2020-04-22T12:41:21-07:00 2019-06-30 990 2018-07-01 381368360 PINE REST CHRISTIAN MENTAL HEALTH SERVICES PINE 6164555000 300 68th Street SE PO Box 165 Grand Rapids MI 495010165 Paul Karsten Vice President & CFO 6164555000 2020-04-22 64.186.46.230 2018 2020-09-23 17:36:50Z Paul Karsten 300 68th St SE Grand Rapids MI 495010165 175211259 0 X pinerest.org X 1908 MI Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity, and compassion. 20 19 2408 188 0 0 2271547 2316948 132130284 143920073 3931099 1576048 2425726 5115349 140758656 152928418 0 0 0 0 103080914 111599901 0 0 688248 47706792 44931062 150787706 156530963 -10029050 -3602545 125334551 118233182 60862348 56729781 64472203 61503401 Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity, and compassion. 0 0 60570917 0 74829160 Hospital Based Services inpatient and partial hospitalization programs include dedicated psychiatric services for children, adolescents, adults and older adults. Clinical conditions addressed included the full array of psychiatric diagnoses, co-occurring substance abuse diagnoses, and psychiatric disorders where treatment is complicated by co-existing medical conditions. Patients experience professional assessment and individualized treatment including: diagnosis, medication management and education, individual and group therapies, individual and family consultations and therapy, case management, discharge planning and aftercare. The inpatient and partial hospitalization programs are accredited by the Joint Commission of Accreditation of Healthcare Organizations (JCAHO). Pine Rest 226 beds available. Hospital Based Services, had 66,357 patient days of care in Fiscal year 2019. 35378496 0 36693209 Clinic Network through its twenty one clinics, offers outpatient, ambulatory care at locations throughout West and Northern Michigan, and in Iowa. For people who do not require the structured environment of the inpatient or residential care settings, outpatient services are at the center of the behavioral health continuum. Nearly 75% of all persons who come to Pine Rest are served through outpatient care. Clinicians provide a broad spectrum of intervention across the age continuum in convenient, non-restrictive environments. In addition to traditional outpatient care, Pine Rest provides a variety of specialty services including assessment through the Psychological Consultation Center, intensive outpatient and residential substance abuse/addictions services, court-related services and assessments, and more. The Clinic Network had 289,824 patient visits in fiscal year 2019. 6093656 0 7984705 Pine Rest has operated a psychiatry residency program since July 2014, successfully beginning the fifth year of the program on July 1, 2018. There are currently 44 residents that spend 1 - 2 half days in lectures and individual supervision. The remaining time is spent on their rotations, working under the supervision of a psychiatrist to provide care to patients. Rotations include addictions, Network 180 (emergency psychiatry), child and adolescent, adult inpatient, older adult inpatient, primary care (OP family practice locations), neurology (Spectrum Health and Mercy Health) and outpatient clinic services. And, the Pine Rest OP Residency Clinic opened in October 2015 and is currently providing services to numerous community members. Applications for the next year's residency program are received in the fall. Pine Rest is pleased that our residents come from a variety of excellent medical schools located throughout the country. The candidates are ranked based on their past record in medical school, test scores and performance on their interviews with faculty. The Graduate Medical Education match system then assigns the residents to Pine Rest. The Pine Rest Psychiatry Residency Program is currently accredited by the ACGME through 2025. A fellowship to train Child and Adolescent psychiatrists began in July 2017. This two year training program involves rotations in the child and adolescent inpatient unit, residential program, partial hospital and outpatient services, as well as rotations at locations in the community such as community mental health and adolescent addiction programs. Research has shown that over 60% of psychiatry residents stay and work in the community where they train. Pine Rest's goal is to ensure over time that West Michigan has a sufficient amount of psychiatry to serve our community. 5455431 0 5857510 Behavioral Health Solutions provides assistance to other health systems with behavioral health services. Regionally, this process creates a hospital network and referral process focused on appropriate care in proper location. Essentially, Pine Rest is reimbursed, at a break-even level, as a means to assure long-term availability of program and operations oversight, psychiatrists and consultation at the local level. 5262086 0 4611027 Pine Rest Adolescent Services offers 24/7 supervision by experienced professionals to guide the activities of daily life for adolescents aged 12 to 18 years when hospitalization is not required. With capacity for 48, referrals are accepted based on age and behavioral criteria. A supportive milieu in both a locked and unlocked setting helps adolescents develop relationship and independent living skills. Social skills training is geared toward promoting positive relationships with peers and adults. Residents in treatment attend Kentwood Public Schools and receive homework help; they engage in on-campus and community activities to reinforce skills and foster goal achievement. The Pine Rest Adolescent services program had 13,449 patient days of care in fiscal year 2019. 4543056 0 4052444 The Pine Rest Adult Residential Division offers longer term psychiatric services to adults with mental health needs in a residential setting. These programs include both locked and unlocked settings. These services and facilities are licensed and accredited by the State of Michigan as well as the Commission on Accreditation of Rehabilitation Facilities (CARF). The Caring Communities Program brings Pine Rest into invited partnerships with established community organizations to introduce behavioral health services to under-served populations. Clients typically have limited resources and limited access to behavioral healthcare. With partners like Baxter Community Center, Belknap Commons, Dwelling Place, Grand Rapids Public Schools, Heartside Ministries, Grand Rapids Housing Commission and many more, Pine Rest addresses behavioral health needs in a non-traditional model. Adult Residential services had 8,085 patient days of care in fiscal year 2019. 4266801 0 3547732 Homes for the Developmentally Disabled serves adults with developmental disabilities in exceptional residential settings with multiple opportunities for engaging in on-site and community activities that match abilities. Homes for the Developmentally Disabled services program had 23,541 patient days of care in fiscal year 2019. 2154665 0 2510202 The Pine Rest Community Services Programs provide outpatient mental health services as part of the community mental health system. The Community and Elderly Case Management Programs provide intensive case management services to adults with chronic mental health needs. The Integrated Medical Clinic offers immediate psychiatric services to the public patient as needed through a psychiatrist and a team of mid-level practitioners. In addition, a variety of outpatient substance abuse services as well as services to the homeless are provided. Residential Supports Coordinators work in a number of community settings to support individuals with disabilities to maintain stable housing as well. 2622421 0 1723202 Addiction Treatment Services offers a wide range of addiction and recovery services including outpatient and residential services for those with co-occurring substance use and mental health disorders. Professional services are designed to provide a safe, caring environment where persons gain insight and acquire skills for ongoing recovery. Transitional housing is available for clients who need safe, substance-free housing while transitioning to community living. Addiction facilities are state-licensed where appropriate and accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). The Addiction treatment services program had 17,495 patient days of care in fiscal year 2019. 746573 0 824456 Education and Prevention offers a range of education and prevention activities that help promote community wellness. Pine Rest is the recipient of several grants that promote education and prevention activities around mental health as well as perform research to further determine best practice models of care. An internship program for graduate students studying psychology is offered. 805091 0 811737 Pine Rest has begun a new Grants Management Program designed to introduce new research and programs to the organization and provide better services to our patients and community. 687121 0 474688 The Pine Rest Ventures program includes the employee assistance program, Church assistance and school assistance programs. These services leverage behavioral health expertise to facilitate individual and organizational well-being to enable those served to productively thrive. PAX Crisis Response is a service line within these programs that provides immediate crisis consultation after tragedies. These programs align with the Pine Rest goal of serving our community. 26543245 0 24412998 128586314 1 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 199 0 1 2408 1 0 0 0 0 0 0 0 0 X 20 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IA MI X Paul H Karsten 6162816363 300 68th St SE Grand Rapids MI 495010165 Mark C Eastburg PhD President & CEO 58 2 X X 385286 0 19679 Jon Swets Chairperson 3 0 X X 0 0 0 John Lichtenberg Vice Chairperson 4 0 X X 0 0 0 Gary Werkman Treasurer 2.00 0 X X 0 0 0 Scott Bolinger Secretary 2.0 0 X X 0 0 0 Mary Ann Cartwright Board Member 1 0 X 0 0 0 Randall Christenson MD Board Member 1 0 X 0 0 0 Sylvia Daining Board Member 1.00 0 X 0 0 0 LaRissa Hollingsworth Board Member 1 0 X 0 0 0 Art Jongsma PhD Board Member 1 0 X 0 0 0 Doug Josephson Board Member 1 0 X 0 0 0 Ron Kool Board Member 1 0 X 0 0 0 Glenn Mitcham Board Member 1 0 X 0 0 0 David McKeague Board Member 1 0 X 0 0 0 Laurie Murphy Board Member 1 0 X 0 0 0 Alvin Padilla Board Member 1 0 X 0 0 0 Jack Roeda Board Member 1 0 X 0 0 0 Susan Valcq Board Member 1 0 X 0 0 0 Jody Vanderwel Board Member 1 0 X 0 0 0 Kathleen Vogelsang Board Member 1.00 0 X 0 0 0 Alam M Armstrong MD Chief Medical Officer 60 0 X 284963 0 17836 Paul H Karsten VP & CFO 58 2.0 X 244234 0 19404 Scott A Wagner VP BHS 60 0 X 147783 0 14436 Thomas Elzinga VP General Services 60 0 X 138752 0 8768 Robert L Nykamp VP & COO 60 0 X 261960 0 16500 Susan Langeland Chief Information Officer 60 0 X 226735 0 16768 Jack Mahdasian Medical Staff 55 0 X 443142 0 18723 Valerie MathisAllen Medical Staff 55 0 X 364915 0 11293 William Sanders Medical Staff 55 0 X 404991 0 19653 Amandeep S Saluja Medical Staff 55 0 X 516774 0 16213 Katherine Jawor Medical Staff 55 0 X 378605 0 9875 David G Folks Medical Staff 55 0 X 349379 0 21435 Bibhas Singla Medical Staff 55 0 X 350539 0 17099 Marwan Tabbara Medical Staff 55 0 X 339467 0 18127 Verle Bell Medical Staff 55 0 X 270526 0 14398 Daniel Schellenberg Medical Staff 55 0 X 342919 0 19050 5450970 0 279257 135 1 1 0 Epic Systems Corporation 1979 Milky Way Verona WI 53593 Electronic Medical Record 6853831 Unidine Corporation PO Box 360639 Pittsburgh PA 152516639 Patient Dietary and Cafeteria Services 2640657 US Signal LLC 201 Ionia Avenue SW Grand Rapids MI 49503 Cloud Data Hosting 1700240 Blue Cirrus Consulting 8595 Pelham Rd Ste 400-402 Greenville SC 29615 Electronic Medical Record Training 1353751 Institutional Pharmacy Solutions 3480 EAstern Boulevard Montgomery AL 36116 Pharmacy 1192188 62 0 0 0 1869377 447571 0 0 2316948 Inpatient Care 622000 85678169 85678169 0 0 Outpatient Clinics 621400 37094478 37094478 0 0 Residential 623000 15233516 15233516 0 0 Inpatient Contracted Services 622000 5913910 5913910 0 0 0 0 0 0 143920073 560327 0 0 560327 0 0 0 0 0 0 0 0 127832 0 22911 0 104921 0 104921 0 0 104921 23275651 0 22259930 0 1015721 0 1015721 0 0 1015721 0 0 0 0 0 0 0 Streetreach Community Support 624200 2363787 0 0 2363787 Employee Assistance Program 624230 458351 0 0 458351 MSU Medical Education 611310 292278 0 0 292278 1896012 0 0 1896012 5010428 152928418 143920073 0 6691397 0 0 0 0 0 0 0 0 5730276 4229971 1500305 0 0 0 0 0 87270026 78320478 8626274 323274 892001 791772 97128 3101 11497036 10345676 1101915 49445 6210562 5488906 697446 24210 0 0 0 0 253414 43425 209989 0 200725 26655 174070 0 81 81 178879 0 178879 0 10146014 7382629 2655684 107701 784929 243958 505428 35543 1761446 1377415 313054 70977 5757270 232691 5523449 1130 0 0 0 0 4065128 3233608 806006 25514 351973 265148 85729 1096 0 0 0 0 630956 563575 67356 25 1520139 0 1520139 0 0 0 0 0 7119470 5663185 1411601 44684 632180 0 632180 0 Bad Debt 3706772 3706772 0 0 Food 3147895 3079521 67810 564 Patient Assistance 1907979 1907979 0 0 Medical Supplies 761365 761365 0 0 2004447 921585 1081878 984 156530963 128586314 27256401 688248 751765 349795 8764704 0 1048176 87755 17264617 23152901 0 0 0 0 0 0 89866 109528 1003589 2551985 130372910 70023285 63974929 60349625 29661092 29600836 0 0 685849 777578 0 0 2089964 1253179 125334551 118233182 13035886 15568338 0 0 293179 136177 38072848 33710377 0 0 0 0 0 0 6752367 4615932 2708068 2698957 60862348 56729781 X 62968214 59930416 1503989 1572985 0 0 64472203 61503401 125334551 118233182 X -3602545 163400 0 0 0 470343 X 0 1 X 1 0 X 0 0 0 0 0 0 1 81 0 0 81 0 Schedule C, Part II-B, Line 1 Verbal and written communication with public officials regarding legislation and proposals affecting the delivery of health care in Michigan and Nationally. 24572355 704814 1632181 1193500 0 0 25715850 24177318 176400 1366629 1132261 15731 0 24572355 23301864 790005 1954474 1534202 334823 0 24177318 24825767 251951 -189133 1513848 72873 0 23301864 24711782 1247071 608038 1555088 186036 0 24825767 0.85 0.15 0 0 1 1 0 102148 102148 0 77147668 41276935 35870733 0 300093 0 300093 0 46861167 25736326 21124841 0 5961834 3010024 2951810 60349625 0 Deferred Compensation 2590298 Interest Rate Swap Liability 108659 2698957 X 152772450 0 22911 0 0 22911 152749539 178879 0 178879 152928418 156374995 22911 0 0 0 22911 156352084 178879 0 178879 156530963 Schedule D, Part V, Line 4 The spending policy allows for annual spending of 5% of the average fair market value of the net assets for the prior three years. This amount is transferred from the Foundation to the operating funds of the Corporation to provide for the care of patients and other initiatives that benefit the organization. The spending policy allows for the use of investment earnings on permanently restricted endowment funds in accordance with donor wishes. Schedule D, Part X, Line 2 The Corporation is a not-for-profit corporation pursuant to Section 501(C)(3) of the Internal Revenue Code and is exempt from income taxes on related income pursuant to Section 501(a). The Corporation recognizes interest and penalties related to unrecognized tax positions an includes these in interest and income tax expense. The Corporation has no amounts accrued for interest and penalties as of June 30, 2019. The Corporation does not expect the total amount of unrecognized tax benefits to significantly change over the next twelve months. The Corporation is no longer subject to examination by tax authorities for years before 2016. Schedule D, Part XI, Line 4b Rental Expense 1 1 X 1 X 2.5 1 X 1 1 0 0 2968540 0 2968540 0.019 36520346 38048539 -1528193 0 0 0 0 0 0 0 39488886 38048539 1440347 0.019 12743 0 12743 0.0001 0 0 0 0 108841698 94836967 14004731 0.0895 0 0 0 0 580245 0 580245 0.0037 0 0 109434686 94836967 14597719 0.0933 0 0 148923572 132885506 16038066 0.1123 0 3706772 2613969 11949274 12162499 -213225 X 1 1 1 1 Pine Rest Christian Mental Health Services 300 68th Street SE PO Box 165 Grand Rapids MI 495010165 www.pinerest.org X Pine Rest Christian Mental Health Services 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X https://www.pinerest.org/about-us/#KCCNA X http://www.kentcountychna.org/workgroups.html 1 16 1 https://www.pinerest.org/media/Pine-Rest-Strategy-for-Community-Needs-Assessment-Report.pdf 0 0 1 X 250 250 X X X 1 1 X X X X 1 X https://www.pinerest.org/about-us/financial-assistance/ X https://www.pinerest.org/about-us/financial-assistance/ X https://www.pinerest.org/about-us/financial-assistance/ X X X X X X 1 X 0 X X X X 0 X X X X 0 0 Schedule H, Part V, Section B, Line 5-Pine Rest Christian Mental Health Services See Kent County Community Needs Assessment for details on methods employed, data collection, sources of input and key findings. Pine Rest collaborates in the development and utilizes these findings to establish strategic initiatives that support the community needs identified and correlate with the services provided and capabilities of Pine Rest. see https://www.pinerest.org/about-us/#KCCNA Schedule H, Part V, Section B, Line 6a-Pine Rest Christian Mental Health Services , Mercy Healthcare, Spectrum Health, Metro Health and Mary Free Bed. Schedule H, Part V, Section B, Line 6b-Pine Rest Christian Mental Health Services see www.kentcountychna.org for a complete list of participants. Schedule H, Part V, Section B, Line 11-Pine Rest Christian Mental Health Services Each year, Pine Rest assesses and updates a response to the most recent CHNA. Consequently, Pine Rest has selected issues from the CHNA that can and should be addressed by Pine Rest. Schedule H, Part V, Section B, Line 13h-Pine Rest Christian Mental Health Services In determining financial assistance eligibility, Pine Rest will evaluate the patient/guarantor's ability to reimburse Pine Rest for the services being requested or previously rendered. Pine Rest will evaluate information such as the following: 1. Income Level 2. Net Worth 3. Employment status 4. Other financial obligations 5. Amount and frequency of healthcare bills. Schedule H, Part V, Section B, Line 21c-Pine Rest Christian Mental Health Services Pine Rest is a psychiatric facility. We do not provide emergency medical care and do not fall under EMTALA. Schedule H, Part V, Section B, Line 21d-Pine Rest Christian Mental Health Services Pine Rest is a psychiatric facility. We do not provide emergency medical care and do not fall under EMTALA. 37 Pine Rest - Cedar Units 300 68th Street SE Grand Rapids MI 49548 Child Caring Institution Pine Rest - Campus Clinic 300 68th Street SE PO Box 165 Grand Rapids MI 495010165 Outpatient clinic, residential detox, screening, assessment, referral Pine Rest - Southwest Clinic 4211 Parkway Place Grandville MI 49418 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Traverse City Clinic 1050 Silver Drive Traverse City MI 49684 Outpatient Clinic, mental health, addiction treatment and follow up Pine Rest - Northeast Clinic 3225 North Evergreen Drive NE Suite 301 Grand Rapids MI 49525 Outpatient Clinic, screening, assessment, referal and follow up Pine Rest - Northwest Clinic 2118 3 Mile Road Grand Rapids MI 49544 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Northshore Clinic 17325 VanWagoner Road Spring Lake MI 49456 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - ECT TMS Clinic 300 68th Street SE Grand Rapids MI 49508 Outpatient and Inpatient, screening, assessment, referral and follow up Pine Rest - Christian Counseling Center 1870 Leonard NE Grand Rapids MI 49505 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - PCC Psychological Consolation Center 300 68th St Grand Rapids MI 49548 PCC Psychological Consolation Center Pine Rest - InterActions Residential Treatment 300 68th Street SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Sub-Acute Detox 300 68th Street SE Grand Rapids MI 49548 Residential mental health and addiction treatment and detox Pine Rest - Holland Clinic 926 S Washington Ave Suite 210 Holland MI 49423 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Kalamazoo Clinic 1530 Nichols Road Kalamazoo MI 49006 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Addictions Medicine 300 68th Street SE Grand Rapids MI 49548 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Jellema Treatment Center 243 68th Street SE Grand Rapids MI 49548 Residential mental health and addiction treatment, screening, assessment Pine Rest - Community Case Management 320 Commerce Avenue SW Grand Rapids MI 49503 Outpatient Clinic, comm change alternative informatin training, prevention and mental health Pine Rest - Zeeland Clinic 8333 Felch Suite 210 Zeeland MI 49464 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Caledonia Clinic 9090 S Rogers Court SE Caledonia MI 49316 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - CenterPointe Recovery Center 1145 Oakland Drive Kalamazoo MI 49008 Adult Foster Care Pine Rest - Community Based Grant Program 320 Commerce Ave SW Grand Rapids MI 49503 Community Based Grants Coordination Pine Rest - Cameron 6680 Adrian SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - SEQUOIA Program 300 68th Street SE Grand Rapids MI 49548 Education, awareness, access and non-traditional services to the community Pine Rest - Westwood 7047 Madison SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Pine Grove 7051 Madison SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Maple 300 68th Street SE Grand Rapids MI 49548 Child Caring Institution Pine Rest - Community Support Coord 320 Commerce Ave SW Grand Rapids MI 49503 Community Support Coordination Pine Rest - Portage Clinic 1350 W Centre Avenue Portage MI 49024 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Streetreach 347 S Division SE Grand Rapids MI 49503 Education, awareness, access and non-traditional services to the community. Pine Rest - Adrian 6700 Adrian SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Eastwood 7041 Madison SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Freedom House 300 68th Street SE Grand Rapids MI 49548 Residential mental health, addiction, case management, screening, assessment, referral, follow up Pine Rest - DeMey Clinic 620 Century SE Grand Rapids MI 49503 Outpatient Clinic, comm change alternative info training, screening, assessment, referal, follow up Pine Rest - Elder Case Management 320 Commerce Ave SW Grand Rapids MI 49503 Outpatient Clinic, comm change alternative information training, prevention and mental health Pine Rest - Supported Independent Living 300 68th Street SE Grand Rapids MI 49508 Residential supervised independent living Pine Rest - Integrated Med Clinic 300 68th St Grand Rapids MI 49503 Outpatient Clinic, screening, assessment, referral, follow up Pine Rest - Recovery Residence 47 Prospect Grand Rapids MI 49503 Residential addictions recovery home Pine Rest - Pella Clinic 2611 Washington Street Westport Medical Plaza Pella IA 50219 Outpatient Clinic, screening, assessment, referral and follow up Schedule H, Part I, Line 7 Utilized prescribed worksheets 1 through 8 as defined by the IRS. Schedule H, Part III, Section A, Line 4 The provision for bad debts is based upon management's assessment of historical and expected collections of accounts receivable considering business and economic conditions, trends in healthcare coverage and other collection indicators. Accounts receivable are written off and charged to the provision for bad debts after collections efforts have been made in accordance with the Corporation policies. Recoveries are treated as a reduction to the provision for patient bad debts. Accounts receivable are reduced by an allowance for doubtful accounts. Periodically, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by major payer category. Schedule H, Part III, Section B, Line 8 Source is the Medicare Cost Report. Schedule H, Part III, Section C, Line 9b If a patient is eligible for financial assistance for their care, Pine Rest will notify the patient that they are eligible and let them know what amount they will receive through financial assistance and what reduced amount they would be responsible for, if any. The patient will be refunded any amount he or she paid for the care if that amount exceeds the amount that he or she is determined to be responsible for paying under the Financial Assistance Program, unless such excess amount is less than $10.00. Pine Rest will take all reasonably available measures to reverse any extraordinary collection actions taken against the individual to obtain payment for care. Schedule H, Part VI, Line 2 Each year, Pine Rest assesses and updates a response to the CHNA. Pine Rest is a psychiatric hospital. Consequently Pine Rest is selecting the issues from the CHNA that can and should be addressed by Pine Rest. Schedule H, Part VI, Line 3 At admission, the organization attempts to communicate to the patient or family as appropriate, the benefits public or private, available for the prescribed care. Once the patients responsibility is established, the patient's status relative to charity care is reviewed and a decision is made about the availability of patient assistance funds. Schedule H, Part VI, Line 4 Pine Rest Christian Mental Health Services (Pine Rest) is a multi-service behavioral health organization serving a diverse group of people in multiple settings throughout West Michigan and with a location in Iowa. Its network of inpatient, residential and outpatient services reaches people of all ages, from children to older adults. The majority of people served by Pine Rest are identified and being from counties within the state of Michigan, with 39.2% from Kent county. 7% are from States and counties outside of Michigan. Pine Rest's main campus is located in Kent county with a population of 648,594 according to the last census data. This ranks Kent county as one of the most populated counties in Michigan. The racial make up of Kent county per census data is 82.5% White, 10.5% African American, 10.6% Hispanic or Latino, 3.2% Asian and 2.9% two or more races. In Kent county, 10.4% of the population are below the poverty level. Schedule H, Part VI, Line 5 To assure a strategic focus on the health needs of the community served 86% of the governing body is composed of persons who reside in the organizations primary service are and who a re neither employees nor contractors of the organization. In addition, the organization has an open medical staff allowing hospital staff membership to all physicians in the community who meet membership and clinical privilege requirements. This improves care to the community served by Pine rest through greater availability of medical staff within the service area. Since 1908, the organization has consistently applied surplus funds to the improvement of patient care and access, staff education and research designed to expand and improve the level of patient care provided to all patients. Pine Rest has board designated funds that fund outreach services improving access to the community. Pine Rest also provides many educational opportunities to the community on various behavioral health topics. X 1 1 X 0 0 0 0 0 0 0 1 0 Amandeep S Saluja Medical Staff 316303 0 199942 0 529 0 3458 0 12755 0 532987 0 409816 0 Jack Mahdasian Medical Staff 401397 0 23720 0 18025 0 4452 0 14321 0 461915 0 481431 0 William Sanders Medical Staff 342574 0 32300 0 30117 0 4569 0 15084 0 424644 0 396207 0 Katherine Jawor Medical Staff 375016 0 0 0 3589 0 3303 0 6572 0 388480 0 0 0 Valerie MathisAllen Medical Staff 305503 0 57065 0 2347 0 4650 0 6643 0 376208 0 412172 0 Bibhas Singla Medical Staff 261778 0 88250 0 511 0 0 0 17099 0 367638 0 374461 0 David G Folks Medical Staff 323596 0 400 0 25383 0 4976 0 16459 0 370814 0 383918 0 Daniel Schellenberg Medical Staff 245858 0 76385 0 20676 0 4009 0 15041 0 361969 0 347859 0 Marwan Tabbara Medical Staff 260950 0 77200 0 1317 0 3900 0 14227 0 357594 0 329431 0 Verle Bell Medical Staff 251009 0 13990 0 5527 0 1933 0 12465 0 284924 0 314159 0 Mark C Eastburg PhD President & CEO 352882 0 0 0 32404 0 4596 0 15083 0 404965 0 391369 0 Alam M Armstrong MD Chief Medical Officer 260080 0 0 0 24883 0 4256 0 13580 0 302799 0 306649 0 Robert L Nykamp VP & COO 254613 0 0 0 7347 0 3906 0 12594 0 278460 0 276084 0 Paul H Karsten VP & CFO 236750 0 0 0 7484 0 3565 0 15839 0 263638 0 259173 0 Susan Langeland Chief Information Officer 214659 0 10000 0 2076 0 1812 0 14956 0 243503 0 0 0 Scott A Wagner VP BHS 145707 0 0 0 2076 0 2316 0 12120 0 162219 0 153675 0 Thomas Elzinga VP General Services 136903 0 0 0 1849 0 1973 0 6795 0 147520 0 147304 0 Schedule J, Part I, Line 1a Taxable term life premiums added to taxable income were grossed up to compensate for taxes on premiums. Grossed up amounts were taxed. Schedule J, Part I, Line 3 The Board of Directors has adopted a written Executive Compensation Plan and has delegated to the Compensation Committee the responsibility for implementing and overseeing compensation issues with regular reporting to the board. In setting and reviewing executive compensation for the COO, CFO, CMO and Vice Presidents, the Compensation Committee relies on market data for similarly situated hospital executives in comparable organizations. The Compensation Committee also reviews salary market information for the CEO and makes recommendations to the Executive Committee. The Executive Committee oversees CEO compensation. In setting and reviewing compensation for Physicians (both employed and independent contractors), the Compensation Committee relies on market data for similarly situated professionals serving comparable institutions. The organization regularly commissions studies by integrated Healthcare Strategies to assure that the total compensation paid to physicians is reasonable, consistent with objective market data and in the best interest of the organization. The compensation model for Physicians was adopted by the organization based upon those studies. Review and approval of all new physician employment contracts by both the CFO and Chairman of the Compensation Committee is required to insure that all compensation packages are within the approval limits. Documentation and supporting detail are maintained for all compensation decisions. Schedule J, Part I, Line 7 Employment contracts with officers of the organization allow for performance based incentives. Each year the Board of Directors articulates and approves objective measurable performance criteria. If performance criteria are met, then performance based incentives are paid. A Kent Hospital Finance Authority 381603110 490576AC9 2015-10-01 10330000 Refinancing of original debt 0 0 0 B Kent Hospital Finance Authority 381603110 2017-12-29 24000000 Expansion of Hospital Facility 0 0 0 A 0 0 0 0 0 0 0 0 0 0 0 0 2023 1 0 1 1 B 0 0 0 0 0 0 0 0 0 0 0 0 2027 1 0 1 1 A 0 0 0 0 0 0 0 1 0 1 B 0 0 0 0 0 0 0 1 0 1 A 1 1 1 Macatawa Bank 1.0 0 0 0 0 1 B 1 1 1 Macatawa Bank 1.0 0 0 0 0 1 A 0 B 0 William Sanders Medical Staff X 100000 20000 0 1 1 20000 Form 990, Part VI, Section B, Line 11b The Board of Directors has authorized the Finance committee of the Board of Directors to review and approve the form 990 each year prior to submission to the IRS. Each year a copy of the Form 990 is given to the external auditors for review. Every three years, the external auditors are engaged to perform a quality review of the draft Form 990 prior to Finance Committee approval. Recommended changes are made to the Form 990 and supporting schedules. The Finance Committee votes on a motion to approve the form as amended. The final filed Form 990 is made available to all Board members for their review and information. Form 990, Part VI, Section B, Line 12c Ongoing Board of Directors and Board Committee discussions in concert with the annual audit and Corporate Integrity Office activities monitor and maintain an oversight of this activity. Form 990, Part VI, Section B, Line 15 The Board of Directors has adopted a written Executive compensation plan and has designated the Compensation Committee the responsibility for implementing and overseeing issues with regular reporting to the Board. In setting and reviewing executive compensation for the COO, CFO, CMO and Vice Presidents, the Compensation Committee relies on market data for similarly situated hospital executives in comparable institutions. The Compensation Committee also reviews salary market information for the CEO and makes recommendations to the Executive Committee. The Executive Committee oversees CEO compensation. In setting and reviewing compensation for Physicians (both employed and independent contractors), the Compensation Committee relies on market data for similarly situated professionals serving in comparable institutions. The corporation regularly commissions studies by Integrated Healthcare Strategies to assure that the total compensation paid to physicians is reasonable, consistent with objective market data and in the best interest of the corporation. The compensation model for Physicians adopted by the corporation is based on those studies. Review and approval of all new Physician employment contracts by both the CFO And Chairman of the Compensation Committee is required to assure that all compensation packages are within the approval limits. Documentation and supporting detail are maintained for all compensation decisions. Form 990, Part VI, Section C, Line 19 All documents are available upon request. Form 990, Part XI, Line 9 This is the difference between the contributions restricted by donors as to use and the amount released from restriction during the fiscal year 2019. Pine Rest Foundation 300 68th Street SE PO Box 165 Grand Rapids MI 495011065 381676540 Fundraising MI 501(c)(3) Type 1 Pine Rest Christian Mental Health Services 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 Pine Rest Foundation c 1183288 Each year, following a specific formula, the Pine Rest Foundation awards grants to Pine Rest Christian Mental Health Services to fund various aspects of behavioral healthcare and counseling programs. Pine Rest Foundation p 119544 Pine Rest Accounts Payable department processes all invoices for the Pine Rest Foundation. Pine Rest Foundation then reimburses Pine Rest an amount equal to the invoices that have been paid on their behalf. Pine Rest Foundation m 1701964 The Pine Rest Foundation, the related organization, serves as the "single-portal" for all donations intended for the Pine Rest Foundation and Pine Rest Christian Mental Health Services. Pine Rest Christian Mental Health Services received approval of form 8868 extending the deadline to May 15, 2020