2014-02-14T17:00:22-06:00 2013-06-30 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2012-07-01 381358412 SPECTRUM HEALTH UNITED SPEC 6167747322 615 S Bower Greenville MI 488382628 RYAN K JOHNSON 2014-02-06 true Geralyn R Hurd P00933422 3128997000 2012 2015-11-30 17:44:51Z BRIAN BRASSER 615 S Bower Greenville MI 488382628 82403209 false X HTTP://WWW.SPECTRUMHEALTH.ORG/UNITED X 1911 MI TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. 14 10 659 65 0 0 1824429 537666 67314122 72927630 -70433 217788 -289956 443219 68778162 74126303 0 2700 0 0 27984554 30777926 0 0 0 32762073 36661655 60746627 67442281 8031535 6684022 65227192 69032510 42311078 38654541 22916114 30377969 TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. false false 61064712 2700 72853081 SPECTRUM HEALTH UNITED PROVIDES HEALTHCARE RELATED SERVICES TO THE GREATER MONTCALM COMMUNITY REGARDLESS OF ABILITY TO PAY. OUR MORE THAN 180 PROFESSIONAL STAFF, 270 CLINICAL STAFF, AND 200 MEDICAL STAFF PROVIDE QUALITY CARE TO PATIENTS AND FAMILIES. OUR COMMUNITY HOSPITAL HAS 61 ACUTE CARE-BEDS AND 39 LONG-TERM BEDS. IT ALSO INCLUDES SPECIALTY CRITICAL CARE UNITS, OUTPATIENT SERVICES, AND LONG TERM SKILLED NURSING. THERE WERE 2,498 INPATIENT ADMISSIONS, 8,649 INPATIENT DAYS, 237 REHAB & NURSING CENTER ADMISSIONS, 12,967 REHAB & NURSING CENTER PATIENT DAYS, AND 28,359 EMERGENCY ROOM VISITS IN FISCAL YEAR 2013. SPECTRUM HEALTH UNITED WAS NAMED ONE OF TRUVEN HEALTH ANALYTICS 100 TOP HOSPITALS IN THE COUNTRY IN AN ANNUAL STUDY WHERE HOSPITAL RANKINGS ARE BASED ON MEASURES OF OVERALL ORGANIZATION PERFORMANCE, INCLUDING PATIENT CARE, OPERATIONAL EFFICIENCY AND FINANCIAL STABILITY. ADDITIONALLY, THEY WERE ALSO NAMED ONE OF THE NATION'S TOP PERFORMERS ON KEY QUALITY MEASURES BY THE JOINT COMMISSION, THE LEADING ACCREDITOR OF HEALTH CARE ORGANIZATIONS IN AMERICA. 61064712 true true false false false false false false false true false false false true false false true false false false false false false false false true true false false true true false false false false false false false false true true false false false false false true true true true false true 78 0 true 659 true false false false false false false false false false false X 14 10 false false true false true true true true true false false true true true true true true true true false X Ryan K Johnson 6162256310 615 S Bower Greenville MI 488382628 X CHRISTINA FREESE-DECKER 46.00 4.00 X X 388108 0 107120 DAVID MACK 2.00 4.00 X X 0 18000 0 LINDA BLANCHARD 2.00 2.00 X X 0 0 0 WILLIAM HAM 2.00 4.00 X X 0 0 0 DOMENICO AUSIELLO MD 2.00 2.00 X 0 0 0 DOUGLAS APPLE MD 2.00 48.00 X 0 338648 28718 FRANZ MOGDIS 2.00 2.00 X 0 0 0 JEFFERY LOOMIS 2.00 4.00 X 0 0 0 KEVIN O'CONNOR 2.00 2.00 X 0 0 0 MARC CHIRCOP 2.00 48.00 X 0 678791 186859 MATTHEW DEKRAKER DC 2.00 2.00 X 0 0 0 PETER HAINES 2.00 2.00 X 0 0 0 STEVE BOWSER 2.00 2.00 X 0 0 0 TAD CHARLES SIMON 2.00 2.00 X 0 0 0 RYAN JOHNSON 46.00 4.00 X 140497 0 22326 BRIAN BRASSER 48.00 2.00 X 166465 0 25601 PRISCILLA MAHAR 48.00 2.00 X 167383 0 24304 VICKI JENSEN 48.00 2.00 X 158624 0 25295 BENNETT WALSTATTER 50.00 0.00 X 362756 0 35298 CONNIE JANUZELLI 50.00 0 X 324958 0 27420 JUSITH AMPARO 50.00 0 X 279972 0 12785 KELLY WIERSEMA 50.00 0 X 242440 0 23020 KRISTINA MIXER 50.00 0 X 242580 0 24101 DAVID OEHRING 0.00 0.00 X 167839 0 10176 MARY ANNE JONES 0.00 50.00 X 0 273228 72862 PAUL BONIS 0.00 50.00 X 0 517456 127067 2641622 1826124 752951 18 true true false ELZINGA & VOLKERS 86 E 6TH ST HOLLAND MI 49423 CONSTRUCTION 5753886 WEST MICHIGAN ANESTHESIA PC 3333 EVERGREEN NE GRAND RAPIDS MI 49525 MEDICAL 802175 ANESTHESIA MEDICAL CONSULTANTS 3333 EVERGREEN NE SUITE 100 GRAND RAPIDS MI 49525 MEDICAL 400000 WEST MICHIGAN SHARED HOSPITAL PO BOX 1134 GRAND RAPIDS MI 495011134 LAUNDRY 210428 INCREMEDICAL LLC 8259 WICKER AVE ST JOHN IN 46373 REHAB SERVICES 180722 9 496853 6584 34229 537666 PATIENT SERVICE REVENUE 622110 71496566 71496566 OTHER OPERATING INCOME 900099 1431064 1431064 0 0 0 0 0 0 0 72927630 78007 78007 0 0 231806 172600 59206 0 59206 59206 8238205 5882 8023875 80431 214330 -74549 139781 -74549 214330 0 0 0 CAFETERIA REVENUE 722212 384013 384013 0 0 0 0 0 0 384013 74126303 72853081 0 735556 0 2700 2700 0 0 1225722 1105933 119789 281590 254070 27520 22382192 20194800 2187392 936370 844859 91511 4231573 3818025 413548 1720479 1552338 168141 0 107769 107769 0 0 0 0 2618663 2446387 172276 0 442719 18742 423977 1577562 1327497 250065 39206 37817 1389 0 2911580 2848025 63555 255256 233094 22162 0 115264 77183 38081 1232874 1232874 0 3378814 3305060 73754 616012 602565 13447 BAD DEBTS 4789352 4789352 MEDICAL SUPPLIES 9418292 9385541 32751 SHARED SERVICES / MANAGEMENT FEES 8372453 6697962 1674491 MEDICAID QUALITY ASSESSMENT TAX 80223 80223 705616 209665 495951 0 67442281 61064712 6377569 0 0 16630113 4814836 6398085 8053310 0 0 903504 1123238 819147 545634 68010823 26643682 36764504 41367141 1969487 10724424 0 0 85000 85000 1657352 2318927 65227192 69032510 6756542 6969753 19230 24455337 23829580 0 11079969 7855208 42311078 38654541 X 21632285 28316307 1283829 2011794 49868 22916114 30377969 65227192 69032510 X 6684022 777833 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1179706 1179706 45439198 14190402 31248796 1832373 1351577 480796 19237678 10970811 8266867 321868 130892 190976 41367141 0 DUE TO AFFILIATES 3560829 THIRD PARTY PAYABLE 4294379 7855208 FIN 48 FOOTNOTE SCHEDULE D, PART X, LINE 2 SPECTRUM HEALTH SYSTEM CONDUCTS AN ANALYSIS ANNUALLY TO DETERMINE THE ORGANIZATION'S LIABILITY WITH RESPECT TO UNCERTAIN TAX POSITIONS. FOR THE YEAR ENDED JUNE 30, 2013 IT WAS DETERMINED THAT THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS TO DISCLOSE. AS SUCH, THERE WAS NO FOOTNOTE ADDED TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. true true X true X false true true false true true 1091055 1091055 0.01740 13441770 13404690 37080 0.00060 0 0.00000 0 0 14532825 13404690 1128135 0.01800 367755 367755 0.00590 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 367755 0 367755 0.00590 0 0 14900580 13404690 1495890 0.02390 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 true 4789352 25235532 27626770 -2391238 X true false 1 1 SPECTRUM HEALTH UNITED

615 S BOWER GREENVILLE MI 488382628

HTTP://WWW.SPECTRUMHEALTH.ORG/UNITED X X X SPECTRUM HEALTH UNITED 1 true X X X X X X X X X 11 true true true X X X X X X X X X X true false true true 200 false true X true true X X X true false X X X X true X false false 1 SPECTRUM HEALTH REHAB AND NURSING CENTER

615 SOUTH BOWER ST GREENVILLE MI 48838

NURSING HOME Eligibility criteria for free or discounted care Schedule H, Part I, Line 3c THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE. Community benefit report prepared by related organization Schedule H, Part I, Line 6a SPECTRUM HEALTH SYSTEM (EIN: 38-3382353) RELATED ORGANIZATION INFORMATION SCHEDULE H, PART I, LINE 6A THE HEALTH SYSTEM PUBLISHES A CONSOLIDATED COMMUNITY BENEFIT REPORT ON ITS WEBSITE AT WWW.SPECTRUMHEALTH.ORG (CLICK THE LINK TITLED "ABOUT US"). IN ADDITION, THE HEALTH SYSTEM HOLDS AN ANNUAL MEETING TO THE PUBLIC TO DISCUSS ITS COMMUNITY COMMITMENTS. Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 THE ORGANIZATION CALCULATES AN OVERALL COST-TO-CHARGE RATIO DERIVED BY USING THE IRS WORKSHEET 2 FORMAT, RATIO OF PATIENT CARE COST-TO-CHARGES. ALL PATIENT SEGMENTS AND PAYERS ARE USED IN THE CALCULATION. MEDICAID SCHEDULE H, PART I, LINE 7B DURING THE TAX YEAR THE ORGANIZATION RECEIVED A LARGE ALLOCATION FROM THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH'S RURAL ACCESS POOL RESULTING IN LOWER THAN NORMAL COMMUNITY BENEFIT EXPENSE RELATED TO MEDICAID. HOSPITALS CATEGORIZED BY CENTERS FOR MEDICARE AND MEDICAID SERVICES AS SOLE COMMUNITY HOSPITALS ARE ELIGIBLE FOR ALLOCATIONS FROM THE POOL. EACH HOSPITALS ALLOCATION FROM THE POOL IS CALCULATED AS THE UNREIMBURSED COST THE HOSPITAL INCURRED PROVIDING INPATIENT AND OUTPATIENT SERVICES TO MICHIGAN MEDICAID BENEFICIARIES DURING ITS COST PERIOD THAT ENDED DURING THE SECOND PREVIOUS FY. Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 4,789,352 Bad debt expense - methodology used to estimate amount Schedule H, Part III, Line 2 THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE, PAYOR COMPOSITION AND AGING, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTED ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR THIRD-PARTY PAYERS, THE PROVISION IS DETERMINED BY ANALYZING CONTRACTUALLY DUE AMOUNTS FROM PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES. FOR SELF-PAY PATIENTS, THE PROVISION IS BASED ON AN ANALYSIS OF PAST EXPERIENCE RELATED TO PATIENTS UNWILLING TO PAY STANDARD RATES CHARGED. THE DIFFERENCE BETWEEN THAT STANDARD RATE CHARGED (LESS THE NEGOTIATE DISCOUNTED RATE) AND THE AMOUNT ACTUALLY COLLECTED AFTER THE REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ALL CHARGES ARE REPORTED AT GROSS, WHICH IS CONSISTENT WITH THE REPORTING METHODOLOGY USED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. Bad debt expense - methodology used to estimate amount as community benefit Schedule H, Part III, Line 3 THE ORGANIZATION IS UNABLE TO ESTIMATE ACCURATELY THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY. ALTHOUGH A PORTION OF BAD DEBT EXPENSES MAY RELATE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE, A REPORTABLE FIGURE CANNOT BE REASONABLY ESTIMATED. THE ORGANIZATION HAS IMPLEMENTED A "PROPENSITY TO PAY" EVALUATION TOOL THAT PROACTIVELY ASSESSES ONE'S ABILITY AND LIKELIHOOD TO PAY. WITH THIS TOOL, THE ORGANIZATION HAS BEEN ABLE TO PROVIDE A HIGHER DEGREE OF FOCUSED FINANCIAL COUNSELING EFFORTS, RESULTING IN A SUBSTANTIAL REDUCTION OF BAD DEBT AND HIGHER RATE OF IDENTIFICATION OF CHARITY ACCOUNTS. Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 THE NET PATIENT SERVICE REVENUE, PATIENT ACCOUNTS RECEIVABLE, AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOOTNOTE IS ON PAGES 14 TO 16 OF THE ORGANIZATIONS CONSOLIDATED FINANCIAL STATEMENT. Community benefit & methodology for determining medicare costs Schedule H, Part III, Line 8 THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. IN DETERMINING MEDICARE SHORTFALLS THE ORGANIZATION USES A RATIO OF COST TO CHARGES. IN DETERMINING THE RATIO OF COST TO CHARGES THE ORGANIZATION ADJUSTS FOR BAD DEBT EXPENSES, NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES AND COMMUNITY BENEFITS ACCOUNTED FOR, AND OR REPORTED, ELSEWHERE. THE RATIO OF COST TO CHARGES IS APPLIED TO MEDICARE CHARGES TO DETERMINE SHORTFALLS IN MEDICARE REIMBURSEMENTS. COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE SCHEDULE H, PART III, LINE 9B THE ORGANIZATION PROVIDES FREE CARE TO ALL PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE WILL NOT OWE ANYTHING, AND THUS WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES. Community Served by Needs Assessment Schedule H, Part V Section B, Line 3 (1) SPECTRUM HEALTH UNITED - PRIMARY AND SECONDARY DATA WERE IDENTIFIED, COLLECTED AND ANALYZED, WHICH INCLUDED THE DEVELOPMENT AND DISTRIBUTION OF A COMMUNITY AND HEALTH CARE PROVIDER SURVEY. THE COMMUNITY SURVEY WAS MAILED IN TO 1,500 RANDOMLY SELECTED HOUSEHOLDS WITHIN MONTCALM COUNTY WITH 424 RETURNED BY MAIL FOR ANALYSIS. AN ADDITIONAL 51 SURVEYS WERE COMPLETED AND RETURNED FROM CLIENTS OF LOCAL SERVICE AGENCIES FOR A TOTAL OF 475 SURVEYS USED FOR ANALYSIS. COUNTY-SPECIFIC SECONDARY DATA FROM A VARIETY OF SOURCES WAS ALSO COLLECTED AND ANALYZED. MANY EXPERTS ON PUBLIC HEALTH WERE CONSULTED AS MEMBERS OF THE STEERING COMMITTEE INCLUDING MID-MICHIGAN DISTRICT HEALTH DEPARTMENT, UNITED WAY, AND THE DEPARTMENT OF HUMAN SERVICES. FOR THE ENTIRE LISTING OF INDIVIDUALS, SEE THE MONTCALM COUNTY CHNA.; Other Hospital Facilities included in Needs Assessment Schedule H, Part V Section B, Line 4 (1) SPECTRUM HEALTH UNITED - CARSON CITY HOSPITAL SHERIDAN COMMUNITY HOSPITAL; Used FPG to determine eligibility for providing discounted care criteria Schedule H, Part V Section B, Line 11 (1) SPECTRUM HEALTH UNITED - THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE.; Other factors included in calculating amounts charges to patients Schedule H, Part V Section B, Line 12h (1) SPECTRUM HEALTH UNITED - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.; Other ways hospital publicized Financial Assistance Policy Schedule H, Part V Section B, Line 14g (1) SPECTRUM HEALTH UNITED - THE ORGANIZATION PUBLICIZES THE FINANCIAL ASSISTANCE POLICY BY COMMUNICATING ITS AVAILABILITY VIA A PATIENT HANDBOOK, SIGNAGE, INFORMATIONAL BROCHURES, COMMUNITY PUBLICATIONS, AND VIA WORD OF MOUTH BY FINANCIAL COUNSELORS ASSISTING PATIENTS. REFERENCE TO THE AVAILABILITY OF THE POLICY IS PUBLICLY POSTED IN WAITING ROOMS. ; Means used to determine amounts billed Schedule H, Part V Section B, Line 20d (1) SPECTRUM HEALTH UNITED - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.; Needs assessment. Schedule H, Part VI, Line 2 THE CHNA DATA PROVIDES A LEVEL FOUNDATION ON WHICH TO PLAN, DEVELOP, AND IMPLEMENT NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF OUR COMMUNITY. OPERATIONAL SERVICES IDENTIFIED BY THE CHNA, E.G. RETENTION OF QUALIFIED PROVIDERS, HAVE BEEN BUILT INTO THE STRATEGIC PLAN AND BUDGET, AND A RECRUITMENT PLAN HAS BEEN CREATED BASED ON CONVERSATIONS AROUND THE COMMUNITY BENEFIT DOLLARS. THE CHNA AND IMPLEMENTATION PLAN IS LOCATED AT: HTTP://WWW.SPECTRUMHEALTH.ORG/ABOUT-UNITED-HOSPITAL-COMMUNITY-HEALTH-NEEDS-ASSESSMENT SPECTRUM HEALTH ALSO PREPARES AN ANNUAL CORPORATE SOCIAL RESPONSIBILITY REPORT THAT FOCUSES ON NINE KEY AREAS: HEALTHIER COMMUNITIES, EDUCATION, COMMUNITY ENGAGEMENT, RESEARCH, INNOVATION, EMPLOYEE ENGAGEMENT, SUSTAINABILITY, REGIONAL RELATIONSHIPS AND COMMUNITY BENEFIT. Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH PRODUCING INFORMATION CARDS FOR THE UNINSURED, COMMUNITY OUTREACH PROGRAMS, CONSUMER INFORMATION CLASSES, ORGANIZATION WEBSITE, PERSONAL FINANCIAL COUNSELING, AND BY PROVIDING ASSISTANCE IN THE ACTUAL ENROLLMENT OF SUCH PROGRAMS. THE ORGANIZATION HAS A DEPARTMENT OF FINANCIAL COUNSELORS WHO WORK WITH PATIENTS THAT EXPRESS ANY LEVEL OF CONCERN WITH PAYING THEIR BILL. IN ADDITION, THE ORGANIZATION ALSO PROACTIVELY IDENTIFIES PATIENTS WHO HAVE QUALIFYING FACTORS FOR GOVERNMENTAL ASSISTANCE AND PARTNERS WITH ORGANIZATIONS THAT SPECIALIZE IN THE QUALIFICATION PROCESS. IF THE NEED FOR ASSISTANCE IS NOT IDENTIFIED PRIOR TO BILLING, PATIENT CONCERNS THAT ARE RECEIVED AS A RESULT OF RECEIVING A BILL ARE ADDRESSED BY FINANCIAL COUNSELORS AT THAT TIME. THE ORGANIZATION WIDELY PUBLICIZES COMMUNICATIONS TO PATIENTS AND THE PUBLIC ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH VARIOUS METHODS INCLUDING, BUT NOT LIMITED TO, VIA THE SPECTRUM HEALTH PATIENT HANDBOOK, VARIOUS INFORMATIONAL BROCHURES, SIGNAGE IN EACH HOSPITAL DEPARTMENT, ADMISSIONS OFFICES AND OTHER PUBLIC LOCATIONS, UPON REQUEST BY ANY PATIENT, GUARANTOR OR COMMUNITY MEMBER, WORD OF MOUTH VIA FINANCIAL COUNSELORS AND OTHERS, AND THROUGH COMMUNITY PUBLICATIONS AND OUTREACH EVENTS. IN ADDITION, THE ORGANIZATION LISTS OPTIONS FOR THE UNINSURED AND UNDERINSURED ON THEIR WEBSITE, ALONG WITH A COPY OF THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY (SEARCH "FINANCIAL ASSISTANCE" AT WWW.SPECTRUMHEALTH.ORG). Community information. Schedule H, Part VI, Line 4 THE TAXPAYER HAS IDENTIFIED A PRIMARY SERVICE AREA COMPRISED OF 19 ZIP CODES SURROUNDING GREENVILLE, WHERE UNITED HOSPITAL IS LOCATED. THE OVERALL SERVICE AREA INCLUDES MONTCALM AND PORTIONS OF ADJACENT COUNTIES THAT IN TOTAL SUPPORTS A POPULATION OF OVER 100,000 RESIDENTS. FOR SPECIFIC POPULATION STATISTICS SEE THE COMMUNITY HEALTH NEEDS ASSESSMENT ACCESSIBLE AT HTTP://WWW.SPECTRUMHEALTH.ORG/ABOUT-UNITED-HOSPITAL-COMMUNITY-HEALTH-NEEDS-ASSESSMENT Promotion of community health Schedule H, Part VI, Line 5 SPECTRUM HEALTH UNITED'S BOARD OF DIRECTORS IS COMPOSED OF MEMBERS OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN SPECTRUM HEALTH UNITED'S PRIMARY SERVICE AREA. SPECTRUM HEALTH UNITED ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SPECTRUM HEALTH UNITED INVESTS NET EARNINGS IN IMPROVING PATIENT CARE, BUILDING AND RENOVATING FACILITIES, PURCHASING NEW TECHNOLOGY, PROVIDING HEALTH EDUCATION AND FUNDING COMMUNITY PROGRAMS. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON SPECTRUM HEALTH UNITED TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY. Affiliated health care system Schedule H, Part VI, Line 6 SPECTRUM HEALTH IS AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM IN WEST MICHIGAN OFFERING A FULL CONTINUUM OF CARE THROUGH THE SPECTRUM HEALTH HOSPITAL GROUP, WHICH IS COMPRISED OF NINE HOSPITALS INCLUDING HELEN DEVOS CHILDREN'S HOSPITAL, A STATE OF THE ART CHILDREN'S HOSPITAL THAT OPENED IN JANUARY 2011, AND 183 SERVICE SITES; THE SPECTRUM HEALTH MEDICAL GROUP AND WEST MICHIGAN HEART, PHYSICIAN GROUPS TOTALING MORE THAN 700 PROVIDERS; AND PRIORITY HEALTH, A HEALTH PLAN WITH 600,000 MEMBERS. SPECTRUM HEALTH IS WEST MICHIGAN'S LARGEST EMPLOYER WITH 19,000 EMPLOYEES. THE ORGANIZATION PROVIDED $250 MILLION IN COMMUNITY BENEFIT DURING ITS 2013 FISCAL YEAR. SPECTRUM HEALTH UNITED IS A MEMBER OF THE AFFILIATED GROUP OF ENTITIES WITHIN THE SPECTRUM HEALTH SYSTEM ("SPECTRUM HEALTH"). EACH MEMBER CREATES VALUE WITHIN ITS RESPECTIVE COMMUNITY AND IS RESPONSIBLE FOR THEIR ACTIONS AND THE IMPACT THESE ACTIONS HAVE. FROM ITS INCEPTION, SPECTRUM HEALTH HAS BEEN A FAITHFUL STEWARD OF ITS COMMUNITY ASSETS. AS A WEST MICHIGAN-BASED NOT-FOR-PROFIT HEALTH SYSTEM, THE ORGANIZATION INVESTS ITS NET EARNINGS TO IMPROVE PATIENT CARE, BUILD AND RENOVATE FACILITIES, PURCHASE NEW TECHNOLOGY, PROVIDE HEALTH EDUCATION AND FUND LOCAL COMMUNITY PROGRAMS. OVER THE YEARS, OUR MISSION HAS REMAINED THE SAME-TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. WE TAKE OUR MISSION SERIOUSLY. IT IS CENTRAL TO OUR STRATEGIC DISCUSSIONS AND GUIDES OUR INVESTMENTS AND THE ALLOCATION OF OUR RESOURCES. SPECTRUM HEALTH IS COMMITTED TO PROVIDING VALUE TO THE PEOPLE WE SERVE. "VALUE" MEANS ACCESS TO HIGH-QUALITY HEALTH CARE AT AFFORDABLE COSTS, AS WELL AS ACCESS TO THE FULL CONTINUUM OF HEALTH CARE SERVICES, FROM HEALTH INSURANCE TO OUTPATIENT CARE TO INPATIENT AND HOME CARE, AND EVERYTHING IN BETWEEN. SPECTRUM HEALTH HAS HUNDREDS OF PROGRAMS THAT SUPPORT ITS MISSION "TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE." THESE PROGRAMS ARE BROUGHT TOGETHER UNDER NINE KEY AREAS: HEALTHIER COMMUNITIES, EDUCATION, COMMUNITY ENGAGEMENT, RESEARCH, INNOVATION, EMPLOYEE ENGAGEMENT, SUSTAINABILITY, REGIONAL RELATIONSHIPS AND COMMUNITY BENEFIT. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 THE ORGANIZATION IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE HOWEVER THE ORGANIZATION VOLUNTARILY REPORTS COMMUNITY BENEFIT INFORMATION TO THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION AND IN AN ANNUAL MEETING TO THE COMMUNITY. THE COMMUNITY BENEFIT REPORT IS ALSO AVAILABLE ON THE ORGANIZATION'S WEBSITE. X X X X X true true false false false false false false false BENNETT WALSTATTER 349391 0 6000 0 7365 0 10630 0 24668 0 398054 0 0 0 BRIAN BRASSER 140182 0 25268 0 1014 0 6012 0 19589 0 192065 0 0 0 CHRISTINA FREESE-DECKER 235924 0 151236 0 947 0 62349 0 44771 0 495228 0 97867 0 CONNIE JANUZELLI 324160 0 0 0 799 0 10000 0 17420 0 352378 0 0 0 DAVID OEHRING 54612 0 0 0 113227 0 2500 0 7676 0 178015 0 0 0 DOUGLAS APPLE MD 0 287167 0 50854 0 627 0 13750 0 14968 0 367365 0 0 JUSITH AMPARO 277738 0 1250 0 984 0 6926 0 5860 0 292758 0 0 0 KELLY WIERSEMA 241977 0 0 0 463 0 8322 0 14698 0 265460 0 0 0 KRISTINA MIXER 242117 0 0 0 463 0 9829 0 14272 0 266681 0 0 0 MARC CHIRCOP 0 375829 0 284273 0 18690 0 126548 0 60311 0 865650 0 173508 MARY ANNE JONES 0 240202 0 27001 0 6025 0 48317 0 24545 0 346090 0 0 PAUL BONIS 0 297773 0 214015 0 5669 0 76409 0 50658 0 644524 0 113828 PRISCILLA MAHAR 140937 0 24553 0 1893 0 5942 0 18362 0 191687 0 0 0 RYAN JOHNSON 127438 0 12690 0 369 0 5439 0 16887 0 162823 0 0 0 VICKI JENSEN 133857 0 23361 0 1406 0 7841 0 17453 0 183918 0 0 0 Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 THE SPECTRUM HEALTH SYSTEM BOARD OF DIRECTORS (THROUGH ITS EXECUTIVE COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF THE TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES AT SPECTRUM HEALTH UNITED. LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON. COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED TO THE EXECUTIVE COMMITTEE IN ADVANCE OF MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM AND, FOR FY 2013 (7/1/12-6/30/13), WAS BASED ON THE FOLLOWING INDEPENDENT SURVEYS OF HEALTH CARE EXECUTIVES AT COMPARABLE HEALTH SYSTEMS, HEALTH PLANS, AND MEDICAL GROUPS: * AMERICAN MEDICAL GROUP ASSOCIATION: 2012 MEDICAL GROUP COMPENSATION & FINANCIAL SURVEY * INTEGRATED HEALTHCARE STRATEGIES: 2012 HEALTH CARE EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2012 EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2012 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY * MEDICAL GROUP MANAGEMENT ASSOCIATION: 2012 MANAGEMENT COMPENSATION SURVEY * SULLIVAN, COTTER AND ASSOCIATES: 2012 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS * SULLIVAN, COTTER AND ASSOCIATES: 2012 PHYSICIAN COMPENSATION AND PRODUCTIVITY SURVEY REPORT * TOWERS WATSON: 2012/2013 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT * TOWERS WATSON: 2012/2013 TOP MANAGEMENT COMPENSATION REPORT * WARREN: 2012 COMPENSATION SURVEY COMPENSATION ADJUSTMENTS ARE APPROVED BY EXECUTIVE COMMITTEE MEMBERS, CONSISTENT WITH THE SPECTRUM HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE EXECUTIVE COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE EXECUTIVE COMMITTEE IS NATIONAL AND REFLECTS THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTHCARE ORGANIZATIONS. SPECTRUM HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTHCARE MARKET PRACTICES. GEOGRAPHIC PAY DIFFERENTIAL AND COST OF LIVING DATA INDICATES CONSISTENCY WITH NATIONAL DATA. THIS PROCESS IS INTENDED TO ASSIST SPECTRUM HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND COMPLYING WITH THE POTENTIAL SPECTRUM HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III). Severance or change-of-control payment Schedule J, Part I, Line 4a $112,358 DAVID OEHRING Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b $113,828 PAUL BONIS $173,508 MARC CHIRCOP $ 97,867 CHRISTINA FREESE-DECKER SCHEDULE J, PART I, LINE 4B IS ANSWERED "YES" BECAUSE CERTAIN INDIVIDUALS, WHOSE SALARY AND BENEFITS ARE PAID BY THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION, DO "PARTICIPATE IN" SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN(S). SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN(S) BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN SCHEDULE J, PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR. A MICHIGAN STATE HOSPITAL FINANCE AUTHORITY 382889417 59465HHD1 2008-03-27 7500000 CAPITAL FUNDING false false true B KENT HOSPITAL FINANCING AUTHORITY (2011C) 382350002 490580ED5 2011-11-09 75511075 2008B2 REVENUE REFUNDING BONDS false false true A 1427738 0 2000000 0 0 0 23778 0 0 1976222 0 0 2008 false false true true B 0 0 23241041 0 0 0 257183 0 0 0 22983858 0 2011 true false true true A false false false false false false 0.0000 0.0000 0.0000 false false 0.0000 false true B false false false false false false 0.0000 0.0000 0.0000 false false 0.0000 false true A false false false true true false 0.0 false false false 0.0 false false true B false false false true false false 0.0 false false false 0.0 false false true A true B true TAX EXEMPT BONDS SCHEDULE K, PART I BONDS ARE ISSUED ON BEHALF OF AN OBLIGATED GROUP UNDER 1989 MTI AND OBLIGATED GROUP AND DESIGNATED AFFILIATES UNDER 1998 MTI. ALL OBLIGATED GROUP MEMBERS AND OR DESIGNATED AFFILIATES ARE PART OF THE SAME HEALTH SYSTEM AND ARE TAX-EXEMPT 501(C)(3) CHARITABLE ORGANIZATIONS. THE 2011C BOND IS ATTRIBUTABLE TO TWO LEGAL ENTITIES WITHIN THE OBLIGATED GROUP (SEE ALSO FORM 990, PART X, LINE 20): * SPECTRUM HEALTH HOSPITALS (EIN 38-1360529) AND * SPECTRUM HEALTH UNITED (EIN 38-1358412) AS IT RELATES TO THIS BOND, THE INFORMATION REPORTED IN SCHEDULE K, PART I IS REPEATED FOR EACH MEMBER OF THE OBLIGATED GROUP. THE INFORMATION REPORTED IN PART II IS REPRESENTATIVE OF THE REPORTING ENTITIES PORTION OF THE TAX-EXEMPT BOND. THE MICHIGAN HEALTH & HOSPITAL ASSOCIATION SERVICE CORPORATION AND THE MICHIGAN STATE HOSPITAL FINANCE AUTHORITY OFFER THE HEALTHCARE LOAN PROGRAM (HELP). HELP IS A POOLED, TAX-EXEMPT FINANCING PROGRAM THAT INVOLVES A NUMBER OF HEALTH CARE ORGANIZATIONS PARTICIPATING IN A SINGLE PUBLIC FINANCING AND SHARING IN THE PROCEEDS AND COSTS ASSOCIATED WITH THAT FINANCING. THE PROGRAM TAKES ADVANTAGE OF ECONOMIES OF SCALE THROUGH GROUP PARTICIPATION, ALLOWING EACH BORROWER TO ACCESS LOW COST FINANCING WITHOUT INDIVIDUALLY INCURRING ALL OF THE TRANSACTION COSTS ASSOCIATED WITH PUBLIC FINANCING. THE ISSUE PRICE OF THE HELP LOANS, IN PART I OF SCHEDULE K, REPRESENTS THE ENTIRE AMOUNT OF THE ISSUE AND IS NOT REFLECTIVE OF THE ORGANIZATION'S PORTION OF THE LOAN. THE AMOUNTS REPORTED ON LINE 1(E) REPRESENT THE ENTIRE BOND ISSUE, WHILE THE AMOUNTS IN PART II RELATE TO THE PORTION OF THE BONDS ALLOCATED TO SPECTRUM HEALTH UNITED. ISSUER NAME: Michigan State Hospital Finance Authority: No Rebate Due. Schedule K, Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON MARCH 27, 2008. ISSUER NAME: Kent Hospital Financing Authority (2011C): No Rebate Due. Schedule K, Part IV, Line 2c THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON AUGUST 13, 2012. JACOB BRASSER FAMILY 14566 SEE SCHEDULE L, PART V false HATHAWAY PROPERTIES LLC BUSINESS 429406 SEE SCHEDULE L, PART V false MARGARET MAHAR FAMILY 52397 SEE SCHEDULE L, PART V false KELLY JOHNSON FAMILY 36612 SEE SCHEDULE L, PART V false WEST MICHIGAN SHARED HOSPITAL LAUNDRY BUSINESS 210428 SEE SCHEDULE L, PART V false BUSINESS/FAMILY RELATIONSHIPS & TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART V MR. WILLIAM HAM, A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, HAS OWNERSHIP IN A TAXABLE ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH THE ORGANIZATION. (PART IV, LINE 1) MS. PRISCILLA MAHAR, A KEY EMPLOYEE OF THE ORGANIZATION, IS A DIRECTOR OF A TAXABLE ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH THE ORGANIZATION. ADDITIONALLY, MS. MAHAR HAS A SISTER-IN-LAW THAT IS EMPLOYED BY THE ORGANIZATION. (PART IV, LINES 2 & 3) MR. RYAN JOHNSON, OFFICER OF THE ORGANIZATION, HAS A SPOUSE EMPLOYED BY THE ORGANIZATION. (PART IV, LINE 4) MR. BRIAN BRASSER, A KEY EMPLOYEE OF THE ORGANIZATION, HAS A SON EMPLOYED BY THE ORGANIZATION. (PART IV, LINE 5) THROUGH THE ANNUAL CONFLICT OF INTEREST AND TAX REPORTING PROCESSES, CERTAIN INDIVIDUALS LISTED IN SCH L HAVE REPORTED THAT THEY, OR COMPANIES THEY WORK FOR, HAVE BUSINESS OR FAMILY RELATIONSHIPS WITH THE REPORTING ORGANIZATION THAT EXCEED THRESHHOLDS PROVIDED IN THE INSTRUCTIONS TO THE FORM 990. IF AN AMOUNT IS NOT LISTED IN SCH L, A STATEMENT IS PROVIDED ABOVE EXPLAINING THE NATURE OF THE TRANSACTION(S). ENDOWMENT FUNDS FORM 990, PART IV, LINE 10 SPECTRUM HEALTH FOUNDATION (38-2752328) HOLDS AN UNRESTRICTED, BOARD DESIGNATED ENDOWMENT TO BE USED FOR THE BENEFIT OF SPECTRUM HEALTH UNITED (38-1358412) AND SPECTRUM HEALTH KELSEY (38-1297435). THE ENDOWMENT FUND IS PROPERLY REPORTED ON SCHEDULE D, PART V OF SPECTRUM HEALTH FOUNDATION'S FORM 990. Significant changes to organizational documents Form 990, Part VI, Section A, Line 4 THE ORGANIZATION'S BYLAWS WERE AMENDED TO INCREASE THE MAXIMUM NUMBER OF DIRECTORS ON THE BOARD OF DIRECTORS FROM THIRTEEN TO FIFTEEN. THE AMENDED BYLAWS INDICATE THE START OF A DIRECTOR'S TERM OF OFFICER WILL BEGIN AS DETERMINED BY SPECTRUM HEALTH SYSTEM. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE ORGANIZATION HAS ONE MEMBER/STOCKHOLDER AS FOLLOWS: - SPECTRUM HEALTH SYSTEM (EIN 38-3382353), A MICHIGAN NONPROFIT CORPORATION. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a THE SOLE MEMBER OF THE ORGANZIATION (SEE FORM 990, PART VI, LINE 6) APPOINTS ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b THE SOLE MEMBER OF THE ORGANIZATION (SEE FORM 990, PART VI, LINE 6) HAS RETAINED CERTAIN RESERVED POWERS IN ORGANIZATION EXCLUSIVELY, WHICH SHALL NOT BE DEEMED AUTHORIZED UNLESS AND UNTIL APPROVED BY THE SOLE MEMBER OF ORGANIZATION: - ELECTION AND/OR REMOVAL OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND THE ORGANIZATION'S CHAIR OF THE BOARD; - APPROVAL OF ALL ORGANIZATION'S (OR AN ENTITY DIRECTLY OR INDIRECTLY CONTROLLED BY THE ORGANIZATION ("SUBSIDIARY") CAPITAL EXPENDITURES IN EXCESS OF THE AMOUNT SPECIFIED IN THE AUTHORITY MATRIX, ADOPTED BY THE SOLE MEMBER OF ORGANIZATION AND AS AMENDED BY THE SOLE MEMBER OF ORGANIZATION FROM TIME TO TIME ("AUTHORITY MATRIX AMOUNT"); - APPROVAL OF ALL BORROWING BY THE ORGANIZATION OR A SUBSIDIARY FOR CAPITAL OR OPERATING PURPOSES, AND ALL GUARANTEES OF INDEBTEDNESS, INCLUDING ANY OPERATING LEASE IN AN AMOUNT GREATER THAN ONE MILLION DOLLARS ($1,000,000) DURING THE INITIAL LEASE TERM, NOT INCLUDING RENEWALS AND/OR EXTENSIONS; - APPROVAL OF ALL LOANS IN EXCESS OF THE AUTHORITY MATRIX AMOUNT BY THE ORGANIZATION OR A SUBSIDIARY TO PERSONS OR ENTITIES OTHER THAN THE SOLE MEMBER OF ORGANIZATION OR AN ENTITY CONTROLLED BY THE SOLE MEMBER OF ORGANIZATION; - THE CREATION OF ANY ENTITY CONTROLLED, DIRECTLY OR INDIRECTLY, BY THE ORGANIZATION; AND - THE ORGANIZATION'S OR ANY SUBSIDIARY'S INVESTMENTS OF CASH AND/OR RESERVES, WHETHER ON AN INDIVIDUAL BASIS OR AS PART OF A POOLED INVESTMENT STRATEGY. IN ADDITION TO THE RESERVED POWERS RETAINED EXCLUSIVELY BY THE SOLE MEMBER OF ORGANIZATION ABOVE, THE SOLE MEMBER OF ORGANIZATION HAS DELEGATED CERTAIN RESERVED POWERS IN ORGANIZATION REGARDING MANAGEMENT AND GOVERNANCE TO SPECTRUM HEALTH HOSPITALS D/B/A SPECTRUM HEALTH HOSPITAL GROUP ("SHHG"), THE BOARD OF WHICH OVERSEES ALL OF THE HOSPITAL OPERATIONS OF THE SOLE MEMBER OF ORGANIZATION. THE SOLE MEMBER OF ORGANIZATION ALSO RETAINS THE UNILATERAL AUTHORITY TO EXERCISE ANY OF THE RESERVED POWERS BELOW. THE ACTIONS LISTED BELOW MAY BE UNILATERALLY CAUSED AND OR TAKEN BY SHHG, WITHIN ITS SOLE AND EXCLUSIVE POWER AND DISCRETION AND SHALL NOT BE DEEMED AUTHORIZED UNLESS AND UNTIL APPROVED BY SHHG: - HIRING, DISCHARGE, AND EVALUATION OF THE ORGANIZATION'S PRESIDENT AND/OR CEO AS DELEGATED BY THE SOLE MEMBER OF ORGANIZATION'S BOARD OF DIRECTORS TO THE SOLE MEMBER OF ORGANIZATION'S CHIEF EXECUTIVE OFFICER (OR DESIGNEE) OR SHHG'S PRESIDENT; - THE ADOPTION OF THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE ORGANIZATION, AND ANY AMENDMENTS TO SUCH BUDGETS IN EXCESS OF THE AUTHORITY MATRIX AMOUNT; - THE ADOPTION OF THE ORGANIZATION'S STRATEGIC PLANS; - THE ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION; - MERGER OR CONSOLIDATION OF THE ORGANIZATION OR A SUBSIDIARY, ANY OTHER CHANGE IN CONTROL, OWNERSHIP PERCENTAGES OR CAPITAL STRUCTURE OF THE ORGANIZATION OR A SUBSIDIARY; - SALE OR TRANSFER OF MORE THAN TEN PERCENT (10%) OF THE ASSETS OF THE ORGANIZATION OR A SUBSIDIARY TO ANY PERSON OR ENTITY NOT CONTROLLED BY THE SOLE MEMBER OF ORGANIZATION; - DISSOLUTION OF THE ORGANIZATION; - THE SELECTION AND RETENTION OF AUDITORS FOR THE ORGANIZATION OR A SUBSIDIARY; AND - ANY OTHER APPROVAL FOR WHICH THE SOLE MEMBER OF ORGANIZATION'S APPROVAL IS REQUIRED BY LAW. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. THE REVIEW PROCESS FOR THIS FORM 990 IS AS FOLLOWS: 1. PREPARATION OF THE RETURN IS SUPERVISED AND REVIEWED BY THE ORGANIZATION'S CORPORATE TAX MANAGER. 2. A SECOND REVIEW IS PERFORMED BY AN EXTERNAL CPA FIRM WITH EXPERTISE IN TAX-EXEMPT RETURN PREPARATION. 3. THE RETURN IS REVIEWED BY THE ORGANIZATION'S FINANCE AND LEGAL DEPARTMENTS (INCLUDING THE VICE PRESIDENT OF FINANCE OR CHIEF FINANCIAL OFFICER) AND SHARED WITH THE MEMBERS OF THE BOARD OF DIRECTORS. 4. THE ORGANIZATION'S VICE PRESIDENT OF FINANCE OR CHIEF FINANCIAL OFFICER REVIEWS COMMENTS OR QUESTIONS RECEIVED BY MEMBERS OF THE BOARD OF DIRECTORS, IF ANY, TO ADDRESS OR TO INCORPORATE, AS APPROPRIATE, INTO THE RETURN PRIOR TO FILING. Conflict of interest policy Form 990, Part VI, Section B, Line 12c BOARD OF DIRECTORS 1. CONFLICTS OF INTEREST MUST BE DISCLOSED, BOTH VIA AN ANNUAL ELECTRONIC DISCLOSURE PROCESS AS WELL AS VERBALLY AT A BOARD MEETING PRIOR TO DISCUSSION OF ANY AGENDA ITEM WITH REGARD TO WHICH A BOARD MEMBER HAS A CONFLICT. 2. A PERSON HAVING A FINANCIAL INTEREST IN A PROPOSED TRANSACTION OR ARRANGEMENT MAY MAKE A PRESENTATION AT A MEETING OF THE BOARD OF DIRECTORS OR COMMITTEE CONSIDERING THAT TRANSACTION OR ARRANGEMENT, BUT AFTER THAT PRESENTATION HE OR SHE SHALL LEAVE THE MEETING DURING DISCUSSION AND VOTING ON THAT PROPOSED TRANSACTION OR ARRANGEMENT. THE PERSON HAVING THE FINANCIAL INTEREST SHALL NOT BE COUNTED IN DETERMINING WHETHER A QUORUM IS PRESENT. 3. THE CHAIRPERSON OF THE BOARD OF DIRECTORS OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE (INCLUDING OUTSIDE ADVISORS) TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND TO ADVISE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST. 4. THE BOARD OF DIRECTORS OR COMMITTEE SHALL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER THE ORGANIZATION CAN, WITH REASONABLE EFFORTS, OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 5. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OF DIRECTORS OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS AND MEMBERS WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. 6. THE MINUTES OF THE MEETINGS OF THE BOARD OF DIRECTORS AND ALL OF THE ORGANIZATION'S COMMITTEES SHALL SET FORTH: A)THE NAMES OF THE PERSONS WHO DISCLOSED A FINANCIAL INTEREST IN A PROPOSED TRANSACTION OR ARRANGEMENT INVOLVING THE ORGANIZATION OR ANY OF ITS SUBSIDIARIES AND THE NATURE OF THE FINANCIAL INTEREST; AND B)THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO SUCH TRANSACTION OR ARRANGEMENT, INCLUDING ANY DISCUSSION OF ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THAT MATTER. THE VOTES OF INDIVIDUAL MEMBERS NEED NOT BE RECORDED UNLESS OTHERWISE DIRECTED BY THE BOARD OF DIRECTORS OR COMMITTEE. 7. THERE IS AN ONGOING REQUIREMENT THAT MEMBERS OF THE BOARD OF DIRECTORS COMPLETE ANOTHER DISCLOSURE QUESTIONNAIRE AT ANY POINT DURING HIS/HER TENURE ON THE BOARD OF DIRECTORS WHEN A NEW POTENTIAL CONFLICT OF INTEREST ARISES. IF A MEMBER OF THE BOARD OF DIRECTORS COMPLETES A DISCLOSURE QUESTIONNAIRE AS A RESULT OF A NEW POTENTIAL CONFLICT OF INTEREST, THAT DISCLOSURE QUESTIONNAIRE IS SUBMITTED TO THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS FOR REVIEW. MANAGEMENT 1. UPON ACCEPTANCE OF AN EMPLOYMENT OFFER, EACH MEMBER OF MANAGEMENT COMPLETES A CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE QUESTIONNAIRE IS SENT TO THE ORGANIZATION'S LEGAL DEPARTMENT. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE IS REVIEWED BY THE ORGANIZATION'S COI COORDINATOR AND ESCALATED TO THE COI COMMITTEE IF NECESSARY. 2. ANNUALLY, EACH MEMBER OF MANAGEMENT COMPLETES AN ANNUAL CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE ELECTRONICALLY. THE DISCLOSURE QUESTIONNAIRE IS REVIEWED THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS. 3. THERE IS AN ONGOING REQUIREMENT THAT MEMBERS OF MANAGEMENT COMPLETE ANOTHER DISCLOSURE QUESTIONNAIRE AT ANY POINT DURING HIS/HER EMPLOYMENT WHEN A NEW POTENTIAL CONFLICT OF INTEREST ARISES. IF A MEMBER OF MANAGEMENT COMPLETES A DISCLOSURE QUESTIONNAIRE AS A RESULT OF A NEW POTENTIAL CONFLICT OF INTEREST, THAT DISCLOSURE QUESTIONNAIRE IS SUBMITTED TO THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS. 4. THE LEGAL, ORGANIZATIONAL INTEGRITY, INTERNAL AUDIT, AND HUMAN RESOURCES DEPARTMENTS, IN CONSULTATION WITH EXECUTIVE MANAGEMENT, DETERMINE HOW ANY REPORTED CONFLICTS SHOULD BE MANAGED. MANAGEMENT OF A CONFLICT MAY TAKE A VARIETY OF DIFFERENT FORMS FROM IMPLEMENTATION OF A MANAGEMENT PLAN TO REQUIRING THAT THE MEMBER OF MANAGEMENT CEASE THE ACTIVITY CREATING THE CONFLICT OR, IN EXTREME CASES, LEAVE THE ORGANIZATION'S EMPLOYMENT. MANAGEMENT IS DETERMINED ON AN INDIVIDUAL BASIS BASED UPON THE FACTS AND CIRCUMSTANCES SURROUNDING THE DISCLOSURE. THE PURPOSE OF CONFLICT MANAGEMENT IS TO PROVIDE TRANSPARENCY WITHIN THE ORGANIZATION AND TO ENSURE THAT THE ORGANIZATION'S EMPLOYEES ARE ALWAYS ACTING IN THE BEST INTEREST OF THE ORGANIZATION. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE SPECTRUM HEALTH SYSTEM BOARD OF DIRECTORS (THROUGH ITS EXECUTIVE COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF THE TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES AT SPECTRUM HEALTH UNITED. LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON. COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED TO THE EXECUTIVE COMMITTEE IN ADVANCE OF MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM AND, FOR FY 2013 (7/1/12-6/30/13), WAS BASED ON THE FOLLOWING INDEPENDENT SURVEYS OF HEALTH CARE EXECUTIVES AT COMPARABLE HEALTH SYSTEMS, HEALTH PLANS, AND MEDICAL GROUPS: * AMERICAN MEDICAL GROUP ASSOCIATION: 2012 MEDICAL GROUP COMPENSATION & FINANCIAL SURVEY * INTEGRATED HEALTHCARE STRATEGIES: 2012 HEALTH CARE EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2012 EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2012 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY * MEDICAL GROUP MANAGEMENT ASSOCIATION: 2012 MANAGEMENT COMPENSATION SURVEY * SULLIVAN, COTTER AND ASSOCIATES: 2012 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS * SULLIVAN, COTTER AND ASSOCIATES: 2012 PHYSICIAN COMPENSATION AND PRODUCTIVITY SURVEY REPORT * TOWERS WATSON: 2012/2013 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT * TOWERS WATSON: 2012/2013 TOP MANAGEMENT COMPENSATION REPORT * WARREN: 2012 COMPENSATION SURVEY COMPENSATION ADJUSTMENTS ARE APPROVED BY EXECUTIVE COMMITTEE MEMBERS, CONSISTENT WITH THE SPECTRUM HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE EXECUTIVE COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE EXECUTIVE COMMITTEE IS NATIONAL AND REFLECTS THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTHCARE ORGANIZATIONS. SPECTRUM HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTHCARE MARKET PRACTICES. GEOGRAPHIC PAY DIFFERENTIAL AND COST OF LIVING DATA INDICATES CONSISTENCY WITH NATIONAL DATA. THIS PROCESS IS INTENDED TO ASSIST SPECTRUM HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND COMPLYING WITH THE POTENTIAL SPECTRUM HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III). Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b SEE EXPLANATION PROVIDED FOR FORM 990, PART VI, LINE 15A. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION HAVE BEEN PROVIDED TO THE STATE OF MICHIGAN AND ARE AVAILABLE TO THE PUBLIC ON THE STATE'S WEBSITE. THE ORGANIZATION'S BYLAWS AND INTERNAL POLICIES ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. THE OVERALL SYSTEM CONSOLIDATED FINANCIAL STATEMENTS ARE PROVIDED AT WWW.SPECTRUMHEALTH.ORG IN THE SECTION TITLED "ABOUT US." FINANCIAL PERFORMANCE IS DISCUSSED AT AN ANNUAL PUBLIC MEETING HELD AND POSTED TO WWW.SPECTRUMHEALTH.ORG ANNUALLY (UNDER THE SECTION TITLED "ABOUT US"). COMPENSATION FORM 990, PART VII, SECTION A, LINE 1A CONSISTENT WITH PRIOR YEARS, THE COMPENSATION REPORTED FOR THESE INDIVIDUALS IS NOT FOR SERVICES IN THEIR CAPACITY AS MEMBERS OF THE BOARD OF DIRECTORS BUT FOR SERVICES AS EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION. CONSISTENT WITH PRIOR YEARS, COMPENSATION AND BENEFITS ARE REPORTED USING THE MOST RECENT CALENDAR YEAR COMPENSATION DATA. THE COMPENSATION FIGURES REPORTED IN THESE SECTIONS ARE FOR THE YEAR ENDED DECEMBER 31, 2012. Other changes in net assets or fund balances Form 990 , Part XI, Line 9 CHANGE IN BENEFICIAL INTEREST IN FOUNDATION ASSETS - 777833; OVERSIGHT OF THE AUDIT FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION WERE AUDITED BY AN INDEPENDENT AUDITOR AS PART OF THE CONSOLIDATED AUDIT OF SPECTRUM HEALTH SYSTEM (EIN 38-3382353). THE OVERSIGHT OF THAT AUDIT IS BEING ASSUMED BY SPECTRUM HEALTH SYSTEM. IRS TAX FILINGS FORM 990, PART V, LINE 1A, 2A, AND PART VII, SECTION B, LINE 2 SPECTRUM HEALTH UNITED, THE SOLE MEMBER OF SPECTRUM HEALTH KELSEY (38-1297435) AND SPECTRUM HEALTH UNITED MEMORIAL FOUNDATION (38-2990574), FILES ALL APPLICABLE IRS TAX FILINGS, INCLUDING FORMS 1099, 1096, W-2, & W-3 ON BEHALF OF SPECTRUM HEALTH KELSEY AND SPECTRUM HEALTH UNITED MEMORIAL FOUNDATION. FORM 990, PART V, LINE 1A AND 2A REPRESENTS THE 1099'S AND W-2'S ALLOCABLE TO THE ACTIVITIES OF SPECTRUM HEALTH UNITED. THE 1099'S AND W-2'S ALLOCABLE TO SPECTRUM HEALTH KELSEY AND SPECTRUM HEALTH UNITED MEMORIAL FOUNDATION ARE REPORTED ON THEIR RESPECTIVE FORM 990. SPECTRUM HEALTH SYSTEM 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 MANAGEMENT MI 501(C)(3) 11 - Type III - FI NA false SPECTRUM HEALTH HOSPITALS 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 HEALTHCARE MI 501(C)(3) 3 SPECTRUM HEALTH SYSTEM false SPECTRUM HEALTH PRIMARY CARE PTNRS 1840 WEALTHY ST SE GRAND RAPIDS MI 49506 HEALTHCARE MI 501(C)(3) 3 SPECTRUM HEALTH SYSTEM false SPECTRUM HEALTH FOUNDATION 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 PHILANTHROPY MI 501(C)(3) 7 SPECTRUM HEALTH SYSTEM false SPECTRUM HEALTH CONTINUING CARE 750 FULLER AVE NE GRAND RAPIDS MI 49503 REHAB/CARE MI 501(C)(3) 9 SPECTRUM HEALTH SYSTEM false PRIORITY HEALTH 1231 EAST BELTLINE NE GRAND RAPIDS MI 49525 HMO MI 501(C)(4) N/A SPECTRUM HEALTH SYSTEM false SPECTRUM HEALTH KELSEY 615 S BOWER GREENVILLE MI 48838 HEALTHCARE MI 501(C)(3) 3 SPECTRUM HEALTH UNITED true REED CITY HOSPITAL CORPORATION 300 N PATTERSON RD REED CITY MI 49677 HEALTHCARE MI 501(C)(3) 3 SPECTRUM HEALTH SYSTEM false NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION 212 S SULLIVAN AVENUE FREMONT MI 49412 HEALTHCARE MI 501(C)(3) 3 SPECTRUM HEALTH SYSTEM false ZEELAND COMMUNITY HOSPITAL 8333 FELCH STREET ZEELAND MI 49464 HEALTHCARE MI 501(C)(3) 3 SPECTRUM HEALTH SYSTEM false SH UNITED MEMORIAL FOUNDATION 615 S BOWER GREENVILLE MI 48838 PHILANTHROPY - DISSOLVED 4/17/13 MI 501(C)(3) 11 - Type I SPECTRUM HEALTH UNITED true PRIORITY HEALTH MANAGED BENEFITS 1231 EAST BELTLINE NE GRAND RAPIDS MI 49525 383085182 ADMIN MI N/A C CORPORATION MICHIGAN MEDICAL PATIENT CARE 1840 WEALTHY ST SE MC498 GRAND RAPIDS MI 49506 382851295 MEDICAL MI N/A C CORPORATION WEST MICHIGAN HEART 2900 BRADFORD STREET NE GRAND RAPIDS MI 49525 382125186 PHYSICIANS MI N/A C CORPORATION SPECTRUM HEALTH PHYSICIAN ALLIANCE 100 MICHIGAN ST NE GRAND RAPIDS MI 49503 371655728 PHYSICIANS MI N/A C CORPORATION false false true false false false false false false true true true true true true false false true true PRIORITY HEALTH M 3709453 GAAP, CASH, OR FMV PRIORITY HEALTH L 8772031 GAAP, CASH, OR FMV SPECTRUM HEALTH UNITED MEMORIAL FOUNDATION S 1927023 GAAP, CASH, OR FMV SPECTRUM HEALTH UNITED MEMORIAL FOUNDATION C 388444 GAAP, CASH, OR FMV SECTION 512(B)(13) CONTROLLED ENTITY? PART II, COLUMN (G) THE ORGANIZATION IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, SPECTRUM HEALTH SYSTEM.