2012-11-13T13:11:28-06:00 2011-12-31 990 2011-01-01 382947657 HENRY FORD MACOMB HOSPITAL CORPORATION HENR 3138768714 ONE FORD PLACE - 5F DETROIT MI 48202 JAMES CONNELLY 3138768714 2012-11-13 2011 2016-02-24 21:20:13Z JAMES CONNELLY ONE FORD PLACE - 5F DETROIT MI 48202 507103127 0 X WWW.HENRYFORD.COM/HOMEPAGE_MACOMB X 1990 DE TO IMPROVE PEOPLE'S LIVES THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING.VISION: TRANSFORMING LIVES AND COMMUNITIES THROUGH HEALTH AND WELLNESS-ONE PERSON AT A TIME. 21 13 5166 871 572190 -614678 1201571 3302882 446886250 493565368 958026 1184360 6143495 6384510 455189342 504437120 0 0 0 0 225038016 250937922 0 0 374606 234798069 281052695 459836085 531990617 -4646743 -27553497 350606680 322185740 247991656 254719568 102615024 67466172 X HENRY FORD MACOMB HOSPITAL (HFMH) IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM SERVING THE NORTHEASTERN METROPOLITAN DETROIT MICHIGAN COMMUNITIES. AS AN INTEGRATED COMPONENT OF ONE OF THE NATION'S LEADING COMPREHENSIVE, INTEGRATED HEALTH SYSTEMS, IT IS THE MISSION OF HFMH TO IMPROVE HUMAN LIFE THROUGH THE EXCELLENCE OF THE SCIENCE AND ART OF HEALTH CARE AND HEALING. HFMH IS COMMITTED TO PROVIDING HEALTH SERVICES AND IMPROVING THE QUALITY OF LIFE OF ALL OF THE CITIZENS OF THE COMMUNITIES IT SERVES REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. THE ORGANIZATION PROVIDES FINANCING AND HEALTH CARE DELIVERY, INCLUDING ACUTE, SPECIALTY, PRIMARY AND PREVENTATIVE CARE SERVICES BACKED BY EXCELLENCE IN RESEARCH AND EDUCATION. 0 0 370247033 351459408 HFMH IS RECOGNIZED FOR ITS EXCELLENCE IN PROVIDING INPATIENT CARE TO THE RESIDENTS OF THE MACOMB COUNTY MICHIGAN AS WELL AS ALL OF THE OTHER COMMUNITIES LOCATED NORTHEAST OF THE CITY OF DETROIT. DURING 2011 HFMH HAD 31,033 DISCHARGES, AND 156,323 PATIENT DAYS.HENRY FORD MACOMB HOSPITAL-CLINTON TOWNSHIP PROVIDES COMPREHENSIVE ACUTE AND TERTIARY CARE. SPECIALTY SERVICES INCLUDE A HEART & VASCULAR INSTITUTE, JOSEPHINE FORD CANCER CENTER, A WOMEN'S HEALTH CENTER, ALONG WITH A BIRTHING CENTER THAT FEATURES 18 LABOR, DELIVERY, RECOVERY AND POST-PARTUM SUITES. THE HOSPITAL ALSO HAS A 42-BED INPATIENT REHABILITATION PROGRAM, AN AMBULATORY AND MINIMALLY INVASIVE SURGERY CENTER AND LEADING DIAGNOSTIC IMAGING, ALONG WITH ADVANCED TRAUMA CAPABILITIES AND EMERGENCY SERVICES.HENRY FORD MACOMB HOSPITAL - WARREN OFFERS SUPERIOR EMERGENCY, INPATIENT REHABILITATION, MEDICAL AND SURGICAL CARE. THE CAMPUS FEATURES A BARIATRIC SURGERY CENTER OF EXCELLENCE, A CENTER FOR JOINT REPLACEMENT, A SPECIALIZED STROKE PROGRAM, TRAUMA SERVICES, PLUS A UNIQUE ACUTE CARE OF THE ELDERLY UNIT TO SERVE THE SPECIAL NEEDS OF PATIENTS 65 AND OLDER. THE HOSPITAL ALSO OFFERS A FULL ARRAY OF OUTPATIENT SERVICES, INCLUDING LEADING IMAGING TECHNOLOGY PLUS PHYSICAL THERAPY, CARDIAC REHAB, PULMONARY REHAB AND PRIMARY AND SPECIALTY CARE PHYSICIAN OFFICES ON CAMPUS.HENRY FORD HOSPITAL DOCTORS TRAIN MORE THAN 600 MEDICAL SCHOOL STUDENTS, 500 RESIDENTS AND 150 FELLOWS ACROSS 46 DIFFERENT AREAS OF MEDICINE EVERY YEAR. HENRY FORD HOSPITAL RESIDENCY AND FELLOWSHIP PROGRAMS ARE NATIONALLY ACCREDITED M.D. (DOCTORATE OF MEDICINE) TRAINING PROGRAMS. HENRY FORD MACOMB HOSPITALS OFFER NATIONALLY ACCREDITED D.O. (DOCTORATE OF OSTEOPATHIC MEDICINE) AND D.P.M. (DOCTORATE OF PODIATRIC MEDICINE) TRAINING PROGRAMS, AND TRAINED 116 MEDICAL RESIDENTS DURING 2011. 77049659 89896993 HFMH PROVIDES OUTPATIENT SERVICES AT MULTIPLE LOCATIONS THROUGHOUT THE NORTH EASTERN METROPOLITAN COMMUNITIES OF DETROIT. IN TOTAL THIS REPRESENTED MORE THAN 185,000 OUTPATIENT VISITS, MORE THAN 16,000 OUTPATIENT SURGICAL AND ENDOSCOPY PROCEDURES, AND MORE THAN 50,000 URGENT CARE VISITS DURING 2011. 37638156 42873674 HFMH OPERATES TWO 24-HOUR EMERGENCY FACILITIES. EMERGENCY SERVICES REPRESENTED 90,264 PATIENT VISITS DURING 2011. 4392048 12399456 OTHER PROGRAM SERVICES INCLUDE ANCILLARY SERVICES LOCATED WITHIN THE MEDICAL FACILITIES. 4392048 12399456 489326896 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 0 1 263 19 1 5166 1 1 1 0 0 0 0 1 1 0 0 0 0 0 X 21 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X JAMES CONNELLY 3138768714 ONE FORD PLACE DETROIT MI 48202 ALANDT PAUL D 1.00 X 0 0 0 BERGMAN RSM MYRA 1.00 X 0 0 0 CALLAGHAN PHD EDWARD D 1.00 X 0 0 0 HUSAIN MD S NASIR 1.00 X 0 0 0 DIMITRIJEVIC MD RODOLJUB 1.00 X 39600 0 0 HARRINGTON MD STEVEN D 1.00 X 0 0 0 KINNER DO CAROLANN K 1.00 X 0 0 0 LOPE RAYMOND C 1.00 X 0 0 0 LORENZO PHD ALBERT L 2.00 X X 0 0 0 MELDRUM THOMAS B 1.00 X 0 0 0 MORELLI SR WILLIAM A 1.00 X 0 0 0 PESTA DO CARL M 1.00 X 92000 0 0 SHEHADEH DO LAILA 1.00 X 241040 0 40145 RICHARDSON ROSS C 1.00 X 0 0 0 RINEY ROBERT G 1.00 X 0 1569281 41971 ROSSMANN BARBARA W 60.00 X X X 723019 0 155808 SAYERS DO DIANE 1.00 X 0 317725 47082 CERVENAK MICHAEL 1.00 X 299565 0 44715 VIVIANO ANTHONY J 1.00 X 0 0 0 WULF ANDREA L 2.00 X X 0 0 0 THOMPSON DD JAMES E 1.00 X 0 0 0 GIRODAT DAVID F 1.00 X 0 0 0 EISENMANN EDITH L 5.00 X 0 211931 29942 CONNELLY JAMES M 5.00 X 0 1273512 39986 GOODBALIAN TERRY A 60.00 X X 284141 0 45589 BEAULAC GARY 60.00 X 391504 0 42140 PEASE DO JOANNA R 60.00 X 324996 0 36740 AGOSTA MD ANDREW M 60.00 X 558538 0 52197 LEVIN MD RONALD 60.00 X 691139 0 38680 RYANDO MARK T 60.00 X 647244 0 8151 SCOTT DO FREMONT 60.00 X 614443 0 38888 HILL DO DEREK 60.00 X 465628 0 33748 HATHAWAY STEPHEN J 0.00 X 0 359131 56953 5372857 3731580 752735 204 1 1 0 TRINITY INFORMATION SERVICES 34605 WEST 12 MILE ROAD FARMINGTON HILLS MI 48331 IT CONSULTING 14601259 MICHIGAN COTENANCY LABORATORIES DEPT CH 14271 PALATINE IL 60055 LABORATORY SERVICES 1386918 EXECUTIVE HEALTH RESOURCES INC PO BOX 822688 PHILADELPHIA PA 19182 EHR SERVICES 1141593 INTEGRATED SUPPLY CHAIN SOLUTIONS LLC 1600 EAST GRAND BLVD DETROIT MI 48211 SUPPLY CHAIN 939370 ADVOMAS 335 E BIG BEAVER RD SUITE 100 TROY MI 48083 PATIENT FINANCE SVCS 890618 48 589165 2713717 210609 3302882 HOSPITAL SERVICES 900099 343986820 343986820 OUTPATIENT SERVICES 621400 89896993 89896993 EMERGENCY SERVICES 900099 42873674 42873674 MEDICAL EDUCATION-GME 900099 7472588 7472588 9335293 8763103 572190 493565368 981997 981997 1276861 1276861 1276861 1276861 156378 2308899 2262914 156378 45985 202363 45985 156378 349424 589165 403093 -53669 -53669 CAFETERIA 900099 1570950 1570950 JOINT VENTURES 900099 1130278 1130278 GIFT SHOP 453220 740788 740788 1719302 1719302 5161318 504437120 496629531 572190 3932517 2808085 1038425 1670336 99324 562462 562462 200568974 194430841 5997870 140263 10025701 9636953 381853 6895 23174032 22275455 882639 15938 13798668 13263622 525556 9490 108200 108200 35653348 31917655 3734739 954 2131035 487188 1639752 4095 10954080 9850501 1099713 3866 9307313 9159352 147961 10536911 9204001 1287406 45504 489319 406715 63922 18682 285586 285586 6989273 139241 6850032 21250090 19819047 1420360 10683 4810394 1584224 3226170 MEDICAL SUPPLIES 83238530 83082494 156036 BAD DEBT EXPENSE 28574001 28574001 REPAIRS & MAINTENANCE 9517580 9320990 196590 QUAAP TAX 9201661 9201661 48005374 35086482 12899980 18912 531990617 489326896 42289115 374606 11856 11520 55358044 55608314 928114 592691 51056398 48446927 9055865 9454860 5256493 4472724 310426082 148974282 190301046 161451800 26710143 29097564 278345 689092 675451 73920 73920 11165709 12021624 350606680 322185740 35435167 31168062 163421590 160625461 49134899 62926045 247991656 254719568 X 94708530 57962742 5687481 7348507 2219013 2154923 102615024 67466172 350606680 322185740 X -27553497 -7595355 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7906493 3249213 -11640 1640636 9503430 7002141 1150549 41284 861779 -574298 7906493 1284494 6266095 -130441 418007 7002141 2089568 -492533 312541 1284494 0.22680 0.77320 0 0 12482134 12482134 172154064 55847062 116307002 840948 308130 532818 122183667 92819090 29364577 2765269 2765269 161451800 MALPRACTICE LIABILITY 20656322 CORPORATE RESERVE 4446848 WORKERS COMP LIABILITY 3099024 DEFERRED COMPENSATION 2666145 RETIREMENT ANNUITY 16120349 POST RETIREMENT BENEFITS 15380273 OTHER LONG TERM LIABILITIES 557084 62926045 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: EARNINGS FROM THE ORGANIZATION'S ENDOWMENTS FUNDS ARE UTILIZED BASED ON THE NATURE OF THE SPECIFIC ASSOCIATED RESTRICTION. THESE PRIMARILY RELATE TO FUNDING INITIATIVES ASSOCIATED WITH SPECIFIC DISEASE CONDITIONS AND FURTHERING MEDICAL EDUCATION AND RESEARCH INITIATIVES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2011 AND 2010. EARNINGS FROM THE ORGANIZATION'S ENDOWMENTS FUNDS ARE UTILIZED BASED ON THE NATURE OF THE SPECIFIC ASSOCIATED RESTRICTION. THESE PRIMARILY RELATE TO FUNDING INITIATIVES ASSOCIATED WITH SPECIFIC DISEASE CONDITIONS AND FURTHERING MEDICAL EDUCATION AND RESEARCH INITIATIVES. MEDALLION EVENT 384566 239917 144649 59433 100167 SHOWTIME EVENT 244221 197949 46272 1090 87831 2 309802 151299 158503 54919 99653 938589 589165 349424 115442 287651 403093 -53669 MI 1 0 0 0 1.00000 CHRISTINE ANDREWS PHILANTHROPHY DEPT ONE FORD PLACE DETROIT MI 48202 0 0 1 1 X 1 X 1 X 1 1 1 0 1 1 5906167 5906167 0.01170 65599370 46813040 18786330 0.03730 71505537 46813040 24692497 0.04900 3847033 63204 3783829 0.00750 17273262 7472588 9800674 0.01950 11303303 8100607 3202696 0.00640 431798 21600 410198 0.00080 32855396 15657999 17197397 0.03420 104360933 62471039 41889894 0.08320 194771 194771 0.00040 24832 24832 0.00010 124672 124672 0.00020 59485 59485 0.00010 7500 7500 0.00000 411260 411260 0.00080 0 28574001 14287000 145569166 145742768 -173602 X 1 1 2 1 HENRY FORD MACOMB HOSPITAL - CLINTON

15855 19 MILE ROAD CLINTON TOWNSHIP MI 48038

X X X X 2 HENRY FORD MACOMB HOSPITAL - WARREN

13355 E TEN MILE ROAD WARREN MI 48089

X X X X HENRY FORD MACOMB HOSPITAL-CLINTON TWP 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 HENRY FORD MACOMB HOSPITAL-WARREN 2 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 29 HENRY FORD MACOMB-BRUCE TOWNSHIP MED CTR

80650 VAN DYKE BRUCE TOWNSHIP MI 48065

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-CHESTERFIELD MED CNTR

30795 23 MILE ROAD CHESTERFIELD TOWNSHI MI 48047

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB CENTER-CLINTON TWP

16151 19 MILE ROAD CLINTON TOWNSHIP MI 48038

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-FRASER HEALTH CENTER

15717 15 MILE ROAD FRASER MI 48035

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-RICHMOND MEDICAL CNTR

31505 32 MILE ROAD RICHMOND MI 48062

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SLEEP MEDICINE

15945 19 MILE ROAD CLINTON TOWNSHIP MI 48038

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SHELBY OBGYN

49050 SCHOENHERR SHELBY TOWNSHIP MI 48316

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-WASHINGTON TWP MED CTR

12150 30 MILE ROAD WASHINGTON TOWNSHIP MI 48095

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-HEMATOLOGYONCOLOGY

15520 19 MILE ROAD-SUITE 400 CLINTON TOWNSHIP MI 48038

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-CHESTERFIELD OBGYN

51086 FAIRCHILD CLINTON TOWNSHIP MI 48038

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-EASTRIDGE FAMILY MEDIC

16570 19 MILE ROAD CLINTON TOWNSHIP MI 48038

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-PARK PLACE PEDIATRICS

20373 HALL ROAD MACOMB MI 48044

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SHELBY OBGYN

51221 SCHOENHERR SHELBY TOWNSHIP MI 48315

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SHELBY FAMILY MED

49310 VAN DYKE SHELBY TOWNSHIP MI 48317

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-HARPER FAMILY MEDICINE

36539 HARPER AVENUE CLINTON TOWNSHIP MI 48035

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-MACOMB FAMILY MED

48924 HAYES ROAD MACOMB MI 48044

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-SHELBY RHEUMATOLOGY

50505 SCHOENHERR-SUITE 175 SHELBY TOWNSHIP MI 48315

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB-CNTR FOR HEALTH MGMT

42850 GARFIELD ROAD CLINTON TOWNSHIP MI 48038

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB CENTER-CLINTON TWP

43401 GARFIELD ROAD CLINTON TOWNSHIP MI 48038

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB CENTER-CLINTON TWP

43411 GARFIELD ROAD CLINTON TOWNSHIP MI 48038

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HENRY FORD MACOMB REHAB-STERLING HEIGHTS

44800 DELCO BLVD STERLING HEIGHTS MI 48313

REHABILITATION SERVIES HENRY FORD MACOMB REHAB-WARREN

3601 E ELEVEN MILE ROAD WARREN MI 48092

REHABILITATION SERVIES HENRY FORD MACOMB REHAB-CLINTON TWP

16301 NINETEEN NIME ROAD CLINTON TOWNSHIP MI 48308

REHABILITATION SERVIES HFMH-WARREN INTERNAL MEDICINE

25531 SCHOENHERR WARREN MI 48089

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN MEDICAL CENTER

25625 SCHOENHERR WARREN MI 48089

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN MARTIN MEDICAL CENTER

28001 SCHOENHERR WARREN MI 48088

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN FAMILY MEDICINE

30205 SCHOENHERR WARREN MI 48093

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN SLEEP MEDICINE

13251 E TEN MILE ROAD WARREN MI 48089

CLINICAL/DIAGNOSTIC MEDICAL SERVICES HFMH-WARREN VASCULAR SURGERY

27500 HOOVER WARREN MI 48093

CLINICAL/DIAGNOSTIC MEDICAL SERVICES PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 28574001. PART II: HFMH BELIEVES THAT THE STRENGTH AND VITALITY OF A COMMUNITY HAS A SIGNIFICANT IMPACT ON THE BEHAVIORS OF ITS RESIDENTS AND THAT THERE IS DIRECT CORRELATION BETWEEN THE VIABILITY OF A COMMUNITY AND THE ATTITUDE OF ITS RESIDENTS TOWARD HEALTHIER BEHAVIORS. THEREFORE, HFMH INCLUDES IN ITS COMMITTMENT TO COMMUNITY BENEFIT A FOCUS ON DIRECT INVOLVEMENT IN THE COMMUNITY TO BOTH IMPROVE THE ENVIRONMENT AND ENSURE THAT CRITICAL MESSAGES ON THE BENEFITS OF HEALTHIER BEHAVIORS ARE HEARD. HFMH LEADERS COLLABORATE WITH COMMUNITY TASK FORCES AND COALITIONS IN ADDRESSING THE NEEDS OF OUR SERVICE AREA. PART III, LINE 4: THE ORGANIZATION'S FOOTNOTE ON UNCOMPENSATED CARE AND COMMUNITY BENEFIT READS IN PART, "THE SYSTEM PROVIDED HEALTH CARE SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. IN ADDITION TO CHARITY CARE, THE SYSTEM PROVIDED SERVICES TO MEDICAID AND OTHER PUBLIC PROGRAMS FOR FINANCIALLY NEEDY PATIENTS, FOR WHICH THE PAYMENTS RECEIVED, WERE LESS THAN THE COST OF PROVIDING SERVICES. THE UNPAID COSTS ATTRIBUTED TO PROVIDING SERVICES UNDER THIS PROGRAM ARE CONSIDERED A COMMUNITY BENEFIT."THE ORGANIZATION DETERMINES THE COSTS OF SUCH UNPAID SERVICES BY APPLYING A COST-TO-CHARGE RATIO TO THE BILLED CHARGES.IT IS THE GOAL OF THE ORGANIZATION TO DETERMINE IF THE PATIENT QUALIFIES UNDER ITS CHARITY CARE POLICY PRIOR TO BILLING FOR SERVICES. HOWEVER, MANY FACTORS CONTRIBUTE TO THE INABILITY TO ACCOMPLISH THIS IN MANY SITUATIONS. IF THE ORGANIZATION IS UNABLE TO OBTAIN INFORMATION FROM THE PATIENT REGARDING THEIR AVAILABLE MEANS TO PAY OR FINANCIAL STATUS, THE PATIENT WILL BE BILLED FOR THE SERVICES PROVIDED. IF THE PATIENT IS ULTIMATELY DETERMINED TO QUALIFY UNDER THE CHARITY CARE POLICY ANY BILLINGS WILL BE APPROPRIATELY ADJUSTED. PART III, LINE 9B: IF THE PATIENT IS DETERMINED TO QUALIFY UNDER THE ORGANIZATION'S CHARITY CARE POLICY PRIOR TO BILLING, NO BILL IS EVER GENERATED AND THEREFORE THE ELEMENTS OF THE COLLECTION POLICY ARE NEVER INVOKED. WHEN THE DETERMINATION IS NOT MADE PRIOR TO BILLING, THE ORGANIZATION'S COLLECTION POLICY WOULD APPLY. THIS POLICY READS IN PART:- "PATIENTS WILL BE EVALUATED FOR THE SYSTEM'S PATIENT FINANCIAL ASSISTANCE PROGRAM"- "UNINSURED PATIENTS WILL BE GIVEN A DISCOUNT"- "UNDERINSURED PATIENTS MAY QUALIFY FOR DISCOUNTED SERVICES BASED UPON THEIR AGGREGATE HOUSEHOLD INCOME"- "THE ORGANIZATION WILL REVIEW THE PATIENTS'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS REQUESTED"- "LEGAL ACTION...MAY BE TAKEN...WHEN THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS TO MEET HIS OR HER OBLIGATION"- "THE ORGANIZATION WILL NOT FORCE THE SALE OR FORECLOSURE OF ANY PATIENT OR GUARANTOR'S PRIMARY RESIDENCE TO PAY AN OUTSTANDING MEDICAL BILL"- "THE ORGANIZATION WILL NOT...REQUIRE THE PATIENT OR RESPONSIBLE PARTY TO APPEAR IN COURT"- "THE ORGANIZATION WILL DIRECT THEIR COLLECTION AGENCIES TO FOLLOW THESE GUIDELINES"SCHEDULE H, PART I, QUESTION 6:THE COMMUNITY BENEFIT ACTIVITIES OF HFMH ARE INCORPORATED IN THE CONSOLIDATED ANNUAL REPORT OF HENRY FORD HEALTH SYSTEM WHICH IS AVAILABLE ON ITS WEB SITE AT:HTTP://WWW.HENRYFORD.COM/BODY/CFM?ID=57195 HENRY FORD MACOMB HOSPITAL-CLINTON TWP PART V, SECTION B, LINE 19D: FOR PATIENTS THAT QUALIFY UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAM WHOSE HOUSEHOLD INCOME IS AT 200%, OR LESS THAN THE FEDERAL POVERTY LEVEL QUALIFYING SERVICES ARE PROVIDED AT NO COST. IN SITUATIONS WHERE THE QUALIFYING PATIENTS HOUSEHOLD INCOME IS GREATER THAN 200%, BUT LESS THAN 400% OF THE FEDERAL POVERTY LEVEL, SERVICES ARE PROVIDED BASED UPON A STEPPED DISCOUNT RATE. MEDICARE RATES ARE USED IN DETERMINING THIS DISCOUNT. HENRY FORD MACOMB HOSPITAL-WARREN PART V, SECTION B, LINE 19D: FOR PATIENTS THAT QUALIFY UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAM WHOSE HOUSEHOLD INCOME IS AT 200%, OR LESS THAN THE FEDERAL POVERTY LEVEL QUALIFYING SERVICES ARE PROVIDED AT NO COST. IN SITUATIONS WHERE THE QUALIFYING PATIENTS HOUSEHOLD INCOME IS GREATER THAN 200%, BUT LESS THAN 400% OF THE FEDERAL POVERTY LEVEL, SERVICES ARE PROVIDED BASED UPON A STEPPED DISCOUNT RATE. MEDICARE RATES ARE USED IN DETERMINING THIS DISCOUNT. PART VI, LINE 2: HFMH CONSIDERS THE ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AS AN ESSENTIAL FUNCTION; PROVIDING KEY INFORMATION REGARDING THE DEMOGRAPHICS AND MAJOR NEEDS OF THE COMMUNITIES SERVED. IT SUPPORTS THE PRIORITIZATION OF THE SERVICES, AND IT HELPS TARGET POPULATIONS WITH THE MOST VULNERABILITY TO HEALTH NEEDS SUCH AS THE POOR, UNINSURED, AS WELL AS VARIOUS OTHER POPULATIONS THAT MAY HAVE BEEN OVERLOOKED. THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO PROVIDES VALUABLE INFORMATION REGARDING OTHER ORGANIZATIONS SUPPORTING THE NEEDS WITHIN THE COMMUNITY SO PROGRAMS CAN BE COORDINATED AND LEVERAGED TO ENSURE THAT EVERY DOLLAR IS INVESTED WISELY. DATA SOURCES EVALUATED TO DETERMINE COMMUNITY NEED INCLUDED THE FOLLOWING:MICHIGAN SURGEON GENERAL'S HEALTH STATUS REPORT - HEALTH MICHIGAN 2010MACOMB COUNTY BEHAVIORAL RISK FACTOR SURVEY - 2009 (WWW.MACOMBCOUNTYMI.GOV) HEALTH RISK BEHAVIORS IN THE STATE OF MICHIGAN - 2006-2008 BEHAVIORAL RISK FACTOR SURVEYHEALTH INDICATORS AND RISK ESTIMATES BY COMMUNITY HEALTH ASSESSMENT REGIONS & LOCAL HEALTH DEPARTMENTS - MICHIGAN BEHAVIORAL RISK FACTOR SURVEY 2006-2008 COMBINEDMICHIGAN DEPARTMENT OF COMMUNITY HEALTH WEBSITE (WWW.MDCH.MI.US)BENCHMARK REPORT: THE STATE OF HOMELESSNESS IN MICHIGAN. 2007 ANNUAL REPORTMICHIGAN'S CAMPAIGN TO END HOMELESSNESS (WWW.THECAMPAIGNTOENDHOMELESSNESS.ORG)MICHIGAN CRITICAL HEALTH INDICATORS 2007 REPORT, MICHIGAN DEPARTMENT OF COMMUNITY HEALTHHEALTH DISPARITIES IMPACTING RACIAL AND ETHNIC MINORITIES IN MICHIGAN PRESENTATION, MICHIGAN DEPARTMENT OF COMMUNITY HEALTHTHOMSON MARKET EXPERT DATABASE - PROPRIETARY DATABASE OFFERING MARKET DEMOGRAPHIC AND HEALTHCARE UTILIZATION DATAMICHIGAN HEALTH AND HOSPITAL ASSOCIATIONOFFICIAL RESOLUTION OF THE BOARD OF COMMISSIONERS, MACOMB COUNTY, MICHIGAN PART VI, LINE 3: HFMH HAS VARIOUS APPROACHES TO TARGET AND INFORM RESIDENTS OF ITS COMMUNITIES ABOUT THE PROGRAMS AND SERVICES IT OFFERS. PROGRAMS WHERE WE PARTNER WITH ORGANIZATIONS WITH ESTABLISHED RELATIONSHIPS WITH THE INDIVIDUALS SUCH AS THROUGH COMMUNITY HEALTH CENTERS, THE PUBLIC SCHOOLS AND FAITH-BASED ORGANIZATIONS HAVE BEEN PARTICULARLY SUCCESSFUL. HFMH FOLLOWS THE HFHS CHARITY CARE POLICY. ALL PATIENTS ARE SEEN WITHOUT REGARD TO ABILITY TO PAY. INTAKE STAFF IS TRAINED WITH REGARD TO HOW TO APPROACH AND ENGAGE AN INDIVIDUAL WHEN THERE IS AN APPARENT LACK OF ADEQUATE HEALTH COVERAGE. THIS INCLUDES INFORMING THEM OF THE PROGRAMS OFFERED BY HFMH AS WELL AS OTHER COMMUNITY, LOCAL, STATE AND FEDERAL PROGRAMS OFFERING POTENTIAL SUPPORT. HFMH HAS DEDICATED STAFF RESPONSIBLE TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR SUPPORTIVE PROGRAMS AND ASSIST THEM WITH THE ENROLLMENT PROCESS. THERE ARE MANY REASONS WHY A PATIENT IN NEED OF FINANCIAL ASSISTANCE WITH THEIR MEDICAL CARE MAY NOT HAVE BEEN IDENTIFIED AT THE TIME OF THE CARE DELIVERY. PATIENT FINANCIAL SERVICE AND COLLECTION STAFFS ARE TRAINED TO RECOGNIZE THESE INDIVIDUALS AND PROVIDE THEM WITH ADVICE REGARDING THE VARIOUS OPTIONS AVAILABLE TO SUPPORT THEIR CARE NEEDS. PART VI, LINE 4: HFMH DEFINES THE COMMUNITIES SERVED BASED ON GEOGRAPHIC AREAS GENERATING THE HIGHEST INPATIENT VOLUMES. THIS INCLUDES ALL REGIONS OF MACOMB COUNTY AS WELL AS FIVE ZIP CODES IN NORTHERN WAYNE COUNTY. THE NUMBER OF RESIDENTS IN THIS REGION IS EXPECTED TO INCREASE BY 1.5 % OVER THE NEXT FIVE YEARS, IN CONTRAST TO A NATIONAL GROWTH TREND OF 4.6%, IN ADDITION FEMALES OF CHILD BEARING YEARS, CURRENTLY REPRESENTING 20% OF THE POPULATION IS EXPECTED TO DECLINE BY 3.6%. THE REGION IS MADE UP OF 36 ZIP CODES IN MACOMB COUNTY AND FIVE IN NORTHERN WAYNE COUNTY, WITH A POPULATION OF JUST OVER 1 MILLION AND WITH 51% BEING FEMALE.THE AGE DISTRIBUTION IS SIMILAR TO THE NATIONAL NORMS WITH 24% OF THE POPULATION BEING UNDER THE AGE OF 18 AND APPROXIMATELY 13% BEING AGE 65 OR OVER. HOWEVER,IT IS EXPECTED THAT THIS POPULATION WILL AGE SIGNIFICANTLY OVER THE COMING 20 YEARS WITH THE EXPECTATION THAT THE OVER 65 GROUP WILL INCREASE TO 25% BY 2035. THE SERVICES AREA IS DIVERSE IN REGARDS TO POPULATION, RACIAL/ETHNIC COMPOSITION, ECONOMIC GROWTH AND DEVELOPMENT. THE AUTOMOTIVE SECTOR REMAINS THE LARGEST EMPLOYER IN THE SECTOR, WITH HEALTHCARE FOLLOWING. UNEMPLOYMENT IS ESTIMATED TO BE NEARLY TWICE THE NATIONAL AVERAGE AND ONLY 17% OF THE RESIDENTS HAVING A COLLEGE LEVEL DEGREE. THE RACIAL COMPOSITION IS 73% WHITE, 19% BLACK AND 3% ASIAN AND 2% HISPANIC. THE REGION ENCOMPASSES TREMENDOUS VARIABILITY OF RESOURCES. ON AVERAGE, HOUSEHOLD INCOME TRACKS NEAR THE NATIONAL AVERAGE. HOWEVER, FOUR OF THE COMMUNITIES IN NORTHERN WAYNE COUNTY AND SIX IN SOUTH CENTRAL MACOMB COUNTY WHEN CONSIDERED TOGETHER AVERAGE HOUSEHOLD INCOMES NEARLY 30% BELOW THE NATIONAL NORM, HAVE MUCH GREATER ETHNIC DIVERSITY AND A MUCH HIGHER PERCENTAGE OF RESIDENTS WITHOUT HIGH SCHOOL COMPLETION. STUDIES OF THE INDICATED POPULATIONS REVEAL THAT MANY OF THE SIGNIFICANT HEALTH ISSUES FACED ARE ALSO OBSERVED AT THE STATE AND NATIONAL LEVEL. THESE INCLUDE PREVALENCE OF CARDIOVASCULAR DISEASE, CANCER AND DIABETES, AS WELL AS HIGH RISK FACTORS THAT CONTRIBUTE TO DEVELOPING CHRONIC CONDITIONS SUCH AS OBESITY, LOW PHYSICAL ACTIVITY AND POOR NUTRITION.THE ORGANIZATION CONSIDERS THE FOLLOWING FACTORS TO BE THE LEADING INDICATORS OF AT-RISK POPULATIONS: UNINSURED AND UNDERINSURED ARE AT PARTICULAR RISK FOR NOT SEEKING PREVENTATIVE CARE SUCH AS CANCER SCREENINGS. POCKETS OF THE REGION WITH LOWER EDUCATION LEVELS EXHIBIT BEHAVIORAL CORRELATIONS WITH HIGH RISK BEHAVIORS SUCH AS HIGH CONSUMPTION OF ALCOHOL, SMOKING, AND LACK OF PHYSICAL ACTIVITY, POOR NUTRITION, AND OBESITY. THESE ALL CONTRIBUTE TO EARLY ONSET OF MANY CHRONIC CONDITIONS. PART VI, LINE 5: HENRY FORD MACOMB HOSPITALS (HFMH) IS PART OF HENRY FORD HEALTH SYSTEM, ONE OF THE NATION'S LARGEST INTEGRATED HEALTH DELIVERY SYSTEMS SERVING ALL OF SOUTHEASTERN MICHIGAN. THIS TAX RETURN REFLECTS ACTIVITIES OF THE CLINTON TOWNSHIP CAMPUS OF HFMH, WHICH INCLUDES APPROXIMATELY 400 INPATIENT BEDS WITH AN OPEN MEDICAL STAFF, A BEHAVIORAL HEALTH FACILITY, AS WELL AS SEVERAL OUTPATIENT LOCATIONS SERVING THE MACOMB COUNTY AREA OF MICHIGAN. HFMH IS GOVERNED BY A DEDICATED VOLUNTEER COMMUNITY BOARD AND IT PROVIDES ITS COMMUNITIES WITH A FULL RANGE OF CLINICAL SERVICES INCLUDING GENERAL MEDICINE, SURGERY, OBSTETRICS, PEDIATRICS, CARDIAC CARE, PHYSICAL AND REHABILITATION MEDICINE, AMBULATORY SURGERY, INPATIENT AND OUTPATIENT BEHAVIORAL SERVICES, AND 24 HOUR EMERGENCY CARE. PART VI, LINE 6: THE SYSTEM DEMONSTRATES ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY BY OPERATING EMERGENCY ROOMS OPEN TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK; PROVIDING FACILITIES FOR THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS; AND MAINTAINING RESEARCH FACILITIES FOR THE STUDY OF NEW DRUGS AND MEDICAL DEVICES THAT OFFER THE PROMISE OF IMPROVING HEALTH CARE. THE SYSTEM ALSO PROVIDES COMMUNITY HEALTH SERVICES, SUCH AS COMMUNITY EDUCATION AND OUTREACH IN THE FORM OF FREE OR LOW-COST CLINICS; HEALTH EDUCATION TELEVISION PROGRAMMING; DONATIONS FOR THE COMMUNITY; MULTIPLE HEALTH PROMOTION AND WELLNESS PROGRAMS, SUCH AS HEALTH SCREENING; AND VARIOUS COMMUNITY PROJECTS AND SUPPORT GROUPS X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 SHEHADEH DO LAILA 237746 0 2708 0 586 0 25047 0 15098 0 281185 0 0 0 RINEY ROBERT G 0 788460 0 579333 0 201488 0 22097 0 19874 0 1611252 0 0 ROSSMANN BARBARA W 414747 0 225066 0 83206 0 132850 0 22958 0 878827 0 0 0 SAYERS DO DIANE 0 275077 0 39808 0 2840 0 24372 0 22710 0 364807 0 0 CERVENAK MICHAEL 234985 0 62636 0 1944 0 24979 0 19736 0 344280 0 0 0 EISENMANN EDITH L 0 138674 0 54560 0 18697 0 17607 0 12335 0 241873 0 0 CONNELLY JAMES M 0 607114 0 460119 0 206279 0 19647 0 20339 0 1313498 0 0 GOODBALIAN TERRY A 212711 0 66881 0 4549 0 21504 0 24085 0 329730 0 0 0 BEAULAC GARY 262064 0 109307 0 20133 0 21778 0 20362 0 433644 0 0 0 PEASE DO JOANNA R 240599 0 80145 0 4252 0 22758 0 13982 0 361736 0 0 0 AGOSTA MD ANDREW M 448120 0 16934 0 93484 0 33073 0 19124 0 610735 0 0 0 LEVIN MD RONALD 414293 0 272049 0 4797 0 20916 0 17764 0 729819 0 0 0 RYANDO MARK T 366257 0 232562 0 48425 0 7731 0 420 0 655395 0 0 0 SCOTT DO FREMONT 487070 0 90240 0 37133 0 17197 0 21691 0 653331 0 0 0 HILL DO DEREK 320285 0 120192 0 25151 0 19000 0 14748 0 499376 0 0 0 HATHAWAY STEPHEN J 0 262440 0 90115 0 6576 0 36734 0 20219 0 416084 0 0 PART I, LINE 1A IT IS THE ORGANIZATION'S POLICY TO PAY OR REIMBURSE EMPLOYEES FOR BONAFIDE BUSINESS TRAVEL BASED ON THE MOST COST EFFECTIVE MEANS AVAILABLE. GENERALLY, WHEN AIR TRAVEL IS INVOLVED THIS EQUATES TO COACH CLASS AIR FARE. UNDER CERTAIN CIRCUMSTANCES, SUCH AS WHEN COACH CLASS IS NOT AVAILABLE OR THE TRIP IS OF AN EXTENSIVE DURATION, SENIOR LEADERSHIP HAS APPROVED BUSINESS CLASS, FIRST CLASS OR CHARTER TRAVEL. IN SUCH CIRCUMSTANCES, THE TRAVEL IS CONSIDERED TO BE FOR A BONAFIDE BUSINESS PURPOSE; ACCORDINGLY NO TAXABLE INCOME IS REPORTED. NO QUALIFYING INDIVIDUALS RECEIVED PAID OR REIMBURSED FIRST CLASS TRAVEL DURING 2011. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PROGRAM THAT RESULTS IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP ALSO HAVE THE OPTION TO PARTICIPATE IN NON-QUALIFIED 457 BENEFIT PROGRAMS WHICH RESULTS IN REPORTABLE TAXABLE INCOME AS BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. IT IS AN ELEMENT OF THE PLAN DESIGN TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. SEE Q. 4B FOR THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS. PART I, LINE 4B SCH J, LINE 4B, PERSONS PARTICIPATING IN NONQUALIFIED RETIREMENT PLANS SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TAXABLE REPORTABLE VALUE OF 2011 ACCRUAL 2011 DISTRIBUTIONS W-2 AMOUNTS PARTICIPANT JAMES CONNELLY 175,059 - 175,059 ROBERT RINEY 181,833 - 181,833 BARBARA ROSSMANN 59,044 - 59,044 CONTRIBUTIONS TO SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2011 CONTRIBUTIONS 2011 CONTRIBUTIONS TAX GROSS-UP W-2 AMOUNTS BARBARA ROSSMANN 6,455 10,035 148 16,638 RONALD LEVIN, M.D. - 1,971 29 2,000 ANDREW AGOSTA, M.D. 13,047 3,453 51 16,551 STEVEN HATHAWAY - 1,650 24 1,674 GARY BEAULAC 15,051 1,449 21 16,521 ROBERT RINEY - 16,500 243 16,743 EDITH EISENMANN 16,500 - - 16,500 ACCRUALS TO SELECT SEC 457(F)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN 2011 ACCRUALS BARBARA ROSSMANN 92,000 ADVANCED CARDIOTHORACIC SURGEONS PLLC SEE BELOW 534387 SEE BELOW 0 WILMA DIMITRIJEVIC MD SEE BELOW 270651 SEE BELOW 0 MARTIN BEAULAC SEE BELOW 174736 SEE BELOW 0 ROSEMARY MINJEUR SEE BELOW 68598 SEE BELOW 0 RAYMOND MINJEUR SEE BELOW 48477 SEE BELOW 0 COLLEEN HARRINGTON SEE BELOW 15216 SEE BELOW 0 (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: OWNER/TRUSTEE(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR MEDICAL SERVICES(A) NAME OF PERSON: WILMA DIMITRIJEVIC, M.D.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/TRUSTEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: MARTIN BEAULAC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: ROSEMARY MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: RAYMOND MINJEUR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/KEY EMPLOYEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION(A) NAME OF PERSON: COLLEEN HARRINGTON(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER/TRUSTEE(D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION PAID BY THE ORGANIZATION X EVENT COSTS 31 96094 FAIR MARKET VALUE X EVENT PRIZES 120 70726 FAIR MARKET VALUE X MISCELLANEOUS 18 43789 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A TAX EXEMPT STOCK CORPORATION AND HENRY FORD HEALTH SYSTEM HOLDS ALL OF THE ISSUED AND OUTSTANDING SHARES OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE STOCK HOLDER OF THE ORGANIZATION, HFHS HOLDS THE RESERVE POWER TO APPROVE OR DISAPPROVE TRUSTEE APPOINTMENTS. FORM 990, PART VI, SECTION A, LINE 7B BASED ON THE ESTABLISHED RESERVE POWERS, CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) AND THE TAX DEPARTMENT OF HFHS PREPARES THE ORGANIZATION'S FORM 990. AS PART OF THE PREPARATION AND REVIEW PROCESS PRIOR TO FILING THE RETURN THE FOLLOWING REVIEW PROCESS IS CONDUCTED: - REVIEW OF THE ENTIRE RETURN WITH THE HFHS AND ORGANIZATION CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER AND CHIEF EXECUTIVE OFFICER - REVIEW OF ALL COMPENSATION MATTERS AND DISCLOSURES WITH THE COMPENSATION COMMITTEE OF THE HFHS BOARD OF TRUSTEES - REVIEW OF THE RETURN WITH THE HFHS AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES - PROVIDE A COPY OF THE RETURN TO THE ORGANIZATION'S BOARD OF TRUSTEES FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO OVERSEES THE CONFLICT OF INTEREST PROCESS WITH REGARD TO THE ORGANIZATION. HFHS HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE HFHS CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES AND EMPLOYEES. ANNUALLY, TRUSTEES, EMPLOYEES OF A MANAGEMENT LEVEL, RESEARCHERS, AS WELL AS EMPLOYEES ASSOCIATED WITH PROCUREMENT, OR IN CERTAIN OTHER PREDEFINED ROLES MUST COMPLETE AN ANNUAL DISCLOSURE DESIGNED TO IDENTIFY ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. IT IS THE RESPONSIBILITY OF THE COMMITTEE TO REVIEW THESE DISCLOSURES AND DETERMINE THE NEED FOR ANY ACTION TO MANAGE THE POTENTIAL CONFLICT. THE COMMITTEE ANNUALLY REPORTS THE RESULTS OF ITS ACTIVITIES TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE HFHS BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM (HFHS) WHO HAS RESPONSIBILITY TO OVERSEE THE COMPENSATION PRACTICES OF THE ORGANIZATION. HFHS HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES CONSISTING OF ALL EXTERNAL TRUSTEES. THEY MEET PERIODICALLY THROUGHOUT THE YEAR. THEY ARE CHARGED WITH APPROVAL OF THE ORGANIZATION'S OVERALL COMPENSATION AND BENEFIT PROGRAMS AS WELL AS THE SPECIFIC REVIEW AND APPROVAL OF THE COMPENSATION OF CERTAIN EMPLOYEES INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THEY DIRECTLY ENGAGE AN INDEPENDENT COMPENSATION ADVISOR TO ASSIST WITH THIS PROCESS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE, UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS, AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTH CARE ORGANIZATIONS. THE REASONABLENESS OF COMPENSATION IS EVALUATED BASED UPON THESE AND OTHER FACTORS. THE COMMITTEE ALSO REVIEWS THE COMPENSATION DISCLOSURES TO BE MADE ON FORM 990 IN ADVANCE OF FILING. FORM 990, PART VI, SECTION C, LINE 19 IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION. AS A HOLDER OF TAX EXEMPT DEBT THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO A PUBLIC CLEARING HOUSE ON A QUARTERLY BASIS. PART IV, LINE 12 THE ORGANIZATION IS AN ELEMENT OF THE EXTERNAL AUDIT REPORT OBTAINED FOR THE CONSOLIDATED OPERATIONS OF HENRY FORD HEALTH SYSTEM. FORM 990, PART IV, LINE 24A, TAX-EXEMPT BOND ISSUE: THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM. THE ALLOCATED TAX-EXEMPT BOND LIABILITY OF THE ORGANIZATION IS REPORTED UNDER THE FORM 990, SCHEDULE K OF ITS PARENT, HENRY FORD HEALTH SYSTEM. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -296,027. MINIMUM PENSION LIABILITY ADJUSTMENT -7,299,328. AFFILIATE EQUITY TRANSFER TOTAL TO FORM 990, PART XI, LINE 5: -7,595,355. FORM 990, PART VII AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: MANY EXECUTIVE EMPLOYEES OF HFHS PROVIDE SERVICES TO MULTIPLE AFFILIATED ENTITIES. HENRY FORD HEALTH SYSTEM USES ESTIMATES FOR REPORTING AVERAGE HOURS PER WEEK IN ALL SECTIONS OF FORM 990. GENERALLY 60 HOURS ARE REPORTED FOR THE HOURS ASSOCIATED FOR THE ORGANIZATION THAT THE INDIVIDUAL HAS PRINCIPAL RESPONSIBILITY FOR. HOURS ASSOCIATED WITH OTHER HOSPITAL OR LARGER ORGANIZATIONS ARE REPORTED AT 5 PER WEEK AND FOR SMALLER ORGANIZATIONS 1 HOUR PER WEEK IS REPORTED. 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