4A (Expenses $ 102417395 including grants of $ 0) (Revenue $ 116221174)
EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF GAYLORD, MICHIGAN AND THE SURROUNDING AREA WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY. MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL HAD 1,581 INPATIENT ADMISSIONS IN FISCAL YEAR 2022 AND OVER 109,000 OUTPATIENT VISITS. THE HOSPITAL SERVED MORE THAN 2,700 SURGICAL CASES, 353 OBSTETRICAL BIRTHS, AND OVER 18,900 EMERGENCY ROOM VISITS. MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ACCEPTS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAS APPROXIMATELY 59 ACTIVE MEDICAL STAFF AND 22 VOLUNTEERS. INCLUDED IN PROGRAM SERVICE EXPENSES ARE 712,000 OF COVID-19 EXPENSES FOR PATIENT CAREAND OTHER RELATED EXPENSES.

FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 3E
THE SIGNIFICANT PRIORITIZED HEALTH NEEDS OF THE COMMUNITY ARE IDENTIFIED IN THE CHNA UNDER THE KEY FINDINGS HEADING. IN THE NORTHEAST REGION, THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN ORDER OF PRIORITY: SUBSTANCE USE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND CHRONIC DISEASE. THESE THEMES WERE PRIORITIZED THROUGH A PRIORITIZATION MATRIX, FOR WHICH MITHRIVE DESIGN TEAM MEMBERS SORTED THE DATA RECEIVED FOR THE THREE REGIONS INTO PRIMARY AND SECONDARY DATA. THEY CLUSTERED DATA POINTS BASED ON TOPIC, THEME AND INTERCONNECTEDNESS. THE THEMES WHICH COULD BE FOUND IN THE HIGH SECONDARY DATA/ HIGH PRIMARY DATA QUADRANT WERE A COMBINATION OF THE ABOVE TOPICS BASED ON REGION.

FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 5
WE ARE FOLLOWING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP FRAMEWORK TO GUIDE OUR PROCESS WHICH INCLUDES FOUR ASSESSMENTS TO GATHER INPUT. 1.COMMUNITY THEMES AND STRENGTHS ASSESSMENT: THIS ASSESSMENT PROVIDES A DEEP UNDERSTANDING OF THE ISSUES THAT RESIDENTS FEEL ARE SIGNIFICANT BY ANSWERING THE FOLLOWING QUESTIONS: WHAT IS IMPORTANT TO OUR COMMUNITY?; HOW IS QUALITY PERCEIVED IN OUR COMMUNITY?; WHAT ASSETS DO WE HAVE THAT CAN BE USED TO IMPROVE WELLBEING? IT CONSISTED OF THREE SURVEYS: COMMUNITY SURVEY, HEALTHCARE PROVIDER SURVEY, AND PULSE SURVEY. RESULTS FROM EACH WERE ANALYZED BY COUNTY, HOSPITAL SERVICE AREA, AND THE THREE MITHRIVE REGIONS. 2.COMMUNITY HEALTH STATUS ASSESSMENT: THE COMMUNITY HEALTH STATUS ASSESSMENT IDENTIFIES PRIORITY COMMUNITY HEALTH AND QUALITY OF LIFE ISSUES. IT ANSWERS THE QUESTIONS, HOW HEALTHY ARE OUR RESIDENTS? AND WHAT DOES THE HEALTH STATUS OF OUR COMMUNITY LOOK LIKE? ITS PURPOSE IS TO COLLECT QUANTITATIVE SECONDARY DATA ABOUT THE HEALTH AND WELL-BEING OF RESIDENTS AND COMMUNITIES. WE COLLECTED APPROXIMATELY 100 STATISTICS, BY COUNTY, FOR THE 31-COUNTY REGION FROM RELIABLE SOURCES SUCH AS THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE US CENSUS BUREAU. 3.COMMUNITY SYSTEM ASSESSMENT: THE COMMUNITY SYSTEM ASSESSMENT FOCUSES ON ORGANIZATIONS THAT CONTRIBUTE TO WELL-BEING. IT ANSWERS THE QUESTIONS, WHAT ARE THE COMPONENTS, ACTIVITIES, COMPETENCIES, AND CAPACITIES IN THE REGIONAL SYSTEM? AND HOW ARE SERVICES BEING PROVIDED TO OUR RESIDENTS? FIRST, COMMUNITY-WIDE VIRTUAL MEETINGS WERE CONVENED IN THE NORTHWEST, NORTHEAST, AND NORTH CENTRAL MITHRIVE REGIONS WHERE PARTICIPANTS DISCUSSED VARIOUS ATTRIBUTES OF THE COMMUNITY SYSTEM. THESE WERE FOLLOWED BY RELATED DISCUSSIONS AT LOCAL COMMUNITY COLLABORATIVE MEETINGS. 4.FORCES OF CHANGE ASSESSMENT: THE FORCES OF CHANGE ASSESSMENT IDENTIFIES FORCES SUCH AS LEGISLATION, TECHNOLOGY, AND OTHER FACTORS THAT AFFECT THE COMMUNITY CONTEXT. IT ANSWERS THE QUESTIONS, WHAT IS OCCURRING OR MIGHT OCCUR THAT AFFECTS THE HEALTH OF OUR COMMUNITY OR THE LOCAL SYSTEM? AND WHAT SPECIFIC THREATS OR OPPORTUNITIES ARE GENERATED BY THESE OCCURRENCES? LIKE THE COMMUNITY SYSTEM ASSESSMENT, THE FORCES OF CHANGE ASSESSMENT WAS COMPOSED OF COMMUNITY MEETINGS CONVENED VIRTUALLY IN THE NORTHWEST, NORTHEAST, AND NORTH CENTRAL REGIONS. AS ONE OF THE FIRST STEPS OF ACHIEVING HEALTH EQUITY IS TO UNDERSTAND CURRENT HEALTH DISPARITIES, WE INVITED DIVERSE COMMUNITY PARTNERS TO JOIN THE MITHRIVE STEERING COMMITTEE, DESIGN TEAM, AND WORKGROUPS, AND WE GATHERED PRIMARY AND SECONDARY DATA FROM MEDICALLY UNDERSERVED, MINORITY, AND LOW-INCOME POPULATIONS IN EACH OF THE FOUR MITHRIVE ASSESSMENTS, BY THE FOLLOWING METHODS: CROSS-TABULATING DEMOGRAPHIC INDICATORS SUCH AS AGE, RACE, AND SEX FOR THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT ENGAGING RESIDENTS EXPERIENCING BARRIERS TO SOCIAL DETERMINANTS OF HEALTH AND ORGANIZATIONS THAT SERVE THEM IN THE COMMUNITY SYSTEM ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT REACHING OUT TO MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS THROUGH PULSE SURVEYS ADMINISTERED BY ORGANIZATIONS THAT SERVE THEM INCREASING INCLUSION OF PEOPLE WITH DISABILITIES IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH PARTNERSHIP WITH THE DISABILITY NETWORK OF NORTHERN MICHIGAN SURVEYING PROVIDERS WHO CARE FOR PATIENTS/CLIENTS ENROLLED IN MEDICAID HEALTH PLANS RECRUITING 1) RESIDENTS EXPERIENCING BARRIERS TO SAFE, AFFORDABLE, AND ACCESSIBLE HOUSING; HEALTHY FOOD; TRANSPORTATION OPTIONS; AND OTHER SOCIAL DETERMINANTS OF HEALTH AND 2) REPRESENTATIVES FROM THE DIVERSE ORGANIZATIONS THAT SERVE THEM TO MITHRIVE DATA WALKS AND PRIORITY-SETTING EVENTS

FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 6A
MITHRIVE WAS IMPLEMENTED ACROSS A 31-COUNTY REGION THROUGH A PARTNERSHIP OF HOSPITAL SYSTEMS, LOCAL HEALTH DEPARTMENTS, AND OTHER COMMUNITY PARTNERS. OUR AIM IS TO LEVERAGE RESOURCES AND REDUCE DUPLICATION WHILE STILL ADDRESSING UNIQUE LOCAL NEEDS FOR HIGH QUALITY, COMPARABLE, COUNTY-LEVEL DATA. THE 2021 MITHRIVE COMMUNITY HEALTH NEEDS ASSESSMENT UTILIZED THREE REGIONS: NORTHWEST, NORTHEAST, AND NORTH CENTRAL. ALL OF THE MUNSON HEALTHCARE HOSPITALS WORKED TOGETHER ON REGIONAL CHNA EFFORTS AS PART OF THE MITHRIVE REGIONAL CHNA INITIATIVE. THESE INCLUDE: MUNSON MEDICAL CENTER, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL, AND KALKASKA MEMORIAL HEALTH CENTER. IN ADDITION, HOSPITALS FORM THE MCLAREN AND SPECTRUM HEALTH SYSTEMS COLLABORATED ON THIS EFFORT.

FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 6B
IN ADDITION TO DOZENS OF LOCAL AND REGIONAL ORGANIZATIONS, ALL HEALTH DEPARTMENTS IN THE REGION SERVED PARTICIPATED, INCLUDING: GRAND TRAVERSE HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 10, HEALTH DEPARTMENT OF NORTHWEST MICHIGAN, BENZIE LEELANAU DISTRICT HEALTH DEPARTMENT, CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT, DISTRICT HEALTH DEPARTMENT 2, DISTRICT HEALTH DEPARTMENT 4. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 7A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 10A HTTPS://WWW.MUNSONHEALTHCARE.ORG/SERVICES/COMMUNITY-HEALTH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - PART V, LINE 11
WE IDENTIFIED STRATEGIC ISSUES AS PART OF THE MITHRIVE COLLABORATIVE. STRATEGIC ISSUES ARE BROADER THAN INDIVIDUAL HEALTH CONDITIONS, AND REPRESENT UNDERLYING CHALLENGES THAT NEED TO BE ADDRESSED, WHICH WOULD LEAD TO IMPROVEMENT IN HEALTH CONDITIONS. EACH STRATEGIC ISSUE SHOULD IMPACT MORE THAN ONE HEALTH CONDITION. THE TOP PRIORITY ISSUES TO BE ADDRESSED: MENTAL HEALTH AND SUBSTANCE USE DISORDERS SAFE, AFFORDABLE AND ACCESSIBLE HOUSING ACCESS TO HEALTHCARE CHRONIC DISEASE A COMPLETE LIST OF STRATEGIES PLANNED TO ADDRESS THE PRIORITIZED NEEDS MAY BE VIEWED WITHIN THE CHNA IMPLEMENTATION PLAN. GENERALLY, THE HOSPITAL SYSTEM IS COMMITTED TO PROVIDING RESOURCES TO SUPPORT PROGRAMMING, PARTICIPATION IN COLLABORATIVE PROJECTS, BOARDS, AND SUPPORT FOR OTHER COMMUNITY IMPROVEMENT PROJECTS RELATED TO OUR PRIORITY STRATEGIC ISSUES. IN ADDITION TO THE STRATEGIC ISSUES LISTED ABOVE, THE FOLLOWING CHALLENGES WERE ALSO UNCOVERED IN THE DATA: BROADBAND ACCESS COVID-19 ECONOMIC SECURITY EQUITY HEALTHY FOOD HEALTHY WEIGHT INFRASTRUCTURE FOR HEALTHY LIVES SAFETY AND WELL-BEING TRANSPORTATION MUNSON HEALTHCARE ACKNOWLEDGES THE WIDE RANGE OF ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT WITH THE BROAD NATURE OF THE STRATEGIC ISSUES WE COULD EFFECTIVELY FOCUS ON ONLY THOSE ISSUES THAT WERE PRIORITIZED THE HIGHEST BY OUR COMMUNITY. HOWEVER, SOME OF THESE ISSUES INCLUDING EQUITYARE FOUNDATIONAL COMPONENTS OF ALL THE WORK OF THE ORGANIZATION AND WILL BE INDIRECTLY TARGETED THROUGH MANY OF THE STRATEGIES LISTED IN THIS PLAN.

FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - 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 SOLD DISCRETION OF MUNSON HEALTHCARE. FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16A HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16B HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL - PART V, LINE 16C HTTPS://WWW.MUNSONHEALTHCARE.ORG/PATIENTS-VISITORS/BILL-PAY/ FINANCIAL-ASSISTANCE

FACILITY 1, MUNSON HEALTHCARE OTSEGO MEMORIAL H - 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 OTSEGO MEMORIAL H - PART V, LINE 20E
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL 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. MUNSON WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1.VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2.DOCUMENTING THAT MUNSON HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS; 3.DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE METHOD IN WHICH MUNSON DOES THIS IS AS FOLLOWS: ALL STATEMENTS INCLUDE A STATEMENT REGARDING THE AVAILABILITY OF PAYMENT PLANS, FINANCIAL ASSISTANCE AND CHARITY CARE. MUNSON 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.

SCHEDULE H, PART I, LINE 3C
UNDER IT'S ASSISTANCE PROGRAM MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO) WILL MAKE AVAILABLE A REASONABLE AMOUNT OF UNCOMPENSATED OR REDUCED PRICE SERVICES TO PERSONS ELIGIBLE UNDER APPLICABLE GUIDELINES. OTSEGO ASSISTANCE PROGRAM SERVICES ARE NOT LIMITED TO ANY SPECIFIC HOSPITAL SERVICE. INDIVIDUAL ELIGIBILITY FOR ASSISTANCE IS DETERMINED BY MEASURING FAMILY INCOME IN RELATION TO FAMILY SIZE AGAINST THE INCOME POVERTY GUIDELINE ESTABLISHED BY THE COMMUNITY SERVICE ADMINISTRATION. IF THE HOSPITAL DETERMINES THAT SERVICES ARE ELECTIVE OR OTHERWISE NOT MEDICALLY NECESSARY, THE HOSPITAL CAN DENY SERVICES UNDER THE FINANCIAL ASSISTANCE PROGRAM. ASSETS ARE NOT CONSIDERED AS PART OF EVALUATION FOR ASSISTANCE AS REQUIRED UNDER THE NATIONAL HEALTH SERVICE CORP. AGREEMENT FOR WHICH OTSEGO PARTICIPATES.

SCHEDULE H, PART I, LINE 7, COLUMN (F)
TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, ARE 116,666,755. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS 3,889,550. THE NET EXPENSE OF 112,777,205 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 OTSEGO MEMORIAL HOSPITAL (OTSEGO HOSPITAL) PROVIDED 10,969 OF COMMUNITY BUILDING ACTIVITIES DURING THE 2022 FISCAL YEAR. OTSEGO HOSPITAL PROVIDED A MENU REVIEW FOR PRESQUE ISLE JAIL. OTSEGO HOSPITAL GAVE PATIENTS ASSISTANCE TO ENROLL IN PUBLIC MEDICAL HEALTH PROGRAMS AND PROVIDED TRANSPORTATION. THE MEDSAFE PROGRAM WAS CONTINUED IN OTSEGO, AS WAS THE PRECEPTORSHIP PROGRAM FOR GRAND VALLEY DIETETICS STUDENTS. ADVANCED DIRECTIVE BROCHURES CONTINUE TO BE DISTRIBUTED TO THE PUBLIC.

SCHEDULE H, PART III, LINE 2
DIRECT WRITE-OFF FROM UNPAID ACCOUNTS WHICH ARE DEEMED NO LONGER COLLECTIBLE ARE RECORDED AGAINST THE ALLOWANCE FOR BAD DEBT. AN ESTIMATE OF BAD DEBT EXPENSE IS RECORDED BASED ON 1)AN ANALYSIS OF THE DIRECT WRITE- OFFS AND 2)AN ESTIMATE OF THE AMOUNT OF BAD DEBT, NET OF DISCOUNTS, IN THE ACCOUNTS RECEIVABLE BALANCE, CONSIDERING THE PAST EXPERIENCE AND CURRENT TRENDS OF PAYMENTS ON PATIENT ACCOUNTS FOR EACH OF THE MAJOR PAYOR SOURCES OF REVENUE.

SCHEDULE H, PART III, LINE 3
THE METHODOLOGY USED TO DETERMINE THE ESTIMATED AMOUNT OF CHARITY IN BAD DEBT IS AS FOLLOWS. WE DETERMINED THE APPROVAL RATE OF FINANCIAL COUNSELING BY TAKING THE VALUE OF THE ACCOUNTS THAT SUCCESSFULLY QUALIFIED FOR CHARITY (INCLUDING PRESUMPTIVE APPROVALS) AND DIVIDING THAT NUMBER BY THE ACCOUNTS THAT WERE APPROVED FOR CHARITY PLUS THE ACCOUNTS THAT WERE DENIED. THEN WE APPLIED THAT PERCENTAGE TO THE VALUE OF ACCOUNTS THAT DID NOT COMPLETE FINANCIAL COUNSELING AND WERE ASSIGNED TO BAD DEBT, MULTIPLIED BY THE APPROVAL RATE FOR FINANCIAL COUNSELING.

SCHEDULE H, PART III, LINE 4
SEE NOTE 2 ON PAGE 10 OF ATTACHED AUDITED FINANCIAL STATEMENTS UNDER ACCOUNTS RECEIVABLE.

SCHEDULE H, PART III, LINE 8
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL CONSIDERS THE ENTIRE MEDICARE SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. THAT AMOUNT IS 314,410. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES.

SCHEDULE H, PART III, LINE 9B
ALL PATIENTS RECEIVING TREATMENT AT MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ARE RESPONSIBLE FOR PAYING IN FULL ALL CHARGES FOR SUCH TREATMENT, LESS ANY AMOUNTS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, DISCOUNT CONSIDERATIONS OR INSURANCE COVERAGE, PER POINT OF SERVICE COLLECTION POLICY. MUNSON HEALTHCARES INTERNAL AND EXTERNAL COLLECTION PRACTICES REFERENCED IN THE CREDIT AND COLLECTION POLICY (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTIONS AND REPORTING TO COLLECTION AGENCIES) SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENTS GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE (MHC), AND A PATIENTS GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS WITH MHC. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MHC MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY. MHC WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE: 1) VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENTS HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL; 2) DOCUMENTING THAT MHC HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITALS APPLICATION REQUIREMENTS; 3) DOCUMENTING THAT THE PATIENT HAS BEEN OFFERED THE OPPORTUNITY TO ENTER INTO A PAYMENT PLAN BUT HAS NOT DONE SO, OR HAS ENTERED INTO A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. PATIENTS WILL BE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE CONSIDERATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. MEMBERS OF THE PUBLIC MAY OBTAIN THE CURRENT CREDIT AND COLLECTION POLICY FOR ANY MUNSON HEALTHCARE HOSPITAL ON THE WEBSITE, IN WRITING, AND FREE OF CHARGE BY CONTACTING MUNSON HEALTHCARE PATIENT FINANCIAL SERVICES DEPARTMENT AT 4230 COPPER RIDGE DR., TRAVERSE CITY, MI 49684

SCHEDULE H, PART VI, LINE 7
MICHIGAN

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.OMH PATIENT ACCESS SERVICES (PAS) EDUCATOR/COORDINATOR OR THE FINANCIAL ASSISTANCE SPECIALIST ATTEMPTS TO SEE THE PATIENTS IN ER OR IP. PAS STAFF HAS ALSO BEEN TRAINED TO HAND OUT ASSISTANCE PACKAGES AND TO DIRECT PATIENTS TO SEE THE FINANCIAL ASSISTANCE SPECIALIST/FINANCIAL ADVISOR. WHEN THE PATIENT COMES IN ON THE WORK LIST THEY ARE ALSO INFORMED OF ASSISTANCE PACKAGE AND/OR APPLICATION. THE FORM IS ON THE OMH WEBSITE. WHEN THERE IS A SCHEDULED PROCEDURE AND THE PATIENT DOES NOT HAVE INSURANCE, A CALL IS MADE FOR PAYMENT, FINANCIAL ASSISTANCE APPOINTMENT AND/OR CHARITY ARRANGEMENTS. PATIENTS IDENTIFIED WITHOUT INSURANCE OR NEEDING FINANCIAL EDUCATION, ARE SCHEDULED FOR AN APPOINTMENT WITH THE FINANCIAL ASSISTANCE SPECIALIST. THE FINANCIAL ASSISTANCE SPECIALIST HELPS PATIENTS TO APPLY FOR MEDICAID, INSURANCE EXCHANGE PLANS, OTHER PROGRAMS OR FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE SPECIALIST HELPS PATIENTS APPLY FOR FINANCIAL ASSISTANCE.

SCHEDULE H, PART VI, LINE 4
DESCRIPTION MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (OTSEGO HOSPITAL) IS LOCATED IN GAYLORD, MI AND SERVES THE COUNTIES OF CHEBOYGAN, OTSEGO, MONTMORENCY AND ANTRIM. ALL FOUR COUNTIES SERVED BY OTSEGO HOSPITAL ARE EXTREMELY RURAL. THE ORGANIZATION HAS AN ACTIVE MEDICAL STAFF (PRIMARY FACILITY) OF 59 AND IS ONE OF THE LARGEST EMPLOYERS IN THE REGION. HOSPITAL SERVICES OTSEGO HOSPITAL PROVIDES IT'S RESIDENCE WITH ACUTE INPATIENT STAYS (INCLUDING MEDICAL, INTENSIVE CARE AND OBSTETRICS), 4 SURGICAL SUITES THAT PERFORM BOTH IN AND OUT-PATIENT SERVICES (GENERAL, ORTHOPEDIC AND GASTROINTESTINAL), LABORATORY, DIAGNOSTIC RADIOLOGY SERVICES (GENERAL, ULTRASOUND, NUCLEAR MEDICINE, MAMMOGRAPHY, PET, CT AND MRI), RESPIRATORY THERAPY, THERAPIES, INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH AND WOUND CARE. EMERGENCY ROOM SERVICES OPEN 24 HOURS A DAY 365 DAYS A YEAR. OTSEGO HOSPITAL ALSO PROVIDES A LONG-TERM CARE STAY FACILITY (INCLUDING SKILLED AND NON-SKILLED CARE). CARDIAC REHAB AND PREVENTION SERVICES ARE ALSO OFFERED AT OTSEGO HOSPITAL. IN ADDITION, OTSEGO HOSPITAL OFFERS MANY OUTPATIENT SERVICES CLINICS INCLUDING URGENT CARE, GYNECOLOGIC AND OBSTETRICS, INTERNAL MEDICINE, UROLOGY, ORTHOPEDICS, SURGICAL CARE, ONCOLOGY, PEDIATRICS AND FAMILY PRACTICES. THE HOSPITAL SERVED OVER 2,700 SURGICAL CASES, OVER 109,000 OUTPATIENT VISITS, OVER 18,900 EMERGENCY ROOM VISITS, 1,581 INPATIENT ADMISSIONS AND 353 BIRTHS IN FISCAL YEAR 2022. POPULATION SERVED IN OTSEGO 94% OF RESIDENTS ARE NON-HISPANIC WHITE AND 95% IN ANTRIM COUNTY, 91.5% IN CHEBOYGAN COUNTY AND 94.9% IN MONTMORENCY COUNTY. HISPANICS REPRESENT THE LARGEST MINORITY GROUP IN OTSEGO (1.9%), MONTMORENCY (1.6%), AND ANTRIM (2.4%) COUNTIES WHILE NATIVE AMERICANS REPRESENT THE LARGEST MINORITY GROUP IN CHEBOYGAN COUNTY WITH 3,1%. AT 21.8%, OLDER ADULTS REPRESENT A LARGER PROPORTION OF THE POPULATION IN OTSEGO COUNTY THAN THEY DO STATEWIDE (18.1%), 28% PERCENT OF CHEBOYGAN COUNTY AND ANTRIM COUNTY'S POPULATION IS AGE 65 AND OLDER AND IN MONTMORENCY COUNTY, THEY REPRESENT AN EVEN LARGER SHARE AT 33.5%. (SOURCE: CENSUS BUREAU QUICKFACTS). OTSEGO HOSPITAL SERVES A VERY RURAL AGING POPULATION. QUALITY OTSEGO HOSPITAL HAS A FIVE-STAR RATING FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL IS AT THE FOREFRONT OF MEDICAL TECHNIQUES, TREATMENTS, AND TECHNOLOGY TO ENSURE A HIGH QUALITY EXPERIENCE FOR ITS PATIENTS INCLUDING ADVANCED BREAST CANCER SCREENINGS WITH 3-D TOMOGRAPHY.

SCHEDULE H, PART VI, LINE 5
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL'S (OTSEGO HOSPITAL) BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, THE MAJORITY OF WHOM RESIDE IN THE MUNSON HEALTHCARE PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS. THE HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT THE SERVICE AREA. THESE FUNDS ARE REINVESTED INTO OUR HOSPITALS IN THE FORM OF EMPLOYEE WAGE ADJUSTMENTS, TECHNOLOGY, AND SERVICES NEEDED TO ENSURE THE HIGHEST QUALITY CARE IS AVAILABLE IN NORTHERN MICHIGAN. THE HOSPITAL ALSO HAS AN OPEN MEDICAL STAFF WHERE PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF TRUSTEES. IN ADDITION, THE HOSPITAL CONTINUES TO INVEST IN PUBLIC HEALTH PROGRAMING AND INITIATIVES. OTSEGO HOSPITAL PROVIDED DISCOUNTED SPORTS PHYSICALS TO AREA STUDENT ATHLETES; OTSEGO HOSPITAL HOSTS MONTHLY WELLNESS WEDNESDAYS, OFFERING CHOLESTEROL, BLOOD PRESSURE, BMI, HEIGHT, WEIGHT AT A DISCOUNTED RATE TO COMMUNITY MEMBERS AND FREE TO ANYONE WHO IS UNABLE TO PAY THE NOMINAL RATE. WELLNESS WEDNESDAYS HAVE ALSO EXPANDED TO OPERATE AS A SAFE NEEDLE DROP OFF FOR AREA RESIDENTS. A NEW MEDSAFE DISPOSAL CONTAINER IS BEING INSTALLED ON THE HOSPITAL CAMPUS TO OFFER AREA RESIDENTS A SAFE AND EASY METHOD TO DISPOSE OF UNUSED OR EXPIRED MEDICATIONS. THE HOSPITAL OFFERS A MAMMOGRAPHY ASSISTANCE PROGRAM, TO ENSURE THAT WOMEN WHO DO NOT QUALIFY FOR A FREE MAMMOGRAM THROUGH THE LOCAL HEALTH DEPARTMENT, YET HAVE NO MEANS TO PAY FOR IT PRIVATELY, ARE COVERED AND RECEIVE A SCREENING AND IF NECESSARY DIAGNOSTIC MAMMOGRAM AND OTHER SERVICES AT NO CHARGE. ADDITIONALLY, THE HOSPITAL OFFERS A DIABETES ASSISTANCE PROGRAM AND AN ONCOLOGY ASSISTANCE PROGRAM DESIGNED TO HELP THOSE DIAGNOSED WITH THOSE DISEASES AND STRUGGLING FINANCIALLY TO RECEIVE THE ASSISTANCE THEY NEED TO ATTEND TREATMENTS AND TEST REGULARLY FOR DIABETES. OTSEGO HOSPITAL CONTINUES TO OFFER THE CDC'S YEAR-LONG DIABETES PREVENTION PROGRAM, WORKING WITH INDIVIDUALS WHO HAVE BEEN DIAGNOSED AS PRE DIABETIC TO REDUCE CALORIE INTAKE, INCREASE EXERCISE, AND UNDERSTAND PORTION CONTROL AMONG OTHERS. THIS PROGRAM HAS SEEN A HIGH SUCCESS RATE OF COMPLETION AND BMI REDUCTION. THE PROGRAM AT OTSEGO HOSPITAL IS ONE OF THE ONLY RECOGNIZED PROGRAMS IN NORTHERN MICHIGAN. OTSEGO HOSPITAL ALSO WORKS CLOSELY WITH THE LOCAL SCHOOLS TO ASSIST THE HIGH SCHOOL LEVEL MEDICAL OCCUPATIONAL PROGRAM IN JOB SHADOWING AND EDUCATION PROGRAM FOR STUDENTS THROUGHOUT THE FACILITY AND SCHOOL YEAR. NEW PARENTS ARE INVITED TO PARTICIPATE IN CHILDBIRTH EDUCATION CLASSES OFFERED BY OTSEGO HOSPITAL STAFF FOR A NOMINAL FEE OR FREE TO THOSE UNABLE TO PAY. ON A BIMONTHLY BASIS, THE HOSPITAL PRODUCES AND DISTRIBUTES TO MORE THAN 47,000 HOUSEHOLDS THROUGHOUT THE SERVICE AREA LITERATURE ON VARIOUS HEALTHCARE ISSUES AND TOPICS, INCLUDING INFORMATION ON LOCAL FREE HEALTH EVENTS. IN THE OFF MONTHS, AN EMAIL NEWSLETTER IS DEPLOYED TO MORE THAN 17,000 RECIPIENTS WITH SIMILAR CONTENT. OTSEGO HOSPITAL HAS NUMEROUS MEDICAL PRACTICES THAT ARE FEDERALLY QUALIFIED RURAL HEALTHCARE CLINICS. ADDITIONALLY, OTSEGO HOSPITAL IS LOCATED WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA. BOTH OF THESE QUALIFICATIONS DEMONSTRATE OTSEGO HOSPITAL'S ISOLATED SERVICE AREA WHICH HAS RESULTED IN CHALLENGING PHYSICIAN RECRUITMENT AND RETENTION. OTSEGO HOSPITAL'S COMMITMENT TO PROVIDING THE HIGHEST LEVEL OF CARE STARTS WITH PHYSICIAN AND OTHER PROVIDERS. EXTENSIVE RECRUITMENT ACTIVITIES MUST TAKE PLACE IN ORDER TO PROVIDE CARE TO THESE HEALTH PROFESSIONAL SHORTAGE AREAS. ADDITIONALLY, OTSEGO HOSPITAL IS WORKING DILIGENTLY TO BRING SERVICES INTO THE RURAL SETTING. THE HOSPITAL APPLIES SURPLUS FUNDS, INCLUDING DONATIONS FROM THE FOUNDATION, TO ASSIST IN PURCHASING EQUIPMENT FOR PATIENT USE AND FUNDING MANY OF THE COMMUNITY HEALTH EDUCATION PROGRAMS LISTED ABOVE. ADDITIONALLY, THE HOSPITAL WORKS TO USE ANY SURPLUS FUNDS TO CONTINUE TO ADVANCE THE MISSION OF THE ORGANIZATION THROUGH GROWTH AND DEVELOPMENT OPPORTUNITIES.

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MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITALS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE, A 501(C)(3) CORPORATION. THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL, SEVERAL RURAL-BASED MEDICAL CENTERS, EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES, AND ANCILLARY EMERGENCY, TRANSPORTATION AND HOME-BASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER (MMC). MMC IS ONE OF NINE NOT-FOR-PROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES. EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES AND/OR PROMOTION ACTIVITIES, AS WELL AS SHARED INITIATIVES. THE OWNED HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM WHICH INCLUDE MUNSON MEDICAL CENTER, PAUL OLIVER MEMORIAL HOSPITAL, MUNSON HEALTHCARE CADILLAC, MUNSON HEALTHCARE GRAYLING, MUNSON HEALTHCARE CHARLEVOIX HOSPITAL, MUNSON HEALTHCARE MANISTEE HOSPITAL AND MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL PROVIDED 141.2 MILLION OF COMMUNITY BENEFIT IN THE 2021 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 1.7 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2021. 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 153.3 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.