SHERIDAN COMMUNITY HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SHERIDAN COMMUNITY HOSPITAL (EIN 38-1369796)
- Tax period
- 2016-04-01 to 2017-03-31
- Filed
- 2018-02-09
- IRS object ID
- 201830409349300928
- Schema version
- 2016v3.0
- 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 C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-02-09T11:22:10-06:00 | ReturnTs |
| Tax Period End | 2017-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wipfli LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 12237 | AddressLine1Txt |
| City | Green Bay | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381369796 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sheridan Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SHER | BusinessNameControlTxt |
| Phone | 9892913261 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 North Main Street | AddressLine1Txt |
| City | Sheridan | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48884 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RANDOLPH FLECHSIG | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9892913261 | PhoneNum |
| Signature | 2018-02-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Terri Rexrode CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2018-02-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 74.87.127.142 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-02-07 | IPDt |
| IP Tm | 10:34:23 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A43ECD1EE6AF4781A69F6BFA161A98BDE8FA2C07 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Randolph Flechsig | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 North Main Street | AddressLine1Txt |
| City | Sheridan | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48884 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,820,382 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.sheridanhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1950 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | ACUTE CARE HOSPITAL and clinics | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 262 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $53,523 | PYContributionsGrantsAmt |
| CY Contributions Grants | $39,440 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,388,879 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,485,237 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,752 | PYInvestmentIncomeAmt |
| CY Investment Income | $13,229 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$10,235 | PYOtherRevenueAmt |
| CY Other Revenue | $253,320 | CYOtherRevenueAmt |
| PY Total Revenue | $15,447,919 | PYTotalRevenueAmt |
| CY Total Revenue | $15,791,226 | 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 | $10,918,032 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,085,595 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,791,339 | PYOtherExpensesAmt |
| CY Other Expenses | $4,793,678 | CYOtherExpensesAmt |
| PY Total Expenses | $15,709,371 | PYTotalExpensesAmt |
| CY Total Expenses | $14,879,273 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$261,452 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $911,953 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,408,653 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,055,467 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,401,196 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,136,057 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,007,457 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,919,410 | NetAssetsOrFundBalancesEOYAmt |
| Mission | ABOVE ALL ELSE, WE ARE COMMITTED TO THE CARE AND IMPROVEMENT OF HUMAN LIFE. IN RECOGNITION OF THIS COMMITMENT, WE CONTINUE TO STRIVE TO DELIVER "ACCESSIBLE, PERSONALIZED, EFFICIENT, QUALITY HEALTHCARE BASED ON THE NEEDS OF THOSE WE SERVE." | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,832,815 | ExpenseAmt |
| Revenue | $15,675,531 | RevenueAmt |
| Desc | SHERIDAN COMMUNITY HOSPITAL PROVIDED CARE TO 131 INPATIENTS AND 57 SWING BED PATIENTS WITH 1,008 DAYS OF CARE. WE ALSO PROVIDED 21,313 AMBULATORY VISITS WHICH INCLUDED 8,142 VISITS THROUGH OUR EMERGENCY ROOM. SHERIDAN COMMUNITY HOSPITAL PROVIDED $25,825 IN CHARITY CARE AND $1,588,668IN OTHER UNCOMPENSATED CARE DURING THE YEAR.SHERIDAN COMMUNITY HOSPITAL'S RURAL HEALTH CLINICS PROVIDED 9,842 AMBULATORY ENCOUNTERS TO PATIENTS IN THE SURROUNDING AREA. LARGELY THIS PATIENT POPULATION CONSISTS OF MEDICARE, MEDICAID AND UNINSURED INDIVIDUALS. | Desc |
| Total Program Service Expenses | $11,832,815 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 96 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 262 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Randolph Flechsig | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9812913261 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 North Main Street | AddressLine1Txt |
| City | Sheridan | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48884 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JAY TANS | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID STEERE | |||||||
| TREASURER/SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DIANE BEACH | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MAUREEN HOCKSTRA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| emily longnecker | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAN WYCKOFF | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RONALD STEURY DO | |||||||
| DIRECTOR/ER PHYSICIAN | 40.00 | Yes (X) | $184,936 | $0 | $21,689 | ||
| RANDOLPH FLECHSIG | |||||||
| CEO/HOSPITAL ADMINISTRATOR | 40.00 | Yes (X) | Yes (X) | $132,165 | $0 | $27,448 | |
| Esther COMBS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RON SPRINGSTEEN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MINDY BUFFMAN | |||||||
| FORMER CFO | 40.00 | Yes (X) | $31,312 | $0 | $3,376 | ||
| DENISE IDE | |||||||
| CFO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| Michael Cearlock | |||||||
| Physician | 40.00 | $290,629 | $0 | $19,169 | Yes (X) | ||
| STEPHEN FRY | |||||||
| Physician | 40.00 | $258,198 | $0 | $13,778 | Yes (X) | ||
| MONICA STEURY | |||||||
| Physician | 40.00 | $209,389 | $0 | $50,392 | Yes (X) | ||
| FRANKLIN WEST | |||||||
| Physician | 40.00 | $207,814 | $0 | $20,982 | Yes (X) | ||
| Monish Sharma | |||||||
| physician | 40.00 | $183,690 | $0 | $23,445 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,498,133 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $180,279 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| J G Anesthesia Services Inc | |||||
| PO Box 923 | Alma | MI | 48801 | CRNA - Anesthesia | $248,219 |
| WIPFLI LLP | |||||
| 11 SCOTT STREET | WAUSAU | WI | 544028010 | AUDIT SERVICES | $117,951 |
| COVENANT MEDICAL CENTER | |||||
| 1447 N HARRISON | SAGINAW | MI | 48602 | PHARMACEUTICAL SUPPLIES/SERIVCES | $115,020 |
| Hall Render Killian Heath & Lyman PC | |||||
| 39778 Treasury Center | Chicago | IL | 60694 | Legal Services | $113,982 |
| ECLINICAL WORKS LLC | |||||
| 2 TECHNOLOGY DRIVE | WESTBOROUGH | MA | 01581 | EMR SOFTWARE/HARDWARE/SERVICE | $103,469 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $31,387 | FundraisingAmt |
| All Other Contributions | $8,053 | AllOtherContributionsAmt |
| Total Contributions | $39,440 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PROGRAM SERVICE REVENUE | 623990 | $14,822,343 | $14,822,343 | |
| QAAP Revenue | 623990 | $581,997 | $581,997 | |
| Other revenue | 909999 | $63,305 | $63,305 | |
| Medical office building | 621110 | $16,259 | $16,259 | |
| CAFETERIA REVENUE | 624200 | $1,333 | $1,333 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,485,237 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,713 | TotalRevenueColumnAmt |
| Exclusion | $11,713 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $29,060 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $27,544 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,516 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,516 | TotalRevenueColumnAmt |
| Exclusion | $1,516 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $31,387 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $1,612 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,612 | TotalRevenueColumnAmt |
| Exclusion | -$1,612 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | incentives/ehr | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $254,932 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $254,932 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $254,932 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,791,226 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,675,531 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $76,255 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $400,925 | TotalAmt |
| Program Services | $206,625 | ProgramServicesAmt |
| Management And General | $194,300 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,904,041 | TotalAmt |
| Program Services | $5,758,197 | ProgramServicesAmt |
| Management And General | $1,145,844 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,843 | TotalAmt |
| Program Services | $117,685 | ProgramServicesAmt |
| Management And General | $24,158 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,079,453 | TotalAmt |
| Program Services | $1,666,546 | ProgramServicesAmt |
| Management And General | $412,907 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $559,333 | TotalAmt |
| Program Services | $458,354 | ProgramServicesAmt |
| Management And General | $100,979 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,890 | TotalAmt |
| Program Services | $57,890 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,412 | TotalAmt |
| Management And General | $14,412 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,180 | TotalAmt |
| Program Services | $1,180 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,647,905 | TotalAmt |
| Program Services | $1,252,867 | ProgramServicesAmt |
| Management And General | $395,038 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,046 | TotalAmt |
| Management And General | $68,046 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,997 | TotalAmt |
| Program Services | $213,357 | ProgramServicesAmt |
| Management And General | $41,640 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,747 | TotalAmt |
| Program Services | $15,853 | ProgramServicesAmt |
| Management And General | $29,894 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,962 | TotalAmt |
| Program Services | $48,497 | ProgramServicesAmt |
| Management And General | $9,465 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $524,866 | TotalAmt |
| Program Services | $439,157 | ProgramServicesAmt |
| Management And General | $85,709 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,150 | TotalAmt |
| Management And General | $150,150 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| medical contracted serv | $711,617 | $711,617 | |
| PROVISION FOR BAD DEBTS | $645,113 | $645,113 | |
| repairs and maintenance | $222,796 | $205,069 | $17,727 |
| collection expense | $101,673 | $101,673 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,324 | TotalAmt |
| Program Services | $34,808 | ProgramServicesAmt |
| Management And General | $254,516 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,879,273 | TotalAmt |
| Program Services | $11,832,815 | ProgramServicesAmt |
| Management And General | $3,046,458 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $425,973 | BOYAmt |
| EOY | $305,405 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,596,141 | BOYAmt |
| EOY | $79,258 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,726,995 | BOYAmt |
| EOY | $2,417,554 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,264 | BOYAmt |
| EOY | $243,264 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,402 | BOYAmt |
| EOY | $82,305 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,270,444 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,360,487 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,381,878 | BOYAmt |
| EOY | $2,909,957 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $17,724 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,408,653 | BOYAmt |
| EOY | $6,055,467 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,853,437 | BOYAmt |
| EOY | $1,775,184 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,277,410 | BOYAmt |
| EOY | $267,820 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,349 | BOYAmt |
| EOY | $93,053 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,401,196 | BOYAmt |
| EOY | $2,136,057 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,964,232 | BOYAmt |
| EOY | $3,888,039 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,225 | BOYAmt |
| EOY | $31,371 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,007,457 | BOYAmt |
| EOY | $3,919,410 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,408,653 | BOYAmt |
| EOY | $6,055,467 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $911,953 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,187 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,187 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF DUES PAID TO MHA (16.96%) ARE ALLOCATED TO LOBBYING EXPENSE. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $410,366 | OtherCostOrOtherBasisAmt |
| Book Value | $410,366 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,478,693 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,177,762 | DepreciationAmt |
| Book Value | $1,300,931 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,381,385 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,182,725 | DepreciationAmt |
| Book Value | $1,198,660 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,909,957 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COST REPORT SETTLEMENTS PAYABLE | Desc |
| Amt | $93,053 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $93,053 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $15,146,113 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$645,113 | OtherRevenueAmt |
| Revenue Not Reported | -$645,113 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,791,226 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,791,226 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,234,160 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,234,160 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $645,113 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $645,113 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $14,879,273 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d - Other Adjustments: | PROVISION FOR BAD DEBTS -645,113. |
| Part XII, Line 4b - Other Adjustments: | PROVISION FOR BAD DEBTS 645,113. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | TREE OF LIGHTS | Event1Nm |
| Gross Receipts Event1 | $11,063 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $11,063 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $1,612 | OtherDirectExpensesEvent1Amt |
| Event2 | Auction | Event2Nm |
| Gross Receipts Event2 | $20,324 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $20,324 | CharitableContriEvent2Amt |
| Gross Receipts Total | $31,387 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $31,387 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $1,612 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $1,612 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$1,612 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,825 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,825 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,406,212 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,817,544 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,588,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11160 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,432,037 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,817,544 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,614,493 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11340 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,741 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,741 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,741 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,741 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,434,778 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,817,544 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,617,234 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11360 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $645,113 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $212,887 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,667,291 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,756,254 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$88,963 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| 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 | SHERIDAN COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 N MAIN STREET | AddressLine1Txt |
| City | SHERIDAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48884 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SHERIDANHOSPITAL.COM | WebsiteAddressTxt |
| State License | 1060000119 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHERIDAN COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://sheridanhospital.com/documents/Montcalm_County_CHA_Updated_2015.pdf | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.sheridanhospital.com | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.sheridanhospital.com/payments.asp | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.sheridanhospital.com/payments.asp | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.sheridanhospital.com/payments.asp | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | 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 |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SHERIDAN COMMUNITY HOSPITAL | Part V, Section B, Line 5: SHERIDAN used data from the local and regional behavioral risk factor surveillances, as well as from individuals and local service agencies in the surrounding community. COUNTY-SPECIFIC SECONDARY DATA FROM A VARIETY OF SOURCES WAS ALSO COLLECTED AND ANALYZED. |
| SHERIDAN COMMUNITY HOSPITAL | Part V, Section B, Line 6a: Sheridan Community Hospital conducted a community health needs assessment in conjunction with Spectrum United, Spectrum Kelsey, and Carson City Hospital - Healthy Montcalm. |
| SHERIDAN COMMUNITY HOSPITAL | Part V, Section B, Line 11: A Community Health Needs Assessment (CHNA) was performed in the fall of 2015 in collaboration with Healthy Montcalm, to determine the most prevalent health needs of the community served by Sheridan Community Hospital. Sheridan Community Hospital as a collaborative part of the Montcalm County Community Health Improvement Plan for 2016-2019 has incorporated and adopted pertinent elements of the Healthy Montcalm's Community Health Needs Assessment (CHNA) as its own assessment, to determine the most prevalent health needs of the community served by Sheridan Community Hospital.Information needed to identify and determine the community's significant health needs was obtained by gathering input selecting strategies from Montcalm Human Services Coalition. Implementation Plan Goals: Sheridan Community Hospital's Board of Directors, has determined that the following health needs identified in the CHNA, will be addressed through the implementation strategy noted for each such need as listed:Priority Health Issue: Access to HealthcareGoal: Increase access/utilization of primary and preventive health servicesObjective 1: Increase access by implementing and promoting the utilization of preventive health servicesObjective 2: Increase access to care by implementing telehealth services Baseline Measure: People who delayed health care: 15% (2018 Goal +12%)Population Served: All residents of Sheridan Community Hospital Service AreaA. Strategy: Increase the number of primary care providers, including midlevel, accepting Medicaid and Medicare with an eye toward manage population health.Action: Increase the number of primary care providers in Sheridan Community Hospital clinics including Allied Health Providers accepting all insurances including Medicare and Medicaid.Performance Measure: Increase in number of primary care providers accepting all insurances including Medicare and/or Medicaid above current staff:a. One provider by March 2017b. Two providers by March 2018c. Three providers by March 2018Action: Increase primary care provider availabilitya. Improve operational efficiency to optimize the number of appointments available per day, and hours for access.b. Ensure at least two open appointments available each day for Emergency Room/Walk in Clinic f/u appointments or need to be seen today appointments.c. Implementation of new clinic EMR to enhance provider productivity with documentation and integration of wellness metrics.Performance Measure: Increase number of patients seen by 10% by March 2017 Increase number of patients seen by 20% by March 2018 Increase number of patients seen by 30% by March 2019UPDATE: Full time physician assistant hired September 2016 for Sheridan Care. Full time in-house physician recruiter was hired December 2016 to assist with the searching of providers. At this time SCH has not hired a new physician.B. Strategy: Expand telemedicine communication technology (Use of medical information exchanged from one site to another via electronic communications to improve a patient's clinical health status)Action: Use of technology to overcome transportation barriers by using telemedicine visits from provider to service location.a. Apply for grant fundingb. Initiate telemedicine program by March 2017 Performance Measure:Upon receipt of funding initiate program by March 2017Increase number of first year patients utilizing telemedicine by 10% by March 2018Increase number of patients utilizing telemedicine by 20% by March 2019 UPDATE: No action taken at this time to financial constraints.Other significant needs identified in the CHNA but not addressed in this plan: Each of the health needs listed are important and are being addressed by numerous programs and initiatives operated by neighboring healthcare system, and other community partners of Sheridan Community Hospital.However, Sheridan Community Hospital will not address the following significant health needs identified in the CHNA as part of this implementation plan due to limited resources and the need to allocate significant resources to the priority health needs identified above.Reduce the prevalence of obesity for adults and youth of Montcalm CountyNeeds are currently being addressed by the Great Start Collaborative of Montcalm County and existing programs through Spectrum Health United Life Styles. These programs address the overweight adult and children issues identified in needs assessment. Assist people with mental illness in leading more productive and autonomous lifestyles, and to promote mental health through advocacy and education. Needs are currently being addressed by Montcalm Center for Behavioral Health and Montcalm Human Services Coalition. These programs address the mental health and suicide issues identified in the needs assessment. Substance use and abuse to reduce tobacco, alcohol and other drug use. Needs are currently being addressed by Cherry Health Promotion Services, Spectrum Health United Lifestyles, You Think Coalition, Mid Michigan District Health Department and Great Start. These programs address alcohol/drug use, smoking, second-hand smoke, use of e-cigarettes, prescription drug abuse, and substance abuse treatment issues identified in the Community Health Needs Assessments.Strengthen early family development and support, especially as it relates to health for children and youth. Needs are being addressed by Great Start, Spectrum Health United Lifestyles through education to young families and the community about family development as well expanding opportunities for comprehensive heath activities in schools and other care settings. |
| SHERIDAN COMMUNITY HOSPITAL | Part V, Section B, Line 16j: We were not required to translate our FAP, FAP application form and plain language summary of the FAP into any other languages. |
| SHERIDAN COMMUNITY HOSPITAL | Part V, Section B, Line 20e: We let all self-pay individuals know at the time of admission and again at discharge. They are given contact information for our FAP coordinator. We also offer to anyone asking the same information if they have a high deductible. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SHERIDAN CARE | ||||
| 303 CONGRESS | SHERIDAN | MI | 48884 | OUTPATIENT CLINIC |
| 2 - STANTON FIRST CARE | ||||
| 620 WEST MAIN | STANTON | MI | 48888 | OUTPATIENT CLINIC |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Ln 7 Col(f): | Bad debt expense of $645,113 included on Form 990, Part IX, Line 25 was excluded from the denominator per instructions when calculating the percent total expenses on schedule H. |
| Part II, Community Building Activities: | Sheridan Community Hospital offers a variety of health and wellness programs including education workshops, health screenings, community health fairs, blood pressure clinics, diabetes education, and support groups. These programs are open to everyone and are generally free of charge. |
| Part III, Line 4: | An allowance for uncollectible accounts is established on an aggregate basis by using historical write-off rate factors applies to upaid accounts based on aging. Loss rate factors are based on historical loss experience and adjusted for economic conditions and other trends affecting the hospital's ability to collect outstanding amounts. Uncollectible accounts are written off against the allowance for doubtful accounts in the period they are determined to be uncollectible. |
| Part III, Line 8: | COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS 990 INSTRUCTIONS. THE ENTIRE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT DUE TO ITS REPRESENTATION OF COST TO PROVIDE SERVICES TO THE COMMUNITY WITHOUT PAYMENT. |
| Part III, Line 9b: | Patients fill out a financial application and also apply for medicaid for current services (past 90 days). If services are past 90 days, there is no application to medicaid. Medicaid will be billed if patient is deemed medicaid eligible. If the patient does not qualify for medicaid but is found eligible under the hospital's financial application guidelines, then the charges are written off to charity care. |
| Part VI, Line 2: | PARTICIPATING IN COMMUNITY INITIATIVES EVERY THREE YEARS. |
| Part VI, Line 3: | Related information is posted by the entrance doors to the hospital as well as on the wall next to ER. |
| Part VI, Line 4: | Sheridan Community Hospital serves a population of all ages but continues to see an increase in its aging population as well as quite a large migrant population. Over the past several years, thousands of jobs have been lost and unemployment has been on the rise in the communities SCH serves. There has been a large increase in foreclosures and healthcare reform impact. |
| Part VI, Line 5: | Sheridan Community Hospital and its hospital-owned family practices offer free or low-cost immunization clinics, free sports exams for students and provide a low cost lifeline program (Emergency Response System). |
| Part VI, Line 7, Reports Filed With States | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (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 | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RONALD STEURY DO | ||||||||||||||
| DIRECTOR/ER PHYSICIAN | $184,822 | $0 | $0 | $0 | $114 | $0 | $2,000 | $0 | $19,689 | $0 | $206,625 | $0 | $0 | $0 |
| RANDOLPH FLECHSIG | ||||||||||||||
| CEO/HOSPITAL ADMINISTRATOR | $131,823 | $0 | $0 | $0 | $342 | $0 | $2,000 | $0 | $25,448 | $0 | $159,613 | $0 | $0 | $0 |
| Michael Cearlock | ||||||||||||||
| Physician | $290,515 | $0 | $0 | $0 | $114 | $0 | $0 | $0 | $19,169 | $0 | $309,798 | $0 | $0 | $0 |
| STEPHEN FRY | ||||||||||||||
| Physician | $258,084 | $0 | $0 | $0 | $114 | $0 | $0 | $0 | $13,778 | $0 | $271,976 | $0 | $0 | $0 |
| MONICA STEURY | ||||||||||||||
| Physician | $209,275 | $0 | $0 | $0 | $114 | $0 | $2,000 | $0 | $48,392 | $0 | $259,781 | $0 | $0 | $0 |
| FRANKLIN WEST | ||||||||||||||
| Physician | $207,472 | $0 | $0 | $0 | $342 | $0 | $2,000 | $0 | $18,982 | $0 | $228,796 | $0 | $0 | $0 |
| Monish Sharma | ||||||||||||||
| physician | $183,576 | $0 | $0 | $0 | $114 | $0 | $0 | $0 | $23,445 | $0 | $207,135 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Monica Steury | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Daughter of Ronald Steury board member | RelationshipDescriptionTxt |
| Transaction | $259,781 | TransactionAmt |
| Transaction | Paid by Sheridan Community Hospital | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | All board members were provided a copy of the Form 990 before it was filed. The form 990 will be presented at a future board meeting. |
| Form 990, Part VI, Section B, line 12c | A CONFLICT OF INTEREST QUESTIONNAIRE IS COMPLETED ANNUALLY BY THE BOARD OF DIRECTORS AND REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD. IF A CONFLICT DOES EXIST, IT IS UP TO THE EXECUTIVE COMMITTEE OF THE BOARD TO TAKE SUCH STEPS TO PROTECT THE HOSPITAL AS MAY BE REQUIRED OR APPROPRIATE. INDIVIDUALS INVOLVED WILL BE NOTIFIED TO TAKE CORRECTIVE ACTION BEFORE ANY PENALIZING AND REMEDIAL ACTION IS UNDERTAKEN BY THE HOSPITAL. |
| Form 990, Part VI, Section B, line 15 | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPENSATION DATA PROVIDED BY MHA IN THE FORM OF EXECUTIVE COMPENSATION SURVEY. THE BOARD OF DIRECTORS APPROVES EXECUTIVE COMPENSATION AND DOCUMENTS CONCLUSIONS IN THE BOARD MINUTES. THE MOST RECENT YEAR THIS WAS UNDERTAKEN WAS FISCAL YEAR 2013. |
| Form 990, Part VI, Section C, line 19 | Any governing documents, conflict of interest policy and/or financial statements that are required to be open for public inspection, are available upon request. |
| FORM 990, PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR |