PART I, LINE 3C:
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THE ORGANIZATION USES THE FOLLOWING FPG TO DETERMINE ELIGIBILITY FORPROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS:200% OR BELOW OF FPL IS ENTITLED TO A 100% REDUCTION250% OF FPL IS ENTITLED TO A 90% REDUCTION300% OF FPL IS ENTITLED TO A 80% REDUCTION350% OF FPL IS ENTITLED TO A 75% REDUCTION
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PART I, LINE 7:
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(A) - (C) COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS INSTRUCTIONS FOR LINES A-C. (E) - (I) COSTING METHODOLOGY IS ACTUAL COSTS PER THE HOSPITAL ACCOUNTING SYSTEM FOR LINES E-I.
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PART I, LINE 7, COLUMN (F):
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THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,723,263.
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PART II, COMMUNITY BUILDING ACTIVITIES:
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1. PHYSICAL IMPROVEMENTS AND HOUSINGA. THE HEALTHY VAN BUREN PROJECT: A POLICY SYSTEMS AND ENVIRONMENTAL CHANGE INITIATIVE. A 20+ PERSON COALITION FORMED TO GATHER AND ASSESS VAN BUREN COUNTY RESIDENTS' NEEDS SPECIFICALLY RELATED TO BARRIERS TO HEALTHY EATING AND BEING PHYSICALLY ACTIVE. REACH: 641 COMMUNITY MEMBERS.B. HOSPITAL HOSPITALITY HOUSE OF SOUTHWEST MICHIGAN: HOSPITAL HOSPITALITY HOUSE OF SOUTHWEST MICHIGAN CONSTRUCTED TWO NEW HOUSES TO REPLACE ITS COSTLY AND OUTDATED HISTORIC HOUSE ON SOUTH STREET. BRONSON DONATED LAND AND MADE FINANCIAL AND IN-KIND CONTRIBUTIONS TO THE CAMPAIGN INCLUDING A $15,000 SPONSORSHIP OF ITS RECEPTION AREA BY THE BRONSON EXECUTIVE TEAM. THE BURDICK STREET HOUSE NEAR BMH OPENED IN FEBRUARY 2019 AND PROVIDED 3,100 GUEST NIGHTS TO BRONSON FAMILIES IN 2019.2. COMMUNITY SUPPORT A. COMMUNITY OUTREACH AND SUPPORT: THE EMPLOYEES AT BLH HOLD FOOD DRIVES FOR THE LOCAL FOOD PANTRIES AND ADOPT SEVERAL IN NEED FAMILIES EACH HOLIDAY SEASON. EMPLOYEES ARE ABLE TO PROVIDE MEDICAL SUPPORT TO MANY COMMUNITY ACTIVITIES AS PART OF THEIR SCHEDULED WORK TIME. BLH IS THE ONLY HOSPITAL IN THE BRONSON SYSTEM THAT HAS CRITICAL ACCESS HOSPITAL (CAH) DESIGNATION. BLH PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A HOST OF EDUCATIONAL PROGRAMS AND ACTIVITIES, INCLUDING CPR CLASSES, BLOOD PRESSURE SCREENINGS, MAMMOGRAPHY SCREENINGS AND SUPPORT GROUPS FOR CAREGIVERS OF PATIENTS WITH ALZHEIMER'S DISEASE.B. INSURANCE ENROLLMENT OUTREACH AND SUPPORT: THE BRONSON CERTIFIED APPLICATION COUNSELORS ARE AN IMPORTANT COMMUNITY SERVICE PROVIDED THROUGH THE COMMUNITY HEALTH, EQUITY AND INCLUSION OF BRONSON HEALTHCARE GROUP. THE CHEI SPECIALIST PROVIDES HEALTH COVERAGE ENROLLMENT ASSISTANCE TO CONSUMERS IN SOUTHWEST MICHIGAN FOR THE PERIOD OF JANUARY 1, 2019-DECEMBER 31, 2019. OVER THE PROJECT PERIOD, TARGETED OUTREACH AND ENROLLMENT SERVICES WERE PROVIDED, TO BOTH CONSUMERS ENROLLING IN THE HEALTH INSURANCE MARKETPLACE AND IN THE HEALTHY MICHIGAN PLAN, MICHIGAN'S EXPANDED MEDICAID PROGRAM, AS WELL AS IN OTHER MEDICAID/CHIP PROGRAMS. ASSISTANCE WAS PROVIDED DURING ONE OPEN ENROLLMENT PERIOD IN THE HEALTH INSURANCE MARKETPLACE (NOVEMBER 1, 2019-DECEMBER 15, 2019). ASSISTANCE WITH MARKETPLACE APPLICATIONS TO CONSUMERS WHO WERE ELIGIBLE FOR COVERAGE OUTSIDE OF THE ANNUAL ENROLLMENT DUE TO ELIGIBILITY FOR A SEP (SPECIAL ENROLLMENT PERIOD) WAS OFFERED ALL YEAR. DURING THE YEAR, ASSISTANCE WAS GIVEN TO CONSUMERS WITH ENROLLMENT AND ANNUAL REDETERMINATION IN THE HEALTHY MICHIGAN PLAN AND OTHER MEDICAID PROGRAMS.3. COALITION BUILDING A. SOUTHWEST MICHIGAN PERINATAL COLLABORATIVE: OUR FOCUS REMAINS ON BOTH OVERALL INFANT MORTALITY (GOAL OF 3.0/1000) AND THE ELIMINATION OF DISPARITIES. BRONSON ALSO CONTINUES TO PARTICIPATE IN THE MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES (MDHHS) MOTHER INFANT HEALTH & EQUITY IMPROVEMENT PLAN, A STATEWIDE EFFORT TO IMPROVE THE HEALTH OF MOMS AND BABIES IN MICHIGAN. THROUGH THE SOUTHWEST MICHIGAN PERINATAL QUALITY IMPROVEMENT COLLABORATIVE, BRONSON STAFF WORKED WITH MULTIPLE MEMBERS ACROSS SEVEN COUNTIES TO CREATE "A LOCALLY LINKED AND COORDINATED NETWORK OF SERVICES FOR MOTHERS AND THEIR BABIES COMMITTED TO THE HIGHEST ATTAINABLE STANDARD OF HEALTH AVAILABLE IN MICHIGAN" WITH THE VISION OF "ZERO PREVENTABLE DEATHS. ZERO DISPARITIES."B. VAN BUREN COMMUNITY HEALTH COMMITTEE: FORMED IN 2018, THE FOCUS OF THIS COLLABORATIVE HAS BEEN TO ELEVATE COMMUNITY VOICE TO ADDRESS THE ROOT CAUSES OF HEALTH DISPARITIES IN VAN BUREN COUNTY. BRONSON HEALTHCARE SERVES IN A LEADERSHIP CAPACITY AND HAS CONTINUED TO SUPPORT THE COLLABORATIVE WITH VARIOUS COMMUNITY HEALTH INITIATIVES. 4. WORKFORCE DEVELOPMENT A. WORKFORCE ENGAGEMENT AND DIVERSITY NEEDS: THE RECRUITMENT AND RETENTION OF STAFF CONTINUES TO BE A CHALLENGE FOR BRONSON AS WE DEAL WITH NATIONAL SHORTAGES IN VARIOUS HEALTHCARE OCCUPATIONS AND A LOW UNEMPLOYMENT RATE. THE MULTI-YEAR RECRUITMENT AND RETENTION PLAN IMPLEMENTED IN EARLY 2018 WAS DESIGNED TO MEET THESE CHALLENGES WITH THE FOLLOWING AREAS OF FOCUS IN 2019: - MAINTAINED OUR AVERAGE TIME TO FILL POSITIONS OF 36 DAYS - ENGAGED IN CAREER PREPARATION THROUGH SCHOOL AND PROFESSIONAL PARTNERSHIPS (COMPASS HIGH SCHOOLCNA PROGRAM, WOMEN'S CO-OP, MICHIGAN REHABILITATION SERVICES, YOUTH OPPORTUNITIES UNLIMITED, MICHIGAN CAREER & TECHNICAL INSTITUTE) - EXPANDED DIGITAL AND SOCIAL MEDIA RECRUITMENT TACTICS (E.G. HANDSHAKE ALLOWS US TO BE INTENTIONAL WITH ADVERTISING POSITIONS/EVENTS AT HISTORICALLY BLACK COLLEGES AND UNIVERSITIES) - CONTINUED TO HOST RECRUITMENT EVENTS SUCH AS TEST DRIVES AND OPEN INTERVIEW/OPEN HOUSES FOR RELEVANT OPENINGS AT TARGETED LOCATIONS AS WELL AS COMMUNITY AGENCIES - USED RETENTION AND SIGN ON BONUSES FOR HARD TO FILL POSITIONS - ENHANCED INTERNAL CAREER DEVELOPMENT PATHWAYS 5. OTHER A. IMPLEMENTATION OF THE AHA EQUITY PLEDGE PLAN: BRONSON CREATED AN EQUITY OF CARE FRAMEWORK TO PROVIDE SYSTEM GOALS AND TACTICS FOR THE AHA EQUITY OF CARE PLEDGE. ADDITIONALLY, WE CREATED A HEALTH EQUITY OF CARE PERFORMANCE IMPROVEMENT COMMITTEE TO GUIDE THE ORGANIZATION IN THIS WORK. THERE ARE FOUR HEALTH EQUITY OF CARE GOALS: 1) BUILD AND STRENGTHEN COMMUNITY RELATIONSHIPS AND PARTNERSHIPS TO ADVANCE HEALTH EQUITY; 2) INCREASE THE COLLECTION, REPORTING AND ANALYSIS OF ACCURATE SOCIAL DEMOGRAPHIC DATA TO PRIORITIZE AND DETERMINE INTERVENTIONS; 3) IMPROVE OUR KNOWLEDGE, SKILLS AND BEHAVIORS TO MEET THE SOCIAL, CULTURAL AND LINGUISTIC NEEDS OF OUR EMPLOYEES, PATIENTS AND FAMILIES; AND 4) INCREASE THE DIVERSITY OF LEADERSHIP AND GOVERNANCE TO SUPPORT, ASSIST, AND ADVOCATE FOR EMPLOYEES, PATIENTS AND FAMILIES. BRONSON EXPANDED COLLECTION OF RACE, ETHNICITY AND LANGUAGE DATA AND BEGAN STRATIFYING PATIENT EXPERIENCE DATA BY AGE, GENDER, RACE AND ETHNICITY. WE CONTINUE TO IMPROVE OUR KNOWLEDGE, SKILLS AND BEHAVIORS TO MEET THE SOCIAL, CULTURAL AND LINGUISTIC NEEDS OF OUR EMPLOYEES, PATIENTS AND FAMILIES IN SEVERAL WAYS. WE INCREASED AMBULATORY SELF-SCHEDULING OF INTERPRETERS AND A NEW EQUITY OF CARE COMPUTER-BASED LEARNING MODULE WAS REQUIRED FOR ALL BRONSON EMPLOYEES. THE COMMUNITY HEALTH, EQUITY AND INCLUSION TEAM EDUCATED OVER 2,400 EMPLOYEES AS WELL AS 3,300 PEOPLE IN OUR PRIMARY SERVICE AREA.
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PART III, LINE 2:
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UNCOLLECTIBLE AMOUNTS ARE WRITEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. BAD DEBT EXPENSE IS DISCLOSED BASED ON GROSS CHARGES.
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PART III, LINE 3:
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BAD DEBT WRITEOFFS SUPPORT THE COMMUNITY BY PROVIDING A PORTION OF SERVICES WITHOUT PAYMENT. THE AMOUNT OF BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS ESTIMATED BY REVIEWING THE BAD DEBT DETAIL FOR A SPECIFIC WRITE-OFF CODE.
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PART III, LINE 4:
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ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE 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 SIGNIFICANT IMPLICIT PRICE CONCESSIONS 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. THIS CAN BE FOUND IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER NOTE 2 SIGNIFICANT ACCOUNTING POLICIES FOR ACCOUNTS RECEIVABLE.
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PART III, LINE 8:
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COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS 990 INSTRUCTIONS. SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT DUE TO ITS REPRESENTATION OF COST OF A PORTION OF SERVICES PROVIDED TO THE COMMUNITY WITHOUT PAYMENT.
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PART III, LINE 9B:
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THE POLICY REQUIRES THE COLLECTION AGENCY BE NOTIFIED AND ACTIVITY SUSPENDED WHEN A REQUEST FOR FINANCIAL ASSISTANCE IS MADE AND A PATIENT SUBMITS AN APPLICATION ON A PREVIOUSLY LISTED ACCOUNT. THE COLLECTION AGENCY IS NOTIFIED THE SAME DAY THE APPLICATION IS RECEIVED. IF A PATIENT QUALIFIES FOR FULL FINANCIAL ASSISTANCE, THE ACCOUNT IS RETURNED TO BRONSON FROM THE AGENCY AND ANY INITIATED ECA IS REVERSED. IF THE PATIENT QUALIFIES FOR PARTIAL FINANCIAL ASSISTANCE, A DETERMINATION IS SENT TO THE AGENCY INDICATING THE NEW BALANCE AND ANY INITIATED ECA IS REVERSED. IF THE PATIENT DOES NOT PROVIDE COMPLETE APPLICATION INFORMATION OR IS DETERMINED TO BE INELIGIBLE, A DENIAL LETTER IS ISSUED AND THE AGENCY RESUMES COLLECTION ACTIVITY. FURTHERMORE, THE POLICY REQUIRES THAT BRONSON SEND A RESPONSE TO PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE WITHIN 30 BUSINESS DAYS (45 DAYS). IF THE APPLICATION IS APPROVED, THE APPLICATION WILL WORK THROUGH THE FINAL PROCESSES. IF BRONSON NEEDS MORE INFORMATION, BRONSON MUST REQUEST IT FROM THE PATIENT WITHIN THE 45 DAY TIME FRAME. IF REQUESTED INFORMATION IS NOT RECEIVED WITHIN 15 DAYS OF THE LETTER, BRONSON WILL DENY THE APPLICATION AND A DENIAL LETTER SENT TO THE PATIENT. BRONSON WILL HOLD THE APPLICATION FOR 60 DAYS IN CASE THE REQUESTED INFORMATION COMES IN AFTER THE 15 DAYS. IF THE APPLICATION IS 60 DAYS OLD, AND REQUESTED INFORMATION IS NOT RECEIVED, THE APPLICATION IS DECLINED, AND THE PATIENT WOULD NEED TO SUBMIT A NEW APPLICATION. IF THE APPLICATION IS DECLINED, BRONSON THEN NOTIFIES THE COLLECTION AGENCY TO RESUME COLLECTIONS. SIGNATURES ARE ONLY GOOD FOR 60 DAYS WHEN BRONSON IS REQUESTING ADDITIONAL INFORMATION. ONCE AN APPLICATION IS APPROVED, THE COLLECTION AGENCY IS NOTIFIED VIA EMAIL OF THE APPROVAL PERCENTAGE OR DENIED ON THE SAME DAY THE APPLICATION IS COMPLETED.
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PART VI, LINE 2:
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BRONSON HEALTHCARE GROUP UTILIZES A STRATEGIC MANAGEMENT MODEL TO DEVELOP BOTH A LONG TERM (3 YEAR) AND ANNUAL STRATEGIC PLAN. INPUTS INTO THE PLAN ARE DOCUMENTED IN OUR STRATEGIC INPUT DOCUMENT. ONE OF THE IMPORTANT INPUTS INTO THIS PLAN IS THE HEALTH OF OUR COMMUNITY. IN ADDITION TO THE CHNA DATA SOURCES LISTED IN PART V SECTION B LINE 5, THE FOLLOWING SOURCES ARE USED TO INFORM OUR STRATEGIC PLAN:1. SG2 MARKET ESTIMATES2. SG2 IP/OP FORECAST3. SG2 AMBULATORY MARKET STRATEGIST4. SG2 MARKET DEMOGRAPHICS FROM CLARITAS
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PART VI, LINE 3:
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THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE EMERGENCY ROOM, THE ADMITTING DEPARTMENT, THE PATIENT FINANCIAL COUNSELING OFFICE, AND THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). THE PLAIN LANGUAGE SUMMARY IS ALSO INCLUDED IN THE PATIENT'S DISCHARGE DOCUMENTS, ON PATIENT STATEMENTS AND THE HOSPITAL'S WEBSITE. BOTH THE POLICY AND THE PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST.
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PART VI, LINE 4:
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BRONSON LAKEVIEW HOSPITAL (BLH) SERVES VAN BUREN COUNTY WHICH IS APPROXIMATELY 75,000 RESIDENTS. THE COUNTY IS AGRICULTURAL AND HAS HIGHER THAN STATE AVERAGE UNEMPLOYMENT. FIVE PROVIDER BASED HEALTH CLINICS ARE STRATEGICALLY PLACED THROUGHOUT EASTERN VAN BUREN COUNTY TO PROVIDE ACCESS TO CARE. THE CLINICS ACCEPT PATIENTS REGARDLESS OF ABILITY TO PAY AND HAVE CHARITY CARE PROCESSES IN PLACE.
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PART VI, LINE 5:
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COLLABORATION WITH COMMUNITY STAKEHOLDERSAS PREVIOUSLY MENTIONED, BSHH SEEKS COMMUNITY COLLABORATORS AND STAKEHOLDERS AS PARTNERS ON MEETING COMMUNITY HEALTH NEEDS, ADDRESSING MULTI-SECTOR ISSUES, AND LEADING DISASTER/EMERGENCY EFFORTS. TOWARDS THIS END, BSHH AND ITS EMPLOYEES ACTIVELY PARTICIPATE IN AND PROVIDE SUPPORT TO MANY COMMUNITY ORGANIZATIONS. THESE INCLUDE PARTICIPATION IN THE 5TH DISTRICT MEDICAL RESPONSE COALITION, VAN BUREN COUNTY MEDICAL COUNTRY AUTHORITY, VAN BUREN EMERGENCY OPERATIONS AND LOCAL EMERGENCY PLANNING COMMITTEES, HEALTH FAIRS AND EXPOS, UNITED WAY OF SOUTHWEST MICHIGAN, VAN BUREN COMMUNITY HEALTH COMMITTEE, VAN BUREN HUMAN SERVICES COLLABORATIVE, KIWANIS LEADERSHIP, LAKEVIEW FOUNDATION, GIRLS ON THE RUN OF SOUTHWEST MICHIGAN ADVISORY BOARD, AREA AGENCY ON AGING, AND PAW PAW CORPORATE COLLABORATIONS. REPORTING TO THE COMMUNITYBLH CONDUCTS AN ANNUAL COMMUNITY BENEFIT INVENTORY TO AGGREGATE THE NON-MISSION MANDATED SERVICES WE PROVIDE TO THE COMMUNITY. THIS INVENTORY IS SHARED WITH BRONSON STAKEHOLDERS AND REPORTED TO THE COMMUNITY. INFORMATION IS AVAILABLE TO ALL THROUGH BRONSONHEALTH.COM
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PART VI, LINE 6:
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BLH IS PART OF AN AFFILIATED SYSTEM THAT SERVES NINE COUNTIES AND INCLUDES THREE OTHER HOSPITALS, BRONSON BATTLE CREEK HOSPITAL, BRONSON SOUTH HAVEN HOSPITAL, AND BRONSON METHODIST HOSPITAL. ALL OF THESE HOSPITALS ARE CONTROLLED BY BRONSON HEALTHCARE GROUP, WHICH IS A COMMUNITY-OWNED AND GOVERNED NON-FOR-PROFIT HOLDING COMPANY. THE BRONSON HEALTHCARE GROUP (BHG) BOARD IS COMPRISED OF 21 MEMBERS FROM THE COMMUNITIES IT SERVES. EACH OF THE THREE HOSPITALS IN THE BRONSON HEALTHCARE SYSTEM ADMITS PATIENTS REGARDLESS OF ABILITY TO PAY AND PROVIDES OUTREACH SERVICES TO THEIR RESPECTIVE COMMUNITIES. IN ADDITIONAL TO THE FOUR HOSPITALS, THE BHG SYSTEM INCLUDES SEVERAL SMALLER ENTITIES WHOSE ACTIVITIES SUPPORT THE HOSPITALS AND THEIR MISSION OF "TOGETHER, WE ADVANCE THE HEALTH OF OUR COMMUNITIES." THESE ENTITIES INCLUDE: BRONSON HEALTHCARE GROUP, BRONSON COMMONS, BRONSON LIFESTYLE IMPROVEMENT & RESEARCH CENTER, BRONSON HEALTHCARE FOUNDATION, BRONSON AT HOME, VAN BUREN EMERGENCY MEDICAL SERVICES, AND BRONSON PROPERTIES CORPORATION.
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PART VI, LINE 7, REPORTS FILED WITH STATES
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MI
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