EATON RAPIDS MEDICAL CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- EATON RAPIDS MEDICAL CENTER (EIN 38-1559180)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-11
- IRS object ID
- 202301319349304100
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-11T12:08:00-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 MICHIGAN AVE STE 100 | AddressLine1Txt |
| City | EAST LANSING | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48823 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381559180 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EATON RAPIDS MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EATO | BusinessNameControlTxt |
| Phone | 5176632671 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 SOUTH MAIN STREET | AddressLine1Txt |
| City | EATON RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48827 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHARI GLYNN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5176632671 | PhoneNum |
| Signature | 2023-05-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SHARI | PersonFirstNm |
| Person Last | GLYNN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 5173326200 | PhoneNum |
| Preparation | 2023-05-03 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHARI GLYNN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 SOUTH MAIN STREET | AddressLine1Txt |
| City | EATON RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48827 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $40,386,161 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.EATONRAPIDSMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | CARE. SERVE. INSPIRE. BY PROVIDING HEALTHCARE SERVICES IN EATON RAPIDS, MI | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 351 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $45,634 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,634,867 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,687,262 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,508,511 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,033,735 | CYProgramServiceRevenueAmt |
| PY Investment Income | $205,235 | PYInvestmentIncomeAmt |
| CY Investment Income | $287,173 | CYInvestmentIncomeAmt |
| PY Other Revenue | $64,988 | PYOtherRevenueAmt |
| CY Other Revenue | $106,553 | CYOtherRevenueAmt |
| PY Total Revenue | $37,413,601 | PYTotalRevenueAmt |
| CY Total Revenue | $40,114,723 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,038,787 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,131,615 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,872,661 | PYOtherExpensesAmt |
| CY Other Expenses | $18,895,667 | CYOtherExpensesAmt |
| PY Total Expenses | $35,911,448 | PYTotalExpensesAmt |
| CY Total Expenses | $37,027,282 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,502,153 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,087,441 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $46,019,452 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,636,717 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,746,649 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,926,553 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $32,272,803 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $34,710,164 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CARE. SERVE. INSPIRE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $29,966,681 | ExpenseAmt |
| Revenue | $36,034,835 | RevenueAmt |
| Desc | EATON RAPIDS MEDICAL CENTER OPERATES A SHORT-TERM, ACUTE CARE HOSPITAL SERVING THE EATON RAPIDS, MICHIGAN COMMUNITY. THE HOSPITALS VISION IS TO BE THE HOSPITAL PATIENTS TRUST, PHYSICIANS PREFER, AND STAFF MEMBERS LOVE.EATON RAPIDS MEDICAL CENTER PROVIDES TOOLS AND EDUCATION TO HELP PATIENTS AND THE COMMUNITY LEAD HEALTHY LIFESTYLES THROUGH PROGRAMS SUCH AS: A HEALTHWORKS PROGRAM, AND HEALTH FAIRS. SUPPORT GROUPS AND SEMINARS ARE OFFERED ON CHRONIC DISEASES INCLUDING: A DIABETES SUPPORT GROUP, ARTHRITIS CLASSES, AND LUNCH WITH A MEDICAL PROFESSIONAL. PATIENTS ARE ALSO PROVIDED ASSISTANCE TO NAVIGATE THE HEALTH INSURANCE EXCHANGES AND ARE ASSISTED WITH THE ENROLLMENT PROCESS. IN 2022 EATON RAPIDS MEDICAL CENTER SAW THE FOLLOWING VOLUME OF PATIENTS: - INPATIENT ADMISSIONS = 288, INPATIENT DAYS = 1,142, AND EMERGENCY ROOM VISITS = 9,348. - OUTPATIENT VISITS TOTALED: LABORATORY = 15,591, RADIOLOGY =5,904, RESPIRATORY = 164, CARDIOLOGY =1,208, REHAB = 8,389 AND CLINICS = 5,794.EATON RAPIDS MEDICAL CENTER ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PROVIDED $48,544 OF CHARITY CARE DURING 2022 AND RECORDED $1,546,501 OF BAD DEBT EXPENSE. | Desc |
| Total Program Service Expenses | $29,966,681 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 54 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 351 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHARI GLYNN VP OF FINANCECFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5176639456 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 SOUTH MAIN STREET | AddressLine1Txt |
| City | EATON RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48827 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TIM JOHNSON | ||||||||
| CEO | 40.00 | 0.00 | Yes (X) | Yes (X) | $272,942 | $0 | $19,199 | |
| STEVEN PETERS | ||||||||
| CHAIRPERSON | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RUSSELL HALSEY | ||||||||
| VICE CHAIRPERSON | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NANCY POPLE | ||||||||
| VICE CHAIRPERSON - PART YEAR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARTY DEBOW | ||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DONNA ADAM | ||||||||
| SECRETARY - PART YEAR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT DICKINS | ||||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CARL DAVIS | ||||||||
| TREASURER - PART YEAR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JODI BACKOFEN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KYLE BOOHER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ASHOK GUPTA MD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DOUG REAVES | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIE REINCKE | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| NATE SKINNER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA VANDENBERG | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SHARI GLYNN | ||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $194,761 | $0 | $10,896 | ||
| ESLI GOLLAPALLI | ||||||||
| ED PHYSICIAN | 36.00 | 0.00 | $442,944 | $0 | $20,400 | Yes (X) | ||
| JOHN FATA | ||||||||
| ED PHYSICIAN | 36.00 | 0.00 | $384,685 | $0 | $28,176 | Yes (X) | ||
| RYAN JONES | ||||||||
| ED PHYSICIAN | 40.00 | 0.00 | $349,751 | $0 | $26,888 | Yes (X) | ||
| DONNA BROWN | ||||||||
| ED PHYSICIAN | 36.00 | 0.00 | $309,401 | $0 | $12,958 | Yes (X) | ||
| LOWELL FERNANDER | ||||||||
| RHC PHYSICIAN | 40.00 | 0.00 | $202,628 | $0 | $3,936 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,157,112 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $122,453 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 26 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LUTZ ENTERPRISES | |||||
| 9103 WEST END DR | PORTAGE | MI | 49002 | ANESTHESIA SERVICES | $879,140 |
| PGPA LLC | |||||
| 3544 MERIDIAN CROSSING DR SUITE 120 | OKEMOS | MI | 48864 | PHARMACY SERVICES | $312,708 |
| AUREUS RADIOLOGY LLC | |||||
| PO BOX 310856 | DES MOINES | IA | 50331 | RADIOLOGY SERVICES | $235,469 |
| ALLIANCE-HNI LLC | |||||
| PO BOX 772550 | DETROIT | MI | 48277 | EQUIPMENT SERVICES | $218,047 |
| THE BUSINESS OFFICE PC | |||||
| 8085 KNUE ROAD | INDIANAPOLIS | IA | 46250 | HEALTHCARE SERVICES | $132,505 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,100 | RelatedOrganizationsAmt |
| Government Grants | $3,630,740 | GovernmentGrantsAmt |
| All Other Contributions | $55,422 | AllOtherContributionsAmt |
| Total Contributions | $3,687,262 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $35,237,643 | $35,237,643 |
| LAB REVENUE | 621500 | $423,401 | $423,401 |
| PHYSICIAN STAFFING/SUPPORT | 621110 | $308,838 | $308,838 |
| SPECIALISTS RENTAL FEES | 621110 | $63,853 | $63,853 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,033,735 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $240,547 | TotalRevenueColumnAmt |
| Exclusion | $240,547 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $29,366 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $40,481 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$11,115 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$11,115 | TotalRevenueColumnAmt |
| Exclusion | -$11,115 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $277,583 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $230,957 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $46,626 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,626 | TotalRevenueColumnAmt |
| Exclusion | $46,626 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| CAFETERIA | 722514 | $64,245 | $64,245 | |
| FITNESS CENTER | 713940 | $45,634 | $45,634 | |
| EMPLOYEE PHARMACY SALES | 446110 | $7,789 | $7,789 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $117,668 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,114,723 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,033,735 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $45,634 | UnrelatedBusinessRevenueAmt |
| Exclusion | $348,092 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $517,020 | TotalAmt |
| Management And General | $517,020 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,019,133 | TotalAmt |
| Program Services | $11,168,188 | ProgramServicesAmt |
| Management And General | $2,850,945 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,853 | TotalAmt |
| Management And General | $142,853 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,452,349 | TotalAmt |
| Program Services | $1,911,246 | ProgramServicesAmt |
| Management And General | $541,103 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000,260 | TotalAmt |
| Program Services | $770,007 | ProgramServicesAmt |
| Management And General | $230,253 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,672 | TotalAmt |
| Management And General | $32,672 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,550 | TotalAmt |
| Management And General | $96,550 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,102,292 | TotalAmt |
| Program Services | $3,190,556 | ProgramServicesAmt |
| Management And General | $911,736 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,983 | TotalAmt |
| Program Services | $170 | ProgramServicesAmt |
| Management And General | $148,813 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $671,442 | TotalAmt |
| Program Services | $322,956 | ProgramServicesAmt |
| Management And General | $348,486 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416,591 | TotalAmt |
| Program Services | $28,235 | ProgramServicesAmt |
| Management And General | $388,356 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,900 | TotalAmt |
| Program Services | $2,636 | ProgramServicesAmt |
| Management And General | $2,264 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,124 | TotalAmt |
| Program Services | $126,215 | ProgramServicesAmt |
| Management And General | $43,909 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,746,411 | TotalAmt |
| Program Services | $1,295,660 | ProgramServicesAmt |
| Management And General | $450,751 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $218,568 | TotalAmt |
| Program Services | $149,208 | ProgramServicesAmt |
| Management And General | $69,360 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUG | $8,299,383 | $8,273,428 | $25,955 |
| BAD DEBT EXPENSE | $1,546,501 | $1,546,501 | |
| QUALITY ASSURANCE TAXES | $650,972 | $650,972 | |
| MAINTENANCE & REPAIRS | $218,339 | $51,766 | $166,573 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $571,939 | TotalAmt |
| Program Services | $478,937 | ProgramServicesAmt |
| Management And General | $93,002 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,027,282 | TotalAmt |
| Program Services | $29,966,681 | ProgramServicesAmt |
| Management And General | $7,060,601 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $560,325 | BOYAmt |
| EOY | $560,880 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,148,014 | BOYAmt |
| EOY | $14,252,845 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,598,085 | BOYAmt |
| EOY | $2,893,482 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $683,363 | BOYAmt |
| EOY | $764,646 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,801,691 | BOYAmt |
| EOY | $1,679,299 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $38,765,079 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,361,011 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,721,893 | BOYAmt |
| EOY | $15,404,068 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,882,083 | BOYAmt |
| EOY | $3,469,141 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,700,421 | BOYAmt |
| EOY | $1,700,421 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,923,577 | BOYAmt |
| EOY | $2,911,935 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,019,452 | BOYAmt |
| EOY | $43,636,717 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,536,350 | BOYAmt |
| EOY | $4,009,112 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,986,002 | BOYAmt |
| EOY | $3,634,136 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,038,800 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,497 | BOYAmt |
| EOY | $1,283,305 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,746,649 | BOYAmt |
| EOY | $8,926,553 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,272,803 | BOYAmt |
| EOY | $34,710,164 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,272,803 | BOYAmt |
| EOY | $34,710,164 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,019,452 | BOYAmt |
| EOY | $43,636,717 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,087,441 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$650,080 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | 0 | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,997 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,997 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | PORTION OF ANNUAL DUES TO MICHIGAN HEALTH & HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION THAT ARE USED TOWARD LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $724,719 | OtherCostOrOtherBasisAmt |
| Book Value | $724,719 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,825,789 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,238,149 | DepreciationAmt |
| Book Value | $10,587,640 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,603,080 | OtherCostOrOtherBasisAmt |
| Depreciation | $655,569 | DepreciationAmt |
| Book Value | $947,511 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,453,026 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,467,293 | DepreciationAmt |
| Book Value | $2,985,733 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $158,465 | OtherCostOrOtherBasisAmt |
| Book Value | $158,465 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,404,068 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INVESTMENT IN ER MED PARK, LLC | $2,739 |
| INVESTMENT IN MEDICAL PROPERTIES | $210,500 |
| COST REPORT SETTLEMENT RECEIVABLE | $2,649,155 |
| FMV INTEREST RATE SWAP | $49,541 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,911,935 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COST REPORT SETTLEMENT PAYABLE | Desc |
| Amt | $1,283,305 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,283,305 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $37,588,833 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$650,080 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$650,080 | RevenueNotReportedAmt |
| Revenue Subtotal | $38,238,913 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,875,810 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,875,810 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $40,114,723 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $35,151,472 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $35,151,472 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,875,810 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,875,810 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $37,027,282 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,546,501. EXPENSES RECORDED AGAINST INCOME 329,309. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,546,501. EXPENSES RECORDED AGAINST INCOME 329,309. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 133.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,998 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,998 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,356,120 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,627,420 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,728,700 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04870 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,384,118 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,627,420 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,756,698 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04950 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,384,118 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,627,420 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,756,698 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04950 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,546,501 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $309,300 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,697,703 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,753,630 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$55,927 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EATON RAPIDS MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 SOUTH MAIN STREET | AddressLine1Txt |
| City | EATON RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48827 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.EATONRAPIDSMEDICALCENTER.ORG | WebsiteAddressTxt |
| State License | 1060000161 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EATON RAPIDS MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://TINYURL.COM/BDEPJK4W | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HTTP://WWW.HEALTHYCAPITALCOUNTIES.ORG/ | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://TINYURL.COM/YBC7YRBR | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 133.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://TINYURL.COM/Y9VU5SDC | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://TINYURL.COM/Y9VU5SDC | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://TINYURL.COM/Y9VU5SDC | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| EATON RAPIDS MEDICAL CENTER | PART V, SECTION B, LINE 3J: THE CHNA INCLUDES OPPORTUNITY MEASURES; SOCIAL, ECONOMIC AND ENVIRONMENTAL FACTORS; BEHAVIORS, STRESS AND PHYSICAL CONDITIONS; AND HEALTH OUTCOMES. IT ALSO INCLUDES FOCUS GROUPS AND SURVEY RESULTS. |
| EATON RAPIDS MEDICAL CENTER | PART V, SECTION B, LINE 5: THE FOLLOWING INDIVIDUALS WERE CONSULTED DURING THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT:- MADHUR CHANDRA, MPA, PHD SENIOR COMMUNITY EPIDEMIOLOGIST, INGHAM COUNTY HEALTH DEPARTMENT- AMANDA DARCHE, MPH INNOVATION AND PLANNING MANAGER, INGHAM COUNTY HEALTH DEPARTMENT- REX HOYT, BS DATA SPECIALIST, MID-MICHIGAN DISTRICT HEALTH DEPARTMENT- EMILY SMALE, MPH COMMUNITY HEALTH PROMOTION SPECIALIST II, BARRY-EATON DISTRICT HEALTH DEPARTMENT- SUSAN PAULSON, PHD HEALTH ANALYST, INGHAM COUNTY HEALTH DEPARTMENT- JONAS NDEKE, MD MPH COMMUNITY EPIDEMIOLOGIST, INGHAM COUNTY HEALTH DEPARTMENT- JANINE SINNO JANOUDI, PHD HEALTH ANALYST / HEALTHY COMMUNITIES COORDINATOR, INGHAM COUNTY HEALTH DEPARTMENT- JESSA MURSHAK, MPH STUDENT INTERN II, BARRY-EATON DISTRICT HEALTH DEPARTMENT |
| EATON RAPIDS MEDICAL CENTER | PART V, SECTION B, LINE 6A: MCLAREN GREATER LANSINGSPARROW HEALTH SYSTEM |
| EATON RAPIDS MEDICAL CENTER | PART V, SECTION B, LINE 6B: BARRY-EATON DISTRICT HEALTH DEPARTMENTINGHAM COUNTY HEALTH DEPARTMENTMID-MICHIGAN DISTRICT HEALTH DEPARTMENT |
| EATON RAPIDS MEDICAL CENTER | PART V, SECTION B, LINE 7D: SOCIAL MEDIA PAGEPUTTING A COPY AT THE LOCAL LIBRARY PRESS RELEASES TO THE LOCAL NEWSPAPERSA FULL COPY OF THE CHNA AND IMPLEMENTATION PLAN CAN BE FOUND AT: HTTPS://WWW.EATONRAPIDSMEDICALCENTER.ORG/ABOUT/COMMUNITY/ |
| EATON RAPIDS MEDICAL CENTER | PART V, SECTION B, LINE 11: EATON RAPIDS MEDICAL CENTER IS EVALUATING THE EFFECTIVENESS OF THE CURRENT PROGRAMS AND SERVICES TO BETTER ALIGN THEM WITH THE NEEDS OF OUR SERVICE AREA. FOR EXAMPLE, WE REOPENED OUR SWING BED PROGRAM BECAUSE THERE WAS A NEED TO SERVE THOSE WITH CHRONIC DISEASES BEYOND INPATIENT STATUS. WE ALSO ARE HIRING MORE PRIMARY CARE PROVIDERS TO MEET THE ACCESS TO CARE NEED AND REPLACE THE AGING PRIMARY CARE PHYSICIAN POPULATIONS. WE INCREASED OUR BEHAVIORAL AND MENTAL HEALTH STAFF TO ASSIST WITH THE MENTAL HEALTH NEEDS OF THE COMMUNITY. WE FOCUS ON DIRECT INTERVENTIONS FOR THE FIRST THREE PRIORITIES (HEALTHY LIFESTYLES, CHRONIC DISEASE AND ACCESS TO CARE). IF WE CANNOT MEET THE HEALTH NEEDS OF THE COMMUNITY DIRECTLY, OUR FINAL PRIORITY IS TO CONNECT THEM TO RESOURCES THAT CAN HELP. ERMC DID NOT ADDRESS AFFORDABLE HOUSING IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT AS IT IS NOT APPLICABLE TO HOSPITALS. |
| EATON RAPIDS MEDICAL CENTER | PART V, SECTION B, LINE 15E: EATON RAPIDS MEDICAL CENTER HAS STAFF ONSITE AVAILABLE TO ASSIST PATIENTS WITH THE COMPLETION OF THE FINANCIAL ASSISTANCE FORMS FOR BOTH CHARITY CARE AND WHEN POSSIBLE WITH OTHER PROGRAMS SUCH AS MEDICAID AND MEDICARE PART D |
| EATON RAPIDS MEDICAL CENTER | PART V, SECTION B, LINE 16J: LINE 16I DISCLOSURE - THE HOSPITAL FACILITY HAS REVIEWED THE POPULATION OF ITS COMMUNITY AND CONCLUDED THAT ENGLISH IS THE ONLY PRIMARY LANGUAGE AS DEFINTED BY THE REGULATIONS OF MORE THAN 5% OR 1,000 PERSONS. THEREFORE, THE FAP, FAP APPLICATION FORM, OR PLAIN LANGUAGE SUMMARY HAVE NOT BEEN TRANSLATED INTO ANOTHER LANGUAGE. THE HOSPITAL FACILITY WILL CONTINUE TO MONITOR THIS GOING FORWARD AS NEW CENSUS DATA BECOMES AVAILABLE. |
| PART V LINE 22B: | BASED ON INTERNAL LIMITATIONS THE AMOUNTS GENERALLY BILLED COMPUTATION MAY NOT HAVE TAKEN INTO ACCOUNT THE COMBINED AMOUNT OF MEDICARE AND PRIVATE INSURANCE. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $1,546,501. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY IT SERVES THROUGH A FREE HEALTH FAIR, FREE HEALTH SCREENINGS, DIABETES SUPPORT GROUP, EDUCATIONAL TOURS FOR SECOND GRADERS, FARMERS MARKET HELD ON HOSPITAL GROUNDS, ARTICLES IN THE NEWSPAPER ABOUT MEDICAL CONDITIONS AND HEALTHY LIVING, TRAINING FOR STUDENTS IN THE HEALTHCARE FIELD, FREE EDUCATIONAL SEMINARS, FREE FITNESS, NUTRITION AND CONFIDENCE PROGRAM FOR 4TH THROUGH 6TH GRADERS, CONTRIBUTIONS TO ORGANIZATIONS SUCH AS EATON COMMUNITY HOSPICE AND MEALS ON WHEELS, COALITION BUILDING PARTICIPATION AND CONTRIBUTIONS TO ORGANIZATIONS SUCH AS EATON RAPIDS ROTARY AND LIONS CLUB AS WELL AS THE CHAMBER OF COMMERCE, HOSTING BABYSITTING AND CPR CLASSES, AND HOSTING TWO AMERICAN RED CROSS BLOOD DRIVES PER YEAR. |
| PART III, LINE 2: | THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX. |
| PART III, LINE 3: | THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY, $309,300 IS EQUAL TO APPROXIMATELY 20 PERCENT OF BAD DEBT EXPENSE. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE: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 CENTER'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 CENTER'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE CENTER 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 MEDICARE SURPLUS (SHORTFALL), FROM THE MEDICARE COST REPORT, WAS CALCULATED BY UTILIZING A COST TO CHARGE RATIO. ANY SHORTFALLS WOULD BE CONSIDERED COMMUNITY BENEFIT. |
| PART III, LINE 9B: | ALL PATIENTS' COLLECTIONS ARE TREATED THE SAME. |
| PART VI, LINE 2: | THE ORGANIZATION ASSESSES NEEDS THROUGH PATIENT SATISFACTION SURVEYS, SUGGESTIONS FROM EMPLOYEES THAT RESIDE IN OUR SERVICE AREA, RESPONSES FROM FOCUS GROUP PARTICIPANTS, COMMENTS ON OUR SOCIAL MEDIA PAGES, SUGGESTION BOXES, AND REQUESTS FROM COMMUNITY GROUPS. |
| PART VI, LINE 3: | INFORMATION REGARDING ELIGIBILITY IS PROVIDED AT TIME OF SERVICE AS WELL AS ATTACHED TO BILLING INVOICES, POSTED IN THE ADMISSIONS OFFICE, AND AVAILABLE UPON REQUEST. |
| PART VI, LINE 4: | EATON RAPIDS MEDICAL CENTER'S IMMEDIATE SERVICE AREA INCLUDES EATON RAPIDS, SPRINGPORT, AND ONONDAGA. WE ALSO DRAW PATIENTS FROM LESLIE, MASON, DIAMONDALE AND CHARLOTTE. 7% OF OUR PATIENTS ARE AGES 0-14, 7% OF PATIENTS AGES 15-24, 15% OF PATIENTS AGES 25-44, 32% OF PATIENTS AGES 45-64, 21% OF PATIENTS AGES 65-74,18% OF PATIENTS AGES 75+. PATIENT INSURANCE DEMOGRAPHICS ARE MEDICARE 46%, MEDICAID 11%, COMMERCIAL 8%, HMO/PPO 4%, BLUE CROSS 29%, AND SELF-PAY 2%. |
| PART VI, LINE 5: | THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY IT SERVES THROUGH A FREE HEALTH FAIR, FREE HEALTH SCREENINGS, DIABETES SUPPORT GROUP, EDUCATIONAL TOURS FOR SECOND GRADERS, FARMERS MARKET HELD ON HOSPITAL GROUNDS, ARTICLES IN NEWSPAPERS ABOUT MEDICAL CONDITIONS AND HEALTHY LIVING, TRAINING FOR STUDENTS IN THE HEALTH CARE FIELD, FREE EDUCATIONAL SEMINARS, FREE FITNESS, NUTRITION AND SELF-CONFIDENCE PROGRAM FOR 4TH THROUGH 6TH GRADERS, CONTRIBUTIONS TO ORGANIZATIONS SUCH AS EATON COMMUNITY HOSPICE AND MEALS ON WHEELS, COALITION BUILDING PARTICIPATION AND CONTRIBUTIONS TO ORGANIZATIONS SUCH AS THE EATON RAPIDS ROTARY AND LIONS CLUB AS WELL AS THE CHAMBER OF COMMERCE, HOSTING BABYSITTING AND CPR CLASSES, AND HOSTING TWO AMERICAN RED CROSS BLOOD DRIVES EACH YEAR. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ESLI GOLLAPALLI | ||||||||||||||
| ED PHYSICIAN | $442,944 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,400 | $0 | $463,344 | $0 | $0 | $0 |
| JOHN FATA | ||||||||||||||
| ED PHYSICIAN | $384,685 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $28,176 | $0 | $412,861 | $0 | $0 | $0 |
| RYAN JONES | ||||||||||||||
| ED PHYSICIAN | $349,751 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $26,888 | $0 | $376,639 | $0 | $0 | $0 |
| DONNA BROWN | ||||||||||||||
| ED PHYSICIAN | $309,401 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,958 | $0 | $322,359 | $0 | $0 | $0 |
| TIM JOHNSON | ||||||||||||||
| CEO | $267,292 | $0 | $5,650 | $0 | $0 | $0 | $5,454 | $0 | $13,746 | $0 | $292,142 | $0 | $0 | $0 |
| LOWELL FERNANDER | ||||||||||||||
| RHC PHYSICIAN | $202,628 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $3,936 | $0 | $206,564 | $0 | $0 | $0 |
| SHARI GLYNN | ||||||||||||||
| CFO | $193,261 | $0 | $1,500 | $0 | $0 | $0 | $3,917 | $0 | $6,979 | $0 | $205,657 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | THE CEO BONUS IS DETERMINED BY THE BOARD AND THE REMAINING BONUSES ARE DETERMINED BY THE EXECUTIVE MANAGEMENT COUNCIL AND APPROVED BY THE BOARD. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF EATON RAPIDS HOSPITAL FINANCE AUTHORITY BOND PAYABLE - SERIES 2017 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 386004609 | BondIssuerEIN |
| CUSIP | NONEAVAIL | CUSIPNum |
| Bond Issued | 2017-10-16 | BondIssuedDt |
| Issue Price | $5,200,000 | IssuePriceAmt |
| Purpose | NEW PROFESSIONAL BUILDING AND REFINANCE OF 2008 BOND | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $358,800 | RetiredAmt |
| Total Proceeds | $5,200,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $104,000 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $5,096,000 | WorkingCapitalExpendituresAmt |
| Substantial Completion | 2018 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.06900 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.06900 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | Yes (1) | Form8038TFiledInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PNC BANK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 15.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY ACCOUNTING STAFF AND PRESENTED TO THE FINANCE COMMITTEE PRIOR TO SUBMISSION. THE FORM 990 IS NOT PROVIDED TO THE FULL BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | IN ACCORDANCE WITH EATON RAPIDS MEDICAL CENTER'S CONFLICT OF INTEREST POLICY, CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE SIGNED ANNUALLY BY THE HOSPITAL'S BOARD. THE FORMS ARE REVIEWED BY THE CEO WHO TRACKS AND MONITORS THE CONFLICTS THAT ARISE. THE CEO NOTIFIES THE BOARD OF ANY CONFLICTS AND THOSE PERSONS ARE PROHIBITED FROM PARTICIPATING IN THE DELIBERATIONS AND DECISIONS, INCLUDING BEING ASKED TO LEAVE THE ROOM. |
| FORM 990, PART VI, SECTION B, LINE 15 | CURRENTLY THE BOARD REVIEWS COMPENSATION STUDIES FROM SIMILAR HOSPITALS AND THE COMMITTEE USES THAT TO DETERMINE THE COMPENSATION FOR THE CEO. THIS IS DOCUMENTED IN THE BOARD MINUTES. THE BOARD ALSO DETERMINES COMPENSATION BASED ON PRIOR YEAR PERFORMANCE. A COMPARABILITY STUDY WAS LAST DONE FOR THE CEO, OTHER OFFICERS AND KEY EMPLOYEES IN 2022. THE CEO REVIEWS THE COMPARABILITY STUDY AS WELL AS PRIOR YEAR PERFORMANCE TO DETERMINE COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES, THIS PROCESS WAS LAST COMPLETED IN 2022. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE THESE DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 721,458. MANAGEMENT AND GENERAL EXPENSES 412,006. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,133,464. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 529,322. MANAGEMENT AND GENERAL EXPENSES 320,717. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 850,039. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,670,740. MANAGEMENT AND GENERAL EXPENSES 179,013. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,849,753. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 269,036. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 269,036. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS FOR THE COMMITTEE THAT ASSUMES THE RESPONSIBILITY OF OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT AUDITORS HAS NOT CHANGED. |
| FORM 990, PART XII, LINE 3B: | THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT YET BEEN COMPLETED. PLANS HAVE BEEN MADE TO HAVE THE REQUIRED SINGLE AUDIT COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-20-26. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EATON RAPIDS MEDICAL CENTER FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 SOUTH MAIN ST | AddressLine1Txt |
| City | EATON RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48827 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383582316 | EIN |
| Primary Activities | TO RECEIVE AND ADMINISTER FUNDS AND USE THEM FOR EATON RAPIDS MEDICAL CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EATON RAPIDS MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |