2012-05-14T13:11:15-05:00 2011-06-30 990 2010-07-01 381362830 MUNSON MEDICAL CENTER MUNS 2319355000 PO BOX 1188 TRAVERSE CITY MI 496851188 MARK A HEPLER 2319355000 2012-05-11 2010 2016-02-24 21:20:13Z EDWIN A NESS 1105 SIXTH ST TRAVERSE CITY MI 49684 463304755 false X WWW.MUNSONHEALTHCARE.ORG X 1947 MI AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON MEDICAL CENTER EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. 19 12 4161 408 2240 453 2339335 1661786 431377303 445989729 14957443 10773131 4391805 4820790 453065886 463245436 50778 50294 0 213178649 220681498 0 573220 198083904 205231661 411313331 425963453 41752555 37281983 527853976 572910970 296258478 266902186 231595498 306008784 AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON MEDICAL CENTER EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. false false 385683927 50294 447967013 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF TRAVERSE 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12500 0 0 JOSEPH KOSTRZEWA 4.00 X 12500 0 0 MICHAEL D SIMPSON 4.00 X 12500 0 0 NANCY FISHER 4.00 X 12500 0 0 PATRICK E HEINTZ 6.00 X X 12500 0 0 SHIRLANNA CORREIA 4.00 X 12500 0 0 GEORGE BEARUP 6.00 X X 12500 0 0 REX ANTINOZZI MD 6.00 X X 12500 0 0 EDWARD J RUTKOWSKI MD 4.00 X 12500 0 0 DANIEL NAVIN MD 4.00 X 0 12500 0 JOHN E PELIZZARI 4.00 X 0 0 0 MARK A HEPLER 28.00 X 0 249099 45753 PAUL M SHIRILLA 6.00 X 0 322529 46557 DAVID MCGREAHAM MD 40.00 X 312469 0 48755 CHRISTOPHER PODGES 40.00 X 289065 0 50564 KATHLEEN MCMANUS 36.00 X 275200 0 43909 SUZANNE K PETERS 40.00 X 249669 0 33010 MARK R ANTHONY 40.00 X 247554 0 32433 JAMES P FISCHER 40.00 X 202643 0 40006 THOMAS SCHERMERHORN MD 40.00 X 727932 0 31782 AHMET SEVIMLI MD 40.00 X 322046 0 37837 DAVID B MARTIN MD 40.00 X 254816 0 28248 JOHN D FAICHNEY MD 40.00 X 244820 0 31959 DANIEL M WEBSTER MD 40.00 X 236417 0 28597 EDWARD CARLSON 0.00 X 214490 9506 0 4414377 630634 638856 124 true true false HOSPITALISTS OF NORTHWEST MICHIGAN 1105 SIXTH ST TRAVERSE CITY MI 49684 MEDICAL SERVICE 4853078 SODEXO INC AND AFFILIATES 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 DIETARY 1409009 PULMONARY AND CRITICAL CARE PHYSICI 5087 N ROYAL DR TRAVERSE CITY MI 49684 MEDICAL SERVICE 1329682 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 55480 LABORATORY SRV 1251055 CARDIOTHORACIC SURGEONS GT PC 107 S CASS ST TRAVERSE CITY MI 49684 MEDICAL SERVICE 1124879 55 885750 625748 150288 1661786 MEDICARE AND MEDICAID PMTS 621990 239865000 239865000 PATIENT SERVICE REVENUE 621990 200416188 200416188 HEALTH SERVICE REVENUE 621990 2891429 2891429 SERVICES TO OTHER ORGANIZATIO 621990 2377970 2377970 RENT FROM RELATED ORGS 531120 439142 439142 445989729 5228819 1975044 3253775 248062 248062 248062 248062 5502373 57438 15499 5502373 41939 5544312 5544312 46060 43820 2240 2240 CAFETERIA SALES 722210 3572151 3572151 MISCELLANEOUS 621990 613614 613614 AUXILIARY GIFT SHOP 446199 384723 384723 4570488 463245436 447964773 2240 13616637 50294 50294 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302895376 2257425 3113408 231595498 306008784 527853976 572910970 X 37281983 37131303 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false true true false false false true 8100 true 22 false false 8122 false false false false false false false false false false false false 143412065 996567 23516814 141430 787311 166996705 128015726 2073910 14807677 1054734 430514 143412065 151976653 815757 -19831956 4238065 706662 128015726 0.98140 0.01860 false true true 12502880 12502880 277651118 117464160 160186958 265646 65088 200558 166290036 116873517 49416519 16936861 1460635 15476226 237783141 MINIMUM PENSION LIABILITY 64285054 DEFERRED POST RETIREMENT BENEFITS 11955316 RESERVE FOR THIRD PARTY SETTLEMENTS 11000000 SWAP MARKET VALUE BASIS 5146157 CAREPAYMENT LIABILITY 3772000 ESTIMATED THIRD PARTY SETTLEMENTS 2450376 98608903 INTENDED USES FOR ENDOWMENT FUNDS SCHEDULE D, PAGE 2, PART V, LINE 4 THE BOARD OF TRUSTEES DESIGNATES SUBSTANTIAL INVESTMENTS FOR THE REPLACEMENT, IMPROVEMENT, AND THE EXPANSION OF TANGIBLE FACILITIES OWNED BY MUNSON MEDICAL CENTER TO ENSURE FUNDS ARE AVAILABLE TO MAINTAIN THE HOSPITAL ASSETS TO CARRY OUT ITS MISSION. A PORTION OF THE TERM ENDOWMENT ASSETS ARE THOSE HELD FOR SPECIFIC MEDICAL PURPOSES, AS DEFINED BY DONORS. THOSE ASSETS ARE BEING HELD FOR A VARIETY OF DONOR INTERESTS INCLUDING ADAPTIVE SPORTS, PEDIATRIC THERAPY, OTHER PEDIATRIC MEDICAL NEEDS, RESEARCH, AND PATIENT ASSISTANCE. true true true X false true true false true true 7070420 7070420 0.01690 39614580 30682601 8931979 0.02140 985362 541140 444222 0.00110 47670362 31223741 16446621 0.03940 3338362 23365 3314997 0.00790 4332800 1334519 2998281 0.00720 468131 4655 463476 0.00110 764577 764577 0.00180 327560 1400 326160 0.00080 9231430 1363939 7867491 0.01880 56901792 32587680 24314112 0.05820 3665 3665 17868 17868 43061 43061 0.00010 153051 153051 0.00040 6648 6648 10144 10144 407278 407278 0.00100 641715 641715 0.00160 true 5280469 895567 179592155 175118665 4473490 X true true NW MI SURGERY CENTER AMBULATORY SURGERY CENTER 0.49000 0.51000 3 1 MUNSON MEDICAL CENTER

1105 SIXTH ST TRAVERSE CITY MI 49684

X X X X X 2 MUNSON MEDICAL CENTER ACUTE INPATIENT PSYCHIATRIC PROGRAM

1105 SIXTH ST TRAVERSE CITY MI 49684

X INPATIENT PSYCHIATRIC PROGRAM 3 MUNSON MEDICAL CENTER OUTPATIENT PSYCHIATRIC PROGRAM

1105 SIXTH ST TRAVERSE CITY MI 49684

X OUTPATIENT PSYCHIATRIC PROGRAM MUNSON MEDICAL CENTER 1 MUNSON MEDICAL CENTER 2 MUNSON MEDICAL CENTER 3 10 MUNSON COMMUNITY HEALTH CENTER

550 MUNSON AVENUE TRAVERSE CITY MI 49686

OUTPATIENT BIEDERMAN CANCER CENTER

1120 SIXTH ST TRAVERSE CITY MI 49684

RADIATION THERAPY MRI CENTER

217 S MADISON TRAVERSE CITY MI 49684

MRI SMITH FAMILY BREAST HEALTH CENTER

COPPER RIDGE TRAVERSE CITY MI 49684

MAMMOGRAPHY AND WOMEN'S HEALTH IV THERAPY

1200 SIXTH ST TRAVERSE CITY MI 49684

IV THERAPY CHEMICAL DEPENDENCY CENTER

420 BROOK ST TRAVERSE CITY MI 49684

REHABILITATION PHYSICAL THERAPY

3643 WEST FRONT ST TRAVERSE CITY MI 49684

PHYSICAL THERAPY MUNSON MANOR

1220 MEDICAL CAMPUS DR TRAVERSE CITY MI 49684

HOSPITALITY HOUSE PHYSICAL THERAPY

211 S HIGH ST NORTHPORT MI 49670

PHYSICAL THERAPY ADVANCED WOUND CENTER

5085 ANNA DR TRAVERSE CITY MI 49684

PATIENT WOUND CARE 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 FPG 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 SUBSIDIZED HEALTH SERVICES EXPLANATION PART I LINE 7G THERE ARE NO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F TOTAL EXPENSES FROM FORM 990 PART IX LINE 25 ARE XXX-XX-XXXX AND THE PROPORTIONATE SHARE OF TOTAL EXPENSES OF THE AMBULATORY SURGERY CENTER IS 6978333 THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS 14702161 THE NET EXPENSE OF XXX-XX-XXXX WAS USED FOR PURPOSES OF CALCULATING LINE 7 COLUMN F COSTING METHODOLOGY EXPLANATION PART I LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION COMMUNITY BUILDING ACTIVITIES PART II MUNSON MEDICAL CENTER MMC PROVIDED 641716 IN COMMUNITYBUILDING ACTIVITIES DURING THE 2011 FISCAL YEAR THESE ACTIVITIES INCLUDED A CASH DONATION FOR COALITION BUILDING ACTIVITIES IN GRAND TRAVERSE COUNTY ADMINISTRATIVE SUPPORT ON MANY BOARDS SUPPORTING CHANGES IN SOCIAL DETERMINATES OF HEALTH ADDRESSING ADEQUATE COMMUNITYWIDE HOUSING POVERTY REDUCTION AND WORKFORCE DEVELOPMENT ENVIRONMENTAL IMPROVEMENTS INCLUDING WASTE REDUCTION AND RECYCLING AND COMMUNITY HEALTH IMPROVEMENT ADVOCACY ESPECIALLY IN THE AREAS OF IMPROVED SCHOOL NUTRITION AND COMMUNITY GARDENS MMC CONTINUES AS A GUIDING FORCE IN MICHIGANS REGION 7 BIOTERRORISMDISASTER PREPAREDNESS AS PART OF CRITICAL WORKFORCE DEVELOPMENT MUNSON STAFF ATTENDS MANY REGIONAL CAREER DAYS PROVIDING STUDENTS WITH INFORMATION ON WHY THEY MIGHT WANT TO BE EMPLOYED IN THE OFTENCRITICAL AREA OF HEALTH CARE ALSO DESIGNATED AS A MEDICALLY UNDERSERVED AREA MUNSON 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 MUNSON MEDICAL CENTERS CHARITY CARE POLICY MUNSON DIRECTED AN INTERNAL STUDY FROM A 3MONTH SAMPLE OF CURRENT BAD DEBT ACCOUNTS FIRST THE STUDY IDENTIFIED THE SELFPAY PORTION OF THE BAD DEBT EXPENSE THEN THE SELFPAY ACCOUNTS WERE ANALYZED USING REVENUE CYCLE ANALYTIC SOFTWARE TO IDENTIFY POTENTIAL CHARITY CARE CANDIDATES USING THE SOFTWARE ESTIMATIONS A PORTION OF THE SELFPAY ACCOUNTS WERE DEEMED CHARITY CARE ELIGIBLE THAT ESTIMATED PORTION WAS APPLIED TO THE SELFPAY BAD DEBT DOLLAR AMOUNT TO DETERMINE THE AMOUNT OF BAD DEBT THAT WOULD BE CONSIDERED CHARITY IF THE PROPER APPLICATIONS AND DOCUMENTATION WERE AVAILABLE FROM THE PATIENTS THE ACCOUNTS RECEIVABLE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF MUNSON HEALTHCARE AND SUBSIDIARIES STATES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC 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 MUNSON HEALTHCARES INTERNAL AND EXTERNAL COLLECTION PRACTICES INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NONPAYMENT INCLUDING COLLECTIONS ACTIONS AND REPORTING TO COLLECTION AGENCIES SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY A PATIENTS GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE AND A PATIENTS GOOD FAITH EFFORT TO COMPLY WITH HISHER PAYMENT AGREEMENTS WITH MUNSON HEALTHCARE FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS MUNSON HEALTHCARE MAY OFFER EXTENDED PAYMENT PLANS WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY NEEDS ASSESSMENT PART VI THE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE CHC TO SERVE THE MUNSON HEALTHCARE SYSTEM THE CHC CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM MUNSON HEALTHCARE HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON HEALTHCARE BOARD CHAIRPERSON THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS CONSIDER THE MHC RESPONSE TO ANY EMERGING HEALTH TRENDS AS IDENTIFIED BY COMMUNITY HEALTH NEEDS ASSESSMENT AND REVIEW ANY NEW COMMUNITY HEALTH BASED COLLABORATION OR PROGRAM THE CHC IS RESPONSIBLE FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MHC COMMUNITY BENEFIT PROGRAMS AND SERVICES THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT OF MUNSON MEDICAL CENTER MUNSON MEDICAL CENTER MMC IS A SIGNIFICANT CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN OUR EXTENSIVE GEOGRAPHICAL AREA COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED AS WELL AS WHERE PROGRESS HAS BEEN MADE THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITYWIDE MUNSON IS PREPARING A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY 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 ADDITIONALLY MUNSON WORKS IN CONJUNCTION WITH COMMUNITY COLLABORATIVES IN FIVE COUNTIES ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA THE TRAVERSE CITY CHAMBER OF COMMERCE THE LOCAL UNITED WAY THE POVERTY REDUCTION INITIATIVE AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY NEED PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS BROCHURES THAT DESCRIBE MUNSON HEALTHCARES FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR STATEMENT ON BILLS STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL SIGNS IN THE ER REGISTRATION AREA ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY REFERRAL BY REGISTRATION STAFF AT THE TIME OF REGISTRATION SELFPAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF MUNSON MEDICAL CENTER FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS THE COUNSELORS VISIT ALL INPATIENTS THAT ARE DEEMED SELFPAY TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP IF THE PATIENT WOULD LIKE HELP THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID GENERALLY THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS THE COUNSELORS ALSO IDENTIFY ALL SELFPAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS ONLY BY PHONE THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION BUT WHEN THAT IS NOT POSSIBLE THE CALL IS MADE SOON AFTER DISCHARGE AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO MEDICAID AND ALL OF ITS SUBSETS SOCIAL SECURITY DISABILITY TRAVERSE HEALTH CLINIC MUNSON HEALTHCARE CHARITY CARE MUNSON MEDICAL CENTER CATASTROPHIC CARE AND MUNSON MEDICAL CENTER MEDS PROGRAM COMMUNITY INFORMATION PART VI MUNSON MEDICAL CENTER DESCRIPTION MUNSON MEDICAL CENTER MMC IS THE LARGEST HOSPITAL IN NORTHERN LOWER MICHIGAN WITH 391 LICENSED ACUTE CARE BEDS ONE OF SEVEN HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM MMC PROVIDES MORE THAN 300000 ANNUAL PATIENT VISITS MMC SERVES APPROXIMATELY 23800 INPATIENTS HAS 2000 OBSTETRICAL BIRTHS AND 48000 EMERGENCY ROOM PATIENTS EVERY YEAR MMC IS ALSO THE LARGEST EMPLOYER IN NORTHERN MICHIGAN DUE TO ITS GEOGRAPHIC LOCATION AND COMPREHENSIVE ARRAY OF SERVICES OFFERED MMC HAS BEEN NAMED A RURAL REFERRAL CENTER BY THE CENTERS FOR MEDICARE AND MEDICAID MMC IS ALSO RECOGNIZED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES CMS AS A SOLE COMMUNITY HOSPITAL BECAUSE OF THIS STATUS IT IS EQUIPPED TO PROVIDE CRITICAL CARE FOR PATIENTS IN 24 COUNTIES HOSPITAL SERVICES MUNSON MEDICAL CENTER PROVIDES SERVICES IN 33 DIFFERENT MEDICAL SPECIALTIES AND OFFERS A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING CARDIAC SURGERY CARDIAC CATHETERIZATION RADIATION ONCOLOGY NEONATAL INTENSIVE CARE AND COMPREHENSIVE EMERGENCY SERVICES MUNSON MEDICAL CENTER IS A LEVEL II TRAUMA CENTER AND IS THE ONLY RECOGNIZED TRAUMA CENTER IN MICHIGANS REGION 7 WHICH COVERS 17 COUNTIES SPECIALIZED INPATIENT UNITS AVAILABLE AT MMC INCLUDE MEDICALSURGICAL INTENSIVE CARE CARDIAC INTENSIVE CARE NEONATAL INTENSIVE CARE ONCOLOGY MENTAL HEALTH AND PHYSICAL MEDICINE AND REHABILITATION A BROAD SPECTRUM OF DIAGNOSTIC AND THERAPEUTIC SERVICES SUPPORTS MMCS PROGRAMS THE SERVICES AVAILABLE TO INPATIENTS AND OUTPATIENTS CONSIST OF RADIOLOGY INCLUDING MRI CT SCAN PET SCAN ULTRASOUND NUCLEAR MEDICINE AND RADIATION THERAPY COMPUTERIZED LABORATORY REHABILITATION SERVICES INCLUDING PHYSICAL OCCUPATIONAL AND SPEECH AND HEARING THERAPY CARDIAC CATHETERIZATION COMPREHENSIVE CANCER TREATMENT OBSTETRIC CLINIC FOR INDIGENT PATIENTS MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES HOME HEALTH DME AND DIALYSIS SERVICES AND COMPLEX SURGERY SUCH AS VASCULAR AND NEUROSURGERY AS WELL AS LESS COMPLEX SAMEDAY SURGERY POPULATION SERVED BY MUNSON MEDICAL CENTER MMC SERVES PATIENTS FROM 24 COUNTIES IN NORTHERN LOWER MICHIGAN AND THE EASTERN PORTION OF THE UPPER PENINSULA A POPULATION BASE OF APPROXIMATELY 580000 IN THE 11 COUNTY REGION IMMEDIATELY SURROUNDING MMC 184 OF THE POPULATION ARE 65 YEARS OR OLDER UNEMPLOYMENT IS 12 OR HIGHER ALMOST 23 OF ADULTS AGED 1864 YEARS OF AGE LACK HEALTH INSURANCE 58 OF BIRTHS ARE COVERED BY MEDICAID ABOUT 70 OF MMC INPATIENT DISCHARGES ORIGINATE FROM THE 5 COUNTIES IN CLOSEST PROXIMITY TO MMC ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA QUALITY MUNSON MEDICAL CENTER HAS WON NUMEROUS AWARDS FOR OUTSTANDING CLINICAL QUALITY CARE HEALTH GRADES 5 STAR RATING FOR CARDIAC STROKE ORTHOPEDIC PULMONARY CARE AMERICAS 50 BEST HOSPITALS OUTSTANDING PATIENT EXPERIENCE HOSPITAL TOP 100 HOSPITAL 12 TIMES ONLY 2 OTHER HOSPITALS NATIONWIDE HAVE BEEN SO RECOGNIZED AMONG 23 NATIONALLY NAMED AS AN EVEREST AWARD FOR NATIONAL BENCHMARKS WINNER FOR THE SECOND YEAR IN A ROW THIS AWARD RECOGNIZES A HOSPITALS RATE OF LONGTERM IMPROVEMENT AND ESTABLISHES MUNSON MEDICAL CENTER AS A NATIONAL BENCHMARK AGAINST WHICH OTHER HOSPITALS WILL BE COMPARED 2008 AMERICAN HOSPITAL ASSOCIATION MCKESSON QUEST FOR QUALITY PRIZE RUNNER UP WAS UNIVERSITY OF MICHIGAN HOSPITALS AND HEALTH CENTERS AMERICAN NURSES CREDENTIALING CENTER MAGNET HOSPITAL 3 OF HOSPITALS NATIONWIDE QUALIFY HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI THE MUNSON MEDICAL CENTER BOARD OF TRUSTEES IS MADE UP OF COMMUNITY MEMBERS ALL OF WHOM RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA THESE INDIVIDUALS GIVE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF TRUSTEES MUNSON MEDICAL CENTER UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA EXAMPLES OF HOW MUNSON MEDICAL CENTER PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PROGRAMS INCLUDE HEALTHY FUTURES A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS HEALTH DEPARTMENTS AND MUNSON HEALTHCARE CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UP TO AGE TWO THE PROGRAM INCLUDES CENTRAL ACCESSDATA MANAGEMENT REGISTERED NURSE RN CARE COORDINATION EDUCATIONAL MAILINGS TO AGE 5 AND HEALTH CARERELATED FINANCIAL ASSISTANCE THEHEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMESBASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY ACCESS TO HEALTH CARE AND IMMUNIZATIONS MEDS PROGRAM A PROGRAM THAT PROVIDES TO PATIENTS WITHOUT RESOURCES BEING DISCHARGED FROM THE HOSPITAL NEEDED MEDICATIONS AS WELL AS ENROLLING THOSE PATIENTS INTO PHARMACEUTICAL COMPANY SPONSORED ASSISTANCE PROGRAMS SO THEY MAY CONTINUE TO GET THE NEEDED PHARMACEUTICALS POVERTY REDUCTION INITIATIVE PRI A COLLABORATIVE GROUP OF ORGANIZATIONS AND INDIVIDUALS WORKING TO ADDRESS ISSUES OF POVERTY IN THE FIVE COUNTY SERVICE AREA OF MUNSON MEDICAL CENTER PROJECTS SUPPORTED BY THE PRI WORK GROUPS INCLUDE EFFORTS TO EXPAND ACCESS TO MEDICAL AND DENTAL CARE JOB TRAINING OPPORTUNITIES JOB RETENTION COMMUNITY RESOURCE MOBILIZATION AND DATA COLLECTION MUNSONS INVOLVEMENT IN PRI INCLUDES MEMBERSHIP ON THE ADVISORY COUNCIL STEERING COMMITTEE AND NAVIGATING WORKGROUP 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 OPERATING UNDER AN INDIGENT CARE AGREEMENT UTILIZING MUNSON MEDICAL CENTERS DSH CAPACITY PROVIDES ACCESS TO 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 WITH MEDICAID AND RUNS THE COALITION HEALTH ACCESS PROGRAM CHAP FOR THOSE ADULTS WITH NO INSURANCE WHO QUALIFY INCOMES 200 OF FPG MUNSON DONATES TO THC THROUGH INKIND DONATIONS OF MEDICATIONS AND STAFFING GRANTS ETC WHILE NOT COUNTABLE AS MUNSON COMMUNITY BENEFIT MANY MUNSON EMPLOYEES ALSO VOLUNTEER THEIR TIME PROVIDING CARE AT THE THC MEDICAL EDUCATIONTHE MUNSON FAMILY PRACTICE RESIDENCY PROGRAM INTEGRATES OSTEOPATHIC AND ALLOPATHIC MEDICINE TOGETHER WITH THE RESOURCES OF MUNSON MEDICAL CENTER THIS DUALLY ACCREDITED 555 PROGRAM ACCEPTS BOTH DO AND MD TRAINEES THE PROGRAM IS AFFILIATED WITH THE MICHIGAN STATE UNIVERSITY MMC ALSO PARTNERS WITH SEVERAL SCHOOLS OF NURSING TO PROVIDE INTERNSHIPS AND CLINICAL EXPERIENCES FOR REGISTERED NURSES RESPIRATORY THERAPISTS PHARMACISTS AND OTHER HEALTH PROFESSIONALS AFFILIATED HEALTH CARE INFORMATION PART VI MUNSON MEDICAL CENTERS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE A 501C3 CORPORATION THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL SEVERAL RURALBASED MEDICAL CENTERS EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES AND ANCILLARY EMERGENCY TRANSPORTATION AND HOMEBASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER MMC MMC IS ONE OF SEVEN NOTFORPROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES ANDOR PROMOTION ACTIVITIES AS WELL AS SHARED INITIATIVES MMC WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON CAMPUS 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 MMC PERFORMS THE NEEDS ASSESSMENTS FOR MUNSON HEALTHCARE UTILIZING THIS NEEDS ASSESSMENT MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING DEVELOPING IMPLEMENTING EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS true MEDICAL INSURANCE PAYMENT 11 12714 EQUIP RENTAL AND SUPPLIES 13 7972 CLIENT TRANSPORT & FOOD 13 2720 MEDICAL, TRANSPORT & DRUG 129 26888 X X X X true true false false false false false false false EDWIN A NESS 515678 120976 1102 119320 20126 777202 MARK A HEPLER 208875 38795 1429 26375 19378 294852 PAUL M SHIRILLA 259556 60698 2275 31769 14788 369086 DAVID MCGREAHAM MD 246483 46908 19078 31257 17498 361224 CHRISTOPHER PODGES 236237 51366 1462 28808 21756 339629 KATHLEEN MCMANUS 232504 41769 927 29602 14307 319109 SUZANNE K PETERS 152851 34434 62384 19503 13507 282679 45835 MARK R ANTHONY 192948 37485 17121 24357 8076 279987 JAMES P FISCHER 166625 33467 2551 20395 19611 242649 THOMAS SCHERMERHORN MD 727250 682 12144 19638 759714 AHMET SEVIMLI MD 321100 946 19266 18571 359883 DAVID B MARTIN MD 235020 3698 16098 14101 14147 283064 JOHN D FAICHNEY MD 216403 24730 3687 11348 20611 276779 DANIEL M WEBSTER MD 217537 14464 4416 13052 15545 265014 EDWARD CARLSON 214490 9506 214490 9506 14872 SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 107,176 0 MARK A. HEPLER 0 13,842 0 PAUL M. SHIRILLA 0 16,196 0 DAVID MCGREAHAM, MD 0 16,468 0 CHRISTOPHER PODGES 0 14,634 0 KATHLEEN MCMANUS 0 15,652 0 SUZANNE K. PETERS 0 10,332 0 MARK R. ANTHONY 0 12,780 0 JAMES P. FISCHER 0 10,398 0 EDWARD CARLSON 209,123 0 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III EXECUTIVE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. FOR THE PRESIDENT, THE PLAN PROVIDES A TARGETED BENEFIT AT AGE 62. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. FOR VICE-PRESIDENTS, AFTER WORKING FOR MUNSON FOR 3 YEARS, A VICE-PRESIDENT IS ELIGIBLE TO PARTICIPATE IN A NON-QUALIFIED RETIREMENT PLAN, WHICH IS FUNDED ANNUALLY AT THE SOLE DISCRETION OF MUNSON IN AN AMOUNT NOT TO EXCEED 6% OF BASE COMPENSATION. THE PARTICIPANT BECOMES ELIGIBLE FOR THIS BENEFIT UPON THEIR RETIREMENT FROM MUNSON. EXECUTIVE SEVERANCE PLAN: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, A COMPETITIVE BENEFIT PACKAGE IS OFFERED TO THE PRESIDENT AND VICE-PRESIDENTS WHICH INCLUDES A SEVERANCE PLAN. MUNSON HAS A SEVERANCE PLAN FOR THE PRESIDENT AND THE VICE-PRESIDENT/EXECUTIVE LEVEL POSITIONS WHICH PROVIDES FOR THE PRESIDENT UP TO TWO YEARS OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS AND ONE-YEAR OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS. THE PLAN PROVIDES FOR A 50% OFFSET FOR SUBSEQUENT EMPLOYMENT DURING THE SEVERANCE PERIOD. MEDICAL BENEFITS ARE PROVIDED DURING THE SEVERANCE PERIOD. COUNTY OF GRAND TRAVERSE HOSPITAL F 386004832 386523DK7 2005-11-03 25000000 ADVANCE REFUND 1998 false false false COUNTY OF GRAND TRAVERSE HOSPITAL F 386004832 386523DL5 2005-11-03 30000000 NEW CONSTRUCTION false false false 27259026 270982 528444 26459600 false true true true 30474818 323467 713293 29437958 2007 false false true true false false false false false false false false true true false true false true true JP MORGAN CHASE BANK 22.7 false false false true false false true true MERRILL LYNCH CAPITAL SERVICES INC 29.7 false false false true true DIFFERENCES IN ISSUE PRICE EXPLANATION SCHEDULE K COUNTY OF GRAND TRAVERSE HOSPITAL F INVESMENT EARNINGS TOTALED 2259026 DURING THE PERIOD BETWEEN THE BOND ISSUE AND THE DATE OF OF THE REFUNDING ADDITIONAL INFORMATION SCHEDULE K COUNTY OF GRAND TRAVERSE HOSPITAL F PART I DESCRIPTION OF PURPOSE THE 2005A ISSUE WAS USED TO ADVANCE REFUND 39 OF THE CALLABLE ORIGINAL PRINCIPAL AMOUNT OF THE COUNTY OF GRAND TRAVERSE HOSPITAL AUTHORITY HOSPITAL REVENUE AND REFUNDING BONDS MUNSON HEALTHCARE OBLIGATED GROUP SERIES 1998A ISSUED 9198 COUNTY OF GRAND TRAVERSE HOSPITAL F THE 2005B ISSUE FUNDED A PROJECT FOR THE CONSTRUCTION AND EQUIPPING OF A 4STORY ADDITION TO THE HOSPITAL THAT INCLUDED A NEW EMERGENCY ROOM A 60BED ACUTE CARE NURSING UNIT SPACE FOR FUTURE CLINICAL NEEDS AND AN ENERGY CENTER PART III QUESTION 3C MUNSON MEDICAL CENTER MAINTAINS POLICIES AND PROCEDURES TO REVIEW AND MONITOR ALL CONTRACTS THE REVIEW PROCESS INCLUDES A REVIEW BY THE INTERNAL LEGAL DEPARTMENT OUTSIDE COUNSEL MAY BE CONSULTED AS NECESSARY OUTSIDE COUNSEL IS RETAINED FOR ALL NEW EXEMPT BOND OFFERINGS DURING WHICH A THOROUGH DUE DILIGENCE PROCESS REVIEWS APPLICABLE CONTACTS MAUREEN CARLSON FAMILY OF FORME 51839 RELATED FAMILY COMP false MEGAN COX FAMILY OF TRUST 53689 RELATED FAMILY COMP false GLORIA WOLF FAMILY OF TRUST 74634 RELATED FAMILY COMP false GRAND TRAVERSE CHILDRENS CLINIC OWNER ISTRUSTEE 179414 GROUP PRACTICE PHYSI false HOSPITALISTS OF NORTHWEST MI OWNER ISTRUSTEE 4948832 GROUP PRACTICE PHYSI false MUNSON SUPPORT SERVICES E NESS TRUSTEE 2068778 LAUNDRY SERVICES false MUNSON SERVICES INC C PODGESTRUSTEE 2021387 CONTRACT EMPLOYEES false PULMONARY AND CRITICAL CARE PHYSICI OWNER ISTRUSTEE 1361885 GROUP PRACTICE PHYSI false RELATED PARTY INFORMATION AMONG OFFICERS FORM 990, PAGE 6, PART VI, LINE 2 EDWIN A. NESS CHRISTOPHER PODGES PRESIDENT KEY EMPLOYEE MUNSON MEDICAL CENTER EMPLOYER EDWIN A. NESS MARK R. ANTHONY PRESIDENT KEY EMPLOYEE MUNSON MEDICAL CENTER EMPLOYER EDWIN A. NESS SUZANNE K. PETERS PRESIDENT KEY EMPLOYEE MUNSON MEDICAL CENTER EMPLOYER EDWIN A. NESS JAMES P. FISCHER PRESIDENT KEY EMPLOYEE MUNSON MEDICAL CENTER EMPLOYER EDWIN A. NESS KATHLEEN MCMANUS PRESIDENT KEY EMPLOYEE MUNSON MEDICAL CENTER EMPLOYER EDWIN A. NESS DAVID MCGREAHAM PRESIDENT KEY EMPLOYEE MUNSON MEDICAL CENTER EMPLOYER MARK A. HEPLER PAUL M. SHIRILLA CFO KEY EMPLOYEE MUNSON HEALTHCARE EMPLOYER CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MUNSON MEDICAL CENTER IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. IN THE EVENT OF DISSOLUTION, MUNSON MEDICAL CENTER'S NET ASSETS WOULD BE DISTRIBUTED TO MUNSON HEALTHCARE. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A FOUR TRUSTEES OF MUNSON MEDICAL CENTER ARE DIRECTORS OF MUNSON HEALTHCARE. OTHER TRUSTEES ARE CHOSEN FROM AMONG THOSE NOMINATED BY THE GOVERNANCE COMMITTEE. DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON MEDICAL CENTER TRUSTEES ARE APPROVED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING THE ACCEPTANCE OF THE ANNUAL BUDGET, AND ANNUAL FINANCIAL STATEMENTS, INCURRENCE OF CERTAIN DEBT, AND APPOINTMENT OF THE PRESIDENT. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON MEDICAL CENTER BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON MEDICAL CENTER BELONGS TO THE MUNSON HEALTHCARE SYSTEM. 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 MEDICAL CENTER 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 TRUSTEE AND KEY EMPLOYEE TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THE RESPONSES ARE REVIEWED AND SUMMARIZED BY MUNSON MEDICAL CENTER'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 IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MHC'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON EXECUTIVES IS DETERMINED IN PART BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES FOR MUNSON MEDICAL CENTER. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON MEDICAL CENTER ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON MEDICAL CENTER DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. ADDITIONALLY, MUNSON MEDICAL CENTER PREPARES AND DISTRIBUTES AN ANNUAL REPORT TO THE COMMUNITY, WHICH CONTAINS FINANCIAL AS WELL AS PROGRAM DATA. GROUP RETURN METHOD FORM 990, PAGE 7, PART VII PARENT ORGANIZATION HAS FILED A SEPARATE RETURN RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII EDWIN A. NESS WAS PRESIDENT OF MUNSON HEALTHCARE AND ALLOCATED 95% OF HIS TIME TO MUNSON HEALTHCARE SYSTEM MATTERS AND 5% OF HIS TIME TO THE MUNSON HEALTHCARE REGIONAL FOUNDATION. 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. 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. KATHLEEN MCMANUS, SENIOR VICE PRESIDENT OF MUNSON MEDICAL CENTER, ALLOCATES 90% OF HER TIME TO MUNSON MEDICAL CENTER AND THE REMAINDER TO SYSTEM ENTITIES. MARK ANTHONY IS A VICE PRESIDENT FOR MUNSON MEDICAL CENTER AND ALLOCATES 95% OF THIS TIME TO THAT COMPANY. HE DEVOTES APPROXIMATELY 2-3 HOURS A WEEK TO MUNSON MOBILE IMAGING AND GREAT LAKES MOBILE PET AS PRESIDENT OF BOTH ENTITIES. OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 THE OTHER CHANGES IN NET ASSETS INCLUDE THE FOLLOWING ITEMS: CHANGE IN MINIMUM PENSION LIABILITY 26,582,239 UNREALIZED GAINS ON POOLED INVESTMENT ACCOUNTS 14,254,237 CHANGE IN VALUE OF INTEREST RATE SWAPS 1,763,406 CHANGE IN INVESTMENT VALUE OF ASSETS HELD AT THE FOUNDATION 855,878 TRANSFERS TO AFFILIATES (6,324,457) TOTAL 37,131,303 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 HEALTHCARE MI (C)(3) 11B N/A 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 MUNSON 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 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 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI (C)(3) 3 MUNSON HC MUNSON HEALTHCARE false PAUL OLIVER MEMORIAL HOSPITAL FOUND 1105 SIXTH ST TRAVERSE CITY MI 49684 237201619 RAISE FUND MI (C)(3) 7 PAUL OLV H PAUL OLIVER MEMORIAL HOSPITAL false MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI (C)(3) 9 MUNSON MED MUNSON MEDICAL CENTER true MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER RELATED 217973 1809871 false true 0.56540 NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MUNSON MEDICAL BUILDING PARTNERS PO BOX 1188 TRAVERSE CITY MI 496851188 382830005 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER RELATED 217973 1809871 false true 0.56540 NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE CONDOMINIUM MEDICAL OFFICE CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER C CORP 171696 33579 0.74000 SIXTH STREET DRUGS PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI MUNSON MED MUNSON MEDICAL CENTER C CORP 4262322 4697275 1.00000 MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A MEDICAL OFFICE BUILDING CONDOMINIUM MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER C CORP 49382 50486 1.00000 MEDICAL OFFICE CONDOMINIUM MEDICAL OFFICE CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER C CORP 171696 33579 0.74000 SIXTH STREET DRUGS PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A MUNSON SUPPORT SERVICES PO BOX 1188 TRAVERSE CITY MI 496851188 382872821 LAUNDRY MI MUNSON MED MUNSON MEDICAL CENTER C CORP 4262322 4697275 1.00000 MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A MEDICAL OFFICE BUILDING CONDOMINIUM MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI MUNSON MED MUNSON MEDICAL CENTER C CORP 49382 50486 1.00000 false true true true true false false false true true true true false true true true true true MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION P 219689 FMV MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION J 177622 FMV MUNSON DIALYSIS CENTER K 117888 FMV MUNSON DIALYSIS CENTER P 968479 FMV MUNSON DIALYSIS CENTER N 1769724 FMV MUNSON HEALTHCARE B 3000000 FMV MUNSON HEALTHCARE D 175000 FMV MUNSON HEALTHCARE L 1296936 FMV MUNSON HEALTHCARE N 537361 FMV MUNSON HEALTHCARE O 3801201 FMV MUNSON HEALTHCARE P 6803977 FMV MUNSON HEALTHCARE R 2017267 FMV MUNSON HEALTHCARE E 175000 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI C 885750 FMV MUNSON HEALTHCARE REGIONAL FOUNDATI L 541361 FMV MUNSON HOME CARE I 131462 FMV MUNSON HOME CARE K 171983 FMV MUNSON HOME CARE P 13958889 FMV MUNSON HOME CARE R 418000 FMV MUNSON HOME HEALTH I 58800 FMV MUNSON HOME HEALTH P 1907512 FMV MUNSON HOME SERVICES K 147425 FMV MUNSON HOME SERVICES P 3563145 FMV MUNSON MEDICAL BUILDING PARTNERS J 634584 FMV MUNSON MEDICAL BUILDING PARTNERS Q 634584 FMV MUNSON MEDICAL GROUP B 3324457 FMV MUNSON MEDICAL GROUP D 900000 FMV MUNSON MEDICAL GROUP O 230660 FMV MUNSON MEDICAL GROUP P 2625033 FMV MUNSON MEDICAL GROUP N 1173909 FMV MUNSON MOBILE IMAGING O 54837 FMV MUNSON MOBILE IMAGING P 1214143 FMV MUNSON SERVICES INC K 93329 FMV MUNSON SERVICES INC N 2021387 FMV MUNSON SERVICES INC P 55870 FMV MUNSON SERVICES INC O 64212 FMV MUNSON SUPPORT SERVICES L 2086049 FMV MUNSON SUPPORT SERVICES P 2165095 FMV NORTH FLIGHT INC L 55783 FMV NORTH FLIGHT INC P 6400955 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE D 10306000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE I 126000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE O 17315778 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE R 10181000 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE N 473916 FMV NORTHERN MICHIGAN SUPPLY ALLIANCE L 2753851 FMV PAUL OLIVER MEMORIAL HOSPITAL K 1688687 FMV PAUL OLIVER MEMORIAL HOSPITAL N 939935 FMV PAUL OLIVER MEMORIAL HOSPITAL O 182903 FMV PAUL OLIVER MEMORIAL HOSPITAL P 5629919 FMV SIXTH STREET CONDO ASSOCIATION J 130178 FMV SIXTH STREET CONDO ASSOCIATION P 240132 FMV ADDITIONAL INFORMATION SCHEDULE R MUNSON MEDICAL CENTER USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED SUMMARIZED AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS