SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
MCLAREN GREATER LANSING
 
Employer identification number

38-1434090
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    178,331   178,331 0.040 %
b Medicaid (from Worksheet 3, column a) . . . . .     69,881,018 55,836,551 14,044,467 3.390 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     70,059,349 55,836,551 14,222,798 3.430 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     108,465 11,299 97,166 0.020 %
f Health professions education (from Worksheet 5) . . .     13,704,696 6,810,935 6,893,761 1.660 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     902,369   902,369 0.220 %
j Total. Other Benefits . .     14,715,530 6,822,234 7,893,296 1.900 %
k Total. Add lines 7d and 7j .     84,774,879 62,658,785 22,116,094 5.330 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 26 11,299 108,465   108,465 0.030 %
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total 26 11,299 108,465   108,465 0.030 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
23,181,943
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
102,247,892
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
88,088,052
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
14,159,840
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
11 LAKE LANSING ASC PARTNERS LLC
  		AMBULATORY SURGERY CENTERS 27.000 %   46.000 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
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?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 MCLAREN GREATER LANSING
401 W GREENLAWN AVENUE
LANSING,MI48910
1060000073 		X X   X     X      
2 IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL
2727 S PENNSYLVANIA AVENUE
LANSING,MI48910
1060000171 		X X   X   X        
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
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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)
MCLAREN GREATER LANSING
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://TINYURL.COM/YAWXCYL4
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Page 5
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MCLAREN GREATER LANSING
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPS://TINYURL.COM/YYA9C5OC
b
HTTPS://TINYURL.COM/YYA9C5OC
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
MCLAREN GREATER LANSING
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
MCLAREN GREATER LANSING
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Page 4
Schedule H (Form 990) 2018
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)
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://TINYURL.COM/Y2SX632W
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Page 5
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPS://TINYURL.COM/YYA9C5OC
b
HTTPS://TINYURL.COM/YYA9C5OC
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Page 6
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
Page 7
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Page 8
Schedule H (Form 990) 2018
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, 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
MCLAREN GREATER LANSING PART V, SECTION B, LINE 5: TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT, MCLAREN GREATER LANSING PARTICIPATED IN A COMMUNITY COLLABORATIVE CALLED HEALTHY CAPITAL COUNTIES (HCC). TWO PRIMARY DATA SOURCES WERE USED IN THE DEVELOPMENT OF THIS REPORT: FOCUS GROUPS AND THE CAPITAL AREA BEHAVIORAL RISK FACTOR AND SOCIAL CAPITAL SURVEY.
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL PART V, SECTION B, LINE 5: TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT, MCLAREN GREATER LANSING PARTICIPATED IN A COMMUNITY COLLABORATIVE CALLED HEALTHY CAPITAL COUNTIES (HCC). TWO PRIMARY DATA SOURCES WERE USED IN THE DEVELOPMENT OF THIS REPORT: FOCUS GROUPS AND THE CAPITAL AREA BEHAVIORAL RISK FACTOR AND SOCIAL CAPITAL SURVEY.
MCLAREN GREATER LANSING PART V, SECTION B, LINE 6A: EATON RAPIDS MEDICAL CENTERHAYES GREEN BEACH MEMORIAL HOSPITALSPARROW HEALTH SYSTEMMCLAREN ORTHOPEDIC HOSPITAL
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL PART V, SECTION B, LINE 6A: EATON RAPIDS MEDICAL CENTERHAYES GREEN BEACH MEMORIAL HOSPITALSPARROW HEALTH SYSTEMMCLAREN GREATER LANSING HOSPITAL
MCLAREN GREATER LANSING PART V, SECTION B, LINE 6B: BARRY-EATON DISTRICT HEALTH DEPARTMENTINGHAM COUNTY HEALTH DEPARTMENTMID-MICHIGAN DISTRICT HEALTH DEPARTMENT
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL PART V, SECTION B, LINE 6B: BARRY-EATON DISTRICT HEALTH DEPARTMENTINGHAM COUNTY HEALTH DEPARTMENTMID-MICHIGAN DISTRICT HEALTH DEPARTMENT
MCLAREN GREATER LANSING PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN CAN BE FOUND AT HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN CAN BE FOUND AT HTTP://WWW.MCLAREN.ORG/LANSING/HEALTH-COMMUNITY-NEEDS.ASPX
MCLAREN GREATER LANSING PART V, SECTION B, LINE 11: THE HOSPITAL HAS SELECTED TO FOCUS ITS LIMITED RESOURCES ON FOUR OF THE FIVE NEEDS DETERMINED IN THE CHNA. WE WILL BE FOCUSING ON ACCESS TO PRIMARY HEALTHCARE PROVIDERS BY ENSURING ADEQUATE SUCCESSION PLANNING FOR PROVIDERS, RESIDENT RETENTION, ADDING MIDLEVEL PROVIDERS, MAINTAINING OUR LOW OR NO COST MULTISPECIALTY CLINIC, AND SUPPORTING OTHER LOW COST PRIMARY CARE SERVICES. OUR STRATEGY FOR QUALITY HEALTHCARE IS BEING A PART OF A STATEWIDE HEALTH CARE SYSTEM WHOSE MISSION IS TO PROVIDE THE BEST VALUE IN HEALTHCARE DEFINED BY QUALITY OUTCOMES AND COST. IN ADDITION WE WILL ALSO PARTICIPATE IN NUMEROUS CONSORTIUMS AND COLLABORATIVES WITH THE PURPOSE OF PROVIDING QUALITY HEALTHCARE. THE MENTAL HEALTH NEEDS WILL BE ADDRESSED BY ADDING ADDITIONAL PSYCHIATRIC NURSE PRACTITIONER TO THE INPATIENT SETTING, EXPANDING PSYCHIATRIC SOCIAL WORK IN THE ED, AND PARTNERING WITH PHYSICIANS IN THE OUTPATIENT SETTING TO STANDARDIZE SCREENINGS AND EVALUATION TOOLS IN ADDITION TO MAINTAINING OUR GEMS CARE FOR THE ELDERLY. LASTLY CHRONIC DISEASE STRATEGIES WILL INCLUDE INCREASING PREVENTATIVE SCREENINGS AND INCREASED OFFERINGS AND PUBLIC AWARENESS OF DISEASE MANAGEMENT RESOURCES. THE FULL PLAN CAN BE READ AT: HTTPS://WWW.MCLAREN.ORG/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENTTHE ONLY NEED NOT BEING ADDRESSED IN THE PLAN IS FINANCIAL STABILITY. THIS RELATES TO THE PATIENT'S FINANCIAL STABILITY WHICH THE HOSPITAL ADDRESSES EVERY DAY IN OUR DAY TO DAY OPERATIONS. OUR MISSION STATEMENT IS TO PROVIDE THE BEST VALUE IN HEALTHCARE AS DEFINED BY QUALITY OUTCOMES AND COST. WITH THIS MISSION WE ARE BRINGING THE LOWEST COST AND BEST QUALITY HEALTHCARE TO THE PATIENTS, THUS HELPING IN THEIR FINANCIAL STABILITY. SO WHILE WE ARE NOT DIRECTLY ADDRESSING IT IN OUR CHNA IMPLEMENTATION PLAN, WE DO ADDRESS IT EVERY DAY DURING OUR NORMAL OPERATIONS.
IRMC DBA MCLAREN ORTHOPEDIC HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL HAS SELECTED TO FOCUS ITS LIMITED RESOURCES ON FOUR OF THE FIVE NEEDS DETERMINED IN THE CHNA. WE WILL BE FOCUSING ON ACCESS TO PRIMARY HEALTHCARE PROVIDERS BY ENSURING ADEQUATE SUCCESSION PLANNING FOR PROVIDERS, RESIDENT RETENTION, ADDING MIDLEVEL PROVIDERS, MAINTAINING OUR LOW OR NO COST MULTISPECIALTY CLINIC, AND SUPPORTING OTHER LOW COST PRIMARY CARE SERVICES. OUR STRATEGY FOR QUALITY HEALTHCARE IS BEING A PART OF A STATEWIDE HEALTH CARE SYSTEM WHOSE MISSION IS TO PROVIDE THE BEST VALUE IN HEALTHCARE DEFINED BY QUALITY OUTCOMES AND COST. IN ADDITION WE WILL ALSO PARTICIPATE IN NUMEROUS CONSORTIUMS AND COLLABORATIVES WITH THE PURPOSE OF PROVIDING QUALITY HEALTHCARE. THE MENTAL HEALTH NEEDS WILL BE ADDRESSED BY ADDING ADDITIONAL PSYCHIATRIC NURSE PRACTITIONER TO THE INPATIENT SETTING, EXPANDING PSYCHIATRIC SOCIAL WORK IN THE ED, AND PARTNERING WITH PHYSICIANS IN THE OUTPATIENT SETTING TO STANDARDIZE SCREENINGS AND EVALUATION TOOLS IN ADDITION TO MAINTAINING OUR GEMS CARE FOR THE ELDERLY. LASTLY CHRONIC DISEASE STRATEGIES WILL INCLUDE INCREASING PREVENTATIVE SCREENINGS AND INCREASED OFFERINGS AND PUBLIC AWARENESS OF DISEASE MANAGEMENT RESOURCES. THE FULL PLAN CAN BE READ AT: WWW.MCLAREN.ORG/LANSING/HEALTH-COMMUNITY-NEEDS.ASPXTHE ONLY NEED NOT BEING ADDRESSED IN THE PLAN IS FINANCIAL STABILITY. THIS RELATES TO THE PATIENT'S FINANCIAL STABILITY WHICH THE HOSPITAL ADDRESSES EVERY DAY IN OUR DAY TO DAY OPERATIONS. OUR MISSION STATEMENT IS TO PROVIDE THE BEST VALUE IN HEALTHCARE AS DEFINED BY QUALITY OUTCOMES AND COST. WITH THIS MISSION WE ARE BRINGING THE LOWEST COST AND BEST QUALITY HEALTHCARE TO THE PATIENTS, THUS HELPING IN THEIR FINANCIAL STABILITY. SO WHILE WE ARE NOT DIRECTLY ADDRESSING IT IN OUR CHNA IMPLEMENTATION PLAN, WE DO ADDRESS IT EVERY DAY DURING OUR NORMAL OPERATIONS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
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?29
Name and address Type of Facility (describe)
1 1 - MGL MMP IMAGING CENTER
1540 LAKE LANSING RD SUITE 107
LANSING,MI48912 		PHYSICIAN PRACTICE
2 2 - MCLAREN MEDICAL ONCOLOGY
2901 STABLER STREET
LANSING,MI48910 		PHYSICIAN PRACTICE
3 3 - MCLAREN CARDIOVASCULAR GROUP
2134 HAMPTON PLACE
OKEMOS,MI48864 		PHYSICIAN PRACTICE
4 4 - MGL MMP HEALTH ASSOCIATES
1540 LAKE LANSING RD STE 102
LANSING,MI48912 		PHYSICIAN PRACTICE
5 5 - MGL MMP INTERNAL MEDICINE ASSOCIATE
1540 LAKE LANSING RD STE 201
LANSING,MI48912 		PHYSICIAN PRACTICE
6 6 - MCLAREN DIGESTIVE DISEASE CENTER
3937 PATIENT CARE WAY 106
LANSING,MI48911 		PHYSICIAN PRACTICE
7 7 - MGL MMP HEMATOLOGY ONCOLOGY
1540 LAKE LANSING RD STE 103
LANSING,MI48912 		PHYSICIAN PRACTICE
8 8 - MCLAREN CARDIOTHORACIC & VASCULAR
405 W GREENLAWN 305
LANSING,MI48910 		PHYSICIAN PRACTICE
9 9 - MCLAREN JOLLY RD OT
3394 E JOLLY RD
LANSING,MI48910 		PHYSICAL AND OCCUPATIONAL THERAPY
10 10 - MCLAREN DEWITT HEALTHCARE
12805 ESCANABA DR SUITE 2
DEWITT,MI48820 		PHYSICIAN PRACTICE
11 11 - MGL MMP URGENT CARE
5525 S MARTIN LUTHER KING BLVD
LANSING,MI48911 		URGENT CARE
12 12 - MGL MMP CARDIOLOGY
1540 LAKE LANSING RD STE G02
LANSING,MI48912 		PHYSICIAN PRACTICE
13 13 - MCLAREN PRIMARY CARE
2270 JOLLY OAK RD 1
OKEMOS,MI48864 		PHYSICIAN PRACTICE
14 14 - MCLAREN GRAND LEDGE
1035 CHARLEVOIX
GRAND LEDGE,MI48837 		PHYSICIAN PRACTICE
15 15 - MCLAREN OKEMOS WOMENS HEALTH
2104 JOLLY RD 220
OKEMOS,MI48864 		PHYSICIAN PRACTICE
16 16 - MCLAREN OKEMOS COMMUNITY MEDICINE
2104 JOLLY RD 240
OKEMOS,MI48864 		PHYSICIAN PRACTICE
17 17 - MCLAREN LANSING FAMILY MEDICINE
2815 S PENNSYLVANIA AVE STE 105
LANSING,MI48910 		PHYSICIAN PRACTICE
18 18 - MGL MMP FAMILY MEDICINE & LIPIDOLOGY
1540 LAKE LANSING RD STE 202
LANSING,MI48912 		PHYSICIAN PRACTICE
19 19 - MCLAREN REDI CARE
6910 S CEDAR ST 1
LANSING,MI48911 		URGENT CARE
20 20 - MGL MMP FAMILY MEDICINE EAST LANSING
3515 COOLIDGE RD 4
EAST LANSING,MI48823 		PHYSICIAN PRACTICE
21 21 - MGL MMP NORTHSIDE FAMILY MEDICINE
1457 N M52 STE 2
OWOSSO,MI48867 		PHYSICIAN PRACTICE
22 22 - MCLAREN INTERNAL MEDICINE
6465 MILLENNIUM DR 100
LANSING,MI48917 		PHYSICIAN PRACTICE
23 23 - MGL MMP PORTLAND FAMILY MEDICINE
406 KENT ST
PORTLAND,MI48875 		PHYSICIAN PRACTICE
24 24 - MGL MMP MMINIMALLY INVASIVE SURGERY
1540 LAKE LANSING RD STE 104
LANSING,MI48912 		PHYSICIAN PRACTICE
25 25 - MCLAREN WILLIAMSTON FAMILY MEDICINE
1288 WEST GRAND RIVER AVE
WILLIAMSTON,MI48895 		PHYSICIAN PRACTICE
26 26 - MGL MMP FAMILY MEDICINE GRAND LEDGE
11615 HARTEL RD 108
GRAND LEDGE,MI48837 		PHYSICIAN PRACTICE
27 27 - MCLAREN HOLT FAMILY MEDICINE
2450 DELHI COMMERCE DR 16
HOLT,MI48842 		PHYSICIAN PRACTICE
28 28 - MCLAREN PAIN CLINIC
2815 S PENNSYLVANIA AVE STE 101
LANSING,MI48911 		PAIN CLINIC
29 29 - MGL MMP INFECTIOUS DISEASE
1808 S PENNSYLVANIA STE E
LANSING,MI48910 		PHYSICIAN PRACTICE
Schedule H (Form 990) 2018
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Schedule H (Form 990) 2018
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: INCOME CRITERIA IS BASED UPON 200%-400% OF THE FEDERAL POVERTY GUIDELINES PER THE FEDERAL REGISTER. COLLECTIONS MAY BE CONSIDERED IF THE PATIENT HAS SUFFICIENT LIQUID ASSETS.
PART I, LINE 6A: OUR PARENT, MCLAREN HEALTH CARE CORPORATION, PREPARES AN ANNUAL REPORT OF ITS MEMBER HOSPITALS. THIS ANNUAL REPORT IS AVAILABLE ON OUR WEBSITE.
PART I, LINE 7: COSTING METHODOLOGY - USED COST TO CHARGE RATIO FOR LINES 7A, 7B, AND 7C AND ACTUAL COST PER ACCOUNTING SYSTEM FOR LINES 7E, 7F, 7H AND 7I.
PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24E - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $23,181,943.
PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY-BUILDING ACTIVITIES ARE DESIGNED AND IMPLEMENTED BASED ON COMMUNITY NEEDS ASSESSMENTS AND INPUT FROM COMMUNITY-BASED ORGANIZATIONS AND OTHER COMMUNITY STAKEHOLDERS, INCLUDING BUSINESS VENDORS, RELIGIOUS ORGANIZATIONS AND POLITICAL LEADERS. EACH ORGANIZATION DEFINES ANNUAL COMMUNITY-BUILDING AND OUTREACH ACTIVITY PLANS. THESE PLANS ARE DESIGNED TO ADDRESS THE SPECIFIC HEALTH PREVENTION, EDUCATION, DIAGNOSIS, TREATMENT AND FOLLOW-UP CARE REQUIREMENTS OF UNIQUE DISEASE, DEMOGRAPHIC AND GEOGRAPHIC COMMUNITIES IDENTIFIED BY ONGOING NEEDS ASSESSMENTS DESCRIBED ABOVE.
PART III, LINE 2: BAD DEBT EXPENSE ON LINE 2 IS THE BAD DEBT EXPENSE AS REPORTED ON FORM 990 PART IX.
PART III, LINE 4: 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 THE CORPORATION'S 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 CORPORATION'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 CORPORATION 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.
PART III, LINE 8: THE REQUIRED COST REPORT METHODOLOGY WAS USED IN DETERMINING THE ALLOWABLE COSTS REPORTED IN THE COST REPORT.
PART III, LINE 9B: AT THIS TIME WE DO NOT HAVE A FORMAL DEBT COLLECTION POLICY. CURRENTLY OUR PROCESS INCLUDES: SENDING OUR SELF AND PRIVATE PAY PATIENT ACTIVITY TO AN OUTSIDE VENDOR FOR FOLLOW-UP AND ASSISTANCE FOR THE PATIENT. SELF PAY PATIENTS REQUESTING FINANCIAL ASSISTANCE AT REGISTRATION ARE GIVEN A FINANCIAL ASSISTANCE APPLICATION WHICH IS THEN EVALUATED TO DETERMINE IF CHARITY CARE IS APPLICABLE. AN ATTEMPT IS ALSO MADE AT THAT TIME TO ASSIST PATIENTS WHO MEET MEDICAL ELIGIBILITY REQUIREMENTS.
PART VI, LINE 2: PRIMARY AND SECONDARY MARKET RESEARCH IS CONDUCTED BY AND THROUGH COMMUNITY-BASED HEALTH COALITIONS, ACADEMIC INSTITUTIONS, THIRD PARTY DATA ANALYTICS ORGANIZATIONS, HEALTH NEEDS ASSESSMENTS AND SURVEYS, HISTORIC HEALTH SERVICES UTILIZATION PATTERNS, DEMOGRAPHIC ANALYSIS AND POPULATION-BASED HEALTH CARE SERVICES UTILIZATION FORECASTS.
PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION AND APPLICATIONS ARE PROVIDED AT ALL INPATIENT AND OUTPATIENT REGISTRATION POINTS-OF-SERVICE. INFORMATION AND EDUCATION IS ALSO AVAILABLE THROUGH THE ORGANIZATION'S WEBSITE(S). ORGANIZATION AND ITS SUBSIDIARIES/AFFILIATES ALSO PROVIDE SPECIALLY-TRAINED COUNSELORS TO ASSIST PATIENTS AND REVIEW ELIGIBILITY FOR FEDERAL, STATE AND OTHER GOVERNMENT PROGRAMS, INCLUDING, BUT NOT LIMITED TO, MEDICAID, DISABILITY, SOCIAL SECURITY, AND ANY OTHER FORMS OF THIRD PARTY PAYMENT.
PART VI, LINE 4: THE SERVICE AREA OF MCLAREN GREATER LANSING IS COMPOSED OF 51 ZIP CODES AND IS CENTERED PRINCIPALLY ON THE CITY OF LANSING, MI IN THE COUNTY OF INGHAM. THE PRIMARY SERVICE AREA, ACCOUNTING FOR 92% OF ANNUAL INPATIENT DISCHARGES, IS COMPOSED OF 27 ZIP CODES AND CAN BE CHARACTERIZED AS LARGELY URBAN IN NATURE. THE SECONDARY SERVICE AREA, ACCOUNTING FOR 8% OF ANNUAL INPATIENT DISCHARGES, IS COMPOSED OF 24 ZIP CODES AND CAN BE CHARACTERIZED AS A COMBINATION OF URBAN AND RURAL IN NATURE. PRIMARY SERVICE AREA DEMOGRAPHIC DISTRIBUTIONSAGE DISTRIBUTION0 - 14 18.2%15 - 17 4.1%18 - 24 14.2%25 - 34 12.9%35 - 54 26.6%55 - 64 12.0%65+ 11.9%EDUCATION LEVELLESS THAN HIGH SCHOOL 2.6%SOME HIGH SCHOOL 5.6%HIGH SCHOOL DEGREE 26.8%SOME COLLEGE/ASSOC. DEGREE 34.2%BACHELOR'S DEGREE OR GREATER 30.6%HOUSEHOLD INCOME DISTRIBUTION<$15K 12.4%$15 - 25K 11.0%$25 - 50K 27.9%$50 - 75K 20.7%$75 - 100K 12.7%OVER $100K 15.3%RACE/ETHNICITYWHITE NON-HISPANIC 81.2%BLACK NON-HISPANIC 7.8%HISPANIC 5.0%ASIAN & PACIFIC IS. NON-HISPANIC 3.2%ALL OTHERS 2.8%
PART VI, LINE 5: THE PARENT ORGANIZATION AND EACH OF ITS SUBSIDIARY/AFFILIATE MEMBERS MAINTAIN A LOCAL COMMUNITY-BASED BOARD WITH POWERS, RESPONSIBILITIES AND ACCOUNTABILITIES FOR THE OVERSIGHT OF THE OPERATION OF THEIR RESPECTIVE ORGANIZATIONS. EACH SUBSIDIARY/AFFILIATE ORGANIZATION MAINTAINS AN OPEN MEDICAL STAFF ALLOWING ANY PHYSICIAN OR OTHER CARE PROVIDER WITH PROPER CREDENTIALS TO JOIN THE STAFF AND PROVIDE APPROVED CARE. THE ORGANIZATION FUNDS AND MAINTAINS OVER 500 MEDICAL RESIDENCY AND FELLOWSHIP PROGRAMS TO TRAIN FUTURE GENERATIONS OF PHYSICIANS; ORGANIZATION FUNDS, OPERATES AND MAINTAINS NUMEROUS HEALTH CARE EDUCATION PROGRAMS AT THE HIGH SCHOOL, COMMUNITY COLLEGE, UNIVERSITY AND POST-GRADUATE LEVELS OF EDUCATION. ORGANIZATION PROVIDES SPONSORSHIP (FINANCIAL AND IN-KIND RESOURCES) SUPPORT TO COMMUNITY-LEVEL ACTIVITIES (HEALTH WALKS AND RACES, FITNESS TRAINING, DISEASE AWARENESS EVENTS, CULTURAL EVENTS AND OTHER HEALTH-RELATED NON-PROFIT ACTIVITIES, EVENTS AND ORGANIZATIONS). ORGANIZATION ALSO DIRECTS, FUNDS, SUPPORTS AND PARTICIPATES IN FUNDRAISING ACTIVITIES THAT SUPPORT HEALTH PREVENTION/EDUCATION, DIAGNOSIS AND TREATMENT PROVIDED BY OTHER NON-PROFIT COMMUNITY ORGANIZATIONS.
PART VI, LINE 6: THE ROLE OF THE PARENT ORGANIZATION IS TO SET THE VISION AND STRATEGIC DIRECTION FOR THE ORGANIZATION AS A WHOLE. THIS INCLUDES THE DEVELOPMENT OF THE ANNUAL STRATEGIC PLAN WHICH DEFINES THE STRATEGIC PRIORITIES FOR THE ORGANIZATION AND ITS MEMBERS, THE METRICS TO BE MEASURED FOR EACH STRATEGIC PROGRAMS AND THE BENCHMARK OR TARGET/GOALS FOR EACH METRIC. STRATEGIC PRIORITIES DIRECTLY ADDRESS AND MEASURE (AT A SUBSIDIARY LEVEL) CLINICAL QUALITY AND CLINICAL OUTCOMES; PATIENT, PHYSICIAN, EMPLOYEE AND COMMUNITY SATISFACTION WITH THE ORGANIZATION AND ITS SUBSIDIARY/AFFILIATE MEMBERS; AND DEVELOPMENT OF NEW SERVICES TO IMPROVE ACCESS TO, QUALITY OF, AND COST OF HEALTH SERVICES.THE ROLE OF THE ORGANIZATION'S SUBSIDIARIES/AFFILIATES IS THE DEVELOPMENT AND IMPLEMENTATION OF ANNUAL STRATEGIC AND OPERATIONAL PLANS THAT SUPPORT AND ADVANCE THE STRATEGIC PLAN OF THE PARENT ORGANIZATION. ALL LOCAL PLANS ARE DEVELOPED AND DESIGNED TO REFLECT THE UNIQUE POPULATION-BASED HEALTH CARE NEEDS AND REQUIREMENTS OF THE COMMUNITIES SERVED BY THE SUBSIDIARY/AFFILIATE ORGANIZATION.ALL LOCAL SUBSIDIARIES/AFFILIATES HAVE FULL AUTHORITY AND DECISION-MAKING POWERS TO DEFINE AND EXECUTE THE STRATEGIC AND OPERATIONAL PLANS INTENDED TO IMPROVE THE HEALTH AND WELFARE OF THE COMMUNITIES THEY SERVE.
PART VI, LINE 7, REPORTS FILED WITH STATES MI
Schedule H (Form 990) 2018
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