2013-11-11T15:15:42-06:00 2012-12-31 990 2012-01-01 382791823 HENRY FORD WYANDOTTE HOSPITAL HENR 3138768714 2333 BIDDLE AVENUE WYANDOTTE MI 48192 JAMES CONNELLY 3138768714 2013-11-11 2012 2016-02-24 21:20:13Z JAMES CONNELLY ONE FORD PLACE - 5F DETROIT MI 48202 294254598 0 X WWW.HENRYFORD.COM/HOMEPAGE_WYANDOTTE X 1987 MI TO IMPROVE HUMAN LIFE THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING. 21 14 2805 475 0 0 1334046 933331 284679769 290259451 696780 644376 1877565 2066926 288588160 293904084 0 0 0 0 136232419 136513849 0 0 225422 154994712 153503655 291227131 290017504 -2638971 3886580 189772958 196933586 102299803 99704314 87473155 97229272 X HENRY FORD WYANDOTTE HOSPITAL (HFWH) IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM SERVING THE SOUTHERN METROPOLITAN DETROIT MICHIGAN COMMUNITIES. ESTABLISHED IN 1926, OUR MISSION IS TO IMPROVE HUMAN HEALTH THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE HEALING.AS AN INTEGRATED COMPONENT OF ONE OF THE NATION'S LEADING COMPREHENSIVE, INTEGRATED HEALTH SYSTEMS, IT IS THE MISSION OF HFWH TO IMPROVE HUMAN LIFE THROUGH THE EXCELLENCE OF THE SCIENCE AND ART OF HEALTH CARE AND HEALING. HFWH IS 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 FINANCING AND HEALTH CARE DELIVERY, INCLUDING ACUTE, SPECIALTY, PRIMARY AND PREVENTATIVE CARE SERVICES BACKED BY EXCELLENCE IN RESEARCH AND EDUCATION. 0 0 207532507 227881387 FOR MORE THAN 90 YEARS HENRY FORD WYANDOTTE HOSPITAL HAS SERVED THE DOWNRIVER COMMUNITY AND SURROUNDING AREA WITH A COMMITMENT TO CHARITABLE GIVING, OUTREACH AND BUILDING STRONGER, HEALTHIER INDIVIDUALS AND FAMILIES. THE 379-BED ACUTE CARE HOSPITAL OFFERS A FULL RANGE OF CLINICAL SERVICES, INCLUDING GENERAL MEDICINE, SURGERY, BIRTHING CENTER AND 24-HOUR EMERGENCY CARE. HENRY FORD WYANDOTTE HOSPITAL ALSO PROVIDES PHYSICAL MEDICINE AND REHAB, ADULT MENTAL HEALTH AND NEUROSURGICAL SERVICES. DURING 2012 HFWH HAD 18,466 ADMISSIONS AND 87,532 PATIENT DAYS.WITH A SENSE OF HUMAN COMPASSION, WE GIVE, ORGANIZE, LEAD, PARTNER AND EMBRACE THE WIDE-RANGING COMMUNITY PROGRAMS AND SERVICES. IN GIVING BACK TO THE CULTURE AND PEOPLE THAT SURROUND US, WE GAIN A PRICELESS FULFILLMENT IN KNOWING WE HAVE INVESTED IN THE HEALTH AND WELL-BEING OF OUR NEIGHBORS. ESTABLISHED IN 1926, OUR MISSION IS TO IMPROVE HUMAN HEALTH THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE HEALING. SERVING THE DOWNRIVER REGION AND SURROUNDING COMMUNITIES OF SOUTHEAST MICHIGAN, HENRY FORD WYANDOTTE HOSPITAL IS ONE OF THE MAJOR EMPLOYERS OF THE CITY OF WYANDOTTE. THE HOSPITAL ALSO HAS AN OSTEOPATHIC GRADUATE MEDICAL EDUCATION PROGRAM, OFFERING ROTATIONS TO RESIDENTS, INTERNS AND THIRD-AND-FOURTH-YEAR MEDICAL STUDENTS.HENRY FORD WYANDOTTE HOSPITAL IS ACCREDITED BY MANY PRESTIGIOUS AGENCIES AND ORGANIZATIONS. THESE SEALS OF APPROVAL GIVE OUR PATIENTS THE CONFIDENCE IN KNOWING THEY ARE RECEIVING THE HIGHEST QUALITY HEALTH CARE POSSIBLE. OUR ACCREDITATIONS INCLUDE:AMERICAN OSTEOPATHIC ASSOCIATION THE REHABILITATION ACCREDITATION COMMISSION FOR INPATIENT MEDICAL REHABILITATIONCOLLEGE OF AMERICAN PATHOLOGISTS AMERICAN ASSOCIATION OF BLOOD BANKS AMERICAN COLLEGE OF RADIOLOGISTS AMERICAN PSYCHOLOGICAL ASSOCIATION 36887358 30118803 HFWH PROVIDES OUTPATIENT SERVICES AT MULTIPLE LOCATIONS THROUGHOUT THE SOUTHERN METROPOLITAN COMMUNITIES. IN TOTAL THIS REPRESENTED 229,409 OUTPATIENT VISITS AND 9,013 OUTPATIENT SURGERIES DURING 2012.HENRY FORD HEALTH CENTER - BROWNSTOWN IS A STATE-OF-THE-ART FACILITY THAT OFFERS THE CONVENIENCE OF WALK-IN APPOINTMENTS FOR A VARIETY OF CLINICAL NEEDS, INCLUDING LABORATORY AND RADIOLOGY SERVICES. IT ALSO OFFERS SAME-DAY SURGERIES, EMERGENCY ROOM SERVICES, A SLEEP STUDIES CENTER, AND PHYSICIAN OFFICES FOR ALLERGY, DERMATOLOGY, PEDIATRICS AND OTHER SPECIALTIES. 27292888 32532797 HFWH OPERATES TWO 24 HOUR EMERGENCY FACILITIES, EMERGENCY SERVICES REPRESENTED 93,821 PATIENT VISITS DURING 2012. OTHER REVENUE CONSISTS OF RECORD FEES, PARKING FEES, TUITION, MEDICAL RESIDENT TRAINING & OTHER MISCELLANEIOUS INCOME 271712753 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 1 0 1 172 9 1 2805 1 0 0 0 0 0 1 1 0 0 0 0 0 X 21 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 X JAMES CONNELLY 3138768714 ONE FORD PLACE DETROIT MI 48202 DELORIS ANN BERRIEN-JONES MD 1.00 60.00 X 0 283482 43108 SAROJ V BHAT MD 2.00 60.00 X 8707 244883 53808 JOHN M BUSSA 1.00 0.00 X 0 0 0 VONDA R CINI 1.00 0.00 X 0 0 0 THOMAS G COSTANTINO DO 1.00 0.00 X 0 0 0 JAMES P DALY 1.00 0.00 X 0 0 0 JAMES H DAVIS JR 1.00 0.00 X 0 0 0 DEBORAH Y EDWARDS 1.00 0.00 X 0 0 0 HEIDIE M GORNO 1.00 0.00 X 0 0 0 JERRY D GRIFFITH 1.00 0.00 X 0 0 0 SYED M JAFRI MD 10.00 0.00 X 80081 0 0 LAWRENCE J KEARNEY JR 1.00 0.00 X 0 0 0 JOHN F KILL 1.00 0.00 X 0 0 0 J WES PAISLEY 2.00 0.00 X X 0 0 0 ROBERT G RINEY 1.00 64.00 X 0 1678444 52189 MOHINDER P SINGH-SANDHU MD 60.00 1.00 X 184247 4800 162 RICH A POSTON DO 1.00 0.00 X 0 0 0 JAMES J SEXTON 60.00 0.00 X X 593082 0 45343 MELANIE L MCCOY 1.00 0.00 X 0 0 0 KIMBERLY A KOVAC 1.00 0.00 X 0 0 0 BARBARA R LOTT 1.00 0.00 X 0 0 0 JAMES M CONNELLY 1.00 66.00 X 0 1275356 48083 EDITH L EISENMANN 1.00 68.00 X 0 237367 34743 JAMES J MILLER 60.00 0.00 X 234635 0 45015 DENNIS R LEMANSKI DO 60.00 0.00 X 383433 0 52995 RAND O'LEARY 60.00 0.00 X 302353 0 53193 MICHAEL D CALLAN MD 60.00 0.00 X 373622 0 40182 LANCE CHALDECOTT MD 60.00 0.00 X 671674 0 52237 GLENN J MINSTER MD 60.00 0.00 X 666071 0 8750 LEO D OTTONI MD 60.00 0.00 X 559360 0 44887 HENRI M PEIRRE-JACQUES MD 60.00 0.00 X 342559 0 49757 4399824 3724332 624452 89 0 1 0 MUNTHER ALAIWAT MD PC 15675 NORTHLINE RD SOUTHGATE MI 48195 CONTRACTED MEDICAL SVCS 2570005 GEORGE W AUCH COMPANY PO BOX 430719 48343-0719 PONTIAC MI 48341 CONSTRUCTION SERVICES 2399098 HOSPITALISTS PHYSICIANS MEDICAL GROUP 2000 GREEN RD SUITE 300 ANN ARBOR MI 481051571 CONTRACTED MEDICAL SVCS 1120410 EXECUTIVE HEALTH RESOURCES INC PO BOX 822688 PHILADELPHIA PA 19182 UTILIZATION REVIEW 478441 HARRISON MEDIA 24416 CROCKER BLVD CLINTON TOWNSHIP MI 48036 MARKETING/ADVERTISING 388591 31 198566 734765 142548 933331 HOSPITAL OPERATIONS 900099 224136134 224136134 EMERGENCY SERVICES 900099 32532797 32532797 AMBULATORY SERVICES 621400 30118803 30118803 MEDICAL EDUCATION-GME 900099 3471717 3471717 290259451 672412 672412 618129 133028 0 0 618129 133028 751157 751157 17920 113235 0 159191 17920 -45956 -28036 -45956 17920 87740 198566 176825 -89085 -89085 51916 14498 37418 37418 CAFETERIA SALES 900099 570870 570870 GIFT SHOP SALES 453220 477074 477074 319492 319492 1367436 293904084 290532987 0 2437766 1627700 491411 1068564 67725 144504 144504 109283653 102837831 6326411 119411 5312521 4949820 356989 5712 12402898 11556115 833447 13336 7742573 7213964 520283 8326 735 735 70798 70798 27180732 24771293 2406311 3128 718036 166538 551498 5388745 5071022 311672 6051 1490891 1421183 69555 153 5984191 5968126 15670 395 161691 142357 18299 1035 220933 216844 4059 30 2332196 2332196 9055257 7751376 1303881 2840427 2840427 MEDICAL SUPPLIES 37961237 37955112 6125 BAD DEBT EXPENSE 27264201 27264201 QAAP TAX 5575407 5575407 REPAIRS & MAINTENANCE 3650672 3585187 65485 23607506 19457104 4150282 120 290017504 271712753 18079329 225422 8558 13688 53745490 55170833 18181306 24253564 31500 209485 5040239 4688537 2430623 2418149 215043840 130169215 86674291 84874625 22775323 23625398 667687 885628 1011620 189772958 196933586 15659839 17901163 57423775 56459996 29216189 25343155 102299803 99704314 X 85738618 95365657 1627986 1446903 106551 416712 87473155 97229272 189772958 196933586 X 3886580 664215 5205322 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1734537 881664 22253 774839 1863615 1687424 819057 13196 785140 1734537 1358529 733694 6435 411234 1687424 1366799 560198 1371 569839 1358529 1545226 324766 32948 536141 1366799 0.22360 0.77640 0 0 10104173 10104173 116114911 58484772 57630139 689388 71211 618177 85514089 71613232 13900857 2621279 2621279 84874625 MALPRACTICE 19338238 OTHER LONG TERM LIABILITIES 6004917 25343155 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: EARNINGS FROM THE ORGANIZATION'S ENDOWMENT FUNDS ARE UTILIZED BASED ON THE NATURE OF THE SPECIFIC ASSOCIATED RESTRICTION. 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 AND 2011. GOLF EVENT 163014 111741 51273 13302 102454 HARVEST MOON BALL 123292 86825 36467 15900 45169 286306 198566 87740 29202 147623 176825 -89085 51916 14398 100 1 1.00000 51916 14398 100 14498 37418 MI 1 0 1 0 1.00000 SVEN GIERLINGER ONE FORD PLACE-SPECIAL EVENTS DETROIT MI 48202 0 0 1 1 X 1 X 1 X 1 1 1 0 1 1 2468337 2468337 0.00940 34919591 30018846 4900745 0.01870 37387928 30018846 7369082 0.02810 523431 28025 495406 0.00190 7624838 3471717 4153121 0.01580 9469432 7579150 1890282 0.00720 1301202 1301202 0.00500 18918903 11078892 7840011 0.02990 56306831 41097738 15209093 0.05800 40965 40965 0.00020 140605 140605 0.00050 181570 181570 0.00070 0 27264201 6816050 81387179 76849288 4537891 X 1 1 1 1 HENRY FORD WYANDOTTE HOSPITAL

2333 BIDDLE AVE WYANDOTTE MI 48192

X X X X HENRY FORD WYANDOTTE 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 9 HENRY FORD WYANDOTTE CNTR FOR HEALTH SVC

23050 WEST ROAD BROWNSTOWN TOWNSHIP MI 48183

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HENRY FORD WYANDOTTE PRIMARY CARE CLINIC

21969 HURON RIVER DRIVE ROCKWOOD MI 48173

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HF WYANDOTTE CLINIC - REHAB & ORTHO

3200 BIDDLE AVE WYANDOTTE MI 48192

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HF WYANDOTTE CLINIC -RVRSD FMLY PHYSNS

1640 FORT ST SUITES B D F TRENTON MI 48183

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HF WYANDOTTE HOSP-GENERAL SRGRY ASSOC

3333 BIDDLE AVE SUITES A C WYANDOTTE MI 48192

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HF WYANDOTTE CLINIC - BARIATRIC SURGRY

3333 BIDDLE AVE SUITES C WYANDOTTE MI 48192

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HF WYANDOTTE CLINIC - INTERNAL MED

15450 NORTHLINE RD SOUTHGATE MI 48195

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HF WYANDOTTE CLINIC - FAMILY MEDICINE

7226 ALLEN RD ALLEN PARK MI 48101

OUTPATIENT CLINIC/DIAGNOSTIC CENTER HF WYANDOTTE CLINIC - WOMEN'S HEALTH

15675 NORTHLINE RD SOUTHGATE MI 48195

OUTPATIENT CLINIC/DIAGNOSTIC CENTER PART I, LINE 7G: SUBSIDIZED SERVICES CONSIST OF FACILITY COSTS OF WOMENS' AND BEHAVIORAL HEALTH SERVICES. 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 $ 27264201. PART II: HFWH 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, HFWH 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. HFWH LEADERS COLLABORATE WITH COMMUNITY TASK FORCES AND COALITIONS IN ADDRESSING 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 THE 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 ASISTANCE 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 OF 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"SCHEDULE H, PART I, QUESTION 6:THE COMMUNITY BENEFIT ACTIVITIES OF HFWH ARE INCORPORATED IN THE CONSOLIDATED ANNUAL REPORT OF HENRY FORD HEALTH SYSTEM WHICH IS AVAILABLE ON ITS WEB SITE AT:HTTP://WWW.HENRYFORD.COM/BODY/CFM?ID=57195 HENRY FORD WYANDOTTE HOSPITAL PART V, SECTION B, LINE 19C: 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 WYANDOTTE 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: HFWH CONSIDERS THE ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AS AN ESSENTIAL FUNCTION, PROVIDING KEY INFORMATION REGARDING THE DEMOGRAPHICS AND MAJOR NEEDS OF THE COMMUNITIES SERVED. IT SUPPORTS THE PRIORITIZATION OF THE SERVICES, 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 THE FOLLOWING:1. MICHIGAN INPATIENT DATABASE (MIDB) - PROPRIETARY DATABASE OFFERING INPATIENT AND OUTPATIENT DATA FOR HOSPITAL AND HEALTH SYSTEMS WITHIN THE STATE OF MICHIGAN.2. THOMSON MARKET EXPERT DATABASE - PROPRIETARY DATABASE OFFERING MARKET DEMOGRAPHIC AND HEALTHCARE UTILIZATION DATA.3. MICHIGAN'S GREATEST TREASURE - IT'S PEOPLE, SEPTEMBER 1999 (WWW.DETNEWS.COM)4. MICHIGAN SURGEON GENERAL'S HEALTH STATUS REPORT - HEALTHY MICHIGAN 20105. HEALTH CARE AND HOMELESS: NCH FACT SHEET #8, JUNE 2006 (WWW.NATIONALHOMELESS.ORG)6. BASELINE DATE REPORT: THE STATE OF MICHIGAN'S HOMELESS, JANUARY 2006-JUNE 20067. HEALTH INDICATORS AND RISK ESTIMATES BY COMMUNITY HEALTH ASSESSMENT REGIONS & LOCAL HEALTH DEPARTMENTS - MICHIGAN BEHAVIORAL RISK FACTOR SURVEY 2002-2006 COMBINED8. HEALTH RISK BEHAVIORS IN THE STATE OF MICHIGAN - 2006 BEHAVIORAL RISK FACTOR SURVEY9. MICHIGAN DEPARTMENT OF COMMUNITY HEALTH (WWW.MDCH.MI.US)10. WAYNE COUNTY WEBSITE (WWW.WAYNECOUNTY.COM)11. HEALTH DISPARITIES IMPACTING RACIAL AND ETHNIC MINORITIES IN MICHIGAN PRESENTATION, MICHIGAN DEPARTMENT OF COMMUNITY HEALTH12. MICHIGAN CRITICAL HEALTH INDICATORS 2007 REPORT, MICHIGAN DEPARTMENT OF COMMUNITY HEALTH PART VI, LINE 3: HFWH 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. HFWH FOLLOWS THE HFHS CHARITY CARE POLICY. 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 HFWH AS WELL AS OTHER COMMUNITY, LOCAL, STATE AND FEDERAL PROGRAMS OFFERING POTENTIAL SUPPORT. HFWH 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 STAFF 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: HFWH DEFINES THE COMMUNITIES SERVED BASED ON GEOGRAPHIC AREAS GENERATING THE HIGHEST INPATIENT VOLUMES AND THE AREAS FROM WHICH ITS AMBULATORY SURGICAL CENTER DRAWS PATIENT VISITS. A CIRCLE WITH A TEN MILE RADIUS ORIGINATING FROM HFWH ENCOMPASSES THE HOME RESIDENCES OF 85% OF THE HFWH INPATIENT ADMISSIONS, AND WITH THE ADDITION OF TWO OTHER ZIP CODES, CAPTURES THE MAJORITY OF THE ACTIVITY FOR THE AMBULATORY SURGERY CENTER AS WELL.THE NUMBER OF RESIDENTS IN WESTERN/DOWNRIVER WAYNE COUNTY IS EXPECTED TO DECLINE BY .5% OVER THE NEXT SEVERAL YEARS, IN CONTRAST TO A NATIONAL GROWTH TREND OF 4.6%; IN ADDITION FEMALES OF CHILD BEARING YEARS, CURRENTLY REPRESENTING 20% OF THE POPULATION IS EXPECTED TO DECLINE BY 4%. THE REGION IS MADE UP OF 33 CITIES, 10 TOWNSHIPS, AND ONE VILLAGE; EXCLUDING THE DETROIT ZIP CODES THIS REPRESENTS A POPULATION OF NEARLY 1.1 MILLION WITH 51% BEING FEMALE.THIS AREA HAS A SLIGHTLY OLDER POPULATION THAN THE NATIONAL NORM, WITH 13% BEING AGE 65 OR OVER. THE RACIAL COMPOSITION IS 82% WHITE, 8.5% BLACK AND 3.5% HISPANIC. OF PARTICULAR NOTE THIS AREA CONTAINS THE HIGHEST CONCENTRATION OF MIDDLE EASTERN RESIDENTS OUTSIDE OF THE MIDDLE EAST ITSELF.THE REGION ENCOMPASSES TREMENDOUS VARIABILITY OF RESOURCES. ON AVERAGE HOUSEHOLD INCOME TRACKS 10% ABOVE THE NATIONAL AVERAGE. HOWEVER, FIVE OF THE COMMUNITIES INCLUDED IN THIS AREA REPRESENT AREAS WITH SIGNIFICANTLY LOWER INCOME LEVELS (30% BELOW THE NATIONAL NORM), MUCH GREATER ETHNIC DIVERSITY AND A MUCH HIGHER PERCENTAGE OF RESIDENTS WITHOUT HIGH SCHOOL LEVEL EDUCATION. ALTHOUGH THERE HAS BEEN SIGNIFICANT JOB LOSS IN RECENT YEARS, AUTOMOTIVE COMPANIES CONTINUE TO REPRESENT 2 OF THE LARGEST 3 EMPLOYERS IN THE REGION. 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.THE ORGANIZATION CONSIDERS THE FOLLOWING FACTORS TO BE THE LEADING INDICATORS OF AT-RISK POPULATIONS:UNINSURED AND UNDERINSURED ARE AT PARTICULAR RISK FOR NOT SEEKING PREVENTATIVE CARE SUCH AS CANCER SCREENINGS. THE HOMELESS ARE AT PARTICULAR RISK OF DEVELOPING MANY CHRONIC CONDITIONS. APPROXIMATELY 40% OF THE STATE OF MICHIGAN'S HOMELESS POPULATION IS ESTIMATED TO BE WITHIN THE HFWH AREA. BEHAVIORS SUCH AS HIGH CONSUMPTION OF ALCOHOL, SMOKING, LACK OF PHYSICAL ACTIVITY, POOR NUTRITION, UNSAFE SEXUAL PRACTICES AND OBESITY IMPACT EARLY ONSET OF MANY CHRONIC CONDITIONS. INFANT MORTALITY IS AN AREA IN NEED OF PARTICULAR FOCUS IN SOUTHEAST MICHIGAN. THE MORTALITY RATE FOR AFRICAN AMERICANS IS MORE THAN TWICE THE OVERALL POPULATION. PART VI, LINE 5: HENRY FORD WYANDOTTE HOSPITAL (HFWH) IS PART OF HENRY FORD HEALTH SYSTEM (HFHS), ONE OF THE NATION'S LARGEST INTEGRATED HEALTH DELIVERY SYSTEMS SERVING ALL OF SOUTHEASTERN MICHIGAN. THIS TAX RETURN REFLECTS THE ACTIVITIES OF HENRY FORD WYANDOTTE HOSPITAL, WHICH INCLUDES A 379 BED HOSPITAL WITH AN OPEN MEDICAL STAFF, AN OUTPATIENT SURGICAL CENTER, TWO 24-HOUR EMERGENCY DEPARTMENTS, AND SEVERAL OTHER OUTPATIENT LOCATIONS SERVING WESTERN WAYNE COUNTY AND THE DOWNRIVER COMMUNITIES IN SOUTHEASTERN MICHIGAN. HFWH IS GOVERNED BY A DEDICATED VOLUNTEER COMMUNITY BOARD AND IT PROVIDES ITS' COMMUNITIES WITH A FULL RANGE OF CLINICAL SERVICES INCLUDING GENERAL MEDICINE, SURGERY, OBSTETRICS, PEDIATRICS, CARDIAC CARE, PHYSICAL AND REHABILITATION MEDICINE, AMBULATORY SURGERY, INPATIENT AND OUTPATIENT BEHAVIORAL SERVICES, HOSPICE CARE AND 24 HOUR EMERGENCY CARE. PART VI, LINE 6: 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. X 1 1 X X X X X 0 1 0 1 0 0 0 0 0 DELORIS ANN BERRIEN-JONES MD 0 219456 0 64026 0 0 0 27611 0 15497 0 326590 0 0 SAROJ V BHAT MD 8707 197124 0 14259 0 33500 178 29749 0 23881 8885 298513 0 0 ROBERT G RINEY 0 893875 0 581886 0 202683 0 31295 0 20894 0 1730633 0 0 MOHINDER P SINGH-SANDHU MD 3528 0 0 0 180719 4800 162 0 0 0 184409 4800 0 0 JAMES J SEXTON 360890 0 171465 0 60727 0 28795 0 16548 0 638425 0 0 0 JAMES M CONNELLY 0 649286 0 441140 0 184930 0 28795 0 19288 0 1323439 0 0 EDITH L EISENMANN 0 172474 0 44910 0 19983 0 24585 0 10158 0 272110 0 0 JAMES J MILLER 190381 0 37956 0 6298 0 24770 0 20245 0 279650 0 0 0 DENNIS R LEMANSKI DO 292456 0 70897 0 20080 0 31295 0 21700 0 436428 0 0 0 RAND O'LEARY 242648 0 56786 0 2919 0 46196 0 6997 0 355546 0 0 0 MICHAEL D CALLAN MD 244607 0 109823 0 19192 0 25045 0 15137 0 413804 0 0 0 LANCE CHALDECOTT MD 211270 0 437251 0 23153 0 26295 0 25942 0 723911 0 0 0 GLENN J MINSTER MD 274515 0 383971 0 7585 0 8750 0 0 0 674821 0 0 0 LEO D OTTONI MD 108175 0 428425 0 22760 0 17117 0 27770 0 604247 0 0 0 HENRI M PEIRRE-JACQUES MD 231807 0 87247 0 23505 0 28795 0 20962 0 392316 0 0 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. NO QUALIFYING INDIVIDUALS RECEIVED PAID OR REIMBURSED FIRST CLASS TRAVEL 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 A 457 BENEFIT PROGRAM WHICH 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 REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS. PART I, LINE 4B SCH J, LINE 4B, PERSONS PARTICIPATING IN NONQUALIFIED RETIREMENT PLANS SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) 2012 TAXABLE REPORTABLE ACCRUAL 2012 DIST. W-2 AMOUNTS PARTICIPANT JAMES CONNELLY 163,180 - 163,180 ROBERT RINEY 182,470 - 182,740 JAMES SEXTON 43,438 - 43,438 CONTRIBUTIONS TO SEC 457(F)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2012 CONTRIBUTIONS 2012 CONTRIBUTIONS TAX GROSS-UP W-2 AMOUNTS L. R. CHALDECOTT, MD 16,440 560 8 17,008 LEO OTTONI, MD 17,000 - - 17,000 JAMES SEXTON 10,903 6,097 90 17,090 PIERRE-JACQUES, MD 15,605 1,395 21 17,021 GLENN MINSTER, MD - 1,085 16 1,101 DENNIS LEMANSKI, DO 7,800 3,800 56 11,656 JAMES CONNELLY 17,000 250 17,250 ROBERT RINEY - 17,000 250 17,250 EDITH EISENMANN 17,000 - - 17,000 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 CASH COLLECTIONS EXCEEDS A PREDETERMINED LEVEL. SUCH ARRANGEMENTS AND THE RESULTING COMPENSATION ARE CONSIDERED IN THE EVALUATION OF REASONABLE COMPENSATION. WYANDOTTE MUNICIPAL SERVICES SEE BELOW 3361935 SEE BELOW 0 D-M INVESTMENTS SEE BELOW 264237 SEE BELOW 0 CAROL BRIDGES SEE BELOW 105624 SEE BELOW 0 TRISHA LEMANSKI SEE BELOW 38880 SEE BELOW 0 (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: OFFICER/TRUSTEE (D) DESCRIPTON OF TRANSACTION: UTILITY SERVICES(A) NAME OF PERSON: D-M INVESTMENTS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/TRUSTEE(D) DESCRIPTON OF TRANSACTION: RENTAL PAYMENTS (A) NAME OF PERSON: CAROL BRIDGES(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/TRUSTEE(D) DESCRIPTON OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: TRISHA LEMANSKI(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTON OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION X 1 12000 FAIR MARKET VALUE X VEHICLE 1 23490 FAIR MARKET VALUE X EVENTS PRIZES 23 26368 FAIR MARKET VALUE X CONSULTING FEES 1 44000 FAIR MARKET VALUE X MISCELLANEOUS 10 36690 FAIR MARKET VALUE 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A TAX EXEMPT MEMBERSHIP CORPORATION AND THE SOLE MEMBER OF THE ORGANIZATION IS HENRY FORD HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF THE ORGANIZATION, HFHS HOLDS THE RESERVE POWER TO APPROVE OR DISAPPROVE TRUSTEE APPOINTMENTS. FORM 990, PART VI, SECTION A, LINE 7B BASED ON THE ESTABLISHED RESERVE POWERS, CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) AND THE TAX DEPARTMENT OF HFHS PREPARES THE ORGANIZATION'S FORM 990. 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 AND ORGANIZATION'S 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 ORGANIZATION'S BOARD OF TRUSTEES FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO OVERSEES THE CONFLICT OF INTEREST PROCESS WITH REGARD TO THE ORGANIZATION. HFHS HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE HFHS 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 HFHS BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO HAS RESPONSIBILITY TO OVERSEE THE COMPENSATION PRACTICES OF THE ORGANIZATION. HFHS 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. FORM 990, PART IV, LINE 24A, TAX-EXEMPT BOND ISSUE: THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM. THE ALLOCATED TAX-EXEMPT BOND LIABILITY OF THE ORGANIZATION IS REPORTED UNDER THE FORM 990, SCHEDULE K OF ITS PARENT, HENRY FORD HEALTH SYSTEM. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: ADJUSTMENT TO MINIMUM PENSION LIABILITY 5,205,322. FORM 990 - PART XII - LINE 2C: HENRY FORD WYANDOTTE HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF HENRY FORD HEALTH SYSTEM. THE GOVERNING BODY OF HFHS HAS DELEGATED THE OVERSIGHT OF THE FINANCIAL STATEMENTS, INCLUDING THE CHOICE OF INDEPENDENT AUDITORS, TO ITS AUDIT COMMITTEE. FORM 5713 - INTERNATIONAL BOYCOTT ACTIVITY: A FORM 5713, INTERNATIONAL BOYCOTT REPORT, HAS BEEN FILED ON OUR BEHALF BY HENRY FORD HEALTH SYSTEM (PARENT OF OUR CONTROLLED GROUP). THE ORGANIZATION DID NOT ITSELF HAVE ANY ACTIVITIES ASSOCIATED WITH AN INTERNATIONAL BOYCOTT COUNTRY. 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. HENRY FORD HEALTH SYSTEM ONE FORD PLACE DETROIT MI 48202 381357020 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) 3 N/A 0 HENRY FORD MACOMB HOSPITAL CORPORATION ONE FORD PLACE DETROIT MI 48202 382947657 HEALTHCARE SERVICE PROVIDER DE 501(C)(3) 3 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM FOUNDATION ONE FORD PLACE DETROIT MI 48202 237383042 SUPPORTING ORGANIZATION MI 501(C)(3) 11A-TYPE 1 HENRY FORD HEALTH SYSTEM 1 HEALTH ALLIANCE PLAN 2850 W GRAND BLVD DETROIT MI 48202 382242827 HEALTH MAINTENANCE ORGANIZATION MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HFHS SELF FUNDED LIABILITY ONE FORD PLACE DETROIT MI 48202 386553031 MALPRACTICE INSURANCE MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 DOWNRIVER CENTER FOR ONCOLOGY ONE FORD PLACE DETROIT MI 48202 383193008 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) 3 HENRY FORD HEALTH SYSTEM 1 HENRY FORD CONTINUING CARE ONE FORD PLACE DETROIT MI 48202 382433285 NURSING HOMES MI 501(C)(3) 9 HENRY FORD HEALTH SYSTEM 1 HFII CORPORATION ONE FORD PLACE DETROIT MI 48202 900840304 SCIENTIFIC RESEARCH MI 501(C)(3) 7 HENRY FORD HEALTH SYSTEM 1 NORTHWEST DETROIT DIALYSIS 30100 TELEGRAPH BINGHAM FARMS MI 48025 383232668 OPERATE DIALYSIS CLINIC MI HENRY FORD HEALTH SYSTEM N/A 0 0 DIALYSIS PARTNERS OF NW OHIO 30100 TELEGRAPH BINGHAM FARMS MI 48025 341877956 OPERATE DIALYSIS CLINIC OH HENRY FORD HEALTH SYSTEM N/A 0 0 MACOMB REGIONAL DIALYSIS CENTERS 16151 NINETEEN MILE RD CLINTON TOWNSHIP MI 48038 260423581 OPERATE DIALYSIS CLINICS MI HENRY FORD HEALTH SYSTEM N/A 0 0 SHA REALTY INC ONE FORD PLACE DETROIT MI 48202 381378121 REAL ESTATE HOLDING MI HENRY FORD HEALTH SYSTEM C 1 FAIRLANE HEALTH SERVICES 30100 TELEGRAPH BINGHAM FARMS MI 48025 382565235 HEALTHCARE MANAGEMENT MI HENRY FORD HEALTH SYSTEM C 1 ALLIANCE HEALTH AND LIFE INSURANCE 2850 W GRAND BLVD DETROIT MI 48202 383291563 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 HAP PREFERRED INC 2850 W GRAND BLVD DETROIT MI 48202 382513504 PROVIDER NETWORK LEASING MI HEALTH ALLIANCE PLAN C 1 HORIZON PROPERTIES INC ONE FORD PLACE DETROIT MI 48202 382679527 REAL ESTATE - LESSOR BUILDINGS MI HENRY FORD MACOMB HOSPITAL CORPORATION C 1 FIRST OPTOMETRY EYE CARE CENTERS INC 655 W 13 MILE RD MADISON HEIGHTS MI 48071 382299059 FRANCHISING EYE CARE CENTERS MI HENRY FORD HEALTH SYSTEM C 1 FIRST OPTOMETRY VISION PLANS INC 655 W 13 MILE RD MADISON HEIGHTS MI 48071 382594841 VISION CARE PLANS MI HENRY FORD HEALTH SYSTEM C 1 ONIKA INSURANCE LTD FIRST CARRIBEAN HOUSE GRAND CAYMAN CJ CAPTIVE INSURANCE CJ HENRY FORD HEALTH SYSTEM C 1 HENRY FORD PHYSICIAN NETWORK ONE FORD PLACE DETROIT MI 48202 320306774 PHYSICIAN NETWORK MI HEALTH ALLIANCE PLAN C 1 ADMINISTRATION SYSTEMS RESEARCH CORPORATION 2850 W GRAND BLVD DETROIT MI 48202 382651185 THIRD PARTY INSURANCE MI HEALTH ALLIANCE PLAN C 1 MIDWEST HEALTH PLAN 4700 SHAEFER ROAD SUITE 340 DEARBORN MI 48126 383123777 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 HEALTH ALLIANCE PLAN L 31064485 CASH VALUE HEALTH ALLIANCE PLAN M 14987882 CASH VALUE ONIKA INSURANCE LTD P 695000 CASH VALUE HFHS SELF FUNDED LIABILITY P 550000 CASH VALUE