TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) AARON S BOATIN...................................................................... TRUSTEE - SECRETARY/TREASURER	2.00 ................. 4.00	X	X	0	0	0
(2) DENISE BROOKS-WILLIAMS...................................................................... TRUSTEE	1.00 ................. 62.00	X		0	1,641,896	47,881
(3) DAVID W CRAFT...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(4) SAIRIA DASS RAMCHARAN MD...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(5) MARTHA A FUERSTENAU...................................................................... TRUSTEE- CHAIR	2.00 ................. 2.00	X	X	0	0	0
(6) CATHERINE A HENDRIAN...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(7) MOHAN G KULKARNI MD...................................................................... PHYSICIAN TRUSTEE	60.00 ................. 1.00	X		1,103,312	0	54,695
(8) MUMTAZ A MEMON MD...................................................................... PHYSICIAN TRUSTEE	60.00 ................. 2.00	X		679,300	0	36,528
(9) EMILY S MOORHEAD...................................................................... DIRECTOR - PRESIDENT & CEO	55.00 ................. 10.00	X	X	471,292	61,540	51,999
(10) MONICA M MOSER...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(11) ADNAN R MUNKARAH MD...................................................................... PHYSICIAN TRUSTEE	1.00 ................. 64.00	X		0	2,335,257	68,285
(12) LAWRENCE NARKIEWICZ JR MD...................................................................... PHYSICIAN TRUSTEE	60.00 ................. 1.00	X		591,213	0	35,812
(13) MARK S OLSON...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(14) KEVIN E OXLEY...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(15) SAMIR PARIKH MD...................................................................... TRUSTEE	1.00 ................. 1.00	X		57,262	0	0
(16) DANIEL J PHELAN PHD...................................................................... TRUSTEE - VICE CHAIR	2.00 ................. 6.00	X	X	0	30,000	0
(17) CHRISTINA M SIDERS...................................................................... TRUSTEE	1.00 ................. 3.00	X		0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
INDEPENDENT HOSPITALIST PHYSICIANS PLLC PO BOX 100 ROYAL OAK,MI48068	HEALTHCARE SERVICES	12,657,899
PROLINK HEALTHCARE LLC 4600 MONTGOMERY RD STE 300 CINCINNATI,OH45212	TEMP NURSING SERVICES	10,468,928
PULMONARY CLINICS OF SOUTHERN MI PC 900 E MICHIGAN AVENUE STE 105 JACKSON,MI49201	HEALTHCARE SERVICES	3,777,762
OBHG MICHIGAN PC 777 LOWNDES HILL ROAD BLDG 1 GREENVILLE,SC296068261	HEALTHCARE SERVICES	2,181,485
INDEPENDENT EMERGENCY PHYSICIANS PC 37000 GRAND RIVER AVE FARMINGTION HILLS,MI48335	HEALTHCARE SERVICES	1,793,240
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 66

- TIN:

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

2023

Open to Public
Inspection

Name of the organization

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 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

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. 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—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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

Schedule A (Form 990) 2023

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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.)..

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

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990) 2023

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

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer 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).

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

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

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

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

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).

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

Did one or more disqualified persons (as defined 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.

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.

10a

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

10a

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

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

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

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.

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

By reason of the relationship described in 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.

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990) 2023

Page 6

Part V

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

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

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

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

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

Schedule A (Form 990) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2023

Name of the organization

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

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

Special Rules

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

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

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

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization WA FOOTE MEMORIAL HOSPITAL

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization WA FOOTE MEMORIAL HOSPITAL		Employer identification number 38-2027689

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization WA FOOTE MEMORIAL HOSPITAL			Employer identification number 38-2027689
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

right arrow

Complete if the organization is described below. 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

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

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

A Check right arrow

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

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

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

Yes

42,138

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

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

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

42,138

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	HEALTH CARE IS A HIGHLY-REGULATED FIELD, REQUIRING FREQUENT AND HIGH-LEVEL COMMUNICATION WITH REGULATORS AND ELECTED OFFICIALS. A SMALL INVESTMENT IN LOBBYING ENABLES US TO REMAIN IN CONTACT WITH LEGISLATORS AND GOVERNMENT AGENCIES, MAXIMIZE THE RESOURCES WITH WHICH WE ARE ENTRUSTED AND ASSURE THAT WE PROVIDE THE BEST CARE TO OUR COMMUNITY. W.A. FOOTE MEMORIAL HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL ENLISTS THE SERVICES OF SEVERAL LOBBYING CONSULTANTS, ATTORNEYS AND HEALTHCARE TRADE ASSOCIATIONS.

Return Reference

Explanation

PART II-B, LINE 1:

HEALTH CARE IS A HIGHLY-REGULATED FIELD, REQUIRING FREQUENT AND HIGH-LEVEL COMMUNICATION WITH REGULATORS AND ELECTED OFFICIALS. A SMALL INVESTMENT IN LOBBYING ENABLES US TO REMAIN IN CONTACT WITH LEGISLATORS AND GOVERNMENT AGENCIES, MAXIMIZE THE RESOURCES WITH WHICH WE ARE ENTRUSTED AND ASSURE THAT WE PROVIDE THE BEST CARE TO OUR COMMUNITY. W.A. FOOTE MEMORIAL HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL ENLISTS THE SERVICES OF SEVERAL LOBBYING CONSULTANTS, ATTORNEYS AND HEALTHCARE TRADE ASSOCIATIONS.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
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

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

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

Number of states where property subject to conservation easement is located right arrow

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	5,337,392	3,925,913	3,089,845	2,864,539	3,183,393
b	Contributions ...	3,567,344	3,614,133	2,032,607	1,790,548
c	Net investment earnings, gains, and losses	127,629	-145,673	184,527	125,594	192,950
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	3,084,501	2,056,981	1,381,066	1,690,836	2,311,804
f	Administrative expenses ....
g	End of year balance ......	5,947,864	5,337,392	3,925,913	3,089,845	2,864,539

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

53.240 %

Term endowment right arrow

46.760 %

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	9,537,626		9,537,626
b	Buildings ....	209,161,417	71,167,975	137,993,442
c	Leasehold improvements	1,217,809	219,192	998,617
d	Equipment ....	172,855,994	131,719,613	41,136,381
e	Other .....	7,629,216		7,629,216
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				197,295,282

Schedule D (Form 990) 2022

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.)

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.)

Part IX

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

(a) Description				(b) Book value

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

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
RETIREMENT PLAN LIABILITY	28,961,598
DEFERRED COMP	17,872,043
CORPORATE RESERVE	6,612,431
LIABILITY INSURANCE	25,098,076
WORKERS COMP LIABILITY	1,320,441
CURRENT OPERATING LEASE LIABILITY	2,238,644
LONG TERM OPERATING LEASE LIABILITY	10,263,067
OPERATING LEASE A/P PAYMENT	-271,293

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	92,095,007
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) 2022

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
PART V, LINE 4:	THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR VARIOUS CHARITABLE HOSPITAL PROGRAMS INCLUDING TREATMENT OF UNINSURED PATIENTS, COMMUNITY PREVENTATIVE HEALTH EDUCATION, PROGRAM DEVELOPMENT AND CAPITAL IMPROVEMENTS.
PART X, LINE 2:	THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2023 AND 2022.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. 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

2023

Open to Public Inspection

Name of the organization
WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990) 2023

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 PINK BALL (event type)	(b) Event #2 LIGHTS OF LOVE (event type)	(c) Other events (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	118,048	32,202		150,250
2	Less: Contributions . . . .	85,129	44,962		130,091
3	Gross income (line 1 minus line 2) . . . . . .	32,919	-12,760		20,159

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	65,329	29,551	94,880
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			94,880
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			-74,721

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .			42,720	42,720

2	Cash prizes . . . . .
3	Noncash prizes . . . .	11,818	11,818
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes100.000 %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

11,818

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

30,902

Enter the state(s) in which the organization conducts gaming activities: MI

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2023

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

100.000 %

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

AMY STRAUSS SPECIAL EVENTS DEPT

Address

ONE FORD PLACE DETROIT, MI48202

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other 25000.0000000000 %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	12,280,650	0	12,280,650	1.600 %
b	Medicaid (from Worksheet 3, column a) . . . . .	210,142,206	161,956,557	48,185,649	6.280 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	0	0
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	222,422,856	161,956,557	60,466,299	7.880 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,325,016	0	1,325,016	0.170 %
f	Health professions education (from Worksheet 5) . . .	18,955,727	9,248,033	9,707,694	1.260 %
g	Subsidized health services (from Worksheet 6) . . . .	18,056,526	13,887,290	4,169,236	0.540 %
h	Research (from Worksheet 7) .	0	0
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1,100,204		1,100,204	0.140 %
j	Total. Other Benefits . .	39,437,473	23,135,323	16,302,150	2.110 %
k	Total. Add lines 7d and 7j .	261,860,329	185,091,880	76,768,449	9.990 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing			0	0
2	Economic development			0	0
3	Community support			19,466	0	19,466	0 %
4	Environmental improvements			0	0
5	Leadership development and training for community members			0	0
6	Coalition building			625,000	0	625,000	0.080 %
7	Community health improvement advocacy			0	0
8	Workforce development			0	0
9	Other			0	0
10	Total			644,466		644,466	0.080 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

16,595,838

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. ......

4,148,960

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

Section B. Medicare

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

216,344,138

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

251,575,280

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

-35,231,142

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 FOOTE HEALTH CENTER ASSOCIATES	ENTITY LEASES MEDICAL OFFICE SPACE.	92.870 %	0 %	7.130 %
22 GRASS LAKE REAL ESTATE LLC	TO BUILD AND MANAGE OUTPATIENT SURGICAL CENTER	46.000 %	0 %	46.000 %
33 GRASS LAKE SURGERY CENTER LLC	TO OPERATE OUTPATIENT SURGICAL CENTER	46.000 %	0 %	46.000 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	HENRY FORD HEALTH JACKSON HOSPITAL 205 N EAST AVENUE JACKSON,MI49201 WWW.HENRYFORD.COM	X	X	X	X	X

Schedule H (Form 990) 2023

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)

	HENRY FORD HEALTH JACKSON HOSPITAL
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

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

Yes

6 a

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): SEE LINE 10A BELOW

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

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

Yes

If "Yes" (list url): SEE PART V, PAGE 8

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	HENRY FORD HEALTH JACKSON HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE

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

HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.HENRYFORD.COM/VISITORS/BILLING/FINANCIAL-ASSISTANCE

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	HENRY FORD HEALTH JACKSON HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

	HENRY FORD HEALTH JACKSON HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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
HENRY FORD HEALTH JACKSON HOSPITAL	PART V, SECTION B, LINE 5: TO GET A COMPREHENSIVE PICTURE OF THE HEALTH OF THE COMMUNITIES WE SERVE, OUR CHNA PROCESS INCLUDED AN IN-DEPTH REVIEW OF STATE AND LOCAL DATA, FROM WHICH MANY COMMON HEALTH ISSUES AND TRENDS EMERGED. THESE DATA WERE GATHERED LARGELY FROM THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES (MDHHS) VITAL STATISTICS, THE MICHIGAN BEHAVIORAL RISK FACTOR (BRFS) SURVEY, AND THE AMERICAN COMMUNITIES SURVEY. THE MOST UPDATED DATA WERE GENERALLY COLLECTED FROM 2018 TO 2020. DATA FROM 2020 MAY BE INFLUENCED BY THE COVID-19 PANDEMIC. HOWEVER, SINCE DATA MORE RECENT THAN 2020 IS LARGELY NOT YET AVAILABLE, THIS CHNA IS NOT ABLE TO FULLY REFLECT THE IMPACT OF COVID-19. WE ALSO EXAMINED TRENDS IN THESE DATA SINCE COMPLETING OUR LAST COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019, FROM WHICH DATA WERE MOSTLY COLLECTED DURING 2015-2017.OUR METHODOLOGY INCLUDED REVIEWING DATA COLLECTED FROM STATE AND LOCAL SOURCES AND COMMUNITY/STAKEHOLDER INPUT FROM SURVEYS.JACKSON COUNTY WAS SURVEYED THROUGH THE JACKSON COLLABORATIVE NETWORK'S NEEDS ASSESSMENT PROCESS, WHICH UTILIZES A PHONE SURVEY SAMPLING STRATEGY. THE METHOD USED FOR THIS SURVEY WAS A RANDOM DIGIT DIAL TELEPHONE SURVEY OF JACKSON COUNTY RESIDENTS. THE SAMPLE WAS STRATIFIED BY CENSUS TRACT, MEANING THE POPULATION WAS SAMPLED EVENLY THROUGHOUT ALL CENSUS TRACTS IN THE COUNTY (WITH THE PRISON CENSUS TRACT BEING OMITTED). CELLULAR AND LANDLINE TELEPHONE NUMBERS OF JACKSON COUNTY RESIDENTS IN EACH CENSUS TRACT WERE RANDOMLY DIALED UNTIL THE TARGET NUMBER OF SURVEYS WAS COMPLETED FOR EACH TRACT. THIS CYCLE INCLUDED AN OVERSAMPLING OF RESIDENTS WHO SELF-IDENTIFIED AS BLACK/AFRICAN AMERICAN TO HELP STRENGTHEN THE SAMPLE AND HELP TO REVEAL EVIDENCE OF RACIAL DISPARITIES IN THE JACKSON COMMUNITY. A TOTAL OF 1,300 ADULTS IN JACKSON COUNTY COMPLETED THE TELEPHONE SURVEY. WITHIN JACKSON COUNTY, 26% OF RESPONDENTS LIVED IN THE CITY OF JACKSON, 59% LIVED OUTSIDE OF THE CITY, AND THE REMAINING 15% HAD AN UNKNOWN LOCATION WITHIN JACKSON COUNTY.RESPONSES TO SURVEYS WERE RECEIVED FROM ORGANIZATIONS AND INDIVIDUALS REPRESENTING A RANGE OF RACIAL/ETHNIC BACKGROUNDS. RACIAL/ETHNIC MINORITIES REPRESENTED AMONGST SURVEY RESPONDENTS INCLUDE BLACK, ASIAN, NATIVE AMERICAN, MULTI-RACIAL, HISPANIC OR LATINO, AND MIDDLE EASTERN OR NORTH AFRICAN DESCENT.INDIVIDUALS SURVEYED INCLUDED LEADERS FROM AGENCIES SUCH AS JACKSON COUNTY HEALTH DEPARTMENT, JACKSON HEALTH NETWORK, JACKSON COMMUNITY FOUNDATION, JACKSON COUNTY INTERMEDIATE SCHOOL DISTRICT, UNITED WAY OF JACKSON COUNTY AND MANY OTHERS. PARTICIPANTS HAD A WIDE RANGE OF EXPERTISE. FROM THEIR SURVEY RESPONSES, WE GAINED INSIGHT INTO THE KINDS OF HEALTH ISSUES FACING OUR COMMUNITIES.
HENRY FORD HEALTH JACKSON HOSPITAL	PART V, SECTION B, LINE 6A: HENRY FORD HEALTH HOSPITALHENRY FORD HEALTH KINGSWOOD HOSPITALHENRY FORD HEALTH MACOMB HOSPITALHENRY FORD HEALTH WEST BLOOMFIELD HOSPITALHENRY FORD HEALTH WYANDOTTE HOSPITALHENRY FORD HEALTH COTTAGE HOSPITAL/MEDICAL CENTERHENRY FORD HEALTH ALLEGIANCE SPECIALTY HOSPITAL
HENRY FORD HEALTH JACKSON HOSPITAL	PART V, SECTION B, LINE 11: CHNA PRIORITIESTHE THREE (3) SELECTED PRIORITIES WHICH EMERGED FROM THE 2022 CHNA WERE: CHRONIC DISEASE PREVENTION & MANAGEMENT, BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER AND INFANT MORTALITY.THE FOLLOWING ARE STRATEGIES TO ADDRESS THE HEALTH PRIORITIES IDENTIFIED THROUGH THE CHNA. CHRONIC DISEASE PREVENTION & MANAGEMENT EVALUATE AND IDENTIFY IMPROVEMENT OPPORTUNITIES TO ENSURE DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT (DSMES) PROGRAMS ARE ACHIEVING EQUITY IN ACCESS AND OUTCOMES FOR COMMUNITIES OF COLOR.CONTINUE TO ENHANCE PROGRAMMING AND EVALUATE AND IDENTIFY IMPROVEMENT OPPORTUNITIES TO ENSURE DIABETES PREVENTION PROGRAMS (DPP) ARE ACHIEVING EQUITY IN ACCESS AND OUTCOMES FOR COMMUNITIES OF COLOR.ENGAGE PROVIDER ORGANIZATIONS IN SYSTEMATIC CLINICAL IMPROVEMENTS TO REDUCE RACIAL DISPARITIES IN HYPERTENSION AND/OR DIABETES CONTROL.HENRY FORD HEALTH WILL PARTNER WITH COMMUNITY ORGANIZATIONS VIA A COMMUNITY INFORMATION EXCHANGE (CIE) TO CLOSE 50% OF THE SOCIAL NEEDS GAPS IDENTIFIED (REFERRALS MADE) WITHIN POPULATIONS SCREENED BY 2025. BY 2025, HENRY FORD HEALTH WILL INVEST $15 MILLION THROUGH INTERMEDIARIES INTO PROJECTS THAT POSITIVELY IMPACT SOCIAL DETERMINANTS OF HEALTH (SDOH) ACROSS MARKETS WE SERVE. INVESTMENTS WILL YIELD RETURNS THAT MAY BE BELOW GENERAL MARKET EXPECTATIONS, BUT SUFFICIENT TO REPLENISH FUNDING FOR FUTURE ROUNDS OF INVESTMENT. BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER PROVIDE DEPRESSION SCREENING FOR ALL THOSE SEEKING PSYCHIATRIC CARE.PATIENTS SUFFERING FROM OPIATE USE DISORDER (OUD), NOT IN REMISSION, WILL BE PRESCRIBED NAXLOXONE AS A SAFETY MEASURE TO PREVENT MORBIDITY AND MORTALITY.IMPROVE ACCESS IN OUR PSYCHIATRIC SPECIALTY CLINICS AND IN OUR COLLABORATIVE CARE MODEL FOR ADULT PATIENTS. INFANT MORTALITY IMPROVE PRENATAL AND PEDIATRIC ASSESSMENTS OF ALL PATIENTS BY IDENTIFYING AND ADDRESSING SDOH AND PROVIDING IMPROVED CARE NAVIGATION. EXPAND IMPLICIT BIAS EDUCATION/TRAINING TO ALL HFHS OBSTETRIC, PEDIATRIC/NEONATOLOGY NURSING AND PROVIDERS (INCLUDES REDUCING UNCONSCIOUS BIAS, AND IMPERATIVE (RUBI) CURRICULUM).ENSURE OB/GYN PATIENTS ARE RECEIVING RESPECTFUL CARE.SCALE WIN NETWORK: DETROIT ENHANCED MODEL OF GROUP PRENATAL CARE TO ADDITIONAL SITES.CHNA SIGNIFICANT NEEDS NOT ADDRESSEDSIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT CHNA WHICH ARE NOT BEING ADDRESSED IN THE CHNA IMPLEMENTATION PLANS: VACCINATIONS ASTHMA ALZHEIMER'S KIDNEY DISEASE PNEUMONIA AND INFLUENZA HENRY FORD HEALTH ACKNOWLEDGES THE NUMEROUS AND WIDE RANGE OF HEALTH NEEDS THAT EXIST IN OUR COMMUNITIES SERVED, AND WE ACKNOWLEDGE THAT THERE ARE CERTAIN HEALTH NEEDS NOT CHOSEN AS PRIORITIES, LISTED ABOVE. WE HAVE DETERMINED THAT OUR IMPLEMENTATION PLANS ARE ONLY ABLE TO EFFECTIVELY ADDRESS THE MOST PRESSING NEEDS IDENTIFIED BY OUR STAKEHOLDERS AND IN RELEVANT DATA AND SURVEYS, WHICH INCLUDE CHRONIC DISEASE, MENTAL HEALTH AND SUBSTANCE USE, CANCER, AND INFANT MORTALITY. THE SELECTED PRIORITIES WERE ANALYZED THROUGH THE LENS OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY, AS WELL AS HEALTH SYSTEM RESOURCES, AND REPRESENT THE KEY HEALTH ISSUES WHICH ARE MOST PRESSING WITH THE MOST COMPELLING DATA. WHILE HFH PROVIDES SUPPORTIVE CLINICAL SERVICES IN THESE AREAS, THEY WILL NOT BE INCLUDED AS AREAS OF PRIMARY ACTIVITY AS IT RELATES TO THE IMPLEMENTATION PLANS.
HENRY FORD HEALTH JACKSON HOSPITAL	PART V, SECTION B, LINE 13B: HENRY FORD HEALTH JACKSON HOSPITAL ADMINISTERS A PATIENT FINANCIAL ASSISTANCE POLICY DESIGNED TO PROVIDE FINANCIAL ASSISTANCE FOR UNINSURED PATIENTS AS WELL AS FOR INSURED PATIENTS WITH LIMITED RESOURCES. FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE SYSTEM OFFERS A DISCOUNTED RATE THAT DOES NOT EXCEED 138% OF MEDICARE PAYMENT RATES. INSURED PATIENTS WITH LIMITED FINANCIAL RESOURCES MAY QUALIFY FOR A DISCOUNT ON SELF-PAY BALANCES.
PART V, LINE 10A	HTTPS://WWW.HENRYFORD.COM/ABOUT/COMMUNITY-HEALTH/NEEDS-ASSESSMENT

Schedule H (Form 990) 2023

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?50
Name and address		Type of Facility (describe)
1	1 - HFHJH HEMATOLOGYONCOLOGY 1100 E MICHIGAN AVE STE 307 JACKSON,MI49201	SPECIALTY PRACTICE AND INFUSION CENTER
2	2 - HFHJH ORTHOPEDIC & NEUROSCIENCE CNTR 1201 E MICHIGAN AVENUE JACKSON,MI49201	OUTPATIENT SPECIALTY, DIAGNOSTIC AND REHAB FACILITY
3	3 - HFHJH SURGERY CENTER 1125 E MICHIGAN AVENUE JACKSON,MI49201	OUTPATIENT SURGERY CENTER
4	4 - HFHJH DIGESTIVE HEALTH 205 S EAST AVE JACKSON,MI49201	OUTPATIENT SURGERY CENTER
5	5 - HFHJH RADIATION ONCOLOGY 1102 E MICHIGAN AVE JACKSON,MI49201	RADIATION THERAPY
6	6 - HFHJH HEALTH CARDIOLOGY 309 PAGE AVENUE JACKSON,MI49201	SPECIALTY PRACTICE AND DIAGNOSTIC TESTING CENTER
7	7 - HFHJH HEALTH CENTER - CASCADE RIDGE 3305/3333 SPRING ARBOR RD JACKSON,MI49203	FAMILY AND SPECIALTY PRACTICES, DIAGNOSTIC CENTER
8	8 - HFHJH VASCULAR LABORATORY 300 W WASHINGTON AVENUE STE 350 JACKSON,MI49201	VASCULAR TESTING
9	9 - HFHJH HEALTH CENTER - TOWNSEND 400 HINCKLEY BLVD JACKSON,MI49203	FAMILY MEDICINE AND DIAGNOSTIC CENTER
10	10 - HFHJH HEALTH CENTER - NORTH STREET 1401 W NORTH STREET JACKSON,MI49202	FAMILY MEDICINE AND DIAGNOSTIC CENTER
11	11 - HFHJH HEALTH CENTER - SPRINGPORT 2200 SPRINGPORT ROAD JACKSON,MI49202	OUTPATIENT SERVICES, DIAGNOSTIC CENTER, PHARMACY SVCS
12	12 - HFHJH GASTROENTEROLOGY 744 W MICHIGAN AVE STE 201 JACKSON,MI49201	SPECIALTY PRACTICE
13	13 - HFHJH ENTHEARING CENTER 1111 TENEYCK ST JACKSON,MI49201	SPECIALTY PRACTICE AND AUDIOLOGY SALES/SERVICE
14	14 - HFHJH ADDICTION RECOVERY CENTER 2424 W WASHINGTON AVE JACKSON,MI49203	INPATIENT AND OUTPATIENT TREATMENT CENTER
15	15 - HFHJH HOME HEALTH CARE 100 E MICHIGAN AVE STE 400 JACKSON,MI49201	CLINICAL HOME CARE SERVICES
16	16 - HFHJH UROLOGY - SPRING ARBOR ROAD 2800 SPRING ARBOR RD JACKSON,MI49201	SPECIALTY PRACTICE
17	17 - HFHJH UROLOGY - W MICHIGAN AVE 744 W MICHIGAN AVE STE 300 JACKSON,MI49201	SPECIALTY PRACTICE
18	18 - HFHJH PHYSICAL REHAB-JACKSON 100 E MICHIGAN AVE STE 103 JACKSON,MI49201	PHYSICAL REHABILITATION
19	19 - HFHJH HEALTH CENTER - EAST MICHIGAN 3235 E MICHIGAN AVENUE JACKSON,MI49202	FAMILY MEDICINE AND BEHAVIORAL HEALTH SERVICES
20	20 - HFHJH PEDIATRICS 760 W FRANKLIN JACKSON,MI49203	PEDIATRIC MEDICINE
21	21 - HFHJH HEALTH CENTER - MASON 810 HOGSBACK RD MASON,MI48854	FAMILY AND SPECIALTY PRACTICE, DIAGNOSTICS, REHAB
22	22 - HFHJH HOME MEDICAL EQUIP 700 E MICHIGAN AVE JACKSON,MI49201	SALE OF DURABLE MEDICAL EQUIPMENT
23	23 - HFHJH FAMILY MEDICINE AND DIAGNOSTIC CNT 153 WAMPLERS LAKE RD BROOKLYN,MI49230	FAMILY MEDICINE AND DIAGNOSTIC CENTER
24	24 - HFHJH HEALTH CENTER - LESLIE 130 N SHERMAN ST LESLIE,MI49251	FAMILY MEDICINE AND DIAGNOSTIC CENTER
25	25 - HFHJH HEALTH CENTER - SPRING ARBOR 7845 SPRING ARBOR ROAD SPRING ARBOR,MI49283	FAMILY MEDICINE AND DIAGNOSTIC CENTER
26	26 - HFHJH HEALTH CENTER - MICHIGAN CENTER 4304 PAGE AVE MICHIGAN CENTER,MI49254	SPECIALTY PRACTICE, DIAGNOSTICS, REHAB
27	27 - HFHJH BEHAVIORAL HEALTH 744 W MICHIGAN AVE STE 200 JACKSON,MI49201	OUTPATIENT BEHAVIORAL HEALTH
28	28 - HFHJH GENERAL SURGERY 1100 E MICHIGAN AVE STE 300 JACKSON,MI49201	SPECIALTY PRACTICE
29	29 - HFHJH HEALTH CENTER - ALBION 27931 C DRIVE NORTH ALBION,MI49224	FAMILY AND SPECIALTY MEDICINE, DIAGNOSTIC CENTER
30	30 - HFHJH FAMILY MEDICINE - SUMMIT WOODS 2585 SPRING ARBOR ROAD JACKSON,MI49203	FAMILY MEDICINE
31	31 - HFHJH THORACIC SURGERY 1100 E MICHIGAN AVE STE 201 JACKSON,MI49201	SPECIALTY PRACTICE
32	32 - HFHJH VASCULAR HEALTH 300 W WASHINGTON AVENUE STE 300 JACKSON,MI49201	SPECIALTY PRACTICE
33	33 - HFHJH OCCUPATIONAL HEALTH 100 E MICHIGAN AVE STE 101 JACKSON,MI49201	EMPLOYMENT SCREENING, WORK-RELATED INJURY TREATMENT
34	34 - HFHJH CARDIAC SURGERY 1100 E MICHIGAN AVE STE 201 JACKSON,MI49201	SPECIALTY PRACTICE
35	35 - HFHJH FAMILY MEDICINE AND DIAGNOSTIC CNT 12369 E MICHIGAN AVE GRASS LAKE,MI49240	FAMILY MEDICINE AND DIAGNOSTIC CENTER
36	36 - HFHJH INTERNAL MEDICINE 100 E MICHIGAN AVE STE 102 JACKSON,MI49201	OUTPATIENT SERVICES
37	37 - HFHJH DIAGNOSTIC CENTER - NORTH JACKSON 505 N JACKSON ST STE 178 JACKSON,MI49201	LAB AND IMAGING SERVICES
38	38 - HFHJH OUTPATIENT PROCEDURE CENTER 1100 E MICHIGAN AVE STE 109 JACKSON,MI49201	OUTPATIENT SERVICES
39	39 - HFHJH CARDIAC REHAB 1100 E MICHIGAN AVE STE 100/102 JACKSON,MI49201	POST-SURGICAL REHABILITATION
40	40 - HFHJH BARIATRIC CENTER 744 W MICHIGAN AVE STE 101 JACKSON,MI49201	SPECIALTY PRACTICE
41	41 - HFHJH PHYSICAL REHAB - HILLSDALE 61 W CARLTON HILLSDALE,MI49242	PHYSICAL REHABILITATION
42	42 - HFHJH DIAGNOSTIC CENTER 1100 E MICHIGAN AVE STE 104 JACKSON,MI49201	LAB AND IMAGING SERVICES
43	43 - HFHJH DIAGNOSTIC CENTER - GREENWOOD AVE 1310 GREENWOOD AVE JACKSON,MI49203	LABORATORY SERVICES
44	44 - HFHJH OUTPATIENT TRAUMA 1100 E MICHIGAN AVE STE 300 JACKSON,MI49201	SPECIALTY PRACTICE
45	45 - HFHJH HEALTH CENTER-CHELSEA 1145 S MAIN ST UNIT A CHELSEA,MI48119	LAB
46	46 - HFHJH HEALTH CENTER-COLDWATER 605 W CHICAGO STREET COLDWATER,MI49036	LAB
47	47 - HFHJH DIAGNOSTIC CENTER-HILLSDALE 3271 W CARLETON HILLSDALE,MI49242	LAB
48	48 - HENRY FORD MILK BANK-JACKSON 200 S EAST AVENUE JACKSON,MI49201	MILK BANK
49	49 - HFHJH ORTHO CLINIC-ALBION 415 S HANNAH ALBION,MI49224	SPECIALTY PRACTICE
50	50 - HFHJH CARDIOLOGY CLINIC-JONESVILLE 216 OLDS STREET JONESVILLE,MI49250	SPECIALTY PRACTICE

Schedule H (Form 990) 2023

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 7G:	SUBSIDIZED SERVICES CONSIST PRIMARILY OF PHYSICIAN AND FACILITY COSTS OF WOMEN'S AND BEHAVIORAL HEALTH SERVICES.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $16,595,838
PART II, COMMUNITY BUILDING ACTIVITIES:	OUR VISION IS TO BE THE TRUSTED PARTNER IN HEALTH, LEADING THE NATION IN SUPERIOR CARE AND VALUE-ONE PERSON AT A TIME. TO BE A TRULY TRANSFORMATIVE FORCE FOR COMMUNITIES AND A TRUSTED PARTNER, IT IS IMPERATIVE THAT AS AN ORGANIZATION, WE LISTEN TO THE VOICES OF THOSE WE SERVE. WE SERVE MANY DIVERSE COMMUNITIES AND POPULATIONS WITH UNIQUE HISTORIES, CHARACTERISTICS, STRUGGLES AND STRENGTHS.TO ACHIEVE THIS VISION, WE MUST BUILD TRUSTED RELATIONSHIPS WITH OUR PATIENTS AND COMMUNITY MEMBERS AND ENSURE THOSE WE SERVE THAT THEIR NEEDS INFORM OUR PRACTICES, POLICIES AND ALLOCATION OF RESOURCES. OUR PATIENTS ENTRUST OUR ORGANIZATION WITH THEIR LIVES AND THE LIVES OF THOSE THEY LOVE. ASSESSING AND RESPONDING TO THE CHANGING NEEDS OF THESE PATIENTS IS VITAL TO DEVELOPING AND MAINTAINING TRUSTED RELATIONSHIPS AS WE WORK TOWARD A COMMON GOAL COMMUNITIES FULL OF HEALTHY, THRIVING PEOPLE OF ALL AGES.
PART III, LINE 2:	THE ORGANIZATION'S BAD DEBT EXPENSE IS STATED IN PATIENT GROSS CHARGES.
PART III, LINE 4:	IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE ORGANIZATION RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. AT SUCH POINT IN TIME THAT A BILLED SERVICE IS BELIEVED TO BE UNCOLLECTIBLE, THE RELATED RECEIVABLE IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ESTIMATES OF RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE RECEIVED.FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION OFFERS A DISCOUNT OFF STANDARD RATES FOR SERVICES PROVIDED THAT RESULT IN NET CHARGES THAT DO NOT EXCEED 138% OF MEDICARE RATES.FOR UNINSURED PATIENTS WHO MEET THE QUALIFICATIONS STIPULATED IN THE ORGANIZATION'S PATIENT FINANCIAL ASSISTANCE POLICY, EMERGENCY AND OTHER MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES ARE PROVIDED AT NO COST. THE ORGANIZATION DETERMINES THE COSTS OF SUCH UNPAID SERVICES BY APPLYING A COST-TO-CHARGE RATIO TO THE BILLED CHARGES
PART III, LINE 9B:	SHOULD A PATIENT BE DEEMED ELIGIBLE FOR ASSISTANCE ANY COLLECTION EFFORTS ASSOCIATED WITH THE QUALIFYING SERVICE ARE SUSPENDED. IF THE PATIENT IS DETERMINED TO QUALIFY UNDER THE ORGANIZATION'S PATIENT FINANCIAL ASSISTANCE POLICY PRIOR TO BILLING, NO BILL IS EVER GENERATED AND THEREFORE THE ELEMENTS OF THE COLLECTION POLICY ARE NEVER INVOKED. WHEN THE DETERMINATION IS NOT MADE PRIOR TO THE BILLING, THE ORGANIZATION'S COLLECTION POLICY WOULD APPLY. THIS POLICY READS IN PART:- "PATIENTS WILL BE EVALUATED FOR THE SYSTEM'S PATIENT FINANCIAL ASSISTANCE PROGRAM"- "UNINSURED PATIENTS WILL BE GIVEN A DISCOUNT"- "UNDERINSURED PATIENTS MAY QUALIFY FOR DISCOUNTED SERVICES BASED UPON THEIR AGGREGATE HOUSEHOLD INCOME" - "THE ORGANIZATION WILL REVIEW THE PATIENTS'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS REQUESTED"- "LEGAL ACTION...MAY BE TAKEN...WHEN THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS TO MEET HIS OR HER OBLIGATION"- "THE ORGANIZATION WILL NOT FORCE THE SALE OR FORECLOSURE OF ANY PATIENT OR GUARANTOR'S PRIMARY RESIDENCE TO PAY AN OUTSTANDING MEDICAL BILL"- "THE ORGANIZATION WILL NOT...REQUIRE THE PATIENT OR RESPONSIBLE PARTY TO APPEAR IN COURT"- "THE ORGANIZATION WILL DIRECT THEIR COLLECTION AGENCIES TO FOLLOW THESE GUIDELINES"
PART VI, LINE 2:	COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES ARE SELECTED AFTER CONSIDERING THE DATA ON HEALTH AND SOCIAL NEEDS, WEIGHED ALONGSIDE INPUT RECEIVED FROM COMMUNITY MEMBERS AND STAKEHOLDERS REGARDING THE ISSUES THEY BELIEVE TO BE MOST IMPORTANT TO IMPROVING COMMUNITY HEALTH. THE FOLLOWING CRITERIA WERE CONSIDERED MOST IMPORTANT WHEN THE CHNA WORKGROUP WAS SELECTING THE RECOMMENDED PRIORITIES: ISSUES SIGNIFICANTLY CONTRIBUTING TO DEATH ISSUES SIGNIFICANTLY CONTRIBUTING TO PREVENTABLE HOSPITALIZATIONS SIGNIFICANT RACIAL DISPARITIES IN DISEASE OR MORTALITY PREVALENCE SIGNIFICANT WORSENING OF A HEALTH ISSUE SINCE 2019 CHNA RANKING IN TOP 4 ISSUES IMPORTANT TO IMPROVING COMMUNITY HEALTH BY COMMUNITY MEMBERS AND STAKEHOLDERSHENRY FORD'S CHNA WORKGROUP, A WORKGROUP OF COMMUNITY HEALTH ANCHOR COUNCIL ENTERPRISE-WIDE (CHANCE), REVIEWED THE DATA COLLECTED FROM STATE AND LOCAL SOURCES AND THE COMMUNITY/STAKEHOLDER INPUT FROM SURVEYS. THE WORKGROUP IDENTIFIED HIGHLY PREVALENT HEALTH ISSUES, ISSUES WHICH AFFECT PEOPLE IN OUR SERVICE AREA MORE THAN MICHIGAN RESIDENTS ON AVERAGE, AND ISSUES WHICH HAVE SIGNIFICANTLY WORSENED SINCE THE 2019 CHNA. AFTER CONSIDERING THE DATA, COMMUNITY INPUT, AND OUR RESOURCES AND INITIATIVES, PRIORITIES WERE RECOMMENDED BY THE CHNA WORKGROUP FOR APPROVAL BY THE PRESIDENT OF EACH HENRY FORD HEALTH HOSPITAL. CHNA WORKGROUP LEADERSHIP MET ONE-ON-ONE WITH EACH HOSPITAL PRESIDENT TO PRESENT NEEDS ASSESSMENT FINDINGS, PRIORITY RECOMMENDATIONS AND JUSTIFICATIONS FOR THE SELECTED PRIORITIES. APPROVAL WAS RECEIVED FROM EACH PRESIDENT FOR THE RECOMMENDED PRIORITIES. THE RECOMMENDED PRIORITIES WERE THEN PRESENTED TO AND RATIFIED BY EACH HOSPITAL BOARD OF TRUSTEES AND THE HENRY FORD HEALTH EXECUTIVE COUNCIL IN THE THIRD QUARTER OF 2022. THE COMMUNITY HEALTH LEADERSHIP COUNCIL RECOMMENDED THIS CHNA FOR APPROVAL BY THE BOARD OF DIRECTORS ON NOVEMBER 4, 2022. THE SELECTED PRIORITIES WERE RATIFIED BY THE HENRY FORD HEALTH BOARD OF DIRECTORS ON DECEMBER 16, 2022.
PART VI, LINE 3:	HFHJH HAS VARIOUS APPROACHES TO TARGET AND INFORM RESIDENTS OF ITS COMMUNITIES ABOUT THE PROGRAMS AND SERVICES IT OFFERS. PROGRAMS WHERE WE PARTNER WITH ORGANIZATIONS WITH ESTABLISHED RELATIONSHIPS WITH THE INDIVIDUALS SUCH AS THROUGH COMMUNITY HEALTH CENTERS, THE PUBLIC SCHOOLS AND FAITH-BASED ORGANIZATIONS HAVE BEEN PARTICULARLY SUCCESSFUL. HFHJH FOLLOWS THE HFHS PATIENT FINANCIAL ASSISTANCE POLICY. HF HEALTH HAS A SINGULAR PATIENT FINANCIAL ASSISTANCE POLICY (PFAP). INDIVIDUALS WITHOUT ADEQUATE HEALTH INSURANCE COVERAGE MOST FREQUENTLY APPEAR IN OUR EMERGENCY ROOM FOR SERVICES, ALL PATIENTS ARE SEEN WITHOUT REGARD TO ABILITY TO PAY. INTAKE STAFF IS TRAINED HOW TO APPROACH AND ENGAGE AN INDIVIDUAL WHEN THERE IS AN APPARENT LACK OF ADEQUATE HEALTH COVERAGE. THIS INCLUDES INFORMING THEM OF THE PROGRAMS OFFERED BY HFHJH AS WELL AS OTHER COMMUNITY, LOCAL, STATE AND FEDERAL PROGRAMS OFFERING POTENTIAL SUPPORT. HFHJH HAS DEDICATED STAFF RESPONSIBLE TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR SUPPORTIVE PROGRAMS AND ASSIST THEM WITH THE ENROLLMENT PROCESS. THERE ARE MANY REASONS WHY A PATIENT IN NEED OF FINANCIAL ASSISTANCE WITH THEIR MEDICAL CARE MAY NOT HAVE BEEN IDENTIFIED AT THE TIME OF THE CARE DELIVERY. PATIENT FINANCIAL SERVICE AND COLLECTION STAFFS ARE TRAINED TO RECOGNIZE THESE INDIVIDUALS AND PROVIDE THEM WITH ADVICE REGARDING THE VARIOUS OPTIONS AVAILABLE TO SUPPORT THEIR CARE NEEDS.
PART VI, LINE 4:	THE FOUR-COUNTY AREA INCLUDES THE WAYNE, OAKLAND, MACOMB AND JACKSON COUNTIES, WHICH ARE LOCATED IN SOUTHEASTERN AND SOUTHCENTRAL MICHIGAN AND ACCOUNT FOR 41% OF THE MICHIGAN POPULATION. WAYNE, OAKLAND, AND MACOMB (IN THAT ORDER) ARE THE MOST POPULOUS COUNTIES IN MICHIGAN; JACKSON IS A MUCH SMALLER COUNTY. OF THE OVER 4 MILLION RESIDENTS IN THE FOUR-COUNTY AREA, APPROXIMATELY 51% OF THE POPULATION IS FEMALE. THE FOUR-COUNTY AREA IS 63% WHITE, 24% BLACK, AND 5% HISPANIC.POPULATION IN THE FOUR-COUNTY AREA IS EXPECTED TO REMAIN FLAT UNTIL 2026. WHEN EXAMINING AGE DISTRIBUTION, THE FOUR-COUNTY AREA HAS A COMPARABLE POPULATION TO THAT OF THE COUNTRY WITH 18% OF THE POPULATION ABOVE THE AGE OF 65. OF PARTICULAR INTEREST TO HEALTHCARE PROVIDERS IS THE AGING POPULATION OF THE FOUR-COUNTY AREA WITH THE 65-YEAR-OLD AND ABOVE POPULATION EXPECTED TO RISE BY 14% FROM 2021 TO 2026.REGARDING EDUCATION, THE FOUR-COUNTY AREA HAS APPROXIMATELY 10% OF RESIDENTS WHO HAVE SOME HIGH SCHOOL EDUCATION OR LESS COMPARED TO THE NATIONAL AVERAGE OF 12%. FURTHER, 30% OF RESIDENTS HAVE A BACHELOR'S DEGREE OR GREATER, WHICH IS COMPARABLE TO THE NATIONAL AVERAGE. THE FOURCOUNTY AREA IS DIVERSE IN POPULATION, RACE/ETHNICITY, ECONOMIC GROWTH AND DEVELOPMENT. THE AUTOMOTIVE INDUSTRY REMAINS THE LARGEST EMPLOYER IN THE REGION, BUT THE HEALTHCARE SECTOR IS REPRESENTED AMONG THE TOP EMPLOYERS IN THE REGION AS WELL.WITHIN THE FOUR-COUNTY AREA, THE MEDIAN HOUSEHOLD INCOME IN OAKLAND COUNTY ($81,587) IS SIGNIFICANTLY HIGHER THAN WAYNE COUNTY ($49,359), JACKSON COUNTY ($54,511), AND MACOMB COUNTY ($64,641). THE UNITED WAY ALICE (ASSET LIMITED, INCOME CONSTRAINED, EMPLOYED) REPORT SHOWS THE NUMBER OF HOUSEHOLDS WHOSE AVERAGE INCOME IS INSUFFICIENT TO AFFORD BASIC EXPENSES, INCLUDING HOUSING, CHILDCARE, HEALTH CARE AND TRANSPORTATION, BY COUNTY AND CITY.LOWER HOUSEHOLD INCOMES NEGATIVELY IMPACT PURCHASING POWER, HEALTH INSURANCE COVERAGE, AND ABILITY TO AFFORD NECESSITIES. THE FOUR-COUNTY AREA'S SAFETY NETS, INCLUDING HEALTHCARE SYSTEMS, ARE BEING STRETCHED TO THE LIMIT. MICHIGAN RANKS 33RD IN THE COUNTRY FOR CHILDREN UNDER AGE 18 IN FAMILIES BELOW POVERTY LEVEL, AT 17.3% IN 2019, A 2% IMPROVEMENT FROM 2018.IN ORDER TO INCREASE THE UTILITY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, IT IS IMPORTANT TO ANALYZE THE PROFILE(S) OF EACH OF THESE COUNTIES AT A MORE DETAILED LEVEL, SUCH AS ZIP CODES, SO THAT CERTAIN DIFFERENCES WITHIN THE AREA BECOME EVIDENT.ONE COMMUNITY IN PARTICULAR NEED OF ATTENTION IS THE CITY OF DETROIT, WHERE THE AVERAGE HOUSEHOLD INCOME IS $52,005, SIGNIFICANTLY LESS THAN AVERAGE HOUSEHOLD INCOME OF THE OVERALL FOUR-COUNTY AREA ($96,462). 18% OF DETROIT RESIDENTS HAVE LESS THAN A HIGH SCHOOL EDUCATION AND ONLY 15% HAVE A BACHELOR'S DEGREE OR HIGHER.IN ADDITION TO THE CITY OF DETROIT, THERE ARE OTHER ZIP CODES IN THE FOUR-COUNTY AREA WITH LOWER INCOMES AND LOWER EDUCATIONAL ATTAINMENT. THE AVERAGE HOUSEHOLD INCOME OF THESE ZIP CODES RANGES FROM $27,380-$65,690, LOWER THAN THE FOUR-COUNTY SERVICE AREA. OVERALL, 17% OF RESIDENTS IN THESE ZIP CODES HAVE LESS THAN A HIGH SCHOOL EDUCATION COMPARED TO 9% FOR THE FOUR-COUNTY AREA.THE POPULATIONS IN THESE ZIP CODES ARE MORE RACIALLY AND ETHNICALLY DIVERSE COMPARED TO THE FOUR-COUNTY AREA. 39% OF THE RESIDENTS OF THESE TOP 20 ZIP CODES ARE RACIAL MINORITIES COMPARED TO 37% OF RESIDENTS IN THE ENTIRE FOUR-COUNTY AREA.AS A RESULT, THE CITY OF DETROIT AND ABOVE TWENTY ZIP CODES ARE OF PARTICULAR INTEREST IN PLANNING COMMUNITY NEEDS INITIATIVES WITHIN THE FOUR-COUNTY AREA.
PART VI, LINE 5:	HENRY FORD HEALTH JACKSON HOSPITAL (HFHJH) IS PART OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH"), ONE OF THE NATION'S LARGEST INTEGRATED HEALTH DELIVERY SYSTEMS SERVING SOUTHEASTERN MICHIGAN. THIS TAX RETURN REFLECTS ACTIVITIES OF HFHJH, WHICH INCLUDES 365 LICENSED INPATIENT BEDS WITH AN INTEGRATED MEDICAL STAFF SERVING MORE THAN 40 FACILITIES IN THE JACKSON COUNTY AREA OF MICHIGAN. HFHJH IS GOVERNED BY A DEDICATED VOLUNTEER COMMUNITY BOARD AND IT PROVIDES ITS COMMUNITIES WITH A FULL RANGE OF CLINICAL SERVICES INCLUDING GENERAL MEDICINE, SURGERY, PRIMARY CARE, OBSTETRICS, PEDIATRICS, CARDIAC CARE, CANCER CARE, ORTHOPEDICS, NEUROSURGERY, PHYSICAL AND REHABILITATION MEDICINE, AMBULATORY SURGERY, INPATIENT AND OUTPATIENT BEHAVIORAL SERVICES, AND 24-HOUR EMERGENCY CARE.
PART VI, LINE 6:	THE SYSTEM DEMONSTRATES ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY BY OPERATING EMERGENCY ROOMS OPEN TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK; PROVIDING FACILITIES FOR THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS; AND MAINTAINING RESEARCH FACILITIES FOR THE STUDY OF NEW DRUGS AND MEDICAL DEVICES THAT OFFER THE PROMISE OF IMPROVING HEALTH CARE. THE SYSTEM ALSO PROVIDES COMMUNITY HEALTH SERVICES, SUCH AS COMMUNITY EDUCATION AND OUTREACH IN THE FORM OF FREE OR LOW-COST CLINICS; HEALTH EDUCATION TELEVISION PROGRAMMING; DONATIONS FOR THE COMMUNITY; MULTIPLE HEALTH PROMOTION AND WELLNESS PROGRAMS, SUCH AS HEALTH SCREENING; AND VARIOUS COMMUNITY PROJECTS AND SUPPORT GROUPS.

Schedule H (Form 990) 2023

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
WA FOOTE MEMORIAL HOSPITAL

Employer identification number
38-2027689

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(f) Method of valuation (book, FMV, appraisal, other)	(h) Purpose of grant or assistance
(1) ENTERPRISE GROUP 100 E MICHIGAN AVE 1100 JACKSON,MI49201	38-3326101	501(C)(6)	55,000	N/A	ORGANIZATIONAL SUPPORT
(2) JACKSON COMMUNITY FOUNDATION 100 S JACKSON ST SUITE 200 JACKSON,MI49201	38-6070739	501(C)(3)	50,000	N/A	ORGANIZATIONAL SUPPORT
(3) PARTIAL TO GIRLS 620 GREENWOOD AVE JACKSON,MI49203	85-1394411		25,000	N/A	ORGANIZATIONAL SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) STAFF ASSISTANCE FUND FOR EMERGENCIES	58	46,409
(2) WE CARE PATIENT NEEDS FUND	193	19,344
(3) CANCER PATIENT IMMEDIATE NEEDS FUNDS	17	8,358
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference	Explanation
PART I, LINE 2:	AWARDS ARE GRANTED BASED ON AN APPLICATION AND REVIEW PROCESS.THE ORGANIZATION SENDS OUT AN AWARD LETTER TO ALL GRANTEE RECIPENTS. THE LETTER OUTLINES WHAT THE FUNDING MAY BE USED FOR AND REQUESTS A FINAL REPORT DETAILING THE YEAR'S ACTIVITIES.

Schedule I (Form 990) 2023

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1ROBERT G RINEY FORMER TRUSTEE	(i) (ii)	0 ------------- 2,165,620	0 ------------- 1,535,761	0 ------------- 766,542	0 ------------- 27,441	0 ------------- 29,598	0 ------------- 4,524,962	0 ------------- 0
2AZAM BASHEER MD PHYSICIAN	(i) (ii)	744,765 ------------- 0	1,660,376 ------------- 0	315,654 ------------- 0	4,950 ------------- 0	31,984 ------------- 0	2,757,729 ------------- 0	0 ------------- 0
3FRANK LAMARCA MD PHYSICIAN	(i) (ii)	1,054,270 ------------- 0	1,207,358 ------------- 0	425,964 ------------- 0	5,775 ------------- 0	32,925 ------------- 0	2,726,292 ------------- 0	0 ------------- 0
4ADNAN R MUNKARAH MD PHYSICIAN TRUSTEE	(i) (ii)	0 ------------- 1,372,925	0 ------------- 523,983	0 ------------- 438,349	0 ------------- 27,441	0 ------------- 40,844	0 ------------- 2,403,542	0 ------------- 0
5DENISE BROOKS-WILLIAMS TRUSTEE	(i) (ii)	0 ------------- 1,054,577	0 ------------- 317,037	0 ------------- 270,282	0 ------------- 27,441	0 ------------- 20,440	0 ------------- 1,689,777	0 ------------- 0
6VISHAL GUPTA MD PHYSICIAN	(i) (ii)	743,263 ------------- 0	403,457 ------------- 0	81,389 ------------- 0	5,775 ------------- 0	19,806 ------------- 0	1,253,690 ------------- 0	0 ------------- 0
7MOHAN G KULKARNI MD PHYSICIAN TRUSTEE	(i) (ii)	427,575 ------------- 0	316,135 ------------- 0	359,602 ------------- 0	4,950 ------------- 0	49,745 ------------- 0	1,158,007 ------------- 0	0 ------------- 0
8BIPIN RAVINDRAN MD PHYSICIAN	(i) (ii)	657,331 ------------- 0	351,467 ------------- 0	39,007 ------------- 0	4,950 ------------- 0	3,843 ------------- 0	1,056,598 ------------- 0	0 ------------- 0
9TIMOTHY EPHRIAM EKPO DO PHYSICIAN	(i) (ii)	684,334 ------------- 0	215,247 ------------- 0	113,307 ------------- 0	5,775 ------------- 0	28,687 ------------- 0	1,047,350 ------------- 0	0 ------------- 0
10MUMTAZ A MEMON MD PHYSICIAN TRUSTEE	(i) (ii)	445,449 ------------- 0	147,351 ------------- 0	86,500 ------------- 0	4,950 ------------- 0	31,578 ------------- 0	715,828 ------------- 0	0 ------------- 0
11MICHAEL GRISDELA FORMER INTERIM CENTRAL MAR	(i) (ii)	0 ------------- 402,797	0 ------------- 121,344	0 ------------- 28,044	0 ------------- 56,087	0 ------------- 33,532	0 ------------- 641,804	0 ------------- 0
12MARK A SMITH MD CMO/CEO HFAHMG	(i) (ii)	361,331 ------------- 0	115,991 ------------- 0	106,906 ------------- 0	4,950 ------------- 0	49,698 ------------- 0	638,876 ------------- 0	0 ------------- 0
13LAWRENCE NARKIEWICZ JR MD PHYSICIAN TRUSTEE	(i) (ii)	378,378 ------------- 0	29,194 ------------- 0	183,641 ------------- 0	5,655 ------------- 0	30,157 ------------- 0	627,025 ------------- 0	0 ------------- 0
14EMILY S MOORHEAD DIRECTOR - PRESIDENT & CEO	(i) (ii)	354,485 ------------- 58,644	115,907 ------------- 0	900 ------------- 2,896	50,604 ------------- 0	1,180 ------------- 215	523,076 ------------- 61,755	0 ------------- 0
15KENNETH W EMPEY GENERAL COUNSEL	(i) (ii)	0 ------------- 277,293	0 ------------- 70,873	0 ------------- 22,500	0 ------------- 4,650	0 ------------- 16,588	0 ------------- 391,904	0 ------------- 0
16PAULA AUTRY FORMER TRUSTEE - PRESIDENT & CEO	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 368,899	0 ------------- 0	0 ------------- 0	0 ------------- 368,899	0 ------------- 0
17JIM BONGIORNO CENTRAL MARKET CFO (THRU 12/2023)	(i) (ii)	0 ------------- 215,560	0 ------------- 46,527	0 ------------- 320	0 ------------- 16,665	0 ------------- 27,306	0 ------------- 306,378	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
PART I, LINE 1A	IT IS THE ORGANIZATION'S POLICY TO PAY OR REIMBURSE EMPLOYEES FOR BONAFIDE BUSINESS TRAVEL BASED ON THE MOST COST EFFECTIVE MEANS AVAILABLE. GENERALLY, WHEN AIR TRAVEL IS INVOLVED THIS EQUATES TO COACH CLASS AIR FARE. UNDER CERTAIN CIRCUMSTANCES, SUCH AS WHEN COACH CLASS IS NOT AVAILABLE OR THE TRIP IS OF AN EXTENSIVE DURATION, SENIOR LEADERSHIP HAS APPROVED BUSINESS CLASS, FIRST CLASS OR CHARTER TRAVEL. IN SUCH CIRCUMSTANCES, THE TRAVEL IS CONSIDERED TO BE FOR A BONAFIDE BUSINESS PURPOSE; ACCORDINGLY, NO TAXABLE INCOME IS REPORTED. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP RECEIVE MEMBERSHIP TO SOCIAL CLUBS INTENDED TO FURTHER THE BUSINESS NEEDS OF THE ORGANIZATION. USAGE IS REIMBURSED ON A CASE-BY-CASE BASIS BASED UPON DOCUMENTATION OF BUSINESS PURPOSE. IN CONNECTION WITH THE RECRUITMENT AND EMPLOYMENT OF LEADERS AND PHYSICIANS, THE ORGANIZATION AGREES AT TIMES TO PROVIDE TEMPORARY HOUSING AND RELOCATION SERVICES. INTERNAL REVENUE SERVICE GUIDELINES ARE ADHERED TO REGARDING THE REPORTING AND TAXATION OF ALL SUCH ITEMS. THE VALUE OF SUCH SERVICES IS ALSO INCLUDED IN THE EVALUATION OF REASONABLE COMPENSATION. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PROGRAM THAT RESULTS IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. THE ORGANIZATION ALSO OFFERS CERTAIN MEMBERS OF LEADERSHIP THE OPTION OF PARTICIPATING IN AN IRC SEC 457 BENEFIT PROGRAM WHICH ALSO RESULTS IN REPORTABLE TAXABLE INCOME AS BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. IT IS AN ELEMENT OF THE PLAN DESIGN TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. SEE Q. 4B FOR THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS.
PART I, LINE 3	THE CHIEF EXECUTIVE OFFICER FOR HENRY FORD HEALTH JACKSON HOSPITAL IS AN EMPLOYEE OF HENRY FORD HEALTH (THE SOLE MEMBER OF HENRY FORD ALLEGIANCE HEALTH GROUP). HENRY FORD HEALTH ("HF HEALTH") HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES CONSISTING OF ALL INDEPENDENT TRUSTEES. THE COMMITTEE MEETS THROUGHOUT THE YEAR AND IS CHARGED WITH THE APPROVAL OF THE ORGANIZATION'S OVERALL COMPENSATION AND BENEFIT PROGRAMS AS WELL AS THE SPECIFIC REVIEW AND APPROVAL OF THE COMPENSATION OF CERTAIN EMPLOYEES INCLUDING THE CHIEF EXECUTIVE OFFICER OF HENRY FORD HEALTH JACKSON HOSPITAL. THE COMMITTEE DIRECTLY ENGAGES AN INDEPENDENT COMPENSATION ADVISOR TO ASSIST WITH THIS PROCESS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE, UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTH CARE ORGANIZATIONS. THE REASONABLENESS OF COMPENSATION IS EVALUATED BASED UPON THESE AND OTHER FACTORS. THE CEO IS ACCOUNTABLE FOR ENSURING THAT HENRY FORD HEALTH JACKSON HOSPITAL'S MISSION IS EFFICIENTLY CARRIED OUT WITH THE HIGHEST LEVELS OF QUALITY, SAFETY AND SERVICE, WHILE AT THE SAME TIME ENSURING THAT THE ORGANIZATION IS FINANCIALLY HEALTHY. EXECUTIVE COMPENSATION IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THIS COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT TO ENSURE THAT HENRY FORD HEALTH JACKSON HOSPITAL COMPENSATION PRACTICES ARE CONSISTENT WITH INDUSTRY STANDARDS AND THAT COMPENSATION LEVELS ARE FAIR COMPARED TO SIMILAR HEALTHCARE ORGANIZATIONS NATIONALLY. THE COMPENSATION CONSULTANT BENCHMARKS HENRY FORD HEALTH JACKSON HOSPITAL'S POSITIONS AGAINST DATA FROM MULTIPLE PUBLISHED SURVEYS OF HEALTH CARE EXECUTIVE COMPENSATION IN THE NATIONAL HEALTH CARE LABOR MARKET. BASED UPON THE CONSULTANTS RECOMMENDATIONS, THE EXECUTIVE COMPENSATION COMMITTEE MAKES A RECOMMENDATION TO THE BOARD OF TRUSTEES FOR APPROVAL OF THE EXECUTIVE COMPENSATION PROGRAM. ONLY INDEPENDENT TRUSTEES VOTE ON THIS RECOMMENDATION.
PART I, LINES 4A-B	4B. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN SUPPLEMENTAL RETIREMENT PROGRAMS THAT RESULT IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, AND/OR AS PAID. IT IS AN ELEMENT OF SOME PLAN DESIGNS TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. THE FOLLOWING PROVIDES THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS: PART I, LINES 4A: SEVERANCE PAYMENTS PAULA AUTRY $368,899 SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) - HENRY FORD HEALTH SYSTEM PARTICIPANT ACCRUAL DISTRIBUTION NON-VESTED REPORTABLE W-2 ROBERT G. RINEY 736,518 - - 736,518 ADNAN R. MUNKARAH, M.D. 359,641 - - - 359,641 DENISE BROOKS-WILLIAMS 229,220 - - 229,220 MICHAEL GRISDELA - - 51,137 - SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - HENRY FORD HEALTH SYSTEM EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2023 CONTR. 2023 CONTR. TAX GROSS-UP W-2 AMOUNTS ROBERT G. RINEY 22,500 - - 22,500 DENISE BROOKS-WILLIAMS 16,900 - - 16,900 ADNAN R. MUNKARAH, M.D. 22,500 - - 22,500 EMILY MOORHEAD 2,896 - - 2,896 MICHAEL GRISDELA 22,500 - - 22,500 KENNETH EMPEY 22,500 - - 22,500 SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - W.A. FOOTE MEMORIAL HOSPITAL EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2023 CONTR. 2023 CONTR. TAX GROSS-UP W-2 AMOUNTS FRANK LAMARCA, M.D. - 22,500 541 23,041 AZAM BASHEER, M.D - 14,700 354 15,054 MOHAN KULKARNI, M.D. 16,425 6,075 146 22,646 BIPIN RAVINDRAN, M.D. 12,239 10,260 247 22,746 TIMOTHY E. EKPO - 12,950 312 13,262 MUMTAZ MEMON, M.D. 16,550 5,950 143 22,643 LAWRENCE NARKIEWICZ, M.D. 19,700 2,800 67 22,567 EMILY MOORHEAD 900 - - 900 VISHAL GUPTA, M.D. - 14,700 354 15,054 SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) -W.A. FOOTE MEMORIAL HOSPITAL PARTICIPANT ACCRUAL DISTRIBUTION NON-VESTED REPORTABLE W-2 EMILY MOORHEAD - - 45,654 - TIMOTHY E. EKPO 22,822 - - 22,822 MARK A. SMITH 17,973 - - 17,973
PART I, LINE 7	COLUMN B(II) OF PART II, SCHEDULE J INCLUDES NON-FIXED PAYMENTS TO CERTAIN PHYSICIANS BASED ON THEIR PRODUCTIVITY AND OTHER PERFORMANCE METRICS.

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

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

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

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

Part II

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

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




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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990) 2023

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	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SEE BELOW				No

Part V

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

Return Reference	Explanation
SCHEDULE L. PART IV - BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS	(A) NAME OF PERSON: SUBSTANTIAL CONTRIBUTOR #12(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DONOR AS LISTED ON SCH. B(C) AMOUNT OF TRANSACTION $ 1,832,998(D) DESCRIPTION OF TRANSACTION: PROVIDED HEALTH CARE SERVICES(E) SHARING OF ORGANIZATION'S REVENUE? NO

Schedule L (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE CORPORATION IS ORGANIZED ON A MEMBERSHIP BASIS. THE SOLE CORPORATE MEMBER OF THE CORPORATION IS HENRY FORD ALLEGIANCE HEALTH GROUP (FORMERLY ALLEGIANCE HEALTH SERVICES).
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER OF THE ORGANIZATION MAY ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE CORPORATION'S TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE CORPORATE MEMBER OF THE CORPORATION IS HENRY FORD ALLEGIANCE HEALTH GROUP ("MEMBER"). THE MEMBER'S SOLE CORPORATE MEMBER IS HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH"). HF HEALTH SHALL HAVE THE SOLE AUTHORITY TO TAKE OR CAUSE TO BE TAKEN ANY OF THE FOLLOWING ACTIONS (THE "HF HEALTH'S RESERVED POWERS"). - APPOINT THE BOARD OF TRUSTEES, CHAIRPERSON, AND PRESIDENT OF THE CORPORATION AND THE OTHER SYSTEM ENTITIES - REMOVE THE BOARD OF TRUSTEES, CHAIRPERSON AND PRESIDENT OF THE CORPORATION AND THE OTHER SYSTEM ENTITIES - CHANGE THE CORPORATE MEMBER OF THE CORPORATION OR ANY SYSTEM ENTITY, PROVIDED SUCH ACTION SHALL HAVE BEEN APPROVED BY A VOTE OF THE MEMBER'S BOARD OF DIRECTORS; - AMEND THESE BYLAWS, THE CORPORATION'S ARTICLES OF INCORPORATION OR THE GOVERNING DOCUMENTS OF ANY SYSTEM ENTITY, PROVIDED (I) HF HEALTH FIRST CONSULTS WITH THE MEMBER'S BOARD OF DIRECTORS REGARDING THE PROPOSED AMENDMENT AND (II) THE AMENDMENT COMPLIES WITH ARTICLE XV OF THE BYLAWS REGARDING KEY SECTIONS; - APPROVE AN AGREEMENT OF (A) MERGER OR CONSOLIDATION OF THE CORPORATION OR ANY SYSTEM ENTITY, OR (B) SALE, LEASE, OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR ANY SYSTEM ENTITY, PROVIDED SUCH AGREEMENT SHALL HAVE BEEN APPROVED BY VOTE OF TWO-THIRDS OF THE MEMBER'S LOCAL DIRECTORS (AS DEFINED IN THE MEMBER'S BYLAWS) AND FURTHER PROVIDED THAT APPROVAL OF THE LOCAL DIRECTORS SHALL NOT BE REQUIRED WITH RESPECT TO (I) AN OVERALL AFFILIATION OR CHANGE IN OWNERSHIP OF HF HEALTH (INCLUDING THE SYSTEM) IF THE TERMS OF THAT TRANSACTION DO NOT VIOLATE THE KEY SECTIONS OR (II) A SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF HF HEALTH (INCLUDING THE ASSETS OF THE CORPORATION) TO A FOR-PROFIT ENTITY WHICH TRIGGERS APPLICATION OF THE TERMS OF SECTION 6.8(B) OF THE AFFILIATION AGREEMENT DATED MARCH 4, 2016 BETWEEN THE MEMBER (THEN KNOWN AS ALLEGIANCE HEALTH SERVICES) AND HF HEALTH, AS AMENDED FROM TIME TO TIME; - DISSOLVE THE CORPORATION OR ANY SYSTEM ENTITY OR REVOKE SUCH DISSOLUTION, PROVIDED SUCH ACTION SHALL HAVE BEEN APPROVED BY A VOTE OF THE MEMBER'S BOARD OF DIRECTORS; - RECEIVE FROM THE MEMBER STRATEGIC AND ANNUAL OPERATING PLANS AND ANNUAL OPERATING AND CAPITAL BUDGETS FOR THE SYSTEM ENTITIES, INCLUDING THE CORPORATION, THAT ARE DEVELOPED COLLABORATIVELY BY THE MEMBER'S AND HF HEALTH'S RESPECTIVE LEADERSHIP AND RECOMMENDED BY THE MEMBER'S BOARD OF DIRECTORS, AND ADOPT SUCH RECOMMENDED PLANS AND BUDGETS UNLESS AN UNUSUAL CIRCUMSTANCE ARISES IN WHICH HF HEALTH DETERMINES A CHANGE TO A PLAN OR BUDGET IS NECESSARY, AND APPROVE EXPENDITURES BY THE SYSTEM ENTITIES NOT INCLUDED IN SUCH BUDGETS OF AN ANNUAL AGGREGATE AMOUNT EXCEEDING $500,000. - CAUSE ANY SYSTEM ENTITY TO INCUR, ASSUME OR GUARANTY INDEBTEDNESS OR FULFILL OTHER OBLIGATIONS REQUIRED UNDER HF HEALTH DEBT AGREEMENTS, OR APPROVE INDEBTEDNESS OF THE SYSTEM ENTITIES IN AN ANNUAL AGGREGATE AMOUNT EXCEEDING $2,000,000 PROVIDED ALL INDEBTEDNESS SHALL COMPLY WITH HF HEALTH'S MASTER INDENTURE AND OTHER HF HEALTH CREDIT DOCUMENTS. - ENCUMBER THE ASSETS OF ANY SYSTEM ENTITY AS SECURITY FOR DEBTS OR OTHER LAWFUL ENGAGEMENTS SECURING INDEBTEDNESS, OR APPROVE ENCUMBRANCES SECURING INDEBTEDNESS OF THE SYSTEM ENTITIES IN AN ANNUAL AGGREGATE AMOUNT EXCEEDING $2,000,000 PROVIDED ALL ENCUMBRANCES SHALL COMPLY WITH HF HEALTH'S MASTER INDENTURE AND OTHER HF HEALTH CREDIT DOCUMENTS. - EXCHANGE, ABANDON OR DISPOSE OF FIXED ASSETS OF ANY SYSTEM ENTITY BY MEANS OF SALE, LEASE OR TRANSFER, AND APPROVE ALL SUCH ACTIONS PROPOSED BY THE SYSTEM ENTITIES WITH AN ANNUAL AGGREGATE VALUE IN EXCESS OF $2,000,000, PROVIDED SUCH ACTION SHALL HAVE BEEN APPROVED BY A VOTE OF THE MEMBER'S BOARD OF DIRECTORS. - AUTHORIZE THE FORMATION OR ACQUISITION OF NEW SUBSIDIARIES OF THE CORPORATION FOLLOWING CONSULTATION WITH THE MEMBER'S BOARD OF DIRECTORS. AS USED HEREIN, "INDEBTEDNESS" OF A PERSON SHALL MEAN: (A) OBLIGATIONS OF SUCH PERSON RELATING TO INDEBTEDNESS FOR BORROWED MONEY; (B) OBLIGATIONS OF SUCH PERSON EVIDENCED BY BONDS, NOTES, DEBENTURES OR SIMILAR INSTRUMENTS; AND (C) OBLIGATIONS IN THE NATURE OF GUARANTEES BY, OR JOINT AND SEVERAL LIABILITY OF, SUCH PERSON WITH RESPECT TO THE OBLIGATIONS OF ANY OTHER PERSON OF THE TYPE DESCRIBED IN CLAUSES (A) AND (B) ABOVE. RESPONSIBILITIES AND RESERVED POWERS OF THE MEMBER (HENRY FORD ALLEGIANCE HEALTH GROUP): IN ADDITION TO DOING ALL THINGS RESERVED TO THE MEMBER BY LAW AND WHICH ARE CONSISTENT WITH HF HEALTH'S RESERVED POWERS, THE MEMBER OF THE CORPORATION SHALL TAKE THE FOLLOWING ACTIONS WITH RESPECT TO THIS CORPORATION ("MEMBER'S RESERVED POWERS"): - ADOPT THE VISION, MISSION AND VALUES; AND - RATIFY OR REJECT OPERATING AND CAPITAL BUDGETS RECOMMENDED BY THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11B	THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH") AND THE TAX DEPARTMENT OF HF HEALTH PREPARES THE ORGANIZATION'S FORM 990. AS PART OF THE PREPARATION AND REVIEW PROCESS PRIOR TO FILING THE RETURN, THE FOLLOWING REVIEW PROCESS IS CONDUCTED: - REVIEW OF THE ENTIRE RETURN WITH THE HF HEALTH AND ORGANIZATION'S SENIOR VICE PRESIDENT FINANCIAL OPERATIONS, CHIEF FINANCIAL OFFICER, AND DIRECTOR OF ACCOUNTING. - REVIEW OF ALL COMPENSATION MATTERS AND DISCLOSURES WITH THE COMPENSATION COMMITTEE OF THE HF HEALTH BOARD OF DIRECTORS - REVIEW OF THE RETURN WITH THE HF HEALTH CEO AND AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS - FINAL COPIES OF THE RETURN ARE DISTRIBUTED TO THE HOSPITAL'S BOARD OF TRUSTEES BEFORE THE RETURN IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH (HF HEALTH) WHO OVERSEES THE CONFLICT OF INTEREST PROCESS WITH REGARD TO THE ORGANIZATION. HF HEALTH HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE HF HEALTH CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS AND EMPLOYEES. ANNUALLY, DIRECTORS, EMPLOYEES OF A MANAGEMENT LEVEL, RESEARCHERS, AS WELL AS EMPLOYEES ASSOCIATED WITH PROCUREMENT, OR IN CERTAIN OTHER PREDEFINED ROLES MUST COMPLETE AN ANNUAL DISCLOSURE DESIGNED TO IDENTIFY ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. IT IS THE RESPONSIBILITY OF THE COMMITTEE TO REVIEW THESE DISCLOSURES AND DETERMINE THE NEED FOR ANY ACTION TO MANAGE THE POTENTIAL CONFLICT. THE COMMITTEE ANNUALLY REPORTS THE RESULTS OF ITS ACTIVITIES TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE HF HEALTH BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH (HF HEALTH) WHO HAS RESPONSIBILITY TO OVERSEE THE COMPENSATION PRACTICES OF THE ORGANIZATION. HF HEALTH HAS A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS CONSISTING OF ALL EXTERNAL DIRECTORS. THEY MEET PERIODICALLY THROUGHOUT THE YEAR. THEY ARE CHARGED WITH APPROVAL OF THE ORGANIZATION'S OVERALL COMPENSATION AND BENEFIT PROGRAMS AS WELL AS THE SPECIFIC REVIEW AND APPROVAL OF THE COMPENSATION OF CERTAIN EMPLOYEES INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THEY DIRECTLY ENGAGE AN INDEPENDENT COMPENSATION ADVISOR TO ASSIST WITH THIS PROCESS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE, UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS, AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTH CARE ORGANIZATIONS. THE REASONABLENESS OF COMPENSATION IS EVALUATED BASED UPON THESE AND OTHER FACTORS. THE COMMITTEE ALSO REVIEWS THE COMPENSATION DISCLOSURES TO BE MADE ON FORM 990 IN ADVANCE OF FILING.
FORM 990, PART VI, SECTION C, LINE 19	IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION. AS A HOLDER OF TAX EXEMPT DEBT THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO A PUBLIC CLEARING HOUSE ON A QUARTERLY BASIS. PART IV, LINE 12 THE ORGANIZATION IS AN ELEMENT OF THE EXTERNAL AUDIT REPORT OBTAINED FOR THE CONSOLIDATED OPERATIONS OF HENRY FORD HEALTH. FORM 990, PART IV, LINE 24A, TAX-EXEMPT BOND ISSUE: THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH. THE ALLOCATED TAX-EXEMPT BOND LIABILITY OF THE ORGANIZATION IS REPORTED UNDER THE FORM 990, SCHEDULE K OF ITS PARENT, HENRY FORD HEALTH.
FORM 990, PART XI, LINE 9:	PENSION LIABILITY ADJUSTMENT -6,919,422.
FORM 990, PART XII, LINE 2C	HENRY FORD HEALTH JACKSON HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF HENRY FORD HEALTH (THE SOLE MEMBER OF HENRY FORD ALLEGIANCE HEALTH GROUP). THE GOVERNING BODY OF HENRY FORD HEALTH HAS DELEGATED THE OVERSIGHT OF ITS FINANCIAL STATEMENTS, INCLUDING THE CHOICE OF INDEPENDENT AUDITORS, TO ITS AUDIT COMMITTEE.
FORM 990, PART VII:	AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: MANY EXECUTIVE EMPLOYEES OF HENRY FORD HEALTH AND AFFILIATES PROVIDE SERVICES TO MULTIPLE AFFILIATED ENTITIES. HENRY FORD HEALTH AND AFFILIATES USE ESTIMATES FOR REPORTING AVERAGE HOURS PER WEEK IN ALL SECTIONS OF FORM 990. GENERALLY 60 HOURS ARE REPORTED FOR THE HOURS ASSOCIATED FOR THE ORGANIZATION THAT THE INDIVIDUAL HAS PRINCIPAL RESPONSIBILITY FOR. HOURS ASSOCIATED WITH OTHER HOSPITALS OR AFFILIATES ARE REPORTED AT BETWEEN 1 TO 5 HOURS PER WEEK.
FORM 990 DIVERSITY, EQUITY AND INCLUSION (DEIJ):	HENRY FORD HEALTH IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF MICHIGAN'S DIVERSE COMMUNITIES, WHILE SERVING AS ONE OF THE REGION'S LARGEST AND MOST DIVERSE EMPLOYERS. THE SYSTEM HAS STRENGTHENED ITS COMMITMENT TO DIVERSITY, EQUITY, INCLUSION AND JUSTICE (DEIJ) BY EMBEDDING SOCIAL JUSTICE PRINCIPLES IN EVERY ASPECT OF ITS OPERATION. BUILDING ON A TRADITION OF MORE THAN 100 YEARS OF EXCELLENCE IN HEALTHCARE, HENRY FORD RECOGNIZES THAT THERE ARE DISPROPORTIONATE NUMBERS OF UNDERREPRESENTED RACIAL AND ETHNIC POPULATIONS AFFECTED BY SERIOUS AND CHRONIC MEDICAL CONDITIONS. THE SYSTEM WORKS TO UNDERSTAND AND ADDRESS RACIAL AND ETHNIC HEALTH DISPARITIES BY SUPPORTING RESEARCH AND PROGRAMS CONDUCTED BY ITS RESEARCH AND POPULATION HEALTH TEAMS, HEALTH DISPARITIES RESEARCH COLLABORATIVE AND INSTITUTE ON MULTICULTURAL HEALTH. OPERATIONALLY, HENRY FORD IS DEVELOPING A FIVE-YEAR DEIJ STRATEGIC PLAN TO ENSURE THAT ITS WORKPLACE IS INCREASINGLY DIVERSE AND OFFERS GENUINE OPPORTUNITY, THAT IT SERVES A THRIVING COMMUNITY OFFERING QUALITY CARE IN CULTURALLY SENSITIVE WAYS, AND THAT IT COLLABORATES WITH A FLOURISHING BUSINESS COMMUNITY COMMITTED TO THE SAME PRINCIPLES. THIS MEANS THE SYSTEM WILL VALUE AND ENCOURAGE DIVERSITY IN ITS WORKFORCE; MANAGE AND MAINTAIN AN INVESTMENT PORTFOLIO THAT REFLECTS ITS VALUES; CREATE AND SUPPORT A DIVERSE SUPPLIER NETWORK; CULTIVATE VOLUNTEER LEADERSHIP THAT REFLECTS THE DIVERSE COMMUNITIES SERVED; ACTIVELY ADVOCATE FOR DEIJ AMONG ELECTED OFFICIALS, LAW ENFORCEMENT AND THE BUSINESS COMMUNITY; AND, CONSISTENTLY WORK TO IDENTIFY AND ELIMINATE RACIAL AND CULTURAL DISPARITIES IN HEALTH CARE.
FORM 990 SUSTAINABILITY:	ENVIRONMENTAL FACTORS IMPACT COMMUNITY HEALTH AND HENRY FORD HEALTH RECOGNIZES THAT AS A COMMUNITY PARTNER WE CAN INFLUENCE MANY OF THESE FACTORS. OUR SUSTAINABILITY GOALS ARE INTENDED TO SIMULTANEOUSLY REDUCE GREENHOUSE GAS EMISSIONS, REDRESS ENVIRONMENTAL INJUSTICES, AND IMPROVE THE HEALTH OF THE PATIENTS, EMPLOYEES, AND COMMUNITIES WE SERVE. HENRY FORD HEALTH HAS ESTABLISHED THE FOLLOWING SUSTAINABILITY GOALS TO BE ACHIEVED BY 2030: REDUCE GREENHOUSE GAS EMISSIONS FROM OPERATIONS BY 50%, TARGETING NET-ZERO BY 2040 ELIMINATE CHEMICALS OF CONCERN FROM PRIORITY PRODUCTS REDUCE WASTE SENT TO LANDFILL BY 50% MEET LOCAL OR SUSTAINABLE CRITERIA FOR 30% OF FOOD PURCHASES INCREASE ANNUAL INVESTMENT IN GREEN AND HEALTHY INFRASTRUCTURE
FORM 5713 - INTERNATIONAL BOYCOTT ACTIVITY:	A FORM 5713, INTERNATIONAL BOYCOTT REPORT, HAS BEEN FILED ON OUR BEHALF BY HENRY FORD HEALTH (SOLE MEMBER OF HENRY FORD ALLEGIANCE HEALTH GROUP). HENRY FORD HEALTH JACKSON HOSPITAL DID NOT ITSELF HAVE ANY ACTIVITIES ASSOCIATED WITH AN INTERNATIONAL BOYCOTT COUNTRY.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

WA FOOTE MEMORIAL HOSPITAL

Employer identification number

38-2027689

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
(1) PHYSICIANS CHOICE NETWORK LLC 205 N EAST AVENUE JACKSON,MI49201	PROVIDER NETWORK	MI	0	0	HENRY FORD ALLEGIANCE HEALTH
(2) HENRY FORD HEALTH CLINICALLY INTEGRATED NETWORK LLC 205 N EAST AVENUE JACKSON,MI49201 45-3253643	CLINICALLY INTEGRATED NETWORK	MI	4,317,782	6,359,331	HENRY FORD ALLEGIANCE HEALTH
(3) IT'S YOUR LIFE SERVICES LLC 205 N EAST AVENUE JACKSON,MI49201	PREVENTION AND COMMUNITY HEALTH	MI	0	0	HENRY FORD ALLEGIANCE HEALTH

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)HENRY FORD ALLEGIANCE HEALTH GROUP 205 N EAST AVENUE JACKSON,MI49201 38-2756428	EXEMPT ORGANIZATION	MI	501(C)(3)	LINE 12B, II	HENRY FORD HEALTH SYSTEM	Yes
(2)ALLEGIANCE HEALTH FOUNDATION 205 N EAST AVENUE JACKSON,MI49201 38-3607833	SUPPORTING ORGANIZATION	MI	501(C)(3)	LINE 12B, II	HENRY FORD ALLEGIANCE HEALTH GROUP	Yes
(3)HOSPICE OF JACKSON DBA ALLEGIANCE HOSPICE 205 N EAST AVENUE JACKSON,MI49201 38-2336367	HOSPICE CARE	MI	501(C)(3)	LINE 7	HEATHLINK	Yes
(4)HEALTHLINK 205 N EAST AVENUE JACKSON,MI49201 38-2756425	HOME HEALTH CARE	MI	501(C)(3)	LINE 12A, I	HENRY FORD ALLEGIANCE HEALTH GROUP	Yes
(5)CARELINK OF JACKSON 110 NORTH ELM AVENUE JACKSON,MI49202 38-1218485	LONG TERM ACUTE CARE HOSPITAL	MI	501(C)(3)	LINE 3	HENRY FORD ALLEGIANCE HEALTH GROUP	Yes
(6)HENRY FORD HEALTH SYSTEM ONE FORD PLACE DETROIT,MI48202 38-1357020	HEALTHCARE SERVICE PROVIDER	MI	501(C)(3)	LINE 3	N/A		No
(7)HENRY FORD WYANDOTTE HOSPITAL 2333 BIDDLE AVE WYANDOTTE,MI48192 38-2791823	HEALTHCARE SERVICE PROVIDER	MI	501(C)(3)	LINE 3	HENRY FORD HEALTH SYSTEM	Yes
(8)HENRY FORD HEALTH SYSTEM FOUNDATION ONE FORD PLACE DETROIT,MI48202 23-7383042	SUPPORTING ORGANIZATION	MI	501(C)(3)	LINE 12A, I	HENRY FORD HEALTH SYSTEM	Yes
(9)HEALTH ALLIANCE PLAN 3031 W GRAND BLVD DETROIT,MI48202 38-2242827	HEALTH MAINTENANCE ORGANIZATION	MI	501(C)(4)	N/A	HENRY FORD HEALTH SYSTEM	Yes
(10)HFII CORPORATION ONE FORD PLACE DETROIT,MI48202 90-0840304	SCIENTIFIC RESEARCH	MI	501(C)(3)	LINE 7	HENRY FORD HEALTH SYSTEM	Yes
(11)HENRY FORD HEALTH SYSTEM GOVERNMENT AFFAIRS SERVICES ONE FORD PLACE DETROIT,MI48202 46-4064067	ADVOCACY SERVICES FOR HF HEALTH AND AFFILIATES	ME	501(C)(4)	N/A	HENRY FORD HEALTH SYSTEM	Yes
(12)HENRY FORD MACOMB HOSPITAL CORPORATION ONE FORD PLACE DETROIT,MI48202 38-2947657	HEALTHCARE SERVICE PROVIDER	DE	501(C)(3)	LINE 3	HENRY FORD HEALTH SYSTEM	Yes
(13)THE CLARENCE S LIVINGOOD LECTURESHIP AND EDUCATION FUND 3031 WEST GRAND BOULEVARD NO 800 DETROIT,MI48202 38-2682321	SUPPORTING ORGANIZATION	MI	501(C)(3)	LINE 12B, II	HENRY FORD HEALTH SYSTEM	Yes
(14)HENRY FORD PHYSICIAN PARTNERS ONE FORD PLACE DETROIT,MI48202 87-1633901	PHYSICIAN SERVICES	MI	501(C)(3)		HENRY FORD HEALTH SYSTEM	Yes
(15)HENRY FORD HEALTH PARENT ONE FORD PLACE DETROIT,MI48202 93-4079536	SUPPORTING ORGANIZATION	MI	501(C)(3)	LINE 12B, II	HENRY FORD HEALTH SYSTEM	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) FOOTE HEALTH CENTER ASSOCIATES 1100 E MICHIGAN AVENUE JACKSON,MI49201 38-3017711	LESSOR OF MEDICAL CONDOMINIUMS	MI	HENRY FORD HEALTH JACKSON HOSPITAL	N/A	970,240	1,250,612		No			No	92.870 %
(2) NORTHWEST DETROIT DIALYSIS 30100 TELEGRAPH BINGHAM FARMS,MI48025 38-3232668	OPERATE DIALYSIS CLINIC	MI	HENRY FORD HEALTH SYSTEM	N/A				No			No
(3) MACOMB REGIONAL DIALYSIS CENTERS 16151 NINETEEN MILE RD CLINTON TOWNSHIP,MI48038 26-0423581	OPERATE DIALYSIS CLINIC	MI	HENRY FORD HEALTH SYSTEM	N/A				No			No
(4) HFHS-SCA HOLDINGS LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM,AL35209 46-5291602	OUTPATIENT SURGERY CLINICS	MI	HENRY FORD HEALTH SYSTEM	N/A				No			No
(5) HAP EMPOWERED HOLDING LLC 3031 WEST GRAND BOULEVARD DETROIT,MI48202 92-3877012	HOLDING COMPANY	DE	HEALTH ALLIANCE PLAN OF MICHIGAN	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?
(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	Yes	No
(1) HENRY FORD ALLEGIANCE PHARMACY 205 N EAST AVENUE JACKSON,MI49201 38-3370242	PHARMACY	MI	HENRY FORD ALLEGIANCE HEALTH GROUP	C				Yes
(2) SHA REALTY INC ONE FORD PLACE DETROIT,MI48202 38-1378121	REAL ESTATE HOLDING	MI	HENRY FORD HEALTH SYSTEM	C				Yes
(3) FAIRLANE HEALTH SERVICES 30100 TELEGRAPH BINGHAM FARMS,MI48025 38-2565235	HEALTHCARE MANAGEMENT	MI	HENRY FORD HEALTH SYSTEM	C				Yes
(4) ALLIANCE HEALTH AND LIFE INSURNACE 3031 W GRAND BLVD DETROIT,MI48202 38-3291563	HEALTH INSURANCE PROVIDER	MI	HEALTH ALLIANCE PLAN	C				Yes
(5) ONIKA INSURANCE LTD FIRST CARRIBEAN HOUSE GRAND CAYMAN CJ	CAPTIVE INSURANCE	CJ	HENRY FORD HEALTH SYSTEM	C				Yes
(6) HENRY FORD PHYSICIAN NETWORK ONE FORD PLACE DETROIT,MI48202 32-0306774	PHYSICIAN NETWORK	MI	HENRY FORD HEALTH SYSTEM	C				Yes
(7) ADMINSTRATION SYSTEMS RESEARCH CORPORATION 3031 W GRAND BLVD DETROIT,MI48202 38-2651185	THIRD PARTY INSURANCE ADMIN.	MI	HEALTH ALLIANCE PLAN	C				Yes
(8) HAP CARESOURCE 3031 W GRAND BLVD DETROIT,MI48202 38-3123777	HEALTH INSURANCE PROVIDER	MI	HEALTH ALLIANCE PLAN OF MICHIGAN	C				Yes
(9) HENRY FORD ELIJAH MCCOY CONDOMINIUM ASSOCIATION 1150 ELIJAH MCCOY DR DETROIT,MI48202 85-2144748	CONDOMINIUM ASSOCIATION	MI	HENRY FORD HEALTH SYSTEM	C				Yes

Schedule R (Form 990) 2023

Page 3

Part V

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

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

Yes

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

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

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

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

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

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

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

Yes

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ALLIANCE HEALTH AND LIFE INSURANCE CO	M	2,608,748	COST
(2) HENRY FORD ALLEGIANCE PHARMACY	Q	4,656,474	COST
(3) HENRY FORD HEALTH CLINICALLY INTEGRATED NETWORK LLC	S	10,288,813	COST
(4) COMMUNITY HEALTH TECH NETWORK	P	993,475	COST
(5) ONIKA INSURANCE LTD	P	2,563,284	COST
(6) FOOTE HEALTH CENTER ASSOCIATES	M	46,312	COST
(7) HEALTH ALLIANCE PLAN	L	7,485,894	COST
(8) FOOTE HEALTH CENTER ASSOCIATES	K	900,058	COST
(9) HOSPICE OF JACKSON DBA ALLEGIANCE HOSPICE	Q	1,689,653	COST
(10) CARELINK OF JACKSON	Q	129,044	COST

Schedule R (Form 990) 2023

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation
SCHEDULE R, PART V, LINE 1D & 1E:	THE ORGANIZATION IS A MEMBER OF THE HENRY FORD HEALTH SYSTEM OBLIGATED GROUP. MEMBERS OF THE OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR OUTSTANDING OBLIGATIONS ISSUED UNDER THE 2016, 2019 AND 2022 HFHS BOND MASTER INDENTURES.

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: WE IMPROVE PEOPLE'S LIVES THROUGH EXCELLENCE IN THE SCIENCE AND ART OF HEALTH CARE AND HEALING.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	4,574
6	Total number of volunteers (estimate if necessary) .............	6	88
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

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	10,833,229	6,099,123
9	Program service revenue (Part VIII, line 2g) .........	709,090,457	752,325,591
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	23,078,980	12,747,710
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	51,120,129	56,880,939
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	794,122,795	828,053,363
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	352,336	238,263
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)	353,933,964	368,700,695
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 80,915
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	410,304,273	415,171,053
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	764,590,573	784,110,011
19	Revenue less expenses. Subtract line 18 from line 12.......	29,532,222	43,943,352
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	762,216,405	807,404,458
21	Total liabilities (Part X, line 26).............	333,441,992	310,840,865
22	Net assets or fund balances. Subtract line 21 from line 20.....	428,774,413	496,563,593

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 726,494,843 including grants of $ 238,263 ) (Revenue $ 821,644,991 )
	FOR MORE THAN 100 YEARS, HENRY FORD HEALTH JACKSON HOSPITAL HAS SERVED A NINE-COUNTY EXPANSE OF SOUTH-CENTRAL MICHIGAN WITH A COMMITMENT TO CHARITABLE GIVING, OUTREACH AND BUILDING STRONGER, HEALTHIER INDIVIDUALS AND FAMILIES. THE 365 LICENSED BED ACUTE CARE HOSPITAL AND LEVEL II TRAUMA CENTER OFFERS A FULL RANGE OF CLINICAL SERVICES, INCLUDING GENERAL MEDICINE, SURGERY, BIRTHING CENTER AND 24-HOUR EMERGENCY CARE. HENRY FORD HEALTH JACKSON HOSPITAL ALSO PROVIDES PHYSICAL MEDICINE AND REHAB, CARDIAC, CANCER AND NEUROSURGICAL SERVICES. DURING 2023, HENRY FORD HEALTH JACKSON HOSPITAL HAD 16,276 DISCHARGES.WITH A SENSE OF HUMAN COMPASSION, WE GIVE, ORGANIZE, LEAD, PARTNER AND EMBRACE THE WIDE-RANGING COMMUNITY PROGRAMS AND SERVICES. IN GIVING BACK TO THE CULTURE AND PEOPLE THAT SURROUND US, WE GAIN FULFILLMENT IN KNOWING WE HAVE INVESTED IN THE HEALTH AND WELL-BEING OF THE COMMUNITY WHICH WE SERVE. ESTABLISHED IN 1918, OUR COMMITMENT TO THE COMMUNITY IS TO LEAD THEM TO BETTER HEALTH AND WELL-BEING AT EVERY STAGE OF LIFE. SERVING SOUTH CENTRAL MICHIGAN, HENRY FORD HEALTH JACKSON HOSPITAL IS THE LARGEST EMPLOYER IN JACKSON COUNTY. THE CORONAVIRUS IMPACT WITH AN ESTABLISHED RESEARCH STRUCTURE AND ACCESS TO A DIVERSE PATIENT COMMUNITY, HENRY FORD WAS ABLE TO ACT IMMEDIATELY WHEN THE CORONAVIRUS PANDEMIC STRUCK. HENRY FORD UTILIZED EMERGENCY-USE AUTHORIZATIONS FROM THE FDA TO TREAT AND TRACK COVID-19 PATIENTS, CREATING AND MONITORING DATABASE REGISTRIES TO INFORM FUTURE CLINICAL TREATMENT. HENRY FORD RESEARCHERS INITIATED AND CONTINUE TO LEAD A COLLABORATIVE REGISTRY THAT INCLUDES NEARLY ALL COVID INPATIENTS AND TREATMENT-RELATED OUTCOME DATA FROM DETROIT-AREA HOSPITALS. MEDICAL EDUCATION:HENRY FORD HEALTH JACKSON HOSPITAL HAS AN OSTEOPATHIC GRADUATE MEDICAL EDUCATION PROGRAM, OFFERING ROTATIONS TO RESIDENTS, INTERNS AND THIRD-AND-FOUTH-YEAR MEDICAL STUDENTS.HENRY FORD HEALTH JACKSON HOSPITAL TRAINS 35 MEDICAL STUDENTS AND 166 RESIDENTS IN 6 PROGRAMS.A NATIONAL LEADER IN FORMING COMMUNITY PARTNERSHIPS, HENRY FORD HEALTH JACKSON HOSPITAL PROMOTES WELLNESS AND PREVENTION THROUGH OUR HEALTH IMPROVEMENT ORGANIZATION.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	HENRY FORD HEALTH JACKSON HOSPITAL PROVIDES OUTPATIENT SERVICES AT APPROXIMATELY 50 LOCATIONS THROUGHOUT SOUTH CENTRAL MICHIGAN. IN TOTAL THIS REPRESENTED 1,299,789 TOTAL OUTPATIENT FACILITY VISITS DURING 2023.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	HENRY FORD HEALTH JACKSON HOSPITAL OPERATES A 24 HOUR EMERGENCY DEPARTMENT. EMERGENCY SERVICES REPRESENTED 72,801 PATIENT VISITS DURING 2023.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses726,494,843

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W-2/1099-MISC/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
(A) Name and title
(18) KENNETH W EMPEY........................................................................ GENERAL COUNSEL	55.00 .......................5.00	X			0	370,666	21,238
(19) JIM BONGIORNO........................................................................ CENTRAL MARKET CFO (THRU 12/2023)	55.00 .......................5.00	X			0	262,407	43,971
(20) MARK A SMITH MD........................................................................ CMO/CEO HFAHMG	55.00 .......................5.00	X			584,228	0	54,648
(21) AZAM BASHEER MD........................................................................ PHYSICIAN	60.00 .......................0.00		X		2,720,795	0	36,934
(22) FRANK LAMARCA MD........................................................................ PHYSICIAN	60.00 .......................0.00		X		2,687,592	0	38,700
(23) VISHAL GUPTA MD........................................................................ PHYSICIAN	60.00 .......................0.00		X		1,228,109	0	25,581
(24) BIPIN RAVINDRAN MD........................................................................ PHYSICIAN	60.00 .......................0.00		X		1,047,805	0	8,793
(25) TIMOTHY EPHRIAM EKPO DO........................................................................ PHYSICIAN	60.00 .......................0.00		X		1,012,888	0	34,462
(26) PAULA AUTRY........................................................................ FORMER TRUSTEE - PRESIDENT & CEO	0.00 .......................0.00			X	0	368,899	0
(27) ROBERT G RINEY........................................................................ FORMER TRUSTEE	0.00 .......................65.00			X	0	4,467,923	57,039
(28) MICHAEL GRISDELA........................................................................ FORMER INTERIM CENTRAL MAR	0.00 .......................60.00			X	0	552,185	89,619

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	12,183,796	10,090,773	706,185

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	130,091
d	Related organizations		1d
e	Government grants (contributions)		1e	3,567,344

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,401,688

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

h Total. Add lines 1a-1f.......		6,099,123

		Business Code
2a	PATIENT SERVICES	621990	752,325,591	752,325,591
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		752,325,591

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,199,579	3,199,579
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	272,023
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	272,023
d	Net rental income or (loss).......			272,023			272,023
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	124,083,297	217,570
b	Less: cost or other basis and sales expenses	7b	114,616,211	136,525
c	Gain or (loss)	7c	9,467,086	81,045
d	Net gain or (loss).........			9,548,131	9,467,086		81,045
8a	Gross income from fundraising events (not including $ 130,091of contributions reported on line 1c). See Part IV, line 18 ....
			8a	20,159
b	Less: direct expenses ...		8b	94,880
c	Net income or (loss) from fundraising events..			-74,721			-74,721
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	42,720
b	Less: direct expenses ...		9b	11,818
c	Net income or (loss) from gaming activities..			30,902			30,902
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..

Business Code
11a	CONTRACTED PHARMACY REVENUE		621110	50,103,194	50,103,194
b	CAFETERIA		900099	2,185,787	2,185,787
c	JHN		621990	1,606,588	1,606,588
d	All other revenue ....			2,757,166	2,757,166
e	Total. Add lines 11a–11d ......			56,652,735
12	Total revenue. See instructions.....			828,053,363	821,644,991	0	309,249

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	164,152	164,152
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	74,111	74,111
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 ...........	4,011,814	3,327,494	635,483	48,837
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	368,900	184,450	166,005	18,445
7	Other salaries and wages........	302,200,563	280,896,041	21,304,522
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	5,991,222	5,557,911	431,996	1,315
9	Other employee benefits .......	36,583,582	33,937,698	2,637,855	8,029
10	Payroll taxes ...........	19,544,614	18,131,063	1,409,262	4,289
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	-2,357	75	-2,432
c	Accounting ...........
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)	61,114,492	57,017,525	4,096,967
12	Advertising and promotion ....	808,082	104,132	703,950
13	Office expenses .......	11,376,456	7,624,286	3,752,170
14	Information technology ......	1,864,781	1,552,666	312,115
15	Royalties ..
16	Occupancy ...........	6,899,437	3,351,410	3,548,027
17	Travel ............	537,605	455,623	81,982
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,010,451	974,368	36,083
20	Interest ...........	6,335,389	6,334,656	733
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	26,108,643	19,419,274	6,689,369
23	Insurance ...	5,894,732	5,894,732
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	81,744,898	81,951,349	-206,451
b	CORP OFFICE ALLOCATION	78,932,854	78,932,854	0
c	PHARMACEUTICAL SUPPLIES	69,550,113	69,429,577	120,536
d	QUAAP TAX	18,895,349	18,895,349	0
e	All other expenses	44,100,128	32,284,047	11,816,081
25	Total functional expenses. Add lines 1 through 24e	784,110,011	726,494,843	57,534,253	80,915
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			178,909	1	248,476
2	Savings and temporary cash investments .........			52,930,307	2	71,829,973
3	Pledges and grants receivable, net ......			2,011,000	3	2,011,000
4	Accounts receivable, net .............			115,951,683	4	114,313,913
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 ............			16,461,895	8	17,789,070
9	Prepaid expenses and deferred charges ......			2,880,388	9	2,927,801
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	400,402,062
b	Less: accumulated depreciation	10b	203,106,780	211,908,905	10c	197,295,282
11	Investments—publicly traded securities .			326,853,923	11	365,421,425
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			6,163,830	13	6,479,617
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			26,875,565	15	29,087,901
16	Total assets. Add lines 1 through 15 (must equal line 33)...			762,216,405	16	807,404,458

17	Accounts payable and accrued expenses .....	104,675,171	17	83,043,370
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	139,373,205	20	135,702,488
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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	89,393,616	25	92,095,007
26	Total liabilities. Add lines 17 through 25..	333,441,992	26	310,840,865

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	423,437,020	27	490,615,729
28	Net assets with donor restrictions ...........	5,337,393	28	5,947,864
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	428,774,413	32	496,563,593
33	Total liabilities and net assets/fund balances ........	762,216,405	33	807,404,458