TRINITY HEALTH GRAND HAVEN HOSPITAL: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- TRINITY HEALTH GRAND HAVEN HOSPITAL (EIN 38-3330803)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-17
- IRS object ID
- 202121379349301912
- Schema version
- 2019v5.2
- 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 L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-17T09:17:31-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S 6TH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383330803 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH OTTAWA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 6168423600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1309 SHELDON ROAD | AddressLine1Txt |
| City | GRAND HAVEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49417 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHELLEYE YAKLIN | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 6168423600 | PhoneNum |
| Signature | 2021-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DARRYN MCGARVEY | PreparerPersonNm |
| PTIN | P00958683 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHELLEYE YAKLIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1309 SHELDON ROAD | AddressLine1Txt |
| City | GRAND HAVEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49417 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $52,514,654 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NOCH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE A NETWORK OF COMMUNITY HEALTHCARE, DELIVERING SERVICE WITH COMPASSION AND RESPECT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 641 | TotalEmployeeCnt |
| Total Volunteers | 180 | TotalVolunteersCnt |
| Total Gross UBI | $2,564,119 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $66,164 | PYContributionsGrantsAmt |
| CY Contributions Grants | $221,205 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $52,611,849 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $48,575,008 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,005,705 | PYInvestmentIncomeAmt |
| CY Investment Income | $303,489 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,967,391 | PYOtherRevenueAmt |
| CY Other Revenue | $3,030,237 | CYOtherRevenueAmt |
| PY Total Revenue | $59,651,109 | PYTotalRevenueAmt |
| CY Total Revenue | $52,129,939 | 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 | $24,776,507 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,259,290 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,593,715 | PYOtherExpensesAmt |
| CY Other Expenses | $31,633,279 | CYOtherExpensesAmt |
| PY Total Expenses | $59,370,222 | PYTotalExpensesAmt |
| CY Total Expenses | $52,892,569 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $280,887 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$762,630 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,928,570 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,092,061 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $51,565,757 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $68,255,689 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$18,637,187 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$25,163,628 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF NORTH OTTAWA COMMUNITY HOSPITAL IS TO ACHIEVE COMMUNITY WELLNESS THROUGH RELATIONSHIPS, RESOURCES AND PERSONALIZED SERVICE. WE WILL PROVIDE PERSONAL, TRUSTED, LIFE-LONG MEDICAL CARE AND GUIDANCE FOR OUR NEIGHBORS, FAMILY AND FRIENDS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,237,943 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $48,575,008 | RevenueAmt |
| Desc | INPATIENT HEALTHCARE SERVICES WERE PROVIDED FOR 1,111 PATIENTS AND 164 NEWBORNS. SERVICE DAYS TOTALED 2,859 INCLUDING 2,564 ADULT/PEDIATRICDAYS AND 295 NURSERY DAYS.EMERGENCY SERVICES WERE PROVIDED TO 13,923 PATIENTS. IN ADDITION, 2,879 SURGERIES WERE PERFORMED AND 1,284 ENDOSCOPIC PROCEDURES WERE PERFORMED.DIAGNOSTIC TESTING, IMAGING, LABORATORY, ELECTRODIAGNOSTICS, AND SLEEP LAB SERVICES WERE PROVIDED TO 89,111 PATIENTS. | Desc |
| Total Program Service Expenses | $38,237,943 | 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 | 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 | Yes (1) | 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 | Yes (1) | 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 | 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 | 125 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 641 | 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 |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 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 | 0 | 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 | SHELLEYE YAKLIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6168423600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1309 SHELDON ROAD | AddressLine1Txt |
| City | GRAND HAVEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49417 | 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 | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| KARL LAUTERBACH MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $307,328 | $0 | $21,147 | |||
| ANDA SCORZA DO | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $299,342 | $0 | $14,468 | |||
| SHELLEYE YAKLIN | ||||||||
| PRESIDENT / CEO | 24.00 | $259,362 | $0 | $16,639 | 16.00 | Yes (X) | ||
| HANEY ASSAAD MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $256,734 | $0 | $4,115 | |||
| STUART VANDERHEIDE MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $224,082 | $0 | $18,563 | |||
| LISA HOEKSTRA JANSEN MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $191,412 | $0 | $18,193 | |||
| RON RYBAR | ||||||||
| INTERIM CFO | 24.00 | $0 | $0 | $0 | 16.00 | Yes (X) | ||
| JOY GAASCH | ||||||||
| CHAIR | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | Yes (X) | |
| TIM PARKER | ||||||||
| VICE CHAIR | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | Yes (X) | |
| JUDITH HOOYENGA | ||||||||
| SECRETARY | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | Yes (X) | |
| DARREN RIOPELLE THROUGH JAN 2020 | ||||||||
| TREASURER | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | Yes (X) | |
| TIM BARRON MD | ||||||||
| TRUSTEE | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | ||
| JEFF BESWICK | ||||||||
| TRUSTEE | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | ||
| HARRY DYCK JR | ||||||||
| TRUSTEE | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | ||
| TOM GODFREY | ||||||||
| TRUSTEE | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | ||
| TAMI HARVEY | ||||||||
| TRUSTEE | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | ||
| ERIC HAYWARD | ||||||||
| TRUSTEE | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | ||
| CLAIRE SHERIDAN | ||||||||
| TRUSTEE | 0.30 | $0 | $0 | $0 | 0.70 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,538,260 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $93,125 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | 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 |
|---|---|---|---|---|---|
| STATE OF MICHIGAN | |||||
| PO BOX 30437 | LANSING | MI | 48909 | MEDICAL SERVICES | $2,395,477 |
| IVY REHAB | |||||
| 1311 MAMARONECK AVE SUITE 140 | WHITE PLAINS | NY | 10605 | THERAPY SERVICES | $1,434,442 |
| COMPREHENSIVE PHARMACY SYSTEMS | |||||
| 5050 BRADENTON AVE | DUBLIN | OH | 43017 | PHARMACY SERVICES | $1,295,777 |
| CARDINAL HEALTH | |||||
| PO BOX 70539 | CHICAGO | IL | 60673 | MEDICAL PRODUCTS | $1,280,353 |
| GRAND HEALTH PARTNERS | |||||
| 2060 EAST PARIS AVE SE SUITE 100 | GRAND RAPIDS | MI | 49546 | MEDICAL SERVICES | $1,062,373 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 48 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $221,205 | AllOtherContributionsAmt |
| Total Contributions | $221,205 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621110 | $43,130,704 | $43,130,704 |
| OTHER PATIENT REVENUE | 621110 | $5,444,304 | $5,444,304 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $48,575,008 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $303,489 | TotalRevenueColumnAmt |
| Exclusion | $303,489 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $682,746 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $382,107 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $300,639 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $300,639 | TotalRevenueColumnAmt |
| Exclusion | $300,639 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $1,010 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $2,608 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,598 | TotalRevenueColumnAmt |
| Exclusion | -$1,598 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| DUNEWOOD PHARMACY | 446110 | $2,564,119 | $2,564,119 | |
| FOOD SERVICES | 722210 | $167,077 | $167,077 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,731,196 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,129,939 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $48,575,008 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,564,119 | UnrelatedBusinessRevenueAmt |
| Exclusion | $769,607 | 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 | $276,000 | TotalAmt |
| Management And General | $276,000 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,425,125 | TotalAmt |
| Program Services | $12,798,055 | ProgramServicesAmt |
| Management And General | $4,627,070 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $489,397 | TotalAmt |
| Program Services | $352,366 | ProgramServicesAmt |
| Management And General | $137,031 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,790,228 | TotalAmt |
| Program Services | $1,288,964 | ProgramServicesAmt |
| Management And General | $501,264 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,278,540 | TotalAmt |
| Program Services | $923,977 | ProgramServicesAmt |
| Management And General | $354,563 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,171 | TotalAmt |
| Management And General | $49,171 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,468 | TotalAmt |
| Management And General | $176,468 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,849,846 | TotalAmt |
| Program Services | $7,171,386 | ProgramServicesAmt |
| Management And General | $1,678,460 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,212 | TotalAmt |
| Program Services | $50,341 | ProgramServicesAmt |
| Management And General | $91,871 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $727,432 | TotalAmt |
| Program Services | $523,751 | ProgramServicesAmt |
| Management And General | $203,681 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,673,556 | TotalAmt |
| Program Services | $1,204,960 | ProgramServicesAmt |
| Management And General | $468,596 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,244 | TotalAmt |
| Program Services | $7,147 | ProgramServicesAmt |
| Management And General | $9,097 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,938 | TotalAmt |
| Management And General | $398,938 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,777,362 | TotalAmt |
| Program Services | $1,415,929 | ProgramServicesAmt |
| Management And General | $361,433 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $769,317 | TotalAmt |
| Management And General | $769,317 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $6,986,383 | $6,986,383 | |
| DRUGS | $3,022,727 | $3,022,727 | |
| PROVISION FOR BAD DEBTS | $2,903,160 | $2,903,160 | |
| MMQAA BED TAX | $1,513,166 | $1,513,166 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,627,297 | TotalAmt |
| Program Services | $2,491,957 | ProgramServicesAmt |
| Management And General | $135,340 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,892,569 | TotalAmt |
| Program Services | $38,237,943 | ProgramServicesAmt |
| Management And General | $14,654,626 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,322 | BOYAmt |
| EOY | $4,322 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $866,540 | BOYAmt |
| EOY | $13,655,680 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,750 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,651,609 | BOYAmt |
| EOY | $5,786,161 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,609,098 | BOYAmt |
| EOY | $1,671,176 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $588,784 | BOYAmt |
| EOY | $504,352 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $87,268,874 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $68,932,324 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,877,788 | BOYAmt |
| EOY | $18,336,550 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,374,497 | BOYAmt |
| EOY | $1,429,134 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,052 | BOYAmt |
| EOY | $109,720 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,120 | BOYAmt |
| EOY | $102,120 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,731,010 | BOYAmt |
| EOY | $1,492,846 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,928,570 | BOYAmt |
| EOY | $43,092,061 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,190,586 | BOYAmt |
| EOY | $17,282,829 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,454 | BOYAmt |
| EOY | $3,094,595 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,032,890 | BOYAmt |
| EOY | $4,948,064 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,515 | BOYAmt |
| EOY | $12,515 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $208,303 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,263,720 | BOYAmt |
| EOY | $2,149,121 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,238,900 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,056,592 | BOYAmt |
| EOY | $35,321,362 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,565,757 | BOYAmt |
| EOY | $68,255,689 | 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 | -$19,054,902 | BOYAmt |
| EOY | -$25,633,231 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $417,715 | BOYAmt |
| EOY | $469,603 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$18,637,187 | BOYAmt |
| EOY | -$25,163,628 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,928,570 | BOYAmt |
| EOY | $43,092,061 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$762,630 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $3,490 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$5,767,301 | 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 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 |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE DUES NORTH OTTAWA PAYS THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION IS FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $85,000 | BeginningYearBalanceAmt |
| End Year Balance | $85,000 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $85,000 | BeginningYearBalanceAmt |
| End Year Balance | $85,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $79,390 | BeginningYearBalanceAmt |
| Contributions | $5,610 | ContributionsAmt |
| End Year Balance | $85,000 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $69,910 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $10,209 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $729 | OtherExpendituresAmt |
| End Year Balance | $79,390 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $76,266 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $10 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,648 | GrantsOrScholarshipsAmt |
| Other Expenditures | $718 | OtherExpendituresAmt |
| End Year Balance | $69,910 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,753,699 | OtherCostOrOtherBasisAmt |
| Book Value | $4,753,699 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,843,421 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,256,388 | DepreciationAmt |
| Book Value | $11,587,033 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $494,090 | OtherCostOrOtherBasisAmt |
| Depreciation | $494,090 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,934,818 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,939,000 | DepreciationAmt |
| Book Value | $1,995,818 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,242,846 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,242,846 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,336,550 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| EMPLOYEE BENEFIT OBLIGATION | $30,623,106 |
| DUE TO/FROM RELATED PARTY | $4,698,256 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $35,321,362 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE AMOUNT INCLUDED ON PART X, LINE 21 REPRESENTS TENANT SECURITY DEPOSITS COLLECTED AT THE COMMENCEMENT OF TENTANT'S RENTAL CONTRACT WITH NOCH, ONCE THE CONTRACT IS TERMINATED THE SECURITY DEPOSITS ARE DUE BACK TO THE TENANT. |
| PART V, LINE 4: | THE ENDOWMENT FUNDS ARE HELD BY THE GRAND HAVEN AREA COMMUNITY FOUNDATION AND THE HOSPITAL USES THE INCOME FOR NURSING EDUCATION. |
| PART X, LINE 2: | INCOME TAXES THE SYSTEM, EXCEPT FOR SYNANON, INC., IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE. NO ENTITIES WITHIN THE SYSTEM ARE CONSIDERED TO BE A PRIVATE FOUNDATION. THE SYSTEM IS ALSO EXEMPT FROM STATE INCOME TAXES. THE SYSTEM'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE SYSTEM IS NOT AWARE OF ANY ADDITIONAL ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES THAN ARE CURRENTLY FILED IN THE TAX RETURN. THE SYSTEM HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE SYSTEM FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $78,431 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $78,431 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,066,311 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,699,617 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,366,694 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02580 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,144,742 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,699,617 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,445,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02730 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $72,579 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $72,579 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $72,584 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $72,584 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,217,326 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,699,617 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,517,709 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02870 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,903,160 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,503,390 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,494,229 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$990,839 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 LAKESHORE HEALTHCARE LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.50000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.50000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | NORTH OTTAWA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1309 SHELDON ROAD | AddressLine1Txt |
| City | GRAND HAVEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49417 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://WWW.NOCH.ORG/ | WebsiteAddressTxt |
| State License | 700010 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH OTTAWA COMMUNITY HOSPITAL | 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 | 17 | 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 | HTTP://WWW.NOCH.ORG/MAIN.ASPX?ID=2624 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.NOCH.ORG/MAIN.ASPX?ID=2624 | 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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.NOCH.ORG/UPLOADEDFILES/PATIENTS_AND_VISITORS/DOC001.PDF | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.NOCH.ORG/UPLOADEDFILES/PATIENTS_AND_VISITORS/DOC002.PDF | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.NOCH.ORG/MAIN.ASPX?ID=4469 | 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 |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| 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 | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NORTH OTTAWA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 5: THE JUNE 30, 2018 COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED IN-DEPTH TELEPHONE INTERVIEWS WITH 10 KEY STAKEHOLDERS (HOSPITAL DIRECTORS, CLINIC EXECUTIVE DIRECTORS, ETC.), AN ONLINE SURVEY WITH 91 KEY INFORMANTS (PHYSICIANS, NURSES, DENTISTS, PHARMACISTS, SOCIAL WORKERS, ETC.), A SELF-ADMINISTERED PAPER SURVEY FROM 489 VULNERABLE AND UNDERSERVED COMMUNITY MEMBERS, AND A TELEPHONE SURVEY FROM 1,318 ADULT COMMUNITY MEMBERS. |
| NORTH OTTAWA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 6A: HOLLAND HOSPITAL AND SPECTRUM HEALTH-ZEELAND COMMUNITY HOSPITAL |
| NORTH OTTAWA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 6B: OTTAWA DEPARTMENT OF PUBLIC HEALTH, COMMUNITY MENTAL HEALTH OTTAWA COUNTY, AND GREATER OTTAWA COUNTY UNITED WAY |
| NORTH OTTAWA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 11: THE HEALTH NEEDS IDENTIFIED IN THE MOST RECENT CHNA WERE: ACCESS TO CARE, MENTAL HEALTH, AND HEALTHY BEHAVIORS. SINCE THESE NEEDS WERE IDENTIFIED NOCH TOOK SPECIFIC ACTIONS, WHICH INCLUDED THE FOLLOWING FOR EACH IDENTIFIED NEED. ACCESS TO CARESTRATEGY 1: EXPANSION OF OTTAWA COUNTY PATHWAYS TO BETTER HEALTH (OPBH) TO ALLOW SERVING A GREATER NUMBER OF PEOPLE- SUPPORT WWW.MIOTTAWA.ORG/OPBH- PATHWAYS TO BETTER HEALTH PARTICIPATION- OAISD SCHOOL NURSE INITIATIVE PARTICIPATION- PCP OFFICE CARE COORDINATORS -INTEGRATE WITH ERSTRATEGY 2: EXPAND CARE COORDINATION IN PRIMARY CARE OFFICES- HIRED SOCIAL WORKER FOR PHYSICIAN OFFICES- PATHWAYS TO BETTER HEALTH PARTICIPATION- PCP OFFICE CARE COORDINATORS -INTEGRATE WITH ER- SPECIALTY CLINICS -ORTHOPEDICS, BARIATRICS- EMR INTEGRATION (NOCH, NOMG); GREAT LAKES HEALTH CONNECT- INTEGRATED COMMUNITY LINKAGES AND LOCAL RESOURCES INTO ROUTINE CARE MANAGEMENT MEETINGS- EMBEDDED PHARMACISTS INTO PCP OFFICES TO ASSIST WITH REAL-TIME MEDICATION MANAGEMENTMENTAL HEALTHSTRATEGY 1: INCREASE PUBLIC AWARENESS OF EXISTING MENTAL HEALTH TREATMENT MODELS AND SERVICES- PARTNERED WITH MOSIAC COUNSELING FOR SUICIDE SAFETY RESPONSE TRAINING FOR STAFF AND COMMUNITY- PARTNERED WITH PINE REST AND OTTAWA COUNTRY DEPARTMENT OF PUBLIC HEALTH FOR CONTINUING MEDICAL EDUCATION WORK FOR PROVIDERS ON SUICIDE PREVENTION- MENTAL ILLNESS TASK FORCE (NORTHERN OTTAWA COUNTY) AND SUICIDE PREVENTION COALITION COLLABORATION- IMPLEMENTED EVIDENCE-BASED SUICIDE SAFETY PROTOCOL AND SCREENING TO PHYSICIAN OFFICES- INTEGRATED INFORMATION ON LOCAL MENTAL HEALTH RESOURCES INTO ER RISK AND CARE MANAGEMENT WITHIN PHYSICIAN PRACTICESSTRATEGY 2: INCREASE COMMUNITY CONVERSATION ABOUT MENTAL HEALTH- LOCAL TOWN HALL SERVICES ON MENTAL ILLNESS- PLANNING COMMITTEE INVOLVEMENTSTRATEGY 3: EDUCATE COMMUNITY ON ADVERSE CHILDHOOD EXPERIENCES (ACES)- THRIVE OTTAWA COUNTY COLLABORATIVE TASK FORCE TO ADDRESS ACES- CREATE PUBLIC AWARENESS CAMPAIGN- MDHHS TRAINED OVER 100 OTTAWA COUNTY COMMUNITY MEMBERS TO BE MASTER ACES COMMUNITY CHAMPIONSHEALTHY BEHAVIORSSTRATEGY 1: INCREASE AWARENESS OF LOW-COST AND FREE OPPORTUNITIES FOR PHYSICAL ACTIVITY IN OTTAWA COUNTY- FITNESS SAMPLER: PARTNERED WITH YMCA, FOUR POINTES, AND CITY OF GRAND HAVEN TO OFFER A VARIETY OF FREE PHYSICAL ACTIVITY CLASSES AT WATERFRONT STADIUM- PARTNERED WITH OTTAWA COUNTY DEPARTMENT OF PUBLIC HEALTH TO OFFER STEP IT UP! PROGRAMSTRATEGY 2: SUPPORT OTTAWA FOOD POLICY COUNCIL EFFORTS- INCORPORATED NUTRITION EDUCATION AND RESOURCE GUIDES FOR LOCAL HEALTH FOOD OPTIONS INTO PHYSICIAN PRACTICES, SERVICE LINES AT NOCHS, FOOD SERVICES, AND COMMUNITY OUTREACH ACTIVITIES- IMPLEMENT AN EDUCATIONAL CAMPAIGN ON IMPORTANCE OF FAMILY MEALS- ASSIST HEALTHCARE PROFESSIONALS IN REDUCING BARRIERS THAT PREVENT THEM FROM PROVIDING WEIGHT-RELATED ADVICE TO OVERWEIGHT AND OBESE PATIENTS. |
| NORTH OTTAWA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 13H: A PATIENT WHO IS IDENTIFIED AS "DECEASED WITH NO ESTATE" WILL QUALIFY FOR A 100% FINANCIAL ASSISTANCE DISCOUNT. |
| NORTH OTTAWA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 24: NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALITY FOR A DISCOUNT UNDER THE FAP. |
| 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 - DUNEWOOD PHARMACY | ||||
| 1445 SHELDON ROAD | GRAND HAVEN | MI | 49417 | RETAIL AND INFUSION PHARMACY |
| 2 - NORTH OTTAWA BARIATRIC CLINIC | ||||
| 1445 SHELDON ROAD | GRAND HAVEN | MI | 49417 | PHYSICIAN SERVICES |
| 3 - NORTH OTTAWA PEDIATRICS | ||||
| 1445 SHELDON ROAD | GRAND HAVEN | MI | 49417 | PHYSICIAN SERVICES |
| 4 - NORTH OTTAWA GENERAL SURGERY | ||||
| 1310 WISCONSIN AVENUE | GRAND HAVEN | MI | 49417 | PHYSICIAN SERVICES |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FIRST WE DETERMINE ELIGIBILITY BASED ON INCOME UP TO 250% OF THE FPG. THEN WE CONSIDER ASSETS. THE INCOME LEVEL WRITE-OFF RATE IS ADJUSTED BY THE ASSET LEVEL WRITE-OFF RATE TO DETERMINE THE TOTAL WRITE OFF RATE. FOR EXAMPLE, FOR INCOME 150-200% OF POVERTY LEVEL, WE WRITE OFF 75%. THIS IS THEN ADJUSTED BY THE ASSET RATE. IF THE PATIENT HAS ASSETS >$35,000, THEN THE ADJUSTMENT PERCENT IS 0%. 0% ASSET RATE X 75% INCOME RATE = 0% WRITE-OFF. IF ASSETS ARE BETWEEN $20,000 - 35,000, THEN THE ADJUSTMENT FACTOR IS 75%, FOR EXAMPLE 75% INCOME RATE X 75% ASSET RATE = 56.25% WRITE-OFF. IF THE PATIENTS ASSETS TOTAL LESS THAN $20,000, THEN THE ASSET ADJUSTMENT RATE IS 100%. |
| PART I, LINE 7: | A COST TO CHARGE RATIO WAS USED. THIS RATIO WAS DERIVED FROM INPUTS FROM THE MHA COMMUNITY BENEFIT TRACKER SOFTWARE, WHICH FOLLOWS WORKSHEET 2 OF THE IRS INSTRUCTIONS TO SCHEDULE H. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE HOSPITAL EMS DEPARTMENT IS PRESENT AT MANY COMMUNITY EVENTS AT NO CHARGE TO THE EVENT ORGANIZERS. THE EMS DEPARTMENT ATTENDS EVENTS SUCH AS LOCAL HIGH SCHOOL FOOTBALL GAMES, RUNNING EVENTS, PARADES, FIRE DEPARTMENT OPEN HOUSES, BEACH EVENTS, AND FESTIVALS. THEIR PRESENCE AT THESE EVENTS PROVIDES EDUCATION TO THE COMMUNITY, BUT MORE IMPORTANTLY AN IMMEDIATE INTERVENTION SHOULD A HEALTHCARE NEED ARISE. THE HOSPITAL ALSO PROVIDES FLU SHOT CLINICS TO AREA NURSING HOMES AND OTHER SUCH FACILITIES. |
| PART III, LINE 2: | THE HOSPITAL DIRECTLY WRITES OFF BAD DEBTS SUCH AS MEDICARE PRIMARY, MEDICAID SECONDARY ACCOUNT IN CASES WE KNOW THAT MEDICAID WILL NOT PAY THE SECONDARY AMOUNT. THE HOSPITAL ALSO CALCULATES A BAD DEBT ALLOWANCE ACCRUAL BASED ON SELF PAY BALANCE WITH THE COLLECTION AGENCIES BASED ON THEIR COLLECTION RATE. |
| PART III, LINE 3: | THE ORGANIZATION HAS NOT IDENTIFIED A METHOD TO REASONABLY CALCULATE THE PORTION OF ITS BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE BUT FAILED TO COMPLETE AN APPLICATION. |
| PART III, LINE 4: | FOR A DESCRIPTION OF THE HOSPITAL'S BAD DEBT EXPENSE, SEE THE 'PATIENT AND RESIDENT ACCOUNTS RECEIVABLE' INFORMATION IN NOTE 1 ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE AMOUNTS INCLUDED IN PART III, LINES 5 AND 6 WERE GENERATED USING THE JUNE 30, 2020 FILED MEDICARE COST REPORT. THIS RESULTED IN A SHORTFALL OF APPROXIMATELY $990,839. SINCE OVER 40% OF OUR PAYORS ARE EITHER MEDICARE FFS OR MEDICARE ADVANTAGE PLANS, THIS IS A SIGNIFICANT SHORTFALL FOR A COMMUNITY HOSPITAL OF OUR SIZE, THEREFORE, WE FEEL THIS AMOUNT IS CONSIDERED A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | THE HOSPITAL WORKS VERY DILIGENTLY TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY OR UNDER-INSURED DISCOUNTS. ULTIMATELY IT IS UP TO THE PATIENT TO PROVIDE THE NECESSARY PAPERWORK TO QUALIFY THEM FOR CHARITY CARE OR UNDERINSURED DISCOUNTS. IN THE EVENT THAT THE PATIENT DOES NOT RESPOND TO REQUESTS FOR INFORMATION, THEY WILL BE SENT TO AN OUTSIDE COLLECTION AGENCY. OFTEN TIMES THE COLLECTION AGENCY HAS SUCCESS IN OBTAINING THE NECESSARY PAPERWORK TO DETERIMINE IF THE PATIENT FALLS WITHIN OUR CHARITY CARE GUIDELINES. IF THE PATIENT IS COMPLIANT IN FILLING OUT THE PAPERWORK AND FOUND TO BE ELIGIBLE FOR CHARITY CARE, WE MOVE THEM FROM BAD DEBT STATUS TO ACCOUNTS RECEIVABLE, AND THEN EVENTUAL ADJUSTMENT OF THEIR BILL TO THE APPROPRIATE ADJUSTMENT CODE. |
| PART VI, LINE 2: | NORTH OTTAWA COMMUNITY HOSPITAL HAS BEEN AN INTEGRAL PART OF THE OTTAWA COUNTY HEALTH ASSESSMENT COMMITTEE, WHICH IS LED BY THE OTTAWA COUNTY HEALTH DEPARTMENT. THE HOSPITAL MEETS FREQUENTLY WITH MUNICIPALITY REPRESENTATIVES TO EVALUATE HEALTH-RELATED SERVICES THAT CAN BE ENHANCED OR ADDED TO OUR FACILITY. WE CONDUCT SURVEYS, HOLD FOCUS GROUPS AND INVITE BUSINESS AND COMMUNITY GROUPS TO HELP US DETERMINE THE NEEDS OF THE COMMUNITY. WE HAVE RELATIONSHIPS WITH "SAFETY NET PROVIDERS" IN OUR LOCAL COMMUNITY THAT FURTHER ENHANCE OUR ABILITY TO PROVIDE CARE AND HEALTH RELATED PROGRAMS TAILORED TO OUR SERVICE AREA. WE ALSO USE COMMUNITY HEALTH STATUS INFORMATION (MORTALITY, MORBIDITY, DISEASE RATES, BIRTH RATES, IMMUNIZATION RATES, ETC) TO HELP US FOCUS ON LOCAL NEEDS. FINALLY, ON A REGIONAL COLLABORATIVE BASIS WE PARTICIPATE IN AH4Q-ALIGNING HEALTHCARE PROVIDERS FOR QUALITY, WHICH ASSESSES, EVALUATES AND PROMOTES BETTER CARE FOR WEST MICHIGAN CITIZENS. |
| PART VI, LINE 3: | AS SOON AS THE HOSPITAL BECOMES AWARE THAT A PATIENT DOES NOT HAVE INSURANCE COVERAGE, OR IS UNDER-INSURED, THAT PERSON IS CONTACTED EITHER BY PHONE, MAIL, OR IN PERSON BY OUR FINANCIAL COUNSELOR. WE HAVE A NUMBER OF PAMPHLETS THAT OUTLINE OUR CHARITY CARE POLICY, AS WELL AS HELP LOANS FOR WHICH THE HOSPITAL UNDERWRITES THE INTEREST PORTION OF THE LOAN. |
| PART VI, LINE 4: | THE HOSPITAL MAINLY SERVES THE CITIZENS OF THE ADJACENT COMMUNITIES OF GRAND HAVEN, GRAND HAVEN TOWNSHIP, FERRYSBURG, VILLAGE OF SPRING LAKE, SPRING LAKE TOWNSHIP, ROBINSON TOWNSHIP, WEST OLIVE TOWNSHIP AND CROCKERY TOWNSHIP. THE HOSPITAL SERVES PATIENTS OF ALL INCOME LEVELS. |
| PART VI, LINE 5: | IN CONJUNCTION WITH THE MICHIGAN HOSPITAL ASSOCIATION, A COMMUNITY BENEFIT SURVEY IS COMPLETED EACH YEAR. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KARL LAUTERBACH MD | ||||||||||||||
| PHYSICIAN | $0 | $0 | $0 | $0 | $307,328 | $0 | $0 | $0 | $21,147 | $0 | $328,475 | $0 | $0 | $0 |
| ANDA SCORZA DO | ||||||||||||||
| PHYSICIAN | $0 | $0 | $0 | $0 | $299,342 | $0 | $0 | $0 | $14,468 | $0 | $313,810 | $0 | $0 | $0 |
| SHELLEYE YAKLIN | ||||||||||||||
| PRESIDENT / CEO | $0 | $0 | $0 | $0 | $259,362 | $0 | $0 | $0 | $16,639 | $0 | $276,001 | $0 | $0 | $0 |
| HANEY ASSAAD MD | ||||||||||||||
| PHYSICIAN | $0 | $0 | $0 | $0 | $256,734 | $0 | $0 | $0 | $4,115 | $0 | $260,849 | $0 | $0 | $0 |
| STUART VANDERHEIDE MD | ||||||||||||||
| PHYSICIAN | $0 | $0 | $0 | $0 | $224,082 | $0 | $0 | $0 | $18,563 | $0 | $242,645 | $0 | $0 | $0 |
| LISA HOEKSTRA JANSEN MD | ||||||||||||||
| PHYSICIAN | $0 | $0 | $0 | $0 | $191,412 | $0 | $0 | $0 | $18,193 | $0 | $209,605 | $0 | $0 | $0 |
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 | ECONOMIC DEVELOPMENT CORPORATION OF THE COUNTY OF OTTAWA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 386004883 | BondIssuerEIN |
| CUSIP | 689238AC7 | CUSIPNum |
| Bond Issued | 2015-12-18 | BondIssuedDt |
| Issue Price | $5,440,000 | IssuePriceAmt |
| Purpose | EMERGENCY DEPARTMENT REMODEL | 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 | $90,000 | RetiredAmt |
| Total Proceeds | $5,284,781 | TotalProceedsAmt |
| In Reserve Fund | $378,438 | InReserveFundAmt |
| Issuance Costs From Proceeds | $106,344 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $4,800,000 | CapitalExpendituresAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | 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 | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| 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 | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| 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 L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON RYBAR RYBAR GROUP | PersonNm |
| Relationship With Org | INTERIM CFO | RelationshipWithOrgTxt |
| Loan Purpose | OUTSTANDING YEAR END PAYABLE BALANCE | LoanPurposeTxt |
| Loan To Organization | Yes (X) | LoanToOrganizationInd |
| Original Principal | $208,303 | OriginalPrincipalAmt |
| Balance Due | $208,303 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | 0 | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $208,303 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON RYBAR RYBAR GROUP | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | INTERIM CFO | RelationshipDescriptionTxt |
| Transaction | $313,708 | TransactionAmt |
| Transaction | INDEPENDENT CONTRACTOR | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II AND PART IV | FormAndLineReferenceDesc |
| Explanation | RON RYBAR OF THE RYBAR GROUP (RGI) PROVIDES INTERIM CHIEF OFFICER SERVICES TO NOCHS AND PROVIDES OVERSIGHT OF THE FINANCIAL REPORTING AND DAY TO DAY FINANCIAL OPERATIONS OF THE ORGANIZATION. RGI ALSO PROVIDES AN INTERIM MANAGER OF REIMBURSEMENT WHO OVERSEES THE DAY TO DAY OPERATIONS OF THIS DEPARTMENT. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE BOARD OF TRUSTEES AND ONE LAY TRUSTEE WHO SHALL BE APPROVED BY THE BOARD OF TRUSTEES THROUGH THE GOVERNANCE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY TO EXERCISE ALL OF THE POWER OF THE BOARD OF TRUSTEES DURING INTERVALS WHEN THE FULL BOARD OF TRUSTEES IN UNABLE TO MEET. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE FULL BOARD OF TRUSTEES AT ITS NEXT MEETING. |
| FORM 990, PART VI, SECTION A, LINE 3 | RON RYBAR OF THE RYBAR GROUP (RGI) PROVIDES INTERIM CHIEF OFFICER SERVICES TO NOCHS AND PROVIDES OVERSIGHT OF THE FINANCIAL REPORTING AND DAY TO DAY FINANCIAL OPERATIONS OF THE ORGANIZATION. RGI ALSO PROVIDES AN INTERIM MANAGER OF REIMBURSEMENT WHO OVERSEES THE DAY TO DAY OPERATIONS OF THIS DEPARTMENT. SEE SCHEDULE L FOR FURTHER DETAILS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATION SHALL BE DIRECTED AND GOVERNED BY A BOARD CONSISTING OF APPOINTED TRUSTEES AND TRUSTEES AT LARGE. THE APPOINTED TRUSTEES SHALL BE APPOINTED BY THE RESPECTIVE LEGISLATIVE BODIES OF THE FOLLOWING MUNICIPALITIES: THE CITY OF GRAND HAVEN, THE TOWNSHIP OF GRAND HAVEN, THE TOWNSHIP OF SPRING LAKE, THE CITY OF FERRYSBURG, THE TOWNSHIP OF CROCKERY, AND THE TOWNSHIP OF ROBINSON. EACH MUNICIPALITY SHALL APPOINT ONE TRUSTEE. THERE SHALL BE FIVE (5) TRUSTEES AT LARGE, WHO SHALL BE SELECTED BY A MAJORITY VOTE OF THE APPOINTED TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | ANY CHANGE IN OWNERSHIP, INCLUDING FACILITY LEASE AGREEMENTS, REQUIRES MAJORITY APPROVAL BY THE VOTERS OF THE SIX MUNICIPALITIES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 AND RELATED SCHEDULES WILL UNDERGO A REVIEW BY FINANCIAL PERSONNEL. A SECOND REVIEW WILL BE PERFORMED BY THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. AFTER CHANGES ARE FINALIZED, AN ELECTRONIC COPY OF THE RETURN WILL BE SENT TO THE FULL BOARD TO REVIEW THE FORM 990 AND RELATED SCHEDULES PRIOR TO SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS AND KEY EMPLOYEES ARE REQURED TO DISCLOSE ON AN ANNUAL BASIS AND TRUSTEES ARE REQUIRED TO DISCLOSE ON A BIANNUAL BASIS ANY CONFLICTS OF INTEREST THROUGH COMPLETION OF A QUESTIONNAIRE. THE QUESTIONNAIRES ARE REVIEWED BY THE BOARD OF TRUSTEES. WHEN A CONFLICT IS DISCLOSED, THE BOARD SHALL DETERMINE IF A MORE BENEFICIAL TRANSACTION OR ARRANGEMENT IS WITHIN REASONABLE EFFORTS OF THE ORGANIZATION. IF A MORE BENEFICIAL ARRANGEMENT IS NOT REASONABLY ATTAINABLE THE BOARD SHALL DETERMINE BY A MAJORITY VOTE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION AND IS FAIR AND REASONABLE. THE CONFLICTED PERSON IS ASKED TO LEAVE THE ROOM WHILE THE TRANSACTION IS BEING DISCUSSED AND VOTED ON. |
| FORM 990, PART VI, SECTION B, LINE 15A | AN INDEPENDENT COMPENSATION CONSULTANT IS HIRED TO HELP SET COMPENSATION FOR THE CEO. THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS INFORMATION, INCLUDING A COMPENSATION SURVEY, SUPPLIED BY THE CONSULTANT. A WRITTEN EMPLOYMENT CONTRACT DETAILS THE COMPENSATION OF THE CEO AND IS REVIEWED BY THE BOARD. COMPENSATION IS ADJUSTED ACCORDINGLY BEFORE THE BOARD APPROVES THE CONTRACT. FOR OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, THE SAME PROCESS IS PERFORMED BY THE CEO. THE MOST RECENT REVIEW TOOK PLACE IN 2017. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 6,130,418. MANAGEMENT AND GENERAL EXPENSES 1,678,460. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,808,878. PROFESSIONAL THERAPY FEES: PROGRAM SERVICE EXPENSES 1,040,968. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,040,968. |
| FORM 990, PART XI, LINE 9: | CHANGE IN NET ASSETS WITH DONOR RESTRICTIONS -50,648. CHANGE IN PENSION PLAN ACCOUNT -7,334,797. CHANGE IN DEFINED BENEFIT PENSION PLAN 1,618,144. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1101 SOUTH BEACON BOULEVARD LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 SOUTH BEACON BOULEVARD | AddressLine1Txt |
| City | GRAND HAVEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49417 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383330803 | EIN |
| Primary Activities | RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH OTTAWA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH OTTAWA CARE CENTER | |||||||||||
| 18525 WOODLAND RIDGE DRIVE | SPRING LAKE | MI | 49456 | 382602971 | NURSING SERVICES | MI | 501(C)(3) | LINE 10 | NORTH OTTAWA COMMUNITY HOSPITAL | Yes (1) | |
| HOSPICE OF NORTH OTTAWA COMMUNITY INC | |||||||||||
| 1061 SOUTH BEACON BLVD | GRAND HAVEN | MI | 49417 | 382370192 | HOSPICE SERVICES | MI | 501(C)(3) | LINE 7 | NORTH OTTAWA COMMUNITY HOSPITAL | Yes (1) | |
| NORTH OTTAWA HOSPITAL AUXILIARY INC | |||||||||||
| 1309 SHELDON ROAD | GRAND HAVEN | MI | 49417 | 386088836 | FUNDRAISING | MI | 501(C)(3) | LINE 12D, III-O | 0 | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SYNANON INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1309 SHELDON ROAD | AddressLine1Txt |
| City | GRAND HAVEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49417 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382715568 | EIN |
| Primary Activities | URGENT CARE | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH OTTAWA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $408,601 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $260,790 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SYNANON INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | A | TransactionTypeTxt |
| Involved | $42,257 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |