TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JEAN MEYER PRESIDENT & CEO	1.0 ................. 59.0	X	X		0	1,764,659	47,235
(2) JOHN SMITH BOARD CHAIR	1.0 ................. 5.0	X	X		0	0	0
(3) MARITA GROBBEL SECRETARY	1.0 ................. 5.0	X	X		0	0	0
(4) KATHY RYAN VICE CHAIR	1.0 ................. 5.0	X	X		0	0	0
(5) JAMES SAWYER TREASURER	1.0 ................. 5.0	X	X		0	0	0
(6) SR XAVIER BALLANCE DC BOARD MEMBER	1.0 ................. 8.0	X			0	0	0
(7) JIM COLE JR BOARD MEMBER	1.0 ................. 7.0	X			0	0	0
(8) CHRISTINE CRADER MD BOARD MEMBER	1.0 ................. 5.0	X			0	0	0
(9) JOHN REEVES BOARD MEMBER	1.0 ................. 5.0	X			0	0	0
(10) DAVE STEPHENS BOARD MEMBER	1.0 ................. 5.0	X			0	0	0
(11) ISAAC GRINBERG MD BOARD MEMBER	1.0 ................. 5.0	X			0	0	0
(12) CHRISTINE PARKS CSJ Board Member	1.0 ................. 5.0	X			0	0	0
(13) STEVEN RIVERA MD BOARD MEMBER	1.0 ................. 5.0	X			0	0	0
(14) TERENCE HAMILTON HOSPITAL PRESIDENT	50.0 ................. 0.0		X		423,844	0	38,583
(15) TOMASINE F MARX VP FINANCE & CFO	1.0 ................. 51.0		X		0	388,557	42,454
(16) MARYANN BARNES VP NURSING	50.0 ................. 0			X	297,415	0	28,408
(17) GARY BERG DO CHIEF MEDICAL OFFICER	50.0 ................. 0			X	419,414	0	39,209

(A) Name and business address	(B) Description of services	(C) Compensation
LINGAREDDY DEVIREDDY MD 11900 E 12 MILE ROAD SUITE 103 WARREN,MI48093	MEDICAL SERVICES	2,463,014
DIAGNOSTIC RADIOLOGY 2668 GENNY RIDGE DRIVE LAPEER,MI484468412	MEDICAL SERVICES	1,076,016
MENDELSON ORTHOPEDICS 27472 SCHOENHERR ROAD SUITE 140 WARREN,MI480886681	MEDICAL SERVICES	821,243
SYNTHES USA SALES LLC 1302 WRIGHTS LN E WEST CHESTER,PA19380	MEDICAL SERVICES	786,084
MACOMB SURGICAL SPECIALISTS 27472 SCHOENHERR RD SUITE 150 WARREN,MI48088	MEDICAL SERVICES	703,274
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 32

- TIN:

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

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

St John Macomb-Oakland Hospital

Employer identification number

38-3322109

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

St John Macomb-Oakland Hospital

Employer identification number

38-3322109

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

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 SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ..............................................................................................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable 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) 2015

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

16,934

Total. Add lines 1c through 1i ....................................................................................................

16,934

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. John Macomb-Oakland Hospital does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. John Macomb-Oakland Hospital does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St John Macomb-Oakland Hospital

Employer identification number

38-3322109

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

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? ...........

Yes No

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? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, 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" on Form 990, Part IV, line 8.

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 XIII, the text of the footnote to its financial statements that describes these items.

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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII 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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on 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 ....	34,805	31,330	45,127	42,637	39,967
b	Contributions ...	1,600	1,874	300	300	599
c	Net investment earnings, gains, and losses	1,645	1,601	2,293	2,190	2,071
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...		0	16,390
f	Administrative expenses ....
g	End of year balance ......	38,050	34,805	31,330	45,127	42,637

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

87 %

Temporarily restricted endowment SchDMd Bullet

13 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. 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 ...	2,060,865		2,060,865
b	Buildings	161,324,487	134,037,381	27,287,106
c	Leasehold improvements	525,935	371,769	154,166
d	Equipment ...	130,852,158	109,705,837	21,146,321
e	Other ...	8,547,733	6,951,089	1,596,644
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				52,245,102

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) SELF INSURANCE FUND				5,109,903
(2) INTEREST IN INVESTMENTS OF AHA				-164,269
(3) WORKERS COMPENSATION FUND				791,205
(4) OTHER ASSETS				10,000
(5) DUE FROM AFFILIATES				223,710,359
(6) ESTIMATED 3RD PARTY PAYOR SETTLEMENTS				4,882,068
(7) OTHER RECEIVABLES				815,333
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				235,154,599

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
ESTIMATED THIRD PARTY SETTLEMENTS	20,934,956
SELF INSURANCE LIABILITY	7,852,431
OTHER LIABILITIES	1,266
INTERCOMPANY DEBT WITH ASCENSION HEALTH ALLIANCE	183,505,797
DUE TO AFFILIATES
HISTORICAL ALLOWANCES
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	212,294,450
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	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 XIII.) ...........	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 XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 XIII.) ............	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 XIII.) ............	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 XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Schedule D, Part V, Line 4 Intended uses of endowment funds

Endowment funds are created to support the healthcare ministry of St. John Health System Hospitals. The distributions from an endowment provide a dependable source of income each year to help St. John continue to meet the community's healthcare needs.

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

From the consolidated audited financial statements of Ascension Health Alliance ("the system") (which include the activity of St. John Macomb-Oakland Hospital): The system accounts for uncertainty in income tax position by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The system has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2016.

Schedule D (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St John Macomb-Oakland Hospital

Employer identification number

38-3322109

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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, as a factor in determining eligibility for free or discounted care.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) . . .			79,645		79,645	0.02 %
b	Medicaid (from Worksheet 3, column a) . . . . .			77,315,325	79,587,834	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	77,394,970	79,587,834	79,645	0.02 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			931,395		931,395	0.24 %
f	Health professions education (from Worksheet 5) . . .			32,997,525	14,730,066	18,267,459	4.62 %
g	Subsidized health services (from Worksheet 6) . . . .			695,814		695,814	0.18 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			408,334		408,334	0.10 %
j	Total. Other Benefits . .	0	0	35,033,068	14,730,066	20,303,002	5.13 %
k	Total. Add lines 7d and 7j .	0	0	112,428,038	94,317,900	20,382,647	5.15 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

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
1	Physical improvements and housing					0
2	Economic development					0
3	Community support		700	1,959		1,959
4	Environmental improvements					0
5	Leadership development and training for community members					0
6	Coalition building					0
7	Community health improvement advocacy					0
8	Workforce development					0
9	Other					0
10	Total	0	700	1,959	0	1,959

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

26,220,050

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

5,918,318

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

204,139,617

Enter Medicare allowable costs of care relating to payments on line 5.....

179,138,592

Subtract line 6 from line 5. This is the surplus (or shortfall)........

25,001,025

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	St John Macomb-Oakland Hospital Warren 11800 E 12 MILE RD WARREN,MI48093 WWW.STJOHNPROVIDNCE.ORG/MACOMB 1060000080	X	X	X	X	A
2	St John Macomb-Oakland Hospital Madison Heights 27351 DEQUINDRE MADISON HEIGHTS,MI48071 WWW.STJOHNPROVIDENCE.ORG/OAKLAND 1060000175	X	X	X	X	A

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): http://www.stjohnprovidence.org/?id=2311&sid=1#.WCeMWuhRDuM.email

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): http://www.stjohnprovidence.org/?id=2311&sid=1#.WCeMWuhRDuM.email

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0% and FPG family income limit for eligibility for discounted care of 300.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

http://www.stjohnprovidence.org/patients-and-visitors/financial-assistance/.

The FAP application form was widely available on a website (list url):

http://www.stjohnprovidence.org/patients-and-visitors/financial-assistance/.

A plain language summary of the FAP was widely available on a website (list url):
http://www.stjohnprovidence.org/patients-and-visitors/financial-assistance/.

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility A, 1	Facility A, 1 - Facility Group A St. John Macomb-Oakland Hospital, Warren Line 1, St. John Macomb-Oakland Hospital, Madison Heights Line 2. A Steering Committee was convened to provide guidance and oversight in the development of the CHNA. The committee included all of the directors from the local health departments, as well as individuals from a variety of health professions such as public health, physicians, nurses, finance, health planning, communications, behavioral health and faith-based leaders. St. John Community Health led the CHNA process for all St. John Providence hospitals. Macomb, Oakland, Wayne, St. Clair and Livingston County, and Detroit Health Departments provided public health expertise about current health issues and trends. Healthy Communities Institute offered us a model for the CHNA and Implementation Strategies as well as a frame work for developing implementation strategies using logic models.
Schedule H, Part V, Section B, Line 6a Facility A, 1	Facility A, 1 - Facility Group A St. John Macomb-Oakland Hospital, Warren Line 1, St. John Macomb-Oakland Hospital, Madison Heights Line 2. The community health needs assessment was conducted with the following facilities: 1. St. John Hospital & Medical Center 2. Providence-Providence Park Hospital-Southfield 3. Providence-Providence Park Hospital-Novi 4. St. John River District Hospital 5. Brighton Center for Recovery
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - Facility Group A St. John Macomb-Oakland Hospital, Warren Line 1, St. John Macomb-Oakland Hospital, Madison Heights Line 2. The significant needs identified in the most recently conducted CHNA are Obesity and Diabetes Prevention, Access to Care and Mental Health and Substance Abuse. Although other health needs were identified, it was determined that the health system will work with other organizations as needed to address health needs not selected. For each selected priority, strategies have been developed that focus on outreach and education, evidence-based interventions or advocacy. Summary of Implementation Strategies Prioritized Need: Obesity and Diabetes Prevention Goal 1: Prevent and reduce obesity in children, youth and adults (across the lifespan). Strategy 1: Implement evidence-based, breast-feeding interventions, including Mother Nurture, to improve awareness, knowledge and behaviors for preventing and reducing obesity, for communities, including those that are diverse and underserved. Strategy 2: Implement 5-2-1-0 as an age-appropriate community-wide education and evidence-based intervention that improves awareness, knowledge and behaviors for preventing and reducing obesity in communities, including those that are diverse and underserved. Strategy 3: Implement Enhance Fitness as an age-appropriate community wide education and evidence-based intervention to improve awareness, knowledge and behaviors for preventing and reducing obesity in communities, including those that are diverse and underserved. Goal 2: Prevent and reduce risk factors for diabetes in adults. Strategy 1: Implement Diabetes Prevention Program as a community-wide education and evidence-based intervention that prevents and reduces the complications of diabetes in communities, including those that are diverse and underserved. Strategy 2: Implement the Diabetes Self-Management Program as a community-wide education and evidence-based intervention that prevents and reduces the complications of diabetes in communities, including those that are diverse and underserved. Prioritized Need: Access to Care Goal 1: Reduce the social determinants of health barriers that impact health equity and access to healthcare. Strategy 1: Implement Mobile Mammography to improve patient access to care. Strategy 2: Implement Asthma Camp and Deep Breath to improve patient access to care. Strategy 3: Convene a transportation workgroup to develop strategies and interventions leading to improved options for transportation to obtain needed care. Strategy 4: Implement a Health Literacy Information and Education Series for physicians, staff and patients to improve knowledge about universal health literacy precautions and strategies for reducing health illiteracy. Prioritized Need: Mental Health & Substance Abuse Goal 1: Decrease youth risk factors for suicide, depression and substance abuse. Strategy 1: : Implement the Rapid Assessment for Adolescent Preventive Services (RAAPS) as a suicide risk screening and provide mental health education, counseling and referral for youth in partner schools. Strategy 2: Implement Red Flags mental health education, counseling and referral for youth in partner schools. Goal 2: Decrease youth and adult risk factors for suicide, depression and substance abuse. Strategy 1: Implement Mental Health First Aid to focus on changing the community/culture and perception of persons with less than optimal mental health. Goal 3: Decrease youth risk factors for post-traumatic stress disorder Strategy 1: Utilize the Trauma Symptoms Checklist for Children to screen for posttraumatic stress and related psychological symptomatology and provide appropriate counseling and referrals. Goal 4: Prevent and reduce addiction / mental illness in children, youth and adults (across the lifespan). Strategy 1: Utilize the Screening, Brief Intervention, and Referral to Treatment (SBIRT). Strategy 2: Provide family education to families involved with and at risk for substance use disorders. St. John Providence will not address certain identified health needs and concerns because other programs are currently offering an array of services for the community and those particular health needs and concerns are listed below with the resources, agencies and services currently established to address them: - Cardiovascular Disease - This is widely addressed through St. John Providence and its Cardiovascular Centers of Excellence; the American Heart Association; and other programs such as the Project Healthy Living multi-county screening program. - Cancer - St. John Providence has 4 cancer centers with 2 located in the service area. Additionally, the American Cancer Society, primary care standards of practice, and other cancer centers in the area provide screening and community-based education. Further, the state of Michigan with its BCCCP (Breast and Cervical Cancer Control Program) provides for routine mammograms for low-income and uninsured women - Asthma - Asthma is predominately a condition of children and youth in the service area. Through the SJP school-based health centers and other school-based health centers in the area, this is being addressed. Asthma education, asthma screening, and summer asthma camps are provided along with the handling of acute episodes in the school clinics with parental consent.
Schedule H, Part V, Section B, Line 11 Facility A, 2	Facility A, 2 - St. John Macomb-Oakland. NEEDS IDENTIFIED IN CHNA 2012 Priority Health Area #1: DIABETES PREVENTION Diabetes is a leading cause of death in Michigan and typically exists as a condition of co-morbidity among individuals with obesity, heart disease, hypertension and renal failure, stroke and other conditions. The activities will be categorized according to three levels of prevention: Primary Prevention will target the "well population." Secondary Prevention will target the at-risk population, and Tertiary Prevention will target the established disease population. We will continue and/or expand the strategies, tactics and programs listed below: -Strategy 1: Increase education for diabetes prevention, early identification and disease management a. Joslin Diabetes Center Hospital-Certified Diabetes Educators provide patients with group and individual education related to diabetes and nutrition; medication management including insulin starts; continuous Glucose Monitoring System; insulin pump therapy; and gestational diabetes education series. Baseline Measures for Strategy 1: Diabetes Prevention 1. The number of participants in the programs. 2. The number of sessions attended by program participants. Strategy 2: Increase opportunities for healthy lifestyle activities. The following are St. John Hospital and Medical Center programs to support healthy lifestyles targeting seniors, children and youth, and uninsured community residents: a. Rock-On program - Targeted to obese children ages 7-18 years old, to achieve weight loss and weight management b. Amazing Steps - Targeted to individuals for fitness through walking programs, and includes mall walking program. c. Kids Mile Program - Provides exercise, nutrition education, and a final contest for low income children and five Detroit schools. d. Faith Community Partnerships with churches in Detroit, Macomb, and St. Clair Counties. Providing health information and education on diabetes and other chronic diseases e. Senior Wellness Center in Detroit - Providing health education, diabetes management classes, exercise classes, and some school limited screening for persons 55 years of age and older. Also includes monthly cooking classes f. Safety Net Health Center Partnerships - Partnership with Mercy Primary Care and the emergency department for referral of uninsured non-elderly adult residents of Detroit who are diabetic or have other chronic diseases g. Clintondale School - Jump Up and Go program is located in Macomb County and provides exercise, fitness, and healthy eating education to students of the school. h. Marcus Garvey elementary and middle school - Healthy eating and activities program is provided to students of this Detroit school i. Weight-loss center is available for residents in the community Baseline Measures for Strategy 2: Health Education Programs 1) The number of participants in the programs 2) The number of sessions attended by program participants. Strategy 3: Increase education for diabetes prevention, early identification and disease management. Note that community diabetes education program is available for newly diagnosed diabetics in the community that spans several weeks. There are a number of these programs that are provided free or low-cost to all residents of the community. There are also diabetes support groups. SJH&MC will fill some gaps with the following programs: a. CareLink Education and Classes - A program that produces a quarterly booklet that includes health education and information for a wide variety of low-cost community-based programs and services addressing prevention and management of chronic disease including diabetes Baseline Measures for Strategy 3: Diabetes Prevention 1) The number of participants in the programs. 2) The number of sessions attended by program participants. Strategy 4: Increase opportunities for healthy lifestyle activities a. Diabetes Discovery Program - Individual and group sessions with diabetes nurse educator and nutritionists. 4-6 sessions include initial assessment and follow-up sessions to check on progress. Attendees can be either insulin or non-insulin dependent diabetics, and do not have to be new onset patients. The goal is to support self-management skills for managing diabetes through medication and diet. b. Health Habits Program - Individual initial and follow-up sessions with nurse and dietician. The goal is to create individualized prevention plans to promote habits to become more healthy, through meal planning, movement and stress reduction, to protect from obesity, diabetes, and cardiovascular disease. Baseline Measure for Strategy 4: Health Education Programs 1. The number of participants in the programs. 2. The number of sessions attended by program participants. Strategy 5: Increase education for diabetes prevention, early identification and disease management a. Diabetes Support Group - Free support group which meets monthly, led by certified diabetes educators and dieticians for people with diabetes, family members of people with diabetes, or community members who want to know more about diabetes prevention and management. The goal is to provide emotional support and information about detection, management and prevention of diabetes. b. While You Wait Program - Group sessions for expectant mothers diagnosed with gestational diabetes. The goal is to promote effective management of gestational diabetes, protect unborn child from risk, and provide skills for management of potential ongoing diabetes after delivery. Baseline Measure for Strategy 5: Diabetes Prevention 1. The number of participants in the programs. 2. The number of sessions attended by program participants.
Schedule H, Part V, Section B, Line 11 Facility A, 3	Facility A, 3 - St. John Macomb-Oakland Hospital. NEEDS IDENTIFIED IN CHNA 2012 Priority Health Area #2: INFANT MORTALITY REDUCTION According to the State of Michigan Health Dashboard, the infant mortality rate (IMR) is worse than the national average and has remained so over the last 20 years in spite of an overall downward trend. Also of concern is the IMR for Detroit (13.5% compared to statewide 7.1%). The rate is also related to the high rates of inadequate prenatal care across southeastern Michigan. We will continue and/or expand the strategies, tactics and programs listed below. St. John Providence will address community needs through collaboration between nursing, case management; community health and social work to identify resources and communication methods with patients (birth folders, prenatal clinic, etc.). Additionally, increase social work and nursing knowledge about programs available. Expectant mothers who receive care in Obstetrics clinic setting are given pro-breastfeeding information regarding prenatal nutrition and infant feeding, and have the opportunity to engage with the lactation consultant and other health providers as needed. Strategy 1: Increase connectivity to and resources for pregnant women and their families -1.1 Provide referral information about local Maternal Infant Health Programs (MIHP) to women with Medicaid Insurance who present for prenatal care and/or for delivery. Baseline Measure: Number of referrals made to MIHP programs. -1.2 Provide referrals to the Strong Start Enhanced Pregnancy Program to women with Medicaid Insurance who present for prenatal care and/or for delivery. Baseline Measure: Number of referrals made to the Strong Start program. -1.3 Provide information and referral to St. John Providence Health System Infant Mortality Program to women who present for prenatal care and/or deliver with other insurance coverage. Baseline Measure: Number of referrals to SJPHS Infant Mortality Program. Strategy 2: Provide enhanced nutrition information and services that support the health of high-risk infants. -2.1 Provide information and/or referrals for all women delivering babies at SJH&MC to the Mother Nurture Breastfeeding Program. Baseline Measure: Number of referrals made. -2.2 Provide referrals to the Outpatient Breastfeeding Clinic for consultation with breastfeeding consultant. Baseline Measure: Number of referrals made to Outpatient Breastfeeding Clinic. -2.3 Provide breast pump to low-income breastfeeding mothers to encourage breastfeeding. Baseline Measure: Number of breast pumps provided. -2.4 80% of all women who deliver at SJH&MC will receive information/referral to the WIC Program. WIC is a special supplemental nutrition program for Women, Infants and Children that provides nutritious foods (primarily through retail grocery stores), nutrition counseling, and referrals to health care and social services. WIC serves low-income pregnant, postpartum and breastfeeding women, infants and children up to age 5 who are at nutritional risk. Baseline Measure: Number of referrals to WIC, and the number of women participating in the WIC program. Strategy 3: Increase education to enhance access to primary care for mothers after delivery of infant and post-partum visit. -3.1 All mothers delivering at SJH&MC will be provided information upon discharge on how to locate Primary Care Medical Home services via the SJPHS "Health Connect" service which can assist in making appointments and referrals to local Federally Qualified Safety Net Health Centers in their vicinity. SJPHS Health Connect is a free health information service designed to help callers locate primary and specialty care physicians, programs, clinics, classes and/or events that fit their health care needs. Baseline Measure: Number of discharge information packets given.
Schedule H, Part V, Section B, Line 11 Facility A, 4	Facility A, 4 - St. John Macomb-Oakland Hospital. NEEDS IDENTIFIED IN CHNA 2012 Priority Health Area #3: ACCESS TO CARE Access to Care for individuals who are uninsured and under-insured is an ongoing concern. The need to address and strengthen Access to Care is an ongoing healthcare system-wide initiative through the Providence Hospital parent company, Ascension Health, through the "Call to Action" policy "Healthcare That Leaves No One Behind". This policy represents Ascension Health's commitment to 100% access and coverage for all Americans. As we move into 2014 and the next phase of implementation of the Affordable Care Act, more and more individuals will become insured with Medicaid expansion, and through the Health Insurance Marketplaces (Exchanges) there will still remain the need to support those unfamiliar with the system in navigating the health system, locating a primary care physician, and obtaining support for other non-medical needs that, if not addressed, may present a barrier to access to care. Strategy 1: Reduce barriers to access the full continuum of health care for low income, uninsured and/or under-insured residents of the service area. -1.1 Develop internet-based resource guide for associates/employees to utilize to locate safety net access points of care for patients. Baseline Measure: Establishment of internet-based resource guide. -1.2 Partner with community-based organizations to increase outreach and education about enrollment for health insurance coverage through the newly created Health Insurance Marketplaces (Exchanges) which are designed to help individuals find, consider options and purchase health insurance that is compatible with various income levels, and an individual's desired medical care coverage. Baseline Measure: Number of events/activities providing Health Insurance Marketplace enrollment support. -1.3 Provide health insurance enrollment assistance to uninsured adults presenting to hospital Emergency Department or inpatients. Baseline Measure: Number of patients receiving health insurance enrollment assistance. -1.4 Support recruitment of "Physicians Who Care." A program comprised of specialists who volunteer to provide medical care for uninsured adults 19 to 64 years old who are referred from partner safety net health centers. Baseline Measure: Number of referrals for "Physicians Who Care." Strategy 2: Increase/support safety net capacity in the service area. -2.1 Explore partnerships/collaboratives with potential safety net providers in Wayne, Oakland and Livingston counties. Baseline Measure: Evidence of identified potential partners and discussions. -2.2 Participation in local access collaboratives such as VODI (Voices of Detroit Initiative), Detroit-Wayne County Health Authority, and the Beacon Project. Baseline Measure: Evidence of assigned health system leadership individual and their participation in the local collaboratives.

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. 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?35
Name and address		Type of Facility (describe)
1	Oakland MRI 27379 Deqindre MADISON HEIGHTS,MI48071	PHYSICIAN GROUP
2	Charwood Medical Building 27450 Schoenherr WARREN,MI48088	PHYSICIAN GROUP
3	Neuro Recovery System 650 Grace ROCHESTER HILL,MI48037	REHABILITATION CLINIC
4	Clinton Township Physical Rehab 37400 Garfield Ste 200 CLINTON TOWNSHIP,MI44803	REHABILITATION CLINIC
5	Adv Wound Healing & Hyperbaric Cntr 11900 E 12 Mile Road Suite 208 WARREN,MI48093	PHYSICIAN GROUP
6	Breast Center 27472 Schoenherr Suite 120 WARREN,MI48088	PHYSICIAN GROUP
7	Cardiac & Pulmonary Rehabilitation 12000 E 12 Mile Road WARREN,MI48093	REHABILITATION CLINIC
8	Cornerstone Almont Family Practice 4260 Van Dyke Suite 102 ALMONT,MI48003	PHYSICIAN GROUP
9	Diabetes Education 12000 E 12 Mile Road WARREN,MI48093	PHYSICIAN GROUP
10	Drs Devireddy & Koneru 11900 E 12 Mile Road Suite 103 WARREN,MI48093	PHYSICIAN GROUP
11	Family Medicine 5555 Metropolitan Parkway Suite 205 MADISON HEIGHTS,MI48071	PHYSICIAN GROUP
12	Howard L Dubin DO 27483 Dequindre Suite 205 MADISON HEIGHTS,MI48071	PHYSICIAN GROUP
13	Lakeshore Mammography 39200 Garfield Road Suite A CLINTON TOWNSHIP,MI48036	PHYSICIAN GROUP
14	Macomb OB-GYN Residency Clinic 11885 E 12 Mile Road Suite 202A WARREN,MI48093	PHYSICIAN GROUP
15	Michigan Neuro Ophthalmology 27450 Schoenherr Suite 200 WARREN,MI48088	PHYSICIAN GROUP
16	Motor City Internists 11885 E 12 Mile WARREN,MI48093	PHYSICIAN GROUP
17	MRI Center Oakland Inc 27379 Dequindre MADISON HEIGHTS,MI48071	PHYSICIAN GROUP
18	Neuro Recovery Systems (NRS) 27450 Schoenherr Road Suite 400 WARREN,MI48088	REHABILITATION CLINIC
19	Oakland Primary Care 27450 Schoenherr Road Suite 400 WARREN,MI48088	PHYSICIAN GROUP
20	Physical Medicine and Rehabilitation 13850 E 12 Mile Road Suite 407 MACOMB,MI48044	REHABILITATION CLINIC
21	Physical Medicine and Rehabilitation 17900 23 Mile Road Suite 407 MACOMB,MI48044	REHABILITATION CLINIC
22	River Park Medical Group 44720 Van Dyke UTICA,MI48317	PHYSICIAN GROUP
23	Roseville Family Practice 19357 13 Mile Road ROSEVILLE,MI48086	PHYSICIAN GROUP
24	Schoenherr Parkway Family Practice 13951 Plumbrook Road STERLING HEIGHTS,MI48312	PHYSICIAN GROUP
25	St Clair Internists 45640 Schoenherr SHELBY TOWNSHIP,MI48315	PHYSICIAN GROUP
26	St John Mac-Oak Partial Day Program 27550 Schoenherr Road Suite 250 WARREN,MI48088	PHYSICIAN GROUP
27	St John Lakeside PT 45660 Schoenherr Suite B SHELBY TOWNSHIP,MI48315	PHYSICIAN GROUP
28	St John Oral Surgery and Dental Clinic 7633 E Jefferson Suite 70 DETROIT,MI48214	PHYSICIAN GROUP
29	St John Pulmonary and Sleep Medicine 17900 23 Mile Road Suite 407 MACOMB,MI48044	PHYSICIAN GROUP
30	St John Weight Loss Center 27483 Dequindre Road Suite 204 MADISON HEIGHTS,MI48071	REHABILITATION CLINIC
31	Warren Rehabilitation Satellite 27450 Schoenherr Road Suite 100A WARREN,MI48088	PHYSICIAN GROUP
32	Windemere Internal Medicine 31700 Van Dyke Suite 120 WARREN,MI48093	PHYSICIAN GROUP

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
Schedule H, Part I, Line 3c ELIGIBILITY FOR FREE OR DISCOUNTED CARE	The organization provides medically necessary care to all patients, regardless of race, color, creed, ethnic origin, gender, disability or economic status. The organization uses a percentage of Federal Poverty Level (FPL) to determine free and discounted care. At a minimum, patients with income less than or equal to 200% of the FPL, which may be adjusted for cost of living utilizing the local wage index compared to national wage index, will be eligible for 100% charity care write off of charges for services that have been provided to them. Also, at a minimum, patients with incomes above 200% of the FPL but not exceeding 300% of the FPL, subject to adjustments for cost of living utilizing the local wage index compared to national wage index, will receive a discount on the services provided to them. Uninsured Patients who are not eligible for financial assistance will be provided a discount based on established Michigan State law requirements. In Michigan, Uninsured patients who do not qualify for charity or any other program will be granted an Uninsured Discount and will be billed at 115% of Medicare Rates.
Schedule H, Part VI Community Benefit Overview	St. John Macomb-Oakland Hospital: 1. Operates an emergency room that is open to all persons regardless of ability to pay. 2. Has on open medical staff with privileges available to all qualified physicians in the area. 3. Has a governing body in which independent persons representative of the community compromise a majority. 4. Engages in medical or scientific research programs. 5. Engages in the training and education of health care professionals. 6. Participates in Medicaid, Medicare, Champus, Triage and/or other government-sponsored health care programs. Identified Needs and Concerns Education material is provided on the web under www.sjhs.com and www.realmedicinefoundation.org Access to Care Programs St. John Macomb-Oakland Hospital operates many public health clinics. Public clinics range from specialty clinics such as pediatrics to general internal medicine clinics. Our Community Health Centers provide care for all community residents, regardless of their ability to pay. Services include the full range of preventive and primary health and some dental care for adults and children, prenatal care, and management of chronic diseases such as asthma, diabetes and heart disease. Community Outreach and Service St. John Macomb-Oakland Hospital (SJMOH) provides charitable contributions to various communities through associate volunteerism, health education and screenings on-site and in the community through partner organizations and/or events, and through numerous sponsorships. Several associates volunteered at the food rescue mission Forgotten Harvest, spending a few hours packing up potatoes that were then distributed to families in need throughout metro Detroit St. John Macomb-Oakland Hospital partners with many organizations to improve community health, such as American Red Cross and the American Diabetes Association. Below is a detailed explanation of some of the community outreach and services provided in Fiscal Year 2016: 1. Ask-A-Nurse: A SJMOH nurse provides onsite health education and screenings to seniors at senior housing units in the surrounding areas. 2. Webber Cancer Center Food Pantry-Macomb Center: The Webber Cancer Center Food Pantry serves patients who use the Webber Cancer Center, Radiation Oncology, or are inpatients on 5-Center at Macomb Center. 3. Clothing Closet -Macomb & Oakland Centers: Patients are provided clothing through the Clothing Closet run by Volunteer Services. The hospital also donated gift cards which are given to patients in need. 4. Tree of Hope: The Tree of Hope fund was used to provide diabetic education to those in need. 5. Bring Your Children to Work Day -Macomb Oakland Centers: Participating children in the annual Bring Your Child to Work Day at SJMOH, toured the hospitals and learned about several departments, including Emergency, Sterile Processing, Radiology, Lab and the OR. 6. Healthy Kids Healthy Futures- Macomb: Associates fitted and provided free bike helmets to local children. Nurses also provided blood pressure screenings to hundreds of adults and children. Healthy Kids Healthy Futures Coalition is a community-based chronic disease prevention coalition targeting children in Macomb County. 7. Macomb Senior Fun Festival, Mt. Clemens: Associates provided information on stroke prevention, as well as several programs/services, including Outpatient Rehab, CareLink, and our Weight Loss, Sleep and Wound Centers at the Macomb County Senior Fun Festival. 8. Sterlingfest, Sterling Heights: Nursing educators along with youth volunteers were on-hand to demonstrate hands -only CPR on resuscitation mannequins. 9. Arts, Beats and Eats, Royal Oak: Associates volunteered at the St. John Providence's Color Me Healthy booth, teaching area children (and their parents) about healthy eating. 10. School Supply Drive - Macomb & Oakland Hospitals: Associates donated backpacks and many school supplies for area schools, including spiral notebooks, reams of paper, glue sticks, crayons, rulers, pens/pencils and hand sanitizer. The supplies collected were donated to local elementary schools in Warren and the Madison Heights School District. 11. Christmas Store - Oakland Center: Area families in need are invited to shop for gifts for their children. Participating families pay $1 to shop at the store and they receive a toy and outfit for each child, a gift certificate and stocking stuffer bag for the family. Kids have fun doing crafts, eating snacks and having their photo taken with Santa. Associate donate clothing, toys, grocery gift cards, school supplies, hats and gloves, coloring books, etc. Associates also volunteer their time to organize and run the Christmas Store and wrap the gifts the parents select. 12. Free Christmas Dinner - Oakland Hospital: Associates serve holiday dinners to local area residents in need. Community Support The Hospital also provides support to the community by providing transportation services at no cost. SJMOH donates space in its facilities to many outside organizations that hold meetings or support groups weekly, bi-weekly or monthly, including: - Depression/Bipolar - Alliance for Mental Ill - Fibromyalgia Support Group - United Ostomy Association - Scleroderma Foundation - AA Support Group - Parenting Class Spring & Fall - Parkinson's support Meeting - Zumba - Sign Language Spring & fall - La Leche League - Tourette Syndrome Support Group - Bariatric Support Group - Food Addicts Class Community Coalition Building 1. SJMOH Professional Nursing Practice Council gift basket raffle, carnation sale: The SJMOH Professional Nursing Practice Council (PNPC) held a gift basket raffle during Nurses Week to benefit the Make a Wish Foundation. One family receives a wish a year. 2. Faith Community Partnerships We partner with a number of area churches to provide health education, health screening and other health promotion activities. The church identifies a registered nurse member and the SJPHS provides training, resources and other assistance in the programs held at the church. The following churches are in the Macomb Hospital Service Area: - St. John of Arc Catholic Church, St. Clair Shores - St. Lucy Catholic Church, St. Clair Shores - Bethel Lutheran, St. Clair Shores - Our Lady of Hope-St. Germaine Campus, St. Clair Shores - Our Lady of Hope-St. Gertrude Campus, St. Clair Shores - Warren Woods Church of the Nazarene, Warren - St. Martin de Porres, Warren - St. Paul of Tarsus Catholic Church, Clinton Township - Immanuel Lutheran Church, Macomb - Christ Lutheran Church, Sterling Heights - Holy Family Parish, Memphis - St. Augustine, Richmond - St. Isadora, Macomb Twp. - St. John Lutheran Church, Ray - St. Basis the Great, Eastpointe - St. Michael Catholic Church, Sterling Heights 3. Summerfest, Warren: Associates provided blood pressure screenings, and assisted in first aid services that ranged from bee stings and scrapes to fainting. Summerfest is an annual event sponsored by Liberty Family Outreach to help struggling families in south Warren. Summerfest participants receive a wide range of services and resources at the yearly event, including groceries, backpacks and school supplies, haircuts, bike repairs and youth sports physicals - Warren Parks and Recreation - Goodfellows Warren/Sterling Heights edition - Warren Symphony - Fraternal Order of Police - Warren Police - Madison Heights Youth Assistance - Warren Schools 4. Leader/Associate participation on non-profit community Boards, Advisory Groups, Councils a. Catholic Social Services of SE Michigan Board b. Warren Rotary Club Board c. Madison Heights/Hazel Park Chamber of Commerce Board d. Macomb Community College Foundation Board e. Population Health Advisory Commission f. Warren Senior Health Care Commission g. Macomb Advisory Council h. Macomb County Medical Control Authority i. Madison Heights Youth Assistance Board j. Macomb Community College Nursing Advisory Board k. Baker College of Nursing/Nursing student mentoring l. Surgical Technology Advisory Group at Macomb Community College m. Respiratory Advisory Group at Macomb Community College n. Go Red planning/event committee o. Baker College of Clinton Township Nursing Advisory Board p. Dorsey Business School Advisory Board q. Wayne County Community College Nursing Advisory Board r. ACE/Alliance for Clinical Experience s. Warren Woods Tower High School t. Warren Consolidated Prep School u. Detroit Regional Chamber v. Leukemia and Lymphoma Society w. Warren Conner Development Coalition x. Archdiocese of Detroit Finance Council y. OCC Radiology Tech School Advisory Board z. Oakland County Board of Directors
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	St. John Macomb-Oakland Hospital is part of a community benefit report which is prepared by St. John Providence on a consolidated basis.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied.
Schedule H, Part II Community Building Activities	Community Building Activities are critical to the five counties that St. John Providence serves. St. John Providence's size means we have a stronger voice when advocating for those who have no voice - the uninsured and poor. Through partnerships, coalitions, and program development and support, our innovative programs increase access to health care services and empower individuals to make informed health choices. Our community health programs include parish nursing, school-based health centers, a grieving children's program, an infant mortality initiative, and a neighborhood health and safety office. We improve access to health care through our community health centers, health screenings and health education. SJP actively participates on coalitions with the Macomb County, Oakland County, St. Clair County and City of Detroit Health Departments to work toward developing collaborative strategies to address community health care issues. It is our calling to serve, and we do it with pride. Our staff of professionals combines the skills of medical experts in various specialties and the talented, compassionate clinical staff to heal and to serve. In addition, the St. John Providence family includes thousands of volunteers and donors who support our health care mission with their generosity. Inventories of some of St. John Providence's community building activities include: Physical Improvements- SJHMC Maintenance and Engineering Department provides physical improvements by annually beautifying a main intersection on the Detroit-Grosse Pointe border. The health system helped to build and improve houses through the local Habitat for Humanity and for low-income families. They also helped to develop a barrier-free environment for individuals with disabilities. Economic Development- St. John Providence Administration is active in various Chambers of Commerce throughout our service area. Community Support- Human Resources provides mentoring and job shadowing programs for high school students. There is a Neighborhood Safety Office that helps residents in their service area learn techniques on how to keep themselves and personal property safe. The hospital provides disaster recovery above and beyond the normal requirements. They also provide mentoring to students interested in health careers. Leadership Dev/Training for Community Members- The health system participates in Executive Women International and the medical department participates in Leadership Development Training for community members in the process of addiction recovery. Community Health Improvement Advocacy- Administrative leaders support advocacy efforts through their membership and participation on various task-forces and committees. Workforce Development- St. John Providence promotes diversity and strives to insure that there are qualified individuals from underrepresented minorities in the pool of candidates for open positions. The health system mentors high school students and educates them about careers in the medical fields. They also assist with college course selection for medical careers and provide assistance with resume writing and interviewing techniques.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2016 was $26,220,050 at charges, ($5,918,318 at cost).
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 18.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply and the financial assistance program is followed.
Schedule H, Part V, Section B, Line 16a FAP website	A - St. John Macomb-Oakland Hospital, Warren: Line 16a URL: http://www.stjohnprovidence.org/patients-and-visitors/financial-assistance/.;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - St. John Macomb-Oakland Hospital, Warren: Line 16b URL: http://www.stjohnprovidence.org/patients-and-visitors/financial-assistance/.;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	A - St. John Macomb-Oakland Hospital, Warren: Line 16c URL: http://www.stjohnprovidence.org/patients-and-visitors/financial-assistance/.;
Schedule H, Part VI, Line 2 Needs assessment	Communities are dynamic systems in which multiple factors interact to impact quality of life and health status. In addition to the formal CHNA conducted every 3 years, St. John Providence helps to lead a community round table whose purpose is to assess needs within the community, prioritize action and work in partnership to address identified challenges. The coalition works closely with its member organizations which come from multiple sectors of the community, including local government, business, education, faith communities, public health, health care providers and other social and human service organizations. In addition, the coalition works closely with other coalitions as well as the local and state health departments to stay abreast of changing needs within the community and to identify evidence-based and promising practices to address these needs.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	St. John Providence communicates with patients in multiple ways to ensure that those who are billed for services are aware of the hospital's financial assistance program as well as their potential eligibility for local, state or federal programs. Signs are prominently posted in each service area, and bills contain a formal notice explaining the hospital's charity care program. In addition, the hospital employs financial counselors, health access workers, and enrollment specialists who consult with patients about their eligibility for financial assistance programs and help patients in applying for any public programs for which they may qualify.
Schedule H, Part VI, Line 4 Community information	St. John Providence and its five hospital campuses including one specialty hospital are located in a five-county area of southeastern Michigan. The health system campuses are organized as follows: Providence/Providence Park Hospitals; St. John Macomb-Oakland Hospital; St. John Hospital & Medical Center, St. John River District Hospital; and Brighton Hospital. The community served by the organization includes Wayne, Oakland, Macomb, Livingston and St. Clair counties. The city of Detroit is part of Wayne County. This service area is predominately urban and suburban with pockets of rural in St. Clair and Livingston counties. The East Community includes Macomb and St. Clair Counties, and parts of Wayne and Oakland Counties. The West Community includes Livingston county, most of Oakland county and parts of Wayne County. Total population in the West Community (2010 Thompson Reuters) is 1,633,906 with 57.7% White, 34.7% Black, 0.2% American Indian and Alaska native, 0.2% Hispanic, 4.3% Asian/Pacific Islander and 0.7% other. Total estimated population in the East Community is 1,432,398 with 70.7% White, 23.0% Black, 0.3% Hispanic, 2.9% Asian/Pacific Islander, and 0.5% other. These counties represent the southeastern Michigan region of the state with a total population of approximately 4 million, which represents 41% of the state's population and accounts for 46% of the federal monies received. Seventeen percent of the service area population is represented by the city of Detroit. Approximately 90% of Detroit consists of minorities, compared to 21% for the state. Thirty-eight percent of Detroiters live below the poverty level compared to 16% statewide. Detroit has higher rates of illness and chronic disease than other parts of the state, and a lack of access to primary care and a shortage of health care professionals.
Schedule H, Part VI, Line 5 Promotion of community health	St. John Providence promotes the health of its communities by striving to improve the quality of life within the community. Research has established that factors such as economic status, employment, housing, education level, and built environment can all be powerful social determinants of health. Additionally, helping to create greater capacity within the community to address a broad range of quality of life issues also impacts health. St. John Providence administrators and staff have provided leadership and participated on collaborative initiatives with Voices of Detroit Initiative, Greater Detroit Area Health Council, Wayne County Health Department, The City of Detroit Department of Health and Wellness Promotion, Wayne County Health Authority, Tomorrow's Child, Michigan Crime Victim Services Commission, The Michigan Department of Health and Human Services, Michigan Primary Care association, area Federally Qualified Health Centers, and other community organizations to identify community needs and address community problems. St. John Providence has a demonstrated history and strong foundation built upon its Mission, Vision, and Values. It is this spirit that leads the institution and drives health care services. Often patients, family members, friends, and the like, are pleased with our position on care - to heal the body, mind, and spirit, have experienced it first-hand, and wish to show their appreciation by making a gift to support care of others that are vulnerable. The spiritual essence that's woven into the fabric of our daily operations allows members of the community to comfortably and directly impact the lives of others through philanthropy. We work to create an ethical legacy for emphasizing the important value of community and encourage the compassionate generosity of others to make gifts that enhance the exemplary care St. John Providence has become recognized for.
Schedule H, Part VI, Line 6 Affiliated health care system	ST. JOHN MACOMB-OAKLAND HOSPITAL IS PART OF THE ASCENSION HEALTH ALLIANCE ("THE SYSTEM"). ASCENSION HEALTH ALLIANCE D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION AND ITS MEMBER ORGANIZATIONS ARE HEREAFTER REFERRED TO COLLECTIVELY AS THE SYSTEM. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. SJPHS LOCATED IN SOUTHEAST MICHIGAN IS A NONPROFIT ACUTE CARE HOSPITAL. SJPHS PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR THE RESIDENTS OF SOUTHEASTERN MICHIGAN. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. SJPHS IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF SJPHS ARE RELATED TO PROVIDING HEALTH CARE SERVICES. THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: - TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. - UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS. - COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. - COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TO THE ENTITY'S BILLED CHARGES FOR PATIENT CARE.

Schedule H (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
St John Macomb-Oakland Hospital

Employer identification number
38-3322109

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC 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) ST JOHN COMMUNITY HEALTH INVESTMENT CORPORATION
28000 DEQUINDRE
WARREN,MI48092

38-2262856

501(C)(3)

869,768

OPERATING SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated 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)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	THE ASSISTANCE GIVEN IS TO RELATED ORGANIZATIONS WHICH HAVE A COMMON CONTROLLING PARENT.

Schedule I (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St John Macomb-Oakland Hospital

Employer identification number

38-3322109

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used 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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on 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 ............

Were any amounts reported on 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 .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

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 on 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 (E) amounts for that individual.

(A) Name and Title		(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 in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JEAN MEYER PRESIDENT & CEO	(i) (ii)	0 ------------- 714,895	0 ------------- 892,876	0 ------------- 156,888	0 ------------- 17,225	0 ------------- 30,010	0 ------------- 1,811,894	0 ------------- 0
2TERENCE HAMILTON HOSPITAL PRESIDENT	(i) (ii)	328,649 ------------- 0	53,982 ------------- 0	41,213 ------------- 0	15,900 ------------- 0	22,683 ------------- 0	462,428 ------------- 0	0 ------------- 0
3TOMASINE F MARX VP FINANCE & CFO	(i) (ii)	0 ------------- 285,463	0 ------------- 61,650	0 ------------- 41,445	0 ------------- 17,225	0 ------------- 25,229	0 ------------- 431,012	0 ------------- 0
4MARYANN BARNES VP NURSING	(i) (ii)	243,494 ------------- 0	32,400 ------------- 0	21,521 ------------- 0	16,546 ------------- 0	11,862 ------------- 0	325,823 ------------- 0	0 ------------- 0
5GARY BERG DO CHIEF MEDICAL OFFICER	(i) (ii)	324,246 ------------- 0	44,468 ------------- 0	50,699 ------------- 0	15,900 ------------- 0	23,309 ------------- 0	458,623 ------------- 0	0 ------------- 0
6ROGER BIGELOW MD LEAD- PHYSICIAN	(i) (ii)	273,638 ------------- 0	0 ------------- 0	3,427 ------------- 0	8,020 ------------- 0	14,918 ------------- 0	300,003 ------------- 0	0 ------------- 0
7SLOBODAN KOVACEVIC MD HOSPITALIST	(i) (ii)	268,495 ------------- 0	0 ------------- 0	690 ------------- 0	14,312 ------------- 0	1,386 ------------- 0	284,882 ------------- 0	0 ------------- 0
8DEBORAH LEVAN DO PHYSICIAN	(i) (ii)	296,088 ------------- 0	0 ------------- 0	18,862 ------------- 0	17,225 ------------- 0	20,857 ------------- 0	353,032 ------------- 0	0 ------------- 0
9GARY L PINEAU DIR. NURSING ANESTHESIA	(i) (ii)	220,575 ------------- 0	21,318 ------------- 0	3,150 ------------- 0	14,623 ------------- 0	8,177 ------------- 0	267,844 ------------- 0	0 ------------- 0
10RAFAEL BARRETTO DIR. MEDICAL EDUCATION	(i) (ii)	224,892 ------------- 0	21,376 ------------- 0	490 ------------- 0	11,573 ------------- 0	18,728 ------------- 0	277,060 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation

ST. JOHN HEALTH, A RELATED ORGANIZATION OF ST. JOHN MACOMB-OAKLAND HOSPITAL, USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. There were no 457(F) payments made in CY 2015.

Schedule J (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

St John Macomb-Oakland Hospital

Employer identification number

38-3322109

Return Reference	Explanation
Form 990, Part IV, Line 20b Explanation of Financial Statements	THE ACTIVITY OF ST. JOHN MACOMB-OAKLAND HOSPITAL IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF ST. JOHN MACOMB-OAKLAND HOSPITAL IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF ST. JOHN MACOMB-OAKLAND HOSPITAL.
Form 990, Part VI, Line 15 COMPENSATION OF TOP MANAGEMENT OFFICIAL	IN DETERMINING COMPENSATION OF THE ORGANIZATION'S PRESIDENT, THE PROCESS, PERFORMED BY ASCENSION MICHIGAN, A RELATED ORGANIZATION OF ST. JOHN MACOMB-OAKLAND HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE AUDIT COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE PRESIDENT WAS COMPARED TO INDIVIDUALS AT OTHER HOSPITALS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS, PERFORMED BY ASCENSION MICHIGAN, A RELATED ORGANIZATION OF ST. JOHN MACOMB-OAKLAND HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE AUDIT COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO INDIVIDUALS AT OTHER HOSPITALS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES.
Form 990, Part VI, Line 4 Significant changes to organizational documents	The articles of incorporation for St. John Macomb-Oakland Hospital were amended, effective July 9, 2015, for a change in corporate membership. The single corporate member changed from St. John Health to Ascension Michigan
Form 990, Part VI, Line 6 Classes of members or stockholders	St. John Macomb-Oakland Hospital has a single corporate member, Ascension Michigan.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	St. John Macomb-Oakland Hospital has a single corporate member, Ascension Michigan, who has the ability to elect members to the governing body of St. John Macomb-Oakland Hospital.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	All decisions that have a material impact to St. John Macomb-Oakland Hospital financial information or corporation as a whole are subject to approval by its sole corporate member, Ascension Michigan
Form 990, Part VI, Line 11b Review of form 990 by governing body	Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all board members are provided the Form 990 and management team members are available to answer any board members questions.
Form 990, Part VI, Line 12c Conflict of interest policy	The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, officer, key employee or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, officer, key employee and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Line 19 Required documents available to the public	The organization will provide any documents open to public inspection upon request.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Management Fee Revenue - Total Revenue: 2035, Related or Exempt Function Revenue: 2035, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Other Miscellaneous Revenue - Total Revenue: 2624930, Related or Exempt Function Revenue: 2624930, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	TRANSFERS WITH AFFILIATES - -1781210;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St John Macomb-Oakland Hospital

Employer identification number

38-3322109

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) 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 entity?
(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	Yes	No
(1)ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS,MO63145 45-3358926	NATIONAL HEALTH SYSTEM	MO	501(c)(3	Type I	NA		No
(2)ASCENSION HEALTH PO BOX 45998 ST LOUIS,MO63145 31-1662309	NATIONAL HEALTH SYSTEM	MO	501(c)(3	Type I	ASCENSION HEALTH ALLIANCE		No
(3)ASCENSION MICHIGAN 28000 DEQUINDRE ROAD WARREN,MI48092 38-2631907	HEALTH CARE	MI	501(c)(3	9	ASCENSION HEALTH		No
(4)ST JOHN PROVIDENCE 28000 DEQUINDRE ROAD WARREN,MI48092 38-2244034	PARENT	MI	501(c)(3	Type III-FI	ASCENSION MICHIGAN	Yes
(5)BRIGHTON CENTER FOR RECOVERY 12851 GRAND RIVER BRIGHTON,MI48116 38-1576680	HOSPITAL	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(6)PROVIDENCE-PROVIDENCE PARK HOSPITAL 16001 WEST NINE MILE ROAD SOUTHFIELD,MI48037 38-1358212	HOSPITAL	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(7)ST JOHN HOSPITAL & MEDICAL CENTER 28000 DEQUINDRE ROAD WARREN,MI48092 38-1359063	HEALTH CARE	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(8)ST JOHN RIVER DISTRICT HOSPITAL 4100 RIVER ROAD EAST CHINA,MI48054 38-3160564	HOSPITAL	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(9)REVERENCE HOME HEALTH & HOSPICE 5445 ALI DRIVE DEPT 800 GRAND BLANC,MI484395172 38-3408684	HEALTH CARE	MI	501(c)(3	7	ST JOHN PROVIDENCE	Yes
(10)EASTWOOD COMMUNITY CLINICS 28000 DEQUINDRE ROAD WARREN,MI48092 38-1958763	HEALTH CARE	MI	501(c)(3	9	ST JOHN PROVIDENCE	Yes
(11)ST JOHN PROVIDENCE PHYSICIANS CMG 28000 DEQUINDRE ROAD WARREN,MI48092 38-2601348	HEALTH CARE	MI	501(c)(3	9	ST JOHN PROVIDENCE	Yes
(12)MEDICAL RESOURCES GROUP 43800 GARFIELD CLINTON TOWNSHIP,MI48038 38-3494637	HEALTH CARE	MI	501(c)(3	9	ST JOHN PROVIDENCE	Yes
(13)PROVIDENCE HEALTH FOUNDATION 22101 MOROSS DETROIT,MI48236 38-3526629	FUNDRAISING	MI	501(c)(3	Type III-FI	ST JOHN PROVIDENCE	Yes
(14)SETON HEALTH CORP OF SE MICHIGAN 28000 DEQUINDRE WARREN,MI48092 38-2820107	HEALTH CARE	MI	501(c)(3	9	ST JOHN PROVIDENCE	Yes
(15)ST JOHN COMMUNITY HEALTH INVESTMENT CORP 28000 DEQUINDRE ROAD WARREN,MI48092 38-2262856	HEALTH CARE	MI	501(c)(3	3	ST JOHN PROVIDENCE	Yes
(16)ST JOHN HOSPITAL FOUNDATION 22101 MOROSS DETROIT,MI48236 20-2961579	FUNDRAISING	MI	501(c)(3	7	ST JOHN PROVIDENCE	Yes
(17)GENESYS HEALTH SYSTEM ONE GENESYS PARKWAY GRAND BLANC,MI484398065 38-3339703	HEALTH SYSTEM PARENT	MI	501(c)(3	Type II	ASCENSION MICHIGAN	Yes
(18)GENESYS REGIONAL MEDICAL CENTER ONE GENESYS PARKWAY GRAND BLANC,MI484398065 38-2377821	HOSPITAL	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(19)GENESYS HEALTH FOUNDATION ONE GENESYS PARKWAY GRAND BLANC,MI484398065 38-3591148	FOUNDATION	MI	501(c)(3	Type I	GENESYS HEALTH SYSTEM	Yes
(20)HEALTH SOURCE GROUP 5455 ALI DR DEPT 200 GRAND BLANC,MI484395195 38-2427678	PRG RELATED INVESTMENTS	MI	501(c)(3	Type I	GENESYS HEALTH SYSTEM	Yes
(21)GENESYS AMBULATORY HEALTH SERVICES 5455 ALI DR DEPT 200 GRAND BLANC,MI484395195 38-2371754	HEALTH SRVCS/STAFFING/PROP MNGT	MI	501(c)(3	Type II	GENESYS HEALTH SYSTEM	Yes
(22)CENTER FOR GERONTOLOGY 5455 ALI DRIVE DEPT200 GRAND BLANC,MI484395195 38-2514708	ADULT DAY CARE	MI	501(c)(3	Type I	GENESYS AMBULATORY HEALTH SERVICES	Yes
(23)GENESYS CONVALESCENT CENTER 8481 HOLLY ROAD GRAND BLANC,MI484391812 38-2317364	CONVALESCENT CENTER	MI	501(c)(3	3	GENESYS AMBULATORY HEALTH SERVICES	Yes
(24)BORGESS HEALTH ALLIANCE INC 1521 GULL ROAD KALAMAZOO,MI49048 38-2335286	HEALTH SYSTEM PARENT	MI	501(c)(3	Type III-FI	ASCENSION MICHIGAN	Yes
(25)LEE MEMORIAL HOSPITAL CORPORATION 420 WEST HIGH STREET DOWAGIAC,MI49047 38-1490190	HEALTHCARE SERVICES	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(26)BORGESS MEDICAL CENTER 1521 GULL ROAD KALAMAZOO,MI49048 38-1360526	HEALTHCARE SERVICES	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(27)BORGESS AMBULATORY CARE CORPORATION 1521 GULL ROAD KALAMAZOO,MI49048 38-2468823	HOLDING COMPANY	MI	501(c)(3	3	BORGESS HEALTH ALLIANCE INC	Yes
(28)BORGESS FOUNDATION 1521 GULL ROAD KALAMAZOO,MI49048 23-7222558	FUNDRAISING	MI	501(c)(3	Type III-FI	BORGESS HEALTH ALLIANCE INC	Yes
(29)LEE MEMORIAL FOUNDATION 420 W HIGH STREET DOWAGIAC,MI49047 38-2860459	FUNDRAISING	MI	501(c)(3	Type III-FI	LEE MEMORIAL HOSPITAL CORPORATION	Yes
(30)PROMED HEALTHCARE 1521 GULL ROAD KALAMAZOO,MI49048 38-3193801	HEALTHCARE SERVICES	MI	501(c)(3	9	BORGESS HEALTH ALLIANCE INC	Yes
(31)ST MARY'S - ST JOSEPH HEALTH SYSTEM 800 S WASHINGTON AVENUE SAGINAW,MI48601 46-1084363	SUPPORTING ORGANIZATION	MI	501(c)(3	Type III-FI	ASCENSION MICHIGAN	Yes
(32)STANDISH COMMUNITY HOSPITAL 805 WEST CEDEAR STREET STANDISH,MI48658 38-1671120	HOSPITAL	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(33)ST MARY'S OF MICHIGAN MEDICAL CENTER 800 S WASHINGTON AVENUE SAGINAW,MI48601 38-0997730	HOSPITAL	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(34)ST MARY'S MEDICAL CENTER FOUNDATION SAGINAW MICHIGAN 800 S WASHINGTON AVENUE SAGINAW,MI48601 38-2246366	FUNDRAISING	MI	501(c)(3	Type II	STMARY'S OF MICHIGAN MEDICAL CENTER	Yes
(35)FIELD NEUROSCIENCES INSTITUTE 800 S WASHINGTON AVENUE SAGINAW,MI48601 38-2790703	MEDICAL RESEARCH ORGANIZATION	MI	501(c)(3	9	STMARY'S OF MICHIGAN MEDICAL CENTER	Yes
(36)ST JOSEPH HEALTH SYSTEM 200 HEMLOCK ROAD TAWAS CITY,MI48763 38-1443395	HEALTH CARE	MI	501(c)(3	3	ASCENSION MICHIGAN	Yes
(37)ST JOSEPH HEALTH SYSTEM FOUNDATION 200 HEMLOCK ROAD TAWAS CITY,MI48763 01-0790428	FUNDRAISING	MI	501(c)(3	Type I	ST JOSEPH HEALTH SYSTEM	Yes
(38)MACOMB HOSPITAL CENTER AUXILIARY 11800 E TWELVE MILE WARREN,MI48093 38-6091287	FUNDRAISING	MI	501(c)(3	Type III-FI	ST JOHN MACOMB-OAKLAND HOSPITAL		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ADVENT PARTNERS LP 28000 DEQUINDRE WARREN,MI48092 38-3544539	RENTAL REAL ESTATE	MI	NA	N/A								0 %
(2) TOWNE CENTRE SURGERY CENETER 4599 TOWNE CENTRE SAGINAW,MI48604 20-4943843	OUTPATIENT SERVICES	MI	NA	N/A								0 %

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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) ST JOSEPH HEALTH ENTERPRISES 200 HEMLOCK ROAD TAWAS CITY,MI48764 38-2686747	OTHER MEDICAL	MI	NA	C Corporation			Yes
(2) GENESYS PRACTICE PARTNERS 5445 ALI DRIVE DEPT 200 GRAND BLANC,MI48439 03-0516871	EMPLOYED PHY PRACTICE	MI	NA	C Corporation			Yes
(3) BEECHER BALLENGER SERVICES ONE GENESYS PARKWAY GRAND BLANC,MI484398065 38-2497922	HOLDING COMPANY	MI	NA	C Corporation			Yes
(4) ADVENT INC 28000 DEQUINDRE WARREN,MI48092 38-2971743	RENTAL REAL ESTATE	MI	NA	C Corporation			Yes
(5) AFFILIATED HEALTH SERVICES INC 28000 DEQUINDRE WARREN,MI48092 38-2292922	MEDICAL SERVICES	MI	NA	C Corporation			Yes
(6) St Mary's Health 800 S Washington Avenue Saginaw,MI48601 38-3477017	Dormant	MI	NA	C Corporation			Yes
(7) TEXTILE SYSTEMS INC 817 WALBRIDGE KALAMAZOO,MI49007 38-2705047	LAUNDRY SERVICES	MI	NA	C Corporation			Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Medical Resources Group	O	71,244	Actual Amount Paid
(2) Medical Resources Group	S	10,989,798	Actual Amount Paid
(3) Providence-Providence Park Hospital	O	319,824	Actual Amount Paid
(4) Providence-Providence Park Hospital	P	245,286	Actual Amount Paid
(5) Providence-Providence Park Hospital	S	50,876	Actual Amount Paid
(6) St John River District Hospital	O	118,429	Actual Amount Paid
(7) St John River District Hospital	R	57,057	Actual Amount Paid
(8) Seton Health Corp of SE Michigan	S	69,729	Actual Amount Paid
(9) St John Providence	O	429,411	Actual Amount Paid
(10) St John Providence	P	165,193,009	Actual Amount Paid
(11) St John Providence	R	319,843,508	Actual Amount Paid
(12) St John Hospital & Medical Center	O	490,934	Actual Amount Paid
(13) St John Hospital & Medical Center	P	54,421	Actual Amount Paid
(14) St John Hospital & Medical Center	S	3,924,573	Actual Amount Paid
(15) Affiliated Health Services	S	124,464	Actual Amount Paid
(16) ST JOHN COMMUNITY HEALTH INVESTMENT CORPORATION	B	869,768	ACTUAL AMOUNT PAID

Schedule R (Form 990) 2015

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

1	Briefly describe the organization’s mission or most significant activities: Our Catholic Health Ministry is dedicated to spiritually centered, holistic care.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	3,387
6	Total number of volunteers (estimate if necessary) .............	6	283
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	151,461	45,136
9	Program service revenue (Part VIII, line 2g) .........	394,950,260	412,833,019
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,456,980	-627,066
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,208,691	3,253,916
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	405,767,392	415,505,005
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	869,768
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	176,855,211	184,516,389
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	204,108,553	210,085,395
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	380,963,764	395,471,552
19	Revenue less expenses. Subtract line 18 from line 12.......	24,803,628	20,033,453
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	335,493,171	352,494,776
21	Total liabilities (Part X, line 26).............	240,558,441	244,294,732
22	Net assets or fund balances. Subtract line 21 from line 20.....	94,934,730	108,200,044

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	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 298,847,239 including grants of $ 869,768 ) (Revenue $ 415,658,590 )
	IN FURTHERANCE OF ITS MISSION AND IN AN EFFORT TO REDUCE THE GOVERNMENT'S FINANCIAL BURDEN, ST. JOHN MACOMB-OAKLAND HOSPITAL PROVIDES ESSENTIAL HEALTH CARE SERVICES, SUCH AS EMERGENCY ROOMS AND OTHER FACILITIES THAT SERVE LOW-INCOME PATIENTS, AS WELL AS COMMUNITY SERVICES, WHICH SUSTAINS AND IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. SEE SCHEDULE H FOR COMMUNITY BENEFIT REPORT.

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 expenses298,847,239

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(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
(A) Name and Title
(18) ROGER BIGELOW MD LEAD- PHYSICIAN	50.0 .......................0	X	277,065	0	22,938
(19) SLOBODAN KOVACEVIC MD HOSPITALIST	50.0 .......................0	X	269,185	0	15,698
(20) DEBORAH LEVAN DO PHYSICIAN	50.0 .......................0	X	314,951	0	38,082
(21) GARY L PINEAU DIR. NURSING ANESTHESIA	50.0 .......................0	X	245,044	0	22,800
(22) RAFAEL BARRETTO DIR. MEDICAL EDUCATION	50.0 .......................0	X	246,759	0	30,301

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,493,676	2,153,217	325,708

1a	Federated campaigns..		1a	0
b	Membership dues..		1b	0
c	Fundraising events..		1c	0
d	Related organizations		1d	0
e	Government grants (contributions)		1e	0

f	All other contributions, gifts, grants, and similar amounts not included above		1f	45,136

g	Noncash contributions included in lines 1a-1f:$ 0
h Total.Add lines 1a-1f.......		45,136

		Business Code
2a	NET PATIENT SVC REV	921990	412,172,225	412,172,225
b	MEDICAL EDUCATION	531110	550,687	550,687	0	0
c	I/C RENTAL INCOME	532000	113,361	113,361	0	0
d	ANCILLARY REVENUE	621300	-3,254	-3,254	0	0
e			0	0	0	0
f	All other program service revenue.			0	0	0	0
g Total.Add lines 2a–2f.....			412,833,019

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			0	0	0	0
4 Income from investment of tax-exempt bond proceeds			0	0	0	0
5 Royalties...........			0	0	0	0
		(ii) Personal	(i) Real
6a	Gross rents		132,912
b	Less: rental expenses		658,499
c	Rental income or (loss)	0	-525,587
d	Net rental income or (loss)......			-525,587	0	0	-525,587
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	142,617
b	Less: cost or other basis and sales expenses	0	769,683
c	Gain or (loss)	142,617	-769,683
d	Net gain or (loss).....			-627,066	0	0	-627,066
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from fundraising events..			0		0	0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0	0	0	0
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0	0	0	0
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		722210	953,932	0	0	953,932
b	RESIDENT INCOME		621300	122,875	122,875	0	0
c	SELF INSURANCE		900099	75,731	75,731	0	0
d	All other revenue ....			2,626,965	2,626,965	0	0
e	Total. Add lines 11a–11d ......			3,779,503
12	Total revenue. See Instructions......			415,505,005	415,658,590	0	-198,721

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	869,768	869,768
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,246,873	0	1,246,873	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0	0	0	0
7	Other salaries and wages	157,565,987	118,174,490	39,391,497	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,214,735	911,051	303,684	0
9	Other employee benefits .......	13,601,573	10,201,180	3,400,393	0
10	Payroll taxes ...........	10,887,221	8,165,416	2,721,805	0
11	Fees for services (non-employees):
a	Management ......	9,662,059	7,246,544	2,415,515	0
b	Legal .........	106,512	0	106,512	0
c	Accounting ...........	342	0	342	0
d	Lobbying ...........	16,934	0	16,934	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	13,330,411	9,997,809	3,332,602	0
12	Advertising and promotion ....	87,826	87,826	0	0
13	Office expenses .......	2,534,240	1,900,680	633,560	0
14	Information technology ......	21,087,380	15,815,535	5,271,845	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	5,635,193	4,226,395	1,408,798	0
17	Travel ............	421,209	421,209	0	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	623,855	623,855	0	0
20	Interest ...........	3,720,613	3,720,613	0	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	17,051,777	12,788,833	4,262,944	0
23	Insurance ...	5,830,304	5,830,304	0	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	PURCHASED SERVICES	62,626,577	46,969,933	15,656,644	0
b	MEDICAL SUPPLIES	53,922,693	40,442,020	13,480,673	0
c	REPAIRS & MAINTENANCE	1,504,137	1,128,103	376,034	0
d	CATERING EXPENSE	1,532,699	1,532,699	0	0
e	All other expenses	10,390,634	7,792,976	2,597,658	0
25	Total functional expenses. Add lines 1 through 24e	395,471,552	298,847,239	96,624,313	0
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			649,543	1	1,533,018
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			130,744,016	4	45,659,903
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6
7	Notes and loans receivable, net ....			0	7	0
8	Inventories for sale or use ........			6,849,497	8	6,979,200
9	Prepaid expenses and deferred charges ......			1,070,920	9	797,034
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	303,311,178
b	Less: accumulated depreciation	10b	251,066,076	52,967,337	10c	52,245,102
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			169,084	12	164,269
13	Investments—program-related. See Part IV, line 11 ..			69,676	13	9,422
14	Intangible assets ...............			12,267,643	14	9,952,229
15	Other assets. See Part IV, line 11 ...........			130,705,455	15	235,154,599
16	Total assets. Add lines 1 through 15 (must equal line 34)...			335,493,171	16	352,494,776

17	Accounts payable and accrued expenses .....	27,719,155	17	32,000,282
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
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	212,839,286	25	212,294,450
26	Total liabilities. Add lines 17 through 25..	240,558,441	26	244,294,732

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	94,765,646	27	108,035,775
28	Temporarily restricted net assets ...........	169,084	28	164,269
29	Permanently restricted net assets	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....	0	30	0
31	Paid-in or capital surplus, or land, building or equipment fund ...	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	0	32	0
33	Total net assets or fund balances ...........	94,934,730	33	108,200,044
34	Total liabilities and net assets/fund balances ........	335,493,171	34	352,494,776