2026-05-14T13:21:05-04:00 2025-06-30 990 2024-07-01 471161992 MUNSON HEALTHCARE GRAYLING MUNS 2319355000 1105 SIXTH STREET TRAVERSE CITY MI 49684 PAUL KONOPACKI CFO 2319355000 2026-05-12 false 2024 2025-03-06 01:10:19Z KIRSTEN KORTH-WHITE 1100 E MICHIGAN AVENUE GRAYLING MI 49738 106876728 false X WWW.MUNSONHEALTHCARE.ORG X 2014 MI MUNSON HEALTHCARE GRAYLING AND ITS PARTNERS WORK TOGETHER TO PROVIDE SUPERIOR QUALITY CARE AND PROMOTE COMMUNITY HEALTH. 22 18 635 24 0 602696 576142 96381475 105654861 22645 27544 855228 615005 97862044 106873552 0 0 44868206 45101626 0 100626 54266351 58213194 99134557 103314820 -1272513 3558732 37383364 41977245 15116448 16151597 22266916 25825648 AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON HEALTHCARE GRAYLING EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS. false false 88141871 105666744 EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF THE CRAWFORD COUNTY REGION WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE GRAYLING HAD 1,911 INPATIENT ADMISSIONS IN FISCAL YEAR 2025 AND OVER 106,000 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 3,000 SURGICAL CASES, 289 OBSTETRICAL BIRTHS, AND OVER 17,800 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE GRAYLING ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS 101 ACTIVE MEDICAL STAFF AND 24 VOLUNTEERS. 88141871 true false 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 false false false true 25 0 true 635 true false false false false false false false false false false false false X 22 18 false false false false true true true true true false false true true true true true true true true false X NICOLE SULAK MUNSON HEALTHCARE 2319357777 4230 COPPER RIDGE DR TRAVERSE CITY MI 49684 EDWIN A NESS DIRECTOR 2.00 40.00 X 0 2668995 253876 JAMES SHURLOW SURGEON 1.00 39.00 X 1892 1362545 48297 LAURA GLENN COO 2.00 40.00 X 0 1029397 111766 MICHAEL VANWAGNER DO ORTHOPEDIC S 1.00 39.00 X 25885 934188 29957 PAUL KONOPACKI CFO 2.00 40.00 X 0 708738 92977 MATTHEW DUBIEL MD ORTHOPEDIC S 4.00 36.00 X 68945 655932 46392 DINO RECCHIA MD DIRECTOR 0.00 40.00 X 0 715300 31094 JASON BENNETT DO ORTHOPEDIC S 40.00 X 605602 0 47417 BRIAN STIRLING MD PHYSICIAN 40.00 X 600916 0 49344 ELLEN SMITH PRESIDENT AM 2.00 40.00 X 0 538574 9670 KIRSTEN KORTH-WHITE PRESIDENT 40.00 X X 0 454581 55874 KATHLEEN LARAIA VP ONCOLOGY 2.00 40.00 X 0 377922 59521 VINCENT SCHULTZ MD DIRECTOR 0.00 40.00 X 0 355887 45583 CHRISTOPHER SQUIRE VP ANCILLARY 2.00 40.00 X 0 303027 21246 MICHAEL HODNETT CNO/COO 40.00 X 251351 0 48067 BONNIE KRUSZKA CHIEF APP/CF 2.00 40.00 X 0 257229 28633 KENNETH BLOEM CHAIR 0.00 12.00 X X 0 5000 0 MATT BULLOCH DIRECTOR 0.00 1.00 X 0 5000 0 NICK CEGLAREK DIRECTOR 0.00 1.00 X 0 5000 0 KATHY DIXON DIRECTOR 0.00 1.00 X 0 5000 0 JENNIFER KING DIRECTOR 0.00 1.00 X 0 5000 0 KARL KLIMEK DIRECTOR 0.00 1.00 X 0 5000 0 RUTH HOPPE MD V CHAIR 0.00 8.00 X X 0 5000 0 DAVE MENGEBIER TREASURER 0.00 6.00 X X 0 5000 0 KIM MORLEY DIRECTOR 0.00 1.00 X X 0 5000 0 TIM NELSON SECRETARY 0.00 7.00 X X 0 5000 0 ANDY PAGE DIRECTOR 0.00 1.00 X 0 5000 0 BRIAN POSTMA DIRECTOR 0.00 2.00 X 0 5000 0 OWEN ROBERTS DIRECTOR 0.00 2.00 X 0 5000 0 MARY SANDERS DIRECTOR 0.00 3.00 X 0 5000 0 KRISTINE THOMAS DIRECTOR 0.00 3.00 X 0 5000 0 TOM VERYSER DIRECTOR 0.00 1.00 X 0 5000 0 ELAINE WOOD DIRECTOR 0.00 6.00 X 0 5000 0 DAVID MCCURDY DIRECTOR 0.00 3.00 X 0 0 0 SAKURA TAKANO DIRECTOR 0.00 1.00 X 0 0 0 1554591 10447315 979714 62 false true false MARY FREE BED REHABILITATION HOSP 235 WEALTHY ST SE GRAND RAPDIS MI 49503 REHABILITATION 3205851 CABERFAE ANESTHESIA ASSOCIATES PC PO BOX 677979 DALLAS TX 752677979 MEDICAL 2505800 GRAYLING ANESTHESIA ASSOCIATES PC 450 MAMARONECK AVE STE 201 HARRISON NY 10528 MEDICAL 1920551 SOUND PHYSICIANS PO BOX 742936 LOS ANGELES CA 900742936 MEDICAL 1382339 WEST MI SHARED HOSPITAL LAUNDRY 3003 WALKENT DR GRAND RAPIDS MI 49544 LAUNDRY 311820 9 576142 576142 MEDICARE/MEDICAID PAYMENTS 621990 51022031 51022031 PATIENT SERVICE REVENUE 621990 48740323 48740323 340B PRESCRIPTION REVENUE 621990 5210247 5210247 QUALITY INCENTIVE PAYMENTS 621990 682260 682260 105654861 21689 6028 15661 53656 53656 53656 53656 9031 3176 5855 5855 5855 CAFETERIA SALES 722210 454846 454846 MISCELLANEOUS INCOME 621990 106503 106503 561349 106873552 105660889 636521 X 304267 304267 36758024 36561006 197018 1588576 1580004 8572 4677550 4652510 25040 1773209 1763771 9438 25321 25321 7212 7212 12351477 12174924 160987 15566 701 701 408744 329819 78925 1031222 1031222 1598100 1597677 423 146924 143587 3337 59196 58536 660 333060 284146 48914 2252311 1921534 330777 425168 339535 85633 MEDICAL SUPPLIES 17868432 17868432 SHARED SERVICES 13935630 -218165 14068735 85060 BAD DEBT EXPENSE 3753514 3753514 QAAP TAXES 3343827 3343827 672355 651024 21331 103314820 88141871 15072323 100626 4129 4329 339493 531875 13316603 15304015 2067608 2155458 207191 165599 40495484 17971711 20479520 22523773 968820 1292196 37383364 41977245 7773368 9705441 7343080 6446156 15116448 16151597 X 22266916 25825648 22266916 25825648 37383364 41977245 3558732 X false true X true false X false false false false false false false false true 7212 7212 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 OSTEOPATHIC ASSOCIATION AND THE AMERICAN ACADEMY OF FAMILY PHYSICIANS. 1535000 1535000 19589248 7430934 12158314 18345842 10123095 8222747 1025394 417682 607712 22523773 RESERVE FOR THIRD PARTY SETTLEMENTS 4947421 ESTIMATE FOR THIRD PARTY SETTLEMENTS 787955 LT OPERATING LEASE LIABILITY 402482 ST OPERATING LEASE LIABILITY 308298 6446156 true true X true X true X true true false true true 479215 479215 0.00480 9366002 9366002 9845217 9366002 479215 0.00480 314154 314154 0.00320 79117 3098 76019 0.00080 45913571 36851967 9061604 0.09100 3796 3796 46310638 36855065 9455573 0.09500 56155855 46221067 9934788 0.09980 true 3753514 1024709 9583289 6571875 3011414 X true true 1 1 MUNSON HEALTHCARE GRAYLING 1100 E MICHIGAN AVE GRAYLING MI 49738 HTTP://WWW.MUNSONHEALTHCARE.ORG 1060000029 X X X X X MUNSON HEALTHCARE GRAYLING 1 false false true X X X X X X X X X X 24 true true true true X HTTPS://TINYURL.COM/YSZBXMYS X true 25 true HTTPS://TINYURL.COM/YSZBXMYS false true X 200.000000000000 400.000000000000 X X X X X true true X X X true X HTTPS://TINYURL.COM/2TNSZ8PS X HTTPS://TINYURL.COM/2TNSZ8PS X HTTPS://TINYURL.COM/2TNSZ8PS X X X X X X X true X false X X X X X true X false false FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 3E YES, THESIGNIFICANT HEALTH NEEDS ARE A PRIORITIZEDDESCRIPTION OF THESIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND WEREIDENTIFIEDTHROUGH THE CHNA.THESIGNIFICANT PRIORITIZED HEALTH NEEDS OF THE COMMUNITY AREIDENTIFIEDIN THE CHNA UNDER THE KEY FINDINGS HEADING.IN THE NORTHWEST AND NORTHEAST CHIR REGIONSWHICH COVER THE PRIMARY MUNSON HEALTHCARE SERVICE AREATHE SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN ORDER OF PRIORITY: ACCESS TO HEALTHCARE, MENTAL HEALTH, AND ECONOMIC SECURITY. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 5 WE ARE FOLLOWING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP FRAMEWORK TO GUIDE OURPROCESSWHICH INCLUDESFOUR ASSESSMENTS TO GATHER INPUT.1. COMMUNITY STATUS ASSESSMENT (CSA), COLLECTS QUANTITATIVE DATA ON THE STATUS OF COMMUNITIES FROM TRUSTED LOCAL, STATE, AND NATIONAL SOURCES (SECONDARY DATA), BUT THEN MOVES BEYOND NUMERICAL OUTCOMES TO TEST THEIR ASSOCIATION WITH UPSTREAM ISSUES, INCLUDING SDOHS BY EVALUATING THE DATA NEXT TO A COMMUNITY SURVEY AND A PROVIDER SURVEY WITH OPEN-ENDED QUESTIONS AND SECONDARY DATA COLLECTED THROUGH THIS PROCESS. 2. COMMUNITY CONTEXT ASSESSMENT (CCA): A QUALITATIVE PROCESS TO UNDERSTAND COMMUNITY STRENGTHS, ASSETS, BUILT ENVIRONMENT, AND FORCES OF CHANGE THROUGH LIVED EXPERIENCE. MITHRIVE USED PHOTOVOICE, ASSET MAPPING, AND RESIDENT QUOTES TO FILL DATA GAPS AND EXPLORE CONTEXT. 3. COMMUNITY PARTNER ASSESSMENT (CPA): ENGAGES PARTNERS TO ASSESS INDIVIDUAL AND COLLECTIVE CAPACITY TO ADDRESS HEALTH INEQUITIES AND IDENTIFY ACTIONS AT SYSTEMIC AND STRUCTURAL LEVELS. MITHRIVE CONDUCTED A PARTNER SURVEY AND TWO VIRTUAL EVENTS. TO ENSURE DATA REPRESENTED THE FULL COMMUNITY, WE INVITED A DIVERSE GROUP OF COMMUNITY PARTNERS TO JOIN THE MITHRIVE STEERING COMMITTEE, DESIGN TEAM AND WORKGROUPS, AND GATHERED DATA FROM MEDICALLY UNDERSERVED, MINORITY AND LOW-INCOME POPULATIONS FOR EACH OF THE ASSESSMENTS. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 6A YES: IN ADDITION TO DOZENS OF LOCAL AND REGIONAL ORGANIZATIONS, ALL HEALTHCARE SYSTEMS IN THE REGION PARTICIPATED,INCLUDING MCLAREN, MYMICHIGAN HEALTH, AND COREWELL HEALTH. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 6B YES: IN ADDITION TO DOZENS OF LOCAL AND REGIONAL ORGANIZATIONS, ALL HEALTH DEPARTMENTS IN THE REGION PARTICIPATED,INCLUDINGGRAND TRAVERSE HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 10, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, BENZIE LEELANAU DISTRICT HEALTH DEPARTMENT, CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT2, AND DISTRICT HEALTH DEPARTMENT 4. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 11 WEIDENTIFIEDSTRATEGIC ISSUES AS PART OF THEMITHRIVECOLLABORATIVE. 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 SHOULDIMPACTMORE THAN ONE HEALTH CONDITION. THE TOP THREEPRIORITYISSUES TOBEADDRESSED INCLUDE:ACHIEVE GREATER ECONOMIC SECURITY, IMPROVE BEHAVIORAL HEALTH, AND INCREASE ACCESS TO CARE. A COMPLETE LIST OF STRATEGIES PLANNED TO ADDRESS THE PRIORITIZED NEEDS MAY BE VIEWED WITHIN THE CHNA IMPLEMENTATION STRATEGY.GENERALLY, THEHOSPITAL 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:HOUSING, SAFETY AND WELLBEING, EDUCATION, OBESITY, BROADBAND, AND ENVIRONMENT/INFRASTRUCTURE. MUNSON RECOGNIZES THE WIDE RANGE OF HEALTH-RELATED ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. GIVEN THE COMPLEXITY AND BREADTH OF THESE CHALLENGES, THE ORGANIZATION HAS CHOSEN TO FOCUS ITS EFFORTS ON THE HIGHEST PRIORITY NEEDS IDENTIFIED BY THE COMMUNITY. THIS TARGETED APPROACH ENABLES THE STRATEGIC ALLOCATION OF RESOURCES TO AREAS WHERE THEY CAN HAVE THE GREATEST IMPACT. SHOULD ADDITIONAL RESOURCES OR ORGANIZATIONAL CAPACITY BECOME AVAILABLE, MUNSON WILL EXPLORE OPPORTUNITIES TO EXPAND ITS INITIATIVES TO ADDRESS OTHER IDENTIFIED NEEDS. IT IS ALSO IMPORTANT TO NOTE THAT SOME ISSUESSUCH AS HOUSINGARE BEING ADDRESSED WITHIN THE CONTEXT OF BROADER STRATEGIC PRIORITIES, SUCH AS ECONOMIC SECURITY. THIS INTEGRATED APPROACH ENSURES THAT INTERCONNECTED SOCIAL DETERMINANTS OF HEALTH ARE CONSIDERED WITHIN A COMPREHENSIVE FRAMEWORK FOR COMMUNITY HEALTH IMPROVEMENT. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 13H PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, AT THE SOLE DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 16J IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY. THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS; BROCHURES DISTRIBUTED TO ALL SELF-PAY PATIENTS; INFORMATION POSTED ON THE WEBSITE; STATEMENT ON BILLS; SIGNS IN THE REGISTRATION AREAS; AND CALLS MADE TO ALL SELF-PAY PATIENTS AFTER SERVICE. FACILITY 1, MUNSON HEALTHCARE GRAYLING - PART V, LINE 20E MUNSON HEALTHCARE GRAYLING(GRAYLING) REVIEWS LARGE DOLLAR ACCOUNTS TO ENSURE ASSISTANCE HAS BEEN OFFERED TO PATIENTS BEFORE THE ACCOUNTS ARE TRANSFERRED TO A CREDIT AGENCY. ONCE AN ACCOUNT HAS BEEN TRANSFERRED TO A CREDIT AGENCY, THE AGENCY REVIEWS THE ACCOUNT TO SEE IF THE PATIENT WOULD BE A POSSIBLE CANDIDATE FOR FINANCIAL ASSISTANCE BEFORE FILING ANY LAWSUITS OR LIENS. GRAYLING WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY GRAYLING; 2.DOCUMENTING THAT GRAYLING HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH GRAYLING 'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH GRAYLING DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. GRAYLING WORKS WITH THE COLLECTION AGENCIES TO IDENTIFY INDIVIDUALS THAT MAY QUALIFY FOR CHARITY. IF THEY FIND AN INDIVIDUAL, THEY MAY REFER THE PATIENT TO PATIENT ACCOUNTS FOR EVALUATION. ALL ACCOUNTS THAT ARE PATIENT-PAY RECEIVE A PHONE CALL TO MAKE THE PATIENT AWARE OF OUR FINANCIAL ASSISTANCE POLICY PRIOR TO THEM GOING TO COLLECTIONS. 2 CRAWFORD CONTINUING CARE CENTER 1100 EAST MICHIGAN AVE GRAYLING MI 49738 EXTENDED CARE FACILITY GRAYLING SURGICAL SERVICES 1010 W NORTH DOWN RIVER RD GRAYLING MI 49738 SURGICAL SERVICES SCHEDULE H, PART I, LINE 3C INCOME UP TO 200% OF THE FPG = 100% DISCOUNT ON CHARGES INCOME BETWEEN 201% AND 300% FPG = 75% DISCOUNT ON CHARGES INCOME BETWEEN 301% AND 400% FPG = 65% DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE, OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS. FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG: EARNINGS, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES; CASH, CHECKING AND SAVINGS BALANCES, MONEY MARKET ACCOUNTS, CERTIFICATES OF DEPOSIT, IRAS TRUSTS, INHERITANCES, ANNUITIES, SAVINGS BONDS, STOCKS, MUTUAL FUNDS, AND/OR CASH VALUE OF LIFE INSURANCE. SCHEDULE H, PART I, LINE 7G THE COSTS RELATED TO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES TOTAL 24,906,623. 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 103,314,820. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 3,753,514. THE NET EXPENSE OF 99,561,306 WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). SCHEDULE H, PART I, LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION OR ACTUAL CASH PAID. SCHEDULE H, PART II MUNSON HEALTHCARE GRAYLING BELIEVES COMMUNITY BUILDING ACTIVITIES PROMOTE HEALTH BY ADDRESSING UNDERLYING COMMUNITY HEALTH CHALLENGES. COMMUNITY BUILDING WORK IS DONE AT THE CORPORATE LEVEL ON BEHALF OF THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE INVESTS DEEPLY IN BUILDING AND SUSTAINING REGION-WIDE COLLABORATIVES THAT TACKLE THE ROOT CAUSES OF POOR HEALTH OUTCOMES. CURRENT EFFORTS FOCUS ON THREE MAJOR INITIATIVES: 1. NORTHERN MICHIGAN COMMUNITY HEALTH INNOVATION REGION (CHIR): THE CHIR UNITES CROSS-SECTOR PARTNERS ACROSS 31 COUNTIESINCLUDING HEALTH DEPARTMENTS, BUSINESSES, RESIDENTS, AND HUMAN SERVICESTO ALIGN SYSTEMS, SET SHARED PRIORITIES, AND CO-LEAD STRATEGIES THAT TRANSFORM HEALTH AND WELLNESS IN NORTHERN MICHIGAN. THIS INTERDISCIPLINARY GROUP CONDUCTS A REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COORDINATES IMPLEMENTATION STRATEGIES TO ENSURE ALIGNMENT AND IMPACT. THE MOST RECENT CHNA WAS COMPLETED IN JUNE, WITH STRATEGIES APPROVED IN OCTOBER 2025. THIS WORK REDUCES DUPLICATION, ADDRESSES ROOT CAUSES, AND DRIVES MEASURABLE CHANGE. CHIR ALSO DEVELOPED AND SUSTAINS THE COMMUNITY CONNECTIONS MODEL, WHERE PATIENTS ARE UNIVERSALLY SCREENED IN HEALTHCARE SETTINGSINCLUDING MUNSONAND CONNECTED TO COMMUNITY HEALTH WORKERS FOR HELP WITH BASIC NEEDS. 2. BEHAVIORAL HEALTH INITIATIVE (BHI): THE BHI WAS FORMED IN RESPONSE TO THE BEHAVIORAL HEALTH CRISIS, IDENTIFIED AS A TOP PRIORITY THROUGH CHIR-LED CHNA ASSESSMENTS. THE GROUP CREATED A SHARED ROADMAP AND ACTION TEAMS, WITH MUNSON PLAYING A MAJOR ROLE. THIS COLLABORATION LED TO THE OPENING OF THE GRAND TRAVERSE MENTAL HEALTH CRISIS AND ACCESS CENTER IN FY25A MILESTONE THAT WILL TRANSFORM BEHAVIORAL HEALTH CARE IN NORTHERN MICHIGAN. BEYOND THIS, THE INITIATIVE CONTINUES TO EXPAND ACCESS THROUGH EFFORTS SUCH AS CONVENING A REGIONAL CONSORTIUM, EXPANDING A COMMUNITY SCORECARD, INTRODUCING THERAPY CORPS, AND DEVELOPING A BEHAVIORAL HEALTH RESOURCE HUB. 3. MICHIGAN REGIONS 2 & 3 PERINATAL QUALITY COLLABORATIVE (RPQC): MUNSON SERVES AS CO-LEAD AND FIDUCIARY FOR THIS COLLABORATIVE, WHICH BRINGS TOGETHER FAMILIES, BIRTH WORKERS, HEALTHCARE SYSTEMS, HOME VISITING AGENCIES, FAITH-BASED ORGANIZATIONS, NONPROFITS, AND HEALTH DEPARTMENTS. ITS MISSION: IMPROVE PREGNANCY, BIRTH, AND POSTPARTUM OUTCOMES THROUGH A SUSTAINABLE, COORDINATED NETWORK OF CARE. QUALITY IMPROVEMENT EFFORTS ARE DATA-DRIVEN AND INFORMED BY COMMUNITY LISTENING SESSIONS. RECENT INITIATIVES INCLUDE: 1. UPDATING BIRTHING CENTER PROTOCOLS TO PROMOTE CULTURALLY CONSCIOUS CARE, 2. LISTENING SESSIONS WITH UNDERSERVED GROUPS TO IMPROVE OUTCOMES FOR BIRTHING FAMILIES, 3. INTEGRATING DOULA CARE INTO HEALTHCARE SYSTEMS AND SUPPORTING DOULA MENTORSHIP, 4. INCREASING PERINATAL EDUCATION UPTAKE AND PUBLIC AWARENESS OF URGENT MATERNAL WARNING SIGNS. MUNSON ACTIVELY ADVOCATES FOR POLICIES THAT PROTECT HEALTH SERVICES, EXPAND ACCESS, AND ADDRESS ESSENTIAL NEEDS LIKE HOUSING AND SOCIAL SUPPORTS. EXAMPLES INCLUDE: SUPPORTED A STATE BUDGET THAT FULLY FUNDS MICHIGANS MEDICAID PROGRAM (SIGNED INTO LAW BY GOVERNOR WHITMER OCTOBER 2025); SUPPORTED HOUSING SOLUTIONS FOR PATIENTS AND EMPLOYEES THROUGH ENGAGEMENT WITH HOUSING NORTH AND THE HOUSING SUMMIT ALONG WITH BEING THE RECIPIENT OF STATE FUNDS THAT WILL HELP TO RECRUIT AND RETAIN HEALTHCARE WORKERS. (THROUGHOUT 2024 AND 2025); LED EFFORTS TO OPEN THE GRAND TRAVERSE MENTAL HEALTH CRISIS AND ACCESS CENTER AND EXPAND OPERATIONS TO 24/7 CARE (THROUGHOUT 2024 AND 2025); ADVOCATED FOR THE PASSAGE OF STATE LEGISLATION THAT ADDS PROTECTIONS FOR THE 340B DRUG PRICING PROGRAM FROM WHICH WE GAIN COSTSAVINGSTHAT ARE REINVESTED INTO SUPPORTING ACCESS TO CARE FOR PATIENTS; ADVOCATED FOR FEDERAL LEGISLATION THAT EXPANDS ACCESS TO HEALTHCARE THROUGH THE USE OF TELEHEALTH; SUPPORTED THE STATES APPLICATION FOR 173 MILLION IN FEDERAL RURAL HEALTH TRANSFORMATION PROGRAM FUNDS; IN ADDITION TO OVER 300,000 IN DIRECT INVESTMENTS TO NONPROFITS CLOSING CHNA GAPS, MUNSON ALIGNED SPONSORSHIPS AND EVENT PARTICIPATION WITH CHNA PRIORITIES. IN FY25, 77,000 WAS INVESTED IN ALIGNED SPONSORSHIPS AND EVENTS, INCLUDING FINANCIAL SUPPORT TO THE FOLLOWING NON-PROFIT, TAX-EXEMPT CHARITIES: MICHAELS PLACE, ROTARY CLUB, YMCA, HOUSING NORTH, OUT OF THE DARKNESS WALK, HABITAT FOR HUMANITY, MANNA FOOD PROJECT, GROW BENZIE, ARMORY YOUTH PROJECT, NORTHWEST FOOD COALITION, NORTE, BENZIE SENIOR RESOURCES, AND MORE. SCHEDULE H, PART III, LINE 2 DIRECT WRITE-OFF FROM UNPAID ACCOUNTS WHICH ARE DEEMED NO LONGER COLLECTIBLE ARE RECORDED AGAINST THE ALLOWANCE FOR BAD DEBT. AN ESTIMATE OF BAD DEBT EXPENSE IS RECORDED BASED ON 1) AN ANALYSIS OF THE DIRECT WRITE- OFFS AND 2) AN ESTIMATE OF THE AMOUNT OF BAD DEBT, NET OF DISCOUNTS, IN THE ACCOUNTS RECEIVABLE BALANCE, CONSIDERING THE PAST EXPERIENCE AND CURRENT TRENDS OF PAYMENTS ON PATIENT ACCOUNTS FOR EACH OF THE MAJOR PAYOR SOURCES OF REVENUE. SCHEDULE H, PART III, LINE 3 THE METHODOLOGY USED TO DETERMINE THE ESTIMATED AMOUNT OF CHARITY IN BAD DEBT IS AS FOLLOWS. WE DETERMINED THE APPROVAL RATE OF FINANCIAL COUNSELING BY TAKING THE VALUE OF THE ACCOUNTS THAT SUCCESFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING. SCHEDULE H, PART III, LINE 4 SEE NOTE 2 ON PAGE 10 OF ATTACHED AUDITED FINANCIAL STATEMENTS UNDER ACCOUNTS RECEIVABLE. SCHEDULE H, PART III, LINE 9B MUNSON HEALTHCARE'S INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1)VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2)DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3)DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684. SCHEDULE H, PART VI, LINE 2 THE HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM PARTICIPATE IN A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501(R) IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD. IN ADDITION, THE HOSPITAL IS A MEMBER OF THE MUNSON HEALTHCARE SYSTEM, WHICH WORKS TO UNDERSTAND THE NEEDS OF THE SERVICE AREA THROUGH VARIOUS SERVICE LINE AND DEPARTMENT-BASED ASSESSMENT AND BUSINESS PLANNING STRATEGIES. THE HOSPITAL ALSO REGULARLY SEEKS INFORMATION FROM AND PARTICIPATES IN THE COUNTY COLLABORATIVE, MITHRIVE WORKGROUPS, AND OTHER REGIONAL COLLABORATIVES TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY HEALTH NEEDS. THE HOSPITAL MAINTAINS A COMMUNITY HEALTHCARE COUNCIL MADE UP OF LOCAL LEADERS AND AREA ORGANIZATIONS WHICH PROVIDE INPUT INTO EMERGING TRENDS AND ISSUES SPECIFIC TO THEIR COMMUNITIES. FINALLY, HEALTHCARE SYSTEM MAINTAINS A STANDING COMMUNITY AND POPULATION HEALTH COMMITTEE WHICH CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM REGIONAL HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS. THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS, CONSIDER THE MHC RESPONSE TO EMERGING HEALTH TRENDS, AND REVIEW NEW COMMUNITY HEALTH-BASED COLLABORATION OR PROGRAMS. SCHEDULE H, PART VI, LINE 3 IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS: INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS: BROCHURES THAT DESCRIBE MUNSON HEALTHCARE'S FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES. THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR. STATEMENT ON BILLS: STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL. SIGNS IN THE ER REGISTRATION AREA: ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY. THE MUNSON HEALTHCARE INTERNET HAS THE FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, THE PLAIN LANGUAGE SUMMARY AND THE BILLING AND COLLECTIONS POLICY AVAILABLE TO REVIEW AND PRINT. REFERRAL BY REGISTRATION STAFF: AT THE TIME OF REGISTRATION, SELF-PAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF. MUNSON HEALTHCARE FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS. THE COUNSELOR VISIT ALL INPATIENTS THAT ARE DEEMED SELF-PAY, TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP. IF THE PATIENT WOULD LIKE HELP, THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID. GENERALLY, THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR. ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR, THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS. THE COUNSELORS ALSO IDENTIFY ALL SELF-PAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS, ONLY BY PHONE. THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION, BUT WHEN THAT IS NOT POSSIBLE, THE CALL IS MADE SOON AFTER DISCHARGE. AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: MEDICAID (AND ALL OF ITS SUBSETS), SOCIAL SECURITY DISABILITY, TRAVERSE HEALTH CLINIC, MUNSON HEALTHCARE FINANCIAL ASSISTANCE, AND MUNSON MEDICAL CENTER MEDS PROGRAM. MUNSON HEALTHCARE MAKES A PHONE CALL TO ALL PRIVATE-PAY PATIENTS PRIOR TO TRANSFERRING THEIR ACCOUNT TO A COLLECTION AGENCY TO INFORM THEM OF OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART VI, LINE 4 DESCRIPTION MUNSON HEALTHCARE GRAYLING (GRAYLING HOSPITAL) SERVES A SPARSELY POPULATED, RURAL REGION IN CENTRAL NORTHERN MICHIGAN. IT IS ONE OF NINE COMMUNITY HOSPITALS THAT ARE PART OF THE MUNSON HEALTHCARE SYSTEM. THE HOSPTIAL HAS 71 LICENSED INPATIENT BEDS, A 39-BED SKILLED NURSING/ LONG-TERM CARE UNIT, 101 ACTIVE MEDICAL STAFF (PRIMARY FACILITY), AND 635 EMPLOYEES MAKING IT ONE OF THE LARGEST EMPLOYERS IN THE REGION. THE HOSPITAL SERVED MORE THAN 3,000 SURGICAL CASES, 106,000 OUTPATIENT VISITS, 1,911 INPATIENT ADMISSIONS, OVER 17,800 EMERGENCY ROOM VISITS, AND 289 BIRTHS IN FISCAL YEAR 2025. HOSPITAL SERVICES THIS 71-BED HOSPITAL OFFERS A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES: 24 HOUR EMERGENCY CARE SPECIALTIES INCLUDING ORTHOPEDICS, UROLOGY, CARDIOLOGY, CANCER SERVICES AND MORE. RADIOLOGY SERVICES WITH X-RAY, 3D MAMMOGRAPHY, MRI, ULTRASOUND AND CT. OBSTETRICS & GYNECOLOGY PHYSICIAN OFFICES LOCATED IN GRAYLING, PRUDENVILLE AND ROSCOMMON AREA OFFER VARYING SERVICES: PRIMARY CARE, BEHAVIORAL HEALTH, LAB SERVICES, URGENT AND WALK-IN CARE. LONG-TERM CARE AT CRAWFORD CONTINUING CARE CENTER ATTACHED TO GRAYLING HOSPITAL GENERAL, ORTHOPEDIC AND OUTPATIENT SURGERY POPULATION SERVED GRAYLING HOSPITAL IS LOCATED IN CRAWFORD COUNTY. CRAWFORD, OSCODA, AND ROSCOMMON COUNTIES ARE CONSIDERED THE HOSPITALS SERVICE AREA, WITH CRAWFORD BEING THE PRIMARY. WITHIN THIS COUNTY, THE FOLLOWING DEMOGRAPHIC DATA APPLIES: -CRAWFORD COUNTY IS HOME TO 13,599 PEOPLE. -MOST OF THE POPULATION ARE WHITE (95.3%) WITH THE LARGEST MINORITY GROUPS INCLUDING HISPANIC/LATINO (2.6%), AFRICAN AMERICAN (1%), AMERICAN INDIAN/ALASKA NATIVE (0.9%), AND ASIAN (0.9%). -THE PROPORTION OF ADULTS OVER 65 YEARS IS 28.5% WITH PERSONS UNDER 18 YEARS MAKING UP 17.6%. -91.4% OF RESIDENTS AGE 25 YEARS+ HAVE A HIGH SCHOOL DIPLOMA WITH 20.2% HAVING A BACHELORS DEGREE OR HIGHER. -MEDIAN HOUSEHOLD INCOME IS 58,614 WHICH IS BELOW THE STATE AVERAGE (71,149) AND THE UNEMPLOYMENT RATE IS 4.9%. -THE PERCENT OF UNINSURED INDIVIDUALS (UNDER 65 YEARS) IS 6%. QUALITY NOVEMBER 2024 - THE LEAPFROG GROUP GRADE A 2024 - CMS 5-STAR RATING BLUE CROSS/BLUE SHIELD DISTINCTION CENTER FOR KNEE AND HIP REPLACEMENT AND MATERNITY CARE BLUE CROSS/BLUE SHIELD DESIGNATION FOR HOSPITALS MEETING AND EXCEEDING THEIR CARE BENCHMARKS SCHEDULE H, PART VI, LINE 5 MUNSON HEALTHCARE GRAYLING UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT THE SERVICE AREA. MUNSON REINVESTS 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 CREDENTIAL REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS. BEYOND THESE MEASURES, MUNSON PUTS COMMUNITY HEALTH AT THE CENTER OF WHAT THEY DO AND INVESTS HEAVILY IN COMMUNITY HEALTH PROGRAMS, PARTNERSHIPS AND INITIATIVES, INCLUDING THE FOLLOWING: MENTAL HEALTH AND SUBSTANCE USE DISORDERS: IN JANUARY, MUNSON AND NORTHERN LAKES COMMUNITY MENTAL HEALTH AUTHORITY OPENED THE GRAND TRAVERSE MENTAL HEALTH CRISIS AND ACCESS CENTER, EXPANDING FROM LIMITED HOURS TO 24/7 SERVICE. THIS CENTER DELIVERS FACE-TO-FACE CRISIS INTERVENTION, PSYCHIATRIC URGENT CARE, MOBILE RESPONSE, PEER SUPPORT, AND COMMUNITY REFERRALSTRANSFORMING BEHAVIORAL HEALTH ACCESS IN NORTHERN MICHIGAN. COMPLEMENTARY INITIATIVES INCLUDED: 1. PERINATAL LOSS SUPPORT: TRAINED 54 STAFF IN GRIEF CARE, DISTRIBUTED RESOURCES TO BIRTHING HOSPITALS, AND LAUNCHED A SUPPORT GROUP FOR FAMILIES. 2. COMMUNITY INVESTMENTS: 10,000 TO KIERSTENS RIDE FOR SUICIDE PREVENTION AND 5,000 TO LAKESHORE CHILDRENS ADVOCACY CENTER FOR FREE COUNSELING FOR CHILDREN AFFECTED BY ABUSE. 3. HIGH-TECH HIGH TOUCH (HT2): SCREENED 1,600 PRENATAL PATIENTS FOR MENTAL HEALTH AND SUBSTANCE USE NEEDS; OVER HALF ACCEPTED BRIEF INTERVENTIONS, IMPROVING MATERNAL AND INFANT OUTCOMES. 4. BEHAVIORAL HEALTH EQUITY: PARTNERED WITH THE UNIVERSITY OF MICHIGAN ON PEDIATRIC EQUITY RESEARCH AND COLLABORATED WITH SCHOOLS TO STANDARDIZE CRISIS RESPONSE LANGUAGE AND TOOLS. IN FY25, WE ADVANCED CARE FOR CHILDREN WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. THIS INCLUDES, CONTRACTING APPLIED BEHAVIORAL ANALYSIS (ABA) SPECIALISTS TO DEVELOP FUTURE THERAPY SERVICES IN THE EMERGENCY DEPARTMENT FOR CHILDREN WITH BEHAVIORAL HEALTH NEEDS. ADDITIONAL INITIATIVES INCLUDED THE INTRODUCTION OF SENSORY TOOLS, PARTNERSHIP WITH CHILD LIFE TO REDUCE TRAUMA IN THE EMERGENCY DEPARTMENT, DEVELOPING COLOR-CODED HANDOFF SIGNAGE AND INTERVENTION PROTOCOLS TO PREVENT ESCALATION AND SHORTEN STAYS, IMPROVING EMR DATA ACCURACY FOR RACE AND ETHNICITY, AND ANALYZING ACCESS TO LACTATION CONSULTANTS FOR UNDERSERVED POPULATIONS. MUNSON CONTINUES TO ADVANCE A COMPREHENSIVE NO WRONG DOOR APPROACH TO SUBSTANCE USE DISORDER (SUD) TREATMENT, ENSURING SEAMLESS ACCESS TO CARE IN EMERGENCY, PRIMARY, AND BEHAVIORAL HEALTH SETTINGS. IN FY25, A FULL-TIME PROGRAM MANAGER WAS HIRED TO LEAD THIS WORK. THANKS TO FUNDING SUPPORT FROM MHA FOR THE HOSPITAL- BASED PEER RECOVERY COACH SERVICES EXPANSION INITIATIVE, WE ADDED THREE ADDITIONAL PRC POSITIONS AND CREATED A COORDINATOR OF PEER SERVICES ROLE, BRINGING THE TEAM TO 10 PRC ACROSS NINE CLINICS TO SUPPORT DELIVERY OF GOLD-STANDARD CARE. TO BUILD PROVIDER CAPACITY, MUNSON LAUNCHED WEEKLY CLINICIAN MENTORSHIP SESSIONS FOR BEST-PRACTICE SHARING AND COLLABORATIVE LEARNING. THE SYSTEM IS ALSO IMPLEMENTING THE SUD HEALTH HOME MODEL, INTEGRATING CARE MANAGEMENT AND PROMOTING SUSTAINABILITY THROUGH VALUE- BASED REIMBURSEMENT. ADDITIONALLY, MUNSON INTRODUCED AN EAST REGION SUD NURSE NAVIGATOR TO STRENGTHEN CARE COORDINATION. COMPLEMENTARY HARM REDUCTION EFFORTS INCLUDED INSTALLING 25 NARCAN DISTRIBUTION BINS ACROSS HOSPITALS, URGENT CARE CENTERS, AND CLINICS IN PARTNERSHIP WITH MICHIGAN HARM REDUCTION. THE ANNUAL VOICES FOR COMMUNITY HEALTH ART INITIATIVE FOCUSED ON RECOVERY, GENERATING SIGNIFICANT ENGAGEMENT AND MEDIA COVERAGE INCLUDING A MUNSON PRC FEATURED ON THE FRONT PAGE OF THE RECORD EAGLE. THESE COMBINED STRATEGIESPROTOCOL STANDARDIZATION, WORKFORCE EXPANSION, EDUCATION, PARTNERSHIPS, AND INTEGRATED CAREARE BUILDING A ROBUST, SUSTAINABLE SYSTEM FOR INDIVIDUALS WITH SUD. CHRONIC DISEASE PREVENTION AND MANAGEMENT: MUNSON PRIORITIZED CHRONIC DISEASE PREVENTION THROUGH COMMUNITY PARTNERSHIPS AND INNOVATIVE OUTREACH, INCLUDING: 1. FRUIT & VEGETABLE PRESCRIPTION PROGRAM WITH LOCAL GROCERS, FARMERS MARKETS, AND MSU EXTENSION, PROVIDING VOUCHERS AND NUTRITION EDUCATION, 2. DIRECT PATIENT OUTREACH VIA TEXT FOR CANCER SCREENINGS, WELL VISITS, AND DIABETES CARE, 3. SUPPORT FOR NONPROFITS LIKE YMCA AND MANNA FOOD PROJECT TO EXPAND ACCESS TO NUTRITIOUS FOOD AND MOVEMENT OPPORTUNITIES, 4. CULINARY MEDICINE SERIES WITH GROUNDWORK CENTER TO EQUIP PROVIDERS FOR MEANINGFUL NUTRITION CONVERSATIONS, 5. LAUNCHED AN OPT-IN, TEXT-BASED DIABETES EDUCATION PROGRAM, DELIVERING WEEKLY TIPS ON BLOOD SUGAR TESTING, MEAL PLANNING, EXERCISE, AND STRESS MANAGEMENTREDUCING BARRIERS AND INCREASING ENGAGEMENT. ACCESS TO HEALTHCARE: MUNSON HAS PRIORITIZED SEVERAL OPERATIONAL ADVANCEMENTS, LEVERAGING INNOVATION TO INTRODUCE NEW MODELS OF CARE THAT IMPROVE ACCESS ACROSS RURAL NORTHERN MICHIGAN. THIS INCLUDES: 1. CENTRALIZED CARE COORDINATION: LAUNCHED THE MUNSON TRANSFER CENTER AND A REGIONAL REFERRAL HUB, STREAMLINING PATIENT PLACEMENT AND SPECIALTY REFERRALS FOR 24 COUNTIES. THIS HUB HAS REDUCED ED DELAYS, OPTIMIZED BED USE, AND IMPROVED ACCESS TO ADVANCED SERVICES SUCH AS TRAUMA, NICU, STROKE CARE, AND ORTHOPEDICSADDRESSING A TOP CHNA PRIORITY. 2. EXPANDED PATIENT SUPPORT: THE ASK-A-NURSE LINE HANDLED 37,000 CALLS IN FY25, SAFELY REDIRECTING 26% OF POTENTIAL ER VISITS AND IMPROVING CARE COORDINATION WHILE FREEING PRIMARY CARE CAPACITY FOR SAME-DAY AND PREVENTIVE APPOINTMENTS. 3. THE MOST RECENT STRATEGIC PLANREGIONAL CARE TRANSFORMATIONPRIORITIZED AN EXPANSION OF OUTPATIENT, SPECIALTY SERVICES WHILE ELEVATING SPECIALTY SERVICES AVAILABLE AT THE MEDICAL CENTER. MUNSON RECRUITED 23 NEUROSCIENCE PROVIDERS, REDUCING WAIT TIMES FROM 123 TO 25 DAYS, AND LAUNCHED A HIGH-RISK BREAST CANCER CLINIC WITH PREDICTIVE SOFTWARECRITICAL FOR COMMUNITIES WITH SOME OF MICHIGANS HIGHEST BREAST CANCER RATES. 4. WORKFORCE STRATEGY: ADDRESSED RURAL STAFFING SHORTAGES VIA INTERNATIONAL RECRUITMENT (170 NURSES FROM THE PHILIPPINES), EXPANDED LOCAL PIPELINES (EARLY HIRE PROGRAM, RESIDENCIES), AND RETENTION INITIATIVES (NURSE RESIDENCY PROGRAM). SECURED A 500K HOUSING GRANT TO SUPPORT RELOCATION AND AFFORDABLE HOUSING, EXPECTED TO ATTRACT 4060 HIRES. 5. MATERNAL & CHILD HEALTH: THE HEALTHY FUTURES PROGRAM SERVED 1,300 FAMILIES THROUGH FREE POSTPARTUM HOME VISITS, BREASTFEEDING SUPPORT, AND EDUCATION. FY25 ADDED PRENATAL AND NEWBORN CARE CLASSES AND ADVANCED A CARE COORDINATION PORTAL LINKING HOME VISITS TO CLINICAL CARE. A BLOOD PRESSURE INITIATIVE PREVENTED LIFE-THREATENING POSTPARTUM COMPLICATIONS. 6. IMPROVING HEALTH OUTCOMES FOR NON-MAJORITY GROUPS: ANALYSIS OF PAST COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) SHOWS THAT, DESPITE PRIORITIZING NON-MAJORITY POPULATIONS, HEALTH OUTCOMES AND TRUST HAVE NOT SIGNIFICANTLY IMPROVED. TO ADDRESS THIS, ROTARY CHARITIES FUNDED A TWO-YEAR INITIATIVE IN PARTNERSHIP WITH MUNSON HEALTHCARE, DISTRICT HEALTH DEPARTMENT 10, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, AND THE NORTHERN MICHIGAN COMMUNITY HEALTH INNOVATION REGION (NMCHIR). WE ENGAGED AN INDIGENOUS COACH WITH A MASTERS IN ORGANIZATIONAL PSYCHOLOGY TO GUIDE US IN DEVELOPING IMPACTFUL STRATEGIES. TOGETHER, WE CONDUCTED ORGANIZATIONAL ASSESSMENTS TO ESTABLISH BASELINE UNDERSTANDING, HELD SIX LISTENING SESSIONS WITH DIVERSE NON- MAJORITY GROUPS, AND INTRODUCED CONCEPTS LIKE THE FOUR LEVELS OF LISTENING TO HELP ORGANIZATIONS SHIFT THEIR APPROACH. THESE EFFORTS HAVE SURFACED KEY THEMES AND EVIDENCE THAT WILL INFORM ACTIONABLE RECOMMENDATIONS. FUTURE WORK WILL FOCUS ON CO-DEVELOPING STRATEGIES WITH COMMUNITY PARTNERS AND IMPLEMENTING A CYCLICAL, EXPERIMENTAL PROCESS TO TEST AND REFINE APPROACHES FOR IMPROVING OUTCOMES MORE QUICKLY. HOUSING: RECOGNIZING HOUSING AS FOUNDATION TO HEALTH, MUNSON HAS MADE SIGNIFICANT INVESTMENTS TO EXPAND EMERGENCY SHELTER, SUPPORTIVE HOUSING, AND RELATED SERVICES. THIS INCLUDES A TWO-YEAR COMMITMENT OF 75,000 ANNUALLY TO GOODWILL NORTHERN MICHIGAN, A LEADER IN ADDRESSING EMERGENCY SHELTER NEEDS AND ENDING CHRONIC HOMELESSNESS. ADDITIONAL LOCAL INVESTMENTS TARGET COMMUNITIES WITH THE HIGHEST DENSITY OF UNHOUSED INDIVIDUALS, INCLUDING A 50,000 ANNUAL COMMITMENT FOR TWO YEARS TO SAFE HARBOR TO SUPPORT ITS TRANSITION TO YEAR- ROUND OPERATIONS AND EXPAND WRAPAROUND SERVICES. MUNSON ALSO PARTNERS WITH THE CHIR COMMUNITY CONNECTIONS PROGRAM, WHICH LINKS PATIENTS TO ESSENTIAL RESOURCES SUCH AS HOUSING, FOOD, TRANSPORTATION, AND HEALTHCARE THROUGH ONE-ON-ONE SUPPORT. IN 2025, MORE THAN 2,000 PATIENTS WERE REFERRED. MUNSON CONTRIBUTES 60,000 ANNUALLY WHILE MANAGING A 150,000 MICHIGAN HEALTH ENDOWMENT FUND GRANT TO SUSTAIN AND GROW THIS WORK. TO REACH INDIVIDUALS EX SCHEDULE H, PART VI, LINE 6 MUNSON HEALTHCARE GRAYLINGS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM WHICH INCLUDE MUNSON MEDICAL CENTER, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL AND MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL PROVIDED 120.7 MILLION OF COMMUNITY BENEFIT IN THE 2024 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 4.1 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2024. 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 149.8 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 1017265 532036 1119694 223966 29910 2922871 1086251 JAMES SHURLOW SURGEON 1873 945143 394011 19 23391 17285 31 30981 1923 1410811 LAURA GLENN COO 627293 354753 47351 85536 26230 1141163 23351 MICHAEL VANWAGNER DO ORTHOPEDIC SURGEON 25207 690480 211836 678 31872 101 17184 480 12192 26466 963564 PAUL KONOPACKI CFO 564989 142802 947 69237 23740 801715 MATTHEW DUBIEL MD ORTHOPEDIC SURGEON 66643 553814 81009 2302 21109 521 16764 2913 26194 72379 698890 DINO RECCHIA MD DIRECTOR 651441 38148 25711 17285 13809 746394 JASON BENNETT DO ORTHOPEDIC SURGEON 566106 15000 24496 17285 30132 653019 BRIAN STIRLING MD PHYSICIAN 525748 40381 34787 17285 32059 650260 ELLEN SMITH PRESIDENT AMB SERVIC 320045 218529 6460 3210 548244 122177 KIRSTEN KORTH-WHITE PRESIDENT 323674 107072 23835 46041 9833 510455 KATHLEEN LARAIA VP ONCOLOGY & PROF S 295038 74331 8553 33981 25540 437443 VINCENT SCHULTZ MD DIRECTOR 311935 28428 15524 17285 28298 401470 CHRISTOPHER SQUIRE VP ANCILLARY SER EAS 207778 94786 463 4270 16976 324273 MICHAEL HODNETT CNO/COO 211092 39711 548 21822 26245 299418 BONNIE KRUSZKA CHIEF APP/CFO PHYS N 241950 14760 519 26882 1751 285862 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 BUSINESS 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 68,251 0 PAUL KONOPACKI 0 57,121 0 ELLEN SMITH 94,157 0 0 KIRSTEN KORTH-WHITE 0 35,691 0 KATHLEEN LARAIA 0 18,364 0 MICHAEL HODNETT 0 11,913 0 BONNIE KRUSZKA 0 14,760 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 EXECUTIVE SUPPLEMENTAL 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 OF MUNSON HEALTHCARE, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE RETIREMENT FUNDS ARE AVAILABLE TO THE PARTICIPANTS UPON THEIR RETIREMENT FROM MUNSON. PART II, LINE 1, COLUMN B(III) CEO EDWIN NESS, A 25 YEAR EMPLOYEE, HAS BEGUN VESTING IN HIS SERP PLAN. IN 2024, THE TAXABLE AMOUNT WAS 1,086,251. THIS ONE-TIME TAXABLE AMOUNT IS REFLECTED IN HIS 2024 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 1,086,251 WERE PREVIOUSLY REPORTED AS BENEFITS IN PRIOR YEAR FORMS 990. FORM 990, PAGE 6, PART VI, LINE 6 MUNSON HEALTHCARE GRAYLING IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE TRUSTEES FOR ALL SUBSIDIARY ENTITIES, INCLUDING MUNSON HEALTHCARE GRAYLING. THE BOARD OF TRUSTEES OF MUNSON HEALTHCARE GRYALING CONSISTS OF THOSE INDIVIDUALS THAT ARE ELECTED OR APPOINTED TO SERVE AS THE DIRECTORS OF MUNSON HEALTHCARE. NOMINATIONS TO MUNSON HEALTHCARE ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON HEALTHCARE GRAYLING (GRY) TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF TRUSTEES INCLUDING THE ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF GRY; THE ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION; THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF GRY; THE ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF GRY; THE ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR GRY; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY GRY WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF GRY WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF THE BUDGET; THE ADOPTION OR AMENDMENT OF THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF GRY; CHANGE IN SCOPE OF CLINICAL SERVICES OR PROGRAMS PROVIDED BY GRY; AND APPOINTMENT OR REMOVAL OF THE PRESIDENT. FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON HEALTHCARE GRAYLING BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE GRAYLING BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE EXECUTIVE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE EXECUTIVE COMPENSATION PROCESS AND THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE FINANCE AND AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF EXECUTIVE COMPENSATION AND FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER. FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED THROUGH THE FOLLOWING ANNUAL PROCESS: FIRST, AN INDEPENDENT FIRM IS ENGAGED TO PROVIDE COMPARABILITY DATA. THEN, THAT DATA IS REVIEWED BY TWO MUNSON HEALTHCARE COMMITTEES, EACH OF WHICH ARE COMPRISED OF INDIVIDUALS WHO ARE NOT EMPLOYEES OR OTHERWISE INSIDERS (DEFINED AS BOARD MEMBERS, PHYSICIANS & EXECUTIVES) OF THE ORGANIZATION. FIRST, THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE EVALUATES THE DATA AND DETERMINES A RECOMMENDED COMPENSATION MODEL BASED ON THE COMPARABILITY DATA. NEXT, THE BOARD CONFLICT, VALUATION AND COMPLIANCE COMMITTEE REVIEWS THE RECOMMENDATIONS AS COMPARED TO THE COMPARABILITY DATA. THIS COMMITTEE'S ROLE IS TO DETERMINE WHETHER THE PROPOSED COMPENSATION IS CONSISTENT WITH FAIR MARKET VALUE. IF PHYSICIANS ARE INCLUDED IN THE DEFINITION OF KEY EMPLOYEE, THE BOARD CONFLICT, VALUATION, AND COMPLIANCE COMMITTEE REVIEWS ALL FINANCIAL RELATIONSHIPS WITH PHYSICIANS AND COMPARES THE PROPOSED FINANCIAL ARRANGEMENT WITH COMPARABILITY DATA PRODUCED BY AN OUTSIDE, INDEPENDENT FIRM. PHYSICIAN COMPENSATION DOES NOT GO TO THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMPARABILITY DATA AS WELL AS THE MINUTES OF EACH OF THESE COMMITTEE MEETINGS ARE MAINTAINED FOR FUTURE REFERENCE. THE MHC BOARD APPROVES THE MHC CEO'S COMPENSATION. THE MHC BOARD HAS DELEGATED TO THE CVC COMMITTEE THE AUTHORITY TO REVIEW AND APPROVE COMPENSATION ARRANGEMENTS WITH INSIDERS. FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES OF MUNSON HEALTHCARE GRAYLING AND MUNSON HEALTHCARE. FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON HEALTHCARE GRAYLING ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE GRAYLING DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. FORM 990, PART IX, LINE 11G PURCHASED SERVICES 7,263,496 35,061 15,566 PROFESSIONAL FEES 4,911,428 125,926 0 TOTAL 12,174,924 160,987 15,566 MUNSON DIALYSIS CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 383097861 DIALYSIS MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382640544 HEALTHCARE MI C3 12B N/A false MUNSON HEALTHCARE FOUNDATIONS 1105 SIXTH ST TRAVERSE CITY MI 49684 382642724 RAISE FUND MI C3 7 MUNSON HC MUNSON HEALTHCARE true MUNSON HOME CARE 1105 SIXTH ST TRAVERSE CITY MI 49684 382191390 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true MUNSON HOME SERVICES 1105 SIXTH ST TRAVERSE CITY MI 49684 382543463 HOME HEALT MI C3 10 MUN HOME H MUNSON HOME HEALTH true NORTH FLIGHT INC 1105 SIXTH ST TRAVERSE CITY MI 49684 382657917 MED TRANSP MI C3 12B MUNSON HC MUNSON HEALTHCARE true PAUL OLIVER MEMORIAL HOSPITAL 1105 SIXTH ST TRAVERSE CITY MI 49684 381415623 HEALTHCARE MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON MEDICAL GROUP 1105 SIXTH ST TRAVERSE CITY MI 49684 273600575 PHYSICIAN MI C3 10 MUNSON MED MUNSON MEDICAL CENTER true MUNSON MEDICAL CENTER 1105 SIXTH ST TRAVERSE CITY MI 49684 381362830 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CADILLAC 1105 SIXTH ST TRAVERSE CITY MI 49684 471156297 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true MUNSON HEALTHCARE CHARLEVOIX HOSPIT 1105 SIXTH ST TRAVERSE CITY MI 49684 381459366 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE MANISTEE HOSPITAL 1465 E PARKDALE AVE MANISTEE MI 496609709 380350304 HOSPITAL MI C3 3 MUNSON HC true MUNSON HEALTHCARE OTSEGO MEMORIAL H 825 N CENTER AVE GAYLORD MI 497351592 381303843 HOSPITAL MI C3 3 MUNSON HC MUNSON HEALTHCARE true NORTHERN MICHIGAN SUPPLY ALLIANCE 2651 AERO PARK DR TRAVERSE CITY MI 49686 383453378 PURCHASING MI N/A false false MEDICAL OFFICE BUILDING CONDOMINIUM PO BOX 1188 TRAVERSE CITY MI 496851188 383567278 REAL ESTAT MI N/A true MUNSON SERVICES INC PO BOX 1188 TRAVERSE CITY MI 496851188 383144382 PHARMACY MI N/A true SIXTH STREET DRUGS INC PO BOX 1188 TRAVERSE CITY MI 496851188 382298290 PHARMACY MI N/A true MEDICAL OFFICE CONDOMINIUM ASSOCIAT PO BOX 1188 TRAVERSE CITY MI 496851188 201902620 REAL ESTAT MI N/A true false false false false false false false false false false false false true false true true true false false MUNSON HEALTHCARE M 13496903 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE O 1038702 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE P 8744678 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE Q 100128 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC M 232200 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC P 108171 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CADILLAC Q 786135 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT O 157180 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE CHARLEVOIX HOSPIT Q 423655 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE FOUNDATIONS M 100626 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H O 144803 ACTUAL AMOUNTS PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H P 1254866 ACTUAL AMOUNT PAID MUNSON HEALTHCARE OTSEGO MEMORIAL H Q 2313716 ACTUAL AMOUNTS PAID MUNSON HELATHCARE MANISTEE HOSPITAL Q 677293 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER M 692350 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER O 27794454 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER P 19707120 ACTUAL AMOUNTS PAID MUNSON MEDICAL CENTER Q 16637465 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP M 221565 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP O 826752 ACTUAL AMOUNTS PAID MUNSON MEDICAL GROUP Q 85069 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALIANCE M 571832 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALIANCE P 2348824 ACTUAL AMOUNTS PAID NORTHERN MI SUPPLY ALLIANCE Q 139484 ACTUAL AMOUNTS PAID PAUL OLIVER MEMORIAL HOSPITAL Q 646131 ACTUAL AMOUNTS PAID SCHEDULE R MUNSON HEALTHCARE GRAYLING USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS.