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AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE."},{"form_and_line_reference":"Schedule H, Part I, Line 6a","explanation":"SPECTRUM HEALTH SYSTEM (EIN 38-3382353)"},{"form_and_line_reference":"SCHEDULE H, PART I, LINE 6A","explanation":"THE HOSPITAL REGULARLY PUBLISHES ITS \"WELL FOR LIFE\" NEWSLETTER THAT INCLUDES, AMONG OTHER PERTINENT HEALTH AND WELLNESS INFORMATION, SUMMARY FINANCIAL RESULTS INCLUDING COMMUNITY BENEFIT AND CHARITY CARE ACTIVITY. THE CONSOLIDATED HEALTH SYSTEM PUBLISHES A CONSOLIDATED COMMUNITY BENEFIT REPORT ON ITS WEBSITE AT WWW.SPECTRUMHEALTH.ORG (CLICK THE LINK TITLED \"ABOUT US\"). IN ADDITION, THE HEALTH SYSTEM HOLDS AN ANNUAL MEETING TO THE PUBLIC TO DISCUSS ITS COMMUNITY COMMITMENTS."},{"form_and_line_reference":"Schedule H, Part I, Line 7","explanation":"THE ORGANIZATION CALCULATES AN OVERALL COST-TO-CHARGE RATIO DERIVED BY USING THE IRS WORKSHEET 2 FORMAT, RATIO OF PATIENT CARE COST-TO-CHARGES. ALL PATIENT SEGMENTS AND PAYERS ARE USED IN THE CALCULATION."},{"form_and_line_reference":"Schedule H, Part I, Line 7, column(f)","explanation":"3,117,858"},{"form_and_line_reference":"Schedule H, Part II","explanation":"THE ORGANIZATION PARTICIPATES IN A VARIETY OF PROGRAMS INCLUDING INVOLVEMENT IN ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, COALITION BUILDING, AND COMMUNITY HEALTH ADVOCACY. DURING FY2013 THE ORGANIZATION FUNDED COMMUNITY GROUPS THROUGH ZEELAND ACTION COALITION, TOBACCO FREE PARTNERS, AND OTTAWA SUBSTANCE ABUSE COALITION."},{"form_and_line_reference":"Schedule H, Part III, Line 2","explanation":"THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE, PAYOR COMPOSITION AND AGING, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTED ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR THIRD-PARTY PAYERS, THE PROVISION IS DETERMINED BY ANALYZING CONTRACTUALLY DUE AMOUNTS FROM PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES. FOR SELF-PAY PATIENTS, THE PROVISION IS BASED ON AN ANALYSIS OF PAST EXPERIENCE RELATED TO PATIENTS UNWILLING TO PAY STANDARD RATES CHARGED. THE DIFFERENCE BETWEEN THAT STANDARD RATE CHARGED (LESS THE NEGOTIATE DISCOUNTED RATE) AND THE AMOUNT ACTUALLY COLLECTED AFTER THE REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ALL CHARGES ARE REPORTED AT GROSS, WHICH IS CONSISTENT WITH THE REPORTING METHODOLOGY USED IN THE ORGANIZATION'S FINANCIAL STATEMENTS."},{"form_and_line_reference":"Schedule H, Part III, Line 3","explanation":"THE ORGANIZATION IS UNABLE TO ESTIMATE ACCURATELY THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY. ALTHOUGH A PORTION OF BAD DEBT EXPENSES MAY RELATE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE, A REPORTABLE FIGURE CANNOT BE REASONABLY ESTIMATED. THE ORGANIZATION HAS IMPLEMENTED A \"PROPENSITY TO PAY\" EVALUATION TOOL THAT PROACTIVELY ASSESSES ONE'S ABILITY AND LIKELIHOOD TO PAY. WITH THIS TOOL, THE ORGANIZATION HAS BEEN ABLE TO PROVIDE A HIGHER DEGREE OF FOCUSED FINANCIAL COUNSELING EFFORTS, RESULTING IN A SUBSTANTIAL REDUCTION OF BAD DEBT AND HIGHER RATE OF IDENTIFICATION OF CHARITY ACCOUNTS."},{"form_and_line_reference":"Schedule H, Part III, Line 4","explanation":"THE NET PATIENT SERVICE REVENUE, PATIENT ACCOUNTS RECEIVABLE, AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOOTNOTE IS ON PAGES 14 TO 16 OF THE ORGANIZATIONS CONSOLIDATED FINANCIAL STATEMENT."},{"form_and_line_reference":"Schedule H, Part III, Line 8","explanation":"THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. IN DETERMINING MEDICARE SHORTFALLS THE ORGANIZATION USES A RATIO OF COST TO CHARGES. IN DETERMINING THE RATIO OF COST TO CHARGES THE ORGANIZATION ADJUSTS FOR BAD DEBT EXPENSES, NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES AND COMMUNITY BENEFITS ACCOUNTED FOR, AND OR REPORTED, ELSEWHERE. THE RATIO OF COST TO CHARGES IS APPLIED TO MEDICARE CHARGES TO DETERMINE SHORTFALLS IN MEDICARE REIMBURSEMENTS."},{"form_and_line_reference":"SCHEDULE H, PART III, LINE 9B","explanation":"THE ORGANIZATION PROVIDES FREE CARE TO ALL PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE WILL NOT OWE ANYTHING, AND THUS WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES."},{"form_and_line_reference":"Schedule H, Part V Section B, Line 3","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - DATA WAS GATHERED FROM A VARIETY OF SOURCES AND USING MULTIPLE METHODOLOGIES. RESIDENT FEEDBACK WAS OBTAINED VIA A BEHAVIORAL RISK FACTOR SURVEY AND FOCUS GROUPS. THIS FEEDBACK WAS OBTAINED FROM COMMUNITY RESIDENTS INCLUDING PROVIDERS, LOW INCOME, HISPANIC, SENIOR ADULTS AND AT-HOME PARENTS. HEALTH CARE PROFESSIONALS AND OTHER COMMUNITY LEADERS, KNOWN AS KEY STAKEHOLDERS OR KEY INFORMANTS, PROVIDED INPUT VIA IN-DEPTH INTERVIEWS AND AN ONLINE SURVEY. SECONDARY DATA GATHERED FROM STATE AND NATIONAL DATABASES WAS ALSO USED TO SUPPLEMENT THE OVERALL FINDINGS. MANY EXPERTS ON PUBLIC HEALTH WERE CONSULTED AS MEMBERS OF THE CHNA TASK FORCE INCLUDING OTTAWA COUNTY HEALTH DEPARTMENT, GREATER OTTAWA COUNTY UNITED WAY, HOLLAND HOSPITAL, AND NORTH OTTAWA COMMUNITY HEALTH SYSTEM. FOR A LISTING OF ALL INDIVIDUALS AND SOURCES CONSULTED, SEE THE OTTAWA COUNTY CHNA. ADDITIONALLY KEY STAKEHOLDERS WHO WERE INTERVIEWED ARE DEFINED AS EXECUTIVE-LEVEL COMMUNITY LEADERS HAVING EXTENSIVE KNOWLEDGE AND EXPERTISE ON PUBLIC HEALTH ISSUES AND ARE OFTEN INVOLVED IN POLICY DECISION MAKING. KEY INFORMANTS WHO PARTICIPATED IN THE ONLINE SURVEY ARE DEFINED AS COMMUNITY LEADERS HAVING EXTENSIVE KNOWLEDGE AND EXPERTISE ON PUBLIC HEALTH ISSUES OR HAVE EXPERIENCE WITH SUBPOPULATIONS IMPACTED MOST BY ISSUES IN HEALTH CARE.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 4","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - HOLLAND HOSPITAL NORTH OTTAWA COMMUNITY HEALTH SYSTEM ;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 11","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 12h","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 14g","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION PUBLICIZES THE FINANCIAL ASSISTANCE POLICY BY COMMUNICATING ITS AVAILABILITY VIA A PATIENT HANDBOOK, SIGNAGE, INFORMATIONAL BROCHURES, COMMUNITY PUBLICATIONS, AND VIA WORD OF MOUTH BY FINANCIAL COUNSELORS ASSISTING PATIENTS. REFERENCE TO THE AVAILABILITY OF THE POLICY IS PUBLICLY POSTED IN WAITING ROOMS. ;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 20d","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.;"},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"THE CHNA DATA PROVIDES A LEVEL FOUNDATION ON WHICH TO PLAN, DEVELOP, AND IMPLEMENT NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF OUR COMMUNITY. OPERATIONAL SERVICES IDENTIFIED BY THE CHNA, E.G. MEDICAL CLINIC, HAVE BEEN BUILT INTO THE STRATEGIC PLAN AND BUDGET, AND A RECRUITMENT PLAN HAS BEEN CREATED BASED ON CONVERSATIONS AROUND THE COMMUNITY BENEFIT DOLLARS. THE CHNA AND IMPLEMENTATION PLAN IS LOCATED AT: HTTP://WWW.SPECTRUMHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-4450 SPECTRUM HEALTH ALSO PREPARES AN ANNUAL CORPORATE SOCIAL RESPONSIBILITY REPORT THAT FOCUSES ON NINE KEY AREAS: HEALTHIER COMMUNITIES, EDUCATION, COMMUNITY ENGAGEMENT, RESEARCH, INNOVATION, EMPLOYEE ENGAGEMENT, SUSTAINABILITY, REGIONAL RELATIONSHIPS AND COMMUNITY BENEFIT."},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH PRODUCING INFORMATION CARDS FOR THE UNINSURED, COMMUNITY OUTREACH PROGRAMS, CONSUMER INFORMATION CLASSES, ORGANIZATION WEBSITE, PERSONAL FINANCIAL COUNSELING, AND BY PROVIDING ASSISTANCE IN THE ACTUAL ENROLLMENT OF SUCH PROGRAMS. THE ORGANIZATION HAS A DEPARTMENT OF FINANCIAL COUNSELORS WHO WORK WITH PATIENTS THAT EXPRESS ANY LEVEL OF CONCERN WITH PAYING THEIR BILL. IN ADDITION, THE ORGANIZATION ALSO PROACTIVELY IDENTIFIES PATIENTS WHO HAVE QUALIFYING FACTORS FOR GOVERNMENTAL ASSISTANCE AND PARTNERS WITH ORGANIZATIONS THAT SPECIALIZE IN THE QUALIFICATION PROCESS. IF THE NEED FOR ASSISTANCE IS NOT IDENTIFIED PRIOR TO BILLING, PATIENT CONCERNS THAT ARE RECEIVED AS A RESULT OF RECEIVING A BILL ARE ADDRESSED BY FINANCIAL COUNSELORS AT THAT TIME. THE ORGANIZATION WIDELY PUBLICIZES COMMUNICATIONS TO PATIENTS AND THE PUBLIC ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH VARIOUS METHODS INCLUDING, BUT NOT LIMITED TO, VIA THE SPECTRUM HEALTH PATIENT HANDBOOK, VARIOUS INFORMATIONAL BROCHURES, SIGNAGE IN EACH HOSPITAL DEPARTMENT, ADMISSIONS OFFICES AND OTHER PUBLIC LOCATIONS, UPON REQUEST BY ANY PATIENT, GUARANTOR OR COMMUNITY MEMBER, WORD OF MOUTH VIA FINANCIAL COUNSELORS AND OTHERS, AND THROUGH COMMUNITY PUBLICATIONS AND OUTREACH EVENTS. IN ADDITION, THE ORGANIZATION LISTS OPTIONS FOR THE UNINSURED AND UNDERINSURED ON THEIR WEBSITE, ALONG WITH A COPY OF THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY (SEARCH \"FINANCIAL ASSISTANCE\" AT WWW.SPECTRUMHEALTH.ORG)."},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"THE ORGANIZATION HAS IDENTIFIED A PRIMARY SERVICE AREA INCLUSIVE OF MUCH OF OTTAWA COUNTY AND THE SURROUNDING LAKESHORE REGION. FOR SPECIFIC POPULATION STATISTICS SEE THE COMMUNITY HEALTH NEEDS ASSESSMENT ACCESSIBLE AT HTTP://WWW.SPECTRUMHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-4450"},{"form_and_line_reference":"Schedule H, Part VI, Line 5","explanation":"ZEELAND COMMUNITY HOSPITAL'S BOARD OF DIRECTORS IS COMPOSED OF MEMBERS OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN ZEELAND COMMUNITY HOSPITAL'S PRIMARY SERVICE AREA. ZEELAND COMMUNITY HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. ZEELAND COMMUNITY HOSPITAL INVESTS NET EARNINGS IN IMPROVING PATIENT CARE, BUILDING AND RENOVATING FACILITIES, PURCHASING NEW TECHNOLOGY, PROVIDING HEALTH EDUCATION AND FUNDING COMMUNITY PROGRAMS. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON ZEELAND COMMUNITY HOSPITAL TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY."},{"form_and_line_reference":"Schedule H, Part VI, Line 6","explanation":"SPECTRUM HEALTH IS AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM IN WEST MICHIGAN OFFERING A FULL CONTINUUM OF CARE THROUGH THE SPECTRUM HEALTH HOSPITAL GROUP, WHICH IS COMPRISED OF NINE HOSPITALS INCLUDING HELEN DEVOS CHILDREN'S HOSPITAL, A STATE OF THE ART CHILDREN'S HOSPITAL THAT OPENED IN JANUARY 2011, AND 183 SERVICE SITES; THE SPECTRUM HEALTH MEDICAL GROUP AND WEST MICHIGAN HEART, PHYSICIAN GROUPS TOTALING MORE THAN 700 PROVIDERS; AND PRIORITY HEALTH, A HEALTH PLAN WITH 600,000 MEMBERS. SPECTRUM HEALTH IS WEST MICHIGAN'S LARGEST EMPLOYER WITH 19,000 EMPLOYEES. THE ORGANIZATION PROVIDED $250 MILLION IN COMMUNITY BENEFIT DURING ITS 2013 FISCAL YEAR. SPECTRUM HEALTH ZEELAND COMMUNITY HOSPITAL IS A MEMBER OF THE AFFILIATED GROUP OF ENTITIES WITHIN THE SPECTRUM HEALTH SYSTEM (\"SPECTRUM HEALTH\"). EACH MEMBER CREATES VALUE WITHIN ITS RESPECTIVE COMMUNITY AND IS RESPONSIBLE FOR THEIR ACTIONS AND THE IMPACT THESE ACTIONS HAVE. FROM ITS INCEPTION, SPECTRUM HEALTH HAS BEEN A FAITHFUL STEWARD OF ITS COMMUNITY ASSETS. AS A WEST MICHIGAN-BASED NOT-FOR-PROFIT HEALTH SYSTEM, THE ORGANIZATION INVESTS ITS NET EARNINGS TO IMPROVE PATIENT CARE, BUILD AND RENOVATE FACILITIES, PURCHASE NEW TECHNOLOGY, PROVIDE HEALTH EDUCATION AND FUND LOCAL COMMUNITY PROGRAMS. OVER THE YEARS, OUR MISSION HAS REMAINED THE SAME-TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. WE TAKE OUR MISSION SERIOUSLY. IT IS CENTRAL TO OUR STRATEGIC DISCUSSIONS AND GUIDES OUR INVESTMENTS AND THE ALLOCATION OF OUR RESOURCES. SPECTRUM HEALTH IS COMMITTED TO PROVIDING VALUE TO THE PEOPLE WE SERVE. \"VALUE\" MEANS ACCESS TO HIGH-QUALITY HEALTH CARE AT AFFORDABLE COSTS, AS WELL AS ACCESS TO THE FULL CONTINUUM OF HEALTH CARE SERVICES, FROM HEALTH INSURANCE TO OUTPATIENT CARE TO INPATIENT AND HOME CARE, AND EVERYTHING IN BETWEEN. SPECTRUM HEALTH HAS HUNDREDS OF PROGRAMS THAT SUPPORT ITS MISSION \"TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.\" THESE PROGRAMS ARE BROUGHT TOGETHER UNDER NINE KEY AREAS: HEALTHIER COMMUNITIES, EDUCATION, COMMUNITY ENGAGEMENT, RESEARCH, INNOVATION, EMPLOYEE ENGAGEMENT, SUSTAINABILITY, REGIONAL RELATIONSHIPS AND COMMUNITY BENEFIT."},{"form_and_line_reference":"SCHEDULE H, PART VI, LINE 7","explanation":"THE ORGANIZATION IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE HOWEVER THE ORGANIZATION VOLUNTARILY REPORTS COMMUNITY BENEFIT INFORMATION TO THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION AND IN AN ANNUAL MEETING TO THE COMMUNITY. THE COMMUNITY BENEFIT REPORT IS ALSO AVAILABLE ON THE ORGANIZATION'S WEBSITE."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":71600,"reported_domestic_individual_grants":4000,"reported_domestic_org_grants_program_services":71600,"reported_domestic_individual_grants_program_services":4000,"total_501c3_and_government_organizations":1,"total_other_organizations":0,"grants":[{"ein":381358164,"irc_section":"501(C)(3)","cash":71600,"purpose":"PATIENT CENTERED MEDICAL HOME PROJECTS","address_line1":"1840 WEALTHY ST SE","city":"GRAND RAPIDS","state":"MI","zip":"49506","name":"SPECTRUM HEALTH PRIMARY CARE PARTNERS","address":"1840 WEALTHY ST SE, GRAND RAPIDS, MI, 49506"}],"total_domestic_grants":75600,"total_domestic_program_services":75600,"detail_org_grants_total":71600,"detail_domestic_grants_total":71600,"supplemental_information":[{"identifier":"Procedures for monitoring use of grant funds","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"THE ORGANIZATION MONITORS USE OF SPECIFIC PURPOSE FUNDS AND REQUIRES FUND MANAGERS TO SUBMIT ANNUAL STEWARDSHIP REPORTS."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"THE ORGANIZATION MONITORS USE OF SPECIFIC PURPOSE FUNDS AND REQUIRES FUND MANAGERS TO SUBMIT ANNUAL STEWARDSHIP REPORTS.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"independent_consultant":true,"written_employment_contract":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":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"CAROLE MONTGOMERY","title":"DIRECTOR","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":222878,"compensation_based_on_related_orgs":332031,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":145697,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":111835,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":54001,"other_compensation_filing_org":0,"other_compensation_related_orgs":1048,"total_compensation_filing_org":0,"total_compensation_related_orgs":721793,"name":"CAROLE MONTGOMERY"},{"person_name":"DALE TERPSTRA","title":"VP PHYSICAN SERVICES","base_compensation_filing_org":200422,"bonus_filing_org":25184,"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":4492,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":16544,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":1201,"other_compensation_related_orgs":0,"total_compensation_filing_org":247843,"total_compensation_related_orgs":0,"name":"DALE TERPSTRA"},{"person_name":"HENRY VEENSTRA","title":"PRESIDENT","base_compensation_filing_org":218367,"bonus_filing_org":87843,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":37703,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":45613,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":42746,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":3264,"other_compensation_related_orgs":0,"total_compensation_filing_org":397834,"total_compensation_related_orgs":0,"name":"HENRY VEENSTRA"},{"person_name":"JANE CZEREW","title":"VP CLINICAL SVCS & QUALITY","base_compensation_filing_org":124783,"bonus_filing_org":11257,"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":2899,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":17080,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":4744,"other_compensation_related_orgs":0,"total_compensation_filing_org":160763,"total_compensation_related_orgs":0,"name":"JANE CZEREW"},{"person_name":"JOSEPH FIFER","title":"FORMER OFFICER","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":43127,"compensation_based_on_related_orgs":140179,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":43127,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":61079,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":54694,"other_compensation_filing_org":0,"other_compensation_related_orgs":688,"total_compensation_filing_org":0,"total_compensation_related_orgs":299767,"name":"JOSEPH FIFER"},{"person_name":"MARC CHIRCOP","title":"DIRECTOR","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":284273,"compensation_based_on_related_orgs":375829,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":173508,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":126548,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":60311,"other_compensation_filing_org":0,"other_compensation_related_orgs":18690,"total_compensation_filing_org":0,"total_compensation_related_orgs":865650,"name":"MARC CHIRCOP"},{"person_name":"RUEL LIRIO","title":"DIRECTOR","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":243169,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":13750,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":19008,"other_compensation_filing_org":0,"other_compensation_related_orgs":1073,"total_compensation_filing_org":0,"total_compensation_related_orgs":277000,"name":"RUEL LIRIO"},{"person_name":"RYAN POWERS","title":"VP, FINANCE","base_compensation_filing_org":129431,"bonus_filing_org":22605,"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":5323,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":14338,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":815,"other_compensation_related_orgs":0,"total_compensation_filing_org":172513,"total_compensation_related_orgs":0,"name":"RYAN POWERS"},{"person_name":"THOMAS VISSER","title":"DIRECTOR","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":510216,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":13750,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":16399,"other_compensation_filing_org":0,"other_compensation_related_orgs":1448,"total_compensation_filing_org":0,"total_compensation_related_orgs":541814,"name":"THOMAS VISSER"}],"supplemental_information":[{"identifier":"Arrangement used to establish the top management official's compensation","form_and_line_reference":"Schedule J, Part I, Line 3","explanation":"THE SPECTRUM HEALTH SYSTEM BOARD OF DIRECTORS (THROUGH ITS EXECUTIVE COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF THE TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES AT ZEELAND COMMUNITY HOSPITAL. LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON. COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED TO THE EXECUTIVE COMMITTEE IN ADVANCE OF MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM AND, FOR FY 2013 (7/1/12-6/30/13), WAS BASED ON THE FOLLOWING INDEPENDENT SURVEYS OF HEALTH CARE EXECUTIVES AT COMPARABLE HEALTH SYSTEMS, HEALTH PLANS, AND MEDICAL GROUPS: * AMERICAN MEDICAL GROUP ASSOCIATION: 2012 MEDICAL GROUP COMPENSATION & FINANCIAL SURVEY * INTEGRATED HEALTHCARE STRATEGIES: 2012 HEALTH CARE EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2012 EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2012 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY * MEDICAL GROUP MANAGEMENT ASSOCIATION: 2012 MANAGEMENT COMPENSATION SURVEY * SULLIVAN, COTTER AND ASSOCIATES: 2012 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS * SULLIVAN, COTTER AND ASSOCIATES: 2012 PHYSICIAN COMPENSATION AND PRODUCTIVITY SURVEY REPORT * TOWERS WATSON: 2012/2013 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT * TOWERS WATSON: 2012/2013 TOP MANAGEMENT COMPENSATION REPORT * WARREN: 2012 COMPENSATION SURVEY COMPENSATION ADJUSTMENTS ARE APPROVED BY EXECUTIVE COMMITTEE MEMBERS, CONSISTENT WITH THE SPECTRUM HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE EXECUTIVE COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE EXECUTIVE COMMITTEE IS NATIONAL AND REFLECTS THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTHCARE ORGANIZATIONS. SPECTRUM HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTHCARE MARKET PRACTICES. GEOGRAPHIC PAY DIFFERENTIAL AND COST OF LIVING DATA INDICATES CONSISTENCY WITH NATIONAL DATA. THIS PROCESS IS INTENDED TO ASSIST SPECTRUM HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND COMPLYING WITH THE POTENTIAL SPECTRUM HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III)."},{"identifier":"Supplemental nonqualified retirement plan","form_and_line_reference":"Schedule J, Part I, Line 4b","explanation":"$173,508 MARC CHIRCOP $ 43,127 JOSEPH FIFER $145,697 CAROLE MONTGOMERY $ 37,703 HENRY VEENSTRA SCHEDULE J, PART I, LINE 4B IS ANSWERED \"YES\" BECAUSE CERTAIN INDIVIDUALS, WHOSE SALARY AND BENEFITS ARE PAID BY THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION, DO \"PARTICIPATE IN\" A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN SCHEDULE J, PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR."}]},"ScheduleK":{"bond_issues":[{"bond_reference":"A","issuer_ein":386004744,"business_name_line1":"CITY OF ZEELAND HOSPITAL FINANCE AUTHORITY","date_issued":"2012-07-02T00:00:00","issue_price":23465000,"purpose":"REFUND 2004 BONDS","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"CITY OF ZEELAND HOSPITAL FINANCE AUTHORITY"}],"bond_proceeds":[{"bond_reference":"A","total_proceeds":23465000,"gross_proceeds_in_reserve_funds":0,"capitalized_interest":0,"issuance_costs_from_proceeds":0,"credit_enhancement":0,"working_capital_expenditures":0,"capital_expenditures":0,"other_spent_proceeds":23465000,"refunding_escrow":0,"amount_bond_defeased":0,"amount_retired":880000,"amount_unspent":0,"substantial_completion_year":2012,"current_refunding":true,"advance_refunding":false,"final_allocation_made":true,"adequate_books_and_records_maintained":true}],"private_business_use":[{"bond_reference":"A","private_security_or_payment_test":false,"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"management_contract":false,"bond_counsel_management_contracts":false,"research_agreements":false,"bond_counsel_research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false,"change_in_use_bond_financed_property":false,"change_in_use_bond_financed_property_percentage":0.0,"remedial_action_taken":false,"nonqualified_bond_remediated_procedures":true}],"arbitrage":[{"bond_reference":"A","gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"term_of_gic_percentage":0.0,"regulatory_safe_harbor_satisfied":false,"hedge_identified_in_books_and_records":false,"term_of_hedge_percentage":0.0,"superintegrated_hedge":false,"hedge_terminated":false,"variable_rate_issue":true,"written_procedures_to_monitor_requirements":true,"rebate_not_due_yet":false,"exception_to_rebate":false,"no_rebate_due":true,"form_8038t_filed":false}],"corrective_action_procedures":[{"bond_reference":"A","procedures_corrective_action":true}],"supplemental_information":[{"identifier":"DATE ISSUED","form_and_line_reference":"SCHEDULE K, PART I, COLUMN (D)","explanation":"THE 2010 BONDS (ORIGINALLY ISSUED 5/3/2010) WERE AMENDED AND REISSUED ON JULY 2, 2012. THE NAME OF THE AMENDED 2010 BOND ISSUE IS: CITY OF ZEELAND HOSPITAL FINANCE AUTHORITY ADJUSTABLE RATE REVENUE REFUNDING BONDS, SERIES 2010 - REISSUED (ZEELAND COMMUNITY HOSPITAL)."},{"identifier":"ISSUER NAME: City of Zeeland Hospital Finance Authority: No Rebate Due.","form_and_line_reference":"Schedule K, Part IV, Line 2c","explanation":"THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON JULY 2, 2012."}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"business_name_line1":"HUNTINGTON BANK","relationship":"BUSINESS","description":"SEE SCH L, PART V","amount":875581,"sharing_of_revenues":false,"name":"HUNTINGTON BANK"},{"business_name_line1":"MARLENE HOLSTINE","relationship":"FAMILY","description":"SEE SCH L, PART V","amount":84817,"sharing_of_revenues":false,"name":"MARLENE HOLSTINE"},{"business_name_line1":"LORI BRUINS","relationship":"FAMILY","description":"SEE SCH L, PART V","amount":60880,"sharing_of_revenues":false,"name":"LORI BRUINS"},{"business_name_line1":"CHRISTA THELEN","relationship":"FAMILY","description":"SEE SCH L, PART V","amount":37805,"sharing_of_revenues":false,"name":"CHRISTA THELEN"}],"supplemental_information":[{"identifier":"FAMILY & BUSINESS RELATIONSHIPS WITH INTERESTED PERSONS","form_and_line_reference":"SCHEDULE L, PART IV","explanation":"MR. MARK WILSON, A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, IS A DIRECTOR OF A TAXABLE ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH THE ORGANIZATION. (PART IV, LINE 1) MR. STAN KONYNENBELT, A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, HAS A SIBLING THAT WORKS FOR THE ORGANIZATION. (PART IV, LINE 2) MR. HENRY VEENSTRA, AN OFFICER AND MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, HAS A DAUGHTER THAT WORKS FOR THE ORGANIZATION. (PART IV, LINE 3) MR. RANDY THELEN, A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, HAS A SPOUSE THAT WORKS FOR THE ORGANIZATION. (PART IV, LINE 4)"}]},"ScheduleR":{"tax_exempt_organizations":[{"business_name_line1":"SPECTRUM HEALTH SYSTEM","primary_activities":"MANAGEMENT","exempt_code_section":"501(C)(3)","public_charity_status":"11 - Type III - FI","controlled_organization":false,"legal_domicile_state":"MI","direct_controlling_business_name_line1":"NA","address_line1":"100 MICHIGAN ST NE","city":"GRAND RAPIDS","state":"MI","zip":"49503","name":"SPECTRUM HEALTH SYSTEM","address":"100 MICHIGAN ST NE, GRAND RAPIDS, MI, 49503"},{"business_name_line1":"SPECTRUM HEALTH HOSPITALS","primary_activities":"HEALTHCARE","exempt_code_section":"501(C)(3)","public_charity_status":"3","controlled_organization":false,"legal_domicile_state":"MI","direct_controlling_business_name_line1":"SPECTRUM HEALTH SYSTEM","address_line1":"100 MICHIGAN ST NE","city":"GRAND RAPIDS","state":"MI","zip":"49503","name":"SPECTRUM HEALTH HOSPITALS","address":"100 MICHIGAN ST NE, GRAND RAPIDS, MI, 49503"},{"business_name_line1":"SPECTRUM HEALTH 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Using this informational tax return for its intended purpose, the Taxpayer chooses to be fully transparent and share all the costs of providing charity care and community benefits to the communities we serve, which includes charity care, the costs of free or subsidized community programs, bad debt expenses reduced to cost and shortfalls in government reimbursements (Medicare and Medicaid).RATIONAL FOR EXCLUDING (OR REPORTING ZERO) BAD DEBTS (AT COST) IN SCH. H, PART III, LINE 3 The Taxpayer has not identified the amount of bad debt expenses (at cost) attributable to patients eligible for free or discounted services under the financial assistance policy. Although it's certain that a portion of bad debt expenses (at cost) relates to patients who would qualify for charity care (had they provided information to determine eligibility for financial assistance), a reportable figure cannot be reasonably estimated.","community_building_activities":"Part VI, Line 5: The organization participates in a variety of programs including involvement in economic development, community support, coalition building, and community health advocacy.","community_information":"Part VI, Line 4: The Taxpayer has identified a primary service area inclusive of much of Ottawa County and the surrounding Lakeshore region.","debt_collection_policy":"Part III, Line 9b: The Taxpayer cooperatively works with patients having self-pay balances to determine eligibility for financial assistance in accordance with the Financial Assistance Eligibility Policy.","income_based_criteria":"Part I, Line 3c: The Taxpayer may provide discounted care to eligible individuals whose income level is up to 300% of the federal poverty guidelines. 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In addition, the Taxpayer also proactively identified patients who have qualifying factors for governmental assistance and partner with organizations that specialize in the qualification process. If the need for assistance is not identified prior to billing, patient concerns that are received as a result of receiving a bill are addressed by financial counselors at that time.","percent_of_total_expense":"Part I, Line 7f: The Taxpayer has not identified the amount of bad debt expenses (at cost) attributable to patients eligible for free or discounted services under the financial assistance policy. Although it's certain that a portion of bad debt expenses (at cost) relates to patients who would qualify for charity care (had they provided information to determine eligibility for financial assistance), a reportable figure cannot be reasonably estimated.","reports_filed_with_states":"MI","shortfall_as_community_benefit":"Part III, Line 8: The methodology described in the instructions to schedule H, Part III, Section B, Line 6 does not take into account all costs incurred by the hospital and does not represent the total community benefit conferred in this area. Reasons why Medicare shortfall should be treated as community benefit are:(1) absent the Medicare program, it is likely many of the individuals would qualify for charity care or other needs-based government programs;(2) by accepting payment below cost to treat these individuals, the burdens of government are relieved with respect to these individuals; (3) there is a significant possibility that continued reduction in reimbursement may actually create difficulties in access for these individuals; and (4) the amount spent to cover the Medicare shortfall is money not available to cover charity care and other community benefit needs.In determining Medicare shortfalls the Taxpayer uses a ratio of cost to charges. In determining the ratio of cost to charges the Taxpayer adjusts for bad debt expenses, non-patient care activities, Medicaid provider taxes and community benefits accounted for and or reported elsewhere. The ratio of cost to charges is applied to Medicare charges to determine shortfalls in Medicare reimbursements."}},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_individual_grants":9000,"reported_domestic_individual_grants_program_services":9000,"individual_grants":[{"type":"NURSING SCHOLARSHIP","recipient_count":6,"cash":9000,"noncash":0}],"total_domestic_grants":9000,"total_domestic_program_services":9000,"detail_individual_grants_total":9000,"detail_domestic_grants_total":9000,"supplemental_information":[{"identifier":"Procedure for Monitoring Grants in the U.S.:","form_and_line_reference":"Part I, Line 2:","explanation":"Schedule I, Part I, Line 2: GRANTS ARE GIVEN TOWARDS EDUCATION. APPLICANTS SUBMIT THEIR LETTERS OF ACCEPTANCE FROM THEIR SCHOOL. 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We give back to our community by providing community education classes and nutrition services.\n\nFamily practices - spectrum health zeeland community hospital's family practices provide outpatient healthcare at two locations in the community. The staff includes family medicine physicians, obstetricians/gynecologists , and pediatricians who are committed to high standards of patient care and satisfaction. 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WE HAVE PROVIDED PERSONAL, COMPASSIONATE, HIGH-QUALITY HEALTH CARE FOR OVER 80 YEARS AND WE REMAIN COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. WE HAVE AN EXCELLENT NURSE-TO-PATIENT RATIO AND CONTINUALLY INVEST IN THE LATEST MEDICAL TECHNOLOGY. WE PROVIDE HIGH QUALITY, AWARD-WINNING CARE FOR OUR PATIENTS, OUR VISITORS AND OUR EMPLOYEES. WE OFFER ADVANCED INPATIENT, OUTPATIENT AND TESTING SERVICES WITH GENUINE COMPASSION AND UNDERSTANDING. WE GIVE BACK TO OUR COMMUNITY BY PROVIDING COMMUNITY EDUCATION CLASSES AND NUTRITION SERVICES.","expense":29903861,"revenue":43360341},{"description":"FAMILY PRACTICES - SPECTRUM HEALTH ZEELAND COMMUNITY HOSPITAL'S FAMILY PRACTICES PROVIDE OUTPATIENT HEALTHCARE AT TWO LOCATIONS IN THE COMMUNITY. THE STAFF INCLUDES FAMILY MEDICINE PHYSICIANS, OBSTETRICIANS/GYNECOLOGISTS , AND PEDIATRICIANS WHO ARE COMMITTED TO HIGH STANDARDS OF PATIENT CARE AND SATISFACTION. 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ALL PATIENT SEGMENTS AND PAYERS ARE USED IN THE CALCULATION."},{"form_and_line_reference":"Schedule H, Part I, Line 7, column(f)","explanation":"2,358,681"},{"form_and_line_reference":"Schedule H, Part II","explanation":"THE ORGANIZATION PARTICIPATES IN A VARIETY OF PROGRAMS INCLUDING INVOLVEMENT IN ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, COALITION BUILDING, AND COMMUNITY HEALTH ADVOCACY."},{"form_and_line_reference":"Schedule H, Part III, Line 4","explanation":"CONSOLIDATED FINANCIAL STATEMENT FOOTNOTE EXTRACT RELATED TO UNCOLLECTIBLE ACCOUNTS: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE, PAYOR COMPOSITION AND AGING, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTED ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER AMOUNTS DUE FROM THIRD-PARTY PAYORS ARE SATISFIED, AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH EXTERNAL COLLECTION AGENCIES. COSTING METHODOLOGY USED IN DETERMINING THE FIGURES REPORTED IN SCHEDULE H, PART III, SECTION A: ALL CHARGES ARE REPORTED AT GROSS, WHICH IS CONSISTENT WITH THE REPORTING METHODOLOGY USED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. RATIONALE FOR INCLUDING BAD DEBTS (AT GROSS CHARGES) IN SCHEDULE H, PART III, LINE 2: BAD DEBTS REPRESENT AN UNREIMBURSED LIABILITY TO THE ORGANIZATION AND FURTHER DEMONSTRATE HOW, BY ASSUMING THOSE COSTS, THE ORGANIZATION PROVIDES AND FULFILLS A HEALTH NEED IN THE COMMUNITY. IN ADDITION, EMERGENCY CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. SOME SERVICES ARE PROVIDED TO INDIVIDUALS WHO QUALIFY FOR FINANCIAL ASSISTANCE BUT, FOR PERSONAL OR OTHER PRIVATE REASONS, DON'T APPLY FOR FINANCIAL ASSISTANCE. USING THIS INFORMATIONAL TAX RETURN FOR ITS INTENDED PURPOSE, THE ORGANIZATION CHOOSES TO BE FULLY TRANSPARENT AND SHARE ALL OF THE COSTS OF PROVIDING CHARITY CARE AND COMMUNITY BENEFITS TO THE COMMUNITIES WE SERVE, WHICH INCLUDES CHARITY CARE, THE COSTS OF FREE OR SUBSIDIZED COMMUNITY PROGRAMS, BAD DEBT EXPENSES AND SHORTFALLS IN GOVERNMENT REIMBURSEMENTS (MEDICARE AND MEDICAID). RATIONALE FOR REPORTING ZERO ON SCHEDULE H, PART III, LINE 3 (OR RATIONALE FOR EXCLUDING A PORTION OF BAD DEBT AMOUNTS AS COMMUNITY BENEFIT): THE ORGANIZATION HAS NOT IDENTIFIED THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY. ALTHOUGH A PORTION OF BAD DEBT EXPENSES RELATES TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE (HAD THEY PROVIDED INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE), A REPORTABLE FIGURE CANNOT BE REASONABLY ESTIMATED. THE ORGANIZATION IS IN THE PROCESS OF IMPLEMENTING A \"PROPENSITY TO PAY\" EVALUATION TOOL TO PROACTIVELY ASSESS PAYMENT RISK AND USE PREDICTIVE ANALYSIS TO DETERMINE A PATIENT'S LIKELIHOOD TO PAY MEDICAL BILLS. WITH THIS INFORMATION, THE ORGANIZATION WILL BE ABLE TO INITIATE MORE PRODUCTIVE FINANCIAL COUNSELING DISCUSSIONS WHICH WILL ULTIMATELY RESULT IN THE REDUCTION OF PATIENT BAD DEBT."},{"form_and_line_reference":"Schedule H, Part III, Line 8","explanation":"THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. IN DETERMINING MEDICARE SHORTFALLS THE ORGANIZATION USES A RATIO OF COST TO CHARGES. IN DETERMINING THE RATIO OF COST TO CHARGES THE ORGANIZATION ADJUSTS FOR BAD DEBT EXPENSES, NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES AND COMMUNITY BENEFITS ACCOUNTED FOR, AND OR REPORTED, ELSEWHERE. THE RATIO OF COST TO CHARGES IS APPLIED TO MEDICARE CHARGES TO DETERMINE SHORTFALLS IN MEDICARE REIMBURSEMENTS."},{"form_and_line_reference":"Schedule H, Part III, Line 9b","explanation":"THE ORGANIZATION'S COLLECTION POLICY THAT APPLIES TO THE LARGEST NUMBER OF ITS PATIENTS DURING THE TAX YEAR CONTAINS PROVISIONS TO ENSURE COLLECTION ACTIVITY OCCURS ONLY FOR THOSE WHO ARE UNWILLING TO PAY, OPPOSED TO THOSE NOT ABLE. PATIENTS EXPRESSING OR IDENTIFIED AS HAVING INABILITY TO PAY ARE ASSESSED FOR ASSISTANCE."},{"form_and_line_reference":"Schedule H, Part V Section B, Line 10","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 11h","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 13g","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION PUBLICIZES THE FINANCIAL ASSISTANCE POLICY BY COMMUNICATING ITS AVAILABILITY VIA A PATIENT HANDBOOK, SIGNAGE, INFORMATIONAL BROCHURES, COMMUNITY PUBLICATIONS, AND VIA WORD OF MOUTH BY FINANCIAL COUNSELORS ASSISTING PATIENTS. ALTHOUGH THE POLICY ITSELF IS NOT PUBLICLY POSTED IN WAITING ROOMS OR ATTACHED TO BILLS, THERE IS REFERENCE THAT IT IS AVAILABLE. THE ORGANIZATION IS REVIEWING ITS POLICIES COMPARED TO THE REQUIREMENTS OF THE 501(R) PROPOSED REGULATIONS THAT WERE PUBLISHED ON JUNE 22, 2012.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 19d","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.;"},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"THE OTTAWA COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS A SYSTEMATIC PROCESS FOR INVOLVING COMMUNITY PARTNERS IN EXAMINING INDICATORS OF HEALTH IN THE POPULATION, GATHERING INPUT FROM COMMUNITY MEMBERS IDENTIFYING STRATEGIC ISSUES, AND IDENTIFYING STRATEGIC PRIORITIES THAT, IF ADDRESSED, WOULD IMPROVE THE HEALTH OF OTTAWA COUNTY RESIDENTS. THE OVERALL OBJECTIVE OF THIS CHNA IS TO IDENTIFY KEY HEALTH AND HEALTH SERVICE ISSUES IN OTTAWA COUNTY. THE RESULTS WILL BE USED TO ASSIST IN PLANNING, IMPLEMENTATION OF PROGRAMS AND SERVICES, EVALUATING RESULTS, ALLOCATION OF RESOURCES, AND ACHIEVING IMPROVED HEALTH OUTCOMES, SPECIFICALLY RELATED TO IDENTIFIED NEEDS. MORE SPECIFICALLY, OBJECTIVES INCLUDE: * GAUGE THE OVERALL HEALTH CLIMATE OR LANDSCAPE IN OTTAWA COUNTY * DETERMINE POSITIVE AND NEGATIVE HEALTH INDICATORS * IDENTIFY RISK BEHAVIORS * ESTABLISH EXISTING CLINICAL PREVENTIVE PRACTICES * MEASURE THE PREVALENCE OF CHRONIC CONDITIONS * DETERMINE DEGREE/LEVEL OF HEALTH CARE ACCESS * ASCERTAIN BARRIERS AND OBSTACLES TO HEALTH CARE * UNCOVER GAPS IN HEALTH CARE SERVICES OR PROGRAMS * IDENTIFY HEALTH DISPARITIES"},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH PRODUCING INFORMATION CARDS FOR THE UNINSURED, COMMUNITY OUTREACH PROGRAMS, CONSUMER INFORMATION CLASSES, ORGANIZATION WEBSITE, PERSONAL FINANCIAL COUNSELING, AND BY PROVIDING ASSISTANCE IN THE ACTUAL ENROLLMENT OF SUCH PROGRAMS. THE ORGANIZATION HAS A DEPARTMENT OF FINANCIAL COUNSELORS WHO WORK WITH PATIENTS THAT EXPRESS ANY LEVEL OF CONCERN WITH PAYING THEIR BILL. IN ADDITION, THE ORGANIZATION ALSO PROACTIVELY IDENTIFIES PATIENTS WHO HAVE QUALIFYING FACTORS FOR GOVERNMENTAL ASSISTANCE AND PARTNERS WITH ORGANIZATIONS THAT SPECIALIZE IN THE QUALIFICATION PROCESS. IF THE NEED FOR ASSISTANCE IS NOT IDENTIFIED PRIOR TO BILLING, PATIENT CONCERNS THAT ARE RECEIVED AS A RESULT OF RECEIVING A BILL ARE ADDRESSED BY FINANCIAL COUNSELORS AT THAT TIME. THE ORGANIZATION WIDELY PUBLICIZES COMMUNICATIONS TO PATIENTS AND THE PUBLIC ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH VARIOUS METHODS INCLUDING, BUT NOT LIMITED TO, VIA THE SPECTRUM HEALTH PATIENT HANDBOOK, VARIOUS INFORMATIONAL BROCHURES, SIGNAGE IN EACH HOSPITAL DEPARTMENT, ADMISSIONS OFFICES AND OTHER PUBLIC LOCATIONS, UPON REQUEST BY ANY PATIENT, GUARANTOR OR COMMUNITY MEMBER, WORD OF MOUTH VIA FINANCIAL COUNSELORS AND OTHERS, AND THROUGH COMMUNITY PUBLICATIONS AND OUTREACH EVENTS. IN ADDITION, THE ORGANIZATION LISTS OPTIONS FOR THE UNINSURED AND UNDERINSURED ON THEIR WEBSITE, ALONG WITH A COPY OF THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY (SEARCH \"FINANCIAL ASSISTANCE\" AT WWW.SPECTRUMHEALTH.ORG)."},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"THE ORGANIZATION HAS IDENTIFIED A PRIMARY SERVICE AREA INCLUSIVE OF MUCH OF OTTAWA COUNTY AND THE SURROUNDING LAKESHORE REGION."},{"form_and_line_reference":"Schedule H, Part VI, Line 5","explanation":"ZEELAND COMMUNITY HOSPITAL'S BOARD OF DIRECTORS IS COMPOSED OF MEMBERS OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN ZEELAND COMMUNITY HOSPITAL'S PRIMARY SERVICE AREA. ZEELAND COMMUNITY HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON ZEELAND COMMUNITY HOSPITAL TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY."},{"form_and_line_reference":"Schedule H, Part VI, Line 6","explanation":"SPECTRUM HEALTH IS AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM IN WEST MICHIGAN OFFERING A FULL CONTINUUM OF CARE THROUGH THE SPECTRUM HEALTH HOSPITAL GROUP, WHICH IS COMPRISED OF NINE HOSPITALS INCLUDING HELEN DEVOS CHILDREN'S HOSPITAL, A STATE OF THE ART CHILDREN'S HOSPITAL THAT OPENED IN JANUARY 2011, AND 183 SERVICE SITES; THE SPECTRUM HEALTH MEDICAL GROUP AND WEST MICHIGAN HEART, PHYSICIAN GROUPS TOTALING MORE THAN 700 PROVIDERS; AND PRIORITY HEALTH, A HEALTH PLAN WITH 600,000 MEMBERS. SPECTRUM HEALTH IS WEST MICHIGAN'S LARGEST EMPLOYER WITH 19,000 EMPLOYEES. THE ORGANIZATION PROVIDED $204 MILLION IN COMMUNITY BENEFIT DURING ITS 2012 FISCAL YEAR. SPECTRUM HEALTH ZEELAND COMMUNITY HOSPITAL IS A MEMBER OF THE AFFILIATED GROUP OF ENTITIES WITHIN THE SPECTRUM HEALTH SYSTEM (\"SPECTRUM HEALTH\"). EACH MEMBER CREATES VALUE WITHIN ITS RESPECTIVE COMMUNITY AND IS RESPONSIBLE FOR THEIR ACTIONS AND THE IMPACT THESE ACTIONS HAVE. FROM ITS INCEPTION, SPECTRUM HEALTH HAS BEEN A FAITHFUL STEWARD OF ITS COMMUNITY ASSETS. AS A WEST MICHIGAN-BASED NOT-FOR-PROFIT HEALTH SYSTEM, THE ORGANIZATION INVESTS ITS NET EARNINGS TO IMPROVE PATIENT CARE, BUILD AND RENOVATE FACILITIES, PURCHASE NEW TECHNOLOGY, PROVIDE HEALTH EDUCATION AND FUND LOCAL COMMUNITY PROGRAMS. OVER THE YEARS, OUR MISSION HAS REMAINED THE SAME-TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. WE TAKE OUR MISSION SERIOUSLY. IT IS CENTRAL TO OUR STRATEGIC DISCUSSIONS AND GUIDES OUR INVESTMENTS AND THE ALLOCATION OF OUR RESOURCES. SPECTRUM HEALTH IS COMMITTED TO PROVIDING VALUE TO THE PEOPLE WE SERVE. \"VALUE\" MEANS ACCESS TO HIGH-QUALITY HEALTH CARE AT AFFORDABLE COSTS, AS WELL AS ACCESS TO THE FULL CONTINUUM OF HEALTH CARE SERVICES, FROM HEALTH INSURANCE TO OUTPATIENT CARE TO INPATIENT AND HOME CARE, AND EVERYTHING IN BETWEEN. SPECTRUM HEALTH HAS HUNDREDS OF PROGRAMS THAT SUPPORT ITS MISSION \"TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.\" THESE PROGRAMS ARE BROUGHT TOGETHER UNDER NINE KEY AREAS: HEALTHIER COMMUNITIES, EDUCATION, COMMUNITY ENGAGEMENT, RESEARCH, INNOVATION, EMPLOYEE ENGAGEMENT, SUSTAINABILITY, REGIONAL RELATIONSHIPS AND COMMUNITY BENEFIT."}]},"ScheduleI":{"reported_domestic_org_grants":0,"reported_domestic_individual_grants":4000,"reported_domestic_individual_grants_program_services":4000,"total_domestic_grants":4000,"total_domestic_program_services":4000,"grant_monitoring":{"claims_monitoring_procedures":false,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false}},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"independent_consultant":true,"written_employment_contract":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":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"ANNICA WAALKES","base_compensation_filing_org":205806,"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":15760,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":3364,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":321,"other_compensation_related_orgs":0,"total_compensation_filing_org":225251,"total_compensation_related_orgs":0,"name":"ANNICA WAALKES"},{"person_name":"DALE TERPSTRA","base_compensation_filing_org":212986,"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":17011,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":17376,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":868,"other_compensation_related_orgs":0,"total_compensation_filing_org":248240,"total_compensation_related_orgs":0,"name":"DALE TERPSTRA"},{"person_name":"HENRY VEENSTRA","base_compensation_filing_org":199936,"bonus_filing_org":23322,"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":32865,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":38902,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":1757,"other_compensation_related_orgs":0,"total_compensation_filing_org":296781,"total_compensation_related_orgs":0,"name":"HENRY VEENSTRA"},{"person_name":"JOHN DYKSTRA","base_compensation_filing_org":234084,"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":19311,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":16929,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":270324,"total_compensation_related_orgs":0,"name":"JOHN DYKSTRA"},{"person_name":"JOSEPH 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LIRIO","base_compensation_filing_org":242095,"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":18864,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":19786,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":473,"other_compensation_related_orgs":0,"total_compensation_filing_org":281218,"total_compensation_related_orgs":0,"name":"RUEL LIRIO"},{"person_name":"RYAN POWERS","base_compensation_filing_org":126972,"bonus_filing_org":22910,"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":5259,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":14117,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":1587,"other_compensation_related_orgs":0,"total_compensation_filing_org":170845,"total_compensation_related_orgs":0,"name":"RYAN POWERS"},{"person_name":"THOMAS VISSER","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":420421,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":13373,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":16784,"other_compensation_filing_org":0,"other_compensation_related_orgs":1598,"total_compensation_filing_org":0,"total_compensation_related_orgs":452176,"name":"THOMAS VISSER"},{"person_name":"TODD VANHEEST","base_compensation_filing_org":247362,"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":20228,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":19551,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":806,"other_compensation_related_orgs":0,"total_compensation_filing_org":287946,"total_compensation_related_orgs":0,"name":"TODD VANHEEST"}],"supplemental_information":[{"identifier":"Arrangement used to establish the top management official's compensation","form_and_line_reference":"Schedule J, Part I, Line 3","explanation":"THE SPECTRUM HEALTH SYSTEM BOARD OF DIRECTORS (THROUGH ITS EXECUTIVE COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF THE TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES AT ZEELAND COMMUNITY HOSPITAL. LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON. COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED TO THE EXECUTIVE COMMITTEE IN ADVANCE OF MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM AND, FOR FY 2012 (7/1/11-6/30/12), WAS BASED ON THE FOLLOWING INDEPENDENT SURVEYS OF HEALTH CARE EXECUTIVES AT COMPARABLE HEALTH SYSTEMS: * SULLIVAN, COTTER AND ASSOCIATES, INC.: 2011 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS * INTEGRATED HEALTHCARE STRATEGIES: 2011 HEALTHCARE EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2011 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY * TOWERS WATSON DATA SERVICES: 2011/2012 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT THESE SOURCES ARE CONSISTENT WITH THOSE USED IN LAST YEAR'S ANALYSIS. COMPENSATION ADJUSTMENTS ARE APPROVED BY EXECUTIVE COMMITTEE MEMBERS, CONSISTENT WITH THE SPECTRUM HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE EXECUTIVE COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE EXECUTIVE COMMITTEE IS NATIONAL AND REFLECTS THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTHCARE ORGANIZATIONS. SPECTRUM HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTHCARE MARKET PRACTICES. GEOGRAPHIC PAY DIFFERENTIAL AND COST OF LIVING DATA INDICATE CONSISTENCY WITH NATIONAL DATA. THIS PROCESS IS INTENDED TO ASSIST SPECTRUM HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND COMPLYING WITH THE POTENTIAL SPECTRUM HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III)."},{"identifier":"Supplemental nonqualified retirement plan","form_and_line_reference":"Schedule J, Part I, Line 4b","explanation":"$40,380 JOSEPH FIFER SCHEDULE J, PART I, LINE 4B IS ANSWERED \"YES\" BECAUSE CERTAIN INDIVIDUALS, WHOSE SALARY AND BENEFITS ARE PAID BY THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION, DO \"PARTICIPATE IN\" A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. HOWEVER, NOT ALL OF THESE PARTICIPANTS \"RECEIVED PAYMENT FROM\" THESE PLANS DURING THE TAX YEAR."}]},"ScheduleK":{"federal_tax_requirements_compliance":true,"bond_issues":[{"issuer_ein":386004744,"business_name_line1":"CITY OF ZEELAND HOSPITAL FINANCE AUTHORITY","date_issued":"2010-05-03T00:00:00","issue_price":25600000,"purpose":"REFUND 2004 BONDS","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"CITY OF ZEELAND HOSPITAL FINANCE 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FOR THE YEAR ENDED JUNE 30, 2013 IT WAS DETERMINED THAT THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS TO DISCLOSE. AS SUCH, THERE WAS NO FOOTNOTE ADDED TO THE CONSOLIDATED AUDITED 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":false,"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":3117858,"reimbursed_by_medicare":12077255,"cost_of_care_reimbursed_by_medicare":15127581,"medicare_surplus_or_shortfall":-3050326,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":false},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":358504,"net_community_benefit_expense":358504,"total_expense_percentage":0.0079},"unreimbursed_medicaid":{"total_community_benefit_expense":5161260,"direct_offsetting_revenue":3635401,"net_community_benefit_expense":1525859,"total_expense_percentage":0.0336},"unreimbursed_costs":{"net_community_benefit_expense":0,"total_expense_percentage":0.0},"total_financial_assistance":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":5519764,"direct_offsetting_revenue":3635401,"net_community_benefit_expense":1884363,"total_expense_percentage":0.0415},"community_health_services":{"total_community_benefit_expense":225027,"net_community_benefit_expense":225027,"total_expense_percentage":0.005},"health_professions_education":{"total_community_benefit_expense":186973,"net_community_benefit_expense":186973,"total_expense_percentage":0.0041},"subsidized_health_services":{"net_community_benefit_expense":0,"total_expense_percentage":0.0},"research":{"net_community_benefit_expense":0,"total_expense_percentage":0.0},"cash_and_inkind_contributions":{"total_community_benefit_expense":26407,"net_community_benefit_expense":26407,"total_expense_percentage":0.0006},"total_other_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":438407,"direct_offsetting_revenue":0,"net_community_benefit_expense":438407,"total_expense_percentage":0.0097},"total_community_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":5958171,"direct_offsetting_revenue":3635401,"net_community_benefit_expense":2322770,"total_expense_percentage":0.0512}},"community_building":{"physical_improvements_and_housing":{"net_community_benefit_expense":0,"total_expense_percentage":0.0},"economic_development":{"total_community_benefit_expense":4250,"net_community_benefit_expense":4250,"total_expense_percentage":0.0},"community_support":{"total_community_benefit_expense":16773,"net_community_benefit_expense":16773,"total_expense_percentage":0.0004},"environmental_improvements":{"net_community_benefit_expense":0,"total_expense_percentage":0.0},"leadership_development":{"net_community_benefit_expense":0,"total_expense_percentage":0.0},"coalition_building":{"total_community_benefit_expense":975,"net_community_benefit_expense":975,"total_expense_percentage":0.0},"health_improvement_advocacy":{"total_community_benefit_expense":6494,"net_community_benefit_expense":6494,"total_expense_percentage":0.0001},"workforce_development":{"net_community_benefit_expense":0,"total_expense_percentage":0.0},"other_community_building_activities":{"net_community_benefit_expense":0,"total_expense_percentage":0.0},"total_community_building_activities":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":28492,"direct_offsetting_revenue":0,"net_community_benefit_expense":28492,"total_expense_percentage":0.0006}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"ZEELAND COMMUNITY HOSPITAL","address_line1":"8333 FELCH ST","city":"ZEELAND","state":"MI","zip":"49464","website":"HTTP://WWW.SPECTRUMHEALTH.ORG/ZEELAND","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"ZEELAND COMMUNITY HOSPITAL","address":"8333 FELCH ST, ZEELAND, MI, 49464"}],"facility_policies":[{"business_name_line1":"ZEELAND COMMUNITY HOSPITAL","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":11,"took_into_account_others_input":true,"chna_conducted_with_other_facilities":true,"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":true,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":true,"fpg_family_income_limit_free_care_percentage":200.0,"fpg_used_determine_discounted_care":false,"other_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,"other_publicity":true,"fap_actions_on_nonpayment":true,"collection_activities":false,"provided_written_notice":true,"made_effort_orally_notify":true,"processed_fap_application":true,"nondiscriminatory_emergency_care_policy":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":"ZEELAND COMMUNITY HOSPITAL"}],"supplemental_information":[{"form_and_line_reference":"Schedule H, Part I, Line 3c","explanation":"THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE."},{"form_and_line_reference":"Schedule H, Part I, Line 6a","explanation":"SPECTRUM HEALTH SYSTEM (EIN 38-3382353)"},{"form_and_line_reference":"SCHEDULE H, PART I, LINE 6A","explanation":"THE HOSPITAL REGULARLY PUBLISHES ITS \"WELL FOR LIFE\" NEWSLETTER THAT INCLUDES, AMONG OTHER PERTINENT HEALTH AND WELLNESS INFORMATION, SUMMARY FINANCIAL RESULTS INCLUDING COMMUNITY BENEFIT AND CHARITY CARE ACTIVITY. THE CONSOLIDATED HEALTH SYSTEM PUBLISHES A CONSOLIDATED COMMUNITY BENEFIT REPORT ON ITS WEBSITE AT WWW.SPECTRUMHEALTH.ORG (CLICK THE LINK TITLED \"ABOUT US\"). IN ADDITION, THE HEALTH SYSTEM HOLDS AN ANNUAL MEETING TO THE PUBLIC TO DISCUSS ITS COMMUNITY COMMITMENTS."},{"form_and_line_reference":"Schedule H, Part I, Line 7","explanation":"THE ORGANIZATION CALCULATES AN OVERALL COST-TO-CHARGE RATIO DERIVED BY USING THE IRS WORKSHEET 2 FORMAT, RATIO OF PATIENT CARE COST-TO-CHARGES. ALL PATIENT SEGMENTS AND PAYERS ARE USED IN THE CALCULATION."},{"form_and_line_reference":"Schedule H, Part I, Line 7, column(f)","explanation":"3,117,858"},{"form_and_line_reference":"Schedule H, Part II","explanation":"THE ORGANIZATION PARTICIPATES IN A VARIETY OF PROGRAMS INCLUDING INVOLVEMENT IN ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, COALITION BUILDING, AND COMMUNITY HEALTH ADVOCACY. DURING FY2013 THE ORGANIZATION FUNDED COMMUNITY GROUPS THROUGH ZEELAND ACTION COALITION, TOBACCO FREE PARTNERS, AND OTTAWA SUBSTANCE ABUSE COALITION."},{"form_and_line_reference":"Schedule H, Part III, Line 2","explanation":"THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE, PAYOR COMPOSITION AND AGING, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTED ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR THIRD-PARTY PAYERS, THE PROVISION IS DETERMINED BY ANALYZING CONTRACTUALLY DUE AMOUNTS FROM PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES. FOR SELF-PAY PATIENTS, THE PROVISION IS BASED ON AN ANALYSIS OF PAST EXPERIENCE RELATED TO PATIENTS UNWILLING TO PAY STANDARD RATES CHARGED. THE DIFFERENCE BETWEEN THAT STANDARD RATE CHARGED (LESS THE NEGOTIATE DISCOUNTED RATE) AND THE AMOUNT ACTUALLY COLLECTED AFTER THE REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ALL CHARGES ARE REPORTED AT GROSS, WHICH IS CONSISTENT WITH THE REPORTING METHODOLOGY USED IN THE ORGANIZATION'S FINANCIAL STATEMENTS."},{"form_and_line_reference":"Schedule H, Part III, Line 3","explanation":"THE ORGANIZATION IS UNABLE TO ESTIMATE ACCURATELY THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY. ALTHOUGH A PORTION OF BAD DEBT EXPENSES MAY RELATE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE, A REPORTABLE FIGURE CANNOT BE REASONABLY ESTIMATED. THE ORGANIZATION HAS IMPLEMENTED A \"PROPENSITY TO PAY\" EVALUATION TOOL THAT PROACTIVELY ASSESSES ONE'S ABILITY AND LIKELIHOOD TO PAY. WITH THIS TOOL, THE ORGANIZATION HAS BEEN ABLE TO PROVIDE A HIGHER DEGREE OF FOCUSED FINANCIAL COUNSELING EFFORTS, RESULTING IN A SUBSTANTIAL REDUCTION OF BAD DEBT AND HIGHER RATE OF IDENTIFICATION OF CHARITY ACCOUNTS."},{"form_and_line_reference":"Schedule H, Part III, Line 4","explanation":"THE NET PATIENT SERVICE REVENUE, PATIENT ACCOUNTS RECEIVABLE, AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOOTNOTE IS ON PAGES 14 TO 16 OF THE ORGANIZATIONS CONSOLIDATED FINANCIAL STATEMENT."},{"form_and_line_reference":"Schedule H, Part III, Line 8","explanation":"THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. IN DETERMINING MEDICARE SHORTFALLS THE ORGANIZATION USES A RATIO OF COST TO CHARGES. IN DETERMINING THE RATIO OF COST TO CHARGES THE ORGANIZATION ADJUSTS FOR BAD DEBT EXPENSES, NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES AND COMMUNITY BENEFITS ACCOUNTED FOR, AND OR REPORTED, ELSEWHERE. THE RATIO OF COST TO CHARGES IS APPLIED TO MEDICARE CHARGES TO DETERMINE SHORTFALLS IN MEDICARE REIMBURSEMENTS."},{"form_and_line_reference":"SCHEDULE H, PART III, LINE 9B","explanation":"THE ORGANIZATION PROVIDES FREE CARE TO ALL PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE WILL NOT OWE ANYTHING, AND THUS WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES."},{"form_and_line_reference":"Schedule H, Part V Section B, Line 3","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - DATA WAS GATHERED FROM A VARIETY OF SOURCES AND USING MULTIPLE METHODOLOGIES. RESIDENT FEEDBACK WAS OBTAINED VIA A BEHAVIORAL RISK FACTOR SURVEY AND FOCUS GROUPS. THIS FEEDBACK WAS OBTAINED FROM COMMUNITY RESIDENTS INCLUDING PROVIDERS, LOW INCOME, HISPANIC, SENIOR ADULTS AND AT-HOME PARENTS. HEALTH CARE PROFESSIONALS AND OTHER COMMUNITY LEADERS, KNOWN AS KEY STAKEHOLDERS OR KEY INFORMANTS, PROVIDED INPUT VIA IN-DEPTH INTERVIEWS AND AN ONLINE SURVEY. SECONDARY DATA GATHERED FROM STATE AND NATIONAL DATABASES WAS ALSO USED TO SUPPLEMENT THE OVERALL FINDINGS. MANY EXPERTS ON PUBLIC HEALTH WERE CONSULTED AS MEMBERS OF THE CHNA TASK FORCE INCLUDING OTTAWA COUNTY HEALTH DEPARTMENT, GREATER OTTAWA COUNTY UNITED WAY, HOLLAND HOSPITAL, AND NORTH OTTAWA COMMUNITY HEALTH SYSTEM. FOR A LISTING OF ALL INDIVIDUALS AND SOURCES CONSULTED, SEE THE OTTAWA COUNTY CHNA. ADDITIONALLY KEY STAKEHOLDERS WHO WERE INTERVIEWED ARE DEFINED AS EXECUTIVE-LEVEL COMMUNITY LEADERS HAVING EXTENSIVE KNOWLEDGE AND EXPERTISE ON PUBLIC HEALTH ISSUES AND ARE OFTEN INVOLVED IN POLICY DECISION MAKING. KEY INFORMANTS WHO PARTICIPATED IN THE ONLINE SURVEY ARE DEFINED AS COMMUNITY LEADERS HAVING EXTENSIVE KNOWLEDGE AND EXPERTISE ON PUBLIC HEALTH ISSUES OR HAVE EXPERIENCE WITH SUBPOPULATIONS IMPACTED MOST BY ISSUES IN HEALTH CARE.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 4","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - HOLLAND HOSPITAL NORTH OTTAWA COMMUNITY HEALTH SYSTEM ;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 11","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 12h","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 14g","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION PUBLICIZES THE FINANCIAL ASSISTANCE POLICY BY COMMUNICATING ITS AVAILABILITY VIA A PATIENT HANDBOOK, SIGNAGE, INFORMATIONAL BROCHURES, COMMUNITY PUBLICATIONS, AND VIA WORD OF MOUTH BY FINANCIAL COUNSELORS ASSISTING PATIENTS. REFERENCE TO THE AVAILABILITY OF THE POLICY IS PUBLICLY POSTED IN WAITING ROOMS. ;"},{"form_and_line_reference":"Schedule H, Part V Section B, Line 20d","explanation":"(1) ZEELAND COMMUNITY HOSPITAL - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.;"},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"THE CHNA DATA PROVIDES A LEVEL FOUNDATION ON WHICH TO PLAN, DEVELOP, AND IMPLEMENT NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF OUR COMMUNITY. OPERATIONAL SERVICES IDENTIFIED BY THE CHNA, E.G. MEDICAL CLINIC, HAVE BEEN BUILT INTO THE STRATEGIC PLAN AND BUDGET, AND A RECRUITMENT PLAN HAS BEEN CREATED BASED ON CONVERSATIONS AROUND THE COMMUNITY BENEFIT DOLLARS. THE CHNA AND IMPLEMENTATION PLAN IS LOCATED AT: HTTP://WWW.SPECTRUMHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-4450 SPECTRUM HEALTH ALSO PREPARES AN ANNUAL CORPORATE SOCIAL RESPONSIBILITY REPORT THAT FOCUSES ON NINE KEY AREAS: HEALTHIER COMMUNITIES, EDUCATION, COMMUNITY ENGAGEMENT, RESEARCH, INNOVATION, EMPLOYEE ENGAGEMENT, SUSTAINABILITY, REGIONAL RELATIONSHIPS AND COMMUNITY BENEFIT."},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH PRODUCING INFORMATION CARDS FOR THE UNINSURED, COMMUNITY OUTREACH PROGRAMS, CONSUMER INFORMATION CLASSES, ORGANIZATION WEBSITE, PERSONAL FINANCIAL COUNSELING, AND BY PROVIDING ASSISTANCE IN THE ACTUAL ENROLLMENT OF SUCH PROGRAMS. THE ORGANIZATION HAS A DEPARTMENT OF FINANCIAL COUNSELORS WHO WORK WITH PATIENTS THAT EXPRESS ANY LEVEL OF CONCERN WITH PAYING THEIR BILL. IN ADDITION, THE ORGANIZATION ALSO PROACTIVELY IDENTIFIES PATIENTS WHO HAVE QUALIFYING FACTORS FOR GOVERNMENTAL ASSISTANCE AND PARTNERS WITH ORGANIZATIONS THAT SPECIALIZE IN THE QUALIFICATION PROCESS. IF THE NEED FOR ASSISTANCE IS NOT IDENTIFIED PRIOR TO BILLING, PATIENT CONCERNS THAT ARE RECEIVED AS A RESULT OF RECEIVING A BILL ARE ADDRESSED BY FINANCIAL COUNSELORS AT THAT TIME. THE ORGANIZATION WIDELY PUBLICIZES COMMUNICATIONS TO PATIENTS AND THE PUBLIC ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH VARIOUS METHODS INCLUDING, BUT NOT LIMITED TO, VIA THE SPECTRUM HEALTH PATIENT HANDBOOK, VARIOUS INFORMATIONAL BROCHURES, SIGNAGE IN EACH HOSPITAL DEPARTMENT, ADMISSIONS OFFICES AND OTHER PUBLIC LOCATIONS, UPON REQUEST BY ANY PATIENT, GUARANTOR OR COMMUNITY MEMBER, WORD OF MOUTH VIA FINANCIAL COUNSELORS AND OTHERS, AND THROUGH COMMUNITY PUBLICATIONS AND OUTREACH EVENTS. IN ADDITION, THE ORGANIZATION LISTS OPTIONS FOR THE UNINSURED AND UNDERINSURED ON THEIR WEBSITE, ALONG WITH A COPY OF THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY (SEARCH \"FINANCIAL ASSISTANCE\" AT WWW.SPECTRUMHEALTH.ORG)."},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"THE ORGANIZATION HAS IDENTIFIED A PRIMARY SERVICE AREA INCLUSIVE OF MUCH OF OTTAWA COUNTY AND THE SURROUNDING LAKESHORE REGION. FOR SPECIFIC POPULATION STATISTICS SEE THE COMMUNITY HEALTH NEEDS ASSESSMENT ACCESSIBLE AT HTTP://WWW.SPECTRUMHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-4450"},{"form_and_line_reference":"Schedule H, Part VI, Line 5","explanation":"ZEELAND COMMUNITY HOSPITAL'S BOARD OF DIRECTORS IS COMPOSED OF MEMBERS OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN ZEELAND COMMUNITY HOSPITAL'S PRIMARY SERVICE AREA. ZEELAND COMMUNITY HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. ZEELAND COMMUNITY HOSPITAL INVESTS NET EARNINGS IN IMPROVING PATIENT CARE, BUILDING AND RENOVATING FACILITIES, PURCHASING NEW TECHNOLOGY, PROVIDING HEALTH EDUCATION AND FUNDING COMMUNITY PROGRAMS. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON ZEELAND COMMUNITY HOSPITAL TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY."},{"form_and_line_reference":"Schedule H, Part VI, Line 6","explanation":"SPECTRUM HEALTH IS AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM IN WEST MICHIGAN OFFERING A FULL CONTINUUM OF CARE THROUGH THE SPECTRUM HEALTH HOSPITAL GROUP, WHICH IS COMPRISED OF NINE HOSPITALS INCLUDING HELEN DEVOS CHILDREN'S HOSPITAL, A STATE OF THE ART CHILDREN'S HOSPITAL THAT OPENED IN JANUARY 2011, AND 183 SERVICE SITES; THE SPECTRUM HEALTH MEDICAL GROUP AND WEST MICHIGAN HEART, PHYSICIAN GROUPS TOTALING MORE THAN 700 PROVIDERS; AND PRIORITY HEALTH, A HEALTH PLAN WITH 600,000 MEMBERS. SPECTRUM HEALTH IS WEST MICHIGAN'S LARGEST EMPLOYER WITH 19,000 EMPLOYEES. THE ORGANIZATION PROVIDED $250 MILLION IN COMMUNITY BENEFIT DURING ITS 2013 FISCAL YEAR. SPECTRUM HEALTH ZEELAND COMMUNITY HOSPITAL IS A MEMBER OF THE AFFILIATED GROUP OF ENTITIES WITHIN THE SPECTRUM HEALTH SYSTEM (\"SPECTRUM HEALTH\"). EACH MEMBER CREATES VALUE WITHIN ITS RESPECTIVE COMMUNITY AND IS RESPONSIBLE FOR THEIR ACTIONS AND THE IMPACT THESE ACTIONS HAVE. FROM ITS INCEPTION, SPECTRUM HEALTH HAS BEEN A FAITHFUL STEWARD OF ITS COMMUNITY ASSETS. AS A WEST MICHIGAN-BASED NOT-FOR-PROFIT HEALTH SYSTEM, THE ORGANIZATION INVESTS ITS NET EARNINGS TO IMPROVE PATIENT CARE, BUILD AND RENOVATE FACILITIES, PURCHASE NEW TECHNOLOGY, PROVIDE HEALTH EDUCATION AND FUND LOCAL COMMUNITY PROGRAMS. OVER THE YEARS, OUR MISSION HAS REMAINED THE SAME-TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. WE TAKE OUR MISSION SERIOUSLY. IT IS CENTRAL TO OUR STRATEGIC DISCUSSIONS AND GUIDES OUR INVESTMENTS AND THE ALLOCATION OF OUR RESOURCES. SPECTRUM HEALTH IS COMMITTED TO PROVIDING VALUE TO THE PEOPLE WE SERVE. \"VALUE\" MEANS ACCESS TO HIGH-QUALITY HEALTH CARE AT AFFORDABLE COSTS, AS WELL AS ACCESS TO THE FULL CONTINUUM OF HEALTH CARE SERVICES, FROM HEALTH INSURANCE TO OUTPATIENT CARE TO INPATIENT AND HOME CARE, AND EVERYTHING IN BETWEEN. SPECTRUM HEALTH HAS HUNDREDS OF PROGRAMS THAT SUPPORT ITS MISSION \"TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.\" THESE PROGRAMS ARE BROUGHT TOGETHER UNDER NINE KEY AREAS: HEALTHIER COMMUNITIES, EDUCATION, COMMUNITY ENGAGEMENT, RESEARCH, INNOVATION, EMPLOYEE ENGAGEMENT, SUSTAINABILITY, REGIONAL RELATIONSHIPS AND COMMUNITY BENEFIT."},{"form_and_line_reference":"SCHEDULE H, PART VI, LINE 7","explanation":"THE ORGANIZATION IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE HOWEVER THE ORGANIZATION VOLUNTARILY REPORTS COMMUNITY BENEFIT INFORMATION TO THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION AND IN AN ANNUAL MEETING TO THE COMMUNITY. THE COMMUNITY BENEFIT REPORT IS ALSO AVAILABLE ON THE ORGANIZATION'S WEBSITE."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":71600,"reported_domestic_individual_grants":4000,"reported_domestic_org_grants_program_services":71600,"reported_domestic_individual_grants_program_services":4000,"total_501c3_and_government_organizations":1,"total_other_organizations":0,"grants":[{"ein":381358164,"irc_section":"501(C)(3)","cash":71600,"purpose":"PATIENT CENTERED MEDICAL HOME PROJECTS","address_line1":"1840 WEALTHY ST SE","city":"GRAND RAPIDS","state":"MI","zip":"49506","name":"SPECTRUM HEALTH PRIMARY CARE PARTNERS","address":"1840 WEALTHY ST SE, GRAND RAPIDS, MI, 49506"}],"total_domestic_grants":75600,"total_domestic_program_services":75600,"detail_org_grants_total":71600,"detail_domestic_grants_total":71600,"supplemental_information":[{"identifier":"Procedures for monitoring use of grant funds","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"THE ORGANIZATION MONITORS USE OF SPECIFIC PURPOSE FUNDS AND REQUIRES FUND MANAGERS TO SUBMIT ANNUAL STEWARDSHIP REPORTS."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"THE ORGANIZATION MONITORS USE OF SPECIFIC PURPOSE FUNDS AND REQUIRES FUND MANAGERS TO SUBMIT ANNUAL STEWARDSHIP REPORTS.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"independent_consultant":true,"written_employment_contract":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":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"CAROLE MONTGOMERY","title":"DIRECTOR","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":222878,"compensation_based_on_related_orgs":332031,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":145697,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":111835,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":54001,"other_compensation_filing_org":0,"other_compensation_related_orgs":1048,"total_compensation_filing_org":0,"total_compensation_related_orgs":721793,"name":"CAROLE MONTGOMERY"},{"person_name":"DALE TERPSTRA","title":"VP PHYSICAN SERVICES","base_compensation_filing_org":200422,"bonus_filing_org":25184,"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":4492,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":16544,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":1201,"other_compensation_related_orgs":0,"total_compensation_filing_org":247843,"total_compensation_related_orgs":0,"name":"DALE TERPSTRA"},{"person_name":"HENRY VEENSTRA","title":"PRESIDENT","base_compensation_filing_org":218367,"bonus_filing_org":87843,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":37703,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":45613,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":42746,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":3264,"other_compensation_related_orgs":0,"total_compensation_filing_org":397834,"total_compensation_related_orgs":0,"name":"HENRY VEENSTRA"},{"person_name":"JANE CZEREW","title":"VP CLINICAL SVCS & QUALITY","base_compensation_filing_org":124783,"bonus_filing_org":11257,"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":2899,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":17080,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":4744,"other_compensation_related_orgs":0,"total_compensation_filing_org":160763,"total_compensation_related_orgs":0,"name":"JANE CZEREW"},{"person_name":"JOSEPH FIFER","title":"FORMER OFFICER","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":43127,"compensation_based_on_related_orgs":140179,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":43127,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":61079,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":54694,"other_compensation_filing_org":0,"other_compensation_related_orgs":688,"total_compensation_filing_org":0,"total_compensation_related_orgs":299767,"name":"JOSEPH FIFER"},{"person_name":"MARC CHIRCOP","title":"DIRECTOR","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":284273,"compensation_based_on_related_orgs":375829,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":173508,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":126548,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":60311,"other_compensation_filing_org":0,"other_compensation_related_orgs":18690,"total_compensation_filing_org":0,"total_compensation_related_orgs":865650,"name":"MARC CHIRCOP"},{"person_name":"RUEL LIRIO","title":"DIRECTOR","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":243169,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":13750,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":19008,"other_compensation_filing_org":0,"other_compensation_related_orgs":1073,"total_compensation_filing_org":0,"total_compensation_related_orgs":277000,"name":"RUEL LIRIO"},{"person_name":"RYAN POWERS","title":"VP, FINANCE","base_compensation_filing_org":129431,"bonus_filing_org":22605,"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":5323,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":14338,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":815,"other_compensation_related_orgs":0,"total_compensation_filing_org":172513,"total_compensation_related_orgs":0,"name":"RYAN POWERS"},{"person_name":"THOMAS VISSER","title":"DIRECTOR","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":510216,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":13750,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":16399,"other_compensation_filing_org":0,"other_compensation_related_orgs":1448,"total_compensation_filing_org":0,"total_compensation_related_orgs":541814,"name":"THOMAS VISSER"}],"supplemental_information":[{"identifier":"Arrangement used to establish the top management official's compensation","form_and_line_reference":"Schedule J, Part I, Line 3","explanation":"THE SPECTRUM HEALTH SYSTEM BOARD OF DIRECTORS (THROUGH ITS EXECUTIVE COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF THE TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES AT ZEELAND COMMUNITY HOSPITAL. LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON. COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED TO THE EXECUTIVE COMMITTEE IN ADVANCE OF MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM AND, FOR FY 2013 (7/1/12-6/30/13), WAS BASED ON THE FOLLOWING INDEPENDENT SURVEYS OF HEALTH CARE EXECUTIVES AT COMPARABLE HEALTH SYSTEMS, HEALTH PLANS, AND MEDICAL GROUPS: * AMERICAN MEDICAL GROUP ASSOCIATION: 2012 MEDICAL GROUP COMPENSATION & FINANCIAL SURVEY * INTEGRATED HEALTHCARE STRATEGIES: 2012 HEALTH CARE EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2012 EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2012 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY * MEDICAL GROUP MANAGEMENT ASSOCIATION: 2012 MANAGEMENT COMPENSATION SURVEY * SULLIVAN, COTTER AND ASSOCIATES: 2012 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS * SULLIVAN, COTTER AND ASSOCIATES: 2012 PHYSICIAN COMPENSATION AND PRODUCTIVITY SURVEY REPORT * TOWERS WATSON: 2012/2013 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT * TOWERS WATSON: 2012/2013 TOP MANAGEMENT COMPENSATION REPORT * WARREN: 2012 COMPENSATION SURVEY COMPENSATION ADJUSTMENTS ARE APPROVED BY EXECUTIVE COMMITTEE MEMBERS, CONSISTENT WITH THE SPECTRUM HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE EXECUTIVE COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE EXECUTIVE COMMITTEE IS NATIONAL AND REFLECTS THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTHCARE ORGANIZATIONS. SPECTRUM HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTHCARE MARKET PRACTICES. GEOGRAPHIC PAY DIFFERENTIAL AND COST OF LIVING DATA INDICATES CONSISTENCY WITH NATIONAL DATA. THIS PROCESS IS INTENDED TO ASSIST SPECTRUM HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND COMPLYING WITH THE POTENTIAL SPECTRUM HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III)."},{"identifier":"Supplemental nonqualified retirement plan","form_and_line_reference":"Schedule J, Part I, Line 4b","explanation":"$173,508 MARC CHIRCOP $ 43,127 JOSEPH FIFER $145,697 CAROLE MONTGOMERY $ 37,703 HENRY VEENSTRA SCHEDULE J, PART I, LINE 4B IS ANSWERED \"YES\" BECAUSE CERTAIN INDIVIDUALS, WHOSE SALARY AND BENEFITS ARE PAID BY THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION, DO \"PARTICIPATE IN\" A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN SCHEDULE J, PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR."}]},"ScheduleK":{"bond_issues":[{"bond_reference":"A","issuer_ein":386004744,"business_name_line1":"CITY OF ZEELAND HOSPITAL FINANCE AUTHORITY","date_issued":"2012-07-02T00:00:00","issue_price":23465000,"purpose":"REFUND 2004 BONDS","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"CITY OF ZEELAND HOSPITAL FINANCE AUTHORITY"}],"bond_proceeds":[{"bond_reference":"A","total_proceeds":23465000,"gross_proceeds_in_reserve_funds":0,"capitalized_interest":0,"issuance_costs_from_proceeds":0,"credit_enhancement":0,"working_capital_expenditures":0,"capital_expenditures":0,"other_spent_proceeds":23465000,"refunding_escrow":0,"amount_bond_defeased":0,"amount_retired":880000,"amount_unspent":0,"substantial_completion_year":2012,"current_refunding":true,"advance_refunding":false,"final_allocation_made":true,"adequate_books_and_records_maintained":true}],"private_business_use":[{"bond_reference":"A","private_security_or_payment_test":false,"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"management_contract":false,"bond_counsel_management_contracts":false,"research_agreements":false,"bond_counsel_research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false,"change_in_use_bond_financed_property":false,"change_in_use_bond_financed_property_percentage":0.0,"remedial_action_taken":false,"nonqualified_bond_remediated_procedures":true}],"arbitrage":[{"bond_reference":"A","gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"term_of_gic_percentage":0.0,"regulatory_safe_harbor_satisfied":false,"hedge_identified_in_books_and_records":false,"term_of_hedge_percentage":0.0,"superintegrated_hedge":false,"hedge_terminated":false,"variable_rate_issue":true,"written_procedures_to_monitor_requirements":true,"rebate_not_due_yet":false,"exception_to_rebate":false,"no_rebate_due":true,"form_8038t_filed":false}],"corrective_action_procedures":[{"bond_reference":"A","procedures_corrective_action":true}],"supplemental_information":[{"identifier":"DATE ISSUED","form_and_line_reference":"SCHEDULE K, PART I, COLUMN (D)","explanation":"THE 2010 BONDS (ORIGINALLY ISSUED 5/3/2010) WERE AMENDED AND REISSUED ON JULY 2, 2012. THE NAME OF THE AMENDED 2010 BOND ISSUE IS: CITY OF ZEELAND HOSPITAL FINANCE AUTHORITY ADJUSTABLE RATE REVENUE REFUNDING BONDS, SERIES 2010 - REISSUED (ZEELAND COMMUNITY HOSPITAL)."},{"identifier":"ISSUER NAME: City of Zeeland Hospital Finance Authority: No Rebate Due.","form_and_line_reference":"Schedule K, Part IV, Line 2c","explanation":"THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON JULY 2, 2012."}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"business_name_line1":"HUNTINGTON BANK","relationship":"BUSINESS","description":"SEE SCH L, PART V","amount":875581,"sharing_of_revenues":false,"name":"HUNTINGTON BANK"},{"business_name_line1":"MARLENE HOLSTINE","relationship":"FAMILY","description":"SEE SCH L, PART V","amount":84817,"sharing_of_revenues":false,"name":"MARLENE HOLSTINE"},{"business_name_line1":"LORI BRUINS","relationship":"FAMILY","description":"SEE SCH L, PART V","amount":60880,"sharing_of_revenues":false,"name":"LORI BRUINS"},{"business_name_line1":"CHRISTA THELEN","relationship":"FAMILY","description":"SEE SCH L, PART V","amount":37805,"sharing_of_revenues":false,"name":"CHRISTA THELEN"}],"supplemental_information":[{"identifier":"FAMILY & BUSINESS RELATIONSHIPS WITH INTERESTED PERSONS","form_and_line_reference":"SCHEDULE L, PART IV","explanation":"MR. MARK WILSON, A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, IS A DIRECTOR OF A TAXABLE ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH THE ORGANIZATION. (PART IV, LINE 1) MR. STAN KONYNENBELT, A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, HAS A SIBLING THAT WORKS FOR THE ORGANIZATION. (PART IV, LINE 2) MR. HENRY VEENSTRA, AN OFFICER AND MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, HAS A DAUGHTER THAT WORKS FOR THE ORGANIZATION. (PART IV, LINE 3) MR. RANDY THELEN, A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, HAS A SPOUSE THAT WORKS FOR THE ORGANIZATION. (PART IV, LINE 4)"}]},"ScheduleR":{"tax_exempt_organizations":[{"business_name_line1":"SPECTRUM HEALTH SYSTEM","primary_activities":"MANAGEMENT","exempt_code_section":"501(C)(3)","public_charity_status":"11 - Type III - FI","controlled_organization":false,"legal_domicile_state":"MI","direct_controlling_business_name_line1":"NA","address_line1":"100 MICHIGAN ST NE","city":"GRAND RAPIDS","state":"MI","zip":"49503","name":"SPECTRUM HEALTH SYSTEM","address":"100 MICHIGAN ST NE, GRAND RAPIDS, MI, 49503"},{"business_name_line1":"SPECTRUM HEALTH HOSPITALS","primary_activities":"HEALTHCARE","exempt_code_section":"501(C)(3)","public_charity_status":"3","controlled_organization":false,"legal_domicile_state":"MI","direct_controlling_business_name_line1":"SPECTRUM HEALTH SYSTEM","address_line1":"100 MICHIGAN ST NE","city":"GRAND RAPIDS","state":"MI","zip":"49503","name":"SPECTRUM HEALTH HOSPITALS","address":"100 MICHIGAN ST NE, GRAND RAPIDS, MI, 49503"},{"business_name_line1":"SPECTRUM HEALTH 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