2025-05-14T13:47:48-04:00 2024-06-30 990 2023-07-01 380350304 MUNSON HEALTHCARE MANISTEE HOSPITAL MUNS 2313981000 1465 EAST PARKDALE AVENUE MANISTEE MI 496609709 PAUL KONOPACKI CFO 2313981000 2025-05-13 false 2023 2025-03-06 01:10:19Z KELLY TOMASZEWSKI 1105 SIXTH STREET TRAVERSE CITY MI 49684 59300979 false X WWW.MUNSONHEALTHCARE.ORG/MANISTEE X 1988 MI MUNSON HEALTHCARE MANISTEE HOSPITAL AND ITS PARTNERS WILL WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. 23 19 328 19 0 1608963 405149 56619599 57702326 -40116 236334 432618 484577 58621064 58828386 0 0 26940300 26237506 0 59530 34333357 31609258 61273657 57846764 -2652593 981622 51198011 37447926 7861234 6129527 43336777 31318399 AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON HEALTHCARE MANISTEE HOSPITAL EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. false false 49016157 57922930 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF MANISTEE, MICHIGAN AND THE SURROUNDING AREA WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE MANISTEE HOSPITAL HAD 676 INPATIENT ADMISSIONS IN FISCAL YEAR 2024 AND OVER 59,400 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 1,700 SURGICAL CASES AND OVER 13,200 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE MANISTEE HOSPITAL ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS APPROXIMATELY 69 ACTIVE MEDICAL STAFF AND 19 VOLUNTEERS. 49016157 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 false false true true true false false true 27 0 true 328 true false false false false false false false false false false false false X 23 19 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 2319357792 4230 COPPER RIDGE DR TRAVERSE CITY MI 49684 EDWIN A NESS DIRECTOR 2.00 40.00 X 0 2245580 251955 LAURA GLENN MHC SYSTEM C 2.00 40.00 X 0 839007 105311 PAUL KONOPACKI CFO 2.00 40.00 X 0 720042 86525 DINO RECCHIA MD DIRECTOR 40.00 X 0 691094 27597 ROBERT BARRY MD ORTHOPEDIC S 40.00 X 573402 0 37518 LYNNE MCCORMICK DO PHYSICIAN 39.00 1.00 X 535520 3640 37418 ELLEN SMITH PRESIDENT AM 2.00 40.00 X 0 464827 60006 WILLIAM BELL DO SURGEON 40.00 X 451641 0 42323 MARIAN FULLER MD PHYSICIAN 34.00 6.00 X 317865 63579 41253 NATHAN BOSS MD PHYSICIAN 3.00 37.00 X 27954 343682 41760 KELLY TOMASZEWSKI PRESIDENT 20.00 20.00 X X 0 297671 65475 VINCENT SCHULTZ MD DIRECTOR 40.00 X 0 313737 42486 KATHLEEN LARAIA VP ONCOLOGY 2.00 40.00 X 0 314675 35733 ROBERT RICHARDSON VP FACILITIE 2.00 40.00 X 0 267416 55111 KATHLEEN MALY FORMER INTER X 0 222122 7314 CASEY KANDOW FORMER VP AN X 0 114566 0 KENNETH BLOEM PT-YR CHAIR 3.00 X X 0 5000 0 MATT BULLOCH DIRECTOR 1.00 X 0 5000 0 NICK CEGLAREK DIRECTOR 1.00 X 0 5000 0 ALAN CONRAD DIRECTOR 1.00 X 0 5000 0 KATHY DIXON 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 PT-YR SEC/PT 3.00 X X 0 5000 0 DAVE MENGEBIER PT-YR TREASU 2.00 X X 0 5000 0 KIM MORLEY PT-YR VICE C 1.00 X X 0 5000 0 TIM NELSON PT-YR SEC/PT 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 TOM VERYSER DIRECTOR 1.00 X 0 5000 0 ELAINE WOOD PT-YR CHAIR 2.00 X X 0 5000 0 JENNIFER KING DIRECTOR 1.00 X 0 0 0 KARL KLIMEK DIRECTOR 1.00 X 0 0 0 BEN MULADORE DIRECTOR 1.00 X 0 0 0 ANDY PAGE DIRECTOR 1.00 X 0 0 0 SAKURA TAKANO DIRECTOR 1.00 X 0 0 0 1906382 6991638 937785 36 true true false SODEXO INC AND AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 FOOD 1813823 ECS LAKESHORE PC 4100 EMBASSY DR SE STE 400 GRAND RAPIDS MI 49546 MEDICAL 1469790 SOUND PHYSICIANS PO BOX 742936 LOS ANGELES CA 900742936 MEDICAL 1411164 ORTHOPEDIC SPORTS MED OF MANISTEE 3234 W COUNTYLINE RD MANISTEE MI 49660 MEDICAL 501250 SPENCE BROTHERS 203 S WASHINGTON AVE STE 360 SAGINAW MI 48607 CONSTRUCTIONS 312882 11 202086 203063 405149 PATIENT SERVICE REVENUE 621990 31518372 31518372 MEDICARE/MEDICAID PAYMENTS 621990 25400504 25400504 INCENTIVE PAYMENTS 621990 601193 601193 MISC HEALTHCARE REVENUE 621990 177061 177061 RENT FROM RELATED ORGS 621990 5196 5196 57702326 15730 15730 199953 199953 199953 199953 693197 472593 220604 220604 220604 CAFETERIA SALES 621990 258174 258174 MISCELLANEOUS 446199 26450 26450 284624 58828386 57922930 500307 X 21506874 20823388 683486 1011548 979401 32147 2497952 2418567 79385 1221132 1182325 38807 7500 7500 7490315 7485315 5000 6000 6000 258647 189052 69595 974218 974218 1525016 1525016 61339 52666 8673 37937 37937 605185 512800 92385 2469204 2092267 376937 259248 196883 62365 SHARED SERVICES 6394928 -956171 7291569 59530 MEDICAL SUPPLIES 5919545 5919545 QAAP TAXES 2623275 2623275 BAD DEBT EXPENSE 2276330 2276330 700571 683343 17228 57846764 49016157 8771077 59530 13213540 1207131 267456 280565 5434349 5860527 642352 733672 325946 181670 91133352 62332798 30570725 28800554 743643 383807 51198011 37447926 3091174 3297005 225321 200740 4544739 2631782 7861234 6129527 X 43336777 31318399 43336777 31318399 51198011 37447926 X 981622 -13000000 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7500 7500 false SCHEDULE C, PART II-B, LINE 1 OTHER ACTIVITIES INDICATE THE PORTION OF DUES ALLOCATED TO LOBBYING EXPENSES PAID TO VARIOUS REGIONAL OR NATIONAL ORGANIZATIONS, SUCH AS THE THE AMERICAN HOSPITAL ASSOCIATION, THE AMERICAN ACADEMY OF SLEEP MEDICINE, THE AMERICAN ACADEMY OF FAMILY PHYSICIANS AND THE NATIONAL ASSOCIATION OF RURAL HEALTH CLINICS. 1849703 1849703 53825190 31790711 22034479 238924 238924 33384511 28848192 4536319 1835024 1454971 380053 28800554 RESERVE FOR THIRD PARTY SETTLEMENTS 2025524 LONG TERM OPERATING LEASE LIABILITY 333180 SHORT TERM OPERATING LEASE LIABILITY 185580 CAPITAL LEASE 87498 2631782 true true X true X true X true true false true true 87329 87329 0.00160 8360425 7588465 771960 0.01330 8447754 7588465 859289 0.01490 240240 127051 113189 0.00200 82016 2468 79548 0.00140 16280053 12382016 3898037 0.06740 57938 57938 0.00100 16660247 12511535 4148712 0.07180 25108001 20100000 5008001 0.08670 18905 18905 0.00030 1703 1703 20608 20608 0.00040 true 2276330 780000 8305224 6663344 1641880 X true true 1 1 MUNSON HEALTHCARE MANISTEE HOSPITAL 1465 EAST PARKDALE AVENUE MANISTEE MI 496609709 WWW.MUNSONHEALTHCARE.ORG/MANISTEE 1060000184 X X X MUNSON HEALTHCARE MANISTEE HOSPITAL 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 MANISTEE HOSPITAL - PART V, LINE 3E YES, THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND WERE IDENTIFIED THROUGH THE CHNA. FACILITY 1, MUNSON HEALTHCARE MANISTEE HOSPITAL - 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. 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 MANISTEE HOSPITAL - 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 MANISTEE HOSPITAL - 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 MANISTEE HOSPITAL - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE MANISTEE HOSPITAL - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE MANISTEE HOSPITAL - 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 MANISTEE HOSPITAL - 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 MANISTEE HOSPITAL - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE MANISTEE HOSPITAL - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE MANISTEE HOSPITAL - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE MANISTEE HOSPITAL - 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 MANISTEE HOSPITAL - PART V, LINE 20E MUNSON HEALTHCARE MANISTEE HOSPITAL (MANISTEE) 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. MANISTEE 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 MUNSON 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. THE METHOD IN WHICH MANISTEE DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. MANISTEE 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. 1 MHC MANISTEE WELLNESS CENTER 2198 US-31 S MANISTEE MI 49660 REHABILITATION 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 8,801,242. 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 57,846,764. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 2,276,330. THE NET EXPENSE OF 55,570,434 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 MANISTEE HOSPITAL 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 ACROSS A 31-COUNTY AREA, 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. THE WORK ENSURES STRATEGIES ADDRESS ROOT CAUSES, REDUCE DUPLICATION OF EFFORTS, AND IMPROVE IMPACT. TOGETHER, THE CHIR ALSO DEVELOPED AND CONTINUES TO SUPPORT THE COMMUNITY CONNECTIONS MODEL WHERE CLIENTS ARE UNIVERSALLY SCREENED IN A HEALTHCARE SETTINGINCLUDING AT MUNSON HEALTHCAREAND CONNECTED TO COMMUNITY HEALTH WORKERS FOR SUPPORT WITH BASIC NEEDS. THE BEHAVIORAL HEALTH INSTITUTE (BHI): THIS GROUP WAS FORMED IN RESPONSE TO THE BEHAVIORAL HEALTH CRISIS IN OUR REGION. TOGETHER, THE GROUP DEVELOPED A SHARED ROADMAP, INCLUDING TWELVE ACTION TEAMS, EACH OF WHICH MUNSON CONTRIBUTES TO. SOME OF THE GROUPS ACCOMPLISHMENTS INCLUDE: 1. RECRUIT BEHAVIORAL HEALTH INTERNS AND PROVIDERS: LAUNCH OF FIRST EVER BEHAVIORAL HEALTH INTERNSHIP WEBSITE WITH SEARCHABLE OPPORTUNITIES AND RESOURCES TO HELP STUDENTS RELOCATE TO RURAL, NORTHERN MICHIGAN. THIS TEAM ALSO DEVELOPED A HEALTHY WORKPLACES = THRIVING EMPLOYEES TOOLKIT, BEST PRACTICE GUIDES, AND A LUNCH AND LEARN WEBINAR SERIES FOCUSED ON ACTIONABLE STRATEGIES TO HELP EMPLOYERS BETTER SUPPORT AND RETAIN THEIR BEHAVIORAL HEALTH PROVIDERS.2. REDUCE STIGMA AROUND MENTAL HEALTH AND SUBSTANCE USE DISORDERS: STIGMA REDUCTION EFFORTS, INCLUDED SURVEYS TO BETTER UNDERSTAND COMMUNITY PERCEPTIONS AROUND MENTAL ILLNESS AND SUBSTANCE USE DISORDER, VIDEO-BASED STORIES HIGHLIGHTING PEOPLE WITH LIVED EXPERIENCES, A YOUTH PHOTOVOICE PROJECT TO EDUCATE AUDIENCES AND ENCOURAGE FURTHER LEARNING, PUBLIC SERVICE ANNOUNCEMENTS TO NORMALIZE CONVERSATIONS AROUND MENTAL HEALTH, AN IMPLICIT BIAS TRAINING FOR PROVIDERS, A WORDS HOLD POWER LANGUAGE GUIDE, AND MORE. 3. STRENGTHEN CRISIS SERVICES: THIS TEAM SUCCESSFULLY OBTAINED A 5 MILLION DOLLAR GRANT TO BUILD A CRISIS CENTER FOR THE REGION. CONSTRUCTION ON MUNSONS CAMPUS AND HIRING ARE WELL-UNDERWAY WITH AN EXPECTED OPEN DATE IN JANUARY OF 2025. 4. ENHANCE AVAILABILITY OF CHW NAVIGATION SUPPORT: COMMUNITY HEALTH WORKER PILOT PROGRAMS WERE DEVELOPED IN FOUR AREA SCHOOLS. ADDITIONALLY, A WEBSITE WITH A COMPREHENSIVE RESOURCE DIRECTORY WAS CREATED SO CHWS COULD EASILY ACCESS RESOURCES NEEDED TO SUPPORT CLIENTS, AS WELL AS A SHARED SLACK LINE TO LINK CHWS FOR ONGOING COLLABORATION. 5. RECRUIT BEHAVIORAL HEALTH PROVIDERS: THIS GROUP HELD A LISTENING SESSION TO BETTER UNDERSTAND RECRUITMENT CHALLENGES RELATED TO BEHAVIORAL HEALTH PROFESSIONALS, HOSTED TWO EDUCATION SESSIONS ON LOAN REPAYMENT PROGRAMS, AND CONTINUE TO MEET WITH COLLEGES AND UNIVERSITIES TO EXPLORE STRATEGIES THAT STRENGTHEN THE BEHAVIORAL HEALTH PROVIDER PIPELINE. 6. PROMOTE BEHAVIORAL HEALTH PARITY: THIS TEAM PUBLISHED AN INFOGRAPHIC AND SUBSEQUENT CASE STUDY GUIDE TO EDUCATE PATIENTS AND PROVIDERS ABOUT THEIR RIGHTS TO BEHAVIORAL HEALTH PARITY. MICHIGANS REGION 2 & 3 PERINATAL QUALITY COLLABORATIVE (RPQC): MUNSON SERVES AS THE CO-LEAD AND FIDUCIARY OF THIS GROUP, WORKING WITH SEVERAL OTHER PARTNERS, INCLUDING: OTHER HEALTHCARE SYSTEMS IN THE REGION, HOME VISITING AGENCIES, HEALTHCARE PROFESSIONALS, FAITH-BASED ORGANIZATIONS, GREAT START COLLABORATIVES, NONPROFIT ORGANIZATIONS, COMMUNITY OUTREACH GROUPS, AND HEALTH DEPARTMENTS. ITS PURPOSE IS TO IMPROVE PREGNANCY, BIRTH, AND POSTPARTUM OUTCOMES THROUGH A SUSTAINABLE AND COORDINATED NETWORK OF CARE.QUALITY IMPROVEMENT EFFORTS ARE DATA-DRIVEN AND ALIGNED WITH COMMUNITY FEEDBACK OBTAINED THROUGH LISTENING SESSIONS AND TAILORED TO REGIONAL STRENGTHS AND CHALLENGES. RECENT INITIATIVES INCLUDE: 1. THE INTEGRATION OF INDIGENOUS BIRTHING CULTURE AND EDUCATION WITHIN MUNSON HEALTHCARE, 2. BUILDING AND IMPLEMENTATION OF EVIDENCE-BASED SUPPORTS FOR FAMILIES EFFECTED BY PERINATAL SUBSTANCE USE DISORDER, 3. THE PROVISION OF CHILDBIRTH EDUCATION MATERIALS TO PREPARE BIRTHING PEOPLE FOR MORTALITY RISK INDICATORS SUCH AS HIGH BLOOD PRESSURE, AND 4. BUILDING A CULTURALLY SENSITIVE BIRTH PLAN WITH COMMUNITY INPUT, AND MORE. FINALLY, THE ORGANIZATION 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 SUPPORT POLICIES THAT WOULD PROVIDE SUPPORT FOR TELEHEALTH SERVICES, BEHAVIORAL HEALTHCARE CRISIS SERVICES, WELLNESS PROGRAMMING AND EDUCATION, AFFORDABLE HOUSING, AND TRANSPORTATION. 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 SUCCESSFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT WERE DENIED. THEN WE APPLIED THAT PERCENTAGE TO THE VALUE OF 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 HEALTHCARES 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 PATIENTS GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENTS 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 HOSPITALS 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 MANISTEE HOSPITAL IS ONE OF NINE COMMUNITY HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM. MANISTEE COUNTY COVERS A TOTAL OF 542 SQUARE MILES OF LAND AND IS CLASSIFIED AS RURAL BY THE US CENSUS BUREAU. THE HOSPITAL HAS 69 ACTIVE MEDICAL STAFF (PRIMARY FACILITY) AND IS ONE OF THE LARGEST EMPLOYERS IN THE COUNTY. THE HOSPITAL SERVED OVER 1,700 SURGICAL CASES, MORE THAN 59,400 OUTPATIENT VISITS, 676 INPATIENT ADMISSIONS, AND OVER 13,200 EMERGENCY ROOM VISITS IN FISCAL YEAR 2024. HOSPITAL SERVICES THIS 45 BED HOSPITAL PROVIDES HIGH QUALITY MEDICAL CARE AND ADVANCED DIAGNOSTIC SERVICES TO RESIDENTS OF MANISTEE COUNTY AND SURROUNDING COMMUNITIES. HOSPITAL SERVICES INCLUDE: THIS 45 BED HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES: COMPREHENSIVE RADIOLOGY SERVICES WITH MRI, CT, ULTRASOUND, 3D MAMMOGRAPHY, AND X-RAY OUTPATIENT LABORATORY SERVICES COMPREHENSIVE REHABILITATION SERVICES, INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH AND HEARING, AND WOUND THERAPY PROGRAMS 24-HOUR EMERGENCY CARE GYNECOLOGY SLEEP DISORDERS SPECIALTIES, INCLUDING ORTHOPEDICS, UROLOGY, OPHTHALMOLOGY, EAR NOSE AND THROAT, CARDIOLOGY, CANCER SERVICES AND MORE CARDIAC AND PULMONARY REHABILITATION PRIMARY CARE DIALYSIS GENERAL, ORTHOPEDIC AND OUTPATIENT SURGERY POPULATION SERVED MUNSON HEALTHCARE MANISTEE HOSPITAL IS IN MANISTEE COUNTY, WHICH IS THE HOSPITALS PRIMARY SERVICE AREA. WITHIN THIS COUNTY, THE FOLLOWING DEMOGRAPHIC INFORMATION APPLIES: MANISTEE COUNTY IS HOME TO 25,562 PEOPLE MOST RESIDENTS ARE WHITE (91.4%), WITH THE LARGEST MINORITIES BEING AFRICAN AMERICAN (3.5%), AMERICAN. INDIAN/ALASKAN NATIVE (2.4%), AND ASIAN (0.4%) THE PROPORTION OF ADULTS OVER 65 IS SIGNIFICANTLY HIGHER THAN THE STATE AVERAGE (18.7%) AT 28% THE MEDIAN HOUSEHOLD INCOME IS 59,467 WHICH IS WELL BELOW THE STATE AVERAGE THE UNEMPLOYMENT RATE IS 5%. THE PERCENT OF UNINSURED INDIVIDUALS IS 7% QUALITY RECEIVED AN A GRADE FROM THE LEAPFROG GROUP FOR SPRING 2024. THE LEAPFROG GROUP IS AN INDEPENDENT NATIONAL WATCHDOG GROUP THAT EXAMINES HOSPITAL QUALITY AND SAFETY. 2024 TOP 100 RURAL & COMMUNITY HOSPITALS BY THE CHARTIS CENTER FOR RURAL HEALTH, AMONG SEVEN OTHER HOSPITALS IN MICHIGAN TO RECEIVE THE RECOGNITION. 2023 RECEIVED A LEVEL IV TRAUMA CENTER DESIGNATION AWARDED BY THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES SCHEDULE H, PART VI, LINE 5 MUNSON HEALTHCARE MANISTEE 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, INCLUDING: 1. FOR OVER 25 YEARS, HEALTHY FUTURES A PARTNERSHIP OF MUNSON, LOCAL HEALTH DEPARTMENTS, AND PROVIDER OFFICES HAS HELPED PARENTS AND BABIES HAVE A HEALTHY START. THIS INCLUDESA FREE AND UNIVERSAL POSTPARTUM HOME VISITING PROGRAM,1:1 BREASTFEEDING ASSISTANCE,INFANT SLEEP AND IMMUNIZATION EDUCATION, AND AGE-APPROPRIATE NEWSLETTERS AND TEXT MESSAGES FOR OVER 1,300 FAMILIES ANNUALLY.THE PROGRAM IS AVAILABLE TO ALL, WITH OR WITHOUT INSURANCE. 2. WORK CONTINUES TO CREATE A NO WRONG DOOR APPROACH TO SUBSTANCE USE DISORDER TREATMENT. THIS INCLUDES THE DEVELOPMENT AND IMPLEMENTATION OF A STANDARD BEST-PRACTICE PROTOCOL WITHIN EMERGENCY AND PRIMARY CARE SETTINGS. MUNSON ALSO EXPANDED IN-PERSON AND VIRTUAL PEER RECOVERY SERVICES, PEER SUPPORT FOR PROVIDERS TREATING PATIENTS WITH SUD, AND EXPANDED HARM REDUCTION RESOURCES, INCLUDING MEDSAFE RECEPTACLES AND NARCAN ACCESS. 3. 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. RECENT 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. 4. MUNSON IS CURRENTLY PARTNERED WITH THE UNIVERSITY OF MICHIGAN IN A PEDIATRIC BEHAVIORAL HEALTH EQUITY STUDY TO LOOK AT CARE DELIVERY AND IMPLEMENT QUALITY IMPROVEMENT PROJECTS. IN ADDITION, THE HOSPITAL PARTNERS WITH LOCAL SCHOOL SYSTEMS AND NORTHWEST EDUCATION TO HELP FIND COMMON LANGUAGE, COMMUNICATION TOOLS, BASELINE INTERVENTIONS AND RECOMMENDED NEXT STEPS TO BETTER SERVE KIDS WHEN THEY ARE EXPERIENCING A MENTAL HEALTH CRISIS. 5. THE PERINATAL GRIEF GRANT WAS FUNDED BY MDHHS WITH THE GOAL OFCREATINGLOCAL AND SUSTAINABLE BEREAVEMENT SUPPORT NETWORKS THROUGHA COLLECTIVE IMPACT APPROACH. THESE FUNDS WERE USED TO PROVIDE EVIDENCE-BASED TRAINING TO HEALTHCARE STAFF AND COMMUNITY PARTNERS, EMPOWERING THEM TO PROVIDE COMPASSIONATE CARE TO THOSE EXPERIENCING GRIEF AND LOSS. A TOTAL OF 54 MUNSON STAFF AND GRIEF SUPPORT PARTNERS COMPLETED THE RESOLVE THROUGH SHARING TRAINING. ADDITIONAL WORK INCLUDED VIRTUAL FOCUS GROUPS, EXPANDED SUPPORT GROUP OFFERINGS, PROCUREMENT OF GRIEF SUPPORT MATERIALS FOR MATERNITY UNITS, AND INCREASED AWARENESS AND OUTREACH TO OB OFFICES. 6. VOICES FOR COMMUNITY HEALTH IS AN ANNUAL ART PROGRAM THAT INVITES ARTWORK ADDRESSING IMPORTANT TOPICS LIKE YOUTH MENTAL HEALTH AND RECOVERY. THE MUNSON-OWNED PROJECT AIMS TO RAISE AWARENESS, REDUCE STIGMA, AND INSPIRE HOPE. THE COMMUNITY IS ENCOURAGED TO VISIT THE GALLERY AND MAKE A PLEDGE TO SUPPORT THESE CAUSES. LAST YEARS PROJECT COLLECTED OVER 130 PIECES AND 220 PLEDGES, WITH AN OVERALL REACH OF 30,000. 7. MUNSON COLLABORATES WITH TRAVERSE HEALTH CLINIC AND GOODWILL NORTHERN MICHIGAN TO OFFER 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. DURING FY24, MUNSON HEALTHCARE INVESTED AN ADDITIONAL 300,000 TO SUPPORT AN FTE TO INCREASE COORDINATION AND PROGRAM EXPANSION. 8. 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. FINALLY, MUNSON ENHANCED THEIR DIRECT PATIENT OUTREACH BY USING TEXT MESSAGES TO PROVIDE RESOURCES, REMINDERS, AND EDUCATION AROUND TOPICS SUCH AS CANCER, DIABETES, HEART HEALTH, AND TOBACCO. 10. MUNSON MAKES FINANCIAL CONTRIBUTIONS TO COMMUNITY CAUSES AND EVENTS FOCUSED ON MENTAL HEALTH, CHRONIC DISEASE, AND HOUSING, WHILE PARTICIPATING ON COMMITTEES AND BOARDS THAT WORK TO ADDRESS SYSTEMATIC CHALLENGES FACING THESE PRIORITY AREAS. THE HOSPITAL PROVIDES DEDICATED PERSONAL TO RESEARCH AND APPLY FOR FUNDING FOR UNDER-RESOURCED PATIENTS WHO HAVE CANCER. THIS TEAM ALSO PROVIDES HEALTH INSURANCE NAVIGATION FOR COMMUNITY MEMBERS TO ENROLL IN PUBLIC INSURANCE PROGRAMS. SCHEDULE H, PART VI, LINE 6 MUNSON HEALTHCARE MANISTEE HOSPITALS 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 153.5 MILLION OF COMMUNITY BENEFIT IN THE 2023 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 4.6 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2023. 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 179.2 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 1019734 200000 1025846 222314 29641 2497535 834836 LAURA GLENN MHC SYSTEM COO 602996 150000 86011 81533 23778 944318 PAUL KONOPACKI CFO 582360 70000 67682 65902 20623 806567 DINO RECCHIA MD DIRECTOR 648678 17144 25272 16533 11064 718691 ROBERT BARRY MD ORTHOPEDIC SURGEON 549096 24306 16533 20985 610920 LYNNE MCCORMICK DO PHYSICIAN 512713 3529 22807 111 16459 74 20723 162 572702 3876 ELLEN SMITH PRESIDENT AMB SERVIC 398576 66251 56118 3888 524833 WILLIAM BELL DO SURGEON 422918 5304 23419 16533 25790 493964 MARIAN FULLER MD PHYSICIAN 303018 63579 14847 14809 1294 22419 2731 355093 67604 NATHAN BOSS MD PHYSICIAN 1836 256445 26118 85811 1426 575 16057 1589 23539 30118 383278 KELLY TOMASZEWSKI PRESIDENT 246534 51137 42498 22977 363146 VINCENT SCHULTZ MD DIRECTOR 278379 19933 15425 15990 26496 356223 KATHLEEN LARAIA VP ONCOLOGY & PROF S 282571 32104 27111 8622 350408 ROBERT RICHARDSON VP FACILITIES & SUPP 232921 34495 28323 26788 322527 KATHLEEN MALY FORMER INTERIM CFO 84251 75000 62871 2947 4367 229436 CASEY KANDOW FORMER VP ANCILLARY 114566 114566 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 0 206,681 0 LAURA GLENN 0 65,000 0 PAUL KONOPACKI 0 56,002 0 ELLEN SMITH 0 40,000 0 KELLY TOMASZEWSKI 0 27,498 0 KATHLEEN LARAIA 0 17,471 0 ROBERT RICHARDSON 0 14,520 0 CASEY KANDOW 114,566 0 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. PART II, COLUMN B(III) IN JULY 2023, MUNSON HEALTHCARE TRANSITIONED EXECUTIVE PTO FROM AN ACCRUAL PLAN TO AN UP FRONT ANNUAL ALLOTMENT PLAN WITH A USE-IT-OR-LOSE-IT BALANCE DISPOSITION. CURRENT EXECUTIVES ON THE PTO ACCRUAL PLAN WERE PAID OUT THEIR EXISTING BALANCES IN JULY 2023. THE FIRST 80 HOURS OF ACCRUED PTO WAS PAID AT 90% OF VALUE AND THE BALANCE WAS PAID AT 80% OF VALUE. THIS PAYOUT IS LESS FAVORABLE THAN EXISTING POLICY, WHICH PAYS OUT ACCRUED PTO AT 100% UPON SEPARATION OF EMPLOYMENT. THIS ONE-TIME PAYOUT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J. PART II, LINE 1, COLUMN B(III) CEO EDWIN NESS, A 25 YEAR EMPLOYEE, HAS BEGUN VESTING IN HIS SERP PLAN. IN 2023, THE TAXABLE AMOUNT WAS 834,836. THIS ONE-TIME TAXABLE AMOUNT IS REFLECTED IN HIS 2023 COMPENSATION IN COLUMN B(III) OF SCHEULE J. OF THE AMOUNT REPORTED IN THE CURRENT FORM 990 SCHEDULE J, SERP PLAN CONTRIBUTIONS IN THE AMOUNT OF 834,836 WERE PREVIOUSLY REPORTED AS BENEFITS IN PRIOR YEAR FORMS 990. FORM 990, PAGE 6, PART VI, LINE 6 MUNSON HEALTHCARE MANISTEE HOSPITAL 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 MANISTEE HOSPITAL. THE BOARD OF TRUSTEES OF MUNSON HEALTHCARE MANISTEE HOSPITAL 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 MANISTEE HOSPITAL (MAN) 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 MAN; 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 MAN; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF MAN; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR MAN; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY MAN 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 MAN 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 MAN; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY MAN; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE MANISTEE HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE MANISTEE HOSPITAL 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 COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE 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 MANISTEE HOSPITAL AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE MANISTEE HOSPITAL ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE MANISTEE HOSPITAL 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 4,810,494 5,000 0 PROFESSIONAL FEES 2,674,821 0 0 TOTAL 7,485,315 5,000 0 FORM 990, PART XI, LINE 9 EQUITY TRANSFER TO PARENT -13,000,000 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 PARENT MI C3 12B N/A false 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 MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE 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 HEALTHCARE CADILLAC 1105 SIXTH ST TRAVERSE CITY MI 49684 471156297 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE GRAYLING 1105 SIXTH ST TRAVERSE CITY MI 49684 471161992 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 FOUNDATIONS 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE 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 MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true MEDICAL OFFICE CONDOMINIUM ASSOCIATION PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true true false true false false false false false false false false true true false true true true false false MUNSON HEALTHCARE B 13000000 ACTUAL AMOUNT PAID MUNSON HEALTHCARE M 6890171 ACTUAL AMOUNT PAID MUNSON HEALTHCARE O 940913 ACTUAL AMOUNT PAID MUNSON HEALTHCARE P 6068734 ACTUAL AMOUNT PAID MUNSON HEALTHCARE Q 278575 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC L 950955 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC P 124098 ACTUAL AMOUNT PAID MUNSON HEALTHCARE CADILLAC Q 263508 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS C 202086 ACTUAL AMOUNT PAID MUNSON HEALTHCARE FOUNDATIONS M 59530 ACTUAL AMOUNT PAID MUNSON HEALTHCARE GRAYLING P 453918 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER O 14591182 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER P 2147073 ACTUAL AMOUNT PAID MUNSON MEDICAL CENTER Q 3440347 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP A 5196 LEASE CONTRACT AMOUNT MUNSON MEDICAL GROUP M 920004 ACTUAL AMOUNT PAID MUNSON MEDICAL GROUP O 2326378 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE M 401398 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE P 1077458 ACTUAL AMOUNT PAID NORTHERN MICHIGAN SUPPLY ALLIANCE Q 229735 SCHEDULE R MUNSON HEALTHCARE MANISTEE HOSPITAL 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.