2025-11-13T13:01:30-06:00 2024-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 20 STANWIX STREET PITTSBURGH PA 15222 990 2024-01-01 381358208 MEMORIAL HOSPITAL MEMO 9897235211 826 WEST KING STREET OWOSSO MI 48867 JORRI TREMAIN CFO 9897235211 2025-11-10 1 1 KELLY A BROCIOUS P01254262 4126976400 2025-11-10 2024 2025-03-06 01:10:19Z MEMORIAL HEALTHCARE JORRI TREMAIN 826 WEST KING STREET OWOSSO MI 48867 352399300 0 X WWW.MEMORIALHEALTHCARE.ORG X 1919 MI TO PROVIDE HEALTHCARE SERVICES TO PATIENTS. 15 11 1918 60 1023260 0 716910 257670 291540581 344822095 1785612 2455186 4537773 4864349 298580876 352399300 0 0 0 0 131460935 153278436 0 0 171928 161003510 187519987 292464445 340798423 6116431 11600877 196134747 215085800 88065026 97104342 108069721 117981458 X TO PROMOTE HEALTH AND PROVIDE QUALITY COMPASSIONATE HEALTHCARE IN OUR REGION THROUGH A COMMITMENT TO SERVICE EXCELLENCE, TEAMWORK AND INNOVATION. 0 0 50747388 95669246 A MEDICAL AND SURGICAL HOSPITAL THAT PROVIDES INPATIENT AND OUTPATIENT SERVICES TO ALL PATIENTS.INPATIENT DISCHARGES: 4,048, PATIENT DAYS: 23,046, INPATIENT SURGERIES: 694, BIRTHS: 475 118874217 218794753 ANCILLARY SERVICES (OUTPATIENT VISITS: 251,310, OUTPATIENT SURGERIES: 4,189, PAIN MANAGEMENT VISITS: 6,054 63555884 27897816 MMA SERVICES (PHYSICIAN CLINICS, MMA RVU'S: 542,437 62112334 5311979 ALL OTHER PROGRAM SERVICES 62112334 5311979 295289823 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 257 0 1918 1 1 1 0 0 0 0 0 0 0 0 0 X 15 11 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 1 0 MI X ROSE BROWN 9897294717 826 WEST KING STREET OWOSSO MI 48867 GREGORY P BONTRAGER PRESIDENT 2.00 X X 0 0 0 TONY M YOUNG VICE PRESIDENT 2.00 X X 0 0 0 WILFRED BILL A FARRELL TREASURER 2.00 X X 0 0 0 JERRY D WALDEN SECRETARY 2.00 X X 0 0 0 BARBARA BAKEROMEROD MEMBER 2.00 X 0 0 0 MICHAEL L ASH MEMBER 2.00 1.00 X 0 0 0 SHANA M ESPINOZA MEMBER 2.00 X 0 0 0 THOMAS E CAMPBELL MEMBER 2.00 X 0 0 0 BRUCE J WENZLICK MEMBER 2.00 X 0 0 0 BRYAN K MARKS MEMBER 2.00 X 0 0 0 DAVID R WAKELAND MEMBER 2.00 X 0 0 0 MARGARET R FREY DO MEMBER 40.00 X 370276 0 10596 ANTHONY A PATSY DO MEMBER 39.00 1.00 X 349505 0 32726 JOSEPH E TESTA DO MEMBER 40.00 X 484024 0 38131 BRIAN L LONG EXECUTIVE DIRECTOR/CEO 58.00 2.00 X X 885461 0 32620 JORRI TREMAIN CFO 40.00 X 311587 0 9974 THOMAS KURTZ COO 40.00 X 355238 0 32786 JOSEPH M BUSTAMANTE DO CHIEF MEDICAL OFFICER 40.00 X 527057 0 26066 HAZEM TABBAA DO VICE CHIEF OF STAFF 40.00 X 940087 0 41328 ABBIE MAJZEL COA 40.00 X 273852 0 9152 JOYCE BREMER VP PHYSICIAN PRACTICE MANAGEMENT 40.00 X 264534 0 23148 RAMY M KURDI DO PHYSICIAN 40.00 X 1214202 0 41034 TAREK R PACHA DO PHYSICIAN 40.00 X 1132745 0 33613 SASHA M SPENCLEY DO PHYSICIAN 40.00 X 850108 0 18116 ASHRAF M ELBANNA MD PHYSICIAN 40.00 X 938969 0 33808 IRA STANLEY FRYE MD PHYSICIAN 40.00 X 825084 0 38882 9722729 0 421980 232 0 1 0 ACCOUNTABLE HEALTHCARE STAFFING 999 YAMATO ROAD 210 BOCA RATON FL 33431 STAFFING SERVICES 4571889 ALLIANCE HNI LLC PO BOX 772550 DETROIT MI 48277 RENTAL OF EQUIPMENT 2605758 AMERICAN HEALTHCARE STAFFING ASSOCIATION PO BOX 670529 DALLAS TX 75267 STAFFING SERVICES 1616396 ECS CENTRAL MICHIGAN PC 4100 EMBASSY DR SE STE 400 GRAND RAPIDS MI 49546 CONTRACTED EMERGECY ROOM PHYSICIANS 1572498 UMS SHIAWASSEE COUNTY URS LITHOTRIPSY 1700 WEST PARK DRIVE SUITE 410 WASHINGTON MA 01581 ABLATION TREATMENTS 1512613 46 147264 110406 257670 NET PATIENT SERVICE REVENUE 900099 341862320 341862320 PHYSICIAN REVENUE 900099 2916277 2916277 BILLING SERVICE REVENUE 561000 43498 43498 344822095 2321905 2321905 2895197 0 2895197 2895197 2895197 35064 98217 0 0 35064 98217 133281 133281 CAFETERIA REVENUE 722513 989390 989390 WELLNESS CENTER 623000 979762 979762 1969152 352399300 347673794 1023260 3444576 5018146 5018146 117955858 107324723 10496518 134617 2534877 2478838 56039 19970302 19561624 395576 13102 7799253 6826930 972323 611555 611555 110265 110265 130804 130804 19135066 17209577 1925097 392 719003 3458 715545 1718477 1490787 211003 16687 351533 210197 141281 55 14874174 13286778 1587396 218446 155241 63205 147889 86841 61048 1525059 1521657 3402 9155654 272261 8883393 2318288 427621 1890667 PHARMACEUTICAL EXPENSES 74615423 74615423 MEDICAL SUPPLIES 22653569 22635488 18081 QAAP TAX EXPENSE 13786510 13786510 PROVISION FOR BAD DEBTS 12923585 1438426 11485159 12524687 11957443 560169 7075 340798423 295289823 45336672 171928 7159490 20961882 30137 31364 25847352 24514789 5968183 6081859 1706408 1824536 208563399 112194320 95566210 96369079 36275072 38715145 4504737 3684671 19077158 22902475 196134747 215085800 29403496 38257407 52666006 48660761 2391965 2133206 3603559 8052968 88065026 97104342 X 108069721 117981458 108069721 117981458 196134747 215085800 X 11600877 598091 -2287231 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 41850 41850 0 PART II-B, LINE 1: MEMORIAL HEALTHCARE PAYS DUES TO MICHIGAN HEALTH AND HOSPITAL ASSOCIATION & MICHIGAN HEALTH COUNCIL. A PORTION OF THESE DUES GO TOWARDS LOBBYING. CONTRACTED WITH CONSULTING FIRMS ON A FEDERAL AND STATE LEVEL REGARDING VARIOUS HEALTHCARE LEGISLATION. INCLUDED IN THE LINE 1I IS COMPENSATION PAID TO STAFF AS INDICATED ON LINE 1B. 5384159 248833 5632992 4967011 417148 5384159 5649953 -682942 4967011 5665470 316175 105527 226165 5649953 5342671 7082 333532 17814 5665471 0.94356 0.05644 0 1 1 5098180 5098180 117023630 49270813 67752817 2356515 715824 1640691 80199000 59849164 20349836 3886074 2358519 1527555 96369079 WELLS FARGO MUTUAL FUNDS 38715145 F 38715145 DUE FROM AFFILIATES 549866 FINANCE LEASE RIGHT-OF-USE ASSETS 529944 OPERATING LEASE RIGHT-OF-USE ASSETS 1184613 OTHER ASSETS 20359524 THIRD-PARTY PAYOR SETTLEMENTS 278528 22902475 ESTIMATED THIRD-PARTY PAYOR 4467028 FINANCE LEASE OBLIGATION 551710 OPERATING LEASE OBLIGATION 1260181 DUE TO AFFILIATES 64389 OTHER LIABILITIES 1709660 8052968 X 342139199 598091 2334329 2932420 339206779 13192521 13192521 352399300 329762265 2156363 2156363 327605902 13192521 13192521 340798423 PART V, LINE 4: THERE ARE VARIOUS PERMANENT AND BOARD DESIGNATED ENDOWMENT FUNDS. THE ONLY SPECIFICALLY IDENTIFIED USES OF THE VARIOUS FUNDS ARE AS FOLLOWS: NURSING SCHOLARSHIP AWARDS AND NURSING AND HEALTHCARE FOR THE ELDERLY. PART X, LINE 2: THE ORGANIZATION AND THE FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON THEIR EXEMPT INCOME UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND A SIMILAR PROVISION OF STATE LAW. THESE ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. DEV CORP AND ASSISTED LIVING ARE SINGLE MEMBER LIMITED LIABILITY COMPANIES, WHICH ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES. PAIN MANAGEMENT IS A LIMITED LIABILITY COMPANY AND HAS ELECTED TO HAVE ITS INCOME TAXED AS A PARTNERSHIP UNDER THE PROVISIONS OF THE IRC. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKE-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO UNCERTAIN TAX POSITIONS THAT MET THE RECOGNITION THRESHOLD IN 2024 AND 2023. PART XI, LINE 2D - OTHER ADJUSTMENTS: CONSOLIDATED ENTITY - PAIN MANAGEMENT 2,334,329. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT EXPENSES 130,804. BAD DEBT EXPENSE 12,923,585. EXPENSES RECORDED AS REVENUE 138,132. PART XII, LINE 2D - OTHER ADJUSTMENTS: CONSOLIDATED ENTITY - PAIN MANAGEMENT 2,156,363. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT EXPENSES 130,804. BAD DEBT EXPENSE 12,923,585. EXPENSES RECORDED AS REVENUE 138,132. 1 1 X 1 X 1 X 1 1 1 0 1 1 337571 337571 0.00100 61404772 56500677 4904095 0.01500 61742343 56500677 5241666 0.01600 153544 153544 0.00050 583376 583376 0.00180 22997607 15557664 7439943 0.02270 640214 640214 0.00200 141883 141883 0.00040 24516624 15557664 8958960 0.02740 86258967 72058341 14200626 0.04340 11235 11235 0.00000 3789 3789 0.00000 115659 115659 0.00040 8668 8668 0.00000 139351 139351 0.00040 0 12923585 27478806 31684179 -4205373 X 1 1 1 1 MEMORIAL HEALTHCARE 826 WEST KING STREET OWOSSO MI 48867 MEMORIALHEALTHCARE.ORG X X X LONG-TERM CARE HOSPITAL MEMORAL HEALTHCARE 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X MEMORIALHEALTHCARE.ORG/ABOUT/REPORTS-AND-PUBLICATIONS X MEMORIALHEALTHCARE.ORG/ABOUT/REPORTS-AND-PUBLICATIONS X 1 22 1 MEMORIALHEALTHCARE.ORG/ABOUT/REPORTS-AND-PUBLICATIONS 0 1 X 150.000000000000 250.000000000000 X X X X 1 1 X X X 1 X MEMORIALHEALTHCARE.ORG/PATIENT-INFORMATION/FINANCIAL-SERVICES X MEMORIALHEALTHCARE.ORG/PATIENT-INFORMATION/FINANCIAL-SERVICES X MEMORIALHEALTHCARE.ORG/PATIENT-INFORMATION/FINANCIAL-SERVICES X X X X X X X 1 X 0 X X X X 1 X 0 0 MEMORAL HEALTHCARE PART V, SECTION B, LINE 5: PARTICIPANTS IN THE CHNA AND IMPLEMENTATION: CATHOLIC CHARITIES COOK FAMILY FOUNDATION CORUNNA PUBLIC SCHOOLS FITNESS COLISEUM GREAT LAKES BAY HEALTH MEMORIAL HEALTHCARE MICHIGAN STATE UNIVERSITY EXTENSION OWOSSO PUBLIC SCHOOLS PEER360 RESPITE VOLUNTEERS OF SHIAWASSEE COUNTY SAFECENTER SHIAWASSEE COUNCIL ON AGING SHIAWASSEE COUNTY HEALTH DEPARTMENT SHIAWASSEE FAMILY YMCA SHIAWASSEE GREAT START INITIATIVE SHIAWASSEE HEALTH AND HUMAN SERVICES COUNCIL SHIAWASSEE HEALTH AND WELLNESS MEMORAL HEALTHCARE PART V, SECTION B, LINE 6B: MEMORIAL WAS THE LEAD ON THE CHNA BUT THERE WAS A SHIAWASSEE COMMUNITY HEALTH NEEDS TEAM THAT CONSISTED OF THEFOLLOWING ORGANIZATIONS:A. SHIAWASSEE UNITED WAYB. SHIAWASSEE REGIONAL EDUCATION SERVICEC. SHIAWASSEE COUNTY COMMUNITY MENTAL HEALTH AUTHORITYD. SHIAWASSEE COUNTY HEALTH DEPARTMENT MEMORAL HEALTHCARE PART V, SECTION B, LINE 11: AFTER THE COMPLETION OF THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, A COMMUNITY REVEAL EVENT WAS HELD TO SHARE AND ANALYZE THE DATA, AND DISCUSS THE CURRENT ENVIRONMENT IN SHIAWASSEE COUNTY. FROM THIS INFORMATION, THREE STRATEGIC PRIORITIES WERE IDENTIFIED BY THOSE ATTENDING: 1. SEXUAL VIOLENCE PREVENTION 2. SUBSTANCE MISUSE 3. MENTAL HEALTHAS WITH MOST HEATH CARE FACILITIES, MEMORIAL HEALTHCARE HAS LIMITED FINANCIAL RESOURCES TO ADDRESS ALL ISSUES. MEMORAL HEALTHCARE PART V, SECTION B, LINE 16J: THE FAP POLICY IS ALSO STATED ON ALL BILLING STATEMENTS SENT FROM THE HOSPITAL. MEMORAL HEALTHCARE PART V, SECTION B, LINE 20E: SEND SELF-PAY ACCOUNTS TO ADVOMAS, A MEDICAL BILLING SERVICE, PRIOR TO SENDING TO CAREPAYMENT AND BEFORE SENDING TO BAD DEBT. 42 1 - MEMORIAL HEALTHCARE CANCER CENTER 721 N SHIAWASSEE OWOSSO MI 48867 CANCER CARE SERVICES/ONCOLOGY/ANTICOAG 2 - MEMORIAL HEALTHCARE OUT PT SERVICES 1637 W MAIN STREET OWOSSO MI 48867 HOME HEALTH/HOSPICE 3 - MEMORIAL HEALTHCARE CARE FAM MEDOCC HLT 100 HEALTH PARK DRIVE OWOSSO MI 48867 MH LAB/MH RAD, MMA & OCC HEALTH 4 - MEMORIAL HEALTHCARE PAIN CLINIC 818 W KING ST STE 300 OWOSSO MI 48867 PAIN MGMNT 5 - MEMORIAL HEALTHCARE ENT & AUDIOLOGY 1002 E MAIN ST OWOSSO MI 48867 PEDS 6 - MID MICHIGAN ORTHOPEDICS 819 N SHIAWASSEE ST STE 200 OWOSSO MI 48867 ORTHO & MH PT 7 - MEMORIAL HEALTHCARE OBGYN 818 W KING ST LOWER LEVEL OWOSSO MI 48867 OBGYN 8 - MEMORIAL OVID-ELSIE OFFICES 9900 W M-21 OVID MI 48866 MMA PRIMARY CARE, MH LAB, MH RAD 9 - MEMORIAL PEDIATRIC CLINIC 802 W KING ST STE M OWOSSO MI 48867 PEDS 10 - MEMORIAL LAINGSBURG OFFICES 317 E GRAND RIVER LAINGSBURG MI 48848 FAMILY MEDICINE, MH LAB, MH RAD 11 - MEMORIAL SURGICAL ASSOCIATESWOUND CLINI 818 W KING ST STE 201 OWOSSO MI 48867 SURGERY & WOUND CLINIC 12 - MEMORIAL CHESANING FAMILY PRACTICE 300 S CHAPMAN CHESANING MI 48616 FAMILY MEDICINE 13 - MEMORIAL PHYSICAL REHABILITATION CENTER 8906 E LANSING ROAD DURAND MI 48429 REHAB SERVICES 14 - MMA GASTRO OFFICES 721 N SHIAWASSEE STE 202 OWOSSO MI 48867 GASTROENTEROLOGY 15 - MEMORIAL OUTPATIENT SERVICES - CHESANING 305 S SAGINAW STREET CHESANING MI 48616 LAB, RAD, PT SERVICES 16 - MEMORIAL STATE ROAD OFFICES 239 N STATE ROAD OWOSSO MI 48867 MH LAB, MH RAD, MMA SHIAWASSEE FAMILY MED, URGENT CARE 17 - INTERNAL MEDICINE ASSOCIATES OF OWOSSO 300 HEALTH PARK DR STE 302 OWOSSO MI 48867 INTERNAL MED 18 - MEMORIAL HEALTHCARE ENDOCRINOLOGY 802 W KING ST STE E OWOSSO MI 48867 ENDOCRINOLOGY 19 - MEMORIAL UROLOGY 818 W KING ST STE 202 OWOSSO MI 48867 UROLOGY 20 - MEMORIAL PHYSICAL REHAB - PERRY 3737 W LANSING ROAD PERRY MI 48872 REHAB SERVICES 21 - MEMORIAL HEALTHCARE HOSPITAL MEDICINE 826 W KING ST 3RD FLOOR OWOSSO MI 48867 HOSPITALISTS 22 - MEMORIAL HEALTHCARE ALLERGY & IMMUNOLOGY 317 S ELM ST STE 205A OWOSSO MI 48867 ALLERGIST 23 - MEMORIAL HEALTHCARE INSTITUTE FOR NEURO 4600 GARFIELD RD AUBURN MI 48611 NEURO 24 - MEMORIAL HEALTHCARE NUTRITION & DIABETES 819 N SHIAWASSEE ST STE 120 OWOSSO MI 48867 DIABETES 25 - MEMORIAL CARDIOLOGY SERVICES 503 E MAIN ST OWOSSO MI 48867 CARDIO 26 - MEMORIAL HEALTHCARE PULMONOLOGY 826 W KING ST STE 200 OWOSSO MI 48867 PULMOMOLGIST 27 - MEMORIAL HEALTHCARE PHYSICAL MED & REHAB 1501 WATERFORD PARKWAY STE B ST JOHNS MI 48879 PHYSCIAL MEDICINE & REHABILIATION 28 - MEMORIAL HEALTHCARE NEURO SAGINAW 4200 FASION SQUARE BLVD STE 301 SAGINAW MI 48604 NEURO 29 - FAMILY MED KING ST 818 W KING ST STE 101 OWOSSO MI 48867 FAMILY MEDICINE 30 - ENT AND AUDIOLOGY 818 W KING ST STE 301 OWOSSO MI 48867 ENT 31 - INSTITUTE FOR NEURO PRACTICE POOL ACCOUN 2525 JOLLY RD OKEMOS MI 48864 NEURO 32 - MEMORIAL DURAND OFFICES 9099 E LANSING ROAD DURAND MI 48429 MMA FAMILY MED & URGENT CARE 33 - INSTITUTE FOR NEUROSCIENCE & MULTIPLE SC 819 N SHIAWASSEE ST STE 100 OWOSSO MI 48867 NEUROLOGY 34 - MEMORIAL PERRY OFFICES 3337 W BRITTON ROAD PERRY MI 48872 MMA FAMILY MEDICINE, MH LAB, MH RAD, URGENT CARE 35 - MEMORIAL HEALTHCARE SOCIAL WORKERS 802 W KING ST SUITE O OWOSSO MI 48867 SOCIAL WORKER (SCHAUFELE) 36 - MEMORIAL HEALTHCARE NEURO PRACTICE POOL 715 BYRON RD SUITE 1 HOWELL MI 48843 NEURO HOWELL 37 - MEMORIAL HEALTHCARE OPHTHALMOLOGY 802 W KING ST SUITE A OWOSSO MI 48867 OPHTHALMOLOGY 38 - MEMORIAL HEALTHCARE PALLIATIVE MEDICINE 818 W KING ST STE 101 OWOSSO MI 48867 PALLIATIVE CARE 39 - MEMORIAL HEALTHCARE PARK - LABRAD ONLY 100 HEALTH PARK DRIVE OWOSSO MI 48867 FAMILY MEDICINE 40 - MEMORIAL HEALTHCARE OUTPATIENT REHAB 819 N SHIAWASSEE ST OWOSSO MI 48867 PHYSICAL THERAPY REHAB SERVICES/CARDIAC REHAB 41 - MEMORIAL HEALTHCARE - MEADOWS OF OWOSSO 245 CALEDONIA DRIVE OWOSSO MI 48867 HOME HEALTH/HOSPICE 42 - MEMORIAL HEALTHCARE HEALTH PARK 200 HEALTH PARK DR OWOSSO MI 48867 PEDS GASTRO PART I, LINE 7: THE COSTING METHODOLOGY USED FOR LINE 7A WAS THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 IN ADDITION TO DISCOUNTS AT COST PER THE HOSPITAL'S ACCOUNTING RECORDS. THE COSTING METHODOLOGY USED FOR LINES 7B - 7C WAS THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE COSTING METHODOLOGY USED FOR LINES 7E - 7I WERE ACTUAL COSTS PER THE HOSPITAL'S ACCOUNTING RECORDS. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE EMERGENCY ROOM AND OR SERVICES. NO PHYSICIAN CLINICS ARE INCLUDED. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990 PART IX LINE 25 COLUMN A WAS SUBTRACTED FROM THE DENOMINATOR FOR PURPOSES OF CALCULATING THE PERCENT OF TOTAL EXPENSES. THE BAD DEBT EXPENSE EXCLUDED WAS $12,923,585. PART II, COMMUNITY BUILDING ACTIVITIES: MEMORIAL HEALTHCARE HAS A STRONG REPUTATION AS A COLLABORATOR AND SUPPORTER OF AGENCIES AND ORGANIZATIONS WORKING TO IMPROVE THE QUALITY OF LIFE IN OUR REGION. INCLUDED IN THESE EFFORTS IS A VIGOROUS SUPPORT BOTH FINANCIALLY AND IN-KIND OF THE ECONOMIC DEVELOPMENT EFFORTS IN OUR COUNTY. WE PLAY A LEADERSHIP ROLE IN THE HEALTH & HUMAN SERVICES COLLABORATIVE IN SHIAWASSEE COUNTY WHICH HAS MADE A DIFFERENCE IN IMPORTANT ISSUES TO OUR RESIDENTS SUCH AS: TRANSPORTATION, ACCESS TO HEALTH AND DENTAL CARE FOR THOSE ON MEDICAID OR UNINSURED, HOMELESSNESS PREVENTION, SUICIDE PREVENTION, ELDER CARE, ETC. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX. PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDE PRIMARILY TO SELF-PAY PATIENTS.ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVAN PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING MEMORIAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), MEMORIAL RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. INPATIENT AND OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. COSTS ON STRESS, SUBACUTE AND LONG-TERM CARE ARE ALSO INCLUDED. MEDICARE REVENUE AND COSTS RELATED TO THE SUBSIDIZED HEALTH SERVICES HAVE BEEN REMOVED IN ORDER TO AVOID DUPLICATION. ANY SHORTFALLS CALCULATED HERE ARE CONSIDERED TO BE A COMMUNITY BENEFIT. PART III, LINE 9B: PATIENT ACCOUNTS ARE MOVED TO MAGNET (VENDOR THAT SENDS STATEMENTS AND MANAGE PAYMENT PLANS) WITHIN 1 BUSINESS DAY OF WHEN THE BALANCE MOVES TO SELF-PAY OR THE TRUE SELF PAY ACCOUNT IS CODED AND FINALIZED. WITHIN 1-3 DAYS, PATIENTS RECEIVE A TEXT OR EMAIL REGARDING A NEW ACCOUNT. IF THE PATIENT DOES NOT ENGAGE WITH THE TEXT OR EMAIL, A PAPER STATEMENT IS SENT. TEXT/EMAILS/PAPER STATEMENTS GO OUT EVERY 30 DAYS. IF PATIENTS TO NOT ENGAGE IN A PAYMENT PLAN OR PAY OFF THE ACCOUNT, THE ACCOUNT GETS A STATEMENT EVERY 30 DAYS FOR 120 DAYS, THEN A FINAL ECA NOTICE, THEN ARE REFERRED BACK TO US TO MOVE TO COLLECTIONS. PART VI, LINE 2: WE ASSESS THE HEALTH NEEDS OF OUR RESIDENTS THROUGH COLLABORATIONS WITH THE COUNTY HEALTH DEPARTMENT, OUR 10 SCHOOL DISTRICTS, OUR COUNCIL OF HEALTH & HUMAN SERVICE AGENCIES AND THROUGH PHYSICIAN OBSERVATION AND REQUESTS. PART VI, LINE 3: WE COMMUNICATE THIS THROUGH SEVERAL METHODS INCLUDING: POSTING AT REGISTRATION POINTS, IN THE PATIENT HANDBOOK PROVIDED TO ALL INPATIENTS, IN A GUIDE TO THE BILLING PROCESS PAMPHLET HANDED OUT AT REGISTRATION POINTS, ON THE BACK OF OUR PATIENT STATEMENTS, VERBALLY THRU OUR FINANCIAL COUNSELING STAFF WHEN PATIENTS ARE IN-HOUSE AS WELL AS THROUGH PHONE CONVERSATIONS WITH PATIENTS CONCERNING THEIR BILLS. PART VI, LINE 4: MEMORIAL HEALTHCARE SERVES SHIAWASSEE COUNTY AND THE SURROUNDING REGION. SHIAWASSEE COUNTY IS LOCATED IN CENTRAL MICHIGAN AND IS CLASSIFIED AS A RURAL COUNTY. THE ESTIMATED POPULATION IN 2024 IS APPROXIMATELY 68,000, WITH OWOSSO SERVING AS THE COUNTY SEAT. ACCORDING TO THE MOST RECENT AVAILABLE DATA (20232024), THE MEDIAN AGE OF RESIDENTS IS 43 YEARS, AND THE MEDIAN HOUSEHOLD INCOME IS $64,464. THE UNEMPLOYMENT RATE IN MID-2024 WAS 6.1%. ABOUT 12% OF RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL, AND APPROXIMATELY 17% OF CHILDREN UNDER AGE 18 LIVE IN POVERTY. THE COUNTY'S RACIAL COMPOSITION IS APPROXIMATELY 97% NON-HISPANIC WHITE, WITH THE REMAINING 3% IDENTIFYING AS HISPANIC, AFRICAN AMERICAN, OR MULTIRACIAL. SHIAWASSEE COUNTY REMAINS PRIMARILY RURAL, WITH MOST RESIDENTS LIVING OUTSIDE CITY LIMITS. PART VI, LINE 5: MEMORIAL HEALTHCARE DEVELOPED A COLLABORATION WITH GREAT LAKES BAY HEALTH CENTER OF SAGINAW TO SET UP A COMMUNITY HEALTH CENTER IN SHIAWASSEE COUNTY. THIS CENTER SERVES AS THE MEDICAL HOME FOR THOUSANDS WHO HAD NO ACCESS TO CARE. THROUGH A PARTNERSHIP WITH COMMUNITY MENTAL HEALTH, THIS CENTER ALSO NOW HAS A FULL TIME SOCIAL WORKER. CURRENTLY, WE ARE WORKING TO INCREASE ACCESS TO DENTAL HEALTH. PART VI, LINE 6: MEMORIAL HEALTHCARE FOUNDATION PROVIDES FUND DEVELOPMENT SERVICES TO ASSIST MEMORIAL HEALTHCARE. MEMORIAL HEALTHCARE OPERATES A SHORT-TERM, ACUTE-CARE FACILITY OFFERING INPATIENT AND OUTPATIENT HEALTHCARE, MENTAL HEALTH SERVICES, AND HOME CARE PRIMARILY TO CITIZENS OF SHIAWASSEE COUNTY, MICHIGAN. PART VI, LINE 7, REPORTS FILED WITH STATES MI X 1 1 X X X 0 0 0 0 0 0 0 1 0 RAMY M KURDI DO PHYSICIAN 1073501 0 140701 0 0 0 12060 0 28974 0 1255236 0 0 0 TAREK R PACHA DO PHYSICIAN 835677 0 297068 0 0 0 11303 0 22310 0 1166358 0 0 0 HAZEM TABBAA DO VICE CHIEF OF STAFF 898561 0 41526 0 0 0 12075 0 29253 0 981415 0 0 0 ASHRAF M ELBANNA MD PHYSICIAN 847274 0 91695 0 0 0 12075 0 21733 0 972777 0 0 0 BRIAN L LONG EXECUTIVE DIRECTOR/CEO 670771 0 214690 0 0 0 12075 0 20545 0 918081 0 0 0 SASHA M SPENCLEY DO PHYSICIAN 445248 0 404860 0 0 0 9003 0 9113 0 868224 0 0 0 IRA STANLEY FRYE MD PHYSICIAN 388405 0 436679 0 0 0 10322 0 28560 0 863966 0 0 0 JOSEPH M BUSTAMANTE DO CHIEF MEDICAL OFFICER 386141 0 140916 0 0 0 7945 0 18121 0 553123 0 0 0 JOSEPH E TESTA DO MEMBER 460026 0 23998 0 0 0 9682 0 28449 0 522155 0 0 0 THOMAS KURTZ COO 298033 0 57205 0 0 0 6549 0 26237 0 388024 0 0 0 ANTHONY A PATSY DO MEMBER 319890 0 29615 0 0 0 6505 0 26221 0 382231 0 0 0 MARGARET R FREY DO MEMBER 334451 0 35825 0 0 0 6859 0 3737 0 380872 0 0 0 JORRI TREMAIN CFO 268099 0 43488 0 0 0 5691 0 4283 0 321561 0 0 0 JOYCE BREMER VP PHYSICIAN PRACTICE MANAGEMENT 235238 0 29296 0 0 0 5700 0 17448 0 287682 0 0 0 ABBIE MAJZEL COA 241349 0 32503 0 0 0 5229 0 3923 0 283004 0 0 0 PART I, LINE 1A PHYSICIANS LISTED IN FORM 990, PART VII (AS WELL AS ALL THE PHYSICIANS ON STAFF) ARE GENERALLY ALLOWED $4,000/YEAR PER THEIR CONTRACTS. USUALLY, THIS MONEY IS USED FOR BOOKS AND CONTINUING EDUCATION. THIS IS NOT REPORTED AS TAXABLE COMPENSATION TO THE PHYSICIANS. PART I, LINE 7 MEMORIAL BONUSES ARE BASED ON OPERATING TARGETS BUT ARE PAID OUT AT THE DISCRETION AND APPROVAL OF THE BOARD OF DIRECTORS. A MICHIGAN FINANCE AUTHORITY 381358208 2015-07-29 7055000 FUND $7 MILLON OF 2015 CAPITAL BUDGET 0 0 0 B MICHIGAN FINANCE AUTHORITY 381358208 59447PXT3 2013-08-06 19369159 PAY DOWN DEBT - $12 MILLION / FUND $8 MILLION OF 2013 CAPITAL BUDGET 0 0 0 C MICHIGAN FINANCE AUTHORITY 381358208 2020-12-22 40000000 FUNDING OF A NEW BUILDING 0 0 0 D MICHIGAN FINANCE AUTHORITY 381358208 2020-06-30 10000000 FUND TEH NEW EMR PROJECT 0 0 0 A 6408292 7055000 64952 6990048 2015 1 0 1 1 B 14499199 19369159 70728 9991669 9306762 2014 1 0 1 1 C 2662735 40000000 148000 11593116 28406884 0 0 0 1 D 4044198 10000000 117484 9882516 2021 0 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 1 0 B 0 0 0 1 0 0 0 1 0 C 0 0 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 0 0 A 1 B 1 C 1 D 1 ALYSSA LONG FAMILY MEMBER OF BRIAN LONG, CEO 67165 EMPLOYEE OF THE HOSPITAL 0 LAUREN TREMAIN FAMILY MEMBER OF JORRI TREMAIN, CFO 19746 EMPLOYEE OF THE HOSPITAL 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS MEMORIAL HEALTH SYSTEM, A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS ARE APPROVED BY THE SOLE MEMBER, MEMORIAL HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT. THE CEO, CFO, AND THE FINANCE DIRECTOR ALL REVIEWED THE 990. TAX RETURNS WILL BE MADE AVAILABLE TO ALL FINANCE COMMITTEE MEMBERS AND BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS AND LEADERSHIP TEAM MEMBERS ARE COVERED BY THIS POLICY. EACH COVERED MEMBER IS REQUIRED TO COMPLETE A DISCLOSURE STATEMENT ANNUALLY. ANY POTENTIAL CONFLICT THAT ARISES DURING THE YEAR MUST BE DISCLOSED WITHIN 14 DAYS OF FIDUCIARY'S KNOWLEDGE THAT A CONFLICT MAY EXIST. THE BOARD CHAIR HAS ULTIMATE RESPONSIBILITY FOR ENFORCEMENT OF THE POLICY. IF A CONFLICT DOES EXIST, THE MEMBER WITH THE CONFLICT ABSTAINS FROM VOTING AND THE CONFLICT IS NOTED IN THE MINUTES OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION UPON HIRING. THE FULL BOARD OF DIRECTORS REVIEWS THE CEO'S COMPENSATION ANNUALLY. A COMPENSATION COMMITTEE HAS BEEN FORMED AND ACTIVELY PARTICIPATES IN DECISIONS RELATED TO CEO AND EXECUTIVE PAY AND BENEFITS AS WELL AS PROVIDING INPUT AND OVERSIGHT FOR THE ORGANIZATIONS COMPENSATION PHILOSOPHY AND PROGRAM. CEO AND EXECUTIVE PAY IS REVIEWED AT LEAST ANNUALLY BY THIS COMMITTEE. THE MOST RECENT REVIEW OF CEO AND EXECUTIVE PAY WAS JUNE 2024. UPDATED SALARY RANGES ARE PROVIDED BY AN OUTSIDE COMPENSATION CONSULTING COMPANY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: DISTRIBUTION TO NONCONTROLLING INTEREST 218,451. OTHER NET ASSET ACTIVITY -2,506,792. TRANSFERS TO AFFILIATES 1,110. MEMORIAL ASSISTED LIVING LLC 826 WEST KING STREET OWOSSO MI 48867 464831571 PROVIDE HOUSING AND SUPPORT FOR THE ELDERLY MI -103730 6482720 MEMORIAL HOSPITAL MEMORIAL HEALTHCARE FOUNDATION 826 WEST KING STREET OWOSSO MI 48867 383036586 TO PROVIDE FUND DEVELOPMENT SERVICES TO ASSIST MEMORIAL MI 501(C)(3) LINE 12A, I MEMORIAL HOSPITAL 1 MEMORIAL HEALTH SYSTEM 826 WEST KING STREET OWOSSO MI 48867 934897020 HEALTH SYSTEM MI 501(C)(3) LINE 12C, III-FI 0 MEMORIAL HEALTHCARE PAIN MANAGEMENT 826 WEST KING STREET OWOSSO MI 48867 472218456 PROVIDE OUTPATIENT PAIN MANAGEMENT SERVICES MI MEMORIAL HOSPITAL RELATED 113555 312003 0 0 0.51000 MHC DEVELOPEMENT CORPORATION 826 WEST KING STREET OWOSSO MI 48867 463742868 DEVELOPMENT OF ASSISTED LIVING PROPERTY MI MEMORIAL HOSPITAL C 100829 4033588 1.00000 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 MEMORIAL HEALTHCARE FOUNDATION P 201951 ACTUAL CASH MEMORIAL HEALTHCARE FOUNDATION C 147264 ACTUAL CASH MEMORIAL HEALTHCARE PAIN MANAGEMENT P 86577 ACTUAL CASH