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ACTIVITIES."}]},"ScheduleD":{"land_buildings_equipment":{"land":{"other_cost_or_other_basis":850127,"book_value":850127},"buildings":{"other_cost_or_other_basis":32065728,"book_value":9655592,"depreciation":22410136},"leasehold_improvements":{"other_cost_or_other_basis":677111,"book_value":57065,"depreciation":620046},"equipment":{"other_cost_or_other_basis":32504851,"book_value":9208207,"depreciation":23296644},"other_land_buildings":{"other_cost_or_other_basis":607084,"book_value":607084},"total_book_value":20378075},"other_liabilities":{"liabilities":[{"description":"LIABILITY UNDER CAPITAL LEASE","amount":106200},{"description":"PATIENT HEALTH ORG (PHO) LIABILITY","amount":216393},{"description":"COST REPORT SETTLEMENT PAYABLE","amount":486397}],"total_liability":808990,"footnote_text":true},"supplemental_information":[{"identifier":"DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:","form_and_line_reference":"PART X, LINE 2:","explanation":"THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL AND ITS SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPALS GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF JUNE 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2008."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_200":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":3238564,"bad_debt_expense_attributable_to_financial_assistance":323856,"reimbursed_by_medicare":14997533,"cost_of_care_reimbursed_by_medicare":15169021,"medicare_surplus_or_shortfall":-171488,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":433538,"net_community_benefit_expense":433538,"total_expense_percentage":0.0074},"unreimbursed_medicaid":{"total_community_benefit_expense":9751169,"direct_offsetting_revenue":8138385,"net_community_benefit_expense":1612784,"total_expense_percentage":0.0275},"total_financial_assistance":{"total_community_benefit_expense":10184707,"direct_offsetting_revenue":8138385,"net_community_benefit_expense":2046322,"total_expense_percentage":0.0349},"total_community_benefits":{"total_community_benefit_expense":10184707,"direct_offsetting_revenue":8138385,"net_community_benefit_expense":2046322,"total_expense_percentage":0.0349}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER","address_line1":"605 OAK STREET","city":"BIG RAPIDS","state":"MI","zip":"49307","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"MECOSTA COUNTY MEDICAL CENTER","address":"605 OAK STREET, BIG RAPIDS, MI, 49307"}],"facility_policies":[{"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER","facility_number":1,"chna_conducted":true,"community_definition":true,"community_demographics":true,"existing_resources":true,"how_data_obtained":true,"community_health_needs":true,"other_health_issues":true,"community_health_needs_identification_process":true,"consulting_process":true,"chna_conducted_year":12,"took_into_account_others_input":true,"chna_conducted_with_other_facilities":false,"chna_report_widely_available":true,"report_available_on_own_website":true,"paper_copy_public_inspection":true,"implementation_strategy_adopted":true,"strategy_posted_website":true,"organization_incurred_excise_tax":false,"adopt_budget":true,"all_needs_addressed":false,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":true,"fpg_family_income_limit_free_care_percentage":200.0,"fpg_family_income_limit_discounted_care_percentage":200.0,"fpg_used_determine_discounted_care":true,"income_level_criteria":true,"asset_level_criteria":true,"medical_indigency_criteria":true,"insurance_status_criteria":true,"basis_explained":true,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_website":true,"fap_available_on_request_no_charge":true,"fap_notified_all_patients":true,"fap_actions_on_nonpayment":true,"attached_to_invoice":true,"provided_on_admission":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"medicaid_medicare":true,"state_regulation":true,"uninsured_discount":true,"amounts_generally_billed":false,"gross_charges":false,"develop_community_wide_plan":true,"exec_community_wide_plan":true,"include_operational_plan":true,"information_gaps":true,"prioritize_health_needs":true,"prioritize_services":true,"name":"MECOSTA COUNTY MEDICAL CENTER"}],"supplemental_information":[{"explanation":"PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM WORKSHEET 2, IS USED FOR LINES 7A AND 7B."},{"explanation":"PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE IS $3,238,564."},{"explanation":"PART II: THE ADMINISTRATIVE/HOSPITAL/PHYSICIAN STAFF OF MECOSTA COUNTY MEDICAL CENTER PARTICIPATE IN VARIOUS COMMUNITY ACTIVITIES. THEY PROVIDE PHYSICIAN CLINICS FOR SPORTS PHYSICALS AND PARTICIPATE IN LOCAL EVENTS WITHIN THE COMMUNITY. MECOSTA COUNTY MEDICAL CENTER'S WEBSITE PROVIDES HEALTH-RELATED ARTICLES, HEALTH CARE LINKS AND INFORMATION ON COMMUNITY EVENTS SUCH AS FREE VASCULAR SCREENING, DIABETES NUTRITION WORKSHOP AND NUTRITION THERAPY."},{"explanation":"PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL LOSS RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES.THE METHOD USED TO CALCULATE THE AMOUNT OF BAD DEBT THAT IS ATTRIBUTABLE TO PATIENTS WHO QUALIFY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS 10 PERCENT, WHICH IS AN ESTIMATE BASED ON INFORMATION FROM THE PATIENT FINANCIAL SERVICES DIRECTOR RELATED TO THE AMOUNT OF ACCOUNTS IN COLLECTION AND DISCUSSIONS WITH PATIENTS REGARDING THEIR ACCOUNT. THE HOSPITAL HAS A CONSIDERABLE AMOUNT OF PEOPLE NOT WISHING TO DISCUSS FINANCIAL INFORMATION AND THEN END UP IN COLLECTION."},{"explanation":"PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED ON THE METHODOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT. THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT."},{"explanation":"PART III, LINE 9B: PATIENTS WHO MAY QUALIFY FOR ASSISTANCE AND WHO DID NOT GET PRESCREENED FOR ONE OF OUR PROGRAMS AND WHO MAY FALL INTO THE CHARITY CARE OR FINANCIAL ASSISTANCE CATEGORY, MAY DISCUSS THEIR INDIVIDUAL OPTIONS DURING THE COLLECTION PROCESS BY CALLING/VISITING OUR ASSISTANCE OFFICE. IF A PATIENT HAS RECEIVED A COLLECTION NOTICE, CONTACT WITH OUR ASSISTANCE COUNSELORS SHOULD BE MADE IMMEDIATELY FOR PROMPT ATTENTION AND ASSISTANCE. THIS WILL STOP THE COLLECTION PROCESS FROM CONTINUING. THE PATIENT WILL HAVE OPTIONS AVAILABLE DISCUSSED AT THIS TIME."},{"explanation":"PART V, SECTION B, LINE 3: SEE THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT, LOCATED AT HTTP://WWW.MCMCBR.COM."},{"explanation":"PART V, SECTION B, LINE 7: SEE THE HOSPITAL'S IMPLEMENTATION PLAN, LOCATED AT HTTP://WWW.MCMCBR.COM. OTHER NEEDS IDENTIFIED IN THE CHNA BUT NOT ADDRESSED IN THE PLAN: EACH NEED IDENTIFIED BELOW IS SIGNIFICANT AND IS BEING ADDRESSED BY A VARIETY OF PROGRAMS OPERATED BY THE HOSPITAL, SPECTRUM HEALTH OR OTHER ORGANIZATIONS IN THE COMMUNITY. THESE ISSUES WERE IDENTIFIED IN MECOSTA COUNTY HEALTH PROFILE SUMMARY BUT DETERMINED TO NOT BE OF SUFFICIENTLY HIGH PRIORITY. THEY MAY BEST BE ADDRESSED THROUGH LOCAL AND REGIONAL COUNCILS OR GOVERNMENTAL DEPARTMENTS. THE HOSPITAL WILL NOT ADDRESS THESE NEEDS AS PART OF THIS IMPLEMENTATION PLAN DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES TO THE PRIORITIES IDENTIFIED IN THE IMPLEMENTATION PLAN: - OBESITY EDUCATION, DIETARY CONSULTATION, OVERWEIGHT POPULATION-COOPERATIVE EXTENSION SERVICE. SHBRH DIETICIANS, PRIMARY CARE PROVIDERS- DEPARTMENT OF COMMUNITY HEALTH 4X4 PROGRAMS. - BIRTH CONTROL, BIRTH CONTROL EDUCATION-PLANNED PARENTHOOD. - SUBSTANCE/DRUG ABUSE-1016 RECOVERY NETWORK. - DIABETES EDUCATION-SHBRH, SHRCH DIABETIC EDUCATORS. - NEED FOR DENTAL/ORTHODONTIC CARE-NO DENTAL HEALTH VISIT IN PAST YEAR-FSU DENTAL CLINIC, AREA DENTISTS. - MENTAL HEALTH SERVICES-COMMUNITY MENTAL HEALTH FOR CENTRAL MICHIGAN. - FINANCIAL SERVICES ADVICE-LOCAL BANKS, AMERICAN RED CROSS, DEPARTMENT OF HUMAN SERVICES. - VISION CARE-LOCAL OPHTHALMOLOGISTS AND OPTOMETRISTS, MICHIGAN COLLEGE OF OPTOMETRY. - WELLNESS AND PREVENTION PROGRAMS-SHBRH OCCUPATIONAL MEDICINE, AREA HOLISTIC PROVIDERS, COMPLEMENTARY MEDICINE OFFICES, FITNESS CENTERS. - FLU AND PNEUMONIA SHOTS FOR SENIORS-AREA PRIMARY CARE OFFICES. - HIGH UNEMPLOYMENT JOBLESS RATE-MICHIGAN WORKS, MICHIGAN REHABILITATION SERVICES, MECOSTA COUNTY ECONOMIC DEVELOPMENT CORPORATION. - LACK OF COLLEGE DEGREE-FERRIS STATE UNIVERSITY. - PERSONS BELOW POVERTY-DEPARTMENT OF HUMAN SERVICES, MECOSTA-OSCEOLA HUMAN SERVICES. COLLABORATIVE BODY, MECOSTA-OSCEOLA POVERTY REDUCTION INITIATIVE, UNITED WAY AGENCIES. - HIGH NUMBER OF CHILDREN ON FREE AND REDUCED FEE LUNCH PROGRAMS-DEPARTMENT OF HUMAN SERVICES, DEPARTMENT OF COMMUNITY HEALTH, AND ANGELS OF ACTION. - HIGH NUMBER OF MEDICAID PAID BIRTHS-DEPARTMENT OF COMMUNITY HEALTH. - HIGH INFANT MORTALITY RATE-DEPARTMENT OF COMMUNITY HEALTH, AREA PEDIATRIC PROVIDERS, DEPARTMENT OF HUMAN SERVICES. - HIGH NUMBER OF PEOPLE LACKING HEALTH INSURANCE-SHBRH CHARITY CARE, DEPARTMENT OF HUMAN SERVICES. - HIGH RATES OF SMOKING AND SMOKING DURING PREGNANCY-DEPARTMENT OF COMMUNITY HEALTH, AMERICAN CANCER SOCIETY (QUIT KIT, ONLINE SERVICES). - URGENT CARE SERVICES- RESPONDENTS IDENTIFIED THESE AS IMPORTANT AND THEY ARE CURRENTLY PROVIDED BY PHYSICIAN HEALTH SERVICES. THERE ARE NOT SUFFICIENT HOSPITAL RESOURCES TO PROVIDE THIS SERVICE TO THE COMMUNITY AS A SHBRH SERVICE LINE."},{"explanation":"PART V, SECTION B, LINE 20D: THE HOSPITAL STARTS WITH A BASE CHARGE, WHICH COMES DIRECTLY FROM THE CHARGEMASTER. FROM THERE, IF THE DETERMINATION HAS BEEN MADE REGARDING THE PATIENTS INABILITY TO PAY, A 20 PERCENT AUTOMATIC DISCOUNT IS APPLIED. IN ADDITION, A 10 PERCENT DISCOUNT IS GIVEN FOR PROMPT PAYMENT WITHIN 20 DAYS FROM THE ORIGINAL STATEMENT DATE. THE TOTAL AVAILABLE 30 PERCENT DISCOUNT IS WHAT THE HOSPITAL HAS DETERMINED WOULD HAVE BEEN A REASONABLE CONTRACTUAL ALLOWANCE FOR ACCOUNTS WITH NO INSURANCE."},{"explanation":"PART VI, LINE 2: - INTERACTION WITH THE HUMAN SERVICES COLLABORATIVE BODY. - THE NINE MEMBER BOARD OF TRUSTEES IS APPOINTED BY THE MECOSTA COUNTY COMMISSION. MEMBERS ARE REQUIRED TO BE COUNTY RESIDENTS.- THE AFFORDABLE CARE ACT REQUIRES THAT A DOCUMENTED ASSESSMENT BE CONDUCTED AND THE RESULTS OF THAT ASSESSMENT BE PUBLISHED ON THE HOSPITALS WEBSITE AND AVAILABLE TO INDIVIDUALS SERVED BY THE HOSPITAL."},{"explanation":"PART VI, LINE 3: UNDER THE ORGANIZATION'S CHARITY CARE POLICY, APPLICATIONS ARE PROVIDED TO ASSESS A PATIENT'S ELIGIBILITY. INFORMATION IS PROVIDED AT THE FACILITY OR MAY BE REQUESTED BY PHONE. MECOSTA COUNTY MEDICAL CENTER'S WEBSITE STATES THAT A FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE AND PROVIDES A CONTACT NUMBER.ASSISTANCE PROGRAMS ARE DISCUSSED WITH PATIENTS WHO APPEAR TO QUALIFY FOR ASSISTANCE DURING REGISTRATION/VISIT. IF CONTACT CAN NOT BE ACHIEVED DURING THE VISIT THEN NOTIFICATION OF POTENTIAL QUALIFICATION FOR ASSISTANCE IS SENT VIA MAIL. ALL PATIENTS WHO MAY QUALIFY ARE ENCOURAGED TO APPLY AND TO DISCUSS AVAILABLE OPTIONS VIA PHONE OR IN PERSON."},{"explanation":"PART VI, LINE 4: MECOSTA COUNTY MEDICAL CENTER IS LOCATED IN THE MID-WESTERN PORTION OF THE STATE OF MICHIGAN. IT SERVES A FIVE COUNTY AREA THAT INCLUDES A LARGE POPULATION WITH LOW INCOME STATUS. ACCORDING TO THE 2008 US CENSUS ROUGHLY 20 PERCENT OF THE POPULATION IN THIS AREA LIVES BELOW THE POVERTY LINE."},{"explanation":"PART VI, LINE 5: MECOSTA COUNTY MEDICAL CENTER FUNDS AND ORGANIZES PROGRAMS TO IMPROVE COMMUNITY AWARENESS OF HEALTH ISSUES. CURRENT COMMUNITY EDUCATION CLASSES INCLUDE: ACLS/PALS COURSES, HEALTHCARE PROVIDER, BIG BROTHER BIG SISTER, BREASTFEEDING, CHILDBIRTH REFRESHER, DIABETES SELF MANAGEMENT, EXPECTANT PARENTS, AND FREEDOM FROM SMOKING."},{"explanation":"MI"}]},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":false,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"THOMAS SAM E 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ACTIVITIES."}]},"ScheduleD":{"land_buildings_equipment":{"land":{"other_cost_or_other_basis":850127,"book_value":850127},"buildings":{"other_cost_or_other_basis":31932344,"book_value":10244717,"depreciation":21687627},"leasehold_improvements":{"other_cost_or_other_basis":671080,"book_value":66596,"depreciation":604484},"equipment":{"other_cost_or_other_basis":36190022,"book_value":10124991,"depreciation":26065031},"other_land_buildings":{"other_cost_or_other_basis":24997,"book_value":24997},"total_book_value":21311428},"securities":{"other_securities":[{"description":"MUTUAL FUNDS","book_value":977000,"method_of_valuation":"F"},{"description":"CERTIFICATES OF DEPOSIT","book_value":2119998,"method_of_valuation":"F"},{"description":"MONEY MARKET FUNDS","book_value":1032000,"method_of_valuation":"F"}],"total_book_value":4128998},"other_liabilities":{"liabilities":[{"description":"LIABILITY UNDER CAPITAL LEASE","amount":111437},{"description":"OTHER ACCRUED LIABILITIES","amount":27954},{"description":"COST REPORT SETTLEMENT PAYABLE","amount":377159},{"description":"RESERVE FOR MALPRACTICE","amount":196500}],"total_liability":713050},"supplemental_information":[{"identifier":"DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:","form_and_line_reference":"PART X:","explanation":"THE HOSPITAL IS EXEMPT FROM INCOME TAX UNDER PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3); THEREFORE, A PROVISION FOR INCOME TAXES HAS NOT BEEN INCLUDED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT AS OF JUNE 30 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_200":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":true,"bad_debt_expense":2791574,"bad_debt_expense_attributable_to_financial_assistance":279157,"reimbursed_by_medicare":14346318,"cost_of_care_reimbursed_by_medicare":13710246,"medicare_surplus_or_shortfall":636072,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":415361,"net_community_benefit_expense":415361,"total_expense_percentage":0.0079},"unreimbursed_medicaid":{"total_community_benefit_expense":9471666,"direct_offsetting_revenue":8674850,"net_community_benefit_expense":796816,"total_expense_percentage":0.0152},"total_financial_assistance":{"total_community_benefit_expense":9887027,"direct_offsetting_revenue":8674850,"net_community_benefit_expense":1212177,"total_expense_percentage":0.0231},"community_health_services":{"total_community_benefit_expense":21675,"net_community_benefit_expense":21675,"total_expense_percentage":0.0004},"total_other_benefits":{"total_community_benefit_expense":21675,"net_community_benefit_expense":21675,"total_expense_percentage":0.0004},"total_community_benefits":{"total_community_benefit_expense":9908702,"direct_offsetting_revenue":8674850,"net_community_benefit_expense":1233852,"total_expense_percentage":0.0235}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER","address_line1":"605 OAK STREET","city":"BIG RAPIDS","state":"MI","zip":"49307","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"MECOSTA COUNTY MEDICAL CENTER","address":"605 OAK STREET, BIG RAPIDS, MI, 49307"}],"facility_policies":[{"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER","facility_number":1,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":true,"fpg_family_income_limit_free_care_percentage":200.0,"fpg_family_income_limit_discounted_care_percentage":200.0,"fpg_used_determine_discounted_care":true,"income_level_criteria":true,"insurance_status_criteria":true,"basis_explained":true,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_website":true,"fap_available_on_request_no_charge":true,"fap_actions_on_nonpayment":true,"attached_to_invoice":true,"provided_on_admission":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"uninsured_discount":true,"amounts_generally_billed":false,"gross_charges":false,"name":"MECOSTA COUNTY MEDICAL CENTER"}],"supplemental_information":[{"explanation":"PART I, LINE 3C: THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY."},{"explanation":"PART I, LINE 6A: N/A - NO RELATED PARTIES IDENTIFIED."},{"explanation":"PART I, LINE 7: THE COSTING METHODOLOGY USED IS THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2."},{"explanation":"PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, THAT IS SUBTRACTED FROM TOTAL EXPENSES FOR PART I, LINE 7, COLUMN (F) IS $2,791,574."},{"explanation":"PART II: THE ADMINISTRATIVE/HOSPITAL/PHYSICIAN STAFF OF MECOSTA COUNTY MEDICAL CENTER PARTICIPATE IN VARIOUS COMMUNITY ACTIVITIES. THEY PROVIDE PHYSICIAN CLINICS FOR SPORTS PHYSICALS AND PARTICIPATE IN LOCAL EVENTS WITHIN THE COMMUNITY. MECOSTA COUNTY MEDICAL CENTER'S WEBSITE PROVIDES HEALTH-RELATED ARTICLES, HEALTH CARE LINKS AND INFORMATION ON COMMUNITY EVENTS SUCH AS FREE VASCULAR SCREENING, DIABETES NUTRITION WORKSHOP AND NUTRITION THERAPY."},{"explanation":"PART III, LINE 4: THERE IS NO FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE.BAD DEBT EXPENSE REPORTED ON LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES.THE METHOD USED TO CALCULATE THE AMOUNT OF BAD DEBT THAT IS ATTRIBUTABLE TO PATIENTS WHO QUALIFY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS 10 PERCENT, WHICH IS AN ESTIMATE BASED ON INFORMATION FROM THE PATIENT FINANCIAL SERVICES DIRECTOR RELATED TO THE AMOUNT OF ACCOUNTS IN COLLECTION AND DISCUSSIONS WITH PATIENTS REGARDING THEIR ACCOUNT. THE HOSPITAL HAS A CONSIDERABLE AMOUNT OF PEOPLE NOT WISHING TO DISCUSS FINANCIAL INFORMATION AND THEN END UP IN COLLECTION."},{"explanation":"PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED ON THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT."},{"explanation":"PART III, LINE 9B: PATIENTS WHO MAY QUALIFY FOR ASSISTANCE, AND WHO DID NOT GET PRE-SCREENED FOR ONE OF OUR PROGRAMS, AND WHO MAY FALL INTO THE CHARITY CARE OR FINANCIAL ASSISTANCE CATEGORY, MAY DISCUSS THEIR INDIVIDUAL OPTIONS DURING THE COLLECTION PROCESS BY CALLING/VISITING OUR ASSISTANCE OFFICE. IF A PATIENT HAS RECEIVED A COLLECTION NOTICE, CONTACT WITH OUR ASSISTANCE COUNSELORS SHOULD BE MADE IMMEDIATELY FOR PROMPT ATTENTION AND ASSISTANCE. THIS WILL STOP THE COLLECTION PROCESS FROM CONTINUING. THE PATIENT WILL HAVE OPTIONS AVAILABLE DISCUSSED AT THIS TIME."},{"explanation":"PART V, SECTION A: AS PER THE INSTRUCTIONS, SCHEDULE H, PART III, LINES 5 AND 6 ARE DERIVED DIRECTLY FROM THE MEDICARE COST REPORT. THOSE MEDICARE COSTS NOT INCLUDED IN THE MEDICARE COST REPORT (MEDICARE ADVANTAGE AND FEE FOR SERVICE PHYSICIANS) ARE SUMMARIZED AS FOLLOWS:TOTAL COST: $7,517,729TOTAL REIMBURSEMENT: $7,059,031COST IN EXCESS OF REIMBURSEMENT: $ 458,698"},{"explanation":"PART V, SECTION B, LINE 19D: THE HOSPITAL STARTS WITH A BASE CHARGE, WHICH COMES DIRECTLY FROM THE CHARGEMASTER. FROM THERE, IF THE DETERMINATION HAS BEEN MADE REGARDING THE PATIENTS INABILITY TO PAY, A 20 PERCENT AUTOMATIC DISCOUNT IS APPLIED. IN ADDITION, A 10 PERCENT DISCOUNT IS GIVEN FOR PROMPT PAYMENT WITHIN 20 DAYS FROM THE ORIGINAL STATEMENT DATE. THE TOTAL AVAILABLE 30 PERCENT DISCOUNT IS WHAT THE HOSPITAL HAS DETERMINED WOULD HAVE BEEN A REASONABLE CONTRACTUAL ALLOWANCE FOR ACCOUNTS WITH NO INSURANCE."},{"explanation":"PART VI, LINE 2: - INTERACTION WITH THE HUMAN SERVICES COLLABORATIVE BODY.- THE NINE MEMBER BOARD OF TRUSTEES IS APPOINTED BY THE MECOSTA COUNTY COMMISSION. MEMBERS ARE REQUIRED TO BE COUNTY RESIDENTS.- THE AFFORDABLE CARE ACT REQUIRES THAT A DOCUMENTED ASSESSMENT BE CONDUCTED AND THE RESULTS OF THAT ASSESSMENT BE PUBLISHED ON THE HOSPITALS WEBSITE AND AVAILABLE TO INDIVIDUALS SERVED BY THE HOSPITAL."},{"explanation":"PART VI, LINE 3: UNDER THE ORGANIZATION'S CHARITY CARE POLICY, APPLICATIONS ARE PROVIDED TO ASSESS A PATIENT'S ELIGIBILITY. INFORMATION IS PROVIDED AT THE FACILITY OR MAY BE REQUESTED BY PHONE. MECOSTA COUNTY MEDICAL CENTER'S WEBSITE STATES THAT A FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE AND IT PROVIDES A CONTACT NUMBER.ASSISTANCE PROGRAMS ARE DISCUSSED WITH PATIENTS WHO APPEAR TO QUALIFY FOR ASSISTANCE DURING REGISTRATION/VISIT. IF CONTACT CAN NOT BE ACHIEVED DURING THE VISIT THEN NOTIFICATION OF POTENTIAL QUALIFICATION FOR ASSISTANCE IS SENT VIA MAIL. ALL PATIENTS WHO MAY QUALIFY ARE ENCOURAGED TO APPLY AND TO DISCUSS AVAILABLE OPTIONS VIA PHONE OR IN PERSON."},{"explanation":"PART VI, LINE 4: MECOSTA COUNTY MEDICAL CENTER IS LOCATED IN THE MID-WESTERN PORTION OF THE STATE OF MICHIGAN. IT SERVES A FIVE COUNTY AREA THAT INCLUDES A LARGE POPULATION WITH LOW INCOME STATUS. ACCORDING TO THE 2008 US CENSUS ROUGHLY 20 PERCENT OF THE POPULATION IN THIS AREA LIVES BELOW THE POVERTY LINE."},{"explanation":"PART VI, LINE 5: MECOSTA COUNTY MEDICAL CENTER FUNDS AND ORGANIZES PROGRAMS TO IMPROVE COMMUNITY AWARENESS OF HEALTH ISSUES. CURRENT COMMUNITY EDUCATION CLASSES INCLUDE: ACLS/PALS COURSES, HEALTHCARE PROVIDER, BIG BROTHER BIG SISTER, BREASTFEEDING, CHILDBIRTH REFRESHER, DIABETES SELF MANAGEMENT, EXPECTANT PARENTS, AND FREEDOM FROM SMOKING."},{"explanation":"PART VI, LINE 6: N/A - NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM."},{"explanation":"MI"}]},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":false,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"THOMAS SAM E 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PEARSON","base_compensation_filing_org":257022,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":5078,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":12757,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":274857,"total_compensation_related_orgs":0,"name":"DR JERRY PEARSON"},{"person_name":"DR SARA 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SERVICES"},{"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER FOUNDATION","amount_involved":287055,"method_of_amount_determination":"CASH","transaction_type":"C","name":"MECOSTA COUNTY MEDICAL CENTER FOUNDATION"},{"business_name_line1":"MECOSTA HEALTH SERVICES","amount_involved":85750,"method_of_amount_determination":"CASH","transaction_type":"A","name":"MECOSTA HEALTH SERVICES"}]},"source_xml":"201321349349306827_public.xml"},{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"Mecosta county medical center is a 74 bed, acute-care hospital serving the needs of its community and providing quality, consumer-focused health care and education with a personal touch.","primary_activities":"Provide quality and short-term acute inpatient and outpatient health care services primarily to the citizens of the greater big rapids, mi area","year":2009,"name":"MECOSTA COUNTY MEDICAL 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ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION, AND HAS CONCLUDED THAT AS OF JUNE 30, 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS."},{"identifier":"PART XI, LINE 8 - OTHER ADJUSTMENTS:","explanation":"CANCELLATION OF DEBT TO RELATED ORGANIZATION -10,892,395."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_200":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":true,"bad_debt_expense":1356974,"bad_debt_expense_attributable_to_financial_assistance":293045,"reimbursed_by_medicare":14325151,"cost_of_care_reimbursed_by_medicare":13516383,"medicare_surplus_or_shortfall":808768,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":269486,"net_community_benefit_expense":269486,"total_expense_percentage":0.0063},"unreimbursed_medicaid":{"total_community_benefit_expense":8485996,"direct_offsetting_revenue":7078066,"net_community_benefit_expense":1407930,"total_expense_percentage":0.0327},"total_financial_assistance":{"total_community_benefit_expense":8755482,"direct_offsetting_revenue":7078066,"net_community_benefit_expense":1677416,"total_expense_percentage":0.039},"total_community_benefits":{"total_community_benefit_expense":8755482,"direct_offsetting_revenue":7078066,"net_community_benefit_expense":1677416,"total_expense_percentage":0.039}},"community_building":{"community_support":{"activities_or_programs":1,"total_community_benefit_expense":1000,"net_community_benefit_expense":1000,"total_expense_percentage":0.0},"leadership_development":{"activities_or_programs":8,"persons_served":1225,"total_community_benefit_expense":895,"net_community_benefit_expense":895,"total_expense_percentage":0.0},"health_improvement_advocacy":{"activities_or_programs":90,"persons_served":25,"total_community_benefit_expense":17980,"net_community_benefit_expense":17980,"total_expense_percentage":0.0004},"total_community_building_activities":{"activities_or_programs":99,"persons_served":1250,"total_community_benefit_expense":19875,"net_community_benefit_expense":19875,"total_expense_percentage":0.0004}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER","address_line1":"605 OAK STREET","city":"BIG RAPIDS","state":"MI","zip":"49307","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"MECOSTA COUNTY MEDICAL CENTER","address":"605 OAK STREET, BIG RAPIDS, MI, 49307"}],"facility_policies":[{"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER","facility_number":1,"eligibility_criteria_explained":false,"fpg_family_income_limit_free_discounted":false,"fpg_used_determine_discounted_care":false,"basis_explained":false,"application_financial_assistance_explanation":false,"includes_publicity_measures":false,"fap_actions_on_nonpayment":false,"collection_activities":false,"nondiscriminatory_emergency_care_policy":false,"amounts_generally_billed":false,"gross_charges":false,"name":"MECOSTA COUNTY MEDICAL CENTER"}],"supplemental_information":[{"explanation":"PART I, LINE 3C: THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY."},{"explanation":"PART I, LINE 7: THE COSTING METHODOLOGY USED IS THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2."},{"explanation":"PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990 PART IX LINE 25 THAT IS SUBTRACTED FROM TOTAL EXPENSES FOR PART I LINE 7 COLUMN (F) IS $3,512,414"},{"explanation":"PART II: THE ADMINISTRATIVE/HOSPITAL/PHYSICIAN STAFF OF MCMC PARTICIPATE IN VARIOUS COMMUNITY ACTIVITIES. 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THE HOSPITAL HAS A CONSIDERABLE AMOUNT OF PEOPLE NOT WISHING TO DISCUSS FINANCIAL INFORMATION AND THEN END UP IN COLLECTION.THERE IS NO FOOTNOTE IN THE FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE."},{"explanation":"PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED ON THE METHODOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT."},{"explanation":"PART III, LINE 9B: PATIENTS WHO MAY QUALIFY FOR ASSISTANCE AND WHO DID NOT GET PRESCREENED FOR ONE OF OUR PROGRAMS AND WHO MAY FALL INTO THE CHARITY CARE OR FINANCIAL ASSISTANCE CATEGORY, MAY DISCUSS THEIR INDIVIDUAL OPTIONS DURING THE COLLECTION PROCESS BY CALLING/VISITING OUR ASSISTANCE OFFICE. IF A PATIENT HAS RECEIVED A COLLECTION NOTICE, CONTACT WITH OUR ASSISTANCE COUNSELORS SHOULD BE MADE IMMEDIATELY FOR PROMPT ATTENTION AND ASSISTANCE. THIS WILL STOP THE COLLECTION PROCESS FROM CONTINUING. 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MCMC'S WEBSITE STATES THAT A FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE AND PROVIDES A CONTACT NUMBER.ASSISTANCE PROGRAMS ARE DISCUSSED WITH PATIENTS WHO APPEAR TO QUALIFY FOR ASSISTANCE DURING REGISTRATION/VISIT. IF CONTACT CAN NOT BE ACHIEVED DURING THE VISIT THEN NOTIFICATION OF POTENTIAL QUALIFICATION FOR ASSISTANCE IS SENT VIA MAIL. ALL PATIENTS WHO MAY QUALIFY ARE ENCOURAGED TO APPLY AND TO DISCUSS AVAILABLE OPTIONS VIA PHONE OR IN PERSON."},{"explanation":"PART VI, LINE 4: MECOSTA COUNTY MEDICAL CENTER IS LOCATED IN THE MID-WESTERN PORTION OF THE STATE OF MICHIGAN. IT SERVES A FIVE COUNTY AREA THAT INCLUDES A LARGE POPULATION WITH LOW INCOME STATUS. ACCORDING TO THE 2008 US CENSUS ROUGHLY 20% OF THE POPULATION IN THIS AREA LIVES BELOW THE POVERTY LINE."},{"explanation":"PART VI, LINE 6: MCMC FUNDS AND ORGANIZES PROGRAMS TO IMPROVE COMMUNITY AWARENESS OF HEALTH ISSUES. 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RULED THAT THE HOSPITAL AND ITS SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPALS GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF JUNE 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2008."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_200":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":3238564,"bad_debt_expense_attributable_to_financial_assistance":323856,"reimbursed_by_medicare":14997533,"cost_of_care_reimbursed_by_medicare":15169021,"medicare_surplus_or_shortfall":-171488,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":433538,"net_community_benefit_expense":433538,"total_expense_percentage":0.0074},"unreimbursed_medicaid":{"total_community_benefit_expense":9751169,"direct_offsetting_revenue":8138385,"net_community_benefit_expense":1612784,"total_expense_percentage":0.0275},"total_financial_assistance":{"total_community_benefit_expense":10184707,"direct_offsetting_revenue":8138385,"net_community_benefit_expense":2046322,"total_expense_percentage":0.0349},"total_community_benefits":{"total_community_benefit_expense":10184707,"direct_offsetting_revenue":8138385,"net_community_benefit_expense":2046322,"total_expense_percentage":0.0349}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER","address_line1":"605 OAK STREET","city":"BIG RAPIDS","state":"MI","zip":"49307","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"MECOSTA COUNTY MEDICAL CENTER","address":"605 OAK STREET, BIG RAPIDS, MI, 49307"}],"facility_policies":[{"business_name_line1":"MECOSTA COUNTY MEDICAL CENTER","facility_number":1,"chna_conducted":true,"community_definition":true,"community_demographics":true,"existing_resources":true,"how_data_obtained":true,"community_health_needs":true,"other_health_issues":true,"community_health_needs_identification_process":true,"consulting_process":true,"chna_conducted_year":12,"took_into_account_others_input":true,"chna_conducted_with_other_facilities":false,"chna_report_widely_available":true,"report_available_on_own_website":true,"paper_copy_public_inspection":true,"implementation_strategy_adopted":true,"strategy_posted_website":true,"organization_incurred_excise_tax":false,"adopt_budget":true,"all_needs_addressed":false,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":true,"fpg_family_income_limit_free_care_percentage":200.0,"fpg_family_income_limit_discounted_care_percentage":200.0,"fpg_used_determine_discounted_care":true,"income_level_criteria":true,"asset_level_criteria":true,"medical_indigency_criteria":true,"insurance_status_criteria":true,"basis_explained":true,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_website":true,"fap_available_on_request_no_charge":true,"fap_notified_all_patients":true,"fap_actions_on_nonpayment":true,"attached_to_invoice":true,"provided_on_admission":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"medicaid_medicare":true,"state_regulation":true,"uninsured_discount":true,"amounts_generally_billed":false,"gross_charges":false,"develop_community_wide_plan":true,"exec_community_wide_plan":true,"include_operational_plan":true,"information_gaps":true,"prioritize_health_needs":true,"prioritize_services":true,"name":"MECOSTA COUNTY MEDICAL CENTER"}],"supplemental_information":[{"explanation":"PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM WORKSHEET 2, IS USED FOR LINES 7A AND 7B."},{"explanation":"PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE IS $3,238,564."},{"explanation":"PART II: THE ADMINISTRATIVE/HOSPITAL/PHYSICIAN STAFF OF MECOSTA COUNTY MEDICAL CENTER PARTICIPATE IN VARIOUS COMMUNITY ACTIVITIES. THEY PROVIDE PHYSICIAN CLINICS FOR SPORTS PHYSICALS AND PARTICIPATE IN LOCAL EVENTS WITHIN THE COMMUNITY. MECOSTA COUNTY MEDICAL CENTER'S WEBSITE PROVIDES HEALTH-RELATED ARTICLES, HEALTH CARE LINKS AND INFORMATION ON COMMUNITY EVENTS SUCH AS FREE VASCULAR SCREENING, DIABETES NUTRITION WORKSHOP AND NUTRITION THERAPY."},{"explanation":"PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL LOSS RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES.THE METHOD USED TO CALCULATE THE AMOUNT OF BAD DEBT THAT IS ATTRIBUTABLE TO PATIENTS WHO QUALIFY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS 10 PERCENT, WHICH IS AN ESTIMATE BASED ON INFORMATION FROM THE PATIENT FINANCIAL SERVICES DIRECTOR RELATED TO THE AMOUNT OF ACCOUNTS IN COLLECTION AND DISCUSSIONS WITH PATIENTS REGARDING THEIR ACCOUNT. THE HOSPITAL HAS A CONSIDERABLE AMOUNT OF PEOPLE NOT WISHING TO DISCUSS FINANCIAL INFORMATION AND THEN END UP IN COLLECTION."},{"explanation":"PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED ON THE METHODOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT. THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT."},{"explanation":"PART III, LINE 9B: PATIENTS WHO MAY QUALIFY FOR ASSISTANCE AND WHO DID NOT GET PRESCREENED FOR ONE OF OUR PROGRAMS AND WHO MAY FALL INTO THE CHARITY CARE OR FINANCIAL ASSISTANCE CATEGORY, MAY DISCUSS THEIR INDIVIDUAL OPTIONS DURING THE COLLECTION PROCESS BY CALLING/VISITING OUR ASSISTANCE OFFICE. IF A PATIENT HAS RECEIVED A COLLECTION NOTICE, CONTACT WITH OUR ASSISTANCE COUNSELORS SHOULD BE MADE IMMEDIATELY FOR PROMPT ATTENTION AND ASSISTANCE. THIS WILL STOP THE COLLECTION PROCESS FROM CONTINUING. THE PATIENT WILL HAVE OPTIONS AVAILABLE DISCUSSED AT THIS TIME."},{"explanation":"PART V, SECTION B, LINE 3: SEE THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT, LOCATED AT HTTP://WWW.MCMCBR.COM."},{"explanation":"PART V, SECTION B, LINE 7: SEE THE HOSPITAL'S IMPLEMENTATION PLAN, LOCATED AT HTTP://WWW.MCMCBR.COM. OTHER NEEDS IDENTIFIED IN THE CHNA BUT NOT ADDRESSED IN THE PLAN: EACH NEED IDENTIFIED BELOW IS SIGNIFICANT AND IS BEING ADDRESSED BY A VARIETY OF PROGRAMS OPERATED BY THE HOSPITAL, SPECTRUM HEALTH OR OTHER ORGANIZATIONS IN THE COMMUNITY. THESE ISSUES WERE IDENTIFIED IN MECOSTA COUNTY HEALTH PROFILE SUMMARY BUT DETERMINED TO NOT BE OF SUFFICIENTLY HIGH PRIORITY. THEY MAY BEST BE ADDRESSED THROUGH LOCAL AND REGIONAL COUNCILS OR GOVERNMENTAL DEPARTMENTS. THE HOSPITAL WILL NOT ADDRESS THESE NEEDS AS PART OF THIS IMPLEMENTATION PLAN DUE TO LIMITED RESOURCES AND THE NEED TO ALLOCATE SIGNIFICANT RESOURCES TO THE PRIORITIES IDENTIFIED IN THE IMPLEMENTATION PLAN: - OBESITY EDUCATION, DIETARY CONSULTATION, OVERWEIGHT POPULATION-COOPERATIVE EXTENSION SERVICE. SHBRH DIETICIANS, PRIMARY CARE PROVIDERS- DEPARTMENT OF COMMUNITY HEALTH 4X4 PROGRAMS. - BIRTH CONTROL, BIRTH CONTROL EDUCATION-PLANNED PARENTHOOD. - SUBSTANCE/DRUG ABUSE-1016 RECOVERY NETWORK. - DIABETES EDUCATION-SHBRH, SHRCH DIABETIC EDUCATORS. - NEED FOR DENTAL/ORTHODONTIC CARE-NO DENTAL HEALTH VISIT IN PAST YEAR-FSU DENTAL CLINIC, AREA DENTISTS. - MENTAL HEALTH SERVICES-COMMUNITY MENTAL HEALTH FOR CENTRAL MICHIGAN. - FINANCIAL SERVICES ADVICE-LOCAL BANKS, AMERICAN RED CROSS, DEPARTMENT OF HUMAN SERVICES. - VISION CARE-LOCAL OPHTHALMOLOGISTS AND OPTOMETRISTS, MICHIGAN COLLEGE OF OPTOMETRY. - WELLNESS AND PREVENTION PROGRAMS-SHBRH OCCUPATIONAL MEDICINE, AREA HOLISTIC PROVIDERS, COMPLEMENTARY MEDICINE OFFICES, FITNESS CENTERS. - FLU AND PNEUMONIA SHOTS FOR SENIORS-AREA PRIMARY CARE OFFICES. - HIGH UNEMPLOYMENT JOBLESS RATE-MICHIGAN WORKS, MICHIGAN REHABILITATION SERVICES, MECOSTA COUNTY ECONOMIC DEVELOPMENT CORPORATION. - LACK OF COLLEGE DEGREE-FERRIS STATE UNIVERSITY. - PERSONS BELOW POVERTY-DEPARTMENT OF HUMAN SERVICES, MECOSTA-OSCEOLA HUMAN SERVICES. COLLABORATIVE BODY, MECOSTA-OSCEOLA POVERTY REDUCTION INITIATIVE, UNITED WAY AGENCIES. - HIGH NUMBER OF CHILDREN ON FREE AND REDUCED FEE LUNCH PROGRAMS-DEPARTMENT OF HUMAN SERVICES, DEPARTMENT OF COMMUNITY HEALTH, AND ANGELS OF ACTION. - HIGH NUMBER OF MEDICAID PAID BIRTHS-DEPARTMENT OF COMMUNITY HEALTH. - HIGH INFANT MORTALITY RATE-DEPARTMENT OF COMMUNITY HEALTH, AREA PEDIATRIC PROVIDERS, DEPARTMENT OF HUMAN SERVICES. - HIGH NUMBER OF PEOPLE LACKING HEALTH INSURANCE-SHBRH CHARITY CARE, DEPARTMENT OF HUMAN SERVICES. - HIGH RATES OF SMOKING AND SMOKING DURING PREGNANCY-DEPARTMENT OF COMMUNITY HEALTH, AMERICAN CANCER SOCIETY (QUIT KIT, ONLINE SERVICES). - URGENT CARE SERVICES- RESPONDENTS IDENTIFIED THESE AS IMPORTANT AND THEY ARE CURRENTLY PROVIDED BY PHYSICIAN HEALTH SERVICES. THERE ARE NOT SUFFICIENT HOSPITAL RESOURCES TO PROVIDE THIS SERVICE TO THE COMMUNITY AS A SHBRH SERVICE LINE."},{"explanation":"PART V, SECTION B, LINE 20D: THE HOSPITAL STARTS WITH A BASE CHARGE, WHICH COMES DIRECTLY FROM THE CHARGEMASTER. FROM THERE, IF THE DETERMINATION HAS BEEN MADE REGARDING THE PATIENTS INABILITY TO PAY, A 20 PERCENT AUTOMATIC DISCOUNT IS APPLIED. IN ADDITION, A 10 PERCENT DISCOUNT IS GIVEN FOR PROMPT PAYMENT WITHIN 20 DAYS FROM THE ORIGINAL STATEMENT DATE. THE TOTAL AVAILABLE 30 PERCENT DISCOUNT IS WHAT THE HOSPITAL HAS DETERMINED WOULD HAVE BEEN A REASONABLE CONTRACTUAL ALLOWANCE FOR ACCOUNTS WITH NO INSURANCE."},{"explanation":"PART VI, LINE 2: - INTERACTION WITH THE HUMAN SERVICES COLLABORATIVE BODY. - THE NINE MEMBER BOARD OF TRUSTEES IS APPOINTED BY THE MECOSTA COUNTY COMMISSION. MEMBERS ARE REQUIRED TO BE COUNTY RESIDENTS.- THE AFFORDABLE CARE ACT REQUIRES THAT A DOCUMENTED ASSESSMENT BE CONDUCTED AND THE RESULTS OF THAT ASSESSMENT BE PUBLISHED ON THE HOSPITALS WEBSITE AND AVAILABLE TO INDIVIDUALS SERVED BY THE HOSPITAL."},{"explanation":"PART VI, LINE 3: UNDER THE ORGANIZATION'S CHARITY CARE POLICY, APPLICATIONS ARE PROVIDED TO ASSESS A PATIENT'S ELIGIBILITY. INFORMATION IS PROVIDED AT THE FACILITY OR MAY BE REQUESTED BY PHONE. MECOSTA COUNTY MEDICAL CENTER'S WEBSITE STATES THAT A FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE AND PROVIDES A CONTACT NUMBER.ASSISTANCE PROGRAMS ARE DISCUSSED WITH PATIENTS WHO APPEAR TO QUALIFY FOR ASSISTANCE DURING REGISTRATION/VISIT. IF CONTACT CAN NOT BE ACHIEVED DURING THE VISIT THEN NOTIFICATION OF POTENTIAL QUALIFICATION FOR ASSISTANCE IS SENT VIA MAIL. ALL PATIENTS WHO MAY QUALIFY ARE ENCOURAGED TO APPLY AND TO DISCUSS AVAILABLE OPTIONS VIA PHONE OR IN PERSON."},{"explanation":"PART VI, LINE 4: MECOSTA COUNTY MEDICAL CENTER IS LOCATED IN THE MID-WESTERN PORTION OF THE STATE OF MICHIGAN. IT SERVES A FIVE COUNTY AREA THAT INCLUDES A LARGE POPULATION WITH LOW INCOME STATUS. ACCORDING TO THE 2008 US CENSUS ROUGHLY 20 PERCENT OF THE POPULATION IN THIS AREA LIVES BELOW THE POVERTY LINE."},{"explanation":"PART VI, LINE 5: MECOSTA COUNTY MEDICAL CENTER FUNDS AND ORGANIZES PROGRAMS TO IMPROVE COMMUNITY AWARENESS OF HEALTH ISSUES. CURRENT COMMUNITY EDUCATION CLASSES INCLUDE: ACLS/PALS COURSES, HEALTHCARE PROVIDER, BIG BROTHER BIG SISTER, BREASTFEEDING, CHILDBIRTH REFRESHER, DIABETES SELF MANAGEMENT, EXPECTANT PARENTS, AND FREEDOM FROM SMOKING."},{"explanation":"MI"}]},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":false,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"THOMAS SAM E 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