Community Benefit Insight - Tax-exempt hospital

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Sturgis Hospital Inc

Sturgis Hospital Inc

916 Myrtle Street
Sturgis, MI 49091

Bed count	94	Medicare provider number	230096	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 352362438

Display data for year:

Community Benefit Spending- 2017
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

2.66%

Spending by Community Benefit Category- 2017
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2017

Additional data

Community Benefit Expenditures: 2017

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 54,124 0.11 %
Medicaid as % of operating expenses	$ 1,263,609 2.52 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 0 0 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 3,406 0.01 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 11,928 0.02 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2017

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 3,277,072 6.53 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 1,592,634 48.60 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2017

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2017

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 36779430 including grants of $ 0) (Revenue $ 44687597)
STURGIS HOSPITAL IS AN 84-BED LICENSED, ACUTE CARE FACILITY. NEARLY 40 ACTIVE MEDICAL STAFF MEMBERS, AVAILABLE WITHIN THE STURGIS AND SURROUNDING COMMUNITIES, REPRESENT A WIDE VARIETY OF SPECIALTIES INCLUDING ANESTHESIOLOGY, FAMILY PRACTICE, GENERAL SURGERY, GYNECOLOGY, INTERNAL MEDICINE, OBSTETRICS, OPHTHALMOLOGY, ORTHOPAEDICS, PATHOLOGY, PEDIATRICS, PODIATRY, RADIOLOGY, UROLOGY AND VASCULAR SURGERY. ADDITIONAL SPECIALTIES ARE OFFERED THROUGH THE HOSPITAL'S COURTESY, CONSULTING AND AFFILIATE MEDICAL STAFF MEMBERS. THESE SERVICES INCLUDE CARDIOLOGY, NEUROLOGY, NEUROSURGERY, ONCOLOGY, AND PULMONARY MEDICINE. MEDICAL/SURGICAL CARE IS OFFERED ON AN INPATIENT AND OUTPATIENT LEVEL. BOTH LASER AND LAPAROSCOPIC PROCEDURES ARE PERFORMED IN THE HOSPITAL'S THREE ROOM SURGICAL SUITE. A FOUR-BED CORONARY/INTENSIVE CARE UNIT IS ALSO AVAILABLE FOR CRITICAL PATIENTS. THE 12-BED OBSTETRICAL DEPARTMENT OFFERS LABOR/DELIVERY/RECOVERY/POSTPARTUM ROOMS FOR THE EXPECTANT MOM AND HER FAMILY. EMERGENCY SERVICES ARE AVAILABLE 24 HOURS A DAY, 365 DAYS A YEAR, WITH FULL-TIME MEDICAL STAFF COVERAGE. CARDIAC REHABILITATION AND PHYSICAL THERAPY PROGRAMS AS WELL AS COMMUNITY EDUCATION PROGRAMS DESIGNED TO HELP OUR COMMUNITY LEAD A HEALTHIER LIFESTYLE, ARE ALSO AVAILABLE. STURGIS HOSPITAL HAS A COMMITMENT TO MAINTAIN STATE-OF-THE-ART DIAGNOSTIC TECHNOLOGY, WHICH INCLUDES ANGIOGRAPHY, 64-SLICE CT SCANNING, MAMMOGRAPHY, MOBILE MRI, A SLEEP DISORDER LABORATORY AND SPECT IMAGING AND ULTRASOUND.STURGIS HOME HEALTH CARE--A TOP 500 AGENCY IN THE NATION--IS A DIVISION OF STURGIS HOSPITAL. IT WORKS CLOSELY WITH PHYSICIANS TO PROVIDE QUALITY HOME HEALTH CARE SERVICES FOLLOWING DISCHARGE FROM A HOSPITAL OR FOR THOSE WITH SPECIAL MEDICAL NEEDS THAT DO NOT REQUIRE HOSPITALIZATION. THESE SERVICES INCLUDE NURSING ASSISTANCE, AIDS, COMPANIONS, PHYSICAL, OCCUPATIONAL, SPEECH AND LANGUAGE THERAPIES, AS WELL AS A MEDICAL SOCIAL WORKER. HOSPICE OF STURGIS PROVIDES SUPPORT AND CARE FOR PERSONS IN THE LAST PHASES OF AN INCURABLE DISEASE. THESE SERVICES CAN BE PROVIDED IN A PATIENT'S HOME, NURSING HOME OR ADULT FOSTER CARE SETTING. THE HOSPICE TEAM INCLUDES PHYSICIANS, NURSES, THERAPISTS, AIDES, SOCIAL WORKERS, NUTRITIONISTS, VOLUNTEERS AND CLERGY, AS WELL AS BEREAVEMENT AND SUPPORT GROUPS.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

STURGIS HOSPITAL
"PART V, SECTION B, LINE 5: STURGIS HOSPITAL PARTNERED WITH QUORUM HEALTH RESOURCES TO CONDUCT THE CHNA. QUORUM TAKES A COMPREHENSIVE APPROACH TO ASSESS COMMUNITY HEALTH NEEDS. THEY PERFORM SEVERAL INDEPENDENT DATA ANALYSES BASED ON SECONDARY SOURCE DATA, AUGMENT THIS WITH LOCAL EXPERT ADVISOR OPINIONS, AND RESOLVE ANY DATA INCONSISTENCY OR DISCREPANCIES BY REVIEWING THE COMBINED OPINIONS FORMED FROM LOCAL EXPERTS. ""LOCAL EXPERT"" IS AN ADVISORY GROUP OF AT LEAST 15 LOCAL RESIDENTS WITH WHOM THE HOSPITAL SOLICITED TO PARTICIPATE IN THE QHR/HOSPITAL CHNA PROCESS. QUORUM RELIES ON SECONDARY SOURCE DATA, AND MOST SECONDARY SOURCES USE THE COUNTY AS THE SMALLEST UNIT OF ANALYSIS. THEY ASKED THEIR LOCAL EXPERT AREA RESIDENTS TO NOTE IF THEY PERCEIVED THE PROBLEMS OR NEEDS IDENTIFIED BY SECONDARY SOURCES EXISTED IN THEIR PORTION OF THE COUNTY."

STURGIS HOSPITAL
PART V, SECTION B, LINE 6A: THE HOSPITAL'S CHNA WAS CONDUCTED WITH THREE RIVERS HOSPITAL.

STURGIS HOSPITAL
PART V, SECTION B, LINE 6B: THE HOSPITAL COLLABORATED AND OBTAINED ASSISTANCE IN CONDUCTING THE CHNA FROM QUORUM HEALTH RESOURCES (QHR).

STURGIS HOSPITAL
PART V, SECTION B, LINE 11: THE CHNA IDENTIFIED MULTIPLE AREAS WITH SIGNIFICANT NEEDS. THE TOP 5 NEEDS ARE SHOWN BELOW BY ACTION STEPS STRUGIS HOSPITAL WILL TAKE TO ADDRESS THE NEEDS.1) OBESITY/PHYSICAL INACTIVITY-CONTINUE EXISTING PROGRAMS-PARTNERING WITH SENIOR ENRICHMENT CENTER FOR FREE HEALTH ASSESSMENTS AND FREE LUNCH N LEARNS WITH A REGISTERED DIETICIAN-PARTNERING WITH MEIJER TO OFFER HEALTH ASSESSMENTS AND WORKING WITH THE PRODUCE DEPARTMENT TO PROMOTE HEALTHY EATING-AS PART OF ACO, STARTING SENIOR WELLNESS PROGRAM TO ENCOURAGE ANNUAL VISITS AND HEALTH SCREENINGS-PARTNERING WITH STEP UP ST. JOSEPH TO PROMOTE AND ORGANIZE WALKING PROGRAM/ACTIVITIES (WALKING CLUB PROGRAM)-INVESTIGATING HISPANIC OBESITY PROGRAMS AND SEEKING GRANT FUNDING-UPCOMING LUNCH N LEARNS IN SCHOOLS INCLUDING RETHINK YOUR DRINK, HEALTHY EATING, ETC.2) MENTAL HEALTH/SUICIDE/SUBSTANCE ABUSE-COLLABORATING TO DEVELOP FQHC, WHICH INCLUDES BEHAVIORAL HEALTH SERVICES-LOOK AT PROVIDING EDUCATION SESSIONS TO LOCAL SCHOOLS ABOUT SUBSTANCE ABUSE/MENTAL HEALTH-COUNSELOR WITH SCHOOL-LINKED CLINIC WILL BE PROVIDING EDUCATION TO TEACHERS TO HELP IDENTIFY AND ADDRESS MENTAL HEALTH ISSUES IN STUDENTS -PARTNERING WITH CMH TO PLACE RECOVERY COACHES IN THE FACILITY TO PROVIDE OUTREACH-PARTICIPATING IN TRAINING PROVIDED BY CMH TO HELP PRIMARY CARE PROVIDERS IDENTIFY SUBSTANCE ABUSE-WORKING GERIATRIC-PSYCH INPATIENT UNIT3) PHYSICIAN SERVICES-CONTINUE EXISTING PROGRAMS-ADDING NEW FASTCARE TO CLINIC TO ADDRESS MINOR/NON-EMERGENT NEEDS-ACTIVELY RECRUITING A CARDIOLOGIST-WORKING GERIATRIC-PSYCH INPATIENT UNIT4) EDUCATION/PREVENTION-CONTINUE EXISTING PROGRAMS-EXPAND HEALTH AND WELLNESS ONLINE MARKETING INITIATIVES5) DIABETES-CONTINUE EXISTING PROGRAMS-COLLABORATING WITH MSU EXTENSION TO OFFER DINING WITH DIABETES CLASS IN SPANISHBY DEFINITION, THE NEEDS IDENTIFIED AS LOW PRIORITY AND FOR WHICH STURGIS HOSPITAL HOLDS LOW RESPONSIBILITY FOR IMPLEMENTATION ARE NEEDS THE HOSPITAL WILL MONITOR, BUT OTHERWISE NOT ADDRESS. SOME OF THE REASONS FOR THIS RESPONSE INCLUDE:- ACTIONS REQUIRED ARE BEYOND THE MISSION OF THE HOSPITAL-THE HOSPITAL DOES NOT POSSESS THE REQUIRED EXPERTISE-THE HOSPITAL CAN BE MORE EFFECTIVE APPLYING ITS RESOURCES TO HIGHER PRIORITY NEEDS-IMPLEMENTATION FALLS MORE APPROPRIATELY TO OTHER ORGANIZATIONS

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
ACCORDING TO THE HOSPITAL'S EXISTING PUBLIC POLICY, ALL PATIENTS RECEIVING MEDICALLY NECESSARY SERVICES ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE NEED OF THE PATIENTS, LACK OF EXISTING INSURANCE, AND OTHER RESOURCES REQUIRED FOR PAYMENT. ELIGIBILITY CRITERIA IS FURTHER BASED ON THE FEDERAL POVERTY GUIDELINES AT A LEVEL OF 200% OF THAT GUIDELINE.

PART I, LINE 6A:
STURGIS HOSPITAL PUBLISHES ITS ANNUAL REPORT WHICH INCLUDES ALL RELATED ORGANIZATIONS' PROGRAMS AND SERVICES DESIGNED TO LEAD THE COMMUNITY TO IMPROVED HEALTH AND PROMOTE HEALTHY LIFESTYLES. THE REPORT IS AVAILABLE ON STURGIS' WEBSITE.

PART I, LN 7 COL(F):
"BAD DEBT EXPENSE IN THE AMOUNT OF $3,277,072 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) (""TOTAL FUNCTIONAL EXPENSES""), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. THE ORGANIZATION USES A COMBINATION OF THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H AND DIRECT COSTING METHOD OF CERTAIN PROGRAMS."

PART III, LINE 3:
THE AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE IS ESTIMATED BASED UPON PAST EXPERIENCE.

PART III, LINE 4:
ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).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), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS 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. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.

PART III, LINE 8:
COSTING METHODOLOGY TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MCR IS A STATISTICAL STEP DOWN ALLOCATION METHOD. ANY SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE THE HOSPITAL PROVIDES THESE SERVICES AS A COMMUNITY BENEFIT DESPITE THE FACT THAT THEY ARE PROVIDED AT A FINANCIAL LOSS.

PART III, LINE 9B:
ONCE THE EVALUATION IS COMPLETED AND A DETERMINATION HAS BEEN MADE THAT PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, NO COLLECTION EFFORTS ARE MADE. CONSIDERATION FOR ASSISTANCE IS ALSO GIVEN TO OTHER TYPES OF PATIENTS IF THE NEED FOR ASSISTANCE IS REQUIRED.

PART VI, LINE 2:
DURING 2018 THE HOSPITAL HELD 20 GENERAL HEALTH EDUCATION EVENTS REACHING MORE THAN 600 PEOPLE, PROVIDED COMMUNITY HEALTH EDUCATION SUPPORT GROUPS, HEALTH FAIRS, HEALTH SCREENING CLINICAL SERVICES, AND HELD AN IMMUNIZATION CLINIC REACHING 28 PEOPLE.STURGIS HOSPITAL COLLABORATED AND OBTAINED ASSISTANCE IN CONDUCTING THE CHNA FROM QUORUM HEALTH RESOURCES (QHR).

PART VI, LINE 3:
THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY AND AVAILABILITY OF FINANCIAL ASSISTANCE BY:-POSTING THE ORGANIZATIONS CHARITY CARE POLICY IN ACCESS AND REGISTRATION AREAS WITHIN THE HOSPITAL-INDIVIDUAL INTERVIEW OF PATIENTS BY FINANCIAL COUNSELORS AND PREADMISSION STAFF WITH DISCUSSION CONCERNING FINANCIAL ASSISTANCE, AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS AND ASSISTANCE WITH THE APPLICATION FOR ASSISTANCE.-THE HOSPITAL HAS ENTERED A MEMORANDUM OF UNDERSTANDING WITH THE COUNTY WHEREAS THE HOSPITAL MAKES A COMMITMENT TO PROVIDE HEALTH CARE SERVICES TO LOW INCOME RESIDENTS OF THE COUNTY (PUBLIC RECORD)

PART VI, LINE 4:
ST. JOSEPH COUNTY IS LOCATED IN SOUTHWEST MICHIGAN, ON THE BORDER OF INDIANA. THE SERVICE AREA HAS APPROXIMATELY OF 23,000 HOUSEHOLDS COMPRISING OF AROUND 61,000 PEOPLE. THE ETHNIC MAKEUP IS 88% WHITE, 2.5% AFRICAN AMERICAN, 6.6% HISPANIC WITH THE REST BEING MADE UP OF NATIVE AMERICAN, ASIAN AND OTHERS. THE MEDIAN HOUSEHOLD INCOME IS ABOUT $44,000.

PART VI, LINE 6:
THE HOSPITAL IS NOT A PART OF AN AFFILIATED HEALTH CARE SYSTEM.

PART VI, LINE 7, REPORTS FILED WITH STATES
MI

PART VI, LINE 5:
THE HOSPITAL DEMONSTRATES ITS DESIRE TO FURTHER ITS EXEMPT PURPOSE AND MISSION BY:-A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED BY PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA, WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF.-THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY (OPEN MEDICAL STAFF).-ALL SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO PROMOTE SERVICE ENHANCEMENT TO ITS COMMUNITY AS WELL AS CAPITAL REPLACEMENT AND SERVICE DEVELOPMENT.-THE ORGANIZATION FURTHER PROMOTES ITS MISSION BY PARTICIPATION IN HEALTH CARE SCREENING, HEALTH CARE EDUCATION AND CERTAIN SERVICES MADE TO THE COMMUNITY AT NO COST TO THE COMMUNITY.-ORGANIZATION HAS ENTERED INTO MEMORANDUM OF UNDERSTANDING WITH ST. JOSEPH COUNTY COMMITTING TO PROVIDE SERVICES TO THE COMMUNITY REGARDLESS OF THE ABILITY TO PAY FOR THOSE SERVICES.

Operating expenses	$ 50,171,826
Total amount spent on community benefits as % of operating expenses	$ 1,333,067 2.66 %