2013-11-11T15:15:42-06:00 2012-12-31 861065772 DELOITTE TAX LLP 200 RENAISSANCE CENTER SUITE 3900 DETROIT MI 48243 990 2012-01-01 381357020 HENRY FORD HEALTH SYSTEM HENR 3138768714 ONE FORD PLACE - 5F DETROIT MI 48202 JAMES CONNELLY 3138768714 2013-11-11 P00121981 3133963000 2012 2016-02-24 21:20:13Z JAMES CONNELLY ONE FORD PLACE DETROIT MI 48202 2451573231 0 X WWW.HENRYFORD.COM X 1915 MI TO IMPROVE PEOPLE'S LIVES THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING.VISION: TRANSFORMING LIVES AND COMMUNITIES THROUGH HEALTH AND WELLNESS-ONE PERSON AT A TIME. 24 17 18790 1250 9618446 -5470693 35912596 39102359 2198317808 2246297088 7142072 22055433 41981305 52541957 2283353781 2359996837 3060609 3713320 0 0 1258154276 1303406357 184571 378507 4732946 975127261 1045667322 2236526717 2353165506 46827064 6831331 1874131097 1917359827 1325634445 1356831080 548496652 560528747 X AS ONE OF THE NATION'S LEADING INTEGRATED HEALTH SYSTEMS, IT IS THE MISSION OF HENRY FORD HEALTH SYSTEM TO IMPROVE HUMAN LIFE THROUGH THE EXCELLENCE OF THE SCIENCE AND ART OF HEALTH CARE AND HEALING. SINCE ITS FOUNDING IN 1915, HFHS HAS BEEN COMMITTED TO PROVIDING HEALTH SERVICES AND IMPROVING THE QUALITY OF LIFE OF ALL OF THE CITIZENS OF THE COMMUNITIES IT SERVES REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. THE ORGANIZATION PROVIDES HEALTH CARE DELIVERY, INCLUDING ACUTE, SPECIALTY, PRIMARY AND PREVENTATIVE CARE SERVICES BACKED BY EXCELLENCE IN RESEARCH AND EDUCATION. 0 0 1071927958 3713320 1095285668 INPATIENT HOSPITALS: HENRY FORD HEALTH SYSTEM IS HONORED TO BE THE ONLY ORGANIZATION IN MICHIGAN AND ONE OF FOUR NATIONALLY TO RECEIVE THE 2011 MALCOLM BALDRIGE NATIONAL QUALITY AWARD FOR PERFORMANCE EXCELLENCE. A KEY FACET OF OUR AWARD-WINNNING OPERATIONS IS THE COMMUNITY PILLAR, SUPPORTING OUR VISION OF TRANSFORMING LIVES AND COMMUNITIES THROUGH HEALTH AND WELLNESS-ONE PERSON AT A TIME. THE ORGANIZATION OPERATES HENRY FORD HOSPITAL (HFH), AN 877 BED TERTIARY CARE HOSPITAL, EDUCATION AND RESEARCH COMPLEX IN THE NEW CENTER AREA OF DETROIT, MICHIGAN. THE HOSPITAL IS RECOGNIZED FOR CLINICAL EXCELLENCE AND INNOVATION IN THE FIELDS OF CARDIOLOGY AND CARDIOVASCULAR SURGERY, NEUROLOGY AND NEUROSURGERY, ORTHOPEDICS AND SPORTS MEDICINE, AND TREATMENT OF PROSTATE, BREAST AND LUNG CANCERS AMONG OTHERS. THE HOSPITAL IS A MULTI-ORGAN TRANSPLANT CENTER AND LEVEL 1 TRAUMA CENTER. THE HOSPITAL HAD REVENUES OF MORE THAN $867 MILLION AND MORE THAN 46,000 ADMISSIONS DURING 2012. MORE THAN 1,000 MEDICAL RESIDENTS, FELLOWS AND STUDENTS PARTICIPATED IN THE ORGANIZATION'S VARIOUS EDUCATIONAL PROGRAMS.WEST BLOOMFIELD HOSPITAL, AN OPERATING UNIT OF HFHS, OPENED MARCH 15, 2009. LOCATED IN WEST BLOOMFIELD, THE 300-BED, ALL PRIVATE ROOM HOSPITAL OPENED WITH 191 BEDS, WITH AN ADDITIONAL 109 BEDS PLANNED. OFFERS COMPREHENSIVE MEDICAL CARE, INCLUDING 24-HOUR EMERGENCY CARE, NEUROSCIENCES, WOMEN'S AND CHILDREN'S HEALTH, ORTHOPAEDICS, DIAGNOSTIC TESTING AND A WELLNESS CENTER WITH COMPLEMENTARY THERAPIES. A GREENHOUSE GROWS ORGANIC PRODUCE FOR PATIENTS, STAFF AND COMMUNITY.THE HOSPITAL HAD REVENUES OF MORE THAN $228 MILLION, AND ADMITTED MORE THAN 13,000 PATIENTS DURING 2012.TEACHING, RESEARCH, AND ADVANCED PATIENT CARE MAKE HFHS A PREMIER ACADEMIC MEDICAL CENTER. AFFILIATED WITH WAYNE STATE UNIVERSITY'S SCHOOL OF MEDICINE, HENRY FORD PROVIDES INNOVATIVE PHYSICIAN TRAINING PROGRAMS AND COLLABORATES ON LEADING-EDGE MEDICAL RESEARCH.HENRY FORD MEDICAL EDUCATION OVERVIEW:MEDICAL EDUCATION PROGRAMS OFFERED BY HENRY FORD HEALTH SYSTEM INCLUDE UNDERGRADUATE, GRADUATE, CONTINUING, AND ALLIED HEALTH TRAINING PROGRAMS THROUGHOUT SOUTHEAST MICHIGAN. THE SYSTEM'S FLAGSHIP HOSPITAL, HENRY FORD HOSPITAL IN DETROIT, IS ONE OF THE NATION'S LARGEST RESEARCH CENTERS, WITH MORE THAN $70 MILLION IN RESEARCH FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH AND OTHER SOURCES. AS ONE OF THE LARGEST MEDICAL EDUCATION TEACHING CENTERS IN THE NATION, HENRY FORD TRAINS MORE THAN 1,600 DOCTORS EVERY YEAR.HENRY FORD HOSPITAL DOCTORS TRAIN MORE THAN 600 MEDICAL SCHOOL STUDENTS, 500 RESIDENTS AND 150 FELLOWS ACROSS 46 DIFFERENT AREAS OF MEDICINE EVERY YEAR. HENRY FORD HOSPITAL RESIDENCY AND FELLOWSHIP PROGRAMS ARE NATIONALLY ACCREDITED M.D. (DOCTORATE OF MEDICINE) TRAINING PROGRAMS. HENRY FORD MACOMB HOSPITALS AND HENRY FORD WYANDOTTE HOSPITAL TRAIN MORE THAN 200 MEDICAL STUDENTS AND 200 RESIDENTS EVERY YEAR. THESE HOSPITALS OFFER NATIONALLY ACCREDITED D.O. (DOCTORATE OF OSTEOPATHIC MEDICINE) AND D.P.M. (DOCTORATE OF PODIATRIC MEDICINE) TRAINING PROGRAMS. AS TEACHING PHYSICIANS, HENRY FORD MEDICAL GROUP DOCTORS ARE ALSO FACULTY MEMBERS AT THE WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE, AND MANY OTHER HENRY FORD TEACHING DOCTORS ARE FACULTY MEMBERS AT THE MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE. HENRY FORD HOSPITAL HEALTH SYSTEM'S CENTER FOR SIMULATION, EDUCATION AND RESEARCH ALLOWS DOCTORS TO PRACTICE NEW SKILLS ON LIFE-LIKE MANNEQUINS (ADULT AND CHILD) TO GAIN EXPERIENCE BEFORE CARING FOR THE HUMAN PATIENT.THIS 15,000 SQUARE FOOT TRAINING CENTER INCLUDES HIGH-TECH COMPUTERS WHICH CREATE HUNDREDS OF DIFFERENT MEDICAL CONDITIONS IN SURGERY, LABOR AND DELIVERY, INTENSIVE CARE, EMERGENCY AND ROUTINE HOSPITAL PROCEDURES. 773791387 678396207 OUTPATIENT CLINICS: THE ORGANIZATION INCLUDES THE HENRY FORD MEDICAL GROUP (HFMG),ONE OF THE NATION'S LARGEST GROUP PRACTICES, WITH 1,200 PHYSICIANS AND RESEARCHERS IN 40 SPECIALTIES FROM 60 COUNTRIES WHO STAFF HENRY FORD HOSPITAL AND HENRY FORD WEST BLOOMFIELD HOSPITAL, ALONG WITH 29 HENRY FORD MEDICAL CENTERS, ENCOMPASSING MORE THAN 2.2 MILLION VISITS. HENRY FORD'S MEDICAL CENTERS ARE LOCATED IN WAYNE, OAKLAND, MACOMB AND WASHTENAW COUNTIES. SOME MEDICAL GROUP PHYSICIANS ALSO ARE ON STAFF AT OTHER HENRY FORD HOSPITALS. THREE MEDICAL CENTERS PROVIDE 24-HOUR EMERGENCY CARE AND AMBULATORY SURGERY AND ARE PRIMARY CARE STROKE CENTERS.FOUNDED IN 1915 AFTER CONSULTATIONS WITH PHYSICIANS AT JOHNS HOPKINS HOSPITAL AND THE MAYO CLINIC, THE HENRY FORD MEDICAL GROUP HAS ESTABLISHED ITSELF AS ONE OF THE PREMIER GROUP PRACTICES IN THE NATION. OUR LARGE ACADEMIC ENTERPRISE PLACES US IN THE TOP THREE OF TRADITIONALLY INDEPENDENT GROUP PRACTICES THROUGH:CLINICAL CARE: THE BREADTH AND DEPTH OF THE HENRY FORD MEDICAL GROUP'S CLINICAL SERVICES IS UNPARALLELED BY ANY OTHER INDEPENDENT ACADEMIC MEDICAL CENTER. OUR SCALE AND SCOPE ARE IN THE 99TH PERCENTILE OF ALL GROUP PRACTICES, WITH VISIT VOLUMES LARGER THAN MOST GROUP PRACTICES. WE ARE NATIONAL LEADERS IN PRIMARY CARE WITH EXPERTISE IN PREVENTIVE CARE SERVICES AND THE HEALTH MANAGEMENT OF SENIOR CITIZENS. OUR SPECIALTY CENTERS OF EXCELLENCE ARE NATIONAL LEADERS AS WELL, PROVIDING ADVANCED TERTIARY AND QUATERNARY CARE WITH A FOCUS ON DISCOVERY AND INNOVATION.EDUCATION: ONE-THIRD OF ALL PHYSICIANS IN MICHIGAN RECEIVED TRAINING AT HENRY FORD, AND OUR POST-GRADUATE MEDICAL EDUCATION ENTERPRISE IS AMONG THE LARGEST IN THE COUNTRY.RESEARCH: HENRY FORD IS IN THE TOP 20% OF ALL INSTITUTIONS GRANTED FUNDING BY THE NIH AND U.S. PUBLIC HEALTH SERVICE, AND RANKS FIRST IN MICHIGAN FOR NIH-RESEARCH FUNDING FOR NON-UNIVERSITY BASED HEALTH CARE SYSTEMS.LEADERS IN ACADEMIC MEDICINE AND CLINICAL CARE: THE HENRY FORD MEDICAL GROUP IS AMONG THE BEST ORGANIZED IN THE COUNTRY. OUR SELF-GOVERNED, EMPLOYED PHYSICIAN PRACTICE PROGRAM HAS BEEN COPIED BY MANY OTHERS BECAUSE OF OUR CONTINUING SUCCESS EVEN THROUGH THE TOUGHEST ECONOMIC TIMES. THE BRIGHTEST MINDS IN MEDICINE ARE ATTRACTED TO BECOME PART OF THE HENRY FORD MEDICAL GROUP BECAUSE OUR ORGANIZATION PROVIDES PHYSICIANS THE INDEPENDENCE TO PURSUE ADVANCED CLINICAL CARE WHILE UNDERTAKING RESEARCH AS WELL AS ACADEMIC EDUCATIONAL INITIATIVES.FOR NEARLY 100 YEARS NOW THE HENRY FORD MEDICAL GROUP HAS FOSTERED ADVANCEMENT IN PATIENT CARE, RESEARCH, AND EDUCATION WHILE ENCOURAGING INNOVATION IN TECHNOLOGY AND PATIENT CARE PROCESSES BOTH IN THE OUTPATIENT AND HOSPITAL SETTINGS. FOR THESE REASONS HENRY FORD MEDICAL GROUP PHYSICIANS ARE CONSISTENTLY SELECTED BY THEIR PHYSICIAN PEERS AS TOP DOCTORS IN VARIOUS LOCAL AND NATIONAL PUBLISHED SURVEYS AND TO LEAD NATIONAL AND STATE MEDICAL ASSOCIATIONS. HENRY FORD MEDICAL GROUP PHYSICIANS WORK TOGETHER IN LEADERSHIP AND AS EVERYDAY PARTNERS TO CONTINUE TO BRING THE BEST POSSIBLE CARE TO EVERY PATIENT WE SERVE. 127450469 128116329 EMERGENCY ROOM SERVICES: THE ORGANIZATION DIRECTLY OPERATES FIVE 24 HOUR EMERGENCY FACILITIES, ONE OF WHICH IS A LEVEL 1 TRAUMA CENTER LOCATED IN THE CITY OF DETROIT. EMERGENCY SERVICES RECOGNIZED MORE THAN $128 MILLION IN REVENUE DURING 2012 REPRESENTING 220,000 PATIENT VISITS. 122680830 379659075 OTHER PROGRAM SERVICES INCLUDES HFHS RESEARCH SERVICES, ALONG WITH HFHS COMMUNITY CARE SERVICES, WHICH OFFERS A BROAD LEVEL OF SERVICES AT NUMEROUS GEOGRAPHIC LOCATIONS INCLUDING NURSING CARE, HOME CARE, SENIOR CARE, PHARMACIES, EYE CARE, HOSPICE CARE, OCCUPATIONAL HEALTH, DIALYSIS AND A DEDICATED CANCER CENTER; APARTMENT RENTALS FOR MEDICAL RESIDENTS & PATIENT FAMILY MEMBERS; FITNESS CENTER & ATHLETIC TRAINING SERVICES, AND SCHOOL BASED HEALTH PROGRAMS.RESEARCH IS A VITAL COMPONENT OF THE MISSION OF HENRY FORD HEALTH SYSTEM-HENRY FORD HEALTH SYSTEM'S MISSION IS TO IMPROVE HUMAN LIFE THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING. THIS MISSION IS STRONGLY SUPPORTED AND ENHANCED BY THE DEDICATED STAFF PURSUING SCIENTIFIC ACTIVITIES. SINCE 1915, HENRY FORD HOSPITAL PHYSICIANS AND SCIENTISTS HAVE FOCUSED THEIR EFFORTS ON A WIDE VARIETY OF TOPICS CRITICAL TO UNDERSTANDING THE MECHANISMS OF DISEASE AND DEVELOPING NEW, VIABLE TREATMENT OPTIONS. HENRY FORD HOSPITAL RESEARCH IS FOCUSED IN THE FOLLOWING AREAS: -CARDIOVASCULAR AND RENAL RESEARCH (E.G. HIGH BLOOD PRESSURE AND HEART FAILURE) -NEUROSCIENCES RESEARCH (E.G. STROKE, TRAUMATIC BRAIN INJURY AND BRAIN TUMORS) -BONE AND JOINT RESEARCH (E.G. OSTEOPOROSIS, OSTEOARTHRITIS, JOINT MOTION) -CANCER RESEARCH (E.G. PROSTATE, BREAST, HEAD AND NECK CANCERS) -IMMUNOLOGY RESEARCH (E.G. AUTOIMMUNE DISEASES) -POPULATION, HEALTH AND HEALTHCARE RESEARCHMUCH OF HENRY FORD HOSPITAL RESEARCH IS TRANSLATIONAL IN NATURE - FROM BENCH TO BEDSIDE. TO THIS END, OUR BASIC SCIENCE STUDIES RUN THE GAMUT FROM WHOLE ANIMAL PHYSIOLOGY TO CELL AND MOLECULAR BIOLOGY TO BIOENGINEERING WITH AN EMPHASIS ON STUDIES THAT CAN DIRECTLY IMPACT PATIENT CARE. THE DEPARTMENTS WITH THE LARGEST BASIC SCIENCES PROGRAMS ARE MEDICINE, NEUROLOGY, BIOSTATISTICS AND RESEARCH EPIDEMIOLOGY, NEUROSURGERY, AND RADIATION ONCOLOGY.OUR HEALTH CARE RESEARCH FOCUSES ON DISEASE SCREENING, PREVENTION AND MANAGEMENT, HEALTH OUTCOMES, DISPARITIES IN CARE, AND HEALTH ECONOMICS. THIS GROUP OF RESEARCHERS COLLABORATES WITH MEMBERS OF THE HENRY FORD MEDICAL GROUP AS WELL AS RESEARCHERS IN OTHER STATES TO ENHANCE THE QUALITY OF HEALTH CARE NATIONALLY. THESE STUDIES ARE HOUSED IN THE DEPARTMENTS OF BIOSTATISTICS AND RESEARCH EPIDEMIOLOGY, THE CENTER FOR HEALTH SERVICES RESEARCH, THE CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION AND THE INSTITUTE OF MULTICULTURAL HEALTH.HENRY FORD HOSPITAL SCIENTISTS AND PHYSICIANS PARTICIPATE IN AND LEAD MANY CLINICAL TRIALS WHICH HELP US UNDERSTAND HOW TO BEST TREAT DISEASES. THIS IS THE MECHANISM BY WHICH NEW AND POTENTIALLY LIFE-SAVING DRUGS ARE TESTED FOR SAFETY AND THERAPEUTIC EFFICACY. BY WORKING TOGETHER, DOCTOR TO DOCTOR, NURSE TO DOCTOR, RESEARCHER TO PHYSICIAN, HENRY FORD CAN MAXIMIZE CLINICAL INNOVATIONS TO PROVIDE THE HIGHEST QUALITY OF CARE. THE CLINICAL TRIALS OFFICE SERVES TO IDENTIFY AND IMPLEMENT STRATEGIES FOR GROWING CLINICAL RESEARCH. CLINICAL TRIALS ARE COORDINATED AND RUN BY PHYSICIANS AND RESEARCH NURSES IN THE MAJORITY OF HENRY FORD HOSPITAL DEPARTMENTS. INTERNAL MEDICINE DIVISIONS INVOLVED IN RUNNING SIGNIFICANT NUMBERS OF CLINICAL TRIALS ARE CARDIOLOGY, GASTROENTEROLOGY, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASES, NEPHROLOGY AND PULMONARY MEDICINE. OTHER DEPARTMENTS WITH SIGNIFICANT CLINICAL RESEARCH INCLUDE DERMATOLOGY AND NEUROLOGY.ALTOGETHER, THERE ARE APPROXIMATELY 1,700 ACTIVE STUDIES IN OUR MEDICAL AND SURGICAL DEPARTMENTS. OUR RESEARCH STUDIES ARE DIRECTED BY A GROUP OF SCIENTISTS (81 BIOSCIENTIFIC STAFF) AND THEIR SUPPORT PERSONNEL, AS WELL AS DOZENS OF PHYSICIAN-SCIENTISTS AND PHDS ENGAGED IN CLINICAL RESEARCH ACTIVITIES.RESEARCH FUNDING: - RESEARCHERS ARE ENGAGED IN MORE THAN 1,700 STUDIES;- HENRY FORD RANKED FIRST IN NON-UNIVERSITY BASED MICHIGAN HEALTH SYSTEMS FOR FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH;- HENRY FORD HEALTH SYSTEM: RANKED FOURTH IN THE STATE OF MICHIGAN IN NIH FUNDING; AND RANKED 211 OUT OF 1,167 INSTITUTIONS RECEIVING NIH GRANT AWARDSSCOPE OF RESEARCH AWARDS:OUR RESEARCHERS PROGRAMS ARE FOCUSED ON: BONE AND JOINT, CANCER, HEART, VASCULAR AND KIDNEY, IMMUNOLOGY, NEUROSCIENCE,POPULATION, HEALTH AND HEALTHCARE. WHETHER IT IS TWO NIH PROGRAM PROJECT GRANTS TOTALING $4.5 MILLION IN THE SYSTEM'S DEPARTMENT OF HYPERTENSION AND VASCULAR RESEARCH, OR $1 MILLION OF NIH FUNDING IN THE DEPARTMENT OF NEUROLOGY RESEARCH FOR THE STUDY OF STROKE, OR $5.3 MILLION IN STUDIES ON ASTHMA,ALLERGY AND CANCER PREVENTION IN THE DEPARTMENT OF PUBLIC HEALTH SCIENCE, THE SYSTEM'S RESEARCH EXCELLENCE SECURES THE GRANT.RESEARCH STAFF:- EIGHTY FULL-TIME SCIENTISTS ENGAGE IN TRANSLATIONAL RESEARCH- MANY OF THE 1,200 HENRY FORD PHYSICIANS LEAD OR PARTICIPATE IN CLINICAL TRIALS- OTHER RESEARCHERS FOCUS ON: DISEASE SCREENING, PREVENTION AND MANAGEMENT, HEALTH OUTCOMES, DISPARITIES IN CARE, HEALTH ECONOMICS. RESEARCHERS COLLABORATE WITH MEMBERS OF THE HENRY FORD MEDICAL GROUP AND HEALTH ALLIANCE PLAN, AS WELL AS WITH FELLOW RESEARCHERS AND HEALTH CARE RESEARCH NETWORKS IN OTHER STATES.ECONOMIC ENGINE:- RESEARCH ACTIVITIES CONTINUE TO SERVE AS AN ECONOMIC ENGINE FOR DETROIT AND MICHIGAN- FEDERAL DOLLARS SUPPORT THE LOCAL ECONOMY- PHYSICIANS AND SCIENTISTS RELOCATE HERE FROM ALL AROUND THE WORLD.- PARTNERSHIP WITH TECH TOWN AND WAYNE STATE UNIVERSITYIN 2012 AND BEYOND, LEVERAGING OUR STRENGTHS IN CLINICAL INNOVATION AND CARE COORDINATION AND IMPLEMENTING NEW OPPORTUNITIES FOR ACADEMIC PARTNERSHIP AND FACILITIES WILL CONTINUE TO BE A SYSTEM PRIORITY. 122680830 379659075 2095850644 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 1 0 0 1 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 870 30 1 18790 1 1 1 1 CJ 0 0 0 1 1 0 0 0 0 X 24 17 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 1 1 FL X JAMES CONNELLY 3138768714 ONE FORD PLACE DETROIT MI 48202 LYNN FORD ALANDT 1.00 2.00 X 0 0 0 N CHARLES ANDERSON 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THESE PRIMARILY RELATE TO FUNDING INITIATIVES ASSOCIATED WITH SPECIFIC DISEASE CONDITIONS AND FURTHERING MEDICAL EDUCATION AND RESEARCH INITIATIVES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2012 & 2011. 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X X PSYCHIATRIC HOSPITAL 5 HENRY FORD MAPLEGROVE HOSPITAL

6773 W MAPLE RD WEST BLOOMFIELD MI 48322

X CHEMICAL DEPENDENCY FACILITY HENRY FORD HOSPITAL 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 HENRY FORD WEST BLOOMFIELD HOSPITAL 2 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 HENRY FORD COTTAGE HOSPITAL 3 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 HENRY FORD KINGSWOOD HOSPITAL 4 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 HENRY FORD MAPLEGROVE HOSPITAL 5 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 73 HENRY FORD MEDICAL CENTER - FAIRLANE

19401 HUBBARD DRIVE DEARBORN MI 48126

OUTPATIENT CLINIC/DIAGNOSTIC CENTER; EMERGENCY ROOM HENRY FORD MEDICAL CENTER - LAKESIDE

14500 HALL RD STERLING HEIGHTS MI 48313

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - STERLING HGT

3500 FIFTEEN MILE RD STERLING HEIGHTS MI 48310

OUTPATIENT CLINIC/DIAGNOSTIC CENTER; EMERGENCY ROOM HENRY FORD MEDICAL CENTER - LIVONIA

29200 SCHOOLCRAFT RD LIVONIA MI 48150

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - COLUMBUS

39450 W TWELVE MILE ROAD NOVI MI 48377

CLINICAL DIAGNOSIS MEDICAL SERVICES HENRY FORD MEDICAL CENTER - TAYLOR

24555 HAIG RD TAYLOR MI 48180

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - DETROIT NW

7800 W OUTER DRIVE DETROIT MI 48235

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - CANTON

6100 HAGGERTY CANTON MI 48187

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - E JEFFERSON

24725 E JEFFERSON SAINT CLAIR SHORES MI 48080

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - PIERSONGPF

131 KERCHEVAL AVENUE GROSSE POINTE FARMS MI 48236

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - TROY

2825 LIVERNOIS RD TROY MI 48083

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - PLYMOUTH

14300 BECK RD PLYMOUTH MI 48170

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - WOODHAVEN

25505 ALLEN ROAD WOODHAVEN MI 48183

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - BLOOMFIELD

2520 S TELEGRAPH ROAD BLOOMFIELD HILLS MI 48302

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - FARMINGTON

6530 FARMINGTON ROAD WEST BLOOMFIELD MI 48322

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - ANN ARBOR

2755 CARPENTER RD ANN ARBOR MI 48108

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - SOUTHLAND

21901 EUREKA RD TAYLOR MI 48180

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - HAMTRAMCK

9100 BROMBACK STREET HAMTRAMCK MI 48212

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - ROYAL OAK

26300 WOODWARD AVENUE ROYAL OAK MI 48067

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - SOUTHFIELD

22777 W ELEVEN MILE RD SOUTHFIELD MI 48034

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - WARREN

8600 CHICAGO RD SOUTH WARREN MI 48093

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - DEARBORN

5500 AUTO CLUB DRIVE DEARBORN MI 48126

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - HARBORTOWN

3370 E JEFFERSON AVENUE DETROIT MI 48207

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - NEW CNTR ONE

3031 W GRAND BLVD DETROIT MI 48202

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD MEDICAL CENTER - CHRYSLER

800 CHRYSLER DRIVE AUBURN HILLS MI 48326

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HFHS - NORTHWEST DETROIT DIALYSIS

7800 W OUTER DRIVE DETROIT MI 48325

DIALYSIS CENTER HFHS - NORTHWEST LAHSER DIALYSIS

25664 LAHSER RD SOUTHFIELD MI 48034

DIALYSIS CENTER HFHS - EASTPOINTE DIALYSIS

21400 KELLY RD EASTPOINTE MI 48021

DIALYSIS CENTER HFHS - FAIRLANE DIALYSIS

19001 HUBBARD DR DEARBORN MI 48126

DIALYSIS CENTER HFHS - GLENDALE CENTER DIALYSIS

3401 GLENDALE AVE SUITE 110 TOLEDO OH 43614

DIALYSIS CENTER HFHS - MAUMEE BAY DIALYSIS

3310 DUSTIN RD OREGON OH 43616

DIALYSIS CENTER HFHS - ST JOSEPH DIALYSIS

44200 WOODWARD SUITE 109 PONTIAC MI 48341

DIALYSIS CENTER HFHS - TAYLOR DIALYSIS

24555 HAIG RD TAYLOR MI 48180

DIALYSIS CENTER HFHS - TROY DIALYSIS

2050 LIVERNOIS SUITE A TROY MI 48083

DIALYSIS CENTER HFHS - DIALYSIS PARTNERSFLOWER HOSPITAL

5308 HARROUN - SUITE 060 SYLVANIA OH 43560

DIALYSIS CENTER HFHS - MACOMB REGIONAL DIALYSIS CNTR

16151 NINETEEN MILE RD SUITE 200 CLINTON TOWNSHIP MI 48038

DIALYSIS CENTER HFHS - ST MARY DIALYSIS

14555 LEVAN LIVONIA MI 48154

DIALYSIS CENTER HFHS - OPTIMEYES SUPER VISION CENTER

32600 GRATIOT ROSEVILLE MI 48066

VISION SERVICES HFHS - OPTIMEYES SUPER VISION CENTER

35184 CENTRAL CITY PARKWAY WESTLAND MI 48185

VISION SERVICES HFHS - OPTIMEYES SUPER VISION CENTER

6530 FARMINGTON ROAD WEST BLOOMFIELD MI 48322

VISION SERVICES HFHS - OPTIMEYES SUPER VISION CENTER

43910 SCHOENHERR STERLING HEIGHTS MI 48313

VISION SERVICES HFHS - OPTIMEYES SUPER VISION CENTER

735 JOHN R ROAD TROY MI 48083

VISION SERVICES HFHS - OPTIMEYES SUPER VISION CENTER

18900 EUREKA RD SOUTHGATE MI 48195

VISION SERVICES HFHS - OPTIMEYES

2799 W GRAND BLVD DETROIT MI 48202

VISION SERVICES HFHS - OPTIMEYES

516 HIGHLAND AVE MILFORD MI 48381

VISION SERVICES HFHS - OPTIMEYES

22850 MICHIGAN AVE DEARBORN MI 48124

VISION SERVICES HFHS - OPTIMEYES

4355 24TH AVE SUITE 5 FORT GRATIOT MI 48059

VISION SERVICES HFHS - OPTIMEYES

38487 W 10 MILE RD FARMINGTON HILLS MI 48335

VISION SERVICES HFHS - OPTIMEYES

7800 W OUTER DRIVE DETROIT MI 48235

VISION SERVICES HFHS - OPTIMEYES

30800 SOUTHFIELD RD SOUTHFIELD MI 48076

VISION SERVICES HFHS - OPTIMEYES

19401 HUBBARD DRIVE DEARBORN MI 48126

VISION SERVICES HFHS - OPTIMEYES

684 S LAPEER RD LAKE ORION MI 48362

VISION SERVICES HFHS - OPTIMEYES

3500 FIFTEEN MILE RD STERLING HEIGHTS MI 48310

VISION SERVICES HFHS - OPTIMEYES

15401 E JEFFERSON GROSSE POINTE PARK MI 48230

VISION SERVICES HFHS - OPTIMEYES

1385 E MAIN STREET OWOSSO MI 48867

VISION SERVICES HENRY FORD MEDICAL CLINIC - SOUTHFIELD

26400 W TWELVE MILE ROAD SOUTHFIELD MI 48034

PHYSICIAN PRACTICE HENRY FORD MEDICAL CENTER - TROY IVF

1500 W BIG BEAVER RD SUITE 105 TROY MI 48084

PHYSICIAN PRACTICE HENRY FORD MEDICAL CENTER - RESEARCH

440 BURROUGHS DETROIT MI 48202

RESEARCH CENTER HFHS - ALLEN PARK REHABILITATION

7445 ALLEN RD SUITE 102 ALLEN PARK MI 48101

REHABILITATION SERVICES HFHS - CENTER FOR ATHLETIC MEDICINE

6525 SECOND AVENUE DETROIT MI 48202

CLINICAL DIAGNOSIS MEDICAL SERVICES HFHS - HOSPICE RESIDENT CARE

11700 E TEN MILE ROAD WARREN MI 48089

HOSPICE CARE HFHS - HOSPICE RESIDENT CARE

26900 FRANKLIN ROAD SOUTHFIELD MI 48033

HOSPICE CARE HFHS - BEHAVIORAL SERVICES

42633 GARFIELD ROAD CLINTON TOWNSHIP MI 48038

CLINICAL DIAGNOSIS MEDICAL SERVICES HFHS - BEHAVIORAL SERVICES

5110 AUTO CLUB DRIVE SUITE 112 DEARBORN MI 48126

CLINICAL DIAGNOSIS MEDICAL SERVICES HENRY FORD HEALTH PRODUCTS - WALLED LAKE

39630 FOURTEEN MILE ROAD WALLED LAKE MI 48390

MEDICAL EQUIPMENT SUPPLY SERVICES HFHS - ONE FORD PLACE

ONE FORD PLACE DETROIT MI 48202

CLINICAL DIAGNOSIS MEDICAL SERVICES HENRY FORD HEALTH PRODUCTS - NW DETROIT

7940 W OUTER DRIVE DETROIT MI 48235

MEDICAL EQUIPMENT SUPPLY SERVICES HENRY FORD HEALTH PRODUCTS - RIVERVIEW

17763 FORT STREET RIVERVIEW MI 48192

MEDICAL EQUIPMENT SUPPLY SERVICES HENRY FORD HEALTH PRODUCTS - WOODHAVEN

23400 ALLEN ROAD WOODHAVEN MI 48183

MEDICAL EQUIPMENT SUPPLY SERVICES HFHS - FAIRLANE REHABILITATION

5225 AUTO CLUB DRIVE SUITE 100 DEARBORN MI 48126

REHABILITATION SERVICES HENRY FORD HEALTH PRODUCTS - WARREN

13355 E TEN MILE ROAD WARREN MI 48089

MEDICAL EQUIPMENT SUPPLY SERVICES HENRY FORD MEDICAL CENTER - NOVI

40000 8 MILE RD NORTHVILLE MI 48167

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD HEALTH - CARDIOVASCULAR SV

16001 W NINE MILE ROAD SOUTHFIELD MI 48075

OUTPATIENT CLINIC/DIAGNOSTIC CENTER PART I, LINE 7G: SUBSIDIZED SERVICES CONSIST OF INPATIENT WOMENS' SERVICES AND BEHAVIORAL HEALTH SERVICES. THIS INCLUDES BOTH PHYSICIAN AND FACILITY COSTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ XXX-XX-XXXX. SCHEDULE H, PART I, QUESTION 6A:THE ORGANIZATION PREPARES AN ANNUAL REPORT WHICH CAN BE OBTAINED AT THE FOLLOWING WEB ADDRESS:HTTP://WWW.HENRYFORD.COM/DOCUMENTS/COMMUNITYHEALTH/COMUNITYREPORT.PDF PART II: HFHS BELIEVES THAT THE STRENGTH AND VITALITY OF A COMMUNITY HAS A SIGNIFICANT IMPACT ON THE BEHAVIORS OF ITS RESIDENTS AND THAT THERE IS A DIRECT CORRELATION BETWEEN THE VIABILITY OF A COMMUNITY AND THE ATTITUDE OF ITS RESIDENTS TOWARD HEALTHIER BEHAVIORS. THEREFORE, HFHS INCLUDES IN ITS COMMITMENT TO COMMUNITY BENEFIT A FOCUS ON DIRECT INVOLVEMENT IN THE COMMUNITY TO BOTH IMPROVE THE ENVIRONMENT AND ENSURE THAT CRITICAL MESSAGES ON THE BENEFITS OF HEALTHIER BEHAVIORS ARE HEARD. HFHS LEADERS COLLABORATE WITH COMMUNITY TASK FORCES AND COALITIONS TO ADDRESS THE NEEDS OF OUR SERVICE AREA. PART III, LINE 4: THE ORGANIZATION'S FOOTNOTE ON UNCOMPENSATED CARE AND COMMUNITY BENEFIT READS IN PART, "THE SYSTEM PROVIDED HEALTH CARE SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. IN ADDITION TO CHARITY CARE, THE SYSTEM PROVIDED SERVICES TO MEDICAID AND OTHER PUBLIC PROGRAMS FOR FINANCIALLY NEEDY PATIENTS, FOR WHICH THE PAYMENTS RECEIVED, WERE LESS THAN THE COST OF PROVIDING SERVICES. THE UNPAID COSTS ATTRIBUTED TO PROVIDING SERVICES UNDER THIS PROGRAM ARE CONSIDERED A COMMUNITY BENEFIT." THE ORGANIZATION DETERMINES THE COSTS OF SUCH UNPAID SERVICES BY APPLYING A COST-TO-CHARGE RATIO TO THE BILLED CHARGES. IT IS THE GOAL OF THE ORGANIZATION TO DETERMINE IF THE PATIENT QUALIFIES UNDER ITS CHARITY CARE POLICY PRIOR TO BILLING FOR SERVICES. HOWEVER, MANY FACTORS CONTRIBUTE TO THE INABILITY TO ACCOMPLISH THIS IN MANY SITUATIONS. IF THE ORGANIZATION IS UNABLE TO OBTAIN INFORMATION FROM THE PATIENT REGARDING THEIR AVAILABLE MEANS TO PAY OR FINANCIAL STATUS, THE PATIENT WILL BE BILLED FOR THE SERVICES PROVIDED. IF THE PATIENT IS ULTIMATELY DETERMINED TO QUALIFY UNDER THE CHARITY CARE POLICY ANY BILLINGS WILL BE APPROPRIATELY ADJUSTED. PART III, LINE 9B: IF THE PATIENT IS DETERMINED TO QUALIFY UNDER THE ORGANIZATION'S CHARITY CARE POLICY PRIOR TO BILLING, NO BILL IS EVER GENERATED AND THEREFORE THE ELEMENTS OF THE COLLECTION POLICY ARE NEVER INVOKED. WHEN THE DETERMINATION IS NOT MADE PRIOR TO BILLING, THE ORGANIZATION'S COLLECTION POLICY WOULD APPLY. THIS POLICY READS IN PART:- "PATIENTS WILL BE EVALUATED FOR THE SYSTEM'S PATIENT FINANCIAL ASSISTANCE PROGRAM"- "UNINSURED PATIENTS WILL BE GIVEN A DISCOUNT"- "UNDERINSURED PATIENTS MAY QUALIFY FOR DISCOUNTED SERVICES BASED UPON THEIR AGGREGATE HOUSEHOLD INCOME"- "THE ORGANIZATION WILL REVIEW THE PATIENTS'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS REQUESTED"- "LEGAL ACTION...MAY BE TAKEN...WHEN THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS TO MEET HIS OR HER OBLIGATION"- "THE ORGANIZATION WILL NOT FORCE THE SALE OR FORECLOSURE OF ANY PATIENT OR GUARANTOR'S PRIMARY RESIDENCE TO PAY AN OUTSTANDING MEDICAL BILL"- "THE ORGANIZATION WILL NOT...REQUIRE THE PATIENT OR RESPONSIBLE PARTY TO APPEAR IN COURT"- "THE ORGANIZATION WILL DIRECT THEIR COLLECTION AGENCIES TO FOLLOW THESE GUIDELINES"PATIENTS NOT DEEMED TO QUALIFY UNDER OUR PATIENT FINANCIAL ASSISTANCE PROGRAM (PFAP) RECEIVE 2 CYCLES OF INTERNAL BILLING STATEMENTS INCLUDING INSTRUCTIONS ON APPLYING FOR OUR PFAP. BASED ON THE VOLUME OF OUTSTANDING SERVICES, DETERMINATION ON FURTHER COLLECTIONS EFFORTS WILL BE MADE WHICH INCLUDE INTERNAL COLLECTION EFFORTS OR ASSIGNMENT TO AN EXTERNAL COLLECTION AGENCY. HENRY FORD HOSPITAL PART V, SECTION B, LINE 20D: FOR PATIENTS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM WHOSE HOUSEHOLD INCOME IS AT 200%, OR LESS THAN THE FEDERAL POVERTY LEVEL, QUALIFYING SERVICES ARE PROVIDED AT NO COST. IN SITUATIONS WHERE THE QUALIFYING PATIENTS HOUSEHOLD INCOME IS GREATER THAN 200%, BUT LESS THAN 400% OF THE FEDERAL POVERTY LEVEL, SERVICES ARE PROVIDED BASED UPON A STEPPED DISCOUNT RATE. MEDICARE RATES ARE USED IN DETERMINING THIS DISCOUNT. HENRY FORD WEST BLOOMFIELD HOSPITAL PART V, SECTION B, LINE 20D: FOR PATIENTS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM WHOSE HOUSEHOLD INCOME IS AT 200%, OR LESS THAN THE FEDERAL POVERTY LEVEL, QUALIFYING SERVICES ARE PROVIDED AT NO COST. IN SITUATIONS WHERE THE QUALIFYING PATIENTS HOUSEHOLD INCOME IS GREATER THAN 200%, BUT LESS THAN 400% OF THE FEDERAL POVERTY LEVEL, SERVICES ARE PROVIDED BASED UPON A STEPPED DISCOUNT RATE. MEDICARE RATES ARE USED IN DETERMINING THIS DISCOUNT. HENRY FORD COTTAGE HOSPITAL PART V, SECTION B, LINE 20D: FOR PATIENTS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM WHOSE HOUSEHOLD INCOME IS AT 200%, OR LESS THAN THE FEDERAL POVERTY LEVEL, QUALIFYING SERVICES ARE PROVIDED AT NO COST. IN SITUATIONS WHERE THE QUALIFYING PATIENTS HOUSEHOLD INCOME IS GREATER THAN 200%, BUT LESS THAN 400% OF THE FEDERAL POVERTY LEVEL, SERVICES ARE PROVIDED BASED UPON A STEPPED DISCOUNT RATE. MEDICARE RATES ARE USED IN DETERMINING THIS DISCOUNT. HENRY FORD KINGSWOOD HOSPITAL PART V, SECTION B, LINE 20D: FOR PATIENTS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM WHOSE HOUSEHOLD INCOME IS AT 200%, OR LESS THAN THE FEDERAL POVERTY LEVEL, QUALIFYING SERVICES ARE PROVIDED AT NO COST. IN SITUATIONS WHERE THE QUALIFYING PATIENTS HOUSEHOLD INCOME IS GREATER THAN 200%, BUT LESS THAN 400% OF THE FEDERAL POVERTY LEVEL, SERVICES ARE PROVIDED BASED UPON A STEPPED DISCOUNT RATE. MEDICARE RATES ARE USED IN DETERMINING THIS DISCOUNT. HENRY FORD MAPLEGROVE HOSPITAL PART V, SECTION B, LINE 20D: FOR PATIENTS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM WHOSE HOUSEHOLD INCOME IS AT 200%, OR LESS THAN THE FEDERAL POVERTY LEVEL, QUALIFYING SERVICES ARE PROVIDED AT NO COST. IN SITUATIONS WHERE THE QUALIFYING PATIENTS HOUSEHOLD INCOME IS GREATER THAN 200%, BUT LESS THAN 400% OF THE FEDERAL POVERTY LEVEL, SERVICES ARE PROVIDED BASED UPON A STEPPED DISCOUNT RATE. MEDICARE RATES ARE USED IN DETERMINING THIS DISCOUNT. PART VI, LINE 2: HENRY FORD HEALTH SYSTEM (HFHS) CONSIDERS THE ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AS AN ESSENTIAL FUNCTION. IT PROVIDES KEY INFORMATION REGARDING THE DEMOGRAPHICS AND MAJOR NEEDS OF THE COMMUNITIES SERVED, IT SUPPORTS THE PRIORITIZATION OF THE SERVICES MADE AVAILABLE, AND IT HELPS TARGET POPULATIONS WITH THE MOST VULNERABILITY TO HEALTH NEEDS SUCH AS THE POOR, UNINSURED, AS WELL AS VARIOUS OTHER POPULATIONS THAT MAY HAVE BEEN OVERLOOKED. THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO PROVIDES VALUABLE INFORMATION REGARDING OTHER ORGANIZATIONS SUPPORTING THE NEEDS WITHIN THE COMMUNITY SO PROGRAMS CAN BE COORDINATED AND LEVERAGED TO ENSURE THAT EVERY DOLLAR IS INVESTED WISELY. DATA SOURCES EVALUATED TO DETERMINE COMMUNITY NEED INCLUDED:MICHIGAN SURGEON GENERAL'S HEALTH STATUS REPORT - HEALTHY MICHIGAN 2010HEALTH INDICATORS AND RISK ESTIMATES BY COMMUNITY HEALTH ASSESSMENT REGIONS & LOCAL HEALTH DEPARTMENTS - MICHIGAN BEHAVIORAL RISK FACTOR SURVEY 2002-2006 COMBINEDMICHIGAN DEPARTMENT OF COMMUNITY HEALTH WEBSITE (WWW.MDCH.MI.US)STATE OF MICHIGAN WEBSITE (WWW.MICHIGAN.GOV) OAKLAND COUNTY WEBSITE (WWW.OAKGOV.COM)WAYNE COUNTY WEBSITE (WWW.WAYNECOUNTY.COM)INCOME DOWN ACROSS STATE: POVERTY IS INCREASING AND SPREADING THROUGHOUT THE TRI-COUNTY AREA. UNITED WAY RESEARCH. UNITED WAY OF SOUTHEASTERN MICHIGAN (WWW.UWSEM.ORG) OAKLAND COUNTY IS WELL EQUIPPED TO WEATHER THE ECONOMIC STORM. UNIVERSITY OF MICHIGAN NEWS SERVICE (APRIL 26, 2007)BENCHMARK REPORT: THE STATE OF HOMELESSNESS IN MICHIGAN. 2007 ANNUAL REPORTMICHIGAN'S CAMPAIGN TO END HOMELESSNESS (WWW.THECAMPAIGNTOENDHOMELESSNESS.ORG)MICHIGAN CRITICAL HEALTH INDICATORS 2007 REPORT, MICHIGAN DEPARTMENT OF COMMUNITY HEALTHHEALTH DISPARITIES IMPACTING RACIAL AND ETHNIC MINORITIES IN MICHIGAN PRESENTATION, MICHIGAN DEPARTMENT OF COMMUNITY HEALTHTHOMSON MARKET EXPERT DATABASE - PROPRIETARY DATABASE OFFERING MARKET DEMOGRAPHIC AND HEALTHCARE UTILIZATION DATAMICHIGAN INPATIENT DATABASE (MIDB) - PROPRIETARY DATABASE OFFERING INPATIENT AND OUTPATIENT DATA FOR HOSPITAL AND HEALTH SYSTEMS WITHIN THE STATE OF MICHIGAN. PART VI, LINE 3: HFHS HAS VARIOUS APPROACHES TO TARGET AND INFORM RESIDENTS OF ITS COMMUNITIES ABOUT THE PROGRAMS AND SERVICES IT OFFERS. PROGRAMS WHERE WE PARTNER WITH ORGANIZATIONS WITH ESTABLISHED RELATIONSHIPS WITH THE INDIVIDUALS SUCH AS THROUGH COMMUNITY HEALTH CENTERS, THE PUBLIC SCHOOLS AND FAITH-BASED ORGANIZATIONS HAVE BEEN PARTICULARLY SUCCESSFUL. HFHS HAS A SINGULAR CHARITY CARE POLICY. INDIVIDUALS WITHOUT ADEQUATE HEALTH INSURANCE COVERAGE MOST FREQUENTLY APPEAR IN ONE OF OUR EMERGENCY ROOMS FOR SERVICES.ALL PATIENTS ARE SEEN WITHOUT REGARD TO ABILITY TO PAY. INTAKE STAFF MEMBERS ARE TRAINED WITH REGARD TO HOW TO APPROACH AND ENGAGE AN INDIVIDUAL WHEN THERE IS AN APPARENT LACK OF ADEQUATE HEALTH COVERAGE. THIS INCLUDES INFORMING THEM OF THE PROGRAMS OFFERED BY HFHS AS WELL AS OTHER COMMUNITY, LOCAL, STATE AND FEDERAL PROGRAMS OFFERING POTENTIAL SUPPORT. HFHS HAS DEDICATED STAFF RESPONSIBLE TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR SUPPORTIVE PROGRAMS AND ASSIST THEM WITH THE ENROLLMENT PROCESS. THERE ARE MANY REASONS WHY A PATIENT IN NEED OF FINANCIAL ASSISTANCE WITH THEIR MEDICAL CARE MAY NOT HAVE BEEN IDENTIFIED AT THE TIME OF THE CARE DELIVERY. PATIENT FINANCIAL SERVICE AND COLLECTION STAFFS ARE TRAINED TO RECOGNIZE THESE INDIVIDUALS AND PROVIDE THEM WITH ADVICE REGARDING THE VARIOUS OPTIONS AVAILABLE TO SUPPORT THEIR CARE NEEDS. PART VI, LINE 4: ALTHOUGH HFHS AND ITS AFFILIATES PROVIDE SERVICES TO INDIVIDUALS RESIDING THROUGHOUT THE STATE OF MICHIGAN AND IN SOME CASES FROM AROUND THE WORLD, IT DEFINES ITS COMMUNITIES SERVED BASED ON THE AREAS GENERATING THE HIGHEST INPATIENT VOLUMES. MORE THAN 90% OF THIS VOLUME FOR HFHS ORIGINATES IN THE THREE COUNTIES THAT IMMEDIATELY SURROUND HENRY FORD HOSPITAL: WAYNE, OAKLAND AND MACOMB. THE COMBINED POPULATION OF THIS AREA IS NEARLY 4 MILLION AND REPRESENTS 40% OF THE OVERALL POPULATION OF THE STATE. KEY DEMOGRAPHICS INCLUDE 51.3 % MALE, 65.2 % WHITE, 25.1 % BLACK (TWICE THE NATIONAL AVERAGE) AND 3.7% HISPANIC (25% OF THE NATIONAL AVERAGE). THE AREA IS EXTREMELY DIVERSE IN REGARD TO POPULATION, RACIAL/ETHNIC COMPOSITION, AND ECONOMIC POSITION.IT IS ANTICIPATED THE NUMBER OF AGGREGATE RESIDENTS WILL DECREASE SLIGHTLY OVER THE NEXT SEVERAL YEARS. FEMALES OF CHILD BEARING YEARS CURRENTLY REPRESENT NEARLY 20% OF THE POPULATION, BUT THIS IS ANTICIPATED TO DECLINE BY NEARLY 5 % OVER THE NEXT SEVERAL YEARS. UNEMPLOYMENT IS HIGHER THAN THE NATIONAL AVERAGE WITHIN THIS AREA, WITH PARTICULAR HIGH LEVELS IN WAYNE COUNTY AND THE CITY OF DETROIT. MEDIAN HOUSEHOLD INCOMES HAVE DECLINED IN RECENT YEARS, MOST DRAMATICALLY IN SEVERAL KEY ZIP CODES AND WITHIN THE CITY OF DETROIT. THIS IMPACTS OVERALL PURCHASING POWER OF EACH HOUSEHOLD AND RESULTS IN LOSS OF EMPLOYER PROVIDED HEALTH CARE COVERAGE AND INCREASES THE BURDEN ON ESTABLISHED HEALTH CARE SAFETY NETS.STUDIES OF THE INDICATED POPULATIONS REVEAL THAT MANY OF THE SIGNIFICANT HEALTH ISSUES FACED ARE ALSO OBSERVED AT THE STATE AND NATIONAL LEVEL. THESE INCLUDE PREVALENCE OF CARDIOVASCULAR DISEASE, CANCER AND DIABETES, AS WELL AS HIGH RISK FACTORS THAT CONTRIBUTE TO DEVELOPING CHRONIC CONDITIONS SUCH AS OBESITY, LOW PHYSICAL ACTIVITY AND POOR NUTRITION.VARIOUS POCKETS OF THE COMMUNITIES ALSO HAVE SIGNIFICANT NEGATIVE SOCIETAL FACTORS SUCH AS LACK OF ADEQUATE HEALTH INSURANCE, LOW EDUCATION LEVELS, AND LOW INCOME. THE ORGANIZATION CONSIDERS THE FOLLOWING FACTORS TO BE THE LEADING INDICATORS OF AT-RISK POPULATIONS:- LOWER INCOME AND/OR EDUCATION - THERE IS A STRONG CORRELATION THAT SUGGESTS AS INCOME AND EDUCATION LEVELS DROP, THE PREVALENCE OF CHRONIC CONDITIONS AND BEHAVIORS THAT CAN LEAD TO CHRONIC CONDITIONS INCREASES. THIS HAS LED HFHS TO PRIORITIZE ITS EFFORTS IN AREAS OF LOWER INCOME AND/OR LOWER EDUCATIONAL LEVEL AND TO ESTABLISH PROGRAMS DESIGNED TO PROMOTE ONGOING EDUCATION.- UNINSURED OR UNDERINSURED - THE SAME CORRELATION INDICATED ABOVE CAN BE SEEN IN POCKETS OF THE POPULATION WITH INADEQUATE HEALTH INSURANCE COVERAGE. THIS IS ANOTHER FOCUS GROUP FOR HFHS.- RACIAL AND ETHNIC MINORITIES ARE ANOTHER AT RISK GROUP FOR DEVELOPING CERTAIN CHRONIC DISEASES AND ILLNESSES. LEADING INDICATORS OF HEALTH DISPARITIES BETWEEN THESE GROUPS INCLUDE INFANT MORTALITY, ADULT IMMUNIZATIONS AND DEATHS FROM HIV RELATED INFECTIONS. THESE ARE ALL AREAS OF FOCUS FOR THE HEALTH SYSTEM. PART VI, LINE 5: HFHS IS ONE OF THE NATION'S LARGEST INTEGRATED HEALTH DELIVERY SYSTEMS SERVING ALL OF SOUTHEASTERN MICHIGAN. HFHS IS GOVERNED BY DEDICATED COMMUNITY BOARDS, AND IN TOTAL PROVIDES APPROXIMATELY 55,000 INPATIENTS STAYS AND 2.1 MILLION PHYSICIAN VISITS ANNUALLY. THIS TAX RETURN REFLECTS THE ACTIVITIES OF HENRY FORD HOSPITAL AN 877 BED TERTIARY CARE HOSPITAL WITH A LEVEL 1 TRAUMA CENTER LOCATED IN THE CITY OF DETROIT, SERVING AS A COMMUNITY HOSPITAL FOR ITS IMMEDIATE NEIGHBORHOODS AS WELL AS A REFERRAL CENTER FOR THE SURROUNDING REGION. IT IS SUPPORTED BY THE HENRY FORD MEDICAL GROUP (HFMG) WHO ALSO PROVIDES CARE IN THE MORE THAN 30 OUTPATIENT MEDICAL CENTERS LOCATED THROUGHOUT SOUTHEAST MICHIGAN. HFHS ALSO INCLUDES HENRY FORD WEST BLOOMFIELD HOSPITAL, A 191 BED COMMUNITY HOSPITAL, BEHAVIORAL HEALTH SERVICES PROVIDED THROUGHOUT THE ABOVE FACILITIES AS WELL AS AT HENRY FORD KINGSWOOD HOSPITAL, A 100 BED PSYCHIATRIC HOSPITAL, AND THE MAPLEGROVE CENTER, A 67 BED FACILITY. HFHS COMMUNITY CARE SERVICES OFFERS A BROAD LEVEL OF SERVICES AT NUMEROUS GEOGRAPHIC LOCATIONS INCLUDING NURSING CARE, HOME CARE, SENIOR CARE, PHARMACIES, EYE CARE, HOSPICE CARE, OCCUPATIONAL HEALTH, DIALYSIS AND A DEDICATED CANCER CENTER.THE SYSTEM DEMONSTRATES ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY BY OPERATING EMERGENCY ROOMS OPEN TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK; PROVIDING FACILITIES FOR THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS; AND MAINTAINING RESEARCH FACILITIES FOR THE STUDY OF NEW DRUGS AND MEDICAL DEVICES THAT OFFER THE PROMISE OF IMPROVING HEALTH CARE. THE SYSTEM ALSO PROVIDES COMMUNITY HEALTH SERVICES, SUCH AS COMMUNITY EDUCATION AND OUTREACH IN THE FORM OF FREE OR LOW-COST CLINICS; HEALTH EDUCATION TELEVISION PROGRAMMING; DONATIONS FOR THE COMMUNITY; MULTIPLE HEALTH PROMOTION AND WELLNESS PROGRAMS, SUCH AS HEALTH SCREENING; AND VARIOUS COMMUNITY PROJECTS AND SUPPORT GROUPS.COMMUNITY PARTNERSHIPS:HENRY FORD DEVELOPS INNOVATIVE WAYS TO ADDRESS THE SOCIAL, ECONOMIC AND EDUCATIONAL ISSUES THAT AFFECT THE HEALTH OF THE METRO DETROIT COMMUNITY. THESE INCLUDE:CENTER FOR HEALTH SERVICES RESEARCH-CONDUCTS RESEARCH FOCUSING ON OUTCOMES, EFFECTIVENESS AND COST-EFFECTIVENESS OF THE PREVENTION, DIAGNOSIS, TREATMENT AND MANAGEMENT OF SUCH DISEASES AS CANCER, DIABETES, ASTHMA AND CONGESTIVE HEART FAILURE AS WELL AS COMMON ACUTE CONDITIONS.COMMUNITY HEALTH AND SOCIAL SERVICES (CHASS) CLINIC-PROVIDES PRIMARY CARE SERVICES TO MORE THAN 3,500 UNINSURED DETROIT RESIDENTS EVERY MONTH. HFHS PHYSICIANS STAFF THE TWO CLINICS, WHICH ARE LOCATED IN SOUTHWEST DETROIT AND IN THE NEW CENTER AREA.INNOVATION INSTITUTE AT HENRY FORD HOSPITAL - IN COLLABORATION WITH WAYNE STATE UNIVERSITY SCHOOL OF ENGINEERING AND CENTER FOR CREATIVE STUDIES, THE INNOVATION INSTITUTE AIMS TO RESEARCH AND DESIGN MEDICAL PRODUCTS TO ENHANCE MEDICAL USE AND TO CREATE NEW INDUSTRY IN THE REGIONINSTITUTE ON MULTICULTURAL HEALTH-STUDIES THE DISPARITIES IN HEALTH CARE AMONG PEOPLE OF COLOR AND FINDS SOLUTIONS FOR GETTING EARLY DIAGNOSIS AND TREATMENT OF DISEASES.SCHOOL-BASED AND COMMUNITY HEALTH PROGRAM - PROVIDES STUDENTS ACCESS TO A HEALTH CARE CLINIC IN EIGHT DETROIT SCHOOLS, ONE DETROIT YOUTH CENTER AND ONE WARREN SCHOOL, INCLUDING PRIMARY CARE, DENTAL SERVICES, MENTAL HEALTH AND HEALTH EDUCATION. IT HAS DEMONSTRATED BETTER ATTENDANCE AND TEST SCORES BY STUDENTS. THE PROGRAM ALSO OFFERS A MOBILE PEDIATRIC MEDICAL CLINIC CALLED HANK, WHICH TRAVELS TO SEVEN DETROIT SCHOOLS EVERY WEEK AND IS FUNDED BY THE CHILDREN'S HEALTH FUND. PART VI, LINE 6: THE INTEGRATED HEALTH SYSTEM ALSO INCLUDES 4 COMMUNITY HOSPITALS ENCOMPASSING MORE THAN 1,000 BEDS WITH EMERGENCY SERVICES AND OPEN MEDICAL STAFFS LOCATED IN SUBURBAN REGIONS OF SOUTHEAST MICHIGAN. THESE ENTITIES ARE SEPARATE CORPORATIONS AND THE RESULTS OF THEIR COMMUNITY BENEFIT ACTIVITIES ARE REFLECTED IN THEIR RESPECTIVE TAX RETURNS. 1 AMERICAN KIDNEY FUND 6110 EXECUTIVE BLVD-STE 1010 ROCKVILLE MD 20852 237124261 501(C)(3) 150000 ORGANIZATIONAL SUPPORT DETROIT CRISTO REY HIGH SCHOOL 5679 W VERNOR HIGHWAY DETROIT MI 48209 043730980 501(C)(3) 30200 ORGANIZATIONAL SUPPORT GREATER DETROIT AREA HEALTH COUNCIL 333 W FORT STREET DETROIT MI 48226 381360904 501(C)(3) 91580 ORGANIZATIONAL SUPPORT CITY YEAR DETROIT (CITY YEAR INC) 1 FORD PLACE-SUITE 1F DETROIT MI 48202 222882549 501(C)(3) 17650 99465 FAIR MARKET VALUE PROVISION OF OFFICE SPACE & POSTAGE AT NO COST ORGANIZATIONAL SUPPORT AMERICAN HEART ASSOCIATION 24445 NORTHWESTERN HWY SOUTHFIELD MI 48075 135613797 501(C)(3) 25000 ORGANIZATIONAL SUPPORT NATIONAL KIDNEY FOUNDATION OF MICHIGAN 1169 OAK VALLEY DRIVE ANN ARBOR MI 48108 381559941 501(C)(3) 25500 ORGANIZATIONAL SUPPORT THE GROSSE POINTE ACADEMY 171 LAKE SHORT ROAD GROSSE POINTE FARMS MI 48236 381359080 501(C)(3) 20000 ORGANIZATIONAL SUPPORT OAKLAND UNIVERSITY 2200 NORTH SQUIRREL ROAD ROCHESTER MI 48309 381714400 501(C)(3) 8650 ORGANIZATIONAL SUPPORT CHILDREN'S CENTER OF WAYNE COUNTY 79 W ALEXANDRINE DETROIT MI 48201 381359505 501(C)(3) 10000 ORGANIZATIONAL SUPPORT 100 BLACK MEN OF GREATER DETROIT 1 FORD PLACE DETROIT MI 48202 383124115 501(C)(3) 13800 FAIR MARKET VALUE BUILDING SPACE PROVISION ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT VATTIKUTI FOUNDATION 3350 EASTPOINTE LN BLOOMFIELD MI 48302 383380162 501(C)(3) 15000 ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT DETROIT BRANCH-NAACP 8220 SECOND AVE DETROIT MI 48202 131084135 501(C)(3) 7700 ORGANIZATIONAL SUPPORT VOICES OF DETROIT INITIATIVE 4201 ST ANTOINE-UHC 9D DETROIT MI 48201 202333719 501(C)(3) 25000 ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT BIG BROTHERS BIG SISTERS OF METROPOLITAN DETROIT 7700 SECOND STREET - 602 DETROIT MI 48202 386112533 501(C)(3) 6500 ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT FRIENDSHIP CIRCLE 6892 WEST MAPLE ROAD W BLOOMFIELD MI 48322 383613944 501(C)(3) 10000 ORGANIZATIONAL SUPPORT ST JOSEPH MERCY HOSPITAL-OAKLAND 44405 WOODWARD AVENUE PONTIAC MI 48341 382113393 501(C)(3) 7500 ORGANIZATIONAL SUPPORT HABITAT FOR HUMANITY DETROIT 14325 JANE STREET DETROIT MI 48205 382708025 501(C)(3) 10000 ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT DETROIT REGIONAL CHAMBER FOUNDATION INC ONE WOODWARD AVE-SUITE 1900 DETROIT MI 48226 322352462 501(C)(3) 13570 ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT CORNERSTONE SCHOOLS ASSOCIATION 6861 EAST NEVADA DETROIT MI 48234 382995984 501(C)(3) 7500 ORGANIZATIONAL SUPPORT COMMUNITY HEALTH & SOCIAL SERVICES CENTER INC (CHASS) 5635 W FORT STREET DETROIT MI 48209 383094394 501(C)(3) 7542 1252297 COST PROVISION OF MEDICAL OFFICE & STAFF FOR COMMUNITY HEALTH CENTER ORGANIZATIONAL SUPPORT THE PARADE COMPANY 9500 MT ELLIOTT-SUITE A DETROIT MI 48211 382684772 501(C)(3) 7000 ORGANIZATIONAL SUPPORT UNIVERSITY CULTURAL CENTER ASSOCIATION 3939 WOODWARD AVENUE DETROIT MI 48201 382134035 501(C)(3) 700009 ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT MHA PATIENT SAFETY ORGANIZATION 6215 W ST JOSEPH HWY LANSING MI 48917 386091188 501(C)(3) 68731 ORGANIZATIONAL SUPPORT SAFETY NET HOSPITALS FOR PHARMACEUTICAL ACCESS 1501 M STREET NW-7TH FLOOR WASHINGTN DC 20005 205913680 501(C)(3) 7900 ORGANIZATIONAL SUPPORT ORGANIZATIONAL SUPPORT 24 0 HELPING HANDS PROGRAM 128 229906 PATIENT MEDICAL SUPPLIES & PHARMACEUTICALS 1115 836329 COST PATIENTS MEETING FINANCIAL ASSISTANCE PROGRAM GUIDELINES MAY BE PROVIDED WITH PHARMACEUTICALS & MEDICAL SUPPLIES AT NO CHARGE UPON DISCHARGE PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE HENRY FORD HEALTH SYSTEM HELPING HANDS PROGRAM IS A CHARITABLE INITIATIVE SPONSORED AND FUNDED ENTIRELY BY EMPLOYEES TO HELP CO-WORKERS, VOLUNTEERS AND RETIREES IN TIMES OF NEED. SINCE ITS INCEPTION IN 1992, THE PROGRAM HAS PROVIDED FINANCIAL ASSISTANCE TO HUNDREDS OF PEOPLE. HELPING HANDS PROVIDES FINANCIAL ASSISTANCE OF UP TO $1,800 TO ELIGIBLE EMPLOYEES AND UP TO $500 TO ELIGIBLE VOLUNTEERS AND RETIREES WHO, DUE TO A CATASTROPHE-SUCH AS A HOME FIRE, ILLNESS OR INJURY-CAN'T AFFORD BASIC NECESSITIES INCLUDING FOOD, CLOTHING AND MEDICAL CARE. A HELPING HANDS EXECUTIVE COMMITTEE ("THE COMMITTEE") COMPRISED OF A REPRESENTATIVE FROM EACH BUSINESS UNIT OF THE HEALTH SYSTEM OVERSEES THE HELPING HANDS PROGRAM. THE COMMITTEE PROVIDES PERIODIC OVERSIGHT OF THE POLICIES AND CRITERIA THAT GOVERN THE DISTRIBUTION OF FUNDS AND PRODUCES AND MAINTAINS THE PROGRAM'S FINANCIAL REPORTS. APPLICATIONS FOR FUNDS, ELIGIBILITY DETERMINATIONS AND DISTRIBUTION OF FUNDS ARE ADMINISTERED AT THE BUSINESS UNIT LEVEL EITHER BY A BUSINESS UNIT HELPING HANDS COMMITTEE OR A HELPING HANDS REPRESENTATIVE. THE COMMUNITY OUTREACH DEPARTMENT MONITORS GRANTS PAID TO CHARITABLE AND GOVERNMENTAL ENTITIES. X 1 1 X X X X X 0 1 0 1 0 0 0 0 0 GREGORY L BARKLEY MD 270869 0 5000 0 45630 0 31295 0 26194 0 378988 0 0 0 WILLIAM A CONWAY MD 478866 0 64954 0 17186 0 31295 0 18782 0 611083 0 0 0 MARK A KELLEY MD 795791 0 697618 0 249350 0 28795 0 22670 0 1794224 0 0 0 NANCY M SCHLICTING 1371098 0 1157905 0 728800 0 28796 0 22406 0 3309005 0 0 0 KATHLEEN L YAREMCHUK MD 599500 0 81107 0 20554 0 31295 0 26916 0 759372 0 0 0 JAMES M CONNELLY 649286 0 441140 0 184930 0 28795 0 19288 0 1323439 0 0 0 EDITH L EISENMANN 172474 0 44910 0 19983 0 24585 0 10158 0 272110 0 0 0 BRIAN R GAMBLE 182756 0 41033 0 11865 0 24560 0 18550 0 278764 0 0 0 WILLIAM ALVIN 553929 0 365303 0 24011 0 132334 0 13625 0 1089202 0 0 0 GERALD VAN GRINSVEN 422991 0 227039 0 67687 0 26295 0 20894 0 764906 0 0 0 JOHN POPOVICH MD 707291 0 344397 0 117726 0 115295 0 26350 0 1311059 0 0 0 JOHN J POLANSKI 429684 0 254109 0 78200 0 31296 0 6109 0 799398 0 0 0 ROBERT G RINEY 893875 0 581886 0 202683 0 31295 0 20894 0 1730633 0 0 0 MANI MENON MD 879188 0 1402165 0 24974 0 28796 0 25488 0 2360611 0 0 0 MARK L ROSENBLUM MD 780132 0 206009 0 641509 0 31295 0 27583 0 1686528 0 391259 0 MANUEL BROWN MD 564422 0 77947 0 458502 0 28795 0 17589 0 1147255 0 428534 0 THEODORE W PARSONS MD 888348 0 120778 0 22852 0 26295 0 26447 0 1084720 0 0 0 GHAUS MALIK MD 542460 0 19222 0 410333 0 31295 0 24307 0 1027617 0 86761 0 PART I, LINE 1A IT IS THE ORGANIZATION'S POLICY TO PAY OR REIMBURSE EMPLOYEES FOR BONAFIDE BUSINESS TRAVEL BASED ON THE MOST COST EFFECTIVE MEANS AVAILABLE. GENERALLY, WHEN AIR TRAVEL IS INVOLVED THIS EQUATES TO COACH CLASS AIR FARE. UNDER CERTAIN CIRCUMSTANCES, SUCH AS WHEN COACH CLASS IS NOT AVAILABLE OR THE TRIP IS OF AN EXTENSIVE DURATION, SENIOR LEADERSHIP HAS APPROVED BUSINESS CLASS, FIRST CLASS OR CHARTER TRAVEL. IN SUCH CIRCUMSTANCES, THE TRAVEL IS CONSIDERED TO BE FOR A BONAFIDE BUSINESS PURPOSE; ACCORDINGLY NO TAXABLE INCOME IS REPORTED. THERE WERE NO PAYMENTS OR REIMBURSEMENTS OF FIRST CLASS DURING 2012. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PROGRAM THAT RESULTS IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. THE ORGANIZATION ALSO OFFERS CERTAIN MEMBERS OF LEADERSHIP THE OPTION OF PARTICIPATING IN AN IRC SEC 457 BENEFIT PROGRAM WHICH ALSO RESULTS IN REPORTABLE TAXABLE INCOME AS BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. IT IS AN ELEMENT OF THE PLAN DESIGN TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. SEE Q. 4B FOR THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS. PART I, LINE 4B 4B. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PROGRAM THAT RESULTS IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. IT IS AN ELEMENT OF THE PLAN DESIGN TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. THE FOLLOWING PROVIDES THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS: SCH J, LINE 4B, PERSON PARTICIPATING IN NONQUALIFIED RETIREMENT PLANS SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) PARTICIPANT ACCRUAL NON-VESTED REPORTABLE W-2 NANCY SCHLICHTING 700,416 - 700,416 MARK KELLEY, M.D. 217,979 - 217,979 JAMES CONNELLY 163,489 - 163,489 PARTICIPANT ACCRUAL NON-VESTED REPORTABLE W-2 ROBERT RINEY 182,470 - 182,470 JOHN POLANSKI 57,289 - 57,289 JOHN POPOVICH, M.D. 95,656 - 95,656 GERARD VAN GRINSVEN 61,956 - 61,956 WILLIAM ALVIN 101,039 101,039 - CONTRIBUTIONS TO SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2012 CONTR. 2012 CONTR. TAX GROSS-UP W-2 AMOUNTS NANCY SCHLICHTING - 17,000 250 17,250 MANI MENON, M.D. - 17,000 250 17,250 MARK KELLEY, M.D. - 17,000 250 17,250 MARK ROSENBLUM, M.D. - 17,000 250 17,250 THEODORE PARSONS, MD - 17,000 250 17,250 JAMES CONNELLY 17,000 250 17,250 ROBERT RINEY - 17,000 250 17,250 EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2012 CONTR. 2012 CONTR. TAX GROSS-UP W-2 AMOUNTS GHAUS MALIK, M.D. - 17,000 250 17,250 JOHN POPOVICH, M.D. - 17,000 250 17,250 WILLIAM ALVIN 1,559 15,441 227 17,227 JOHN POLANSKI 7,016 9,984 147 17,147 EDITH EISENMANN 17,000 - - 17,000 KATHLEEN YAREMCHUK, M.D. - 17,000 250 17,250 GERARD VAN GRINSVEN - 5,451 80 5,531 DISTRIBUTIONS FROM NON-QUALIFIED DEFERRED COMPENSATION ARRANGEMENT (DCA) PLAN REPORTABLE W-2 2012 DISTR. AMOUNTS VINOD SAHNEY 245,741 245,741 GHAUS MALIK, M.D. 86,767 86,767 ACCRUALS TO SELECT SEC 457(F)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN 2012 ACCRUALS JOHN POPOVICH, M.D. 84,000 PART I, LINE 5 CERTAIN PHYSICIANS EMPLOYED BY THE ORGANIZATION RECEIVE COMPENSATION BASED ON A CONTRACTUAL FORMULA THAT PROVIDES FOR A MINIMUM BASE SALARY AND INCREMENTAL COMPENSATION WHEN DEPARTMENTAL NET REVENUE EXCEEDS A PREDETERMINED LEVEL. SUCH ARRANGEMENTS AND THE RESULTING COMPENSATION ARE CONSIDERED IN THE EVALUATION OF REASONABLE COMPENSATION. PART I, LINE 7 CERTAIN PHYSICIANS EMPLOYED BY THE ORGANIZATION RECEIVE COMPENSATION BASED ON A BASE SALARY AND AN INCENTIVE PAYMENT WHEN SERVICE VOLUMES EXCEED A PREDETERMINED LEVEL. SUCH AGREEMENTS AND THE RESULTING COMPENSATION ARE CONSIDERED IN THE EVALUATION OF REASONABLE COMPENSATION. A MICHIGAN STATE HOSPITAL FINANCE AUTHORITY 382889417 59465HDM5 2006-06-27 403115204 SEE PART VI 0 0 0 B MICHIGAN STATE HOSPITAL FINANCE AUTHORITY 382889417 59465HGS9 2007-11-29 165735000 SEE PART VI 0 0 0 C MICHIGAN STATE HOSPITAL FINANCE AUTHORITY 382889417 594654MA1 2009-11-03 322571412 SEE PART VI 0 0 0 A 17750000 441530925 24165427 58310840 3541881 253937393 101575384 2009 0 1 1 1 B 11635000 165735000 1453729 164281271 2007 0 0 1 1 C 15635000 322571784 23348894 12938234 4474851 87119305 194690500 2009 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 1 0.01990 1 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 1 0.00140 1 1 A 0 0 0 1 0 0 0 1 1 B 0 0 0 1 1 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 PART I, COLUMN (F), DESCRIPTION OF PURPOSE (A) ISSUER NAME: MICHIGAN STATE HOSPITAL FINANCE AUTHORITY (F) DESCRIPTION OF PURPOSE: REFUND 1999 (10/12/99), 1992A (9/16/92) & 2003A BONDS (2/13/03); FUND NEW CONSTRUCTION (B) ISSUER NAME: MICHIGAN STATE HOSPITAL FINANCE AUTHORITY (F) DESCRIPTION OF PURPOSE: FUND ACQUISITION OF ASSETS (C) ISSUER NAME: MICHIGAN STATE HOSPITAL FINANCE AUTHORITY (F) DESCRIPTION OF PURPOSE: REFUND 2006B&C (6/27/06) BONDS; FUND NEW CONSTRUCTION PART I, COLUMN (E) AND PART II, LINE 3 - DIFFERENCES BETWEEN THE ISSUE PRICE SHOWN IN PART I, COLUMN (E) AND TOTAL PROCEEDS SHOWN IN PART II, LINE 3 ARE DUE TO INVESTMENT EARNINGS. PART II, LINE 3, COLUMN A - FOR PURPOSES OF DETERMINING PROCEEDS ON THE ISSUE, WE HAVE ASSUMED THAT THE "PROJECT PERIOD" WITH RESPECT TO THE REFUNDING PORTION OF AN ISSUE ENDS ON THE DATE THE REFUNDED BONDS ARE CALLED AND RETIRED. PART IV, LINE 2C, COLUMN A - DATE OF REBATE COMPUTATION, 3/24/2011 PART IV, LINE 2C, COLUMN B - DATE OF REBATE COMPUTATION, 11/28/2012 PART IV, LINE 6, COLUMN A - THIS WAS AN ADVANCE REFUNDING ISSUE, WHICH HAS A 30-DAY TEMPORARY PERIOD. AS SUCH, THE PROCEEDS HAVE BEEN YIELD RESTRICTED. PART V - PROCEDURES TO UNDERTAKE CORRECTIVE ACTIONS HENRY FORD HEALTH SYSTEM HAS HAD AD HOC COMPLIANCE PROCEDURES FOR MANY YEARS. ON 11/13/2012, WRITTEN PROCEDURES WERE FORMALLY ADOPTED. COMERICA BANK SEE BELOW 909402 SEE BELOW 0 STERIS CORP SEE BELOW 381393 SEE BELOW 0 NANCY SAMMONS SEE BELOW 137862 SEE BELOW 0 JOSHUA GAMBLE SEE BELOW 24063 SEE BELOW 0 WALGREENS SEE BELOW 5526346 SEE BELOW 0 SUSAN CONWAY SEE BELOW 14074 SEE BELOW 0 LYNETTE DAVENPORT MD SEE BELOW 223551 SEE BELOW 0 THOMAS EISENMANN SEE BELOW 57250 SEE BELOW 0 COLLEEN GRACE MD SEE BELOW 236145 SEE BELOW 0 PEGGY ORR SEE BELOW 95739 SEE BELOW 0 0 SCHED L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:(A) NAME OF PERSON: COMERICA BANK(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER/BOARD MEMBER(D) DESCRIPTION OF TRANSACTION: BANKING SERVICES(A) NAME OF PERSON: STERIS CORP.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER/BOARD MEMBER(D) DESCRIPTION OF TRANSACTION: MEDICAL SUPPLIES(A) NAME OF PERSON: NANCY SAMMONS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION(A) NAME OF PERSON: JOSHUA GAMBLE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/CURRENT OFFICER(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION(A) NAME OF PERSON: WALGREENS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER/CURRENT OFFICER (D) DESCRIPTION OF TRANSACTION: PHARMACY PAYMENTS(A) NAME OF PERSON: SUSAN CONWAY(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/TRUSTEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION(A) NAME OF PERSON: LYNETTE DAVENPORT, M.D.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/TRUSTEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION(A) NAME OF PERSON: THOMAS EISENMANN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/CURRENT OFFICER(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION(A) NAME OF PERSON: COLLEEN GRACE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/TRUSTEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION(A) NAME OF PERSON: PEGGY ORR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/CURRENT OFFICER(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION X 8 89960 FAIR MARKET VALUE X 26 1354737 MARKET VALUE X 2 215654 FAIR MARKET VALUE X SOFTWARE 1 707080 FAIR MARKET VALUE X MISCELLANEOUS 251 237410 FAIR MARKET VALUE X LAND LEASE 1 96000 FAIR MARKET VALUE 0 0 1 1 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): REFLECTS THE NUMBER OF CONTRIBUTIONS THIRD PARTY USE: PART I, LINE 32B: BROKERAGE FIRM SELLS DONATIONS OF STOCK FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP - STEPHANIE BERGERON (CURRENT TRUSTEE) AND EDWARD CALLAGHAN, PHD. (CURRENT TRUSTEE) FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS CONTRACTED WITH H2O, LLC TO PROVIDE SENIOR LEADERSHIP TO ITS HUMAN RESOURCES FUNCTION. UNDER THE TERMS OF THIS AGREEMENT, H2O PROVIDES HFHS WITH THE SERVICES OF THE CHIEF HUMAN RESOURCES OFFICER OF HFHS. FORM 990, PART VI, SECTION B, LINE 11 THE TAX DEPARTMENT OF THE ORGANIZATION PREPARES THE FORM 990 AND HAS IT REVIEWED BY ITS INDEPENDENT TAX SERVICE PROVIDER. AS PART OF THE PREPARATION AND REVIEW PROCESS PRIOR TO FILING THE RETURN, THE FOLLOWING REVIEW PROCESS IS CONDUCTED: - REVIEW OF THE ENTIRE RETURN WITH THE HFHS CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER AND CHIEF EXECUTIVE OFFICER - REVIEW OF ALL COMPENSATION MATTERS AND DISCLOSURES WITH THE COMPENSATION COMMITTEE OF THE HFHS BOARD OF TRUSTEES - REVIEW OF THE RETURN WITH THE HFHS AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES - PROVIDE A COPY OF THE RETURN TO THE HFHS BOARD OF TRUSTEES FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES AND EMPLOYEES. ANNUALLY, TRUSTEES, EMPLOYEES OF A MANAGEMENT LEVEL, RESEARCHERS, AS WELL AS EMPLOYEES ASSOCIATED WITH PROCUREMENT, OR IN CERTAIN OTHER PREDEFINED ROLES MUST COMPLETE AN ANNUAL DISCLOSURE DESIGNED TO IDENTIFY ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. IT IS THE RESPONSIBILITY OF THE COMMITTEE TO REVIEW THESE DISCLOSURES AND DETERMINE THE NEED FOR ANY ACTION TO MANAGE THE POTENTIAL CONFLICT. THE COMMITTEE ANNUALLY REPORTS THE RESULTS OF ITS ACTIVITIES TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES CONSISTING OF ALL EXTERNAL TRUSTEES. THEY MEET PERIODICALLY THROUGHOUT THE YEAR. THEY ARE CHARGED WITH APPROVAL OF THE ORGANIZATION'S OVERALL COMPENSATION AND BENEFIT PROGRAMS AS WELL AS THE SPECIFIC REVIEW AND APPROVAL OF THE COMPENSATION OF CERTAIN EMPLOYEES INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THEY DIRECTLY ENGAGE AN INDEPENDENT COMPENSATION ADVISOR TO ASSIST WITH THIS PROCESS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE, UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS, AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTH CARE ORGANIZATIONS. THE REASONABLENESS OF COMPENSATION IS EVALUATED BASED UPON THESE AND OTHER FACTORS. THE COMMITTEE ALSO REVIEWS THE COMPENSATION DISCLOSURES TO BE MADE ON FORM 990 IN ADVANCE OF FILING. FORM 990, PART VI, SECTION C, LINE 19 IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION. AS A HOLDER OF TAX EXEMPT DEBT THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO A PUBLIC CLEARING HOUSE ON A QUARTERLY BASIS. PART IV, LINE 12 THE ORGANIZATION IS AN ELEMENT OF THE EXTERNAL AUDIT REPORT OBTAINED FOR THE CONSOLIDATED OPERATIONS OF HENRY FORD HEALTH SYSTEM. SCHEDULE R, PART V, LINE 1D AND 1E THE ORGANIZATION IS A MEMBER OF THE HENRY FORD HEALTH SYSTEM OBLIGATED GROUP. MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR OUTSTANDING OBLIGATIONS ISSUED UNDER THE BOND MASTER INDENTURE. SCHEDULE R, PART II, IDENTIFICATION OF OTHER RELATED ORGANIZATIONS THE ORGANIZATION HAS THE FOLLOWING OPERATING DIVISIONS THAT ARE NOT SEPARATE LEGAL ENTITIES BUT HAVE THEIR OWN UNIQUE ASSIGNED EIN'S. FINANCIAL INFORMATION RELATING TO THESE DIVISIONS ARE INCLUDED IN THIS RETURN. -HENRY FORD WEST BLOOMFIELD HOSPITAL (26-3896897) -CENTER FOR COMPLEMENTARY AND INTEGRATIVE MEDICINE (30-0092342) -HENRY FORD HEALTH SYSTEM - SCHOOL BASED HEALTH INITIATIVE (87-0729167) -COTTAGE HOSPITAL PHYSICIAN PRACTICE (26-4245539) -HENRY FORD PATHOLOGY (41-2223561) SCHEDULE R, PART V, LINE 2, COLUMN C ALL TRANSACTIONS REPORTED ARE BASED ON CASH VALUE CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT 2,508,101. OTHER INTERCOMPANY TRANSFERS -7,695,451. FORM 990, PART XII, LINE 2C THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF HENRY FORD HEALTH SYSTEM (HFHS) AND AFFILIATES. THE GOVERNING BODY OF HFHS HAS DELEGATED THE OVERSIGHT OF FINANCIAL STATEMENTS, INCLUDING THE CHOICE OF FINANCIAL AUDITORS, TO ITS AUDIT COMMITTEE. FORM 990, PART VII AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: MANY EXECUTIVE EMPLOYEES OF HFHS PROVIDE SERVICES TO MULTIPLE AFFILIATED ENTITIES. HENRY FORD HEALTH SYSTEM USES ESTIMATES FOR REPORTING AVERAGE HOURS PER WEEK IN ALL SECTIONS OF FORM 990. GENERALLY 60 HOURS ARE REPORTED FOR THE HOURS ASSOCIATED FOR THE ORGANIZATION THAT THE INDIVIDUAL HAS PRINCIPAL RESPONSIBILITY FOR. HOURS ASSOCIATED WITH OTHER HOSPITAL OR LARGER ORGANIZATIONS ARE REPORTED AT 5 PER WEEK, AND FOR SMALLER ORGANIZATIONS 1 HOUR PER WEEK IS REPORTED. WILLIAM ALVIN IS AN EMPLOYEE OF HFHS BUT SERVES AS THE CEO OF OUR AFFILIATE, HEALTH ALLIANCE PLAN. 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