2014-05-14T13:48:54-05:00 2013-06-30 990 2012-07-01 381362830 MUNSON MEDICAL CENTER MUNS 2319355000 PO BOX 1188 TRAVERSE CITY MI 496851188 MARK A HEPLER 2319355000 2014-05-12 false 2012 2015-11-30 17:44:51Z ALFRED PILONG 1105 SIXTH ST TRAVERSE CITY MI 49684 512037725 false X WWW.MUNSONHEALTHCARE.ORG X 1947 MI AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON MEDICAL CENTER EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. 20 13 4248 350 50877 12567 2890667 13692326 455632762 476205605 10157619 15845427 4847918 5165395 473528966 510908753 273071 723296 0 220279573 232012235 0 523199 215244905 235489843 435797549 468225374 37731417 42683379 587352193 644627684 312256159 275686748 275096034 368940936 AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON MEDICAL CENTER EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. false false 421031628 723296 478372131 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF 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CORREIA 4.00 X 12500 0 0 GEORGE BEARUP 6.00 X X 12500 0 0 REX ANTINOZZI MD 1.00 4.00 X X 12500 0 0 DANIEL NAVIN MD 4.00 X X 12500 0 0 GORDON H WINSTANLEY 4.00 X 9375 0 0 MICHAEL D SIMPSON 4.00 X 9375 0 0 EDWARD J RUTKOWSKI MD 4.00 X 9375 0 0 DOUGLAS LUCIANI 4.00 X 9375 0 0 CARL B ANDERS MD 4.00 X 3125 0 0 JOHN E PELIZZARI 1.00 5.00 X 0 0 0 DANIEL C EDSON 4.00 X 0 0 0 JAMES W HOOK 4.00 X 0 0 0 ROBERT P SCHAFER 4.00 X 0 0 0 ALFRED PILONG 40.00 X X 0 0 0 TIMOTHY NELSON 4.00 X 0 0 0 MARK A HEPLER 22.00 18.00 X 0 290343 59971 KATHLEEN MCMANUS 40.00 X 308169 0 56328 PAUL M SHIRILLA 6.00 32.00 X 0 302295 46971 DAVID MCGREAHAM MD 40.00 X 298346 0 49662 CHRISTOPHER PODGES 40.00 X 277254 0 39820 SUZANNE K PETERS 40.00 X 210965 0 34609 JAMES P FISCHER 40.00 X 196483 0 26486 THOMAS SCHERMERHORN MD 40.00 X 824854 0 31791 AHMET SEVIMLI MD 40.00 X 466026 0 46523 PHILOMENA COLUCCI 40.00 X 317640 0 20018 KAREN SPEIRS DO 40.00 X 277170 0 15614 DANIEL M WEBSTER 40.00 X 261048 0 30879 3615580 1358304 700968 134 false true false HOSPITALISTS OF NORTHWEST MICHIGAN 1105 SIXTH ST TRAVERSE CITY MI 49684 MEDICAL SERVICE 5378669 HURON CONSULTING 3005 MOMENTUM PLACE CHICAGO IL 60689 CONSULTING 3986349 CERNER CORPORATION PO BOX 412702 KANSAS CITY MO 64151 INFO TECHNOLOGY 3239894 CARDIOTHORACIC SURGEONS GT PC 107 S CASS ST TRAVERSE CITY MI 49684 MEDICAL SERVICE 2086533 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 55480 LABORATORY SRV 1728191 110 1748120 11622269 321937 13692326 MEDICARE AND MEDICAID PMTS 621990 240286585 240286585 PATIENT SERVICE REVENUE 621990 231568040 231568040 SERVICES TO OTHER ORGANIZATIO 621990 2442098 2442098 HEALTH SERVICE REVENUE 621990 1686543 1686543 RENT FROM RELATED ORGS 531120 173211 173211 49128 49128 476205605 6914448 2745542 4168906 498144 498144 498144 498144 9579553 446220 389794 705000 9189759 -258780 8930979 -580765 9511744 35927 34178 1749 1749 CAFETERIA SALES 722210 3770385 3770385 MISCELLANEOUS 621990 475212 475212 AUXILIARY GIFT SHOP 446199 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OTHER ACTIVITIES INDICATE THE PORTION OF DUES ALLOCATED TO LOBBYING EXPENSES PAID TO REGIONAL OR NATIONAL ORGANIZATIONS. 180234157 12760078 18163160 589921 80507 792541 209694426 166996705 9477532 4724667 87150 877667 180234157 143412065 996567 23516814 141430 787311 166996705 128015726 2073910 14807677 1054734 430514 143412065 151976653 815757 -20538618 4238065 128015726 0.89670 0.10330 false true true 14105697 14105697 295065384 137246959 157818425 265646 87260 178386 190398293 143507054 46891239 19188934 1701815 17487119 236480866 MINIMUM PENSION LIABILITY 78671744 DEFERRED POST RETIREMENT BENEFITS 14106111 RESERVE FOR THIRD PARTY SETTLEMENTS 5303335 ESTIMATED THIRD PARTY SETTLEMENTS 5280407 SWAP MARKET VALUE BASIS 3750957 CAREPAYMENT LIABILITY 1831662 CAPITAL LEASE 31796 108976012 INTENDED USES FOR ENDOWMENT FUNDS SCHEDULE D, PAGE 2, PART V, LINE 4 THE BOARD OF TRUSTEES DESIGNATES SUBSTANTIAL INVESTMENTS FOR THE REPLACEMENT, IMPROVEMENT, AND THE EXPANSION OF TANGIBLE FACILITIES OWNED BY MUNSON MEDICAL CENTER TO ENSURE FUNDS ARE AVAILABLE TO MAINTAIN THE HOSPITAL ASSETS TO CARRY OUT ITS MISSION. A PORTION OF THE TERM ENDOWMENT ASSETS ARE THOSE HELD FOR SPECIFIC MEDICAL PURPOSES, AS DEFINED BY DONORS. THOSE ASSETS ARE BEING HELD FOR A VARIETY OF DONOR INTERESTS INCLUDING ADAPTIVE SPORTS, PEDIATRIC THERAPY, OTHER PEDIATRIC MEDICAL NEEDS, RESEARCH, AND PATIENT ASSISTANCE. MUNSON MEDICAL CENTER HAS NO FIN 48 LIABILITIES; AND THEREFORE, NO FOOTNOTE DISCLOSURE ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. true true true X true X true true false true true 5097633 5097633 0.01120 41146801 30344920 10801881 0.02370 545142 259580 285562 0.00060 46789576 30604500 16185076 0.03550 3678395 338230 3340165 0.00730 4868150 1310630 3557520 0.00780 322056 583 321473 0.00070 1156007 87000 1069007 0.00230 638915 638915 0.00140 10663523 1736443 8927080 0.01950 57453099 32340943 25112156 0.05500 25984 25984 0.00010 21752 21752 303336 303336 0.00070 625 625 29249 29249 0.00010 380946 380946 0.00090 true 6684728 886395 232165370 225751640 6413730 X true true NW MI SURGERY CENTER AMBULATORY SURGERY CENTER 0.49000 0.51000 1 1 MUNSON MEDICAL CENTER

1105 SIXTH ST TRAVERSE CITY MI 49684

X X X X X X MUNSON MEDICAL CENTER 1 true X X X X X X X X X X 12 true true true X X X X X X X X X X false false true true 200.0 true 400.0 true X X X X true true X X true false true X false false 13 MUNSON COMMUNITY HEALTH CENTER

550 MUNSON AVENUE TRAVERSE CITY MI 49686

OUTPATIENT BIEDERMAN CANCER CENTER

1120 SIXTH ST TRAVERSE CITY MI 49684

RADIATION THERAPY MRI CENTER

217 S MADISON TRAVERSE CITY MI 49684

MRI SMITH FAMILY BREAST HEALTH CENTER

COPPER RIDGE TRAVERSE CITY MI 49684

MAMMOGRAPHY AND WOMEN'S HEALTH IV THERAPY

1200 SIXTH ST TRAVERSE CITY MI 49684

IV THERAPY CHEMICAL DEPENDENCY CENTER

420 BROOK ST TRAVERSE CITY MI 49684

REHABILITATION PHYSICAL THERAPY

3643 WEST FRONT ST TRAVERSE CITY MI 49684

PHYSICAL THERAPY MUNSON MANOR

1220 MEDICAL CAMPUS DR TRAVERSE CITY MI 49684

HOSPITALITY HOUSE PHYSICAL THERAPY

211 S HIGH ST NORTHPORT MI 49670

PHYSICAL THERAPY ADVANCED WOUND CENTER

5085 ANNA DR TRAVERSE CITY MI 49684

PATIENT WOUND CARE MUNSON HOSPICE HOUSE

450 BROOK ST TRAVERSE CITY MI 49684

HOSPICE CARE HOUSE MUNSON RENAL DIALYSIS

4062 WEST ROYAL DRIVE TRAVERSE CITY MI 49684

RENAL DIALYSIS UNIT REHAB POOL FACILITY

1202 GARFIELD TRAVERSE CITY MI 49684

POOL FOR REHAB OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE PART I LINE 3C INCOME UP TO 200 OF THE FPG 100 DISCOUNT ON CHARGES INCOME BETWEEN 201 AND 300 FPG 75 DISCOUNT ON CHARGES INCOME BETWEEN 301 AND 400 FPG 50 DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG INCLUDES EARNINGS UNEMPLOYMENT COMPENSATION WORKERS COMPENSATION SOCIAL SECURITY SUPPLEMENTAL SECURITY INCOME PUBLIC ASSISTANCE VETERANS PAYMENTS SURVIVOR BENEFITS PENSION OR RETIREMENT INCOME INTEREST DIVIDENDS RENTS ROYALTIES INCOME FROM ESTATES EDUCATIONAL ASSISTANCE ALIMONY CHILD SUPPORT ASSISTANCE FROM OUTSIDE THE HOUSEHOLD AND OTHER MISCELLANEOUS SOURCES CASH CHECKING AND SAVINGS BALANCES MONEY MARKET ACCOUNTS CERTIFICATES OF DEPOSIT IRAS TRUSTS INHERITANCES ANNUITIES SAVINGS BONDS STOCKS MUTUAL FUNDS ANDOR CASH VALUE OF LIFE INSURANCE SUBSIDIZED HEALTH SERVICES EXPLANATION PART I LINE 7G THERE ARE NO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F TOTAL EXPENSES FROM FORM 990 PART IX LINE 25 ARE XXX-XX-XXXX AND THE PROPORTIONATE SHARE OF TOTAL EXPENSES OF THE AMBULATORY SURGERY CENTER IS 8065840 THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS 19587287 THE NET EXPENSE OF XXX-XX-XXXX WAS USED FOR PURPOSES OF CALCULATING LINE 7 COLUMN F COSTING METHODOLOGY EXPLANATION PART I LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION COMMUNITY BUILDING ACTIVITIES PART II MUNSON MEDICAL CENTER MMC PROVIDED 380946 IN COMMUNITYBUILDING ACTIVITIES DURING THE 2012 TAX YEAR THE MOST SIGNIFICANT PORTION OF THIS INVESTMENT WAS AN ENVIRONMENTAL PROJECT TO RESTORE A LOCAL CREEK ON HOSPITAL PROPERTY ADDITIONAL ACTIVITIES INCLUDED ADMINISTRATIVE SUPPORT ON MANY BOARDS WORKFORCE DEVELOPMENT AND ENVIRONMENTAL IMPROVEMENTS INCLUDING WASTE REDUCTION AND RECYCLING MMC CONTINUES AS A GUIDING FORCE IN MICHIGANS REGION 7 BIOTERRORISMDISASTER PREPAREDNESS AS PART OF CRITICAL WORKFORCE DEVELOPMENT MUNSON STAFF ATTENDS MANY REGIONAL CAREER DAYS PROVIDING STUDENTS WITH INFORMATION ON WHY THEY MIGHT WANT TO BE EMPLOYED IN THE OFTENCRITICAL AREA OF HEALTH CARE MUNSON ALSO IS COLLABORATING WITH THE LOCAL COLLEGE TO DEVELOP HEALTHCARE INFORMATION TECHNOLOGY PROGRAMS BAD DEBT EXPENSE EXPLANATION PART III LINE 4 TO DETERMINE THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS WHO WOULD PROBABLY QUALIFY UNDER MUNSON MEDICAL CENTERS CHARITY CARE POLICY MUNSON DIRECTED AN INTERNAL STUDY FROM A 3MONTH SAMPLE OF CURRENT BAD DEBT ACCOUNTS FIRST THE STUDY IDENTIFIED THE SELFPAY PORTION OF THE BAD DEBT EXPENSE THEN THE SELFPAY ACCOUNTS WERE ANALYZED USING REVENUE CYCLE ANALYTIC SOFTWARE TO IDENTIFY POTENTIAL CHARITY CARE CANDIDATES USING THE SOFTWARE ESTIMATIONS A PORTION OF THE SELFPAY ACCOUNTS WERE DEEMED CHARITY CARE ELIGIBLE THAT ESTIMATED PORTION WAS APPLIED TO THE SELFPAY BAD DEBT DOLLAR AMOUNT TO DETERMINE THE AMOUNT OF BAD DEBT THAT WOULD BE CONSIDERED CHARITY IF THE PROPER APPLICATIONS AND DOCUMENTATION WERE AVAILABLE FROM THE PATIENTS THE ACCOUNTS RECEIVABLE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF MUNSON HEALTHCARE AND SUBSIDIARIES STATES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS 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 THROUGHOUT THE YEAR MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND HISTORICAL WRITEOFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AFTER AMOUNTS DUE FROM THIRDPARTY PAYORS ARE SATISFIED AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED THE ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PASTDUE PATIENT BALANCES WITH COLLECTION AGENCIES COLLECTION PRACTICES EXPLANATION PART III LINE 9B MUNSON HEALTHCARES INTERNAL AND EXTERNAL COLLECTION PRACTICES INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NONPAYMENT INCLUDING COLLECTIONS ACTIONS AND REPORTING TO COLLECTION AGENCIES SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY A PATIENTS GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE AND A PATIENTS GOOD FAITH EFFORT TO COMPLY WITH HISHER PAYMENT AGREEMENTS WITH MUNSON HEALTHCARE FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS MUNSON HEALTHCARE MAY OFFER EXTENDED PAYMENT PLANS WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY NEEDS ASSESSMENT PART VI THE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE CHC TO SERVE THE MUNSON HEALTHCARE SYSTEM THE CHC CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM MUNSON HEALTHCARE HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON HEALTHCARE BOARD CHAIRPERSON THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS CONSIDER THE MHC RESPONSE TO ANY EMERGING HEALTH TRENDS AS IDENTIFIED BY COMMUNITY HEALTH NEEDS ASSESSMENT AND REVIEW ANY NEW COMMUNITY HEALTH BASED COLLABORATION OR PROGRAM THE CHC IS RESPONSIBLE FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MHC COMMUNITY BENEFIT PROGRAMS AND SERVICES THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT OF MUNSON MEDICAL CENTER MUNSON MEDICAL CENTER MMC IS A SIGNIFICANT CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN OUR EXTENSIVE GEOGRAPHICAL AREA COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED AS WELL AS WHERE PROGRESS HAS BEEN MADE THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITYWIDE MUNSON PREPARED A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501R DURING FISCAL 2013 IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD ADDITIONALLY MUNSON WORKS IN CONJUNCTION WITH COMMUNITY COLLABORATIVES IN FIVE COUNTIES ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA THE TRAVERSE CITY CHAMBER OF COMMERCE THE LOCAL UNITED WAY THE POVERTY REDUCTION INITIATIVE AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY NEED PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS BROCHURES THAT DESCRIBE MUNSON HEALTHCARES FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR STATEMENT ON BILLS STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL SIGNS IN THE ER REGISTRATION AREA ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY REFERRAL BY REGISTRATION STAFF AT THE TIME OF REGISTRATION SELFPAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF MUNSON MEDICAL CENTER FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS THE COUNSELORS VISIT ALL INPATIENTS THAT ARE DEEMED SELFPAY TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP IF THE PATIENT WOULD LIKE HELP THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID GENERALLY THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS THE COUNSELORS ALSO IDENTIFY ALL SELFPAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS ONLY BY PHONE THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION BUT WHEN THAT IS NOT POSSIBLE THE CALL IS MADE SOON AFTER DISCHARGE AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO MEDICAID AND ALL OF ITS SUBSETS SOCIAL SECURITY DISABILITY TRAVERSE HEALTH CLINIC MUNSON HEALTHCARE FINANCIAL ASSITANCE AND MUNSON MEDICAL CENTER MEDS PROGRAM COMMUNITY INFORMATION PART VI MUNSON MEDICAL CENTER DESCRIPTION MUNSON MEDICAL CENTER MMC IS THE LARGEST HOSPITAL IN NORTHERN LOWER PENINSULA OF MICHIGAN WITH 391 LICENSED ACUTE CARE BEDS AND FACILITIES ON TWO MAJOR CAMPUSES ONE OF EIGHT HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM MMC SERVES AS A RURAL REFERRAL CENTER FOR THE SURROUNDING 24COUNTY AREA WITH MORE THAN 22000 INPATIENT ADMISSIONS AND 489000 OUTPATIENT VISITS IN 2013 THE HOSPITAL SERVED MORE THAN 14000 SURGICAL CASES JUST OVER 1800 OBSTETRICAL BIRTHS AND NEARLY 52000 EMERGENCY ROOM VISITS LAST YEAR THE HOSPITAL HAS AN ACTIVE MEDICAL STAFF OF 420 AND MORE THAN 370 VOLUNTEERS WITH MORE THAN 3700 EMPLOYEES MMC IS THE LARGEST EMPLOYER IN NORTHERN MICHIGAN DUE TO ITS GEOGRAPHIC LOCATION AND COMPREHENSIVE ARRAY OF SERVICES OFFERED MMC IS DESIGNATED A RURAL REFERRAL CENTER BY THE CENTERS FOR MEDICARE AND MEDICAID MMC IS ALSO RECOGNIZED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES CMS AS A SOLE COMMUNITY HOSPITAL BECAUSE OF THIS STATUS IT IS EQUIPPED TO PROVIDE CRITICAL CARE FOR PATIENTS IN 24 COUNTIES HOSPITAL SERVICES MMC PROVIDES SERVICES IN MORE THAN 50 DIFFERENT MEDICAL SPECIALTIES AND OFFERS A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICE MMC HAS AN AWARDWINNING OPENHEART SURGERY AND INTERVENTIONAL CARDIOLOGY PROGRAM PLUS THE ONLY LEVEL II TRAUMA CENTER IN MICHIGANS REGION 7 WHICH COVERS 17 COUNTIES AND THE ONLY NEONATAL INTENSIVE CARE UNIT IN NORTHERN LOWER MICHIGAN MMC IS ALSO A DESIGNATED PRIMARY STROKE CENTER BY THE JOINT COMMISSION AND ACCREDITED AS A COMPREHENSIVE COMMUNITY CANCER CENTER BY THE AMERICAN COLLEGE OF SURGEONS SPECIALIZED INPATIENT UNITS AVAILABLE AT MMC INCLUDE MEDICALSURGICAL INTENSIVE CARE CARDIAC INTENSIVE CARE NEONATAL INTENSIVE CARE ONCOLOGY ORTHOPEDICS INPATIENT MENTAL HEALTH AND PHYSICAL MEDICINE AND REHABILITATION COMPLEX SURGERY SUCH AS VASCULAR AND NEUROSURGERY ARE AVAILABLE AS WELL AS LESS COMPLEX SAMEDAY SURGERY A BROAD SPECTRUM OF DIAGNOSTIC AND THERAPEUTIC SERVICES SUPPORT MMCS PROGRAMS INCLUDING COMPREHENSIVE RADIOLOGY SERVICES WITH CT MRI TRADITIONAL AND OPEN PETCT ULTRASOUND NUCLEAR MEDICINE DIGITAL MAMMOGRAPHY AND XRAY COMPREHENSIVE CANCER TREATMENT INCLUDING RADIATION ONCOLOGY DELIVERED VIA BRACHYTHERAPY IMRT RADIATION THERAPY AND THE LATEST IN STEREOTACTIC RADIOSURGERY COMPUTERIZED INPATIENT AND OUTPATIENT LABORATORY SERVICES COMPREHENSIVE REHABILITATION SERVICES INCLUDING PHYSICAL OCCUPATIONAL SPEECH AND HEARING AND WOUND THERAPY PROGRAMS A DEDICATED CARDIAC DIAGNOSTIC SUITE USING THE LATEST IS ECHOCARDIOGRAPHY AN ADJACENT LAB FOR DIAGNOSTIC CATHETERIZATION AND ELECTROPHYSIOLOGY STUDIES AND A DEDICATED CARDIAC REHABILITATION AND PREVENTION PROGRAM OBSTETRIC CLINIC FOR INDIGENT PATIENTS MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES HOME HEALTH DME AND DIALYSIS SERVICES POPULATION SERVED BY MUNSON MEDICAL CENTER MMC SERVES PATIENTS FROM 24 COUNTIES IN NORTHERN LOWER MICHIGAN AND THE EASTERN PORTION OF THE UPPER PENINSULA A POPULATION BASE OF APPROXIMATELY 580000 IN THE 11COUNTY REGION IMMEDIATELY SURROUNDING MMC 20 OF THE POPULATION ARE 65 YEARS OR OLDER UNEMPLOYMENT RATE IS 10 IN 8 OF THE 11 COUNTIES SERVED 154 OF ADULTS AGED 1864 YEARS OF AGE LACK HEALTH INSURANCE 45 OF BIRTHS ARE COVERED BY MEDICAID 1956 DISCHARGES ABOUT 70 OF MMC INPATIENT DISCHARGES ORIGINATE FROM THE FIVE COUNTIES IN CLOSEST PROXIMITY TO MMC ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA QUALITY MMCS REPUTATION FOR THE HIGHEST QUALITY CARE IS REPRESENTED BY REPEATED NATIONAL RECOGNITION RECEIVED NAMED AMONG THE 100 TOP HOSPITAL 14 TIMES BY THOMSON REUTERS NOW TRUVEN HEALTH ANALYTICS ONLY 3 OTHER HOSPITALS NATIONWIDE RECOGNIZED THIS MANY TIMES OR MORE NAMED ONE OF THE NATIONS 50 TOP CARDIOVASCULAR HOSPITALS IN 2010 FOR SUPERIOR CLINICAL AND OPERATIONAL PERFORMANCE AND AMONG THE 100 TOP CARDIOVASCULAR HOSPITALS IN 2009 2008 2006 2001 2000 AND 1999 RECOGNIZED WITH THE EVEREST AWARD FOR NATIONAL BENCHMARKS BY THOMSON REUTERS NOW TRUVEN HEALTH ANALYTICS TWICE FOR THE HOSPITALS RATE OF LONGTERM IMPROVEMENT THIS RECOGNITION HELPED ESTABLISH MMC AS A NATIONAL BENCHMARK AGAINST WHICH OTHER HOSPITALS ARE COMPARED RECOGNIZED WITH THE 2008 AMERICAN HOSPITAL ASSOCIATIONMCKESSON QUEST FOR QUALITY PRIZE RUNNER UP WAS UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS MMC RECEIVED THE MAGNET RECOGNITION AWARD FROM THE AMERICAN NURSES CREDENTIALING CENTER IN 2006 AND WAS REDESIGNATED IN 2011 MAGNET DESIGNATION RECOGNIZES EXCELLENCE IN PATIENT CARE STANDARDS RESPECT OF CULTURAL AND ETHNIC DIVERSITY LEADERSHIP OF THE NURSE ADMINISTRATOR IN SUPPORTING PROFESSIONAL NURSING PRACTICE AND THE MANAGEMENT AND PHILOSOPHY OF NURSING SERVICES ONLY 65 PERCENT OF HOSPITALS NATIONALLY HAVE ACHIEVED MAGNET STATUS HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI THE MUNSON MEDICAL CENTER BOARD OF TRUSTEES IS MADE UP OF COMMUNITY MEMBERS ALL OF WHOM RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA THESE INDIVIDUALS GIVE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE ADDITIONALLY 100 OF MUNSON MEDICAL CENTER TRUSTEES SUPPORT MUNSON FINANCIALLY MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF TRUSTEES MUNSON MEDICAL CENTER UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA EXAMPLES OF HOW MUNSON MEDICAL CENTER PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PROGRAMS INCLUDE HEALTHY FUTURES A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS HEALTH DEPARTMENTS AND MUNSON HEALTHCARE CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UP TO AGE FIVE THE PROGRAM INCLUDES CENTRAL ACCESSDATA MANAGEMENT REGISTERED NURSE RN CARE COORDINATION EDUCATIONAL MAILINGS AND HEALTH CARERELATED FINANCIAL ASSISTANCE THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMESBASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY ACCESS TO HEALTH CARE AND IMMUNIZATIONS MEDS PROGRAM A PROGRAM THAT PROVIDES TO PATIENTS WITHOUT RESOURCES BEING DISCHARGED FROM THE HOSPITAL NEEDED MEDICATIONS AS WELL AS ENROLLING THOSE PATIENTS INTO PHARMACEUTICAL COMPANY SPONSORED ASSISTANCE PROGRAMS SO THEY MAY CONTINUE TO GET THE NEEDED PHARMACEUTICALS THE MEDS PROGRAM ALSO PROVIDES ASSISTANCE TO THOSE NEEDING MEDICATIONS FROM THE OUTPATIENT INFUSION CLINIC POVERTY REDUCTION INITIATIVE PRI A COLLABORATIVE GROUP OF ORGANIZATIONS AND INDIVIDUALS WORKING TO ADDRESS ISSUES OF POVERTY IN THE FIVE COUNTY SERVICE AREA OF MUNSON MEDICAL CENTER PROJECTS SUPPORTED BY THE PRI WORK GROUPS INCLUDE EFFORTS TO EXPAND ACCESS TO MEDICAL AND DENTAL CARE JOB TRAINING OPPORTUNITIES JOB RETENTION COMMUNITY RESOURCE MOBILIZATION AND DATA COLLECTION MUNSONS INVOLVEMENT IN PRI INCLUDES MEMBERSHIP ON THE ADVISORY COUNCIL STEERING COMMITTEE AND NAVIGATORS NORTHERN MICHIGAN DIABETES INITIATIVE NMDI A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 12 COUNTY SERVICE AREA WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES NMDI IS COMMITTED TO PROVIDING LOCAL REGIONAL AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS THE GENERAL COMMUNITY THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION AND RURAL PRIMARY CARE PROVIDERS PCP CARING FOR DIABETIC PATIENTS COLLABORATION WITH THE TRAVERSE HEALTH CLINIC TRAVERSE HEALTH CLINIC THC SERVES AS A MAJOR PRIMARY CARE SAFETY NET PROVIDER FOR LOW INCOME UNINSURED PERSONS IN THE REGION THC OPERATES A LARGE VOLUNTEER ACCESS PROGRAM COALITION HEALTH ACCESS PROGRAMCHAP FOR THE UNINSURED IN COLLABORATION WITH COMMUNITY PROVIDERS IN THE REGION MUNSON PROVIDES DIRECT FUNDS TO THC THROUGH A FORMAL SERVICE AGREEMENT AND A COMMUNITY BENEFIT SUBSIDY TO HELP SUPPORT OPERATIONS MUNSON DONATES MILLIONS OF DOLLARS WORTH OF DIRECT SERVICES TO UNINSURED THC CHAP PATIENTS EACH YEAR AND ALSO DONATES MEDICATIONS PHARMACIST STAFF TIME AND OTHER INKIND SERVICES TO THC THC HAS JUST TRANSITIONED IN 2013 FROM A FREE CLINIC MODEL TO BECOME AN FQHC COMMUNITY HEALTH CENTER MEDICAL EDUCATIONTHE MUNSON FAMILY PRACTICE RESIDENCY PROGRAM INTEGRATES OSTEOPATHIC AND ALLOPATHIC MEDICINE TOGETHER WITH THE RESOURCES OF MUNSON MEDICAL CENTER THIS DUALLY ACCREDITED 555 PROGRAM ACCEPTS BOTH DO AND MD TRAINEES THE PROGRAM IS AFFILIATED WITH THE MICHIGAN STATE UNIVERSITY MMC ALSO PARTNERS WITH SEVERAL COLLEGES AND SCHOOLS OF NURSING TO PROVIDE INTERNSHIPS AND CLINICAL EXPERIENCES FOR REGISTERED NURSES RESPIRATORY THERAPISTS PHARMACISTS AND OTHER HEALTH PROFESSIONALS OBESITY INITIATIVE A COLLABORATIVE EFFORT LED BY MUNSON MEDICAL CENTER WITH OVER TWENTY COMMITTED COMMUNITY PARTNERS FOUR FOCUS AREA STRATEGIES WERE SELECTED FOR GREATEST COMMUNITY IMPACT PROVIDERS SCHOOLS BUSINESSES AND COMMUNITY AWARENESS THIS COLLABORATION ALLOWS PARTNERS TO WORK TOGETHER TO ADOPT CONSISTENT CLEAR AND UNIFIED MESSAGES AND DEVELOP COMMON INTERVENTION STRATEGIES IN AN EFFORT TO CREATE COLLECTIVE IMPACT MATERNAL SMOKING A COLLABORATIVE GROUP OF 11 PLUS PARTNERS COVERING 21 COUNTIES WHOSE FOCUS IS TO REDUCE THE MATERNAL SMOKING RATE IN THIS AREA RECENT SURVEYS HAVE BEEN COMPLETED TO FURTHER UNDERSTAND WHY MOTHERS SMOKE DURING PREGNANCY WORKING TOGETHER THIS TEAM IS CREATING A COMPREHENSIVE COMMUNICATION PLAN TO HELP EDUCATE MOTHERS ON THE DANGERS OF MATERNAL SMOKING THIS TEAM WILL BE WORKING WITH HEALTHCARE PROVIDERS TO ENSURE THIS INFORMATION IS COMMUNICATED TO THEIR PATIENTS TRAINING ON MOTIVATIONAL INTERVIEWING WILL ALSO BE PROVIDED TO HEALTH CARE PROFESSIONALS AFFILIATED HEALTH CARE INFORMATION PART VI MUNSON MEDICAL CENTERS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE A 501C3 CORPORATION THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL SEVERAL RURALBASED MEDICAL CENTERS EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES AND ANCILLARY EMERGENCY TRANSPORTATION AND HOMEBASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER MMC MMC IS ONE OF SEVEN NOTFORPROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES ANDOR PROMOTION ACTIVITIES AS WELL AS SHARED INITIATIVES MMC WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON CAMPUS CLOSE TO 210000 DOLLARS IN COMMUNITY BENEFIT IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR NORTH FLIGHT INC IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM WITH ITS FIXED WING AND HELICOPTER AIR SERVICES IN COMBINATION WITH GROUND TRANSPORT PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE NORTH FLIGHT INC PROVIDED 12 MILLION IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR MUNSON MEDICAL GROUP THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM PROVIDED ALMOST A HALF MILLION DOLLARS IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2012 MMC PERFORMS THE NEEDS ASSESSMENTS FOR MUNSON HEALTHCARE UTILIZING THIS NEEDS ASSESSMENT MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING DEVELOPING IMPLEMENTING EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS IN TOTAL THE MUNSON HEALTHCARE SYSTEM PROVIDED 419 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS OUTREACH PROGRAMS BAD DEBT AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 3 PART V LINE 3 A COLLABORATIVE 12MEMBER STEERING COMMITTEE GUIDED THE CHNA PROCESS THIS STEERING COMMITTEE WAS COMPRISED OF HOSPITAL LEADERS AND PUBLIC HEALTH OFFICIALS AS THE CHNA PROCESS PROGRESSED 129 INDIVIDUALS FROM MULTIPLE AREA ORGANIZATIONS WERE INVOLVED TO ENSURE INPUT FROM THOSE WHO HAVE A BROAD KNOWLEDGE OF THE COMMUNITY FURTHER A GROUP OF KEY PHYSICIAN LEADERS FROM THE REGION ALSO WAS CONSULTED FOR INPUT INDIVIDUALS POSSESSING BROAD KNOWLEDGE OF ALL SEGMENTS OF THE FIVECOUNTY AREA PARTICIPATED IN 10 FOCUS GROUPS TO HELP ASSESS HEALTH CARE NEEDS SESSIONS WERE CONDUCTED WITH FIVE AREA COUNTY COLLABORATIVES AS WELL AS PEOPLE LIVING IN POVERTY YOUTH THOSE WHO PROVIDE SERVICES TO SENIORS AND BEHAVIORAL HEALTH PROVIDERS THESE GROUPS WERE SELECTED BECAUSE OF THEIR KNOWLEDGE OF PEOPLE AND AREAS MOST IMPACTED BY HEALTH DISPARITIES BEHAVIORAL HEALTH PROVIDERS WERE AN IMPORTANT INITIAL FOCUS GROUP BECAUSE THERE IS ALMOST NO SECONDARY MENTAL HEALTH DATA AVAILABLE FOCUS GROUPS SERVING A SPECIFIC POPULATION IE SENIORS BEHAVIORAL HEALTH WERE ASKED ABOUT HEALTH NEEDS SPECIFIC TO THE GROUPS AREA OF EXPERTISE EACH FOCUS GROUP DETERMINED A COMPREHENSIVE LIST OF HEALTH NEEDS THEN PRIORITIZED ITS TOP FOUR TO SIX HEALTH NEEDS IN ADDITION SIXTEEN KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN JANUARY 2012 TO JULY 2012 WITH INDIVIDUALS FROM THE COURTS AREA FOUNDATIONS FREE AND FEDERALLY QUALIFIED HEALTH CENTER CLINICS THE MIGRANT CLINIC THE TRIBAL CLINIC ORGANIZATIONS WHO SERVE SENIORS AND ADOLESCENT HEALTH CLINIC PROVIDERS TO ASSESS THE GREATEST HEALTH NEEDS THEY OBSERVE KEY INFORMANTS WERE ASKED THE SAME FOUR QUESTIONS AS THE FOCUS GROUPS FOCUSING ON THEIR SPECIFIC POPULATION AREA OF EXPERTISE KEY INFORMANTS WERE CHOSEN BECAUSE OF THEIR KNOWLEDGE OF PEOPLE AND AREAS MOST IMPACTED BY HEALTH DISPARITIES MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 4 PART V LINE 4 PAUL OLIVER MEMORIAL HOSPITAL MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 7 PART V LINE 7 WHILE MMC ASSESSES AND SUPPORTS SMOKING CESSATION EFFORTS FOR THEIR EMPLOYEES THROUGH THE HEALTH BY CHOICE PROGRAM ENCOURAGES ALL PATIENTS TO QUIT AND MAINTAINS A TOBACCO FREE CAMPUS IT DOES NOT CURRENTLY OFFER ANY SMOKING CESSATIONCOUNSELING PROGRAMS BECAUSE IT SEEKS TO AVOID DUPLICATION OF SERVICES CURRENTLY COMMUNITY PROGRAMS ARE OFFERED BY THE TRAVERSE BAY AREA TOBACCO COALITION AND THE ADOLESCENT HEALTH CLINICS WHICH OFFER INDIVIDUALIZED QUIT PLANS FOR THE POPULATION THEY SERVE MMC DOES OFFER PRINTED AND ELECTRONIC RESOURCES TO PATIENTS AND EMPLOYEES WHO EXPRESS THE DESIRE TO QUIT USING TOBACCO AND REFERS THEM TO THE STATE OF MICHIGAN WEBSITE WHICH OFFERS RESOURCES AND TIPS FOR QUITTING AS WELL AS THE ABILITY TO CREATE A PERSONALIZED PLAN MMC DOES NOT DIRECTLY ADDRESS HOUSING ISSUES AFFORDABILITY FORECLOSURE VACANCIES THIS PRIORITY DID NOT MEET THE DEFINED EVALUATION CRITERIA AND IT WAS DETERMINED INTERNALLY THAT MMC DOES NOT HAVE THE ABILITY TO DIRECTLY AFFECT CHANGE WITHIN THIS NEED NOR ARE THERE SYSTEM RESOURCES AVAILABLE TO INFLUENCE CHANGE IT WAS ALSO DETERMINED THERE ARE OTHER COMMUNITY ORGANIZATIONS BETTER ALIGNED TO ADDRESS THIS PRIORITY MMC IS HOWEVER A MEMBER OF THE FIVE AREA COUNTY COLLABORATIVES WHICH INCLUDE REPRESENTATION FROM AGENCIES THAT ADDRESS HOUSING ISSUES SUCH AS NORTHWEST COMMUNITY ACTION AGENCY THE MICHIGAN STATE HOUSING DEVELOPMENT AUTHORITY AND THE GRAND VISION MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 12H PART V LINE 12H PATIENTS WHOSE FAMILY INCOME EXCEEDS 400 OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASEBYCASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES IE HIGH DEBTTOINCOME RATIO AT THE SOLE DISCRETION OF MUNSON HEALTHCARE MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 14G PART V LINE 14G IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS INFORMATION POSTED ON THE WEBSITE STATEMENT ON BILLS ANDOR SIGNS IN THE REGISTRATION AREAS MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 20D PART V LINE 20D SELFPAYNO INSURANCE PATIENTS ARE GIVEN A DISCOUNT EQUAL TO 15 OFF THEIR TOTAL BILL FOR ALL MEDICALLY NECESSARY AND EMERGENCY SERVICES THIS RATE WAS DETERMINED BY TAKING THE AVERAGE OF COMMERCIAL RATES NOT INCLUDING BLUE CROSS true TRAVERSE HEALTH CLINIC 3155 LOGAN VALLEY TRAVERSE CITY MI 49684 300224028 501(C) 300000 MEDICALLY UNDERSERVE 1 MEDICAL INSURANCE PAYMENT 14 7542 TRANSPORT, HOUSING, WIGS 100 72638 MEDICAL, TRANSPORT & DRUG 144 85795 MAMMOGRAPHY ASSISTANCE 332 19042 TRANSPORT, HOUSING, FOOD 721 171863 HOUSING ASSISTANCE 39 30277 HEART SCREENING 53 3916 SCHOLARSHIPS FOR BABY SWI 30 18407 DIABETES ED SCHOLARSHIP 17 4350 MEALS FOR PATIENT FAMILY 2122 9466 FMV MEALS X X X X false true false false false false false false false EDWIN A NESS 581988 157658 1520 223317 18979 983462 MARK A HEPLER 241424 31844 17075 39379 20592 350314 4348 KATHLEEN MCMANUS 258858 48113 1198 41735 14593 364497 PAUL M SHIRILLA 264793 33615 3887 32025 14946 349266 DAVID MCGREAHAM MD 250654 28110 19582 31384 18278 348008 CHRISTOPHER PODGES 242682 33004 1568 31652 8168 317074 SUZANNE K PETERS 161334 21315 28316 20586 14023 245574 3245 JAMES P FISCHER 173886 19810 2787 21041 5445 222969 THOMAS SCHERMERHORN MD 807049 17805 12375 19416 856645 AHMET SEVIMLI MD 448570 17456 26914 19609 512549 PHILOMENA COLUCCI 278323 39317 12375 7643 337658 KAREN SPEIRS DO 259939 16000 1231 12375 3239 292784 DANIEL M WEBSTER 242668 13890 4490 14560 16319 291927 SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 210,942 0 MARK A. HEPLER 0 24,893 0 KATHLEEN MCMANUS 0 26,204 0 PAUL M. SHIRILLA 0 16,138 0 DAVID MCGREAHAM, MD 0 16,345 0 CHRISTOPHER PODGES 0 14,926 0 SUZANNE K. PETERS 0 10,906 0 JAMES P. FISCHER 0 10,608 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III EXECUTIVE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. FOR THE PRESIDENT, THE PLAN PROVIDES A TARGETED BENEFIT AT AGE 62. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. VICE-PRESIDENTS ARE ELIGIBLE TO PARTICIPATE IN AN AMOUNT NOT TO EXCEED 6% OF BASE COMPENSATION, FUNDED ANNUALLY, AT THE SOLE DISCRETION OF MUNSON. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON. EXECUTIVE SEVERANCE PLAN: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, A COMPETITIVE BENEFIT PACKAGE IS OFFERED TO THE PRESIDENT AND VICE-PRESIDENTS WHICH INCLUDES A SEVERANCE PLAN. MUNSON HAS A SEVERANCE PLAN FOR THE PRESIDENT AND THE VICE-PRESIDENT/EXECUTIVE LEVEL POSITIONS WHICH PROVIDES FOR THE PRESIDENT UP TO TWO YEARS OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS AND FOR VICE PRESIDENTS, UP TO ONE-YEAR OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS. THE PLAN PROVIDES FOR A 50% OFFSET FOR SUBSEQUENT EMPLOYMENT DURING THE SEVERANCE PERIOD. MEDICAL BENEFITS ARE PROVIDED DURING THE SEVERANCE PERIOD. A CTY GRD TRAVSE HOSP FIN AUTH 2011 386004832 386523EE0 2011-08-10 128728067 REFUND PRIOR BONDS false false false A 128728067 1756787 126971281 true false true true A false true true false true false false false false true A false false false true true false false false true A true PURPOSE OF ISSUE DESCRIPTION SCHEDULE K CTY GRD TRAVSE HOSP FIN AUTH 2011 THE SERIES 2011A 2011B AND 2011C BONDS WERE ISSUED TO PURCHASE AND CANCEL TENDERED BONDS TENDERED DURING A TENDER PROGRAM INITIATED BY MUNSON HEALTHCARE THE TENDERED BONDS INCLUDED COUNTY OF GRAND TRAVERSE HOSPITAL AUTHORITY MUNSON HEALTHCARE OBLIGATED GROUP HOSPITAL REVENUE AND REFUNDING BONDS SERIES 1998A ISSUED 9198 REVENUE BONDS SERIES 2001A ISSUED 1901 REVENUE REFUNDING BONDS SERIES 2002A ISSUED 91702 REVENUE REFUNDING BONDS SERIES 2005A ISSUED 11305 AND REVENUE BONDS SERIES 2005B ISSUED 11305 DATE REBATE COMPUTATION PERFORMED SCHEDULE K CTY GRD TRAVSE HOSP FIN AUTH 2011 081013 MEGAN COX FAMILY OF TRUST 53731 RELATED FAMILY COMP false HOSPITALISTS OF NORTHWEST MI OWNER ISTRUSTEE 5690967 GROUP PRACTICE PHYSI false MUNSON SERVICES INC E NESS TRUSTEE 2318252 CONTRACT EMPLOYEES false PULMONARY AND CRITICAL CARE PHYSICI OWNER ISTRUSTEE 1617120 GROUP PRACTICE PHYSI false GLORIA WOLF FAMILY OF TRUST 75529 RELATED FAMILY COMP false JEFF BERRY FAMILY OF TRUST 92485 RELATED FAMILY COMP false ADDITIONAL INFORMATION FORM 990, PART VI WRITTEN JOINT VENTURE POLICY APPROVED AFTER YEAR-END. CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MUNSON MEDICAL CENTER IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. IN THE EVENT OF DISSOLUTION, MUNSON MEDICAL CENTER'S NET ASSETS WOULD BE DISTRIBUTED TO MUNSON HEALTHCARE. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A FOUR TRUSTEES OF MUNSON MEDICAL CENTER ARE DIRECTORS OF MUNSON HEALTHCARE. OTHER TRUSTEES ARE CHOSEN FROM AMONG THOSE NOMINATED BY THE GOVERNANCE COMMITTEE. DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON MEDICAL CENTER (MMC) TRUSTEES ARE APPROVED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING: ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF MMC; ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION INVOLVING MMC; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF MMC; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF MMC; ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR MMC; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY MMC WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF MMC, WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF MMC'S BUDGET; ADOPTION OR CHANGE IN THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF MMC; CHANGING SUBSTANTIALLY THE SCOPE OF MMC'S CLINICAL SERVICES AND PROGRAMS OFFERED BY MMC; AND APPOINTMENT OR REMOVAL THE PRESIDENT OF MMC. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON MEDICAL CENTER BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON MEDICAL CENTER BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THRU THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MHC'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON EXECUTIVES IS DETERMINED IN PART BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES FOR MUNSON MEDICAL CENTER. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON MEDICAL CENTER ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON MEDICAL CENTER DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. ADDITIONALLY, MUNSON MEDICAL CENTER PREPARES AND DISTRIBUTES AN ANNUAL REPORT TO THE COMMUNITY, WHICH CONTAINS FINANCIAL AS WELL AS PROGRAM DATA. GROUP RETURN METHOD FORM 990, PAGE 7, PART VII PARENT ORGANIZATION HAS FILED A SEPARATE RETURN OTHER FEES FOR SERVICES FORM 990, PART IX, LINE 11G PURCHASED SERVICES 21,494,571 10,219,164 523,199 PROFESSIONAL FEES 18,062,300 1,506,421 0 OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 9 INVEST IN MUNSON HEALTHCARE FOUNDATION CONTRIBUTIO 12,832,478 PENSION AND POST RETIREMENT CHANGES 41,109,930 SWAP MARKET VALUE CHANGE 2,208,255 TRANSFERS TO AFFILIATES -8,100,000 TEMPORARILY RESTRICTED ACTIVITY -669,434 - MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE false MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 HEALTHCARE MI C3 11B N/A false MUNSON HEALTHCARE REGIONAL FOUNDATI 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE false MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI C3 9 MUN HOME H MUNSON HOME HEALTH false MUNSON HOME HEALTH 1105 SIXTH ST TRAVERSE CITY MI 49684 383335362 HOME HEALT MI C3 11B MUNSON HC MUNSON HEALTHCARE false MUNSON HOME SERVICES 1105 SIXTH ST TRAVERSE CITY MI 49684 382543463 HOME HEALT MI C3 9 MUN HOME H MUNSON HOME HEALTH false NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 11B MUNSON HC MUNSON HEALTHCARE false PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC MUNSON HEALTHCARE false PAUL OLIVER MEMORIAL HOSPITAL FOUND 1105 SIXTH ST TRAVERSE CITY MI 49684 237201619 RAISE FUND MI C3 7 PAUL OLV H PAUL OLIVER MEMORIAL HOSPITAL false MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI C3 9 MUNSON MED MUNSON MEDICAL CENTER true MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER RELATED 787235 2510747 false true 0.72480 NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER RELATED 787235 2510747 false true 0.72480 NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE CONDOMINIUM MEDICAL OFFICE CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER C CORP 115629 34425 0.74000 false SIXTH STREET DRUGS PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A false MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A false MEDICAL OFFICE BUILDING CONDOMINIUM MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER C CORP 60202 21733 0.78000 false MUNSON MOBILE IMAGING PO BOX 1188 TRAVERSE CITY MI 496851188 382704069 IMAGING MI N/A false MEDICAL OFFICE CONDOMINIUM MEDICAL OFFICE CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER C CORP 115629 34425 0.74000 false SIXTH STREET DRUGS PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A false MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A false MEDICAL OFFICE BUILDING CONDOMINIUM MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER C CORP 60202 21733 0.78000 false MUNSON MOBILE IMAGING PO BOX 1188 TRAVERSE CITY MI 496851188 382704069 IMAGING MI N/A false true true true false true false false false false true false true true false true true true true true MUNSON DIALYSIS CENTER L 130451 FMV MUNSON DIALYSIS CENTER Q 754248 FMV MUNSON DIALYSIS CENTER O 2280379 FMV MUNSON HEALTHCARE B 3200000 FMV MUNSON HEALTHCARE M 1541796 FMV MUNSON HEALTHCARE O 915348 FMV MUNSON HEALTHCARE P 2153009 FMV MUNSON HEALTHCARE Q 6865785 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 1748120 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI M 523199 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI Q 90872 FMV MUNSON HOME CARE J 131304 FMV MUNSON HOME CARE L 54536 FMV MUNSON HOME CARE Q 11138017 FMV MUNSON HOME HEALTH J 58800 FMV MUNSON HOME HEALTH Q 2035777 FMV MUNSON HOME SERVICES Q 3393853 FMV MUNSON MEDICAL BUILDING PARTNERS K 725305 FMV MUNSON MEDICAL BUILDING PARTNERS Q 211893 FMV MUNSON MEDICAL GROUP B 4900000 FMV MUNSON MEDICAL GROUP L 440712 FMV MUNSON MEDICAL GROUP P 86697 FMV MUNSON MEDICAL GROUP Q 17062339 FMV MUNSON MEDICAL GROUP O 5901702 FMV MUNSON MEDICAL GROUP M 482674 FMV MUNSON SERVICES INC L 115257 FMV MUNSON SERVICES INC O 2318252 FMV MUNSON SERVICES INC P 80622 FMV MUNSON SERVICES INC Q 5357472 FMV MUNSON SUPPORT SERVICES M 2169305 FMV MUNSON SUPPORT SERVICES Q 1958963 FMV MUNSON SUPPORT SERVICES R 132175 FMV NORTH FLIGHT INC P 51499 FMV NORTH FLIGHT INC Q 5716790 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE E 915000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE J 173211 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE P 18761541 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 1077734 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE Q 1031346 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE M 1888464 FMV PAUL OLIVER MEMORIAL HOSPITAL L 811113 FMV PAUL OLIVER MEMORIAL HOSPITAL O 1044383 FMV PAUL OLIVER MEMORIAL HOSPITAL Q 6135851 FMV SIXTH STREET CONDO ASSOCIATION Q 243680 FMV SIXTH STREET CONDO ASSOCIATION K 371384 FMV SIXTH STREET CONDO ASSOCIATION L 56184 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION Q 222710 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION K 179072 FMV MUNSON DIALYSIS CENTER L 130451 FMV MUNSON DIALYSIS CENTER Q 754248 FMV MUNSON DIALYSIS CENTER O 2280379 FMV MUNSON HEALTHCARE B 3200000 FMV MUNSON HEALTHCARE M 1541796 FMV MUNSON HEALTHCARE O 915348 FMV MUNSON HEALTHCARE P 2153009 FMV MUNSON HEALTHCARE Q 6865785 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 1748120 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI M 523199 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI Q 90872 FMV MUNSON HOME CARE J 131304 FMV MUNSON HOME CARE L 54536 FMV MUNSON HOME CARE Q 11138017 FMV MUNSON HOME HEALTH J 58800 FMV MUNSON HOME HEALTH Q 2035777 FMV MUNSON HOME SERVICES Q 3393853 FMV MUNSON MEDICAL BUILDING PARTNERS K 725305 FMV MUNSON MEDICAL BUILDING PARTNERS Q 211893 FMV MUNSON MEDICAL GROUP B 4900000 FMV MUNSON MEDICAL GROUP L 440712 FMV MUNSON MEDICAL GROUP P 86697 FMV MUNSON MEDICAL GROUP Q 17062339 FMV MUNSON MEDICAL GROUP O 5901702 FMV MUNSON MEDICAL GROUP M 482674 FMV MUNSON SERVICES INC L 115257 FMV MUNSON SERVICES INC O 2318252 FMV MUNSON SERVICES INC P 80622 FMV MUNSON SERVICES INC Q 5357472 FMV MUNSON SUPPORT SERVICES M 2169305 FMV MUNSON SUPPORT SERVICES Q 1958963 FMV MUNSON SUPPORT SERVICES R 132175 FMV NORTH FLIGHT INC P 51499 FMV NORTH FLIGHT INC Q 5716790 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE E 915000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE J 173211 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE P 18761541 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 1077734 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE Q 1031346 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE M 1888464 FMV PAUL OLIVER MEMORIAL HOSPITAL L 811113 FMV PAUL OLIVER MEMORIAL HOSPITAL O 1044383 FMV PAUL OLIVER MEMORIAL HOSPITAL Q 6135851 FMV SIXTH STREET CONDO ASSOCIATION Q 243680 FMV SIXTH STREET CONDO ASSOCIATION K 371384 FMV SIXTH STREET CONDO ASSOCIATION L 56184 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION Q 222710 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION K 179072 FMV MUNSON DIALYSIS CENTER L 130451 FMV MUNSON DIALYSIS CENTER Q 754248 FMV MUNSON DIALYSIS CENTER O 2280379 FMV MUNSON HEALTHCARE B 3200000 FMV MUNSON HEALTHCARE M 1541796 FMV MUNSON HEALTHCARE O 915348 FMV MUNSON HEALTHCARE P 2153009 FMV MUNSON HEALTHCARE Q 6865785 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 1748120 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI M 523199 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI Q 90872 FMV MUNSON HOME CARE J 131304 FMV MUNSON HOME CARE L 54536 FMV MUNSON HOME CARE Q 11138017 FMV MUNSON HOME HEALTH J 58800 FMV MUNSON HOME HEALTH Q 2035777 FMV MUNSON HOME SERVICES Q 3393853 FMV MUNSON MEDICAL BUILDING PARTNERS K 725305 FMV MUNSON MEDICAL BUILDING PARTNERS Q 211893 FMV MUNSON MEDICAL GROUP B 4900000 FMV MUNSON MEDICAL GROUP L 440712 FMV MUNSON MEDICAL GROUP P 86697 FMV MUNSON MEDICAL GROUP Q 17062339 FMV MUNSON MEDICAL GROUP O 5901702 FMV MUNSON MEDICAL GROUP M 482674 FMV MUNSON SERVICES INC L 115257 FMV MUNSON SERVICES INC O 2318252 FMV MUNSON SERVICES INC P 80622 FMV MUNSON SERVICES INC Q 5357472 FMV MUNSON SUPPORT SERVICES M 2169305 FMV MUNSON SUPPORT SERVICES Q 1958963 FMV MUNSON SUPPORT SERVICES R 132175 FMV NORTH FLIGHT INC P 51499 FMV NORTH FLIGHT INC Q 5716790 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE E 915000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE J 173211 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE P 18761541 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 1077734 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE Q 1031346 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE M 1888464 FMV PAUL OLIVER MEMORIAL HOSPITAL L 811113 FMV PAUL OLIVER MEMORIAL HOSPITAL O 1044383 FMV PAUL OLIVER MEMORIAL HOSPITAL Q 6135851 FMV SIXTH STREET CONDO ASSOCIATION Q 243680 FMV SIXTH STREET CONDO ASSOCIATION K 371384 FMV SIXTH STREET CONDO ASSOCIATION L 56184 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION Q 222710 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION K 179072 FMV MUNSON DIALYSIS CENTER L 130451 FMV MUNSON DIALYSIS CENTER Q 754248 FMV MUNSON DIALYSIS CENTER O 2280379 FMV MUNSON HEALTHCARE B 3200000 FMV MUNSON HEALTHCARE M 1541796 FMV MUNSON HEALTHCARE O 915348 FMV MUNSON HEALTHCARE P 2153009 FMV MUNSON HEALTHCARE Q 6865785 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 1748120 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI M 523199 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI Q 90872 FMV MUNSON HOME CARE J 131304 FMV MUNSON HOME CARE L 54536 FMV MUNSON HOME CARE Q 11138017 FMV MUNSON HOME HEALTH J 58800 FMV MUNSON HOME HEALTH Q 2035777 FMV MUNSON HOME SERVICES Q 3393853 FMV MUNSON MEDICAL BUILDING PARTNERS K 725305 FMV MUNSON MEDICAL BUILDING PARTNERS Q 211893 FMV MUNSON MEDICAL GROUP B 4900000 FMV MUNSON MEDICAL GROUP L 440712 FMV MUNSON MEDICAL GROUP P 86697 FMV MUNSON MEDICAL GROUP Q 17062339 FMV MUNSON MEDICAL GROUP O 5901702 FMV MUNSON MEDICAL GROUP M 482674 FMV MUNSON SERVICES INC L 115257 FMV MUNSON SERVICES INC O 2318252 FMV MUNSON SERVICES INC P 80622 FMV MUNSON SERVICES INC Q 5357472 FMV MUNSON SUPPORT SERVICES M 2169305 FMV MUNSON SUPPORT SERVICES Q 1958963 FMV MUNSON SUPPORT SERVICES R 132175 FMV NORTH FLIGHT INC P 51499 FMV NORTH FLIGHT INC Q 5716790 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE E 915000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE J 173211 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE P 18761541 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 1077734 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE Q 1031346 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE M 1888464 FMV PAUL OLIVER MEMORIAL HOSPITAL L 811113 FMV PAUL OLIVER MEMORIAL HOSPITAL O 1044383 FMV PAUL OLIVER MEMORIAL HOSPITAL Q 6135851 FMV SIXTH STREET CONDO ASSOCIATION Q 243680 FMV SIXTH STREET CONDO ASSOCIATION K 371384 FMV SIXTH STREET CONDO ASSOCIATION L 56184 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION Q 222710 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION K 179072 FMV MUNSON DIALYSIS CENTER L 130451 FMV MUNSON DIALYSIS CENTER Q 754248 FMV MUNSON DIALYSIS CENTER O 2280379 FMV MUNSON HEALTHCARE B 3200000 FMV MUNSON HEALTHCARE M 1541796 FMV MUNSON HEALTHCARE O 915348 FMV MUNSON HEALTHCARE P 2153009 FMV MUNSON HEALTHCARE Q 6865785 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 1748120 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI M 523199 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI Q 90872 FMV MUNSON HOME CARE J 131304 FMV MUNSON HOME CARE L 54536 FMV MUNSON HOME CARE Q 11138017 FMV MUNSON HOME HEALTH J 58800 FMV MUNSON HOME HEALTH Q 2035777 FMV MUNSON HOME SERVICES Q 3393853 FMV MUNSON MEDICAL BUILDING PARTNERS K 725305 FMV MUNSON MEDICAL BUILDING PARTNERS Q 211893 FMV MUNSON MEDICAL GROUP B 4900000 FMV MUNSON MEDICAL GROUP L 440712 FMV MUNSON MEDICAL GROUP P 86697 FMV MUNSON MEDICAL GROUP Q 17062339 FMV MUNSON MEDICAL GROUP O 5901702 FMV MUNSON MEDICAL GROUP M 482674 FMV MUNSON SERVICES INC L 115257 FMV MUNSON SERVICES INC O 2318252 FMV MUNSON SERVICES INC P 80622 FMV MUNSON SERVICES INC Q 5357472 FMV MUNSON SUPPORT SERVICES M 2169305 FMV MUNSON SUPPORT SERVICES Q 1958963 FMV MUNSON SUPPORT SERVICES R 132175 FMV NORTH FLIGHT INC P 51499 FMV NORTH FLIGHT INC Q 5716790 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE E 915000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE J 173211 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE P 18761541 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 1077734 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE Q 1031346 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE M 1888464 FMV PAUL OLIVER MEMORIAL HOSPITAL L 811113 FMV PAUL OLIVER MEMORIAL HOSPITAL O 1044383 FMV PAUL OLIVER MEMORIAL HOSPITAL Q 6135851 FMV SIXTH STREET CONDO ASSOCIATION Q 243680 FMV SIXTH STREET CONDO ASSOCIATION K 371384 FMV SIXTH STREET CONDO ASSOCIATION L 56184 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION Q 222710 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION K 179072 FMV MUNSON DIALYSIS CENTER L 130451 FMV MUNSON DIALYSIS CENTER Q 754248 FMV MUNSON DIALYSIS CENTER O 2280379 FMV MUNSON HEALTHCARE B 3200000 FMV MUNSON HEALTHCARE M 1541796 FMV MUNSON HEALTHCARE O 915348 FMV MUNSON HEALTHCARE P 2153009 FMV MUNSON HEALTHCARE Q 6865785 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 1748120 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI M 523199 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI Q 90872 FMV MUNSON HOME CARE J 131304 FMV MUNSON HOME CARE L 54536 FMV MUNSON HOME CARE Q 11138017 FMV MUNSON HOME HEALTH J 58800 FMV MUNSON HOME HEALTH Q 2035777 FMV MUNSON HOME SERVICES Q 3393853 FMV MUNSON MEDICAL BUILDING PARTNERS K 725305 FMV MUNSON MEDICAL BUILDING PARTNERS Q 211893 FMV MUNSON MEDICAL GROUP B 4900000 FMV MUNSON MEDICAL GROUP L 440712 FMV MUNSON MEDICAL GROUP P 86697 FMV MUNSON MEDICAL GROUP Q 17062339 FMV MUNSON MEDICAL GROUP O 5901702 FMV MUNSON MEDICAL GROUP M 482674 FMV MUNSON SERVICES INC L 115257 FMV MUNSON SERVICES INC O 2318252 FMV MUNSON SERVICES INC P 80622 FMV MUNSON SERVICES INC Q 5357472 FMV MUNSON SUPPORT SERVICES M 2169305 FMV MUNSON SUPPORT SERVICES Q 1958963 FMV MUNSON SUPPORT SERVICES R 132175 FMV NORTH FLIGHT INC P 51499 FMV NORTH FLIGHT INC Q 5716790 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE E 915000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE J 173211 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE P 18761541 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 1077734 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE Q 1031346 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE M 1888464 FMV PAUL OLIVER MEMORIAL HOSPITAL L 811113 FMV PAUL OLIVER MEMORIAL HOSPITAL O 1044383 FMV PAUL OLIVER MEMORIAL HOSPITAL Q 6135851 FMV SIXTH STREET CONDO ASSOCIATION Q 243680 FMV SIXTH STREET CONDO ASSOCIATION K 371384 FMV SIXTH STREET CONDO ASSOCIATION L 56184 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION Q 222710 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION K 179072 FMV MUNSON DIALYSIS CENTER L 130451 FMV MUNSON DIALYSIS CENTER Q 754248 FMV MUNSON DIALYSIS CENTER O 2280379 FMV MUNSON HEALTHCARE B 3200000 FMV MUNSON HEALTHCARE M 1541796 FMV MUNSON HEALTHCARE O 915348 FMV MUNSON HEALTHCARE P 2153009 FMV MUNSON HEALTHCARE Q 6865785 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 1748120 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI M 523199 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI Q 90872 FMV MUNSON HOME CARE J 131304 FMV MUNSON HOME CARE L 54536 FMV MUNSON HOME CARE Q 11138017 FMV MUNSON HOME HEALTH J 58800 FMV MUNSON HOME HEALTH Q 2035777 FMV MUNSON HOME SERVICES Q 3393853 FMV MUNSON MEDICAL BUILDING PARTNERS K 725305 FMV MUNSON MEDICAL BUILDING PARTNERS Q 211893 FMV MUNSON MEDICAL GROUP B 4900000 FMV MUNSON MEDICAL GROUP L 440712 FMV MUNSON MEDICAL GROUP P 86697 FMV MUNSON MEDICAL GROUP Q 17062339 FMV MUNSON MEDICAL GROUP O 5901702 FMV MUNSON MEDICAL GROUP M 482674 FMV MUNSON SERVICES INC L 115257 FMV MUNSON SERVICES INC O 2318252 FMV MUNSON SERVICES INC P 80622 FMV MUNSON SERVICES INC Q 5357472 FMV MUNSON SUPPORT SERVICES M 2169305 FMV MUNSON SUPPORT SERVICES Q 1958963 FMV MUNSON SUPPORT SERVICES R 132175 FMV NORTH FLIGHT INC P 51499 FMV NORTH FLIGHT INC Q 5716790 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE E 915000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE J 173211 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE P 18761541 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 1077734 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE Q 1031346 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE M 1888464 FMV PAUL OLIVER MEMORIAL HOSPITAL L 811113 FMV PAUL OLIVER MEMORIAL HOSPITAL O 1044383 FMV PAUL OLIVER MEMORIAL HOSPITAL Q 6135851 FMV SIXTH STREET CONDO ASSOCIATION Q 243680 FMV SIXTH STREET CONDO ASSOCIATION K 371384 FMV SIXTH STREET CONDO ASSOCIATION L 56184 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION Q 222710 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION K 179072 FMV MUNSON DIALYSIS CENTER L 130451 FMV MUNSON DIALYSIS CENTER Q 754248 FMV MUNSON DIALYSIS CENTER O 2280379 FMV MUNSON HEALTHCARE B 3200000 FMV MUNSON HEALTHCARE M 1541796 FMV MUNSON HEALTHCARE O 915348 FMV MUNSON HEALTHCARE P 2153009 FMV MUNSON HEALTHCARE Q 6865785 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 1748120 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI M 523199 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI Q 90872 FMV MUNSON HOME CARE J 131304 FMV MUNSON HOME CARE L 54536 FMV MUNSON HOME CARE Q 11138017 FMV MUNSON HOME HEALTH J 58800 FMV MUNSON HOME HEALTH Q 2035777 FMV MUNSON HOME SERVICES Q 3393853 FMV MUNSON MEDICAL BUILDING PARTNERS K 725305 FMV MUNSON MEDICAL BUILDING PARTNERS Q 211893 FMV MUNSON MEDICAL GROUP B 4900000 FMV MUNSON MEDICAL GROUP L 440712 FMV MUNSON MEDICAL GROUP P 86697 FMV MUNSON MEDICAL GROUP Q 17062339 FMV MUNSON MEDICAL GROUP O 5901702 FMV MUNSON MEDICAL GROUP M 482674 FMV MUNSON SERVICES INC L 115257 FMV MUNSON SERVICES INC O 2318252 FMV MUNSON SERVICES INC P 80622 FMV MUNSON SERVICES INC Q 5357472 FMV MUNSON SUPPORT SERVICES M 2169305 FMV MUNSON SUPPORT SERVICES Q 1958963 FMV MUNSON SUPPORT SERVICES R 132175 FMV NORTH FLIGHT INC P 51499 FMV NORTH FLIGHT INC Q 5716790 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE E 915000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE J 173211 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE P 18761541 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 1077734 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE Q 1031346 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE M 1888464 FMV PAUL OLIVER MEMORIAL HOSPITAL L 811113 FMV PAUL OLIVER MEMORIAL HOSPITAL O 1044383 FMV PAUL OLIVER MEMORIAL HOSPITAL Q 6135851 FMV SIXTH STREET CONDO ASSOCIATION Q 243680 FMV SIXTH STREET CONDO ASSOCIATION K 371384 FMV SIXTH STREET CONDO ASSOCIATION L 56184 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION Q 222710 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION K 179072 FMV ADDITIONAL INFORMATION SCHEDULE R MUNSON MEDICAL CENTER USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED SUMMARIZED AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS