2024-05-14T08:33:15-04:00 2023-06-30 990 2022-07-01 471161992 MUNSON HEALTHCARE GRAYLING MUNS 2319355000 1105 SIXTH STREET TRAVERSE CITY MI 49684 PAUL KONOPACKI CFO 2319355000 2024-05-10 PAUL KONOPACKI 999009999 false 2022 2023-04-26 12:10:37Z KIRSTEN KORTH-WHITE 1100 E MICHIGAN AVENUE GRAYLING MI 49738 94710766 false X WWW.MUNSONHEALTHCARE.ORG X 2014 MI MUNSON HEALTHCARE GRAYLING AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. X 22 20 756 22 0 6397448 370437 96973682 93424593 4264 54996 795574 627017 104170968 94477043 0 0 47037363 45679773 0 98322 54720582 53271060 101757945 98950833 2413023 -4473790 57547384 37925022 31223640 14385593 26323744 23539429 AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON HEALTHCARE GRAYLING EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. false false 84253184 93452907 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF THE CRAWFORD COUNTY REGION WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE GRAYLING HAD 1,617 INPATIENT ADMISSIONS IN FISCAL YEAR 2023 AND OVER 109,800 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 3,100 SURGICAL CASES, 300 OBSTETRICAL BIRTHS, AND OVER 18,000 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE GRAYLING ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS 114 ACTIVE MEDICAL STAFF AND 22 VOLUNTEERS. 84253184 true true false true false false false false false false true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false true false true false false false true 35 0 true 756 true false false false false false false false false false false false false X 22 20 false false false false true true true true true false false true true true true true true true true false X NICOLE SULAK MUNSON HEALTHCARE 2319357777 4230 COPPER RIDGE DR TRAVERSE CITY MI 49684 EDWIN A NESS DIRECTOR 2.00 40.00 X 0 2074924 229071 LAURA GLENN PRESIDENT AM 2.00 40.00 X 0 692839 103817 BRIAN N STIRLING DO PHYSICIAN 40.00 X 648318 0 44174 JASON D BENNETT DO ORTHOPEDIC S 40.00 X 588384 0 42551 LYNNE MCCORMICK DO PHYSICIAN 1.00 40.00 X 1745 524140 36128 GARRICK CVITKOVICH MD SURGEON 40.00 X 483648 0 34923 KIRSTEN KORTH-WHITE PRESIDENT 2.00 40.00 X X 0 440949 72517 CARL SCHUBERT MD PHYSICIAN 39.00 1.00 X 429857 3963 32806 ALICIA MAITLAND CFO PT-YR 2.00 40.00 X 0 435628 27634 CASEY KANDOW VP ANCILLARY 2.00 40.00 X 0 428900 27931 CHRISTOPHER SQUIRE VP ANCILLARY 2.00 40.00 X 0 373647 67970 ELLEN SMITH COO PHYSICIA 2.00 40.00 X 0 380194 57688 TONYA SMITH DIRECTOR 1.00 40.00 X 0 412863 22637 KATHLEEN MALY INTERIM CFO 2.00 40.00 X 0 288390 32174 KATHLEEN LARAIA VP ONCOLOGY 2.00 40.00 X 0 218881 32198 MICHAEL HODNETT CNO 40.00 X 189716 0 43041 THEODORE BATZER DIRECTOR 1.00 X 0 5000 0 KENNETH BLOEM VICE CHAIR 2.00 X X 0 5000 0 NICK CEGLAREK DIRECTOR 1.00 X 0 5000 0 ALAN CONRAD DIRECTOR 1.00 X 0 5000 0 CASEY COWELL DIRECTOR 1.00 X 0 5000 0 TOM VERYSER DDS DIRECTOR 1.00 X 0 5000 0 KATHY DIXON DIRECTOR 1.00 X 0 5000 0 MARLENE HULTEEN DIRECTOR 1.00 X 0 5000 0 DOUG LUCIANI DIRECTOR 1.00 X 0 5000 0 DAVID MCCURDY DIRECTOR 3.00 X 0 5000 0 RUTH HOPPE MD SECRETARY 3.00 X X 0 5000 0 KIMBERLY MORLEY DIRECTOR 1.00 X 0 5000 0 TIM NELSON TREASURER 3.00 X X 0 5000 0 BRIAN POSTMA DIRECTOR 2.00 X 0 5000 0 OWEN ROBERTS DIRECTOR 2.00 X 0 5000 0 MICHELLE RUSSELL DIRECTOR 1.00 X 0 5000 0 MARY SANDERS DIRECTOR 2.00 X 0 5000 0 KRISTINE THOMAS DIRECTOR 2.00 X 0 5000 0 ELAINE WOOD CHAIR 3.00 X X 0 5000 0 BRUCE ZENNER DIRECTOR 1.00 X 0 5000 0 MATT BULLOCH DIRECTOR 1.00 X 0 0 0 DAVID MENGEBIER DIRECTOR 2.00 X 0 0 0 BEN MULADORE DIRECTOR 1.00 X 0 0 0 SAKURA TAKANO DIRECTOR 1.00 X 0 0 0 2341668 6375318 907260 74 false true false MARY FREE BED REHABILITATION HOSP 235 WEALTHY ST SE GRAND RAPDIS MI 49503 REHABILITATION 3712169 HALLMARK HEALTHCARE SOLUTIONS PO BOX 22937 NEW YORK NY 100872938 STAFFING 2124014 GRAYLING ANESTHESIA ASSOCIATES PC 450 MAMARONECK AVE STE 201 HARRISON NY 10528 MEDICAL 1608542 SOUND PHYSICIANS PO BOX 742936 LOS ANGELES CA 900742936 MEDICAL 1527122 EPMG OF MICH PC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 MEDICAL 768826 13 146275 224162 370437 MEDICARE/MEDICAID PAYMENTS 621990 49967601 49967601 PATIENT SERVICE REVENUE 621990 39049345 39049345 340B PRESCRIPTION REVENUE 621990 3421747 3421747 QUALITY INCENTIVE PAYMENTS 621990 983912 983912 MISC HEALTHCARE REVENUE 621990 1988 1988 93424593 26682 26682 50766 50766 50766 50766 262037 233723 28314 28314 28314 CAFETERIA SALES 722210 309650 309650 MISCELLANEOUS INCOME 621990 266601 266601 576251 94477043 93452907 653699 X 251568 247568 4000 36733231 35386827 1346404 1829387 1761820 67567 5575129 5370360 204769 1290458 1243283 47175 34734 34734 5399 5399 12926769 12880444 46325 1193 1193 408445 303080 105365 830524 821236 9288 1531910 1531323 587 160276 141677 18599 103530 97083 6447 358008 304831 53177 2170335 1847965 322370 503196 323903 179293 MEDICAL SUPPLIES 15252710 15252710 SHARED SERVICES 13542271 1351323 12092626 98322 BAD DEBT EXPENSE 2771398 2771398 QAAP TAXES 2031648 2031648 638714 583512 55202 98950833 84253184 14599327 98322 4129 4129 19835149 4380681 12212036 9584360 2143738 2447705 334899 437211 36973107 16905298 21316627 20067809 567301 1133505 1003127 57547384 37925022 9761828 7323213 12143054 9318758 7062380 31223640 14385593 X 25756443 23539429 567301 26323744 23539429 57547384 37925022 X -4473790 1689475 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5399 5399 false SCHEDULE C, PART II-B, LINE 1 OTHER ACTIVITIES INDICATE THE PORTION OF DUES ALLOCATED TO LOBBYING EXPENSES PAID TO REGIONAL OR NATIONAL ORGANIZATIONS INCLUDING THE AMERICAN HOSPITAL ASSOCIATION AND THE MICHIGAN SOCIETY OF HEMATOLOGY AND ONCOLOGY. 1535000 1535000 18435594 5793781 12641813 16241228 10775903 5465325 761285 335614 425671 20067809 RESERVE FOR THIRD PARTY SETTLEMENTS 5520622 LT OPERATING LEASE LIABILITY 602180 ESTIMATE FOR THIRD PARTY SETTLEMENTS 553135 ST OPERATING LEASE LIABILITY 338536 CAPITAL LEASE 47907 7062380 true true X true X true X true true false true true 189781 189781 0.00200 13706388 11259947 2446441 0.02540 13896169 11259947 2636222 0.02740 56012 56012 0.00060 72466 6781 65685 0.00070 30896151 23951033 6945118 0.07220 9753 9753 0.00010 31034382 23957814 7076568 0.07360 44930551 35217761 9712790 0.10100 3035 3035 552 552 3587 3587 true 2771398 1017022 14871209 12764234 2106975 X true true 1 1 MUNSON HEALTHCARE GRAYLING 1100 E MICHIGAN AVE GRAYLING MI 49738 HTTP://WWW.MUNSONHEALTHCARE.ORG 1060000029 X X X X X MUNSON HEALTHCARE GRAYLING 1 false false true X X X X X X X X X X 21 true true true true X HTTPS://TINYURL.COM/YSZBXMYS X true 22 true HTTPS://TINYURL.COM/YSZBXMYS false true X 200.000000000000 400.000000000000 X X X X X true true X X X true X HTTPS://TINYURL.COM/2TNSZ8PS X HTTPS://TINYURL.COM/2TNSZ8PS X HTTPS://TINYURL.COM/2TNSZ8PS X X X X X X X true X false X X X X X true X false false FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 3E THE SIGNIFICANT PRIORITIZED HEALTH NEEDS OF THE COMMUNITY ARE IDENTIFIED IN THE CHNA UNDER THE KEY FINDINGS HEADING. IN THE NORTHEAST REGION, THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN ORDER OF PRIORITY: SUBSTANCE USE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND CHRONIC DISEASE. THESE THEMES WERE PRIORITIZED THROUGH A PRIORITIZATION MATRIX, FOR WHICH MITHRIVE DESIGN TEAM MEMBERS SORTED THE DATA RECEIVED FOR THE THREE REGIONS INTO PRIMARY AND SECONDARY DATA. THEY CLUSTERED DATA POINTS BASED ON TOPIC, THEME AND INTERCONNECTEDNESS. THE THEMES WHICH COULD BE FOUND IN THE HIGH SECONDARY DATA/ HIGH PRIMARY DATA QUADRANT WERE A COMBINATION OF THE ABOVE TOPICS BASED ON REGION. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 5 WE ARE FOLLOWING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP FRAMEWORK TO GUIDE OUR PROCESS WHICH INCLUDES FOUR ASSESSMENTS TO GATHER INPUT. 1.COMMUNITY THEMES AND STRENGTHS ASSESSMENT: THIS ASSESSMENT PROVIDES A DEEP UNDERSTANDING OF THE ISSUES THAT RESIDENTS FEEL ARE SIGNIFICANT BY ANSWERING THE FOLLOWING QUESTIONS: WHAT IS IMPORTANT TO OUR COMMUNITY?; HOW IS QUALITY PERCEIVED IN OUR COMMUNITY?; WHAT ASSETS DO WE HAVE THAT CAN BE USED TO IMPROVE WELLBEING? IT CONSISTED OF THREE SURVEYS: COMMUNITY SURVEY, HEALTHCARE PROVIDER SURVEY, AND PULSE SURVEY. RESULTS FROM EACH WERE ANALYZED BY COUNTY, HOSPITAL SERVICE AREA, AND THE THREE MITHRIVE REGIONS. 2.COMMUNITY HEALTH STATUS ASSESSMENT: THE COMMUNITY HEALTH STATUS ASSESSMENT IDENTIFIES PRIORITY COMMUNITY HEALTH AND QUALITY OF LIFE ISSUES. IT ANSWERS THE QUESTIONS, HOW HEALTHY ARE OUR RESIDENTS? AND WHAT DOES THE HEALTH STATUS OF OUR COMMUNITY LOOK LIKE? ITS PURPOSE IS TO COLLECT QUANTITATIVE SECONDARY DATA ABOUT THE HEALTH AND WELL-BEING OF RESIDENTS AND COMMUNITIES. WE COLLECTED APPROXIMATELY 100 STATISTICS, BY COUNTY, FOR THE 31-COUNTY REGION FROM RELIABLE SOURCES SUCH AS THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE US CENSUS BUREAU. 3.COMMUNITY SYSTEM ASSESSMENT: THE COMMUNITY SYSTEM ASSESSMENT FOCUSES ON ORGANIZATIONS THAT CONTRIBUTE TO WELL-BEING. IT ANSWERS THE QUESTIONS, WHAT ARE THE COMPONENTS, ACTIVITIES, COMPETENCIES, AND CAPACITIES IN THE REGIONAL SYSTEM? AND HOW ARE SERVICES BEING PROVIDED TO OUR RESIDENTS? FIRST, COMMUNITY-WIDE VIRTUAL MEETINGS WERE CONVENED IN THE NORTHWEST, NORTHEAST, AND NORTH CENTRAL MITHRIVE REGIONS WHERE PARTICIPANTS DISCUSSED VARIOUS ATTRIBUTES OF THE COMMUNITY SYSTEM. THESE WERE FOLLOWED BY RELATED DISCUSSIONS AT LOCAL COMMUNITY COLLABORATIVE MEETINGS. 4.FORCES OF CHANGE ASSESSMENT: THE FORCES OF CHANGE ASSESSMENT IDENTIFIES FORCES SUCH AS LEGISLATION, TECHNOLOGY, AND OTHER FACTORS THAT AFFECT THE COMMUNITY CONTEXT. IT ANSWERS THE QUESTIONS, WHAT IS OCCURRING OR MIGHT OCCUR THAT AFFECTS THE HEALTH OF OUR COMMUNITY OR THE LOCAL SYSTEM? AND WHAT SPECIFIC THREATS OR OPPORTUNITIES ARE GENERATED BY THESE OCCURRENCES? LIKE THE COMMUNITY SYSTEM ASSESSMENT, THE FORCES OF CHANGE ASSESSMENT WAS COMPOSED OF COMMUNITY MEETINGS CONVENED VIRTUALLY IN THE NORTHWEST, NORTHEAST, AND NORTH CENTRAL REGIONS. AS ONE OF THE FIRST STEPS OF ACHIEVING HEALTH EQUITY IS TO UNDERSTAND CURRENT HEALTH DISPARITIES, WE INVITED DIVERSE COMMUNITY PARTNERS TO JOIN THE MITHRIVE STEERING COMMITTEE, DESIGN TEAM, AND WORKGROUPS, AND WE GATHERED PRIMARY AND SECONDARY DATA FROM MEDICALLY UNDERSERVED, MINORITY, AND LOW-INCOME POPULATIONS IN EACH OF THE FOUR MITHRIVE ASSESSMENTS, BY THE FOLLOWING METHODS: CROSS-TABULATING DEMOGRAPHIC INDICATORS SUCH AS AGE, RACE, AND SEX FOR THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT ENGAGING RESIDENTS EXPERIENCING BARRIERS TO SOCIAL DETERMINANTS OF HEALTH AND ORGANIZATIONS THAT SERVE THEM IN THE COMMUNITY SYSTEM ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT REACHING OUT TO MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS THROUGH PULSE SURVEYS ADMINISTERED BY ORGANIZATIONS THAT SERVE THEM INCREASING INCLUSION OF PEOPLE WITH DISABILITIES IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH PARTNERSHIP WITH THE DISABILITY NETWORK OF NORTHERN MICHIGAN SURVEYING PROVIDERS WHO CARE FOR PATIENTS/CLIENTS ENROLLED IN MEDICAID HEALTH PLANS RECRUITING 1) RESIDENTS EXPERIENCING BARRIERS TO SAFE, AFFORDABLE, AND ACCESSIBLE HOUSING; HEALTHY FOOD; TRANSPORTATION OPTIONS; AND OTHER SOCIAL DETERMINANTS OF HEALTH AND 2) REPRESENTATIVES FROM THE DIVERSE ORGANIZATIONS THAT SERVE THEM TO MITHRIVE DATA WALKS AND PRIORITY-SETTING EVENTS FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 6A MITHRIVE WAS IMPLEMENTED ACROSS A 31-COUNTY REGION THROUGH A PARTNERSHIP OF HOSPITAL SYSTEMS, LOCAL HEALTH DEPARTMENTS, AND OTHER COMMUNITY PARTNERS. OUR AIM IS TO LEVERAGE RESOURCES AND REDUCE DUPLICATION WHILE STILL ADDRESSING UNIQUE LOCAL NEEDS FOR HIGH QUALITY, COMPARABLE, COUNTY-LEVEL DATA. THE 2021 MITHRIVE COMMUNITY HEALTH NEEDS ASSESSMENT UTILIZED THREE REGIONS: NORTHWEST, NORTHEAST, AND NORTH CENTRAL. ALL OF THE MUNSON HEALTHCARE HOSPITALS WORKED TOGETHER ON REGIONAL CHNA EFFORTS AS PART OF THE MITHRIVE REGIONAL CHNA INITIATIVE. THESE INCLUDE: MUNSON MEDICAL CENTER, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL, AND KALKASKA MEMORIAL HEALTH CENTER. IN ADDITION, HOSPITALS FORM THE MCLAREN AND SPECTRUM HEALTH SYSTEMS COLLABORATED ON THIS EFFORT. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 6B IN ADDITION TO DOZENS OF LOCAL AND REGIONAL ORGANIZATIONS, ALL HEALTH DEPARTMENTS IN THE REGION SERVED PARTICIPATED, INCLUDING: GRAND TRAVERSE HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 10, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, BENZIE LEELANAU DISTRICT HEALTH DEPARTMENT, CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 2, DISTRICT HEALTH DEPARTMENT 4. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 11 WE IDENTIFIED STRATEGIC ISSUES AS PART OF THE MITHRIVE COLLABORATIVE. STRATEGIC ISSUES ARE BROADER THAN INDIVIDUAL HEALTH CONDITIONS, AND REPRESENT UNDERLYING CHALLENGES THAT NEED TO BE ADDRESSED, WHICH WOULD LEAD TO IMPROVEMENT IN HEALTH CONDITIONS. EACH STRATEGIC ISSUE SHOULD IMPACT MORE THAN ONE HEALTH CONDITION. THE TOP PRIORITY ISSUES TO BE ADDRESSED: MENTAL HEALTH AND SUBSTANCE USE DISORDERS SAFE, AFFORDABLE AND ACCESSIBLE HOUSING ACCESS TO HEALTHCARE CHRONIC DISEASE A COMPLETE LIST OF STRATEGIES PLANNED TO ADDRESS THE PRIORITIZED NEEDS MAY BE VIEWED WITHIN THE CHNA IMPLEMENTATION PLAN. GENERALLY, THE HOSPITAL SYSTEM IS COMMITTED TO PROVIDING RESOURCES TO SUPPORT PROGRAMMING, PARTICIPATION IN COLLABORATIVE PROJECTS, BOARDS, AND SUPPORT FOR OTHER COMMUNITY IMPROVEMENT PROJECTS RELATED TO OUR PRIORITY STRATEGIC ISSUES. IN ADDITION TO THE STRATEGIC ISSUES LISTED ABOVE, THE FOLLOWING CHALLENGES WERE ALSO UNCOVERED IN THE DATA: BROADBAND ACCESS COVID-19 ECONOMIC SECURITY EQUITY HEALTHY FOOD HEALTHY WEIGHT INFRASTRUCTURE FOR HEALTHY LIVES SAFETY AND WELL-BEING TRANSPORTATION MUNSON HEALTHCARE ACKNOWLEDGES THE WIDE RANGE OF ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT WITH THE BROAD NATURE OF THE STRATEGIC ISSUES WE COULD EFFECTIVELY FOCUS ON ONLY THOSE ISSUES THAT WERE PRIORITIZED THE HIGHEST BY OUR COMMUNITY. HOWEVER, SOME OF THESE ISSUES INCLUDING EQUITYARE FOUNDATIONAL COMPONENTS OF ALL THE WORK OF THE ORGANIZATION AND WILL BE INDIRECTLY TARGETED THROUGH MANY OF THE STRATEGIES LISTED IN THIS PLAN. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 13H PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, AT THE SOLE DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16J IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 20E MUNSON HEALTHCARE GRAYLING(GRAYLING) REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. GRAYLING WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY GRAYLING; 2.DOCUMENTING THAT GRAYLING HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH GRAYLING 'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH GRAYLING DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. GRAYLING WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS. 2 CRAWFORD CONTINUING CARE CENTER 1100 EAST MICHIGAN AVE GRAYLING MI 49738 EXTENDED CARE FACILITY GRAYLING SURGICAL SERVICES 1010 W NORTH DOWN RIVER RD GRAYLING MI 49738 SURGICAL SERVICES SCHEDULE H, PART I, LINE 3C INCOME UP TO 200% OF THE FPG = 100% DISCOUNT ON CHARGES INCOME BETWEEN 201% AND 300% FPG = 75% DISCOUNT ON CHARGES INCOME BETWEEN 301% AND 400% FPG = 65% DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE, OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS. FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG: EARNINGS, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES; CASH, CHECKING AND SAVINGS BALANCES, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, IRAS TRUSTS, INHERITANCES, ANNUITIES, SAVINGS BONDS, STOCKS, MUTUAL FUNDS, AND/OR CASH VALUE OF LIFE INSURANCE. SCHEDULE H, PART I, LINE 7G THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 24,972,175. THESE COSTS ARE OFFSET BY RELATED REVENUES IN COMPUTING THE NET COMMUNITY BENEFIT. SCHEDULE H, PART I, LINE 7, COLUMN (F) TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 98,950,833. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 2,771,398. THE NET EXPENSE OF 96,179,435 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). SCHEDULE H, PART I, LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION OR ACTUAL CASH PAID. SCHEDULE H, PART II MUNSON HEALTHCARE GRAYLING BELIEVES COMMUNITY BUILDING ACTIVITIES PROMOTE HEALTH BY ADDRESSING UNDERLYING COMMUNITY HEALTH CHALLENGES. COMMUNITY BUILDING WORK IS DONE AT THE CORPORATE LEVEL ON BEHALF OF THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE HAS SHIFTED SIGNIFICANT RESOURCES TO THE DEVELOPMENT AND CONTINUATION OF REGION-WIDE COLLABORATIVES THAT ADDRESS ROOT CAUSES. CURRENT COMMUNITY BUILDING ACTIVITIES INCLUDE: THE NORTHERN MICHIGAN COMMUNITY HEALTH INNOVATION REGION (CHIR). THIS GROUP BRINGS TOGETHER CROSS-SECTOR PARTNERS, INCLUDING HEALTH DEPARTMENTS, BUSINESSES, RESIDENTS, AND HUMAN SERVICES TO ALIGN SYSTEMS AND PRIORITIES, DEVELOP A SHARED AGENDA, AND CO-LEAD STRATEGIES THAT TRANSFORM HEALTH AND WELLNESS IN NORTHERN MICHIGAN. THIS INTERDISCIPLINARY GROUP CONDUCTS A COLLABORATIVE, REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, WITH CONTINUED COORDINATION AS IMPLEMENTATION PLANS ARE DEVELOPED AND IMPLEMENTED. THIS WORK ENSURES STRATEGIES ADDRESS ROOT CAUSES, REDUCE DUPLICATION OF EFFORTS, AND IMPROVE IMPACT. TOGETHER, THIS GROUP ALSO DEVELOPED AND CONTINUES TO SUPPORT THE COMMUNITY CONNECTIONS MODEL WHERE CLIENTS ARE UNIVERSALLY SCREENED IN A HEALTHCARE SETTING AND CONNECTED TO COMMUNITY HEALTH WORKERS FOR SUPPORT WITH BASIC NEEDS. THE BEHAVIORAL HEALTH INSTITUTE (BHI) WAS FORMED IN RESPONSE TO THE BEHAVIORAL HEALTH CRISIS IN OUR REGION. THIS GROUP DEVELOPED A SHARED ROADMAP, INCLUDING TWELVE ACTION TEAMS, EACH OF WHICH MUNSON CONTRIBUTES TO. RECENT ACCOMPLISHMENTS INCLUDE: LAUNCH OF FIRST EVER BEHAVIORAL HEALTH INTERNSHIP WEBSITE WITH SEARCHABLE OPPORTUNITIES AND RESOURCES TO HELP STUDENTS RELOCATE TO RURAL, NORTHERN MICHIGAN. STIGMA REDUCTION EFFORTS, INCLUDING SURVEYS TO BETTER UNDERSTAND COMMUNITY PERCEPTIONS AROUND MENTAL ILLNESS AND SUBSTANCE USE DISORDER, VIDEO-BASED STORIES HIGHLIGHTING PEOPLE WITH LIVED EXPERIENCES, AND A YOUTH PHOTOVOICE PROJECT TO EDUCATE AUDIENCES AND ENCOURAGE FURTHER LEARNING. THE DEVELOPMENT OF A HEALTHY WORKPLACES = THRIVING EMPLOYEES TOOLKIT AND A LUNCH AND LEARN WEBINAR SERIES FOCUSED ON ACTIONABLE STRATEGIES TO HELP EMPLOYERS BETTER SUPPORT AND RETAIN THEIR BEHAVIORAL HEALTH PROVIDERS. DEVELOPMENT OF A COLLABORATIVE MODEL AND SUCCESSFUL GRANT APPLICATION TO FUND THE GRAND TRAVERSE CENTER FOR MENTAL WELLNESS CENTER, WHICH WILL PLAY AN IMPORTANT ROLE IN PEDIATRIC MENTAL HEALTH AND CRISIS STABILIZATION SERVICES. COMMUNITY HEALTH WORKER PILOT PROGRAMS IN MULTIPLE AREA SCHOOLS AND THE DEVELOPMENT OF A CHW NAVIGATOR TRAINING TO BETTER COORDINATE THE EXISTING, DISPARATE CHW SERVICES IN THE AREA. MUNSON HEALTHCARE ALSO LEADS THE REGION 2 AND 3 REGIONAL PERINATAL QUALITY COLLABORATIVE (RPQC). THE RPQC ADDRESSES ROOT CAUSES OF COMPLEX HEALTH ISSUES USING BOTH COMMUNITY AND CLINICAL APPROACHES BY BRINGING TOGETHER HEALTH CARE PROFESSIONALS, COMMUNITY PARTNERS, FAMILIES, FAITH-BASED ORGANIZATIONS, GREAT START COLLABORATIVES, HOME VISITING AGENCIES, AND OTHERS IN A UNIFIED, COLLABORATIVE EFFORT. THE GROUP CONVENES PERINATAL STAKEHOLDERS AND PARTNERS IN REGULAR MONTHLY MEETINGS TO ADDRESS THE REGIONS LARGEST CONCERNS WITH INDIVIDUALIZED ATTENTION. EFFORTS OF THIS GROUP AIM TO IMPROVE BIRTH OUTCOMES FOR BIRTHING PEOPLE, INFANTS AND FAMILIES THROUGH DATA-DRIVEN QUALITY IMPROVEMENT EFFORTS THAT ARE TAILORED TO THE STRENGTHS AND CHALLENGES OF THE REGION. FINALLY, THE MUNSON HEALTHCARE SYSTEM ACTIVELY ADVOCATES AT THE LOCAL, STATE, AND FEDERAL LEVEL ON ISSUES IMPACTING HEALTHCARE ACCESS IN RURAL AREAS. RECENT WORK INCLUDES SERVING IN BOTH A LEADERSHIP AND SUPPORTIVE ROLE IN PROJECTS TO INFLUENCE POLICIES THAT WOULD PROVIDE SUPPORT FOR TELEHEALTH SERVICES, BEHAVIORAL HEALTHCARE CRISIS SERVICES, WELLNESS PROGRAMMING AND EDUCATION, AFFORDABLE HOUSING, AND AIR AMBULANCE SERVICES. SCHEDULE H, PART III, LINE 2 DIRECT WRITE-OFF FROM UNPAID ACCOUNTS WHICH ARE DEEMED NO LONGER COLLECTIBLE ARE RECORDED AGAINST THE ALLOWANCE FOR BAD DEBT. AN ESTIMATE OF BAD DEBT EXPENSE IS RECORDED BASED ON 1) AN ANALYSIS OF THE DIRECT WRITE- OFFS AND 2) AN ESTIMATE OF THE AMOUNT OF BAD DEBT, NET OF DISCOUNTS, IN THE ACCOUNTS RECEIVABLE BALANCE, CONSIDERING THE PAST EXPERIENCE AND CURRENT TRENDS OF PAYMENTS ON PATIENT ACCOUNTS FOR EACH OF THE MAJOR PAYOR SOURCES OF REVENUE. SCHEDULE H, PART III, LINE 3 THE METHODOLOGY USED TO DETERMINE THE ESTIMATED AMOUNT OF CHARITY IN BAD DEBT IS AS FOLLOWS. WE DETERMINED THE APPROVAL RATE OF FINANCIAL COUNSELING BY TAKING THE VALUE OF THE ACCOUNTS THAT SUCCESFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING. SCHEDULE H, PART III, LINE 4 SEE NOTE 2 ON PAGE 10 OF ATTACHED AUDITED FINANCIAL STATEMENTS UNDER ACCOUNTS RECEIVABLE. SCHEDULE H, PART III, LINE 9B MUNSON HEALTHCARE'S INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC 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. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684. SCHEDULE H, PART VI, LINE 2 THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM PARTICIPATE IN A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. IN ADDITION, THE HOSPITAL IS A MEMBER OF THE MUNSON HEALTHCARE SYSTEM, WHICH WORKS TO UNDERSTAND THE NEEDS OF THE SERVICE AREA THROUGH VARIOUS SERVICE LINE AND DEPARTMENT-BASED ASSESSMENT AND BUSINESS PLANNING STRATEGIES. THE HOSPITAL ALSO REGULARLY SEEKS INFORMATION FROM AND PARTICIPATES IN THE COUNTY COLLABORATIVE, MITHRIVE WORKGROUPS, AND OTHER REGIONAL COLLABORATIVES TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY HEALTH NEEDS. THE HOSPITAL MAINTAINS A COMMUNITY HEALTHCARE COUNCIL MADE UP OF LOCAL LEADERS AND AREA ORGANIZATIONS WHICH PROVIDE INPUT INTO EMERGING TRENDS AND ISSUES SPECIFIC TO THEIR COMMUNITIES. FINALLY, HEALTHCARE SYSTEM MAINTAINS A STANDING COMMUNITY AND POPULATION HEALTH COMMITTEE WHICH CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM REGIONAL HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MHC RESPONSE TO EMERGING HEALTH TRENDS, AND REVIEW NEW COMMUNITY HEALTH-BASED COLLABORATION OR PROGRAMS. SCHEDULE H, PART VI, LINE 3 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 HEALTHCARE'S 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. THE MUNSON HEALTHCARE INTERNET HAS THE FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, THE PLAIN LANGUAGE SUMMARY AND THE BILLING AND COLLECTIONS POLICY AVAILABLE TO REVIEW AND PRINT. REFERRAL BY REGISTRATION STAFF: AT THE TIME OF REGISTRATION, SELF-PAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF. MUNSON HEALTHCARE FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS. THE COUNSELOR VISIT ALL INPATIENTS THAT ARE DEEMED SELF-PAY, 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 SELF-PAY 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 FINANCIAL ASSISTANCE, AND MUNSON MEDICAL CENTER MEDS PROGRAM. MUNSON HEALTHCARE MAKES A PHONE CALL TO ALL PRIVATE-PAY PATIENTS PRIOR TO TRANSFERRING THEIR ACCOUNT TO A COLLECTION AGENCY TO INFORM THEM OF OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART VI, LINE 4 DESCRIPTION MUNSON HEALTHCARE GRAYLING (GRAYLING HOSPITAL) SERVES A SPARSELY POPULATED, RURAL REGION IN CENTRAL NORTHERN MICHIGAN COMPRISED OF ALL OF CRAWFORD COUNTY (WHERE THE HOSPITAL IS LOCATED) AND MOST OF ROSCOMMON COUNTY, AS WELL AS MUCH OF OSCODA COUNTY AND SMALL PORTIONS OF MONTMORENCY AND OTSEGO COUNTIES. IT IS ONE OF NINE COMMUNITY HOSPITALS THAT ARE PART OF THE MUNSON HEALTHCARE SYSTEM. THE HOSPTIAL HAS 71 LICENSED INPATIENT BEDS, A 39-BED SKILLED NURSING/ LONG-TERM CARE UNIT, 114 ACTIVE MEDICAL STAFF (PRIMARY FACILITY), AND 756 EMPLOYEES MAKING IT ONE OF THE LARGEST EMPLOYERS IN THE REGION. THE HOSPITAL SERVED MORE THAN 3,100 SURGICAL CASES, OVER 109,800 OUTPATIENT VISITS, 1,617 INPATIENT ADMISSIONS, OVER 18,000 EMERGENCY ROOM VISITS, AND 300 BIRTHS IN FISCAL YEAR 2023. HOSPITAL SERVICES GRAYLING HOSPITAL IS A 71 BED HOSPITAL. IT HAS AN ACTIVE EMERGENCY DEPARTMENT, OUTPATIENT SURGERY DEPARTMENT, CANCER AND INFUSION DEPARTMENT, AND SIX PHYSICIAN OFFICES LOCATED IN GRAYLING, PRUDENVILLE AND ROSCOMMON OFFERING PRIMARY CARE, PEDIATRICS, OBSTETRICS AND GYNECOLOGY, UROLOGY, GENERAL SURGERY , ORTHOPEDICS, WALK-IN CARE. CLINICS IN GRAYLING ROSCOMMON AND PRUDENVILLE ALSO PROVIDE OUT-PATIENT PHYSICAL REHAB SERVICES. BEHAVIORAL HEALTH IS OFFERED AT THE GRAYLING COMMUNITY HEALTH CENTER, ROSCOMMON COMMUNITY HEALTH CENTER AND PRUDENVILLE COMMUNITY HEALTH CENTER. GRAYLING HOSPITAL OFFERS A DIABETES SELF MANAGEMENT EDUCATION PROGRAM THAT IS RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION. GRAYLING HOSPITAL IS SUPPORTED IN ITS MISSION WITH VISITING SPECIALTY PHYSICIANS AND HEALTHCARE PROFESSIONALS PROVIDING LOCAL ACCESS TO ALLERGY AND IMMUNOLOGY SERVICES, CARDIOLOGY, NEUROLOGY, NEUROSURGERY, NEUROLOGY AND AUDIOLOGY SERVICES. POPULATION SERVED GRAYLING HOSPITAL IS IN CRAWFORD COUNTY. CRAWFORD, OSCODA, AND ROSCOMMON COUNTIES ARE CONSIDERED THE HOSPITALS SERVICE AREA, WITH CRAWFORD BEING THE MOST PRIMARY. WITHIN THIS COUNTY, THE FOLLOWING DEMOGRAPHIC DATA APPLIES: TOTAL POPULATION: 13,491. MEDIAN HOUSEHOLD INCOME: 59,330. 27% OF ADULTS ARE AGE 65 OR OLDER, SIGNIFICANTLY MORE THAN THE STATE AVERAGE OF 18.7%. THE RACIAL MAKEUP OF THE COUNTY IS 96% WHITE, 0.8% BLACK OR AFRICAN AMERICAN, .8% AMERICAN INDIAN/ALASKAN NATIVE, 0.7% ASIAN, 2.4% HISPANIC OR LATINO. OF PEOPLE AGED 25 OR OLDER, 91.4% HAVE A HIGH SCHOOL DIPLOMA OR HIGHER. THE UNEMPLOYMENT RATE IS 4.9% QUALITY GRAYLING HOSPITAL IS FULLY ACCREDITED BY THE JOINT COMMISSION FALL OF 2023- GRAYLING HOSPITAL RECEIVED A GRADE "B" FROM THE LEAPFROG GROUP IN 2022 GRAYLING HOSPITAL WAS DESIGNATED BY BLUE CROSS BLUE SHIELD OF MICHIGAN AS A BLUE DISTINCTION CENTER+ FOR MATERNITY CARE AND KNEE AND HIP REPLACEMENT. GRAYLING HOSPITAL IS RECOGNIZED AS A LEVEL IV TRAUMA HOSPITAL BY THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES. GRAYLING HOSPITAL HAS RECEIVED A 4- STAR BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FY'23. THE OBSTETRICS INITIATIVE (OBI) THROUGH BCBS AWARD GRAYLING RECEIVED, 1 IN THE STATE FOR NTSV C-SECTION RATE SCHEDULE H, PART VI, LINE 5 THE HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT THE SERVICE AREA. THESE FUNDS ARE REINVESTED INTO OUR HOSPITALS IN THE FORM OF EMPLOYEE WAGE AND BENEFIT ENHANCEMENTS, TECHNOLOGY, AND SERVICES NEEDED TO ENSURE THE HIGHEST QUALITY CARE IS AVAILABLE IN NORTHERN MICHIGAN. THE HOSPITAL ALSO HAS AN OPEN MEDICAL STAFF WHERE 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. IN ADDITION, THE HOSPITAL CONTINUES SUPPORT FOR EXISTING COMMUNITY HEALTH PROGRAMMING AND INITIATIVES WHILE INVESTING IN NEW AND EXPANDED OFFERINGS: FOR OVER 20 YEARS, HEALTHY FUTURES A PARTNERSHIP OF MUNSON HEALTHCARE, LOCAL HEALTH DEPARTMENTS, AND PROVIDER OFFICES HAS HELPED PARENTS AND BABIES HAVE A HEALTHY START. THIS INCLUDES A POSTPARTUM HOME VISITING PROGRAM, 1:1 BREASTFEEDING ASSISTANCE, INFANT SLEEP AND IMMUNIZATION EDUCATION, AND AGE-APPROPRIATE NEWSLETTERS AND TEXT MESSAGES. HEALTHY FUTURES ENROLLS OVER 1,300 FAMILIES ANNUALLY. EXPANSION OF SUBSTANCE USE DISORDER TREATMENT, INCLUDING THE DEVELOPMENT OF A STANDARD PROTOCOL TO EXTEND BEST PRACTICE TREATMENT ACROSS THE SERVICE AREA. THIS STANDARD ALLOWS FOR THE INITIATION OF TREATMENT IN EMERGENCY MEDICINE SETTINGS WITH WARM HANDOFFS TO PRIMARY CARE. WORK CONTINUES TO INCREASE THE NUMBER OF ACCESS POINTS AND ENHANCE TRAINING AND EDUCATION. IN TANDEM WITH TREATMENT EXPANSION, MUNSON HEALTHCARE CONTINUES TO SUPPORT AND EXPAND HARM REDUCTION EFFORTS, INCLUDING MAKING NARCAN KITS AVAILABLE IN ALL EMERGENCY DEPARTMENTS, OFFERING TRAINING AND EDUCATION TO EMERGENCY RESPONDERS, AND PROMOTING MEDSAFE RETURN RECEPTACLES TO INCREASE UNUSED MEDICATION COLLECTION. HIGH TECH HIGH TOUCH (HTH2) IS A SCREENING-BASED PREVENTION TOOL TO SUPPORT SELF-DISCLOSURE OF SUBSTANCES USED DURING PREGNANCY AND CONNECT PATIENTS WITH BRIEF INTERVENTIONS AND EARLY TREATMENT. WORK HAS SUPPORTED THE SUCCESSFUL IMPLEMENTATION OF THE TOOL IN 60 PERCENT OF AREA CLINICS SERVING PREGNANT PEOPLE, WITH CONTINUED WORK TO IMPLEMENT WITHIN THE REMAINING OFFICES. EAT SLEEP CONSOLE IS A FAMILY-CENTERED, BEST PRACTICE APPROACH FOR CARING FOR INFANTS WITH NEONATAL ABSTINENCE SYNDROME (NAS). IN THE PAST YEAR, MUNSON HEALTHCARE IMPLEMENTED THIS PRACTICE AT ALL BIRTHING HOSPITALS, INCLUDING THE PURCHASE OF EQUIPMENT AND HEALTHCARE TEAM EDUCATION, WHICH RESULTED IN IMPROVED CLINICAL OUTCOMES, INCLUDING PHARMACOLOGICAL MANAGEMENT AND LENGTH OF STAY. COLLABORATION WITH TRAVERSE HEALTH CLINIC AND GOODWILL NORTHERN MICHIGAN TO EXPAND THE STREET MEDICINE PROGRAM, WHICH EXTENDS PHYSICAL AND BEHAVIORAL HEALTHCARE TO INDIVIDUALS WHO ARE UNHOUSED IN THE TRAVERSE CITY AREA. THIS WORK ALSO CONNECTS PATIENTS WITH BASIC NEEDS, SUCH AS FOOD, CLOTHING, AND CLEAN WATER, WHILE ADVOCATING FOR AND CREATING PATHWAYS TO ATTAINABLE HOUSING. RECENT ADVANCEMENTS INCLUDE THE PROCUREMENT OF A MOBILE MEDICAL UNIT AND ELECTRONIC MEDICAL RECORD TO ENHANCE COORDINATION OF CARE AND REACH MORE INDIVIDUALS. INITIATIVES AIMED AT THE REDUCTION AND MANAGEMENT OF CHRONIC DISEASE HAVE ALSO BEEN PRIORITIZED. THESE INCLUDE AN ENHANCED PARTNERSHIP WITH LOCAL HEALTH DEPARTMENTS TO IMPROVE THE REFERRAL AND FEEDBACK PROCESS FOR PATIENTS WHO USE TOBACCO. IN ADDITION, CONTINUED PARTNERSHIP WITH LOCAL GROCERY, FARMERS MARKETS, AND MICHIGAN STATE UNIVERSITY EXTENSION EXTENDS ACCESS TO FREE NUTRITION AND COOKING EDUCATION AND VOUCHERS TO PURCHASE FRUITS AND VEGETABLES THROUGH THE PRESCRIPTION FOR HEALTH PROGRAM. DIABETES EDUCATION CONTINUES TO BE AN IMPORTANT SERVICE AND CONTINUES TO EXPAND OFFERINGS TO MEET DEMAND, INCLUDING VIRTUAL IMPROVEMENTS, GROUP CLASSES, ADDITIONAL EDUCATORS, AND A STREAMLINED INTAKE PROCESS. FINALLY, THE HEALTHCARE SYSTEM HAS COMPLETED FOUNDATIONAL WORK NEEDED TO EXPAND DIRECT PATIENT OUTREACH EFFORTS USING TEXT REMINDERS FOR IMPORTANT HEALTH SCREENINGS AND RESOURCES, SUCH AS CANCER, DIABETES MANAGEMENT, AND TOBACCO CESSATION. THESE ENHANCED DIRECT PATIENT REMINDERS AND EDUCATION PROGRAMS ARE EXPECTED TO BEGIN IN FY24. THE ORGANIZATION PROVIDES 1:1 SUPPORT TO PATIENTS ENROLLING IN PUBLIC ASSISTANCE PROGRAMS, SUCH AS MEDICAID AND MAKES REFERRALS TO OTHER COMMUNITY SERVICES. THE ORGANIZATION OFFERS ROBUST STUDENT, INTERN, AND RESIDENCE EXPERIENCES AT EACH OF THE SYSTEMS HOSPITALS AND CONTRIBUTES TO COMMUNITY-WIDE EFFORTS THAT HELP STUDENTS IDENTIFY PLACEMENTS. MHC MAKES FINANCIAL CONTRIBUTIONS TO COMMUNITY CAUSES AND EVENTS FOCUSED ON MENTAL HEALTH, CHRONIC DISEASE, AND HOUSING, WHILE PARTICIPATING ON SPECIFIC COMMITTEES AND BOARDS WORKING TO ADDRESS SYSTEMATIC CHALLENGES FACING THESE PRIORITY AREAS. SCHEDULE H, PART VI, LINE 6 MUNSON HEALTHCARE GRAYLINGS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED 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 NINE NOT-FOR-PROFIT 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 AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM WHICH INCLUDE MUNSON MEDICAL CENTER, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL AND MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL PROVIDED 150.6 MILLION OF COMMUNITY BENEFIT IN THE 2022 TAX YEAR. ADDITIONALLY, 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. COMMUNITY BENEFIT, IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR. MUNSON MEDICAL GROUP, THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM, PROVIDED 4.2 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2022. 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. IN TOTAL, THE MUNSON HEALTHCARE SYSTEM PROVIDED 172.1 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS, INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS, OUTREACH PROGRAMS, BAD DEBT, AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN. SCHEDULE H, PART VI, LINE 7 MICHIGAN X true true true true false false false false false true false EDWIN A NESS DIRECTOR 984135 271268 819521 195058 34013 2303995 776855 LAURA GLENN PRESIDENT AMB SERVIC 565550 126428 861 80280 23537 796656 BRIAN N STIRLING DO PHYSICIAN 512446 114063 21809 15280 28894 692492 JASON D BENNETT DO ORTHOPEDIC SURGEON 561466 20000 6918 15280 27271 630935 LYNNE MCCORMICK DO PHYSICIAN 1692 502960 53 21180 15280 71 20777 1816 560197 GARRICK CVITKOVICH MD SURGEON 473123 5000 5525 11223 23700 518571 KIRSTEN KORTH-WHITE PRESIDENT 337739 89708 13502 47093 25424 513466 CARL SCHUBERT MD PHYSICIAN 286178 3766 120187 23492 197 15202 78 17347 179 462406 4220 ALICIA MAITLAND CFO PT-YR 249058 105150 81420 14698 12936 463262 CASEY KANDOW VP ANCILLARY SERV 332447 96453 6130 21801 456831 38923 CHRISTOPHER SQUIRE VP ANCILLARY SER EAS 302913 70268 466 43945 24025 441617 ELLEN SMITH COO PHYSICIAN NETWOR 323437 54090 2667 54746 2942 437882 TONYA SMITH DIRECTOR 293848 112050 6965 5411 17226 435500 KATHLEEN MALY INTERIM CFO PT-YR 254344 10326 23720 13974 18200 320564 KATHLEEN LARAIA VP ONCOLOGY & PROF S 188734 22459 7688 10176 22022 251079 MICHAEL HODNETT CNO 162382 26880 454 18608 24433 232757 SCHEDULE J, PAGE 1, PART I, LINE 1A MUNSON HEALTHCARE MAINTAINS A SOCIAL MEMBERSHIP AT THE TRAVERSE CITY COUNTRY CLUB. A REQUIREMENT OF THE COUNTRY CLUB IS THAT A MEMBERSHIP BE IN AN INDIVIDUAL NAME AND NOT A CORPORATE NAME, SO EDWIN NESS IS LISTED AS THE INDIVIDUAL FOR THE MEMBERSHIP. MUNSON HEALTHCARE USES THE SOCIAL MEMBERSHIP TO CONDUCT OFF-SITE MEETINGS AND RETREATS. SCHEDULE J, PAGE 1, PART I, LINE 3 THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 179,779 0 LAURA GLENN 0 65,000 0 KIRSTEN KORTH-WHITE 0 34,651 0 CASEY KANDOW 12,730 0 0 CHRISTOPHER SQUIRE 0 30,975 0 ELLEN SMITH 0 40,000 0 MICHAEL HODNETT 0 10,709 0 SCHEDULE J, PAGE 1, PART I, LINE 7 MUNSON HEALTHCARE EXECUTIVES ARE ELIGIBLE FOR AN ANNUAL BONUS BASED ON MEETING ORGANIZATIONAL GOALS, WHICH ARE SET IN ADVANCE AND APPROVED BY THE COMPENSATION COMMITTEE OF THE MUNSON HEALTHCARE BOARD. THE GOALS INCLUDE A COMBINATION OF FINANCIAL TARGETS, STRATEGIC TARGETS AND OPERATIONAL TARGETS INCLUDING QUALITY HEALTHCARE DELIVERY, DISEASE MANAGEMENT, PATIENT SATISFACTION, EMPLOYEE SAFETY, AND EMPLOYEE ENGAGEMENT. AT THE END OF EACH FISCAL YEAR, THE COMPENSATION COMMITTEE OF THE MUNSON HEALTHCARE BOARD IS CHARGED WITH REVIEWING AND APPROVING EXECUTIVE BONUSES BASED ON PROGRESS TOWARD MEETING ORGANIZATIONAL GOALS. SCHEDULE J, PART III PART I, LINE 4A 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 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 FOR VICE-PRESIDENTS, UP TO 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. PART I, LINE 4B 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 NON-QUALIFIED 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. VICE-PRESIDENTS ARE ELIGIBLE TO PARTICIPATE IN AN AMOUNT NOT TO EXCEED 6% OF BASE COMPENSATION, FUNDED ANNUALLY, AT THE SOLE DISCRETION OF MUNSON. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON. TRANSFER INVESTMENTS 2022-07-26 9994047 MARKET VAL 382640544 MUNSON HEALTHCARE 1105 SIXTH STREET TAVERSE CITY MI 49684 501(C)(3) false false false false SCHEDULE N TRANSFER INVESTMENTS TO MUNSON HEALTHCARE, PARENT CORPORATION. FORM 990, PAGE 6, PART VI, LINE 6 MUNSON HEALTHCARE GRAYLING IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE TRUSTEES FOR ALL SUBSIDIARY ENTITIES, INCLUDING MUNSON HEALTHCARE GRAYLING. THE BOARD OF TRUSTEES OF MUNSON HEALTHCARE GRYALING CONSISTS OF THOSE INDIVIDUALS THAT ARE ELECTED OR APPOINTED TO SERVE AS THE DIRECTORS OF MUNSON HEALTHCARE. NOMINATIONS TO MUNSON HEALTHCARE ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON HEALTHCARE GRAYLING (GRY) TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF GRY; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF GRY; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF GRY; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR GRY; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY GRY WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF GRY WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF GRY; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY GRY; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE GRAYLING BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE GRAYLING BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE EXECUTIVE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE EXECUTIVE COMPENSATION PROCESS AND THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE FINANCE AND AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF EXECUTIVE COMPENSATION AND FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER. FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED THROUGH THE FOLLOWING PROCESS: FIRST, AN INDEPENDENT FIRM IS ENGAGED TO PROVIDE COMPARABILITY DATA. THEN, THAT DATA IS REVIEWED BY TWO MUNSON HEALTHCARE COMMITTEES, EACH OF WHICH ARE COMPRISED OF INDIVIDUALS WHO ARE NOT EMPLOYEES OR OTHERWISE INSIDERS (DEFINED AS BOARD MEMBERS, PHYSICIANS & EXECUTIVES) OF THE ORGANIZATION. FIRST, THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE EVALUATES THE DATA AND DETERMINES A RECOMMENDED COMPENSATION MODEL BASED ON THE COMPARABILITY DATA. NEXT, THE BOARD CONFLICT, VALUATION AND COMPLIANCE COMMITTEE REVIEWS THE RECOMMENDATIONS AS COMPARED TO THE COMPARABILITY DATA. THIS COMMITTEE'S ROLE IS TO DETERMINE WHETHER THE PROPOSED COMPENSATION IS CONSISTENT WITH FAIR MARKET VALUE. IF PHYSICIANS ARE INCLUDED IN THE DEFINITION OF KEY EMPLOYEE, THE BOARD CONFLICT, VALUATION, AND COMPLIANCE COMMITTEE REVIEWS ALL FINANCIAL RELATIONSHIPS WITH PHYSICIANS AND COMPARES THE PROPOSED FINANCIAL ARRANGEMENT WITH COMPARABILITY DATA PRODUCED BY AN OUTSIDE, INDEPENDENT FIRM. PHYSICIAN COMPENSATION DOES NOT GO TO THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMPARABILITY DATA AS WELL AS THE MINUTES OF EACH OF THESE COMMITTEE MEETINGS ARE MAINTAINED FOR FUTURE REFERENCE. THE MHC BOARD APPROVES THE MHC CEO'S COMPENSATION. THE MHC BOARD HAS DELEGATED TO THE CVC COMMITTEE THE AUTHORITY TO REVIEW AND APPROVE COMPENSATION ARRANGEMENTS WITH INSIDERS. FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES OF MUNSON HEALTHCARE GRAYLING AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE GRAYLING ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE GRAYLING 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. FORM 990, PART IX, LINE 11G PURCHASED SERVICES 7,838,988 35,941 0 PROFESSIONAL FEES 5,041,456 10,384 0 TOTAL 12,880,444 46,325 0 FORM 990, PART XI, LINE 9 TRANSFER LONG TERM DEBT TO PARENT 12,250,823 CHANGE IN ACCOUNTING FOR INVEST MUNSON HC FOUND -567,301 TRANSFER INVESTMENTS TO PARENT -9,994,047 TOTAL 1,689,475 MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 HEALTHCARE MI C3 12B N/A false MUNSON HEALTHCARE FOUNDATIONS 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE true MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true MUNSON HOME SERVICES 1105 SIXTH ST TRAVERSE CITY MI 49684 382543463 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 12B MUNSON HC MUNSON HEALTHCARE true PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI C3 10 MUNSON MED MUNSON MEDICAL CENTER true MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CADILLAC 1105 SIXTH ST TRAVERSE CITY MI 49684 471156297 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CHARLEVOIX HOSPIT 1105 SIXTH ST TRAVERSE CITY MI 49684 381459366 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE MANISTEE HOSPITAL 1465 E PARKDALE AVE MANISTEE MI 496609709 380350304 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE OTSEGO MEMORIAL H 825 N CENTER AVE GAYLORD MI 497351592 381303843 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true MEDICAL OFFICE CONDOMINIUM ASSOCIAT PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true false false true false false false false false false false false true true false true true true false true MUNSON HEALTHCARE M 11472379 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE O 1847108 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE P 10163525 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE Q 996209 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE S 2256776 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC P 67266 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC Q 58971 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC L 75600 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS C 146275 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS M 98322 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H O 51307 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H P 152731 ACTUAL AMOUNT PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H Q 82063 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER M 457842 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER O 28437702 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER P 11023461 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER Q 10644010 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT O 58370 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP O 235647 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALIANCE M 698698 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALIANCE P 2146431 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALLIANCE Q 66005 ACTUAL AMOUNTS PAID MUNSON HELATHCARE MANISTEE HOSPITAL Q 90951 ACTUAL AMOUNTS PAID MUNSON HELATHCARE MANISTEE HOSPITAL P 51861 ACTUAL AMOUNTS PAID SCHEDULE R MUNSON HEALTHCARE GRAYLING 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.