Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2022 , and ending 06-30-2022
BCheck if applicable:
CName of organization
MYMICHIGAN MEDICAL CENTER SAULT
 
 
Doing business as
CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL INC
 
Number and street (or P.O. box if mail is not delivered to street address)
500 OSBORN BOULEVARD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SAULT STE MARIE, MI49783
D Employer identification number

38-2602147
E Telephone number

G Gross receipts $ 62,049,124
F Name and address of principal officer:
DAVID JAHN CEO
500 OSBORN BOULEVARD
SAULT STE MARIE,MI49783
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MYMICHIGAN.ORG/LOCATIONS/PROFILE/
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1985
M State of legal domicile: MI
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTH CARE SERVICES AND ACCESS TO THE RESIDENTS OF SAULT STE. MARIE AND THE EASTERN UPPER PENINSULA. OUR COMMITMENT IS TO IMPROVE THE QUALITY OF LIFE AND HEALTH THROUGH PARTNERSHIPS WITH THOSE WE SERVE.
2 Check this box MediumBullet
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 8
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 35
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 7,026,868 555,502
9 Program service revenue (Part VIII, line 2g) ......... 108,221,927 60,225,909
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,793,041 947,781
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 390,824 206,339
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 117,432,660 61,935,531
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 60,323,405 35,091,299
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet30,920    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 47,789,915 28,717,978
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 108,113,320 63,809,277
19 Revenue less expenses. Subtract line 18 from line 12....... 9,319,340 -1,873,746
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 104,046,577 111,839,563
21 Total liabilities (Part X, line 26)............. 53,018,405 57,073,263
22 Net assets or fund balances. Subtract line 21 from line 20..... 51,028,172 54,766,300
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: OUR COMMITMENT IS TO IMPROVE THE QUALITY OF LIFE AND HEALTH THROUGH PARTNERSHIPS WITH THOSE WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 35,703,544 including grants of $   ) (Revenue $ 49,751,977 )
HOSPITAL INPATIENT AND OUTPATIENT SERVICES - MYMICHIGAN MEDICAL CENTER SAULT PROVIDED INPATIENT CARE TO 1,088 PATIENTS AND THERE WERE OVER 125,992 PATIENT REGISTRATIONS FOR THE HOSPITAL'S MULTIPLE OUTPATIENT SERVICE DEPARTMENTS (LAB, RADIOLOGY, CARDIOPULMONARY, REHABILITATION, NUCLEAR MEDICINE, SURGICAL SERVICES).OUR OBSTETRICS/NURSERY UNIT REPORTED 145 BIRTHS AND OUR SURGICAL SERVICES DEPARTMENT PROVIDED SURGICAL CARE FOR 2,567 PATIENTS.THE REHABILITATION DEPARTMENT CONTINUED ITS EXPANSION OF SERVICES IN CONTRACTING TO PROVIDE REHABILITATION SERVICES WITH MULTIPLE ORGANIZATIONS IN THE REGION; INCLUDING, BUT NOT LIMITED TO, AREA SCHOOLS, HOSPITALS, AND HOME HEALTH AGENCIES. NEARLY 186,969 REHABILITATION TREATMENTS WERE REPORTED IN THE DISCIPLINES OF PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY AND AUDIOLOGY SERVICES.
4b (Code:   ) (Expenses $ 10,088,819 including grants of $   ) (Revenue $ 7,072,112 )
PROFESSIONAL SERVICES - THE HOSPITAL'S TWENTY FOUR HOUR EMERGENCY DEPARTMENT AND THE COMMUNITY CARE CLINIC (WALK-IN URGENT CARE CENTER) RECORDED 7,684 VISITS AND 4,658 VISITS RESPECTIVELY FOR A TOTAL CARE PROVIDED TO 12,342 PATIENTS.VISITS BY PHYSICIAN CLINIC:WMH CARDIOLOGY CLINIC 1,113WMH DERMATOLOGY 539WMH DRUMMOND ISLAND MEDICAL 795WMH EAR, NOSE & THROAT 1,080WMH ENDOCRINOLOGY 1,160WMH FAMILY MEDICINE CEDARVILLE 1,314WMH FAST CARE - MEIJER 1,819WMH FOOT & ANKLE 952WMH GENERAL SURGICAL CARE 1,971WMH MAT COMMUNITY CARE CLINIC 1,421WMH NEPHROLOGY 823WMH NEUROLOGY 837WMH OCCUPATIONAL HEALTH 204WMH ORTHO NEWBERRY OUTPUT CLINI 85WMH ORTHOPEDICS 2,620WMH ORTHOPEDICS & SPINE 939WMH OUTPATIENT PSYCHIATRY 1,733WMH PAIN MANAGEMENT KIN 601WMH PAIN MANAGEMENT SSM 1,182WMH PRIMARY CARE SSM CMC 5,548WMH PRIMARY CARE SSM HERITAGE 6,161WMH PRIMARY CARE SSM MAGAZINE 3,962WMH PULMONOLOGY 664WMH SLEEP DISORDERS CENTER 1,364WMH SSM COMMUNITY CARE CLINIC 4,658WMH UROLOGY 2,060WMH WOMENS HEALTH 3,929WMH WOMENS NEWBERRY OUTPT CLINIC 120
4c (Code:   ) (Expenses $ 2,517,170 including grants of $   ) (Revenue $ 2,092,091 )
INPATIENT/ OUTPATIENT PSYCH WITH 236 ADMISSIONS AND 1,801 PATIENT DAYS.
(Code:   ) (Expenses $ 2,033,873 including grants of $   ) (Revenue $ 1,374,631 )
OTHER PROGRAM SERVICES - WHICH INCLUDES, BUT IS NOT LIMITED TO, OBSTETRICS WITH 19 ADMISSIONS AND 298 PATIENT DAYS.
4d Other program services (Describe in Schedule O.)
(Expenses $ 2,033,873 including grants of $   ) (Revenue $ 1,374,631 )
4e Total program service expensesMediumBullet50,343,406
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment
List of Attached Documents:
// Content
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J.......................
23
 
No
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
List of Attached Documents:
// Content
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
List of Attached Documents:
// Content
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment
List of Attached Documents:
// Content
...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment
List of Attached Documents:
// Content
.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
List of Attached Documents:
// Content
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
List of Attached Documents:
// Content
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
12
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletKEVIN KALCHIK CFO500 OSBORN BOULEVARD   SAULT STE MARIE,MI49783 (906) 635-4456
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

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

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

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) DAVID JAHN......................................................................
CEO
40.00
.................
0.00
X   X       0 0 0
(2) TOM COATES......................................................................
CHAIR
1.00
.................
0.00
X   X       0 0 0
(3) JOHN JORGENSON......................................................................
SECRETARY
1.00
.................
0.00
X   X       0 0 0
(4) MAXINE ANDERSON......................................................................
TREASURER
1.00
.................
0.00
X   X       0 0 0
(5) GREGORY ROGERS......................................................................
MYMICHIGAN PRESIDENT
1.00
.................
40.00
X           0 0 0
(6) JAMIE ADAIR......................................................................
BOARD/PHYSICIAN
40.00
.................
0.00
X           0 0 0
(7) AMY GOETZ......................................................................
BOARD
1.00
.................
0.00
X           0 0 0
(8) HOLLY KIBBLE......................................................................
BOARD
1.00
.................
0.00
X           0 0 0
(9) GARTH MACMASTER......................................................................
BOARD
1.00
.................
0.00
X           0 0 0
(10) CHARLES PALMER......................................................................
BOARD
1.00
.................
0.00
X           0 0 0
(11) KYLE RAYCRAFT......................................................................
BOARD/PHYSICIAN
40.00
.................
0.00
X           0 0 0
(12) MARK SAVOIE......................................................................
BOARD
1.00
.................
0.00
X           0 0 0
(13) RALPH DUMAN......................................................................
BOARD - PART YEAR
1.00
.................
0.00
X           0 0 0
(14) KEVIN KALCHIK......................................................................
VICE PRESIDENT
40.00
.................
0.00
    X       0 0 0
(15) MARLA BUNKER......................................................................
VICE PRESIDENT
40.00
.................
0.00
    X       0 0 0




Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 0 0 0
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
 
No
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet0
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 432,755
f All other contributions, gifts, grants, and similar amounts not included above1f 122,747
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 555,502
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 621400 60,150,909 60,150,909    
b OTHER RELATED REVENUE 621400 75,000 75,000    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 60,225,909
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 940,581     940,581
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   172,306 6a
b Less: rental expenses   107,404 6b
c Rental income or (loss)   64,902 6c
d Net rental income or (loss).......MediumBullet 64,902 64,902    
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 13,389   7a
b Less: cost or other basis and sales expenses 6,189   7b
c Gain or (loss) 7,200   7c
d Net gain or (loss).........MediumBullet 7,200     7,200
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a CAFETERIA REVENUE 624210 141,437     141,437
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 141,437
12 Total revenue. See instructions.....MediumBullet 61,935,531 60,290,811 0 1,089,218
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 1,414,003 388,676 1,025,327  
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........ 25,668,617 21,207,757 4,460,860  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,266,928   1,266,928  
9 Other employee benefits ....... 4,921,138 3,670,080 1,251,058  
10 Payroll taxes ........... 1,820,613 1,618,125 202,488  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 116,587   116,587  
c Accounting ........... 137,000   137,000  
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) 9,191,278 7,834,887 1,356,391  
12 Advertising and promotion ....        
13 Office expenses ....... 3,467,576 2,689,606 758,754 19,216
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 217,289 115,000 102,289  
17 Travel ............ 209,545 119,895 89,650  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 162,716 154,512 8,204  
20 Interest ........... 834,229 560,100 271,189 2,940
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 2,463,933 1,654,280 800,969 8,684
23 Insurance ... 507,412 87,484 419,928  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 6,368,163 6,368,163   0
b QUALITY ASSESSMENT FEES 1,934,259 1,934,259    
c REPAIRS AND MAINTENANCE 1,623,691 717,456 906,235  
d PROVISION FOR BAD DEBTS 1,168,675 1,168,675    
e All other expenses 315,625 54,451 261,094 80
25 Total functional expenses. Add lines 1 through 24e 63,809,277 50,343,406 13,434,951 30,920
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 5,725 1 430,525
2 Savings and temporary cash investments ......... 28,504,889 2 22,882,222
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 9,638,227 4 12,623,496
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............ 3,211,747 8 2,978,661
9 Prepaid expenses and deferred charges ...... 1,504,954 9 6,621
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 52,282,588
b Less: accumulated depreciation 10b 2,463,931 37,086,014 10c 49,818,657
11 Investments—publicly traded securities . 22,355,455 11 7,122
12 Investments—other securities. See Part IV, line 11 ..... 256,681 12 256,681
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 1,482,885 15 22,835,578
16 Total assets. Add lines 1 through 15 (must equal line 33)... 104,046,577 16 111,839,563
Liabilities 17 Accounts payable and accrued expenses ..... 9,516,742 17 10,802,788
18 Grants payable ...   18  
19 Deferred revenue ......... 0 19 0
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 30,019,361 23 35,536,280
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 13,482,302 25 10,734,195
26 Total liabilities. Add lines 17 through 25.. 53,018,405 26 57,073,263
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 51,028,172 27 54,766,300
28 Net assets with donor restrictions ...........   28 0
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 51,028,172 32 54,766,300
33 Total liabilities and net assets/fund balances ........ 104,046,577 33 111,839,563
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
61,935,531
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
63,809,277
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-1,873,746
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
51,028,172
5
Net unrealized gains (losses) on investments ...............
5
-1,912,227
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
7,524,101
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
54,766,300
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
33 1/3% support test—2022. 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
b
33 1/3% support test—2021. 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—2022. 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
b
10%-facts-and-circumstances test—2021. 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
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 on line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
First 5 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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. 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
b
33 1/3% support tests—2021. 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
20
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) 2022

Schedule A (Form 990) 2022
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 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 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2022 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2022
(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, 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 2022. 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 2023. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
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) 2022


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Name of the organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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) (2022)
Schedule B (Form 990) (2022) Page 2
Name of organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number
38-2602147
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 3
Name of organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
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) (2022)
Schedule B (Form 990) (2022)
Page 4
Name of organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2022)
Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   917,000 917,000
b Buildings ....   38,330,590 1,096,874 37,233,716
c Leasehold improvements   179,210 18,079 161,131
d Equipment ....   12,685,958 1,348,978 11,336,980
e Other .....   169,830   169,830
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 49,818,657
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)ACCRUED MALPRACTICE ASSET 1,482,885
(2)COST REPORT SETTLEMENT RECEIVABLE -499,156
(3)RIGHT OF USE ASSETS 21,851,849
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 22,835,578
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  
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 10,734,195
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) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    89,492   89,492 0.140 %
b Medicaid (from Worksheet 3, column a) . . . . .     11,380,501 15,389,000 0 0 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     11,469,993 15,389,000 89,492 0.140 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 1,636 23,201 80,960   80,960 0.130 %
f Health professions education (from Worksheet 5) . . . 133 301 220,034   220,034 0.350 %
g Subsidized health services (from Worksheet 6) . . . .     8,471,478 3,835,174 4,636,304 7.400 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 9   17,261   17,261 0.030 %
j Total. Other Benefits . . 1,778 23,502 8,789,733 3,835,174 4,954,559 7.910 %
k Total. Add lines 7d and 7j . 1,778 23,502 20,259,726 19,224,174 5,044,051 8.050 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,168,061
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
584,031
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
7,816,575
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
4,899,489
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
2,917,086
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 MYMICHIGAN MEDICAL CENTER SAULT
500 OSBORN BOULEVARD
SAULT STE MARIE,MI49783
WWW.MYMICHIGAN.ORG/LOCATIONS/PROFILE/M
1060000093
X X         X      
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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)
MYMICHIGAN MEDICAL CENTER SAULT
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):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://TINYURL.COM/MTRKRSRF
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MYMICHIGAN MEDICAL CENTER SAULT
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPS://TINYURL.COM/5YVMFHUM
b
HTTPS://TINYURL.COM/5YVMFHUM
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
MYMICHIGAN MEDICAL CENTER SAULT
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
MYMICHIGAN MEDICAL CENTER SAULT
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
MYMICHIGAN MEDICAL CENTER SAULT PART V, SECTION B, LINE 5: A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITALS WEBSITE LOCATED AT HTTPS://WWW.MYMICHIGAN.ORG/ABOUT/COMMUNITY-BENEFITS/CHNA/THE WESTERN UPPER PENINSULA HEALTH DEPARTMENT, WITH FUNDING FROM THE MICHIGAN HEALTH ENDOWMENT FUND, SPEARHEADED A COMMUNITY HEALTH NEEDS ASSESSMENT THROUGHOUT THE UPPER PENINSULA. ONCE AGAIN, MYMICHIGAN MEDICAL CENTER SAULT AND THE CHIPPEWA COUNTY HEALTH DEPARTMENT PARTNERED TO BRING THE OUTCOMES OF THE ASSESSMENT TO THE RESIDENTS OF CHIPPEWA COUNTY. THE COMMUNITY HEALTH NEEDS ASSESSMENT REFLECTED DATA DERIVED DIRECTLY FROM QUESTIONNAIRES THAT WERE COMPLETED BY RANDOMLY SELECTED COUNTY RESIDENTS, AS WELL AS DATA COLLECTED THROUGH SECONDARY SURVEYS AND SOURCES.THE TOP FOUR PRIORITY ISSUES IDENTIFIED FROM AMONG 16LISTED CONCERNS WERE:-SUBSTANCE ABUSE-BEHAVIORAL HEALTH-GENERAL HEALTH - HEART DISEASE, CANCER, UNINTENTIONAL INJURIES, CHRONIC LOWER RESPIRATORY DISEASE, AND STROKE.ACHIEVING "HEALTHY PEOPLE IN HEALTHY COMMUNITIES", A GOAL ARTICULATED BY THE CDC, WILL REQUIRE U.P. COMMUNITIES TO EMBRACE THE IDEA THAT HEALTH IS ABOUT MORE THAN PERSONAL BEHAVIORS, IT IS ABOUT THE HOMES WE GROW UP IN, THE FAMILIES WE ARE PART OF, THE SCHOOLS WE ATTEND AND THE NEIGHBORHOODS IN WHICH WE LIVE. HEALTH IS NOT SOMETHING WE ACHIEVE IN ISOLATION, HEALTH IS SOMETHING WE CAN AND MUST HELP EACH OTHER ATTAIN.
MYMICHIGAN MEDICAL CENTER SAULT PART V, SECTION B, LINE 6B: CHIPPEWA COUNTY HEALTH DEPARTMENT AND WESTERN UPPER PENINSULA HEALTH DEPARTMENT (WUPHD)
MYMICHIGAN MEDICAL CENTER SAULT PART V, SECTION B, LINE 11: BEHAVIORAL HEALTH - GOALS AND OBJECTIVESINCREASE ACCESS TO CARE FOR BEHAVIORAL HEALTH ISSUES AMONG ADULTS AND YOUTH WITHIN CHIPPEWA COUNTY BY:(1) PROVIDING MEDICAL AND BEHAVIORAL HEALTH PROVIDERS WITH INFORMATION REGARDING AVAILABLE SERVICES;(2) PROVIDING COUNTY RESIDENTS WITH INFORMATION REGARDING THE BENEFITS OF EARLY TREATMENT AND RESOURCES FOR TREATMENT;(3) INCREASING THE PERCENTAGE OF CHIPPEWA COUNTY RESIDENTS ACCESSING CARE FOR BEHAVIORAL HEALTH.SUBSTANCE ABUSE - GOALS AND OBJECTIVESINCREASE KNOWLEDGE AND UNDERSTANDING SURROUNDING THE EFFECTS OF TREATMENT OPPORTUNITIES FOR SUBSTANCE MISUSE THROUGHOUT CHIPPEWA COUNTY THROUGH PREVENTION BY:(1) INCREASING EDUCATION AND AWARENESS OF SUD TO YOUTH AND GENERAL COMMUNITY MEMBERS;(2) INCREASING PRO-SOCIAL ACTIVITIES/OPPORTUNITIES FOR YOUTH; THROUGH SUPPORT BY:(A) INCREASING AWARENESS OF ADDICTION AND KNOWLEDGE OF SUPPORT RESOURCES FOR PERSONS WITH ADDICTION, THEIR FAMILY MEMBERS AND AREA EMPLOYERS; THROUGH RECOVERY BY:(B) INCREASING THE NUMBER OF REGISTERED WAIVERED MEDICATION-ASSISTED TREATMENT PROVIDERS IN CHIPPEWA COUNTY(C) INCREASING THE AWARENESS OF AVAILABLE TREATMENT OPTIONS WITHIN THE REGIONHEALTH - GOALS AND OBJECTIVESCREATE A HEALTHIER COMMUNITY THROUGH EDUCATION AND OPPORTUNITIES BY:(1) DECREASING TOBACCO USE AMONG PREGNANT WOMEN(2) INCREASING AWARENESS OF THE BENEFITS OF PHYSICAL ACTIVITY AS A PREVENTATIVE MEASURE OF CHRONIC DISEASEWHILE THE CHNA IDENTIFIED OTHER HEALTH NEEDS, THEY WERE SEEN TO BE BEYOND THE SCOPE OF OUR SERVICES OR WE COULD NOT MAKE A SIGNIFICANT IMPACT UPON THEM DUE TO LIMITED PERSONNEL AND/OR FINANCIAL RESOURCES.THE FULL COPY OF THE IMPLEMENTATION PLAN CAN BE FOUND AT A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON THE HOSPITALS WEBSITE LOCATED AT HTTPS://WWW.MYMICHIGAN.ORG/ABOUT/COMMUNITY-BENEFITS/CHNA/
MYMICHIGAN MEDICAL CENTER SAULT PART V, SECTION B, LINE 16J: PART V, SECTION B, LINE 16I - THE HOSPITAL FACILITY HAS REVIEWED THE POPULATION OF ITS COMMUNITY AND CONCLUDED THAT ENGLISH IS THE ONLY PRIMARY LANGUAGE AS DEFINTED BY THE REGULATIONS OF MORE THAN 5% OR 1,000 PERSONS. THEREFORE, THE FAP, FAP APPLICATION FORM, OR PLAIN LANGUAGE SUMMARY HAVE NOT BEEN TRANSLATED INTO ANOTHER LANGUAGE. THE HOSPITAL FACILITY WILL CONTINUE TO MONITOR THIS GOING FORWARD AS NEW CENSUS DATA BECOMES AVAILABLE.
MYMICHIGAN MEDICAL CENTER SAULT PART V, SECTION B, LINE 20E: THE HOSPITAL FACILITY MAILS A FINANCIAL ASSISTANCE POLICY APPLICATION WHEN SETTING UP A PAYMENT PLAN FOR A PATIENT AND WHEN SENDING PAST DUE LETTERS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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?2
Name and address Type of Facility (describe)
1 1 - LONG TERM CARE
500 OSBORN BOULEVARD
SAULT STE MARIE,MI49783
SKILLED NURSING FACILITY
2 2 - BEHAVIORAL HEALTH CENTER
500 OSBORN BOULEVARD
SAULT STE MARIE,MI49783
INPATIENT PSYCHIATRIC FACILITY
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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 I, LINE 3C: THE HOSPITAL, THROUGH ITS PARTNERSHIP WITH COMMUNITY HEALTH ACCESS COALITION (CHAC), UTILIZES 200% OF POVERTY GUIDELINES FOR INITIAL ACCESS AND APPLICATION FOR MEDICAID. FOR THOSE COMMUNITY MEMBERS THAT DO NOT QUALIFY, 250% OF POVERTY GUIDELINES ARE UTILIZED FOR ADDITIONAL OPTIONS FOR IMMEDIATE DISCOUNTS. ALL PATIENTS ARE ABLE TO REQUEST ADDITIONAL DISCOUNTS OR FREE CARE ON REMAINING BALANCES AND NON-COVERED SERVICES THROUGH THE HOSPITAL FINANCIAL ASSITANCE PROGRAM (FAP).
PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED TO COMPLETE THE CHARITY CARE (LINE 7A) AND MEANS-TESTED GOVERNMENT PROGRAMS (LINE 7B). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 THAT ACCOMPANIES THE INSTRUCTIONS TO THIS SCHEDULE. THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS (LINE 7E) AND HEALTH PROFESSIONS EDUCATION (LINE 7F).A DIRECT COST AND STEP-DOWN APPROACH WAS USED TO COMPLETE THE SUBSIDIZED HEALTH SERVICES PROGRAMS (LINE 7G).
PART I, LINE 7G: INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE: HOSPITAL AND TRAUMA BASED PROFESSIONAL SERVICES, SURGICAL ASSISTANT, BEHAVIORAL HEALTH, OB PROFESSIONAL, OB PROGRAM, AND DIALYSIS.
PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $1,168,061.
SCHEDULE H, PART I, LINE 7B: THE HOSPITAL PARTICIPATES IN THE MICHIGAN DISPROPORTIONATE SHARE PROGRAM (DSH) AS WELL AS THE MICHIGAN QUALITY ASSURANCE ASSESSMENT PROGRAMS (QAAP). THE DSH PROGRAM IS SET UP TO SUPPLEMENT FOR SHORTFALLS INCURRED DUE TO SERVING INDIGENT POPULATIONS IN THE COMMUNITY (SELF-PAY, MEDICAID, MEDICAID ADVANTAGE). THE QAAP PROGRAM IS SET UP TO SUPPLEMENT FOR SHORTFALLS INCURRED DUE TO SERVING MEDICAID PATIENTS. THE HOSPITAL PAID IN AMOUNTS TO FUND THE PROGRAM AND IN RETURN RECEIVED THEIR RESPECTIVE SHARE OF THE STATE DSH AND QAAP FUNDS. THE RESULT WAS A GAIN TO THE HOSPITAL, AS DETAILED BELOW: DSH PROGRAM QAAP PROGRAMREVENUE $66,434 $4,192,909EXPENSE - $1,896,141 --------- -----------GAIN $66,434 $2,296,768 IF THESE PROGRAMS DID NOT EXIST, THE HOSPITAL WOULD HAVE REPORTED A SHORTFALL FROM PROVIDING SERVICES TO MEDICAID PATIENTS.
PART II, COMMUNITY BUILDING ACTIVITIES: MYMICHIGAN MEDICAL CENTER SAULT IS ACTIVE IN BOTH THE PROMOTION OF HEALTHY LIFESTYLES FOR BOTH ITS EMPLOYEES AND COMMUNITY MEMBERS. MYMICHIGAN MEDICAL CENTER SAULT WILL TAKE A LEAD ROLE IN MANY OF THESE ENDEAVORS, BUT ALSO IS WILLING TO BE A SUPPORTIVE PARTNER AND TEAM MEMBER AS WELL.
PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:PATIENT ACCOUNTS RECEIVABLE ARE STATED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHER INSURERS TO WHICH MYMICHIGAN HEALTH EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. MANAGEMENT PERIODICALLY REVIEWS THE ADEQUACY OF THE IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, MYMICHIGAN HEALTH ANALYZES CONTRACTUALLY DUE AMOUNTS AND IMPLICIT PRICE CONCESSIONS (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY) TO RECORD RECEIVABLES AT THEIR ESTIMATED NET REALIZABLE VALUE. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), MYMICHIGAN HEALTH RECORDS SIGNIFICANT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTORICAL EXPERIENCE.
PART III, LINE 8: THE MEDICARE SURPLUS (SHORTFALL) WAS CALCULATED BY UTILIZING COST ACCOUNTING WHEN APPROPRIATE AND AVAILABLE. IN SOME AREAS A COST TO CHARGE METHODOLOGY WAS REQUIRED. THE SURPLUS SHOULD BE CONSIDERED AND INCLUDED IN THE COMMUNITY BENEFIT AS THE REIMBURSEMENT DID NOT MEET THE "COST" OF THE EXPENSE BASED ON REASONABLE COSTING METHODOLOGIES.
PART III, LINE 9B: MYMICHIGAN MEDICAL CENTER SAULT UTILIZES AN ON-LINE INSURANCE VERIFICATION PROCESS TO INITIATE THE EDUCATION AND ELIGIBILITY FROM THE ON-SET OF SERVICES. UPFRONT COLLECTIONS ARE AN ACTIVE PART OF THE PROCESS TO BOTH EDUCATE THE PATIENT AND TO REDUCE BACK-END COSTS OF COLLECTIONS. AT ANY TIME DURING THE PROCESS STAFF ARE TRAINED TO ADDRESS THE PERCEIVED FINANCIAL ASSISTANT NEEDS AND PROVIDE ACCESS TO THE IN-HOUSE PATIENT FINANCIAL COUNSELOR, COMMUNITY HEALTH ACCESS COALITION, OR THE DEPARTMENT OF HEALTH SERVICES REPRESENTATIVE. IN THE BILLING PROCESS, PATIENTS ARE STILL OFFERED ANY EDUCATION NECESSARY TO OBTAIN ASSISTANCE. ONCE SERVICES ARE RECEIVED AND THE PATIENT CHARGES HAVE ACCUMULATED PRIMARY SOURCES OF COVEAGE ARE BILLED. AFTER ALL EFFORTS OF COLLECTION FROM PRIMARY PAYOR (INSURANCE) THE PATIENT IS BALANCED BILL AND PROVIDED THE OPPORTUNITY FOR PAYMENT IN FULL OR OTHER PAYMENT OPTIONS.
SCHEDULE H, PART III, LINES 5 AND 6: OTHER INFORMATION: AS PER THE INSTRUCTIONS, SCHEDULE H, PART III, LINES 5 AND 6 ARE DERIVED DIRECTLY FROM THE MEDICARE COST REPORT. THOSE MEDICARE COSTS NOT INCLUDED IN THE MEDICARE COST REPORT (MEDICARE ADVANTAGE AND FEE FOR SERVICE PHYSICIANS) ARE SUMMARIZED AS FOLLOWS:TOTAL COST: 11,608,470TOTAL REIMBURSEMENT: 10,602,095COST IN EXCESS OF REIMBURSEMENT 1,006,375
PART VI, LINE 2: MYMICHIGAN MEDICAL CENTER SAULT WORKS IN CONJUNCTION WITH MANY OF THE HOSPITALS IN THE NORTHERN MICHIGAN AND THE UPPER PENINSULA. IN THESE EFFORTS "NEEDS" OF THE COMMUNITIES ARE ASSESSED THROUGH WORK WITH OTHER HOSPITALS, HEALTH RELATED ORGANIZATIONS, AND IN COMMUNITY FORUMS. IN ADDITION, MYMICHIGAN MEDICAL CENTER SAULT HAS ENGAGED OUTSIDE ASSISTANCE IN THE PLANNING FOR "NEEDS" OF BOTH SERVICES AND PHYSICIANS TO BEST PLAN FOR CAPITAL AND RECRUITMENT APPROPRIATIONS.
PART VI, LINE 3: MYMICHIGAN MEDICAL CENTER SAULT PRIDES ITSELF ON PROVIDING NEEDED CARE TO THE INDIGENT OF THE EASTERN UPPER PENINSULA IN A DIGNIFIED MANNER. THIS EDUCATION AND ASSISTANCE IS DONE THROUGH PARTNERSHIPS WITH OTHER "ACCESS" POINTS. SPECIFICALLY, MYMICHIGAN MEDICAL CENTER SAULT HAS PROVIDED RESOURCES TO THE CHAC (COMMUNITY HEALTH ACCESS COALTION) AND MYMICHIGAN MEDICAL CENTER SAULT HAS ENTERED INTO AN AGREEMENT WITH THE STATE OF MICHIGAN TO PROVIDE A DHS (DEPARTMENT OF HEALTH SERVICES) WORKER ON-SITE FOR READY ACCESS FOR OUR PATIENTS. THROUGH THE COLLABORATION OF THESE RELATIONSHIPS OUR PATIENTS ARE FIRST NOTIFIED AND REFERRED TO THE APPROPRIATE RESOURCE FROM THE ON-SET OF RECEIVING HEALTH CARE SERVICES.
PART VI, LINE 4: MYMICHIGAN MEDICAL CENTER SAULT'S PRIMARY SERVICE AREA IS THE EASTERN UPPER PENINSULA OF MICHIGAN. IN THIS AREA THERE ARE THREE COUNTIES WHICH CONSIST OF CHIPPEWA, MACKINAC, AND LUCE. MYMICHIGAN MEDICAL CENTER SAULT PRIDES ITSELF ON THE QUALITY OF SERVICES IT PROVIDES AS A RURAL SOLE COMMUNITY HOSPITAL. THE CLOSEST HOSPITAL IS 50 MILES AWAY AND IS A CRITICAL CARE HOSPITAL. THE CLOSEST TERTIARY FACILITY IS OVER 90 MILES AWAY. MYMICHIGAN MEDICAL CENTER SAULT STRIVES FOR PROVIDING SERVICES TO THE COMMUNITY FOR WHICH OTHERWISE THE COMMUNITY MEMBER WOULD MOST LIKELY HAVE TO TRAVEL TO A TERTIARY FACILITY. THROUGH ITS OWN EFFORTS AND JOINT VENTURES AREAS OF CARE SUCH AS OBSTETRICS AND DELIVERY, DIALYSIS, ONCOLOGY, CARDIOLOGY, PULMONOLOGY, INFECTIOUS DISEASE, AND I/P PSYCHIATRIC SERVICES WOULD NOT BE AVAILABLE.MYMICHIGAN MEDICAL CENTER SAULT IS ONE OF THE TOP THREE LARGEST EMPLOYERS IN OUR REGION. WE EMPLOY MORE THAN 900 PEOPLE AND HAVE AN ANNUAL PAYROLL OF APPROXIMATELY $50 MILLION; PROVIDING A POSITIVE ECONOMIC IMPACT IN THE COMMUNITY.
PART VI, LINE 5: MYMICHIGAN MEDICAL CENTER SAULT PROVIDES MANY POINTS OF ACCESS THAT ARE NOT PROFITABLE, BUT OTHERWISE WOULD REQUIRE OUR COMMUNITY MEMBERS TO TRAVEL GREAT DISTANCES. THE HOSPITAL MANAGEMENT AND STAFF PARTICIPATE ACTIVELY IN MANY HEALTH AND EDUCATIONAL ENDEAVORS. AN EXAMPLE IS PROVIDING CLINICAL STAFF TO THE LOCAL STATE UNIVERSITY TO ASSIST IN THE EDUCATION OF REGISTERED NURSES. OTHER EXAMPLES INCLUDE INFORMAL PARTNERSHIPS WITH TWO LOCALLY RECOGNIZED NATIVE AMERICAN TRIBES AND FULL SUPPORT OF COUNTY HEALTH INITIATIVES. PROGRAM EXAMPLES WOULD INCLUDE INDIGENT HEALTH ACCESS, FLU-CLINIC, DIALYSIS, DIABETIC EDUCATION, COUNTY HEALTH DEPARTMENT COLON SCREENING, PHYSICALS FOR STUDENT ATHLETES, AND REGIONAL CHARITY CARE INITIATIVES.MYMICHIGAN MEDICAL CENTER SAULT CONTINUES TO PARTNER WITH TERTIARY FACILITIES TO PROVIDE CONSISTENT ACCESS TO PROVIDERS OF CARDIOLOGY. DUE TO THE HOSPITAL'S GEOGRAPHIC LOCATION AND COMMUNITY SIZE, THE HOSPITAL HAS CONTINUED TO INDEPENDENTLY RECRUIT OTHER SPECIALISTS TO ENSURE THAT COMMUNITY ACCESS TO SERVICES AND PROVIDERS IS ACCOMPLISHED THROUGH PROVIDER BASED CLINICS. THE HOSPITAL CONTINUES ITS EFFORTS IN PROVIDING PRIMARY CARE IN OUTREACH AREAS OF THE EASTERN UPPER PENINSULA. WITH THESE EFFORTS AND PARTNERSHIPS THE HOSPITAL HAS BEEN SUCCESSFUL IN MAINTAINING ALL OTHER SERVICES.MYMICHIGAN MEDICAL CENTER SAULT CONTINUED ITS LEADERSHIP AND INVOLVEMENT WITHIN THE COMMUNITY AND THE HEALTHCARE PROVIDER COMMUNITY BY PROVIDING EDUCATION AND TRAINING. EXAMPLES OF COMMUNITY EDUCATION AND/OR HEALTH SCREENINGS INCLUDED A SENIOR HEALTH FAIR, EARLY PRE-NATAL EDUCATION AND CHILDBIRTH CLASSES. THE HOSPITAL'S INVOLVEMENT IN HEALTHCARE PROVIDER EDUCATION AND TRAINING INCLUDED NURSE AIDE TRAINING PROGRAMS AND SERVING AS CLINICAL INTERNSHIP SITE FOR MANY COLLEGE AND UNIVERSITY TRAINING PROGRAMS FOR STUDENTS IN REGISTERED NURSING, PHARMACY, MEDICAL TECHNOLOGY, HEALTH INFORMATION MANAGEMENT, AND PHYSICIAN ASSISTANT PROGRAMS. THE HOSPITAL IS ALSO DESIGNATED AS A COMMUNITY TRAINING CENTER OFFERING TRAINING TO AREA PHYSICIANS AND STAFF ON PEDIATRIC ADVANCED LIFE SUPPORT, ADVANCED CARDIAC LIFE SUPPORT AND BASIC LIFE SUPPORT. THE HOSPITAL IS ALSO CERTIFIED TO PROVIDE CONTINUING MEDICAL EDUCATION TO AREA PHYSICIANS AND STAFF AND CONDUCTS MORE THAN 25 ON-SITE PROGRAMS PER YEAR. VIDEO CONFERENCING CAPABILITIES ALSO PROVIDE ACCESS TO COMMUNITY AND HEALTHCARE PROVIDER TRAINING THROUGHOUT THE YEAR.MYMICHIGAN MEDICAL CENTER SAULT EMPLOYEES HAVE EMPLOYMENT BENEFITS WHICH INCLUDE PAYMENT FOR EXPENSES FOR THE COMPLETION OF A BACHELOR OF SCIENCE IN NURSING FOR CURRENT REGISTERED NURSES. ADDITIONALLY, OTHER EMPLOYEES HAVE ANNUAL EDUCATION BENEFITS FOR CONTINUING OR ADVANCING THEIR EDUCATION IN A HEALTHCARE FIELD. THE HOSPITAL ALSO OFFERS AN EDUCATIONAL LOAN PROGRAM WITH A PERIOD OF NO-INTEREST LOANS WHILE ENROLLED IN AN EDUCATIONAL PROGRAM. FOR NEWLY HIRED EMPLOYEES IN JOB SHORTAGE CLASSIFICATIONS, EMPLOYEES CAN RECEIVE FUNDS FOR STUDENT LOAN REPAYMENT FOR A COMMITMENT TO SERVE MYMICHIGAN MEDICAL CENTER SAULT FOR A SPECIFIED NUMBER OF YEARS.
PART VI, LINE 6: NOT AFFILIATED.
PART VI, LINE 7, REPORTS FILED WITH STATES MI
Schedule H (Form 990) 2022
Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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) 2021
Schedule L (Form 990) 2021
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) CEDAR STRAITS RADIOLOGY
 
OWNED MORE THAN 35% BY RALPH DUMAN, A BOARD MEMBER 288,667 PAYMENT FOR PROFESSIONAL RADIOLOGIST   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 4 THE NAME OF THE CORPORATION IS MYMICHIGAN MEDICAL CENTER SAULT ARTICLE V SECTION 1. THE SOLE MEMBER OF THE CORPORATION IS MYMICHIGAN HEALTH F/K/A MIDMICHIGAN HEALTH, A MICHIGAN NONPROFIT CORPORATION. ARTICLE VI SECTION 1. THE PURPOSES OF THE CORPORATION SHALL INCLUDE PROVIDING A BENEFIT TO ITS MEMBER, AND THE CORPORATION MAY PAY DIVIDENDS OR DISTRIBUTE ITS INCOME OR PROFIT TO MYMICHIGAN HEALTH, ITS SOLE MEMBER AND A MICHIGAN NONPROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, PROVIDED ANY SUCH PAYMENTS OR DISTRIBUTIONS ARE OTHERWISE CONSISTENT WITH THE CORPORATION'S PURPOSES AND ARE OTHERWISE PERMITTED UNDER THE MICHIGAN NONPROFIT CORPORATION ACT, AS AMENDED. SECTION 2. THE CORPORATION SHALL NOT TAKE ANY ACTION THAT, IF TAKEN DIRECTLY BY MYMICHIGAN HEALTH, WOULD REQUIRE APPROVAL OF ALL MEMBER CLASSES OF MYMICHIGAN HEALTH, UNLESS SUCH ACTION IS APPROVED BY MYMICHIGAN HEALTH AS THE SOLE MEMBER OF THE CORPORATION. SECTION 3. NO PART OF THE NET EARNINGS OF THE CORPORATION SHALL INURE TO THE BENEFIT OF OR BE DISTRIBUTABLE TO ITS DIRECTORS, OFFICERS, OR OTHER PRIVATE PERSONS, EXCEPT THAT THE CORPORATION SHALL BE AUTHORIZED AND EMPOWERED TO MAKE PAYMENTS AND DISTRIBUTIONS IN FURTHERANCE OF THE PURPOSES SET FORTH IN ARTICLE II HEREOF. NO SUBSTANTIAL PART OF THE ACTIVITIES OF THE CORPORATION SHALL BE THE CARRYING ON OF PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION, AND THE CORPORATION SHALL NOT PARTICIPATE IN, OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTION OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE. NOTWITHSTANDING ANY OTHER PROVISION OF THESE ARTICLES, THE CORPORATION SHALL NOT CARRY ON ANY OTHER ACTIVITIES NOT PERMITTED TO BE CARRIED ON (I) BY A CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, OR (II) BY A CORPORATION, CONTRIBUTIONS TO WHICH ARE DEDUCTIBLE UNDER SECTION 170(C)(2) OF THE INTERNAL REVENUE CODE OF 1986, OR CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW. ARTICLE VII SECTION 1. THE CORPORATION SHALL, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, INDEMNIFY ANY PERSON THAT WAS OR IS A PARTY OR IS THREATENED TO BE MADE A PARTY TO A THREATENED, PENDING OR COMPLETED ACTION OR SUIT BY REASON OF THE FACT THAT THE PERSON IS OR WAS A DIRECTOR, OFFICER, EMPLOYEE, NONDIRECTOR VOLUNTEER, OR AGENT OF THE CORPORATION, OR IS OR WAS SERVING AT THE REQUEST OF THE CORPORATION AS A DIRECTOR, OFFICER, PARTNER, TRUSTEE, EMPLOYEE, NONDIRECTOR VOLUNTEER, OR AGENT OF ANOTHER FOREIGN OR DOMESTIC CORPORATION, BUSINESS CORPORATION, PARTNERSHIP, JOINT VENTURE, TRUST, OR OTHER ENTERPRISE, WHETHER FOR PROFIT OR NOT. HOWEVER, THE CORPORATION WILL NOT PAY OR REIMBURSE THE EXPENSES OF A PARTY ENTITLED TO INDEMNIFICATION UNDER THE PRECEDING SENTENCE IN ADVANCE OF FINAL DISPOSITION OF THE PROCEEDING UNLESS (I) THE CORPORATION AUTHORIZES THE ADVANCE CONSISTENT WITH THE REQUIREMENTS OF THE ACT, AND (II) THE PERSON FURNISHES THE CORPORATION A WRITTEN AGREEMENT, CONSISTENT WITH THE REQUIREMENTS OF THE ACT, TO REPAY THE ADVANCE IF IT IS ULTIMATELY DETERMINED THAT THE PERSON DID NOT MEET THE STANDARD OF CONDUCT, IF ANY, REQUIRED BY THE ACT FOR THE INDEMNIFICATION. SECTION 2. THE CORPORATION MAY, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW (INCLUDING BUT NOT LIMITED TO THE LAWS GOVERNING THE CORPORATION AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE), PURCHASE AND MAINTAIN INSURANCE ON BEHALF OF ANY PERSON DESCRIBED IN SECTION 1 OF THIS ARTICLE VII AGAINST ANY LIABILITY ASSERTED AGAINST THE PERSON AND INCURRED BY THE PERSON IN THAT CAPACITY OR ARISING OUT OF THE PERSON'S STATUS AS SUCH, WHETHER OR NOT THE CORPORATION HAS THE POWER TO INDEMNIFY THE PERSON AGAINST LIABILITY. ARTICLE VIII SECTION 1. EXCEPT AS OTHERWISE PROVIDED BY LAW AND IN ACCORDANCE WITH A DISSOLUTION PLAN APPROVED BY MYMICHIGAN HEALTH AS MAY BE REQUIRED BY THE CORPORATION'S BYLAWS, UPON THE DISSOLUTION OF THE CORPORATION, THE BOARD OF DIRECTORS OF THE CORPORATION SHALL, AFTER PAYING OR MAKING PROVISIONS FOR THE PAYMENT OF ALL OF THE LIABILITIES OF THE CORPORATION, DISTRIBUTE ALL OF THE ASSETS OF THE CORPORATION TO MYMICHIGAN HEALTH, A 501(C)(3) ORGANIZATION, SO LONG AS IT REMAINS EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, OR TO A NONPROFIT FUND, FOUNDATION, OR CORPORATION WHICH IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES AND WHICH HAS ESTABLISHED ITS TAX EXEMPT STATUS UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE OF 1986, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, OR SHALL BE DISTRIBUTED TO THE FEDERAL GOVERNMENT, OR TO A STATE OR LOCAL GOVERNMENT FOR PUBLIC PURPOSE. ANY SUCH ASSETS NOT SO DISPOSED OF SHALL BE DISPOSED OF BY THE CIRCUIT COURT FOR THE COUNTY IN WHICH THE PRINCIPAL OFFICE OF THE CORPORATION IS THEN LOCATED, EXCLUSIVELY FOR SUCH PURPOSES OR TO SUCH ORGANIZATION OR ORGANIZATIONS, AS SAID COURT SHALL DETERMINE, WHICH IS OR ARE ORGANIZED AND OPERATED EXCLUSIVELY FOR SUCH PURPOSES.
FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS MYMICHIGAN HEALTH.
FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF MYMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF ANY AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; AND G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE DEPARTMENT WORKS WITH THE APPROPRIATE DEPARTMENTS TO PROVIDE RELEVANT INFORMATION TO THE PREPARER OF THE 990 (AN OUTSIDE FIRM SPECIALIZING IN TAX PREPARATION). REVIEW AND DISCUSSION OF ALL INFORMATION TAKES PLACE BETWEEN THE FINANCE DEPARTMENT AND THE CFO. THE FORM 990 IS THEN PROVIDED TO THE FULL BOARD, BEFORE FILING, WHERE THEY ARE GIVEN AN OPPORTUNITY TO ASK QUESTIONS.
FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST STATEMENT IS COMPLETED ANNUALLY FOR ALL BOARD MEMBERS AND SENIOR LEVEL ADMINISTRATION. ANY CONFLICTS WOULD BE REVIEWED AND KEPT UNDER CONSIDERATION ON AN ONGOING BASIS. BOARD MEMBERS AND ADMINISTRATION INFORM OR REMIND THE ATTENDEES IN THESE SITUATIONS AND ABSTAIN FROM BOTH DISCUSSION AND VOTE ON THE ITEM UNDER DISCUSSION.
FORM 990, PART VI, SECTION B, LINE 15 MANAGEMENT: THE HOSPITAL IS COMMITTED TO COMPENSATING ALL EMPLOYEES AN EQUITABLE AND FAIR WAGE. THE HOSPITAL HAS CONSULTED AND CONTINUES TO WORK WITH AN INDEPENDENT SPECIALIST TO REVIEW ALL JOB DESCRIPTIONS TO ASSIST IN THE CLASSIFICATION OF WAGES BASED ON LOCAL, REGIONAL, AND NATIONAL STANDARDS. THE CLASSIFICATION AND COMPARISON OF LOCALITY IS BASED ON THE ABILITY TO RECRUIT AND TRAIN THE SPECIFIC JOB CLASSIFICATION. THIS SAME PROCESS IS FIRST UTILIZED FOR MANAGEMENT AND SENIOR LEADERS. IN ADDITION, SENIOR LEADERS ARE COMPARED TO THE MHA SURVEY THAT IS PUBLICIZED. ANY INCREASES IN SENIOR LEADERS IS PROPOSED BY THE PRESIDENT/CEO AND APPROVED BY THE BOARD OF TRUSTEES. THE CEO AND HUMAN RESOURCES DIRECTOR PROVIDES THE BOARD WITH CEO WAGE INFORMATION AND THE BOARD (CEO IS REQUESTED TO LEAVE THE MEETING AND IS NOT INVOLVED IN THE VOTE) APPROVES AND MAKES ANY CHANGES THAT ARE NECESSARY. THESE RECOMMENDATIONS ARE NOT ANNUAL AS THEY ARE ALSO BASED ON THE FINANCIAL PERFORMANCE OF THE HOSPITAL AND THE CONTRACTUAL ARRANGEMENT OF THE CEO. THESE RECOMMENDATIONS ARE FURTHER COMPARED TO LIKE SIZE" HOSPITAL'S WITHIN THE MHA SURVEY. HUMAN RESOURCES MONITORS THIS PROCESS ANNUALLY AT VARIOUS LEVELS AND WAS LAST COMPLETED IN 2021. PHYSICIANS: AS A RURAL HOSPITAL AND DESIGNATED AS UNDERSERVED, MYMICHIGAN MEDICAL CENTER SAULT HAS BEEN FACED WITH THE NEED TO EMPLOY PHYSICIANS IN ORDER TO RECRUIT AND RETAIN PROVIDERS TO MEET THE NEEDS OF THE COMMUNITY. THE NEEDS OF OUR COMMUNITY ARE BASED ON INDEPENDENT EVALUATIONS AND COMMUNITY SURVEYS. BASED ON THESE NEEDS THE HOSPITAL UTILIZES MGMA DATA BASED ON SPECIALTY FOR ALL PROVIDERS IN THE UNITED STATES. THIS DATA PROVIDES INFORMATION SUCH AS RELATIVE VALUE UNITS, ENCOUNTER, AND COMPENSATION. THE INFORMATION IS CLASSIFIED BY THE 25TH, MEDIAN, 75TH, AND 90TH PERCENTILE AND IS USED TO DESIGNATE THE PHYSICIAN COMPENSATION AS THE HOSPITAL ESTABLISHES COMPENSATION DURING RECRUITMENT AND RETENTION EFFORTS. MEDIAN BASED COMPENSATION IS MOST TYPICAL FOR PHYSICIAN CONTRACTS WITH THE ABILITY FOR THE PROVIDER TO EARN ADDITIONAL COMPENSATION BASED ON THEIR ACTUAL WORKLOAD/ PRODUCTIVITY (RVU AND ENCOUNTER) WITH NO RELATIONSHIP TO REFERRALS TO THE HOSPITAL. IN RETENTION CONTRACTS THE BASE COMPENSATION IS SOMETIMES INCREASED BASED ON HISTORICAL WORKLOADS/ PRODUCTIVITY AND BASED ON THE MARKET COMPETITIVENESS FOR THE RESPECTIVE SPECIALTY.
FORM 990, PART VI, SECTION C, LINE 19 THE 990 AND THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH A DISSEMINATION AGENT AND UPON REQUEST.
FORM 990, PART IX, LINE 11G DIETARY: PROGRAM SERVICE EXPENSES 7,916. MANAGEMENT AND GENERAL EXPENSES 360,520. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 368,436. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 7,661,621. MANAGEMENT AND GENERAL EXPENSES 905,721. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,567,342. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 165,350. MANAGEMENT AND GENERAL EXPENSES 90,150. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 255,500.
FORM 990, PART XII, LINE 2C: NO CHANGES FROM PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
MYMICHIGAN MEDICAL CENTER SAULT
 
Employer identification number

38-2602147
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)MYMICHIGAN MEDICAL CENTER MIDLAND
4000 WELLNESS DR

MIDLAND,MI48670
38-0833014
HOSPITAL MI 501(C)(3) LINE 3 MYMICHIGAN HEALTH
 
Yes
 
(2)MYMICHIGAN HEALTH
4000 WELLNESS DR

MIDLAND,MI48670
38-2459948
SUPPORT MI 501(C)(3) LINE 12A, I N/A
 
No
(3)MYMICHIGAN MEDICAL CENTER ALMA
300 E WARWICK DR

ALMA,MI48801
38-1437919
HOSPITAL MI 501(C)(3) LINE 3 MYMICHIGAN HEALTH
 
Yes
 
(4)MYMICHIGAN MEDICAL CENTER CLARE
703 N MCEWAN ST

CLARE,MI48617
38-1518643
HOSPITAL MI 501(C)(3) LINE 3 MYMICHIGAN HEALTH
 
Yes
 
(5)MYMICHIGAN MEDICAL CENTER GLADWIN
515 QUARTER ST

GLADWIN,MI48624
38-6020434
HOSPITAL MI 501(C)(3) LINE 3 MYMICHIGAN HEALTH
 
Yes
 
(6)MYMICHIGAN MEDICAL CENTER ALPENA
1501 W CHISHOLM ST

ALPENA,MI49707
38-6000029
HOSPITAL MI 501(C)(3) LINE 3 MYMICHIGAN HEALTH
 
Yes
 
(7)MYMICHIGAN HOME CARE
3007 N SAGINAW RD

MIDLAND,MI48640
38-1459397
HOME CARE MI 501(C)(3) LINE 10 MYMICHIGAN HEALTH
 
Yes
 
(8)MYMICHIGAN MEDICAL GROUP
2620 W SUGNET RD

MIDLAND,MI48640
38-3317788
MEDICAL OFFICE MI 501(C)(3) LINE 12A, I MYMICHIGAN HEALTH
 
Yes
 
(9)MYMICHIGAN HEALTH DEVELOPMENT ASSOCIATES
4000 WELLNESS DR

MIDLAND,MI48670
38-2459947
OPERATIONS MI 501(C)(2)   MYMICHIGAN HEALTH
 
Yes
 
(10)MYMICHIGAN MEDICAL CENTER MIDLAND VOLUNTEERS
4000 WELLNESS DR

MIDLAND,MI48670
06-1723993
SUPPORT MI 501(C)(3) LINE 12A, I N/A
 
No
(11)MYMICHIGAN HEALTH FOUNDATION
4000 WELLNESS DR

MIDLAND,MI48670
81-2813405
FOUNDATION MI 501(C)(3) LINE 12A, I MYMICHIGAN HEALTH
 
Yes
 
(12)MYMICHIGAN MEDICAL CENTER WEST BRANCH
2463 S M-30

WEST BRANCH,MI48661
46-4088182
HOSPITAL MI 501(C)(3) LINE 3 MYMICHIGAN HEALTH
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) MYMICHIGAN HEALTH PAIN MANAGEMENT

2463 SOUTH M-30
WEST BREANCH,MI48661
83-4186622
HEALTHCARE PAIN MANAGEMENT MI N/A
        No     No  
(2) ISOMM

211 S CRAPO ST STE H
MT PLEASANT,MI48858
27-0867311
MRI SERVICES MI N/A
        No     No  










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












Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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


Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021

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