Community Benefit Insight - Tax-exempt hospital

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Detroit Rec Hosp & Univ Hlth Ctr

Detroit Receiving Hospital & Univ Health Center

4201 St Antoine St - 3m
Detroit, MI 48201

Bed count	320	Medicare provider number	230273	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

EIN: 382320476

Display data for year:

Community Benefit Spending- 2010
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

5.92%

Spending by Community Benefit Category- 2010
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2010

Additional data

Community Benefit Expenditures: 2010

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	$ 11,567,806 2.93 %
Medicaid as % of operating expenses	$ -1,943,908 -0.49 %
Costs of other means-tested government programs as % of operating expenses	$ 2,476,443 0.63 %
Health professions education as % of operating expenses	$ 11,283,990 2.86 %
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.	$ 0 0 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
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: 2010

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	$ 20,706,654 5.24 %
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	$ 124,514,000 601.32 %

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:

Reported to credit agency	Not available
Filed lawsuit	Not available
Placed liens on residence	Not available
Issue body attachments? (an order by the court commanding a sheriff or other official to physically bring before the court a person who is guilty of contempt of court)	Not available

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: 2010

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?	Not available
Did the CHNA define the community served by the tax-exempt hospital?	Not available
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	Not available
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	Not available
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	Not available
Did the tax-exempt hospital execute the implementation strategy?	Not available
Did the tax-exempt hospital participate in the development of a community-wide plan?	Not available

Supplemental Information: 2010

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 $ 123633930 including grants of $ 0) (Revenue $ 69990639)
INTERNAL MEDICINE (GENERAL) DRH HAS BUILT A COMPREHENSIVE INPATIENT AND OUTPATIENT GERIATRIC MEDICINE PROGRAM. ALSO INCLUDED IN THE INTERNAL MEDICINE SERVICES IS AN EXTENSIVE STROKE AND CARDIOLOGY PROGRAM. THE INTERNAL MEDICINE SERVICE IS THE FEEDER TO ALL THE OTHER PROGRAMS DRH WILL EXPAND THE PROGRAM TO CREATE IP/OP CONTINUITY, TO ACHIEVE THE GOALS ESTABLISHED IN THE STRATEGIC PLAN. DRH SAW 30,668 PATIENTS FOR VARIOUS MEDICAL CONDITIONS.

4B (Expenses $ 80621381 including grants of $ 0) (Revenue $ 56238971)
SURGERY (GENERAL) DRH HAD 6,686 PATIENTS FOR VARIOUS SURGICAL PROCEDURES. DRH IS INTEGRAL IN PROVIDING DOOR TO CATH LAB/BALLOON TIMES FOR AMI/STMI'S OF LESS THAT 45 MINUTES AND OFTEN 30 MINUTES; FAR BETTER THAN THE NATIONAL AVERAGE. IN 2010 DRH TOOK CONTINUED STEPS TOWARD BUILDING ELECTIVE SURGICAL COMPONENTS IN UROLOGY AND ORTHOPEDICS. THE DRH UROLOGY SERVICE DEMONSTRATED CONTINUED GROWTH AS A RESULT OF IMPROVED PRODUCTIVITY AND EFFICIENCY OF THE EXISTING UROLOGISTS. THE DEPARTMENT OFFERS A URODYNAMIC PROGRAM. THE SERVICE OFFERS SPECIALIZED SURGICAL PROCEDURES SUCH AS UROLOGIC RECONSTRUCTION NOT DONE WIDELY THEREFORE OFTEN DRAWING PATIENTS FROM OUTSIDE MICHIGAN. THE DEPARTMENT ALSO CONTINUED TO TAKE RESIDENTS FROM A NEWLY ESTABLISHED OSTEOPATHIC UROLOGY RESIDENCY PROGRAM ASSOCIATED WITH MICHIGAN STATE UNIVERSITY. THE DEPARTMENT OF ORTHOPEDICS CONTINUED THE GROWTH OF ELECTIVE SURGERIES ESTABLISHED IN PREVIOUS YEARS WHEN A FULL TIME COMMUNITY SURGEON WAS RECRUITED. PART TIME SURGEONS JOINED THE PRACTICE WHO SPECIALIZE IN PODIATRY, FOOT AND ANKLE SURGERIES AND HAND SURGERIES, AS WELL AS JOINT AND SPINAL SURGERIES.

4C (Expenses $ 58746842 including grants of $ 0) (Revenue $ 30734166)
EMERGENCY MEDICINE DETROIT RECEIVING HOSPITAL & UNIVERSITY HEALTH CENTER (DRH), MICHIGANS FIRST LEVEL I TRAUMA CENTER, IS AN ADULT SPECIALTY HOSPITAL OFFERING EXPERTISE IN EMERGENCY MEDICINE, COMPLEX TRAUMA, CRITICAL CARE, NEUROSCIENCE AND GERONTOLOGY. AS THE REGIONS LEADER IN EMERGENCY MEDICINE, NEARLY 60% OF MICHIGANS EMERGENCY PHYSICIANS ARE TRAINED AT DRH. DRH ALSO FEATURES THE STATES LARGEST BURN CENTER, MICHIGANS FIRST HOSPITAL-BASED 24/7 HYPERBARIC OXYGEN THERAPY PROGRAM, AND METRO DETROITS FIRST CERTIFIED PRIMARY STROKE CENTER. AS A LEVEL 1 TRAUMA CENTER, VERIFIED BY THE AMERICAN COLLEGE OF SURGEONS, AND A MAJOR SOURCE OF EMERGENCY MEDICAL CARE FOR DETROIT, THE HOSPITAL PROVIDES THE HIGHEST STANDARD OF BURN, SPINAL CORD AND OTHER CRITICAL CARE SERVICES, IN ADDITION TO MEDICAL TRAINING AND RESEARCH IN THE AREA. THE HOSPITAL IS PREPARED FOR COMMUNITY DISASTERS AND IS ON ALERT WHENEVER THE PRESIDENT OF THE UNITED STATES OR OTHER VISITING DIGNITARIES ARE IN DETROIT. DRH IS ALSO THE PRIMARY MEDICAL PROVIDER FOR THE RED WINGS, DETROIT TIGERS, FREE PRESS MARATHON, AND OTHER EVENTS THAT TAKE PLACE IN THE CITY OF DETROIT. OUTREACH SERVICES PROVIDED THROUGH DRH INCLUDE INJURY PREVENTION AND SAFETY AWARENESS PROGRAMS AND A FROSTBITE PREVENTION PROGRAM FOR HOMELESS RESIDENTS OF AREA SHELTERS. MAJOR INITIATIVES ARE INCLUDED FOR SCHOOL-BASED PROGRAMS AND COMMUNITY HEALTH FAIRS. DRH ALSO HOUSES AND SUPPORTS THE CITY OF DETROIT'S RAPE CRISIS CENTER, VISUALLY HANDICAPPED SERVICES AND THE UNIVERSITY OF DETROIT DENTISTRY PROGRAM. ALL OF THESE SERVICES ARE FREE OR OFFERED AT LOW COST TO THE COMMUNITY. THE EMERGENCY MISSION OF THE HOSPITAL EXTENDS TO THE UNINSURED AND UNDERINSURED, WHO FREQUENTLY NEED THE FACILITY FOR CARE DUE TO LACK OF ACCESS TO PRIMARY CARE SERVICES. IN 2010, DRH PROVIDED A SIGNIFICANT AMOUNT OF HEALTH CARE FOR WHICH PAYMENT WILL NOT BE RECEIVED (APPROXIMATELY 124,514,000). THE HOSPITAL'S COMMITMENT TO THE POOR IS ALSO DEMONSTRATED THROUGH OFFERING OF FREE PRESCRIPTIONS TO QUALIFIED INDIVIDUALS. DURING 2010, DRH HAD 87,330 ER PATIENT VISITS WITH THE MAJORITY OF THE PATIENTS SEEN WITHIN THE 29 MINUTE GUARANTEE COMMITMENT DRH HAS MADE TO THE PATIENT COMMUNITY IT SERVES.

4D (Expenses $ 106594012 including grants of $ 0) (Revenue $ 89318284)
ORTHOPEDICS - 10,049 TOTAL CASES; 3,094 INPATIENT DAYS; 9,211 OUTPATIENT REGISTRATIONS NEUROLOGY - 1,188 TOTAL CASES; 4,824 INPATIENT DAYS; 418 OUTPATIENT REGISTRATIONS PSYCHIATRY - 11,152 TOTAL CASES; 6,401 INPATIENT DAYS; 10,366 OUTPATIENT REGISTRATIONS CARDIOLOGY - 1,667 TOTAL CASES; 2,077 INPATIENT DAYS; 1,164 OUTPATIENT REGISTRATIONS

Supplemental Information

Schedule H (Form 990) Part VI

COSTING METHODOLOGY EXPLANATION PART I LINE 7
MEDICARE T18 RCC WITHOUT GME

COMMUNITY BUILDING ACTIVITIES PART II
OTHER COMMUNITY BENEFIT PROGRAMS AND SERVICES INCLUDE ANNUAL HEALTH SCREENINGS FOR DISEASES SUCH AS DIABETES STROKE HIGH BLOOD PRESSURE AND CHOLESTEROLALL DISEASES THAT ARE PREVALENT AMONG LOWINCOME POPULATIONS CONTROLLABLE AND IN SOME CASES PREVENTABLE GIVEN BALANCED DIETS AND EXERCISE PROGRAMS EDUCATIONAL CLASSES SPECIAL EXERCISE PROGRAMS FOOD AND CLOTHING DRIVES AND HOME SAFETY SEMINARS FOR SENIORS ARE EXAMPLES OF THE OUTREACH INITIATIVES OFFERED BY DETROIT RECEIVING HOSPITAL SPECIFIC PROGRAMS INCLUDE THE SENIOR RIVERWALKERS EXERCISE PROGRAM SENIOR SATURDAY HEALTH SCREEN HOME SAFETY FOR SENIOR CITIZENS COMMUNITY HEALTH SCREENING ANNUALLY MITTEN MADNESS PROGRAM WITH DETROIT RED WINGS ROSA PARKS GERIATRICS CENTER OUTREACH PROGRAM EDUCATIONAL PROGRAMS CLASSES AND SEMINARS AND JOINT CAMP FOR JOINT PAIN A SAMPLE OF THE CLASSES OFFERED INCLUDE HOW DO YOU PREPARE FOR A STROKE PERSONAL ACTION TOWARD HEALTH WORKSHOPS THE ABCS OF GETTING YOUR ZZZS MEMORY LOSS PREVENTION DEPRESSION AND DEMENTIA

BAD DEBT EXPENSE EXPLANATION PART III LINE 4
MEDICARE T18 RCC ST L24

COLLECTION PRACTICES EXPLANATION PART III LINE 9B
PATIENTS WHO QUALIFY FOR 100 CHARITY CARE BASED UPON DMC POLICY NO STATEMENTS OR COLLECTION ACTIVITY IS INITIATED OUTSTANDING ACCOUNT BALANCES ARE IMMEDIATELY ADJUSTED FROM ACCOUNTS RECEIVABLE PATIENTS WHO QUALIFY FOR A DISCOUNTED RATE BASED UPON DMC POLICY STATEMENTS ARE MAILED TO THE PATIENT AT REDUCED RATES EVERY ATTEMPT WILL BE MADE TO ESTABLISH A PAYMENT ARRANGEMENT COLLECTION ACTIVITY WILL BE INITIATED ONLY IF THE TERMS OF THE PAYMENT ARRANGEMENTS ARE BREECHED

NEEDS ASSESSMENT PART VI
DRH RELIES ON NATIONAL STATE AND LOCAL DEMOGRAPHIC DATA TO ASSESS THE POPULATIONS TO BE SERVED IN THE GREATER METROPOLITAN DETROIT AREA THE DATA IS USED TO DEVELOP PROGRAMS AND SERVICES THAT FIT THE NEEDS OF THE IDENTIFIED POPULATIONS THE HOSPITAL ALSO COLLABORATES WITH LOCAL STATE AND NATIONAL ORGANIZATIONS AREA AGENCIES AND CHURCHES TO PLAN AND IMPLEMENT PROGRAMS AND SERVICES TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED THESE PARTNERSHIPS HELP TO AVOID UNNECESSARY DUPLICATION OF PROGRAMS AND SERVICES AND PROVIDE THE OPPORTUNITY TO SERVE MORE PEOPLE POOL FUNDS WHEN FEASIBLE REALIZE A GREATER COMMUNITY IMPACT AND IMPROVED EFFICIENCIES

PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI
HOSPITAL STAFF PROVIDES INFORMATION ON COMMUNITY RESOURCES AS WELL AS RESOURCES AVAILABLE THROUGH THE HOSPITAL SUCH AS THE PHARMACEUTICAL SUBSIDY PROGRAM AND TRANSPORTATION ASSISTANCE AND MAKES REFERRALS TO OTHER COMMUNITY SERVICES

COMMUNITY INFORMATION PART VI
THE DEMOGRAPHICS FOR THE CITY OF DETROIT INDICATE HIGH CONCENTRATIONS OF UNINSURED AND UNDERINSURED INDIVIDUALS WHO ARE UNEMPLOYED OR UNDEREMPLOYED THESE INDIVIDUALS PRESENT THEMSELVES TO THE DRH EMERGENCY DEPARTMENT FOR HEALTH CARE MAINLY BECAUSE THEY DO NOT HAVE PRIMARY CARE PROVIDERS AND RELY ON THE EMERGENCY DEPARTMENT FOR HEALTH SERVICES

AFFILIATED HEALTH CARE INFORMATION PART VI
DETROIT RECEIVING HOSPITAL AND UNIVERSITY HEALTH CENTER IS PART OF THE DETROIT MEDICAL CENTER AN ORGANIZATION WITH SEVEN AFFILIATE HOSPITALS DMC DETROIT RECEIVING HOSPITAL AND UNIVERSITY HEALTH CENTER MICHIGANS FIRST LEVEL I TRAUMA CENTER IS AN ADULT SPECIALTY HOSPITAL OFFERING EXPERTISE IN EMERGENCY MEDICINE COMPLEX TRAUMA CRITICAL CARE NEUROSCIENCE UROLOGY AND GERIATRICS AS THE REGIONS LEADER IN EMERGENCY MEDICINE RECEIVINGS EMERGENCY DEPARTMENT TREATS MORE THAN 88000 PATIENTS ANNUALLY AND NEARLY 60 OF MICHIGANS EMERGENCY PHYSICIANS ARE TRAINED AT RECEIVING DETROIT RECEIVING ALSO FEATURES THE STATES LARGEST BURN CENTER MICHIGANS FIRST HOSPITALBASED 247 HYPERBARIC OXYGEN THERAPY PROGRAM AND METRO DETROITS FIRST CERTIFIED PRIMARY STROKE CENTER DMC HARPER UNIVERSITY HOSPITAL HAS DISTINGUISHED ITSELF IN SURGICAL MEDICINE AND IS KNOWN FOR ITS CLINICAL EXPERTISE INNOVATIVE RESEARCH AND ADVANCED EDUCATION A SPECIALTY REFERRAL HOSPITAL HARPER HAS ESTABLISHED CENTERS OF EMPHASIS IN NEUROSCIENCES VASCULAR SERVICES MULTIDISCIPLINARY CARDIOVASCULAR SERVICES HYPERTENSION STROKE PREVENTION AND HEART FAILURE ADDITIONAL SPECIALTIES INCLUDE BARIATRIC GASTRIC BYPASS SURGERY CRITICAL CARE PULMONARY MEDICINE KIDNEY AND PANCREAS TRANSPLANTS THORACIC SURGERY AND MINIMALLY INVASIVE CARDIAC PROCEDURES HARPERS NEUROLOGY PROGRAM IS INTERNATIONALLY RECOGNIZED FOR NEW ADVANCES IN MULTIPLE SCLEROSIS NEUROMUSCULAR DISEASES EPILEPSY NEUROGENETIC DISORDERS NEUROBEHAVIORAL DISORDERS AND COGNITIVE DISORDERS AS THE HOSPITAL WITH THE FIRST MECHANICAL HEART BYPASS PUMP HARPER HAS RETAINED ITS LEADERSHIP POSITION IN STATEOFTHEART TECHNOLOGY TODAY HARPER HOUSES A 3T MRI MACHINE A 64SLICE CT SCANNER STATEOFTHEART ELECTROPHYSIOLOGY AND CARDIAC CATHETERIZATION LABS AND NUCLEAR CARDIAC IMAGING FACILITIES DMC HUTZEL WOMENS HOSPITAL IS NATIONALLY RECOGNIZED FOR CUTTINGEDGE RESEARCH IN HIGHRISK OBSTETRICS INFERTILITY REPRODUCTIVE GENETICS NEONATOLOGY MATERNAL SPECIAL CARE MIDWIFERY GYNECOLOGY UROGYNECOLOGY MENOPAUSE PERMANENT BIRTH CONTROL AND ALTERNATIVES TO HYSTERECTOMY HUTZEL HAS BEEN RANKED AS THE NUMBER ONE HOSPITAL IN THE NATION IN RESEARCH AWARDS FOR ITS OBGYN PHYSICIANS WITH A RICH HISTORY OF OVER 137 YEARS AS MICHIGANS FIRST AND ONLY HOSPITAL FOR WOMEN THE PATIENTS ALSO BENEFIT FROM HUTZELS COMMITMENT TO RESEARCH AND EDUCATION HUTZEL WOMENS HOSPITAL IS HOME TO THE NATIONAL INSTITUTES OF HEALTH NIH PERINATOLOGY RESEARCH BRANCH PRB AND IS RECOGNIZED AS A LEADER IN WOMENS HEALTH BY PHYSICIANS AND RESEARCHERS ACROSS THE COUNTRY DMC CHILDRENS HOSPITAL OF MICHIGAN WITH MORE THAN 33 CLINICAL SPECIALTIES IS AN INTERNATIONAL LEADER IN PEDIATRIC AND ADOLESCENT MEDICINE SURGICAL SERVICES INCLUDE ANESTHESIOLOGY CARDIOVASCULAR SURGERY DEVELOPMENTAL DENTISTRY AND ORTHODONTICS NEUROSURGERY OPHTHALMOLOGY ORAL AND MAXILLOFACIAL ORTHOPAEDIC SURGERY OTOLARYNGOLOGY ENT PEDIATRIC SURGERY PLASTIC AND RECONSTRUCTIVE SURGERY SAME DAY SURGERY AND UROLOGY IMAGING TECHNOLOGY DESIGNED ESPECIALLY FOR CHILDREN PROVIDES ADVANCED DIAGNOSTIC SERVICES SUCH AS POSITRON EMISSION TOMOGRAPHY PET AND MRI CHILDRENS HOSPITAL IS SOUTHEAST MICHIGANS ONLY FREESTANDING PEDIATRIC LEVEL I TRAUMA CENTER EQUIPPED TO HANDLE THE MOST SEVERE INJURIES AND ILLNESSES EXPERTS IN PEDIATRIC CRITICAL CARE REHABILITATION NEONATAL AND PERINATAL MEDICINE PROVIDE CARE FOR THOUSANDS OF CHILDREN EVERY YEAR DMC HURON VALLEYSINAI HOSPITAL IN OAKLAND COUNTY HAS EARNED RECOGNITION AS ONE OF THE AREAS AND THE NATIONS TOP HOSPITALS FOR PATIENT SATISFACTION THIS HOSPITAL FEATURES THE HARRIS BIRTHING CENTER WITH ALL PRIVATE BIRTHING SUITES A REGIONAL SPECIALTY CENTER THE CHARACH CANCER CENTER A PART OF THE BARBARA ANN KARMANOS CANCER CENTER THE KRIEGER CENTER FOR SENIOR ADULTS STATEOFTHEART SURGICAL SUITES CARDIAC SERVICES AND COMPREHENSIVE INPATIENT AND OUTPATIENT DIAGNOSTIC CARE DMC KRESGE EYE INSTITUTE IS CONSIDERED A LEADING CENTER FOR THE PRESERVATION OF SIGHT THE INSTITUTE OFFERS GENERAL VISION SERVICES FOR PATIENTS OF ALL AGES KNOWN INTERNATIONALLY FOR ITS CONTRIBUTIONS TO OPHTHALMOLOGY KRESGES CLINICAL SPECIALTIES INCLUDE GLAUCOMA CATARACT SURGERY CORNEA TRANSPLANTATION RETINAL VITREAL AND MACULAR DISEASES PLASTIC AND COSMETIC EYE SURGERY DIABETICRELATED EYE CONDITIONS NEURORELATED EYE DISORDERS AND OCULAR PROSTHETICS KRESGE EYE INSTITUTE HOUSES THE LIGON RESEARCH CENTER OF VISION WHERE PHYSICIANS ARE STUDYING ARTIFICIAL VISION KRESGE PHYSICIANS MAINTAIN A PROMINENT POSITION IN ALL AREAS OF VISION RESEARCH DMC REHABILITATION INSTITUTE OF MICHIGAN IS ONE OF THE NATIONS LARGEST HOSPITALS SPECIALIZING IN REHABILITATION MEDICINE AND RESEARCH THE INSTITUTE IS HOME TO MANY INNOVATIVE PROGRAMS INCLUDING THE SOUTHEASTERN MICHIGAN TRAUMATIC BRAIN INJURY SYSTEM SEMTBIS AND THE CENTER FOR SPINAL CORD INJURY RECOVERY A WORLDCLASS FACILITY DESIGNED TO IMPLEMENT AND STUDY INNOVATIVE TREATMENTS IN SPINAL CORD INJURY RECOVERY WITH 30 OUTPATIENT SITES LOCATED THROUGHOUT SOUTHEAST MICHIGAN IT IS ALSO A CENTER OF CHOICE FOR PERSONS RECOVERING FROM SPORTS AND ORTHOPAEDIC INJURIES DMC SINAI HOSPITAL OF GREATER DETROIT SINAIGRACE IS DMCS LARGEST HOSPITAL AS A FULLSERVICE COMMUNITY HOSPITAL LOCATED IN NORTHWEST DETROIT SINAIGRACE OFFERS A COMPREHENSIVE HEART CENTER CANCER CARE GERONTOLOGY EMERGENCY MEDICINE OBSTETRICSGYNECOLOGY AND COSMETICPLASTIC SURGERY SINAIGRACES JOINT REPLACEMENT PROGRAM FEATURES A REVOLUTIONARY MINIMALLY INVASIVE KNEE REPLACEMENT SURGERY THAT ATTRACTS PEOPLE FROM ALL OVER THE COUNTRY SINAIGRACE ALSO OPERATES MORE THAN 25 OUTPATIENT CARE SITES AND AMBULATORY SURGERY CENTERS THROUGHOUT WAYNE AND OAKLAND COUNTIES RECOGNIZED NATIONALLY FOR QUALITY AND SAFETY SINAIGRACE IS ONE OF THE FEW HOSPITALS SELECTED TO PARTICIPATE IN TWO HEALTH CARE COLLABORATIVES FOCUSED ON DEVELOPING BEST PRACTICES FOR CARE AT THE BEDSIDE AND UPON DISCHARGE DMC SURGERY HOSPITAL DMC SURGERY HOSPITAL IS DEDICATED TO THE SURGICAL NEEDS OF ADULTS AND CHILDREN AND MAINTAINS A COMMITMENT TO EXCELLENCE IN SERVICE FOR PATIENTS PHYSICIANS AND FAMILIES SURGERY FOR ADULTS COVERS THE FULL RANGE OF ORTHOPAEDIC SURGERIES NEUROSURGERY RELATIVE TO THE SPINE AND PODIATRIC SURGERY IN ASSOCIATION WITH CHILDRENS HOSPITAL OF MICHIGAN SURGERY FOR PEDIATRIC PATIENTS PRIMARILY PROVIDES SERVICES FOR ALL OUTPATIENT SURGICAL NEEDS THE MAJOR EMPHASIS OF THE FACILITY IS A COMMITMENT TO ORTHOPAEDIC SPORTS MEDICINE WHICH INCLUDES SERVICES FOR BOTH ADULTS AND ADOLESCENTS THE HOSPITAL ALSO OFFERS 24 HOUR EMERGENCY CARE AND PSYCHIATRIC INPATIENT SERVICES

LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI
MICHIGAN

ADDITIONAL INFORMATION PART VI
SCHEDULE H PART I LINE 7B COLUMN D THE AMOUNTS REPORTED AS DIRECT OFFSETTING REVENUE INCLUDE AMOUNTS FOR 2009 RECEIVED IN 2010

Operating expenses	$ 395,181,951
Total amount spent on community benefits as % of operating expenses	$ 23,384,331 5.92 %