2012-05-14T13:11:15-05:00 2011-06-30 990 2010-07-01 381415623 PAUL OLIVER MEMORIAL HOSPITAL PAUL 2313529621 224 PARK AVE FRANKFORT MI 496359658 MARK A HEPLER 2313529621 2012-05-11 2010 2016-02-24 21:20:13Z JAMES D AUSTIN 224 PARK AVE FRANKFORT MI 49635 16071238 false X WWW.MUNSONHEALTHCARE.ORG X 1944 MI PAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 30 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2010 TAX YEAR. 13 9 190 59 0 74187 27515 14881060 15775190 715391 169951 94177 78952 15764815 16051608 0 0 6411518 6538166 0 46772 7678130 8274372 14089648 14812538 1675167 1239070 14372348 15742268 1709111 1800732 12663237 13941536 X PAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 30 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2010 TAX YEAR. false false 13356398 15658999 PROVIDING HOSPITAL AND LONG-TERM CARE SERVICES TO THE RESIDENTS OF THE BENZIE, MICHIGAN REGION. 13356398 true true false false false false false false false true true true false false true false false true false false false false false false true false true true false false true false false false false false false false true false false false false false true true true true false true X 33 0 true 190 true false false false false false true false false false false false X 13 9 true false false false true true true true true false false true true true true true true true true false X MUNSON HEALTHCARE 2319357777 3668 N US 31 S TRAVERSE CITY MI 49684 X PAUL M SHIRILLA 2.00 X 0 322529 46557 JAMES D AUSTIN 16.00 X X 0 255707 40099 GERARD MAHONEY DO 2.00 X 8200 0 0 GEORGE RYCKMAN DO 2.00 X 2650 0 0 BRENDA SUE WEBBER 2.00 X X 0 0 0 CHARLES TULL 2.00 X 0 0 0 DAVID MICINSKI 2.00 X 0 0 0 HON PAUL J CLULO 2.00 X X 0 0 0 IRENE A NUGENT 2.00 X X 0 0 0 JOETTA RILEY PARRIS 2.00 X 0 0 0 SARA N WINE DO 2.00 X 0 0 0 PAUL PATTERSON 2.00 X 0 0 0 BETSY EVANS 2.00 X 0 0 0 MARK A HEPLER 1.00 X 0 249099 45753 10850 827335 132409 false true false CRYSTAL LAKE EMERGE 6227 FRANKFORT HWY BENZONIA MI 496169654 EMERGENCY SERVI 777277 TRANE PO BOX 98167 CHICAGO IL 60693 CONSTRUCTION 130562 SODEXO INC AND AFFILIATES 4880 PAYSHERE CIRCLE CHICAGO IL 60674 FOOD SERVICE 119029 TOWER PINKSTER TITUS ASSOCIATES 242 E KALAMAZOO AVE KALAMAZOO MI 490075828 CONSTRUCTION 110720 4 17520 9470 525 27515 MEDICARE AND MEDICAID PMTS 621990 8738432 8738432 PATIENT SERVICE REVENUE 621990 6749567 6749567 COMMUNITY FITNESS CENTER 713940 165949 165949 IN HOUSE CHILD CARE 624410 121242 121242 15775190 62472 62472 6698 6698 6698 6698 107479 107479 107479 107479 54552 17520 19630 34922 CAFETERIA SALES 722210 23281 23281 AUXILIARY GIFT SHOP 621990 9000 9000 MISCELLANEOUS 446199 5051 5051 37332 16051608 15658999 330172 4828819 4588920 239899 404609 384508 20101 953873 906484 47389 350865 333434 17431 675 675 29630 29630 3823729 3235150 543106 45473 29764 12109 17655 1595076 1571662 23414 180012 171835 8177 580088 580088 83471 55868 27603 177 177 812424 732563 79861 87554 66536 21018 BAD DEBT 676639 676639 LICENSES AND TAXES 310560 10877 299683 MISCELLANEOUS 37364 18553 17512 1299 DUES AND SUBSCRIPTIONS 23226 7012 16214 BUILDING REPAIRS 4120 4120 -137 -137 14812538 13356398 1409368 46772 750 1050 2638038 2436679 2478841 2169618 189929 146603 17831776 12302422 4764020 5529354 2767648 3211077 1284447 2042406 248675 205481 14372348 15742268 949346 1262817 759765 537915 1709111 1800732 X 11378790 11899130 1284447 2042406 12663237 13941536 14372348 15742268 X 1239070 39229 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false 4052095 757959 458819 15390 5253483 3736794 260254 288192 224769 8376 4052095 4099630 332714 -535126 149924 10500 3736794 0.61120 0.38880 false true true 193750 193750 11423204 8141136 3282068 120618 16585 104033 5981503 4049182 1932321 112701 95519 17182 5529354 INVEST IN PAUL OLIVER MEM FOUNDATION 2042406 F 2042406 ESTIMATED THIRD PARTY PAYMENTS 537915 537915 INTENDED USES FOR ENDOWMENT FUNDS SCHEDULE D, PAGE 2, PART V, LINE 4 THE FUNDS ARE INTENDED FOR THE OPERATIONS AND CAPITAL NEEDS OF THE PAUL OLIVER MEMORIAL HOSPITAL. A SIGNIFICANT PORTION OF THE TEMPORARILY RESTRICTED FUNDS ARE FOR THE RENOVATION OF THE HOSPITAL. MI CHRISTMAS EVENT 27189 8945 18244 9354 GOLF BENEFIT 23168 8575 14593 839 2 20175 20175 7874 70532 17520 53012 18067 18067 34945 true true true X false true true true false true true 207038 207038 0.01460 3907245 3047962 859283 0.06080 4114283 3047962 1066321 0.07540 135884 1435 134449 0.00950 4353 4353 0.00030 29711 29711 0.00210 169948 1435 168513 0.01190 4284231 3049397 1234834 0.08730 382 382 2576 2576 0.00020 3564 3564 0.00030 440 440 3812 3812 0.00030 529 529 20955 20955 0.00150 32258 32258 0.00240 true 362910 61550 5112224 5112224 X true true 1 1 PAUL OLIVER MEMORIAL HOSPITAL

224 PARK AVE FRANKFORT MI 49635

X X X X PAUL OLIVER MEMORIAL HOSPITAL 1 5 PAUL OLIVER MEMORIAL HOSPITAL SNF

224 PARK AVE FRANKFORT MI 49635

LONG TERM CARE PHYSICAL THERAPY

9975 W OTTAWA AVE EMPIRE MI 49630

PHYSICAL THERAPY FITNESS CENTER

102 AIRPORT RD FRANKFORT MI 49635

PHYSICAL THERAPY, CARDIAC REHAB AND EDU PHYSICAL THERAPY

6227 FRANKFORT HIGHWAY BENZONIA MI 49616

PHYSICAL THERAPY PHYSICAL THERAPY

1975 STIRLING DR INTERLOCHEN MI 49643

PHYSICAL THERAPY OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE PART I LINE 3C 100 FINANCIAL ASSISTANCE IS PROVIDED FOR THOSE INDIVIDUALS OR FAMILIES WHOSE INCOME IS 200 OR LESS THAN THE FPIG AND TOTAL ASSETS ARE WITHIN THE PROTECTED LEVELS THE APPROVAL IS VALID FOR 1 YEAR WITH A VERIFICATION OF FINANCIAL STATUS AT 6 MONTHS CATASTROPHIC ASSISTANCE IS AVAILABLE FOR THOSE INDIVIDUALS OR FAMILIES WHO DO NOT MEET THE GUIDELINES FOR FULL CHARITY CARE BUT WHOSE HOSPITAL EXPENSES WILL POSE AN EXTREME FINANCIAL HARDSHIP THE APPLICANT MUST MEET THE FOLLOWING GUIDELINES APPLICANTS CUMULATIVE BALANCE MUST BE GREATER THAN 10000 APPLICANT MUST COMPLETE FINANCIAL ASSISTANCE APPLICATION IF CATASTROPHIC ASSISTANCE IS GRANTED THE APPLICANT WILL BE RESPONSIBLE TO PAY 20 OF THE APPLICANTS ANNUAL HOUSEHOLD INCOME TO THE GRANTING INSTITUTION CATASTROPHIC ASSISTANCE APPROVAL WILL BE VALID FOR 12 MONTHS FROM THE DATE OF APPROVAL RELATED ORGANIZATION INFORMATION PART I LINE 6A MUNSON MEDICAL CENTER BROTHER CORPORATION SUBSIDIZED HEALTH SERVICES EXPLANATION PART I LINE 7G THERE ARE NO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F TOTAL EXPENSES FROM FORM 990 PART IX LINE 25 ARE 14812538 THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS 676639 THE NET EXPENSE OF 14135899 WAS USED FOR PURPOSES OF CALCULATING LINE 7 COLUMN F COSTING METHODOLOGY EXPLANATION PART I LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION COMMUNITY BUILDING ACTIVITIES PART II POMH PROVIDED 32258 TO COMMUNITYBUILDING ACTIVITIES DURING THE 2011 FISCAL YEAR WHILE WE BELIEVE THESE ACTIVITIES PROMOTE COMMUNITY HEALTH BY SUPPORTING THE UNDERLYING CAUSES OF COMMUNITY HEALTH THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON THE SCHEDULE H THESE ACTIVITIES INCLUDE ADMINISTRATIVE AND CASH SUPPORT FOR COALITION BUILDING ACTIVITIES IN BENZIE COUNTY MEETING THE BASIC NEEDS OF PEOPLE IN POVERTY ON A LOCAL LEVEL BY MULTIPLE COLLABORATIVE ACTIVITIES PARTICIPATION IN THE BENZIE COUNTY CHAMBER OF COMMERCE TO PROMOTE WORKFORCE DEVELOPMENT AND SEVERAL ENVIRONMENTAL IMPROVEMENTS RELATED TO COMMUNITY GARDENING AND HEALTHY SCHOOL LUNCHES ALSO BECAUSE BENZIE COUNTY IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA POMH INVESTS DOLLARS INTO THE RECRUITMENT OF CRITICALLY NEEDED PHYSICIANS TO THE AREA TO PROMOTE PATIENT ACCESS TO CARE BAD DEBT EXPENSE EXPLANATION PART III LINE 4 TO DETERMINE THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS WHO WOULD PROBABLY QUALIFY UNDER PAUL OLIVER MEMORIAL HOSPITALS CHARITY CARE POLICY MUNSON HEALTHCARE DIRECTED AN INTERNAL STUDY FROM A 3MONTH SAMPLE OF CURRENT BAD DEBT ACCOUNTS FIRST THE STUDY IDENTIFIED THE SELFPAY PORTION OF THE BAD DEBT EXPENSE THEN THE SELFPAY ACCOUNTS WERE ANALYZED USING REVENUE CYCLE ANALYTIC SOFTWARE TO IDENTIFY POTENTIAL CHARITY CARE CANDIDATES USING THE SOFTWARE ESTIMATIONS A PORTION OF THE SELFPAY ACCOUNTS WERE DEEMED CHARITY CARE ELIGIBLE THAT ESTIMATED PORTION WAS APPLIED TO THE SELFPAY BAD DEBT DOLLAR AMOUNT TO DETERMINE THE AMOUNT OF BAD DEBT THAT WOULD BE CONSIDERED CHARITY IF THE PROPER APPLICATIONS AND DOCUMENTATION WERE AVAILABLE FROM THE PATIENTS THE ACCOUNTS RECEIVABLE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF MUNSON HEALTHCARE AND SUBSIDIARIES STATES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS THROUGHOUT THE YEAR MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITEOFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THE ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PASTDUE PATIENT BALANCES WITH COLLECTION AGENCIES COLLECTION PRACTICES EXPLANATION PART III LINE 9B AT ANY TIME IF A PATIENT STATES THEY ARE HAVING TROUBLE PAYING THEIR BILLS THE CREDIT INTERVIEWERS OR FINANCIAL COUNSELORS SCREEN THE PATIENT FOR FINANCIAL ASSISTANCE ONCE QUALIFIED FOR CHARITY CARE THE PATIENT IS DEEMED QUALIFIED FOR ONE YEAR AND NO COLLECTION IS PURSUED DURING THAT TIME THE COLLECTIONS POLICIES ARE THE SAME FOR ALL PATIENTS IF AT ANY POINT IN THE COLLECTION PROCESS DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE THE ACCOUNT IS REFERRED BACK TO PATIENT FINANCIAL SERVICES FOR REVIEW NEEDS ASSESSMENT PART VI THE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE TO SERVE THE MUNSON SYSTEM BY REVIEWING INFORMATION ON COMMUNITY HEALTH NEEDS PRIORITIZING PROGRAMS AND SERVICES TO BE FUNDED REVIEWING PERFORMANCE INFORMATION REGARDING THE IMPACT AND COST EFFECTIVENESS OF PROGRAMS TARGETED TO IMPROVE THE HEALTH OF THE COMMUNITY IN GENERAL OR A TARGETED POPULATION INCLUDING THE UNDERSERVED AND UNDERINSURED AND TAKING RESPONSIBILITY FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MUNSON HEALTHCARES COMMUNITY BENEFIT PROGRAMS AND EXPENDITURES THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT OF MUNSON MEDICAL CENTER BROTHER CORPORATION PAUL OLIVER MEMORIAL HOSPITAL POMH A MEMBER OF THE MUNSON HEALTHCARE SYSTEM IS A CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN MUNSON HEALTHCARES EXTENSIVE GEOGRAPHICAL AREA COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED AS WELL AS WHERE PROGRESS HAS BEEN MADE THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITYWIDE PAUL OLIVER MEMORIAL HOSPITAL POMH IN CONJUNCTION WITH MUNSON HEALTHCARE PARENT AND SOLE MEMBER IS PREPARING A COMMUNITY NEEDS ASSESSMENT TO MEET THE REQUIREMENTS OF IRC SEC 501R WHICH WILL BE CONDUCTED IN FISCAL 2013 IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD POMH ALSO WILL COMPLETE AN IMPLEMENTATION PLAN IN FISCAL 2013 POMH REGULARLY SEEKS INFORMATION FROM AND PARTICIPATES IN THE BENZIE COUNTY COLLABORATIVE THE LOCAL UNITED WAY AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY HEALTH NEEDS POMH IN CONJUNCTION WITH MUNSON HEALTHCARE SEEKS TO COLLABORATE WITH REGIONAL PARTNERS ASSESSING FOR EXISTING PROGRAMS AND STRATEGIES THAT ARE ALREADY WORKING WELL AND THEN PARTNERING NOT REINVENTING IF A NEW PROGRAMMING NEED IS IDENTIFIED POMH SEEKS TO POOL ASSETS WITH THE MULTICOUNTY HEALTH DEPARTMENTS OTHER NONPROFITS AND LOCAL GOVERNMENTAL SERVICES FOR THE MOST EFFECTIVE USAGE OF RESOURCES ADDITIONALLY MUNSON HEALTHCARE WORKS IN CONJUNCTION WITH EFFORTS BY THE FIVECOUNTY COLLABORATIVES OF ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA COUNTIES THE TRAVERSE CITY CHAMBER OF COMMERCE THE LOCAL UNITED WAY AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY NEED PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS STATEMENT ON BILLS STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL SIGNS IN THE ER REGISTRATION AREA ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY REFERRAL BY REGISTRATION STAFF AT THE TIME OF REGISTRATION SELFPAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF PAUL OLIVER MEMORIAL HOSPITAL FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS IF THE PATIENT WOULD LIKE HELP THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO MEDICAID AND ALL OF ITS SUBSETS SOCIAL SECURITY DISABILITY TRAVERSE HEALTH CLINIC CHARITY CARE CATASTROPHIC CARE COVERAGE AND CAREPAYMENT COMMUNITY INFORMATION PART VI PAUL OLIVER MEMORIAL HOSPITAL POMH IS LOCATED IN FRANKFORT MICHIGAN ONE OF SEVEN HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM POMH OFFERS QUALITY PERSONALIZED CARE FOR PRIMARY AND URGENT MEDICAL NEEDS DUE TO ITS RURAL GEOGRAPHIC LOCATION POMH IS DESIGNATED AS A MICHIGAN CRITICAL ACCESS HOSPITAL LABORATORY RADIOLOGY AND REHABILITATION SERVICES AT POMH ARE NETWORKED WITH MUNSON MEDICAL CENTER MMC BROTHER ORGANIZATION ENSURING PROMPT AND CONVENIENT DIAGNOSIS AND TREATMENT POMH HAS 8 ACUTE CARE BEDS AS WELL AS A 39BED EXTENDED CARE UNIT WHERE RESIDENTS ENJOY A SAFE WARM AND COMFORTABLE HOMELIKE SETTING FOUNDED ON PRINCIPLES OF QUALITY AND PERSONAL CARE BECAUSE THE CARE CENTER IS HOSPITALBASED PHYSICIANS AND EMERGENCY MEDICAL CARE ARE AVAILABLE 24 HOURS A DAY HOSPITAL SERVICES POMH PROVIDES 24HOUR EMERGENCY CARE ACUTE CARE LONGTERM CARE OUTPATIENT SURGICAL SERVICES AND RESPITE CARE MMC SPECIALISTS REGULARLY HOLD CLINICS AT POMH MAKING IT EASY TO RECEIVE SPECIALIZED CARE POPULATION SERVED BY PAUL OLIVER MEMORIAL HOSPITAL IN THE POMH MAIN SERVICE AREA OF BENZIE COUNTY 195 OF THE POPULATION IS 65 YEARS OR OLDER THE CENSUS BUREAU CURRENT POPULATION ESTIMATES 2009 UNEMPLOYMENT IS 11 OR HIGHER 23 OF ADULTS AGED 1864 YEARS OF AGE LACK HEALTH INSURANCE PREVALENCE ESTIMATES FOR BENZIE COUNTY 20062010 MICHIGAN BRFS 103 LIVE BELOW THE FEDERAL POVERTY LEVEL THE CENSUS BUREAU SMALL AREA INCOME POVERTY ESTIMATES 2009 QUALITY PAUL OLIVER MEMORIAL HOSPITAL HAS RECEIVED THE FOLLOWING AWARDS 2009 AND 2010 SUMMIT AWARD FOR EMERGENCY CARE FROM PRESS GANEY ASSOCIATES INC THE SUMMIT AWARD WAS PRESENTED FOR RANKING IN THE TOP 5 PERCENT IN THE NATION FOR PATIENT SATISFACTION FOR 12 CONSECUTIVE QUARTERS IN 2010 PAUL OLIVER MEMORIAL HOSPITAL WAS THE ONLY EMERGENCY DEPARTMENT IN MICHIGAN TO RECEIVE THE SUMMIT AWARD FROM PRESS GANEY THE 2009 AND 2010 MICHIGAN RURAL HEALTH QUALITY IMPROVEMENT AWARD OF EXCELLENCE FOR ITS COMMITMENT TO QUALITY CARE AND EVIDENCEBASED MEDICINE IN THE AREA OF EMERGENCY ROOM TRANSFERS 2010 MICHIGAN RURAL HEALTH QUALITY IMPROVEMENT EXCELLENCE FOR ITS COMMITMENT TO OUTPATIENT CARE THE GOVERNORS AWARD OF EXCELLENCE FOR IMPROVING PATIENT SAFETY AND QUALITY OF CARE IN THE CRITICAL ACCESS SETTING THE AWARD HONORS MICHIGAN HOSPITALS THAT PERFORM QUALITY INITIATIVES AIMED AT IMPROVING PATIENT CARE THE HOSPITAL HAS REPEATEDLY RECEIVED THIS AWARD HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI THE POMH BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS THE MAJORITY OF WHOM RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS IN FUNDRAISING AND IN GENERAL STEWARDSHIP MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS POMH UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA A DESCRIPTION OF SEVERAL SIGNIFICANT PROGRAMS INITIATED BY THE HOSPITAL FOLLOWS HEALTHY FUTURES A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS HEALTH DEPARTMENTS AND MUNSON HEALTHCARE MUNSON HEALTHCARE SYSTEM PARENT AND SOLE MEMBER CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UNDER AGE TWO THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMESBASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY ACCESS TO HEALTH CARE AND IMMUNIZATIONS BECAUSE OF THE RURAL NATURE OF THE COMMUNITY TRAVEL TIME TO THE NEAREST MATERNAL CHILD HEALTHCARE SPECIALIST MAY BE GREATER THAN 30 MINUTES COST AND AVAILABILITY OF TRANSPORTATION CAN BE A DIFFICULT BARRIER TO ACCESS HEALTHCARE FOR YOUNG FAMILIES POMH PARTNERS WITH MUNSON MEDICAL CENTER TO BRING MATERNAL CHILD HEALTHCARE SPECIALISTS TO PAUL OLIVER MAKING IT EASY AND CONVINENT TO RECEIVE THE SPECIALIZED CARE NEEDED TRANSPORTATION AS PART OF MUNSON HEALTHCARE POMH SUBSIDIZES FUNDING FOR COUNTY TRANSPORTATION AUTHORITIES WHICH PROVIDES ACCESS TO HEALTHCARE SERVICES FOR DISADVANTAGED PERSONS SUCH AS THE ELDERLY PERSONS WITH DISABILITIES AND PERSONS OF LOW INCOME WHO HAVE DIFFICULTY PROVIDING THEIR OWN TRANSPORTATION BETSIE HOSICK HEALTH AND FITNESS CENTER THE BETSIE HOSICK HEALTH AND FITNESS CENTER IS OPEN TO PEOPLE OF ALL AGES ABILITIES AND FITNESS LEVELS TO ACHIEVE BETTER HEALTH THE FITNESS CENTER OFFERS A FULL RANGE OF FITNESS EQUIPMENT AND CLASSES MEDICALLY CREDENTIALED FITNESS PROFESSIONALS ARE ON STAFF TO ASSIST MEMBERS CAREGIVER LIBRARY A LIBRARY INCLUDING COMPUTERS TO ASSIST THE PUBLIC TO OBTAIN HEALTHCARE INFORMATION SUPPORT GROUPS AND ASSISTANT ACTIVITIES FOR CHRONIC DISEASES SUCH AS ALZHEIMERS DISEASE PARKINSONS AND CANCER SCREENING SERVICES SUCH AS BLOOD PRESSURE CHECKS MAMMOGRAMS AND LABORATORY TESTS TO THOSE IN NEED NORTHERN MICHIGAN DIABETES INITIATIVE NMDI NORTHERN MICHIGAN DIABETES INITIATIVE NMDI A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 11 COUNTY SERVICE AREA WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES NMDI IS COMMITTED TO PROVIDING LOCAL REGIONAL AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS THE GENERAL COMMUNITY THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION AND RURAL PRIMARY CARE PROVIDERS PCP CARING FOR DIABETIC PATIENTS COLLABORATION WITH THE TRAVERSE HEALTH CLINIC THE TRAVERSE HEALTH CLINIC THC PROVIDES ACCESS TO AFFORDABLE HEALTH SERVICES THROUGH COMMUNITY COLLABORATION TO PEOPLE IN NEED IN BENZIE LEELANAU AND GRAND TRAVERSE COUNTIES THC SERVES AS A PRIMARY CARE PROVIDER FOR THOSE ADULTS WITH MEDICAID AND RUNS THE COALITION HEALTH ACCESS PROGRAM CHAP FOR THOSE ADULTS WITH NO INSURANCE WHO QUALIFY INCOME 200 OF FPG POMH DONATES LABS XRAYS AND OTHER SERVICES TO THC PATIENTS LIVING IN THEIR RURAL SERVICE AREA AFFILIATED HEALTH CARE INFORMATION PART VI PAUL OLIVER MEMORIAL HOSPITAL IS A MEMBER OF THE MUNSON HEALTHCARE SYSTEM A COMMUNITYOWNED HEALTH SYSTEM THAT INCLUDES SEVEN ACUTE CARE HOSPITALS AS WELL AS NUMEROUS OUTPATIENT SERVICES AND CLINICS ALL THE HOSPITALS IN THE SYSTEM ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR RESPECTIVE COMMUNITIES EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL INITIATIVES ANDOR PROMOTION ACTIVITIES AS WELL AS SHARED INITIATIVES PAUL OLIVERS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE A 501C3 CORPORATION AFFILIATES OTHER THAN THE HOSPITALS INCLUDE TWO FOUNDATIONS HOME HEALTH ORGANIZATIONS MOBILE IMAGING COMPANIES AND AN EMERGENCY TRANSPORTATION ORGANIZATION ALL 501C ENTITIES IN ADDITION TO DIRECTING COMMUNITY BENEFIT ACTIVITIES OF THE SYSTEM MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFITS PROGRAMS FOR THE SYSTEM THROUGH PLANNING DEVELOPING IMPLEMENTING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS POMH WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON MEDICAL CENTER CAMPUS OVER A HALF MILLION DOLLARS IN COMMUNITY BENEFIT IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR NORTH FLIGHT INC IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM WITH ITS FIXED WING AND HELICOPTER AIR SERVICES IN COMBINATION WITH GROUND TRANSPORT PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE NORTH FLIGHT INC PROVIDED OVER 12 MILLION IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR X X X X false true false false false false false false false PAUL M SHIRILLA 259556 60698 2275 31769 14788 369086 JAMES D AUSTIN 177207 47730 30770 22638 17461 295806 11444 MARK A HEPLER 208875 38795 1429 26375 19378 294852 SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 PAUL M. SHIRILLA 0 16,196 0 JAMES D. AUSTIN 0 12,006 0 MARK A. HEPLER 0 13,842 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III EXECUTIVE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS OF MUNSON HEALTHCARE, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE RETIREMENT FUNDS ARE AVAILABLE TO THE PARTICIPANTS UPON THEIR RETIREMENT FROM MUNSON. CRYSTAL LAKE CLINIC OWNER DIRECTOR 11895 MEDICAL SERVICES false CRYSTAL LAKE EMERGENCY SERVICES PC OWNER DIRECTOR 867056 GROUP PHYSICIAN PRAC false NRTW LLC OWNER DIRECTOR 62247 LEASE false INTERLOCHEN MEDICAL PROPERTIES LLC OWNER DIRECTOR 77930 LEASE false ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION PAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 30 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2010 TAX YEAR. ADDITIONAL INFORMATION FORM 990, PART V PAUL OLIVER FOUND PHILANTHROPY LEADERSHIP HAS FOLLOWED UP ON DONOR RECEIPTS RELATED PARTY INFORMATION AMONG OFFICERS FORM 990, PAGE 6, PART VI, LINE 2 JAMES D. AUSTIN MARK A. HEPLER PRESIDENT CFO MUNSON HEALTHCARE EMPLOYER JAMES D. AUSTIN PAUL SHIRILLA PRESIDENT DIRECTOR MUNSON HEALTHCARE EMPLOYER CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 PAUL OLIVER MEMORIAL HOSPITAL IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A DIRECTORS ARE ELECTED FROM AMONG THOSE PERSONS RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE AT THE MUNSON HEALTHCARE ANNUAL MEETING. DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE PAUL OLIVER MEMORIAL HOSPITAL DIRECTORS ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING THE AMENDMENT OF THE ARTICLES OF INCORPORATION; AMENDMENT OF THE MISSION STATEMENT; ADOPTION OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION OR REORGANIZATION; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL TO THE PROPERTY AND ASSETS; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF PAUL OLIVER MEMORIAL HOSPITAL; ACCEPTANCE OF THE ANNUAL BUDGET AND ANNUAL FINANCIAL STATEMENTS; INCURRENCE OF EXPENDITURES EXCEEDING BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT; INCURRENCE OF CERTAIN DEBT; CHANGE IN SCOPE OF SERVICES OR PROGRAMS PROVIDED BY PAUL OLIVER MEMORIAL HOSPITAL; AND APPOINTMENT OF THE PRESIDENT. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE PAUL OLIVER MEMORIAL HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. PAUL OLIVER MEMORIAL HOSPITAL BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, BUSINESS, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. BOARD COMMITTEES THEN FURTHER REVIEW SPECIFIC DISCLOSURES. THE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE REVIEWS MUNSON HEALTHCARE, MUNSON MEDICAL CENTER, MUNSON HEALTHCARE REGIONAL FOUNDATION, AND SELECTED OTHER SYSTEM ENTITY FORMS 990 ON AN ANNUAL BASIS. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE, SOLE MEMBER, BOARD HAS A STANDING CONFLICT, VALUATION, AND COMPLIANCE ("CVC") COMMITTEE. ANY TRANSACTIONS WITH DISQUALIFIED PERSONS ARE SUBJECT TO PRIOR APPROVAL OF FAIR MARKET VALUE BY THE CVC COMMITTEE. ANNUALLY, THE CVC COMMITTEE DIRECTS THE PROCESS FOR EACH DIRECTOR AND KEY EMPLOYEE OF PAUL OLIVER MEMORIAL HOSPITAL TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THE RESPONSES ARE REVIEWED AND SUMMARIZED BY MUNSON HEALTHCARE'S LEGAL DEPARTMENT. A REPORT OF IDENTIFIED CONFLICTS IS PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND APPROVAL. THE CVC COMMITTEE UTILIZES THE QUESTIONNAIRE RESPONSES TO EVALUATE ANY TRANSACTION WITH A POTENTIAL CONFLICT. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER OFFICERS IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES PAUL OLIVER MEMORIAL HOSPITAL AND MUNSON HEALTHCARE. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE PAUL OLIVER MEMORIAL HOSPITAL ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. PAUL OLIVER MEMORIAL HOSPITAL DOES NOT MAKE THE BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. GROUP RETURN METHOD FORM 990, PAGE 7, PART VII PARENT ORGANIZATION HAS FILED A SEPARATE RETURN RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII JAMES D. AUSTIN ALLOCATES 16 HOURS TO PAUL OLIVER MEMORIAL HOSPITAL AND THE REMAINDER OF HIS TIME TO OTHER MUNSON HEALTHCARE SYSTEM RESPONSIBILITIES. PAUL M. SHIRILLA, VICE PRESIDENT OF GENERAL COUNSEL FOR THE MUNSON HEALTHCARE SYSTEM, ALLOCATES 85% OF HIS TIME TO SYSTEM MATTERS AND 15% TO MUNSON MEDICAL CENTER. MARK HEPLER, CFO, ALLOCATES 30% OF HIS TIME TO MUNSON HEALTHCARE, SYSTEM PARENT ORGANIZATION; 70% TO MUNSON MEDICAL CENTER; AND LESS THAN AN HOUR A WEEK TO THE REMAINING ORGANIZATIONS IN THE MUNSON HEALTHCARE SYSTEM IN HIS CAPACITY AS CFO FOR ALL MUNSON SYSTEM ORGANIZATIONS. OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 THE OTHER CHANGES IN NET ASSETS INCLUDE THE FOLLOWING ITEM: UNREALIZED GAINS ON POOLED INVESTMENT ACCOUNTS 277,790 AN INCREASE IN THE VALUE OF THE ASSETS HELD BY PAUL OLIVER MEMORIAL HOSPITAL FOUNDATION 757,958 A TRANSFER TO MUNSON HEALTHCARE, PARENT ORGANIZATION 1,000,000 MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI (C)(3) 3 MUNSON HC MUNSON HEALTHCARE false MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 PARENT MI (C)(3) 11B NA false MUNSON HEALTHCARE REGIONAL FOUNDATI 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI (C)(3) 7 MUNSON HC MUNSON HEALTHCARE false MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI (C)(3) 9 MUN HOME H MUNSON HOME HEALTH false MUNSON HOME HEALTH 1105 SIXTH ST TRAVERSE CITY MI 49684 383335362 HOME HEALT MI (C)(3) 11B MUNSON HC HEALTHCARE false MUNSON HOME SERVICES 1105 SIXTH ST TRAVERSE CITY MI 49684 382543463 HOME HEALT MI (C)(3) 9 MUN HOME H MUNSON HOME HEALTH false MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI (C)(3) 3 MUNSON HC MUNSON HEALTHCARE false MUNSON MOBILE IMAGING INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382704069 HEALTHCARE MI (C)(4) MUNSON HC MUNSON HEALTHCARE false NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI (C)(3) 11B MUNSON HC MUNSON HEALTHCARE false PAUL OLIVER MEMORIAL HOSPITAL FOUND 1105 SIXTH ST TRAVERSE CITY MI 49684 237201619 RAISE FUND MI (C)(3) 3 PAUL OLIVE PAUL OLIVER MEMORIAL HOSPITAL true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 HEALTHCARE MI (C)(3) 9 MUNSON MED MUNSON MEDICAL CENTER false MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI N/A false false NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI N/A false false NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE BUILDING CONDOMINIUM MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A MEDICAL OFFICE CONDOMINIUM MEDICAL OFFICE CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A MEDICAL OFFICE BUILDING CONDOMINIUM MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI N/A SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A MEDICAL OFFICE CONDOMINIUM MEDICAL OFFICE CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A false true false false false false false false false false false true false true true true false false MUNSON HEALTHCARE B 1000000 FMV MUNSON HEALTHCARE L 116340 FMV MUNSON HEALTHCARE N 130151 FMV MUNSON HEALTHCARE O 103233 FMV MUNSON MEDICAL CENTER L 1688687 FMV MUNSON MEDICAL CENTER N 939935 FMV MUNSON MEDICAL CENTER O 5629919 FMV MUNSON MEDICAL CENTER P 182903 FMV MUNSON MOBILE IMAGING L 124196 FMV MUNSON SUPPORT SERVICES L 88796 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 194360 FMV MUNSON HEALTHCARE B 1000000 FMV MUNSON HEALTHCARE L 116340 FMV MUNSON HEALTHCARE N 130151 FMV MUNSON HEALTHCARE O 103233 FMV MUNSON MEDICAL CENTER L 1688687 FMV MUNSON MEDICAL CENTER N 939935 FMV MUNSON MEDICAL CENTER O 5629919 FMV MUNSON MEDICAL CENTER P 182903 FMV MUNSON MOBILE IMAGING L 124196 FMV MUNSON SUPPORT SERVICES L 88796 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 194360 FMV ADDITIONAL INFORMATION SCHEDULE R PAUL OLIVER MEMORIAL HOSPITAL USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED SUMMARIZED AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS