TY 2017 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) MARITA GROBBEL CHAIR	1.0 ................. 5.1	X	X			0	0	0
(2) KATHY RYAN VICE CHAIR	1.0 ................. 5.1	X	X			0	0	0
(3) ROB LUBERA SECRETARY	1.0 ................. 5.1	X	X			0	0	0
(4) JAMES SAWYER TREASURER	1.0 ................. 5.1	X	X			0	0	0
(5) JEAN MEYER EX-OFFICIO	0.1 ................. 49.9	X	X			0	1,925,845	45,277
(6) CHRISTINE CRADER MD TRUSTEE	1.0 ................. 5.1	X				0	0	0
(7) ISAAC GRINBERG MD TRUSTEE	1.0 ................. 5.1	X				0	0	0
(8) JAMES HRESKO TRUSTEE	1.0 ................. 8.1	X				0	0	0
(9) IA KUE DO TRUSTEE	1.0 ................. 5.1	X				0	0	0
(10) STEVEN RIVERA MD TRUSTEE	1.0 ................. 5.1	X				0	0	0
(11) CHRISTOPHER J PALAZZOLO PRESIDENT & CEO	35.0 ................. 15.0		X			997,987	0	42,988
(12) NANCY A HAYWOOD CFO	38.0 ................. 12.0		X			463,782	0	42,424
(13) DENNIS V DESIMONE MD VP, MEDICAL AFFAIRS	47.0 ................. 3.0			X		384,349	0	20,818
(14) JOY M FINKENBINER VP, OPERATIONS	47.0 ................. 3.0			X		355,125	0	27,213
(15) NICK S BUTTAR REGIONAL MEDICAL DIRECTOR	50.0 ................. 0				X	1,002,937	0	58,161
(16) MARC C LEWIS SERVICE LINE MEDICAL DIRECTOR	50.0 ................. 0				X	533,557	0	39,083
(17) CLARK J HEADRICK MD CMIO	47.0 ................. 3.0				X	348,956	0	43,637

(A) Name and business address	(B) Description of services	(C) Compensation
AMERICAN ANESTHESIOLOGY OF MI 2432 GENESYS PARKWAY GRAND BLANC,MI48439	ANESTHESIA SERVICES	7,778,891
HOSPITALIST MEDICINE PHYSICIANS OF MICHIGAN PLLC 1498 PACIFIC AVE TACOMA,WA98402	INTERNAL MEDICINE	1,846,841
GENESYS PHO 307 E COURT STREET FLINT,MI48502	MANAGEMENT CARE CONTRACTING	1,820,549
GRMC SURGICAL CO-MANAGEMENT COMPANY LLC 1 GENESYS PKWY GRAND BLANC,MI48439	MEDICAL MANAGEMENT SERVICES	1,621,141
GENESYS TRAUMA & ER SURGERY PLLC 9463 HOLLY ROAD SUITE 102 GRAND BLANC,MI48439	EMERGENCY CENTER SERVICES	1,423,500
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 36

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number

38-2377821

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 12, check only one box.)

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

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

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

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

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

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

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

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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

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

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

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

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

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number

38-2377821

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Part I Contributors	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
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)		Employer identification number 38-2377821

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)			Employer identification number 38-2377821
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2019)

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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

ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number

38-2377821

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

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

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

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

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

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

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

Yes

35,736

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

35,736

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

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

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	LOBBYING EXPENSES INCURRED INCLUDE A PORTION OF DUES PAID TO BOTH NATIONAL AND STATE HEALTH/HOSPITAL ASSOCIATIONS. IN ADDITION, THE HOSPITAL INCURRED SOME LOBBYING EXPENDITURES TO THE MICHIGAN DEPARTMENT OF STATE LOBBY REGISTRATION. IN ADDITION TO THE $6,303 PAID TO AHA AND CHA, ASCENSION GENESYS HOSPITAL ALSO PAID SUCH DUES TO THE FOLLOWING ORGANIZATIONS: -LANSING ADVOCACY: $11,260 -FLINT/GENESSEE CHAMBER: $750 -MICHICAN HOSPITAL ASSN: 17,423 ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	LOBBYING EXPENSES INCURRED INCLUDE A PORTION OF DUES PAID TO BOTH NATIONAL AND STATE HEALTH/HOSPITAL ASSOCIATIONS. IN ADDITION, THE HOSPITAL INCURRED SOME LOBBYING EXPENDITURES TO THE MICHIGAN DEPARTMENT OF STATE LOBBY REGISTRATION. IN ADDITION TO THE $6,303 PAID TO AHA AND CHA, ASCENSION GENESYS HOSPITAL ALSO PAID SUCH DUES TO THE FOLLOWING ORGANIZATIONS: -LANSING ADVOCACY: $11,260 -FLINT/GENESSEE CHAMBER: $750 -MICHICAN HOSPITAL ASSN: 17,423 ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE.

Return Reference

Explanation

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

LOBBYING EXPENSES INCURRED INCLUDE A PORTION OF DUES PAID TO BOTH NATIONAL AND STATE HEALTH/HOSPITAL ASSOCIATIONS. IN ADDITION, THE HOSPITAL INCURRED SOME LOBBYING EXPENDITURES TO THE MICHIGAN DEPARTMENT OF STATE LOBBY REGISTRATION. IN ADDITION TO THE $6,303 PAID TO AHA AND CHA, ASCENSION GENESYS HOSPITAL ALSO PAID SUCH DUES TO THE FOLLOWING ORGANIZATIONS: -LANSING ADVOCACY: $11,260 -FLINT/GENESSEE CHAMBER: $750 -MICHICAN HOSPITAL ASSN: 17,423 ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE.

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number

38-2377821

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

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

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	1,833,657	1,623,159	1,721,396	1,727,819	1,718,835
b	Contributions ...	314,319	134,312	48,980	65,593	44,886
c	Net investment earnings, gains, and losses	87,438	156,233	-82,443	-20,457	154,872
d	Grants or scholarships ...		28,340	32,250	25,950	23,000
e	Other expenditures for facilities and programs ...	61,615	13,199	0	25,609	167,774
f	Administrative expenses ....		38,508	32,524		0
g	End of year balance ......	2,173,799	1,833,657	1,623,159	1,721,396	1,727,819

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

Board designated or quasi-endowment SchDMd Bullet

49.35 %

Permanent endowment SchDMd Bullet

29.9 %

Term endowment SchDMd Bullet

20.75 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

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

Yes

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	6,286,553		6,286,553
b	Buildings ....	224,295,897	117,025,709	107,270,188
c	Leasehold improvements	1,963,808	384,163	1,579,645
d	Equipment ....	125,732,268	108,472,580	17,259,688
e	Other .....	12,047,769	4,668,181	7,379,588
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				139,775,662

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

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

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1)Rent Receivable
(2)Other Long Term Assets				99,773
(3)Other Current Assets				35,189
(4)Due from Affiliates				2,426,757
(5)Other Receivables				564,948
(6)Deferred Compensation/Retirement/Pension Asset				16,617,035
(7)Estimated 3rd Party Payor Settlements				5,350,890
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				25,094,592

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
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	388,309,337
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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds	THE ENDOWMENTS ARE USED FOR BOTH MEDICAL AND EDUCATIONAL (SCHOLARSHIP) PURPOSES.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	HE 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 HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018.

Schedule D (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number

38-2377821

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

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

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

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

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

Yes

100% 150% 200% Other 25000 %

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

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

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

Yes

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

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			946,270		946,270	0.22 %
b	Medicaid (from Worksheet 3, column a) . . . . .			71,081,952	49,100,816	21,981,136	5.22 %
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	72,028,222	49,100,816	22,927,406	5.44 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	0	0	483,683	0	483,683	0.11 %
f	Health professions education (from Worksheet 5) . . .	0	0	9,590,397	0	9,590,397	2.28 %
g	Subsidized health services (from Worksheet 6) . . . .	0	0	136,611	0	136,611	0.03 %
h	Research (from Worksheet 7) .	0	0	0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	0	0	155,675	0	155,675	0.04 %
j	Total. Other Benefits . .	0	0	10,366,366	0	10,366,366	2.46 %
k	Total. Add lines 7d and 7j .	0	0	82,394,588	49,100,816	33,293,772	7.90 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	576	576	0 %
2	Economic development	0	0	0 %
3	Community support	22,020	22,020	0.01 %
4	Environmental improvements	0	0	0 %
5	Leadership development and training for community members	0	0	0 %
6	Coalition building	0	0	0 %
7	Community health improvement advocacy	39,844	39,844	0.01 %
8	Workforce development	0	0	0 %
9	Other	0	0	0 %
10	Total	62,440	62,440	0.01 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

3,127,512

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. ......

1,643,579

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

Section B. Medicare

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

219,366,838

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

221,894,723

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

-2,527,885

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1GENESYS REGIONAL MEDICAL CENTER SURGICAL SERVICES CO-MANAGEMENT COMPANY	SURGICAL ORTHO/NEURO CLINICAL SERVICE LINE	50 %	0 %	50 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

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?1Name, 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)
1	ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER) One Genesys Parkway Grand Blanc,MI484938065 https://healthcare.ascension.org/Locations/Michigan/MIGRA/Grand-Blanc-Ascension-Genesys-Hospital 1060000081	X	X	X	X	X

Schedule H (Form 990) 2019

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)

	ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

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

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): https://healthcare.ascension.org/Locations/Michigan/MIGRA/Grand-Blanc-Ascension-Genesys-Hospital/Com

Other website (list url):

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

Other (describe in Section C)

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

Yes

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

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

Yes

If "Yes" (list url): https://healthcare.ascension.org/Locations/Michigan/MIGRA/Grand-Blanc-Ascension-Genesys-Hospital/Com

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

https://healthcare.ascension.org/Financial-Assistance/Michigan

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

https://healthcare.ascension.org/Financial-Assistance/Michigan

A plain language summary of the FAP was widely available on a website (list url):
https://healthcare.ascension.org/Financial-Assistance/Michigan

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

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

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

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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 3E	To better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - ASCENSION GENESYS HOSPITAL (F/K/AGENESYS REGIONAL MEDICAL CENTER). FOLLOWING COLLECTION OF THE OVER 400 METRICS WITHIN THE CHNA, THE DATA WAS THEN SHARED STRATEGICALLY THROUGH THE GREATER FLINT HEALTH COALITION'S ESTABLISHED NETWORK OF COLLABORATIVE PARTNERS. THE GFHC IS A MULTI-SECTOR COALITION RECOGNIZED IN GENESEE COUNTY AS THE NEUTRAL CONVENER OF COMMUNITY AND POPULATION HEALTH INITIATIVES. THE GFHC REGULARLY CONVENES PERSON AND ORGANIZATIONS REPRESENTING THE COMMUNITY'S CROSS-SECTOR INTERESTS THROUGH ENGAGEMENT OF LEADERSHIP REPRESENTATIVES FROM BUSINESS, EDUCATION, PUBLIC HEALTH, PHYSICIANS, HOSPITALS, HEALTH INSURERS, SAFETY-NET PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, RESIDENTS, POLICYMAKERS, FOUNDATIONS, LABOR AND MEDIA. THIS INPUT IS GATHERED ON AN ONGOING BASIS AS A CONTINUOUS EFFORT DONE BY THE GREATER FLINT HEALTH COALITION SUB COMMITTEES. HOWEVER, COMMUNITY INPUT THAT WAS COLLECTED BY SURVEY WAS OPEN FROM 2/15/16 THROUGH 3/14/16. THIS NETWORK OF COLLABORATIVE PARTNERS IS CONTINUOUSLY ENGAGED TO REVIEW AND PRIORITIZE THE HEALTH INDICATORS AND NEEDS AS DETAILED IN THE CHNA; SPECIFICALLY, THIS COMMUNITY INVOLVEMENT WAS ACHIEVED BY SHARING THE CHNA'S DATA METRICS WITH THE FOLLOWING ENTITIES, AS WELL AS REQUESTING ADDITIONAL COMMUNITY HEALTH NEEDS INPUT FROM AMONG THE FOLLOWING NETWORKS: -THE GFHC'S 35 MEMBER BOARD OF DIRECTORS COMPRISED OF LEADERSHIP REPRESENTATIVES WITHIN THE SECTORS DESCRIBED ABOVE -THE GFHC'S 18 MULTI-SECTOR COMMITTEES AND TASK FORCES THAT WORK ON VARIOUS PROJECTS AND ACTIVITIES WITHIN THE GFHC FOCUS AREAS OF HEALTH IMPROVEMENT, ACCESS AND ENVIRONMENT, QUALITY AND INNOVATION, COST & RESOURCE PLANNING, SECTOR WORKFORCE DEVELOPMENT, AND RACIAL DISPARITIES & HEALTH EQUITY. COLLECTIVELY, THESE COMMITTEES AND TASK FORCES INCLUDE 299 MEMBERS WHO EACH HAVE SPECIAL KNOWLEDGE IN HEALTHCARE, PUBLIC HEALTH, AND COMMUNITY ENGAGEMENT, AS SOURCED FROM THEIR CROSS-SECTOR COMPOSITION. ORGANIZATIONS REPRESENTED IN THESE COMMITTEES INCLUDE: BLUE CROSS BLUE SHIELD OF MICHIGAN, BLUE CARE NETWORK, CITY OF FLINT, GENERAL MOTORS/UNITED AUTOMOBILE WORKERS, GENESEE HEALTH SYSTEM, GENESEE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, GENESEE COUNTY HEALTH DEPARTMENT, GENESEE COUNTY MEDICAL SOCIETY, GENESEE COUNTY OSTEOPATHIC SOCIETY, GENESEE HEALTH PLAN, GENESEE INTERMEDIATE SCHOOL DISTRICT, GENESYS HEALTH SYSTEM, GREATER FLINT HEALTH COALITION, HAMILTON COMMUNITY HEALTH NETWORK, HEALTH PLUS OF MICHIGAN, HURLEY MEDICAL CENTER, MCLAREN FLINT, MCLAREN HEALTH PLAN, MOTT CHILDREN'S HEALTH CENTER. THE GFHC'S COMMUNITY NETWORK, REACHING A GROUP OF APPROXIMATELY 100 COMMUNITY BASED ORGANIZATIONS AND RESIDENTS INCLUDING MINORITY GROUPS, THE UNINSURED, AND LOW-INCOME RESIDENTS. SPECIFICALLY, GENESEE HEALTH PLAN AND HAMILTON HEALTH PLAN FOCUS ON THE UNDERSERVED POPULATION OF GENESEE COUNTY. -STRATEGIC PLANNING REPRESENTATIVES FROM THE PRINCIPAL PARTNERS IN COMPLETING THE CHNA (GENESYS HEALTH SYSTEM, HURLEY MEDICAL CENTER AND MCLAREN FLINT) -LOCAL GOVERNMENT LEADERS FROM THE GENESEE COUNTY HEALTH DEPARTMENT AND THE CITY OF FLINT -LOCAL HEALTH FOUNDATIONS THAT PRIORITIZE FUNDING DECISIONS -ADDITIONAL COMMUNITY AND MEMBERSHIP GROUPS IN THE CITY OF FLINT AND GENESEE COUNTY COMMUNITY. IN TOTAL, THE CHNA PROCESS INCLUDED THE ENGAGEMENT OF OVER 500 PEOPLE IN THE COMMUNITY WHO REPRESENT THE COMMUNITY SERVED INCLUDING EXPERTS IN PUBLIC HEALTHCARE OR COMMUNITY ENGAGEMENT AS WELL AS COMMUNITY RESIDENTS. FURTHERMORE, THE ASSESSMENT PROCESS ALSO INCLUDED A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WITH 728 LOCAL RESIDENTS RESPONDING. RESPONDENTS DEFINED A GEOGRAPHIC CROSS SECTION OF THE COMMUNITY WITH EVERY ZIP CODE REPRESENTED. TO SOLICIT AND TAKE INTO ACCOUNT INPUT FROM MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS SERVED BY THE THREE HOSPITAL SYSTEMS, THE SURVEY WAS DISTRIBUTED TO PATIENTS VISITING EACH HOSPITAL SYSTEM'S PRIMARY CARE RESIDENCY PROGRAMS AND EMERGENCY DEPARTMENTS. IN TOTAL THIS CHNA HAS INCLUDED THE INVOLVEMENT OF APPROXIMATELY 1,128 REPRESENTATIVES OF THE COMMUNITY SERVED--FLINT/GENESEE COUNTY. THROUGH THIS SIGNIFICANT ENGAGEMENT OF THE COMMUNITY SERVED, ALL INDIVIDUALS INVOLVED IN THIS CHNA WERE GRANTED THE OPPORTUNITY TO PROVIDE INPUT RELATIVE TO THE HEALTH NEEDS AND ASSESSMENT PRIORITIES FOR THE FLINT/GENESEE COUNTY COMMUNITY.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER). THE GREATER FLINT HEALTH COALITION CONDUCTED A JOINT CHNA FOR THE FOLLOWING HOSPITAL FACILITIES: Ascension Genesys Hospital (f/k/a Genesys REGIONAL MEDICAL CENTER), HURLEY MEDICAL CENTER AND MCLAREN-FLINT.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) - Part I. ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) is a faith-based healthcare organization dedicated to transformation through innovation across the continuum of care. As a member of Ascension, the largest non-profit health system in the U.S. and the world's largest Catholic health system, ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) is committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. As a leading health care provider in Mid-Michigan, Ascension Genesys is anchored by a 21st century, 412 bed inpatient facility, built both clinically and architecturally around a patient-centered care philosophy. In FY 2018, Ascension Genesys Hospital had over 20,000 patient discharges and provided $37.5 million in care of persons living in poverty and other community benefit programs. Ascension Genesys utilizes a regionally integrated health care delivery system comprised of a complete continuum of care servicing Genesee, Shiawassee, Lapeer, Oakland, Livingston and Tuscola counties. Over 160 family practice physicians in the Ascension Genesys network serve as health advocates through the provision of a primary care "medical home." Committed to the medical, economic and spiritual vitality of the region, Ascension Genesys is one of the area's largest employers with over 2,900 employees who contribute to the regional healthcare economy within a population health model of care to improve health outcomes, enhance the patient and provider experience of care, and lower healthcare costs. All three Genesee County Health Systems - Genesys Health System, Hurley Medical Center, and McLaren Flint, have come together in partnership with the Greater Flint Health Coalition (GFHC) and a collection of multi-sector and community stakeholders to complete a joint Community Health Needs Assessment (CHNA) for Genesee County. Information regarding Genesee County's most important health needs and issues, as well as their prioritization, are based upon information provided by residents, health care consumers, community leaders, health care professionals, and multi-sector representatives, who were interviewed, participated in meetings of the Greater Flint Health Coalition's network of community organizations and partners, or responded to a community-wide survey of individuals who live and/or work in Genesee County. These findings are also informed by the Greater Flint Health Coalition's comprehensive Community Data Scorecard, a collection of over 400 metrics designed to measure health status and chronic disease priorities, social and economic factors impacting residents, and healthcare delivery system access and utilization trends experienced in the region. CHNA identified health needs for 2016 were prioritized based upon potential long term health outcomes, ability for a health system to have an impact on addressing the need, current priorities and programs, and effectiveness of existing programs. The prioritization process involved data review from the GFHC's Data Review Subcommittee and Cost & Resource Planning Committee. Ten priority health needs for Flint/Genesee County were selected: 1. Access to Clean & Safe Drinking Water 2. Infant / Child Health & Development 3. Obesity / Overweight & Healthy Lifestyle 4. Effective Care Delivery for an Aging Population 5. Mental Health 6. Substance Use 7. Education & Employment 8. Food Insecurity 9. Health Care Access 10. Community Safety Genesys leadership in collaboration with the Genesys CHNA Priorities Steering Committee then decided to prioritize and address six out of the ten community needs: Priority 1: Access to Clean & Safe Drinking Water Rationale: Flint, Genesee County's urban core, has had its drinking water contaminated with lead and other toxins. The contamination occurred when the city switched its water supply as a cost saving measure from the Detroit system to Flint River water, which was more corrosive than Detroit water and caused lead to leach from the pipes that connect much of Flint's aging infrastructure to city homes. Research conducted by a Hurley Medical Center pediatrician discovered that the incidence of elevated blood levels in children residing in the city of Flint increased from 2.4% to 4.9% after the switch. When asked in the community health needs assessment survey "what do you think are the three most important environmental factors that affect health in our community?" 86.95% of respondents choose clean and safe drinking water from the list of available options. The biggest concern is for the health and wellbeing of the Flint residents, specifically women, children, and the elderly who are affected the most from the lead exposure. The true magnitude of residents' exposure to lead in the water will never be known since lead has a half-life in blood of only 28 days (approximated), and the interval between warnings not to drink the water and calls for lead testing was greater. Lead is a potent neurotoxin, and childhood lead poisoning has an impact on many developmental and biological processes, most notably intelligence, behavior, and overall life achievement. Strategy: Genesys recognizes the need to support our community through aligning our efforts with the recommendations of the Flint Water Crisis/Health/Medical Intervention Strategy Response Plan via the Greater Flint Health Coalition and Hurley Children's Hospital. Genesys will provide lead mitigation nutrition information and services through currently existing programs: Centering Pregnancy, Lactation services, Diabetes/Gestational Diabetes self-management education, medical nutrition therapy education, and cardiac and pulmonary rehabilitation. Evaluation: Genesys widely distributed lead mitigation and nutrition information and delivered services via: * Lactation services to new mothers * Diabetes/Gestational Diabetes self-management education participants * Ascension Genesys Hospital Health Center, and Ascension Genesys Health Center at Center Rd. patients as part of the community-wide strategy led by the Greater Flint Health Coalition and the Genesee County Health Department. * -From 2016-2018 Genesys provided employees who are Flint residents with bottled water valued at $80,000 to take home with them. -Genesys is a member of the Regional Food System Navigation Initiative led by the Community Foundation of Greater Flint that implemented several programs to mitigate the effects of lead exposure (see RFSN section below). -The Genesys Women in Agriculture Farm Development Center farmers also have intentionally grown led mitigating vegetables that have been sold to communities with the greatest need to access healthy food via the Flint Fresh Mobile Market and in collaboration with the Hurley Food FARMacy. Priority 2: Infant / Child Health & Development Rationale: According to the Annie E. Casey Foundation's Kids Count Data Book, Genesee County ranks 79th out of 81 Michigan counties for trends in Child Health & Well-being. Impoverished children are at significantly higher risk for poor health outcomes and poor educational outcomes over the life course. The Genesee County community has a higher child poverty rate than the state or nation as a whole. In Genesee County trends observed regarding Medicaid insured children (compared to their commercially insured counterparts) have: higher rates of acute care admissions; higher rates of acute care length of stays (45 - 78 days longer); significantly higher rates of emergency department (ED) use for asthma/slightly lower treatment rates of use of appropriate asthma medication; higher rates of appropriate and "inappropriate" use of the ED; lower rates of weight assessment and counseling for nutrition and physical activity; and lower rates of childhood immunizations; lower rates of appropriate testing for children with pharyngitis; and lower rates of utilization of well-child visits in the first 15 months of life. Strategy: Develop and implement an evidence-based standard of care for infants and children in Genesee County that improves health outcomes, enhances patient & provider experience and lowers cost. Genesys has resources for continued and expanded infant and child health programming in our community through the Children's Healthcare Access Program (CHAP), CenteringPregnancy, Lactation Services, Commit to Healthy Hearts, and Student Heart Screenings.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) - Part II. Evaluation: 1. Centering Pregnancy: Due to operational challenges, the program was suspended in October 2016. 2. Lactation Services: Genesys Lactation program provided programming and support services to women. A 2017 Michigan Department of Health and Human Services Michigan Birthing Hospital grant supported the beginning phases to achieve Baby Friendly (BF) Designation including establishment of a BF workplan; Comprehensive staff training for over 100 Labor & Delivery, Special Care Nursery; and Post-partum nurses with practical skills to implement the BF infant feeding policy in a safe, effective manner; and establish a BF data collection/extraction process. 3.Commit to Healthy Hearts: CHH engages multidisciplinary service providers - health, education and community - to develop and implement an innovative, community-based model of cardiovascular risk assessment, population health and primary prevention services to address cardiovascular (CV) risk among 9th grade students in the Grand Blanc School District. Services were provided in two program delivery settings: * The health education element engaged 1,120 9th grade students in wellness and nutrition lectures that showed knowledge gained about making healthy food choices, understanding healthy body fat, understanding proper nutrition and hydration, and staying mindful of overall health. * The primary prevention intervention element was delivered to 7 cohorts comprised of 154 youth and 150 family members for students who were screened for cardiovascular risk. Pre/post tests indicate that overall, students reported increased physical activity, increased intake of fruits and vegetables, and decreased screen time after program participation. Priority 3: Obesity / Overweight & Healthy Lifestyle Rationale: Overall, Genesee County's health behaviors are some of the poorest in the state ranking 77th out of 83 Michigan counties for health behaviors. Community residents lack regular physical activity and healthy eating (dining) practices. Genesee County's obesity rate (35.7%) is significantly higher than state (31.1%) and national (26.59%) averages with the combined obesity and overweight rate being 70.4%. Flint / Genesee County's physical environment presents many challenges for residents attempting to incorporate physical activity into their daily routines including neighborhood blight, crime, and limited recreation and fitness facilities. Poor health behaviors are associated with high rates of chronic diseases and conditions like diabetes mellitus, high cholesterol, and heart disease. The prevalence of diabetes mellitus continues to rise for both adults and children in Genesee County. Genesee County's diabetes prevalence (11.6%) is higher than state (9.48%) and national (9.11%) averages. Diabetes is a significant health status indicator and high cost disease. Strategy: Serve as a vital presence in the community to support physical activity and access to and consumption of healthy food via programming that meets community health needs and supports population health delivery - improved health outcomes, enhanced patient & provider experience, and lower costs. Genesys will address obesity/overweight and support healthy lifestyles among adults and children through our established and dedicated Diabetes programs, employee participation in the GFHC Commit to Fit Initiative, and Genesys Athletic Club Community Wellness programming. Evaluation: Ascension Genesys began their first FY18 DPP cohort in January 2018, after training DPP coaches. Participants included primarily gestational diabetics who previously attended classes at the Genesys Diabetes Learning Center. This cohort had a 5.13% average weight, and a 85% participant retention rate. In addition to the program, the Diabetes Learning Center held 4 presentations and screened and referred more than 30 community members with the pre-diabetes screening test. Ascension Genesys has since submitted an application to attain CDC recognition. The Ascension Michigan approach to addressing pre-diabetes through DPP cohorts and awareness campaigns is now considered a best practice across Ascension. Priority 4: Effective Care Delivery for an Aging Population Rationale: Genesee County's population is aging. The median age of the population has increased 13.71% in the past 13 years, with individuals aged 55 years and older representing a disproportionately high amount of the total population. The percentage of residents 65 years and older has increased 31.03% during the same time period from 11.6% in 2000 to 15.2% in 2013. Older residents as a population have an increased need for social supports and health care services. Local data and studies indicate that Flint / Genesee County residents are commonly not prepared for health care decision-making at the end of life. Strategy: Genesys is committed to caring for the aging and elderly populations of Genesee County through our existing Program for the All-Inclusive Care of the Elderly (PACE) and Advance Care Planning programs. Evaluation: PACE committed to improving ways to reach the Genesee County community with a wide spread messaging campaign. Milestones: * Revised PACE Website & Genesys AdvantAge Publication * Ongoing promotion & invitations of monthly community tours of PACE * Intake Referral and Information Referral Forms for Online Access and Submission * Developed a better way of tracking progress within key opportunity zip codes Priority 5: Food Insecurity Rationale: Food insecurity is the household-level economic and social condition of limited or uncertain access to adequate food. Flint / Genesee County's food insecurity rate (18.02%) is higher than state (16.41%) and national (15.21%) averages. While 82% of county residents report they do not consume an adequate amount of fruits and vegetables, for those living in Flint's food desert, the lack of access prohibits healthy choices. The city of Flint, population 99,002, has only one chain grocery store compared to 54 liquor stores for food access within city limits and only 21% of sampled convenience stores offering fresh produce. Low income residents are disproportionately affected regarding food access. The lack of adequate transportation is one large contributing factor for Flint residents being able to access healthy food. Evaluation: * Michigan Food & Farming Systems (MIFFS) Women in Agriculture (WIA) Farm Development Center: Located on the Ascension Genesys Hospital Campus, the WIA Farm Development Center is a place where beginning women farmers can receive education and development to achieve viable farming careers Ascension Genesys allocated a 3-acre parcel of land on its campus for the WIA Farm including land to farm, a hoop house, and a vermicomposting bin. Ascension Genesys also designates .25 FTE of the Genesys Greenhouse Manager's time to coordinate use of the parcel including road access, use of water and electricity (provided by Genesys) and serving as a liaison between the farm and the health system to manage overall operations. MIFFS provides overall project oversight and day-to-day management of farm activities and designates a .50 FTE WIA Farm Manager to manage farming and education programming. Since April of 2016, over 2,611 pounds of nutrient-rich/lead mitigating food was produced & distributed; 622 volunteer hours have been logged; 14 educational trainings have been conducted; 4 women are newly growing and selling food, with 4 more actively working toward this milestone; and 150 pounds of Genesys food preparation waste per week was diverted from the landfill to the farm's vermiculture compost system. These outcomes have translated into community impact by supporting other food system initiatives dedicated to healthy food access and consumption including: Distribution of Nutrient-rich/lead mitigating food is distributed in high need communities (Veggie Box Program and Flint Fresh Mobile Market); and forming a collaborative relationship with Hurley Medical Center to offer patients in Genesys community clinics who have food-related needs to receive a prescription to the Hurley FoodFarmacy where the WIA farm sells fresh produce to meet food insecurity needs.
Schedule H, Part V, Section B, Line 11 Facility , 3	Facility , 3 - ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) - Part III. * Regional Food System Navigation (RFSN): Since its inception, Genesys has served in a key leadership role in the Regional Food System Navigation (RFSN) initiative, a Community Foundation of Greater Flint -led effort to advance improved health outcomes through access to and consumption of healthy foods. The RFSN initiative was launched with a dedicated Navigator Position to coordinate food system work to achieve access to healthy food for all community members. Through the initiation of new partnerships among historically unconnected people and entities, the RFSN initiative has established a shared, non-proprietary vision for healthy food access aimed at the greater good of all stakeholders - growers, processors, distributors, community-based organizations, and consumers. This work has created a different perspective on how nutrition is viewed by addressing the social determinants of health - meeting people where they are in a culturally competent fashion - to customize food system programming to meet identified community needs. Through the development of reliable relationships and use of tools such as partnership agreements, projects were developed, and funding has been secured by leveraging the strengths of diverse stakeholder partners to meet community needs. Since 2016, $5,599,000 has been secured to advance food system work throughout the community including the Flint Fresh Mobile Market, the Veggie Box Program, healthy food access enhancements for seniors, homebound individuals, veterans, people with disabilities and youth, the Genesee County Food Rescue Program, and the Flint Fresh Food Hub. This systemic approach positioned the community to quickly respond to the Flint water crisis to secure resources to develop food access programs and services with lead mitigating foods and behaviors as their centerpiece. Priority 6: Health Care Access Rationale: Genesys will establish an environment to build the capacity to provide responsive services to Veterans at the right time and in the right place that compliment other Veterans initiatives and leverage emerging Veterans resources. The Genesee County Veteran population is 29,204. Of the Veterans who reside in Genesee County, almost half (14,527) are age 65 and older. Michigan is leaving $800 Million on the table in unclaimed financial benefits for Veterans. Michigan ranks 47th out of 53 states and territories for average dollars spent on Veterans. There is a slow and difficult enrollment process for services and significant service gaps as the number of Veterans in the state continues to grow. Strategy: Ascension Genesys will partner in supporting Veterans Affairs programs to improve services to Veterans that are aligned with population health care delivery and better health, improved patient experience and reduced cost through the Veterans Choice Program and the Genesys Presumptive Illness program designed to access Veterans to health care services and link Veterans to the financial benefits they deserve. Evaluation: Ascension Genesys launched the Veterans Choice program in April 2016. Veterans can now receive care at Ascension Genesys and other sites of care across the country, rather than through the U.S. Department of Veterans Affairs (VA), if they face wait times in excess of 30 days or have to travel farther than 40 miles from their home to a VA facility with a full-time primary care physician. Ascension Genesys providers are authorized to provide primary care, inpatient and outpatient specialty care, and mental health care for eligible veterans outside of the VA. The newly enacted Veterans Access, Choice and Accountability Act provides $10 billion for a temporary program to give non-VA medical care to eligible veterans. Ascension Genesys caregivers are called to sustain and improve the health of individuals and our communities. We are committed to a compassionate and just society. Through the Veterans Choice Program, Ascension sites of care nationwide can help expand the number of healthcare options for our nation's veterans, ensuring more timely access to high-quality care. To advance the Ascension Genesys priority to ensure that Veterans receive timely access to health care and benefits, Ascension Genesys Foundation has allocated funds raised by the Genesys Charity Golf Classic for Veteran Navigation Services in Genesee County to the Genesee Health Plan, an organization that is well-positioned to deliver navigation services to this population. The Empowering Veterans of America with Navigation Services (EVANS) Project is a community-based navigation model to identify and assist Veterans in navigating the healthcare system by linking them to services and benefits within the Veterans Administration (VA) and the community to enable seamless movement between VA and community care and facilitate access to high-quality healthcare options. Launched in the fall of 2018, the EVANS Project has a dedicated Veteran Navigator to support Veterans by reducing barriers to care, establishing a Patient Centered Medical Home (PCMH) for Veterans who do not have one, and improving collaboration among providers to facilitate a seamless continuum of care. Ascension Genesys will not directly address the following priority health needs identified within the 2016 CHNA: Mental Health, Substance Abuse, Education & Employment, and Community Safety. While critically important to overall community health, these specific priorities did not meet internally determined criteria that prioritized addressing needs by either continuing or expanding current programs, services and initiatives to steward resources and achieve the greatest community impact. For the four areas not chosen, there are other service providers in the community better resourced to address these priorities. Genesys will work collaboratively with these organizations as appropriate to ensure optimal service coordination and utilization.
Schedule H, Part V, Section B, Line 18d Facility , 1	Facility , 1 - ASCENSION GENESYS HOSPITAL. Patients can be considered under the Financial Assistance Policy at any point before, during or after receiving services. Patients that are not identified for consideration for Financial Assistance are sent a minimum of 3 billing statements and 3 pre-collection letters prior to being placed with outside collection agencies. Outside collection agencies hold credit reporting for a minimum of 90 days to assure patients are provided an opportunity to be identified and consider for eligibility under the Financial Assistance policy. Financial Assistance policy is widely publicized both inside the organization (posters) and on the organizations websites to assure patients have access to assistance related to bills for health care services. In rare instances, and only after the approval of internal ministry leadership, external collection agencies may file for garnishment or civil judgements on unpaid balances.

Schedule H (Form 990) 2019

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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?5
Name and address		Type of Facility (describe)
1	Genesys MRI Center 981 Health Park Blvd Grand Blanc,MI48439	Magnetic Resonance Imaging Services
2	Genesys Wound and Hyperbaric Center 600 Health Park Blvd Suite 1 Grand Blanc,MI48439	Wound and Hyperbaric Services
3	Genesys Sleep Disorders Center 8200 South Saginaw Street Grand Blanc,MI48439	Sleep Disorder Services
4	Academic Training Clinics 420 South Saginaw Street Flint,MI48502	Resident Training Clinics
5	Academic Training Clinics 1460 North Center Road Burton,MI48509	Resident Training Clinics
6
7
8
9
10

Schedule H (Form 990) 2019

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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 6a COMMUNITY BENEFIT REPORT	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) ANNUALLY COMPILES ITS COMMUNITY BENEFIT INFORMATION AND SUBMITS SUCH INFORMATION TO BOTH THE MICHIGAN HOSPITAL ASSOCIATION ("MHA") AND THE GREATER FLINT HEALTH COALITION FOR INCLUSION INTO FORMAL CONSOLIDATED PUBLICATIONS OF ALL PARTICIPATING ENTITIES.
Schedule H, Part I, Line 7 Community Benefit	To improve the health of the Genesee County community, ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) provided support in the following ways throughout fiscal year 2018: Community Health Education was provided in a number of ways both within the hospital, and out in the community. Community education is offered through lectures, classes, support groups, parent classes, health promotion programs, school-based education, Smoking Cessation programs, car seat safety programs, etc. Community Based Clinical Services ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) currently offers various programs to assist the poor and vulnerable population: prescription assistance, pre-diabetes education classes, access to care for veterans who qualify for the Veterans Choice program. The Dispensary of HOPE program allows Genesys to provide medications to those who qualify for the Dispensary of HOPE program (200% poverty level + uninsured). ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) clinicians and associates participate in various screenings and health fairs to provide education, resources and care to those who are poor and vulnerable within our community. Ascension Genesys recognizes the need to support our community through aligning our efforts with the recommendations of the Flint Water Crisis/Health/Medical Intervention Strategy Response Plan via the Greater Flint Health Coalition and Hurley Children's Hospital. Ascension Genesys provides lead mitigation nutrition information and services through existing programs: Diabetes/Gestational Diabetes self-management education, medical nutrition therapy education, and cardiac and pulmonary rehabilitation. Ascension Genesys is committed and proud to be a teaching hospital. The hospital provides education through hands on training and supervision for students who are certification or degree seeking. ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) makes many annual charitable contributions to support the work of local organizations, free clinics, coalitions, community funds, etc. While community benefit work is embedded within the mission and cultural fabric of the hospital, a few individuals in particular dedicate a significant amount of time to programming, activities, strategic planning, capturing and tracking community benefit, etc. See Schedule H Part V Line 11 for a description of the priority needs being addressed.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied.
Schedule H, Part II Community Building Activities	Not every implementation plan to address the prioritized needs identified in the CHNA can address the social determinants of health. However, they play a large role in the health status of individuals and communities. Here are some examples of community building activities that Genesys leaders and associates participate in: coalition building in the community, participation on advisory boards who aim to improve the health of our community, food system planning and programming, advocacy for the Tobacco 21 law to pass in Genesee County (to increase the age to purchase tobacco to 21), and Human Trafficking community education (lectures, presentations, etc.).
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2018 was $9,773,476 at charges, ($3,127,512 at cost).
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 21.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR THOSE WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY CARE OR FINANCIAL ASSISTANCE, CERTAIN COLLECTION PRACTICES DO NOT APPLY.
Schedule H, Part V, Section B, Line 16a FAP website	- ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER): Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/Michigan;
Schedule H, Part V, Section B, Line 16b FAP Application website	- ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER): Line 16b URL: https://healthcare.ascension.org/Financial-Assistance/Michigan;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER): Line 16c URL: https://healthcare.ascension.org/Financial-Assistance/Michigan;
Schedule H, Part VI, Line 2 Needs assessment	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER)USES RELIABLE, THIRD PARTY REPORTS, INCLUDING DATA FROM GOVERNMENT SOURCES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. THESE REPORTS PROVIDE INFORMATION ABOUT KEY HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC INDICATORS THAT POINT TO AREAS OF NEED AND INCLUDE BUT ARE NOT LIMITED TO REPORTS FROM: - THE GREATER FLINT HEALTH COALITION, U.S. CENSUS BUREAU AND UNIVERSITY OF MICHIGAN.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	THE GENESYS HEALTH SYSTEM/ASCENSION MISSION CALLS FOR SERVICE OF THE POOR. IDENTIFIED ARE THOSE PATIENTS WHO REQUIRE FINANCIAL ASSISTANCE AND TO MAKE SURE THE BILLING OF THEIR ACCOUNT REFLECTS THE LEVEL OF FINANCIAL ASSISTANCE THAT IS APPROPRIATE FOR THEIR CIRCUMSTANCE. FINANCIAL ASSISTANCE PROCEDURES ARE LOCATED IN THE PATIENT ADMISSIONS HANDBOOK. IF A PATIENT ANTICIPATES DIFFICULTY FINANCING HEALTHCARE CHARGES, A CONSULTATION REGARDING VARIOUS PAYMENT OPTIONS ENSUES. UNINSURED PATIENTS WILL RECEIVE AN UNINSURED DISCOUNT. THERE ARE MANY PROGRAMS AVAILABLE TO ASSIST PATIENTS WITH THEIR HEALTH CARE NEEDS; WHEN OPTIONS HAVE BEEN EXHAUSTED, A CHARITY CARE PROGRAM IS AVAILABLE. THERE ARE 3 STEPS TO DETERMINE WHAT DISCOUNT A PATIENT MIGHT BE ENTITLED TO RECEIVE AND HOW TO COMMUNICATE THAT INFORMATION TO THE PATIENT. WHENEVER POSSIBLE, THIS PROCESS IS COMPLETED WITH THE PATIENT IN PERSON. STEP 1-CONDUCT A SELF PAY SCREENING INTERVIEW STEP 2-COMPLETE A FINANCIAL ASSISTANCE APPLICATION STEP 3 -DETERMINE AND COMMUNICATE THE DISCOUNT. FOR EMERGENCY DEPARTMENT TREATMENT AND RELEASE PATIENTS, PATIENT EDUCATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE OCCURS AT THE TIME OF DISCHARGE. PATIENTS WITH A SCHEDULED PROCEDURE, THIS CONVERSATION OCCURS AS PART OF THE FINANCIAL CLEARANCE PROCESS. IF THE PATIENT IS UNSCHEDULED PATIENT, THIS CONVERSATION OCCURS WHEN THE PATIENT'S CONDITION IS STABILIZED AND A REASONABLE ESTIMATE OF THE CHARGES CAN BE MADE. FOR LONGER PATIENT STAYS, SOMETIMES IT MAY BE APPROPRIATE TO COMMUNICATE TO THE PATIENT THAT THEY HAVE QUALIFIED FOR THE DISCOUNT EARLIER IN THE VISIT TO PROVIDE SOME COMFORT TO THE PATIENT THAT THEY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE.
Schedule H, Part VI, Line 4 Community information	Located 70 miles north of Detroit, Genesee County, which includes its major urban core the city of Flint, was at one time the national epicenter of automotive forethought and production. As the birthplace of General Motors (GM) in 1908 and home to the United Auto Workers' (UAW) famous Sit-Down Strike of 1936-37, Flint/ Genesee County helped define the American auto industry. By the late 1970's, GM employed more than 80,000 workers in the county. Impacted by national de-industrialization in the 1980s and thereafter, a period of disinvestment, depopulation, and urban decay would follow as the automotive industry declined rapidly. By 2010, less than 8,000 GM jobs remain, approximately 10% of what once defined the community's manufacturing and economic base. Today, Flint / Genesee County remains a "community in recovery" due to this historical economic shift, having experienced significant unemployment and population declines coupled with overwhelmingly poor measures for both health factors and health outcomes. Genesee County's current population of 412,895 includes a racial composition of 74.5% White, 20.7% African-American, and 3.0% Hispanic/Latino. From 2008 to 2013, the county's population has decreased by over 20,000 residents. While nearly 200,000 people once lived within the city of Flint during its peak in the 1960s and 1970s, today only 99,002 residents remain, a majority being African-American (56.6% ). Outmigration has left Flint/ Genesee County with urban decay and neighborhood blight (35% of all properties are abandoned, vacant homes have increased 74% in the county from 2000-2008), decreased home values (average home values have dropped 56% from $129,300 in 2007 to $82,800 in 2013), and falling tax revenues ($19.2 million loss from 2006-2011 ). Flint's population decline below 100,000 residents will impact its future eligibility to apply for some federal grants. These developments have fueled consistently high unemployment rates (currently at 9.7%) and growing generational poverty. The poverty rate in Flint/ Genesee County (41.1% and 21.7%, respectively) is much higher than state (17.0%) and national (15.8%) rates. Median household income for 2010-2014 for the city of Flint was $24,679; Genesee County $41,879; the state of Michigan $49,087 and the United States $53,482. The percent of households receiving public. assistance income was much higher in Flint and Genesee County (11.67% and 5.78% respectively) than the state (3.69%) and nation (2.82% ). Uncompensated care costs for the three local Genesee County hospitals have risen 78% from 2006 to 2013 (from $78.9 million to $140.1 million). All demographic, social, and economic impact factors are higher among residents within the city of Flint, where higher rates of poverty are associated with poorer educational outcomes, income levels, employment levels, crime/incarceration, and lack of health insurance. Residents who are low-income, minority, or uninsured are disproportionately impacted by environmental issues such as pollution, crime, property abandonment, lack of areas to exercise outdoors, and lack of access to healthy foods. Overall average life expectancy for Genesee County has increased 1.8 years from 2000 to 2013. However, significant disparities exist in life expectancy across the community. Zip codes within the city of Flint have shorter life expectancy while out county areas have better outcomes. The disparity between zip codes has risen from 12.5 years in 2000- 2002 to 14.8 years in 2011-2013. Genesee County ranks 82"' out of 83 Michigan counties for overall health outcomes in the most recent Robert Wood Johnson Foundation County Health Rankings report, including 77th in health behaviors, 79th in physical environment, and 79th in social/economic factors. The age - adjusted death rates for heart disease, stroke, diabetes mellitus, and kidney disease are higher in the county than statewide. While health status indicates poor overall population health, data for minority, low income, and uninsured populations indicate these populations are experiencing worse health outcomes when compared to the population as a whole. Specifically, this relates to life expectancy, sexually transmitted diseases, obesity, heart disease, and birth weight. African Americans are experiencing significant health disparities compared to the total population (e.g. African American death rate for heart disease is 272.4 compared to the state's overall rate of 199.9, for stoke 69.4 compared to 37.7, and for diabetes mellitus 63.4 compared to 23.6). Racial disparities are profound in all Years of Potential Life Lost (TPLL) categories reviewed in the assessment.
Schedule H, Part VI, Line 5 Promotion of community health	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF GENESYS REGIONAL MEDICAL CENTER'S GOVERNING BODY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA; WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES.
Schedule H, Part VI, Line 6 Affiliated health care system	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) IS A WHOLLY OWNED SUBSIDIARY OF GENESYS HEALTH SYSTEM (GHS) 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 24 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION SERVED AS THE MEMBER OR SHAREHOLDER OF VARIOUS SUBSIDIARIES. 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 ORGANIZATIONS/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. GHS IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF ASCENSION HEALTH ARE RELATED TO PROVIDING HEALTH CARE SERVICES. ASCENSION GENESYS HOSPITAL IS A 441 LICENSED BED HOSPITAL WITH 2,754 FULL-TIME EQUIVALENTS IN FY 2016. GRMC PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR THE RESIDENTS OF GENESEE COUNTY AND OTHER SURROUNDING COUNTIES. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATING 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 SERVICE 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 ARE PROVIDED TO THOSE DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FOREGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TOT HE ENTITY'S BILLED CHARGES FOR PATIENT CARE.

Schedule H (Form 990) 2019

Additional Data

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Software Version:	2017v2.2

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number
38-2377821

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) GENESEE COUNTY FREE MEDICAL CLINIC 2437 WELCH BLVD FLINT,MI48504	38-2995700	501(C)(3)	10,000	GENERAL SUPPORT
(2) GENESEE HEALTH PLAN 2171 LINDEN ROAD FLINT,MI48532	38-3625439	501(C)(3)	50,000	GENERAL SUPPORT
(3) ASCENSION GENESYS FOUNDATION FKA GENESYS HEALTH FOUNDATION ONE GENESYS PARKWAY grand blanc,MI484398065	38-3591148	501(c)(3)	1,223,532	GENERAL SUPPORT
(4) GENESYS AMBULATORY HEALTH SERVICES 5455 ALI DR DEPT 200 GRAND BLANC,MI484395195	38-2371754	501(C)(3)	523,501	GENERAL SUPPORT
(5) GENESYS PRACTICE PARTNERS 5445 ALI DRIVE DEPT 200 GRAND BLANC,MI48439	03-0516871		698,899	GENERAL SUPPORT
(6) GENESYS CONVALESCENT CENTER 8481 HOLLY ROAD GRAND BLANC,MI484391812	38-2317364	501(C)(3)	19,223	GENERAL SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2019

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash 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.

ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) NORMALLY REQUIRES AN ANNUAL REPORT (WHERE APPLICABLE) FOR POTENTIAL GRANT ASSISTANCE. IN ADDITION, ASCENSION GENESYS HOSPITAL POINT PERSON WILL NORMALLY ATTEND A MEETING AT THE ENTITY OR WITH AN INDIVIDUAL TO HELP UNDERSTAND THEIR NEEDS. FINAL APPROVAL FOR ANY ASSISTANCE WILL COME FROM THE OFFICE OF THE PRESIDENT. DEPENDING ON THE NATURE OF THE GRANT, A FINAL REPORT OR SUBSTANTIATION OF THE GRANT ASSISTANCE USED, IS REQUIRED TO BE SUBMITTED BACK TO THE HOSPITAL. OTHER TYPES OF GRANTS (FUNDRAISERS) ARE EVALUATED BASED UPON THE PURPOSE OF THE CAMPAIGN.

Schedule I (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number

38-2377821

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes on 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 .........

Yes

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 on Line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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

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

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

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

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

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JEAN MEYER EX-OFFICIO	(i) (ii)	0 ------------- 768,960	0 ------------- 987,366	0 ------------- 169,519	0 ------------- 17,550	0 ------------- 27,727	0 ------------- 1,971,122	0 ------------- 0
2CHRISTOPHER J PALAZZOLO PRESIDENT & CEO	(i) (ii)	544,785 ------------- 0	324,134 ------------- 0	129,068 ------------- 0	16,200 ------------- 0	26,788 ------------- 0	1,040,975 ------------- 0	0 ------------- 0
3NANCY A HAYWOOD CFO	(i) (ii)	339,028 ------------- 0	75,985 ------------- 0	48,769 ------------- 0	17,550 ------------- 0	24,874 ------------- 0	506,206 ------------- 0	0 ------------- 0
4CHARLES HUSSON DO FORMER KEY EMPLOYEE (END 6/2017)	(i) (ii)	369,841 ------------- 0	81,413 ------------- 0	66,596 ------------- 0	17,550 ------------- 0	16,263 ------------- 0	551,663 ------------- 0	0 ------------- 0
5DENNIS V DESIMONE MD VP, MEDICAL AFFAIRS	(i) (ii)	298,103 ------------- 0	54,300 ------------- 0	31,947 ------------- 0	16,200 ------------- 0	4,618 ------------- 0	405,168 ------------- 0	0 ------------- 0
6JOY M FINKENBINER VP, OPERATIONS	(i) (ii)	260,818 ------------- 0	56,880 ------------- 0	37,427 ------------- 0	17,469 ------------- 0	9,744 ------------- 0	382,338 ------------- 0	0 ------------- 0
7NICK S BUTTAR REGIONAL MEDICAL DIRECTOR	(i) (ii)	834,156 ------------- 0	163,879 ------------- 0	4,902 ------------- 0	17,550 ------------- 0	40,611 ------------- 0	1,061,098 ------------- 0	0 ------------- 0
8MARC C LEWIS SERVICE LINE MEDICAL DIRECTOR	(i) (ii)	485,275 ------------- 0	45,000 ------------- 0	3,282 ------------- 0	13,500 ------------- 0	25,583 ------------- 0	572,640 ------------- 0	0 ------------- 0
9CLARK J HEADRICK MD CMIO	(i) (ii)	267,105 ------------- 0	59,703 ------------- 0	22,148 ------------- 0	16,200 ------------- 0	27,437 ------------- 0	392,593 ------------- 0	0 ------------- 0
10FREDERICK C SCHREIBER PROGRAM DIRECTOR, PHARMACY RESIDENCY	(i) (ii)	294,479 ------------- 0	0 ------------- 0	8,382 ------------- 0	6,750 ------------- 0	22,256 ------------- 0	331,867 ------------- 0	0 ------------- 0
11MD BARBARA PAWALCZYK PHYSICIAN	(i) (ii)	281,690 ------------- 0	0 ------------- 0	1,384 ------------- 0	16,200 ------------- 0	27,976 ------------- 0	327,251 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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 1a Health or social club dues or initiation fees	THE GENESYS HEALTH SYSTEM'S TOP MANAGEMENT OFFICIAL HAD FEES THAT WERE PAID FOR A SOCIAL CLUB. THE CLUB DUES WERE PAID FOR BUSINESS PURPOSES. WRITTEN COMPANY POLICY ALONG WITH ANY IRS TAX REQUIREMENTS (WHERE APPLICABLE) WERE FOLLOWED.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	ASCENSION HEALTH, A RELATED ORGANIZATION OF ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER), USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO: -COMPENSATION COMMITTEE, -INDEPENDENT COMPENSATION CONSULTANT, -COMPENSATION SURVEY OR STUDY, AND -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No payments were made to listed persons in Part VII under the non-qualified retirement plan during the year.

Schedule J (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number

38-2377821

Return Reference	Explanation
Form 990, Part IV, Line 20b AUDITED FINANCIAL STATEMENTS	THE ACTIVITY OF ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER).
Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL	IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO, THE PROCESS PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL 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 OR KEY EMPLOYEES	IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE PROCESS PERFORMED BY ASCENSION MICHIGAN, A RELATED ORGANIZATION OF ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER), 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 OFFICERS' SALARIES 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 MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 6 Classes of members or stockholders	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) HAS A SINGLE CORPORATE MEMBER: ASCENSION MICHIGAN.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) HAS A SINGLE CORPORATE MEMBER, ASCENSION MICHIGAN, WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER).
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ASCENSION MICHIGAN.
Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) DOES NOT HAVE ANY COMMITTEES THAT HAVE AUTHORITY TO ACT ON ITS BEHALF.
Form 990, Part VI, Line 11b Review of form 990 by governing body	DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD.
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 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 2f Other Program Service Revenue	Other Program Revenue - Total Revenue: 20, Related or Exempt Function Revenue: 20, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Management Fees - Total Revenue: 117, Related or Exempt Function Revenue: 117, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; State Program Revenue - Total Revenue: 542693, Related or Exempt Function Revenue: 542693, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Clinical Trial Revenue - Total Revenue: 29050, Related or Exempt Function Revenue: 29050, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Medical Records Fees - Total Revenue: 6490, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 6490; Miscellaneous Revenue - Total Revenue: 42222, Related or Exempt Function Revenue: , Unrelated Business Revenue: 390, Revenue Excluded from Tax Under Sections 512, 513, or 514: 41832; Telephone Revenues - Total Revenue: 55032, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 55032;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	FAS 158 - 931702; TRANSFER TO ALPHA - 24958854;
Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant	ASCENSION GENESYS HOSPITAL (F/K/A GENESYS REGIONAL MEDICAL CENTER) is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ASCENSION GENESYS HOSPITAL (FKA GENESYS REGIONAL MEDICAL CENTER)

Employer identification number

38-2377821

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS,MO63145 45-3358926	NATIONAL HEALTH SYSTEM	MO	501(c)(3)	Type I	NA		No
(2)ASCENSION HEALTH PO BOX 45998 ST LOUIS,MO63145 31-1662309	NATIONAL HEALTH SYSTEM	MO	501(c)(3)	Type I	ASCENSION HEALTH ALLIANCE		No
(3)ASCENSION MICHIGAN 28000 DEQUINDRE ROAD WARREN,MI48092 38-2631907	HEALTH CARE	MI	501(c)(3)	10	ASCENSION HEALTH		No
(4)BORGESS HEALTH ALLIANCE INC 1521 GULL ROAD KALAMAZOO,MI49048 38-2335286	HEALTH SYSTEM PARENT	MI	501(c)(3)	Type III-FI	ASCENSION MICHIGAN	Yes
(5)ASCENSION BORGESS HOSPITAL FKA BORGESS MEDICAL CENTER 1521 GULL ROAD KALAMAZOO,MI49048 38-1360526	HEALTHCARE SERVICES	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(6)ASCENSION BRIGHTON CENTER FOR RECOVERY FKA BRIGHTON CENTER FOR RECOVERY 12851 GRAND RIVER BRIGHTON,MI48116 38-1576680	HOSPITAL	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(7)GENESYS HEALTH SYSTEM ONE GENESYS PARKWAY GRAND BLANC,MI484398065 38-3339703	HEALTH SYSTEM PARENT	MI	501(c)(3)	Type II	ASCENSION MICHIGAN	Yes
(8)ASCENSION BORGESS-LEE HOSPITAL FKA LEE MEMORIAL HOSPITAL CORPORATION 420 WEST HIGH STREET DOWAGIAC,MI49047 38-1490190	HEALTHCARE SERVICES	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(9)ASCENSION PROVIDENCE HOSPITAL FKA PROVIDENCE - PROVIDENCE PARK HOSPITAL 16001 WEST NINE MILE ROAD SOUTHFIELD,MI48037 38-1358212	HOSPITAL	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(10)ASCENSION ST JOHN HOSPITAL FKA ST JOHN HOSPITAL & MEDICAL CENTER 28000 DEQUINDRE ROAD WARREN,MI48092 38-1359063	HEALTH CARE	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(11)ASCENSION MACOMB OAKLAND HOSPITAL FKA ST JOHN MACOMB-OAKLAND HOSPITAL 28000 DEQUINDRE ROAD WARREN,MI48092 38-3322109	HOSPITAL	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(12)ST JOHN PROVIDENCE 28000 DEQUINDRE ROAD WARREN,MI48092 38-2244034	PARENT	MI	501(c)(3)	Type III-FI	ASCENSION MICHIGAN	Yes
(13)ASCENSION RIVER DISTRICT HOSPITAL FKA ST JOHN RIVER DISTRICT HOSPITAL 4100 RIVER ROAD EAST CHINA,MI48054 38-3160564	HOSPITAL	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(14)ASCENSION ST JOSEPH'S HOSPITAL FKA ST JOSEPH HEALTH SYSTEM INC 200 HEMLOCK ROAD TAWAS CITY,MI48763 38-1443395	HEALTH CARE	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(15)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
(16)ASCENSION ST MARY'S HOSPITAL FKA ST MARY'S OF MICHIGAN 800 S WASHINGTON AVENUE SAGINAW,MI48601 38-0997730	HOSPITAL	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(17)ASCENSION STANDISH HOSPITAL FKA STANDISH COMMUNITY HOSPITAL 805 WEST CEDEAR STREET STANDISH,MI48658 38-1671120	HOSPITAL	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(18)ASCENSION PROVIDENCE ROCHESTER HOSPITAL FKA CRITTENTON HOSPITAL MEDICAL CEN TER1101 W UNIVERSITY DR ROCHESTER,MI48307 38-1359247	GENERAL HOSPITAL	MI	501(c)(3)	3	ASCENSION MICHIGAN	Yes
(19)BORGESS AMBULATORY CARE CORPORATION 1521 GULL ROAD KALAMAZOO,MI49048 38-2468823	HOLDING COMPANY	MI	501(c)(3)	3	BORGESS HEALTH ALLIANCE INC	Yes
(20)ASCENSION BORGESS FOUNDATION FKA BORGESS FOUNDATION 1521 GULL ROAD KALAMAZOO,MI49048 23-7222558	FUNDRAISING	MI	501(c)(3)	Type III-FI	BORGESS HEALTH ALLIANCE INC	Yes
(21)ASCENSION BORGESS LEE FOUNDATION FKA LEE MEMORIAL FOUNDATION 420 W HIGH STREET DOWAGIAC,MI49047 38-2860459	FUNDRAISING	MI	501(c)(3)	Type III-FI	ASCENSION BORGESS-LEE HOSPITAL FKA LEE MEMORIAL HOSPITAL CORPORATION	Yes
(22)ASCENSION EASTWOOD BEHAVIORAL HEALTH FKA EASTWOOD COMMUNITY CLINICS 28000 DEQUINDRE ROAD WARREN,MI48092 38-1958763	HEALTH CARE	MI	501(c)(3)	10	ST JOHN PROVIDENCE	Yes
(23)ASCENSION PROVIDENCE FOUNDATION 22101 MOROSS DETROIT,MI48236 38-3526629	FUNDRAISING	MI	501(c)(3)	Type III-FI	ST JOHN PROVIDENCE	Yes
(24)SETON HEALTH CORPORATION OF SOUTHEAST MICHIGAN 28000 DEQUINDRE WARREN,MI48092 38-2820107	HEALTH CARE	MI	501(c)(3)	10	ST JOHN PROVIDENCE	Yes
(25)ASCENSION SOUTHEAST MICHIGAN COMMUNITY HEALTH FKA ST JOHN COMMUNITY HEALTH INVESTMENT CORPORATION28000 DEQUINDRE ROAD WARREN,MI48092 38-2262856	HEALTH CARE	MI	501(c)(3)	3	ST JOHN PROVIDENCE	Yes
(26)ASCENSION ST JOHN FOUNDATION FKA ST JOHN HOSPITAL FOUNDATION 22101 MOROSS DETROIT,MI48236 20-2961579	FUNDRAISING	MI	501(c)(3)	7	ST JOHN PROVIDENCE	Yes
(27)ST JOHN PROVIDENCE PHYSICIANS CMG 28000 DEQUINDRE ROAD WARREN,MI48092 38-2601348	HEALTH CARE	MI	501(c)(3)	10	ST JOHN PROVIDENCE	Yes
(28)ST JOSEPH HEALTH SYSTEM FOUNDATION 200 HEMLOCK ROAD TAWAS CITY,MI48763 01-0790428	FUNDRAISING	MI	501(c)(3)	Type I	ASCENSION ST JOSEPH'S HOSPITAL FKA ST JOSEPH HEALTH SYSTEM INC	Yes
(29)FIELD NEUROSCIENCES INSTITUTE 800 S WASHINGTON AVENUE SAGINAW,MI48601 38-2790703	MEDICAL RESEARCH ORGANIZATION	MI	501(c)(3)	10	ASCENSION ST MARY'S HOSPITAL FKA ST MARY'S OF MICHIGAN	Yes
(30)ASCENSION ST MARY'S FOUNDATION FKA ST MARY'S MEDICAL CENTER FOUNDATION SAGI NAW MICHIGAN800 S WASHINGTON AVENUE SAGINAW,MI48601 38-2246366	FUNDRAISING	MI	501(c)(3)	Type II	ASCENSION ST MARY'S HOSPITAL FKA ST MARY'S OF MICHIGAN	Yes
(31)CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION 1101 WEST UNIVERSITY DR ROCHESTER,MI48307 38-2627336	SUPPORTING	MI	501(c)(3)	Type I	ASCENSION PROVIDENCE ROCHESTER HOSPITAL FKA CRITTENTON HOSPITAL MEDICAL CEN TER	Yes
(32)CRITTENTON CANCER CENTER 1101 WEST UNIVERSITY DR ROCHESTER,MI48307 38-3239057	CANCER TREATMENT	MI	501(c)(3)	10	ASCENSION PROVIDENCE ROCHESTER HOSPITAL FKA CRITTENTON HOSPITAL MEDICAL CEN TER	Yes
(33)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
(34)ASCENSION GENESYS FOUNDATION FKA GENESYS HEALTH FOUNDATION ONE GENESYS PARKWAY GRAND BLANC,MI484398065 38-3591148	FOUNDATION	MI	501(c)(3)	Type I	GENESYS HEALTH SYSTEM	Yes
(35)THE 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
(36)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
(37)GENESYS CONVALESCENT CENTER 8481 HOLLY ROAD GRAND BLANC,MI484391812 38-2317364	CONVALESCENT CENTER	MI	501(c)(3)	3	GENESYS AMBULATORY HEALTH SERVICES	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) TOWNE CENTRE SURGERY CENTER LLC 4599 TOWNE CENTRE SAGINAW,MI48604 20-4943843	OUTPATIENT SERVICES	MI	NA	N/A
(2) Open MRI of Michigan 411 W 13 MILE ROAD MADISON HEIGHTS,MI48071 38-3544539	MRI Center	MI	NA	N/A
(3) The Michigan Institute for Advanced Surgery LLC 1375 S Lapeer Rd 109 Lake Orion,MI48360 03-0444972	OUTPATIENT SERVICES	MI	NA	N/A
(4) Hospital Consolidated Laboratories LLC 39595 W 10 Mile Rd Novi,MI48375 38-3318428	LAB 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	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) ST JOSEPH HEALTH ENTERPRISES 200 HEMLOCK ROAD TAWAS CITY,MI48764 38-2686747	OTHER MEDICAL	MI	NA	C Corporation			Yes
(2) GENESYS PRACTICE PARTNERS 5445 ALI DRIVE DEPT 200 GRAND BLANC,MI48439 03-0516871	EMPLOYED PHY PRACTICE	MI	NA	C Corporation			Yes
(3) BEECHER BALLENGER SERVICES ONE GENESYS PARKWAY GRAND BLANC,MI484398065 38-2497922	HOLDING COMPANY	MI	NA	C Corporation			Yes
(4) ADVENT INC 28000 DEQUINDRE WARREN,MI48092 38-2971743	RENTAL REAL ESTATE	MI	NA	C Corporation			Yes
(5) AFFILIATED HEALTH SERVICES INC 28000 DEQUINDRE WARREN,MI48092 38-2292922	MEDICAL SERVICES	MI	NA	C Corporation			Yes
(6) St Mary's Health 800 S Washington Avenue Saginaw,MI48601 38-3477017	Dormant	MI	NA	C Corporation			Yes
(7) TEXTILE SYSTEMS INC 817 WALBRIDGE KALAMAZOO,MI49007 38-2705047	LAUNDRY SERVICES	MI	NA	C Corporation			Yes
(8) CRITTENTON DEVELOPMENT CORPORATION 2251 N SQUIRREL RD STE 310 AUBURN HILLS,MI48326 38-2594115	REAL ESTATE	MI	NA	C Corporation			Yes

Schedule R (Form 990) 2019

Page 3

Part V

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

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

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

Yes

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

Yes

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

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

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

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

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

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

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

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

Yes

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

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

Yes

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

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

Yes

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

Yes

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

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

Yes

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

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) BEECHER BALLENGER SERVICES	R	165,009	FAIR MARKET VALUE
(2) GENESYS AMBULATORY HEALTH SERVICES	K	412,582	FAIR MARKET VALUE
(3) GENESYS AMBULATORY HEALTH SERVICES	O	548,995	FAIR MARKET VALUE
(4) GENESYS AMBULATORY HEALTH SERVICES	S	8,204,141	FAIR MARKET VALUE
(5) ASCENSION GENESYS FOUNDATION FKA GENESYS HEALTH FOUNDATION	P	253,715	FAIR MARKET VALUE
(6) ASCENSION GENESYS FOUNDATION FKA GENESYS HEALTH FOUNDATION	S	590,679	FAIR MARKET VALUE
(7) ASCENSION GENESYS FOUNDATION FKA GENESYS HEALTH FOUNDATION	R	1,058,523	FAIR MARKET VALUE
(8) GENESYS PRACTICE PARTNERS	M	84,307	FAIR MARKET VALUE
(9) GENESYS PRACTICE PARTNERS	S	9,135,088	FAIR MARKET VALUE
(10) GENESYS PRACTICE PARTNERS	R	698,899	FAIR MARKET VALUE
(11) BEECHER BALLENGER SERVICES	K	50,918	FAIR MARKET VALUE
(12) BEECHER BALLENGER SERVICES	S	8,900,079	FAIR MARKET VALUE
(13) GENESYS AMBULATORY HEALTH SERVICES	M	481,631	FAIR MARKET VALUE
(14) GENESYS AMBULATORY HEALTH SERVICES	C	2,062,517	FAIR MARKET VALUE
(15) ASCENSION GENESYS FOUNDATION (FKA GENESYS HEALTH FOUNDATION)	C	716,932	FAIR MARKET VALUE
(16) ASCENSION GENESYS FOUNDATION FKA GENESYS HEALTH FOUNDATION	B	1,223,532	FAIR MARKET VALUE
(17) GENESYS AMBULATORY HEALTH SERVICES	B	523,501	FAIR MARKET VALUE
(18) GENESYS PRACTICE PARTNERS	B	698,899	FAIR MARKET VALUE

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

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) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

1	Briefly describe the organization’s mission or most significant activities: To improve the health and well-being of all people in the communities we serve.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	3,677
6	Total number of volunteers (estimate if necessary) .............	6	399
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	938,240
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	148,296

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	280,322	2,878,255
9	Program service revenue (Part VIII, line 2g) .........	401,719,054	414,299,072
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-3,562	198,826
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	3,396,537	2,444,700
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	405,392,351	419,820,853
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	131,600	2,548,591
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	199,632,201	207,983,856
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	230,610,438	210,778,908
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	430,374,239	421,311,355
19	Revenue less expenses. Subtract line 18 from line 12.......	-24,981,888	-1,490,502
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	237,648,571	248,636,167
21	Total liabilities (Part X, line 26).............	428,874,930	415,462,472
22	Net assets or fund balances. Subtract line 21 from line 20.....	-191,226,359	-166,826,305

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 292,413,328 including grants of $ 2,548,591 ) (Revenue $ 414,158,865 )
	ASCENSION GENESYS HOSPITAL (F/K/AGENESYS REGIONAL MEDICAL CENTER) is a 410-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, ASCENSION GENESYS HOSPITAL (F/K/AGENESYS REGIONAL MEDICAL CENTER) treated 20,064 adults and children for a total of 99,635 patient days of service. The hospital also provided services for 193,695 outpatient visits, which included 8,781 outpatient surgeries and 58,725 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions.

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 expenses292,413,328

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) FREDERICK C SCHREIBER PROGRAM DIRECTOR, PHARMACY RESIDENCY	50.0 .......................0	X		302,861	0	29,006
(19) MD BARBARA PAWALCZYK PHYSICIAN	50.0 .......................0	X		283,075	0	44,176
(20) CHARLES HUSSON DO FORMER KEY EMPLOYEE (END 6/2017)	50.0 .......................0.0		X	517,850	0	33,813

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,190,479	1,925,845	426,596

1a	Federated campaigns..		1a	0
b	Membership dues..		1b	0
c	Fundraising events..		1c	0
d	Related organizations		1d	2,841,130
e	Government grants (contributions)		1e	0

f	All other contributions, gifts, grants, and similar amounts not included above		1f	37,125

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		2,878,255

		Business Code
2a	Net Patient Service Revenue	621990	407,514,035	406,721,642	792,393
b	Services to Affiliates	900099	5,323,206	5,196,958	126,248
c	Income from Joint Ventures	900099	-339,546	-339,546
d	Rental Income	531120	1,227,778	1,227,778
e	Lab Services	621500	1,719	1,719
f	All other program service revenue.		571,880	571,880	0	0
g	Total. Add lines 2a–2f .....		414,299,072

3 Investment income (including dividends, interest, and othersimilar amounts) ......			193,020			193,020
4 Income from investment of tax-exempt bond proceeds			0			0
5 Royalties...........			0			0
		(ii) Personal	(i) Real
6a	Gross rents	0	248,326	6a
b	Less: rental expenses		229,117	6b
c	Rental income or (loss)	0	19,209	6c
d	Net rental income or (loss).......			19,209		19,209
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	5,806	0	7a
b	Less: cost or other basis and sales expenses	0		7b
c	Gain or (loss)	5,806	0	7c
d	Net gain or (loss).........			5,806			5,806
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..			0			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..			0			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0			0
Business Code			Miscellaneous Revenue
11a	Cafeteria/Vending Revenue		722514	1,413,726			1,413,726
b	Education Revenue		611430	778,434	778,434
c	Escheatment Revenue		900099	129,587			129,587
d	All other revenue ....			103,744	0	390	103,354
e	Total. Add lines 11a–11d ......			2,425,491
12	Total revenue. See instructions.....			419,820,853	414,158,865	938,240	1,845,493

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	2,548,591	2,548,591
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,334,686	2,077,871	256,815
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........	168,607,520	150,199,039	18,408,481
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,008,511	7,134,116	874,395
9	Other employee benefits .......	16,159,304	14,394,922	1,764,382
10	Payroll taxes ...........	12,873,835	11,468,140	1,405,695
11	Fees for services (non-employees):
a	Management ......	171,976	29,394	142,582
b	Legal .........	-2,420		-2,420
c	Accounting ...........	117,274		117,274
d	Lobbying ...........	35,736		35,736
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	17,815,116	14,001,137	3,813,979	0
12	Advertising and promotion ....	61,255	33,660	27,595
13	Office expenses .......	1,508,556	465,869	1,042,687
14	Information technology ......	245,470	129,099	116,371
15	Royalties ..
16	Occupancy ...........	4,834,957	563,529	4,271,428
17	Travel ............	235,429	118,857	116,572
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	137,881	94,014	43,867
20	Interest ...........	10,051,624		10,051,624
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	15,482,241	4,971,023	10,511,218
23	Insurance ...	3,189,314	14,746	3,174,568
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Purchased Services	37,101,132	5,975,748	31,125,384
b	Medical Supplies	64,739,809	66,384,336	-1,644,527
c	Management Fee to Affiliate	41,974,953		41,974,953
d	Physician Fee to Affiliate	4,563,896	4,563,896
e	All other expenses	8,514,709	7,245,341	1,269,368	0
25	Total functional expenses. Add lines 1 through 24e	421,311,355	292,413,328	128,898,027	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,607,686	1	3,650
2	Savings and temporary cash investments .........			0	2	12,895,266
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			48,484,543	4	50,417,562
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			2,502,267	7	2,374,683
8	Inventories for sale or use ............			7,183,714	8	6,870,234
9	Prepaid expenses and deferred charges ......			2,675,512	9	3,526,200
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	370,326,295
b	Less: accumulated depreciation	10b	230,550,633	145,115,828	10c	139,775,662
11	Investments—publicly traded securities .				11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			23,758	13	24,755
14	Intangible assets ...............			9,342,269	14	7,653,563
15	Other assets. See Part IV, line 11 ...........			20,712,994	15	25,094,592
16	Total assets. Add lines 1 through 15 (must equal line 33)...			237,648,571	16	248,636,167

17	Accounts payable and accrued expenses .....	25,603,862	17	26,487,670
18	Grants payable ...	0	18	0
19	Deferred revenue .........	683,865	19	665,465
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	402,587,203	25	388,309,337
26	Total liabilities. Add lines 17 through 25..	428,874,930	26	415,462,472

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-191,226,359	32	-166,826,305
33	Total liabilities and net assets/fund balances ........	237,648,571	33	248,636,167