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LINE 4B AN AGGREGATE COST TO CHARGE RATIO WAS USED TO PROVIDE BAD DEBT AT COST FOR LINE 2. LINE 8A FROM COST REPORT LINE 9B PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OF FINANCIAL ASSISTANCE ARE NOT SENT TO A COLLECTION AGENCY. THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAY AND AFTER, AS WELL AS WITH EACH BILLING NOTICE (INFORMATION IS PRINTED DIRECTLY ON THE PATIENT BILL)."},{"explanation":"Financial counselor & Medicaid application vendor discusses charity care options with the uninsured patients. LINE 19D ALL UNINSURED PATIENTS RECEIVED A 30% DISCOUNT FROM THE HOSPITAL FACILITY. UNINSURED PATIENTS RECEIVED ADDITIONAL DISCOUNTS WHICH RESULT IN CHARGES BEING AT OR BELOW THE TYPICAL COMMERCIAL RATE. THE HOSPITAL FACILITY DETERMINES EACH PATIENT'S ABILITY TO PAY ON AN INDIVIDUAL BASIS."},{"explanation":"A NEEDS ASSESSMENT OF THE GARDEN CITY HOSPITAL (GCH) COMMUNITY WAS PERFORMED IN AUGUST 2010. THE ASSESSMENT WAS PERFORMED BY GCH STAFF AND INCLUDED REVIEW OF COMMUNITY HEALTH REPORTS AND NATIONAL COMMUNITY SURVEYS. THE ASSESSMENT LOOKED AT THE GCH COMMUNITY'S DEMOGRAPHIC, SOCIOECONOMIC, HEALTH STATUS AND CHRONIC DISEASE PROFILES. IN ADDITION, THE HOSPITAL AND PHYSICIANS IDENTIFY COMMUNITY NEEDS BASED ON ADMISSION/DISCHARGE AND OTHER HOSPITAL DATA. BASED ON THIS DATA AND INFORMATION, THE HOSPITAL ASSESSES AND CONTINUALLY RESPONDS TO CHANGING COMMUNITY NEEDS."},{"explanation":"ALL UNINSURED PATIENTS THAT ARE ADMITTED TO THE HOSPITAL AS INPATIENTS ARE SCREENED AND INTERVIEWED FOR MEDICAID ELIGIBILITY BY A THIRD PARTY VENDOR. UNINSURED PATIENTS SEEN IN THE EMERGENCY DEPARTMENT ARE CONTACTED BY PHONE AFTER THE VISIT AND SCREENED FOR MEDICAID ELIGIBILITY. IF THE PATIENTS ARE NOT MEDICAID ELIGIBLE, THEY ARE GIVEN INFORMATION REGARDING THE HOSPITAL'S CHARITY CARE PROGRAM. 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THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY SERVED BY THE HOSPITAL. THE HOSPITAL SERVES AS A CLINICAL EXPERIENCE FOR A LARGE NUMBER OF RESIDENTS. 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SECTION B - FINANCIAL ASSISTANCE POLICY LINE 14G FINANCIAL COUNSELOR AND MEDICAID APPLICATION VENDOR DISCUSS CHARITY CARE OPTIONS WITH THE UNINSURED PATIENTS."},{"form_and_line_reference":"LINE 20D","explanation":"30% OFF TOTAL CHARGES FOR ALL UNINSURED PATIENTS. GARDEN CITY HOSPITAL, BASED ON PAST HISTORY, HAS CHOSEN THE 30% DISCOUNT RATE TO REFLECT THE AVERAGE DISCOUNT RECEIVED BY INSURED PATIENTS, AS WELL AS THE AVERAGE MARKET DISCOUNT RATE."},{"form_and_line_reference":"NEEDS ASSESSMENT","explanation":"A NEEDS ASSESSMENT OF THE GARDEN CITY HOSPITAL (GCH) COMMUNITY WAS PERFORMED IN AUGUST OF 2013. THE ASSESSMENT WAS PERFORMED BY GCH STAFF AND INCLUDED REVIEW OF COMMUNITY HEALTH REPORTS AND NATIONAL COMMUNITY SURVEYS. THE ASSESSMENT LOOKED AT THE GCH COMMUNITY'S DEMOGRAPHIC, SOCIOECONOMIC, HEALTH STATUS AND CHRONIC DISEASE PROFILES. IN ADDITION, THE HOSPITAL AND PHYSICIANS IDENTIFY COMMUNITY NEEDS BASED ON ADMISSION/DISCHARGE AND OTHER HOSPITAL DATA. 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THE POPULATION IS OLDER THAN THE AVERAGE FOR BOTH THE NATION AND FOR MICHIGAN; THE PERCENTAGE OF CHILDREN UNDER 18 IS LESS THAN 16 PERCENT, COMPARED TO THE NATIONAL AVERAGE OF 18 PERCENT. HEART DISEASE AND CANCER ARE THE LEADING CAUSES OF DEATH. PROMOTION OF COMMUNITY HEALTH THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN MEDICAID, MEDICARE AND OTHER GOVERNMENT SPONSORED HEALTH PROGRAMS. THE HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED IN THE AREA. THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY SERVED BY THE HOSPITAL. THE HOSPITAL SERVES AS A CLINICAL EXPERIENCE FOR A LARGE NUMBER OF RESIDENTS. IN ADDITION, STUDENTS IN OTHER HEALTH CARE PROFESSIONS SUCH AS NURSING, PHARMACY, DIETARY, AND EMERGENCY TECHNICIANS ARE TRAINED HERE. 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PART XI, LINE 8 RESTRICTED CONTRIBUTIONS (87,319) PENSION ADJUSTMENT (2,185,678) TRANSFERS TO AFFILIATES (329,068) TOTAL (2,602,065) PART XII, LINE 2D & PART XIII, LINE 2D RENT EXPENSE 479,352 FUNDRAISING EXPENSE 8,630 TOTAL 487,982"}]},"ScheduleG":{"fundraising_events":{"event1":{"name":"CARDIAC REHAB","gross_receipts":18058,"charitable_contributions":6049,"gross_revenue":12009,"rent_facility_costs":3500,"other_direct_expenses":5130},"other_events":{"event_count":0},"total":{"gross_receipts":18058,"charitable_contributions":6049,"gross_revenue":12009,"rent_facility_costs":3500,"other_direct_expenses":5130},"direct_expense_summary":8630,"net_income_summary":3379}},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":false},"bad_debt_medicare_collections":{"bad_debt_expense_reported":true,"bad_debt_expense":6342251,"bad_debt_expense_attributable_to_financial_assistance":3266259,"reimbursed_by_medicare":71768832,"cost_of_care_reimbursed_by_medicare":60430074,"medicare_surplus_or_shortfall":11338758,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":154979,"net_community_benefit_expense":154979,"total_expense_percentage":0.0012},"unreimbursed_medicaid":{"total_community_benefit_expense":25697333,"direct_offsetting_revenue":21336597,"net_community_benefit_expense":4360736,"total_expense_percentage":0.0331},"total_financial_assistance":{"total_community_benefit_expense":25852312,"direct_offsetting_revenue":21336597,"net_community_benefit_expense":4515715,"total_expense_percentage":0.0343},"community_health_services":{"total_community_benefit_expense":524860,"net_community_benefit_expense":524860,"total_expense_percentage":0.004},"health_professions_education":{"total_community_benefit_expense":6270181,"direct_offsetting_revenue":6168837,"net_community_benefit_expense":101344,"total_expense_percentage":0.0008},"subsidized_health_services":{"total_community_benefit_expense":464817,"direct_offsetting_revenue":298352,"net_community_benefit_expense":166465,"total_expense_percentage":0.0013},"cash_and_inkind_contributions":{"total_community_benefit_expense":49390,"net_community_benefit_expense":49390,"total_expense_percentage":0.0004},"total_other_benefits":{"total_community_benefit_expense":7309248,"direct_offsetting_revenue":6467189,"net_community_benefit_expense":842059,"total_expense_percentage":0.0065},"total_community_benefits":{"total_community_benefit_expense":33161560,"direct_offsetting_revenue":27803786,"net_community_benefit_expense":5357774,"total_expense_percentage":0.0408}},"community_building":{"economic_development":{"total_community_benefit_expense":25704,"net_community_benefit_expense":25704,"total_expense_percentage":0.0002},"community_support":{"total_community_benefit_expense":1210,"net_community_benefit_expense":14210},"coalition_building":{"total_community_benefit_expense":15000,"net_community_benefit_expense":15000,"total_expense_percentage":0.0001},"total_community_building_activities":{"total_community_benefit_expense":41914,"net_community_benefit_expense":54914,"total_expense_percentage":0.0003}},"management_companies":[{"business_name_line1":"GCH HOME MEDICAL LLC","primary_activities":"PROVIDE MEDICAL EQUIPMENT","organization_profit_or_ownership_percentage":0.5,"officers_profit_or_ownership_percentage":0.0,"physicians_profit_or_ownership_percentage":0.0,"name":"GCH HOME MEDICAL LLC"}],"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"GARDEN CITY HOSPITAL","address_line1":"6245 INKSTER ROAD","city":"GARDEN CITY","state":"MI","zip":"48135","licensed_hospital":true,"general_medical_and_surgical":true,"teaching_hospital":true,"emergency_room_24_hours":true,"name":"GARDEN CITY HOSPITAL","address":"6245 INKSTER ROAD, GARDEN CITY, MI, 48135"}],"facility_policies":[{"business_name_line1":"GARDEN CITY HOSPITAL","facility_number":1,"name":"GARDEN CITY HOSPITAL"}],"supplemental_information":[{"explanation":"The organization's audited financial statements do not contain a footnote that describes bad debt expense. 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SECTION B - FINANCIAL ASSISTANCE POLICY LINE 14G FINANCIAL COUNSELOR AND MEDICAID APPLICATION VENDOR DISCUSS CHARITY CARE OPTIONS WITH THE UNINSURED PATIENTS."},{"form_and_line_reference":"LINE 20D","explanation":"30% OFF TOTAL CHARGES FOR ALL UNINSURED PATIENTS. GARDEN CITY HOSPITAL, BASED ON PAST HISTORY, HAS CHOSEN THE 30% DISCOUNT RATE TO REFLECT THE AVERAGE DISCOUNT RECEIVED BY INSURED PATIENTS, AS WELL AS THE AVERAGE MARKET DISCOUNT RATE."},{"form_and_line_reference":"NEEDS ASSESSMENT","explanation":"A NEEDS ASSESSMENT OF THE GARDEN CITY HOSPITAL (GCH) COMMUNITY WAS PERFORMED IN AUGUST OF 2013. THE ASSESSMENT WAS PERFORMED BY GCH STAFF AND INCLUDED REVIEW OF COMMUNITY HEALTH REPORTS AND NATIONAL COMMUNITY SURVEYS. THE ASSESSMENT LOOKED AT THE GCH COMMUNITY'S DEMOGRAPHIC, SOCIOECONOMIC, HEALTH STATUS AND CHRONIC DISEASE PROFILES. IN ADDITION, THE HOSPITAL AND PHYSICIANS IDENTIFY COMMUNITY NEEDS BASED ON ADMISSION/DISCHARGE AND OTHER HOSPITAL DATA. BASED ON THIS DATA AND INFORMATION, THE HOSPITAL ASSESSES AND CONTINUALLY RESPONDS TO CHANGING COMMUNITY NEEDS. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ALL UNINSURED PATIENTS THAT ARE ADMITTED TO THE HOSPITAL AS INPATIENTS ARE SCREENED AND INTERVIEWED FOR MEDICAID ELIGIBILITY BY A THIRD PARTY VENDOR. UNINSURED PATIENTS SEEN IN THE EMERGENCY DEPARTMENT ARE CONTACTED BY PHONE AFTER THE VISIT AND SCREENED FOR MEDICAID ELIGIBILITY. IF THE PATIENTS ARE NOT MEDICAID ELIGIBLE, THEY ARE GIVEN INFORMATION REGARDING THE HOSPITAL'S CHARITY CARE PROGRAM. PATIENT BILLING STATEMENTS CONTAIN INFORMATION ON THE GUIDELINES AND HOW TO OBTAIN A CHARITY CARE APPLICATION. COMMUNITY INFORMATION GCH SERVES APPROXIMATELY ONE-FOURTH OF THE POPULATION RESIDING IN WAYNE COUNTY. THE POPULATION HAS A UNIQUE MIX OF MINORITIES WHO RESIDE IN SPECIFIC DISTRICTS OF THE COMMUNITY. UNEMPLOYMENT IS HIGHER THAN THE NATIONAL AVERAGE. THE PERCENTAGE OF UNINSURED IS HIGHER THAN MICHIGAN'S AVERAGE. THE POPULATION IS OLDER THAN THE AVERAGE FOR BOTH THE NATION AND FOR MICHIGAN; THE PERCENTAGE OF CHILDREN UNDER 18 IS LESS THAN 16 PERCENT, COMPARED TO THE NATIONAL AVERAGE OF 18 PERCENT. HEART DISEASE AND CANCER ARE THE LEADING CAUSES OF DEATH. PROMOTION OF COMMUNITY HEALTH THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN MEDICAID, MEDICARE AND OTHER GOVERNMENT SPONSORED HEALTH PROGRAMS. THE HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED IN THE AREA. THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY SERVED BY THE HOSPITAL. THE HOSPITAL SERVES AS A CLINICAL EXPERIENCE FOR A LARGE NUMBER OF RESIDENTS. IN ADDITION, STUDENTS IN OTHER HEALTH CARE PROFESSIONS SUCH AS NURSING, PHARMACY, DIETARY, AND EMERGENCY TECHNICIANS ARE TRAINED HERE. STATE FILING OF COMMUNITY BENEFIT REPORT MICHIGAN"}]},"ScheduleI":{"reported_domestic_org_grants":0,"reported_domestic_individual_grants":0,"total_domestic_grants":0},"ScheduleF":{"reported_foreign_grants":0,"regions":[{"region":"Central America and the Caribbean","activity_type":"Program Services","services":"CAPTIVE INSURANCE CO","total_expenditures":238483,"employees":1,"offices":1},{"region":"Central America and the Caribbean","activity_type":"Program Services","services":"CAPTIVE INSURANCE 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