Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 07-01-2015 , and ending 06-30-2016
BCheck if applicable:
CName of organization
Borgess Medical Center
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1521 Gull Road
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Kalamazoo, MI49048
D Employer identification number

38-1360526
E Telephone number

G Gross receipts $ 471,739,902
F Name and address of principal officer:
Kathy Young
1521 Gull Road
Kalamazoo,MI49048
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.borgess.com
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:  
L Year of formation: 1927
M State of legal domicile: MI
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Provide inpatient & outpatient routine & ancillary care to the community.
2 Check this box MediumBullet
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 11
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 3,912
6 Total number of volunteers (estimate if necessary) ............. 6 178
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 2,855,621
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,049,928 1,601,652
9 Program service revenue (Part VIII, line 2g) ......... 444,139,266 461,112,921
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 555,871 319,439
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 22,946,435 8,482,516
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 468,691,500 471,516,528
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 532,694 187,766
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 210,239,993 180,888,699
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet204,709    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 201,768,653 193,875,812
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 412,541,340 374,952,277
19 Revenue less expenses. Subtract line 18 from line 12....... 56,150,160 96,564,251
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 285,408,311 437,334,939
21 Total liabilities (Part X, line 26)............. 351,712,107 435,752,799
22 Net assets or fund balances. Subtract line 21 from line 20..... -66,303,796 1,582,140
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: Borgess Medical Center provides necessary and vital health care services to an area which includes all of S.W. Michigan. This care is given regardless of any individuals' race, color, religion, gender, age, national origin or ability to pay. Borgess Medical Center is committed to cooperating with patients and families in providing holistic treatment by integrating within the healing process the physical, emotional and spiritual needs of each patient. Services include inpatient routine, inpatient and outpatient ancillary care in support of our stated mission.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 326,786,485 including grants of $ 187,766 ) (Revenue $ 464,897,895 )
IN FURTHERANCE OF ITS MISSION, BORGESS MEDICAL CENTER PROVIDES QUALITY MEDICAL SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR ABILITY TO PAY. ADDITIONALLY, THE MEDICAL CENTER PARTICIPATES IN STATE AND FEDERAL PROGRAMS DESIGNED FOR THE INDIGENT AND ELDERLY WHERE REIMBURSEMENTS ARE LESS THAN COST. THESE ESTIMATES DO NOT INCLUDE COMMUNITY HEALTH PROMOTIONS AND OUTREACH PROGRAMS PERFORMED TO ASSIST THOSE IN NEED AND PROVIDED WITHOUT CHARGE. SEE SCHEDULE H FOR THE 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 expensesMediumBullet326,786,485
Form 990 (2015)
Form 990 (2015)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III .............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV
........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
301
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
3,912
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJeff Simpson1521 Gull Road   Kalamazoo,MI49048 (269) 226-7000
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) BETH BRUTSCHE
 
SECRETARY (start 9/2015)
1.0
.................
3.0
X   X       0 0 0
(2) JERRY LOVE
 
CHAIR
1.0
.................
3.0
X   X       0 0 0
(3) SUSAN POZO PHD
 
TREASURER (START 9/15)
1.0
.................
3.0
X   X       0 0 0
(4) KATHY A YOUNG
 
PRESIDENT/CEO
35.0
.................
5.0
X   X       855,101 0 32,291
(5) JONI KNAPPER
 
VICE CHAIR (START 9/2015)
1.0
.................
3.0
X   X       0 0 0
(6) SANJAY DALAL MD
 
TRUSTEE
1.0
.................
3.0
X           0 0 0
(7) GARY DRUSKOVICH MD
 
TRUSTEE
1.0
.................
3.0
X           0 0 0
(8) MARY ELLEN GONDECK CSJ
 
TRUSTEE
1.0
.................
3.0
X           0 0 0
(9) JAMES F HETTINGER
 
TRUSTEE
1.0
.................
3.0
X           0 0 0
(10) ALBERT LITTLE
 
TRUSTEE
1.0
.................
3.0
X           0 0 0
(11) MARY SLATER md
 
TRUSTEE
1.0
.................
3.0
X           0 0 0
(12) MIRJANA STANCIC MD
 
TRUSTEE (END 2/2016)
38.0
.................
2.0
X           268,420 0 23,807
(13) CHARLES BURLING DDS
 
TRUSTEE (START 9/2015)
1.0
.................
3.0
X           0 0 0
(14) THOMAS ROHS JR MD
 
TRUSTEE - (START 2/2016)
37.0
.................
3.0
X           538,005 0 40,058
(15) RICHARD FELBINGER
 
CFO - HEALTH SYSTEM
34.0
.................
6.0
    X       477,756 0 35,180
(16) JAMES B BABEL MD
 
PHYSICIAN
40.0
.................
1.0
      X     320,654 0 31,515
(17) J PATRICK DYSON
 
EXECUTIVE VP
34.0
.................
6.0
      X     631,208 0 27,943
Form 990 (2015)
Form 990 (2015)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (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)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) ROBERT HILL MD
 
CHIEF MEDICAL OFFICER
33.0
.......................7.0
      X     419,898 0 36,357
(19) ANTHONY F MCDONNELL
 
CHIEF DEVELOPMENT OFFICER
0.0
.......................40.0
      X     224,639 0 31,247
(20) JOHN RYDER
 
COO - LEE & PIPP
20.0
.......................23.0
      X     219,752 0 36,005
(21) STACEY WATSON MD
 
PHYSICIAN
40.0
.......................1.0
      X     293,576 0 36,741
(22) JOHN GUSTAFSON MD
 
PHYSICIAN
40.0
.......................0
        X   1,253,076 0 42,332
(23) SREENIVAS KAMATH MD
 
PHYSICIAN
40.0
.......................0
        X   1,225,523 0 42,224
(24) WILLIAM UGGEN MD
 
PHYSICIAN
40.0
.......................0
        X   978,787 0 39,361
(25) VISHAL GUPTA MD
 
PHYSICIAN
40.0
.......................0
        X   948,429 0 41,224
(26) TODD REAM MD
 
PHYSICIAN
40.0
.......................0
        X   890,246 0 42,723
(27) MARK ANTHONY
 
COO - HEALTH SYSTEM (END 6/2015)
40.0
.......................0.0
          X 444,314 0 20,886






1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,989,384 0 559,894
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet519
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
SOUTHWEST MI IMAGING LLC

1700 gull road
kalamazoo,MI49048
imaging services 18,242,330
PREMIER MEDICAL CARE PC

po box 249
goodlettsville,TN37070
medical services 4,908,528
AMERICAN VILLAGE BUILDERS INC

4200 west centre avenue
portage,MI49024
construction services 2,421,351
KALAMAZOO EMERGENCY ASSOC PLC

1535 gull road
kalamazoo,MI49048
medical services 2,181,644
CCS PERFUSION ASSOCIATES LLC

31330 schoolcraft road suite 200
livonia,MI48150
medical services 1,747,172
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet40
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 1,601,652
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 1,601,652
 Program Service RevenueAmt Business Code
2a Net Patient Services 621990 443,563,465 443,563,465    
b Pharmacy 621990 11,641,148 11,641,148    
c Joint Ventures Income 900099 4,792,477 4,792,477    
d Reference Lab 541380 612,242 361,199 251,043  
e Affiliated Rental Inc. 532000 503,589 503,589    
f All other program service revenue. 0 0 0 0
g Total.Add lines 2a–2f.....MediumBullet 461,112,921
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 21,378     21,378
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   387,625
b Less: rental expenses    
c Rental income or (loss) 0 387,625
d Net rental income or (loss)......MediumBullet 387,625     387,625
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 298,061  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 298,061 0
d Net gain or (loss).....MediumBullet 298,061     298,061
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
a 344,736
b Less: cost of goods sold ..b 223,374
c Net income or (loss) from sales of inventory..MediumBullet 121,362     121,362
Business Code Miscellaneous Revenue
11a Affiliate Income 621990 685,227 685,227    
b Laundry Income 812300 3,879,422 1,274,844 2,604,578  
c Cafeteria revenue 722514 1,332,934     1,332,934
d All other revenue .... 2,075,946 2,075,946 0 0
e Total. Add lines 11a–11d ...... MediumBullet 7,973,529
12 Total revenue. See Instructions......MediumBullet 471,516,528 464,897,895 2,855,621 2,161,360
Form 990 (2015)
Form 990 (2015)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 187,766 187,766
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 4,580,153 2,156,188 2,219,256 204,709
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 144,042,294 123,876,371 20,165,923  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,741,406 1,497,609 243,797  
9 Other employee benefits ....... 20,000,868 17,200,746 2,800,122  
10 Payroll taxes ........... 10,523,978 9,050,621 1,473,357  
11 Fees for services (non-employees):        
a Management ...... 1,532,397 1,317,861 214,536  
b Legal ......... 1,408   1,408  
c Accounting ........... 2,787   2,787  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 0   0  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 50,912,354 44,339,565 6,572,789 0
12 Advertising and promotion .... 20,523   20,523  
13 Office expenses ....... 1,504,004 1,273,202 230,802  
14 Information technology ...... 387,223 333,012 54,211  
15 Royalties ..        
16 Occupancy ........... 12,683,187 10,907,541 1,775,646  
17 Travel ............ 423,865 364,514 59,351  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 389,741 335,177 54,564  
20 Interest ........... 4,992,030   4,992,030  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 15,769,129 13,561,451 2,207,678  
23 Insurance ... 3,311,696 2,848,059 463,637  
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 Medical & Pharmaceutical Supplies 84,744,602 84,744,602    
b LAUNDRY EXPENSES 3,812,420 1,207,842 2,604,578  
c COST OF GOODS SOLD 664,974 664,974    
d Equipment Rental 1,461,951 1,257,278 204,673  
e All other expenses 11,261,521 9,662,106 1,599,415 0
25 Total functional expenses. Add lines 1 through 24e 374,952,277 326,786,485 47,961,083 204,709
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 2,455,782 1 10,002,098
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 57,428,556 4 62,844,412
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
  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
  6 0
7 Notes and loans receivable, net ....   7  
8 Inventories for sale or use ........ 7,364,992 8 7,152,150
9 Prepaid expenses and deferred charges ...... 3,457,205 9 4,689,657
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 297,044,216
b Less: accumulated depreciation 10b 157,267,441 149,999,054 10c 139,776,775
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 268,804 12 134,710
13 Investments—program-related. See Part IV, line 11 .. 14,429,962 13 18,460,759
14 Intangible assets ............... 16,533,882 14 8,351,152
15 Other assets. See Part IV, line 11 ........... 33,470,074 15 185,923,226
16 Total assets. Add lines 1 through 15 (must equal line 34)... 285,408,311 16 437,334,939
Liabilities 17 Accounts payable and accrued expenses ..... 32,342,243 17 28,532,014
18 Grants payable ...   18  
19 Deferred revenue ......... 1,350,181 19 2,224,029
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
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..   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 318,019,683 25 404,996,756
26 Total liabilities. Add lines 17 through 25.. 351,712,107 26 435,752,799
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets -66,572,600 27 1,447,430
28 Temporarily restricted net assets ........... 268,804 28 134,710
29 Permanently restricted net assets   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... -66,303,796 33 1,582,140
34 Total liabilities and net assets/fund balances ........ 285,408,311 34 437,334,939
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
471,516,528
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
374,952,277
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
96,564,251
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-66,303,796
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-28,678,315
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,582,140
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow 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
Borgess Medical Center
 
Employer identification number

38-1360526
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4


5
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
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

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) right arrow (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) right arrow (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.  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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

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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2015

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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990 or 990-EZ) 2015

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
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the organization
Borgess Medical Center
 
Employer identification number

38-1360526
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
Borgess Medical Center
 
Employer identification number
38-1360526
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$ RESTRICTED


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
Borgess Medical Center
 
Employer identification number

38-1360526
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
Borgess Medical Center
 
Employer identification number

38-1360526
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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 BulletInformation 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
Borgess Medical Center
 
Employer identification number

38-1360526
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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

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

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the 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


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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
21,935
j
Total. Add lines 1c through 1i ....................................................................................................
21,935
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
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. Borgess Medical Center 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 candidates 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. Borgess Medical Center 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 candidates for public office.
Schedule C (Form 990 or 990EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v3.0

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
Borgess Medical Center
 
Employer identification number

38-1360526
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 ....    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
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.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part 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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
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 ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 ...   4,249,957 4,249,957
b Buildings   205,991,153 103,847,685 102,143,468
c Leasehold improvements   2,262,018 2,042,354 219,664
d Equipment ...   68,914,306 51,377,402 17,536,904
e Other ...   15,626,782   15,626,782
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 139,776,775
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other 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.)Small Bullet  
Part VIII
Investments—Program 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.)Small Bullet  
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) Interest in Investments Held by Ascension Health Alliance  
(2) Deferred Compensation Annuities 14,422,759
(3) Intercompany Receivables 155,835,326
(4) Third Party Settlements 11,793,791
(5) Other Receivables 3,871,350
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 185,923,226
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  
Intercompany Debt with Ascension Health Alliance 159,223,123
Pension Payable 58,798,689
Third Party Settlements 13,160,480
Deferred Compensation 14,422,759
Self Insurance Liability 4,399,582
Other Liabilities 3,545,554
Intercompany Payables 151,446,569
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 404,996,756
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

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 X, Line 2 FIN 48 (ASC 740) footnote From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of Borgess Medical Center: The System accounts for uncertainty in income tax positions 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 bas 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




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
Borgess Medical Center
 
Employer identification number

38-1360526
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) 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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    4,817,153 0 4,817,153 1.28 %
b Medicaid (from Worksheet 3, column a) . . . . .     64,102,791 55,135,249 8,967,542 2.39 %
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 68,919,944 55,135,249 13,784,695 3.68 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     554,808 0 554,808 0.15 %
f Health professions education (from Worksheet 5) . . .     8,972,570 0 8,972,570 2.39 %
g Subsidized health services (from Worksheet 6) . . . .     0 0 0 0 %
h Research (from Worksheet 7) .     1,266,705 0 1,266,705 0.34 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     341,276 0 341,276 0.09 %
j Total. Other Benefits . . 0 0 11,135,359 0 11,135,359 2.97 %
k Total. Add lines 7d and 7j . 0 0 80,055,303 55,135,249 24,920,054 6.65 %
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 (f) Percent of total expense
1 Physical improvements and housing         0 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members
        0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 0 0 0 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,522,188
3
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. ......
3
417,045
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
219,075,404
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
224,649,364
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-5,573,960
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(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
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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Borgess Medical Center
1521 Gull Road
Kalamazoo,MI49048
www.borgess.com
L424370
X X   X   X X     A
2 Borgess PIPP Hospital
411 Naomi Street
Plainwell,MI49080
www.borgess.com
L431681
              X Long-Term Acute Care A
Schedule H (Form 990) 2015
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.borgess.com/about-us/community-health
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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
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 No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.borgess.com/about-us/financial-assistance
b
http://www.borgess.com/about-us/financial-assistance
c
d
e
f
g
h
i
Billing and Collections
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Yes No
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
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 - Borgess Medical Center. In 2015, Borgess Health re-established the Community Benefit Advisory Committee, This committee represents nine (9) community agency leaders throughout Kalamazoo County and is intended to represent a wide range of expertise and services that impact our community's health statue . Each committee member also holds numerous board and community committee positions in Kalamazoo and is adequately positioned to represent the community needs. The Community Benefit Advisory Committee represented a large cross section of community agencies. The committee members' expertise involves public health, not-for-profit agencies, school/educational programs, elderly support services, family health centers, chronic disease specialty clinics, Borgess Health representatives involved in community work, and a local government official. All agencies and their representatives on the committee are involved with providing services to the medically underserved, low income and minority populations. The following list represents the Community Benefit Advisory Committee participating members and data sources: Community Benefit Advisory Committee Members: - Denise Crawford - Tim Lieser - Patrick Dyson - Mary Gustas - Gillian Stoltman - Susan Pozo - Linda Root - John Ryder - Cheryl Tenenbaum
Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - Borgess Medical Center. The CHNA was conducted with the following hospital facility(s): Lee Memorial Hospital and Borgess PIPP Hospital
Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - Borgess Medical Center. The CHNA was conducted with the following non-hospital facility(s): FQFamily Health Center Kalamazoo County Health and Community Services
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Borgess Medical Center. Identification and Process for Prioritization of Needs The results of the key informant interviews and the focus groups were presented to the Borgess Senior Leadership Team, the Borgess Health Community Health Needs Assessment Systems Strategy Council and the Community Benefit Advisory Committee. A copy of the health issues data was provided to each member of the groups. The members were then asked to provide feedback on the results as well as engage in conversation with the rest of their members. The Borgess Health CHNA staff provided a draft of the data collection and community findings to the committees listed above. The groups convened and reviewed the data collection and the draft CHNA report. Criteria considered when making decisions were: - The ability of Borgess Health to make an impact based on current resources - The effectiveness of current Borgess Health programs and services - Avoiding duplication and or enhancing community initiatives already established - The Michigan Department of Community Health statewide health priorities and local health department priorities - Healthy People 2020 goals The nominal group planning process method of identifying and determining needs was used. Nominal group planning can be used to: - determine what community issues are of greatest concern - decide on a strategy for dealing with the identified issues - design improved community services or programs This method is based on group discussion and information exchange. Group members generate a list of ideas or concerns surrounding the topic being discussed. This list becomes decision making criteria and the prioritization is the ultimate result of consensus and a vote to rank order the criteria. Based on the process and criteria listed above, Borgess Health identified the following priorities for the Implementation Plan: - Access to Care - Diabetes - Infant Mortality Description of Community Health Needs Identified Goal 1: Access to Care Access to Care is an ongoing issue and is listed in the Healthy People 2020 report as one of the leading twelve indicators for the nation to focus on. Healthy People 2020 provides science-based, 10-year national objectives for improving the health of all Americans. As we move into 2016 and the next phase of implementation of the Affordable Care Act, more and more individuals will become insured with Medicaid expansion. 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. The need to address and strengthen Access to Care is an ongoing system-wide initiative through the Ascension Health's Call to Action policy "Healthcare That Leaves No One Behind". The policy represents Ascension Health's commitment to 100% access and coverage for all Americans. Ascension Health has evolved its 2020 destination for "Healthcare That Leaves No One Behind" to describe that all people, particularly those who are poor and vulnerable, can access environments and healthcare that (1) create and support the best journey to improved health status for individuals and communities, and (2) are financed in an adequate and sustainable fashion. The vulnerable people we are focused on serving includes individuals who remain uninsured in a post-reform era, but also includes people who are vulnerable due to factors other than insurance coverage, including their economic situation, citizenship status, geographic location, health status, age, education level or decision-making ability. Strategy 1: Borgess Health will design, develop and deliver a Medical Mission at Home in downtown Kalamazoo. Medical Mission at Home is an Ascension initiative that delivers free medical care to those with limited access who are struggling in the community. It provides real time delivery of organized health and social services to those who do not have access to those types of services. There is a large homeless population in downtown Kalamazoo as well as two missions, Ministry with Community and Gospel Mission, who serve this population. A Medical Mission will provide basic wellness screenings and help identify any chronic conditions and make referrals where needed. Working collaboratively with Borgess providers, community partners and volunteers, this will also be an opportune time to provide health education on a number of chronic conditions, education to the attendees on how and when to access the local emergency departments, provide healthy snacks and deliver prescriptions and other basic needs. Strategy 2: This strategy involves two of BH goals, Access to Care and Infant Mortality combined. This strategy is aimed at reducing the racial disparity and improving birth outcomes among high risk women in Kalamazoo by increasing their access to prenatal care. Barriers to be addressed in this strategy are access to prenatal care, coordination of care and follow through, referral to community resources, and transportation. (see Borgess Health Goal 3, Infant Morality) Goal 2: Diabetes Prevention In Michigan, in 2014, an estimated 10.4% of Michigan adults 18 years and older were diagnosed with diabetes. According to the Centers for Disease Control and Prevention (CDC), 27.8% of people of all ages with diabetes are undiagnosed. Also the CDC reported about 37% of adults age 20 years and older were estimated to have pre-diabetes, putting them at high risk for developing type 2 diabetes. However, in 2014, only an estimated 8.2% of Michigan adults reported ever being told that they had pre-diabetes. Michigan ranked 22nd out of 50 states in highest diabetes prevalence among adults 18 years and older in 2013. Diabetes was the seventh leading cause of death in Michigan in 2013 (Michigan Department of Community Health). Although reducing incidence of diabetes was a priority area for the 2013 BHS CHNA, it remains one of the top causes of hospitalizations and death in Kalamazoo and at BHS from 2013 - 2015. Strategy 1: Provide diabetes screenings and education through community groups and local churches. Due to the fact that there remains a large percentage of the population undiagnosed, it is important to reach out to those community members who are at high risk and undiagnosed. Developing a relationship with our local churches and community groups will allow access to community members who may not have a primary care physician and may be undiagnosed or are considered pre-diabetic. Identifying those who are pre-diabetic will allow intervention and education to prevent further progression of the disease. Strategy 2: Design, develop and distribute web based pre-diabetes programs. Working in tandem with Borgess Diabetes and Marketing departments, an online pre-diabetes program will be developed and distributed. This will be done in a culturally appropriate manner and will be distributed widely throughout the community. This strategy greatly improves access to much needed health education where it can be delivered through computer or electronic device at any time at any place. It provides year-round access to life changing health education. Goal 3: Infant Mortality Reduction For every 1,000 Michigan live births, approximately seven infants die before reaching their first birthday. Michigan's infant mortality rate is consistently higher than the national average. The highest disparity is found among African American infants, which are approximately 13 deaths per 1,000 live births. In comparison with white births, this is three times greater. This has been an area of concern for many years in Kalamazoo County. This situation has not shown any sustainable improvement over the course of time and in fact, has only gotten worse. In fact, for every one death of a Caucasian baby, four black babies die. There is a group working diligently on this problem in Kalamazoo County. Some of the causes are social determinants of health such as poverty and race, as well as safe sleep habits, unintended pregnancy, and previous poor birth outcomes. Community Needs Not Addressed Identified needs that will not be addressed were determined by availability of services in the community. Chronic diseases with substantial support in the community such as cancer, lung disease and heart disease are supported by strong Borgess Heath programs with a variety of available resources in addition to the support of the American Cancer Society, American Lung Association and the American Heart Association. Mental Health and lack of providers is certainly a health priority; however, other agencies in the Kalamazoo area have greater resources to address this need. Injury prevention scored moderately high but will not be addressed in the CHNA implementation strategy and action plans.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
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?0
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2015
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 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means tested government programs, and 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 were calculated and applied.
Schedule H, Part II Community Building Activities We have a Community Benefit Advisory Committee that includes community leaders from health and human service organizations, the Borgess Health Board of Trustees and leadership that discusses and collaborates on community building activities. Borgess Health is positioned through its membership on 58 local regional and state health, economic and community service boards and advisory committees to help shape the discussion on health issues in the communities we serve. To that end, Borgess has representation on the Boards and/or advisory committees of Southwest Michigan First, Western Michigan University (WMU) School of Medicine, Kalamazoo Valley Community College and WMU Schools of Nursing, Greater Kalamazoo United Way, Blue Cross/ Blue Shield and Priority Health to name a few. Our participation on the Family Health Center (our local FQHC), Kalamazoo County Health Plan and financial support of Michigan State University/Kalamazoo Center for Medical Studies residency program and the Southwest Michigan Cancer Center insure access to care for vulnerable patients.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote From the consolidated audited financial statements of Ascension Health Alliance and its member entities ("The System") which includes the activity of Borgess Medical Center: The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions historical experience, 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. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Ascension Health and 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 and collection procedures will only pertain to patients that do net qualify for charity or financial assistance and who are not complying with payment arrangements that have been agreed to by the hospital and the patient.
Schedule H, Part V, Section B, Line 16a FAP website A - Borgess Medical Center: Line 16a URL: http://www.borgess.com/about-us/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website A - Borgess Medical Center: Line 16b URL: http://www.borgess.com/about-us/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - Borgess Medical Center: Line 16c URL: http://www.borgess.com/about-us/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment Borgess reviews numerous reports and statistics, including epidemiological reports published by the Kalamazoo County Health and Human Services Department, admission and emergency room data to determine where the specific needs of the community are and where we can focus our efforts to offer assistance.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Information regarding financial assistance is posted in the admitting, and registration departments in addition to the emergency department. Borgess has staff dedicated to assisting uninsured patients complete a means test and complete applications for public assistance. Patients are provided with contact numbers on their medical bills to contact the billing office if assistance is needed to pay their bill. We leave it up to the patient to contact us then we direct them through the Charity Care process or applying for other government assistance programs.
Schedule H, Part VI, Line 4 Community information Kalamazoo is a two-hospital market with the consumers believing that there are two very good, equal healthcare facilities. However, because it's a newer facility with all private rooms, Bronson's reputation is partially based on facility amenities. Many consumers choose a hospital based on specific service needs and/or physician recommendations and preferences. Outside of Kalamazoo, the Borgess Health service area includes several small rural hospitals and two secondary service level hospitals. Description of Community: Assessment of Kalamazoo County and Borgess Health's Primary Service Areas The City of Kalamazoo is located within county and represents approximately 30% of the total population. The average annual income of a Kalamazoo county resident is $46,019 annually with 18.6% of the population falling below the poverty level. The current unemployment rate is 8.8%. Southwest Michigan Population Demographics and Trends Southwest Michigan is comprised of a nine-county region that borders Indiana. Kalamazoo County is at the heart of southwest Michigan and is the most densely populated of the nine counties. Together, the neighboring cities of Kalamazoo and Portage within the county represent the largest metropolitan area in the region. For the purpose of the Community Health Needs Assessment, we will define our focus on Kalamazoo County, which includes the cities Kalamazoo and Portage. In 2013 County Health Rankings were released on March 21, 2013 by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Kalamazoo County places in the middle of the 82 Michigan counties at the 46th rank. According to estimates by the U.S. Census, the City of Kalamazoo's population increased 0.64 percent from 74,262 to 74,743 between 2010 and 2011. During the same timeframe, the population of the City of Portage increased 0.71 percent from 46,292 to 46,624. Population Living in Poverty 2008-2010 estimates projected that 19.2% of the Kalamazoo County population or 46,091 people lived below the poverty level. The proportions of people living below the poverty level in Michigan (15.7%) as well as the proportion in the United States (14.4%) were lower than the proportion in Kalamazoo County. Within Kalamazoo County, the proportion of the population living below the poverty level varied by city and township. In 2008-2010, the City of Kalamazoo had the highest poverty rate with 36.0% of residents living below the poverty level. "Poverty estimates for all cities and townships in Kalamazoo County are available from the American Community Survey as an average rate between 2006 and 2010. The highest rate was in the City of Kalamazoo; lowest rates were in Texas Township, Cooper Township, Climax Township, Ross Township, and Prairie Ronde Township."
Schedule H, Part VI, Line 5 Promotion of community health Borgess provides a number of services to the community at no or a very low cost to the general community and to uninsured patients in our comprehensive Diabetes Uninsured Clinic, Wellness Project offered to adults in Allegan County, pharmaceutical assistance program, and in-home nursing programs. We also provide health screenings e.g., colorectal, immunizations, mammograms and school physicals. Borgess has a history steeped in the tradition of serving the poor and underserved. Borgess leadership including the Board of Trustees are educated on the organization's mission and values and challenge themselves on how to serve the poor and underserved members of our community.
Schedule H, Part VI, Line 6 Affiliated health care system Borgess Medical Center is a wholly owned subsidiary of Borgess Health Alliance, Inc. which is a member of Ascension Health. 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 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. The Medical Center, located in Kalamazoo, Michigan, is a nonprofit acute care hospital. The Medical Center provides inpatient, outpatient, and emergency care services for the residents of Kalamazoo, Michigan. Admitting physicians are primarily practitioners in the local area. Substantially all expenses of Ascension Health and its sponsored organizations 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
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
Borgess Medical Center
 
Employer identification number
38-1360526
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to 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) Greater Kalamazoo United Way
709 South Westnedge
Kalamazoo,MI49007
38-1359193 501(c)(3) 95,000       Community Development
(2) Hospitality House of Kalamazoo
527 W South Street
Kalamazoo,MI49007
38-2540700 501(c)(3) 26,500       Fund local Programs
(3) Western Michigan University School of Medicine
1000 Oakland Drive
Kalamazoo,MI49008
45-4135256 501(c)(3) 15,000       Fund Operations
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
3
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

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. If grant is for a specific event we usually have a representative attend the function. If it is for non- function activities we usually receive a letter detailing our contribution and what it was used for.
Schedule I (Form 990) 2015



Additional Data


Software ID: 15000238
Software Version: 2015v3.0


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
Borgess Medical Center
 
Employer identification number

38-1360526
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization?
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 .............................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1KATHY A YOUNG
  PRESIDENT/CEO
(i)

(ii)
492,971
-------------
0
287,870
-------------
0
74,260
-------------
0
15,900
-------------
0
16,391
-------------
0
887,392
-------------
0
0
-------------
0
2MIRJANA STANCIC MD
  TRUSTEE (END 2/2016)
(i)

(ii)
252,398
-------------
0
15,144
-------------
0
878
-------------
0
13,551
-------------
0
10,256
-------------
0
292,227
-------------
0
0
-------------
0
3THOMAS ROHS JR MD
  TRUSTEE - (START 2/2016)
(i)

(ii)
519,521
-------------
0
16,000
-------------
0
2,484
-------------
0
13,250
-------------
0
26,808
-------------
0
578,063
-------------
0
0
-------------
0
4RICHARD FELBINGER
  CFO - HEALTH SYSTEM
(i)

(ii)
322,951
-------------
0
142,869
-------------
0
11,936
-------------
0
15,900
-------------
0
19,280
-------------
0
512,936
-------------
0
0
-------------
0
5MARK ANTHONY
  COO - HEALTH SYSTEM (END 6/2015)
(i)

(ii)
183,228
-------------
0
0
-------------
0
261,086
-------------
0
9,596
-------------
0
11,290
-------------
0
465,200
-------------
0
0
-------------
0
6JAMES B BABEL MD
  PHYSICIAN
(i)

(ii)
301,197
-------------
0
15,101
-------------
0
4,356
-------------
0
11,925
-------------
0
19,590
-------------
0
352,169
-------------
0
0
-------------
0
7J PATRICK DYSON
  EXECUTIVE VP
(i)

(ii)
380,632
-------------
0
162,663
-------------
0
87,913
-------------
0
15,900
-------------
0
12,043
-------------
0
659,151
-------------
0
72,567
-------------
0
8ROBERT HILL MD
  CHIEF MEDICAL OFFICER
(i)

(ii)
320,566
-------------
0
96,288
-------------
0
3,044
-------------
0
11,925
-------------
0
24,432
-------------
0
456,255
-------------
0
0
-------------
0
9ANTHONY F MCDONNELL
  CHIEF DEVELOPMENT OFFICER
(i)

(ii)
171,727
-------------
0
43,286
-------------
0
9,626
-------------
0
11,059
-------------
0
20,188
-------------
0
255,886
-------------
0
0
-------------
0
10JOHN RYDER
  COO - LEE & PIPP
(i)

(ii)
172,626
-------------
0
38,378
-------------
0
8,748
-------------
0
12,130
-------------
0
23,875
-------------
0
255,757
-------------
0
0
-------------
0
11STACEY WATSON MD
  PHYSICIAN
(i)

(ii)
239,140
-------------
0
53,672
-------------
0
764
-------------
0
12,400
-------------
0
24,341
-------------
0
330,317
-------------
0
0
-------------
0
12JOHN GUSTAFSON MD
  PHYSICIAN
(i)

(ii)
710,284
-------------
0
540,170
-------------
0
2,622
-------------
0
13,250
-------------
0
29,082
-------------
0
1,295,408
-------------
0
0
-------------
0
13SREENIVAS KAMATH MD
  PHYSICIAN
(i)

(ii)
718,077
-------------
0
504,824
-------------
0
2,622
-------------
0
13,250
-------------
0
28,974
-------------
0
1,267,747
-------------
0
0
-------------
0
14WILLIAM UGGEN MD
  PHYSICIAN
(i)

(ii)
670,612
-------------
0
307,149
-------------
0
1,026
-------------
0
13,250
-------------
0
26,111
-------------
0
1,018,148
-------------
0
0
-------------
0
15VISHAL GUPTA MD
  PHYSICIAN
(i)

(ii)
664,541
-------------
0
282,748
-------------
0
1,140
-------------
0
13,250
-------------
0
27,974
-------------
0
989,653
-------------
0
0
-------------
0
16TODD REAM MD
  PHYSICIAN
(i)

(ii)
715,930
-------------
0
172,606
-------------
0
1,710
-------------
0
13,250
-------------
0
29,473
-------------
0
932,969
-------------
0
0
-------------
0
Schedule J (Form 990) 2015

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 Ascension Health, a related organization of Borgess Medical Center uses the following methods to establish the compensation of the organization's CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee.
Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization: Mark Anthony $160,062
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 executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year paid. The following individual(s) received distributions in CY2015: J. Patrick Dyson - $72,567
Schedule J (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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
Borgess Medical Center
 
Employer identification number

38-1360526
Return Reference Explanation
Form 990, Part IV, Line 20b Explanation of Financial Statements The activity of Borgess Medical Center is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Borgess Medical Center is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of Borgess Medical Center.
Form 990, Part VI, Line 15a Process to Establish Compensation of Top Managment Official In determining the compensation of the organization's CEO, the process, performed by Ascension Health, a related organization of Borgess Medical Center, included a review and approval by independent persons, comparability data and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the committee minutes. The individual was not present when his compensation was decided.
Form 990, Part VI, Line 15b Process to Establish Compensation of Other Officers and Key Employees In determining the compensation of other officers and key employees of the organization, the process, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive/Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers and key employees were compared to individuals at other organizations 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 Due to a reorganization effective July 17, 2015, the sole corporate member of Borgess Medical Center changed from Ascension Health to Ascension Michigan.
Form 990, Part VI, Line 6 Classes of members or stockholders Borgess Medical Center has a single corporate member, Ascension Michigan, who has the ability to elect members of the governing body of the Borgess Medical Center.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Borgess Medical Center has a single corporate member, Ascension Michigan who has the ability to elect members to the governing body of the Borgess Medical Center.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.
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, principal officer, 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 meeting will decide if conflicts of interest exist. Each director, principal officer 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 Other Misc - Total Revenue: 2075946, Related or Exempt Function Revenue: 2075946, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees Physician Services - Total Expense: 3234857, Program Service Expense: 3234857, Management and General Expenses: , Fundraising Expenses: ; Purchased Services - Total Expense: 45177507, Program Service Expense: 38852656, Management and General Expenses: 6324851, Fundraising Expenses: ; Joint commission - Total Expense: 11895, Program Service Expense: 11895, Management and General Expenses: , Fundraising Expenses: ; Other Professional Fees - Total Expense: 1770989, Program Service Expense: 1523051, Management and General Expenses: 247938, Fundraising Expenses: ; Medical Director Fees - Total Expense: 717106, Program Service Expense: 717106, Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Deferred Pension Adjustment - -28678315;
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
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach 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
Borgess Medical Center
 
Employer identification number

38-1360526
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?
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)ST JOHN MACOMB-OAKLAND HOSPITAL
28000 DEQUINDRE ROAD

WARREN,MI48092
38-3322109
HOSPITAL MI 501(c)(3 3 ASCENSION MICHIGAN
 
Yes
 
(10)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
 
(11)EASTWOOD COMMUNITY CLINICS
28000 DEQUINDRE ROAD

WARREN,MI48092
38-1958763
HEALTH CARE MI 501(c)(3 9 ST JOHN PROVIDENCE
 
Yes
 
(12)ST JOHN PROVIDENCE PHYSICIANS CMG
28000 DEQUINDRE ROAD

WARREN,MI48092
38-2601348
HEALTH CARE MI 501(c)(3 9 ST JOHN PROVIDENCE
 
Yes
 
(13)MEDICAL RESOURCES GROUP
43800 GARFIELD

CLINTON TOWNSHIP,MI48038
38-3494637
HEALTH CARE MI 501(c)(3 9 ST JOHN PROVIDENCE
 
Yes
 
(14)PROVIDENCE HEALTH FOUNDATION
22101 MOROSS

DETROIT,MI48236
38-3526629
FUNDRAISING MI 501(c)(3 Type III-FI ST JOHN PROVIDENCE
 
Yes
 
(15)SETON HEALTH CORP OF SE MICHIGAN
28000 DEQUINDRE

WARREN,MI48092
38-2820107
HEALTH CARE MI 501(c)(3 9 ST JOHN PROVIDENCE
 
Yes
 
(16)ST JOHN COMMUNITY HEALTH INVESTMENT CORP
28000 DEQUINDRE ROAD

WARREN,MI48092
38-2262856
HEALTH CARE MI 501(c)(3 3 ST JOHN PROVIDENCE
 
Yes
 
(17)ST JOHN HOSPITAL FOUNDATION
22101 MOROSS

DETROIT,MI48236
20-2961579
FUNDRAISING MI 501(c)(3 7 ST JOHN PROVIDENCE
 
Yes
 
(18)GENESYS HEALTH SYSTEM
ONE GENESYS PARKWAY

GRAND BLANC,MI484398065
38-3339703
HEALTH SYSTEM PARENT MI 501(c)(3 Type II ASCENSION MICHIGAN
 
Yes
 
(19)GENESYS REGIONAL MEDICAL CENTER
ONE GENESYS PARKWAY

GRAND BLANC,MI484398065
38-2377821
HOSPITAL MI 501(c)(3 3 ASCENSION MICHIGAN
 
Yes
 
(20)GENESYS HEALTH FOUNDATION
ONE GENESYS PARKWAY

GRAND BLANC,MI484398065
38-3591148
FOUNDATION MI 501(c)(3 Type I GENESYS HEALTH SYSTEM
 
Yes
 
(21)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
 
(22)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
 
(23)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
 
(24)GENESYS CONVALESCENT CENTER
8481 HOLLY ROAD

GRAND BLANC,MI484391812
38-2317364
CONVALESCENT CENTER MI 501(c)(3 3 GENESYS AMBULATORY HEALTH SERVICES
 
Yes
 
(25)BORGESS HEALTH ALLIANCE INC
1521 GULL ROAD

KALAMAZOO,MI49048
38-2335286
HEALTH SYSTEM PARENT MI 501(c)(3 Type III-FI ASCENSION MICHIGAN
 
Yes
 
(26)LEE MEMORIAL HOSPITAL CORPORATION
420 WEST HIGH STREET

DOWAGIAC,MI49047
38-1490190
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
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
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


Yes No Yes No
(1) ADVENT PARTNERS LP

28000 DEQUINDRE
WARREN,MI48092
38-3544539
RENTAL REAL ESTATE MI NA
 
N/A                
(2) TOWNE CENTRE SURGERY CENTER

4599 TOWNE CENTRE
SAGINAW,MI48604
20-4943843
OUTPATIENT SERVICES MI NA
 
N/A                










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) TEXTILE SYSTEMS INC

817 WALBRIDGE
KALAMAZOO,MI49007
38-2705047
LAUNDRY SERVICES MI BORGESS MEDICAL CENTER
 
C Corporation 29,840 3,651,100 100 % Yes  
(2) ST JOSEPH HEALTH ENTERPRISES

200 HEMLOCK ROAD
TAWAS CITY,MI48764
38-2686747
OTHER MEDICAL MI NA
 
C Corporation       Yes  
(3) GENESYS PRACTICE PARTNERS

5445 ALI DRIVE DEPT 200
GRAND BLANC,MI48439
03-0516871
EMPLOYED PHY PRACTICE MI NA
 
C Corporation       Yes  
(4) BEECHER BALLENGER SERVICES

ONE GENESYS PARKWAY
GRAND BLANC,MI484398065
38-2497922
HOLDING COMPANY MI NA
 
C Corporation       Yes  
(5) ADVENT INC

28000 DEQUINDRE
WARREN,MI48092
38-2971743
RENTAL REAL ESTATE MI NA
 
C Corporation       Yes  
(6) AFFILIATED HEALTH SERVICES INC

28000 DEQUINDRE
WARREN,MI48092
38-2292922
MEDICAL SERVICES MI NA
 
C Corporation       Yes  
(7) St Mary's Health

800 S Washington Avenue
Saginaw,MI48601
38-3477017
Dormant MI NA
 
C Corporation       Yes  
Schedule R (Form 990) 2015
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) BORGESS AMBULATORY CARE CORPORATION

Q 454,475 FMV
(2) BORGESS AMBULATORY CARE COPRORATION

P 1,510,754 FMV
(3) BORGESS FOUNDATION

C 1,048,249 FMV
(4) BORGESS FOUNDATION

P 344,251 FMV
(5) BORGESS HEALTH ALLIANCE

R 123,523,070 FMV
(6) BORGESS HEALTH ALLIANCE

Q 36,632,789 FMV
(7) BORGESS LEE MEMORIAL HOSPITAL

Q 172,323 FMV
Schedule R (Form 990) 2015
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2015
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