Lenawee Long Term Care

“As a michigan non-profit organization, this corporation has a corporate member.”

“Promedica health system, inc. (phs) is the parent corporation and sole member of emma l. Bixby medical center which is the sole member of lenawee long term care. Phs has the right to (a) elect a majority of the members and approve all of the members, and remove any member of the board of trustees of lenawee long term care, and (b) fill and/or approve any nomination to fill any vacancy on the board of trustees.”

“While the board of trustees of each business unit is granted certain powers with respect to such business unit's operations, as the member, promedica health system, inc. Retains approval rights with respect to certain corporate actions such as (i) adoption of the business unit's strategic plans and financial plans, (ii) expenditures for non-budgeted items in excess of certain dollar limits set from time to time by the member, (iii) expenditures for items which are included in the business unit's annual budgets but which exceed the budgeted amount by an amount in excess of certain dollar limits set from time to time by the member, (iv) incurrence, assumption or guarantee of any indebtedness, (v) sale, lease or other disposition of real property or assets with a value in excess of certain dollar limits set from time to time by the member and (vi) any merger, consolidation, reorganization, dissolution or liquidation.”

“Under the guidance of promedica health system, inc.'s (phs) tax consultants, form 990s are prepared by the respective accounting department of each affiliate and reviewed by the affiliate's finance leadership. After affiliate's finance leadership approval, copies of the form 990 for phs and their subsidiaries are provided to the respective company's board of trustees and are reviewed and signed by a principal officer prior to filing with the internal revenue service.”

“Promedica health system, inc. And affiliates (phs) have standards of conduct that apply to all phs board members and employees. Board members and employees are expected to certify their compliance with the applicable standards prior to election/appointment or prior to beginning employment. Board members annually (or immediately if new potential conflicts of interest arise), all board members are required to complete and return the board member certification statement within 30 days of dissemination. Board member certification statements are compiled and reviewed by the v.p., audit & compliance/chief compliance officer (cco). Summarized information is forwarded for review to the chief financial officer, general counsel, business unit presidents and the president and chief executive officer (president/ceo), based upon their respective knowledge of the board members. The purpose of this review is to both inform management of the disclosed conflicts and to allow them to identify to the v.p., audit & compliance, any potential undisclosed conflicts. The audit & compliance department then conducts an audit of all board member certification statements (along with any relationships noted through the above review) to identify any positional conflicts of interest and to test material transactions with board members/their affiliates for fair market value. The results of the audit are reported directly to the chair of the audit & compliance committee with a copy to the president/ceo. The report includes a summary of the audit procedures performed, any significant concerns identified and their resolution. Any unresolved conflicts are addressed by the audit committee with recommendations to the full board as needed. Failure to file the certification statement, or the filing of a false or incomplete certification statement, or failure to disclose immediately any new conflicts of interest that may arise, or failure to cooperate without condition, honestly and completely with any investigation or review of the board member's certification statement or his/her actions or circumstances shall be grounds for sanction by the board of trustees up to and including removal from the board/committee/council. Employees, excluding employed physicians annually (or immediately if new conflicts of interest arise), all salaried employees and specifically identified hourly employees, excluding employed physicians, are required to complete and submit an electronic employee certification questionnaire by an established deadline that is communicated to the employee. The human resources department ensures that all questionnaires, which are stored electronically, are completed and provides notification to the v.p., audit & compliance of the number of annual employee certification questionnaires sent and received and copies of any questionnaires containing disclosures that warrant further review by the audit & compliance department. All new employees, excluding employed physicians, are provided either an electronic or paper copy of the employee standard of conduct and the employee certification statement which the new employee is required to complete prior to beginning employment. The audit & compliance department has access to a report that identifies all new hires. A sample of employees is identified and an audit is conducted to ensure that required documentation is on file. Identified conflicts are initially reviewed by the v.p., audit & compliance and if necessary discussed with the business unit president in which the employee works, and general counsel. If the conflict is considered a significant exposure risk for phs, a recommendation will be prepared for final approval of the phs president/ceo. Results of the employee process audit are included in the above report to the chair of the audit & compliance committee. Failure to complete the certification questionnaire, or the completion of a false or incomplete certification questionnaire, or failure to disclose”

“Lenawee long term care's top management official and other officers are compensated by promedica health system, inc. (phs), a related tax-exempt organization. Compensation determinations of lenawee long term care's top management official and other officers are made by a compensation committee of phs. Each year independent consultants conduct an annual survey and recommend executive payroll base salary ranges based upon the market. The data is reviewed and approved by the promedica health system compensation committee every october. Salary adjustments are determined at the december meeting of the compensation committee. The compensation committee approves other forms of compensation based upon the prior year performance at the january meeting each year.”

“Promedica health system, inc. And subsidiaries provide any document open to public inspection upon request.”

“Lenawee long term care is a health facility that is a subsidiary of promedica health system, inc. (phs). Lenawee long term care holds an intercompany note payable to the toledo hospital, which is also a subsidiary of phs. The note payable represents lenawee long term care's portion of taxable and tax-exempt bonds issued by promedica healthcare obligated group.”

“Promedica health system, inc. - program service accomplishments established in 1986, promedica health system, inc. (promedica) is a mission-based, locally owned, not-for-profit healthcare organization highly focused on achieving core values. Headquartered in toledo, ohio, promedica serves 27 counties in northwest ohio and southeast michigan and is one of the region's leading healthcare providers. Our stewardship of resources has enabled us to wisely invest in cutting-edge technology, innovative programs and family-centered facilities that help to ensure patients and area residents have equal access to high-quality, safe care in the most appropriate setting, regardless of a patient's ability to pay. Based on needs that we have assessed within the communities we serve, promedica launched new services and programs in 2015 to help meet the growing demands of local consumers across all spectrums of life, including those individuals who are often the most vulnerable when it comes to health care: the elderly, poor and underserved. Promedica's mission is to improve the health and well-being of those we serve. This is reflected in our four core values, including: compassion - we treat our patients and each other with respect, integrity and dignity; innovation - we continually search to find a better way forward; teamwork - we partner with others because we are better together than apart; and excellence - we strive to be the best in all we do. Promedica and its affiliates comprise 332 sites, more than 2,300 physicians and approximately 17,000 employees and volunteers. During 2015, promedica discharged 82,132 inpatients and served more than 1,535,310 outpatients, while handling 350,316 emergency visits system-wide. Among the region's largest employers, promedica plays a significant role in economic development and stability in our region. During 2015, for every one dollar of revenue, another 43 cents was created in our service-area economy, with a total economic output of $4.5 billion. We also create a direct economic impact with our revenue, payroll and employment. Additionally, spending on services and materials with vendors in our region creates an indirect economic benefit. Our physicians and providers, leadership team members and employees individually contribute personal resources to the community in numerous ways - such as through tutoring elementary students in reading and other life skills, providing monthly health lectures at local senior centers, generously contributing to community fundraising campaigns such as united way, participating in medical missions, serving on local not-for-profit boards, and donating nonperishable goods to numerous local food pantries and churches - underscoring a key benefit of promedica being locally owned and operated. Promedica's member and affiliate hospitals include: the toledo hospital; toledo children's hospital (operating as part of the toledo hospital); promedica wildwood orthopaedic and spine hospital (a division of the toledo hospital); flower hospital; fostoria hospital association; defiance hospital, inc.; bay park community hospital; herrick memorial hospital, inc.; emma l. Bixby medical center; memorial hospital; mercy memorial hospital corporation, and st. Luke's hospital. In 2015, promedica also provided integrated services, comprised of: - promedica continuing care services corporation, providing rehabilitation, hospice, home care, ambulatory and senior services, community health, medical transportation services, and care coordination. - promedica physician group (promedica physicians), with nearly 900 healthcare providers, including primary care, obstetrics and specialty physicians, as well as advanced practice providers. Together, this group helps promedica broaden the care we offer to area residents, including in smaller, outlying communities. - promedica insurance corporation, the largest health maintenance organization physically located in northwest ohio. In 2015, paramount a”

“Cancer screenings and education to the most vulnerable in our community. Free screening mammograms, as well as skin cancer and lung cancer screenings were provided for early detection. Prostate cancer screening education and nutritional programs were developed to keep people healthy, and a colorectal cancer education event took place at huntington center. Pci also hosted annual cancer survivor celebrations for survivors, friends and caregivers across the region and sponsored community events including the annual nw ohio susan g. Komen, race for the cure and american cancer society relay for life in lucas county. - a new food pharmacy pilot launched, serving patients at the adult medicine clinic at promedica's center for health services (chs) and the ww knight family medicine practice. The program refers patients who screen positive for food insecurity to receive food for them and their family from the food pharmacy located at chs. Each patient receives two to three days of supplemental food for their family. Starting in april through december 2015, approximately 1,400 referrals were made to the food pharmacy, providing supplemental food to more than 1,800 households. - through its advocacy fund, promedica continued to support local community organizations that provide assistance to those in need with basic necessities that directly impact individuals' health and well-being. This support amounted to grants totaling more than $315,000 in 2015. - promedica and the aarp foundation (aarp's affiliated charity) joined together as founding members of the new not-for-profit organization the root cause coalition. The coalition is focused on addressing hunger as a public health issue and other social determinants of health. - to help meet the need for additional school nurses in the toledo public school system (tps), promedica began funding nine additional school nurses, enabling all tps elementary schools to have a full-time school nurse. Studies have shown that full-time nurses in public schools can have a positive impact on health and strong academic outcomes. Over the next three years, promedica and tps will track and evaluate student health statistics to develop a sustainability plan and support ongoing funding for the program. - promedica opened the ebeid institute's new market on the green to provide better access to healthy foods in a designated food desert, as well as job training opportunities for residents in the uptown toledo neighborhood. The institute was made possible through a generous donation from promedica board member russell ebeid. - after more than a year of planning, building, testing and training, promedica's new electronic health record (ehr), epic, went live with a successful pilot of 20 promedica physicians and providers. Following epic's methodology, additional go-lives are scheduled through 2016 and 2017 to bring all providers, hospitals and services on board. The new platform will further enable one patient, one record, and one bill for patients regardless of service provided or the location of service across promedica. - toledo and toledo children's hospitals opened a new surgery suite to increase efficiency and provide a better experience for patients and families. It includes 10 replacement operating rooms, larger pre-op and recovery areas, a new pediatric recovery area, and a new text alert system for waiting families. - in collaboration with hcr manorcare, the new heartland at promedica skilled nursing and rehabilitation facility opened on the campus of flower hospital. It provides medically complex and intensive rehabilitation services for short-term patients transitioning between hospital care and home. - flower hospital radiology installed a new mri scanner that provides increased image resolution, resulting in excellent image quality and providing patients with more room during the imaging process. Additionally it can accommodate patients weighing up to 550 lbs. (250 kg) and its short, wide bore des”

“Accommodations made. Promedica's policies are posted and available in writing in all promedica facilities. Also, financial advocates are available to help patients by explaining our free care and discount programs, and to assist with the paperwork necessary to qualify for government funding. Patient bills provide clear explanations, qualifications and reminders of these programs. In summary, promedica demonstrates its mission and core values by providing high-quality health care to all patients, regardless of their race, creed, sex, national origin, disability, or age. And, we recognize that not all individuals possess the ability to purchase essential medical care. Therefore, we provide these healthcare services; recruit and train healthcare professionals to serve the broader community; provide appropriate financial assistance; offer services and contributions to other nonprofit organizations that allow them to provide key services to their constituents; and present free educational classes, health fairs and other activities to our local community to help ensure all members have equal access to care.”

“Lenawee long term care (lltc, d/b/a provincial house of adrian) is a 117-bed nursing home facility located in adrian, michigan. Lltc is part of promedica health system, inc. (promedica), a mission-based, locally owned, nonprofit healthcare organization highly focused on achieving core values. Headquartered in toledo, ohio, promedica serves 27 counties in northwest ohio and southeast michigan, and is one of the region's leading healthcare providers. Our stewardship of resources has enabled us to wisely invest in patient-centered care, advanced technology, innovative programs, and family-oriented facilities that help to ensure patients and area residents have equal access to high-quality, safe care in the most appropriate setting, regardless of patients' ability to pay. Lltc is a long-term care facility designed to provide assistance to individuals who no longer are able to care for themselves because of physical limitations, chronic conditions, disabilities, or other changes in personal health. Its staff provides skilled nursing services to long-term care residents and patients who require post-hospital care in order to return to a home setting. In 2015, lltc provided a total of 40,038 long-term care days to its residents. Thirty-four volunteers donated more than 885 hours of assistance to care for these individuals. Lltc contributed $861,000 in community benefit in 2015, all of which was attributed to the costs - not reimbursed by the government - for treating medicaid patients. Lltc's cost of bad debt for 2015 was $365,000. This amount is not included in the community benefit amount of $861,000 noted above. During 2015, lltc expended $3,784,000 in net payroll, providing 139 jobs in southeast michigan. A total of $167,000 was withheld in employee state and local taxes. Lltc demonstrates promedica's mission and core values by providing high-quality health care to all patients, regardless of their race, creed, sex, national origin, disability, or age. And, we recognize that not all individuals possess the ability to purchase essential medical care. Therefore, promedica provides these healthcare services; recruits and trains healthcare professionals to serve the broader community; provides appropriate financial assistance; offers services and contributions to other nonprofit organizations that allow them to provide key services to their constituents; and presents free educational classes, health fairs and other activities to our local community to help ensure all members have equal access to care.”

“Promedica health system, inc. And its subsidiaries (promedica) prepares its community benefit reports using reporting guidelines published by the catholic health association of the united states and consistent with form 990, schedule h, hospitals, reporting. Community benefits are programs and activities that provide treatment and/or promote health and healing as a response to identified community needs. Community benefits reported by promedica respond to identified community needs and meet at least one of the following criteria: - improve access to healthcare service. - enhance the health of the community. - advance healthcare knowledge. - relieve or reduce the burden of government or other community efforts. Financial assistance consistent with its mission, promedica provides a significant amount of financial assistance to patients with limited or no ability to pay their bill. Promedica hospitals provide free care to those uninsured patients with incomes up to 200% of the federal poverty level. Significant discounts are also provided on a sliding scale to uninsured patients up to 400% of the federal poverty level. Financial assistance is reported in the form of cost to provide services and has been reduced to reflect reimbursement received from state programs designed to relieve the burden of providing financial assistance. The cost of financial assistance does not include the costs for accounts that are written off to bad debt for patients that do not pay their bill. Government-sponsored health care government-sponsored health care include services that are reimbursed or partially reimbursed through federal, state and local means-tested programs such as medicaid. Promedica includes the unpaid costs of these public programs to the extent that payments received are less than the costs of providing services. The unpaid costs of treating medicare patients is reported separately and is not included in promedica's community benefit report. Additionally, the cost of financial assistance has been eliminated from any amounts reported in this category. Community health improvement services & community benefit operations community health improvement services include activities carried out for the express purpose of improving community health. These activities do not generate inpatient or outpatient bills as they extend beyond patient care activities and are subsidized by promedica. Community benefit operations include costs associated with dedicated staff, community health need and/or assessment, and other costs associated with community benefit planning and administration. Health professions education health professions education include costs for all educational programs promedica is involved with, the provision of a clinical setting for training for healthcare students outside the organization, and funding for healthcare education. Subsidized health services subsidized health services are services provided to the community despite a financial loss. These services generate a bill for reimbursement, and include clinical patient care services that are provided because they are needed in the community and other providers are unwilling, or unable, to provide the services, or the services otherwise would not be available to meet community needs. Research research activities include clinical and community health research, as well as studies on healthcare delivery. The amount reported for promedica is reduced by any external subsidies, such as grants. Cash and in-kind contributions cash and in-kind contributions include funds and in-kind services donated to community organizations and the community at large. In-kind services include hours donated by staff for community needs while on work time; as well as donations of food, equipment and supplies.”