Community Benefit Insight - Tax-exempt hospital

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Mymichigan Medical Center Midland

Midmichigan Medical Ctr

4000 Wellness Drive
Midland, MI 48670

Bed count	230	Medicare provider number	230222	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 380833014

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

3.9%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

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	$ 7,245,668 1.28 %
Medicaid as % of operating expenses	$ 11,727,695 2.07 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 2,849,274 0.50 %
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.	$ 227,841 0.04 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 1,368 0.00 %
Community building* as % of operating expenses	$ 9,164 0.00 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	70
Physical improvements and housing	1
Economic development	0
Community support	32
Environmental improvements	1
Leadership development and training for community members	1
Coalition building	30
Community health improvement advocacy	5
Workforce development	0
Other	0
Persons served (optional)	558
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	558
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 9,164 0.00 %
Physical improvements and housing as % of community building expenses	$ 557 6.08 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 5,794 63.23 %
Environmental improvements as % of community building expenses	$ 197 2.15 %
Leadership development and training for community members as % of community building expenses	$ 70 0.76 %
Coalition building as % of community building expenses	$ 1,305 14.24 %
Community health improvement advocacy as % of community building expenses	$ 1,241 13.54 %
Workforce development as % of community building expenses	$ 0 0 %
Other as % of community building expenses	$ 0 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: 2021

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	$ 16,809,471 2.97 %
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	$ 840,474 5.00 %

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: 2021

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: 2021

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 $ 499914521 including grants of $ 0) (Revenue $ 542641265)
MYMICHIGAN MEDICAL CENTER MIDLAND PROVIDES COMPASSIONATE PATIENT CARE SERVICES OF SUPERIOR QUALITY TO MIDLAND AND ITS SURROUNDING COUNTIES. 12,668 INPATIENT ADMISSIONS AND 341,543 OUTPATIENT VISITS WERE PROVIDED IN FISCAL YEAR 2022. CARE IS PROVIDED WITHOUT RESPECT TO A PATIENT'S ABILITY TO PAY.

Facility Information

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

MYMICHIGAN MEDICAL CENTER MIDLAND
PART V, SECTION B, LINE 5: MYMICHIGAN MEDICAL CENTER MIDLAND'S COMMUNITY EDUCATION MANAGER IS A MEMBER OF THE COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT COMMITTEE. THIS COMMITTEE IS A SUBCOMMITTEE OF MIDLAND'S HEALTH AND HUMAN SERVICE COUNCIL. OTHER ORGANIZATIONS WHO PARTICIPATE IN THIS COMMITTEE INCLUDE: THE DOW CHEMICAL COMPANY; MIDLAND SENIOR SERVICES; COUNCIL ON AGING; COMMUNITY MENTAL HEALTH FOR CENTRAL MICHIGAN; AND THE 1016 RECOVERY NETWORK. THE COMMITTEE IS RESPONSIBLE FOR DEVELOPING AND EVALUATING ASSESSMENTS OF COMMUNITY NEED AND DEVELOPING PLANS TO MEET THOSE NEEDS. ADDITIONALLY, MYMICHIGAN MEDICAL CENTER MIDLAND IS A PARTNER WITH MICHIGAN HEALTH INFORMATION ALLIANCE, INC., OR MIHIA, WHICH IS A FORMAL, MULTI-STAKEHOLDER, COMMUNITY COLLABORATION WORKING TO ACHIEVE A COMMUNITY HEALTH EXCELLENCE FOR THE 14-COUNTY REGION IT SERVES. THIS INITIATIVE IS BASED ON A CORE BELIEF THAT SOLUTIONS TO OUR HEALTH AND HEALTH CARE PROBLEMS CAN BE FOUND AND DESIGNED AT A REGIONAL LEVEL, ACCELERATING REGIONAL COMPETITIVE ADVANTAGE AND SUSTAINABILITY.

MYMICHIGAN MEDICAL CENTER MIDLAND
"PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS WERE DETERMINED AND PRIORITIZED BY REVIEWING QUANTITATIVE AND QUALITATIVE DATA, AND RANKING HEALTH ISSUES ACCORDING TO FOCUS. WE INVESTIGATED A VARIETY OF PRIMARY AND SECONDARY DATA SOURCES. A GRID OF OVER 150 INDICATORS FROM 20 DIFFERENT PRIMARY AND SECONDARY SOURCES WAS UTILIZED TO BUILD THE DATA PLATFORM. DATA OUT OF NORMAL RANGE AGAINST A BENCHMARK WAS COMPARED TO CURRENT STANDARDS, THOSE OF OUR COMMUNITY HEALTH TEAM, POPULATION HEALTH COLLABORATIVE TEAM, AND THOSE OF OUR COLLABORATIVE PARTNERS AND COMMUNITY MEMBERS. IN ORDER TO DETERMINE CAUSES OF HEALTH PROBLEMS, DATA WAS CATEGORIZED INTO FOUR AREAS: 1. DETERMINANTS OF HEALTH; 2. CARE ACCESS; 3. HEALTH BEHAVIORS AND 4. HEALTH CONDITIONS. AREAS WHERE HEALTH ISSUES EXISTED WERE REVEALED IN TWO WAYS. FIRST, WHEN COMPARISON OF LOCAL QUANTITATIVE DATA INDICATORS AGAINST STATE OF MICHIGAN BENCHMARKS RESULTED IN POOR PERFORMANCE; AND WHEN THEMES OF UNACCEPTABLE HEALTH EMERGED FROM ANALYSIS OF QUALITATIVE DATA. PRIORITIZATION OCCURRED IN STAGES; INPUT WAS SOLICITED FROM THE COMMUNITY HEALTH TEAM, MYMICHIGAN MEDICAL CENTER MIDLAND LEADERSHIP TEAM, COMMUNITY HEALTH STAFF AND RESPECTIVE COMMUNITY GROUPS.IN ORDER TO RESPOND AND IMPACT THE HEALTH CARE NEEDS THAT WERE IDENTIFIED, THE TOP PRIORITY AREAS FOR MYMICHIGAN HEALTH CHOSEN BY THE COMMUNITY HEALTH TEAM AND REVIEWED BY THE MYMICHIGAN HEALTH POPULATION HEALTH COLLABORATION TEAM AND MYMICHIGAN MEDICAL CENTER MIDLAND BOARD ON JUNE 28, 2019 FOLLOW; ALONG WITH AN UPDATE OF STRATEGIES IMPLEMENTED:A. CHRONIC DISEASE PREVENTION AND TREATMENT. EDUCATE, ENCOURAGE AND PROVIDE OPPORTUNITY FOR IMPROVED HEALTH BEHAVIORS AND INCREASED ACCESS TO HEALTH FOODS. PROJECTS THAT ALIGN WITH PREVENTION OF CHRONIC DISEASE FOLLOW: A. PRESCRIPTION FOR HEALTH PROGRAM IN PARTNERSHIP WITH MSU EXTENSION, MSU COLLEGE OF MEDICINE, AND THE MIDLAND FARMERS MARKET WHICH YIELDED 57 PARTICIPANTS; A VIRTUAL DIABETES PREVENTION PROGRAM IN PARTNERSHIP WITH THE MYMICHIGAN HEALTH DIABETES CENTER AND MYMICHIGAN MEDICAL GROUP OFFICES WHICH YIELDED 200 PARTICIPANTS; AND LOU E LOON EXERCISE POSTERS IN PARTNERSHIP WITH THE GREAT LAKES LOONS.B. MATERNAL/INFANT HEALTH. PREPARE, CARE AND SUPPORT CHILDBEARING FAMILIES IN ORDER TO IMPROVE THE HEALTH AND WELL-BEING OF CHILDBEARING WOMEN AND INFANTS. 1. COFFECTIVE PREGNANCY EDUCATION THROUGH A MOBILE APPLICATION INTRODUCED TO ALL PREGNANT FAMILIES AT PRENATAL OFFICE VISITS IN PARTNERSHIP WITH MYMICHIGAN AND COMMUNITY PRIMARY CARE AND OBSTETRIC OFFICES, THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE MIDLAND HEALTH DEPARTMENT AND WIC. 2. PROVIDING CHILDBIRTH CLASSES TO EXPECTANT FAMILIES IN PARTNERSHIP WITH BOTH HOSPITAL BASED AND COMMUNITY PRIMARY CARE AND OBSTETRIC OFFICES GREAT START COLLABORATIVE AND FAMILY AND CHILDREN'S SERVICES. THERE WERE 584 PARTICIPANTS IN CHILDBIRTH, FEEDING, SAFETY AND BABY CARE RELATED CLASSES; 365 PARTICIPANTS IN UNDERSTANDING BIRTH LIVE VIRTUAL CLASSES HELD IN FY2022 AND 259 PATIENTS WERE PROVIDED SUPPORT FROM CALLS TO THE BREASTFEEDING HELP LINE IN MIDLAND.C. MENTAL HEALTH AND SUBSTANCE USE. LEAD, PARTNER AND SUPPORT EFFORTS TO ENSURE A COMPREHENSIVE SYSTEM OF CARE TO MEET THE BEHAVIORAL HEALTH OF ALL AT THE RIGHT TIME, IN THE RIGHT PLACE, AND WITH THE RIGHT CARE. A. A BELONGING TO END LONELINESS PROJECT IN PARTNERSHIP WITH 211 AND THE MIDLAND AREA COUNCIL ON AGING HAD MORE THAN 1,000 REFERRALS FROM PRACTICES TO ADDRESS LONELINESS. B. PROMOTING MENTAL HEALTH SERVICES IN PARTNERSHIP WITH THE MENTAL HEALTH TEAM OF THE MIDLAND CHIP. C. CONTINUE PROJECT ASSET IN PARTNERSHIP WITH TEN16 RECOVERY NETWORK, AND A ""TRAUMA-SUBSTANCE ABUSE-ADHD CONNECTION: INNOVATIVE DIAGNOSIS TREATMENT OF COMPLEX SUD ADOLESCENTS & YOUNG ADULTS,"" PROGRAM OFFERED VIRTUALLY WITH 41 PARTICIPANTS."

PART V, SECTION B, LINES 7A AND 10A
HTTPS://WWW.MYMICHIGAN.ORG/ABOUT/COMMUNITY-BENEFITS/CHNA/

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
AS WELL AS USING THE FEDERAL POVERTY GUIDELINES, THE PATIENT'S AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT ARE TAKEN INTO CONSIDERATION WHEN DETERMINING FREE OR DISCOUNTED CARE. PATIENTS WHOSE FAMILY INCOME EXCEEDS 350% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 16,809,471.

PART I, LINE 7
NOT ONLY DO THE INDIVIDUAL HOSPITALS PROVIDE COMMUNITY BENEFITS, BUT BASED ON THE NEEDS ASSESSMENTS PROVIDED BY THE HOSPITALS, THE PARENT ORGANIZATION ALSO PROVIDES EDUCATION AND OUTREACH TO COMMUNITY MEMBERS, WHICH IS NOT REFLECTED IN EACH HOSPITALS' COST OF COMMUNITY BENEFIT.

PART II, COMMUNITY BUILDING ACTIVITIES:
MYMICHIGAN MEDICAL CENTER MIDLAND EMPLOYEES CONTRIBUTED MANY HOURS ATTRIBUTED TO COALITION BUILDING AS MEMBERS FOR COMMUNITY BOARDS, CIVIC ORGANIZATIONS, ADVISORY COMMITTEES, COALITIONS AND WORK GROUPS. EXAMPLES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: MIDLAND CHILD ADVOCACY BOARD OF DIRECTORS; MIDLAND HABITAT FOR HUMANITY BOARD OF DIRECTORS; GREAT LAKES BAY REGIONAL ALLIANCE BOARD OF DIRECTORS; UNITED WAY OF MIDLAND COUNTY BOARD OF DIRECTORS; MIDLAND BUSINESS ALLIANCE BOARD OF DIRECTORS; MIDLAND COUNTY COMMUNITY FOUNDATION BOARD AND SCHOLARSHIP COMMITTEE; AMERICAN HOSPITAL ASSOCIATION REGIONAL POLICY BOARD OF DIRECTORS; MIDLAND CENTER FOR THE ARTS BOARD OF DIRECTORS; COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT COMMITTEE; AND GIRL SCOUTS OF MICHIGAN. ADDITIONALLY, COMMUNITY HEALTH IMPROVEMENT ADVOCACY WAS ENACTED THROUGH WORK BY MYMICHIGAN MEDICAL CENTER MIDLAND STAFF FOR THE ORGANIZATIONS THAT FOLLOW: CANCER SERVICES, NORTHWOOD UNIVERSITY, NORTHWOOD HEALTH FAIR, CITY OF MIDLAND, SENIOR SERVICES, MIDLAND'S OPEN DOOR, THE ARNOLD CENTER AND THE MIDLAND COMMUNITY CENTER AND PROVIDING HEALTH EDUCATION AND VOLUNTEERISM AT MULTIPLE HEALTH FAIRS ACROSS THE REGION.

PART III, LINE 2:
THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX.BAD DEBT EXPENSE METHODOLOGY: OTHER UNCOMPENSATED CARE REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH PAYMENT IS EXPECTED AT THE TIME SERVICE IS PROVIDED, BUT PAYMENT IS NOT RECEIVED OR IS LESS THAN THE COST INCURRED TO PROVIDE THE SERVICE. THE FOLLOWING IS INCLUDED AS PROGRAMS AND SERVICES RELATED TO OTHER UNCOMPENSATED CARE: UNCOMPENSATED SERVICES, AT COST REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH A FEE HAS BEEN ASSESSED BUT NOT COLLECTED OR ONLY A PORTION OF THE COST OF THE RENDERED SERVICE HAS BEEN RECOVERED.

PART III, LINE 3:
THE BAD DEBT COST WAS REVIEWED BY THE HOSPITAL'S REVENUE CYCLE TEAM AND THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE QUALIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY IS 5% OF TOTAL BAD DEBTS.

PART III, LINE 4:
PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS

PART III, LINE 8:
THE SOCIAL SECURITY ACT AMENDMENT TO ESTABLISH MEDICARE STATES THAT MEDICARE WILL NOT PAY THE COST TO PROVIDE CARE TO NON-BENEFICIARIES AND NON-BENEFICIARIES WILL NOT PAY THE COST OF CARE FOR BENEFICIARIES. WHEN MEDICARE DOES NOT PAY RATES THAT COVER ALL THE COST OF CARE FOR BENEFICIARIES, IT BECOMES A COMMUNITY BURDEN. THEREFORE, THE FULL AMOUNT OF SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT.THIS ORGANIZATION BELIEVES THE AUDITED FINANCIAL STATEMENT CALCULATION IS A MORE ACCURATE DETERMINATION OF COST THAN THE MEDICARE ALLOWABLE COSTS USED FOR COST REPORTS THAT ARE REQUIRED TO BE UTILIZED ON THIS SCHEDULE IN PART III, SECTION B. THE AUDITED FINANCIAL STATEMENTS INCLUDE ALL MEDICARE REVENUES AND COSTS AND ALSO USE A COST-TO-CHARGE RATIO METHOD.COSTING METHODOLOGY: AN AVERAGE COST-TO-CHARGE RATIO IS APPLIED TO THE CHARGE WRITE-OFF. THE RATIO IS CALCULATED BY REMOVING FROM TOTAL EXPENSE THE OTHER OPERATING INCOME, UNCOMPENSATED CARE EXPENSE AND THE DIRECTLY ASSIGNED MEDICAID ASSESSMENT EXPENSE, THEN DIVIDING THIS NET EXPENSE BY TOTAL GROSS PATIENT REVENUES. THIS RATIO IS MULTIPLIED WITH THE CHARITY CARE CHARGES AND UNCOMPENSATED CARE CHARGES WRITTEN OFF FOR THE RELATED EXPENSE.

PART III, LINE 9B:
"MYMICHIGAN HEALTH DOES NOT TRY TO COLLECT FROM THOSE WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. MYMICHIGAN HEALTH'S POLICY STATES THAT THE PURPOSE OF THE POLICY ""IS TO PROVIDE COST EFFECTIVE PAYMENT OPTIONS TO PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE (PER FINANCIAL AID/CHARITY CARE POLICY) AND EITHER HAVE NO INSURANCE OR HAVE A BALANCE AFTER INSURANCE WHICH IS THEIR RESPONSIBILITY TO PAY."""

PART VI, LINE 2:
IN FY2022, MYMICHIGAN HEALTH'S FOCUS ON IMPROVING THE HEALTH OF OUR COMMUNITIES WAS REFLECTED IN OUR PURPOSE STATEMENT. WE PARTNERED WITH SCHOOLS, BUSINESSES AND HEALTH CARE AGENCIES TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITIES SERVED. OUR HOSPITAL BOARDS ARE COMPRISED OF COMMUNITY MEMBERS WHO PROVIDE INPUT INTO THE COMMUNITY ENDEAVORS WE INSTITUTE. ADDITIONALLY, WE PARTICIPATE IN COMMUNITY COLLABORATIVE PARTNERSHIPS FOR AREA NON-PROFITS WITH A FOCUS ON HEALTH LIKE MIDLAND CANCER SERVICES. WE ALSO PARTNER WITH THE MICHIGAN HEALTH INFORMATION ALLIANCE, INC., OR MIHIA, WHICH IS A DIVERSE GROUP OF STAKEHOLDERS COLLABORATING TOGETHER AS A NON-PROFIT ORGANIZATION TO IMPROVE HEALTH AND HEALTH DELIVERY IN CENTRAL MICHIGAN THROUGH PARTICIPATION IN A REGIONAL POPULATION HEALTH TEAM AND A REGIONAL PERINATAL QUALITY COLLABORATIVE COMMITTEE. THESE COMMUNITY COLLABORATIONS HELP TO BUILD A HEALTH CARE SYSTEM WHERE CONSUMERS, PROVIDERS AND PAYERS MAKE DECISIONS FOR BEST PRACTICE IN THE AREA SERVED. ADDITIONALLY, WE PARTNER ON NEEDED HEALTH INITIATIVES, WORKING WITH LOCAL PUBLIC HEALTH DEPARTMENTS AND HEALTH AND HUMAN SERVICE AGENCIES TO UNDERSTAND THE UNIQUE HEALTH NEEDS OF EACH OF OUR COMMUNITIES. IN 2019, A COMMUNITY HEALTH SURVEY WAS CONDUCTED TO UNDERSTAND THE HEALTH AND HEALTH NEEDS OF PEOPLE LIVING IN MIDLAND COUNTY. A SAGINAW VALLEY STATE UNIVERSITY TEAM WORKED WITH THE HEALTH AND HUMAN SERVICES COUNCIL (HHSC) OF MIDLAND COUNTY TO ADAPT THE SURVEY TO ENSURE IT MET THE NEEDS OF THE HHSC AND MIDLAND COUNTY AGENCIES, AND COLLECTED DATA ON ANY HEALTH ISSUES/FACTORS EMERGING SINCE THE PREVIOUS DATA COLLECTION. THE SAGINAW VALLEY STATE UNIVERSITY TEAM AIMED TO COLLECT DATA FROM A SAMPLE ACROSS MIDLAND COUNTY, INCLUDING A REPRESENTATIVE SAMPLE FROM THE CITY AND COUNTY AREAS. THE TEAM USED EXISTING US CENSUS DATA TO OBTAIN POPULATION ESTIMATES FOR EACH TOWNSHIP/CITY IN MIDLAND COUNTY, TO ENSURE APPROPRIATE REPRESENTATION FROM EACH LOCATION. EFFORTS WERE ALSO MADE TO OBTAIN A SAMPLE THAT WAS REPRESENTATIVE OF THE MIDLAND COUNTY POPULATION (AGE, RACE, EDUCATION, INCOME). THE SAMPLE GENERATED A TOTAL OF 759 SURVEYS TO BE USED FOR ANALYSES (603 ONLINE SURVEYS AND 156 PAPER SURVEYS).

PART VI, LINE 7, REPORTS FILED WITH STATES
MI

PART VI, LINE 3:
INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE IS COMMUNICATED TO THE PUBLIC THROUGH INFORMATIONAL BROCHURES AT REGISTRATION AREAS AND THROUGH PATIENT ACCOUNTING COUNSELORS. PATIENT ACCOUNTING COUNSELORS ARE TRAINED TO HELP PATIENTS OBTAIN FREE OR LOW-COST HEALTH INSURANCE OR TO WORK WITH PATIENTS TO PROVIDE CHARITY CARE OR FINANCIAL AID BASED ON THEIR FINANCIAL STATUS. MYMICHIGAN HEALTH PROVIDES FINANCIAL AID TO PATIENTS BASED ON THEIR INCOME, ASSETS, AND NEEDS. IN ADDITION, MYMICHIGAN HEALTH MAY BE ABLE TO HELP PATIENTS RECEIVE FREE OR LOW-COST HEALTH INSURANCE OR WORK WITH THE PATIENT TO ARRANGE A MANAGEABLE PAYMENT PLAN. ADDITIONALLY, SOCIAL WORKERS PROVIDE INFORMATION, BOTH WRITTEN AND VERBAL, ABOUT PROGRAMS FOR ASSISTANCE. THEY ALSO COORDINATE WITH THE MEDICAID ELIGIBILITY REPRESENTATIVE FROM DHS FOR FOLLOW-UP OR EXPEDITED APPLICATIONS. THEY PROVIDE MEDICAID APPLICATIONS, PERSONAL FINANCIAL STATEMENTS FOR HOSPITAL CHARITY CARE AND REFER TO THE PATIENT ACCOUNTING COUNSELORS. ADDITIONALLY, CONTACT INFORMATION ABOUT FINANCIAL ASSISTANCE IS AVAILABLE ON OUR WEBSITE AT HTTPS://WWW.MYMICHIGAN.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/PATIENT-NOTICE-OF-FINANCIAL-AID.

PART VI, LINE 4:
THE COMMUNITY SERVED FOCUSES ON MYMICHIGAN MEDICAL CENTER CIDLAND, LOCATED IN MIDLAND, MI. THE SERVICE AREA IN MIDLAND COUNTY IS COMPRISED OF ZIP CODES: 48618 (COLEMAN), 48620 (EDENVILLE), 48628 (HOPE), 48640 (MIDLAND), 48641 (MIDLAND), 48642 (MIDLAND), 48657(SANFORD), 48667 (MIDLAND), (48670)MIDLAND), 48674 (MIDLAND) AND 48686 (MIDLAND). SERVICE FOR MYMICHIGAN MEDICAL CENTER MIDLAND EXTENDS TO: 48706 (BAY) 48708 (BAY), 48611 (AUBURN) AND 48623 (FREELAND). ACCORDING TO COUNTY HEALTH RANKINGS THERE ARE 83,411 RESIDENTS IN MIDLAND COUNTY. OF THOSE, 21.5 PERCENT ARE UNDER 18 YEARS OF AGE AND 17.9 PERCENT ARE 65 AND OLDER. FEMALES MAKE UP 50.7 PERCENT OF THE POPULATION WHILE MALES MAKE UP 49.3 PERCENT. THE MEDIAN AGE IN MIDLAND COUNTY IS 38.7 YEARS OF AGE. OF THE POPULATION, 91.5 PERCENT ARE WHITE (NON-HISPANIC) AND 8.5 PERCENT ARE NON-WHITE. IN MIDLAND COUNTY, THE PERCENTAGE OF PEOPLE WHO REPORTED THEIR HEALTH TO BE EXCELLENT WAS 11.4 PERCENT AND FAIR OR POOR WAS 12 PERCENT.

PART VI, LINE 5:
EACH MYMICHIGAN HEALTH SUBSIDIARY ADDRESSES HEALTH AND WELLBEING WITHIN THE COMMUNITIES SERVED. FOUR PORTFOLIOS OF POPULATION HEALTH ARE ADDRESSED: PHYSICAL AND BEHAVIORAL HEALTH; SOCIAL AND SPIRITUAL WELL-BEING; COMMUNITY HEALTH AND WELL-BEING AND COMMUNITIES OF SOLUTIONS. PORTFOLIO ONE AIMS AT IMPROVING THE PHYSICAL AND OR MENTAL HEALTH OF INDIVIDUALS SERVED THROUGH QUALITY MEASUREMENT AND PERFORMANCE IMPROVEMENT INITIATIVES, AS WELL AS THE USE OF PATIENT CARE NAVIGATORS AND CARE MANAGERS IN PRIMARY CARE OFFICES AND INITIATIVES TO IMPROVE ACCESS TO CARE, LIKE INCREASED OPPORTUNITIES FOR TELEMEDICINE. PORTFOLIO TWO ADDRESSES SOCIAL AND SPIRITUAL DRIVERS OF HEALTH AND WELL-BEING, MANY OF WHICH ARE IDENTIFIED THROUGH SYSTEMATIC EVALUATION OF SOCIAL DETERMINANTS OF HEALTH COMPLETED AT SEVERAL POINTS OF CONTACT INCLUDING: NEW PATIENTS, EMERGENCY DEPARTMENT PATIENTS, ANNUAL PHYSICALS, POST HOSPITAL DISCHARGES, REFERRALS TO CARE MANAGERS AND PATIENTS WHO CONSISTENTLY DO NOT SHOW UP FOR APPOINTMENTS TO DETERMINE WHAT BARRIERS THEY MAY BE ENCOUNTERING. PORTFOLIO THREE ACTIVITIES AIM TO IMPROVE COMMUNITY HEALTH AND WELL-BEING BY COMMUNITY PARTNERS WORKING TOGETHER TO ASSESS DATA, DETERMINE FOCUS AREAS OF HEALTH AND POOL STAFF AND RESOURCES TO IMPLEMENT HEALTH IMPROVEMENT PROJECTS LIKE INCREASING PHYSICAL ACTIVITY, ACCESS TO HEALTHY FOODS AND REDUCING OPIOID USAGE. PORTFOLIO FOUR ADDRESSES OUR ROLE AS AN ANCHOR INSTITUTION. WE ARE THE MAJOR EMPLOYER IN EACH COMMUNITY WE SERVE AND AS SUCH, WE PROMOTE HEALTH AND WELL-BEING BY CAPITALIZING ON COMMUNITY ASSETS AND ACTIVE ENGAGEMENT WITH REGIONAL INITIATIVES. A TOTAL OF $3,087,647 IN COMMUNITY BENEFITS WAS PROVIDED BY MYMICHIGAN MEDICAL CENTER MIDLAND IN 2022 THROUGH COMMUNITY EDUCATION PROGRAMS, SCREENINGS, SPECIAL EVENTS AND HEALTH EXPERTISE. IN FY 2022 3,435 PERSONS WERE REACHED WITH GENERAL COMMUNITY EDUCATION TOPICS LIKE ADVANCED DIRECTIVES, CANCER PREVENTION, DRUG AND ALCOHOL DANGERS AND SAFETY EDUCATION. THERE WERE 277 PEOPLE REACHED WITH EDUCATION ON MENTAL HEALTH AND DEPRESSION AND 50 FOR DRUG AND ALCOHOL EDUCATION. ADDITIONALLY, 299 PEOPLE WERE REACHED FOR HEART DISEASE AND HEART HEALTH EDUCATION AND 0 FOR PERIPHERAL ARTERY DISEASE (PAD) EDUCATION. THERE WERE 68 INDIVIDUALS WHO PARTICIPATED IN FREE OR LOW-COST SCREENINGS, INCLUDING SCREENINGS FOR BLOOD PRESSURE, CANCER AND BALANCE. THESE SCREENINGS PROVIDED A MEANS FOR DETECTING POTENTIALLY SERIOUS HEALTH PROBLEMS IN THEIR EARLIEST STAGES, WHEN TREATMENT IS USUALLY MORE SUCCESSFUL, RESULTING IN LOWER MORBIDITY OR MORTALITY. ADDITIONALLY, MYMICHIGAN MEDICAL CENTER MIDLAND PROVIDED DIABETES EDUCATION TO 200 PEOPLE AND REPORTED 259 BREASTFEEDING EDUCATION AND SUPPORT CONTACTS. CHILDBIRTH RELATED EDUCATION WAS PROVIDED TO 584 INDIVIDUALS. THERE WERE 652 INDIVIDUALS WHO RECEIVED SUPPORT THROUGH MEETING GROUPS LIKE: BREATHING, CARDIAC/HEART, NUTRITION/WEIGHT MANAGEMENT, ALS, PARENTING AND PARKINSON'S.

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THE COMMUNITY BENEFITS PROVIDED BY MYMICHIGAN MEDICAL CENTER MIDLAND IN FISCAL YEAR 2022 INCLUDE COMMUNITY EDUCATION PROGRAMS, SCREENINGS, SPECIAL EVENTS AND HEALTH EXPERTISE, INCLUDING INSURANCE UNDER-REIMBURSEMENTS AND SERVICES TO THOSE WHO COULD NOT PAY. $132 MILLION IN COMMUNITY BENEFITS WAS PROVIDED BY MYMICHIGAN HEALTH TO THE COMMUNITIES IT SERVES. THE UNDERLYING PREMISE FOR EACH MYMICHIGAN HEALTH SUBSIDIARY IS SHARED OWNERSHIP FOR COMMUNITY HEALTH. THE PLAN REFLECTS INPUT FROM DESIGNATED INDIVIDUALS IN EACH COMMUNITY INCLUSIVE OF, BUT NOT LIMITED TO, PUBLIC HEALTH EXPERTS, REPRESENTATIVES OF LOW-INCOME AND MEDICALLY UNDERSERVED POPULATIONS AND THOSE SUFFERING FROM CHRONIC DISEASE. THE BROADENED SCOPE FROM WHICH WE FUNCTION IS INHERENT IN THE STRATEGIES WHICH INCLUDE INTERNAL HEALTH IMPROVEMENT INITIATIVES OF MYMICHIGAN MEDICAL CENTER MIDLAND AND MYMICHIGAN HEALTH, AS WELL AS COLLABORATIVE EFFORTS OF THE HOSPITAL WITH PUBLIC HEALTH, THE UNIVERSITY OF MICHIGAN AND OUR COMMUNITY PARTNERS.

Operating expenses	$ 565,362,016
Total amount spent on community benefits as % of operating expenses	$ 22,051,846 3.90 %