MACKINAC STRAITS HEALTH SYSTEM INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MACKINAC STRAITS HEALTH SYSTEM INC (EIN 20-8756459)
- Tax period
- 2020-04-01 to 2021-03-31
- Filed
- 2022-02-09
- IRS object ID
- 202220409349301042
- Schema version
- 2020v4.2
- 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 D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-02-09T14:08:00-06:00 | ReturnTs |
| Tax Period End | 2021-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208756459 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MACKINAC STRAITS HEALTH SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MACK | BusinessNameControlTxt |
| Phone | 9066438585 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1140 N STATE STREET | AddressLine1Txt |
| City | ST IGNACE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49781 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RYAN SPEAS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9066438585 | PhoneNum |
| Signature | 2022-02-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RYAN | PersonFirstNm |
| Person Last | SPEAS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2022-02-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RYAN SPEAS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1140 N STATE STREET | AddressLine1Txt |
| City | ST IGNACE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49781 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $58,908,352 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | MACKINACSTRAITSHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | MACKINAC STRAITS HEALTH SYSTEM WILL BE A DESTINATION HEALTH SYSTEM, DELIVERING THE BEST CARE AND INVESTING IN COMMUNITY WELLNESS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 392 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $35,260 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,261,303 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,951,928 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $48,841,547 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $50,908,770 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,316 | PYInvestmentIncomeAmt |
| CY Investment Income | $35,076 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,162,456 | PYOtherRevenueAmt |
| CY Other Revenue | $2,012,578 | CYOtherRevenueAmt |
| PY Total Revenue | $52,270,622 | PYTotalRevenueAmt |
| CY Total Revenue | $58,908,352 | 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 | $23,828,818 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $23,260,853 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,200,077 | PYOtherExpensesAmt |
| CY Other Expenses | $30,489,851 | CYOtherExpensesAmt |
| PY Total Expenses | $52,028,895 | PYTotalExpensesAmt |
| CY Total Expenses | $53,750,704 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $241,727 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,157,648 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $42,754,641 | TotalAssetsBOYAmt |
| Total Assets EOY | $52,539,258 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $66,952,076 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $73,271,609 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$24,197,435 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$20,732,351 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING QUALITY HEALTHCARE TO THE FAMILIES AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $45,402,614 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $52,760,734 | RevenueAmt |
| Desc | MACKINAC STRAITS HEALTH SYSTEM, INC. OPERATES A 15-BED ACUTE CARE FACILITY, A 48-BED LONG-TERM CARE UNIT, AND SEVERAL PHYSICIAN CLINICS IN MACKINAC COUNTY, MICHIGAN. THE HEALTH SYSTEM PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, AND PHYSICIAN SERVICES TO THE RESIDENTS OF MACKINAC COUNTY AND THE SURROUNDING AREAS. | Desc |
| Total Program Service Expenses | $45,402,614 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | 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 | 0 | 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 | 0 | TaxExemptBondsInd |
| 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | 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 | 48 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 392 | 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 | 8 | 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 | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | 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 | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RYAN SPEAS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9066438585 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1140 N STATE STREET | AddressLine1Txt |
| City | ST IGNACE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49781 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| MATTHEW BOWES | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $551,852 | $0 | $24,915 | |||
| SUSAN STRICH | ||||||||
| CHIEF OF STAFF - ELECT | 40.00 | $464,482 | $0 | $22,915 | Yes (X) | |||
| ROBERT SHARON | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $296,280 | $0 | $22,855 | |||
| GREGORY HESSLER | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $264,781 | $0 | $24,415 | |||
| AMY BOLMER | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $259,307 | $0 | $8,361 | |||
| RODERICK BALTZER | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $259,265 | $0 | $7,548 | |||
| LORETTA LEJA | ||||||||
| CHIEF OF STAFF | 40.00 | $256,241 | $0 | $9,061 | Yes (X) | 3.00 | ||
| KAREN CHEESEMAN | ||||||||
| CEO | 40.00 | $199,280 | $0 | $23,915 | Yes (X) | 3.70 | Yes (X) | |
| RYAN SPEAS | ||||||||
| CFO | 40.00 | $156,868 | $0 | $9,728 | Yes (X) | |||
| CHRISTINE MCPHERSON | ||||||||
| CHAIRMAN OF BOARD | 1.00 | $0 | $0 | $0 | Yes (X) | 3.70 | Yes (X) | |
| STEVE AUTORE | ||||||||
| VICE PRESIDENT OF BOARD | 1.00 | $0 | $0 | $0 | Yes (X) | 3.70 | Yes (X) | |
| JAMES NORTH | ||||||||
| TREASURER OF BOARD | 1.00 | $0 | $0 | $0 | Yes (X) | 3.70 | Yes (X) | |
| MARGARET DOUD | ||||||||
| SECRETARY OF BOARD | 1.00 | $0 | $0 | $0 | Yes (X) | 3.70 | Yes (X) | |
| EDWARD SMITH | ||||||||
| CHIEF OF STAFF - POST | 1.00 | $0 | $0 | $0 | Yes (X) | 3.00 | ||
| PRENTISS BROWN | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | 3.70 | ||
| MARY MAURER | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | 3.00 | ||
| PATRICK SHANNON | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | 3.00 | ||
| RICHARD SMITH | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,708,356 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $153,713 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | 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 |
|---|---|---|---|---|---|
| ONCOLOGY SPECIALISTS PLLC | |||||
| 3541 SOUTH M129 | SAULT STE MARIE | MI | 49783 | ONCOLOGIST | $631,293 |
| DANIEL K WILCOX MD PC | |||||
| 3493 LAKESIDE DR N | PETOSKEY | MI | 49770 | ORTHOPEDIST | $593,828 |
| KITCH DRUTCHEAS WAGNER VALITUTTI & SHERB | |||||
| ONE WOODWARD AVE/STE 2400 | DETROIT | MI | 48226 | LAW FIRM | $420,970 |
| UNIMED MOBILE MRI LLC | |||||
| 7647 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | MRI SERVICES | $340,717 |
| WIPFLI LLP | |||||
| POBOX 3160 | MILWAUKEE | WI | 53201 | ACCOUNTING FIRM | $305,206 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $28,423 | RelatedOrganizationsAmt |
| Government Grants | $5,672,381 | GovernmentGrantsAmt |
| All Other Contributions | $251,124 | AllOtherContributionsAmt |
| Total Contributions | $5,951,928 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|---|
| PATIENT REVENUE | 900099 | $48,172,435 | $48,086,654 | $85,781 | |
| QAAP REVENUE | 900099 | $1,688,664 | $1,688,664 | ||
| 340B REVENUE | 900099 | $1,002,434 | $1,002,434 | ||
| AFFILIATED RENTAL REVENUE | 900099 | $35,260 | $35,260 | ||
| MOB RENTAL REVENUE | 900099 | $9,977 | $9,977 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $50,908,770 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,076 | TotalRevenueColumnAmt |
| Exclusion | $35,076 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| TAX LEVY | 900099 | $1,319,555 | $1,319,555 | |
| LEASED EMPLOYEE INCOME | 900099 | $653,450 | $653,450 | |
| PHYSICIAN INCENTIVES | 900099 | $39,573 | $39,573 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,012,578 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $58,908,352 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $52,760,734 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $35,260 | UnrelatedBusinessRevenueAmt |
| Exclusion | $160,430 | 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 | $1,142,489 | TotalAmt |
| Program Services | $752,698 | ProgramServicesAmt |
| Management And General | $389,791 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,645,123 | TotalAmt |
| Program Services | $13,493,343 | ProgramServicesAmt |
| Management And General | $2,151,780 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,387,265 | TotalAmt |
| Program Services | $1,196,465 | ProgramServicesAmt |
| Management And General | $190,800 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,933,346 | TotalAmt |
| Program Services | $3,398,012 | ProgramServicesAmt |
| Management And General | $535,334 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,152,630 | TotalAmt |
| Program Services | $994,101 | ProgramServicesAmt |
| Management And General | $158,529 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,113 | TotalAmt |
| Management And General | $123,113 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,101 | TotalAmt |
| Management And General | $106,101 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,380,383 | TotalAmt |
| Program Services | $7,920,790 | ProgramServicesAmt |
| Management And General | $2,459,593 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,266 | TotalAmt |
| Management And General | $84,266 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,627 | TotalAmt |
| Program Services | $73,651 | ProgramServicesAmt |
| Management And General | $32,976 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,097,992 | TotalAmt |
| Program Services | $970,309 | ProgramServicesAmt |
| Management And General | $127,683 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,117 | TotalAmt |
| Program Services | $39,798 | ProgramServicesAmt |
| Management And General | $1,319 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,062 | TotalAmt |
| Program Services | $24,641 | ProgramServicesAmt |
| Management And General | $3,421 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,021,947 | TotalAmt |
| Program Services | $2,021,947 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,706,643 | TotalAmt |
| Program Services | $2,706,643 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,588 | TotalAmt |
| Program Services | $18,117 | ProgramServicesAmt |
| Management And General | $210,471 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $9,557,433 | $9,401,355 | $156,078 |
| BAD DEBT EXPENSE | $1,334,521 | $1,334,521 | |
| QAAP TAXES PAID | $1,334,282 | $1,334,282 | |
| REPAIRS AND MAINTENANCE | $739,679 | $679,255 | $60,424 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $599,097 | TotalAmt |
| Program Services | $376,968 | ProgramServicesAmt |
| Management And General | $222,129 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,750,704 | TotalAmt |
| Program Services | $45,402,614 | ProgramServicesAmt |
| Management And General | $8,348,090 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,814 | BOYAmt |
| EOY | $307,288 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,751,828 | BOYAmt |
| EOY | $16,096,765 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,350,011 | BOYAmt |
| EOY | $4,192,946 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,273,578 | BOYAmt |
| EOY | $1,457,398 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $199,005 | BOYAmt |
| EOY | $207,951 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $56,792,789 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $27,041,813 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,131,358 | BOYAmt |
| EOY | $29,750,976 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,833,047 | BOYAmt |
| EOY | $525,934 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,754,641 | BOYAmt |
| EOY | $52,539,258 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,842,104 | BOYAmt |
| EOY | $3,376,057 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,094 | BOYAmt |
| EOY | $16,852 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,741,297 | BOYAmt |
| EOY | $48,467,619 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,351,581 | BOYAmt |
| EOY | $21,411,081 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,952,076 | BOYAmt |
| EOY | $73,271,609 | 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 | -$24,227,525 | BOYAmt |
| EOY | -$20,763,365 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,090 | BOYAmt |
| EOY | $31,014 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$24,197,435 | BOYAmt |
| EOY | -$20,732,351 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,754,641 | BOYAmt |
| EOY | $52,539,258 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,157,648 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,692,564 | OtherChangesInNetAssetsAmt |
| 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 | 0 | FederalGrantAuditRequiredInd |
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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Beginning Balance | $17,124 | BeginningBalanceAmt |
| Distributions During Year | $272 | DistributionsDuringYearAmt |
| Ending Balance | $16,852 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,200,000 | OtherCostOrOtherBasisAmt |
| Book Value | $1,200,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $39,449,285 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,810,561 | DepreciationAmt |
| Book Value | $23,638,724 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,532,302 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,377,621 | DepreciationAmt |
| Book Value | $1,154,681 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,576,536 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,853,631 | DepreciationAmt |
| Book Value | $3,722,905 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,666 | OtherCostOrOtherBasisAmt |
| Book Value | $34,666 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $29,750,976 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| PENSION LIABILITY | $10,783,387 |
| OTHER LIABILITIES | $1,344,251 |
| MEDICARE REFUNDABLE ADVANCE PAYMENTS | $6,088,443 |
| PAYCHECK PROTECTION PROGRAM LOAN PAYABLE | $3,195,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $21,411,081 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $56,858,424 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$2,021,505 | OtherRevenueAmt |
| Revenue Not Reported | -$2,021,505 | RevenueNotReportedAmt |
| Revenue Subtotal | $58,879,929 | RevenueSubtotalAmt |
| Other Revenues Not Included | $28,423 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $28,423 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $58,908,352 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $51,279,335 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $90,638 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $90,638 | ExpensesNotReportedAmt |
| Expenses Subtotal | $51,188,697 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,562,007 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,562,007 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $53,750,704 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | QAAP PAYMENTS -1,334,282. BAD DEBT EXPENSE -1,334,521. FOUNDATION REVENUE 362,787. SAP REVENUE 284,511. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | GRANT FROM FOUNDATION 28,423. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FOUNDATION EXPENSES 90,638. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBT 1,334,521. QAAP PAYMENTS 1,334,282. SAP EXPENSES -106,796. |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $306,083 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $306,083 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,460,605 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,422,746 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,037,859 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05650 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,766,688 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,422,746 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,343,942 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06220 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,236 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,236 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $323,700 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $323,700 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00600 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $554,955 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $186,713 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $368,242 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00690 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $905,891 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $186,713 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $719,178 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01340 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,672,579 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,609,459 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,063,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07560 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 4 | PersonsServedCnt |
| Total Community Benefit Expns | $200 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $200 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 60 | PersonsServedCnt |
| Total Community Benefit Expns | $600 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $600 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 1 | PersonsServedCnt |
| Total Community Benefit Expns | $100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 35 | ActivitiesOrProgramsCnt |
| Persons Served | 75 | PersonsServedCnt |
| Total Community Benefit Expns | $1,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Persons Served | 12 | PersonsServedCnt |
| Total Community Benefit Expns | $300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 4 | PersonsServedCnt |
| Total Community Benefit Expns | $1,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 57 | ActivitiesOrProgramsCnt |
| Persons Served | 156 | PersonsServedCnt |
| Total Community Benefit Expns | $3,700 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,700 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,334,521 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $844,879 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,397,836 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,858,337 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$460,501 | 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 | 0 | 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 | MACKINAC STRAITS HEALTH SYSTEM INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1140 N STATE STREET | AddressLine1Txt |
| City | ST IGNACE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49781 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MACKINACSTRAITSHEALTH.ORG | WebsiteAddressTxt |
| State License | MW0043832 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RHC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MACKINAC STRAITS HEALTH SYSTEM INC | 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 |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE EXPLANATION FOR LINE 7D | OwnWebsiteURLTxt |
| 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 | SEE EXPLANATION FOR LINE 7D | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.MACKINACSTRAITSHEALTH.ORG/CHARITY-CARE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.MACKINACSTRAITSHEALTH.ORG/CHARITY-CARE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MACKINACSTRAITSHEALTH.ORG/CHARITY-CARE/ | 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 Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| 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 (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MACKINAC STRAITS HEALTH SYSTEM, INC. | PART V, SECTION B, LINE 5: KEY INFORMATIONAL INTERVIEWS WERE CONDUCTED WITH MEMBERS OF THE COMMUNITY SERVED BY MACKINAC STRAITS HEALTH SYSTEM. THESE INDIVIDUALS WERE IDENTIFIED BY THE COMMITTEE BASED ON THEIR QUALIFICATIONS TO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED. GENERALLY, THE INTERVIEWEES INCLUDED PERSONS WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AND PERSONS WHO REPRESENT THE MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS. |
| MACKINAC STRAITS HEALTH SYSTEM, INC. | PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A FULL WEBSITE ADDRESS IS: HTTP://MACKINACSTRAITSHEALTH.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT.HTMLPART V, SECTION B, LINE 10A FULL WEBSITE ADDRESS IS: HTTP://MACKINACSTRAITSHEALTH.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT.HTML |
| MACKINAC STRAITS HEALTH SYSTEM, INC. | PART V, SECTION B, LINE 11: THE FOLLOWING NEEDS WERE IDENTIFIED DURING THE CHNA CONDUCTED IN MARCH 2019 (TAX YEAR 2018): MENTAL HEALTH / BEHAVIORAL HEALTH SERVICES, COMMUNITY EDUCATION PROGRAMS, OBESITY AND DIABETES.MENTAL HEALTH / BEHAVIORAL HEALTH SERVICES :-FACILITATE COMMUNITY TASK FORCE AT MACKINAC STRAITS HOSPITAL-COORDINATE WITH RESOURCES IN THE STATE AVAILABLE TO ASSIST CLINIC PATIENTS-COORDINATE WITH LOCAL OR REGIONAL RESOURCES TO PROMOTE DISCUSSION OF COMMUNITY NEEDS AND POSSIBLE SOLUTIONS-PROMOTE MENTAL HEALTH / BEHAVIORAL HEALTH AWARENESS DURING ONE MONTH A YEARCOMMUNITY EDUCATIONAL PROGRAMS:-CONNECT WITH COMMUNITY RESOURCES TO IDENTIFY SCOPE OF SERVICES AVAILABLE-COORDINATE WITH MSHS' CLINIC LEADERS TO SHARE INFORMATION ABOUT COMMUNITY EDUCATION RESOURCES-SCHEDULE MEETINGS AT MSHS, AND PROVIDE THE SPACE AND ASSISTANCE TO HELP ORGANIZATIONS PROMOTE THEIR SERVICES TO MSHS AND MACKINAC COUNTYOBESITY:-SECURE A CARE MANAGER FOR MSHS' CLINICS-CONNECT MSHS PATIENTS WITH LOCAL RESOURCES FOR MANAGING OBESITY-PRESENTATION TABLE FOR ONE MONTH A YEAR TO EDUCATE THE COMMUNITY ON OBESITYDIABETES:-SECURE A CARE MANAGER FOR MSHS' CLINICS-CONNECT MSHS PATIENTS WITH LOCAL RESOURCES FOR MANAGING DIABETES, INCLUDING ON-SITE DIABETES EDUCATORS (E.G., SAULT TRIBE CLINIC)-CONTINUE ASSESSING THE POTENTIAL FOR DEVELOPING A DIABETES EDUCATION PROGRAM-CONTINUE MEETING MONTHLY FOR THE DIABETES SUPPORT GROUP AND INCORPORATE LOCAL OR REGIONAL RESOURCES FOR GUEST SPEAKERS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MACKINAC ISLAND MEDICAL CLINIC | ||||
| 7474 MARKET STREET | MACKINAC ISLAND | MI | 49757 | EMERGENCY ROOM & PHYSICIAN OFFICE |
| 2 - MACKINAW CITY MEDICAL CLINIC | ||||
| 420 SOUTH NICOLET ST | MACKINAW CITY | MI | 49701 | PHYSICIAN OFFICE |
| 3 - RIVERTOWN MEDICAL CENTER | ||||
| 920 SOUTH HURON STREET | CHEBOYGAN | MI | 49721 | PHYSICIAN OFFICE |
| 4 - MACKINAC CITY SPECIALTY CLINIC | ||||
| 580 SOUTH NICOLET ST | MACKINAC CITY | MI | 49701 | PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE ORGANIZATION UTILIZES A COST TO CHARGE RATIO WHEN CALCULATING THE PERCENTAGE OF CHARITY CARE AND COMMUNITY BENEFIT PERCENTAGES. |
| PART I, LINE 7G: | THE ENTIRE AMOUNT OF SUBSIDIZED HEALTH SERVICES IS FROM PHYSICIAN CLINICS. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | PROVIDED 24 HOUR EMERGENCY AND ESSENTIAL HEALTH CARE SERVICES TO RURAL COMMUNITY. |
| PART III, LINE 2: | THE BAD DEBT EXPENSE AT COST IS CALCULATED USING THE COST TO CHARGE RATIO. |
| PART III, LINE 3: | THE BAD DEBT EXPENSE IS CALCULATED UTILIZING ACTUAL WRITE-OFFS AND THE AMOUNTS THAT HAVE BEEN DETERMINED LIKELY TO BE WRITTEN OFF GIVEN PAST EXPERIENCE OF THE COLLECTION POSSIBILITIES. ALTHOUGH THERE ARE SOME AMOUNTS OF CHARITY CARE INCLUDED IN THIS AMOUNT, THERE IS NOT A CURRENT METHOD TO EASILY OBTAIN THE AMOUNT THAT SHOULD HAVE BEEN CHARITY CARE. |
| PART III, LINE 4: | IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE FOR THE PURPOSE OF ESTIMATING THE APPROPRIATE AMOUNTS OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE PROVISION FOR BAD DEBTS. DATA IN EACH MAJOR PAYOR SOURCE IS REGULARLY REVIEWED TO EVALUATE THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES RELATING TO SERVICES PROVIDED TO PATIENTS HAVING THIRD-PARTY COVERAGE, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A CORRESPONDING PROVISION FOR BAD DEBTS ARE ESTABLISHED BASED ON HISTORICAL WRITE-OFF PERCENTAGES; FOR RECEIVABLES RELATING TO SELF-PAY PATIENTS, A PROVISION FOR BAD DEBTS IS MADE IN THE PERIOD SERVICES ARE RENDERED BASED ON EXPERIENCE INDICATING THE INABILITY OR UNWILLINGNESS OF PATIENTS TO PAY AMOUNTS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. |
| PART III, LINE 8: | IT IS CONSIDERED COMMUNITY BENEFIT AS THE HOSPITAL IS REIMBURSED ON MEDICARE ALLOWABLE COSTS. MEDICARE ALLOWABLE COSTS ARE DEFINED BY MEDICARE. THEY DO NOT NECESSARILY CAPTURE ALL COSTS OF THE HOSPITAL PROVIDING SERVICES TO THE COMMUNITY. CONSEQUENTLY, THERE ARE COSTS NOT REIMBURSED BY EITHER PATIENT OR THE PROGRAM. MEDICARE ALLOWABLE COSTS ARE FROM THE MEDICARE COST REPORT. |
| PART VI, LINE 2: | FEEDBACK FROM COMMUNITY MEMBERS VIA SURVEY AND PRESENTATIONS AT LOCAL ORGANIZATIONS. |
| PART VI, LINE 3: | PAMPLETS AND OTHER LITERATURE AND SIGNAGE. |
| PART VI, LINE 4: | MACKINAC COUNTY - A RURAL COUNTY IN MICHIGAN'S UPPER PENNINSULA. SEASONAL ECONOMY WITH HIGHER THAN AVERAGE UNEMPLOYMENT. AGING POPULATION WITH LARGE NUMBER OF NATIVE AMERICANS. |
| PART VI, LINE 5: | A MAJORITY OF OUR ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND ALSO PROVIDES COURTESY PRIVILIGES TO ANY VISITING SPECIALISTS WHO ARE ALSO PROVIDED SPACE IN OUR BUILDINGS IN ORDER TO SEE THEIR PATIENTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATTHEW BOWES | ||||||||||||||
| PHYSICIAN | $551,852 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $24,915 | $0 | $576,767 | $0 | $0 | $0 |
| SUSAN STRICH | ||||||||||||||
| CHIEF OF STAFF - ELECT | $408,189 | $0 | $0 | $0 | $56,293 | $0 | $0 | $0 | $22,915 | $0 | $487,397 | $0 | $0 | $0 |
| ROBERT SHARON | ||||||||||||||
| PHYSICIAN | $296,280 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $22,855 | $0 | $319,135 | $0 | $0 | $0 |
| GREGORY HESSLER | ||||||||||||||
| PHYSICIAN | $258,013 | $0 | $0 | $0 | $6,768 | $0 | $0 | $0 | $24,415 | $0 | $289,196 | $0 | $0 | $0 |
| AMY BOLMER | ||||||||||||||
| PHYSICIAN | $248,123 | $0 | $0 | $0 | $11,184 | $0 | $0 | $0 | $8,361 | $0 | $267,668 | $0 | $0 | $0 |
| RODERICK BALTZER | ||||||||||||||
| PHYSICIAN | $248,417 | $0 | $0 | $0 | $10,848 | $0 | $0 | $0 | $7,548 | $0 | $266,813 | $0 | $0 | $0 |
| LORETTA LEJA | ||||||||||||||
| CHIEF OF STAFF | $245,281 | $0 | $0 | $0 | $10,960 | $0 | $0 | $0 | $9,061 | $0 | $265,302 | $0 | $0 | $0 |
| KAREN CHEESEMAN | ||||||||||||||
| CEO | $182,742 | $0 | $0 | $0 | $16,538 | $0 | $0 | $0 | $23,915 | $0 | $223,195 | $0 | $0 | $0 |
| RYAN SPEAS | ||||||||||||||
| CFO | $147,103 | $0 | $0 | $0 | $9,765 | $0 | $0 | $0 | $9,728 | $0 | $166,596 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MARY MAURER | |||
| BOARD MEMBER | $10,477 | ADVERTISING | 0 |
| KAREN CHEESEMAN | |||
| CEO | $7,442 | INSURANCE | 0 |
| JIM NORTH | |||
| BOARD MEMBER | $1,809 | LOAN PAYMENTS | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS HAS DELEGATED TO REVIEW AND APPROVAL OF THE FORM 990 TO THE CFO. THE 990 RETURN IS E-MAILED TO THE BOARD MEMBERS PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS MONITORS THE CONFLICT OF INTEREST POLICY. NEW CONFLICTS OF INTEREST ARE REVIEWED BY THE BOARD IN ACCORDANCE WITH THE POLICY AND DOCUMENTED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING ALL COMPENSATION IS BASED ON THE MHA ANNUAL SURVEY. THE COMPENSATION IS THEN REVIEWED BY THE BOARD FOR THE CEO AND IS REVIEWED BY THE CEO FOR OTHER OFFICERS AND KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES THEIR DOCUMENTATION AVAILABLE TO THE PUBLIC BY REQUEST ONLY. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 MAKING THEM AVAILABLE FOR PUBLIC INSPECTION. |
| FORM 990, PART IX, LINE 11G | OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 4,047,118. MANAGEMENT AND GENERAL EXPENSES 655,144. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,702,262. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 1,218,766. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,218,766. FISCAL & ADMINISTRATION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 852,077. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 852,077. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 641,723. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 641,723. CLINIC CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,013,183. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,013,183. INFORMATION TECHNOLOGY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 952,372. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 952,372. |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE -1,650,333. CHANGE IN INTEREST IN FOUNDATION -42,231. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MACKINAC STRAITS AREA HEALTH | |||||||||||
| 1140 N STATE STREET | ST IGNACE | MI | 49781 | 472021925 | SUPPORTS MACKINAC STRAITS HEALTH SYSTEM | MI | 501(C)(3) | LINE 12B, II | N/A | 0 | |
| MACKINAC STRAITS HEALTH FOUNDATION | |||||||||||
| 1140 N STATE STREET | ST IGNACE | MI | 49781 | 465296565 | FOUNDATION | MI | 501(C)(3) | LINE 12B, II | Yes (1) | MACKINAC STRAITS HEALTH SYSTEM | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STRAITS AREA PHARMACY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1140 N STATE STREET | AddressLine1Txt |
| City | ST IGNACE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49781 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 813168928 | EIN |
| Primary Activities | RETAIL PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MACKINAC STRAITS HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Ownership | 1.00000 | OwnershipPct |
| 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 | Yes (1) | 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 | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MACKINAC STRAITS HEALTH FOUNDATION | ||
| C | $28,423 | ACTUAL |
| STRAITS AREA PHARMACY | ||
| J | $35,260 | FMV |
| STRAITS AREA PHARMACY | ||
| Q | $653,450 | FMV |