2025-11-14T11:18:15-06:00 2024-12-31 990 2024-01-01 382027689 WA FOOTE MEMORIAL HOSPITAL WAFO 5172054800 205 N EAST AVENUE JACKSON MI 49201 J DOUGLAS CLARK SVP/CHIEF ACCOUNTING OFFICER 5172054800 2025-11-14 0 2024 2025-03-06 01:10:19Z HENRY FORD HEALTH JACKSON HOSPITAL ROBIN DAMSCHRODER 205 N EAST AVENUE JACKSON MI 49201 961471227 0 X WWW.HENRYFORD.COM/LOCATIONS/ALLEGIANCE-HEALTH X 1970 MI WE IMPROVE PEOPLE'S LIVES THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING. 17 9 4462 87 0 0 6099123 8616214 752325591 830355485 12747710 9696990 56880939 58916510 828053363 907585199 238263 238263 0 0 368700695 376124598 0 0 66007 415171053 444833312 784110011 821196173 43943352 86389026 807404458 945166937 310840865 314661960 496563593 630504977 X W.A. FOOTE MEMORIAL HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL ("HFHJH") IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH") SERVING COMMUNITIES IN SOUTH CENTRAL MICHIGAN FOR MORE THAN 100 YEARS. AS AN INTEGRATED COMPONENT OF ONE OF THE NATION'S LEADING COMPREHENSIVE, INTEGRATED HEALTH SYSTEMS, W.A FOOTE MEMORIAL HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL ("HFHJH") SHARES THE MISSION OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH") TO IMPROVE PEOPLE'S LIVES THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING. 0 0 733380985 238263 900846014 FOR MORE THAN 100 YEARS, HENRY FORD HEALTH JACKSON HOSPITAL HAS SERVED A NINE-COUNTY EXPANSE OF SOUTH-CENTRAL MICHIGAN WITH A COMMITMENT TO CHARITABLE GIVING, OUTREACH AND BUILDING STRONGER, HEALTHIER INDIVIDUALS AND FAMILIES. THE 365 LICENSED BED ACUTE CARE HOSPITAL AND LEVEL II TRAUMA CENTER OFFERS A FULL RANGE OF CLINICAL SERVICES, INCLUDING GENERAL MEDICINE, SURGERY, BIRTHING CENTER AND 24-HOUR EMERGENCY CARE. HENRY FORD HEALTH JACKSON HOSPITAL ALSO PROVIDES PHYSICAL MEDICINE AND REHAB, CARDIAC, CANCER AND NEUROSURGICAL SERVICES. DURING 2024, HENRY FORD HEALTH JACKSON HOSPITAL HAD 17,303 DISCHARGES.WITH A SENSE OF HUMAN COMPASSION, WE GIVE, ORGANIZE, LEAD, PARTNER AND EMBRACE THE WIDE-RANGING COMMUNITY PROGRAMS AND SERVICES. IN GIVING BACK TO THE CULTURE AND PEOPLE THAT SURROUND US, WE GAIN FULFILLMENT IN KNOWING WE HAVE INVESTED IN THE HEALTH AND WELL-BEING OF THE COMMUNITY WHICH WE SERVE. ESTABLISHED IN 1918, OUR COMMITMENT TO THE COMMUNITY IS TO LEAD THEM TO BETTER HEALTH AND WELL-BEING AT EVERY STAGE OF LIFE. SERVING SOUTH CENTRAL MICHIGAN, HENRY FORD HEALTH JACKSON HOSPITAL IS THE LARGEST EMPLOYER IN JACKSON COUNTY. MEDICAL EDUCATIONHENRY FORD HEALTH JACKSON HOSPITAL HAS AN OSTEOPATHIC GRADUATE MEDICAL EDUCATION PROGRAM, OFFERING ROTATIONS TO RESIDENTS, INTERNS AND THIRD-AND-FOUTH-YEAR MEDICAL STUDENTS.HENRY FORD HEALTH JACKSON HOSPITAL TRAINS 80 MEDICAL STUDENTS AND 120 RESIDENTS IN 6 PROGRAMS.A NATIONAL LEADER IN FORMING COMMUNITY PARTNERSHIPS, HENRY FORD HEALTH JACKSON HOSPITAL PROMOTES WELLNESS AND PREVENTION THROUGH OUR HEALTH IMPROVEMENT ORGANIZATION. HENRY FORD HEALTH JACKSON HOSPITAL PROVIDES OUTPATIENT SERVICES AT APPROXIMATELY 50 LOCATIONS THROUGHOUT SOUTH CENTRAL MICHIGAN. IN TOTAL THIS REPRESENTED 903,529 TOTAL OUTPATIENT ENCOUNTERS DURING 2024. HENRY FORD HEALTH JACKSON HOSPITAL OPERATES A 24 HOUR EMERGENCY DEPARTMENT. EMERGENCY SERVICES REPRESENTED 72,203 PATIENT VISITS DURING 2024. 733380985 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 1 0 1 371 0 1 4462 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 17 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ROBIN DAMSCHRODER 3138768714 ONE FORD PLACE DETROIT MI 48202 AARON S BOATIN TRUSTEE - SECRETARY/TREASU 2.00 4.00 X X 0 0 0 DENISE BROOKS-WILLIAMS TRUSTEE 1.00 63.00 X 0 2338768 64141 DAVID W CRAFT TRUSTEE 1.00 1.00 X 0 0 0 SAIRIA DASS RAMCHARAN MD TRUSTEE 1.00 1.00 X 0 0 0 MARTHA A FUERSTENAU TRUSTEE- CHAIR 1.00 1.00 X X 0 0 0 CATHERINE A HENDRIAN TRUSTEE 1.00 1.00 X 0 0 0 MOHAN G KULKARNI MD PHYSICIAN TRUSTEE 60.00 1.00 X 1076772 0 58019 MUMTAZ A MEMON MD PHYSICIAN TRUSTEE 60.00 2.00 X 734663 0 40166 EMILY S MOORHEAD TRUSTEE - PRESIDENT & CEO 55.00 10.00 X X 632666 0 59773 MONICA M MOSER TRUSTEE 2.00 2.00 X 0 0 0 ADNAN R MUNKARAH MD PHYSICIAN TRUSTEE 1.00 64.00 X 0 3373948 69819 LAWRENCE NARKIEWICZ JR MD PHYSICIAN TRUSTEE 60.00 1.00 X 602014 0 37916 MARK S OLSON TRUSTEE 1.00 1.00 X 0 0 0 RENELL B WEATHERS TRUSTEE 1.00 1.00 X 0 0 0 SAMIR PARIKH MD TRUSTEE 1.00 1.00 X 62835 0 0 DANIEL J PHELAN PHD TRUSTEE - VICE CHAIR 2.00 6.00 X X 0 30000 0 CHRISTINA M SIDERS TRUSTEE 1.00 3.00 X 0 0 0 KENNETH W EMPEY GENERAL COUNSEL 55.00 5.00 X 386206 0 22967 MARK A SMITH MD CMO/CEO HFAHMG 55.00 5.00 X 615451 0 59155 AZAM BASHEER MD PHYSICIAN 60.00 0.00 X 2771695 0 40375 FRANK LAMARCA MD PHYSICIAN 60.00 0.00 X 2609124 0 42366 KALEN RIMAR MD PHYSICIAN 60.00 0.00 X 1115198 0 54036 BIPIN RAVINDRAN MD PHYSICIAN 60.00 0.00 X 1086497 0 10281 ALFRED MCARTHUR FAULKNER DO PHYSICIAN 60.00 0.00 X 1032112 0 0 ROBERT G RINEY FORMER TRUSTEE 0.00 65.00 X 0 7019469 61705 JIM BONGIORNO FOMER CENTRAL MARKET CFO 0.00 60.00 X 0 254924 45126 MICHAEL GRISDELA FORMER INTERIM CENTRAL MAR 0.00 60.00 X 0 648183 96676 12725233 13665292 762521 602 1 1 0 INDEPENDENT HOSPITALIST PHYSICIANS PLLC PO BOX 100 ROYAL OAK MI 48068 HEALTHCARE SERVICES 5798440 PULMONARY CLINICS OF SOUTHERN MI PC 900 E MICHIGAN AVENUE STE 105 JACKSON MI 49201 HEALTHCARE SERVICES 4481180 OBHG MICHIGAN PC 777 LOWNDES HILL ROAD BLDG 1 GREENVILLE SC 296068261 HEALTHCARE SERVICES 2535984 INDEPENDENT EMERGENCY PHYSICIANS PC 37000 GRAND RIVER AVE FARMINGTION HILLS MI 48335 HEALTHCARE SERVICES 1880806 RAM CONSTRUCTION SERVICES 13800 ECKLES ROAD LIVONIA MI 48150 CONSTRUCTION SERVICES 1593463 65 83634 3829507 4703073 8616214 PATIENT SERVICES 621990 830355485 830355485 830355485 5167787 5167787 299748 0 299748 299748 299748 40898077 17443247 34204307 19607814 6693770 -2164567 4529203 6693770 -2164567 30866 83634 73907 -43041 -43041 30831 0 30831 30831 CONTRACTED PHARMACY REVENUE 621110 53313222 53313222 CAFETERIA 900099 2065342 2065342 JHN 621990 832734 832734 2417674 2417674 58628972 907585199 900846014 0 -1877029 164152 164152 74111 74111 4325766 3570374 700311 55081 309528754 287102397 22426357 5295755 4904695 390131 929 37100414 34360770 2733134 6510 19873909 18406340 1464082 3487 160 160 50930460 48013658 2916802 462939 92737 370202 12177118 9276093 2901025 2045649 1842883 202766 6872942 3514282 3358660 537084 465029 72055 1186466 1117515 68951 5390116 5390100 16 25695975 18969527 6726448 6466518 6466490 28 CORP OFFICE ALLOCATION 82415103 82414863 240 MEDICAL SUPPLIES 81164390 80473035 691355 PHARMACEUTICAL SUPPLIES 71610208 71506914 103294 QUAAP TAX 39307648 4926572 34381076 58570536 50328288 8242248 821196173 733380985 87749181 66007 248476 343253 71829973 146418809 2011000 0 114313913 141208352 17789070 17689511 2927801 3488328 380607359 215329806 197295282 165277553 365421425 405949471 6479617 5971437 29087901 58820223 807404458 945166937 83043370 68887073 135702488 132022031 92095007 113752856 310840865 314661960 X 490615729 621177569 5947864 9327408 496563593 630504977 807404458 945166937 X 86389026 35438497 12113861 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 36007 0 0 36007 0 PART II-B, LINE 1: HEALTH CARE IS A HIGHLY-REGULATED FIELD, REQUIRING FREQUENT AND HIGH-LEVEL COMMUNICATION WITH REGULATORS AND ELECTED OFFICIALS. A SMALL INVESTMENT IN LOBBYING ENABLES US TO REMAIN IN CONTACT WITH LEGISLATORS AND GOVERNMENT AGENCIES, MAXIMIZE THE RESOURCES WITH WHICH WE ARE ENTRUSTED AND ASSURE THAT WE PROVIDE THE BEST CARE TO OUR COMMUNITY. W.A. FOOTE MEMORIAL HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL ENLISTS THE SERVICES OF SEVERAL LOBBYING CONSULTANTS, ATTORNEYS AND HEALTHCARE TRADE ASSOCIATIONS. 5947864 4774497 156263 1551216 9327408 5337392 3567344 127629 3084501 5947864 3925913 3614133 -145673 2056981 5337392 3089845 2032607 184527 1381066 3925913 2864539 1790548 125594 1690836 3089845 0.12830 0.87170 0 1 1 9287626 9287626 185914662 72071238 113843424 1065187 115073 950114 179691000 143143495 36547505 4648884 4648884 165277553 DEFERRED COMPENSATION 19629474 PERM RESTRICTED UNREALIZED G/L 272648 RIGHT OF USE ASSET OPERATING 12369173 RIGHT OF USE ASSET FINANCE 26671705 ACCUM AMORT R OF U ASSET FINANCE -122777 58820223 RETIREMENT PLAN LIABILITY 11405761 DEFERRED COMP 19666441 CORPORATE RESERVE 6087685 LIABILITY INSURANCE 26619655 WORKERS COMP LIABILITY 1345982 CURRENT OPERATING LEASE LIABILITY 2739275 LONG TERM OPERATING LEASE LIABILITY 11001813 OPERATING LEASE A/P PAYMENT -268585 LONG TERM FINANCE LEASE LIABILITY 35152651 CURR FIANCE LEASE LIABILITY 188996 FIANCE LEASE A/P PMT CLEARING -186818 113752856 X PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR VARIOUS CHARITABLE HOSPITAL PROGRAMS INCLUDING TREATMENT OF UNINSURED PATIENTS, COMMUNITY PREVENTATIVE HEALTH EDUCATION, PROGRAM DEVELOPMENT AND CAPITAL IMPROVEMENTS. PART X, LINE 2: THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2024 AND 2023. PINK BALL 114500 83634 30866 73907 114500 83634 30866 73907 73907 -43041 30831 1 1.00000 30831 30831 MI 1 0 1 0 1.00000 AMY STRAUSS SPECIAL EVENTS DEPT ONE FORD PLACE DETROIT MI 48202 0 0 1 1 1 X 250.000000000000 1 X 1 1 0 1 1 11229343 0 11229343 0.01410 194681798 182101569 12580229 0.01570 0 0 205911141 182101569 23809572 0.02980 272 10678 798460 0 798460 0.00100 11 3559 21283860 9133081 12150779 0.01520 4 18042174 13759757 4282417 0.00540 0 0 54 21608 1062093 0 1062093 0.00130 341 35845 41186587 22892838 18293749 0.02290 341 35845 247097728 204994407 42103321 0.05270 1 3345 0 3345 0.00000 0 0 20 3775 22417 0 22417 0.00000 0 0 0 0 1 16000 600035 0 600035 0.00080 0 0 0 0 0 0 22 19775 625797 625797 0.00080 0 22413282 5603321 230308795 264806434 -34497639 X 1 1 1 FOOTE HEALTH CENTER ASSOCIATES ENTITY LEASES MEDICAL OFFICE SPACE. 0.92870 0.00000 0.07130 2 GRASS LAKE REAL ESTATE LLC TO BUILD AND MANAGE OUTPATIENT SURGICAL CENTER 0.46000 0.00000 0.46000 3 GRASS LAKE SURGERY CENTER LLC TO OPERATE OUTPATIENT SURGICAL CENTER 0.46000 0.00000 0.46000 1 1 HENRY FORD HEALTH JACKSON HOSPITAL 205 N EAST AVENUE JACKSON MI 49201 WWW.HENRYFORD.COM X X X X X HENRY FORD HEALTH JACKSON HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 1 0 1 X SEE LINE 10A BELOW X 1 22 1 SEE PART V, PAGE 8 0 1 X 250.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 HENRY FORD HEALTH JACKSON HOSPITAL PART V, SECTION B, LINE 5: TO GET A COMPREHENSIVE PICTURE OF THE HEALTH OF THE COMMUNITIES WE SERVE, OUR CHNA PROCESS INCLUDED AN IN-DEPTH REVIEW OF STATE AND LOCAL DATA, FROM WHICH MANY COMMON HEALTH ISSUES AND TRENDS EMERGED. THESE DATA WERE GATHERED LARGELY FROM THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES (MDHHS) VITAL STATISTICS, THE MICHIGAN BEHAVIORAL RISK FACTOR (BRFS) SURVEY, AND THE AMERICAN COMMUNITIES SURVEY. THE MOST UPDATED DATA WERE GENERALLY COLLECTED FROM 2018 TO 2020. DATA FROM 2020 MAY BE INFLUENCED BY THE COVID-19 PANDEMIC. HOWEVER, SINCE DATA MORE RECENT THAN 2020 IS LARGELY NOT YET AVAILABLE, THIS CHNA IS NOT ABLE TO FULLY REFLECT THE IMPACT OF COVID-19. WE ALSO EXAMINED TRENDS IN THESE DATA SINCE COMPLETING OUR LAST COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019, FROM WHICH DATA WERE MOSTLY COLLECTED DURING 2015-2017.OUR METHODOLOGY INCLUDED REVIEWING DATA COLLECTED FROM STATE AND LOCAL SOURCES AND COMMUNITY/STAKEHOLDER INPUT FROM SURVEYS.JACKSON COUNTY WAS SURVEYED THROUGH THE JACKSON COLLABORATIVE NETWORK'S NEEDS ASSESSMENT PROCESS, WHICH UTILIZES A PHONE SURVEY SAMPLING STRATEGY. THE METHOD USED FOR THIS SURVEY WAS A RANDOM DIGIT DIAL TELEPHONE SURVEY OF JACKSON COUNTY RESIDENTS. THE SAMPLE WAS STRATIFIED BY CENSUS TRACT, MEANING THE POPULATION WAS SAMPLED EVENLY THROUGHOUT ALL CENSUS TRACTS IN THE COUNTY (WITH THE PRISON CENSUS TRACT BEING OMITTED). CELLULAR AND LANDLINE TELEPHONE NUMBERS OF JACKSON COUNTY RESIDENTS IN EACH CENSUS TRACT WERE RANDOMLY DIALED UNTIL THE TARGET NUMBER OF SURVEYS WAS COMPLETED FOR EACH TRACT. THIS CYCLE INCLUDED AN OVERSAMPLING OF RESIDENTS WHO SELF-IDENTIFIED AS BLACK/AFRICAN AMERICAN TO HELP STRENGTHEN THE SAMPLE AND HELP TO REVEAL EVIDENCE OF RACIAL DISPARITIES IN THE JACKSON COMMUNITY. A TOTAL OF 1,300 ADULTS IN JACKSON COUNTY COMPLETED THE TELEPHONE SURVEY. WITHIN JACKSON COUNTY, 26% OF RESPONDENTS LIVED IN THE CITY OF JACKSON, 59% LIVED OUTSIDE OF THE CITY, AND THE REMAINING 15% HAD AN UNKNOWN LOCATION WITHIN JACKSON COUNTY.RESPONSES TO SURVEYS WERE RECEIVED FROM ORGANIZATIONS AND INDIVIDUALS REPRESENTING A RANGE OF RACIAL/ETHNIC BACKGROUNDS. RACIAL/ETHNIC MINORITIES REPRESENTED AMONGST SURVEY RESPONDENTS INCLUDE BLACK, ASIAN, NATIVE AMERICAN, MULTI-RACIAL, HISPANIC OR LATINO, AND MIDDLE EASTERN OR NORTH AFRICAN DESCENT.INDIVIDUALS SURVEYED INCLUDED LEADERS FROM AGENCIES SUCH AS JACKSON COUNTY HEALTH DEPARTMENT, JACKSON HEALTH NETWORK, JACKSON COMMUNITY FOUNDATION, JACKSON COUNTY INTERMEDIATE SCHOOL DISTRICT, UNITED WAY OF JACKSON COUNTY AND MANY OTHERS. PARTICIPANTS HAD A WIDE RANGE OF EXPERTISE. FROM THEIR SURVEY RESPONSES, WE GAINED INSIGHT INTO THE KINDS OF HEALTH ISSUES FACING OUR COMMUNITIES. HENRY FORD HEALTH JACKSON HOSPITAL PART V, SECTION B, LINE 6A: HENRY FORD HEALTH HOSPITALHENRY FORD HEALTH KINGSWOOD HOSPITALHENRY FORD HEALTH MACOMB HOSPITALHENRY FORD HEALTH WEST BLOOMFIELD HOSPITALHENRY FORD HEALTH WYANDOTTE HOSPITALHENRY FORD HEALTH COTTAGE HOSPITAL/MEDICAL CENTERHENRY FORD HEALTH ALLEGIANCE SPECIALTY HOSPITAL HENRY FORD HEALTH JACKSON HOSPITAL PART V, SECTION B, LINE 11: CHNA PRIORITIESTHE THREE (3) SELECTED PRIORITIES WHICH EMERGED FROM THE 2022 CHNA WERE: CHRONIC DISEASE PREVENTION & MANAGEMENT, BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER AND INFANT MORTALITY.THE FOLLOWING ARE STRATEGIES TO ADDRESS THE HEALTH PRIORITIES IDENTIFIED THROUGH THE CHNA. CHRONIC DISEASE PREVENTION & MANAGEMENT EVALUATE AND IDENTIFY IMPROVEMENT OPPORTUNITIES TO ENSURE DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT (DSMES) PROGRAMS ARE ACHIEVING EQUITY IN ACCESS AND OUTCOMES FOR COMMUNITIES OF COLOR.CONTINUE TO ENHANCE PROGRAMMING AND EVALUATE AND IDENTIFY IMPROVEMENT OPPORTUNITIES TO ENSURE DIABETES PREVENTION PROGRAMS (DPP) ARE ACHIEVING EQUITY IN ACCESS AND OUTCOMES FOR COMMUNITIES OF COLOR.ENGAGE PROVIDER ORGANIZATIONS IN SYSTEMATIC CLINICAL IMPROVEMENTS TO REDUCE RACIAL DISPARITIES IN HYPERTENSION AND/OR DIABETES CONTROL.HENRY FORD HEALTH WILL PARTNER WITH COMMUNITY ORGANIZATIONS VIA A COMMUNITY INFORMATION EXCHANGE (CIE) TO CLOSE 50% OF THE SOCIAL NEEDS GAPS IDENTIFIED (REFERRALS MADE) WITHIN POPULATIONS SCREENED BY 2025. BY 2025, HENRY FORD HEALTH WILL INVEST $15 MILLION THROUGH INTERMEDIARIES INTO PROJECTS THAT POSITIVELY IMPACT SOCIAL DETERMINANTS OF HEALTH (SDOH) ACROSS MARKETS WE SERVE. INVESTMENTS WILL YIELD RETURNS THAT MAY BE BELOW GENERAL MARKET EXPECTATIONS, BUT SUFFICIENT TO REPLENISH FUNDING FOR FUTURE ROUNDS OF INVESTMENT. BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER PROVIDE DEPRESSION SCREENING FOR ALL THOSE SEEKING PSYCHIATRIC CARE.PATIENTS SUFFERING FROM OPIATE USE DISORDER (OUD), NOT IN REMISSION, WILL BE PRESCRIBED NAXLOXONE AS A SAFETY MEASURE TO PREVENT MORBIDITY AND MORTALITY.IMPROVE ACCESS IN OUR PSYCHIATRIC SPECIALTY CLINICS AND IN OUR COLLABORATIVE CARE MODEL FOR ADULT PATIENTS. INFANT MORTALITY IMPROVE PRENATAL AND PEDIATRIC ASSESSMENTS OF ALL PATIENTS BY IDENTIFYING AND ADDRESSING SDOH AND PROVIDING IMPROVED CARE NAVIGATION. EXPAND IMPLICIT BIAS EDUCATION/TRAINING TO ALL HFHS OBSTETRIC, PEDIATRIC/NEONATOLOGY NURSING AND PROVIDERS (INCLUDES REDUCING UNCONSCIOUS BIAS, AND IMPERATIVE (RUBI) CURRICULUM).ENSURE OB/GYN PATIENTS ARE RECEIVING RESPECTFUL CARE.SCALE WIN NETWORK: DETROIT ENHANCED MODEL OF GROUP PRENATAL CARE TO ADDITIONAL SITES.CHNA SIGNIFICANT NEEDS NOT ADDRESSEDSIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT CHNA WHICH ARE NOT BEING ADDRESSED IN THE CHNA IMPLEMENTATION PLANS: VACCINATIONS ASTHMA ALZHEIMER'S KIDNEY DISEASE PNEUMONIA AND INFLUENZA HENRY FORD HEALTH ACKNOWLEDGES THE NUMEROUS AND WIDE RANGE OF HEALTH NEEDS THAT EXIST IN OUR COMMUNITIES SERVED, AND WE ACKNOWLEDGE THAT THERE ARE CERTAIN HEALTH NEEDS NOT CHOSEN AS PRIORITIES, LISTED ABOVE. WE HAVE DETERMINED THAT OUR IMPLEMENTATION PLANS ARE ONLY ABLE TO EFFECTIVELY ADDRESS THE MOST PRESSING NEEDS IDENTIFIED BY OUR STAKEHOLDERS AND IN RELEVANT DATA AND SURVEYS, WHICH INCLUDE CHRONIC DISEASE, MENTAL HEALTH AND SUBSTANCE USE, CANCER, AND INFANT MORTALITY. THE SELECTED PRIORITIES WERE ANALYZED THROUGH THE LENS OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY, AS WELL AS HEALTH SYSTEM RESOURCES, AND REPRESENT THE KEY HEALTH ISSUES WHICH ARE MOST PRESSING WITH THE MOST COMPELLING DATA. WHILE HFH PROVIDES SUPPORTIVE CLINICAL SERVICES IN THESE AREAS, THEY WILL NOT BE INCLUDED AS AREAS OF PRIMARY ACTIVITY AS IT RELATES TO THE IMPLEMENTATION PLANS. HENRY FORD HEALTH JACKSON HOSPITAL PART V, SECTION B, LINE 13B: HENRY FORD HEALTH JACKSON HOSPITAL ADMINISTERS A PATIENT FINANCIAL ASSISTANCE POLICY DESIGNED TO PROVIDE FINANCIAL ASSISTANCE FOR UNINSURED PATIENTS AS WELL AS FOR INSURED PATIENTS WITH LIMITED RESOURCES. FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE SYSTEM OFFERS A DISCOUNTED RATE THAT DOES NOT EXCEED 138% OF MEDICARE PAYMENT RATES. INSURED PATIENTS WITH LIMITED FINANCIAL RESOURCES MAY QUALIFY FOR A DISCOUNT ON SELF-PAY BALANCES. TO QUALIFY FOR DISCOUNTED CARE, INCOMES MUST BE LESS THAN 400% OF THE FEDERAL POVERTY LEVEL. PART V, LINE 10A HTTPS://WWW.HENRYFORD.COM/ABOUT/COMMUNITY-HEALTH/NEEDS-ASSESSMENT 49 1 - HFHJH HEMATOLOGYONCOLOGY 1100 E MICHIGAN AVE STE 307 JACKSON MI 49201 SPECIALTY PRACTICE AND INFUSION CENTER 2 - HFHJH ORTHOPEDIC & NEUROSCIENCE CNTR 1201 E MICHIGAN AVENUE JACKSON MI 49201 OUTPATIENT SPECIALTY, DIAGNOSTIC AND REHAB FACILITY 3 - HFHJH SURGERY CENTER 1125 E MICHIGAN AVENUE JACKSON MI 49201 OUTPATIENT SURGERY CENTER 4 - HFHJH DIGESTIVE HEALTH 205 S EAST AVE JACKSON MI 49201 OUTPATIENT SURGERY CENTER 5 - HFHJH RADIATION ONCOLOGY 1102 E MICHIGAN AVE JACKSON MI 49201 RADIATION THERAPY 6 - HFHJH HEALTH CARDIOLOGY 309 PAGE AVENUE JACKSON MI 49201 SPECIALTY PRACTICE AND DIAGNOSTIC TESTING CENTER 7 - HFHJH HEALTH CENTER - CASCADE RIDGE 3305/3333 SPRING ARBOR RD JACKSON MI 49203 FAMILY AND SPECIALTY PRACTICES, DIAGNOSTIC CENTER 8 - HFHJH VASCULAR LABORATORY 300 W WASHINGTON AVENUE STE 350 JACKSON MI 49201 VASCULAR TESTING 9 - HFHJH HEALTH CENTER - TOWNSEND 400 HINCKLEY BLVD JACKSON MI 49203 FAMILY MEDICINE AND DIAGNOSTIC CENTER 10 - HFHJH HEALTH CENTER - NORTH STREET 1401 W NORTH STREET JACKSON MI 49202 FAMILY MEDICINE AND DIAGNOSTIC CENTER 11 - HFHJH HEALTH CENTER - SPRINGPORT 2200 SPRINGPORT ROAD JACKSON MI 49202 OUTPATIENT SERVICES, DIAGNOSTIC CENTER, PHARMACY SVCS 12 - HFHJH GASTROENTEROLOGY 744 W MICHIGAN AVE STE 201 JACKSON MI 49201 SPECIALTY PRACTICE 13 - HFHJH ENTHEARING CENTER 1111 TENEYCK ST JACKSON MI 49201 SPECIALTY PRACTICE AND AUDIOLOGY SALES/SERVICE 14 - HFHJH ADDICTION RECOVERY CENTER 2424 W WASHINGTON AVE JACKSON MI 49203 INPATIENT AND OUTPATIENT TREATMENT CENTER 15 - HFHJH HOME HEALTH CARE 100 E MICHIGAN AVE STE 400 JACKSON MI 49201 CLINICAL HOME CARE SERVICES 16 - HFHJH UROLOGY 150 S EAST AVENUE JACKSON MI 49201 UROLOGY CLINIC 17 - HFHJH RHEUMATOLOGY - W MICHIGAN AVE 744 W MICHIGAN AVE STE 300 JACKSON MI 49201 SPECIALTY PRACTICE 18 - HFHJH PHYSICAL REHAB-JACKSON 100 E MICHIGAN AVE STE 103 JACKSON MI 49201 PHYSICAL REHABILITATION 19 - HFHJH HEALTH CENTER - EAST MICHIGAN 3235 E MICHIGAN AVENUE JACKSON MI 49202 FAMILY MEDICINE AND BEHAVIORAL HEALTH SERVICES 20 - HFHJH PEDIATRICS 214 N WEST AVENUE JACKSON MI 49201 PEDIATRIC CLINIC 21 - HFHJH HEALTH CENTER - MASON 810 HOGSBACK RD MASON MI 48854 FAMILY AND SPECIALTY PRACTICE, DIAGNOSTICS, REHAB 22 - HFHJH HOME MEDICAL EQUIP 700 E MICHIGAN AVE JACKSON MI 49201 SALE OF DURABLE MEDICAL EQUIPMENT 23 - HFHJH FAMILY MEDICINE AND DIAGNOSTIC CNT 153 WAMPLERS LAKE RD BROOKLYN MI 49230 FAMILY MEDICINE AND DIAGNOSTIC CENTER 24 - HFHJH HEALTH CENTER - LESLIE 130 N SHERMAN ST LESLIE MI 49251 FAMILY MEDICINE AND DIAGNOSTIC CENTER 25 - HFHJH HEALTH CENTER - SPRING ARBOR 7845 SPRING ARBOR ROAD SPRING ARBOR MI 49283 FAMILY MEDICINE AND DIAGNOSTIC CENTER 26 - HFHJH BEHAVIORAL HEALTH 744 W MICHIGAN AVE STE 200 JACKSON MI 49201 OUTPATIENT BEHAVIORAL HEALTH 27 - HFHJH GENERAL SURGERY 1100 E MICHIGAN AVE STE 300 JACKSON MI 49201 SPECIALTY PRACTICE 28 - HFHJH HEALTH CENTER - ALBION 27931 C DRIVE NORTH ALBION MI 49224 FAMILY AND SPECIALTY MEDICINE, DIAGNOSTIC CENTER 29 - HFHJH THORACIC SURGERY 1100 E MICHIGAN AVE STE 201 JACKSON MI 49201 SPECIALTY PRACTICE 30 - HFHJH VASCULAR HEALTH 300 W WASHINGTON AVENUE STE 300 JACKSON MI 49201 SPECIALTY PRACTICE 31 - HFHJH OCCUPATIONAL HEALTH 100 E MICHIGAN AVE STE 101 JACKSON MI 49201 EMPLOYMENT SCREENING, WORK-RELATED INJURY TREATMENT 32 - HFHJH CARDIAC SURGERY 1100 E MICHIGAN AVE STE 201 JACKSON MI 49201 SPECIALTY PRACTICE 33 - HFHJH FAMILY MEDICINE AND DIAGNOSTIC CNT 12369 E MICHIGAN AVE GRASS LAKE MI 49240 FAMILY MEDICINE AND DIAGNOSTIC CENTER 34 - HFHJH INTERNAL MEDICINE 100 E MICHIGAN AVE STE 102 JACKSON MI 49201 OUTPATIENT SERVICES 35 - HFHJH DIAGNOSTIC CENTER - NORTH JACKSON 505 N JACKSON ST STE 178 JACKSON MI 49201 LAB AND IMAGING SERVICES 36 - HFHJH OUTPATIENT PROCEDURE CENTER 1100 E MICHIGAN AVE STE 109 JACKSON MI 49201 OUTPATIENT SERVICES 37 - HFHJH CARDIAC REHAB 1100 E MICHIGAN AVE STE 100/102 JACKSON MI 49201 POST-SURGICAL REHABILITATION 38 - HFHJH BARIATRIC CENTER 744 W MICHIGAN AVE STE 101 JACKSON MI 49201 SPECIALTY PRACTICE 39 - HFHJH PHYSICAL REHAB - HILLSDALE 61 W CARLTON HILLSDALE MI 49242 PHYSICAL REHABILITATION 40 - HFHJH DIAGNOSTIC CENTER 1100 E MICHIGAN AVE STE 104 JACKSON MI 49201 LAB AND IMAGING SERVICES 41 - HFHJH OUTPATIENT TRAUMA 1100 E MICHIGAN AVE STE 300 JACKSON MI 49201 SPECIALTY PRACTICE 42 - HFHJH HEALTH CENTER-CHELSEA 1145 S MAIN ST UNIT A CHELSEA MI 48119 LAB 43 - HFHJH HEALTH CENTER-COLDWATER 605 W CHICAGO STREET COLDWATER MI 49036 LAB 44 - HFHJH DIAGNOSTIC CENTER-HILLSDALE 3271 W CARLETON HILLSDALE MI 49242 LAB 45 - HENRY FORD MILK BANK-JACKSON 200 S EAST AVENUE JACKSON MI 49201 MILK BANK 46 - HFHJH ORTHO CLINIC-ALBION 415 S HANNAH ALBION MI 49224 SPECIALTY PRACTICE 47 - HFHJH CARDIOLOGY CLINIC-JONESVILLE 216 OLDS STREET JONESVILLE MI 49250 SPECIALTY PRACTICE 48 - HFHJH BEHAVIORAL HEALTH & AIM SERVICES 425 W NORTH STREET JACKSON MI 49201 BEHVAIORAL HEALTH & AIM SERVICES 49 - HFHJH BEHAVIORAL HEALTH & AIM SERVICES 1501 E GANSON STREET JACKSON MI 49201 BEHVAIORAL HEALTH & AIM SERVICES PART I, LINE 7G: SUBSIDIZED SERVICES CONSIST PRIMARILY OF PHYSICIAN AND FACILITY COSTS OF WOMEN'S AND BEHAVIORAL HEALTH SERVICES. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $22,413,282 PART II, COMMUNITY BUILDING ACTIVITIES: OUR VISION IS TO BE THE TRUSTED PARTNER IN HEALTH, LEADING THE NATION IN SUPERIOR CARE AND VALUE-ONE PERSON AT A TIME. TO BE A TRULY TRANSFORMATIVE FORCE FOR COMMUNITIES AND A TRUSTED PARTNER, IT IS IMPERATIVE THAT AS AN ORGANIZATION, WE LISTEN TO THE VOICES OF THOSE WE SERVE. WE SERVE MANY DIVERSE COMMUNITIES AND POPULATIONS WITH UNIQUE HISTORIES, CHARACTERISTICS, STRUGGLES AND STRENGTHS.TO ACHIEVE THIS VISION, WE MUST BUILD TRUSTED RELATIONSHIPS WITH OUR PATIENTS AND COMMUNITY MEMBERS AND ENSURE THOSE WE SERVE THAT THEIR NEEDS INFORM OUR PRACTICES, POLICIES AND ALLOCATION OF RESOURCES. OUR PATIENTS ENTRUST OUR ORGANIZATION WITH THEIR LIVES AND THE LIVES OF THOSE THEY LOVE. ASSESSING AND RESPONDING TO THE CHANGING NEEDS OF THESE PATIENTS IS VITAL TO DEVELOPING AND MAINTAINING TRUSTED RELATIONSHIPS AS WE WORK TOWARD A COMMON GOAL COMMUNITIES FULL OF HEALTHY, THRIVING PEOPLE OF ALL AGES. PART III, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE IS STATED IN PATIENT GROSS CHARGES. PART III, LINE 3: BAD DEBT IS REPORTED BASED UPON GROSS CHARGES (LINE 2). LINE 3 IS AN ESTIMATE USING 25% OF LINE 2. PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION 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 ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE ORGANIZATION RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. AT SUCH POINT IN TIME THAT A BILLED SERVICE IS BELIEVED TO BE UNCOLLECTIBLE, THE RELATED RECEIVABLE IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ESTIMATES OF RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE RECEIVED.FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION OFFERS A DISCOUNT OFF STANDARD RATES FOR SERVICES PROVIDED THAT RESULT IN NET CHARGES THAT DO NOT EXCEED 138% OF MEDICARE RATES.FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE ORGANIZATION'S PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. THE ORGANIZATION DETERMINES THE COSTS OF SUCH UNPAID SERVICES BY APPLYING A COST-TO-CHARGE RATIO TO THE BILLED CHARGES PART III, LINE 8: MEDICARE AMOUNTS ARE BASED ON THE COST REPORTS. COSTING METHODOLOGY USED IS COST TO CHARGE RATIO PART III, LINE 9B: SHOULD A PATIENT BE DEEMED ELIGIBLE FOR ASSISTANCE ANY COLLECTION EFFORTS ASSOCIATED WITH THE QUALIFYING SERVICE ARE SUSPENDED. IF THE PATIENT IS DETERMINED TO QUALIFY UNDER THE ORGANIZATION'S PATIENT FINANCIAL ASSISTANCE 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 THE 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" PART VI, LINE 2: COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES ARE SELECTED AFTER CONSIDERING THE DATA ON HEALTH AND SOCIAL NEEDS, WEIGHED ALONGSIDE INPUT RECEIVED FROM COMMUNITY MEMBERS AND STAKEHOLDERS REGARDING THE ISSUES THEY BELIEVE TO BE MOST IMPORTANT TO IMPROVING COMMUNITY HEALTH. THE FOLLOWING CRITERIA WERE CONSIDERED MOST IMPORTANT WHEN THE CHNA WORKGROUP WAS SELECTING THE RECOMMENDED PRIORITIES: ISSUES SIGNIFICANTLY CONTRIBUTING TO DEATH ISSUES SIGNIFICANTLY CONTRIBUTING TO PREVENTABLE HOSPITALIZATIONS SIGNIFICANT RACIAL DISPARITIES IN DISEASE OR MORTALITY PREVALENCE SIGNIFICANT WORSENING OF A HEALTH ISSUE SINCE 2019 CHNA RANKING IN TOP 4 ISSUES IMPORTANT TO IMPROVING COMMUNITY HEALTH BY COMMUNITY MEMBERS AND STAKEHOLDERSHENRY FORD'S CHNA WORKGROUP, A WORKGROUP OF COMMUNITY HEALTH ANCHOR COUNCIL ENTERPRISE-WIDE (CHANCE), REVIEWED THE DATA COLLECTED FROM STATE AND LOCAL SOURCES AND THE COMMUNITY/STAKEHOLDER INPUT FROM SURVEYS. THE WORKGROUP IDENTIFIED HIGHLY PREVALENT HEALTH ISSUES, ISSUES WHICH AFFECT PEOPLE IN OUR SERVICE AREA MORE THAN MICHIGAN RESIDENTS ON AVERAGE, AND ISSUES WHICH HAVE SIGNIFICANTLY WORSENED SINCE THE 2019 CHNA. AFTER CONSIDERING THE DATA, COMMUNITY INPUT, AND OUR RESOURCES AND INITIATIVES, PRIORITIES WERE RECOMMENDED BY THE CHNA WORKGROUP FOR APPROVAL BY THE PRESIDENT OF EACH HENRY FORD HEALTH HOSPITAL. CHNA WORKGROUP LEADERSHIP MET ONE-ON-ONE WITH EACH HOSPITAL PRESIDENT TO PRESENT NEEDS ASSESSMENT FINDINGS, PRIORITY RECOMMENDATIONS AND JUSTIFICATIONS FOR THE SELECTED PRIORITIES. APPROVAL WAS RECEIVED FROM EACH PRESIDENT FOR THE RECOMMENDED PRIORITIES. THE RECOMMENDED PRIORITIES WERE THEN PRESENTED TO AND RATIFIED BY EACH HOSPITAL BOARD OF TRUSTEES AND THE HENRY FORD HEALTH EXECUTIVE COUNCIL IN THE THIRD QUARTER OF 2022. THE COMMUNITY HEALTH LEADERSHIP COUNCIL RECOMMENDED THIS CHNA FOR APPROVAL BY THE BOARD OF DIRECTORS ON NOVEMBER 4, 2022. THE SELECTED PRIORITIES WERE RATIFIED BY THE HENRY FORD HEALTH BOARD OF DIRECTORS ON DECEMBER 16, 2022. PART VI, LINE 3: HFHJH 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. HFHJH FOLLOWS THE HFHS PATIENT FINANCIAL ASSISTANCE POLICY. HF HEALTH HAS A SINGULAR PATIENT FINANCIAL ASSISTANCE POLICY (PFAP). INDIVIDUALS WITHOUT ADEQUATE HEALTH INSURANCE COVERAGE MOST FREQUENTLY APPEAR IN OUR EMERGENCY ROOM FOR SERVICES, ALL PATIENTS ARE SEEN WITHOUT REGARD TO ABILITY TO PAY. INTAKE STAFF IS TRAINED 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 HFHJH AS WELL AS OTHER COMMUNITY, LOCAL, STATE AND FEDERAL PROGRAMS OFFERING POTENTIAL SUPPORT. HFHJH 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: THE FOUR-COUNTY AREA INCLUDES THE WAYNE, OAKLAND, MACOMB AND JACKSON COUNTIES, WHICH ARE LOCATED IN SOUTHEASTERN AND SOUTHCENTRAL MICHIGAN AND ACCOUNT FOR 41% OF THE MICHIGAN POPULATION. WAYNE, OAKLAND, AND MACOMB (IN THAT ORDER) ARE THE MOST POPULOUS COUNTIES IN MICHIGAN; JACKSON IS A MUCH SMALLER COUNTY. OF THE OVER 4 MILLION RESIDENTS IN THE FOUR-COUNTY AREA, APPROXIMATELY 51% OF THE POPULATION IS FEMALE. THE FOUR-COUNTY AREA IS 63% WHITE, 24% BLACK, AND 5% HISPANIC.POPULATION IN THE FOUR-COUNTY AREA IS EXPECTED TO REMAIN FLAT UNTIL 2026. WHEN EXAMINING AGE DISTRIBUTION, THE FOUR-COUNTY AREA HAS A COMPARABLE POPULATION TO THAT OF THE COUNTRY WITH 18% OF THE POPULATION ABOVE THE AGE OF 65. OF PARTICULAR INTEREST TO HEALTHCARE PROVIDERS IS THE AGING POPULATION OF THE FOUR-COUNTY AREA WITH THE 65-YEAR-OLD AND ABOVE POPULATION EXPECTED TO RISE BY 14% FROM 2021 TO 2026.REGARDING EDUCATION, THE FOUR-COUNTY AREA HAS APPROXIMATELY 10% OF RESIDENTS WHO HAVE SOME HIGH SCHOOL EDUCATION OR LESS COMPARED TO THE NATIONAL AVERAGE OF 12%. FURTHER, 30% OF RESIDENTS HAVE A BACHELOR'S DEGREE OR GREATER, WHICH IS COMPARABLE TO THE NATIONAL AVERAGE. THE FOURCOUNTY AREA IS DIVERSE IN POPULATION, RACE/ETHNICITY, ECONOMIC GROWTH AND DEVELOPMENT. THE AUTOMOTIVE INDUSTRY REMAINS THE LARGEST EMPLOYER IN THE REGION, BUT THE HEALTHCARE SECTOR IS REPRESENTED AMONG THE TOP EMPLOYERS IN THE REGION AS WELL.WITHIN THE FOUR-COUNTY AREA, THE MEDIAN HOUSEHOLD INCOME IN OAKLAND COUNTY ($81,587) IS SIGNIFICANTLY HIGHER THAN WAYNE COUNTY ($49,359), JACKSON COUNTY ($54,511), AND MACOMB COUNTY ($64,641). THE UNITED WAY ALICE (ASSET LIMITED, INCOME CONSTRAINED, EMPLOYED) REPORT SHOWS THE NUMBER OF HOUSEHOLDS WHOSE AVERAGE INCOME IS INSUFFICIENT TO AFFORD BASIC EXPENSES, INCLUDING HOUSING, CHILDCARE, HEALTH CARE AND TRANSPORTATION, BY COUNTY AND CITY.LOWER HOUSEHOLD INCOMES NEGATIVELY IMPACT PURCHASING POWER, HEALTH INSURANCE COVERAGE, AND ABILITY TO AFFORD NECESSITIES. THE FOUR-COUNTY AREA'S SAFETY NETS, INCLUDING HEALTHCARE SYSTEMS, ARE BEING STRETCHED TO THE LIMIT. MICHIGAN RANKS 33RD IN THE COUNTRY FOR CHILDREN UNDER AGE 18 IN FAMILIES BELOW POVERTY LEVEL, AT 17.3% IN 2019, A 2% IMPROVEMENT FROM 2018.IN ORDER TO INCREASE THE UTILITY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, IT IS IMPORTANT TO ANALYZE THE PROFILE(S) OF EACH OF THESE COUNTIES AT A MORE DETAILED LEVEL, SUCH AS ZIP CODES, SO THAT CERTAIN DIFFERENCES WITHIN THE AREA BECOME EVIDENT.ONE COMMUNITY IN PARTICULAR NEED OF ATTENTION IS THE CITY OF DETROIT, WHERE THE AVERAGE HOUSEHOLD INCOME IS $52,005, SIGNIFICANTLY LESS THAN AVERAGE HOUSEHOLD INCOME OF THE OVERALL FOUR-COUNTY AREA ($96,462). 18% OF DETROIT RESIDENTS HAVE LESS THAN A HIGH SCHOOL EDUCATION AND ONLY 15% HAVE A BACHELOR'S DEGREE OR HIGHER.IN ADDITION TO THE CITY OF DETROIT, THERE ARE OTHER ZIP CODES IN THE FOUR-COUNTY AREA WITH LOWER INCOMES AND LOWER EDUCATIONAL ATTAINMENT. THE AVERAGE HOUSEHOLD INCOME OF THESE ZIP CODES RANGES FROM $27,380-$65,690, LOWER THAN THE FOUR-COUNTY SERVICE AREA. OVERALL, 17% OF RESIDENTS IN THESE ZIP CODES HAVE LESS THAN A HIGH SCHOOL EDUCATION COMPARED TO 9% FOR THE FOUR-COUNTY AREA.THE POPULATIONS IN THESE ZIP CODES ARE MORE RACIALLY AND ETHNICALLY DIVERSE COMPARED TO THE FOUR-COUNTY AREA. 39% OF THE RESIDENTS OF THESE TOP 20 ZIP CODES ARE RACIAL MINORITIES COMPARED TO 37% OF RESIDENTS IN THE ENTIRE FOUR-COUNTY AREA.AS A RESULT, THE CITY OF DETROIT AND ABOVE TWENTY ZIP CODES ARE OF PARTICULAR INTEREST IN PLANNING COMMUNITY NEEDS INITIATIVES WITHIN THE FOUR-COUNTY AREA. PART VI, LINE 5: HENRY FORD HEALTH JACKSON HOSPITAL (HFHJH) IS PART OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH"), ONE OF THE NATION'S LARGEST INTEGRATED HEALTH DELIVERY SYSTEMS SERVING SOUTHEASTERN MICHIGAN. 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. THIS TAX RETURN REFLECTS ACTIVITIES OF HFHJH, WHICH INCLUDES 365 LICENSED INPATIENT BEDS WITH AN INTEGRATED MEDICAL STAFF SERVING MORE THAN 40 FACILITIES IN THE JACKSON COUNTY AREA OF MICHIGAN. HFHJH IS GOVERNED BY A DEDICATED VOLUNTEER COMMUNITY BOARD AND IT PROVIDES ITS COMMUNITIES WITH A FULL RANGE OF CLINICAL SERVICES INCLUDING GENERAL MEDICINE, SURGERY, PRIMARY CARE, OBSTETRICS, PEDIATRICS, CARDIAC CARE, CANCER CARE, ORTHOPEDICS, NEUROSURGERY, PHYSICAL AND REHABILITATION MEDICINE, AMBULATORY SURGERY, INPATIENT AND OUTPATIENT BEHAVIORAL SERVICES, AND 24-HOUR EMERGENCY CARE. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. PART VI, LINE 6: HENRY FORD HEALTH IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE BY ADDRESSING HEALTH DISPARITIES, ENHANCING ACCESS TO QUALITY CARE, AND SUPPORTING INITIATIVES THAT FOSTER COMMUNITY DEVELOPMENT. ALIGNED WITH OUR STRATEGIC VISION, OUR COMMUNITY FOCUS IS TO IMPROVE THE SOCIAL DETERMINANTS OF HEALTH, ENSURE CLINICAL EXCELLENCE, AND CONTRIBUTE TO ECONOMIC AND WORKFORCE DEVELOPMENT. BELOW ARE KEY ACHIEVEMENTS AND ONGOING INITIATIVES ACROSS FOUR CRITICAL AREAS OF IMPACT. SOCIAL DETERMINANTS OF HEALTH HENRY FORD HEALTH RECOGNIZES THAT THE HEALTH OF OUR COMMUNITY IS DEPENDENT UPON MANY FACTORS BEYOND OUR HOSPITAL WALLS, AND WE ACTIVELY WORK TO IMPROVE FACTORS INFLUENCING THE COMMUNITY'S OVERALL WELL-BEING. NUTRITION - THE COMMUNITY INFORMATION EXCHANGE FOR PATIENTS FACING FOOD INSECURITY AND OTHER CHALLENGES AND HENRY FORD HEALTH'S GENERATION WITH PROMISE PROGRAM WHICH PROVIDES EVIDENCE-BASED NUTRITION EDUCATION SUPPORTED NEARLY 20,000 INDIVIDUALS DURING 2024. TRANSPORTATION - HENRY FORD HEALTH WORKS TO HELP PATIENTS FIND LOW OR NO COST OPTIONS FOR TRANSPORTATION FOR MEDICAL APPOINTMENTS, AND DISCHARGE PLANNERS WORK WITH PATIENTS TO HELP THEM ACCESS AVAILABLE TRANSPORTATION BENEFITS THROUGH HEALTH INSURERS. ADDITIONALLY, FOR PATIENTS MEETING ESTABLISHED HIGH-RISK CRITERIA, HENRY FORD HEALTH ARRANGED TRANSPORTATION FOR MEDICAL APPOINTMENTS TO MORE THAN 4,500 PATIENTS IN 2024. ENVIRONMENT - WORKING TOWARD A GOAL OF 50% REDUCTION IN GREENHOUSE GAS EMISSIONS BY 2030, DESTINATION: GRAND HAS BEEN DESIGNED AS THE COUNTRY'S SECOND ALL-ELECTRIC HOSPITAL CAMPUS POWERED BY A DEDICATED CENTRAL ENERGY HUB. EMPLOYMENT - IMPLEMENTED "HIRE LOCAL" CRITERIA IN MAJOR CONSTRUCTION CONTRACTS ASSOCIATED WITH DESTINATION: GRAND THE NEW DETROIT HOSPITAL DEVELOPMENT WHICH IS ANTICIPATED TO EXPAND THE DETROIT-BASED WORKFORCE BY NEARLY 9,000. THIS INCLUDES TRADE APPRENTICESHIPS, JOB FAIRS, AND ESTABLISHING NURSING ASSISTANT AND MEDICAL ASSISTANT APPRENTICESHIP PROGRAMS WITH A PATHWAY TO EMPLOYMENT WITHIN HENRY FORD HEALTH, MOST RECENTLY HOSTING OVER 60 HIRING EVENTS ACROSS MICHIGAN IN PARTNERSHIP WITH MICHIGAN WORKS, FOCUSING ON UNDERSERVED COMMUNITIESHENRY FORD HEALTH REMAINS COMMITTED TO PROVIDING NEEDED HEALTH CARE TO OUR COMMUNITY MEMBERS REGARDLESS OF SOCIOECONOMIC STATUS. IN 2024, HENRY FORD HEALTH PROVIDED APPROXIMATELY $1.1 BILLION IN COMMUNITY BENEFIT, INCLUDING $784.4M IN UNCOMPENSATED CARE. PATIENT FINANCIAL ASSISTANCE PROGRAMS ARE DESIGNED TO REDUCE FINANCIAL BARRIERS AND ENSURE ACCESS TO MEDICAL SERVICES TO PATIENTS EXPERIENCING ECONOMIC HARDSHIP WITH AN AVERAGE OF 20,000 PATIENTS PER MONTH SUPPORTED THROUGH THIS PROGRAM IN 2024. 1 JACKSON COMMUNITY FOUNDATION 100 S JACKSON ST SUITE 200 JACKSON MI 49201 386070739 501(C)(3) 50000 0 N/A ORGANIZATIONAL SUPPORT RESIDENTS IN ACTION INC 915 ORCHARD PL JACKSON MI 49203 932087181 501(C)(3) 67848 0 N/A ORGANIZATIONAL SUPPORT 2 0 STAFF ASSISTANCE FUND FOR EMERGENCIES 51 40604 WE CARE PATIENT NEEDS FUND 35 3476 CANCER PATIENT IMMEDIATE NEEDS FUNDS 19 9647 PART I, LINE 2: AWARDS ARE GRANTED BASED ON AN APPLICATION AND REVIEW PROCESS.THE ORGANIZATION SENDS OUT AN AWARD LETTER TO ALL GRANTEE RECIPENTS. THE LETTER OUTLINES WHAT THE FUNDING MAY BE USED FOR AND REQUESTS A FINAL REPORT DETAILING THE YEAR'S ACTIVITIES. X X X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 ROBERT G RINEY FORMER TRUSTEE 0 2387193 0 3700757 0 931519 0 29501 0 32204 0 7081174 0 0 ADNAN R MUNKARAH MD PHYSICIAN TRUSTEE 0 1609011 0 1312608 0 452329 0 29501 0 40318 0 3443767 0 0 AZAM BASHEER MD PHYSICIAN 734345 0 1733980 0 303370 0 6038 0 34337 0 2812070 0 0 0 FRANK LAMARCA MD PHYSICIAN 1051938 0 1100510 0 456676 0 6038 0 36328 0 2651490 0 0 0 DENISE BROOKS-WILLIAMS TRUSTEE 0 1211247 0 826362 0 301159 0 29501 0 34640 0 2402909 0 0 KALEN RIMAR MD PHYSICIAN 434907 0 644189 0 36102 0 6038 0 47998 0 1169234 0 0 0 MOHAN G KULKARNI MD PHYSICIAN TRUSTEE 425760 0 342996 0 308016 0 6038 0 51981 0 1134791 0 0 0 BIPIN RAVINDRAN MD PHYSICIAN 655981 0 367930 0 62586 0 6038 0 4243 0 1096778 0 0 0 ALFRED MCARTHUR FAULKNER DO PHYSICIAN 231 0 830931 0 200950 0 0 0 0 0 1032112 0 0 0 MUMTAZ A MEMON MD PHYSICIAN TRUSTEE 464220 0 187416 0 83027 0 6038 0 34128 0 774829 0 0 0 MICHAEL GRISDELA FORMER INTERIM CENTRAL MAR 0 431558 0 188081 0 28544 0 61555 0 35121 0 744859 0 0 EMILY S MOORHEAD TRUSTEE - PRESIDENT & CEO 442308 0 190358 0 0 0 58378 0 1395 0 692439 0 0 0 MARK A SMITH MD CMO/CEO HFAHMG 458736 0 146919 0 9796 0 6038 0 53117 0 674606 0 0 0 LAWRENCE NARKIEWICZ JR MD PHYSICIAN TRUSTEE 376713 0 24600 0 200701 0 6038 0 31878 0 639930 0 0 0 KENNETH W EMPEY GENERAL COUNSEL 285546 0 77660 0 23000 0 5588 0 17379 0 409173 0 0 0 JIM BONGIORNO FOMER CENTRAL MARKET CFO 0 195705 0 58933 0 286 0 14841 0 30285 0 300050 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. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP RECEIVE MEMBERSHIP TO SOCIAL CLUBS INTENDED TO FURTHER THE BUSINESS NEEDS OF THE ORGANIZATION. USAGE IS REIMBURSED ON A CASE-BY-CASE BASIS BASED UPON DOCUMENTATION OF BUSINESS PURPOSE. IN CONNECTION WITH THE RECRUITMENT AND EMPLOYMENT OF LEADERS AND PHYSICIANS, THE ORGANIZATION AGREES AT TIMES TO PROVIDE TEMPORARY HOUSING AND RELOCATION SERVICES. INTERNAL REVENUE SERVICE GUIDELINES ARE ADHERED TO REGARDING THE REPORTING AND TAXATION OF ALL SUCH ITEMS. THE VALUE OF SUCH SERVICES IS ALSO INCLUDED IN THE EVALUATION OF REASONABLE COMPENSATION. 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. THE ORGANIZATION ALSO OFFERS CERTAIN MEMBERS OF LEADERSHIP THE OPTION OF PARTICIPATING IN AN IRC SEC 457 BENEFIT PROGRAM WHICH ALSO 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 3 THE CHIEF EXECUTIVE OFFICER FOR HENRY FORD HEALTH JACKSON HOSPITAL IS AN EMPLOYEE OF HENRY FORD HEALTH (THE SOLE MEMBER OF HENRY FORD ALLEGIANCE HEALTH GROUP). HENRY FORD HEALTH ("HF HEALTH") HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES CONSISTING OF ALL INDEPENDENT TRUSTEES. THE COMMITTEE MEETS THROUGHOUT THE YEAR AND IS CHARGED WITH THE 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 OF HENRY FORD HEALTH JACKSON HOSPITAL. THE COMMITTEE DIRECTLY ENGAGES 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 CEO IS ACCOUNTABLE FOR ENSURING THAT HENRY FORD HEALTH JACKSON HOSPITAL'S MISSION IS EFFICIENTLY CARRIED OUT WITH THE HIGHEST LEVELS OF QUALITY, SAFETY AND SERVICE, WHILE AT THE SAME TIME ENSURING THAT THE ORGANIZATION IS FINANCIALLY HEALTHY. EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THIS COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT TO ENSURE THAT HENRY FORD HEALTH JACKSON HOSPITAL COMPENSATION PRACTICES ARE CONSISTENT WITH INDUSTRY STANDARDS AND THAT COMPENSATION LEVELS ARE FAIR COMPARED TO SIMILAR HEALTHCARE ORGANIZATIONS NATIONALLY. THE COMPENSATION CONSULTANT BENCHMARKS HENRY FORD HEALTH JACKSON HOSPITAL'S POSITIONS AGAINST DATA FROM MULTIPLE PUBLISHED SURVEYS OF HEALTH CARE EXECUTIVE COMPENSATION IN THE NATIONAL HEALTH CARE LABOR MARKET. BASED UPON THE CONSULTANTS RECOMMENDATIONS, THE EXECUTIVE COMPENSATION COMMITTEE MAKES A RECOMMENDATION TO THE BOARD OF TRUSTEES FOR APPROVAL OF THE EXECUTIVE COMPENSATION PROGRAM. ONLY INDEPENDENT TRUSTEES VOTE ON THIS RECOMMENDATION. PART I, LINE 4B 4B. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN SUPPLEMENTAL RETIREMENT PROGRAMS THAT RESULT IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, AND/OR AS PAID. IT IS AN ELEMENT OF SOME PLAN DESIGNS 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. THE FOLLOWING PROVIDES THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS: SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) - HENRY FORD HEALTH SYSTEM PARTICIPANT ACCRUAL DISTRIBUTION NON-VESTED REPORTABLE W-2 ROBERT G. RINEY 894,040 - - 894,040 ADNAN R. MUNKARAH, M.D. 421,805 - - - 421,805 DENISE BROOKS-WILLIAMS 273,257 - - 273,257 MICHAEL GRISDELA - - 55,517 - SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - HENRY FORD HEALTH SYSTEM EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2024 CONTR. 2024 CONTR. TAX GROSS-UP W-2 AMOUNTS ROBERT G. RINEY 23,000 - - 23,000 DENISE BROOKS-WILLIAMS 23,000 - - 23,000 ADNAN R. MUNKARAH, M.D. 23,000 - - 23,000 MICHAEL GRISDELA 23,000 - - 23,000 KENNETH EMPEY 23,000 - - 23,000 SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - W.A. FOOTE MEMORIAL HOSPITAL EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2023 CONTR. 2023 CONTR. TAX GROSS-UP W-2 AMOUNTS FRANK LAMARCA, M.D. - 23,000 554 23,554 AZAM BASHEER, M.D - 14,175 - 14,175 MOHAN KULKARNI, M.D. 17,600 5,400 130 23,130 BIPIN RAVINDRAN, M.D. 13,190 9,810 236 23,236 MUMTAZ MEMON, M.D. 17,575 5,425 131 23,131 LAWRENCE NARKIEWICZ, M.D. 20,725 2,275 55 23,055 KALEN RIMAR, M.D. - 3,150 76 3,226 MARK A. SMITH, M.D. - 4,779 115 4,894 SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) -W.A. FOOTE MEMORIAL HOSPITAL PARTICIPANT ACCRUAL DISTRIBUTION NON-VESTED REPORTABLE W-2 EMILY MOORHEAD - - 52,341 - PART I, LINE 7 CERTAIN PHYSICIANS EMPLOYED BY THE ORGANIZATION RECEIVE COMPENSATION BASED ON A BASE SALARY AND AN INCENTIVE PAYMENT WHEN SERVICE VOLUMES EXCEED A PREDETERMINED LEVEL. THE ORGANIZATION MAY ALSO PROVIDE SUPPLEMENTAL COMPENSATION TO LEADERS ASKED TO ASSUME TEMPORARY EXPANDED SCOPES OF RESPONSIBILTIES. IN ALL SUCH CASES TOTAL COMPENSATION IS CONSIDERED IN THE EVALUATION OF REASONABLE COMPENSATION. SEE BELOW 0 SCHEDULE L. PART IV - BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION IS ORGANIZED ON A MEMBERSHIP BASIS. THE SOLE CORPORATE MEMBER OF THE CORPORATION IS HENRY FORD ALLEGIANCE HEALTH GROUP (FORMERLY ALLEGIANCE HEALTH SERVICES). FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION MAY ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE CORPORATION'S TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE CORPORATE MEMBER OF THE CORPORATION IS HENRY FORD ALLEGIANCE HEALTH GROUP ("MEMBER"). THE MEMBER'S SOLE CORPORATE MEMBER IS HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH"). HF HEALTH SHALL HAVE THE SOLE AUTHORITY TO TAKE OR CAUSE TO BE TAKEN ANY OF THE FOLLOWING ACTIONS (THE "HF HEALTH'S RESERVED POWERS"). - APPOINT THE BOARD OF TRUSTEES, CHAIRPERSON, AND PRESIDENT OF THE CORPORATION AND THE OTHER SYSTEM ENTITIES - REMOVE THE BOARD OF TRUSTEES, CHAIRPERSON AND PRESIDENT OF THE CORPORATION AND THE OTHER SYSTEM ENTITIES - CHANGE THE CORPORATE MEMBER OF THE CORPORATION OR ANY SYSTEM ENTITY, PROVIDED SUCH ACTION SHALL HAVE BEEN APPROVED BY A VOTE OF THE MEMBER'S BOARD OF DIRECTORS; - AMEND THESE BYLAWS, THE CORPORATION'S ARTICLES OF INCORPORATION OR THE GOVERNING DOCUMENTS OF ANY SYSTEM ENTITY, PROVIDED (I) HF HEALTH FIRST CONSULTS WITH THE MEMBER'S BOARD OF DIRECTORS REGARDING THE PROPOSED AMENDMENT AND (II) THE AMENDMENT COMPLIES WITH ARTICLE XV OF THE BYLAWS REGARDING KEY SECTIONS; - APPROVE AN AGREEMENT OF (A) MERGER OR CONSOLIDATION OF THE CORPORATION OR ANY SYSTEM ENTITY, OR (B) SALE, LEASE, OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR ANY SYSTEM ENTITY, PROVIDED SUCH AGREEMENT SHALL HAVE BEEN APPROVED BY VOTE OF TWO-THIRDS OF THE MEMBER'S LOCAL DIRECTORS (AS DEFINED IN THE MEMBER'S BYLAWS) AND FURTHER PROVIDED THAT APPROVAL OF THE LOCAL DIRECTORS SHALL NOT BE REQUIRED WITH RESPECT TO (I) AN OVERALL AFFILIATION OR CHANGE IN OWNERSHIP OF HF HEALTH (INCLUDING THE SYSTEM) IF THE TERMS OF THAT TRANSACTION DO NOT VIOLATE THE KEY SECTIONS OR (II) A SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF HF HEALTH (INCLUDING THE ASSETS OF THE CORPORATION) TO A FOR-PROFIT ENTITY WHICH TRIGGERS APPLICATION OF THE TERMS OF SECTION 6.8(B) OF THE AFFILIATION AGREEMENT DATED MARCH 4, 2016 BETWEEN THE MEMBER (THEN KNOWN AS ALLEGIANCE HEALTH SERVICES) AND HF HEALTH, AS AMENDED FROM TIME TO TIME; - DISSOLVE THE CORPORATION OR ANY SYSTEM ENTITY OR REVOKE SUCH DISSOLUTION, PROVIDED SUCH ACTION SHALL HAVE BEEN APPROVED BY A VOTE OF THE MEMBER'S BOARD OF DIRECTORS; - RECEIVE FROM THE MEMBER STRATEGIC AND ANNUAL OPERATING PLANS AND ANNUAL OPERATING AND CAPITAL BUDGETS FOR THE SYSTEM ENTITIES, INCLUDING THE CORPORATION, THAT ARE DEVELOPED COLLABORATIVELY BY THE MEMBER'S AND HF HEALTH'S RESPECTIVE LEADERSHIP AND RECOMMENDED BY THE MEMBER'S BOARD OF DIRECTORS, AND ADOPT SUCH RECOMMENDED PLANS AND BUDGETS UNLESS AN UNUSUAL CIRCUMSTANCE ARISES IN WHICH HF HEALTH DETERMINES A CHANGE TO A PLAN OR BUDGET IS NECESSARY, AND APPROVE EXPENDITURES BY THE SYSTEM ENTITIES NOT INCLUDED IN SUCH BUDGETS OF AN ANNUAL AGGREGATE AMOUNT EXCEEDING $500,000. - CAUSE ANY SYSTEM ENTITY TO INCUR, ASSUME OR GUARANTY INDEBTEDNESS OR FULFILL OTHER OBLIGATIONS REQUIRED UNDER HF HEALTH DEBT AGREEMENTS, OR APPROVE INDEBTEDNESS OF THE SYSTEM ENTITIES IN AN ANNUAL AGGREGATE AMOUNT EXCEEDING $2,000,000 PROVIDED ALL INDEBTEDNESS SHALL COMPLY WITH HF HEALTH'S MASTER INDENTURE AND OTHER HF HEALTH CREDIT DOCUMENTS. - ENCUMBER THE ASSETS OF ANY SYSTEM ENTITY AS SECURITY FOR DEBTS OR OTHER LAWFUL ENGAGEMENTS SECURING INDEBTEDNESS, OR APPROVE ENCUMBRANCES SECURING INDEBTEDNESS OF THE SYSTEM ENTITIES IN AN ANNUAL AGGREGATE AMOUNT EXCEEDING $2,000,000 PROVIDED ALL ENCUMBRANCES SHALL COMPLY WITH HF HEALTH'S MASTER INDENTURE AND OTHER HF HEALTH CREDIT DOCUMENTS. - EXCHANGE, ABANDON OR DISPOSE OF FIXED ASSETS OF ANY SYSTEM ENTITY BY MEANS OF SALE, LEASE OR TRANSFER, AND APPROVE ALL SUCH ACTIONS PROPOSED BY THE SYSTEM ENTITIES WITH AN ANNUAL AGGREGATE VALUE IN EXCESS OF $2,000,000, PROVIDED SUCH ACTION SHALL HAVE BEEN APPROVED BY A VOTE OF THE MEMBER'S BOARD OF DIRECTORS. - AUTHORIZE THE FORMATION OR ACQUISITION OF NEW SUBSIDIARIES OF THE CORPORATION FOLLOWING CONSULTATION WITH THE MEMBER'S BOARD OF DIRECTORS. AS USED HEREIN, "INDEBTEDNESS" OF A PERSON SHALL MEAN: (A) OBLIGATIONS OF SUCH PERSON RELATING TO INDEBTEDNESS FOR BORROWED MONEY; (B) OBLIGATIONS OF SUCH PERSON EVIDENCED BY BONDS, NOTES, DEBENTURES OR SIMILAR INSTRUMENTS; AND (C) OBLIGATIONS IN THE NATURE OF GUARANTEES BY, OR JOINT AND SEVERAL LIABILITY OF, SUCH PERSON WITH RESPECT TO THE OBLIGATIONS OF ANY OTHER PERSON OF THE TYPE DESCRIBED IN CLAUSES (A) AND (B) ABOVE. RESPONSIBILITIES AND RESERVED POWERS OF THE MEMBER (HENRY FORD ALLEGIANCE HEALTH GROUP): IN ADDITION TO DOING ALL THINGS RESERVED TO THE MEMBER BY LAW AND WHICH ARE CONSISTENT WITH HF HEALTH'S RESERVED POWERS, THE MEMBER OF THE CORPORATION SHALL TAKE THE FOLLOWING ACTIONS WITH RESPECT TO THIS CORPORATION ("MEMBER'S RESERVED POWERS"): - ADOPT THE VISION, MISSION AND VALUES; AND - RATIFY OR REJECT OPERATING AND CAPITAL BUDGETS RECOMMENDED BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH") AND THE TAX DEPARTMENT OF HF HEALTH 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 HF HEALTH AND ORGANIZATION'S SENIOR VICE PRESIDENT FINANCIAL OPERATIONS, CHIEF FINANCIAL OFFICER, AND DIRECTOR OF ACCOUNTING. - REVIEW OF ALL COMPENSATION MATTERS AND DISCLOSURES WITH THE COMPENSATION COMMITTEE OF THE HF HEALTH BOARD OF DIRECTORS - REVIEW OF THE RETURN WITH THE HF HEALTH CEO AND AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS - FINAL COPIES OF THE RETURN ARE DISTRIBUTED TO THE HOSPITAL'S BOARD OF TRUSTEES BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH (HF HEALTH) WHO OVERSEES THE CONFLICT OF INTEREST PROCESS WITH REGARD TO THE ORGANIZATION. HF HEALTH HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE HF HEALTH CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS AND EMPLOYEES. ANNUALLY, DIRECTORS, 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 HF HEALTH BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH (HF HEALTH) WHO HAS RESPONSIBILITY TO OVERSEE THE COMPENSATION PRACTICES OF THE ORGANIZATION. HF HEALTH HAS A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS CONSISTING OF ALL EXTERNAL DIRECTORS. 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. FORM 990, PART IV, LINE 24A, TAX-EXEMPT BOND ISSUE: THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH. THE ALLOCATED TAX-EXEMPT BOND LIABILITY OF THE ORGANIZATION IS REPORTED UNDER THE FORM 990, SCHEDULE K OF ITS PARENT, HENRY FORD HEALTH. FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT 13,384,458. AFFILATE EQUITY TRANSFERS -1,270,597. FORM 990, PART XII, LINE 2C HENRY FORD HEALTH JACKSON HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF HENRY FORD HEALTH (THE SOLE MEMBER OF HENRY FORD ALLEGIANCE HEALTH GROUP). THE GOVERNING BODY OF HENRY FORD HEALTH HAS DELEGATED THE OVERSIGHT OF ITS FINANCIAL STATEMENTS, INCLUDING THE CHOICE OF INDEPENDENT AUDITORS, TO ITS AUDIT COMMITTEE. FORM 990, PART VII: AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: MANY EXECUTIVE EMPLOYEES OF HENRY FORD HEALTH AND AFFILIATES PROVIDE SERVICES TO MULTIPLE AFFILIATED ENTITIES. HENRY FORD HEALTH AND AFFILIATES USE 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 HOSPITALS OR AFFILIATES ARE REPORTED AT BETWEEN 1 TO 5 HOURS PER WEEK. FORM 990 SUSTAINABILITY: ENVIRONMENTAL FACTORS IMPACT COMMUNITY HEALTH AND HENRY FORD HEALTH RECOGNIZES THAT AS A COMMUNITY PARTNER WE CAN INFLUENCE MANY OF THESE FACTORS. OUR SUSTAINABILITY GOALS ARE INTENDED TO SIMULTANEOUSLY REDUCE GREENHOUSE GAS EMISSIONS, REDRESS ENVIRONMENTAL INJUSTICES, AND IMPROVE THE HEALTH OF THE PATIENTS, EMPLOYEES, AND COMMUNITIES WE SERVE. HENRY FORD HEALTH HAS ESTABLISHED THE FOLLOWING SUSTAINABILITY GOALS TO BE ACHIEVED BY 2030: REDUCE GREENHOUSE GAS EMISSIONS FROM OPERATIONS BY 50%, TARGETING NET-ZERO BY 2040 ELIMINATE CHEMICALS OF CONCERN FROM PRIORITY PRODUCTS REDUCE WASTE SENT TO LANDFILL BY 50% MEET LOCAL OR SUSTAINABLE CRITERIA FOR 30% OF FOOD PURCHASES INCREASE ANNUAL INVESTMENT IN GREEN AND HEALTHY INFRASTRUCTURE FORM 5713 - INTERNATIONAL BOYCOTT ACTIVITY: A FORM 5713, INTERNATIONAL BOYCOTT REPORT, HAS BEEN FILED ON OUR BEHALF BY HENRY FORD HEALTH (SOLE MEMBER OF HENRY FORD ALLEGIANCE HEALTH GROUP). HENRY FORD HEALTH JACKSON HOSPITAL DID NOT ITSELF HAVE ANY ACTIVITIES ASSOCIATED WITH AN INTERNATIONAL BOYCOTT COUNTRY. PHYSICIANS CHOICE NETWORK LLC 205 N EAST AVENUE JACKSON MI 49201 PROVIDER NETWORK MI 0 0 HENRY FORD ALLEGIANCE HEALTH IT'S YOUR LIFE SERVICES LLC 205 N EAST AVENUE JACKSON MI 49201 PREVENTION AND COMMUNITY HEALTH MI 0 0 HENRY FORD ALLEGIANCE HEALTH HENRY FORD ALLEGIANCE HEALTH GROUP 205 N EAST AVENUE JACKSON MI 49201 382756428 EXEMPT ORGANIZATION MI 501(C)(3) LINE 12B, II HENRY FORD HEALTH SYSTEM 1 ALLEGIANCE HEALTH FOUNDATION 205 N EAST AVENUE JACKSON MI 49201 383607833 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12B, II HENRY FORD ALLEGIANCE HEALTH GROUP 1 HOSPICE OF JACKSON DBA ALLEGIANCE HOSPICE 205 N EAST AVENUE JACKSON MI 49201 382336367 HOSPICE CARE MI 501(C)(3) LINE 7 HEATHLINK 1 HEALTHLINK 205 N EAST AVENUE JACKSON MI 49201 382756425 HOME HEALTH CARE MI 501(C)(3) LINE 12A, I HENRY FORD ALLEGIANCE HEALTH GROUP 1 CARELINK OF JACKSON 110 NORTH ELM AVENUE JACKSON MI 49202 381218485 LONG TERM ACUTE CARE HOSPITAL MI 501(C)(3) LINE 3 HENRY FORD ALLEGIANCE HEALTH GROUP 1 HENRY FORD HEALTH SYSTEM ONE FORD PLACE DETROIT MI 48202 381357020 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 N/A 0 HENRY FORD WYANDOTTE HOSPITAL 2333 BIDDLE AVE WYANDOTTE MI 48192 382791823 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM FOUNDATION ONE FORD PLACE DETROIT MI 48202 237383042 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I HENRY FORD HEALTH SYSTEM 1 HEALTH ALLIANCE PLAN 3031 W GRAND BLVD DETROIT MI 48202 382242827 HEALTH MAINTENANCE ORGANIZATION MI 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HFII CORPORATION ONE FORD PLACE DETROIT MI 48202 900840304 SCIENTIFIC RESEARCH MI 501(C)(3) LINE 7 HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH SYSTEM GOVERNMENT AFFAIRS SERVICES ONE FORD PLACE DETROIT MI 48202 464064067 ADVOCACY SERVICES FOR HF HEALTH AND AFFILIATES ME 501(C)(4) N/A HENRY FORD HEALTH SYSTEM 1 HENRY FORD MACOMB HOSPITAL CORPORATION ONE FORD PLACE DETROIT MI 48202 382947657 HEALTHCARE SERVICE PROVIDER DE 501(C)(3) LINE 3 HENRY FORD HEALTH SYSTEM 1 THE CLARENCE S LIVINGOOD LECTURESHIP AND EDUCATION FUND 3031 WEST GRAND BOULEVARD NO 800 DETROIT MI 48202 382682321 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12B, II HENRY FORD HEALTH SYSTEM 1 HENRY FORD PHYSICIAN PARTNERS ONE FORD PLACE DETROIT MI 48202 871633901 PHYSICIAN SERVICES MI 501(C)(3) LINE 12B, II HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH PARENT ONE FORD PLACE DETROIT MI 48202 934079536 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12B, II HENRY FORD HEALTH SYSTEM 1 HENRY FORD HEALTH ROCHESTER HOSPITAL ONE FORD PLACE DETROIT MI 48202 381359247 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 ASCENSION MICHIGAN 1 HENRY FORD HEALTH PROVIDENCE HOSPITAL ONE FORD PLACE DETROIT MI 48202 381358212 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 ASCENSION MICHIGAN 1 HENRY FORD HEALTH RIVER DISTRICT HOSPITAL ONE FORD PLACE DETROIT MI 48202 383160564 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 ASCENSION MICHIGAN 1 HENRY FORD HEALTH ST JOHN HOSPITAL ONE 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SOUTHEAST MICHIGAN COMMUNITY HEALTH ONE FORD PLACE DETROIT MI 48202 382262856 HEALTHCARE MI 501(C)(3) LINE 3 STJOHN PROVIDENCE 1 GENESYS AMBULATORY HEALTH SERVICES INC ONE FORD PLACE DETROIT MI 48202 382371754 HEALTH SERVICES/STAFFING/PROPERTY MGT MI 501(C)(3) LINE 12B, II GENESYS HEALTH SYSTEM 1 THE HEALTHSOURCE GROUP INC ONE FORD PLACE DETROIT MI 48202 382427678 PRG RELATED INVESTMENTS MI 501(C)(3) LINE 12B, II GENESYS HEALTH SYSTEM 1 HENRY FORD CORNERSTONE MEDICAL GROUP ONE FORD PLACE DETROIT MI 48202 382601348 HEALTHCARE MI 501(C)(3) LINE 10 STJOHN PROVIDENCE 1 HENRY FORD HEALTH ROCHESTER FOUNDATION ONE FORD PLACE DETROIT MI 48202 382627336 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12B, II HENRY FORD HEALTH ROCHESTER HOSPITAL 1 ASCENSION MICHIGAN ONE FORD PLACE DETROIT MI 48202 382631907 SUPPORTING ORGANIZATION MI 501(C)(3) ASCENSION HEALTH 1 SETON HEALTHCARE CORPORATION OF SOUTHEAST MICHIGAN ONE FORD PLACE DETROIT MI 48202 382820107 SOCIAL WELFARE MI 501(C)(4) N/A STJOHN PROVIDENCE 1 GENESYS HEALTH SYSTEM ONE FORD PLACE DETROIT MI 48202 383339703 HOLDING COMPANY MI 501(C)(3) LINE 12B, II ASCENSION MICHIGAN 1 HENRY FORD SEMI MEDICAL GROUP ONE FORD PLACE DETROIT MI 48202 383494637 HEALTHCARE MI 501(C)(3) LINE 10 ASCENSION MICHIGAN 1 HENRY FORD HEALTH PROVIDENCE FOUNDATION ONE FORD PLACE DETROIT MI 48202 383526629 FUNDRAISING MI 501(C)(3) LINE 7 HENRY FORD HEALTH PROVIDENCE HOSPITAL 1 HENRY FORD HEALTH GENESYS FOUNDATION ONE FORD PLACE DETROIT MI 48202 383591148 FOUNDATION MI 501(C)(3) LINE 12B, II HENRY FORD HEALTH GENESYS HOSPITAL 1 HENRY FORD MEDICAL GROUP GENESYS ONE FORD PLACE DETROIT MI 48202 831617112 HEALTHCARE MI 501(C)(3) LINE 10 HENRY FORD SEMI MEDICAL GROUP 1 HFH SRALAB CORPORATION ONE FORD PLACE DETROIT MI 48202 803295211 HEALTHCARE SERVICE PROVIDER MI 501(C)(3) LINE 3 HENRY FORD HEALTH SYSTEM 1 FOOTE HEALTH CENTER ASSOCIATES 1100 E MICHIGAN AVENUE JACKSON MI 49201 383017711 LESSOR OF MEDICAL CONDOMINIUMS MI HENRY FORD HEALTH JACKSON HOSPITAL N/A 0 0 0.92870 NORTHWEST DETROIT DIALYSIS 30100 TELEGRAPH BINGHAM FARMS MI 48025 383232668 OPERATE DIALYSIS CLINIC MI HENRY FORD HEALTH SYSTEM N/A 0 0 MACOMB REGIONAL DIALYSIS CENTERS 16151 NINETEEN MILE RD CLINTON TOWNSHIP MI 48038 260423581 OPERATE DIALYSIS CLINIC MI HENRY FORD HEALTH SYSTEM N/A 0 0 HFHS-SCA HOLDINGS LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL 35209 465291602 OUTPATIENT SURGERY CLINICS MI HENRY FORD HEALTH SYSTEM N/A 0 0 HAP EMPOWERED HOLDING LLC 3031 WEST GRAND BOULEVARD DETROIT MI 48202 923877012 HOLDING COMPANY DE HEALTH ALLIANCE PLAN OF MICHIGAN N/A 0 0 THE MICHIGAN INSTITUTE FOR ADVANCED SURGERY CENTER LLC OFP DETROIT MI 48202 030444972 AMBULATORY SURGERY CENTER MI CRITTENTON DEVELOPMENT CORPORATION RELATED 0 0 HENRY FORD ALLEGIANCE PHARMACY 205 N EAST AVENUE JACKSON MI 49201 383370242 PHARMACY MI HENRY FORD ALLEGIANCE HEALTH GROUP C 1 SHA REALTY INC ONE FORD PLACE DETROIT MI 48202 381378121 REAL ESTATE HOLDING MI HENRY FORD HEALTH SYSTEM C 1 FAIRLANE HEALTH SERVICES 30100 TELEGRAPH BINGHAM FARMS MI 48025 382565235 HEALTHCARE MANAGEMENT MI HENRY FORD HEALTH SYSTEM C 1 ALLIANCE HEALTH AND LIFE INSURNACE 3031 W GRAND BLVD DETROIT MI 48202 383291563 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN C 1 ONIKA INSURANCE LTD FIRST CARRIBEAN HOUSE GRAND CAYMAN CJ CAPTIVE INSURANCE CJ HENRY FORD HEALTH SYSTEM C 1 HENRY FORD PHYSICIAN NETWORK ONE FORD PLACE DETROIT MI 48202 320306774 PHYSICIAN NETWORK MI HENRY FORD HEALTH SYSTEM C 1 ADMINSTRATION SYSTEMS RESEARCH CORPORATION 3031 W GRAND BLVD DETROIT MI 48202 382651185 THIRD PARTY INSURANCE ADMIN. MI HEALTH ALLIANCE PLAN C 1 HAP CARESOURCE 3031 W GRAND BLVD DETROIT MI 48202 383123777 HEALTH INSURANCE PROVIDER MI HEALTH ALLIANCE PLAN OF MICHIGAN C 1 HENRY FORD ELIJAH MCCOY CONDOMINIUM ASSOCIATION 1150 ELIJAH MCCOY DR DETROIT MI 48202 852144748 CONDOMINIUM ASSOCIATION MI HENRY FORD HEALTH SYSTEM C 1 CRITTENTON DEVELOPMENT CORPORATION OFP DETROIT MI 48202 382594115 REAL ESTATE MI HENRY FORD HEALTH ROCHESTER HOSPITAL C 1 AFFILIATED HEALTH SERVICES INC OFP DETROIT MI 48202 382292922 MEDICAL SERVICES MI ST JOHN PROVIDENCE C 1 BEECHER BALLENGER SERVICES INC OFP DETROIT MI 48202 382497922 HOLDING COMPANY MI GENESYS AMBULATORY HEALTH SERVICES INC C 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 ALLIANCE HEALTH AND LIFE INSURANCE CO M 2296291 COST HENRY FORD ALLEGIANCE PHARMACY Q 5839287 COST MOSAIC CLINICALLY INTEGRATED NETWORK LLC S 1997881 COST COMMUNITY HEALTH TECH NETWORK P 844980 COST ONIKA INSURANCE LTD P 2726592 COST HEALTH ALLIANCE PLAN L 6921985 COST FOOTE HEALTH CENTER ASSOCIATES K 888344 COST HOSPICE OF JACKSON DBA ALLEGIANCE HOSPICE Q 1001600 COST ONIKA INSURANCE LTD Q 4358962 COST FOOTE HEALTH CENTER ASSOCIATES M 58943 COST SCHEDULE R, PART V, LINE 1D & 1E: THE ORGANIZATION IS A MEMBER OF THE HENRY FORD HEALTH SYSTEM OBLIGATED GROUP. MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR OUTSTANDING OBLIGATIONS ISSUED UNDER THE 2016, 2019 AND 2022 HFHS BOND MASTER INDENTURES.