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
2020
Open to Public Inspection
Name of the organization
ASCENSION BORGESS HOSPITAL
 
Employer identification number

38-1360526
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
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
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) . . .
    4,357,073 0 4,357,073 0.90 %
b Medicaid (from Worksheet 3, column a) . . . . .     73,414,290 58,643,951 14,770,339 3.05 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 77,771,363 58,643,951 19,127,412 3.95 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     91,425   91,425 0.02 %
f Health professions education (from Worksheet 5) . . .     18,269,122   18,269,122 3.78 %
g Subsidized health services (from Worksheet 6) . . . .         0 0 %
h Research (from Worksheet 7) .     633,824   633,824 0.13 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     207,207   207,207 0.04 %
j Total. Other Benefits . . 0 0 19,201,578 0 19,201,578 3.97 %
k Total. Add lines 7d and 7j . 0 0 96,972,941 58,643,951 38,328,990 7.92 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
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
4,637,174
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
870,503
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
206,950,609
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
233,956,419
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-27,005,810
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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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 Ascension Borgess Hospital
1521 Gull Road
Kalamazoo,MI49048
https://healthcare.ascension.org/Locations/Michigan/MIKAL/Kalamazoo-Ascension-Borgess-Hospital
L424370
X X   X   X X     A
2 Ascension Borgess PIPP Hospital
411 Naomi Street
Plainwell,MI49080
https://healthcare.ascension.org/Locations/Michigan/MIKAL/Plainwell-Ascension-BorgessPipp-Hospital
L431681
X             X Long-Term Acute Care A
Schedule H (Form 990) 2020
Page 4
Schedule H (Form 990) 2020
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)
A
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 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://healthcare.ascension.org/CHNA
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) 2020
Page 5
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
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://healthcare.ascension.org/Financial-Assistance
b
https://healthcare.ascension.org/Financial-Assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Page 6
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
A
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) 2020
Page 7
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
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) 2020
Page 8
Schedule H (Form 990) 2020
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 3E TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED.
Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - Facility Group A. Ascension Borgess Hospital and Ascension Borgess-Pipp Hospital took into account input from hospital leadership as well as representatives from governmental health organizations, and community agency individuals who are directly involved in providing services to the medically underserved, minority, and low-income populations. In the initial stages of the CHNA process, Ascension Borgess Hospital and Ascension Borgess-Pipp Hospital, Bronson Healthcare, and Kalamazoo County Health and Community Services (KCHCS) formed a community planning workgroup. Bronson Hospital, the neighboring Kalamazoo hospital provider, was currently conducting a separate CHNA for its organization, as they were required to submit their CHNA report in December 2019, with an implementation plan to follow in early 2020. Even with differing timelines, both hospitals and KCHCS made every effort to collaborate in the Kalamazoo CHNA process to create a report for Ascension Borgess Hospital and Ascension Borgess-Pipp Hospital, Bronson Health, and KCHCS to use to meet their respective CHNA requirements. The planning workgroup met frequently to collect data and prepare for stakeholder meetings and met six times between November 2018 and May 2019 during the assessment process. The community planning workgroup attempted to be transparent in the CHNA process by sharing data, resources, and together, they convened a mutual group of stakeholders to form the Kalamazoo CHNA Key Stakeholder Workgroup. Throughout FY19 (July 1, 2018 - June 30, 2019) the CHNA Key Stakeholder Workgroup members participated in meetings from and contributed their time through participation in stakeholder surveys, distribution and collection of community surveys, in focus group discussions and during the data review process. They were also actively engaged in the prioritization of health issues. Members of the Kalamazoo CHNA Key Stakeholder Workgroup are listed below: - El Concilio/Hispanic American Council* - non-profit, community-focused organization that seeks to help Latino residents support their families, contribute to society and appreciate their cultural significance in the region. - ERACCE* - Eliminating Racism and Claiming/Celebrating Equity. ERACCE exists to eliminate structural racism and create a network of equitable Antiracist institutions and communities. - United Way* - gathers partners, resources, ideas and advocates to generate solutions to the region's toughest challenges in education, income/financial stability, health and basic needs. - Truth and Racial Healing* - Truth and Racial Healing, a program within the Kalamazoo Community Foundation, is a community-based movement to bring about transformational and sustainable change to address the historic and contemporary effects of racism. - Communities in Schools* - mission is to surround students with a community of support, empowering them to stay in school and achieve life. - Ascension Borgess Medical Group - Local Initiatives Support Corporation (LISC)* - together with community partners, LISC deploys comprehensive strategies to help residents connect to safe, affordable housing, quality education and job training, financial coaching and much more. - Bronson Healthcare - Kalamazoo Township Public Safety - Western Michigan University Medical School - Kalamazoo Promise* - helps remove the barrier of the cost of education through provision of tuition and mandatory fees at over 60 eligible Michigan institutions, from colleges and universities, to trade schools and vocational programs for over 8,000 eligible Kalamazoo Public Schools graduates. - Prevention Works - Kalamazoo Community Foundation* - provides essential funding to programs that ensure all of our children have an equitable chance for success in school, that nurture and prepare all of our young people for life beyond school, that support individuals and families from all walks of life, that enhance community prosperity in every corner of Kalamazoo County, and make life better for all. - Family Health Center of Kalamazoo* - Federally qualified health center. - Western Michigan University (Division of Multicultural Affairs) * - Multicultural Affairs for Students fosters community development and leadership as well as promotes a campus climate that respects and appreciates the history, culture, and traditions of all students. - Ascension Borgess-Pipp Hospital - Kalamazoo Loaves and Fishes* - local food pantry - Kalamazoo Regional Educational Service Agency (KRESA) - Kalamazoo County Community Mental Health & Substance Abuse/Integrated Services of Kalamazoo* - promotes and provides mental health, intellectual/developmental disability, and substance use disorder resources that empower people to succeed. - Kalamazoo County Health & Community Services* - local public health department - Ascension Borgess Health - City of Kalamazoo - Urban Alliance* - in partnership with over 200 employers, levels the playing field for young people in the workforce by equipping them with the tools to overcome the systemic barriers that prevent equal access to economic opportunity. - First United Baptist Church* - pastor, predominantly black church - Sisters of St. Joseph - Western Michigan University (LGBT Student Services) * - offers support, education and advocacy around issues of gender identity/expression and sexual orientation to the WMU community. We collaborate with student organizations, university departments and local organizations to provide our campus community with access to health resources, activities, and support services. - Kalamazoo Public Schools* - serves the majority of minority and under-insured students in the community. - Kalamazoo Valley Community College * An asterisk denotes those members who are directly involved in providing services to the medically underserved, minority, and low-income populations.
Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - Facility Group A. The CHNA was conducted with the following hospital facility(s): BRONSON HEALTHCARE
Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - Facility Group A. The CHNA was conducted with the following non-hospital facility(s): -Kalamazoo County Health and Community Services
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Facility Group A - PART 1. During the most recently conducted CHNA, the following significant needs were identified: 1. Racism and Discrimination 2. Living Wage to Afford (Housing, Childcare, Transportation and Healthy Food) 3. Mental Health Assistance and Access 4. Access to Primary Care Providers The 2019 CHNA Implementation Strategy specifically addressed: 1) Racism and Discrimination 2) Mental Health Assistance and Access 3) Access to Primary Care Providers Living Wage to Afford (Housing, Childcare, Transportation and Health Food will not be addressed by Ascension Borgess Hospital and Ascension Borgess-Pipp Hospital (ABH) because of expertise and capacity limitations. ABH is committed to improving community health by directly, and indirectly, addressing community needs. However, certain factors impact ABH's ability to fully address all of the identified needs. Additional community partners are working to address this need and Ascension Borgess Hospital will support community strategies to the extent this is feasible. In addition to the four significant areas selected, two other areas were identified, but did not garner stakeholder support for inclusion and development into the implementation plan phase. These two areas are: -Safe Housing -Sexual Health Priority Need: Racism and Discrimination Ascension Borgess Hospital's plan to offer trauma informed care workshops, launch an awareness campaign around diversity and racism, as well as implicit bias training, were delayed due to an operational shift in priorities due to the pandemic, yet Ascension Borgess has: -Convened an "Appreciation-Belongingness-Inclusivity-Diversity-Equity (ABIDE) Council" - consistent with the national Ascension ABIDE framework. *Executive Sponsor: Peter Bergmann, Ascension Borgess Hospital President, Dyad Partner: Rosalind Davis *The first council meeting was held November 18 and will meet monthly *purpose of the council: Inclusivity and Diversity is a demonstration of Ascension's Mission, Values, and commitment to social justice. The fundamental purpose of this council is to actively transform our culture. This council will engage in listening, learning, open dialogue and acting together to ensure that all associates have the opportunity to attain their full potential. *Council Functions/Objectives: This council is established to serve as the local/regional council to impact change at the local ministry level to address aspects of education and formation related to equity in the work environment. **An intentional increase in visible diversity of our leaders at every level manager and above across AMI **An intentional increase in visible diversity among our medical staff, medical staff leadership and residency programs. **Capture a seat on the national ASPIRE design team to influence and prioritize candidates of color **Collaborate with Mission for the integration of diversity within formation programs at every level of the organization **Develop affinity groups for new associates that support and mentor all persons within the AMI family **Support leadership development to include assisting leaders to gain confidence in facilitating uncomfortable conversations within their departments and teams **Create an internal/external facing advertisement that identifies the Ascension's commitment to diversity in leadership **Continually challenge ourselves to embody the Essential Behaviors for Building Community when engaging our teams related to equity, diversity and inclusion. -Meetings held with subcommittee to design awareness plan - will work in tandem with ABIDE Council. -Ascension Borgess Hospital is a member of Cradle Kalamazoo, a multi-agency community initiative to bring together community leaders and organizations to implement evidence-based and holistic care interventions. The goal is to reduce infant death and promote respect for families, women and their children. Ascension Borgess Hospital is also a member of the Fetal Infant Mortality Review Team (FIMR). A recent presentation from FIMR to Cradle Kalamazoo members included infant mortality prevention recommendations, many of which are related to racism and discrimination. -48 AMG primary care physicians completed the Stanford Unconscious Bias in Medicine education module (approximately 1 hour) in June, 2021 as part of Blue Cross Blue Shield of Michigan (BCBSM) requirements for participating primary care providers. The pandemic has increased awareness of the impact of health disparities and BCBSM encourages all providers to learn more about the influence of unconscious bias on decisions in health care. -The Resilience documentary, focused on Adverse Child Experiences (ACES) and implicit bias training was held December 14, 2020. 6 members of the Ascension Borgess Senior Leadership team participated in the first workshop. This team recommends Ascension providers and additional leadership are provided an opportunity to view the documentary as well. Scheduled for Fall 2021. -The Ascension Michigan Market has purchased the Resilience DVD and a limited streaming license for all market associates and providers to view. Planning is in process to schedule the viewing and subsequent debrief session, as well as a toolkit related to ACES. Hiring of providers to replace Pro-Med providers has resulted in a very diverse group in the clinics impacted by the transition. Below are demographics of the departing Pro-Med providers: -Portage PC - FM providers: total of 41 individual providers *Asian/Indian American: 1 *Latino: 1 *African American: 1 -Portage PC - pediatric providers: total of 17 individual providers *Asian/Indian American: 2 *Latino: 1 -TOTAL: 58 providers with 6 providers who represent minority ethnic groups. 10% diversity Newly employed providers in these same locations: -Family Medicine Providers: currently have 28 employed providers *Asian American: 3 *Asian/Indian American:1 *African American: 2 *Muslim American: 2 -Pediatric Providers: currently have 6 employed providers *Muslim American: 2 -Total: 28 providers with 10 representing minority ethnic groups. -These 2 groups show an increase of 36% diversity obtained through hiring. Priority Need: Mental Health Assistance and Access -Ascension Borgess has conducted a high volume of virtual visits over the months since the pandemic significantly impacted access to services. -A new child psychiatrist began serving patients in Behavioral Health Services on August 10, 2020 and has been very busy, receiving many referrals. -The Women's Health and Behavioral Health offices also moved amidst the pandemic from a building in the southeast corner of the county, to a location more accessible to the community, and also a location where immediate care, family practice and internal medicine offices serve patients. -The Medical Mission at Home event has been cancelled until state executive orders make it possible to reschedule. -Ascension Medical Group will implement the Collaborative Care Model within selected primary care practices. The Collaborative Care model consists of the Primary Care Provider, Behavioral Health Care Manager and Psychiatrist all working together as a truly integrated team. It leads to better patient outcomes, better patient and provider satisfaction, improved functioning, increased access to care, and reductions in health care costs, achieving the Triple Aim of health care reform. Collaborative Care necessitates a practice change on multiple levels and is nothing short of a new way to practice medicine, but it works. -A marketing plan to increase awareness of AMG and ABH behavioral health services in process. -A Nurse Navigator (new position within the last year) has been well received. She is visiting patients on the inpatient units and connecting them with DeLano and/or other resources needed within the community. She also works with the other Care Coordinators and therapists embedded in our PCP offices to improve access when/where patients are in need. -DeLano behavioral health has been conducting a high volume of virtual visits over the last several months, which has also been well received and significantly assisted with access during this time of Covid. -Therapists certified in postpartum depression/anxiety are providing services in two Women's Health Locations. -Dementia, bariatric and guardianship testing services at DeLano have been added.
Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - Facility Group A - PART 2. Priority Need: Access to Primary Care Providers -Virtual care visits have been well-received, and many more patients have been served due to offering telehealth services. -New providers within Ascension Medical Group began seeing patients in July 2020, and all practices are accepting new patients and Medicaid. Additionally, patients are not prioritized for appointment scheduling based on insurance type. -The Medical Mission at Home event has been cancelled until state executive orders make it possible to reschedule. -Ascension Medical Group is also piloting a Community Health Worker at AMG Crosstown Practice - July 2021 Although many strategies/activities are either lagging or in progress, there is adequate time to move forward as scheduled, as the implementation strategies are three-year plans.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
Page 9
Schedule H (Form 990) 2020
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?106
Name and address Type of Facility (describe)
1 Ascension Borgess Heart Institute -Electrophysiology (EP)
1722 Shaffer Street 3rd Floor
Kalamazoo,MI49048
Cardiology Services
2 Ascension Borgess Family Medicine & Peds - Plainwell Borgess-Pipp Medical
Commons
345 Naomi Street
Plainwell,MI49080
PHYSICIAN PRACTICE
3 Ascension Borgess Wound & Hyperbaric Center
1717 Shaffer Nor Pro 202
Kalamazoo,MI49048
Wound Care
4 Ascension Borgess Hospital Borgess Women's Health Imaging at Angling
7901 Angling Rd
Portage,MI49024
Imaging
5 Ascension Borgess Hospital Physical Therapy at Gull Road
3025 Gull Rd
Kalamazoo,MI49048
Physical Therapy
6 Ascension Borgess Pulmonary & Sleep Medicine
1535 Gull Rd Ste 130
Kalamazoo,MI49048
Pulmonary Services
7 ASCENSION BORGESS IMMEDIATE MEDICAL CARE
7901 ANGLING ROAD
Portage,MI49024
IMMEDIATE CARE
8 Ascension Borgess The Surgical Group
1535 Gull Rd MSB 020
Kalamazoo,MI49048
Surgical Services
9 Ascension Borgess-Pipp Hospital Physical Therapy
407 Naomi St
Plainwell,MI49080
Physical Therapy
10 Ascension Borgess Hospital Borgess at Woodbridge Hills Physical Therapy
8001 Angling Rd
Portage,MI49024
Physical Therapy
11 Ascension Borgess Hospital Borgess Health Park Physical Therapy
3035 Capital Avenue Southwest
Battle Creek,MI49015
Physical Therapy
12 Ascension Borgess Bone & Joint Institute
2490 S 11th Street
Kalamazoo,MI49009
PHYSICIAN PRACTICE
13 Ascension Michigan Lab Services
7901 Angling Rd
Portage,MI49024
Laboratory
14 Ascension Borgess Family & Internal Med BHP
3035 Capital SW
Battle Creek,MI49015
PHYSICIAN PRACTICE
15 ASCENSION BORGESS HOSPITAL WESTSIDE FAMILY PRACTICE
6565 West Main
Kalamazoo,MI49009
PHYSICIAN PRACTICE
16 Ascension Borgess ProMed Richland (FP & Peds)
8450 North 32nd St
Richland,MI49083
Physician Practice
17 Ascension Borgess Spine (BSP)
1717 Shaffer Nor Pro 124
Kalamazoo,MI49048
Spine Services
18 Ascension Borgess Pulmonary & Sleep Medicine
3035 Capital SW
Battle Creek,MI49015
Pulmonary Services
19 Ascension Borgess Hospital Borgess Pulmonary & Sleep Medicine at 1535 Gull
1535 Gull Rd 130
Kalamazoo,MI49048
Pulmonary Services
20 Ascension Borgess DeLano Clinics
1717 Shaffer Street Nor Pro 108
Kalamazoo,MI49048
PHYSICIAN PRACTICE
21 Ascension Borgess Womens HealthGull
1535 Gull Rd MSB 250
Kalamazoo,MI49048
Physician Practice
22 Ascension Borgess Internal MedicineWoodbridge
7775 Angling Road
Portage,MI49002
PHYSICIAN PRACTICE
23 Ascension Borgess ProMed Family Practice -Woodbridge
7901 Angling Road
Portage,MI49024
Physician Practice
24 Ascension Borgess Diabetes & Endocrine Center
1722 Shaffer Street 3rd Floor
Kalamazoo,MI49048
PHYSICIAN PRACTICE
25 Ascension Michigan Lab Services at West Main Street
6565 West Main St
Kalamazoo,MI49009
Laboratory
26 Ascension Borgess Neurology - Kalamazoo
1541 Gull Road Ste 100
Kalamazoo,MI49048
NEUROLOGY SERVICES
27 Ascension Borgess Family Medicine - Delton
11320 S M-43 HWY
DELTON,MI49046
PHYSICIAN PRACTICE
28 Ascension Borgess Internal MedicineNor Pro
1717 Shaffer Rd Nor Pro 108
Kalamazoo,MI49048
PHYSICIAN PRACTICE
29 Ascension Borgess Family & Internal Med-Crosstown
940 John Street
Kalamazoo,MI49007
PHYSICIAN PRACTICE
30 Ascension Borgess ProMed Family Practice - Three Rivers
1241 W Broadway
Three Rivers,MI49093
Physician Practice
31 Ascension Borgess Neurosurgery of Kalamazoo
1541 Gull Road Ste 200
Kalamazoo,MI49048
NEUROLOGY SERVICES
32 Ascension Borgess Pulmonary & Sleep Medicine
555 Linn Street
Allegan,MI49010
Pulmonary Services
33 Ascension Borgess Surgical Specialties - BHP
3035 Capital SW
Battle Creek,MI49015
Surgical Services
34 Ascension Borgess Hospital Borgess Spine
3025 Gull Rd
Kalamazoo,MI49048
Spine Services
35 Ascension Borgess Womens HealthGull
7901 Angling Road Suite 204 207
Portage,MI49024
Physician Practice
36 Ascension Borgess Bariatric Center
1717 Shaffer Street Nor Pro 124
Kalamazoo,MI49048
PHYSICIAN PRACTICE
37 Ascension Borgess Pulmonary & Sleep Medicine
420 WEST HIGH STREET
dowagiac,MI49047
Pulmonary Services
38 Ascension Michigan Lab Services at Capital Avenue
3035 Capital Avenue Southwest
Battle Creek,MI49015
Laboratory
39 Ascension Borgess Neurology - Battle Creek
2845 Capital SW Ste 201
Battle Creek,MI49015
NEUROLOGY SERVICES
40 Ascension Borgess ProMed Family Practice - Galesburg
9880 East Michigan Ste 100
Galesburg,MI49053
Physician Practice
41 Ascension Borgess Heart Failure Clinic (HFC)
1722 Shaffer Street 3rd Floor
Kalamazoo,MI49048
Cardiology Services
42 Ascension Borgess Heart Institute - Cardiothoracic Surgery
1722 Shaffer Ste 2
Kalamazoo,MI49048
Cardiology Services
43 Ascension Borgess ProMed Family Practice & Peds - Mattawan
24466 Red Arrow Hwy
Mattawan,MI49071
Physician Practice
44 Ascension Borgess Womens HealthBHP
3035 Capital SW
Battle Creek,MI49015
Physician Practice
45 Ascension Borgess Heart Institute
7901 Angling Road
Portage,MI49002
Cardiology Services
46 Ascension Borgess Orthopedic Associates
7901 S 12th Street Suite 101
Portage,MI49024
Orthopedic Services
47 Ascension Borgess Palliative Care Services
1521 Gull Road RM 277C
Kalamazoo,MI49048
Palliative Care Services
48 ASCENSION BORGESS HOSPTIAL WESTSIDE URGENT CARE
6565 WEST MAIN
Kalamazoo,MI49009
Urgent Care
49 Ascension Borgess Hospital Borgess Pulmonary & Sleep Medicine at Angling
8001 Angling Rd
Portage,MI49024
Pulmonary Services
50 Ascension Borgess Inpatient Services (Sound Phys)
1521 Gull Rd Rm 174A 1 Center
Kalamazoo,MI49048
Hospitalists
51 Ascension Borgess Behavioral Health Services Inpatient Psych (Dr G Barnas)
1-Center West Rm 183
Kalamazoo,MI49048
PHYSICIAN PRACTICE
52 Ascension Borgess Critical Care Services-Borgess Critical Care Rapid Respon
se
1521 Gull Rd 174A
Kalamazoo,MI49048
PHYSICIAN PRACTICE
53 Ascension Borgess Extended Care
1521 Gull Road 146 E
Kalamazoo,MI49048
PHYSICIAN PRACTICE
54 Ascension Borgess Neonatology Special Care Nursery
1521 Gull Road 6-North
Kalamazoo,MI49048
PHYSICIAN PRACTICE
55 Ascension Borgess Orthopedics Walk-in Clinic
1701 Gull Road
Kalamazoo,MI49045
Orthopedic Services
56 Ascension Medical Group-Colon Family Medicine
111 South St Joseph St
Colon,MI49090
Physician Practice
57 ASCENSION BORGESS WOUND
420 HIGH STREET
dowagiac,MI49047
Wound Care
58 ASCENSION BORGESS DIAGNOSTIC SKIN CLINIC
1717 Shaffer Rd Nor Pro 108
Kalamazoo,MI49048
DIAGNOSTIC SERVICES
59 ASCENSION BORGESS SURGICAL SPECIALTIES - WESTSIDE (BSS)
6565 WEST MAIN STE 205
Kalamazoo,MI49009
Surgical Services
60 ASCENSION BORGESS HOSPITAL LAB SERVICES AT SOUTH M-43
11320 MICHIGAN 432
DELTON,MI49046
Laboratory
61 ASCENSION MICHIGAN PHYSICAL THERAPY AT SOUTH 11TH STREET
2490 SOUTH 11TH ST
Kalamazoo,MI49009
Physical Therapy
62 ASCENSION BORGESS BREAST CARE CENTER - MAMMOGRAPHY
8001 ANGLING RD
Portage,MI49024
MAMMOGRAPHY
63 ASCENSION BORGESS HOSPITAL BORGESS WOMEN'S HEALTH IMAGING AT CURRIER
7895 CURRIER DRIVE
Portage,MI49002
IMAGING/MAMMOGRAPHY
64 KNI SOUTHWEST MICHIGAN IMAGING CENTER AT 1700 GULL
1700 GULL RD
Kalamazoo,MI49048
IMAGING
65 ASCENSION BORGESS HEART INSTITUTE- HAPCARDIO ONCSTRUCTURAL HEARTNORTH PRO
1717 SHAFFER STREET SUITE 232
Kalamazoo,MI49048
Cardiology Services
66 ASCENSION BORGESS HEART INSTITUTE - ANTICOAGULATION & DEVICE CLINIC
3035 CAPITAL SW
Battle Creek,MI49015
Cardiology Services
67 ASCENSION BORGESS HEART INSTITUTE - ANTICOAGULATION & DEVICE CLINICBHP
360 E CHICAGO STE 108
COLDWATER,MI49036
Cardiology Services
68 ASCENSION BORGESS HEART INSTITUTE - SHAFFER
1722 SHAFFER STREET1
Kalamazoo,MI49048
Cardiology Services
69 ASCENSION BORGESS HEART INSTITUTE
555 LINN STREET
Allegan,MI49010
Cardiology Services
70 ASCENSION BORGESS HEART INSTITUTE
11320 S M-43 HWY
DELTON,MI49046
Cardiology Services
71 ASCENSION BORGESS HEART INSTITUTE
61 W CARLETON ST
HILLSDALE,MI49242
Cardiology Services
72 ASCENSION BORGESS HEART INSTITUTE
215 E MANSION STE 3B
MARSHALL,MI49068
Cardiology Services
73 ASCENSION BORGESS HEART INSTITUTE
24466 RED ARROW HWY
Mattawan,MI49071
Cardiology Services
74 ASCENSION BORGESS HEART INSTITUTE
671 W ALLEGAN ST
Plainwell,MI49080
Cardiology Services
75 ASCENSION BORGESS HEART INSTITUTE
916 MYRTLE ST STE 105
STURGIS,MI49091
Cardiology Services
76 ASCENSION BORGESS HEART INSTITUTE
711 S HEALTH PKWY
Three Rivers,MI49093
Cardiology Services
77 ASCENSION BORGESS HEART INSTITUTE
6565 WEST MAINE STE 205
Kalamazoo,MI49009
Surgical Services
78 ASCENSION BORGESS THE SURGICAL GROUP
3035 CAPITAL SW
Battle Creek,MI49015
Surgical Services
79 ASCENSION BORGESS THE SURGICAL GROUP
551 LINN ST SUITE 247
Allegan,MI49010
Surgical Services
80 ASCENSION BORGESS VASCULAR SCREENING CLINIC
1535 GULL ROAD MSB 020
Kalamazoo,MI49048
VASCULAR SERVICES
81 ASCENSION BORGESS ORTHOPEDICS (ORTHO)-BORGESS BONE & JOINT INSTITUTE (BBJI)
2490 S 11TH STREET
Kalamazoo,MI49009
Orthopedic Services
82 ASCENSION BORGESS ORTHOPEDICS
3035 CAPITAL SW
Battle Creek,MI49015
Orthopedic Services
83 ASCENSION BORGESS ORTHOPEDICS
6565 WEST MAINE STE 205
Kalamazoo,MI49009
Orthopedic Services
84 ASCENSION BORGESS PULMONARY HYPERTENSION CLINIC
1722 SHAFFER 3RD FLOOR
Kalamazoo,MI49048
Pulmonary Services
85 ASCENSION BORGESS PULMONARY LUNG NODULE CLINIC
1535 GULL RD STE 130
Kalamazoo,MI49048
Pulmonary Services
86 ASCENSION BORGESS PULMONARY & SLEEP MEDICINE
671 WEST ALLEGAN STREET
Plainwell,MI49080
Pulmonary Services
87 ASCENSION BORGESS PULMONARY & SLEEP MEDICINE
711 S HEALTH PKWY
Three Rivers,MI49093
Pulmonary Services
88 ASCENSION BORGESS DELANO CLINIC -(COUNSELING & PSYCHIATRIC SERVICES)
8001 ANGLING RD
Portage,MI49024
PHYSICIAN PRACTICE
89 ASCENSION BORGESS DELANO CLINICSDIABETES & ENDOCRINE CENTER
520 MAIN STREET
dowagiac,MI49047
PHYSICIAN PRACTICE
90 ASCENSION BORGESS DELANO CLINICSDIABETES & ENDOCRINE CENTER
3035 CAPITAL SW
Battle Creek,MI49015
PHYSICIAN PRACTICE
91 ASCENSION BORGESS DELANO CLINICS
345 NAOMI
Plainwell,MI49080
PHYSICIAN PRACTICE
92 ASCENSION BORGESS DELANO CLINICS
8450 NORTH 32ND ST
Richland,MI49083
PHYSICIAN PRACTICE
93 ASCENSION BORGESS DELANO CLINICS
1241 BROADWAY
Three Rivers,MI49093
PHYSICIAN PRACTICE
94 ASCENSION BORGESS DELANO CLINICS
7901 ANGLING ROAD
Portage,MI49024
PHYSICIAN PRACTICE
95 ASCENSION BORGESS MEDICAL COMMONS - DELTON DIAGNOSTICS & MULTISPECIALTY SER
VICES
11320 SOUTH M-43 SUITE 2
DELTON,MI49046
DIAGNOSTIC SERVICES
96 ASCENSION BORGESS NEUROLOGY
570 LINN ST
Allegan,MI49010
NEUROLOGY SERVICES
97 ASCENSION BORGESS NEUROLOGY
360 E CHICAGO STE 108
COLDWATER,MI49036
NEUROLOGY SERVICES
98 ASCENSION BORGESS NEUROLOGY
6565 WEST MAINE STE 205
Kalamazoo,MI49009
NEUROLOGY SERVICES
99 ASCENSION BORGESS NEUROLOGY
215 E MANSION STE 1-H
MARSHALL,MI49068
NEUROLOGY SERVICES
100 ASCENSION BORGESS NEUROLOGY
711 S HEALTH PKWY
Three Rivers,MI49093
NEUROLOGY SERVICES
101 ASCENSION BORGESS NEUROSURGERY OF KALAMAZOO
551 LINN ST SUITE 120
Allegan,MI49010
NEUROLOGY SERVICES
102 ASCENSION BORGESS NEUROSURGERY OF KALAMAZOO
3035 CAPITAL SW
Battle Creek,MI49015
NEUROLOGY SERVICES
103 ASCENSION BORGESS NEUROSURGERY OF KALAMAZOO
6565 WEST MAIN STE 205
Kalamazoo,MI49009
NEUROLOGY SERVICES
104 ASCENSION BORGESS NEUROSURGERY OF KALAMAZOO
215 E MANSION ST STE 3B
MARSHALL,MI49068
NEUROLOGY SERVICES
105 ASCENSION BORGESS NEUROSURGERY OF KALAMAZOO
600 S LAKEVIEW ST RM 106
STURGIS,MI49091
NEUROLOGY SERVICES
106 ASCENSION BORGESS NEUROSURGERY OF KALAMAZOO
711 S HEALTH PKWY MOB 1
Three Rivers,MI49093
NEUROLOGY SERVICES
Schedule H (Form 990) 2020
Page 10
Schedule H (Form 990) 2020
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
Schedule H, Part I, Line 3c factors used other than fpg Subject to the other provisions of this Financial Assistance Policy, a Patient with income greater than 400% of the FPL may be eligible for financial assistance under a "Means Test" for some discount of Patient's charges for services from the Organization based on a Patient's total medical debt. A Patient will be eligible for financial assistance pursuant to the Means Test if the Patient has excessive total medical debt, which includes medical debt to Ascension and any other health care provider, for emergency and other medically necessary care, that is equal to or greater than such Patient's household's gross income. The level of financial assistance provided pursuant to the Means Test is the same as is granted to a patient with income at 400% of the FPL under Paragraph 2 above, if such Patient submits an Application on or prior to the 240th day after the Patient's first discharge bill and the Application is approved by the Organization. Patient will be eligible for the means test discount financial assistance if such Patient submits the Application after the 240th day after the Patient's first discharge bill, but then the amount of financial assistance available to a Patient in this category is limited to Patient's unpaid balance after taking into account any payments made on Patient's account. A Patient eligible for this category of financial assistance will not be charged more than the calculated AGB charges. ASCENSION BORGESS HOSPITAL ALSO USES ASSET LEVEL, INSURANCE STATUS, AND RESIDENCY AS FACTORS IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE.
Schedule H, Part V, Section B, Line 3 Part 2 PRIORITIZATION OF PRIORITY AREAS As a result of the discussions, the stakeholders determined that the priority area of Racism and Discrimination is an overarching issue that directly impacts all the other priority areas. They also made the decision to combine the proposed priority areas of Affordable Housing, Affordable Child Care (Affordable as well as Quality and Accessible), Transportation (Access and Affordability) and Healthy Food (Access and Affordability) under the Living Wages priority area. The group determined Safe Housing should be a separate priority area. Each stakeholder was asked to vote on their top three priority areas. Four priority areas were selected ranked as follows: 1.Racism and Discrimination 2.Living Wage to Afford (Housing, Childcare, Transportation and Healthy Food) 3.Mental Health Assistance and Access 4.Access to Primary Care Providers Needs Identified, But Not Addressed Living Wage to Afford (Housing, Childcare, Transportation and Health Food will not be addressed by Ascension Borgess Hospital because of expertise and capacity limitations. Additional community partners are working to address this need and Ascension Borgess Hospital will support community strategies to the extent this is feasible. In addition to the four priority areas selected, two other areas were identified, but did not garner stakeholder support for inclusion and development into the implementation plan phase. These two areas are: -Safe Housing -Sexual Health
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied.
Schedule H, Part II Community Building Activities There were no Community Building activities to report this year for Ascension Borgess Hospital (ABLH.) All reported activities qualify as community benefit and are described in the narrative under Sch H Part I Line 7.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE IN FISCAL YEAR 2021 WAS $17,959,023 AT CHARGES, ($4,637,174 AT COST).
Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE, ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE ORGANIZATION IS PART OF THE ASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSES THE BAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGES 14-17.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE EXPENSE TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance ASCENSION BORGESS HOSPITAL FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED.
Schedule H, Part V, Section B, Line 16a FAP website A - Ascension Borgess Hospital: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website A - Ascension Borgess Hospital: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - Ascension Borgess Hospital: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance;
Schedule H, Part VI, Line 2 Needs assessment Ascension Borgess Hospital uses internal and external data and reports from third parties, including government sources, to assess the healthcare needs of the communities we serve. These reports provide key information about health, socioeconomic, demographic factors that identify areas of need and inform our strategies that help to meet those needs of our community. These reports include, but are not limited to: Sg2 Healthcare Intelligence State Datasets Internal Data Sets Ascension Borgess Hospital utilizes information from these secondary sources to develop programs and provide appropriate services needed throughout the region. In addition, Ascension Borgess Hospital considers the health care needs of the overall community when evaluating internal financial and operational decisions.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Ascension Borgess Hospital IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, Ascension Borgess Hospital'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; Ascension Borgess Hospital PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. Ascension Borgess Hospital WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE-https://healthcare.ascension.org/Financial-Assistance Ascension Borgess Hospital MAKES PAPER COPIES OF THE: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION. THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. Ascension Borgess Hospital INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. Ascension Borgess Hospital INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.
Schedule H, Part VI, Line 4 Community information Ascension Borgess Hospital is a 422-bed tertiary care hospital and flagship of Ascension Borgess with a continuum of health services from a Level II Trauma Center to primary and specialty care practices throughout southwest Michigan. While Ascension Borgess Hospital's primary service area reaches five counties in southwest Michigan, and includes two additional counties in its secondary and tertiary service areas, the majority of Ascension Borgess Health inpatient and outpatient services are provided at Ascension Borgess Hospital in Kalamazoo MI and is considered a suburban service area. The demographics of the community are as follows (source, Census Bureau, as of April 1, 2020): -Population size: 261,670 -% below 18 years of age: 21.5% -% of population 65 and older: 15.4% -% of population Non-Hispanic Black: 11.8% -% American Indian & Alaska Native: 0.5% -% Asian: 2.8% -% Native Hawaiian/Other Pacific Islander: 0.1% -% Hispanic: 5.2% -% Non-Hispanic White: 77.0% -% Female: 51.1% -% Male: 48.9% -% Rural: 17.5% -Average income is $56,511 -Percent of income below the federal poverty level is 13.3% -% of community members who are uninsured is 6.8% Bronson Healthcare hospital system also serves several counties in Ascension Borgess Hospital's primary service area, with the main hospital campus located in Kalamazoo, MI. The Family Health Center of Kalamazoo serves as the county's Federally Qualified Health Center to further serve those residents who are medically underserved. Because of its dense population compared to geographical size, Kalamazoo County has significantly higher numbers of people per provider (primary care, dentists, and mental health care) when compared to the rest of the state. According to the Health Resources Services Administration (HRSA), Kalamazoo County Michigan is designated as a healthcare provider shortage area (HPSA). Although almost every health care specialist (i.e. audiologists, cardiologists, rheumatologists, etc.) is represented in Kalamazoo County, the growing population of individuals aged 65 and older has placed a tremendous strain on these professionals and their availability is extremely limited. According to the 2021 County Health Rankings, Kalamazoo County ranks in the highest of counties in the state of Michigan for clinical care. That does not mean there are not medically underserved persons in the county; it does indicate however that Kalamazoo County residents have more access to healthcare providers than in other areas of the state. Kalamazoo County has a higher percentage of its residents who are uninsured than the state average but does have better physician/patient ratios for primary care, mental health, and dental providers.
Schedule H, Part VI, Line 5 Promotion of community health Ascension Borgess Hospital'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE REGION, INCLUDING ASCENSION BORGESS HOSPITAL. MEMBERS OF THE GOVERNING BODY RESIDE IN THE ORGANIZATION'S REGION AND ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. ASCENSION BORGESS HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. ASCENSION BORGESS HOSPITAL APPLIES SURPLUS FUNDS TO FUND IMPROVEMENTS IN PATIENT CARE.
Schedule H, Part VI, Line 6 Affiliated health care system ASCENSION BORGESS HOSPITAL IS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 19 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. ASCENSION BORGESS HOSPITAL OPERATES A HOSPITAL FACILITY IN KALAMAZOO COUNTY MICHIGAN AND IS PART OF ASCENSION HEALTH WHICH ALSO OWNS AND OPERATES OTHER HEALTH CARE RELATED ENTITIES INCLUDING ASCENSION BORGESS ALLEGAN HOSPITAL, ASCENSION BORGESS PIPP HOSPITAL, ASCENSION BORGESS LEE HOSPITAL IN SOUTHWEST MICHIGAN. ASCENSION MICHIGAN ALSO OPERATES HOSPITALS IN THE EASTERN PORTION OF THE STATE INCLUDING ASCENSION ST. JOHN HOSPITAL, ASCENSION RIVER DISTRICT HOSPITAL, ASCENSION MACOMB OAKLAND HOSPITAL WARREN CAMPUS, ASCENSION MACOMB OAKLAND HOSPITAL MADISON HEIGHTS CAMPUS, ASCENSION PROVIDENCE HOSPITAL SOUTHFIELD CAMPUS, ASCENSION PROVIDENCE HOSPITAL NOVI CAMPUS, ASCENSION PROVIDENCE ROCHESTER HOSPITAL, ASCENSION GENESYS HOSPITAL, ASCENSION ST. MARY'S HOSPITAL, ASCENSION STANDISH HOSPITAL, ASCENSION ST. JOSEPH HOSPITAL AND ASCENSION BRIGHTON CENTER FOR RECOVERY. THE HEALTH SYSTEM PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SOUTHWEST MICHIGAN.
Schedule H (Form 990) 2020
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