2014-02-15T16:52:20-06:00 2013-03-31 381357951 PLANTE & MORAN PLLC 750 TRADE CENTRE WAY STE 300 PORTAGE MI 49002 990 2012-04-01 381368347 ELLA E M BROWN CHARITABLE CIRCLE ELLA 2697814271 200 N MADISON STREET MARSHALL MI 49068 GINGER WILLIAMS MD 2697814271 2014-02-17 1 CAROL LALONDE CPA P00181637 2695674500 2012 2015-11-30 17:44:51Z OAKLAWN HOSPITAL GINGER WILLIAMS MD 200 N MADISON STREET MARSHALL MI 49068 124899243 0 X WWW.OAKLAWNHOSPITAL.ORG X 1925 MI WE WILL PROVIDE PERSONAL, ACCESSIBLE AND HIGH QUALITY CARE TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE. 14 14 1132 220 0 0 296383 1193239 105122138 113931426 1262356 3076715 3755485 3683854 110436362 121885234 0 0 0 0 59426155 67076578 0 0 0 48420771 52915846 107846926 119992424 2589436 1892810 179446761 180490059 105907362 106122573 73539399 74367486 WE WILL PROVIDE PERSONAL, ACCESSIBLE AND HIGH QUALITY CARE TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE. 0 0 90483484 93471954 NURSING - PATIENT CARE ON AN ACUTE LEVEL TO IN/OUT PATIENTS INCLUDING INTENSIVE CARE, OBSTETRICAL, EMERGENCY, SURGICAL AND PSYCHIATRIC. IN FISCAL YEAR 2013, THERE WERE 12,912 DAYS OF CARE, 3,793 ADMISSIONS, 746 BIRTHS, AND 4,071 SURGICAL PROCEDURES. 7536222 14400487 LABORATORY - PROVIDING DIAGNOSTIC SERVICES TO INPATIENT AND OUTPATIENTS. IN FISCAL YEAR 2013, THERE WERE 300,706 LABORATORY TESTS. 9988053 6058985 PHARMACY - PROVIDING FULL PHARMACEUTICAL SERVICES TO INPATIENT AND OUTPATIENTS. 108007759 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 105 0 1 1132 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X GERAD THERAD 2697893921 200 N MADISON ST MARSHALL MI 49068 BRUCE RASHER 1.00 0.00 X X 0 0 0 JOSEPH P PALCHAK 1.00 0.00 X X 0 0 0 CHARLIE BLANK 1.00 0.00 X 0 0 0 THOMAS NEIDLINGER MD 1.00 0.00 X 0 0 0 MICHAEL STERRETT MD 1.00 0.00 X 0 0 0 FRANK LINE 1.00 0.00 X 0 0 0 MARK P O'CONNELL 1.00 0.00 X 0 0 0 E MICHAEL BECK 1.00 0.00 X 0 0 0 JACK W TOWNSEND 1.00 0.00 X 0 0 0 DR DONNA M RANDALL 1.00 0.00 X 0 0 0 HEATHER LUCIANI 1.00 0.00 X 0 0 0 MARK MACHALKA MD 1.00 0.00 X 0 0 0 ROSEMARY DAVIS 1.00 0.00 X 0 0 0 JACK H TOWNSEND 1.00 0.00 X 0 0 0 GINGER M WILLIAMS MD 40.00 0.00 X 407784 0 26565 COLLEEN M KOPPENHAVER 40.00 0.00 X 302508 0 25759 ROB COVERT 40.00 0.00 X 651352 0 8849 GERAD THERAD 40.00 0.00 X 0 0 0 KEITH CROWELL 40.00 0.00 X 145037 0 22029 KRISTIN R SIMS 40.00 0.00 X 217258 0 24618 JAN M SINCLAIR 40.00 0.00 X 187195 0 6258 SHARON THOMAS-BOYD 40.00 0.00 X 177379 0 22778 FARID F ZAYED 40.00 0.00 X 552250 0 17489 MORAD M TEHRANI 40.00 0.00 X 471770 0 25390 GUY C POWER 40.00 0.00 X 472643 0 22857 BRIAN C ATKINS 40.00 0.00 X 298076 0 24872 ALCIDES E GIL-ACOSTA 40.00 0.00 X 297706 0 17581 4180958 0 245045 73 0 1 0 GRANGER CONSTRUCTION CO 6267 AURELIUS RD LANSING MI 48909 CONSTRUCTION CONTRACTOR 6428074 REGIONAL MEDICAL LABORATORIES 175 COLLEGE STREET BATTLE CREEK MI 49037 LAB SERVICES 691113 SOAP TRANSCRIPTION PO BOX 373 WAYLAND MI 49348 TRANSCRIPTION SERVICES 518754 LIFE CARE SLEEP DIAGNOSTICS 7200 W SAGINAW LANSING MI 48917 SLEEP STUDY SERVICES 492610 DE LAGE LANDEN PO BOX 41602 PHILADELPHIA PA 19101 LEASING 405548 12 13000 36755 1143484 1193239 NET PATIENT SERVICE REVENUE 621110 113931426 113931426 113931426 951000 951000 232651 0 232651 232651 232651 5096021 21339 2991645 0 2104376 21339 2125715 2125715 90982 36755 22364 68618 68618 MEANINGFUL USE INCENTIVE 900099 1352481 1352481 INCENTIVE BONUSES 900099 800710 800710 CAFETERIA REVENUE 722210 318041 318041 911353 911353 3382585 121885234 113931426 0 6760569 2510433 2510433 50474134 45811851 4662283 1398122 1398122 9275983 9275137 846 3417906 3417906 142677 142677 97915 97915 118723 118723 7399132 6420756 978376 618296 25142 593154 900777 676854 223923 1888611 1750467 138144 269104 254559 14545 314689 209770 104919 3340933 3340933 6961843 6961843 536140 536140 SUPPLIES 15951983 15600660 351323 BAD DEBT 8069493 8069493 CERTIFICATIONS 4574486 2725002 1849484 EQUIPMENT 1475293 1361133 114160 255751 53268 202483 119992424 108007759 11984665 0 5637522 6810398 102027 100181 10688337 12061877 1256569 2232514 2483906 2211875 1314474 1620071 159165499 55341954 102876314 103823545 41317979 37668776 10821452 11485871 1044700 1044700 1903481 1430251 179446761 180490059 14580745 15649703 67000000 66299750 11601512 11165891 12725105 13007229 105907362 106122573 X 73539399 74367486 73539399 74367486 179446761 180490059 X 1892810 -813988 -250735 X X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4427282 4427282 101733400 27653721 74079679 1218135 868311 349824 51223870 26819922 24403948 562812 562812 103823545 FUNDS HELD BY TRUSTEES UNDER BOND INDENTURE 5615498 F FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 5870373 F 11485871 INTEREST RATE SWAP AGREEMENT 11730213 OTHER LIABILITIES 496340 OTHER DEBT 780676 13007229 X 121000434 -813988 25547 -788441 121788875 118723 -22364 96359 121885234 119921612 25547 22364 47911 119873701 118723 118723 119992424 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT AS OF MARCH 31, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2009. PART XI, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSE -22,364. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSE 22,364. ANNUAL BENEFIT AUCTION 127737 36755 90982 7244 9030 6090 127737 36755 90982 7244 9030 6090 22364 68618 1 1 X 1 X 1 X 1 1 0 1 1 885579 885579 0.00790 16390068 10858529 5531539 0.04940 17275647 10858529 6417118 0.05730 265 24706 907694 907694 0.00810 3 279 1472030 1472030 0.01320 69750 69750 0.00060 38 816 88990 88990 0.00080 306 25801 2538464 2538464 0.02270 306 25801 19814111 10858529 8955582 0.08000 4 16159 16159 0.00010 18 77311 77311 0.00070 7 78065 78065 0.00070 10 101652 101652 0.00090 39 273187 273187 0.00240 1 8069493 1210424 22263448 27141814 -4878366 X 1 1 1 1 ELLA E M BROWN CHARITABLE CIRCLE

200 N MADISON STREET MARSHALL MI 49068

X X X OAKLAWN HOSPITAL 1 1 X X X X X X X X 12 1 1 1 X X X X X X X X X X 1 0 1 1 150.000000000000 1 200.000000000000 1 X X X X X X 1 1 X X X X 1 X 0 1 X 0 0 21 OAKLAWN SLEEP CENTER

401 EAST MICHIGNA MARSHALL MI 49068

PHYSICIAN CLINIC OAKLAWN HOMECARE

122 HIGH MARSHALL MI 49068

HOME HEALTH CARE OMG - MIFM

14900 OLD US-27 N MARSHALL MI 49068

PHYSICIAN CLINIC FRESENIUS MEDICAL CARE- OAKLAWN

310 E MICHIGAN AVE MARSHALL MI 49068

DIALYSIS CLINIC OAKLAWN HOSPICE

110 HIGH MARSHALL MI 49068

HOSPICE BEAR CREEK CAMPUS

15217 W MICHIGAN MARSHALL MI 49068

PSYCHIATRIC CENTER OMG - BEADLE LAKE ROAD

14231 BEADLE LAKE ROAD BATTLE CREEK MI 49014

PHYSICIAN CLINIC WOUND CLINIC

13697 15 MILE RD MARSHALL MI 49068

WOUND CLINIC OMG - GASTRO

215 EAST MANSION SUITE 3A MARSHALL MI 49068

PHYSICIAN CLINIC OMG-TEKONSHA

2218 OLD US 27 N TEKONSHA MI 49092

PHYSICIAN CLINIC OMG - ALBION

300 B DRIVE N ALBION MI 49224

PHYSICIAN CLINIC OMG - PULMONOLOGY

103 E MANSION MARSHALL MI 49068

PHYSICIAN CLINIC OAKLAWN HOME MEDICAL EQUIPMENT

413 EAST MICHIGAN MARSHALL MI 49068

DURABLE MEDICAL EQUIPMENT OMG - OLIVET 202 NORTH MAIN

202 NORTH MAIN OLIVET MI 49076

PHYSICIAN CLINIC OMG - BELLEVUE

205 NORTH MAIN BELLEVUE MI 49021

PHYSICIAN CLINIC OMG - FARCHONE

215 EAST MANSION SUITE 1D MARSHALL MI 49068

PHYSICIAN CLINIC OMG - HOMER420 SOUTH HILLSDALE

420 SOUTH HILLSDALE HOMER MI 49245

PHYSICIAN CLINIC OMG - CARDIOLOGY

215 EAST MANSION SUITE 2F MARSHALL MI 49068

PHYSICIAN CLINIC OMG - ENDOCRANOLOGY

215 EAST MANSION SUITE 2C MARSHALL MI 49068

PHYSICIAN CLINIC OMG - ALLERGY

216 EAST MANSION SUITE 2B MARSHALL MI 49069

PHYSICIAN CLINIC OAKLAWN PSYCHIATRIC CENTER

15209 W MICHIGAN MARSHALL MI 49068

PSYCHIATRIC CENTER PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE.THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS (LINE 7E), HEALTH PROFESSIONS EDUCATION (LINE 7F), RESEARCH (LINE 7H) AND CASH AND IN-KIND CONTRIBUTIONS (LINE 7I) LINES. PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $8,069,493. PART II: THE COMMUNITY BUILDING ACTIVITIES THAT OAKLAWN PARTICIPATES IN INCLUDE SERVING ON COMMITTEES AND BOARDS WITHIN THE COMMUNITY AND SURROUNDING AREAS. THESE INCLUDE BUT ARE NOT LIMITED TO, REGIONAL HEALTH ALLIANCE, FOUNTAIN CLINIC BOARD, MARSHALL SCHOOL BOARD, CISD SCHOOL WELLNESS PROGRAM AND HABITAT FOR HUMANITY. THESE AND OTHER ORGANIZATIONS WORK TO PROMOTE AWARENESS OF HEALTHY LIVING ALONG WITH ECONOMIC DEVELOPMENT. WHEN AN ECONOMY IS HEALTHY THE RESIDENTS ARE HEALTHIER. PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALULATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECIEVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD IT IS DETERMINED TO BE UNCOLLECTIBLE.THE BAD DEBT EXPENSE REPORTED IN PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX. PART III, LINE 8: THE MEDICARE SURPLUS(SHORTFALL), TAKEN FROM THE MEDICARE COST REPORT, WAS CALCULATED USING A COST-TO-CHARGE RATIO METHODOLOGY. THE MEDICARE COST REPORT YEAR-END DIFFERS FROM THE TAX FISCAL YEAR-END. THE JUNE 30, 2013 MEDICARE COST REPORT WAS UTILIZED FOR THIS MARCH 31, 2013 TAX RETURN. PART III, LINE 9B: IF THE PATIENT QUALIFIES FOR CHARITY, THE CHARITY WRITE-OFF IS TAKEN REGARDLESS OF THE PAYMENT OF THE BALANCE, WHICH WILL FOLLOW THE NORMAL BILLING CYCLE. EVERY ATTEMPT SHOULD BE MADE TO SECURE PAYMENT ARRANGEMENTS FOR THE BALANCE OWING AT THE TIME THE CHARITY CARE IS APPROVED. PROMPT PAY DISCOUNTS DO NOT APPLY SINCE THE ACCOUNT HAS ALREADY BEEN DISCOUNTED. OAKLAWN HOSPITAL PART V, SECTION B, LINE 3: THIS CHNA INCLUDED INPUT AND DATA FROM PEOPLE AND ORGANIZATIONS THROUGHOUT THE COMMUNITY REPRESENTING THE BROAD INTERESTS OF CALHOUN COUNTY. THE CHNA SURVEYED PERSONS WITH EXPERTISE IN PUBLIC HEALTH, GOVERNMENT HEALTH REPRESENTATIVES, COMMUNITY LEADERS, REPRESENTATIVES AND MEMBERS OF THE MEDICALLY UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS. IT ALSO TOOK INTO ACCOUNT PUBLICLY AVAILABLE DATA FROM THE CALHOUN COUNTY HEALTH DEPARTMENT, THE COORDINATING COUNCIL OF CALHOUN COUNTY, THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH (MDCH), US CENSUS, AMERICAN COMMUNITY SURVEY, AND THE MICHIGAN HEALTH & HOSPITAL ASSOCIATION (MHA). BASED ON THE DATA AND COMMUNITY INPUT, THE PARTNERS IDENTIFIED TEN PRIORITIES IN THE COUNTY." OAKLAWN HOSPITAL PART V, SECTION B, LINE 4: IN 2012, OAKLAWN ELECTED TO JOIN WITH SEVERAL COMMUNITY PARTNERS COMING TOGETHER TO CARRY OUT A COUNTYWIDE CHNA, INCLUDING THE IDENTIFICATION OF PRIORITY HEALTH ISSUES AND STRATEGIES TO ADDRESS THOSE ISSUES. THE PARTNERS INVOLVED IN THIS EFFORT INCLUDED: BATTLE CREEK COMMUNITY FOUNDATION, BRONSON BATTLE CREEK, CALHOUN COUNTY PUBLIC HEALTH DEPARTMENT, COMMUNITY HEALTHCARE CONNECTIONS, FAMILY HEALTH CENTER OF BATTLE CREEK, INTEGRATED HEALTH PARTNERS, NOTTAWASEPPI HURON BAND OF THE POTAWATOMI (NHBP), OAKLAWN HOSPITAL, SOUTHWEST REGIONAL REHABILITATION CENTER, SUMMIT POINTE AND UNITED WAY OF THE BATTLE CREEK AND KALAMAZOO REGION. OAKLAWN HOSPITAL PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS 50% OF GROSS CHARGES. THE AVERAGE COMMERCIAL RATE IS 73% OF CHARGES. PART V, SECTION B, LINE 5A THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN CAN BE FOUND ON-LINE AT HTTP://WWW.OAKLAWNHOSPITAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART VI, LINE 2: DURING ANNUAL BUDGET REVIEW AND PLANNING CYCLES, OAKLAWN ASSESSES THE HEALTHCARE NEEDS OF THE PEOPLE IN COMMUNITIES IT SERVES THROUGH PUBLIC HEALTH DATA PROVIDED AT THE COUNTY LEVEL BY CALHOUN DEPARTMENT OF PUBLIC HEALTH AND THE COORDINATING COUNCIL. THESE RESOURCES ARE COMPLEMENTED BY THE HOSPITAL'S PROPRIETARY SERVICE UTILIZATION DATA, ALONG WITH MARKET DATA FROM THE MICHIGAN INPATIENT AND OUTPATIENT DATABASES (MIDB/MODB) AND SYNDICATED PUBLIC HEALTH/USAGE DATA TO WHICH IT SUBSCRIBES. OAKLAWN FURTHER REQUIRES THAT COMMUNITY/PATIENT HEALTH NEED BE ESTABLISHED AS PART OF JUSTIFYING NEW OR EXPANDED SERVICES, AND CAPITAL EXPENDITURES.ULTIMATELY, A COMMUNITY HEALTH NEEDS ASSESSMENT IS THE PROCESS OF GATHERING INFORMATION AND FEEDBACK ABOUT THE HEALTH STATUS OF A COMMUNITY TO IDENTIFY PROGRAMS AND INITIATIVES THAT WILL CONTRIBUTE TO IMPROVED HEALTH STATUS. DURING FISCAL YEAR ENDED 3/31/13, OAKLAWN CONDUCTED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT OF THE 22 ZIP CODES IN ITS SERVICE AREA. CONSISTENT WITH THE MARCH 2010 PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010, OAKLAWN'S INITIATIVE HAS FOUR KEY FEATURES:A. INFORMATION AND FEEDBACK OBTAINED FROM A VARIETY OF SOURCES.B. COMMUNITY LEADERS, HEALTH CARE PROVIDERS, RESIDENTS AND OTHER KEY AUDIENCES FULLY PARTICIPATE IN THE PROCESS.C. PROCESS SERVES TO IDENTIFY, THEN PRIORITIZE, UNMET OR UNDER-MET HEALTH NEEDS.D. RESULTS UTILIZED TO DEVELOP AND IMPLEMENT PROGRAMS AND INITIATIVES THAT CONTRIBUTE TO IMPROVED HEALTH STATUS IN OAKLAWN'S SERVICE AREA. PART VI, LINE 3: OAKLAWN HOSPITAL MAKES BROCHURES CALLED "ABOUT YOUR HOSPITAL BILL" WHICH ARE AVAILABLE TO OUR PATIENTS BY HANDING THEM OUT AND HAVING THEM IN WAITING ROOMS ETC. OAKLAWN HOSPITAL CALLS PATIENTS THAT HAVE LARGE BALANCES ($5,000 AND OVER) AND MAKE THEM AWARE OF THE ASSISTANCE THAT IS AVAILABLE. OAKLAWN HOSPITAL INCLUDES A STANDARD MESSAGE ON OUR STATEMENTS MAKING PATIENTS AWARE THAT ASSISTANCE MAY BE AVAILABLE. PATIENTS ARE ALSO EDUCATED ABOUT ASSISTANCE AVAILABLE WHEN HARDSHIP IS MENTIONED (INCLUDING INABILITY TO PAY TIMELY AND/OR NEEDING LONG TERM PAYOFFS) DURING PHONE CALLS WITH PATIENT FINANCIAL SERVICES. REGISTRARS ARE ALSO TRAINED TO DIRECT PATIENT TO PFS IF THEY EXPRESS ANY CONCERN WITH PAYING THEIR BILL.OAKLAWN HOSPITAL'S PATIENT CARE RESPONSIBILITY COVERS HEALTH CARE NEEDS FOR UNDERINSURED AND UNINSURED AREA RESIDENTS SEEKING TREATMENT THROUGH OUR EMERGENCY AND URGENT CARE FACILITIES, AND AT THE HOSPITAL. OAKLAWN WORKS PROACTIVELY TO ENROLL QUALIFIED AREA RESIDENTS IN OUR CHARITY CARE PROGRAM, AND TO ASSIST THEM WITH MEDICAID APPLICATIONS IF APPROPRIATE. THIS SUPPORTS THE ACTUAL CARE PROCESS NOT ONLY FOR PATIENTS BUT FOR PROVIDERS AS WELL. IT SAVES THE HOSPITAL TIME AND EFFORT, AND KEEPS PEOPLE FROM HAVING MORE SUBSTANTIAL PROBLEMS WITH CREDIT AGENCIES. OAKLAWN'S PATIENT CARE SUBSIDIES TO ASSIST THE AREA'S UNINSURED AND UNDERINSURED RESIDENTS HAVE INCREASED STEADILY SINCE 2000, AND MORE MARKEDLY IN THE PAST THREE YEARS DUE TO THE ECONOMY. OAKLAWN IS SIMILAR TO ALL NONPROFIT HOSPITALS AND WILL WRITE OFF LARGE AMOUNTS OF MONEY EACH YEAR AS THE NUMBER OF PEOPLE WHO SIMPLY CANNOT PAY FOR THEIR HEALTHCARE SERVICES PERSISTS AT A HIGH LEVEL. THESE PEOPLE INCLUDE THOSE WHO:- HAVE ABSOLUTELY NO INSURANCE;- ARE "UNDERINSURED" AND CANNOT AFFORD TO MAKE UP THE DIFFERENCE OF WHAT THEIR INSURANCE PAYS FOR THE ACTUAL COSTS INCURRED FOR THEIR CARE;- ARE PART OF THE UNDER-REIMBURSED MEDICARE OR MEDICAID PROGRAMS.OAKLAWN HOSPITAL PROVIDES PATIENT CARE WITHOUT DISCRIMINATION ON THE BASIS OF RACE, SEX, OR RELIGIOUS AFFILIATION. CHARITY CARE NEEDS ARE DETERMINED IN ACCORDANCE WITH ESTABLISHED GUIDELINES THAT ARE UPDATED ANNUALLY BY THE FEDERAL CENTER FOR MEDICARE AND MEDICAID SERVICES (FORMERLY THE DEPARTMENT OF HEALTH & HUMAN SERVICES). THOSE RECEIVING COMPENSATED PATIENT CARE INCLUDE ALL AGES AND BOTH GENDERS, AND MAY BE ASSISTED FOR MENTAL HEALTH AS WELL AS MEDICINE AND MEDICAL CARE. OAKLAWN DOES NOT RECORD AND TRACK RACIAL/ETHNIC GROUPS OF OUR PATIENTS IN PROVISION OF CHARITY CARE. PART VI, LINE 4: OAKLAWN HOSPITAL'S SERVICE AREA INCLUDES CALHOUN COUNTY, MICHIGAN, AND PARTS OF BRANCH AND EATON COUNTIES. OVERALL, THE HOSPITAL SERVES AN ESTIMATED MARKET POPULATION OF 178,840 FROM THE 22 ZIP CODES COMPRISING ITS SERVICE AREA. ACCORDING TO THE US CENSUS FINDINGS, CALHOUN COUNTY'S POPULATION (CLOSEST PROXY TO THE SERVICE AREA) SKEWS SIGNIFICANTLY OLDER THAN NATIONAL AND STATE AVERAGES, AT A MEDIAN AGE OF 39.2 YEARS COMPARED TO 37.6 AND 37.2 YEARS RESPECTIVELY. BY RACE AND ETHNICITY, 96.9% OF THE COUNTY'S POPULATION SELF-REPORTS AS ONE RACE, VERSUS 97.7% (MICHIGAN) AND 97.3% (US). IT IS 82.2% WHITE; 10.9% BLACK/AFRICAN AMERICAN; 0.6% AMERICAN INDIAN/ALASKA NATIVE; AND 1.6% ASIAN. THE COUNTY'S CENSUS SHOWED 4.5% CLAIM HISPANIC/LATINO OF ANY RACE. OAKLAWN WAS FOUNDED IN 1925 AS A 12-BED HOSPITAL IN A RESIDENTIAL HOME IN MARSHALL, MICHIGAN, AND HAS SINCE EVOLVED INTO A HIGHLY-REGARDED REGIONAL HEALTH CARE ORGANIZATION, LICENSED FOR 77 ACUTE CARE BEDS AND A 17-BED INPATIENT PSYCHIATRIC UNIT. ITS ACTIVE, COURTESY, AND CONSULTING MEDICAL STAFF CONSISTS OF MORE THAN 150 PHYSICIANS REPRESENTING 34 SPECIALTIES. THE HOSPITAL HAS CONTINUED TO BE AN INDEPENDENTLY OWNED NON-PROFIT HOSPITAL, WITH ITS MAIN CAMPUS RESIDING ON THE SAME SITE AS THE ORIGINAL HOSPITAL. PART VI, LINE 5: HOSPITALS ARE ALREADY KNOWN AS LOCAL CAREGIVERS AND MAJOR EMPLOYERS, BUT THEY MUST ALSO BECOME MORE RECOGNIZED AS COMMUNITY STEWARDS, AFFIRMING THEIR PURPOSE AS TAX-EXEMPT ENTITIES. THE MICHIGAN HOSPITAL & HEALTH ASSOCIATION'S ANNUAL COMMUNITY BENEFITS SURVEY IS OAKLAWN HOSPITAL'S PRIMARY OPPORTUNITY TO PRESENT THE ENTIRETY OF ITS COMMUNITY BENEFIT PROGRAMS AND SERVICES AND TO PROMOTE THE SUCCESS AND IMPACT OF THESE PROGRAMS AND SERVICES. OAKLAWN'S "COMMUNITY BENEFITS" REACHED $17,774,209 IN 2010, THE MOST RECENT REPORTING YEAR AVAILABLE. THE HOSPITAL CONTRIBUTED FINANCIAL OR IN-KIND BENEFITS OF $635,699 TOWARD IMPROVED HEALTH SERVICES, $1,765,000 IN MEDICAL EDUCATION AND RESEARCH, AND $293,246 TO COMMUNITY-BUILDING EFFORTS. OAKLAWN PROVIDED $15.08 MILLION IN UNCOMPENSATED MEDICAL CARE IN 2010, INCLUDING $672,702 IN CHARITY CARE, $2,216,000 IN BAD DEBTS, AND $12,191,672 IN "BELOW COST" REIMBURSEMENTS FROM MEDICAID, MEDICARE, AND OTHER GOVERNMENT-AUTHORIZED PROGRAMS.A MONTHLY "WHAT'S HAPPENING AT OAKLAWN" SCHEDULE IS PUBLISHED IN AREA NEWSPAPERS AND ONLINE AT OAKLAWN'S WEB SITE TO SHOWCASE THE MONTH'S COMMUNITY PROGRAM OFFERINGS AND EVENTS. FURTHER, OAKLAWN ALIGNS WITH AREA SCHOOLS, COMMUNITY AGENCIES, HEALTH CLINICS, AND HEALTHCARE COLLABORATIONS TO PROVIDE EXPERTISE, SERVICES AND PUBLIC HEALTH EVENT SUPPORT ONGOING. REPORTS FILED WITH STATES PART VI, LINE 7 MI X 0 0 X X X 0 1 0 0 0 0 0 0 0 GINGER M WILLIAMS MD 342196 0 61088 0 4500 0 4688 0 21877 0 434349 0 0 0 COLLEEN M KOPPENHAVER 256692 0 45816 0 0 0 4688 0 21071 0 328267 0 0 0 ROB COVERT 514394 0 127823 0 9135 0 4688 0 4161 0 660201 0 0 0 KEITH CROWELL 129329 0 15708 0 0 0 1958 0 20071 0 167066 0 0 0 KRISTIN R SIMS 184966 0 32292 0 0 0 4224 0 20394 0 241876 0 0 0 JAN M SINCLAIR 147328 0 25640 0 14227 0 3582 0 2676 0 193453 0 0 0 SHARON THOMAS-BOYD 152562 0 24817 0 0 0 3433 0 19345 0 200157 0 0 0 FARID F ZAYED 492116 0 0 0 60134 0 4688 0 12801 0 569739 0 0 0 MORAD M TEHRANI 471770 0 0 0 0 0 4688 0 20702 0 497160 0 0 0 GUY C POWER 472643 0 0 0 0 0 4475 0 18382 0 495500 0 0 0 BRIAN C ATKINS 288076 0 10000 0 0 0 4688 0 20184 0 322948 0 0 0 ALCIDES E GIL-ACOSTA 297706 0 0 0 0 0 4688 0 12893 0 315287 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDES A FITNESS CLUB MEMBERSHIP TO ALL EMPLOYEES. PART I, LINE 4B ROBERT COVERT, KRISTIN SIMS, COLLEEN KOPPENHAVER, KEITH CROWELL, AND JAN SINCLAIR ALL PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. SUPPLEMENTAL INFORMATION PART III EXECUTIVE BONUSES ARE BASED ON MEETING BUDGETED REVENUES AND OTHER PERFORMANCE MEASUERES A COUNTY OF CALHOUN HOSPITAL FINANCE AUTHORITY 386004358 NONEAVAIL 2008-11-05 8000000 CURRENT REFUND OF PRIOR BOND ISSUE 0 0 0 B COUNTY OF CALHOUN HOSPITAL FINANCE AUTHORITY 386004358 12964UAB8 2009-12-22 30000000 CURRENT REFUND OF PRIOR BOND ISSUE 0 0 0 C COUNTY OF CALHOUN HOSPITAL FINANCE AUTHORITY 386004358 12964UAC6 2010-12-23 36350000 CURRENT REFUND OF PRIOR BOND ISSUE 0 0 0 A 8000000 8000000 2008 1 0 1 1 B 7090000 30000000 149770 29850230 2009 1 0 1 1 C 990000 36350000 1776818 215896 27307855 6350000 699431 2014 1 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 1 0 0 1 1 MORGAN STANLEY CAPITAL SERVICES 28.100000000000 0 0 0 0 1 C 0 1 0 0 1 1 DEUTSCHE BANK & TRUST 31.100000000000 0 0 0 0 1 A 1 B 1 C 1 PART I, LINE A, COLUMN (F): DATE OF ISSUANCE OF BONDS CURRENLTY REFUNDED: 12/22/2005 PART I, LINE B, COLUMN (F): DATE OF ISSUANCE OF BONDS CURRENLTY REFUNDED: 04/27/2006 PART I, LINE C, COLUMN (F): DATE OF ISSUANCE OF BONDS CURRENLTY REFUNDED: 12/22/2009 PART I, LINE C, COLUMN (F): PURPOSE CONTINUED: FACILITIES IMPROVEMENTS AND EQUIPMENT ACQUISITION AND INSTALLATION. PART II, LINE 1, COLUMN B: INCLUDES A 6,350,000 CURRENT REFUNDED FOR TAX PURPOSES BY "C" BOND ISSUE, AND INCLUDED PRICE OF "C" BOND ISSUE. PART II, LINE 3, COLUMN C: DIFFERENCE BETWEEN THIS FIGURE AND THAT IN PART 1, LINE C, COLUMN (E) ATTRIBUTABLE TO INVESTMENT EARNINGS. PART IV, LINE 2C, COLUMN A DATE OF COMPUTATION WAS OCTOBER 31, 2013 PART IV, LINE 4C, COLUMN B: TERM MEASURE FROM INCEPTION ON DECEMBER 19, 2008 THROUGH FEBRUARY 1, 2037, THE FINAL TERMINATION DATE WHICH EXTENDED IN CONNECTION WITH A RESTRUCTURING OF THIS HEDGE EFFECTIVE SEPTEMBER 1, 2011. PART IV, LINE 4E, COLUMN B: HEDGE WAS "DEEMED TERMINATED" AS OF DECEMBER 22, 2009 IN CONNECTION WITH ISSUANCE OF RELATED BONDS, IN ACCORDANCE WITH TREAS. REG. SECT. 1.148-4(H)(3)(IV)(A) SIMS HEATING AND COOLING THE OWNER OF SIMS HEATING AND COOLING IS THE HUSBAND OF KRISTIN SIMS. 45883 OAKLAWN HOSPITAL PAID SIMS HEATING AND COOLING FOR SERVICES PROVIDED TO THE ORGANIZATION. 0 FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS REVIEWED BY THE CFO AND PRESIDENT/CEO. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS SUBMITTED TO EACH BOARD MEMBER ANNUALLY AND EACH MEMBER ACKNOWLEDGES RECEIPT IN WRITING S0 THAT THE MEMBERS ARE CONTINUOUSLY AWARE OF THE POLICY. IT IS THE DUTY OF THE COMPLIANCE OFFICER TO PERIODICALLY MONITOR COMPLIANCE WITH THE POLICY AND REPORT THE RESULTS OF THIS REVIEW TO THE BOARD OF DIRECTORS. AFTER THE MATERIAL INFORMATION HAS BEEN DISCLOSED AND THE POTENTIAL CONFLICT ANALYZED, IF NO CONFLICT OF INTEREST EXISTS, THE DISCLOSURE, ANALYSIS AND RESOLUTION SHALL BE DOCUMENTED AND SUBMITTED AS DIRECTED IN THE ABOVE PROCEDURE. IF A CONFLICT IS IDENTIFIED, THEN MEASURES SHALL BE INSTITUTED FOR MANAGEMENT OF THE CONFLICT. IN MOST INSTANCES, DISCLOSURE OF THE CONFLICTING OR POTENTIALLY CONFLICTING INTEREST MAY ITSELF SUFFICE TO PROTECT THE INTEGRITY OF THE ACTIVITY. IN OTHER WORDS, ONCE SUCH A CONFLICT IS FULLY DISCLOSED TO THE PERTINENT PARTIES, OFTEN THEY WILL BE ABLE TO TAKE INTO CONSIDERATION THE POSSIBLE INFLUENCE OF DISCLOSED INTEREST. FOR THOSE INSTANCES WHERE DISCLOSURE ALONE WILL NOT PROTECT THE INTEGRITY OF THE ACTIVITY, CONFLICT RESOLUTION STRATEGIES MAY INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: - FULL DISCLOSURE OF POTENTIAL CONFLIECTS TO THE DECISION-MAKING BODY BEFORE ACTION IS TAKEN THAT MAY BE AFFECTED BY THE POTENTIAL CONFLICT - REMOVAL FROM A PART(S) OF THE DECISION-MAKING PROCESS - REMOVAL FROM FINAL DECISION-MAKING PROCESS - RETENTION OF EQUITY UNTIL DECISION IS COMPLETED." FORM 990, PART VI, SECTION B, LINE 15 A BOARD SUBCOMMITTEE REVIEWS THE COMPENSATION PACKAGE ANNUALLY WITH THE ASSISTANCE OF AN INDEPENDENT CONSULTING FIRM. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR ENDING MARCH 31, 2013. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST SWAP AGREEMENTS -250,735. FORM 990, PART VII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR