HILLSDALE COMMUNITY HEALTH CENTER: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HILLSDALE COMMUNITY HEALTH CENTER (EIN 38-6005550)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-11
- IRS object ID
- 201841319349302739
- Schema version
- 2016v3.1
- 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 G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-11T12:56:43-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E Main St Suite 700 | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 386005550 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLSDALE COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % LEYA VANDEUSEN | InCareOfNm |
| Business Name Control | HILL | BusinessNameControlTxt |
| Phone | 5174374451 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 168 SOUTH HOWELL STREET | AddressLine1Txt |
| City | HILLSDALE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49242 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DUKE ANDERSON | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 5174374451 | PhoneNum |
| Signature | 2018-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joyce A Dulworth | PreparerPersonNm |
| PTIN | P00151125 | PTIN |
| Phone | 2604604000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLSDALE HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DUKE ANDERSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 168 SOUTH HOWELL STREET | AddressLine1Txt |
| City | HILLSDALE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49242 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $65,239,753 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HILLSDALEHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1950 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | SHORT-TERM, ACUTE CARE HOSPITAL FACILITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 534 | TotalEmployeeCnt |
| Total Volunteers | 160 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $195,902 | PYContributionsGrantsAmt |
| CY Contributions Grants | $287,579 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $65,874,310 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $61,290,740 | CYProgramServiceRevenueAmt |
| PY Investment Income | $284,035 | PYInvestmentIncomeAmt |
| CY Investment Income | $530,389 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$2,292 | PYOtherRevenueAmt |
| CY Other Revenue | $81,820 | CYOtherRevenueAmt |
| PY Total Revenue | $66,351,955 | PYTotalRevenueAmt |
| CY Total Revenue | $62,190,528 | 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 | $29,248,341 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $27,336,704 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $38,023,165 | PYOtherExpensesAmt |
| CY Other Expenses | $34,637,153 | CYOtherExpensesAmt |
| PY Total Expenses | $67,271,506 | PYTotalExpensesAmt |
| CY Total Expenses | $61,973,857 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$919,551 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $216,671 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $58,042,274 | TotalAssetsBOYAmt |
| Total Assets EOY | $38,465,743 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $34,832,215 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,888,765 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,210,059 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,576,978 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HILLSDALE COMMUNITY HEALTH CENTER IS AN INDEPENDENT, PROGRESSIVE HEALTH CARE TEAM. WE WILL CONTINUE TO UTILIZE THE LATEST TECHNOLOGY AND EXPERTISE WHILE DELIVERING COMPASSIONATE, QUALITY CARE. WE ARE LARGE ENOUGH TO BE OF SERVICE... SMALL ENOUGH TO CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $53,026,255 | ExpenseAmt |
| Revenue | $61,290,740 | RevenueAmt |
| Desc | HILLSDALE HOSPITAL IS A SHORT-TERM, ACUTE CARE HOSPITAL FACILITY INCLUDING A SKILLED NURSING UNIT, A PSYCHIATRIC UNIT, AND HOME HEALTH CARE DEPARTMENT WHICH PROVIDS INPATIENT AND OUTPATIENT SERVICES TO THE HILLSDALE, MICHIGAN AREA. THE HOSPITAL ALSO SUPPORTS UNPROFITABLE/SUBSIDIZED HEALTH SERVICES, INCLUDING BEHAVIORAL HEALTH, OBSTETRICS, AND EMERGENCY SERVICES. HILLSDALE HOSPITAL SAW 2,776 INPATIENT ADMISSIONS IN FY 2017, 99,410 OUTPATIENT VISITS, AND 21,824 EMERGENCY DEPARTMENT VISITS. DURING FY 2017 APPROXIMATELY 47% OF SERVICES RENDERED WERE TO ELDERLY PATIENTS UNDER THE MEDICARE PROGRAM, APPROXIMATELY 22% OF SERVICES PROVIDED WERE TO PATIENTS DEEMED INDIGENT UNDER STATE GUIDELINES AND APPROXIMATELY 3% OF SERVICES PROVIDED WERE TO INDIVIDUALS WITHOUT ANY HEALTHCARE COVERAGE. THE HOSPITAL STRIVES TO MINIMIZE THE FINANCIAL BARRIERS TO HEALTHCARE THAT EXIST FOR CERTAIN MEMBERSOF OUR COMMUNITY, AND IN FY 2017 PROVIDED APPROXIMATELY $406,000 IN CHARITY CARE AND RECORDED A PROVISION FOR BAD DEBT OF $3.9 MILLION. A COMPLETE LIST OF SERVICES OFFERED IS AVAILABLE AT WWW.HILLSDALEHOSPITAL.COM, ALONG WITH THE INFORMATION REGARDING APPLYING FOR FINANCIAL ASSISTANCE. HILLSDALE HOSPITAL GIVES BACK TOTHE COMMUNITY IN MANY WAYS, INCLUDING SUPPORTING THE FREE HEALTH CLINIC AND PROVIDING HIGH SCHOOL AND COMMUNITY LOANS FOR ALLIED HEALTH PROFESSIONS FOR HIGHER EDUCATION. | Desc |
| Total Program Service Expenses | $53,026,255 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 88 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 534 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | Yes (true) | ForeignFinancialAccountInd |
| Foreign Country | CJ | ForeignCountryCd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LEYA VANDEUSEN | PersonNm |
| Phone | 5174375234 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 168 S HOWELL STREET | AddressLine1Txt |
| City | HILLSDALE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49242 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| GREGORY BAILEY | ||||||||
| BOARD CHAIRMAN | 1.5 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ALFRED BEDIAKO MD | ||||||||
| BOARD MEMBER | 1.5 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| KIMBERLY BLYTHE | ||||||||
| BOARD MEMBER | 1.5 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG CONNOR | ||||||||
| BOARD MEMBER | 1.5 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DAVID GOSSAGE | ||||||||
| BOARD VICE CHAIRMAN | 1.5 | 0.0 | Yes (X) | Yes (X) | $23,310 | $0 | $0 | |
| ROBERT HENTHORNE | ||||||||
| BOARD MEMBER | 1.5 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| BEVERLY MARKS | ||||||||
| BOARD SECRETARY | 1.5 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RICHARD MOORE | ||||||||
| BOARD TREASURER | 1.5 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DIANE PHILIPP | ||||||||
| BOARD MEMBER | 1.5 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| LEANNE RUMLER | ||||||||
| BOARD MEMBER | 1.5 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DUKE ANDERSON | ||||||||
| PRESIDENT/CEO | 40.0 | 0.0 | Yes (X) | $317,490 | $0 | $28,225 | ||
| VALERIE FETTERS | ||||||||
| CFO (LEFT 2/2017) | 40.0 | 0.0 | Yes (X) | $195,434 | $0 | $13,211 | ||
| DALE MCCRIRIE | ||||||||
| EX OFFICIO | 1.5 | 0.0 | $313,305 | $0 | $28,225 | Yes (X) | ||
| PARTHIV PATEL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $551,288 | $0 | $23,793 | Yes (X) | ||
| BARRY COLLINS | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $480,450 | $0 | $28,225 | Yes (X) | ||
| NORRIS MARCH | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $357,147 | $0 | $21,194 | Yes (X) | ||
| RAVINDER SHARMA | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $303,985 | $0 | $28,500 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,542,409 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $171,373 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AGILITY HEALTH | |||||
| PO BOX 5509 | CAROL STREAM | IL | 60197 | PT, OT, SPEECH | $2,417,651 |
| MI HOSPITALIST PHYSICIANS | |||||
| PO BOX 674579 | DETROIT | MI | 482674579 | CONTRACT PHYSICIANS | $917,430 |
| ANESTHESIA STAFFING | |||||
| 6225 N STATE HWY 161 | IRVING | TX | 75038 | ANESTHESIA SERVICE | $484,648 |
| MI EMERGENCY PHYSICIANS | |||||
| PO BOX 677979 | DALLAS | TX | 752677979 | EMERGENCY DRS | $360,451 |
| DAVIS LAW FIRM PC | |||||
| 2058 SOUTH STATE STREET | ANN ARBOR | MI | 481044697 | LEGAL | $348,358 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $287,579 | AllOtherContributionsAmt |
| Total Contributions | $287,579 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | $59,404,597 | $59,404,597 |
| CONTRACT PHARMACY | 621110 | $999,847 | $999,847 |
| CAFETERIA SALES | 621110 | $165,356 | $165,356 |
| EMPLOYEE PRESCRIPTION | 621110 | $98,455 | $98,455 |
| EHR INCENTIVE | 621110 | $51,431 | $51,431 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $571,054 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $571,054 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $61,290,740 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $286,667 | TotalRevenueColumnAmt |
| Exclusion | $286,667 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $190,076 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $129,430 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $60,646 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $60,646 | TotalRevenueColumnAmt |
| Exclusion | $60,646 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,081,767 | SecuritiesAmt |
| Other | $77,009 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,892,362 | SecuritiesAmt |
| Other | $22,692 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $189,405 | SecuritiesAmt |
| Other | $54,317 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $243,722 | TotalRevenueColumnAmt |
| Exclusion | $243,722 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $25,915 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $4,741 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,174 | TotalRevenueColumnAmt |
| Exclusion | $21,174 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,190,528 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $61,290,740 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $612,209 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $831,849 | TotalAmt |
| Program Services | $682,116 | ProgramServicesAmt |
| Management And General | $149,733 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,809,099 | TotalAmt |
| Program Services | $17,063,461 | ProgramServicesAmt |
| Management And General | $3,745,638 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $466,801 | TotalAmt |
| Program Services | $382,777 | ProgramServicesAmt |
| Management And General | $84,024 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,706,522 | TotalAmt |
| Program Services | $3,039,348 | ProgramServicesAmt |
| Management And General | $667,174 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,522,433 | TotalAmt |
| Program Services | $1,248,395 | ProgramServicesAmt |
| Management And General | $274,038 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,206 | TotalAmt |
| Management And General | $141,206 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,574 | TotalAmt |
| Management And General | $129,574 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,033 | TotalAmt |
| Management And General | $79,033 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,720,677 | TotalAmt |
| Program Services | $10,430,955 | ProgramServicesAmt |
| Management And General | $2,289,722 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,926 | TotalAmt |
| Program Services | $168,859 | ProgramServicesAmt |
| Management And General | $37,067 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $319,351 | TotalAmt |
| Program Services | $261,868 | ProgramServicesAmt |
| Management And General | $57,483 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,417,745 | TotalAmt |
| Program Services | $2,802,551 | ProgramServicesAmt |
| Management And General | $615,194 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,508 | TotalAmt |
| Program Services | $124,237 | ProgramServicesAmt |
| Management And General | $27,271 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $407,748 | TotalAmt |
| Program Services | $334,353 | ProgramServicesAmt |
| Management And General | $73,395 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $947,077 | TotalAmt |
| Program Services | $776,603 | ProgramServicesAmt |
| Management And General | $170,474 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $695,569 | TotalAmt |
| Program Services | $570,367 | ProgramServicesAmt |
| Management And General | $125,202 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $9,240,133 | $9,240,133 | |
| PROVISION FOR DOUBTFUL | $3,911,360 | $3,911,360 | |
| REPAIR AND MAINTENANCE | $1,402,712 | $1,150,224 | $252,488 |
| RENT TO HHF | $707,056 | $707,056 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,478 | TotalAmt |
| Program Services | $131,592 | ProgramServicesAmt |
| Management And General | $28,886 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,973,857 | TotalAmt |
| Program Services | $53,026,255 | ProgramServicesAmt |
| Management And General | $8,947,602 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $736,090 | BOYAmt |
| EOY | $451,684 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,662,906 | BOYAmt |
| EOY | $9,201,456 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,796,042 | BOYAmt |
| EOY | $6,505,315 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,544,011 | BOYAmt |
| EOY | $1,916,144 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $308,428 | BOYAmt |
| EOY | $340,618 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,013,353 | BOYAmt |
| EOY | $1,023,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,605,141 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,961,904 | BOYAmt |
| EOY | $17,244,660 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,414,399 | BOYAmt |
| EOY | $1,782,866 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,042,274 | BOYAmt |
| EOY | $38,465,743 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,477,735 | BOYAmt |
| EOY | $9,320,871 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,286,250 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284,871 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,783,359 | BOYAmt |
| EOY | $4,567,894 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,832,215 | BOYAmt |
| EOY | $13,888,765 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,120,274 | BOYAmt |
| EOY | $24,491,822 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,785 | BOYAmt |
| EOY | $85,156 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,210,059 | BOYAmt |
| EOY | $24,576,978 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,042,274 | BOYAmt |
| EOY | $38,465,743 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $216,671 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $641,288 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $508,960 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1, LOBBYING ACTIVITIES: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE MHA DUES PAID ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp | |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COST REPORT SETTLEMENTS | Desc |
| Amt | $4,567,894 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,567,894 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $58,714,008 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $641,288 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $134,171 | OtherRevenueAmt |
| Revenue Not Reported | $775,459 | RevenueNotReportedAmt |
| Revenue Subtotal | $57,938,549 | RevenueSubtotalAmt |
| Other Revenues Not Included | $4,251,979 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $4,251,979 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $62,190,528 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $58,196,668 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $134,171 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $134,171 | ExpensesNotReportedAmt |
| Expenses Subtotal | $58,062,497 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,911,360 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,911,360 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $61,973,857 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ASC 740 FOOTNOTE | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS | SPECIAL EVENTS EXPENSES $4,741 RENTAL EXPENSES $129,430 TOTAL: $134,171 PART XI, LINE 4B - OTHER ADJUSTMENTS PROVISION FOR UNCOLLECTIBLE ACCOUNTS $3,911,360 LOSS ON DEBT EXTINGUISHMENT $340,619 TOTAL: $4,251,979 |
| PART XII, LINE 2D - OTHER ADJUSTMENTS | SPECIAL EVENTS EXPENSES $4,741 RENTAL EXPENSES $129,430 TOTAL: $134,171 PART XII, LINE 4B - OTHER ADJUSTMENTS PROVISION FOR UNCOLLECTIBLE ACCOUNTS $3,911,870 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $25,915 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $25,915 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $400 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $680 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $3,606 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $55 | FoodAndBeverageEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $25,915 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $25,915 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $400 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $680 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,606 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $55 | FoodAndBeverageTotalEventsAmt |
| Direct Expense Summary Events | $4,741 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $21,174 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $406,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $406,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00690 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,546,730 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,625,686 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $921,043 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01560 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,952,730 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,625,686 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,327,043 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02250 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 1192 | PersonsServedCnt |
| Total Community Benefit Expns | $10,700 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,725 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,975 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 46 | PersonsServedCnt |
| Total Community Benefit Expns | $488,121 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $677,342 | DirectOffsettingRevenueAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,873,850 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,329,364 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,544,486 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04310 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 1238 | PersonsServedCnt |
| Total Community Benefit Expns | $11,392,171 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,009,431 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,571,961 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04350 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 1238 | PersonsServedCnt |
| Total Community Benefit Expns | $24,344,901 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,635,117 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,899,004 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06600 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,911,360 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,773,278 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $16,754,082 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,504,150 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,249,932 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLSDALE COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 168 S HOWELL STREET | AddressLine1Txt |
| City | HILLSDALE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49242 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | INPATIENT PSYCH UNIT | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HILLSDALE COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.HILLSDALEHOSPITAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.HILLSDALEHOSPITAL.COM | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | 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 |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.HILLSDALEHOSPITAL.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.HILLSDALEHOSPITAL.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.HILLSDALEHOSPITAL.COM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | THE PRIMARY DATA FOR THE ASSESSMENT CONSISTED OF A HEALTH SURVEY OF THE GENERAL COUNTY POPULATION AND AN OPEN FORUM OF HSN MEMBERS. THE HEALTH SURVEY QUESTIONNAIRE WAS DESIGNED TO CREATE A PROFILE OF THE RESPONDENTS, THEIR HEALTH NEEDS, AND VIEWS ON COMMUNITY HEALTH-RELATED ISSUES. ALL RESIDENTS OF THE COUNTY WERE INVITED TO PARTICIPATE IN THE SURVEY THROUGH A WIDE-REACHING INFORMATION CAMPAIGN THAT CONSISTED OF INFORMATIONAL ADS IN THE LOCAL NEWSPAPER, THE LOCAL RADIO STATION, PAPER MAILINGS, THE HOSPITAL WEBSITE, AND PERSONAL REQUESTS BY HOSPITAL VOLUNTEERS. AS A RESULT OF THE CAMPAIGN, 1,110 INDIVIDUALS COMPLETED THE HEALTH SURVEY QUESTIONNAIRE (983 IN 2013). SECONDARY DATA WAS COLLECTED FROM A VARIETY OF COUNTY, STATE, AND FEDERAL SOURCES SUCH AS THE US CENSUS BUREAU, MICHIGAN LABOR AND EDUCATION DEPARTMENTS, MICHIGAN DEPARTMENT OF VITAL STATISTICS, MICHIGAN BEHAVIOR RISK FACTOR SURVEY, AND KIDS COUNT IN MICHIGAN. SCHEDULE H, PART V, SECTION B, LINE 6B HILLSDALE HOSPITAL PARTNERED WITH THE HILLSDALE COUNTY HUMAN SERVICES NETWORK (HSN) TO CREATE A COMPREHENSIVE COMMUNITY BASED HEALTH NEEDS ASSESSMENT. THE HSN HIRED AN INDEPENDENT CONTRACTOR TO HELP DESIGN THE SURVEY, ANALYZE THE DATA, FACILITATE DISCUSSIONS, AND CREATE THE FINAL REPORT. |
| SCHEDULE H, PART V, SECTION B, LINE 7D | THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATIONS PLAN CAN BE FOUND ONLINE AT WWW.HILLSDALEHOSPITAL.COM. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | NEED #1 THE CHNA IDENTIFIED WAS TO PROVIDE "Access to care and more free screenings." HCHC HAS RECENTLY IMPLEMENTED THE FOLLOWING Solutions IN ORDER TO MEET THESE NEEDS: -Increase the number of health screenings for low or no cost. -increase education regarding the services currently available for a reduced price. NEED #2 IDENTIFIED WAS T0 "ENCOURAGE MORE PHYSICIANS TO ACCEPT MEDICAID." An educational campaign on the HCHC Website as well as through THE Community Newsletter, will reinforce and educate HCHC'S commitment to accepting Medicaid as well as employed physicians with THE Hospital. NEED #3 WAS TO "EMPLOY MORE SPECIALISTS." Oncology is a large unmet need in Hillsdale County and recruitment efforts are currently underway to bring a provider to the Hillsdale community to provide this service. Healthcare costs, poverty and lack of transportation are also issues for Hillsdale County, making this effort even more important, as traveling to Ann Arbor or Toledo are often cost prohibitive. NEED #4 IDENTIFIED WAS TO "Provide Physical Therapy Services for those without insurance." HCHC currently contracts with Agility Health to provide both IP and OP PT services and will work with Agility to assure that patients do not go untreated due to financial hardship. Part of this process is educating patients as to the services that are available and the assistance provideD in gaining access to payment plans and Medicaid and Medicare. NEED #5 WAS IDENTIFIED AS THE NEED TO "Provide access to mental health services specifically for depression and dementia screenings." HCHC will provide increased depression and dementia screenings through THE Neurology clinic at reduced or no cost to patients. NEED #6 WAS IDENTIFIED AS THE NEED TO "Reduce opiate prescription use by using the MAPS Program." HCMC will assure all providers and mid-level providers are trained in the appropriate use of MAPS to better serve THE patients. NEED #7 WAS IDENTIFIED AS THE NEED TO at least one detox bed or area in the hospital." When the need arises, HCHC will designate the 4 rooms closest to THE Nursing Station on THE Medical Surgical Unit for use of this process. NEED #8 WAS IDENTIFIED AS THE NEED TO "Train staff to better recognize and to be able to better referral instances of domestic violence and substance abuse." HCHC can seek training from area professionals in recognizing the symptoms and signs of domestic violence aS WELL AS make appropriate referrals and follow up for patients who ARE present at THE hospital. This will be undertaken, primarily with ED staff who have a better chance of encountering such individuals. NEED #9 WAS IDENTIFIED AS THE NEED TO "Increase access to prenatal care and provide more infant safe sleep instruction." HCHC OB department can increase educational opportunities in this area in THE prenatal education classes. NEED #10 WAS IDENTIFIED AS THE NEED TO "Help establish clinics in schools similar to the Branch County model." HCHC did not believe THEY were in a position to apply for such funding and refer this back to the Hillsdale County ISD for their consideration. NEED #11 WAS IDENTIFIED AS THE NEED TO a wellness initiative THAT partnerS with local companies." HCHC currently partners with a handful of local businesses regarding wellness initiatives. Over the next 3 year period HCHC will be expanding these opportunities to other businesses and organizations who wish to partner with the hospital to benefit their employees. THE LAST NEED IDENTIFIED WAS TO "Have a consistent presence at the monthly HSN meeting." The Hospital is committing to send the Chief Quality Officer as the sole representative from this point forward, assuring consistent attendance. SCHEDULE H, PART V, SECTION B, LINE 20E AFTER INSURANCE PAYMENTS, THE SELF PAY PORTION IS BILLED TO THE PATIENT ON A MONTHLY STATEMENT. THE STATEMENT INCLUDES INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY. AFTER THREE CYCLES, IF THE AMOUNT IS NOT PAID, THE GUARANTOR RECEIVES THREE CYCLES OF COLLECTION LETTERS. IF THE AMOUNT IS STILL NOT PAID, THE GUARANTOR CONTINUES TO RECEIVE LETTERS UNTIL THE ACCOUNT IS WRITTEN OFF TO THE COLLECTION AGENCY. DURING THE TIME THE GUARANTOR IS RECEIVING THE STATEMENTS AND LETTERS, SEVERAL TELEPHONE CALLS ARE PLACED TO THE GUARANTOR TO TRY TO DISCUSS THE PAYMENT OR OTHER OPTIONS AVAILABLE TO THE GUARANTOR SUCH AS A PAYMENT PLAN OR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 21 ALL PATIENTS ARE BILLED THE SAME AMOUNT REGARDLESS OF TYPE OF INSURANCE OR LACK OF INSURANCE. DISCOUNTS OFF BILLED CHARGES ARE PROVIDED THROUGH THE CHARITY APPLICATION PROCESS OR PROMPT PAYMENT DISCOUNTS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| HILLSDALE HOME CARE | ||||
| 451 HIDDEN MEADOWS DRIVE | HILLSDALE | MI | 49242 | HOME CARE |
| READING HEALTH CLINIC | ||||
| 143 S MAIN STREET | READING | MI | 49274 | RURAL HEALTH CLINIC |
| HILLSDALE HOME OXYGEN | ||||
| 451 HIDDEN MEADOWS DRIVE | HILLSDALE | MI | 49242 | OXYGEN DIME |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $3,911,360. SCHEDULE H, PART II, COMMUNITY BUILDING ACTIVITIES: HILLSDALE COMMUNITY HEALTH CENTER PROVIDES NUMEROUS COMMUNITY ACTIVITIES IN SUPPORT OF THE RESIDENTS OF HILLSDALE COUNTY, INCLUDING SENIOR SUNDAY WHERE LUNCH IS SERVED TO THE SENIOR COMMUNITY MEMBERS AND A SPEAKER DISCUSSES HEALTH ISSUES AND OTHER TOPICS RELATING TO THIS AGE GROUP. IN ADDITION, THERE ARE SEVERAL SUPPORT GROUPS AND CLASSES, INCLUDING THE BREAST CANCER SUPPORT GROUP, BREAST FEEDING CLASSES, BIRTHING CLASSES, NUTRITION EDUCATION AND DIABETES EDUCATION CLASSES. THERE ARE PERIODIC HEALTH SCREENINGS SUCH AS VARICOSE VEIN, FOOT PAIN, CHOLESTEROL, AND COPD SCREENINGS. HILLSDALE COMMUNITY HEALTH CENTER ALSO PROVIDES FREE SUPPORT TO ST. PETER'S FREE CLINIC AND PARTICIPATES IN THE LOCAL ALLIED HEALTH STUDENT PROGRAM. NUMEROUS HIGH SCHOOL AND COMMUNITY LOANS HAVE BEEN GRANTED FOR FULL TUITION FOR ALLIED HEALTH DEGREES. REPAYMENT OF LOANS IS FULFILLED THROUGH A TIME COMMITMENT TO THE HILLSDALE COMMUNITY HEALTH CENTER. SCHEDULE H, PART III, SECTION A, LINE 2 ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS STRATIFIED BY PAYOR AND NUMBER OF DAYS THE ACCOUNTS ARE OUTSTANDING. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | HILLSDALE HOSPITAL SAW $1,773,278 OF ACCOUNTS WRITTEN OFF TO BAD DEBT THAT WERE ATTRIBUTED TO PATIENTS WITH NO INSURANCE COVERAGE. THE AVERAGE DISCOUNT APPLIED TO ACCOUNTS THROUGH OUR FINANCIAL ASSISTANCE PROGRAM WAS 63.83%. WE APPLIED THAT PERCENTAGE TO THOSE ACCOUNTS WRITTEN OFF WITH NO INSURANCE. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Hillsdale Community Health Center provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Hillsdale Community Health Center bills third-party payers directly and bills the patient when the patients liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Hospitals allowance for doubtful accounts for self-pay patients increased from 71 percent of self-pay accounts receivable at June 30, 2016, to 74 percent of self-pay accounts receivable at June 30, 2017. In addition, the Hospitals write-offs decreased approximately $813,000 from approximately $5,217,000 for the year ended June 30, 2016, to approximately $4,404,000 for the year ended June 30, 2017. These changes were caused by a small shift towards private pay patients in the current year as well as slightly lower volumes in 2017. SCHEDULE H, PART III, SECTION B, LINE 8 THE COST TO CHARGE RATIO IS USED TO DETERMINE MEDICARE SURPLUS AT COST. THE MEDICARE ALLOWABLE COSTS REPORTED DO NOT INCLUDE ALL MEDICARE CHARGES. HAD ALL CHARGES BEEN INCLUDABLE THE RESULT WOULD BE A SHORTFALL. THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS THIS IS THE EXTENT TO WHICH COSTS RELATED TO MEDICARE SERVICES GO UNPAID.IS THE EXTENT TO WHICH COSTS RELATED TO MEDICARE SERVICES GO UNPAID. IS THE EXTENT TO WHICH COSTS RELATED TO MEDICARE SERVICES GO UNPAID. realization of amounts due unlikely). SCHEDULE H, PART III, SECTION B, LINE 8 THE COST TO CHARGE RATIO IS USED TO DETERMINE MEDICARE SURPLUS AT COST. THE MEDICARE ALLOWABLE COSTS REPORTED DO NOT INCLUDE ALL MEDICARE CHARGES. HAD ALL CHARGES BEEN INCLUDABLE THE RESULT WOULD BE A SHORTFALL. THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS THIS IS THE EXTENT TO WHICH COSTS RELATED TO MEDICARE SERVICES GO UNPAID. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | AFTER INSURANCE PAYMENTS, THE SELF PAY PORTION IS BILLED TO THE PATIENT ON A MONTHLY STATEMENT. THE STATEMENT INCLUDES INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY. AFTER THREE CYCLES, IF THE AMOUNT IS NOT PAID, THE GUARANTOR RECEIVES THREE CYCLES OF COLLECTION LETTERS. IF THE AMOUNT IS STILL NOT PAID, THE GUARANTOR CONTINUES TO RECEIVE LETTERS UNTIL THE ACCOUNT IS WRITTEN OFF TO THE COLLECTION AGENCY. DURING THE TIME THE GUARANTOR IS RECEIVING THE STATEMENTS AND LETTERS, SEVERAL TELEPHONE CALLS ARE PLACED TO THE GUARANTOR TO TRY TO DISCUSS THE PAYMENT OR OTHER OPTIONS AVAILABLE TO THE GUARANTOR SUCH AS A PAYMENT PLAN OR FINANCIAL ASSISTANCE. |
| SCHEDULE H, PART VI, LINE 2 | HCHC PARTNERED WITH THE HUMAN SERVICES NETWORK, A COMMUNITY COLLABORATIVE BODY MADE UP OF A MAJORITY OF THE COUNTY'S HUMAN SERVICE, EDUCATIONAL, FAITH BASED, AND NON-PROFIT ORGANIZATIONS WITHIN HILLSDALE COUNTY. THIS GROUP SERVED AS THE STEERING GROUP FOR THE PROJECT, ALONG WITH ITS EXECUTIVE COMMITTEE. |
| SCHEDULE H, PART VI, LINE 3 | IF A PATIENT PRESENTS TO HCHC FOR SERVICES AND INDICATES THEY HAVE NO INSURANCE, THEY ARE PROVIDED A COPY OF THE FAP PLAIN LANGUAGE SUMMARY ALONG WITH A LISTING OF THOSE ORGANIZATIONS THAT ARE AVAILABLE TO PROVIDE ADDITIONAL HELP AND SERVICES. WE ALSO HAVE TWO STATE DSH WORKERS ON SITE WHO ARE AVAILABLE TO WORK WITH THE PATIENTS TO DETERMINE THEIR ELIGIBILITY FOR MEDICAID OR OTHER SERVICES. EACH STATEMENT MAILED TO THE GUARANTOR INCLUDES A STATEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO APPLY OR GET ADDITIONAL INFORMATION. AS COLLECTION CALLS ARE MADE TO THE GUARANTOR THEY ALSO INFORM THEM ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. THERE ARE INFORMATIONAL POSTERS IN THE PATIENT WAITING ROOMS, AND FAP INFORMATION IS INCLUDED IN EACH DISCHARGE PACKET PROVIDED TO ADMITTED PATIENTS. THE COMPLETE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY IS PROVIDED ON THE HOSPITAL WEBSITE. |
| SCHEDULE H, PART VI, LINE 4 | HILLSDALE MICHIGAN IS THE COUNTY SEAT OF HILLSDALE COUNTY. ITS POPULATION IS 8,200 WITH A HOUSEHOLD MEDIAN INCOME OF $32,022. THE CURRENT UNEMPLOYMENT RATE IS 7.5% FOR THE CITY OF HILLSDALE, AND 4.9% FOR HILLSDALE COUNTY. THE COUNTY IS BOUNDED ON THE NORTH BY CALHOUN AND JACKSON COUNTIES, ON THE EAST BY LENAWEE COUNTY, ON THE WEST BY GRANCH COUNTY, AND ON THE SOUTH BY STEUBEN COUNTY INDIANA AND WILLIAMS COUNTY OHIO. THE EXTREME SOUTHWEST CORNER OF HILLSDALE COUNTY IS WHERE THREE STATES OF MICHIGAN, OHIO AND INDIANA MEET. ON MAPS, THE COUNTY IS SITUATED AT 42 NORTH LATITUDE AND 8430' WEST LONGITUDE, AND COMPRISES ABOUT 617 SQUARE MILES, OR 394,880 ACRES. THE LAND LIES AN AVERAGE OF 630 FEET ABOVE LAKE ERIE AND 616 FEET ABOVE LAKE MICHIGAN. |
| SCHEDULE H, PART VI, LINE 5 | HCHC FACILITATES MANY DIFFERENT SUPPORT GROUPS INCLUDING THE BREAST CANCER SUPPORT GROUP, COPD SUPPORT GROUP, AND THE BARIATRIC SUPPORT GROUP. WE ALSO OFFER SEVERAL EDUCATIONAL CLASSES INCLUDING BREAST FEEDING, BIRTHING, NUTRITION, AND DIABETES EDUCATION, AS WELL AS SEVERAL PERIODIC HEALTH SCREENINGS INCLUDING VARICOSE VEIN, FOOT PAIN, ACID REFLUX, CHOLESTEROL, AND COPD SCREENINGS, AS WELL AS PROVIDES FREE FLU SHOTS TO THE MEMBERS OF THE COMMUNITY. HCHC OWNS AND OPERATES A RURAL HEALTH CLINIC IN READING, MICHIGAN THAT PROVIDES HEALTHCARE SERVICES TO THE MEDICAID AND SELF INSURED POPULATION. HCHC ALSO PROVIDES FREE SUPPORT TO ST. PETER'S FREE CLINIC AND PARTICIPATES IN THE LOCAL ALLIED HEALTH STUDENT PROGRAM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DALE MCCRIRIE | ||||||||||||
| EX OFFICIO | $313,305 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $20,275 | $0 | $341,530 | $0 |
| DUKE ANDERSON | ||||||||||||
| PRESIDENT/CEO | $317,490 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $20,275 | $0 | $345,715 | $0 |
| VALERIE FETTERS | ||||||||||||
| CFO (LEFT 2/2017) | $195,434 | $0 | $0 | $0 | $0 | $0 | $5,909 | $0 | $7,302 | $0 | $208,645 | $0 |
| PARTHIV PATEL | ||||||||||||
| PHYSICIAN | $551,288 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $15,843 | $0 | $575,081 | $0 |
| BARRY COLLINS | ||||||||||||
| PHYSICIAN | $480,450 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $20,275 | $0 | $508,675 | $0 |
| NORRIS MARCH | ||||||||||||
| PHYSICIAN | $357,147 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $13,244 | $0 | $378,341 | $0 |
| RAVINDER SHARMA | ||||||||||||
| PHYSICIAN | $303,985 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $20,550 | $0 | $332,485 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | ANNUALLY, THE CEO'S SPOUSE ACCOMPANIES THE CEO ON A BUSINESS TRIP. THE SPOUSE'S TRAVEL COSTS ARE INCLUDED IN THE CEO'S COMPENSATION. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| KAREN LUPARELLO | |||
| WIFE OF DAVID GOSSAGE | $75,120 | COMPENSATED EMPLOYEE | false |
| ARROW SWIFT PRINTING | |||
| BOARD MEMBERS PART OWNER | $188,141 | PRINTING COMPANY | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS | FormAndLineReferenceDesc |
| Explanation | LEANNE RUMLER, HILLSDALE BOARD MEMBER, IS A GREATER THAN 35% OWNER OF ARROW SWIFT. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1B | As of 6/30/2017, David Gossage is considered a non-independent board member because he is a paid employee of the filing organization and also due to the transaction listed on Sch. L. LeAnne Rumler is also considered non-independent board member due to the transaction listed on Sch. L. FORM 990, PART VI, SECTION A, LINE 6 Members of the Corporation shall be appointed for a term of three (3) years. All Members of the Corporation shall be nominated pursuant to Section 5.1, and shall be appointed by the Members at an annual or special meeting of Members. Every attempt shall be made in the selection of candidates for Membership to secure the broadest diversity of representation of the community and its interests as possible, including the consideration of such factors as areas of expertise, background and areas of residency. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATION MEMBERS ELECT THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CORPORATION MEMBERS APPROVE ANY PROPOSED CHANGE IN THE PURPOSE OR PHILOSOPHY OF THE CORPORATION, AND APPROVE A PLAN OF MERGER, CONSOLIDATION, SALE, OR DISSOLUTION OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES FOR THEIR REVIEW. IN ADDITION, THE FORM 990 IS REVIEWED BY THE CFO AND CEO FOR ACCURACY. THE RETURN IS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO DISCLOSE OF ANY CONFLICTS OF INTEREST ANNUALLY. THE BOARD OF TRUSTEES SHALL DETERMINE WHETHER A CONFLICT EXISTS BY MAJORITY VOTE. IF A CONFLICT OF INTEREST IS DEEMED TO EXIST, THE TRUSTEE OR OFFICER SHALL NOT PARTICIPIATE IN DELIBERATIONS OR DISCUSSIONS REGARDING THE TRANSACTION AND ARE NOT ALLOWED TO VOTE ON THE MATTER AT HAND. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | THERE IS A SEPARATE COMPENSATION COMMITTEE OF THE GOVERNING BODY WHICH CONSULTS WITH THE COMPANY'S LEGAL FIRM FOR COMPARABILITY DATA. THERE IS A WRITTEN EMPLOYMENT CONTRACT THAT IS APPROVED BY THE COMPENSATION COMMITTEE. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2017. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE ON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: SPEECH THERAPIST 139,254 COLLECTION SERVICES 126,543 OTHER PURCHASED SERVICES: PSYCH 364,339 E/R 649,479 BACTERIA SERVICES 186,937 MAT MANAGEMENT 131,914 CONTRACT PHYSICIANS 168,872 PHARMACY 833,468 ANESTHESIOLOGIST 441,567 PHYSICAL THERAPY 1,119,362 OCCUPATIONAL THERAPY 562,493 SLEEP STUDY 213,025 HOME CARE 793,956 HOSPITALIST 1,047,192 HEADWATERS 21,780 PULM CLINIC 189,581 ORTHO CLINIC 390,741 QUALITY 82,194 MED RECS 132,567 PATHOLOGY 317,257 ADMINISTRATION 2,452,194 INFORMATIONAL TECHNOLOGY 501,575 QAAP FEE 312,011 LAB SERVICE 244,663 OTHER PURCHASED SERVICES 1,319,491 TOTAL EXPENSES 12,742,455 |
| FORM 990, PART X | IN 2017, PURSUANT TO A DEBT RESTRUCTURING PROGRAM, HILLSDALE COMMUNITY HEALTH CENTER TRANSFERRED ALL OF ITS REAL AND PERSONAL PROPERTY TO HEADWATERS HEALTH FOUNDATION, AN IRC 501C3 ENTITY WHOLLY OWNED AND CONTROLLED BY HCHC. TO REFLECT THE TRANSFER OF THE REAL ESTATE AND DEBT TO HHF, HCHC MADE AN ACCOUNTING ENTRY TO REFLECT THE TRANSFER TO HHF. HHF FINANCED THE ACQUISITION OF THE REAL AND PERSONAL PROPERTY THROUGH A LOAN FACILITY ADMINISTERED BY THE UNITED STATES DEPARTMENT OF AGRICULTURE. AS A RESULT, THE BALANCE SHEET ON PT. X HAS SUBSTANTIAL CHANGES OVER THE PRIOR YEAR. THE FINANCIAL STATEMENT OF HCHC INCLUDE THE OPERATIONS OF BOTH ENTITIES DUE TO THE COMPLETE CONTROL HCHC HAS OVER HHF. FOR TAX REPORTING PURPOSES HOWEVER, HHF MUST BE SEPARATELY REPORTED. |
| FORM 990, PART XI, LINE 9 | LOSS ON DEBT EXTINGUISHMENT -340,619 TRANSFER OF ASSETS TO FOUNDATION 849,579 TOTAL 508,960 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEADWATERS HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 168 S HOWELL SREET | AddressLine1Txt |
| City | HILLSDALE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49242 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 811509725 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Exempt Code Section | 501 (c) (3) | ExemptCodeSectionTxt |
| Public Charity Status | 12A | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HCHC ASSURANCE CO LTD | BusinessNameLine1Txt |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1051 | AddressLine1Txt |
| City | GRAND CAYMAN | CityNm |
| Province Or State | CAYMAN | ProvinceOrStateNm |
| Country | CJ | CountryCd |
| Foreign Postal | KY1-1102 | ForeignPostalCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300548721 | EIN |
| Primary Activities | FINANCIAL | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HCHC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORP | EntityTypeTxt |
| Share Of Total Income | $1,564,993 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,921,419 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HEADWATERS HEALTH FOUNDATION | ||
| A | $707,056 | FMV |
| HEADWATERS HEALTH FOUNDATION | ||
| R | -$849,579 | FMV |