2023-05-11T12:08:00-05:00 2022-06-30 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2021-07-01 381559180 EATON RAPIDS MEDICAL CENTER EATO 5176632671 1500 SOUTH MAIN STREET EATON RAPIDS MI 48827 SHARI GLYNN CFO 5176632671 2023-05-03 1 SHARI GLYNN 999009999 DAVID LOWENTHAL P00378651 5173326200 2023-05-03 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z SHARI GLYNN 1500 SOUTH MAIN STREET EATON RAPIDS MI 48827 40386161 0 X WWW.EATONRAPIDSMEDICALCENTER.ORG X 1954 MI CARE. SERVE. INSPIRE. BY PROVIDING HEALTHCARE SERVICES IN EATON RAPIDS, MI 12 11 351 1 45634 0 3634867 3687262 33508511 36033735 205235 287173 64988 106553 37413601 40114723 0 0 0 0 18038787 18131615 0 0 0 17872661 18895667 35911448 37027282 1502153 3087441 46019452 43636717 13746649 8926553 32272803 34710164 X CARE. SERVE. INSPIRE. 0 0 29966681 36034835 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. 29966681 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 54 0 1 351 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 X SHARI GLYNN VP OF FINANCECFO 5176639456 1500 SOUTH MAIN STREET EATON RAPIDS MI 48827 TIM JOHNSON CEO 40.00 0.00 X X 272942 0 19199 STEVEN PETERS CHAIRPERSON 1.00 0.00 X X 0 0 0 RUSSELL HALSEY VICE CHAIRPERSON 1.00 0.00 X X 0 0 0 NANCY POPLE VICE CHAIRPERSON - PART YEAR 1.00 0.00 X X 0 0 0 MARTY DEBOW SECRETARY 1.00 0.00 X X 0 0 0 DONNA ADAM SECRETARY - PART YEAR 1.00 0.00 X X 0 0 0 ROBERT DICKINS TREASURER 1.00 0.00 X X 0 0 0 CARL DAVIS TREASURER - PART YEAR 1.00 0.00 X X 0 0 0 JODI BACKOFEN DIRECTOR 1.00 0.00 X 0 0 0 KYLE BOOHER DIRECTOR 1.00 0.00 X 0 0 0 ASHOK GUPTA MD DIRECTOR 1.00 0.00 X 0 0 0 DOUG REAVES DIRECTOR 1.00 0.00 X 0 0 0 JULIE REINCKE DIRECTOR 1.00 0.00 X 0 0 0 NATE SKINNER DIRECTOR 1.00 0.00 X 0 0 0 LINDA VANDENBERG DIRECTOR 1.00 0.00 X 0 0 0 SHARI GLYNN CFO 40.00 0.00 X 194761 0 10896 ESLI GOLLAPALLI ED PHYSICIAN 36.00 0.00 X 442944 0 20400 JOHN FATA ED PHYSICIAN 36.00 0.00 X 384685 0 28176 RYAN JONES ED PHYSICIAN 40.00 0.00 X 349751 0 26888 DONNA BROWN ED PHYSICIAN 36.00 0.00 X 309401 0 12958 LOWELL FERNANDER RHC PHYSICIAN 40.00 0.00 X 202628 0 3936 2157112 0 122453 26 0 1 0 LUTZ ENTERPRISES 9103 WEST END DR PORTAGE MI 49002 ANESTHESIA SERVICES 879140 PGPA LLC 3544 MERIDIAN CROSSING DR SUITE 120 OKEMOS MI 48864 PHARMACY SERVICES 312708 AUREUS RADIOLOGY LLC PO BOX 310856 DES MOINES IA 50331 RADIOLOGY SERVICES 235469 ALLIANCE-HNI LLC PO BOX 772550 DETROIT MI 48277 EQUIPMENT SERVICES 218047 THE BUSINESS OFFICE PC 8085 KNUE ROAD INDIANAPOLIS IA 46250 HEALTHCARE SERVICES 132505 7 1100 3630740 55422 3687262 NET PATIENT SERVICE REVENUE 621110 35237643 35237643 LAB REVENUE 621500 423401 423401 PHYSICIAN STAFFING/SUPPORT 621110 308838 308838 SPECIALISTS RENTAL FEES 621110 63853 63853 36033735 240547 240547 29366 40481 -11115 -11115 -11115 277583 230957 46626 46626 46626 CAFETERIA 722514 64245 64245 FITNESS CENTER 713940 45634 45634 EMPLOYEE PHARMACY SALES 446110 7789 7789 117668 40114723 36033735 45634 348092 X 517020 517020 14019133 11168188 2850945 142853 142853 2452349 1911246 541103 1000260 770007 230253 32672 32672 96550 96550 4102292 3190556 911736 148983 170 148813 671442 322956 348486 416591 28235 388356 4900 2636 2264 170124 126215 43909 1746411 1295660 450751 218568 149208 69360 MEDICAL SUPPLIES & DRUG 8299383 8273428 25955 BAD DEBT EXPENSE 1546501 1546501 QUALITY ASSURANCE TAXES 650972 650972 MAINTENANCE & REPAIRS 218339 51766 166573 571939 478937 93002 37027282 29966681 7060601 0 560325 560880 15148014 14252845 2598085 2893482 683363 764646 1801691 1679299 38765079 23361011 16721893 15404068 3882083 3469141 1700421 1700421 2923577 2911935 46019452 43636717 4536350 4009112 3986002 3634136 5038800 0 185497 1283305 13746649 8926553 X 32272803 34710164 32272803 34710164 46019452 43636717 3087441 -650080 0 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1997 1997 0 PART II-B, LINE 1: PORTION OF ANNUAL DUES TO MICHIGAN HEALTH & HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION THAT ARE USED TOWARD LOBBYING ACTIVITIES. 724719 724719 20825789 10238149 10587640 1603080 655569 947511 15453026 12467293 2985733 158465 158465 15404068 INVESTMENT IN ER MED PARK, LLC 2739 INVESTMENT IN MEDICAL PROPERTIES 210500 COST REPORT SETTLEMENT RECEIVABLE 2649155 FMV INTEREST RATE SWAP 49541 2911935 COST REPORT SETTLEMENT PAYABLE 1283305 1283305 37588833 -650080 -650080 38238913 1875810 1875810 40114723 35151472 0 35151472 1875810 1875810 37027282 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. 1 1 X 1 X 133.000000000000 1 X 1 1 0 1 1 27998 27998 0.00080 4356120 2627420 1728700 0.04870 4384118 2627420 1756698 0.04950 4384118 2627420 1756698 0.04950 1 1546501 309300 5697703 5753630 -55927 X 1 1 1 1 EATON RAPIDS MEDICAL CENTER 1500 SOUTH MAIN STREET EATON RAPIDS MI 48827 WWW.EATONRAPIDSMEDICALCENTER.ORG 1060000161 X X X X EATON RAPIDS MEDICAL CENTER 1 0 0 1 X X X X X X X X X X 21 1 1 1 1 X HTTPS://TINYURL.COM/BDEPJK4W X HTTP://WWW.HEALTHYCAPITALCOUNTIES.ORG/ X X 1 18 1 HTTPS://TINYURL.COM/YBC7YRBR 0 1 X 133.000000000000 200.000000000000 X 1 1 X X X X 1 X HTTPS://TINYURL.COM/Y9VU5SDC X HTTPS://TINYURL.COM/Y9VU5SDC X HTTPS://TINYURL.COM/Y9VU5SDC X X X X X X 1 X 0 X X X 1 X 0 0 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. 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 X X 0 0 0 0 0 0 0 1 0 ESLI GOLLAPALLI ED PHYSICIAN 442944 0 0 0 0 0 0 0 20400 0 463344 0 0 0 JOHN FATA ED PHYSICIAN 384685 0 0 0 0 0 0 0 28176 0 412861 0 0 0 RYAN JONES ED PHYSICIAN 349751 0 0 0 0 0 0 0 26888 0 376639 0 0 0 DONNA BROWN ED PHYSICIAN 309401 0 0 0 0 0 0 0 12958 0 322359 0 0 0 TIM JOHNSON CEO 267292 0 5650 0 0 0 5454 0 13746 0 292142 0 0 0 LOWELL FERNANDER RHC PHYSICIAN 202628 0 0 0 0 0 0 0 3936 0 206564 0 0 0 SHARI GLYNN CFO 193261 0 1500 0 0 0 3917 0 6979 0 205657 0 0 0 PART I, LINE 7 THE CEO BONUS IS DETERMINED BY THE BOARD AND THE REMAINING BONUSES ARE DETERMINED BY THE EXECUTIVE MANAGEMENT COUNCIL AND APPROVED BY THE BOARD. A CITY OF EATON RAPIDS HOSPITAL FINANCE AUTHORITY BOND PAYABLE - SERIES 2017 386004609 NONEAVAIL 2017-10-16 5200000 NEW PROFESSIONAL BUILDING AND REFINANCE OF 2008 BOND 0 0 0 A 358800 5200000 104000 5096000 2018 1 0 1 1 A 0 1 0 0 0.06900 0.00000 0.06900 0 0 0 A 1 0 1 PNC BANK 15.000000000000 0 0 0 0 0 A 0 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. EATON RAPIDS MEDICAL CENTER FOUNDATION 1500 SOUTH MAIN ST EATON RAPIDS MI 48827 383582316 TO RECEIVE AND ADMINISTER FUNDS AND USE THEM FOR EATON RAPIDS MEDICAL CENTER MI 501(C)(3) LINE 12A, I EATON RAPIDS MEDICAL CENTER 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0