Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2011 and ending 06-30-2012
BCheck if applicable:
CName of organization
MUNSON MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 1188
 
Room/suite
City or town, state or country, and ZIP + 4
TRAVERSE CITY, MI496851188
D Employer identification number

38-1362830
E Telephone number

G Gross receipts $ 473,734,862
F Name and address of principal officer:
EDWIN A NESS
1105 SIXTH ST
TRAVERSE CITY,MI49684
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MUNSONHEALTHCARE.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1947
M State of legal domicile: MI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON MEDICAL CENTER EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 20
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 13
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 4,174
6 Total number of volunteers (estimate if necessary) .... 6 359
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 2,999
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 1,195
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,661,786 2,890,667
9 Program service revenue (Part VIII, line 2g) ......... 445,989,729 455,632,762
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 10,773,131 10,157,619
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 4,820,790 4,847,918
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 463,245,436 473,528,966
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 50,294 273,071
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 220,681,498 220,279,573
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet500,274    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 205,231,661 215,244,905
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 425,963,453 435,797,549
19 Revenue less expenses. Subtract line 18 from line 12....... 37,281,983 37,731,417
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 572,910,970 587,352,193
21 Total liabilities (Part X, line 26)............. 266,902,186 312,256,159
22 Net assets or fund balances. Subtract line 21 from line 20..... 306,008,784 275,096,034
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: AS A VITAL PART OF MUNSON HEALTHCARE, MUNSON MEDICAL CENTER EXISTS TO DELIVER COMPREHENSIVE QUALITY CARE TO PATIENTS IN PARTNERSHIP WITH PHYSICIANS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 395,921,168 including grants of $ 273,071 ) (Revenue $ 458,012,179 )
EXPENSES INCURRED WHILE PROVIDING HOSPITAL SERVICES TO THE RESIDENTS OF TRAVERSE CITY, MICHIGAN AND THE SURROUNDING AREA WHILE FULFILLING THE HOSPITAL'S MISSION TO PROVIDE HEALTHCARE IN THE COMMUNITY.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 395,921,168
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
369
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
4,174
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
20
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
13
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MUNSON HEALTHCARE
4230 COPPER RIDGE DR
TRAVERSE CITY,MI49684
(231) 935-7777
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) EDWIN A NESS
PRESIDENT
 12.00 X   X       21,991 699,815 240,584
(2) DAVID WRIGHT MD
PRES MED STA
 4.00 X           27,542 0 0
(3) DANIEL T WOLF
TRUSTEE
 4.00 X           0 21,500 0
(4) JOHN ERB
CHAIR
 8.00 X   X       21,500 0 0
(5) CARL G BENNER MD
TRUSTEE
 4.00 X           12,500 0 0
(6) DAVID FRIAR MD
TRUSTEE
 4.00 X           12,500 0 0
(7) GORDON H WINSTANLEY
TRUSTEE
 4.00 X           12,500 0 0
(8) JOSEPH KOSTRZEWA
TRUSTEE
 4.00 X           12,500 0 0
(9) MICHAEL D SIMPSON
TRUSTEE
 4.00 X           12,500 0 0
(10) NANCY FISHER
TRUSTEE
 4.00 X           12,500 0 0
(11) PATRICK E HEINTZ
TREASURER
 6.00 X   X       12,500 0 0
(12) SHIRLANNA CORREIA
TRUSTEE
 4.00 X           12,500 0 0
(13) GEORGE BEARUP
SECRETARY
 6.00 X   X       12,500 0 0
(14) REX ANTINOZZI MD
VICE CHAIR
 6.00 X   X       12,500 0 0
(15) EDWARD J RUTKOWSKI MD
TRUSTEE
 4.00 X           12,500 0 0
(16) DANIEL NAVIN MD
TRUSTEE
 4.00 X           9,375 3,125 0
(17) JOHN E PELIZZARI
TRUSTEE
 4.00 X           0 0 0
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) DANIEL C EDSON
TRUSTEE
 4.00 X           0 0 0
(19) CARL B ANDERS MD
TRUSTEE
 4.00 X           0 0 0
(20) DOUGLAS LUCIANI
TRUSTEE
 4.00 X           0 0 0
(21) MARK A HEPLER
CFO
 28.00     X       0 322,835 48,469
(22) PAUL M SHIRILLA
ASST SEC/VP
 6.00       X     0 293,209 47,142
(23) KATHLEEN MCMANUS
EXECUTIVE VP
 40.00       X     292,567 0 45,904
(24) DAVID MCGREAHAM MD
VP MEDICAL
 40.00       X     292,319 0 49,285
(25) CHRISTOPHER PODGES
VP INFO SYST
 40.00       X     260,878 0 50,919
(26) MARK R ANTHONY
SR VICE PRES
 40.00       X     230,482 0 21,095
(27) SUZANNE K PETERS
VP HUMAN RES
 40.00       X     200,341 0 34,268
(28) JAMES P FISCHER
VP PATIENT C
 40.00       X     191,510 0 26,412
(29) THOMAS SCHERMERHORN MD
NEUROSURGEON
 40.00         X   842,056 0 32,346
(30) AHMET SEVIMLI MD
NEPHROLOGIST
 40.00         X   348,444 0 39,522
(31) PHILOMENA COLUCCI
PHYSICIAN -
 40.00         X   307,203 0 18,110
(32) DAVID B MARTIN MD
INFECTIOUS D
 40.00         X   261,770 0 28,727
(33) KAREN SPEIRS DO
PHYSICIAN
 40.00         X   251,623 0 15,102
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,697,101 1,340,484 697,885
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet126
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
HOSPITALISTS OF NORTHWEST MICHIGAN
1105 SIXTH ST
TRAVERSE CITY,MI49684 		MEDICAL SERVICE 5,346,097
CERNER CORPORATION
PO BOX 412702
KANSAS CITY,MO64151 		INFO TECHNOLOGY 2,829,705
MCKESSON CORPORATION
PO BOX 98347
CHICAGO,IL60693 		INFO TECHNOLOGY 2,129,701
MAYO COLLABORATIVE SERVICES
PO BOX 9146
MINNEAPOLIS,MN55480 		LABORATORY SRV 1,661,398
SODEXO INC AND AFFILIATES
4880 PAYSPHERE CIRCLE
CHICAGO,IL60674 		DIETARY 1,459,044
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet104
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 870,379
e Government grants (contributions)1e 1,787,269
f All other contributions, gifts, grants, and
similar amounts not included above1f 		233,019
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 2,890,667
Program Service Revenue Business Code
2a MEDICARE AND MEDICAID PMTS 621,990 242,214,383 242,214,383    
b PATIENT SERVICE REVENUE 621,990 207,769,174 207,769,174    
c HEALTH SERVICE REVENUE 621,990 3,041,798 3,041,798    
d SERVICES TO OTHER ORGANIZATIO 621,990 2,195,423 2,195,423    
e RENT FROM RELATED ORGS 531,120 411,984 411,984    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 455,632,762
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 6,186,385 2,387,757   3,798,628
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross rents 291,925  
b Less: rental expenses    
c Rental income or (loss) 291,925  
d Net rental income or (loss).......MediumBullet 291,925     291,925
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 3,982,573 136,300
b Less: cost or other basis and sales expenses   147,639
c Gain or (loss) 3,982,573 -11,339
d Net gain or (loss)..........MediumBullet 3,971,234 -11,339   3,982,573
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a 61,256
b Less: cost of goods sold ..b 58,257
c Net income or (loss) from sales of inventory..MediumBullet 2,999   2,999  
Miscellaneous Revenue Business Code
11a CAFETERIA SALES 722,210 3,685,235     3,685,235
b MISCELLANEOUS 621,990 509,284     509,284
c AUXILIARY GIFT SHOP 446,199 358,475     358,475
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 4,552,994
12 Total revenue. See Instructions....MediumBullet 473,528,966 458,009,180 2,999 12,626,120
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 20,000 20,000
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 253,071 253,071
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,919,331   1,918,231 1,100
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 166,783,640 148,655,211 18,128,429  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 11,793,642 10,534,282 1,259,360  
9 Other employee benefits ....... 27,627,282 24,457,758 3,169,524  
10 Payroll taxes ........... 12,155,678 10,727,486 1,428,113 79
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 404,021   404,021  
c Accounting ........... 251,231   251,231  
d Lobbying ........... 8,411   8,411  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 39,503,062 34,401,034 4,602,933 499,095
12 Advertising and promotion .... 774,623 129,501 645,122  
13 Office expenses ....... 5,321,677 3,114,169 2,207,508  
14 Information technology ...... 9,892,657 3,061,574 6,831,083  
15 Royalties ..        
16 Occupancy ........... 8,097,145 7,262,896 834,249  
17 Travel ............ 965,517 750,445 215,072  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 523,925 388,302 135,623  
20 Interest ........... 5,466,493 4,966,309 500,184  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 26,713,692 24,273,038 2,440,654  
23 Insurance .............. 2,627,161 2,178,394 448,767  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a MEDICAL SUPPLIES 101,207,305 101,207,305    
b BAD DEBT 20,171,176 20,168,687 2,489  
c REPAIRS AND MAINTENANCE 5,784,576 5,446,647 337,929  
d MISCELLANEOUS 2,400,379 1,039,795 1,360,584  
e
f All other expenses -14,868,146 -7,114,736 -7,753,410  
25 Total functional expenses. Add lines 1 through 24f 435,797,549 395,921,168 39,376,107 500,274
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 437,164 1 1,084,341
2 Savings and temporary cash investments ....... 76,860,787 2 78,438,418
3 Pledges and grants receivable, net ......... 417,007 3 669,040
4 Accounts receivable, net ......... 59,400,491 4 58,804,499
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 12,007,491 8 10,929,153
9 Prepaid expenses and deferred charges ............ 8,348,302 9 6,234,932
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 500,320,640
b Less: accumulated depreciation. ..... 10b 259,684,546 237,783,141 10c 240,636,094
11 Investments—publicly traded securities .......... 163,883,298 11 170,730,714
12 Investments—other securities. See Part IV, line 11 ...... 8,607,757 12 14,935,549
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ......... 557,485 14 517,604
15 Other assets. See Part IV, line 11 ........... 4,608,047 15 4,371,849
16 Total assets. Add lines 1 through 15 (must equal line 34)... 572,910,970 16 587,352,193
Liabilities 17 Accounts payable and accrued expenses . 39,228,366 17 34,324,376
18 Grants payable ..........   18  
19 Deferred revenue .......... 63,076 19 64,860
20 Tax-exempt bond liabilities .......... 129,001,841 20 128,713,437
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 98,608,903 25 149,153,486
26 Total liabilities. Add lines 17 through 25..... 266,902,186 26 312,256,159
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 302,895,376 27 265,592,590
28 Temporarily restricted net assets ..... 3,113,408 28 9,503,444
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 306,008,784 33 275,096,034
34 Total liabilities and net assets/fund balances ..... 572,910,970 34 587,352,193
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
473,528,966
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
435,797,549
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
37,731,417
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
306,008,784
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-68,644,167
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
275,096,034
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MUNSON MEDICAL CENTER
  		Employer identification number

38-1362830
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MUNSON MEDICAL CENTER
  		Employer identification number

38-1362830
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MUNSON MEDICAL CENTER
  		Employer identification number

38-1362830
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
8,400
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
11
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
10,516
j
Total. Add lines 1c through 1i ...............................
18,927
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
No
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
No
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
No
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
  SCHEDULE C, PART II-B, LINE 1 GRASSROOTS LOBBYING EXPENSES GRANTED TO ORGANIZATIONS. OTHER ACTIVITIES INDICATE THE PORTION OF DUES ALLOCATED TO LOBBYING EXPENSES PAID TO REGIONAL OR NATIONAL ORGANIZATIONS.
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 166,996,705 143,412,065 128,015,726 151,976,653
b Contributions ........ 9,477,532 996,567 2,073,910 815,757
c Net investment earnings, gains, and losses ... 4,724,667 23,516,814 14,807,677 -20,538,618
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		87,150 141,430 1,054,734 4,238,065
f Administrative expenses .... 877,667 787,311 430,514  
g End of year balance ...... 180,234,157 166,996,705 143,412,065 128,015,726
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet94.730 %
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet5.270 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   13,276,090 13,276,090
b Buildings ................   283,936,438 127,624,171 156,312,267
c Leasehold improvements ............   265,646 76,174 189,472
d Equipment ................   176,060,259 130,404,138 45,656,121
e Other .................   26,782,207 1,580,063 25,202,144
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 240,636,094
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes  
MINIMUM PENSION LIABILITY 119,095,923
DEFERRED POST RETIREMENT BENEFITS 13,681,607
RESERVE FOR THIRD PARTY SETTLEMENTS 6,200,000
SWAP MARKET VALUE BASIS 4,615,210
CAREPAYMENT LIABILITY 3,642,685
ESTIMATED THIRD PARTY SETTLEMENTS 1,918,061



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 149,153,486
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
INTENDED USES FOR ENDOWMENT FUNDS SCHEDULE D, PAGE 2, PART V, LINE 4 THE BOARD OF TRUSTEES DESIGNATES SUBSTANTIAL INVESTMENTS FOR THE REPLACEMENT, IMPROVEMENT, AND THE EXPANSION OF TANGIBLE FACILITIES OWNED BY MUNSON MEDICAL CENTER TO ENSURE FUNDS ARE AVAILABLE TO MAINTAIN THE HOSPITAL ASSETS TO CARRY OUT ITS MISSION. A PORTION OF THE TERM ENDOWMENT ASSETS ARE THOSE HELD FOR SPECIFIC MEDICAL PURPOSES, AS DEFINED BY DONORS. THOSE ASSETS ARE BEING HELD FOR A VARIETY OF DONOR INTERESTS INCLUDING ADAPTIVE SPORTS, PEDIATRIC THERAPY, OTHER PEDIATRIC MEDICAL NEEDS, RESEARCH, AND PATIENT ASSISTANCE. MUNSON MEDICAL CENTER HAS NO FIN 48 LIABILITIES; AND THEREFORE, NO FOOTNOTE DISCLOSURE ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. SEE AUDITED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    5,211,725   5,211,725 1.230 %
b Medicaid (from Worksheet 3, column a) .....     40,203,113 31,355,392 8,847,721 2.090 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .     686,877 353,020 333,857 0.080 %
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		    46,101,715 31,708,412 14,393,303 3.400 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    3,747,580 46,937 3,700,643 0.870 %
f Health professions education
(from Worksheet 5) .. 		    4,348,621 1,259,473 3,089,148 0.730 %
g Subsidized health services
(from Worksheet 6) .. 		    442,168 2,038 440,130 0.100 %
h Research (from Worksheet 7)     792,428   792,428 0.190 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....     378,978 1,400 377,578 0.090 %
jTotal Other Benefits ...     9,709,775 1,309,848 8,399,927 1.980 %
kTotal. Add lines 7d and 7j. ..     55,811,490 33,018,260 22,793,230 5.380 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     100,321   100,321 0.020 %
2 Economic development     6,919   6,919  
3 Community support     30,456   30,456 0.010 %
4 Environmental improvements     25,801   25,801 0.010 %
5 Leadership development and training for community members            
6 Coalition building     1,200   1,200  
7 Community health improvement advocacy     1,197   1,197  
8 Workforce development     38,941   38,941 0.010 %
9 Other            
10 Total     204,835   204,835 0.050 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense........
2
7,063,032
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
1,062,280
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
213,993,217
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
207,324,910
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
6,668,307
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1NW MI SURGERY CENTER
  		AMBULATORY SURGERY CENTER 49.000 %   51.000 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 MUNSON MEDICAL CENTER
1105 SIXTH ST
TRAVERSE CITY,MI49684 		X X   X X X X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
MUNSON MEDICAL CENTER
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.0%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?13
Name and address Type of Facility (describe)
1 MUNSON COMMUNITY HEALTH CENTER
550 MUNSON AVENUE
TRAVERSE CITY,MI49686 		OUTPATIENT
2 BIEDERMAN CANCER CENTER
1120 SIXTH ST
TRAVERSE CITY,MI49684 		RADIATION THERAPY
3 MRI CENTER
217 S MADISON
TRAVERSE CITY,MI49684 		MRI
4 SMITH FAMILY BREAST HEALTH CENTER
COPPER RIDGE
TRAVERSE CITY,MI49684 		MAMMOGRAPHY AND WOMEN'S HEALTH
5 IV THERAPY
1200 SIXTH ST
TRAVERSE CITY,MI49684 		IV THERAPY
6 CHEMICAL DEPENDENCY CENTER
420 BROOK ST
TRAVERSE CITY,MI49684 		REHABILITATION
7 PHYSICAL THERAPY
3643 WEST FRONT ST
TRAVERSE CITY,MI49684 		PHYSICAL THERAPY
8 MUNSON MANOR
1220 MEDICAL CAMPUS DR
TRAVERSE CITY,MI49684 		HOSPITALITY HOUSE
9 PHYSICAL THERAPY
211 S HIGH ST
NORTHPORT,MI49670 		PHYSICAL THERAPY
10 ADVANCED WOUND CENTER
5085 ANNA DR
TRAVERSE CITY,MI49684 		PATIENT WOUND CARE
11 MUNSON HOSPICE HOUSE
450 BROOK ST
TRAVERSE CITY,MI49684 		HOSPICE CARE HOUSE
12 MUNSON RENAL DIALYSIS
4062 WEST ROYAL DRIVE
TRAVERSE CITY,MI49684 		RENAL DIALYSIS UNIT
13 REHAB POOL FACILITY
1202 GARFIELD
TRAVERSE CITY,MI49684 		POOL FOR REHAB
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how 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.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE PART I LINE 3C INCOME UP TO 200 OF THE FPG 100 DISCOUNT ON CHARGES INCOME BETWEEN 201 AND 300 FPG 75 DISCOUNT ON CHARGES INCOME BETWEEN 301 AND 400 FPG 50 DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG INCLUDES EARNINGS UNEMPLOYMENT COMPENSATION WORKERS COMPENSATION SOCIAL SECURITY SUPPLEMENTAL SECURITY INCOME PUBLIC ASSISTANCE VETERANS PAYMENTS SURVIVOR BENEFITS PENSION OR RETIREMENT INCOME INTEREST DIVIDENDS RENTS ROYALTIES INCOME FROM ESTATES EDUCATIONAL ASSISTANCE ALIMONY CHILD SUPPORT ASSISTANCE FROM OUTSIDE THE HOUSEHOLD AND OTHER MISCELLANEOUS SOURCES CASH CHECKING AND SAVINGS BALANCES MONEY MARKET ACCOUNTS CERTIFICATES OF DEPOSIT IRAS TRUSTS INHERITANCES ANNUITIES SAVINGS BONDS STOCKS MUTUAL FUNDS ANDOR CASH VALUE OF LIFE INSURANCE
SUBSIDIZED HEALTH SERVICES EXPLANATION PART I LINE 7G THERE ARE NO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F TOTAL EXPENSES FROM FORM 990 PART IX LINE 25 ARE XXX-XX-XXXX AND THE PROPORTIONATE SHARE OF TOTAL EXPENSES OF THE AMBULATORY SURGERY CENTER IS 7389042 THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS 20168687 THE NET EXPENSE OF XXX-XX-XXXX WAS USED FOR PURPOSES OF CALCULATING LINE 7 COLUMN F
COSTING METHODOLOGY EXPLANATION PART I LINE 7 COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION
COMMUNITY BUILDING ACTIVITIES PART II MUNSON MEDICAL CENTER MMC PROVIDED 204835 IN COMMUNITYBUILDING ACTIVITIES DURING THE 2011 TAX YEAR THESE ACTIVITIES INCLUDED A CASH DONATION FOR COALITION BUILDING ACTIVITIES IN GRAND TRAVERSE COUNTY ADMINISTRATIVE SUPPORT ON MANY BOARDS SUPPORTING CHANGES IN SOCIAL DETERMINATES OF HEALTH ADDRESSING ADEQUATE COMMUNITYWIDE HOUSING POVERTY REDUCTION AND WORKFORCE DEVELOPMENT ENVIRONMENTAL IMPROVEMENTS INCLUDING WASTE REDUCTION AND RECYCLING MMC CONTINUES AS A GUIDING FORCE IN MICHIGANS REGION 7 BIOTERRORISMDISASTER PREPAREDNESS AS PART OF CRITICAL WORKFORCE DEVELOPMENT MUNSON STAFF ATTENDS MANY REGIONAL CAREER DAYS PROVIDING STUDENTS WITH INFORMATION ON WHY THEY MIGHT WANT TO BE EMPLOYED IN THE OFTENCRITICAL AREA OF HEALTH CARE
BAD DEBT EXPENSE EXPLANATION PART III LINE 4 TO DETERMINE THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS WHO WOULD PROBABLY QUALIFY UNDER MUNSON MEDICAL CENTERS CHARITY CARE POLICY MUNSON DIRECTED AN INTERNAL STUDY FROM A 3MONTH SAMPLE OF CURRENT BAD DEBT ACCOUNTS FIRST THE STUDY IDENTIFIED THE SELFPAY PORTION OF THE BAD DEBT EXPENSE THEN THE SELFPAY ACCOUNTS WERE ANALYZED USING REVENUE CYCLE ANALYTIC SOFTWARE TO IDENTIFY POTENTIAL CHARITY CARE CANDIDATES USING THE SOFTWARE ESTIMATIONS A PORTION OF THE SELFPAY ACCOUNTS WERE DEEMED CHARITY CARE ELIGIBLE THAT ESTIMATED PORTION WAS APPLIED TO THE SELFPAY BAD DEBT DOLLAR AMOUNT TO DETERMINE THE AMOUNT OF BAD DEBT THAT WOULD BE CONSIDERED CHARITY IF THE PROPER APPLICATIONS AND DOCUMENTATION WERE AVAILABLE FROM THE PATIENTS THE ACCOUNTS RECEIVABLE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF MUNSON HEALTHCARE AND SUBSIDIARIES STATES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS THROUGHOUT THE YEAR MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITEOFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THE ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PASTDUE PATIENT BALANCES WITH COLLECTION AGENCIES
COLLECTION PRACTICES EXPLANATION PART III LINE 9B MUNSON HEALTHCARES INTERNAL AND EXTERNAL COLLECTION PRACTICES INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NONPAYMENT INCLUDING COLLECTIONS ACTIONS AND REPORTING TO COLLECTION AGENCIES SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY A PATIENTS GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE AND A PATIENTS GOOD FAITH EFFORT TO COMPLY WITH HISHER PAYMENT AGREEMENTS WITH MUNSON HEALTHCARE FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS MUNSON HEALTHCARE MAY OFFER EXTENDED PAYMENT PLANS WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY
NEEDS ASSESSMENT PART VI THE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE CHC TO SERVE THE MUNSON HEALTHCARE MHC SYSTEM THE CHC CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM MUNSON HEALTHCARE HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON HEALTHCARE BOARD CHAIRPERSON THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS CONSIDER THE MHC RESPONSE TO ANY EMERGING HEALTH TRENDS AS IDENTIFIED BY COMMUNITY HEALTH NEEDS ASSESSMENT AND REVIEW ANY NEW COMMUNITY HEALTH BASED COLLABORATION OR PROGRAM THE CHC IS RESPONSIBLE FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MHC COMMUNITY BENEFIT PROGRAMS AND SERVICES THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT OF MUNSON MEDICAL CENTER MUNSON MEDICAL CENTER MMC IS A SIGNIFICANT CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN OUR EXTENSIVE GEOGRAPHICAL AREA COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED AS WELL AS WHERE PROGRESS HAS BEEN MADE THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITYWIDE MUNSON IS PREPARING A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501R WHICH WILL BE CONDUCTED IN FISCAL 2013 IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD ADDITIONALLY MUNSON WORKS IN CONJUNCTION WITH COMMUNITY COLLABORATIVES IN FIVE COUNTIES ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA THE TRAVERSE CITY CHAMBER OF COMMERCE THE LOCAL UNITED WAY THE POVERTY REDUCTION INITIATIVE FOUR LOCAL PUBLIC HEALTH DEPARTMENTS AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY NEED
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS BROCHURES THAT DESCRIBE MUNSON HEALTHCARES FINANCIAL ASSISTANCE PROGRAM ARE AVAILABLE AT ALL REGISTRATION SITES THE BROCHURE HAS CLEAR INFORMATION ON HOW TO CONTACT A FINANCIAL COUNSELOR STATEMENT ON BILLS STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL SIGNS IN THE ER REGISTRATION AREA ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY REFERRAL BY REGISTRATION STAFF AT THE TIME OF REGISTRATION SELFPAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF MUNSON MEDICAL CENTER FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS THE COUNSELORS VISIT ALL INPATIENTS THAT ARE DEEMED SELFPAY TO SEE IF THEY HAVE CONCERNS AND TO DETERMINE IF THEY WOULD LIKE HELP IF THE PATIENT WOULD LIKE HELP THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID GENERALLY THESE TWO ACTIONS WILL DETERMINE WHAT PROGRAM THE PATIENT MIGHT QUALIFY FOR ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS THE COUNSELORS ALSO IDENTIFY ALL SELFPAY OUTPATIENTS AND GO THROUGH THE SAME PROCESS ONLY BY PHONE THE GOAL IS TO TALK WITH PATIENTS PRIOR TO ADMISSION BUT WHEN THAT IS NOT POSSIBLE THE CALL IS MADE SOON AFTER DISCHARGE AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO MEDICAID AND ALL OF ITS SUBSETS SOCIAL SECURITY DISABILITY TRAVERSE HEALTH CLINIC MUNSON HEALTHCARE FINANCIAL ASSITANCE AND MUNSON MEDICAL CENTER MEDS PROGRAM
COMMUNITY INFORMATION PART VI MUNSON MEDICAL CENTER DESCRIPTION MUNSON MEDICAL CENTER MMC IS THE LARGEST HOSPITAL IN NORTHERN LOWER MICHIGAN WITH 391 LICENSED ACUTE CARE BEDS ONE OF SEVEN HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM MMC PROVIDES MORE THAN 300000 ANNUAL PATIENT VISITS MMC SERVES APPROXIMATELY 23800 INPATIENTS HAS 2000 OBSTETRICAL BIRTHS AND 48000 EMERGENCY ROOM PATIENTS EVERY YEAR MMC IS ALSO THE LARGEST EMPLOYER IN NORTHERN MICHIGAN DUE TO ITS GEOGRAPHIC LOCATION AND COMPREHENSIVE ARRAY OF SERVICES OFFERED MMC HAS BEEN NAMED A RURAL REFERRAL CENTER BY THE CENTERS FOR MEDICARE AND MEDICAID MMC IS ALSO RECOGNIZED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES CMS AS A SOLE COMMUNITY HOSPITAL BECAUSE OF THIS STATUS IT IS EQUIPPED TO PROVIDE CRITICAL CARE FOR PATIENTS IN 24 COUNTIES HOSPITAL SERVICES MUNSON MEDICAL CENTER PROVIDES SERVICES IN 33 DIFFERENT MEDICAL SPECIALTIES AND OFFERS A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING CARDIAC SURGERY CARDIAC CATHETERIZATION RADIATION ONCOLOGY NEONATAL INTENSIVE CARE AND COMPREHENSIVE EMERGENCY SERVICES MUNSON MEDICAL CENTER IS A LEVEL II TRAUMA CENTER AND IS THE ONLY RECOGNIZED TRAUMA CENTER IN MICHIGANS REGION 7 WHICH COVERS 17 COUNTIES SPECIALIZED INPATIENT UNITS AVAILABLE AT MMC INCLUDE MEDICALSURGICAL INTENSIVE CARE CARDIAC INTENSIVE CARE NEONATAL INTENSIVE CARE ONCOLOGY MENTAL HEALTH AND PHYSICAL MEDICINE AND REHABILITATION A BROAD SPECTRUM OF DIAGNOSTIC AND THERAPEUTIC SERVICES SUPPORTS MMCS PROGRAMS THE SERVICES AVAILABLE TO INPATIENTS AND OUTPATIENTS CONSIST OF RADIOLOGY INCLUDING MRI CT SCAN PET SCAN ULTRASOUND NUCLEAR MEDICINE AND RADIATION THERAPY COMPUTERIZED LABORATORY REHABILITATION SERVICES INCLUDING PHYSICAL OCCUPATIONAL AND SPEECH AND HEARING THERAPY CARDIAC CATHETERIZATION COMPREHENSIVE CANCER TREATMENT OBSTETRIC CLINIC FOR INDIGENT PATIENTS MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES HOME HEALTH DME AND DIALYSIS SERVICES AND COMPLEX SURGERY SUCH AS VASCULAR AND NEUROSURGERY AS WELL AS LESS COMPLEX SAMEDAY SURGERY POPULATION SERVED BY MUNSON MEDICAL CENTER MMC SERVES PATIENTS FROM 24 COUNTIES IN NORTHERN LOWER MICHIGAN AND THE EASTERN PORTION OF THE UPPER PENINSULA A POPULATION BASE OF APPROXIMATELY 580000 IN THE 11 COUNTY REGION IMMEDIATELY SURROUNDING MMC 184 OF THE POPULATION ARE 65 YEARS OR OLDER UNEMPLOYMENT IS 12 OR HIGHER ALMOST 23 OF ADULTS AGED 1864 YEARS OF AGE LACK HEALTH INSURANCE 58 OF BIRTHS ARE COVERED BY MEDICAID ABOUT 70 OF MMC INPATIENT DISCHARGES ORIGINATE FROM THE 5 COUNTIES IN CLOSEST PROXIMITY TO MMC ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA QUALITY MUNSON MEDICAL CENTER HAS WON NUMEROUS AWARDS FOR OUTSTANDING CLINICAL QUALITY CARE HEALTH GRADES 5 STAR RATING FOR CARDIAC STROKE ORTHOPEDIC PULMONARY CARE AMERICAS 50 BEST HOSPITALS OUTSTANDING PATIENT EXPERIENCE HOSPITAL TOP 100 HOSPITAL 12 TIMES ONLY 2 OTHER HOSPITALS NATIONWIDE HAVE BEEN SO RECOGNIZED 2008 AMERICAN HOSPITAL ASSOCIATION MCKESSON QUEST FOR QUALITY PRIZE AMERICAN NURSES CREDENTIALING CENTER MAGNET HOSPITAL 3 OF HOSPITALS NATIONWIDE QUALIFY
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI THE MUNSON MEDICAL CENTER BOARD OF TRUSTEES IS MADE UP OF COMMUNITY MEMBERS ALL OF WHOM RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA THESE INDIVIDUALS GIVE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF TRUSTEES MUNSON MEDICAL CENTER UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA EXAMPLES OF HOW MUNSON MEDICAL CENTER PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PROGRAMS INCLUDE HEALTHY FUTURES A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS HEALTH DEPARTMENTS AND MUNSON HEALTHCARE CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UP TO AGE FIVE THE PROGRAM INCLUDES CENTRAL ACCESSDATA MANAGEMENT REGISTERED NURSE RN CARE COORDINATION EDUCATIONAL MAILINGS AND HEALTH CARERELATED FINANCIAL ASSISTANCE THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMESBASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY ACCESS TO HEALTH CARE AND IMMUNIZATIONS MEDS PROGRAM A PROGRAM THAT PROVIDES TO PATIENTS WITHOUT RESOURCES BEING DISCHARGED FROM THE HOSPITAL NEEDED MEDICATIONS AS WELL AS ENROLLING THOSE PATIENTS INTO PHARMACEUTICAL COMPANY SPONSORED ASSISTANCE PROGRAMS SO THEY MAY CONTINUE TO GET THE NEEDED PHARMACEUTICALS THE MEDS PROGRAM ALSO PROVIDES ASSISTANCE TO THOSE NEEDING MEDICATIONS FROM THE OUTPATIENT INFUSION CLINIC POVERTY REDUCTION INITIATIVE PRI A COLLABORATIVE GROUP OF ORGANIZATIONS AND INDIVIDUALS WORKING TO ADDRESS ISSUES OF POVERTY IN THE FIVE COUNTY SERVICE AREA OF MUNSON MEDICAL CENTER PROJECTS SUPPORTED BY THE PRI WORK GROUPS INCLUDE EFFORTS TO EXPAND ACCESS TO MEDICAL AND DENTAL CARE JOB TRAINING OPPORTUNITIES JOB RETENTION COMMUNITY RESOURCE MOBILIZATION AND DATA COLLECTION MUNSONS INVOLVEMENT IN PRI INCLUDES MEMBERSHIP ON THE ADVISORY COUNCIL STEERING COMMITTEE AND NAVIGATING WORKGROUP NORTHERN MICHIGAN DIABETES INITIATIVE NMDI A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 12 COUNTY SERVICE AREA WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES NMDI IS COMMITTED TO PROVIDING LOCAL REGIONAL AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS THE GENERAL COMMUNITY THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION AND RURAL PRIMARY CARE PROVIDERS PCP CARING FOR DIABETIC PATIENTS COLLABORATION WITH THE TRAVERSE HEALTH CLINIC THE TRAVERSE HEALTH CLINIC THC OPERATING UNDER AN INDIGENT CARE AGREEMENT UTILIZING MUNSON MEDICAL CENTERS DSH CAPACITY PROVIDES ACCESS TO HEALTH SERVICES THROUGH COMMUNITY COLLABORATION TO PEOPLE IN NEED IN BENZIE LEELANAU AND GRAND TRAVERSE COUNTIES THC SERVES AS A PRIMARY CARE PROVIDER FOR THOSE WITH MEDICAID AND RUNS THE COALITION HEALTH ACCESS PROGRAM CHAP FOR THOSE ADULTS WITH NO INSURANCE WHO QUALIFY MUNSON DONATES TO THC THROUGH INKIND DONATIONS OF MEDICATIONS AND STAFFING GRANTS ETC WHILE NOT COUNTABLE AS MUNSON COMMUNITY BENEFIT MANY MUNSON EMPLOYEES ALSO VOLUNTEER THEIR TIME PROVIDING CARE AT THE THC MEDICAL EDUCATION THE MUNSON FAMILY PRACTICE RESIDENCY PROGRAM INTEGRATES OSTEOPATHIC AND ALLOPATHIC MEDICINE TOGETHER WITH THE RESOURCES OF MUNSON MEDICAL CENTER THIS DUALLY ACCREDITED 555 PROGRAM ACCEPTS BOTH DO AND MD TRAINEES THE PROGRAM IS AFFILIATED WITH THE MICHIGAN STATE UNIVERSITY MMC ALSO PARTNERS WITH SEVERAL COLLEGES AND SCHOOLS OF NURSING TO PROVIDE INTERNSHIPS AND CLINICAL EXPERIENCES FOR REGISTERED NURSES RESPIRATORY THERAPISTS PHARMACISTS AND OTHER HEALTH PROFESSIONALS
AFFILIATED HEALTH CARE INFORMATION PART VI MUNSON MEDICAL CENTERS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE A 501C3 CORPORATION THE MUNSON HEALTHCARE SYSTEM CONSISTS OF A MAJOR TERTIARY REFERRAL HOSPITAL SEVERAL RURALBASED MEDICAL CENTERS EXTENSIVE OUTPATIENT TREATMENT AND REHABILITATION FACILITIES AND ANCILLARY EMERGENCY TRANSPORTATION AND HOMEBASED MEDICAL SERVICES THAT COVER 24 COUNTIES IN MICHIGANS NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA THE MOST SIGNIFICANT OF THE MUNSON HEALTHCARE SUBSIDIARIES IS MUNSON MEDICAL CENTER MMC MMC IS ONE OF SEVEN NOTFORPROFIT HOSPITALS WHICH ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR COMMUNITIES EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL COMMUNITY HEALTH INITIATIVES ANDOR PROMOTION ACTIVITIES AS WELL AS SHARED INITIATIVES MMC WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT AND A PALLIATIVE CARE AND HOSPICE PROGRAM ON THE MUNSON CAMPUS CLOSE TO 300000 DOLLARS IN COMMUNITY BENEFIT IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR NORTH FLIGHT INC IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM WITH ITS FIXED WING AND HELICOPTER AIR SERVICES IN COMBINATION WITH GROUND TRANSPORT PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE NORTH FLIGHT INC PROVIDED 12 MILLION IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR MUNSON MEDICAL GROUP THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM PROVIDED OVER A HALF MILLION DOLLARS IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2011 MMC PERFORMS THE NEEDS ASSESSMENTS FOR MUNSON HEALTHCARE UTILIZING THIS NEEDS ASSESSMENT MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING DEVELOPING IMPLEMENTING EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS IN TOTAL THE MUNSON HEALTHCARE SYSTEM PROVIDED 399 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS OUTREACH PROGRAMS BAD DEBT AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN
MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 11H PART V LINE 11H PATIENTS WHOSE FAMILY INCOME EXCEEDS 400 OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASEBYCASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES IE HIGH DEBTTOINCOME RATIO AT THE SOLE DISCRETION OF MUNSON HEALTHCARE
MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 13G PART V LINE 13G IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS INFORMATION POSTED ON THE WEBSITE STATEMENT ON BILLS ANDOR SIGNS IN THE REGISTRATION AREAS
MUNSON MEDICAL CENTER LINE NUMBER 1 PART V LINE 19D PART V LINE 19D SELFPAYNO INSURANCE PATIENTS ARE GIVEN A DISCOUNT EQUAL TO 15 OFF THEIR TOTAL BILL FOR ALL MEDICALLY NECESSARY AND EMERGENCY SERVICES THIS RATE WAS DETERMINED BY TAKING THE AVERAGE OF COMMERCIAL RATES NOT INCLUDING BLUE CROSS
Schedule H (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number
38-1362830
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) CITY OF TRAVERSE CITY400 BOARDMAN
TRAVERSE CITY,MI49684 		38-6004740 GOV 20,000       ROAD CONSTRUCTION






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) MEDICAL INSURANCE PAYMENT 74 15,861      
(2) TRANSPORT, HOUSING, WIGS 114 68,497      
(3) MEDICAL, TRANSPORT & DRUG 78 12,766      
(4) MAMMOGRAPHY ASSISTANCE 384 20,441      
(5) TRANSPORT, HOUSING, FOOD 655 44,884      
(6) CAR SEAT INSPECT & HELMET 9424   55,692 FMV SERVICE & SUPPL
(7) HOUSING ASSISTANCE 48 34,930      

Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) EDWIN A NESS (i)
(ii)		 21,920
548,165 		 
150,241 		71
1,409 		1,083
218,655 		774
20,072 		23,848
938,542 		 
 
(2) MARK A HEPLER (i)
(ii)		  
228,393 		 
25,779 		 
68,663 		 
27,822 		 
20,647 		 
371,304 		 
20,253
(3) PAUL M SHIRILLA (i)
(ii)		  
259,620 		 
29,778 		 
3,811 		 
31,773 		 
15,369 		 
340,351 		 
 
(4) KATHLEEN MCMANUS (i)
(ii)		 253,836
  		37,638
  		1,093
  		30,882
  		15,022
  		338,471
  		 
 
(5) DAVID MCGREAHAM MD (i)
(ii)		 246,704
  		26,598
  		19,017
  		31,270
  		18,015
  		341,604
  		 
 
(6) CHRISTOPHER PODGES (i)
(ii)		 236,655
  		22,680
  		1,543
  		28,833
  		22,086
  		311,797
  		 
 
(7) MARK R ANTHONY (i)
(ii)		 174,837
  		21,128
  		34,517
  		10,490
  		10,605
  		251,577
  		 
 
(8) SUZANNE K PETERS (i)
(ii)		 155,995
  		17,351
  		26,995
  		19,896
  		14,372
  		234,609
  		3,182
 
(9) JAMES P FISCHER (i)
(ii)		 170,964
  		17,501
  		3,045
  		20,656
  		5,756
  		217,922
  		 
 
(10) THOMAS SCHERMERHORN MD (i)
(ii)		 787,299
  		53,952
  		805
  		11,029
  		21,317
  		874,402
  		 
 
(11) AHMET SEVIMLI MD (i)
(ii)		 325,183
  		6,565
  		16,696
  		19,511
  		20,011
  		387,966
  		 
 
(12) PHILOMENA COLUCCI (i)
(ii)		 258,687
  		40,000
  		8,516
  		11,902
  		6,208
  		325,313
  		 
 
(13) DAVID B MARTIN MD (i)
(ii)		 235,596
  		10,071
  		16,103
  		14,136
  		14,591
  		290,497
  		 
 
(14) KAREN SPEIRS DO (i)
(ii)		 241,487
  		8,788
  		1,348
  		12,291
  		2,811
  		266,725
  		 
 


Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 EDWIN A. NESS 0 206,806 0 MARK A. HEPLER 0 14,118 0 PAUL M. SHIRILLA 0 16,196 0 KATHLEEN MCMANUS 0 15,652 0 DAVID MCGREAHAM, MD 0 16,468 0 CHRISTOPHER PODGES 0 14,634 0 SUZANNE K. PETERS 0 10,536 0 JAMES P. FISCHER 0 10,398 0
OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III EXECUTIVE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. FOR THE PRESIDENT, THE PLAN PROVIDES A TARGETED BENEFIT AT AGE 62. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. VICE-PRESIDENTS ARE ELIGIBLE TO PARTICIPATE IN AN AMOUNT NOT TO EXCEED 6% OF BASE COMPENSATION, FUNDED ANNUALLY, AT THE SOLE DISCRETION OF MUNSON. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON. EXECUTIVE SEVERANCE PLAN: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, A COMPETITIVE BENEFIT PACKAGE IS OFFERED TO THE PRESIDENT AND VICE-PRESIDENTS WHICH INCLUDES A SEVERANCE PLAN. MUNSON HAS A SEVERANCE PLAN FOR THE PRESIDENT AND THE VICE-PRESIDENT/EXECUTIVE LEVEL POSITIONS WHICH PROVIDES FOR THE PRESIDENT UP TO TWO YEARS OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS AND FOR VICE PRESIDENTS, UP TO ONE-YEAR OF PAY IN THE EVENT EMPLOYMENT ENDS UNDER CERTAIN CONDITIONS. THE PLAN PROVIDES FOR A 50% OFFSET FOR SUBSEQUENT EMPLOYMENT DURING THE SEVERANCE PERIOD. MEDICAL BENEFITS ARE PROVIDED DURING THE SEVERANCE PERIOD.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number
38-1362830
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CTY GRD TRAVSE HOSP FIN AUTH 2011
  		38-6004832 386523EE0 08-10-2011 128,728,067 REFUND PRIOR BONDS   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 128,728,067      
4 Gross proceeds in reserve funds . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . 1,756,787      
8 Credit enhancement from proceeds . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . .        
11 Other spent proceeds . . . . . . . . . . . 126,970,633      
12 Other unspent proceeds . . . . . . . . . . . 648      
13 Year of substantial completion . . . . . . . . . . .
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . X              
15 Were the bonds issued as part of an advance refunding issue? . . . .   X            
16 Has the final allocation of proceeds been made? . . . . . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X              
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . X              
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .   X            
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . X              
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .   X            
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet   %   %   %   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . .. . . . . . . . .   %   %   %   %
7 Does the bond issue meet the private security or payment test? . . .   X            
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
  X            
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X            
2 Is the bond issue a variable rate issue? X              
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X            
b Name of provider . . . . . .  
  		 
  		 
  		 
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .                
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X            
6 Did the bond issue qualify for an exception to rebate? . X              
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X              
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
PURPOSE OF ISSUE DESCRIPTION SCHEDULE K CTY GRD TRAVSE HOSP FIN AUTH 2011 THE SERIES 2011A 2011B AND 2011C BONDS WERE ISSUED TO PURCHASE AND CANCEL TENDERED BONDS TENDERED DURING A TENDER PROGRAM INITIATED BY MUNSON HEALTHCARE THE TENDERED BONDS INCLUDED COUNTY OF GRAND TRAVERSE HOSPITAL AUTHORITY MUNSON HEALTHCARE OBLIGATED GROUP HOSPITAL REVENUE AND REFUNDING BONDS SERIES 1998A ISSUED 9198 REVENUE BONDS SERIES 2001A ISSUED 1901 REVENUE REFUNDING BONDS SERIES 2002A ISSUED 91702 REVENUE REFUNDING BONDS SERIES 2005A ISSUED 11305 AND REVENUE BONDS SERIES 2005B ISSUED 11305
ADDITIONAL INFORMATION SCHEDULE K CTY GRD TRAVSE HOSP FIN AUTH 2011 ISSUE COUNTY OF GRAND TRAVERSE HOSPITAL FINANCE AUTHORITY REVENUE REFUNDING BONDS MUNSON HEALTHCARE OBLIGATED GROUP SERIES 2011 PART III QUESTION 3C AND D MUNSON MEDICAL CENTER MAINTAINS POLICIES AND PROCEDURES TO REVIEW AND MONITOR ALL CONTRACTS INCLUDING LEASES AND RESEARCH CONTRACTS THE REVIEW PROCESS INCLUDES A REVIEW BY THE INTERNAL LEGAL DEPARTMENT OUTSIDE COUNSEL MAY BE CONSULTED AS NECESSARY OUTSIDE COUNSEL IS RETAINED FOR ALL NEW EXEMPT BOND OFFERINGS DURING WHICH A THOROUGH DUE DILIGENCE PROCESS REVIEWS APPLICABLE CONTACTS SINCE NEW BONDS WERE ISSUED IN 2011 OUTSIDE COUNSEL WAS ENGAGED PART III QUESTION 7 AND PART V MUNSON MEDICAL CENTER MAINTAINS POLICIES AND PROCEDURES TO ENSURE THE POSTISSUANCE COMPLIANCE OF ITS TAXEXEMPT BOND LIABILITIES SUBSEQUENT TO 2011 YEAREND MUNSON MEDICAL CENTER FORMALLY ADOPTED POLICIES TO INCLUDE REMEDIAL ACTION AVAILABLE TO CORRECT NONCOMPLIANCE IN ACCORDANCE WITH TREASURY REGULATION 114112 AND 11452
Schedule K (Form 990) 2011

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MEGAN COX FAMILY OF TRUST 53,284 RELATED FAMILY COMP   No
(2) HOSPITALISTS OF NORTHWEST MI OWNER ISTRUSTEE 4,636,881 GROUP PRACTICE PHYSI   No
(3) MUNSON SUPPORT SERVICES E NESS TRUSTEE 2,111,287 LAUNDRY SERVICES   No
(4) MUNSON SERVICES INC C PODGESTRUSTEE 2,206,069 CONTRACT EMPLOYEES   No
(5) PULMONARY AND CRITICAL CARE PHYSICI OWNER ISTRUSTEE 1,388,475 GROUP PRACTICE PHYSI   No
(6) GLORIA WOLF FAMILY OF TRUST 73,841 RELATED FAMILY COMP   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Identifier Return Reference Explanation
CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MUNSON MEDICAL CENTER IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. IN THE EVENT OF DISSOLUTION, MUNSON MEDICAL CENTER'S NET ASSETS WOULD BE DISTRIBUTED TO MUNSON HEALTHCARE.
ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A FOUR TRUSTEES OF MUNSON MEDICAL CENTER ARE DIRECTORS OF MUNSON HEALTHCARE. OTHER TRUSTEES ARE CHOSEN FROM AMONG THOSE NOMINATED BY THE GOVERNANCE COMMITTEE.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE MUNSON MEDICAL CENTER (MMC) TRUSTEES ARE APPROVED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING: ADOPTION, AMENDMENT, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS OF MMC; ADOPTION, EXECUTION, REVOCATION OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, OR REORGANIZATION INVOLVING MMC; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF MMC; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF MMC; ADOPTION OF ALL OPERATING BUDGETS AND CAPITAL EXPENDITURE BUDGETS FOR MMC; INCURRENCE OF OPERATING OR CAPITAL EXPENDITURES BY MMC WHICH CAUSE THE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT (5%) IN ANY FISCAL YEAR; INCURRENCE OF SECURED BORROWINGS OF MMC, WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS PART OF MMC'S BUDGET; ADOPTION OR CHANGE IN THE MISSION STATEMENT, PURPOSES OR THE STRATEGIC GOALS OF MMC; CHANGING SUBSTANTIALLY THE SCOPE OF MMC'S CLINICAL SERVICES AND PROGRAMS OFFERED BY MMC; AND APPOINTMENT OR REMOVAL THE PRESIDENT OF MMC.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE MUNSON MEDICAL CENTER BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON MEDICAL CENTER BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN.
ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THRU THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE.
COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MHC'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON EXECUTIVES IS DETERMINED IN PART BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS.
COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER KEY EMPLOYEES IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES FOR MUNSON MEDICAL CENTER.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE MUNSON MEDICAL CENTER ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON MEDICAL CENTER DOES NOT MAKE THE BYLAWS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE, PARENT CORPORATION, SUBMITS ITS ANNUAL CONSOLIDATED FINANCIAL STATEMENTS TO THE MSRB IN COMPLIANCE WITH BOND DISCLOSURE REQUIREMENTS. ADDITIONALLY, MUNSON MEDICAL CENTER PREPARES AND DISTRIBUTES AN ANNUAL REPORT TO THE COMMUNITY, WHICH CONTAINS FINANCIAL AS WELL AS PROGRAM DATA.
GROUP RETURN METHOD FORM 990, PAGE 7, PART VII PARENT ORGANIZATION HAS FILED A SEPARATE RETURN
RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII EDWIN A. NESS WAS PRESIDENT OF MUNSON HEALTHCARE AND ALLOCATED 90% OF HIS TIME TO MUNSON HEALTHCARE SYSTEM MATTERS AND 10% OF HIS TIME TO THE MUNSON HEALTHCARE REGIONAL FOUNDATION. MARK HEPLER, CFO, ALLOCATES 40% OF HIS TIME TO MUNSON HEALTHCARE, SYSTEM PARENT ORGANIZATION; 60% TO MUNSON MEDICAL CENTER; AND LESS THAN AN HOUR A WEEK TO THE REMAINING ORGANIZATIONS IN THE MUNSON HEALTHCARE SYSTEM IN HIS CAPACITY AS CFO FOR ALL MUNSON SYSTEM ORGANIZATIONS. PAUL M. SHIRILLA, VICE PRESIDENT OF GENERAL COUNSEL FOR THE MUNSON HEALTHCARE SYSTEM, ALLOCATES 85% OF HIS TIME TO SYSTEM MATTERS AND 15% TO MUNSON MEDICAL CENTER. KATHLEEN MCMANUS, SENIOR VICE PRESIDENT OF MUNSON MEDICAL CENTER, ALLOCATES 90% OF HER TIME TO MUNSON MEDICAL CENTER AND THE REMAINDER TO SYSTEM ENTITIES. MARK ANTHONY IS A VICE PRESIDENT FOR MUNSON MEDICAL CENTER AND ALLOCATES 95% OF THIS TIME TO THAT COMPANY. HE DEVOTES APPROXIMATELY 2-3 HOURS A WEEK TO MUNSON MOBILE IMAGING AND GREAT LAKES MOBILE PET AS PRESIDENT OF BOTH ENTITIES.
OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 THE OTHER CHANGES IN NET ASSETS INCLUDE THE FOLLOWING ITEMS: CHANGE IN MINIMUM PENSION LIABILITY (61,493,753) UNREALIZED LOSSES ON POOLED INVESTMENT ACCOUNTS (3,836,248) CHANGE IN VALUE OF INTEREST RATE SWAPS (4,060,853) CHANGE IN INVESTMENT VALUE OF ASSETS HELD AT THE FOUNDATION 6,388,898 LOSS ON EXTINGUISHMENT OF DEBT (491,045) TRANSFERS TO AFFILIATES (5,151,166) TOTAL (68,644,167)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MUNSON MEDICAL CENTER
 
Employer identification number

38-1362830
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) MUNSON DIALYSIS CENTER

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-3097861 		DIALYSIS MI (C)(3) 3 MUNSON HC
MUNSON HEALTHCARE
 
No
(2) MUNSON HEALTHCARE

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2640544 		HEALTHCARE MI (C)(3) 11B N/A
 
No
(3) MUNSON HEALTHCARE REGIONAL FOUNDATI

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2642724 		RAISE FUND MI (C)(3) 7 MUNSON HC
MUNSON HEALTHCARE
 
No
(4) MUNSON HOME CARE

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2191390 		HOME HEALT MI (C)(3) 9 MUN HOME H
MUNSON HOME HEALTH
 
No
(5) MUNSON HOME HEALTH

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-3335362 		HOME HEALT MI (C)(3) 11B MUNSON HC
MUNSON HEALTHCARE
 
No
(6) MUNSON HOME SERVICES

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2543463 		HOME HEALT MI (C)(3) 9 MUN HOME H
MUNSON HOME HEALTH
 
No
(7) NORTH FLIGHT INC

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-2657917 		MED TRANSP MI (C)(3) 11B MUNSON HC
MUNSON HEALTHCARE
 
No
(8) PAUL OLIVER MEMORIAL HOSPITAL

1105 SIXTH ST

TRAVERSE CITY,MI49684
38-1415623 		HEALTHCARE MI (C)(3) 3 MUNSON HC
MUNSON HEALTHCARE
 
No
(9) PAUL OLIVER MEMORIAL HOSPITAL FOUND

1105 SIXTH ST

TRAVERSE CITY,MI49684
23-7201619 		RAISE FUND MI (C)(3) 7 PAUL OLV H
PAUL OLIVER MEMORIAL HOSPITAL
 
No
(10) MUNSON MEDICAL GROUP

1105 SIXTH ST

TRAVERSE CITY,MI49684
27-3600575 		PHYSICIAN MI (C)(3) 9 MUNSON MED
MUNSON MEDICAL CENTER
Yes
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) MUNSON MEDICAL BUILDING PARTNERS

PO BOX 1188
TRAVERSE CITY,MI496851188
38-2830005 		REAL ESTAT MI MUNSON MED
MUNSON MEDICAL CENTER 		RELATED 264,979 1,809,871   No   Yes   56.540 %
(2) NORTHERN MICHIGAN SUPPLY ALLIANCE

2651 AERO PARK DR
TRAVERSE CITY,MI49686
38-3453378 		PURCHASING MI N/A
         No     No  
(3) MUNSON MEDICAL BUILDING PARTNERS

PO BOX 1188
TRAVERSE CITY,MI496851188
38-2830005 		REAL ESTAT MI MUNSON MED
MUNSON MEDICAL CENTER 		RELATED 264,979 1,809,871   No   Yes   56.540 %
(4) NORTHERN MICHIGAN SUPPLY ALLIANCE

2651 AERO PARK DR
TRAVERSE CITY,MI49686
38-3453378 		PURCHASING MI N/A
         No     No  






Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) MEDICAL OFFICE CONDOMINIUM
MEDICAL OFFICE CONDOMINIUM
PO BOX 1188
TRAVERSE CITY,MI496851188
20-1902620 		REAL ESTAT MI MUNSON MED
MUNSON MEDICAL CENTER 		C CORP 172,004 53,491 74.000 %
(2) SIXTH STREET DRUGS
PO BOX 1188
TRAVERSE CITY,MI496851188
38-2298290 		PHARMACY MI N/A
        
(3) MUNSON SUPPORT SERVICES
PO BOX 1188
TRAVERSE CITY,MI496851188
38-2872821 		LAUNDRY MI MUNSON MED
MUNSON MEDICAL CENTER 		C CORP 4,366,734 4,886,413 100.000 %
(4) MUNSON SERVICES INC
PO BOX 1188
TRAVERSE CITY,MI496851188
38-3144382 		PHARMACY MI N/A
        
(5) MEDICAL OFFICE BUILDING CONDOMINIUM
MEDICAL OFFICE BUILDING CONDOMINIUM
PO BOX 1188
TRAVERSE CITY,MI496851188
38-3567278 		REAL ESTAT MI MUNSON MED
MUNSON MEDICAL CENTER 		C CORP 62,275 19,117 78.000 %
(6) MUNSON MOBILE IMAGING
PO BOX 1188
TRAVERSE CITY,MI496851188
38-2704069 		IMAGING MI N/A
        
(7) MEDICAL OFFICE CONDOMINIUM
MEDICAL OFFICE CONDOMINIUM
PO BOX 1188
TRAVERSE CITY,MI496851188
20-1902620 		REAL ESTAT MI MUNSON MED
MUNSON MEDICAL CENTER 		C CORP 172,004 53,491 74.000 %
(8) SIXTH STREET DRUGS
PO BOX 1188
TRAVERSE CITY,MI496851188
38-2298290 		PHARMACY MI N/A
        
(9) MUNSON SUPPORT SERVICES
PO BOX 1188
TRAVERSE CITY,MI496851188
38-2872821 		LAUNDRY MI MUNSON MED
MUNSON MEDICAL CENTER 		C CORP 4,366,734 4,886,413 100.000 %
(10) MUNSON SERVICES INC
PO BOX 1188
TRAVERSE CITY,MI496851188
38-3144382 		PHARMACY MI N/A
        
(11) MEDICAL OFFICE BUILDING CONDOMINIUM
MEDICAL OFFICE BUILDING CONDOMINIUM
PO BOX 1188
TRAVERSE CITY,MI496851188
38-3567278 		REAL ESTAT MI MUNSON MED
MUNSON MEDICAL CENTER 		C CORP 62,275 19,117 78.000 %
(12) MUNSON MOBILE IMAGING
PO BOX 1188
TRAVERSE CITY,MI496851188
38-2704069 		IMAGING MI N/A
        
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 P 197,936 FMV
(2) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 J 195,821 FMV
(3) MUNSON DIALYSIS CENTER

 K 129,926 FMV
(4) MUNSON DIALYSIS CENTER

 P 851,100 FMV
(5) MUNSON DIALYSIS CENTER

 N 2,000,580 FMV
(6) MUNSON HEALTHCARE

 B 4,100,000 FMV
(7) MUNSON HEALTHCARE

 L 1,428,288 FMV
(8) MUNSON HEALTHCARE

 N 698,791 FMV
(9) MUNSON HEALTHCARE

 O 2,503,939 FMV
(10) MUNSON HEALTHCARE

 P 6,592,892 FMV
(11) MUNSON HEALTHCARE REGIONAL FOUNDATI

 C 870,379 FMV
(12) MUNSON HEALTHCARE REGIONAL FOUNDATI

 L 499,095 FMV
(13) MUNSON HEALTHCARE REGIONAL FOUNDATI

 O 98,395 FMV
(14) MUNSON HEALTHCARE REGIONAL FOUNDATI

 P 511,744 FMV
(15) MUNSON HOME CARE

 I 131,304 FMV
(16) MUNSON HOME CARE

 K 65,871 FMV
(17) MUNSON HOME CARE

 P 12,438,424 FMV
(18) MUNSON HOME HEALTH

 I 58,800 FMV
(19) MUNSON HOME HEALTH

 O 70,955 FMV
(20) MUNSON HOME HEALTH

 P 1,996,655 FMV
(21) MUNSON HOME SERVICES

 K 73,890 FMV
(22) MUNSON HOME SERVICES

 P 3,345,698 FMV
(23) MUNSON MEDICAL BUILDING PARTNERS

 J 636,349 FMV
(24) MUNSON MEDICAL BUILDING PARTNERS

 P 85,762 FMV
(25) MUNSON MEDICAL GROUP

 B 3,855,000 FMV
(26) MUNSON MEDICAL GROUP

 O 61,703 FMV
(27) MUNSON MEDICAL GROUP

 P 15,342,355 FMV
(28) MUNSON MEDICAL GROUP

 N 2,420,780 FMV
(29) MUNSON MEDICAL GROUP

 L 516,707 FMV
(30) MUNSON MOBILE IMAGING

 H 3,162,523 FMV
(31) MUNSON SERVICES INC

 K 107,388 FMV
(32) MUNSON SERVICES INC

 N 2,206,069 FMV
(33) MUNSON SERVICES INC

 O 74,750 FMV
(34) MUNSON SUPPORT SERVICES

 L 2,111,288 FMV
(35) MUNSON SUPPORT SERVICES

 P 2,000,815 FMV
(36) NORTH FLIGHT INC

 L 52,749 FMV
(37) NORTH FLIGHT INC

 P 6,406,734 FMV
(38) NORTHERN MICHIGAN SUPPLY ALLIANCE

 D 7,200,000 FMV
(39) NORTHERN MICHIGAN SUPPLY ALLIANCE

 I 126,000 FMV
(40) NORTHERN MICHIGAN SUPPLY ALLIANCE

 O 15,791,785 FMV
(41) NORTHERN MICHIGAN SUPPLY ALLIANCE

 N 939,525 FMV
(42) NORTHERN MICHIGAN SUPPLY ALLIANCE

 L 1,879,697 FMV
(43) PAUL OLIVER MEMORIAL HOSPITAL

 K 920,273 FMV
(44) PAUL OLIVER MEMORIAL HOSPITAL

 N 1,024,071 FMV
(45) PAUL OLIVER MEMORIAL HOSPITAL

 P 6,375,983 FMV
(46) SIXTH STREET CONDO ASSOCIATION

 I 60,000 FMV
(47) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 P 197,936 FMV
(48) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 J 195,821 FMV
(49) MUNSON DIALYSIS CENTER

 K 129,926 FMV
(50) MUNSON DIALYSIS CENTER

 P 851,100 FMV
(51) MUNSON DIALYSIS CENTER

 N 2,000,580 FMV
(52) MUNSON HEALTHCARE

 B 4,100,000 FMV
(53) MUNSON HEALTHCARE

 L 1,428,288 FMV
(54) MUNSON HEALTHCARE

 N 698,791 FMV
(55) MUNSON HEALTHCARE

 O 2,503,939 FMV
(56) MUNSON HEALTHCARE

 P 6,592,892 FMV
(57) MUNSON HEALTHCARE REGIONAL FOUNDATI

 C 870,379 FMV
(58) MUNSON HEALTHCARE REGIONAL FOUNDATI

 L 499,095 FMV
(59) MUNSON HEALTHCARE REGIONAL FOUNDATI

 O 98,395 FMV
(60) MUNSON HEALTHCARE REGIONAL FOUNDATI

 P 511,744 FMV
(61) MUNSON HOME CARE

 I 131,304 FMV
(62) MUNSON HOME CARE

 K 65,871 FMV
(63) MUNSON HOME CARE

 P 12,438,424 FMV
(64) MUNSON HOME HEALTH

 I 58,800 FMV
(65) MUNSON HOME HEALTH

 O 70,955 FMV
(66) MUNSON HOME HEALTH

 P 1,996,655 FMV
(67) MUNSON HOME SERVICES

 K 73,890 FMV
(68) MUNSON HOME SERVICES

 P 3,345,698 FMV
(69) MUNSON MEDICAL BUILDING PARTNERS

 J 636,349 FMV
(70) MUNSON MEDICAL BUILDING PARTNERS

 P 85,762 FMV
(71) MUNSON MEDICAL GROUP

 B 3,855,000 FMV
(72) MUNSON MEDICAL GROUP

 O 61,703 FMV
(73) MUNSON MEDICAL GROUP

 P 15,342,355 FMV
(74) MUNSON MEDICAL GROUP

 N 2,420,780 FMV
(75) MUNSON MEDICAL GROUP

 L 516,707 FMV
(76) MUNSON MOBILE IMAGING

 H 3,162,523 FMV
(77) MUNSON SERVICES INC

 K 107,388 FMV
(78) MUNSON SERVICES INC

 N 2,206,069 FMV
(79) MUNSON SERVICES INC

 O 74,750 FMV
(80) MUNSON SUPPORT SERVICES

 L 2,111,288 FMV
(81) MUNSON SUPPORT SERVICES

 P 2,000,815 FMV
(82) NORTH FLIGHT INC

 L 52,749 FMV
(83) NORTH FLIGHT INC

 P 6,406,734 FMV
(84) NORTHERN MICHIGAN SUPPLY ALLIANCE

 D 7,200,000 FMV
(85) NORTHERN MICHIGAN SUPPLY ALLIANCE

 I 126,000 FMV
(86) NORTHERN MICHIGAN SUPPLY ALLIANCE

 O 15,791,785 FMV
(87) NORTHERN MICHIGAN SUPPLY ALLIANCE

 N 939,525 FMV
(88) NORTHERN MICHIGAN SUPPLY ALLIANCE

 L 1,879,697 FMV
(89) PAUL OLIVER MEMORIAL HOSPITAL

 K 920,273 FMV
(90) PAUL OLIVER MEMORIAL HOSPITAL

 N 1,024,071 FMV
(91) PAUL OLIVER MEMORIAL HOSPITAL

 P 6,375,983 FMV
(92) SIXTH STREET CONDO ASSOCIATION

 I 60,000 FMV
(93) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 P 197,936 FMV
(94) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 J 195,821 FMV
(95) MUNSON DIALYSIS CENTER

 K 129,926 FMV
(96) MUNSON DIALYSIS CENTER

 P 851,100 FMV
(97) MUNSON DIALYSIS CENTER

 N 2,000,580 FMV
(98) MUNSON HEALTHCARE

 B 4,100,000 FMV
(99) MUNSON HEALTHCARE

 L 1,428,288 FMV
(100) MUNSON HEALTHCARE

 N 698,791 FMV
(101) MUNSON HEALTHCARE

 O 2,503,939 FMV
(102) MUNSON HEALTHCARE

 P 6,592,892 FMV
(103) MUNSON HEALTHCARE REGIONAL FOUNDATI

 C 870,379 FMV
(104) MUNSON HEALTHCARE REGIONAL FOUNDATI

 L 499,095 FMV
(105) MUNSON HEALTHCARE REGIONAL FOUNDATI

 O 98,395 FMV
(106) MUNSON HEALTHCARE REGIONAL FOUNDATI

 P 511,744 FMV
(107) MUNSON HOME CARE

 I 131,304 FMV
(108) MUNSON HOME CARE

 K 65,871 FMV
(109) MUNSON HOME CARE

 P 12,438,424 FMV
(110) MUNSON HOME HEALTH

 I 58,800 FMV
(111) MUNSON HOME HEALTH

 O 70,955 FMV
(112) MUNSON HOME HEALTH

 P 1,996,655 FMV
(113) MUNSON HOME SERVICES

 K 73,890 FMV
(114) MUNSON HOME SERVICES

 P 3,345,698 FMV
(115) MUNSON MEDICAL BUILDING PARTNERS

 J 636,349 FMV
(116) MUNSON MEDICAL BUILDING PARTNERS

 P 85,762 FMV
(117) MUNSON MEDICAL GROUP

 B 3,855,000 FMV
(118) MUNSON MEDICAL GROUP

 O 61,703 FMV
(119) MUNSON MEDICAL GROUP

 P 15,342,355 FMV
(120) MUNSON MEDICAL GROUP

 N 2,420,780 FMV
(121) MUNSON MEDICAL GROUP

 L 516,707 FMV
(122) MUNSON MOBILE IMAGING

 H 3,162,523 FMV
(123) MUNSON SERVICES INC

 K 107,388 FMV
(124) MUNSON SERVICES INC

 N 2,206,069 FMV
(125) MUNSON SERVICES INC

 O 74,750 FMV
(126) MUNSON SUPPORT SERVICES

 L 2,111,288 FMV
(127) MUNSON SUPPORT SERVICES

 P 2,000,815 FMV
(128) NORTH FLIGHT INC

 L 52,749 FMV
(129) NORTH FLIGHT INC

 P 6,406,734 FMV
(130) NORTHERN MICHIGAN SUPPLY ALLIANCE

 D 7,200,000 FMV
(131) NORTHERN MICHIGAN SUPPLY ALLIANCE

 I 126,000 FMV
(132) NORTHERN MICHIGAN SUPPLY ALLIANCE

 O 15,791,785 FMV
(133) NORTHERN MICHIGAN SUPPLY ALLIANCE

 N 939,525 FMV
(134) NORTHERN MICHIGAN SUPPLY ALLIANCE

 L 1,879,697 FMV
(135) PAUL OLIVER MEMORIAL HOSPITAL

 K 920,273 FMV
(136) PAUL OLIVER MEMORIAL HOSPITAL

 N 1,024,071 FMV
(137) PAUL OLIVER MEMORIAL HOSPITAL

 P 6,375,983 FMV
(138) SIXTH STREET CONDO ASSOCIATION

 I 60,000 FMV
(139) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 P 197,936 FMV
(140) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 J 195,821 FMV
(141) MUNSON DIALYSIS CENTER

 K 129,926 FMV
(142) MUNSON DIALYSIS CENTER

 P 851,100 FMV
(143) MUNSON DIALYSIS CENTER

 N 2,000,580 FMV
(144) MUNSON HEALTHCARE

 B 4,100,000 FMV
(145) MUNSON HEALTHCARE

 L 1,428,288 FMV
(146) MUNSON HEALTHCARE

 N 698,791 FMV
(147) MUNSON HEALTHCARE

 O 2,503,939 FMV
(148) MUNSON HEALTHCARE

 P 6,592,892 FMV
(149) MUNSON HEALTHCARE REGIONAL FOUNDATI

 C 870,379 FMV
(150) MUNSON HEALTHCARE REGIONAL FOUNDATI

 L 499,095 FMV
(151) MUNSON HEALTHCARE REGIONAL FOUNDATI

 O 98,395 FMV
(152) MUNSON HEALTHCARE REGIONAL FOUNDATI

 P 511,744 FMV
(153) MUNSON HOME CARE

 I 131,304 FMV
(154) MUNSON HOME CARE

 K 65,871 FMV
(155) MUNSON HOME CARE

 P 12,438,424 FMV
(156) MUNSON HOME HEALTH

 I 58,800 FMV
(157) MUNSON HOME HEALTH

 O 70,955 FMV
(158) MUNSON HOME HEALTH

 P 1,996,655 FMV
(159) MUNSON HOME SERVICES

 K 73,890 FMV
(160) MUNSON HOME SERVICES

 P 3,345,698 FMV
(161) MUNSON MEDICAL BUILDING PARTNERS

 J 636,349 FMV
(162) MUNSON MEDICAL BUILDING PARTNERS

 P 85,762 FMV
(163) MUNSON MEDICAL GROUP

 B 3,855,000 FMV
(164) MUNSON MEDICAL GROUP

 O 61,703 FMV
(165) MUNSON MEDICAL GROUP

 P 15,342,355 FMV
(166) MUNSON MEDICAL GROUP

 N 2,420,780 FMV
(167) MUNSON MEDICAL GROUP

 L 516,707 FMV
(168) MUNSON MOBILE IMAGING

 H 3,162,523 FMV
(169) MUNSON SERVICES INC

 K 107,388 FMV
(170) MUNSON SERVICES INC

 N 2,206,069 FMV
(171) MUNSON SERVICES INC

 O 74,750 FMV
(172) MUNSON SUPPORT SERVICES

 L 2,111,288 FMV
(173) MUNSON SUPPORT SERVICES

 P 2,000,815 FMV
(174) NORTH FLIGHT INC

 L 52,749 FMV
(175) NORTH FLIGHT INC

 P 6,406,734 FMV
(176) NORTHERN MICHIGAN SUPPLY ALLIANCE

 D 7,200,000 FMV
(177) NORTHERN MICHIGAN SUPPLY ALLIANCE

 I 126,000 FMV
(178) NORTHERN MICHIGAN SUPPLY ALLIANCE

 O 15,791,785 FMV
(179) NORTHERN MICHIGAN SUPPLY ALLIANCE

 N 939,525 FMV
(180) NORTHERN MICHIGAN SUPPLY ALLIANCE

 L 1,879,697 FMV
(181) PAUL OLIVER MEMORIAL HOSPITAL

 K 920,273 FMV
(182) PAUL OLIVER MEMORIAL HOSPITAL

 N 1,024,071 FMV
(183) PAUL OLIVER MEMORIAL HOSPITAL

 P 6,375,983 FMV
(184) SIXTH STREET CONDO ASSOCIATION

 I 60,000 FMV
(185) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 P 197,936 FMV
(186) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 J 195,821 FMV
(187) MUNSON DIALYSIS CENTER

 K 129,926 FMV
(188) MUNSON DIALYSIS CENTER

 P 851,100 FMV
(189) MUNSON DIALYSIS CENTER

 N 2,000,580 FMV
(190) MUNSON HEALTHCARE

 B 4,100,000 FMV
(191) MUNSON HEALTHCARE

 L 1,428,288 FMV
(192) MUNSON HEALTHCARE

 N 698,791 FMV
(193) MUNSON HEALTHCARE

 O 2,503,939 FMV
(194) MUNSON HEALTHCARE

 P 6,592,892 FMV
(195) MUNSON HEALTHCARE REGIONAL FOUNDATI

 C 870,379 FMV
(196) MUNSON HEALTHCARE REGIONAL FOUNDATI

 L 499,095 FMV
(197) MUNSON HEALTHCARE REGIONAL FOUNDATI

 O 98,395 FMV
(198) MUNSON HEALTHCARE REGIONAL FOUNDATI

 P 511,744 FMV
(199) MUNSON HOME CARE

 I 131,304 FMV
(200) MUNSON HOME CARE

 K 65,871 FMV
(201) MUNSON HOME CARE

 P 12,438,424 FMV
(202) MUNSON HOME HEALTH

 I 58,800 FMV
(203) MUNSON HOME HEALTH

 O 70,955 FMV
(204) MUNSON HOME HEALTH

 P 1,996,655 FMV
(205) MUNSON HOME SERVICES

 K 73,890 FMV
(206) MUNSON HOME SERVICES

 P 3,345,698 FMV
(207) MUNSON MEDICAL BUILDING PARTNERS

 J 636,349 FMV
(208) MUNSON MEDICAL BUILDING PARTNERS

 P 85,762 FMV
(209) MUNSON MEDICAL GROUP

 B 3,855,000 FMV
(210) MUNSON MEDICAL GROUP

 O 61,703 FMV
(211) MUNSON MEDICAL GROUP

 P 15,342,355 FMV
(212) MUNSON MEDICAL GROUP

 N 2,420,780 FMV
(213) MUNSON MEDICAL GROUP

 L 516,707 FMV
(214) MUNSON MOBILE IMAGING

 H 3,162,523 FMV
(215) MUNSON SERVICES INC

 K 107,388 FMV
(216) MUNSON SERVICES INC

 N 2,206,069 FMV
(217) MUNSON SERVICES INC

 O 74,750 FMV
(218) MUNSON SUPPORT SERVICES

 L 2,111,288 FMV
(219) MUNSON SUPPORT SERVICES

 P 2,000,815 FMV
(220) NORTH FLIGHT INC

 L 52,749 FMV
(221) NORTH FLIGHT INC

 P 6,406,734 FMV
(222) NORTHERN MICHIGAN SUPPLY ALLIANCE

 D 7,200,000 FMV
(223) NORTHERN MICHIGAN SUPPLY ALLIANCE

 I 126,000 FMV
(224) NORTHERN MICHIGAN SUPPLY ALLIANCE

 O 15,791,785 FMV
(225) NORTHERN MICHIGAN SUPPLY ALLIANCE

 N 939,525 FMV
(226) NORTHERN MICHIGAN SUPPLY ALLIANCE

 L 1,879,697 FMV
(227) PAUL OLIVER MEMORIAL HOSPITAL

 K 920,273 FMV
(228) PAUL OLIVER MEMORIAL HOSPITAL

 N 1,024,071 FMV
(229) PAUL OLIVER MEMORIAL HOSPITAL

 P 6,375,983 FMV
(230) SIXTH STREET CONDO ASSOCIATION

 I 60,000 FMV
(231) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 P 197,936 FMV
(232) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 J 195,821 FMV
(233) MUNSON DIALYSIS CENTER

 K 129,926 FMV
(234) MUNSON DIALYSIS CENTER

 P 851,100 FMV
(235) MUNSON DIALYSIS CENTER

 N 2,000,580 FMV
(236) MUNSON HEALTHCARE

 B 4,100,000 FMV
(237) MUNSON HEALTHCARE

 L 1,428,288 FMV
(238) MUNSON HEALTHCARE

 N 698,791 FMV
(239) MUNSON HEALTHCARE

 O 2,503,939 FMV
(240) MUNSON HEALTHCARE

 P 6,592,892 FMV
(241) MUNSON HEALTHCARE REGIONAL FOUNDATI

 C 870,379 FMV
(242) MUNSON HEALTHCARE REGIONAL FOUNDATI

 L 499,095 FMV
(243) MUNSON HEALTHCARE REGIONAL FOUNDATI

 O 98,395 FMV
(244) MUNSON HEALTHCARE REGIONAL FOUNDATI

 P 511,744 FMV
(245) MUNSON HOME CARE

 I 131,304 FMV
(246) MUNSON HOME CARE

 K 65,871 FMV
(247) MUNSON HOME CARE

 P 12,438,424 FMV
(248) MUNSON HOME HEALTH

 I 58,800 FMV
(249) MUNSON HOME HEALTH

 O 70,955 FMV
(250) MUNSON HOME HEALTH

 P 1,996,655 FMV
(251) MUNSON HOME SERVICES

 K 73,890 FMV
(252) MUNSON HOME SERVICES

 P 3,345,698 FMV
(253) MUNSON MEDICAL BUILDING PARTNERS

 J 636,349 FMV
(254) MUNSON MEDICAL BUILDING PARTNERS

 P 85,762 FMV
(255) MUNSON MEDICAL GROUP

 B 3,855,000 FMV
(256) MUNSON MEDICAL GROUP

 O 61,703 FMV
(257) MUNSON MEDICAL GROUP

 P 15,342,355 FMV
(258) MUNSON MEDICAL GROUP

 N 2,420,780 FMV
(259) MUNSON MEDICAL GROUP

 L 516,707 FMV
(260) MUNSON MOBILE IMAGING

 H 3,162,523 FMV
(261) MUNSON SERVICES INC

 K 107,388 FMV
(262) MUNSON SERVICES INC

 N 2,206,069 FMV
(263) MUNSON SERVICES INC

 O 74,750 FMV
(264) MUNSON SUPPORT SERVICES

 L 2,111,288 FMV
(265) MUNSON SUPPORT SERVICES

 P 2,000,815 FMV
(266) NORTH FLIGHT INC

 L 52,749 FMV
(267) NORTH FLIGHT INC

 P 6,406,734 FMV
(268) NORTHERN MICHIGAN SUPPLY ALLIANCE

 D 7,200,000 FMV
(269) NORTHERN MICHIGAN SUPPLY ALLIANCE

 I 126,000 FMV
(270) NORTHERN MICHIGAN SUPPLY ALLIANCE

 O 15,791,785 FMV
(271) NORTHERN MICHIGAN SUPPLY ALLIANCE

 N 939,525 FMV
(272) NORTHERN MICHIGAN SUPPLY ALLIANCE

 L 1,879,697 FMV
(273) PAUL OLIVER MEMORIAL HOSPITAL

 K 920,273 FMV
(274) PAUL OLIVER MEMORIAL HOSPITAL

 N 1,024,071 FMV
(275) PAUL OLIVER MEMORIAL HOSPITAL

 P 6,375,983 FMV
(276) SIXTH STREET CONDO ASSOCIATION

 I 60,000 FMV
(277) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 P 197,936 FMV
(278) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 J 195,821 FMV
(279) MUNSON DIALYSIS CENTER

 K 129,926 FMV
(280) MUNSON DIALYSIS CENTER

 P 851,100 FMV
(281) MUNSON DIALYSIS CENTER

 N 2,000,580 FMV
(282) MUNSON HEALTHCARE

 B 4,100,000 FMV
(283) MUNSON HEALTHCARE

 L 1,428,288 FMV
(284) MUNSON HEALTHCARE

 N 698,791 FMV
(285) MUNSON HEALTHCARE

 O 2,503,939 FMV
(286) MUNSON HEALTHCARE

 P 6,592,892 FMV
(287) MUNSON HEALTHCARE REGIONAL FOUNDATI

 C 870,379 FMV
(288) MUNSON HEALTHCARE REGIONAL FOUNDATI

 L 499,095 FMV
(289) MUNSON HEALTHCARE REGIONAL FOUNDATI

 O 98,395 FMV
(290) MUNSON HEALTHCARE REGIONAL FOUNDATI

 P 511,744 FMV
(291) MUNSON HOME CARE

 I 131,304 FMV
(292) MUNSON HOME CARE

 K 65,871 FMV
(293) MUNSON HOME CARE

 P 12,438,424 FMV
(294) MUNSON HOME HEALTH

 I 58,800 FMV
(295) MUNSON HOME HEALTH

 O 70,955 FMV
(296) MUNSON HOME HEALTH

 P 1,996,655 FMV
(297) MUNSON HOME SERVICES

 K 73,890 FMV
(298) MUNSON HOME SERVICES

 P 3,345,698 FMV
(299) MUNSON MEDICAL BUILDING PARTNERS

 J 636,349 FMV
(300) MUNSON MEDICAL BUILDING PARTNERS

 P 85,762 FMV
(301) MUNSON MEDICAL GROUP

 B 3,855,000 FMV
(302) MUNSON MEDICAL GROUP

 O 61,703 FMV
(303) MUNSON MEDICAL GROUP

 P 15,342,355 FMV
(304) MUNSON MEDICAL GROUP

 N 2,420,780 FMV
(305) MUNSON MEDICAL GROUP

 L 516,707 FMV
(306) MUNSON MOBILE IMAGING

 H 3,162,523 FMV
(307) MUNSON SERVICES INC

 K 107,388 FMV
(308) MUNSON SERVICES INC

 N 2,206,069 FMV
(309) MUNSON SERVICES INC

 O 74,750 FMV
(310) MUNSON SUPPORT SERVICES

 L 2,111,288 FMV
(311) MUNSON SUPPORT SERVICES

 P 2,000,815 FMV
(312) NORTH FLIGHT INC

 L 52,749 FMV
(313) NORTH FLIGHT INC

 P 6,406,734 FMV
(314) NORTHERN MICHIGAN SUPPLY ALLIANCE

 D 7,200,000 FMV
(315) NORTHERN MICHIGAN SUPPLY ALLIANCE

 I 126,000 FMV
(316) NORTHERN MICHIGAN SUPPLY ALLIANCE

 O 15,791,785 FMV
(317) NORTHERN MICHIGAN SUPPLY ALLIANCE

 N 939,525 FMV
(318) NORTHERN MICHIGAN SUPPLY ALLIANCE

 L 1,879,697 FMV
(319) PAUL OLIVER MEMORIAL HOSPITAL

 K 920,273 FMV
(320) PAUL OLIVER MEMORIAL HOSPITAL

 N 1,024,071 FMV
(321) PAUL OLIVER MEMORIAL HOSPITAL

 P 6,375,983 FMV
(322) SIXTH STREET CONDO ASSOCIATION

 I 60,000 FMV
(323) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 P 197,936 FMV
(324) MEDICAL OFFICE BUILDING CONDOMINIUM
ASSOCIATION
 J 195,821 FMV
(325) MUNSON DIALYSIS CENTER

 K 129,926 FMV
(326) MUNSON DIALYSIS CENTER

 P 851,100 FMV
(327) MUNSON DIALYSIS CENTER

 N 2,000,580 FMV
(328) MUNSON HEALTHCARE

 B 4,100,000 FMV
(329) MUNSON HEALTHCARE

 L 1,428,288 FMV
(330) MUNSON HEALTHCARE

 N 698,791 FMV
(331) MUNSON HEALTHCARE

 O 2,503,939 FMV
(332) MUNSON HEALTHCARE

 P 6,592,892 FMV
(333) MUNSON HEALTHCARE REGIONAL FOUNDATI

 C 870,379 FMV
(334) MUNSON HEALTHCARE REGIONAL FOUNDATI

 L 499,095 FMV
(335) MUNSON HEALTHCARE REGIONAL FOUNDATI

 O 98,395 FMV
(336) MUNSON HEALTHCARE REGIONAL FOUNDATI

 P 511,744 FMV
(337) MUNSON HOME CARE

 I 131,304 FMV
(338) MUNSON HOME CARE

 K 65,871 FMV
(339) MUNSON HOME CARE

 P 12,438,424 FMV
(340) MUNSON HOME HEALTH

 I 58,800 FMV
(341) MUNSON HOME HEALTH

 O 70,955 FMV
(342) MUNSON HOME HEALTH

 P 1,996,655 FMV
(343) MUNSON HOME SERVICES

 K 73,890 FMV
(344) MUNSON HOME SERVICES

 P 3,345,698 FMV
(345) MUNSON MEDICAL BUILDING PARTNERS

 J 636,349 FMV
(346) MUNSON MEDICAL BUILDING PARTNERS

 P 85,762 FMV
(347) MUNSON MEDICAL GROUP

 B 3,855,000 FMV
(348) MUNSON MEDICAL GROUP

 O 61,703 FMV
(349) MUNSON MEDICAL GROUP

 P 15,342,355 FMV
(350) MUNSON MEDICAL GROUP

 N 2,420,780 FMV
(351) MUNSON MEDICAL GROUP

 L 516,707 FMV
(352) MUNSON MOBILE IMAGING

 H 3,162,523 FMV
(353) MUNSON SERVICES INC

 K 107,388 FMV
(354) MUNSON SERVICES INC

 N 2,206,069 FMV
(355) MUNSON SERVICES INC

 O 74,750 FMV
(356) MUNSON SUPPORT SERVICES

 L 2,111,288 FMV
(357) MUNSON SUPPORT SERVICES

 P 2,000,815 FMV
(358) NORTH FLIGHT INC

 L 52,749 FMV
(359) NORTH FLIGHT INC

 P 6,406,734 FMV
(360) NORTHERN MICHIGAN SUPPLY ALLIANCE

 D 7,200,000 FMV
(361) NORTHERN MICHIGAN SUPPLY ALLIANCE

 I 126,000 FMV
(362) NORTHERN MICHIGAN SUPPLY ALLIANCE

 O 15,791,785 FMV
(363) NORTHERN MICHIGAN SUPPLY ALLIANCE

 N 939,525 FMV
(364) NORTHERN MICHIGAN SUPPLY ALLIANCE

 L 1,879,697 FMV
(365) PAUL OLIVER MEMORIAL HOSPITAL

 K 920,273 FMV
(366) PAUL OLIVER MEMORIAL HOSPITAL

 N 1,024,071 FMV
(367) PAUL OLIVER MEMORIAL HOSPITAL

 P 6,375,983 FMV
(368) SIXTH STREET CONDO ASSOCIATION

 I 60,000 FMV
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE R MUNSON MEDICAL CENTER USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED SUMMARIZED AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS
Additional Data


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