TY 2018 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)
(1) DAN BABCOCK...................................................................... MRH, CEO	40.00 .................	X	X	193,963	18,917
(2) STEVE BARNETT...................................................................... MHS, CEO	.................	X	X	0	0
(3) CHRISTOPHER CLARK...................................................................... CHAIRMAN	.................	X	X	0	0
(4) ORIN CAMPBELL...................................................................... DIRECTOR	.................	X		0	0
(5) SUE COOK...................................................................... SECRETARY	.................	X	X	0	0
(6) GAIL DENTON...................................................................... TRUSTEE	.................	X		0	0
(7) MIKE DREYER...................................................................... V. CHAIRMAN	.................	X	X	0	0
(8) GLEN KAMPMAN...................................................................... DIRECTOR	.................	X		0	0
(9) LARRY MITCHELL...................................................................... DIRECTOR	.................	X		0	0
(10) SCOTT ORR...................................................................... DIRECTOR	.................	X		0	0
(11) LORRAINE REISH...................................................................... DIRECTOR	.................	X		0	0
(12) ANGELA MCCONNACHIE...................................................................... DIRECTOR	.................	X		0	0
(13) DAVID WEST...................................................................... DIRECTOR	.................	X		0	0
(14) DAVID MESSING...................................................................... DIRECTOR	.................	X		0	0
(15) GERALD KEINATH...................................................................... DIRECTOR	.................	X		0	0
(16) IRENE COLE...................................................................... DIRECTOR	.................	X		0	0
(17) KAREN BENNETT...................................................................... DIRECTOR	.................	X		0	0

(A) Name and business address	(B) Description of services	(C) Compensation
CERNER PO BOX 959156 ST LOUIS,MO631959156	SOFTWARE	381,395
MCKENZIE HEALTH SYSTEM 120 N DELAWARE STREET SANDUSKY,MI48471		296,041
DR LISA LEWIS, 29746 BRIARTON STREET FARMINGTON HILLS,MI483312248	ER DOCTOR	270,384
DR NITIN GOLECHHA, 7630 N CENTRAL PARK SHELBY TWP,MI48317	HOSPITALIST	205,022
SANILAC MEDICAL CARE 137 NORTH ELK SANDUSKY,MI48471	LONG TERM CARE	188,646
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 12

- 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 the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

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) 2018

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) 2018

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) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, 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 2018. 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 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

Additional Data

Software ID:
Software Version:

- 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

2018

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization MARLETTE REGIONAL HOSPITAL

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization MARLETTE REGIONAL HOSPITAL		Employer identification number 38-1507302

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization MARLETTE REGIONAL HOSPITAL			Employer identification number 38-1507302
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) (2018)

Additional Data

Software ID:
Software Version:

- 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 the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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 SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2018

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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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)

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

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 .....	624,658		624,658
b	Buildings ....	24,485,430	14,327,846	10,157,584
c	Leasehold improvements	1,034,293	913,106	121,187
d	Equipment ....	21,907,030	19,515,140	2,391,890
e	Other .....	26,150		26,150
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				13,321,469

Schedule D (Form 990) 2018

Page 3

Part VII

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

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

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
ACCRUED OTHER	963,254
ACCRUED SALARIES	481,275
ACCRUED PAID HOURS OFF	477,190
ACCRUED PAYROLL TAXES	160,041
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	2,081,760
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) 2018

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	31,560,358
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	31,560,358
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	31,560,358

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	31,770,820
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	31,770,820
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	31,770,820

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 (Form 990) 2018

Additional Data

Software ID:
Software Version:

- 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

2018

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	1	31	31,723		31,723	0.100 %
b	Medicaid (from Worksheet 3, column a) . . . . .	1		6,707,822	4,165,120	2,542,702	8.000 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	2	31	6,739,545	4,165,120	2,574,425	8.100 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	386	1,126	70,353	21,155	49,198	0.150 %
f	Health professions education (from Worksheet 5) . . .	56	56	26,735		26,735	0.080 %
g	Subsidized health services (from Worksheet 6) . . . .	6	28,734	4,154,187	2,938,184	1,216,003	3.830 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	148	2,855	30,581	2,160	28,421	0.090 %
j	Total. Other Benefits . .	596	32,771	4,281,856	2,961,499	1,320,357	4.160 %
k	Total. Add lines 7d and 7j .	598	32,802	11,021,401	7,126,619	3,894,782	12.260 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	2	45	2,062	400	1,662	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	12	1,200	720		720
7	Community health improvement advocacy
8	Workforce development	4	48	420		420
9	Other
10	Total	18	1,293	3,202	400	2,802	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

615,226

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. ......

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).....

9,263,235

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

9,336,381

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

-73,146

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 %
1THUMB MRI CENTER LLC	MAGNETIC REASONANCE IMAGING (MRI)	17.000 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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	MARLETTE REGIONAL HOSPITAL 2770 MAIN ST PO BOX 307 MARLETTE,MI484530307	X	X	X	X

Schedule H (Form 990) 2018

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)

	MARLETTE REGIONAL HOSPITAL
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 19

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

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): WWW.MARLETTEREGIONALHOSPITAL.ORG

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 19

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

Yes

If "Yes" (list url): WWW.MARLETTEREGIONALHOSPITAL.ORG

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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MARLETTE REGIONAL HOSPITAL
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 100.000000000000% and FPG family income limit for eligibility for discounted care of 250.000000000000%

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):

WWW.MARLETTEREGIONALHOSPITAL.ORG

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

WWW.MARLETTEREGIONALHOSPITAL.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.MARLETTEREGIONALHOSPITAL.ORG

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) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	MARLETTE REGIONAL HOSPITAL
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

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

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) 2018

Page 7

Part VFacility Information (continued)

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

	MARLETTE REGIONAL HOSPITAL
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? ...........................

Yes

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

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, 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
FACILITY 1, MARLETTE REGIONAL HOSPITAL - PART V, LINE 5	MARLETTE REGIONAL HOSPITAL - PART V - LINE 5 STAKEHOLDER MEETINGS AND SURVEYS INTENTIONALLY SOUGHT TO INCLUDE VULNERABLE POPULATIONS. THIS WAS ACHIEVED BY DISTRIBUTING SURVEYS TO INDIVIDUALS PARTICIPATING IN SERVICES FOR LOW INCOME POPULATION AND SENIOR CITIZENS. ADDITIONALLY, SOCIAL SERVICE ORGANIZATIONS THAT SERVE VULNERABLE POPULATIONS WERE ENGAGED IN STAKEHOLDER MEETINGS. AGENCIES INCLUDED HUMAN DEVELOPMENT COMMISSION, COUNCIL ON AGING, MENTAL HEALTH AGENCIES, THE PUBLIC HEALTH AND SOCIAL SERVICES DIVISION OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, SOCIAL WORKERS, INTERMEDIATE SCHOOL DISTRICTS, STAFF FROM HEALTH CARE SECTOR WITH FREE OR LOW COST HEALTH CLINICS, EARLY CHILDHOOD SERVICE PROVIDERS, AND LAW ENFORCEMENT. BOTH THE MICHIGAN THUMB PUBLIC HEALTH ALLIANCE AND MARLETTE REGIONAL HOSPITAL CONDUCTED FOCUS GROUPS AND SURVEYS IN ORDER TO OBTAIN COMMUNITY INPUT
FACILITY 1, MARLETTE REGIONAL HOSPITAL - PART V, LINE 6B	YES THE COUNTY HEALTH DEPARTMENT FROM SANILAC, TUSCOLA AND HURON COUNTIES ALSO PARTICIPATED IN THE CHNA SURVEY.
FACILITY 1, MARLETTE REGIONAL HOSPITAL - PART V, LINE 11	MARLETTE REGIONAL HOSPITAL - PART V - LINE 11: AS INDICATED IN STEP 4 OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, PRIORITIES MUST BE SELECTED TO ENSURE THAT LIMITED RESOURCES HAVE THE GREATEST IMPACT. SELECTION OF PRIORITIES WILL OFTEN RESULT IN MORE COMPLEX AND EFFECTIVE IMPLEMENTATION STRATEGIES. IDENTIFYING A LIMITED NUMBER OF PRIORITIES ON WHICH TO FOCUS ALSO ALLOWS COMMUNITY INITIATIVES TO BE DEVELOPED WITH COLLABORATING ORGANIZATIONS. EVALUATION AND PROGRESS CAN BE MORE EFFECTIVELY MANAGED WHEN THE PRIORITIES ARE FEWER IN NUMBER. IN REVIEW OF EXISTING EFFORTS, THE TEAM DETERMINED THAT MARLETTE REGIONAL HOSPITAL WOULD HAVE THE GREATEST IMPACT ON COMMUNITY HEALTH BY TARGETING THE FOLLOWING FOCUS AREAS. 1.PRIMARY CARE PROVIDER ACCESS RATE IS LOWEST IN THE FOUR COUNTIES. 2.DIABETES CRUDE DEATH RATE IS HIGHEST IN MALES IN FOUR COUNTIES. 3.HEART DISEASE CRUDE DEATH RATE IS HIGHEST IN FEMALES IN FOUR COUNTIES. 4.TOBACCO USE - USE OF VAPING PRODUCTS HIGHEST IN FOUR COUNTIES AMONG 9TH AND 11TH GRADERS. 5.BREAST CANCER SCREENINGS LOWEST IN FOUR COUNTIES. 6.UNINTENTIONAL INJURIES IN 75+ POPULATION HIGHEST IN FOUR COUNTIES. 7.BEHAVIORAL HEALTH- ACCESS TO MENTAL HEALTH SERVICES AND SUBSTANCE USE DISORDERS COMMUNITY FEEDBACK- MARLETTE REGIONAL HOSPITAL IN APRIL 2019, THE PROJECT CONSULTANT CONDUCTED A FOCUS GROUP WITH TEN PARTICIPANTS. PARTICIPANTS INCLUDED ONE MALE AND NINE FEMALES AND REPRESENTED THE SERVICE AREA OF MARLETTE REGIONAL HOSPITAL (MRH). PARTICIPANTS HAD A DIVERSE BACKGROUND INCLUDING RETIRED INDIVIDUALS, EDUCATION, SOCIAL WORK, MEDICAL, AND COMMUNITY DECISION MAKERS. AHEAD OF THE MEETING, PARTICIPANTS WERE SENT A FACT SHEET WITH DATA THAT LED TO THE SIX PRIORITIES IDENTIFIED BY THE MRH CHNA TEAM. PURPOSES OF THE MEETING WAS DESCRIBED AS WANTING TO LEARN MORE ABOUT: 1.THE CONTRIBUTING FACTORS RELATED TO THE SIX PRIORITIES, 2.PERCEPTIONS AND ATTITUDES ABOUT THE HEALTH OF THE COMMUNITY, 3.SUGGESTIONS FOR IMPROVEMENT, AND 4.HOW LOCAL HEALTH SERVICES ARE USED BY PARTICIPANTS AND OTHER RESIDENTS. OVER A TWO WEEK PERIOD IN MAY/JUNE 2019, MRH ALSO CONDUCTED A SURVEY OF RESIDENTS IN THE SERVICE AREA. THE PURPOSE OF THE SURVEY WAS TO OBTAIN FEEDBACK ON THE PRIORITIES, UNMET NEEDS, ACCESS BARRIERS, AND POTENTIAL STRATEGIES FOR THE IMPLEMENTATION PLAN. THE SURVEY WAS DISTRIBUTED ELECTRONICALLY WITH AN ONLINE COLLECTION LINK AND PAPER COPIES WERE MADE AVAILABLE IN HEALTH CARE SETTINGS. ONE HUNDRED SIXTY-FOUR INDIVIDUALS PARTICIPATED IN THE SURVEY INCLUDING RESIDENTS FROM ALL THREE COUNTIES OF THE HOSPITAL SERVICE AREA. THE SAMPLE INCLUDED 28% PEOPLE AGE 19-40, 53% AGE 41-64, AND 19% OVER AGE 65. THE CHNA TEAM REVIEWED INPUT FROM THE COMMUNITY AND ADJUSTED THEIR PRIORITIES TO INCLUDE BEHAVIORAL HEALTH WITH SUBTOPICS OF ACCESS TO MENTAL HEALTH SERVICES AND SUBSTANCE USE DISORDERS. SUGGESTIONS AND INPUT ON STRATEGIES WERE ALSO INCORPORATED INTO THE 2019 CHNA IMPLEMENTATION PLAN. RESOURCE ASSESSMENT DURING THE DEVELOPMENT OF THE IMPLEMENTATION PLANS, A RESOURCE ASSESSMENT WAS CONDUCTED TO REDUCE DUPLICATION OF EFFORTS, IDENTIFY GAPS, LEVERAGE EXISTING EFFORTS IN THE COMMUNITY, AND DEVELOP STRATEGIES THAT WOULD HAVE THE GREATEST IMPACT. NEEDS: 1.PRIMARY CARE PROVIDER ACCESS: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) "HIRED A FAMILY PRACTICE PHYSICIAN FOR MARLETTE'S CLINIC WHICH WILL INCREASE ACCESS BY TWO DAYS PER WEEK. (B)"EXPANDED HOURS OF OPERATIONS AT MANY CLINICS. (C) "CARE COORDINATORS PROMOTE WELLNESS SCREENINGS AND ASSIST WITH REMOVING BARRIERS TO ACCESS CARE SUCH AS COST, NAVIGATING INSURANCE, AND TRANSPORTATION. CURRENT COMMUNITY EFFORTS - CARING HEART HEALTH CLINIC. 2. CHRONIC DISEASE(DIABETES, HEART DISEASE, OBESITY, PHYSICAL ACTIVTY): CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) DIABETIC EDUCATION CLASSES EXPANDED TO DECKERVILLE. (B) "OFFER PERIODIC LOW-COST HEART DISEASE SCREENINGS. (C) "OFFER COMMUNITY GARDEN PLOTS AND PLANTS FREE OF CHARGE @ MRH. (D) "OFFERED AN INSTAPOT CLASS TO THE COMMUNITY. (E)"WALKING TRAIL SUPPORTER. (F)"OFFER FREE OR LOW COST EXERCISE CLASSES @ MRH SEVERAL TIMES PER WEEK. (G)"MRH COORDINATES A 5K IN BROWN CITY. (H)"EMERGENCY TELEHEALTH SERVICES FOR POSSIBLE STROKE PATIENTS BEGAN IN 2016. (I)"SPECIALTY SERVICES ADDED INCLUDE OUTPATIENT CLINIC SERVICES INCLUDING TELE- PSYCHIATRY, CARDIOLOGY, ENT, ORTHOPEDICS, NEPHROLOGY, AND VASCULAR MEDICINE. CURRENT COMMUNITY EFFORTS - (A) "THE MARLETTE DDA FACILITATES A WEEKLY FARMERS MARKET WITH FRESH PRODUCE OPTIONS. AS DOES THE MARLETTE STOCKYARDS. (B) "SEVERAL COMMUNITY GROUPS SPONSOR 5K RACES THROUGHOUT THE YEAR. ALL COMMUNITIES HAVE FREE COMMUNITY WALKING TRAILS. (C)"MSU EXTENSION NUTRITION AND COOKING CLASSES. 3. TOBACCO USE - USE OF VAPING PRODUCTS: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) "MRH HOSTED THE SANILAC COUNTY DRUG TASK FORCE AND AN ADDITIONAL SPEAKER ON THIS TOPIC ACROSS SEVERAL SPEAKING ENGAGEMENTS FOR THE COMMUNITY. (B) "COMMUNITY LUNCH & LEARNS. (C)"SPORTS SUMMIT. CURRENT COMMUNITY EFFORTS - (A) "THE LOCAL SCHOOLS OFFER ALCOHOL, TOBACCO, AND DRUG CLASSROOM EDUCATION AND STUDENT ASSEMBLIES. (B) "MICHIGAN QUIT LINE SERVICES. 4. BREAST CANCER SCREENING: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) MRH PROVIDES FINANCIAL ASSISTANCE FOR MAMMOGRAMS AND DIAGNOSTIC TESTING SERVICES THROUGH THE B.C.U.P.S. PROGRAM. CURRENT COMMUNITY EFFORTS - (A) "THE HEALTH DEPARTMENT HAS A BREAST CANCER AND CERVICAL CANCER SCREENING PROGRAM. (B) "OTHER HOSPITALS HAVE OR ARE STARTING WOMEN'S HEALTH FUNDS TO HELP WITH SCREENING COSTS. 5. UNINTENTIONAL INJURIES IN 75+ POPULATION: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) "MRH OFFERS FREE MATTER OF BALANCE CLASSES AND SENIOR STRETCH CLASSES TO IMPROVE FLEXIBILITY AND BALANCE. (B) "THE HOSPITAL IS ALSO PLANNING DEVELOPMENT OF AN ASSISTED LIVING COMMUNITY. (C) "FALL RISK ASSESSMENTS ARE CONDUCTED IN PRIMARY CARE WELLNESS VISITS FOR SENIORS. (D) "WE REDUCE FALL RISKS BY ASSISTING PATIENTS WITH ACCESSING MEDICATIONS THAT COULD REDUCE WEAKNESS AND VULNERABILITY TO FALLING (340B AND PHARMACY ASSISTANCE). (E) "SWING BED SERVICES. CURRENT COMMUNITY EFFORTS - (A) "OTHER HOSPITALS OFFER MATTER OF BALANCE CLASSES FOR SENIORS. (B)"HUMAN DEVELOPMENT COMMISSION OFFERS HOME ASSESSMENTS FOR FALL RISKS, HAS SOME FUNDING TO HELP WITH SUPPORTS SUCH AS HANDRAILS, AND OTHER SENIOR SUPPORT SERVICES THAT REDUCE INJURIES. (C) "COUNCIL ON AGING FUNDS PROGRAMS TO SUPPORT SENIORS AND HEALTHY LIVING. (D) "INCREASING TRANSPORTATION SERVICES CAN HELP REDUCE SENIOR AUTO ACCIDENTS. NON-EMERGENCY MEDICAL TRANSPORTATION ORGANIZER (NEMO) AND RISING TIDE PROGRAM. 6. BEHAVIORAL HEALTH (INCLUDES MENTAL HEALTH AND SUBSTANCE USE DISORDERS: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) "MRH HOSTS THE MONTHLY FAN FORUM AND IS A PARTICIPATING MEMBER. (B)"MRH IS A PARTICIPANT IN THE TRHN OPIOID GRANT. (C)"MRH HAD PREVIOUSLY OFFERED TELEPSYCHIATRY THROUGH ST. JOHN'S HOSPITAL. (D) "PHYSICIAN OFFICES AND OUR EMERGENCY DEPARTMENT CONTINUE TO ABIDE BY STRICT GUIDELINES IN THE PRESCRIBING AND ADMINISTRATION OF OPIOIDS AND NARCOTICS. (E) "EXPLORING PSYCHOLOGICAL AND COUNSELING HELP BY EXPANDING OUR SOCIAL WORKER SERVICES AND WORKING WITH WARRIORS HOPE VETERANS SERVICES. CURRENT COMMUNITY EFFORTS - (A)"FAN- FAMILIES AGAINST NARCOTICS FOR SANILAC COUNTY. MEETS MONTHLY AND OFFERS COMMUNITY EDUCATION. (B) "ST. JOHN'S HOSPITAL WILL BE OPERATING OUT OF SANDUSKY TO OFFER TELEPSYCHIATRY. (C) "COMMUNITY MENTAL HEALTH OFFERS RESOURCES AND HELP TO THE COMMUNITY. (D) "SANILAC COUNTY HEALTH DEPARTMENT OFFERS ALCOHOL AND DRUG COUNSELING PROGRAMS. (E) "NUMEROUS MENTAL HEALTH PROVIDERS IN THE COUNTY. (F) "SELF-HELP GROUPS MOSTLY FOR ALCOHOL ADDICTION. SECONDARY PRIORITIES: 1. STROKE: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) WE OFFER TELESTROKE SERVICES THROUGH ST. JOHN'S HOSPITAL. CURRENT COMMUNITY EFFORTS - (A) OTHER HOSPITALS ALSO OFFER TELESTROKE SERVICES. 2. BREASTFEEDING: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) OB-GYN CLINIC CONSULTATIONS. CURRENT COMMUNITY EFFORTS - (A) HEALTH DEPARTMENTS OFFER PEER COACHING AND CONSULTATION FROM CERTIFIED LACTATION CONSULTANTS. 3. PRENATAL CARE: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) "OB-GYN CLINIC CONSULTATIONS (B) "OUR HEALTH CARE PROVIDERS CONTINUE TO DELIVER VARIOUS SEX EDUCATION AND TEEN PREGNANCY CLASSES TO LOCAL COMMUNITY SCHOOL SYSTEMS TO EDUCATE OUR YOUTH. CURRENT COMMUNITY EFFORTS - (A) "SUPPORT SERVICES PROVIDED BY HEALTH DEPARTMENTS. (B) "REGIONAL PERINATAL COLLABORATIVE WORKING TO IMPROVE PERINATAL HEALTH OUTCOMES. 4. ALCOHOL IMPAIRED ACCIDENTS: CURRENT COMMUNITY EFFORTS - (A) SHERRIFF'S OFFICE DOES EDUCATION IN SCHOOLS AND IN COMMUNITY MEDIA OUTLETS. 5. CHILDHOOD LEAD TESTING: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) PRIMARY CARE MAKES REFERRALS FOR TESTING WHEN RISKS ARE IDENTIFIED. CURRENT COMMUNITY EFFORTS - (B) HEALTH DEPARTMENTS PROVIDE AWARENESS AND TESTING FOR LEAD EXPOSURE. 6. ORAL HEALTH: CURRENT MARLETTE REGIONAL HOSPITAL EFFORTS - (A) MRH ER AND PRIMA
FACILITY 1, MARLETTE REGIONAL HOSPITAL - PART V, LINE 13H	NUMBER OF RESIDENTS IN HOUSEHOLD
FACILITY 1, MARLETTE REGIONAL HOSPITAL - PART V, LINE 16J	THE SOCIAL SERVICES DEPARTMENT WILL REVIEW AND DISCUSS THE FINANCIAL ASSISTANCE PROGRAM WITH UNINSURED PATIENTS THAT ARE ADMITTED TO THE HOSPITAL.
FACILITY 1, MARLETTE REGIONAL HOSPITAL - PART V, LINE 24	PATIENTS WHO MAY HAVE QUALIFIED FOR FAP, BUT DID NOT INQUIRE ABOUT THE PROGRAM OR COMPLETE AN APPLICATION WOULD HAVE BEEN CHARGED AND BILLED AT THE GROSS CHARGE LEVEL.

Schedule H (Form 990) 2018

Page 9

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2018

Page 10

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
PART II - COMMUNITY BUILDING ACTIVITIES	MARLETTE REGIONAL HOSPITAL PART II: THE HEALTH OF THE COMMUNITY HAS BEEN PROMOTED BY PROVIDING SPACE FOR LOCAL GROUPS TO MEET AND THROUGH EMPLOYEE SUPPORT OF LOCAL EVENTS.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	BAD DEBTS ARE ESTIMATED BY THE USE OF THE ALLOWANCE METHOD. BAD DEBTS FOR THE YEARS ENDED JUNE 30, 2019 AND 2018, AMOUNTED TO 1,079,402 AND 989,653, RESPECTIVELY. THE BAD DEBT EXPENSE ON LINE 2 OF SECTION A IS DETERMINED USING COST BASED UPON THE COST TO CHARGE THAT IS DEVELOPED IN SCHEDULE H. RATIONALE FOR INCLUDING A PORTION OF BAD DEBT EXPENSE AS A COMMUNITY BENEFIT: PART III LINE 3: - A PORTION OF THE ACCOUNTS WRITTEN OFF AS BAD DEBTS WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE IF AN APPLICATION HAD BEEN COMPLETED AND ACCEPTED BY THE FACILITY. - EMERGENCY SERVICES (WHICH REPRESENTS A SIGNIFICANT PORTION OF THE BAD DEBTS) ARE RENDERED WITHOUT THE CONSIDERATION OF THE PATIENTS ABILITY TO PAY. AS A RESULT, THESE BAD DEBTS SHOULD BE CONSIDERED A PART OF PROVIDING COMMUNITY BENEFIT.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	THE ACCOUNTS RECEIVBLE/BAD DEBT EXPENSE FOOTNOTE IN THE 6/30/19 AUDIT REPORT IS LOCATED ON PAGE 13.
PART III, LINE 8 - MEDICARE EXPLANATION	THE HOSPITAL IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL UNDER MEDICARE REGULATIONS. CRITICAL ACCESS HOSPITALS RECEIVE COST REIMBURSEMENT FOR ACUTE-CARE INPATIENT AND SUBSTANTIALLY ALL OUTPATIENT SERVICES. THERE ARE A FEW SERVICES THAT ARE NOT PAID ON A COST REIMBURSEMENT BASIS AND THOSE SERVICES PROVIDED A SHORT FALL OF 73,146. COST REPORT DATA OR THE APPLICABLE COST TO CHARGE RATIO WERE USED TO DETERMINE ALLOWABLE COST.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	ONCE AN ACCOUNT HAS REACHED THE END OF INTERNAL COLLECTION PROCESS IT IS TURNED OVER TO AN OUTSIDE COLLECTION AGENCY. BAD DEBTS RECOVERIES AMOUNTED TO 46,134 FOR THE YEAR ENDED JUNE 30, 2019 AND 67,367 FOR THE YEAR ENDED JUNE 30, 2018.
PART VI, LINE 2 - NEEDS ASSESSMENT	PLEASE SEE RESPONSE FOR SCHEDULE H, PART V, LINE 3A-I
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	FOR INPATIENT SERVICES WE SEEK ANY INFORMATION REGARDING INSURANCE COVERAGE. IF NO COVERAGE IS AVAILABLE WE REFER THE PATIENT TO OUR SOCIAL WORKER WHO HELPS THE PATIENT APPLY FOR GOVERNMENT ASSISTANCE IF APPLICABLE AND AVAILABLE, AND IF IT IS NOT, THEN WE HELP THEM COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. FOR OUTPATIENT SERVICES THE BILLING DEPARTMENT ASSISTS THE PATIENT IN APPLYING FOR GOVERNMENTAL ASSISTANCE. IF NOT APPLICABLE OR AVAILABLE, THE PATIENT IS ASSISTED IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION AND APPLICATIONS TO SPECIAL ORGANIZATIONS THAT MIGHT OFFER ASSISTANCE AS WELL.
PART VI, LINE 4 - COMMUNITY INFORMATION	MARLETTE REGIONAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN MARLETTE WITHIN SANILAC COUNTY. AREA OF SERVICE INCLUDES THE SOUTHERN PORTION OF HURON COUNTY, THE EASTERN PORTION OF TUSCOLA COUNTY, THE NORTHERN PORTION OF LAPEER COUNTY, AND SANILAC COUNTY. THE TOTAL POPULATION FOR THESE COUNTIES WAS APPROXIMATELY 213,919 IN 2017. UNEMPLOYMENT FOR THESE COUNTIES RANGED AT 4.4% TO 5.2% IN 2018 AND THE MEDIAN HOUSEHOLD INCOME FOR THIS AREA IN 2018 RANGED BETWEEN 46,627 AND 57,621.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	THE HOSPITAL IS GOVERNED BY A COMMUNITY BOARD AND HAS AN OPEN MEDICAL STAFF. IT ALSO PARTICIPATES IN FREE OR REDUCED HEALTH SCREENINGS AND FAIRS THAT ARE AVAILABLE TO THE GENERAL PUBLIC.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	THE ORGANIZATION IS WORKING WITH DECKERVILLE COMMUNITY HOSPITAL AND THE COVENANT REGIONAL THUMB NETWORK TO BETTER SERVE THE NEEDS OF THE COMMUNITY.
ADDITIONAL INFORMATION	PART VI LINE 7 - N/A

Schedule H (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

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) 2018

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)
1DAN BABCOCK MRH, CEO	(i) (ii)	193,963 -------------	-------------	-------------	18,917 -------------	-------------	212,880 -------------	-------------
2DR ALBERS DOCTOR	(i) (ii)	337,182 -------------	-------------	-------------	8,125 -------------	-------------	345,307 -------------	-------------
3DR KITTO DOCTOR	(i) (ii)	290,700 -------------	-------------	-------------	8,078 -------------	-------------	298,778 -------------	-------------
4DR KULICK DOCTOR	(i) (ii)	277,355 -------------	-------------	-------------	20,628 -------------	-------------	297,983 -------------	-------------
5DR AKHTAR DOCTOR	(i) (ii)	265,445 -------------	-------------	-------------	20,767 -------------	-------------	286,212 -------------	-------------
6DR LIVIERATOS DOCTOR	(i) (ii)	242,268 -------------	-------------	-------------	7,817 -------------	-------------	250,085 -------------	-------------

Schedule J (Form 990) 2018

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 (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) GLEN KAMPMAN	DIRECTOR		LEGAL SERVICES		No
(2) STEVE BARNETT	DIRECTOR		HEALTH SERVICES		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART V	GLEN KAMPMAN, MARLETTE REGIONAL HOSPITAL DIRECTOR: PROVIDES LEGAL AND COLLECTION SERVICES TO MARLETTE REGIONAL HOSPITAL. STEVE BARNETT, MARLETTE REGIONAL HOSPITAL DIRECTOR: MR. BARNETT IS A MINORITY OWNER OF CARAVAN HEALTH, WHICH PROVIDES SERVICES TO MARLETTE REGIONAL HOSPITAL.

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- 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

2018

Open to Public
Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

Return Reference	Explanation
FORM 990 - ORGANIZATION'S MISSION	TO PROVIDE MEDICAL AND SURGICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MRH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THIS HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY'S HEALTH STATUS WILL BE CONSIDERED WHERE THE NEED AND/OR THE INDIVIDUAL'S INABILITY TO PAY CO-EXIST. THESE ACTIVITIES INCLUDE ACUTE, EMERGENCY AND OUTPATIENT SERVICES IN ADDITION TO WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.
FORM 990, PAGE 2, PART III, LINE 4A	DURING FISCAL YEAR 2018-2019 MARLETTE REGIONAL HOSPITAL SERVED 281 ACUTE AND 89 SWINGBED INPATIENTS, PROVIDED CARE TO 38,837 OUTPATIENTS, INCLUDING 8,072 EMERGENCY DEPARTMENT PATIENTS, AND SERVED 28,842 PATIENTS IN ITS OWNED MEDICAL AND RURAL HEALTH PRACTICES. RECOGNIZING ITS MISSION TO THE COMMUNITY, THE HOSPITAL PARTICIPATES IN THE FEDERAL GOVERNMENT'S MEDICARE PROGRAM AND NUMEROUS MEDICAID HEALTH PLANS, OFTEN PROVIDING CHARITY CARE OR SERVICE AT RATES OF REIMBURSEMENT THAT ARE BELOW THE HOSPITAL'S ACTUAL COST. IN THE LAST FISCAL YEAR, THE NON-REIMBURSED VALUE OF PROVIDING CARE TO ALL OF MRH'S PATIENTS WAS APPROXIMATELY 19,840,578 REPRESENTING A WRITE-DOWN OF 35.9 PERCENT OF THE HOSPITAL'S CHARGES, INCLUDING CHARITY CARE EXPENSES OF 34,630. ADDITIONALLY, THE HOSPITAL'S ALLOWANCE FOR UNCOLLECTABLE BAD DEBTS ARE ESTIMATED BY THE USE OF THE ALLOWANCE METHOD. BAD DEBTS FOR THE YEARS ENDING JUNE 30, 2019 AND 2018 AMOUNTED TO 1,079,402 AND 989,653, RESPECTIVELY. OTHER COMMUNITY BENEFITS ARE PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED ON ACTIVITIES AND SERVICES THAT MRH BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. A SAMPLING OF THESE COMMUNITY BENEFITS IS PROVIDED BELOW: EDUCATIONAL SERVICES/PROGRAMS "ABUSE AND NEGLECT RECOGNITION TRAINING FOR COMMUNITY AND HOSPITAL STAFF "CAREER GUIDANCE FOR AREA SCHOOL STUDENTS "COOPERATIVE PROFESSIONAL TRAINING WITH LOCAL COLLEGES "DISEASE/CONDITION-SPECIFIC EDUCATION, E.G., DIABETES "EDUCATION/COUNSELING FOR FAMILIES OF PATIENTS "EDUCATION/COUNSELING FOR PATIENTS "EDUCATIONAL PROGRAMS FOR EMPLOYEES (ADULT EDUCATION) "ORGAN DONATION INFORMATION CAMPAIGNS "SCHOOL HEALTH PROGRAMS "SUPPORT GROUPS FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY "TRAINING OF PUBLIC HEALTH AND SAFETY PERSONNEL HEALTH PROMOTION AND PREVENTIONS ACTIVITIES "BLOOD PRESSURE CLINICS "DISCHARGE PLANNING WITH FOLLOW-UP SUPPORT PROGRAMS "HEALTH PROMOTION/WELLNESS PROGRAMS "HEALTH SCREENING/HEALTH FAIRS "NUTRITION AND WEIGHT CONTROL "RURAL HEALTH OUTREACH SERVICES "STRESS MANAGEMENT "WORK SITE HEALTH PROMOTION SERVICE EMERGENCY SERVICES/PROGRAMS "EMERGENCY SERVICES DEPARTMENT "ADVANCED LIFE SUPPORT AMBULANCE SERVICE "FIRE AND POLICE ASSISTANCE "HELICOPTER TRANSFER ASSISTANCE CLINICAL SERVICES "CERTIFIED RURAL HEALTH CLINICS "CHILDHOOD IMMUNIZATIONS "PRIMARY CARE SERVICES "ACUTE MEDICAL AND SURGICAL SERVICES "RESIDENTIAL AND HOME-BASED HOSPICE SERVICES "UNIQUELY-ACCREDITED HOSPITAL, LABORATORY, CARDIOPULMONARY, AND LONG-TERM CARE SERVICES "MOBILE PET AND BONE DENSITY TESTING TECHNOLOGY "COORDINATION OF PATIENT CARE SERVICES IN HOSPITAL "FREE OR LOW COST SERVICES TO LOW INCOME FAMILIES "GENERAL HEALTH SCREENING CLINICS "RESPIRATORY/PULMONARY DISEASE SERVICES "SCHOOL HEALTH CLINICS (PRIMARY CARE) "SCHOOL SPORTS PHYSICALS "SKILLED NURSING SERVICES/INTERMEDIATE CARE FACILITY NON-CLINICAL HOSPITAL SERVICES "ADVOCACY ON BEHALF OF SPECIFIC PATIENTS NEEDING INTERVENTION WITH PUBLIC AGENCIES (SOCIAL SERVICES) "FREE MEETING ROOMS FOR COMMUNITY GROUPS "GUIDANCE AND REFERRAL TO COMMUNITY SERVICES AND PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICAID "MEALS FOR FAMILY MEMBERS "TRANSLATION OR INTERPRETER SERVICES FOR NON-ENGLISH SPEAKING PATIENTS SUPPORT FOR OTHER HEALTH CARE PROVIDERS "RADIATION AND CHEMOTHERAPY SERVICES PROVIDED BY ST. MARYS ON CAMPUS "VISITING MEDICAL AND SURGICAL SPECIALISTS TO COMPLEMENT PRIMARY CARE PHYSICIANS' CARE "SUPPORT FOR BLOOD DRIVES "DONATION OF USED EQUIPMENT TO OTHER PROVIDERS "PHYSICIAN REFERRAL SERVICES "PARTNER IN REGIONAL RURAL HEALTH NETWORKS WORKING RELATIONSHIP WITH OTHERS "CIVIC ORGANIZATIONS SUCH AS LIONS CLUB AND TOYS FOR TOTS "AMERICAN ASSOCIATION OF RETIRED PERSONS "COMMUNITY-BASED BUSINESS GROUPS SUCH AS CHAMBERS OF COMMERCE "ECONOMIC DEVELOPMENT AGENCIES "HOME HEALTH AGENCIES "HOSPICES "LOCAL SCHOOLS AND COLLEGES "NURSING HOMES "SENIOR CITIZENS ORGANIZATIONS "STATE AND LOCAL AGENCIES AND ORGANIZATIONS MARLETTE REGIONAL HOSPITAL IS COMMITTED TO SERVING OUR PATIENTS IN WAYS THAT RESPECT THE ORIGINAL VALUES OF OUR COMMUNITY - A COMPASSION FOR OUR NEIGHBORS AND A SENSE OF DUTY TO SERVE THOSE IN NEED. IN RESPECTING THESE VALUES, MARLETTE REGIONAL HOSPITAL ACKNOWLEDGES ITS OBLIGATION TO OFFER SERVICES TO PATIENTS THAT MAY NOT BE ABLE TO FULLY AFFORD THE CARE THEY NEED, WHILE ALSO SERVING THE HEALTH IMPROVEMENT NEEDS OF OUR LARGER COMMUNITY. TO THAT END, THE HOSPITAL HAS ADOPTED POLICIES THAT DESCRIBE HOW SERVICES ARE DISCOUNTED AND HOW CHARITY CARE IS DETERMINED AND OFFERED.
FORM 990, PAGE 6, PART VI, LINE 11B	THE 990 WILL BE REVIEWED AT THE FINANCE COMMITTEE BY THE CEO AND CFO AND PRESENTED TO THE FULL BOARD FOR APPROVAL. THE RETURN WAS SENT TO THE FINANCE COMMITTEE AND REVIEWED IN DETAIL AT THE 3/26/20 FINANCE COMMITTEE MEETING.
FORM 990, PAGE 6, PART VI, LINE 12C	THE DIRECTORS COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT EACH YEAR. THE FORM IS RETURNED TO THE CHAIRMAN OF THE BOARD WHO ENSURES COMPLIANCE WITH ANY POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PAGE 6, PART VI, LINE 15A	COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL IS BASED UPON APPLICABLE STATEWIDE COMPENSATION SURVEYS. IN ADDITION THE COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS ANNUALLY.
FORM 990, PAGE 6, PART VI, LINE 15B	THE COMPENSATION OF OTHER TOP OFFICIALS ARE BASED UPON APPLICABLE STATEWIDE COMPENSATION SURVEYS.
FORM 990, PAGE 6, PART VI, LINE 19	THE GOVERNING DOCUMENTS, ADMINISTRATIVE POLICIES, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART IX, LINE 11G	CONTRACT SERVICES 3,338,264 952,480 0

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- 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

2018

Open to Public Inspection

Name of the organization

MARLETTE REGIONAL HOSPITAL

Employer identification number

38-1507302

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)MCKENZIE HEALTH SYSTEM 120 N DELAWARE ST SANDUSKY,MI48471	HOSPITAL	MI	501C	3	N/A		No
(2)BLUEWATER HEALTHCARE NETWORK 120 N DELAWARE ST SANDUSKY,MI48471	PARENT	MI	501C	3	N/A		No
(3)DECKERVILLE COMMUNITY HOSPITAL 3559 PINE ST DECKERVILLE,MI48427	HOSPITAL	MI	501C	3	NA		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

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	(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

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

Schedule R (Form 990) 2018

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) ............................

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

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

Yes

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

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

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

Yes

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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) MCKENZIE HEALTH SYSTEM	O	207,471	ACTUAL COSTS
(2) MCKENZIE HEALTH SYSTEM	P	3,431	ACTUAL COSTS
(3) MCKENZIE HEALTH SYSTEM	Q	51,972	ACTUAL COSTS

Schedule R (Form 990) 2018

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) 2018

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) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE MEDICAL AND SURGICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MRH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THIS HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY'S HEALTH STATUS WILL BE CONSIDERED WHERE THE NEED AND/OR THE INDIVIDUAL'S INABILITY TO PAY CO-EXIST. THESE ACTIVITIES INCLUDE ACUTE, EMERGENCY AND OUTPATIENT SERVICES IN ADDITION TO WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	534
6	Total number of volunteers (estimate if necessary) .............	6	150
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	348,908	347,487
9	Program service revenue (Part VIII, line 2g) .........	30,485,672	30,452,800
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	198,079	39,590
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	539,147	720,481
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	31,571,806	31,560,358
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	19,229,134	19,803,032
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	12,278,576	11,967,788
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	31,507,710	31,770,820
19	Revenue less expenses. Subtract line 18 from line 12.......	64,096	-210,462
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	23,491,145	23,439,313
21	Total liabilities (Part X, line 26).............	3,780,052	3,938,682
22	Net assets or fund balances. Subtract line 21 from line 20.....	19,711,093	19,500,631

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 26,938,092 including grants of $ ) (Revenue $ )
	DURING FISCAL YEAR 2018-2019 MARLETTE REGIONAL HOSPITAL SERVED 281 ACUTE AND 89 SWINGBED INPATIENTS, PROVIDED CARE TO 38,837 OUTPATIENTS, INCLUDING 8,072 EMERGENCY DEPARTMENT PATIENTS, AND SERVED 28,842 PATIENTS IN ITS OWNED MEDICAL AND RURAL HEALTH PRACTICES. RECOGNIZING ITS MISSION TO THE COMMUNITY, THE HOSPITAL PARTICIPATES IN THE FEDERAL GOVERNMENT'S MEDICARE PROGRAM AND NUMEROUS MEDICAID HEALTH PLANS, OFTEN PROVIDING CHARITY CARE OR SERVICE AT RATES OF REIMBURSEMENT THAT ARE BELOW THE HOSPITAL'S ACTUAL COST. IN THE LAST FISCAL YEAR, THE NON-REIMBURSED VALUE OF PROVIDING CARE TO ALL OF MRH'S PATIENTS WAS APPROXIMATELY 19,840,578 REPRESENTING A WRITE-DOWN OF 35.9 PERCENT OF THE HOSPITAL'S CHARGES, INCLUDING CHARITY CARE EXPENSES OF 34,630. ADDITIONALLY, THE HOSPITAL'S ALLOWANCE FOR UNCOLLECTABLE BAD DEBTS ARE ESTIMATED BY THE USE OF THE ALLOWANCE METHOD. BAD DEBTS FOR THE YEARS ENDING JUNE 30, 2019 AND 2018 AMOUNTED TO 1,079,402 AND 989,653, RESPECTIVELY. OTHER COMMUNITY BENEFITS ARE PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED ON ACTIVITIES AND SERVICES THAT MRH BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. A SAMPLING OF THESE COMMUNITY BENEFITS IS PROVIDED BELOW: EDUCATIONAL SERVICES/PROGRAMS "ABUSE AND NEGLECT RECOGNITION TRAINING FOR COMMUNITY AND HOSPITAL STAFF "CAREER GUIDANCE FOR AREA SCHOOL STUDENTS "COOPERATIVE PROFESSIONAL TRAINING WITH LOCAL COLLEGES "DISEASE/CONDITION-SPECIFIC EDUCATION, E.G., DIABETES "EDUCATION/COUNSELING FOR FAMILIES OF PATIENTS "EDUCATION/COUNSELING FOR PATIENTS "EDUCATIONAL PROGRAMS FOR EMPLOYEES (ADULT EDUCATION) "ORGAN DONATION INFORMATION CAMPAIGNS "SCHOOL HEALTH PROGRAMS "SUPPORT GROUPS FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY "TRAINING OF PUBLIC HEALTH AND SAFETY PERSONNEL HEALTH PROMOTION AND PREVENTIONS ACTIVITIES "BLOOD PRESSURE CLINICS "DISCHARGE PLANNING WITH FOLLOW-UP SUPPORT PROGRAMS "HEALTH PROMOTION/WELLNESS PROGRAMS "HEALTH SCREENING/HEALTH FAIRS "NUTRITION AND WEIGHT CONTROL "RURAL HEALTH OUTREACH SERVICES "STRESS MANAGEMENT "WORK SITE HEALTH PROMOTION SERVICE EMERGENCY SERVICES/PROGRAMS "EMERGENCY SERVICES DEPARTMENT "ADVANCED LIFE SUPPORT AMBULANCE SERVICE "FIRE AND POLICE ASSISTANCE "HELICOPTER TRANSFER ASSISTANCE CLINICAL SERVICES "CERTIFIED RURAL HEALTH CLINICS "CHILDHOOD IMMUNIZATIONS "PRIMARY CARE SERVICES "ACUTE MEDICAL AND SURGICAL SERVICES "RESIDENTIAL AND HOME-BASED HOSPICE SERVICES "UNIQUELY-ACCREDITED HOSPITAL, LABORATORY, CARDIOPULMONARY, AND LONG-TERM CARE SERVICES "MOBILE PET AND BONE DENSITY TESTING TECHNOLOGY "COORDINATION OF PATIENT CARE SERVICES IN HOSPITAL "FREE OR LOW COST SERVICES TO LOW INCOME FAMILIES "GENERAL HEALTH SCREENING CLINICS "RESPIRATORY/PULMONARY DISEASE SERVICES "SCHOOL HEALTH CLINICS (PRIMARY CARE) "SCHOOL SPORTS PHYSICALS "SKILLED NURSING SERVICES/INTERMEDIATE CARE FACILITY NON-CLINICAL HOSPITAL SERVICES "ADVOCACY ON BEHALF OF SPECIFIC PATIENTS NEEDING INTERVENTION WITH PUBLIC AGENCIES (SOCIAL SERVICES) "FREE MEETING ROOMS FOR COMMUNITY GROUPS "GUIDANCE AND REFERRAL TO COMMUNITY SERVICES AND PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICAID "MEALS FOR FAMILY MEMBERS "TRANSLATION OR INTERPRETER SERVICES FOR NON-ENGLISH SPEAKING PATIENTS SUPPORT FOR OTHER HEALTH CARE PROVIDERS "RADIATION AND CHEMOTHERAPY SERVICES PROVIDED BY ST. MARYS ON CAMPUS "VISITING MEDICAL AND SURGICAL SPECIALISTS TO COMPLEMENT PRIMARY CARE PHYSICIANS' CARE "SUPPORT FOR BLOOD DRIVES "DONATION OF USED EQUIPMENT TO OTHER PROVIDERS "PHYSICIAN REFERRAL SERVICES "PARTNER IN REGIONAL RURAL HEALTH NETWORKS WORKING RELATIONSHIP WITH OTHERS "CIVIC ORGANIZATIONS SUCH AS LIONS CLUB AND TOYS FOR TOTS "AMERICAN ASSOCIATION OF RETIRED PERSONS "COMMUNITY-BASED BUSINESS GROUPS SUCH AS CHAMBERS OF COMMERCE "ECONOMIC DEVELOPMENT AGENCIES "HOME HEALTH AGENCIES "HOSPICES "LOCAL SCHOOLS AND COLLEGES "NURSING HOMES "SENIOR CITIZENS ORGANIZATIONS "STATE AND LOCAL AGENCIES AND ORGANIZATIONS MARLETTE REGIONAL HOSPITAL IS COMMITTED TO SERVING OUR PATIENTS IN WAYS THAT RESPECT THE ORIGINAL VALUES OF OUR COMMUNITY - A COMPASSION FOR OUR NEIGHBORS AND A SENSE OF DUTY TO SERVE THOSE IN NEED. IN RESPECTING THESE VALUES, MARLETTE REGIONAL HOSPITAL ACKNOWLEDGES ITS OBLIGATION TO OFFER SERVICES TO PATIENTS THAT MAY NOT BE ABLE TO FULLY AFFORD THE CARE THEY NEED, WHILE ALSO SERVING THE HEALTH IMPROVEMENT NEEDS OF OUR LARGER COMMUNITY. TO THAT END, THE HOSPITAL HAS ADOPTED POLICIES THAT DESCRIBE HOW SERVICES ARE DISCOUNTED AND HOW CHARITY CARE IS DETERMINED AND OFFERED.

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 expenses26,938,092

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,730,902	89,249

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) JOAN NAGELKIRK........................................................................ DIRECTOR	.......................	X			0	0	0
(19) JIM SINGLES........................................................................ CFO	40.00 .......................		X		123,989	0	4,917
(20) DR ALBERS........................................................................ DOCTOR	40.00 .......................			X	337,182	0	8,125
(21) DR KITTO........................................................................ DOCTOR	40.00 .......................			X	290,700	0	8,078
(22) DR KULICK........................................................................ DOCTOR	40.00 .......................			X	277,355	0	20,628
(23) DR AKHTAR........................................................................ DOCTOR	40.00 .......................			X	265,445	0	20,767
(24) DR LIVIERATOS........................................................................ DOCTOR	40.00 .......................			X	242,268	0	7,817

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

f	All other contributions, gifts, grants, and similar amounts not included above		1f	347,487

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		347,487

		Business Code
2a	PATIENT SERVICE REVENUE		51,326,646	51,326,646
b	BAD DEBT		-1,033,268	-1,033,268
c	CONTRACTUAL ADJUSTMENTS		-19,840,578	-19,840,578
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		30,452,800

3 Investment income (including dividends, interest, and othersimilar amounts) ......			37,339			37,339
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		708,022
b	Less: rental expenses		513,606
c	Rental income or (loss)		194,416
d	Net rental income or (loss)......			194,416			194,416
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	2,251
b	Less: cost or other basis and sales expenses
c	Gain or (loss)	2,251
d	Net gain or (loss).....			2,251	2,251
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	340B PHARMACY PROGRAM			374,001			374,001
b	MEALS SERVED			120,973			120,973
c	MISCELLANEOUS			15,914			15,914
d	All other revenue ....			15,177			15,177
e	Total. Add lines 11a–11d ......			526,065
12	Total revenue. See Instructions......			31,560,358	2,251		31,210,620

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
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, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
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	16,343,443	14,695,163	1,648,280
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	193,549	174,029	19,520
9	Other employee benefits .......	2,139,637	1,863,380	276,257
10	Payroll taxes ...........	1,126,403	1,010,922	115,481
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	31,140		31,140
c	Accounting ...........	36,225		36,225
d	Lobbying ...........
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)	4,290,744	3,338,264	952,480
12	Advertising and promotion ....	107,439	9,777	97,662
13	Office expenses .......	3,151,452	3,073,415	78,037
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	569,295	548,590	20,705
17	Travel ............	118,882	104,689	14,193
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	1,190,600	955,661	234,939
23	Insurance ...	368,697	185,552	183,145
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	TAXES & LICENSES	799,557	81,651	717,906
b	PROFESSIONAL FEES	364,980	342,730	22,250
c	REPAIRS & MAINTANCE	274,369	267,259	7,110
d	COLLECTION EXPENSE	189,386	11,668	177,718
e	All other expenses	475,022	275,342	199,680
25	Total functional expenses. Add lines 1 through 24e	31,770,820	26,938,092	4,832,728	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
2	Savings and temporary cash investments .........			5,320,649	2	6,043,792
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			3,469,974	4	3,350,074
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			349,487	8	267,834
9	Prepaid expenses and deferred charges ......			216,812	9	174,180
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	48,077,561
b	Less: accumulated depreciation	10b	34,756,092	13,851,648	10c	13,321,469
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			282,575	15	281,964
16	Total assets. Add lines 1 through 15 (must equal line 34)...			23,491,145	16	23,439,313

17	Accounts payable and accrued expenses .....	294,410	17	833,986
18	Grants payable ...		18
19	Deferred revenue .........	1,458,503	19	1,022,936
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	2,027,139	25	2,081,760
26	Total liabilities. Add lines 17 through 25..	3,780,052	26	3,938,682

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	19,173,850	27	18,880,784
28	Temporarily restricted net assets ...........	491,522	28	574,126
29	Permanently restricted net assets	45,721	29	45,721
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	19,711,093	33	19,500,631
34	Total liabilities and net assets/fund balances ........	23,491,145	34	23,439,313