT.SJMPH ALSO OFFERS THE ONLY COMPREHENSIVE ARRAY OF CANCER TREATMENT SERVICES TO THE COMMUNITY THROUGH ITS MERCY REGIONAL CANCER CENTER. LED BY THE MERCY CANCER COMMITTEE, THE CENTER NOT ONLY PROVIDES INNOVATIVE TECHNOLOGY SUCH AS THE MOST ADVANCED DIGITAL MAMMOGRAPHY IN PORT HURON, BUT ACCESS TO AN ONCOLOGY NURSE NAVIGATOR AS WELL AS THE MOST EXTENSIVE ARRAY OF CLINICAL CANCER RESEARCH TRIALS AVAILABLE THROUGH M.D. ANDERSON AND THE MAYO CLINIC. ST. MARY MERCY LIVONIARESPONDING TO THE COMMUNITY NEED FOR MORE INPATIENT BEHAVIORAL MEDICINE SERVICES, ST. MARY MERCY OFFERS A ROBUST BEHAVIORAL MEDICINE SERVICE. TO IMPROVE THE ER EXPERIENCE FOR PATIENTS WITH MENTAL ILLNESS OR ADDICTION PROBLEMS, A BEHAVIORAL MEDICINE SECTION WAS DESIGNED IN THE NEW ER THAT OPENED IN OCTOBER OF 2013. THE ER PSYCHIATRIC SOCIAL WORKERS ASSIST PATIENTS AND THEIR FAMILIES IN THE AUTHORIZATION PROCESS FOR INPATIENT ADMISSION OR IN CONNECTING THEM WITH OUTPATIENT SERVICES AVAILABLE IN THE COMMUNITY.WITH LIMITED ACCESS FOR FREE CLINIC HEALTHCARE IN WAYNE COUNTY, ST. MARY MERCY HOSPITAL IS PROUD OF THEIR PARTNERSHIP WITH THE JOY SOUTHFIELD CLINIC AND WAYNE HOPE CLINIC. THE FREE LAB SERVICES AND DIABETES EDUCATION PROGRAM, OFFERED BY THE HOSPITAL, ASSIST WITH THE MANAGEMENT OF CHRONIC DISEASES. THE DEVELOPMENT OF AN IN-HOUSE PROGRAM TO MANAGE FOLLOW-UP SPECIALIST CARE FOR PATIENTS SEEN IN THE ER HAS BEEN GREATLY APPRECIATED BY THE UNINSURED PATIENTS, WHO WOULD HAVE WAITED MONTHS TO RECEIVE THEIR FOLLOW-UP CARE. PART VI, LINE 6: TRINITY HEALTH-MICHIGAN IS A MEMBER OF CHE TRINITY HEALTH, THE SECOND-LARGEST CATHOLIC HEALTH CARE SYSTEM IN THE COUNTRY. CHE TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - COMMUNITY BENEFIT GOALS THAT INCLUDE IMPLEMENTING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, CHE TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. OVERALL, THE ORGANIZATION INVESTS MORE THAN $800 MILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING EACH COMMUNITY'S SPECIFIC NEEDS. FOR MORE INFORMATION ABOUT CHE TRINITY HEALTH, VISIT WWW.NEWHEALTHMINISTRY.ORG. 1 CITY OF CADILLAC 200 NORTH LAKE STREET CADILLAC MI 49601 386004541 CITY GOVERNMENT 5000 SPONSOR 2013 ART PAVILION AMERICAN CANCER SOCIETY INC GREAT LAKES DIVISION INC 1755 ABBEY ROAD EAST LANSING MI 48823 381387120 501(C)(3) 5500 SPONSORSHIP AMERICAN CANCER SOCIETY 250 WILLIAMS STREET NW ATLANTA GA 30303 131788491 501(C)(3) 5000 SPONSORSHIP AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 50000 GENERAL SUPPORT ANN ARBOR AREA COMMUNITY FOUNDATION 301 N MAIN ST STE 300 ANN ARBOR MI 48104 386087967 501(C)(3) 201000 GENERAL SUPPORT ANN ARBOR SYMPHONY ORCHESTRA INC 220 E HURON STE 470 ANN ARBOR MI 48104 386069701 501(C)(3) 5000 2013 ANN ARBOR SYMPHONY ORCHESTRA FAMILY CONCERT CANTON CHAMBER OF COMMERCE 45525 HANFORD RD CANTON MI 48187 382087835 501(C)(6) 5350 SPONSORSHIP CHILD ABUSE & NEGLECT COUNCIL DBA CARE HOUSE OF OAKLAND COUNTY INC 44765 WOODWARD AVE PONTIAC MI 48341 382305297 501(C)(3) 5343 FAIR MARKET VALUE SUPPLIES GENERAL SUPPORT CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION 2929 PLYMOUTH RD STE 245 ANN ARBOR MI 48105 271017827 501(C)(3) 30000 SUPPORT WASHTENAW HEALTH INITIATIVE CITY OF WESTLAND 36601 FORD ROAD WESTLAND MI 48185 381810301 CITY GOVERNMENT 10000 PASSPORT TO A HEALTHY CITY SPONSORSHIP DETROIT REGIONAL CHAMBER PO BOX 33840 DETROIT MI 48232 380477570 501(C)(6) 18900 SPONSORSHIP FOOD GATHERERS PO BOX 131037 ANN ARBOR MI 48113 382853858 501(C)(3) 12500 GENERAL SUPPORT GLEANERS COMMUNITY FOOD BANK OF SOUTHEASTERN MICHIGAN 2131 BEAUFAIT DETROIT MI 48207 382156255 501(C)(3) 10000 GENERAL SUPPORT ROTARY CLUB OF GRAYLING PO BOX 373 GRAYLING MI 49738 382900631 501(C)(4) 8781 GENERAL SUPPORT JOY-SOUTHFIELD COMMUNITY DEVELOPMENT CORPORATION 18917 JOY ROAD DETROIT MI 48228 383622930 501(C)(3) 75000 SUPPORT PATIENT ACCESS LIGHTHOUSE OF OAKLAND COUNTY PO BOX 430508 PONTIAC MI 48343 382391381 501(C)(3) 6000 SPONSORSHIP MAKE A WISH FOUNDATION OF MICHIGAN 2300 GENOA BUSINESS PARK DR ROOM 290 BRIGHTON MI 48114 382505812 501(C)(3) 40000 SPONSORSHIP NEW HOPE SHELTER 814 LYNN STREET CADILLAC MI 49601 320019736 501(C)(3) 14400 FAIR MARKET VALUE MISCELLANEOUS GOODS PROVIDE HOUSING FOR UNFORTUNATE MUNSON HEALTHCARE REGIONAL FOUNDATION PO BOX 1188 TRAVERSE CITY MI 49685 382642724 501(C)(3) 5000 SUPPORT OF NORTHERN MICHIGAN DIABETES INITIATIVE OAKLAND COUNTY-MEDICAL MAIN STREET 2100 PONTIAC LK RD BLDG 41W WATERFORD MI 48382 386004876 CITY GOVERNMENT 5000 SPONSORSHIP OAKLAND UNIVERSITY SCHOOL OF BUSINESS ADMINISTRATION 427 ELLIOTT HALL ROCHESTER MI 48309 381714400 501(C)(3) 15500 SPONSORSHIP OAKLAND UNIVERSITY SCHOOL OF NURSING 2200 NORTH SQUIRREL ROAD ROCHESTER MI 48309 381714400 501(C)(3) 5000 SPONSORSHIP PACKARD HEALTH INC 3174 PACKARD RD ANN ARBOR MI 48108 382269817 501(C)(3) 46250 DONATION TO ESTABLISH EMR SYSTEM STEHOUWER FREE CLINIC 201 N MITCHELL STE L-1 CADILLAC MI 49601 611401888 501(C)(3) 138421 SUPPORT OF FREE CLINIC UNITED WAY OF WASHTENAW COUNTY 2305 PLATT RD ANN ARBOR MI 48104 381951024 501(C)(3) 11271 SPONSORSHIP UNITED WAY OF WEXFORD-MISSAUKEE COUNTIES PO BOX 177 CADILLAC MI 49601 237112549 501(C)(3) 10000 UNITED WAY SUPPORT UNIVERSITY OF MICHIGAN DEPT OF MED ED 1500 E MEDICAL CTR DR 5PC 5201 ANN ARBOR MI 48109 386006309 501(C)(3) 5000 SCHOLARLY ACTIVITY - FUNGAL MENINGITIS OUTBREAK WESTERN WASHTENAW AREA VALUE EXPRESS PO BOX 272 CHELSEA MI 48118 382122970 501(C)(3) 5000 GENERAL SUPPORT MERCY HOSPITAL CADILLAC FOUNDATION 400 HOBART CADILLAC MI 49601 203357131 501(C)(3) 119267 GENERAL SUPPORT 26 3 SCHOLARSHIPS 15 25000 PRESCRIPTION MEDICATIONS 237 22134 FAIR MARKET VALUE PRESCRIPTION MEDICATIONS TRANSPORTATION ASSISTANCE 50 2338 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: DONATIONS MADE BY TRINITY HEALTH - MICHIGAN TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 0 1 0 0 0 0 0 0 0 JOSEPH SWEDISH 0 1402192 0 786411 0 1044897 0 572762 0 28714 0 3834976 0 520902 JUDITH PERSICHILLI 0 1253511 0 735075 0 1901967 0 10500 0 7010 0 3908063 0 0 PAUL NEUMANN 0 494416 0 202805 0 115660 0 77823 0 28506 0 919210 0 0 AGNES HAGERTY 0 344298 0 0 0 24359 0 39568 0 15206 0 423431 0 0 JENNIFER BARNETT 0 544376 0 209584 0 173325 0 11250 0 11351 0 949886 0 0 BENJAMIN CARTER 0 523380 0 202878 0 73045 0 80824 0 31986 0 912113 0 0 JAMES BOSSCHER 0 333362 0 135303 0 117905 0 78514 0 12923 0 678007 0 13830 KEDRICK ADKINS 0 784856 0 366716 0 670047 0 112792 0 13375 0 1947786 0 265335 RICHARD O'CONNELL 0 607209 0 284428 0 144773 0 97104 0 33319 0 1166833 0 0 GARRY FAJA 0 550115 0 201021 0 217895 0 63874 0 20922 0 1053827 0 107922 PHILIP MCCORKLE 0 427388 0 142458 0 83180 0 25000 0 32962 0 710988 0 0 JACK WEINER 0 411489 0 134607 0 91411 0 95936 0 40541 0 773984 0 21121 ROBERT CASALOU 0 417993 0 143567 0 57747 0 71479 0 25846 0 716632 0 0 DAVID SPIVEY 0 351633 0 115242 0 61941 0 81498 0 16212 0 626526 0 12731 CHARLES HOFFMAN SJMHS CFO THR 812 0 410943 0 95498 0 3879 0 34693 0 19263 0 564276 0 0 NANCY GRAEBNER 0 266991 0 80664 0 57477 0 36488 0 13598 0 455218 0 0 BARBARA HERTZLER 0 310662 0 73675 0 20128 0 45155 0 18124 0 467744 0 0 RANDALL WAGNER 0 300310 0 62866 0 4484 0 25303 0 17494 0 410457 0 0 JOHN MACLEOD 0 227116 0 80421 0 42937 0 53432 0 21003 0 424909 0 3375 ROBERT SMYTHE 0 293122 0 48294 0 4448 0 20736 0 14320 0 380920 0 0 STEPHANIE RIEMER-MATUZAK 0 214289 0 77644 0 38504 0 60891 0 24837 0 416165 0 3107 MICHAEL GUSHO 0 271295 0 57174 0 1359 0 41955 0 19563 0 391346 0 0 CLAUDE LAUDERBACH 0 224004 0 49362 0 2088 0 45478 0 15399 0 336331 0 0 DEBORAH ARMSTRONG 0 260000 0 0 0 0 0 19850 0 0 0 279850 0 0 REBEKAH SMITH 0 181154 0 48267 0 16264 0 50243 0 2747 0 298675 0 0 MICHAEL SAMYN 0 193436 0 48872 0 960 0 19265 0 17845 0 280378 0 0 KATHLEEN O'CONNOR 246677 0 28687 0 1095 0 49734 0 10018 0 336211 0 0 0 KRISTOPHER AALDERINK 664505 0 294331 0 663 0 14850 0 12128 0 986477 0 0 0 CREG CARPENTER 313011 0 433750 0 450 0 19978 0 10947 0 778136 0 0 0 GEORGE GIBSON 444883 0 275335 0 464 0 7500 0 12524 0 740706 0 0 0 TALLAL ZENI 418018 0 299549 0 637 0 27205 0 12123 0 757532 0 0 0 MARK KELLEY 635714 0 75970 0 1571 0 20000 0 17159 0 750414 0 0 0 DANIEL HALE 0 527004 0 213622 0 115423 0 42104 0 21386 0 919539 0 24468 MARIANNE CUNNINGHAM 0 164476 0 0 0 803 0 13596 0 18931 0 197806 0 0 STEPHEN PIROG 0 173455 0 60971 0 1980 0 44377 0 8761 0 289544 0 0 PETER KARADJOFF 0 98504 0 0 0 18496 0 9688 0 8907 0 135595 0 4734 PAUL BROWNE 0 243006 0 185010 0 52014 0 28955 0 12897 0 521882 0 21648 DEBRA CANALES 0 508488 0 236816 0 106740 0 82290 0 19743 0 954077 0 22307 PAUL CONLON 0 308921 0 120954 0 58780 0 88694 0 25670 0 603019 0 7849 LOUIS FIERENS 0 329192 0 133901 0 55547 0 53208 0 15721 0 587569 0 9499 PRESTON GEE 0 298570 0 117923 0 51982 0 49970 0 29779 0 548224 0 0 MICHAEL HOLPER 0 292196 0 109035 0 48774 0 69949 0 24350 0 544304 0 5807 TERRENCE O'ROURKE 0 548590 0 254064 0 161351 0 24584 0 32380 0 1020969 0 0 MARIA SZYMANSKI 0 429715 0 159037 0 35632 0 60935 0 15654 0 700973 0 20460 ROGER SPOELMAN 0 467996 0 155249 0 100767 0 103021 0 22195 0 849228 0 25924 GREGORY LOOMIS 0 299220 0 65260 0 4401 0 35430 0 16773 0 421084 0 0 GARY ALLORE 0 271400 0 61821 0 904 0 18951 0 20064 0 373140 0 0 MICHAEL MURPHY 0 139488 0 0 0 41394 0 4650 0 11980 0 197512 0 0 PART I, LINE 3 TRINITY HEALTH - MICHIGAN IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH - MICHIGAN'S HOSPITAL CEOS ARE PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF TRINITY HEALTH - MICHIGAN'S CEOS: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH CASH BALANCE RESTORATION AND RETENTION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETENTION BENEFITS PLUS RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($250,000 FOR 2012). THE FOLLOWING ACCRUALS FOR 2012 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $100,292 JAMES BOSSCHER - $47,142 PAUL BROWNE - $9,066 DEBRA CANALES - $60,671 BENJAMIN CARTER - $60,824 ROBERT CASALOU - $44,129 PAUL CONLON - $42,044 GARRY FAJA - $14,846 LOUIS FIERENS - $33,235 PRESTON GEE - $30,120 NANCY GRAEBNER - $18,488 MICHAEL HOLPER - $38,052 JOHN MACLEOD - $24,967 PAUL NEUMANN - $57,823 RICHARD O'CONNELL - $77,104 STEPHANIE RIEMER-MATUZAK - $23,794 REBEKAH SMITH - $9,568 DAVID SPIVEY - $46,907 ROGER SPOELMAN - $68,609 JOSEPH SWEDISH - $543,977 MARIA SZYMANSKI - $21,247 JACK WEINER - $58,955 PART II: THE FOLLOWING INDIVIDUALS ARE VESTED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $185,540 JENNIFER BARNETT - $140,275 JUDITH PERSICHILLI - $1,855,709 JOSEPH SWEDISH - $530,000 COLUMN F OF SCHEDULE J INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. MARY CONLON FAMILY MEMBER OF PAUL CONLON, FORMER KEY EMPLOYEE 13497 EMPLOYMENT ARRANGEMENT 0 NORTHERN MICHIGAN SUPPLY ALLIANCE LOUIS FIERENS, FORMER KEY EMPLOYEE, IS A BOARD MEMBER OF NMSA 1028457 TRINITY HEALTH - MICHIGAN PURCHASED SERVICES FROM NMSA 0 NORTHERN MICHIGAN SUPPLY ALLIANCE (NMSA) LOUIS FIERENS, FORMER KEY EMPLOYEE, IS A BOARD MEMBER OF NMSA 3981980 TRINITY HEALTH - MICHIGAN PURCHASED SUPPLIES FROM NMSA 0 KATHRYN TUNE FAMILY MEMBER OF BARBARA HERTZLER, KEY EMPLOYEE 91209 EMPLOYMENT ARRANGEMENT 0 METROPOLITAN DETROIT AREA HOSPITAL SERVICES INC CHARLES HOFFMAN, KEY EMPLOYEE, IS A BOARD MEMBER OF METRO DETROIT HOSP SVCS 3482100 TRINITY HEALTH - MICHIGAN PURCHASED LAUNDRY SERVICES FROM METRO DETROIT AREA HOSPITAL SERVICES, INC. 0 JASON CARTER FAMILY MEMBER OF BENJAMIN CARTER, OFFICER 31835 EMPLOYMENT ARRANGEMENT 0 RYAN SMITH FAMILY MEMBER OF REBEKAH SMITH, KEY EMPLOYEE 30385 EMPLOYMENT ARRANGEMENT 0 X 38 108200 FAIR MARKET VALUE X 531 FAIR MARKET VALUE X 16170 FAIR MARKET VALUE X 1 13000 FAIR MARKET VALUE X 12 228907 FAIR MARKET VALUE X 8 6941 FAIR MARKET VALUE X 4 1305 FAIR MARKET VALUE X MISCELLANEOUS 475 151460 FAIR MARKET VALUE 1 1 1 1 DESCRIPTION OF ARRANGEMENT: PART I, LINE 30B: ONE PETER MAX FINE ART PAINTING, AND TWO LESTER JOHNSON FINE ART PAINTINGS ARE REQUIRED BY THE DONOR TO BE ON DISPLAY IN ST. JOSEPH MERCY OAKLAND HOSPITAL FOR A PERIOD OF 5 YEARS (UNTIL 2017). THIRD PARTY USE: PART I, LINE 32B: SPECIAL EVENT COMMITTEE VOLUNTEERS SOLICIT NON-CASH CONTRIBUTIONS FROM LOCAL BUSINESSES. THEY SOLICIT ITEMS TO BE USED DURING THE SPECIAL EVENT, SUCH AS FOOD, PLUS ITEMS TO BE SOLD AT THE EVENT AUCTION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF TRINITY HEALTH - MICHIGAN IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF TRINITY HEALTH - MICHIGAN. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF TRINITY HEALTH - MICHIGAN. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR TRINITY HEALTH - MICHIGAN IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS ARE REVIEWED BY THE LOCAL BOARDS OF THE HOSPITAL DIVISIONS OF TRINITY HEALTH-MICHIGAN. THE BOARD RECEIVES A COPY OF THE RETURN BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C TRINITY HEALTH - MICHIGAN HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF TRINITY HEALTH - MICHIGAN, WHICH INCLUDES TRUSTEES, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH TRINITY HEALTH - MICHIGAN'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO TRINITY HEALTH - MICHIGAN OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF TRUSTEES OF TRINITY HEALTH - MICHIGAN IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO TRINITY HEALTH - MICHIGAN. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF TRUSTEES OF TRINITY HEALTH - MICHIGAN ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF TRINITY HEALTH - MICHIGAN ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 TRINITY HEALTH - MICHIGAN IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, THE HOSPITAL DIVISIONS OF TRINITY HEALTH - MICHIGAN INCLUDE A COPY OF THEIR MOST RECENT SCHEDULE H ON THEIR RESPECTIVE WEBSITES. TRINITY HEALTH ALSO INCLUDES TRINITY HEALTH - MICHIGAN'S MOST RECENTLY FILED SCHEDULE H ON ITS WEBSITE. TRUSTEES: FORM 990, PART VII, SECTION A, LINE 1: SR. SUZANNE BRENNAN, CSC, IS A MEMBER OF THE CONGREGATION OF THE SISTERS OF THE HOLY CROSS. HAVING TAKEN A VOW OF POVERTY, SR. SUZANNE BRENNAN DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED TO TRINITY HEALTH - MICHIGAN. INSTEAD, A TOTAL OF $25,000 WAS PAID BY TRINITY HEALTH CORPORATION DIRECTLY TO THE CONGREGATION OF THE SISTERS OF THE HOLY CROSS FOR SR. SUZANNE BRENNAN'S SERVICES AS A TRUSTEE FOR TRINITY HEALTH CORPORATION, TRINITY HEALTH - MICHIGAN AND MERCY HEALTH SERVICES - IOWA, CORP. SR. MARY MOLLISON, CSA, IS A MEMBER OF THE CONGREGATION OF SAINT AGNES. HAVING TAKEN A VOW OF POVERTY, SR. MARY MOLLISON DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED TO TRINITY HEALTH - MICHIGAN. INSTEAD, A TOTAL OF $50,000 WAS PAID BY TRINITY HEALTH CORPORATION DIRECTLY TO THE CONGREGATION OF SAINT AGNES FOR SR. MARY MOLLISON'S SERVICES AS BOARD CHAIR FOR TRINITY HEALTH CORPORATION, TRINITY HEALTH - MICHIGAN AND MERCY HEALTH SERVICES - IOWA, CORP. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO AFFILIATES: -23,951,910. CHANGE IN DEFERRED RETIREMENT COST: 3,737,781. PARTNERSHIP EQUITY ACTIVITY: 220,000. EQUITY EARNINGS IN AFFILIATES: 2,351,328. OTHER TRANSACTIONS: -682,556,806. INDIGENT CARE AGREEMENT REVENUE: 12,240,597. INDIGENT CARE AGREEMENT CONTRIBUTIONS: -11,209,974. GAIN ON SALE, DIVESTITURES: 7,114,361. FORM 990, PART XII, LINE 2: TRINITY HEALTH - MICHIGAN'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY13 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, DOING BUSINESS AS NAMES: MERCY HEALTH SERVICES, SJMHS SPECIALTY PHYSICIANS, MERCY SURGICAL CARE, SAINT MARY'S HEALTH CARE PROFESSIONAL FINANCIAL SERVICES, MERCY HEALTH, SJMHS ORTHOPEDIC SERVICES, SAINT MARY'S FAMILY PHARMACY-SOUTHWEST, SAINT MARY'S FAMILY PHARMACY-WEGE CENTER, SAINT MARY'S FAMILY PHARMACY-CATHEDRAL SQUARE, MERCY OUTPATIENT PHARMACY, MERCY HOSPITAL OUTPATIENT PHARMACY, SPORTX, CHELSEA ORTHOPEDIC SPECIALISTS, CHELSEACARE, SRSLY, CHELSEA COMMUNITY HOSPITAL CHILDREN'S CENTER, CHELSEA COMMUNITY HOSPITAL, DEXTER INTERNAL MEDICINE AND PEDIATRICS, WHITE OAK INN, WOMEN'S HEALTH CENTER, FAMILY MEDICINE OF STOCKBRIDGE, CONFIDENTIAL ASSISTANCE AND REFERRAL FOR EMPLOYEES, CHELSEACARE PHARMACY, CHELSEACARE HOME HEALTH, CARE (CONFIDENTIAL ASSISTANCE AND REFERRAL FOR EMPLOYEES), CHELSEA COMMUNITY HOSPITAL- A MEMBER OF THE SAINT JOSEPH MERCY HEALTHSYSTEM, ST. JOSEPH MERCY PORT HURON, SAINT MARY'S LTC PHARMACY, SAINT MARY'S CATHEDRAL SQUARE PHARMACY, MERCY PROFESSIONAL SERVICES, HEALTHFIRST MEDICAL CENTER, BALD MOUNTAIN DIAGNOSTIC IMAGING, WEXFORD ORTHOPEDICS, MERCY OB/GYN PARTNERS, CADILLAC OCCUPATIONAL MEDICINE, SAINT JOSEPH MERCY CENTER FOR ADVANCED MEDICINE AND SURGERY, CANTON CENTER FOR ADVANCED MEDICINE AND SURGERY, SAINT JOSEPH MERCY CANTON HEALTH CENTER, CANTON HEALTH CENTER, SAINT JOSEPH MERCY PHARMACY- SALINE, SAINT JOSEPH MERCY PHARMACY- REICHERT, SAINT JOSEPH MERCY PHARMACY- TOWERS, SAINT JOSEPH MERCY PHARMACY- HOWELL, ST. JOSEPH MERCY OAKLAND, ST. JOSEPH MERCY HOSPITAL- PONTIAC, MERCY HOSPITAL- PORT HURON, MERCY HOSPITAL- MUSKEGON, MERCY HOSPITAL- GRAYLING, MERCY HOSPITAL- CADILLAC, MERCY HOSPITAL, LIVINGSTON COMMUNITY HOSPICE, LEILA Y. POST MONTGOMERY HOSPITAL- BATTLE CREEK, SAMARITAN HEALTH CENTER- DETROIT, SALINE COMMUNITY HOSPITAL, ST. MARY'S HOSPITAL- GRAND RAPIDS, SAINT MARY'S HEALTH SERVICES- GRAND RAPIDS, MERCY GENERAL HEALTH PARTNERS, SAINT JOSEPH MERCY LIVINGSTON HOSPITAL, ST. JOSEPH MERCY HOSPITAL- ANN ARBOR, SAINT JOSEPH MERCY SALINE HOSPITAL, SAINT JOSEPH MERCY LIVINGSTON HOME CARE, MICHIGAN STROKE NETWORK REGISTRY, MICHIGAN STROKE NETWORK, TRINITY INFORMATION SERVICES, ST. MARY MERCY HOSPITAL, MERCY ADVANTAGE, MICHIGAN CANCER INSTITUTE, SAINT MARY'S FAMILY PHARMACY- ECS, ST. MARY MERCY WOUND CARE CENTER, MERCY MEDICAL CENTER- NOVI, MERCY PRIMARY CARE CENTER- DETROIT PHARMACY, SAINT JOSEPH MERCY HEALTH SYSTEM CENTER FOR BEHAVIOR & MEDICINE, SAINT MARY'S MERCY WOUND CARE CENTER, WESTSIDE OBSTETRICS AND GYNECOLOGY, MERCY PRIMARY CARE CENTER- DETROIT, MERCY NORTH OUTPATIENT PHARMACY, SAINT MARY'S MERCY MEDICAL CENTER, SAINT MARY'S MERCY HOSPITAL, SAINT MARY'S MERCY WEGE CENTER, HEALTH EXPLORATION STATION, MUSKEGON GENERAL HOSPITAL, SAINT MARY'S FAMILY PHARMACY WEGE CENTER FOR HEALTH AND LEARNING, SAINT JOSEPH MERCY HEALTH NETWORK, SAINT JOSEPH MERCY HEALTH SYSTEM, CLINICA SANTA MARIA, SISTERS OF MERCY HEALTH CORPORATION, WEST MICHIGAN REGIONAL HEART AND VASCULAR INSTITUTE, MERCY MEDICAL GROUP, WESTSHORE FAMILY MEDICINE, SAINT MARY'S FAMILY PHARMACY- LTC, MERCY HEALTH SERVICES NORTH, MERCY FAMILY CARE, EVANGELICAL DEACONESS HOSPITAL, ST. JOSEPH MERCY HOSPITAL- PONTIAC, SAINT MARY'S HEALTH CARE, PARTNERS AT HEART, MICHIGAN BARIATRIC INSTITUTE (MBI), ADVANCED LAPAROSCOPIC SURGICAL ASSOCIATES (ASLA), MICHIGAN HEART, ANN ARBOR HOME INFUSION PHARMACY, ST. JOSEPH MERCY OAKLAND URGENT CARE-BIRMINGHAM, MERCY SURGERY CARE NETWORK, MERCY PATHOLOGY, ST. JOSEPH MERCY-BRIGHTON, SJMHS LIVINGSTON ORTHOPEDIC SURGICAL GROUP, SPARTA FAMILY HEALTH CENTER, SAINT JOSEPH MERCY HEALTH SYSTEM CENTER FOR BEHAVORIAL MEDICINE, ST. MARY MERCY ONCOLOGY PRACTICE, ST. MARY MERCY OUTPATIENT PSYCHIATRIC SERVICES, SAINT MARY'S ADVANCED SPECIALTY CARE, HEARTSIDE HEALTH CLINIC, SJMO ROCHESTER HILLS OB/GYN, MERCY HEALTH - GRAND RAPIDS, MERCY HEALTH PHARMACY - SOUTHWEST, MERCY HEALTH PHARMACY - LONG TERM CARE, MERCY HEALTH PHARMACY - CATHEDRAL SQUARE , MERCY HEALTH PHARMACY - HOME INFUSION, MERCY HEALTH SAINT MARY'S, MERCY HEALTH SOUTHWEST CAMPUS, MERCY HEALTH ROCKFORD CAMPUS, MERCY HEALTH PHARMACY - WEGE CENTER, INSPIRIT CANCER SUPPORT SERVICES, MERCY CADILLAC CANCER CENTER, MERCY PHYSICIAN NETWORK, MERCY CADILLAC PHYSICIAN NETWORK, MERCY PHYSICIAN NETWORK CADILLAC, MERCY CANCER CENTER, MCAULEY HEALTH CENTER, PROFESSIONAL FINANCIAL SERVICES, RICHARD J. LACKS CANCER CENTER, BROWNING CLAYTOR HEALTH CENTER CLR INVESTMENTS LLC 120 W HARRIS ST CADILLAC MI 49601 320008631 REAL ESTATE RENTAL & DEVELOPMENT MI 19367 172831 TRINITY HEALTH-MICHIGAN SAINT MARY'S PHARMACY LLC 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 383404443 PHARMACY MI 0 0 TRINITY HEALTH-MICHIGAN TRINITY HEALTH-WARDE LAB LLC 20555 VICTOR PARKWAY LIVONIA MI 48152 272681908 REAL ESTATE RENTAL DE 845198 8643467 TRINITY HEALTH-MICHIGAN ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTHCARE SERVICES MI 501(C)(3) LINE 9 TRINITY HEALTH-MICHIGAN 1 AMICARE HOSPICE SERVICES INC 20555 VICTOR PARKWAY LIVONIA MI 48152 382949053 PROVIDE HOSPICE SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES INC 0 AUXILIARY OF HOLY ROSARY HOSPITAL 351 SW 9TH STREET ONTARIO OR 97914 943059469 SUPPORTS SERVICES OF RELATED HOSPITAL OR 501(C)(3) LINE 9 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO 0 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 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