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) David Gossage...................................................................... Vice Chair	1.5 .................	X	X		0	0
(2) Gregory Bailey...................................................................... Chair	1.5 .................	X	X		0	0
(3) Richard Moore...................................................................... Treasurer	1.5 .................	X	X		0	0
(4) Robert Henthorne...................................................................... SECRETARY	10.0 .................	X	X		24,000	0
(5) Craig Connor...................................................................... Board Member	1.5 .................	X			0	0
(6) Diane Philipp...................................................................... Board Member	1.5 .................	X			0	0
(7) Karlye Horton...................................................................... Board Member	1.5 .................	X			0	0
(8) Kimberly Blythe...................................................................... Board Member	1.5 .................	X			0	0
(9) Shea Dow...................................................................... Board Member	1.5 .................	X			0	0
(10) Susan Smith...................................................................... Board Member	1.5 .................	X			0	0
(11) Jeremiah J Hodshire...................................................................... President/CEO	40.0 .................		X		602,813	54,975
(12) Mark Gross...................................................................... Vice President/CFO	40.0 .................		X		461,500	58,425
(13) Nichole Ellis...................................................................... Chief of Staff (Ex Oficio)	1.5 .................		X		0	0
(14) Brian Sinischo...................................................................... OBGYN	40.0 .................			X	510,869	18,101
(15) John Anderson...................................................................... Orthopedic Surgeon	40.0 .................			X	567,453	12,472
(16) Norris March...................................................................... General Suregon	40.0 .................			X	599,360	15,542
(17) Parthiv Patel...................................................................... Orthopedic Surgeon	40.0 .................			X	845,775	19,925

(A) Name and business address	(B) Description of services	(C) Compensation
MI Emergency Physicians LLP PO Box 677979 Dallas,TX752677979	Emergency Physicians	2,191,078
Healthpro Heritage LLC PO Box 69268 Baltimore,MD212649268	Therapy Services	1,830,447
Anesthesia Staffing Consultants PO Box 226804 Dallas,TX752226804	Anesthesia Services	1,486,698
Sparrow Hospital 1322 E Michigan Ave Lansing,MI48912	Reference Lab	1,229,968
Forvis PO Box 200870 Dallas,TX753200870	Consulting	1,010,598
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 31

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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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

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:	23017437
Software Version:	2023v6.0

- 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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

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 HILLSDALE COMMUNITY HEALTH CENTER

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
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 HILLSDALE COMMUNITY HEALTH CENTER		Employer identification number 38-6005550

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 HILLSDALE COMMUNITY HEALTH CENTER			Employer identification number 38-6005550
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:	23017437
Software Version:	2023v6.0

- 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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

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

3,000

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

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

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

3,000

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	HILLSDALE COMMUNITY HEALTH CENTER PAID MEMBERSHIP DUES TO THE MICHIGAN HOSPITAL ASSOCIATION, WHICH INCLUDED A PERCENTAGE THAT WAS ATTRIBUTED TO LOBBYING EXPENSES.

Schedule C (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- 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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

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

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

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

1a	Land .....	95,000		95,000
b	Buildings ....	5,336,880	508,591	4,828,289
c	Leasehold improvements	19,790		19,790
d	Equipment ....	10,529,295	7,506,897	3,022,398
e	Other .....	107,428		107,428
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				8,072,905

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)OTHER				2,092,042
(2)ASSETS LIMITED AS TO USE				2,461,556
(3)DUE FROM THIRD PARTY PAYER				859,834
(4)RIGHT OF USE ASSETS				477,716
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				5,891,148

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
COST REPORT SETTLEMENTS	10,702,440








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	10,702,440
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	90,046,769
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	591,382
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d	59,954
e	Add lines 2a through 2d .....................			2e	651,336
3	Subtract line 2e from line 1..................			3	89,395,433
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	156,129
b	Other (Describe in Part XIII.) ...........	4b	4,247,727
c	Add lines 4a and 4b....................			4c	4,403,856
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	93,799,289

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	86,372,072
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	59,954
e	Add lines 2a through 2d....................			2e	59,954
3	Subtract line 2e from line 1...................			3	86,312,118
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	156,129
b	Other (Describe in Part XIII.) ...........	4b	4,247,727
c	Add lines 4a and 4b.....................			4c	4,403,856
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	90,715,974

Part XIII

Supplemental Information

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

Return Reference	Explanation
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990	RENTAL EXPENSES - 59954
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements	PROVISION FOR UNCOLLECTIBLE ACCOUNTS - 4247727
Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990	RENTAL EXPENSES - 59954
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements	PROVISION FOR UNCOLLECTIBLE ACCOUNTS - 4247727

Schedule D (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- 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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			442,912	0	442,912	0.51 %
b	Medicaid (from Worksheet 3, column a) . . . . .			19,761,091	23,009,716	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			14,393,816	9,187,507	5,206,309	6.02 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	34,597,819	32,197,223	5,649,221	6.53 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	3	435	5,694	0	5,694	0.01 %
f	Health professions education (from Worksheet 5) . . .			137,160	15,689	121,471	0.14 %
g	Subsidized health services (from Worksheet 6) . . . .			0	0	0	0 %
h	Research (from Worksheet 7) .			0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			43,726	5,000	38,726	0.04 %
j	Total. Other Benefits . .	3	435	186,580	20,689	165,891	0.19 %
k	Total. Add lines 7d and 7j .	3	435	34,784,399	32,217,912	5,815,112	6.73 %

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					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	0	0	0	0	0	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

4,247,727

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

1,518,859

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).....

25,936,076

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

32,738,731

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

-6,802,655

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 %
1
2
3
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)					Other (describe)
1	Hillsdale Community Health Center 168 S Howell St Hillsdale,MI49242 www.hillsdalehospital.com	X	X	X	Inpatient Psych Unit; Skilled Nursing Facility

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)

	Hillsdale Community Health Center
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

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

Yes

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

Yes

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

Hospital facility’s website (list url): WWW.HILLSDALEHOSPITAL.COM

Other website (list url):

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

Other (describe in Section C)

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

Yes

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

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

Yes

If "Yes" (list url): WWW.HILLSDALEHOSPITAL.COM

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Hillsdale Community Health Center
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.0%
and FPG family income limit for eligibility for discounted care of 300.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

www.hillsdalehospital.com

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

www.hillsdalehospital.com

A plain language summary of the FAP was widely available on a website (list url):
www.hillsdalehospital.com

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

	Hillsdale Community Health Center
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

	Hillsdale Community Health Center
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Hillsdale Community Health Center. THE PRIMARY DATA FOR THE ASSESSMENT CONSISTED OF A HEALTH SURVEY OF THE GENERAL COUNTY POPULATION AND AN OPEN FORUM OF HUMAN SERVICES NETWORK MEMBERS. THE HEALTH SURVEY QUESTIONNAIRE WAS DESIGNED TO CREATE A PROFILE OF THE RESPONDENTS, THEIR HEALTH NEEDS, AND VIEWS ON COMMUNITY HEALTH-RELATED ISSUES. ALL RESIDENTS OF THE COUNTY WERE INVITED TO PARTICIPATE IN THE SURVEY THROUGH A WIDE-REACHING INFORMATION CAMPAIGN THAT CONSISTED OF INFORMATIONAL ADS IN THE LOCAL NEWSPAPER, THE LOCAL RADIO STATION, PAPER MAILINGS, THE HOSPITAL WEBSITE, AND PERSONAL REQUESTS BY HOSPITAL VOLUNTEERS. AS A RESULT OF THE CAMPAIGN, 723 INDIVIDUALS COMPLETED THE HEALTH SURVEY QUESTIONNAIRE (1,200 IN 2019). SECONDARY DATA WAS COLLECTED FROM A VARIETY OF COUNTY, STATE, AND FEDERAL SOURCES SUCH AS THE US CENSUS BUREAU, MICHIGAN LABOR AND EDUCATION DEPARTMENTS, MICHIGAN DEPARTMENT OF VITAL STATISTICS, MICHIGAN BEHAVIOR RISK FACTOR SURVEY, AND KIDS COUNT IN MICHIGAN.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - Hillsdale Community Health Center. HILLSDALE HOSPITAL PARTNERED WITH THE HILLSDALE COUNTY HUMAN SERVICES NETWORK TO CREATE A COMPREHENSIVE COMMUNITY BASED HEALTH NEEDS ASSESSMENT. HILLSDALE HOSPITAL HIRED AN INDEPENDENT CONTRACTOR TO HELP DESIGN THE SURVEY, ANALYZE THE DATA, FACILITATE DISCUSSIONS, AND CREATE THE FINAL REPORT.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - HILLSDALE COMMUNITY HEALTH CENTER. 1. Recommendation from Human Services Network (HSN): Recruiting more professionals in the fields of cardiology, oncology, geriatrics and ENT. Background: Health Professional Shortage Areas (HPSA) designations identify areas, population groups, or facilities within the United States that are experiencing a shortage of health care professionals. Geographic HPSAs have a shortage of services for the entire population within an established geographic area. Hillsdale County has such a determination for the entire county. Hillsdale is designated as a Health Professional Shortage Area by the Federal government for Primary Care, Dental Care and Behavioral Health. Hillsdale Hospital was able to recruit an ENT several years ago, but this provider subsequently left Hillsdale due to lack of sufficient demand (2012-14). In addition, Hillsdale Hospital had oncology service with Dr. Shen for several years, but Dr. Shen subsequently left and his role has been difficult if not impossible to fill. The hospital has looked at several contractual alternatives since his departure, but has not yet been successful in bringing this much needed service back to the county. The leading causes of death in Hillsdale County (reported as a 2018 to 2020 three year average) was heart disease - greater than the next 7 leading causes, combined. Hillsdale County has always had a shortage of cardiology services and that continues. The Hospital has had a collaborative relationship with Ascension Borgess Hospital for cardiology services and we will continue to attempt to bolster this service to meet the demands of our community. We currently have one Cardiology provider for Hillsdale (Dr. Owusu). It will be the intention of the Hospital to actively recruit for this service line in an attempt to fill this important need within the County going forward. There are opportunities to accomplish this via both staffed as well as tele-health alternatives. In addition to the shortage of Primary Care and specialty care in Hillsdale County, the number of geriatricians per 10,000 adults older than 65 years of age has decreased steadily since 2000. Action Plan - Cardiology: The Hospital has had a collaborative relationship with Ascension Borgess Hospital for cardiology services and we will continue to attempt to bolster this service to meet the demands of our community. We currently have one Cardiology provider for Hillsdale (Dr. Owusu). It will be the intention of the Hospital to actively recruit for this service line i-n an attempt to fill this important need within the County going forward. There are opportunities to accomplish this via both staffed as well as tele-health alternatives. Oncology - Hillsdale Hospital currently has a NDA with West Michigan Cancer Center and an affiliation agreement for Oncology services with Ascension Borgess. Unfortunately, there are no oncologist to recruit to Michigan and Ascension is down 4, limiting their ability to come to Hillsdale at this time. Right now, the relationship is going to be a virtual option (telehealth) at our Three Meadows facility until we can get one here very part-time. Gerontology: Geriatricians are fully trained medical doctors. After graduating from medical school, completing residency requirements, and becoming state-licensed to practice medicine, doctors who want to specialize in geriatric medicine must become board-certified in internal medicine or family medicine. Attracting and retaining such specialists in today's market is increasingly difficult. Hillsdale County is extremely fortunate to have 2 such specialist residing and working in our community at this point in time. Fortunate in that, by most estimates, a population the size of Hillsdale County, with a senior population currently at about 20%, we are projected to need between 1.4 and 1.6 FTE gerontology specialists to serve our community. So while we currently appear to have sufficient specialty care in this area, we have two issues of concern. First, the senior population is growing and is currently 4% larger, by percentage, than the senior population in Michigan. In addition, the median age of Hillsdale County residents is nearly 3 years older than that of Michigan, so as time marches on, there will be a larger and larger percentage of seniors who will need care. In addition, providers, believe it or not, are subject to the hands of time as well. We already know we will need to replace one of our two Geriatric specialists within the next 3-5 years. Hillsdale Hospital will be actively seeking providers with this specialty in the coming years so we can 1. Recruit the necessary skills and 2. Attract and retain these professionals as our population will demand it in the coming years. Second, and perhaps as important, it was noted during our community session for this current CHNA, there were many/most of the membership of the Human Service Network that were NOT aware we had Gerontology specialists in our community. The hospital is also firmly committed to engage in a marketing campaign, so that providers as well as our community are fully aware that we have this specialty available for referral and will work hard to maintain and even grow this capacity. ENT - Hillsdale Hospital is proud to announce that at the time of the presenting of this Action Plan to the Board, we will already have and be utilizing the services of an ENT. She will be beginning to service patients in Hillsdale beginning June 9, 2022 on a limited basis, with a potential for increasing availability if demand warrants it.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - HILLSDALE COMMUNITY HEALTH CENTER. 2. Recommendation from HSN: Encourage physicians to take more Medicaid patients, especially in the pediatric field. Background: Hillsdale County has a large number of people living at or near poverty level, and the number is growing. A complete look at the various types of health insurance used by Hillsdale County citizens can be seen using U.S. Census data (below). In addition, hospital data shows that 23% of patients pay for Hospital services utilizing Medicaid. It is a significant payment source in Hillsdale County given the level of poverty within the county. Medicaid also the payment source for approximately 48% of all births within the County. Having sufficient providers who accept Medicaid as a source of payment for patients is critical in providing quality healthcare to our citizens. As such, it was discussed that many providers only accept a small percentage of patients within their panel of patients who are insured by Medicaid. The Collaborative strongly encouraged the Hospital to encourage all providers increase this percentage so that more patients can have access to care. Insurance Types - % of Hillsdale County (Source: US Census) Medicare 15% VA 2% Uninsured 6% Employer based 45% Medicaid 20% Other 12% A poverty level of 100% in the U.S. was defined in 2021 as an annual income of: - $14,097 for one person under age 65. - $12,996 for one person aged 65 or older. - $27,479 for a family of two adults and two children. Hillsdale County has a higher percentage of people below poverty level than Michigan or the United States. Our Survey showed a high degree of concern among those responding to the issue of respondents in the 2022 CHNA survey were asked if they were very concerned, moderately concerned, or not at all concerned about poverty in the community. Of the 683 people who answered this question: - 324 (47.4%) said they were very concerned. - 290 (42.5%) were moderately concerned. A recent study by researchers from the US Bureau of Economic Analysis, the University of Chicago, and the Federal Reserve Bank in San Francisco found providers run into more obstacles when trying to bill Medicaid than they do with other insurers, and that these administrative hurdles explain the access problems experienced by Medicaid patients as much as the program's payment rates. Medicaid payment rates, the amount doctors receive for providing services, are on average lower than Medicare or private coverage. This has typically been used to explain why many physicians are reluctant to take Medicaid and why some Medicaid recipients still struggle to access care. That is on top of the other health challenges that people with lower incomes face. Usually, the access problem is seen as caused by the prices paid by Medicaid. And Medicaid does pay less than the other major insurers: Based on its own data, the average initial claim filed is $98 for Medicaid patients, whereas Medicare averages $137 and private insurers average $180. Action Plan: For many low-income people in the US, getting insured isn't enough to get health access to health care: Patients with Medicaid can struggle to find a doctor willing to take their health insurance. And this happens in large part because, for doctors and providers, billing Medicaid is a challenge. The Hospital can assist the community in the area, as we have Rural Health Centers who take all patients regardless of their ability to pay, and all Hospital owned PCP's also take Medicaid as payment in full. As for our community providers, the Hospital is fully aware that doctors' offices are businesses in addition to healthcare providers, and it's not surprising that they would make participation decisions based not only on how much they get paid, but also on the hassle of doing business with different insurers. They need to make sufficient margin to stay in business. The existing 'rule of thumb' for providers is 80/20, for Medicaid vs. other forms of insurance. Hopefully with the Hospital providing more primary care than ever, and the potential for that to increase over time, there will be sufficient provider capacity to serve this population and this gap. It is the intention of the hospital to provide access to care for as many patients as we serve, providing a variety of options (RHC, Walk in care, PCP care, multiple clinics, ER care).
Schedule H, Part V, Section B, Line 11 Facility , 3	Facility , 3 - HILLSDALE COMMUNITY HEALTH CENTER. 3. Recommendation from HSN: Coordinate the existing pain clinic with Prevention Works. Background: According to the Centers for Disease Control and Prevention, "In 2019, nearly 50,000 people in the United States died from opioid-involved overdoses. The misuse of and addiction to opioids-including prescription pain relievers, heroin, and synthetic opioids such as fentanyl-is a serious national crisis." Opioids work in the nervous system or on specific receptors in the brain to reduce the intensity of pain. Overdose deaths from opioids include those from prescription opioids, heroin, and synthetic opioids like fentanyl. Although prescriptions for opioids account for only some of the drug overdose deaths, the Centers for Disease Control and Prevention has been tracking the prescription dispensing rate per 100 persons over the past years. The rate has been much higher in Michigan than the United States for the years 2018-20 but Hillsdale County rates are lower than both Michigan and the United States rates for 2019 & 2020. The HSN members pointed out that physicians are often "hamstrung" by the government in prescribing pain management drugs. There is a large amount of paperwork needed to be filed on a regular basis for providers to continue to write prescriptions for opioids. Many providers would prefer to refer patients needing opioids for pain management to certified pain management clinics. Pain management clinics should include a mental health component since behavioral modifications can sometimes reduce the need for medications. The HSN members recommended a coordination between Hillsdale Hospital and Prevention Works. Action Plan: The Prevention Works Coalition has been operational in Hillsdale County since the summer of 2007, and currently has seventeen (17) active members. There is representation from law enforcement, human service providers, government, media, SUD treatment, and concerned citizens. Coalition members provide strong linkages across the county and region, with members serving on the local multi-purpose collaborative body (Human Services Network - HSN), CAN council (Child Abuse Prevention and Awareness - CAPA), Family Treatment Court advisory council, 4H groups, and many service clubs, churches, and other organizations. The Coalition staff are active on Tobacco Reduction Action Coalition (TRAC), Coordinated School Health Council, HSN and the HSN Indicators workgroup, C3 (domestic violence community coalition), Hillsdale Community Schools board of education, and the Alpha-Omega Women's Care Center board. This involvement in multiple sectors of the community helps the Coalition to network. Prevention Works seeks to partner with others to continue to expand our prevention efforts in Hillsdale County. That said, Hillsdale Hospital will reach out to Prevention Works to attempt to coordinate our efforts with our existing pain clinic and other services that could benefit or be synergized by collaboration with Prevention Works. The hospital will actively participate with Prevention Works over the next 3 years to assure services are maximized for our patients and coordinated with other providers of care within the County.
Schedule H, Part V, Section B, Line 11 Facility , 4	Facility , 4 - HILLSDALE COMMUNITY HEALTH CENTER. 4. Recommendation from HSN: Address the issue of inadequate prenatal care by creating partnerships with the Branch-Hillsdale-St. Joseph Community Health Agency's WIC program as well as the prenatal care initiatives headed by Great Start. Background: Prenatal care is reported based on the Kessner Index (The Kessner Index is a classification of prenatal care based on the month of pregnancy in which prenatal care began, the number of prenatal visits and the length of pregnancy; i.e. for shorter pregnancies, fewer prenatal visits constitute adequate care). Among the 1,501 births to Hillsdale County residents between 2018-20: - 53.3% of the mothers received adequate prenatal care compared to 67.8% in Michigan. - 35.9% of mothers received intermediate care compared to 23.4% in Michigan. - 10.8% had inadequate care compared to 8.8% in Michigan. Hillsdale Hospital offers a fully equipped birthing center. Not all births to Hillsdale County residents occurred at Hillsdale Hospital, but some out-of-county residents also used the hospital facility. The HSN members were very concerned about the lack of adequate pre-natal care for area moms. One member said the county was the second county in the state of Michigan for inadequate care last year. Several factors that prohibited adequate pre-natal care were discussed including: - Transportation issues, especially for teen moms. - Cultural issues. Some said their moms didn't need early pre-natal care and therefore they did not feel the need for it. - Drug use. Moms using drugs may be reluctant to seek care, concerned about being reported to protective services for abuse of their unborn child. The law in Michigan currently prohibits protective services to intervene until and unless the child is born with drug addiction problems, so this concern may be less than expectant mothers believe. The Branch-Hillsdale-St. Joseph Community Health Agency oversees the WIC Program in Hillsdale County. They have found that younger moms may not be aware of the availability of this program and the requirements necessary to access services. Linking moms on WIC to adequate pre-natal care is sometimes a challenge but HSN members recommended better coordination between the Agency and the OB/GYN area providers. Members also recommended the OB/GYN providers collaborate with Great Start on linking new moms and mother's to be with WIC and other pre-natal and early childhood programs. Action Plan: Actions plans on this longstanding issue in Hillsdale County will come from two sources. First, OB Nursing Management will actively reach out to both the Branch-Hillsdale-St. Joseph Community Health Agency to seek opportunities to collaborate and expand the services provided by WIC for women in Hillsdale County. Additionally, OB Nursing Management will reach out to the Great Start Collaborative to increase the Hospital's presence with this organization to attempt to better serve our patients and their families. Great Start, whose mission is to assure a coordinated system of community resources to assist all Hillsdale County families in providing a great start for their children prenatal through third grade, will be an excellent opportunity for the Hospital to collaborate in this endeavor to assure we are providing the best, coordinated care possible for Hillsdale County moms. In addition to reaching out to community groups to better coordinate care and services, our physician providers here at the Hospital have committed to the following initiatives: 1. Education- improving our patients understanding of risks of obesity, smoking, diabetes etc. Coordinating programs and/or education material will assist in increasing the quality of care we can provide. 2. Centering pregnancy- this is a preset program that groups patients by gestational age and allows them to go through their pregnancy together. Dr. Sinischo (OB/GYN) truly believe this would be an amazing opportunity for our community to access this initiative. The Hospital may need to explore sources of funding and possible grants to afford this. This program gives patients control of their health and educates in important ways. This program has been shown to decrease morbidity and mortality proven through proven research. 3. Providing Mental health professional for needed out-patient care. The hospital is currently positioning to begin the process of providing limited outpatient mental health services in the coming months. This is a great step and we will have many patients, in desperate need, to refer if this program can become a reality.
Schedule H, Part V, Section B, Line 11 Facility , 5	Facility , 5 - HILLSDALE COMMUNITY HEALTH CENTER. 5. Recommendation from HSN: Create (or incorporate) a weight clinic with a program that includes both dietary and behavioral health modifications to address the obesity issue. Background: Obesity is a major factor in the control of diabetes, heart disease and other chronic conditions. Weight control is a problem for many area residents. When asked in the 2022 CHNA survey if they were concerned about their weight, 702 respondents answered the question. Of these: - 334 (47.6%) said they were. - 368 (52.4%) said they were not. When asked how they would best describe their weight, 681 respondents answeredthe question. Of these: - 18 (2.6%) said they were under weight. - 245 (36.0%) said they were average weight. - 350 (51.4%)) said they were overweight. - 68 (10.0%) said they were obese. These results were similar to what was found in the CHNA previous surveys. - 50.5% said they were overweight and 8.6% said they were obese in 2019. - 51.1% said they were overweight and 7.7% said they were obese in 2016. These results indicate little progress has been made in this area. Hillsdale Hospital currently offers a multidisciplinary approach to treat obesity. 1. The hospital has a resident dietician. Area doctors can refer overweight or obese patients to the dietician for consultation on diets and diet modification. 2. Regular seminars are conducted for those interested in weight loss surgery to explain procedures and expected outcomes. 3. The hospital offers several surgical procedures in conjunction with the Hillsdale Surgical Group for those interested in surgical intervention. Surgical options include laparoscopic gastric sleeve resection and laparoscopic adjustable banding. The HSN members commented that some areas have created weight clinics associated with their hospital. The clinics provide dietary programs plus supportive help for patients to make the behavioral modifications needed to reduce their weight. Providers refer for individual counseling - our Hospital Dietician see patients 1-3 visits, depending on insurance mix. 50% of insurance, including Medicare, does not pay for weight management. New preventative codes exist, however, that could include nutrition, that we may be able to use. Hospital Administration is exploring the feasibility of this becoming a reality. Due to limited reimbursement, Hospital Dietary staff typically see patients once, which is not enough to help a person with obesity change their entire life and lose weight. If insurance does not pay, or patients do not want to pay in deductible, the Hospital offers a monthly group nutrition class 1 hours in length for $30. Again, not enough to truly help someone. Action Plan: Pre-Covid: - The Hospital had a group 10-12-week weight management program going right before covid-we had 12 participants and it was going very well. Then we shut down due to covid. We offered it free to employees and charged public $50; it was a pilot program. - Obese patients have many needs that need to be met: food insecurity, disordered eating, h/o misinformation causing yo-yo weight cycles that causes shifts in metabolism that making weight loss very difficult, emotional factors and mobility factors, family issues, etc. Moving Forward: The Hospital will seek to offer a comprehensive weight management program which would address the following, the most important in the order listed: - Behavior change, mental health, disordered eating patterns - Meal planning, cooking and meal prep classes, eating on a budget - Mindful and intuitive eating - Nutrition - Movement and activity This program should include an exercise specialist (I have one from the college), and behavior health specialist and obviously a Registered Dietician. The exercise piece is important but the latest obesity research is showing that the quality of food and eating patterns contribute to weight management more than exercise. Basically, you may be very active and if you are not eating correctly, you will not lose weight; however, movement does assist in disease prevention, quality of life and calorie burning on a daily basis.
Schedule H, Part V, Section B, Line 11 Facility , 6	Facility , 6 - HILLSDALE COMMUNITY HEALTH CENTER. 6. Recommendation from HSN: Refer psychiatric discharge patients to Lifeways for outpatient follow up care when appropriate (they now take all patients regardless of ability to pay). Background: Not all hospitalizations of county residents are at Hillsdale Hospital. But a study of the hospital discharge data shows that the leading causes of hospitalization at Hillsdale Hospital were psychiatric disorders, and obstetrics. Covid 19 discharges in the past year were also significant. There was an active discussion about meeting the mental health needs in the county. Members pointed out that Hillsdale Hospital's psychiatric unit draws residents from the neighboring counties who lack such a facility so the discharge numbers would be less if you just considered county residents. Lifeways has become a Certified Behavioral Mental Health Clinic and currently accepts people with all types of insurance, even if they can only refer them to other resources. The lack of understanding of the services available to county residents suffering mental health issues and the stigma some attach to people seeking mental health treatment is one of the main reasons people do not seek help. The use of telehealth services for psychiatric patients may help to bridge some of the gap due to the lack of area psychiatrists. The HSN recommended a better communication between the hospital discharge personnel and Lifeways for follow up services. Action Plan: Hillsdale Hospital's Behavioral Health Unit currently discharges about 35 patient per month to their home setting. These patients often will need assistance with medication management, and access to follow up Outpatient services to assure they don't return to an inpatient setting. LifeWays of Hillsdale County is the public agency serving people in Jackson and Hillsdale counties. LifeWays, as a Certified Community Behavioral Health Clinic grantee, provides a comprehensive set of services used to increase access to care, support people in crisis, and provide treatment for those with the most serious and complex behavioral health needs regardless of their insurance coverage. Hillsdale Hospital Behavioral Health Unit will refer to Lifeways, to provide a 'medical home' for as many of our discharged patients who this appropriately serves. In Addition, Hillsdale Hospital is exploring providing Outpatient services as well through the addition of a Behavioral Health Outpatient clinic that will be exploring over the next few months. We are optimistic, that with our own Outpatient clinic and through services provided by LifeWays that we can meet the needs of our Behavioral Health patients in the Outpatient setting in Hillsdale County, a service that has been lacking for some time in the Hillsdale community.
Schedule H, Part V, Section B, Line 11 Facility , 7	Facility , 7 - HILLSDALE COMMUNITY HEALTH CENTER. 7. Recommendation from HSN: Encourage discharge planners to become more aware of, and coordinate with, existing programs offered by the various community agencies for improved follow up care. (e.g., MACES). Background: Hospitalizations account for nearly one-third of the total $2 trillion spent on health care in the United States. In the majority of cases, hospitalization is necessary and appropriate. However, a substantial fraction of all hospitalizations are patients returning to the hospital soon after their previous stay. These rehospitalizations are costly, potentially harmful, and often avoidable. Evidence suggests that the rate of avoidable rehospitalization can be reduced by improving core discharge planning and transition processes out of the hospital; improving transitions and care coordination at the interfaces between care settings; and enhancing coaching, education, and support for patient self-management. Validated risk assessment tools such as the Hospital Score and LACE index have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. Hospitals are monitored for the number of patients re-admitted for the same illness within a short period following discharge. Although in some cases this is unavoidable due to the nature of the illness or the actions of the patient following discharge, premature release of patients from a facility or lack of follow-up outpatient monitoring or service coordination and follow-up care can contribute to the likelihood of re-admittance. However, the HSN members recommended there could be better identification of patients at risk, and more coordination between the hospital discharge personnel and area agencies to prevent otherwise avoidable readmissions. Patients being discharged were sometimes not referred to outside agencies that could provide additional follow up services or care. Action Plan: Proper identification of patients 'at-risk' of readmission to the hospital is the best proactive step we can take to begin to tackle this issue. LACE is an indexed scoring tool to identify patients at risk for readmission or death within 30 days of discharge. The LACE index comprises four parameters: length of stay. type of admission (acuity), comorbidities using the Charlson Comorbidity Index, and number of ED visits. Hillsdale Hospital will begin implementation of the utilization of this tool in the coming months, assessing all patients for their level of risk to better identify those patients who need extra attention prior to and during the discharge process. In addition, Case Management Services has been looking into the addition of a transition of care RN. This position would be charged with assessing patient likelihood of readmission, establishing links to resources in the community and assisting patients in obtaining the necessary assistance they will need to transition back to their home or to the next level of care post-discharge. These services will also be coordinated with existing OP clinic services and our ACO Patient Coordinator to avoid duplication of effort and provide seamless assistance to patients during this transition. Many patients discharged from the hospital do not have a primary care physician, so establishing this relationship with providers in the community or one of our hospital-based clinics will be critical.
Schedule H, Part V, Section B, Line 11 Facility , 8	Facility , 8 - HILLSDALE COMMUNITY HEALTH CENTER. 8. Recommendation from HSN: Continue making telehealth services available because of its appeal to the younger population segment. Background: The rise of technology has given rise to many improvements in the health care system. In previous years, the HSN suggested that the development of a telemedicine system would benefit the community. During the Covid 19 epidemic, the use of telemedicine seemed like a viable and desirable option. A telehealth service became available in early 2021 in the Hillsdale County area through nearly all of the health clinics. Respondents in the 2022 CHNA survey were asked about it. The survey asked respondents if they had tried telehealth. Of the 672 who answered this question: - 134 (19.9%) said they had tried it. - 538 (80.1%) had not. A follow up question asked respondents who had not tried telehealth why they had not. Of the 279 who answered this question: - 48 (17.2%) said they did not have a computer or smart phone. - 197 (70.6%) felt it was not personal. - 34 (12.2%) said they had safety concerns. The HSN members pointed out that the 2022 CHNA had a predominately older population than the general county and senior citizens might be less likely to use telehealth services. Younger residents who are use to texting and more experienced in computer use might embrace telehealth, especially if the cost is less, since the lack of medical insurance could be a problem for them. Telehealth may actually be preferred as this generation ages. Action Plan: Hillsdale Hospital has technology in all of our outpatient clinics (Orthopedics, OB/GYN, Reading, Litchfield, Hillsdale Health and Wellness, Hillsdale Surgical) to support the ability of tele-health services for patients. We are lacking, however, in some areas in terms of technology and will need to address these issues. In the coming months we will be upgrading that technology and holding staff meetings with clinical staff (both providers and clinic staff) to discuss making tele-health an equal choice for all patients when scheduling appointments. This will be a cultural shift with some of our clinic staff as well as some clinicians. We also intend to launch a county wide advertising campaign, letting our community know that, if they choose, we are ready and able to provide nearly all of our patient visits in a virtual environment. The hospital will make the necessary upgrades at each of our offices to make this as efficient and pleasant an experience as possible for both the providers of care as well as the patients. It is our intention to increase the percentage of visits provided via tele-health significantly over the next 1-3 years. The population we see within our OP clinical setting is significantly younger than in the Hospital setting and this population is increasingly more technology savvy and looking for the same level of sophistication from our clinics and our providers. This is a cultural change that has already left the station and we need to get on board before our patients look for better solutions elsewhere. This was pointed out by several members of our Human Services Network and felt that the hospital needed to make this a priority or be left behind in the marketplace. Creating this tech-friendly environment as an equal option for our patients will be a central focus in our Outpatient clinics over the coming months and years.
Schedule H, Part V, Section B, Line 20 Facility , 1	Facility , 1 - Hillsdale Community Health Center. AFTER INSURANCE PAYMENTS, THE SELF PAY PORTION IS BILLED TO THE PATIENT ON A MONTHLY STATEMENT. THE STATEMENT INCLUDES INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY. THE GUARANTOR RECEIVES FOUR STATEMENTS. IF THE AMOUNT IS STILL NOT PAID, THE GUARANTOR CONTINUES TO RECEIVE LETTERS UNTIL THE ACCOUNT IS WRITTEN OFF TO THE COLLECTION AGENCY. DURING THE TIME THE GUARANTOR IS RECEIVING THE STATEMENTS AND LETTERS, SEVERAL TELEPHONE CALLS ARE PLACED TO THE GUARANTOR TO TRY TO DISCUSS THE PAYMENT OR OTHER OPTIONS AVAILABLE TO THE GUARANTOR SUCH AS A PAYMENT PLAN OR FINANCIAL ASSISTANCE.

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?6
Name and address		Type of Facility (describe)
1	HILLSDALE HOME CARE 1711 S HILLSDALE RD HILLSDALE,MI49242	HOME CARE
2	HILLSDALE HOME OXYGEN 49 E CARLETON RD HILLSDALE,MI49242	DME
3	READING HEALTH CLINIC 143 S MAIN ST READING,MI49274	RURAL HEALTH CLINIC
4	LITCHFIELD HEALTH CLINIC 535 MARSHALL ST LITCHFIELD,MI49252	RURAL HEALTH CLINIC
5	QUINCY WORK HEALTH 181 E CHICAGO ST QUINCY,MI49082	OCCUPATIONAL HEALTH
6	HILLSDALE HEALTH & WELLNESS 240 W CARLETON RD HILLSDALE,MI49242	RURAL HEALTH CLINIC
7
8
9
10

Schedule H (Form 990) 2023

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 21 Policy Relating to Emergency Medical Care	ALL PATIENTS ARE BILLED THE SAME AMOUNT REGARDLESS OF TYPE OF INSURANCE OR LACK OF INSURANCE. DISCOUNTS OFF BILLED CHARGES ARE PROVIDED THROUGH THE CHARITY APPLICATION PROCESS OR PROMPT PAYMENT DISCOUNTS.
Schedule H, Part II COMMUNITY BUILDING ACTIVITIES	HILLSDALE COMMUNITY HEALTH CENTER PROVIDES NUMEROUS COMMUNITY ACTIVITIES IN SUPPORT OF THE RESIDENTS OF HILLSDALE COUNTY, INCLUDING SENIOR SUNDAY WHERE LUNCH IS SERVED TO THE SENIOR COMMUNITY MEMBERS AND A SPEAKER DISCUSSES HEALTH ISSUES AND OTHER TOPICS RELATING TO THIS AGE GROUP. IN ADDITION, THERE ARE SEVERAL SUPPORT GROUPS AND CLASSES, INCLUDING THE BREAST CANCER SUPPORT GROUP, BREAST FEEDING CLASSES, BIRTHING CLASSES, NUTRITION EDUCATION AND DIABETES EDUCATION CLASSES. THERE ARE PERIODIC HEALTH SCREENINGS SUCH AS VARICOSE VEIN, FOOT PAIN, CHOLESTEROL, AND COPD SCREENINGS. HILLSDALE COMMUNITY HEALTH CENTER ALSO PROVIDES FREE SUPPORT TO ST. PETER'S FREE CLINIC AND PARTICIPATES IN THE LOCAL ALLIED HEALTH STUDENT PROGRAM. NUMEROUS HIGH SCHOOL AND COMMUNITY LOANS HAVE BEEN GRANTED FOR FULL TUITION FOR ALLIED HEALTH DEGREES. REPAYMENT OF LOANS IS FULFILLED THROUGH A TIME COMMITMENT TO THE HILLSDALE COMMUNITY HEALTH CENTER.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	4247727
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS STRATIFIED BY PAYOR AND NUMBER OF DAYS THE ACCOUNTS ARE OUTSTANDING. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	HILLSDALE HOSPITAL SAW $1,518,859 OF ACCOUNTS WRITTEN OFF TO BAD DEBT THAT WERE ATTRIBUTED TO PATIENTS WITH NO INSURANCE COVERAGE. THE AVERAGE DISCOUNT APPLIED TO ACCOUNTS THROUGH OUR FINANCIAL ASSISTANCE PROGRAM WAS 94.6%. WE APPLIED THAT PERCENTAGE TO THOSE ACCOUNTS WRITTEN OFF WITH NO INSURANCE.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HILLSDALE COMMUNITY HEALTH CENTER PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HILLSDALE COMMUNITY HEALTH CENTER BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER 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 HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS IS AT 54 PERCENT OF TOTAL ACCOUNTS RECEIVABLE AT JUNE 30, 2024. IN ADDITION, THE HOSPITAL'S BAD DEBT WRITE-OFFS INCREASED FROM APPROXIMATELY $4,500,000 FOR THE YEAR ENDED JUNE 30, 2023, TO APPROXIMATELY $4,530,000 FOR THE YEAR ENDED JUNE 30, 2024.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	THE COST TO CHARGE RATIO IS USED TO DETERMINE MEDICARE SURPLUS OR SHORTFALL AT COST. THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS THIS IS THE EXTENT TO WHICH COSTS RELATED TO MEDICARE SERVICES GO UNPAID.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	AFTER INSURANCE PAYMENTS, THE SELF PAY PORTION IS BILLED TO THE PATIENT ON A MONTHLY STATEMENT. THE STATEMENT INCLUDES INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY. THE GUARANTOR RECEIVES FOUR STATEMENTS. IF THE AMOUNT IS STILL NOT PAID, THE GUARANTOR CONTINUES TO RECEIVE LETTERS UNTIL THE ACCOUNT IS WRITTEN OFF TO THE COLLECTION AGENCY. DURING THE TIME THE GUARANTOR IS RECEIVING THE STATEMENTS AND LETTERS, SEVERAL TELEPHONE CALLS ARE PLACED TO THE GUARANTOR TO TRY TO DISCUSS THE PAYMENT OR OTHER OPTIONS AVAILABLE TO THE GUARANTOR SUCH AS A PAYMENT PLAN OR FINANCIAL ASSISTANCE.
Schedule H, Part V, Section B, Line 16a FAP website	- Hillsdale Community Health Center: Line 16a URL: www.hillsdalehospital.com;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Hillsdale Community Health Center: Line 16b URL: www.hillsdalehospital.com;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Hillsdale Community Health Center: Line 16c URL: www.hillsdalehospital.com;
Schedule H, Part VI, Line 2 Needs assessment	HCHC PARTNERED WITH THE HUMAN SERVICES NETWORK, A COMMUNITY COLLABORATIVE BODY MADE UP OF A MAJORITY OF THE COUNTY'S HUMAN SERVICE, EDUCATIONAL, FAITH BASED, AND NON-PROFIT ORGANIZATIONS WITHIN HILLSDALE COUNTY. THIS GROUP SERVED AS THE STEERING GROUP FOR THE PROJECT, ALONG WITH ITS EXECUTIVE COMMITTEE.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	IF A PATIENT PRESENTS TO HCHC FOR SERVICES AND INDICATES THEY HAVE NO INSURANCE, THEY ARE PROVIDED A COPY OF THE FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ALONG WITH A LISTING OF THOSE ORGANIZATIONS THAT ARE AVAILABLE TO PROVIDE ADDITIONAL HELP AND SERVICES. WE ALSO HAVE A STATE MEDICAID CASE WORKER ON SITE WHO IS AVAILABLE TO WORK WITH THE PATIENTS TO DETERMINE THEIR ELIGIBILITY FOR MEDICAID OR OTHER SERVICES. EACH STATEMENT MAILED TO THE GUARANTOR INCLUDES A STATEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO APPLY OR GET ADDITIONAL INFORMATION. AS COLLECTION CALLS ARE MADE TO THE GUARANTOR THEY ALSO INFORM THEM ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. THERE ARE INFORMATIONAL POSTERS IN THE PATIENT WAITING ROOMS, AND FINANCIAL ASSISTANCE POLICY INFORMATION IS INCLUDED IN EACH DISCHARGE PACKET PROVIDED TO ADMITTED PATIENTS. THE COMPLETE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY IS PROVIDED ON THE HOSPITAL WEBSITE.
Schedule H, Part VI, Line 4 Community information	HILLSDALE, MICHIGAN IS THE COUNTY SEAT OF HILLSDALE COUNTY. ITS POPULATION IS 7,998 (AS OF 2023) WITH A HOUSEHOLD MEDIAN INCOME OF $47,817 (AS OF 2023). AS OF DECEMBER 2023, THE CURRENT UNEMPLOYMENT RATE IS 3.5% FOR HILLSDALE COUNTY. THE COUNTY IS BOUNDED ON THE NORTH BY CALHOUN AND JACKSON COUNTIES, ON THE EAST BY LENAWEE COUNTY, ON THE WEST BY BRANCH COUNTY, AND ON THE SOUTH BY STEUBEN COUNTY INDIANA AND WILLIAMS COUNTY OHIO. THE EXTREME SOUTHWEST CORNER OF HILLSDALE COUNTY IS WHERE THREE STATES OF MICHIGAN, OHIO AND INDIANA MEET. ON MAPS, THE COUNTY IS SITUATED AT 42 NORTH LATITUDE AND 8430' WEST LONGITUDE, AND COMPRISES ABOUT 617 SQUARE MILES, OR 394,880 ACRES. THE LAND LIES AN AVERAGE OF 630 FEET ABOVE LAKE ERIE AND 616 FEET ABOVE LAKE MICHIGAN.
Schedule H, Part VI, Line 5 Promotion of community health	HCHC FACILITATES SEVERAL EDUCATIONAL CLASSES INCLUDING BREAST FEEDING, BIRTHING, NUTRITION, AND DIABETES EDUCATION, AS WELL AS SEVERAL PERIODIC HEALTH SCREENINGS INCLUDING VARICOSE VEIN, FOOT PAIN, ACID REFLUX, CHOLESTEROL, AND COPD SCREENINGS, AS WELL AS PROVIDES FREE FLU SHOTS AND COVID-19 VACCINES TO THE MEMBERS OF THE COMMUNITY. HCHC OWNS AND OPERATES THREE RURAL HEALTH CLINICS IN READING, LITCHFIELD, AND HILLSDALE, MICHIGAN THAT PROVIDE HEALTHCARE SERVICES TO THE MEDICAID AND SELF INSURED POPULATION. HCHC ALSO PROVIDES FREE SUPPORT TO ST. PETER'S FREE CLINIC AND PARTICIPATES IN THE LOCAL ALLIED HEALTH STUDENT PROGRAM.

Schedule H (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

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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.
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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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 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)
1Jeremiah J Hodshire President/CEO	(i) (ii)	390,861 ------------- 0	170,063 ------------- 0	41,889 ------------- 0	47,400 ------------- 0	7,575 ------------- 0	657,788 ------------- 0	0 ------------- 0
2Mark Gross Vice President/CFO	(i) (ii)	275,928 ------------- 0	143,750 ------------- 0	41,822 ------------- 0	47,400 ------------- 0	11,025 ------------- 0	519,925 ------------- 0	0 ------------- 0
3Parthiv Patel Orthopedic Surgeon	(i) (ii)	559,828 ------------- 0	285,922 ------------- 0	25 ------------- 0	9,900 ------------- 0	10,025 ------------- 0	865,700 ------------- 0	0 ------------- 0
4Norris March General Suregon	(i) (ii)	343,973 ------------- 0	232,862 ------------- 0	22,525 ------------- 0	9,900 ------------- 0	5,642 ------------- 0	614,902 ------------- 0	0 ------------- 0
5John Anderson Orthopedic Surgeon	(i) (ii)	564,212 ------------- 0	0 ------------- 0	3,241 ------------- 0	9,900 ------------- 0	2,572 ------------- 0	579,925 ------------- 0	0 ------------- 0
6Brian Sinischo OBGYN	(i) (ii)	310,809 ------------- 0	200,035 ------------- 0	25 ------------- 0	9,900 ------------- 0	8,201 ------------- 0	528,970 ------------- 0	0 ------------- 0
7Sarah Spencer OBGYN	(i) (ii)	386,329 ------------- 0	15,000 ------------- 0	25 ------------- 0	1,724 ------------- 0	4,573 ------------- 0	407,651 ------------- 0	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
Schedule J, Part I, Line 1a Travel for companions	Annually, the spouses of the CEO and CFO accompany them on a business trip. The cost of the spouse's travel is treated as taxable compensation.
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	Taxable spouse travel and reimbursement for dues is grossed up.
Schedule J, Part I, Line 1a Housing allowance or residence for personal use	THE CFO RESIDES IN A HOUSE OWNED BY THE HOSPITAL. HOUSING COSTS OF $6,000 ARE INCLUDED IN THE CFO'S TAXABLE INCOME PER YEAR. THIS IS DONE THROUGH PAYROLL AT $500 PER MONTH.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	DURING THE YEAR ENDED 6/30/2024, MARK GROSS AND JEREMIAH HODSHIRE PARTICIPATED IN A 457F PLAN. CONTRIBUTIONS TO THE PLAN WERE $37,500 FOR MARK GROSS AND $37,500 FOR JEREMIAH HODSHIRE. DISTRIBUTIONS TO THE PLAN WERE $37,500 FOR MARK GROSS AND $37,500 FOR JEREMIAH HODSHIRE. THE CONTRIBUTIONS WERE FULLY VESTED AND THEREFORE WERE INCLUDED IN TAXABLE WAGES AND ARE REPORTED ON SCHEDULE J, PART II, COLUMN B III.

Schedule J (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- 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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

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	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) The Pediatric Place Of Hillsdae	SEE STATEMENT	125,630	Pediatric Coverage		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	NICHOLE ELLIS, HILLSDALE CHIEF OF STAFF, IS A GREATER THAN 35% OWNER OF THE PEDIATRIC PLACE OF HILLSDALE.

Schedule L (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	3	23,813	Market value
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .	X	1	8,476	Market value
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2023)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
Schedule M, Part I COLUMN B	THE AMOUNTS LISTED IN PART I, COLUMN B ARE BASED ON THE NUMBER OF CONTRIBUTORS FOR EACH TYPE OF PROPERTY CONTRIBUTED.

Schedule M (Form 990) (2023)

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- 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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

Return Reference	Explanation
Form 990, Part VI, Line 15	THERE IS A SEPARATE COMPENSATION COMMITTEE OF THE GOVERNING BODY WHICH CONSULTS WITH THE COMPANY'S LEGAL FIRM FOR COMPARABILITY DATA. THERE IS A WRITTEN EMPLOYMENT CONTRACT THAT IS APPROVED BY THE COMPENSATION COMMITTEE. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2021.
Form 990, Part VI, Line 6 Classes of members or stockholders	MEMBERS OF THE CORPORATION SHALL BE APPOINTED FOR A TERM OF THREE (3) YEARS. ALL MEMBERS OF THE CORPORATION SHALL BE NOMINATED PURSUANT TO SECTION 5.1, AND SHALL BE APPOINTED BY THE MEMBERS AT AN ANNUAL OR SPECIAL MEETING OF MEMBERS. EVERY ATTEMPT SHALL BE MADE IN THE SELECTION OF CANDIDATES FOR MEMBERSHIP TO SECURE THE BROADEST DIVERSITY OF REPRESENTATION OF THE COMMUNITY AND ITS INTERESTS AS POSSIBLE, INCLUDING THE CONSIDERATION OF SUCH FACTORS AS AREAS OF EXPERTISE, BACKGROUND AND AREAS OF RESIDENCY.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE CORPORATION MEMBERS ELECT THE BOARD OF TRUSTEES.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE CORPORATION MEMBERS APPROVE ANY PROPOSED CHANGE IN THE PURPOSE OR PHILOSOPHY OF THE CORPORATION, AND APPROVE A PLAN OF MERGER, CONSOLIDATION, SALE, OR DISSOLUTION OF THE CORPORATION.
Form 990, Part VI, Line 11b Review of form 990 by governing body	A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. IN ADDITION, THE FORM 990 IS REVIEWED BY THE CFO AND CEO FOR ACCURACY. THE RETURN IS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM.
Form 990, Part VI, Line 12c Conflict of interest policy	BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST ANNUALLY. THE BOARD OF TRUSTEES SHALL DETERMINE WHETHER A CONFLICT EXISTS BY MAJORITY VOTE. IF A CONFLICT OF INTEREST IS DEEMED TO EXIST, THE TRUSTEE OR OFFICER SHALL NOT PARTICIPIATE IN DELIBERATIONS OR DISCUSSIONS REGARDING THE TRANSACTION AND ARE NOT ALLOWED TO VOTE ON THE MATTER AT HAND.
Form 990, Part VI, Line 19 Required documents available to the public	DOCUMENTS ARE AVAILABLE ON REQUEST.
Form 990, Part IX, Line 11g Other Fees	SPEECH THERAPIST - Total Expense: 21304, Program Service Expense: 17469, Management and General Expenses: 3835, Fundraising Expenses: ; COLLECTION SERVICES - Total Expense: 184754, Program Service Expense: 151498, Management and General Expenses: 33256, Fundraising Expenses: ; PSYCH - Total Expense: 262229, Program Service Expense: 215028, Management and General Expenses: 47201, Fundraising Expenses: ; E/R - Total Expense: 852484, Program Service Expense: 699037, Management and General Expenses: 153447, Fundraising Expenses: ; MAT MANAGEMENT - Total Expense: 169072, Program Service Expense: 138639, Management and General Expenses: 30433, Fundraising Expenses: ; PHARMACY - Total Expense: 953311, Program Service Expense: 781715, Management and General Expenses: 171596, Fundraising Expenses: ; ANESTHESIOLOGIST - Total Expense: 2047187, Program Service Expense: 1678693, Management and General Expenses: 368494, Fundraising Expenses: ; PHYSICAL THERAPY - Total Expense: 771776, Program Service Expense: 632856, Management and General Expenses: 138920, Fundraising Expenses: ; OCCUPATIONAL THERAPY - Total Expense: 210705, Program Service Expense: 172778, Management and General Expenses: 37927, Fundraising Expenses: ; SLEEP STUDY - Total Expense: 255860, Program Service Expense: 209805, Management and General Expenses: 46055, Fundraising Expenses: ; HOME CARE - Total Expense: 687735, Program Service Expense: 563943, Management and General Expenses: 123792, Fundraising Expenses: ; HOSPITALIST - Total Expense: 1445424, Program Service Expense: 1185248, Management and General Expenses: 260176, Fundraising Expenses: ; PULM CLINIC - Total Expense: 758499, Program Service Expense: 621969, Management and General Expenses: 136530, Fundraising Expenses: ; QUALITY - Total Expense: 213517, Program Service Expense: 175084, Management and General Expenses: 38433, Fundraising Expenses: ; MED RECS - Total Expense: 22402, Program Service Expense: 18370, Management and General Expenses: 4032, Fundraising Expenses: ; PATHOLOGY - Total Expense: 489359, Program Service Expense: 401274, Management and General Expenses: 88085, Fundraising Expenses: ; ADMINISTRATION - Total Expense: 1804979, Program Service Expense: 1480083, Management and General Expenses: 324896, Fundraising Expenses: ; INFORMATIONAL TECHNOLOGY - Total Expense: 520186, Program Service Expense: 426553, Management and General Expenses: 93633, Fundraising Expenses: ; QAAP FEE - Total Expense: 3498846, Program Service Expense: 2869054, Management and General Expenses: 629792, Fundraising Expenses: ; LAB SERVICE - Total Expense: 1239819, Program Service Expense: 1016652, Management and General Expenses: 223167, Fundraising Expenses: ; OTHER PURCHASED SERVICES - Total Expense: 7708368, Program Service Expense: 6320860, Management and General Expenses: 1387508, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	NET ASSETS RELEASED FROM RESTRICTIONS - 625988;

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:	23017437
Software Version:	2023v6.0

- 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

HILLSDALE COMMUNITY HEALTH CENTER

Employer identification number

38-6005550

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Headwaters Health Foundation 168 S Howell St Hillsdale,MI49242 81-1509725	Support	MI	501(c)(3)	Type I	HH	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) HALLETT ST PROFESSIONAL DEVELOPMENT 451 HIDDEN MEADOWS DR HILLSDALE,MI49242 38-3497750	PROFESSIONAL BUILDING	MI	NA	Related	279,324	1,145,008		No		Yes		37.5 %

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) HCHC Assurance Co LTD 30-0548721	Financial	CJ	HCHC	C Corporation	652,251	1,999,916	100 %	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) ............................

Yes

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

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

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

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

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

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

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

Yes

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

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

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

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

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

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

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

Yes

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) HALLETT ST PROFESSIONAL DEVELOPMENT	D	316,393	FMV
(2) HALLETT ST PROFESSIONAL DEVELOPMENT	Q	232,851	FMV

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 (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

1	Briefly describe the organization’s mission or most significant activities: SHORT-TERM, ACUTE CARE HOSPITAL FACILITY
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	671
6	Total number of volunteers (estimate if necessary) .............	6	43
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	26,506
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	14,265

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,264,575	995,772
9	Program service revenue (Part VIII, line 2g) .........	78,152,031	90,139,783
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	716,542	2,654,741
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	3,819	8,993
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	80,136,967	93,799,289
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	38,027,387	38,302,066
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	40,000	0
b	Total fundraising expenses (Part IX, column (D), line 25) 3,000
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	46,358,507	52,413,908
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	84,425,894	90,715,974
19	Revenue less expenses. Subtract line 18 from line 12.......	-4,288,927	3,083,315
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	60,765,502	63,579,298
21	Total liabilities (Part X, line 26).............	25,415,565	23,928,676
22	Net assets or fund balances. Subtract line 21 from line 20.....	35,349,937	39,650,622

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 77,294,501 including grants of $ ) (Revenue $ 90,139,783 )
	HILLSDALE HOSPITAL IS A SHORT-TERM, ACUTE CARE HOSPITAL FACILITY INCLUDING A SKILLED NURSING UNIT, A PSYCHIATRIC UNIT, AND A HOME HEALTH CARE DEPARTMENT, WHICH PROVIDES INPATIENT AND OUTPATIENT SERVICES TO THE HILLSDALE COUNTY, MICHIGAN AREA. THE HOSPITAL ALSO SUPPORTS UNPROFITABLE/SUBSIDIZED HEALTH SERVICES, INCLUDING BEHAVIORAL HEALTH, OBSTETRICS, AND EMERGENCY SERVICES. HILLSDALE HOSPITAL SAW 2,197 INPATIENT ADMISSIONS IN FY 2024, 152,140 OUTPATIENT VISITS, AND 19,095 EMERGENCY DEPARTMENT VISITS. DURING FY 2024 APPROXIMATELY 45.7% OF SERVICES RENDERED WERE TO ELDERLY PATIENTS UNDER THE MEDICARE PROGRAM, APPROXIMATELY 22.3% OF SERVICES PROVIDED WERE TO PATIENTS DEEMED INDIGENT UNDER STATE GUIDELINES AND APPROXIMATELY 2.3% OF SERVICES PROVIDED WERE TO INDIVIDUALS WITHOUT ANY HEALTHCARE COVERAGE. THE HOSPITAL STRIVES TO MINIMIZE THE FINANCIAL BARRIERS TO HEALTHCARE THAT EXIST FOR CERTAIN MEMBERS OF OUR COMMUNITY, AND IN FY 2024 PROVIDED APPROXIMATELY $1,100,000 IN CHARITY CARE AND RECORDED A PROVISION FOR BAD DEBT OF $4.5 MILLION. A COMPLETE LIST OF SERVICES OFFERED IS AVAILABLE AT WWW.HILLSDALEHOSPITAL.COM, ALONG WITH THE INFORMATION REGARDING APPLYING FOR FINANCIAL ASSISTANCE. HILLSDALE HOSPITAL GIVES BACK TO THE COMMUNITY IN MANY WAYS, INCLUDING SUPPORTING THE FREE HEALTH CLINIC AND PROVIDING HIGHER EDUCATION LOANS FOR ALLIED HEALTH PROFESSIONS.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses77,294,501

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	4,013,124	0	185,737

(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) Sarah Spencer........................................................................ OBGYN	40.0 .......................	X	401,354	0	6,297

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

f	All other contributions, gifts, grants, and similar amounts not included above		1f	995,772

g	Noncash contributions included in lines 1a - 1f:$		1g	32,289

h Total. Add lines 1a-1f.......		995,772

		Business Code
2a	NET PATIENT REVENUE	621110	90,211,774	90,211,774
b	CAFETERIA SALES	621110	143,991	143,991
c	EMPLOYEE PRESCRIPTIONS	621110	67,554	67,554
d	OTHER INCOME	621110	-283,536	-283,536
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		90,139,783

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,065,433		26,506	1,038,927
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	68,947
b	Less: rental expenses	6b	59,954
c	Rental income or (loss)	6c	8,993	0
d	Net rental income or (loss).......			8,993			8,993
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	15,575,267	3,509
b	Less: cost or other basis and sales expenses	7b	13,989,468	0
c	Gain or (loss)	7c	1,585,799	3,509
d	Net gain or (loss).........			1,589,308			1,589,308
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
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
b
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See instructions.....			93,799,289	90,139,783	26,506	2,637,228

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........	1,481,843	1,215,111	266,732
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	29,699,376	24,353,488	5,345,888
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	540,005	442,804	97,201
9	Other employee benefits .......	4,481,617	3,674,926	806,691
10	Payroll taxes ...........	2,099,225	1,721,365	377,860
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	183,520		183,520
c	Accounting ...........	110,938		110,938
d	Lobbying ...........	3,000			3,000
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	156,129		156,129
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	24,117,816	19,776,608	4,341,208	0
12	Advertising and promotion ....	262,617	215,346	47,271
13	Office expenses .......	563,316	461,919	101,397
14	Information technology ......	672,761	551,664	121,097
15	Royalties ..
16	Occupancy ...........	2,132,286	1,748,475	383,811
17	Travel ............	148,205	121,528	26,677
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	9,356	7,672	1,684
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,036,095	1,669,598	366,497
23	Insurance ...	966,519	792,546	173,973
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	13,970,848	13,970,848
b	PROVISION FOR DOUBTFUL ACCOUNTS	4,247,727	4,247,727
c	RENT TO HHF	1,334,624	1,094,392	240,232
d	REPAIR & MAINTENANCE	1,302,846	1,068,334	234,512
e	All other expenses	195,305	160,150	35,155	0
25	Total functional expenses. Add lines 1 through 24e	90,715,974	77,294,501	13,418,473	3,000
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 ........			473,359	1	171,786
2	Savings and temporary cash investments .........			7,032,934	2	10,486,165
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			11,624,924	4	13,851,149
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 .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			581,825	7	566,442
8	Inventories for sale or use ............			1,540,688	8	1,599,472
9	Prepaid expenses and deferred charges ......			1,069,949	9	1,053,186
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	16,088,393
b	Less: accumulated depreciation	10b	8,015,488	8,765,376	10c	8,072,905
11	Investments—publicly traded securities .			24,213,777	11	21,887,045
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			5,462,670	15	5,891,148
16	Total assets. Add lines 1 through 15 (must equal line 33)...			60,765,502	16	63,579,298

17	Accounts payable and accrued expenses .....	11,837,808	17	13,226,236
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	13,577,757	25	10,702,440
26	Total liabilities. Add lines 17 through 25..	25,415,565	26	23,928,676

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	35,256,872	27	39,299,495
28	Net assets with donor restrictions ...........	93,065	28	351,127
	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 ...........	35,349,937	32	39,650,622
33	Total liabilities and net assets/fund balances ........	60,765,502	33	63,579,298