HERRICK MEMORIAL HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HERRICK MEMORIAL HOSPITAL INC (EIN 38-3049015)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-09
- IRS object ID
- 201743139349303274
- 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 B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-09T15:42:57-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE STE 4200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 462045108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383049015 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HERRICK MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HERR | BusinessNameControlTxt |
| Phone | 5172650297 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 E POTTAWATAMIE STREET | AddressLine1Txt |
| City | TECUMSEH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 492862097 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL P BROWNING | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 5172650297 | PhoneNum |
| Signature | 2017-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SAMANTHA BOKORI | PreparerPersonNm |
| PTIN | P01057347 | PTIN |
| Phone | 3174648600 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.219.0.212 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-09 | IPDt |
| IP Tm | 13:23:21 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DE7CB8BFECA733C2802C85E125D45E21736079AB | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 49244D1103501C1FC62C4DE15972AF245F6ACEFC | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROMEDICA HERRICK HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL P BROWNING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 MADISON AVE | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $83,790,252 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PROMEDICA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | HERRICK MEMORIAL HOSPITAL, INC. IS AN ACUTE CARE CRITICAL ACCESS HOSPITAL THAT PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS IN LENAWEE COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 274 | TotalEmployeeCnt |
| Total Volunteers | 86 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $262,176 | PYContributionsGrantsAmt |
| CY Contributions Grants | $341,497 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,312,359 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $25,845,844 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,050,971 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,456,028 | CYInvestmentIncomeAmt |
| PY Other Revenue | $689,423 | PYOtherRevenueAmt |
| CY Other Revenue | $230,182 | CYOtherRevenueAmt |
| PY Total Revenue | $36,314,929 | PYTotalRevenueAmt |
| CY Total Revenue | $28,873,551 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,330,774 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,782,047 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,419,560 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,739,465 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,558,092 | PYOtherExpensesAmt |
| CY Other Expenses | $13,681,739 | CYOtherExpensesAmt |
| PY Total Expenses | $34,308,426 | PYTotalExpensesAmt |
| CY Total Expenses | $34,203,251 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,006,503 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$5,329,700 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $105,140,260 | TotalAssetsBOYAmt |
| Total Assets EOY | $94,569,296 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,920,375 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $19,281,731 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $83,219,885 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $75,287,565 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HERRICK MEMORIAL HOSPITAL, INC. IS AN ACUTE CARE CRITICAL ACCESS HOSPITAL THAT PROVIDES HEALTH CARE DEDICATED TO IMPROVING HUMAN LIFE, AND IS DEVOTED TO THE PATIENTS AND FAMILIES WE SERVE THROUGH INNOVATIVE CARE, SUPERIOR QUALITY AND PREMIER CUSTOMER SERVICE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $23,421,275 | ExpenseAmt |
| Grant | $4,782,047 | GrantAmt |
| Revenue | $25,108,465 | RevenueAmt |
| Desc | HERRICK MEMORIAL HOSPITAL, INC. IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,864,032 | ExpenseAmt |
| Desc | CONSISTENT WITH OUR MISSION, HERRICK MEMORIAL HOSPITAL, INC. PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY. - SEE SCHEDULE O. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,258,244 | ExpenseAmt |
| Revenue | $825,666 | RevenueAmt |
| Desc | CONSISTENT WITH OUR MISSION, HERRICK MEMORIAL HOSPITAL, INC. PROVIDES A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES AND SUBSIDIZED HEALTH SERVICES. - SEE SCHEDULE O. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $27,543,551 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | 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 | 0 | 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 274 | 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 | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRIAN HANSEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5675858505 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 MADISON AVE | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43604 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ABDUL G ARSHAD MD FACS | ||||||||||
| TRUSTEE | 1.00 | 41.00 | Yes (X) | $0 | $304,843 | $32,524 | ||||
| ANDRES LOPEZ | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| BARBARA A MITZEL | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| EMORY M SCHMIDT | ||||||||||
| CHAIRPERSON | 1.00 | 9.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| GRACE M GARNO | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JAMES D PHILP | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JEFFREY A KUHMAN | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JULIE K YAROCH DO | ||||||||||
| PRESIDENT, EX-OFFICIO | 1.00 | 40.00 | Yes (X) | $0 | $321,944 | $33,550 | Yes (X) | |||
| KEVIN C WEBB PHD | ||||||||||
| EX OFFICIO | 1.00 | 52.50 | Yes (X) | $0 | $716,751 | $134,986 | ||||
| L CHARLES FORCE | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARCY L BROWN | ||||||||||
| EX OFFICIO | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL J UCKELE | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL R HERR DVM | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL R OLSAVER | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| PAUL R WALKER MD | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT L VOGEL | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RUSSELL L DEMPSEY | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| SAMANTHA M MUCHA MD | ||||||||||
| TRUSTEE | 1.00 | 41.00 | Yes (X) | $0 | $576,653 | $29,728 | ||||
| STACEY L BOCK | ||||||||||
| TRUSTEE | 1.00 | 41.00 | Yes (X) | $0 | $249,319 | $36,368 | ||||
| VICTOR J CHERFAN DO | ||||||||||
| TRUSTEE | 1.00 | 41.00 | Yes (X) | $0 | $558,619 | $32,395 | ||||
| WILLIAM B NOE | ||||||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ALAN M SATTLER | ||||||||||
| TREASURER (THRU 2/16) | 0.50 | 51.00 | $0 | $641,062 | $76,678 | Yes (X) | ||||
| GARY AKENBERGER | ||||||||||
| INTERIM TREASURER (3/16 TO 7/16) | 0.50 | 50.50 | $0 | $461,216 | $92,553 | Yes (X) | ||||
| JEFFREY C KUHN | ||||||||||
| SECRETARY | 0.50 | 51.00 | $0 | $674,920 | $143,195 | Yes (X) | ||||
| MICHAEL P BROWNING | ||||||||||
| TREASURER | 0.50 | 50.50 | $0 | $296,524 | $4,420 | Yes (X) | ||||
| KATHRYN GREENLEE | ||||||||||
| VP CLINICAL SERVICES, LHA | 0.50 | 40.00 | $0 | $180,144 | $43,830 | Yes (X) | ||||
| MARILYN MERKLE | ||||||||||
| ADMINISTRATOR-MANOR | 40.00 | 0.00 | $105,835 | $0 | $25,332 | Yes (X) | ||||
| NANCY MUELLER | ||||||||||
| PHARMACIST | 40.00 | 0.00 | $116,008 | $0 | $13,321 | Yes (X) | ||||
| KATHLEEN S HANLEY | ||||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $1,255,999 | $38,403 | Yes (X) | ||||
| TIMOTHY J JAKACKI | ||||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $398,203 | $16,072 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $221,843 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,636,197 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $753,355 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $323,154 | RelatedOrganizationsAmt |
| All Other Contributions | $18,343 | AllOtherContributionsAmt |
| Total Contributions | $341,497 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| NET PATIENT SERVICES | 621110 | $25,778,423 | $25,778,423 | |
| AFFIL. ORG. RENT REV. | 531120 | $67,421 | $67,421 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $25,845,844 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $922,346 | TotalRevenueColumnAmt |
| Exclusion | $922,346 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,821 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $23,006 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$4,185 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4,185 | TotalRevenueColumnAmt |
| Exclusion | -$4,185 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $56,427,127 | SecuritiesAmt |
| Other | $250 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $54,865,207 | SecuritiesAmt |
| Other | $28,488 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,561,920 | SecuritiesAmt |
| Other | -$28,238 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,533,682 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$28,238 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,561,920 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| WELLNESS FEES | 900099 | $90,298 | $90,298 | |
| SCHOOL PHYSICALS | 900099 | $69,206 | $69,206 | |
| CAFETERIA & VENDING | 722514 | $50,421 | $50,421 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,442 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,442 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $234,367 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,873,551 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,934,131 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,597,923 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,782,047 | TotalAmt |
| Program Services | $4,782,047 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,825,378 | TotalAmt |
| Program Services | $9,747,287 | ProgramServicesAmt |
| Management And General | $3,078,091 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $404,631 | TotalAmt |
| Program Services | $263,010 | ProgramServicesAmt |
| Management And General | $141,621 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,563,103 | TotalAmt |
| Program Services | $1,187,958 | ProgramServicesAmt |
| Management And General | $375,145 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $946,353 | TotalAmt |
| Program Services | $719,228 | ProgramServicesAmt |
| Management And General | $227,125 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,989 | TotalAmt |
| Management And General | $50,989 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,176 | TotalAmt |
| Management And General | $63,176 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,775 | TotalAmt |
| Management And General | $2,775 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,727 | TotalAmt |
| Management And General | $185,727 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,351,450 | TotalAmt |
| Program Services | $3,116,849 | ProgramServicesAmt |
| Management And General | $234,601 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,560 | TotalAmt |
| Management And General | $142,560 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,344 | TotalAmt |
| Program Services | $279,475 | ProgramServicesAmt |
| Management And General | $69,869 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,320,962 | TotalAmt |
| Management And General | $1,320,962 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,051,705 | TotalAmt |
| Program Services | $1,020,154 | ProgramServicesAmt |
| Management And General | $31,551 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,212 | TotalAmt |
| Program Services | $26,716 | ProgramServicesAmt |
| Management And General | $47,496 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $796,063 | TotalAmt |
| Program Services | $796,063 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,641,557 | TotalAmt |
| Program Services | $2,113,246 | ProgramServicesAmt |
| Management And General | $528,311 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,944 | TotalAmt |
| Program Services | $598,895 | ProgramServicesAmt |
| Management And General | $6,049 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,162,697 | $1,162,697 | |
| DRUGS | $736,030 | $736,030 | |
| INTERCOMPANY SERVICES | $533,160 | $490,507 | $42,653 |
| FOOD | $250,577 | $230,531 | $20,046 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363,811 | TotalAmt |
| Program Services | $272,858 | ProgramServicesAmt |
| Management And General | $90,953 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,203,251 | TotalAmt |
| Program Services | $27,543,551 | ProgramServicesAmt |
| Management And General | $6,659,700 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,144,320 | BOYAmt |
| EOY | $346,712 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,678 | BOYAmt |
| EOY | $202,678 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,994,908 | BOYAmt |
| EOY | $3,999,475 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,963 | BOYAmt |
| EOY | $440,867 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,580 | BOYAmt |
| EOY | $77,731 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $54,719,302 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $39,087,719 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,332,462 | BOYAmt |
| EOY | $15,631,583 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,615,664 | BOYAmt |
| EOY | $53,168,905 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,329,685 | BOYAmt |
| EOY | $20,701,345 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,140,260 | BOYAmt |
| EOY | $94,569,296 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,937,475 | BOYAmt |
| EOY | $1,624,448 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,982,900 | BOYAmt |
| EOY | $17,657,283 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,920,375 | BOYAmt |
| EOY | $19,281,731 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,421,788 | BOYAmt |
| EOY | $54,690,332 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,798,097 | BOYAmt |
| EOY | $19,597,233 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,000 | BOYAmt |
| EOY | $1,000,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,219,885 | BOYAmt |
| EOY | $75,287,565 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,140,260 | BOYAmt |
| EOY | $94,569,296 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$5,329,700 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $500,995 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$3,103,615 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,775 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,775 | 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 | HERRICK MEMORIAL HOSPITAL, INC. PAYS ANNUAL DUES TO THE AMERICAN HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,946,310 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $660,240 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $15,606,550 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,129,555 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$183,245 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $14,946,310 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,649,207 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $480,348 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $15,129,555 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,350,907 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,298,300 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $14,649,207 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,195,178 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,190,728 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $34,999 | OtherExpendituresAmt |
| End Year Balance | $12,350,907 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.93590 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.06410 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $442,269 | OtherCostOrOtherBasisAmt |
| Book Value | $442,269 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,481,534 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,599,399 | DepreciationAmt |
| Book Value | $11,882,135 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,891 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,486 | DepreciationAmt |
| Book Value | $10,405 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,945,640 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,937,259 | DepreciationAmt |
| Book Value | $3,008,381 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,808,968 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,520,575 | DepreciationAmt |
| Book Value | $288,393 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,631,583 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN FOUNDATION | $20,557,719 |
| DUE FROM AFFILIATES | $91,797 |
| OTHER RECEIVABLES | $51,829 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $20,701,345 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $1,721,620 |
| ESTIMATED THIRD PARTY SETTLEMENTS PAYABLE | $3,443,657 |
| ASBESTOS REMEDIATION | $921,295 |
| INTERCOMPANY DEBT TO THE TOLEDO HOSPITAL | $11,570,711 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $17,657,283 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT HERRICK MEMORIAL HOSPITAL, INC. CONSISTENT WITH DONOR INTENT. |
| PART X, LINE 2: | HERRICK MEMORIAL HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES (PHS). THE FOLLOWING REFLECTS PHS'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740. EXCEPT AS NOTED BELOW, PHS DID NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2016 AND 2015. FOR THE TAX YEARS ENDED DECEMBER 31, 2016 AND 2015, A TAXABLE SUBSIDIARY OF PHS DID NOT RECOGNIZE A LIABILITY FOR UNCERTAIN TAX POSITIONS. THE SUBSIDIARY RECOGNIZED A CREDIT TO INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS OF $(340,000) AS OF DECEMBER 31, 2016 AND AN EXPENSE OF $169,000 FOR 2015. HERRICK MEMORIAL HOSPITAL, INC. DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2016 AND 2015. |
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 |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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 | $41,254 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $41,254 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,168,143 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,364,702 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,803,441 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08200 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $717,745 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $698,408 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,337 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,927,142 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,063,110 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,864,032 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08380 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,509 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,509 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,254,735 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $825,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $429,069 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01250 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,258,244 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $825,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $432,578 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01260 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,185,386 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,888,776 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,296,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09640 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,020,153 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $153,812 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,503,127 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,561,352 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$58,225 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 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 | HERRICK MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 E POTTAWATAMIE STREET | AddressLine1Txt |
| City | TECUMSEH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 492862097 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PROMEDICA.ORG | WebsiteAddressTxt |
| State License | 1060000169 | 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 | HERRICK MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.PROMEDICA.ORG/PAGES/ABOUT-US/DEFAULT.ASPX | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| 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 | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HERRICK MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT SURVEY PROCESSES, LENAWEE COUNTY CONDUCTED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS TO DEVELOP A COUNTY STRATEGIC PLAN, UTILIZING THE MAPP PROCESS THAT INCLUDES FOUR ASSESSMENTS: COMMUNITY THEMES & STRENGTHS, FORCES OF CHANGE, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND THE COMMUNITY HEALTH STATUS ASSESSMENT. THESE FOUR ASSESSMENTS WERE USED BY THE RESPECTIVE COUNTY CHIP COMMITTEES TO PRIORITIZE SPECIFIC HEALTH ISSUES AND POPULATION GROUPS WHICH ARE THE FOUNDATION OF THE PLAN. A RESOURCE ASSESSMENT AND GAP ANALYSIS WAS PART OF THIS FORMAL PROCESS. THE FINAL CHIP PLANS WERE APPROVED BY THE RESPECTIVE COUNTY CHIP STRATEGIC PLANNING COMMITTEES. THE HOSPITAL THEN UTILIZED THESE DATA AND PLANS TO DEVELOP THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN. FEEDBACK FROM THE LOCAL HEALTH DEPARTMENT WAS REQUESTED AFTER THE HOSPITAL PLAN WAS DRAFTED. PERSONS WHO REPRESENTED THE LENAWEE COUNTY COMMUNITY THROUGH THESE PROCESSES INCLUDED: ADRIAN FARMER'S MARKET, ADRIAN PUBLIC SCHOOLS (HEAD START), AMERICAN CANCER SOCIETY, BOYS & GIRLS CLUB, CATHOLIC CHARITIES, COMMUNITY ACTION AGENCY, FAMILY COUNSELING AND CHILDREN'S SERVICES, FAMILY MEDICAL CENTER, GOODWILL INDUSTRIES, HOPE COMMUNITY CENTER, INTERCONNECTIONS DROP IN CENTER, LENAWEE COMMUNITY FOUNDATION, LENAWEE COMMUNITY MENTAL HEALTH AUTHORITY, LENAWEE COUNTY HEALTH DEPARTMENT, LENAWEE DEPARTMENT ON AGING, LENAWEE GREAT START, LENAWEE DEPARTMENT OF HUMAN SERVICES, LENAWEE INTERMEDIATE SCHOOL DISTRICT, LENAWEE SUBSTANCE ABUSE COALITION, LENAWEE UNITED WAY, MCCULLOUGH, VARGAS & ASSOCIATES, MSU EXTENSION, ONE LENAWEE, PROMEDICA BIXBY HOSPITAL, PROMEDICA HERRICK HOSPITAL, SIENA HEIGHTS, THE CENTRE, THE SALVATION ARMY, YMCA OF LENAWEE, AND PARTICIPATING SCHOOLS IN THE MIPHY SURVEY: BLISSFIELD MIDDLE AND HIGH SCHOOLS, CLINTON HIGH SCHOOL, HUDSON HIGH SCHOOL, MADISON HIGH SCHOOL, ONSTED MIDDLE AND HIGH SCHOOLS, SAND CREEK MIDDLE AND HIGH SCHOOLS, AND TECUMSEH MIDDLE AND HIGH SCHOOLS. |
| HERRICK MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE FOLLOWING HOSPITAL FACILITY: EMMA L. BIXBY MEDICAL CENTER. |
| HERRICK MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO. |
| HERRICK MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 11: HERRICK MEMORIAL HOSPITAL, INC., CONDUCTED AND ADOPTED ITS SECOND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2016 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- SUBSTANCE ABUSE- NUTRITION AND HUNGERNO ACTIONS WERE TAKEN DURING TAX YEAR 2016 TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH HERRICK MEMORIAL HOSPITAL, INC.'S MOST RECENTLY CONDUCTED CHNA IN 2016. THE SECOND CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2016; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS.HERRICK MEMORIAL HOSPITAL, INC. DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2016 SIGNIFICANT HEALTH NEEDS IDENTIFIED, SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2016 IMPLEMENTATION PLAN, INCLUDE: CARDIOVASCULAR HEALTH, CANCER, DIABETES, ASTHMA, TOBACCO USE, ALCOHOL USE, WOMEN'S HEALTH, MEN'S HEALTH, PREVENTIVE MEDICINE AND HEALTH SCREENINGS, ADULT SEXUAL BEHAVIOR AND PREGNANCY OUTCOMES, ENVIRONMENTAL HEALTH/DISASTER PREPAREDNESS, QUALITY OF LIFE, SOCIAL CONTEXT AND SAFETY, MENTAL HEALTH AND SUICIDE, AND ORAL HEALTH.HERRICK MEMORIAL HOSPITAL, INC., DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2016 WITH RESPECT TO ITS PREVIOUSLY CONDUCTED CHNA IN 2013:HEALTH NEED IDENTIFIED: DIABETESSTRATEGY #1 - RESIDENTS OF LENAWEE COUNTY THAT ARE PREDISPOSED TO A DIABETES DIAGNOSIS WILL BENEFIT FROM EDUCATIONAL OUTREACH AND PREVENTIVE SERVICES. ACTIONS TAKEN:- A MONTHLY SUPPORT GROUP WAS HELD FOR DIABETES PATIENTS WITH A TOTAL OF 24 MEETINGS AND A TOTAL OF 262 PARTICIPANTS.- THE HISPANIC DIABETES SUPPORT GROUP DROPPED PARTICIPATION AS A RESULT OF A REORGANIZATION AND CHANGE IN DIRECTION FOR THIS GROUP.- AN ESTIMATED 16 BLOOD SUGAR SCREENING AND EDUCATION EVENTS WITH 236 BLOOD SUGAR TESTS WERE PERFORMED AND PROVIDED AT COMMUNITY EVENTS. - THE 5K RUN, WHICH HAD BEEN RAISING NOMINAL FUNDS, WAS NOT HELD. INSTEAD RESOURCES WERE USED TO INCREASE VISIBILITY AND FOCUS ON ATTENDING MORE COMMUNITY EVENTS WITH DIABETES EDUCATION. - A COMMUNITY DIABETES EDUCATIONAL EVENT WAS HELD IN NOVEMBER 2016, AT SIENA HEIGHTS UNIVERSITY, WITH 94 COMMUNITY MEMBERS IN ATTENDANCE. HEALTH NEED IDENTIFIED: WOMEN'S HEALTH STRATEGY #1 - ACCESS TO PREVENTIVE SCREENINGS AND EDUCATION WOULD HAVE A POSITIVE IMPACT ON THE HEALTH OF WOMEN IN LENAWEE COUNTY. ACTIONS TAKEN:- FREE DEXA SCAN SCREENINGS AND EDUCATION WERE OFFERED IN THE COMMUNITY TWICE WITH A TOTAL OF 13 PARTICIPANTS. THE FEBRUARY 2016 SCREENING EVENT WAS CANCELLED DUE TO INCLEMENT WINTER WEATHER, AND THE JUNE 2016 EVENT REACHED 13 COMMUNITY MEMBERS FOR FREE SCREENING. APPROXIMATELY 30 COMMUNITY MEMBERS RECEIVED EDUCATIONAL LITERATURE.HEALTH NEED IDENTIFIED: CARDIOVASCULAR HEALTHSTRATEGY #1 - INCREASE EARLY DETECTION AND AWARENESS OF STROKE SYMPTOMS. PROVIDE SUPPORT FOR STROKE VICTIMS AND THEIR CAREGIVERS FOR CONTINUUM OF CARE FOR THE COMMUNITY.ACTIONS TAKEN:- A MONTHLY STROKE SUPPORT GROUP WAS HELD WITH A TOTAL OF 40 PARTICIPANTS.- TWO (2) EDUCATIONAL EVENTS WERE PROVIDED TO THE COMMUNITY THROUGH COMMUNITY EVENTS AND RADIO PROMOTIONS, WITH A TOTAL OF APPROXIMATELY 25 PARTICIPANTS RECEIVING EDUCATION AT THE COMMUNITY EVENT. RADIO REACH WAS NOT AVAILABLE. |
| HERRICK MEMORIAL HOSPITAL, INC.: | PART V, SECTION B, LINE 16A: THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXHERRICK MEMORIAL HOSPITAL, INC.:PART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXHERRICK MEMORIAL HOSPITAL, INC.:PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPX |
| 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 - TOTAL REHAB AT BROOKLYN | ||||
| 210 SOUTH MAIN STREET | BROOKLYN | MI | 49228 | PHYSICAL THERAPY |
| 2 - TOTAL REHAB AT DUNDEE | ||||
| 119 WATERSTRADT-COMMERCE DR | DUNDEE | MI | 48131 | PHYSICAL THERAPY |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. |
| PART I, LINE 6A: | HERRICK MEMORIAL HOSPITAL, INC. REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT. |
| PART I, LINE 7: | HERRICK MEMORIAL HOSPITAL, INC. CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS. |
| PART III, LINE 2: | HERRICK MEMORIAL HOSPITAL, INC.'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY. |
| PART III, LINE 3: | HERRICK MEMORIAL HOSPITAL, INC. ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT. |
| PART III, LINE 4: | PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGES 15 AND 16 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS:- THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM.- THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS.- MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER.- MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.HERRICK MEMORIAL HOSPITAL, INC. USED THE MEDICARE ALLOWABLE COSTS PER ITS 2016 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. |
| PART III, LINE 9B: | FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES.VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE.THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING. |
| PART VI, LINE 2: | PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE. |
| PART VI, LINE 3: | THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS. |
| PART VI, LINE 4: | HERRICK MEMORIAL HOSPITAL, INC., LOCATED IN TECUMSEH, MI, SERVES AN AREA PRIMARILY AROUND LENAWEE COUNTY AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 85,000. APPROXIMATELY, 18% OF THE SERVICE AREA IS AGE 65 OR OVER; 39% IS BETWEEN AGE 35 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $50,000; 46% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 51% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. LENAWEE COUNTY HAS A POPULATION OF APPROXIMATELY 99,000 WITH APPROXIMATELY 14% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 17% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 13% OF LENAWEE COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE AT THE END OF 2016 FOR LENAWEE COUNTY WAS 6.4%. THE LEADING CAUSES OF DEATH IN LENAWEE COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, LUNG DISEASE, DIABETES, CANCER, ALZHEIMER'S, AND UNINTENTIONAL INJURIES/ACCIDENTS. ACCORDING TO THE 2016 COUNTY HEALTH RANKINGS, LENAWEE COUNTY RANKED 23 OF 83 COUNTIES FOR HEALTH OUTCOMES, 32 OF 83 FOR LENGTH OF LIFE, AND 17 OF 83 FOR QUALITY OF LIFE. THERE ARE ELEVEN HOSPITALS WITHIN A 30-MILE RADIUS OF HERRICK MEMORIAL HOSPITAL, INC.: EMMA L. BIXBY MEDICAL CENTER, ST. JOSEPH MERCY SALINE HOSPITAL, CHELSEA COMMUNITY HOSPITAL, UNIVERSITY OF MICHIGAN HOSPITALS, VA ANN ARBOR HEALTHCARE SYSTEM, ST. JOSEPH MERCY ANN ARBOR HOSPITAL, FLOWER HOSPITAL, ST. ANNE MERCY HOSPITAL, MERCY MEMORIAL HOSPITAL CORPORATION, THE TOLEDO HOSPITAL, AND ALLEGIANCE HEALTH. |
| PART VI, LINE 5: | HERRICK MEMORIAL HOSPITAL, INC. IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC. WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. - IN 2016, THERE WERE MORE THAN 500 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), INCLUDING ITS SUBSIDIARIES. OF THESE, 99% LIVED WITHIN PROMEDICA'S 27-COUNTY SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN METRO TOLEDO WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. TRUSTEE REPRESENTATION IS COMPRISED OF DIVERSE MEMBERS, INCLUDING 87 PHYSICIANS, FROM NORTHWEST OHIO AND SOUTHEAST MICHIGAN. ADDITIONALLY, PROMEDICA BOARD MEMBERS INCLUDED 186 WOMEN AND 71 RACIAL/ETHNIC MINORITIES.- BOARD MEMBERS ARE NOT COMPENSATED BY PROMEDICA FOR THEIR SERVICE TO OUR HOSPITALS AND OTHER BUSINESS UNITS; THEIR DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, ARE PERFORMED ON A VOLUNTEER BASIS. IN 2016, PROMEDICA BOARD MEMBERS GAVE APPROXIMATELY 28,000 HOURS IN SERVICE TO THE ORGANIZATION, WHICH EQUATES TO AN ESTIMATED CONTRIBUTION OF MORE THAN $3 MILLION TO OUR COMMUNITIES.- PROMEDICA'S MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITIES WHICH PROMEDICA SERVES. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MEETS THOSE QUALIFICATIONS MAY BE GRANTED PRIVILEGES.- IN 2016, PROMEDICA INVESTED SIGNIFICANT TIME AND FINANCIAL RESOURCES TO CONTINUE ROLLING OUT A NEW ELECTRONIC HEALTH RECORD (EHR), EPIC. GO-LIVES FOR HOSPITALS ACROSS THE SYSTEM TOOK PLACE IN MARCH, MAY AND NOVEMBER AND INCLUDED MORE THAN 350 PROMEDICA PHYSICIANS PROVIDERS ACROSS OHIO. THE SYSTEM'S REMAINING HOSPITALS AND PROVIDERS WILL GO-LIVE WITH EPIC IN THE SECOND QUARTER OF 2017. THIS NEW PLATFORM FURTHER ENABLES ONE PATIENT, ONE RECORD, AND ONE BILL FOR PATIENTS REGARDLESS OF SERVICE PROVIDED OR THE LOCATION OF SERVICE ACROSS PROMEDICA.- PROMEDICA PROVIDED MORE THAN 7,000 HEALTH SCREENINGS TO COMMUNITY MEMBERS THROUGHOUT 2016, INCLUDING BLOOD PRESSURE, BLOOD GLUCOSE AND BODY MASS INDEX SCREENINGS AT NUMEROUS HEALTH FAIRS AND SPORTING EVENTS. ADDITIONALLY, FREE SCREENING MAMMOGRAMS, AS WELL AS SKIN CANCER AND LUNG CANCER SCREENINGS AND COLORECTAL CANCER EDUCATION WERE PROVIDED FOR EARLY DETECTION. PROSTATE CANCER SCREENING EDUCATION AND NUTRITIONAL PROGRAMS WERE DEVELOPED TO KEEP PEOPLE HEALTHY.- PROMEDICA'S FOUNDATION RAISES FUNDS FOR PHILANTHROPY IN SUPPORT OF PROMEDICA'S MISSION TO IMPROVE HEALTH AND WELL-BEING. ANNUAL DONOR PROGRAMS, CAPITAL CAMPAIGNS, PLANNED GIVING, AND EVENT FUNDRAISING ACTIVITIES ARE CONDUCTED TO RAISE FUNDS THAT SUPPORT PATIENTS AND FAMILIES, AS WELL AS LOCAL COMMUNITIES, THROUGH HEALTH-RELATED PROGRAMS, SERVICES, EQUIPMENT, AND FACILITY CONSTRUCTION/RENOVATION THAT HAVE BEEN IDENTIFIED, IN PART, THROUGH A COMMUNITY NEEDS ASSESSMENT. |
| PART VI, LINE 6: | PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2016, PROMEDICA WAS COMPRISED OF MORE THAN 15,000 EMPLOYEES, APPROXIMATELY 2,700 VOLUNTEERS AND MORE THAN 2,300 HEALTHCARE PROVIDERS, INCLUDING APPROXIMATELY 900 PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP, WHO HAVE JOINED TOGETHER TO FORM A NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO HELP ENSURE AREA RESIDENTS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES.- PROMEDICA MEMBERS INCLUDE: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA BIXBY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC. D/B/A PROMEDICA HERRICK HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP, A NETWORK OF SYSTEM-EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION, WITH SERVICES SUCH AS SENIOR CARE, HOSPICE, REHABILITATION SERVICES, AND HOME CARE.- IN 2016, PROMEDICA MANAGED APPROXIMATELY 4.7 MILLION PATIENT ENCOUNTERS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF NEARLY $181 MILLION, WHICH INCLUDED FREE HEALTH SCREENINGS AND PARTICIPATION IN PUBLIC HEALTH FAIRS TO MEDICAL LECTURES AT AREA SENIOR CENTERS AND NUTRITION EDUCATION IN ELEMENTARY SCHOOLS, PLUS MUCH MORE.- IN ADDITION, THE PROMEDICA ADVOCACY FUND ASSISTED LOCAL NONPROFIT AGENCIES WITH SIMILAR MISSIONS THROUGH GRANTS TOTALING NEARLY $81,000. AS IN PRIOR YEARS, EMPHASIS WAS PLACED ON ORGANIZATIONS WORKING TO PROVIDE BASIC NEEDS SERVICES SUCH AS CLOTHING, SHELTER AND FOOD AS THESE ARE TIED CLOSELY TO PROMEDICA'S MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITIES IT SERVES.- A SECOND FOOD PHARMACY OPENED IN PROMEDICA'S NEW HEALTH AND WELLNESS CENTER, SERVING PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEM AND THEIR FAMILY FROM THIS LOCATION OR THE ORIGINAL FOOD PHARMACY LOCATED AT PROMEDICA'S CENTER FOR HEALTH SERVICES. AS PART OF THE PROGRAM, EACH PATIENT RECEIVES TWO TO THREE DAYS OF SUPPLEMENTAL FOOD FOR THEIR FAMILY. THROUGH DECEMBER 2016, MORE THAN 6,500 HOUSEHOLDS (2,700 UNIQUE HOUSEHOLDS) PARTICIPATED IN THE PROGRAM AND A TOTAL OF 18,700 PEOPLE WERE SERVED. THIS TRANSLATES TO ABOUT 46,800 DAYS' WORTH OF FOOD, THE EQUIVALENT OF 140,000 MEALS.- PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDES BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD. ALL PROMEDICA FOUNDATIONS COLLABORATED WITH AFFILIATE HARBOR BEHAVIORAL HEALTH TO SPONSOR A YEAR-LONG CAMPAIGN TO HELP RAISE AWARENESS ABOUT MENTAL ILLNESSES AND ASSOCIATED HEALTH ISSUES IMPACTING INDIVIDUALS AND FAMILIES ACROSS OUR REGION. THE UNMASKING MENTAL HEALTH INITIATIVE RAISED MORE THAN $1 MILLION TO SUPPORT MENTAL HEALTH PROGRAMS AND SERVICES IN THE COMMUNITIES WE SERVE.- WITH REGARD TO HEALTH PROFESSIONS EDUCATION, BIWEEKLY, MONTHLY AND ANNUAL PROGRAMS WERE OFFERED THROUGHOUT 2016 FOR CONTINUING MEDICAL EDUCATION CREDIT. MORE THAN 1,500 CREDIT HOURS OF PHYSICIAN EDUCATION WERE OFFERED TO EMPLOYED PROMEDICA PHYSICIANS AND MEDICAL STAFF MEMBERS AS WELL AS NURSES AND OTHER ALLIED HEALTH PROFESSIONALS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | |||||||
| 5855 MONROE ST | SYLVANIA | OH | 43560 | 341880767 | 501(C)(3) | $4,500,000 | OPERATING GRANT |
| PROMEDICA FOUNDATION | |||||||
| 2142 N COVE BLVD | TOLEDO | OH | 43606 | 341517672 | 501(C)(3) | $275,797 | OPERATING GRANT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ABDUL G ARSHAD MD FACS | ||||||||||||||
| TRUSTEE | $0 | $256,324 | $0 | $21,833 | $0 | $26,686 | $0 | $7,364 | $0 | $25,160 | $0 | $337,367 | $0 | $0 |
| JULIE K YAROCH DO | ||||||||||||||
| PRESIDENT, EX-OFFICIO | $0 | $245,821 | $0 | $74,753 | $0 | $1,370 | $0 | $20,303 | $0 | $13,247 | $0 | $355,494 | $0 | $0 |
| KEVIN C WEBB PHD | ||||||||||||||
| EX OFFICIO | $0 | $497,931 | $0 | $205,085 | $0 | $13,735 | $0 | $120,129 | $0 | $14,857 | $0 | $851,737 | $0 | $0 |
| SAMANTHA M MUCHA MD | ||||||||||||||
| TRUSTEE | $0 | $565,293 | $0 | $10,000 | $0 | $1,360 | $0 | $7,950 | $0 | $21,778 | $0 | $606,381 | $0 | $0 |
| STACEY L BOCK | ||||||||||||||
| TRUSTEE | $0 | $205,703 | $0 | $41,129 | $0 | $2,487 | $0 | $14,449 | $0 | $21,919 | $0 | $285,687 | $0 | $0 |
| VICTOR J CHERFAN DO | ||||||||||||||
| TRUSTEE | $0 | $369,284 | $0 | $171,705 | $0 | $17,630 | $0 | $5,418 | $0 | $26,977 | $0 | $591,014 | $0 | $0 |
| ALAN M SATTLER | ||||||||||||||
| TREASURER (THRU 2/16) | $0 | $453,183 | $0 | $182,107 | $0 | $5,772 | $0 | $53,128 | $0 | $23,550 | $0 | $717,740 | $0 | $0 |
| GARY AKENBERGER | ||||||||||||||
| INTERIM TREASURER (3/16 TO 7/16) | $0 | $334,448 | $0 | $103,978 | $0 | $22,790 | $0 | $70,694 | $0 | $21,859 | $0 | $553,769 | $0 | $0 |
| JEFFREY C KUHN | ||||||||||||||
| SECRETARY | $0 | $468,368 | $0 | $174,744 | $0 | $31,808 | $0 | $121,789 | $0 | $21,406 | $0 | $818,115 | $0 | $0 |
| MICHAEL P BROWNING | ||||||||||||||
| TREASURER | $0 | $212,431 | $0 | $75,000 | $0 | $9,093 | $0 | $0 | $0 | $4,420 | $0 | $300,944 | $0 | $0 |
| KATHRYN GREENLEE | ||||||||||||||
| VP CLINICAL SERVICES, LHA | $0 | $141,192 | $0 | $33,623 | $0 | $5,329 | $0 | $28,541 | $0 | $15,289 | $0 | $223,974 | $0 | $0 |
| KATHLEEN S HANLEY | ||||||||||||||
| FORMER OFFICER | $0 | $15,801 | $0 | $203,480 | $0 | $1,036,718 | $0 | $26,039 | $0 | $12,364 | $0 | $1,294,402 | $0 | $534,189 |
| TIMOTHY J JAKACKI | ||||||||||||||
| FORMER OFFICER | $0 | $125,466 | $0 | $42,877 | $0 | $229,860 | $0 | $7 | $0 | $16,065 | $0 | $414,275 | $0 | $231,852 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF HERRICK MEMORIAL HOSPITAL, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4A: | UNDER A VOLUNTARY TERMINATION AGREEMENT ENTERED INTO BY THE EMPLOYEE AND THE ORGANIZATION OR UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM PROMEDICA. SEVERANCE PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: KATHLEEN S. HANLEY $462,102 MARILYN MERKLE $47,083 TIMOTHY J. JAKACKI $231,852 PART I, LINE 4B: ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: KATHLEEN S. HANLEY $572,279 |
| PART I, LINE 6: | CERTAIN LISTED PERSONS RECEIVED INCENTIVES BASED ON INDIVIDUAL PRODUCTIVITY NET EARNINGS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART IV, LINE 24A: | HERRICK MEMORIAL HOSPITAL, INC. IS A HEALTH FACILITY THAT IS A SUBSIDIARY OF PROMEDICA HEALTH SYSTEM, INC. (PHS). HERRICK MEMORIAL HOSPITAL, INC. HOLDS AN INTERCOMPANY NOTE PAYABLE TO THE TOLEDO HOSPITAL, WHICH IS ALSO A SUBSIDIARY OF PHS. THE NOTE PAYABLE REPRESENTS HERRICK MEMORIAL HOSPITAL, INC.'S PORTION OF TAXABLE AND TAX-EXEMPT BONDS ISSUED BY PROMEDICA HEALTHCARE OBLIGATED GROUP. |
| FORM 990, PART VI, SECTION A, LINE 6 | AS A MICHIGAN NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF HERRICK MEMORIAL HOSPITAL, INC. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF HERRICK MEMORIAL HOSPITAL, INC., AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | UNDER THE GUIDANCE OF PROMEDICA HEALTH SYSTEM, INC.'S (PHS) TAX CONSULTANTS, FORM 990S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH AFFILIATE AND REVIEWED BY THE AFFILIATE'S FINANCE LEADERSHIP. AFTER AFFILIATE'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR PHS AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND ARE REVIEWED AND SIGNED BY A PRINCIPAL OFFICER PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER CERTIFICATION STATEMENT WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER CERTIFICATION STATEMENTS ARE COMPILED AND REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER CERTIFICATION STATEMENTS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO FILE THE CERTIFICATION STATEMENT, OR THE FILING OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES AND SPECIFICALLY IDENTIFIED HOURLY EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER FOR PROMEDICA PHYSICIAN GROUP (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PHYSICIANS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PHYSICIAN STANDARD OF CONDUCT AND THE PHYSICIAN CERTIFICATION STATEMENT WHICH THE NEW PHYSICIAN IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER OR THEIR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PHYSICIAN AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE APPROPRIATE PHYSICIAN BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PROMEDICA HEALTH SYSTEM, INC. WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. |
| FORM 990, PART VI, SECTION B, LINE 15 | HERRICK MEMORIAL HOSPITAL, INC.'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF HERRICK MEMORIAL HOSPITAL, INC.'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR. |
| FORM 990, PART VI, SECTION C, LINE 19 | PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | PENSION/POST-RETIREMENT EXPENSE ADJUSTMENT 97,249. BENEFICIAL INTEREST IN FOUNDATION -3,200,864. |
| FORM 990, PART III, LINE 4: | PROMEDICA HEALTH SYSTEM, INC. - PROGRAM SERVICE ACCOMPLISHMENTS ESTABLISHED IN 1986, PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN CUTTING-EDGE TECHNOLOGY, INNOVATIVE PROGRAMS AND FAMILY-CENTERED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF A PATIENT'S ABILITY TO PAY. BASED ON NEEDS THAT WE HAVE ASSESSED WITHIN THE COMMUNITIES WE SERVE, PROMEDICA LAUNCHED NEW SERVICES AND PROGRAMS IN 2016 TO HELP MEET THE GROWING DEMANDS OF LOCAL CONSUMERS ACROSS ALL SPECTRUMS OF LIFE, INCLUDING THOSE INDIVIDUALS WHO ARE OFTEN THE MOST VULNERABLE WHEN IT COMES TO HEALTH CARE: THE ELDERLY, POOR AND UNDERSERVED. PROMEDICA'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. THIS IS REFLECTED IN OUR FOUR CORE VALUES, INCLUDING: COMPASSION - WE TREAT OUR PATIENTS AND EACH OTHER WITH RESPECT, INTEGRITY AND DIGNITY; INNOVATION - WE CONTINUALLY SEARCH TO FIND A BETTER WAY FORWARD; TEAMWORK - WE PARTNER WITH OTHERS BECAUSE WE ARE BETTER TOGETHER THAN APART; AND EXCELLENCE - WE STRIVE TO BE THE BEST IN ALL WE DO. PROMEDICA AND ITS AFFILIATES COMPRISE 332 SITES, MORE THAN 2,300 PHYSICIANS AND APPROXIMATELY 15,000 EMPLOYEES AND VOLUNTEERS. DURING 2016, PROMEDICA DISCHARGED 73,502 INPATIENTS AND SERVED MORE THAN 1,327,996 OUTPATIENTS, WHILE HANDLING 317,795 EMERGENCY VISITS SYSTEM-WIDE. AMONG THE REGION'S LARGEST EMPLOYERS, PROMEDICA PLAYS A SIGNIFICANT ROLE IN ECONOMIC DEVELOPMENT AND STABILITY IN OUR REGION. DURING 2016, FOR EVERY ONE DOLLAR OF REVENUE, ANOTHER 27 CENTS WAS CREATED IN OUR SERVICE-AREA ECONOMY, WITH A TOTAL ECONOMIC OUTPUT OF $4.0 BILLION. WE ALSO CREATE A DIRECT ECONOMIC IMPACT WITH OUR REVENUE, PAYROLL AND EMPLOYMENT. ADDITIONALLY, SPENDING ON SERVICES AND MATERIALS WITH VENDORS IN OUR REGION CREATES AN INDIRECT ECONOMIC BENEFIT. OUR PHYSICIANS AND PROVIDERS, LEADERSHIP TEAM MEMBERS AND EMPLOYEES INDIVIDUALLY CONTRIBUTE PERSONAL RESOURCES TO THE COMMUNITY IN NUMEROUS WAYS - SUCH AS THROUGH TUTORING ELEMENTARY STUDENTS IN READING AND OTHER LIFE SKILLS, PROVIDING MONTHLY HEALTH LECTURES AT LOCAL SENIOR CENTERS, GENEROUSLY CONTRIBUTING TO COMMUNITY FUNDRAISING CAMPAIGNS SUCH AS UNITED WAY, PARTICIPATING IN MEDICAL MISSIONS, SERVING ON LOCAL NOT-FOR-PROFIT BOARDS, AND DONATING NONPERISHABLE GOODS TO NUMEROUS LOCAL FOOD PANTRIES AND CHURCHES - UNDERSCORING A KEY BENEFIT OF PROMEDICA BEING LOCALLY OWNED AND OPERATED. PROMEDICA'S MEMBER AND AFFILIATE HOSPITALS INCLUDE: THE TOLEDO HOSPITAL; TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF THE TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL); FLOWER HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION; DEFIANCE HOSPITAL, INC.; BAY PARK COMMUNITY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC.; EMMA L. BIXBY MEDICAL CENTER; MEMORIAL HOSPITAL; AND MERCY MEMORIAL HOSPITAL CORPORATION. IN 2016, PROMEDICA ALSO PROVIDED INTEGRATED SERVICES, COMPRISED OF: - PROMEDICA CONTINUING CARE SERVICES CORPORATION, PROVIDING REHABILITATION, HOSPICE, HOME CARE, AMBULATORY AND SENIOR SERVICES, COMMUNITY HEALTH, MEDICAL TRANSPORTATION SERVICES, AND CARE COORDINATION. - PROMEDICA PHYSICIAN GROUP (PROMEDICA PHYSICIANS), WITH APPROXIMATELY 900 HEALTHCARE PROVIDERS, INCLUDING PRIMARY CARE, OBSTETRICS AND SPECIALTY PHYSICIANS, AS WELL AS ADVANCED PRACTICE PROVIDERS. TOGETHER, THIS GROUP HELPS PROMEDICA BROADEN THE CARE WE OFFER TO AREA RESIDENTS, INCLUDING IN SMALLER, OUTLYING COMMUNITIES. - PROMEDICA INSURANCE CORPORATION, THE LARGEST HEALTH MAINTENANCE ORGANIZATION PHYSICALLY LOCATED IN NORTHWEST OHIO. IN 2016, PARAMOUNT ADVANTAGE PROVIDED MEDICAID COVERAGE TO MORE THAN 235,000 MEMBERS ACROSS ALL OF OHIO'S 88 COUNTIES. - PROMEDICA INDEMNITY CORPORATION, PROVIDING MEDICAL PROFESSIONAL AND COMPREHENSIVE GENERAL LIABILITY COVERAGE FOR PROMEDICA, INCLUDING IN OUTLYING AREAS WHERE PRIMARY-CARE PHYSICIAN RECRUITMENT IS DIFFICULT. - TWELVE CONTROLLED FOUNDATIONS THAT SERVE AS FUNDRAISING ENTITIES FOR THEIR RESPECTIVE HOSPITALS/BUSINESS UNITS AND FACILITIES, SUCH AS THE EBEID HOSPICE RESIDENCE ON THE FLOWER HOSPITAL CAMPUS AND THE MARY ELLEN FALZONE DIABETES CENTER ON THE CAMPUS OF THE TOLEDO HOSPITAL. PROMEDICA'S SPECIALIZED CARE INCLUDES ONCOLOGY, ORTHOPAEDICS, HEART AND VASCULAR, NEUROLOGY, REHABILITATIVE, AND BEHAVIORAL MEDICINE, AS WELL AS WOMEN'S AND PEDIATRIC CARE. A FUNDAMENTAL PART OF OUR MISSION IS THAT OUR SERVICES ARE TAILORED TO THE NEEDS OF OUR COMMUNITIES AND THEY ARE AVAILABLE TO EVERYONE IN OUR COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION TO BEING A STRONG ADVOCATE FOR THE HEALTH AND WELL-BEING OF OTHERS, PROMEDICA PROVIDES AND PROMOTES COMMUNITY WELLNESS, COLLABORATING WITH APPROXIMATELY 300 NONPROFIT AGENCIES AND ORGANIZATIONS ACROSS OUR REGION IN 2016 THAT HAD VALUES AND MISSIONS SIMILAR TO OUR OWN. PROMEDICA IS CONTINUALLY IMPROVING ITS SERVICES, FACILITIES, TECHNOLOGIES, AND OUTREACH EFFORTS TO MEET THE EVER-CHANGING NEEDS OF ITS DIVERSE POPULATIONS. IN DIRECT RESPONSE TO COMMUNITY NEEDS, A FEW EXAMPLES FROM 2016 INCLUDE THE FOLLOWING: - IN 2016, PROMEDICA WELCOMED ITS FIRST WAVE OF 30 MEDICAL RESIDENTS FROM THE UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE AND LIFE SCIENCES AS PART OF THE ACADEMIC AFFILIATION CREATED IN 2015. THE COLLABORATION WILL HELP ADVANCE MEDICAL EDUCATION AND CLINICAL RESEARCH IN NORTHWEST OHIO, BUILDING A LEGACY MODEL OF HEALTH CARE THAT WILL BENEFIT COMMUNITY MEMBERS ACROSS THE REGION FOR GENERATIONS TO COME. - PROMEDICA CONTINUED TO ROLL OUT ITS NEW ELECTRONIC HEALTH RECORD (EHR), EPIC. THE NOVEMBER GO-LIVE FOR PROMEDICA TOLEDO AND TOLEDO CHILDREN'S HOSPITALS, PROMEDICA BAY PARK HOSPITAL, AND MORE THAN 350 PROMEDICA PHYSICIANS PROVIDERS, WAS THE LARGEST TO DATE. ALSO ON THE NEW EPIC PLATFORM ARE PROMEDICA FLOWER, DEFIANCE REGIONAL, AND FOSTORIA COMMUNITY HOSPITALS AND AFFILIATED PROMEDICA PHYSICIANS PROVIDERS. THE SYSTEM'S REMAINING HOSPITALS AND PROVIDERS WILL GO-LIVE WITH EPIC IN THE SECOND QUARTER OF 2017. THE NEW PLATFORM FURTHER ENABLES ONE PATIENT, ONE RECORD, AND ONE BILL FOR PATIENTS REGARDLESS OF SERVICE PROVIDED OR THE LOCATION OF SERVICE ACROSS PROMEDICA. - PROMEDICA BROKE GROUND FOR CONSTRUCTION OF ITS NEW GENERATIONS BED TOWER ON THE CAMPUS OF PROMEDICA TOLEDO AND TOLEDO CHILDREN'S HOSPITALS. THE NEW FACILITY WILL BE 13 STORIES TALL WITH MORE 300 PATIENT BEDS AND WILL OFFER IMPROVED ACCESS FOR PATIENTS WHILE PROVIDING THE LATEST TECHNOLOGY AND PROCESSES TO ENSURE SAFE, HIGH QUALITY ENVIRONMENT FOR PATIENT CARE AND HEALING. UPON COMPLETION, THE GENERATIONS TOWER WILL REPLACE THE CURRENT LEGACY TOWER PORTION OF TOLEDO HOSPITAL. IT IS EXPECTED TO OPEN FOR PATIENT CARE BY THE END OF 2019. - PROMEDICA OPENED ITS NEW HEALTH AND WELLNESS CENTER, IN SYLVANIA, OHIO, TO PROVIDE CONVENIENT ACCESS TO MORE THAN 100 PRIMARY CARE AND SPECIALTY PROVIDERS AS WELL AS LABORATORY AND DIAGNOSTIC IMAGING SERVICES, FULL SERVICE PHARMACY, ENDOSCOPY CENTER, AN OPTICAL CENTER, AND MORE. THE CENTER WAS DESIGNED TO PROVIDE A FULL RANGE OF PATIENT CARE SERVICES IN A SINGLE, CONVENIENT LOCATION AND TO ENHANCE COLLABORATION AMONG PROVIDERS AND OTHER HEALTHCARE SERVICES. - PROMEDICA CANCER INSTITUTE AND THE CLEVELAND CLINIC CANCER CENTER ESTABLISHED A FORMAL ALLIANCE TO EXPAND ACCESS TO SPECIALIZED CANCER TREATMENTS, CLINICAL EXPERTISE, AND RESEARCH STUDIES FOR PATIENTS IN OUR REGION. THE NEW ALLIANCE ALSO INCLUDES A STREAMLINED REFERRAL PROCESS AND MAKES IT EASIER FOR PATIENTS TO OBTAIN SECOND OPINION CONSULTATIONS WITH A CLEVELAND CLINIC CANCER SPECIALIST. - PROMEDICA PARTNERED WITH STRATEGIC HEALTHCARE TO LAUNCH THE PROMEDICA VETERAN CONNECTION PROGRAM TO IMPROVE HEALTHCARE ACCESS FOR LOCAL VETERANS WHO HAVE SUFFERED SERVICE-RELATED INJURIES. THE PROGRAM ALLOWS VETERANS, WHO PREVIOUSLY HAD TO TRAVEL TO VETERAN'S ADMINISTRATION (VA) MEDICAL CENTERS, TO RECEIVE TREATMENT FROM PROMEDICA PROVIDERS AND FACILITIES UPON MEETING CERTAIN PROGRAM GUIDELINES AND RECEIVING PRE-AUTHORIZATIONS FROM THE VA. - PROMEDICA OPENED ADDITIONAL URGENT CARE CENTERS IN THE METRO-TOLEDO AREA, TO SERVE PATIENTS WHO HAVE MEDICAL CONCERNS THAT DO NOT REQUIRE AN EMERGENCY CENTER. A TOTAL OF FIVE URGENT CARE CENTERS ARE NOW OPEN 10 A.M. TO 10 P.M., 365 DAYS PER YEAR, AND ARE STAFFED BY HIGHLY-TRAINED CERTIFIED NURSE PRACTITIONERS. |
| - PROMEDICA PHYSICIANS EXPANDED CARE TO BETTER COVER LOCAL AND RURAL | COMMUNITIES, ADDING ABOUT 135 NEW PRIMARY CARE PHYSICIANS, SPECIALISTS AND ADVANCED PRACTICE PROVIDERS IN 2016. - PROMEDICA PARTICIPATED IN DOZENS OF COMMUNITY HEALTH FAIRS THAT INCLUDED MORE THAN 7,000 FREE PUBLIC SCREENINGS FOR HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, BODY MASS INDEX AND BONE DENSITY. - A NEW COLLABORATION BETWEEN PROMEDICA PHYSICIANS CARDIOLOGISTS AND HEMATOLOGISTS/ONCOLOGISTS BROUGHT A NEW SERVICE TO PROMEDICA CANCER INSTITUTE PATIENTS AT RISK FOR HEART DAMAGE. LOCATED AT FLOWER HOSPITAL, THE CLINIC SEES CANCER PATIENTS WITH A HISTORY OF HEART DISEASE, AND PATIENTS WHO DEVELOP HEART COMPLICATIONS DURING TREATMENT. IT IS ESTIMATED THAT NEARLY ONE THIRD OF CANCER PATIENTS EXPERIENCE LONG-LASTING HEART DAMAGE AS A RESULT OF THEIR TREATMENT. - AS PART OF ITS HUNGER-FREE INITIATIVE, PROMEDICA CONTINUED TO IMPLEMENT A FOOD RECLAMATION PROGRAM. MORE THAN 315,000 POUNDS OF FOOD HAVE BEEN RECLAIMED FROM PARTNERS SUCH AS HOLLYWOOD CASINO, TOLEDO HOSPITAL, AND FLOWER HOSPITAL SINCE THE PROGRAM STARTED IN 2013. THE FOOD IS DISTRIBUTED DIRECTLY TO COMMUNITY ORGANIZATIONS THAT PROVIDE MEALS FOR THOSE IN NEED. - PROMEDICA CANCER INSTITUTE'S (PCI) COMMUNITY OUTREACH INCLUDED CANCER SCREENINGS AND EDUCATION TO THE MOST VULNERABLE IN OUR COMMUNITY. FREE SCREENING MAMMOGRAMS, AS WELL AS SKIN CANCER AND LUNG CANCER SCREENINGS WERE PROVIDED FOR EARLY DETECTION. PROSTATE CANCER SCREENING, COLORECTAL CANCER EDUCATION, AND NUTRITIONAL PROGRAMS WERE DEVELOPED TO KEEP PEOPLE HEALTHY. PCI ALSO HOSTED ANNUAL CANCER SURVIVOR CELEBRATIONS FOR SURVIVORS, FRIENDS AND CAREGIVERS ACROSS THE REGION AND SPONSORED COMMUNITY EVENTS INCLUDING THE ANNUAL NW OHIO SUSAN G. KOMEN, RACE FOR THE CURE AND AMERICAN CANCER SOCIETY RELAY FOR LIFE IN LUCAS COUNTY. - A SECOND FOOD PHARMACY OPENED IN PROMEDICA'S NEW HEALTH AND WELLNESS CENTER, SERVING PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEM AND THEIR FAMILY FROM THIS LOCATION OR THE ORIGINAL FOOD PHARMACY LOCATED AT PROMEDICA'S CENTER FOR HEALTH SERVICES. AS PART OF THE PROGRAM, EACH PATIENT RECEIVES TWO TO THREE DAYS OF SUPPLEMENTAL FOOD FOR THEIR FAMILY. THROUGH DECEMBER 2016, MORE THAN 6,500 HOUSEHOLDS (2,700 UNIQUE HOUSEHOLDS) PARTICIPATED IN THE PROGRAM AND A TOTAL OF 18,700 PEOPLE WERE SERVED. THIS TRANSLATES TO ABOUT 46,800 DAYS' WORTH OF FOOD, THE EQUIVALENT OF 140,000 MEALS. - PROMEDICA LAUNCHED AN EMPLOYEE FOOD ASSISTANCE PROGRAM IN 2016 THAT IS AVAILABLE AT EACH HOSPITAL SYSTEM-WIDE. IT ALLOWS PROMEDICA EMPLOYEES WHO NEED ASSISTANCE TO RECEIVE A BAG OF FOOD ONCE PER MONTH. IN THE FIRST SIX MONTHS, MORE THAN 650 EMPLOYEES WERE ABLE TO PARTICIPATE IN THIS PROGRAM. - THROUGH ITS ADVOCACY FUND, PROMEDICA CONTINUED TO SUPPORT LOCAL COMMUNITY ORGANIZATIONS THAT PROVIDE ASSISTANCE TO THOSE IN NEED WITH BASIC NECESSITIES THAT DIRECTLY IMPACT INDIVIDUALS' HEALTH AND WELL-BEING. THIS SUPPORT AMOUNTED TO GRANTS TOTALING MORE THAN $81,000 IN 2016. - PROMEDICA'S SUMMER YOUTH EMPLOYMENT PROGRAM PARTNERED 71 CENTRAL-CITY TEENS AGES 16 - 19 WITH MENTORS IN DEPARTMENTS SUCH AS HUMAN RESOURCES, RADIOLOGY, DIETARY, AND INFORMATION TECHNOLOGY TO LEARN SKILLS INCLUDING CUSTOMER SERVICE, PUNCTUALITY AND BEING ACCOUNTABLE TO OTHERS. - TO HELP MEET THE NEED FOR SCHOOL NURSES IN THE TOLEDO PUBLIC SCHOOL SYSTEM (TPS), PROMEDICA IS FUNDING NINE ADDITIONAL SCHOOL NURSES, ENABLING ALL TPS ELEMENTARY SCHOOLS TO HAVE A FULL-TIME SCHOOL NURSE. STUDIES HAVE SHOWN THAT FULL-TIME NURSES IN PUBLIC SCHOOLS CAN HAVE A POSITIVE IMPACT ON HEALTH AND STRONG ACADEMIC OUTCOMES. PROMEDICA AND TPS CONTINUE TO TRACK AND EVALUATE STUDENT HEALTH STATISTICS TO DEVELOP A SUSTAINABILITY PLAN AND SUPPORT ONGOING FUNDING FOR THE PROGRAM. - POSITIONED TO BE A REGIONAL LEADER IN RESEARCH AND INNOVATIONS, PROMEDICA PARTICIPATED IN MORE THAN 220 INDUSTRY-SPONSORED CLINICAL RESEARCH TRIALS AS WELL AS APPROXIMATELY 100 INTERNAL RESEARCH PROJECTS CONDUCTED BY PHYSICIANS, NURSES AND OTHER HEALTH PROFESSIONALS. - ADDITIONALLY, PROMEDICA INNOVATION'S BUSINESS INCUBATOR ALLOWS CLIENT COMPANIES IN THE HEALTHCARE FIELD TO ACCELERATE DEVELOPMENT AND COMMERCIALIZATION OF MEDICAL DEVICES AND HEALTH INFORMATION TECHNOLOGY TO IMPROVE PATIENT CARE LOCALLY AND NATIONALLY. - FLOWER HOSPITAL EXPANDED ITS DIAGNOSTIC IMAGING CAPABILITIES BY INSTALLING A 64-SLICE CT SCANNER THAT WILL IMPROVE IMAGE QUALITY AND THE ADDITION OF A SECOND SCANNER IN 2017 WILL PROVIDE EXPANDED AND MORE EFFICIENT PATIENT CARE AND SERVICE. - THE DOROTHY L. KERN CANCER CENTER OPENED NEAR THE CAMPUS OF PROMEDICA MEMORIAL HOSPITAL, EXPANDING CANCER CARE TO PATIENTS IN THE FREMONT, OHIO, AREA. THE CANCER CENTER OFFERS OUTPATIENT RADIATION, CHEMOTHERAPY, AND INFUSION SERVICES AS WELL AS COMPLEMENTARY SERVICES SUCH AS GENETIC TESTING AND COUNSELING, HEALING CARE, AND SURVIVORSHIP CARE PLANNING. - PROMEDICA BECAME A MAJOR SPONSOR OF THE LUCAS COUNTY TRANSPORTATION PROGRAM THAT HELPS INDIVIDUALS WHO NEED A RIDE TO WORK SO THEY CAN REMAIN EMPLOYED AND ULTIMATELY SECURE THEIR OWN TRANSPORTATION. IN 2016, PROMEDICA CONTRIBUTED $181,263,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THESE NUMBERS NOT ONLY INDICATE PROMEDICA'S LONG-STANDING COMMITMENT TO THE COMMUNITY, BUT ALSO FULFILL OUR NOT-FOR-PROFIT STATUS BY IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS IN THE COMMUNITIES WE SERVE. SPECIFICALLY, THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, PROMEDICA CONTRIBUTED $53,649,000 IN 2016. THESE PROGRAMS INCLUDED FREE COMMUNITY HEALTH SCREENINGS, SUCH AS DIABETES TESTING, BLOOD PRESSURE, BONE DENSITY, BODY MASS, AND CANCER CHECKUPS; MAMMOGRAM SCREENINGS FOR LOW-INCOME AND UNINSURED WOMEN; CHILDHOOD IMMUNIZATIONS; REDUCED-COST SCHOOL-ATHLETIC PHYSICALS; FIRST-AID COVERAGE AT COMMUNITY EVENTS; VOLUNTEER ELEMENTARY SCHOOL MENTORS; PUBLIC HEALTH EDUCATION LECTURES AND SEMINARS; A CHILDHOOD OBESITY PROGRAM; AND MANY OTHER COMMUNITY-BASED INITIATIVES. PROMEDICA ALSO CONTRIBUTED $11,711,000 IN FINANCIAL ASSISTANCE FOR PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. THIS AMOUNT REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. IN ADDITION, PROMEDICA'S COST OF BAD DEBT FOR 2016 WAS $27,877,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $181,263,000 NOTED ABOVE. FURTHER, PROMEDICA CONTINUES TO BE A LEADING PARTICIPANT IN THE LUCAS COUNTY CARENET INITIATIVE - A COLLABORATIVE EFFORT AMONG PROMEDICA, MERCY HEALTH PARTNERS, THE UNIVERSITY OF TOLEDO MEDICAL CENTER, THE CITY OF TOLEDO, AND OTHERS. CARENET WAS CREATED TO PROVIDE FREE OR LOWER-COST HEALTH CARE FOR LOW-INCOME LUCAS COUNTY RESIDENTS. ESTABLISHED IN 2003, CARENET BRIDGES THE GAP BETWEEN ADULTS WITHOUT HEALTH INSURANCE AND NEEDED HEALTHCARE SERVICES. WHILE SOME INDIVIDUALS MAY QUALIFY FOR GOVERNMENTAL INSURANCE PROGRAMS SUCH AS MEDICAID, OTHERS DO NOT; IT IS FOR THESE INDIVIDUALS THAT CARENET WAS ESTABLISHED. |
| ADDITIONALLY DURING 2016, PROMEDICA PROVIDED $115,903,000 OF COMMUNITY | BENEFIT THROUGH THE COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. PROMEDICA'S TOTAL COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS DURING 2016 WAS $152,400,000 AND IS NOT REFLECTED IN THE COMMUNITY BENEFIT AMOUNT OF $181,263,000 NOTED ABOVE. INDEED, PROMEDICA GOES BEYOND INDUSTRY STANDARDS IN MEETING THE GOAL OF PROVIDING CARE TO EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE HOSPITAL CARE FREE-OF-CHARGE TO ALL FAMILIES WITHOUT INSURANCE WITH INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO FREE CARE FOR THOSE FAMILIES UNDER THIS FEDERAL POVERTY LEVEL, PROMEDICA HOSPITALS PROVIDE SIGNIFICANT DISCOUNTS TO FAMILIES WITH INCOMES OF UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN MANY SITUATIONS, OTHER FUNDING SOURCES ARE SECURED AND ACCOMMODATIONS MADE. PROMEDICA'S POLICIES ARE POSTED AND AVAILABLE IN WRITING IN ALL PROMEDICA FACILITIES. ALSO, FINANCIAL ADVOCATES ARE AVAILABLE TO HELP PATIENTS BY EXPLAINING OUR FREE CARE AND DISCOUNT PROGRAMS, AND TO ASSIST WITH THE PAPERWORK NECESSARY TO QUALIFY FOR GOVERNMENT FUNDING. PATIENT BILLS PROVIDE CLEAR EXPLANATIONS, QUALIFICATIONS AND REMINDERS OF THESE PROGRAMS. IN SUMMARY, PROMEDICA DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. |
| HERRICK MEMORIAL HOSPITAL, INC. - PROGRAM SERVICE ACCOMPLISHMENTS | HERRICK MEMORIAL HOSPITAL, INC. (D/B/A PROMEDICA HERRICK HOSPITAL) IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN, AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. PROMEDICA HERRICK HOSPITAL (HH) IS A 25-BED, GENERAL ACUTE CARE HOSPITAL WITH A 10-BED, DISTINCT PART PSYCHIATRIC UNIT. THE FACILITY IS A CRITICAL ACCESS HOSPITAL, PROVIDING HEALTHCARE SERVICES TO RESIDENTS IN TECUMSEH, MICHIGAN, WHICH IS ACCREDITED BY HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP). A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES AT HH INCLUDE GENERAL SURGERY, CARDIOLOGY, GYNECOLOGY, NEUROLOGY, BEHAVIORAL MEDICINE, ONCOLOGY, ORTHOPAEDICS, RESPIRATORY CARE, FAMILY MEDICINE, INTERNAL MEDICINE, UROLOGY, AND VASCULAR CARE AS WELL AS A SLEEP DISORDERS CENTER WHICH IS ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE (AASM) FOR MEETING SPECIFIC AASM STANDARDS AND GUIDELINES IN THE DIAGNOSIS AND TREATMENT OF SLEEP DISORDERS. IN ADDITION, HH OFFERS EMERGENCY MEDICINE SERVICES AND IS ACCREDITED AS A PRIMARY STROKE CARE CENTER BY HFAP. ADDITIONALLY, HH PLAYS A KEY ROLE PROMOTING THE HEALTH AND WELL-BEING OF COMMUNITY MEMBERS THROUGH VARIOUS WELLNESS CLINICS AND OUTREACH SERVICES. FOR EXAMPLE, HH PROVIDES A COMPREHENSIVE WOMEN'S HEALTH CENTER THAT OFFERS SPECIALIZED SERVICES FOR WOMEN, INCLUDING DIGITAL MAMMOGRAPHY, STEREOTACTIC BREAST BIOPSY AND BREAST CANCER SURGERY, BONE DENSITY SCANS, HEART AND VASCULAR HEALTH SERVICES, A MIDLIFE WOMEN'S CLINIC AND SPECIALIZED SUPPORT GROUPS FOR WOMEN. EDUCATION RELATED TO HEART HEALTH AND STROKE PREVENTION ARE PROVIDED TO THE COMMUNITY AS WELL. HH HAS SERVED THE COMMUNITY FOR NEARLY 70 YEARS, AND TODAY HAS MORE THAN 95 ACTIVE PHYSICIANS WORKING TO MEET THE COMMUNITY'S HEALTHCARE NEEDS. HERRICK MANOR, LOCATED ADJACENT TO HH, IS A 25-BED FACILITY OFFERING LONG-TERM CARE SERVICES; RESIDENTS RECEIVE AROUND-THE-CLOCK NURSING CARE ALONG WITH SCHEDULED ACTIVITIES. IN 2016, HERRICK MANOR LOGGED 5,904 LONG-TERM CARE DAYS. IN 2016, HH SERVED 547 INPATIENTS; 28,072 OUTPATIENTS; AND 11,596 EMERGENCY CENTER PATIENTS. HH CONTRIBUTED $3,297,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, SUBSIDIZED HEALTH SERVICES, AND OTHER COMMUNITY BENEFIT OPERATIONS, HH CONTRIBUTED $433,000 TO THE COMMUNITY DURING 2016. BELOW IS A SAMPLING OF SERVICES THAT HH OFFERED TO MEET LOCAL HEALTHCARE NEEDS, WHICH ARE INCLUDED IN THIS COMMUNITY BENEFIT AMOUNT: - HH PROVIDED SELF-HELP PROGRAMS TO THE COMMUNITY, INCLUDING STRESS MANAGEMENT AND SMOKING CESSATION PROGRAMS. - COMMUNITY HEALTH AND WELLNESS EFFORTS INCLUDED PRENATAL AND FAMILY-PLANNING CLASSES, SCHOOL NURSING PROGRAMS, NUTRITION AND FITNESS CLASSES, AND CPR TRAINING. - HH PARTICIPATED WITH JACKSON COLLEGE TO OFFER NURSING, ECHOCARDIOGRAPHY AND CARDIOLOGY CLINICAL ROTATIONS. - HH OFFERED IMMUNIZATIONS, ASTHMA CARE, INDIGENT AND SENIOR HEALTH FAIRS, AS WELL AS FREE HEALTH SCREENINGS AT LOCAL SENIOR CENTERS, WHICH INCLUDED BLOOD PRESSURE, CHOLESTEROL, BODY MASS INDEX, AND DIABETES CHECKS. ADDITIONALLY, HH PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2016, OF WHICH $41,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. HH'S COST OF BAD DEBT FOR 2016 WAS $660,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $3,297,000 NOTED ABOVE. FURTHER, HH PROVIDED $2,823,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS - TESTED PATIENTS. ALSO IN 2016, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $376,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $3,297,000 NOTED ABOVE. DURING 2016, HH PROVIDED 192 JOBS AND EXPENDED $7,139,000 IN NET PAYROLL. A TOTAL OF $325,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, HH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. |
| COMMUNITY BENEFIT DEFINITIONS | PROMEDICA HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES (PROMEDICA) PREPARES ITS COMMUNITY BENEFIT REPORTS CONSISTENT WITH GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES AND CONSISTENT WITH FORM 990, SCHEDULE H, HOSPITALS, REPORTING. COMMUNITY BENEFITS ARE PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFITS REPORTED BY PROMEDICA RESPOND TO IDENTIFIED COMMUNITY NEEDS AND MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: - IMPROVE ACCESS TO HEALTHCARE SERVICE. - ENHANCE THE HEALTH OF THE COMMUNITY. - ADVANCE HEALTHCARE KNOWLEDGE. - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. FINANCIAL ASSISTANCE CONSISTENT WITH ITS MISSION, PROMEDICA PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY THEIR BILL. PROMEDICA HOSPITALS PROVIDE FREE CARE TO THOSE UNINSURED PATIENTS WITH INCOMES UP TO 200% OF THE FEDERAL POVERTY LEVEL. SIGNIFICANT DISCOUNTS ARE ALSO PROVIDED ON A SLIDING SCALE TO UNINSURED PATIENTS UP TO 400% OF THE FEDERAL POVERTY LEVEL. FINANCIAL ASSISTANCE IS REPORTED IN THE FORM OF COST TO PROVIDE SERVICES AND HAS BEEN REDUCED TO REFLECT REIMBURSEMENT RECEIVED FROM STATE PROGRAMS DESIGNED TO RELIEVE THE BURDEN OF PROVIDING FINANCIAL ASSISTANCE. THE COST OF FINANCIAL ASSISTANCE DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS THAT DO NOT PAY THEIR BILL. GOVERNMENT-SPONSORED HEALTH CARE GOVERNMENT-SPONSORED HEALTH CARE INCLUDE SERVICES THAT ARE REIMBURSED OR PARTIALLY REIMBURSED THROUGH GOVERNMENT MEANS-TESTED PROGRAMS SUCH AS MEDICAID. PROMEDICA INCLUDES THE UNPAID COSTS OF THESE PUBLIC PROGRAMS TO THE EXTENT THAT PAYMENTS RECEIVED ARE LESS THAN THE COSTS OF PROVIDING SERVICES. THE UNPAID COSTS OF TREATING MEDICARE PATIENTS IS REPORTED SEPARATELY AND IS NOT INCLUDED IN PROMEDICA'S COMMUNITY BENEFIT REPORT. ADDITIONALLY, THE COST OF FINANCIAL ASSISTANCE HAS BEEN ELIMINATED FROM ANY AMOUNTS REPORTED IN THIS CATEGORY. COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE ACTIVITIES CARRIED OUT FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH. THESE ACTIVITIES GENERALLY DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS AS THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND ARE SUBSIDIZED BY PROMEDICA. COMMUNITY BENEFIT OPERATIONS INCLUDE COSTS ASSOCIATED WITH DEDICATED STAFF, COMMUNITY HEALTH NEED AND/OR ASSESSMENT, AND OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT PLANNING AND ADMINISTRATION. HEALTH PROFESSIONS EDUCATION HEALTH PROFESSIONS EDUCATION INCLUDE COSTS FOR ALL EDUCATIONAL PROGRAMS PROMEDICA IS INVOLVED WITH, THE PROVISION OF A CLINICAL SETTING FOR TRAINING FOR HEALTHCARE STUDENTS OUTSIDE THE ORGANIZATION, AND FUNDING FOR HEALTHCARE EDUCATION. SUBSIDIZED HEALTH SERVICES SUBSIDIZED HEALTH SERVICES ARE SERVICES PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS. THESE SERVICES GENERATE A BILL FOR REIMBURSEMENT, AND INCLUDE CLINICAL PATIENT CARE SERVICES THAT ARE PROVIDED BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND OTHER PROVIDERS ARE UNWILLING, OR UNABLE, TO PROVIDE THE SERVICES, OR THE SERVICES OTHERWISE WOULD NOT BE AVAILABLE TO MEET COMMUNITY NEEDS. RESEARCH RESEARCH ACTIVITIES INCLUDE CLINICAL AND COMMUNITY HEALTH RESEARCH, AS WELL AS STUDIES ON HEALTHCARE DELIVERY. THE AMOUNT REPORTED FOR PROMEDICA IS REDUCED BY ANY EXTERNAL SUBSIDIES, SUCH AS GRANTS. CASH AND IN-KIND CONTRIBUTIONS CASH AND IN-KIND CONTRIBUTIONS INCLUDE FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY ORGANIZATIONS AND THE COMMUNITY AT LARGE. IN-KIND SERVICES INCLUDE HOURS DONATED BY STAFF FOR COMMUNITY NEEDS WHILE ON WORK TIME; AS WELL AS DONATIONS OF FOOD, EQUIPMENT AND SUPPLIES. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (24 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| COBRA VENTURES LLC | |||||||||
| 5901 MONCLOVA RD | MAUMEE | OH | 43537 | 204671613 | LAND LEASING | OH | $642,604 | $736,960 | ST LUKE'S HOSPITAL FOUNDATION |
| MIDWEST CARDIOVASCULAR CONSULTANTS LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 611448753 | EMPLOYS PHYSICIANS | OH | $0 | $535,504 | PROMEDICA PHYSICIAN GROUP |
| PROMEDICA CENTRAL PHYSICIANS LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341881137 | EMPLOYS PHYSICIANS | OH | $301,674,026 | $170,974,642 | PROMEDICA PHYSICIAN GROUP |
| PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 263888045 | EMPLOYS PHYSICIANS | OH | $17,511,703 | -$83,313,139 | PROMEDICA PHYSICIAN GROUP |
| WELLCARE PHYSICIANS LLC | |||||||||
| 5901 MONCLOVA RD | MAUMEE | OH | 43537 | 611528443 | EMPLOYS PHYSICIANS | OH | -$2,244,991 | $8,156,765 | PROMEDICA PHYSICIAN GROUP |
| THE PHARMACY COUNTER LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 271325141 | MEDICAL EQUIPMENT & PHARMACY | OH | $66,763,882 | $19,351,361 | PROMEDICA PHYSICIAN GROUP |
| WOLF CREEK ASSOCIATES LLC | |||||||||
| 901 KIMOLE LN | ADRIAN | MI | 49221 | 383164818 | FACILITY LEASING | MI | $122,499 | $1,417,049 | EMMA L BIXBY MEDICAL CENTER |
| PROMEDICA MONROE CARDIOLOGY PLLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 272920342 | EMPLOYS PHYSICIANS | MI | $1,277,701 | -$5,105,886 | PROMEDICA PHYSICIAN GROUP |
| ERIE WEST HOSPICE & PALLIATIVE CARE LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 205752995 | PROVIDES HOSPICE CARE | OH | $5,923,484 | $12,156,148 | PROMEDICA PHYSICIANS AND CONTINUUM SERVICES |
| PROMEDICA PHYSICIANS MANAGEMENT SERVICES LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 453230331 | PRACTICE MANAGEMENT | OH | $0 | -$3,066,916 | PROMEDICA PHYSICIAN GROUP |
| PROMEDICA SURGICAL SERVICES LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | EMPLOYS PHYSICIANS | OH | $0 | $0 | PROMEDICA PHYSICIAN GROUP | |
| MISSION POINTE GOLF COURSE LLC | |||||||||
| 2142 NORTH COVE | TOLEDO | OH | 43606 | GOLF COURSE | OH | $0 | $392,583 | PROMEDICA FOUNDATION | |
| PROMEDICA INNOVATIONS LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | INVESTMENT COMPANY | OH | $0 | $0 | PROMEDICA HEALTH SYSTEM INC | |
| PROMEDICA GENITO-URINARY SURGEONS LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 461120436 | EMPLOYS PHYSICIANS | OH | $6,790,554 | -$22,865,233 | PROMEDICA PHYSICIAN GROUP |
| PROMEDICA MONROE PHYSICIANS PLLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 461111822 | EMPLOYS PHYSICIANS | MI | -$529 | -$423,769 | PROMEDICA PHYSICIAN GROUP |
| PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 454976786 | EMPLOYS PHYSICIANS | OH | $0 | $159,482 | PROMEDICA PHYSICIAN GROUP |
| PROMEDICA HOSPITALISTS LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | EMPLOYS PHYSICIANS | OH | $0 | $0 | PROMEDICA PHYSICIAN GROUP | |
| PROMEDICA HOSPITALISTS PLLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | EMPLOYS PHYSICIANS | MI | $0 | $0 | PROMEDICA PHYSICIAN GROUP | |
| MEMORIAL ANESTHESIA LTD | |||||||||
| 715 SOUTH TAFT AVE | FREMONT | OH | 43420 | 205763680 | EMPLOYS PHYSICIANS | OH | $0 | $0 | PROMEDICA PHYSICIAN GROUP |
| MEMORIAL PROFESSIONAL SERVICES LTD | |||||||||
| 715 SOUTH TAFT AVE | FREMONT | OH | 43420 | 273763993 | EMPLOYS PHYSICIANS | OH | $8,167,211 | -$4,298,164 | PROMEDICA PHYSICIAN GROUP |
| PHS VENTURES LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341880473 | HEALTH CARE MANAGEMENT SERVICES | DE | $0 | $0 | PROMEDICA HEALTH SYSTEM INC |
| 300 MADISON BUILDING LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 822062486 | REAL ESTATE | OH | $939,747 | $15,910,656 | PROMEDICA HEALTH SYSTEM INC |
| FORT INDUSTRY SQUARE LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | REAL ESTATE | OH | $96,489 | $3,014,067 | PROMEDICA HEALTH SYSTEM INC | |
| MARINA DISTRICT DEVELOPMENT LLC | |||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | REAL ESTATE | OH | $0 | $3,915,257 | PROMEDICA HEALTH SYSTEM INC | |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BAY PARK COMMUNITY HOSPITAL | |||||||||||
| 2801 BAY PARK DR | OREGON | OH | 43616 | 341883132 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| CARE ENTERPRISES INC | |||||||||||
| 5901 MONCLOVA RD | MAUMEE | OH | 43537 | 341366709 | FACILITY LEASING | OH | 501(C)(3) | 12B, II | Yes (1) | N/A | |
| DEFIANCE HOSPITAL AUXILIARY | |||||||||||
| 1200 RALSTON | DEFIANCE | OH | 43512 | 510173779 | HOSPITAL / FOUNDATION SUPPORT | OH | 501(C)(3) | 12D, III-O | DEFIANCE HOSPITAL INC | Yes (1) | |
| DEFIANCE HOSPITAL INC | |||||||||||
| 1200 RALSTON | DEFIANCE | OH | 43512 | 344446484 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| EMMA L BIXBY MEDICAL CENTER | |||||||||||
| 818 RIVERSIDE AVE | ADRIAN | MI | 49221 | 382796005 | HOSPITAL | MI | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| EMMA L BIXBY MEDICAL CENTER AUXILIARY | |||||||||||
| 818 RIVERSIDE AVE | ADRIAN | MI | 49221 | 382149602 | HOSPITAL / FOUNDATION SUPPORT | MI | 501(C)(3) | 12B, II | EMMA L BIXBY MEDICAL CENTER | Yes (1) | |
| FLOWER HOSPITAL | |||||||||||
| 5200 HARROUN RD | SYLVANIA | OH | 43560 | 344428794 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| FOSTORIA HOSPITAL ASSOCIATION | |||||||||||
| 501 VAN BUREN STREET | FOSTORIA | OH | 44830 | 340898745 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| FOSTORIA HOSPITAL AUXILIARY | |||||||||||
| PO BOX 907 | FOSTORIA | OH | 44830 | 346517634 | HOSPITAL / FOUNDATION SUPPORT | OH | 501(C)(3) | 12A, I | FOSTORIA HOSPITAL ASSOCIATION | Yes (1) | |
| HERRICK MEDICAL CENTER AUXILIARY | |||||||||||
| 500 E POTTAWATAMIE ST | TECUMSEH | MI | 49286 | 383076105 | HOSPITAL / FOUNDATION SUPPORT | MI | 501(C)(3) | 12B, II | HERRICK MEMORIAL HOSPITAL INC | Yes (1) | |
| LENAWEE LONG TERM CARE | |||||||||||
| 700 LAKESHIRE TR | ADRIAN | MI | 49221 | 382879330 | LONG TERM CARE | MI | 501(C)(3) | 10 | EMMA L BIXBY MEDICAL CENTER | Yes (1) | |
| PROMEDICA CONTINUING CARE SERVICES CORP | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 344492440 | LONG TERM AND HOME HEALTH CARE | OH | 501(C)(3) | 10 | PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | Yes (1) | |
| PROMEDICA COURIER SERVICES INC | |||||||||||
| 3170 W CENTRAL AVE | TOLEDO | OH | 43606 | 260324790 | COURIER SERVICE | OH | 501(C)(3) | 12B, II | PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | Yes (1) | |
| PROMEDICA HEALTH SYSTEM INC | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341517671 | PARENT COMPANY OF HEALTH SYSTEM | OH | 501(C)(3) | 12B, II | 0 | N/A | |
| PROMEDICA INDEMNITY CORP | |||||||||||
| ONE CHURCH ST 5TH FLOOR | BURLINGTON | VT | 05401 | 341931936 | PROFESSIONAL & GENERAL LIABILITY | VT | 501(C)(3) | 12B, II | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341880767 | PHYSICIAN MANAGEMENT SERVICES | OH | 501(C)(3) | 12B, II | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| PROMEDICA PHYSICIAN GROUP | |||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 341899439 | PHYSICIAN HEALTH CARE SERVICES | OH | 501(C)(3) | 10 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| ST LUKE'S HOSPITAL | |||||||||||
| 5901 MONCLOVA RD | MAUMEE | OH | 43537 | 344428232 | HOSPITAL | OH | 501(C)(3) | 3 | Yes (1) | N/A | |
| ST LUKE'S HOSPITAL FOUNDATION | |||||||||||
| 5901 MONCLOVA RD | MAUMEE | OH | 43537 | 341292849 | FOUNDATION | OH | 501(C)(3) | 12B, II | Yes (1) | N/A | |
| PROMEDICA FOUNDATION | |||||||||||
| 444 N SUMMIT ST | TOLEDO | OH | 43604 | 341517672 | FOUNDATION | OH | 501(C)(3) | 12B, II | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| THE TOLEDO HOSPITAL | |||||||||||
| 2142 N COVE BLVD | TOLEDO | OH | 43606 | 344428256 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| TOLEDO DISTRICT NURSE ASSOCIATION | |||||||||||
| 1946 N 13TH STREET | TOLEDO | OH | 43624 | 344427949 | SKILLED HOME CARE | OH | 501(C)(3) | 10 | PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | Yes (1) | |
| VISITING NURSE HOSPICE AND HEALTH CARE | |||||||||||
| 5855 MONROE ST | SYLVANIA | OH | 43560 | 341831624 | HOSPICE HOME CARE | OH | 501(C)(3) | 10 | PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | Yes (1) | |
| KAITLYN'S COTTAGE INC | |||||||||||
| 1260 RALSTON AVE | DEFIANCE | OH | 43512 | 454781053 | RESPITE CARE | OH | 501(C)(3) | 10 | DEFIANCE HOSPITAL INC | Yes (1) | |
| MEMORIAL HOSPITAL | |||||||||||
| 715 SOUTH TAFT AVE | FREMONT | OH | 43420 | 344430849 | HOSPITAL | OH | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| MONROE CANCER CENTER | |||||||||||
| 800 STEWART RD | MONROE | MI | 48162 | 271302183 | CANCER CENTER | MI | 501(C)(3) | 10 | MERCY MEMORIAL HOSPITAL CORPORATION | Yes (1) | |
| MONROE COMMUNITY HEALTH SERVICES | |||||||||||
| 718 N MACOMB | MONROE | MI | 48162 | 382934134 | LONG TERM CARE | MI | 501(C)(3) | 10 | MERCY MEMORIAL HOSPITAL CORPORATION | Yes (1) | |
| MERCY MEMORIAL HOSPITAL CORPORATION | |||||||||||
| 718 N MACOMB | MONROE | MI | 48162 | 381984289 | HOSPITAL | MI | 501(C)(3) | 3 | PROMEDICA HEALTH SYSTEM INC | Yes (1) | |
| PARAMOUNT ADVANTAGE | |||||||||||
| 1901 INDIAN WOOD CIR | MAUMEE | OH | 43537 | 203376102 | HEALTH INSURANCE | OH | 501(C)(3) | 10 | PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BIXBY MEDICAL OFFICE LIMITED PARTNERSHIP | ||||||||||||||
| 818 RIVERSIDE AVE | ADRIAN | MI | 49221 | 382972398 | FACILITY LEASING | MI | EMMA L BIXBY MEDICAL CENTER | RELATED | $590,528 | $205,342 | 0 | Yes (1) | 0.64600 | |
| REYNOLDS ROAD SURGICAL CENTER LLC | ||||||||||||||
| 2865 N REYNOLDS RD | TOLEDO | OH | 43615 | 311569454 | FREESTANDING AMBULATORY SURGICAL CENTER | OH | THE TOLEDO HOSPITAL | RELATED | $593,234 | $2,488,278 | 0 | 0 | 0.67200 | |
| WATERVILLE MEDICAL CENTER LLC | ||||||||||||||
| 5901 MONCLOVA RD | MAUMEE | OH | 43537 | 320160784 | FACILITY LEASING | OH | N/A | |||||||
| NORTHWEST OHIO DEDICATED BREAST MRI LLC | ||||||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 260679898 | MEDICAL DIAGNOSTICS | OH | THE TOLEDO HOSPITAL | RELATED | $212,065 | $478,795 | 0 | 0 | 0.50000 | |
| WEST CENTRAL SURGICAL CENTER LLC | ||||||||||||||
| 7055 W CENTRAL | TOLEDO | OH | 43617 | 200088459 | AMBULATORY SURGICAL CENTER | OH | THE TOLEDO HOSPITAL | RELATED | $294,994 | $3,087,673 | 0 | Yes (1) | 0.50000 | |
| OHIO CARE AMBULATORY SURGICAL CENTER LLC | ||||||||||||||
| 5959 MONCLOVA RD | MAUMEE | OH | 43537 | 341863472 | AMBULATORY SURGICAL CENTER | OH | N/A | |||||||
| LENAWEE PHYSICIAN HOSPITAL ORGANIZATION LLC | ||||||||||||||
| 818 RIVERSIDE AVE | ADRIAN | MI | 49221 | 383605511 | PHYSICIAN MANAGEMENT SERVICES | MI | EMMA L BIXBY MEDICAL CENTER | RELATED | -$56,130 | $234,194 | 0 | Yes (1) | 0.50000 | |
| PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC | ||||||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 461989695 | PHYSICIAN MANAGEMENT SERVICES | OH | PROMEDICA HEALTH SYSTEM INC | RELATED | $710,041 | $711,752 | 0 | 0 | 0.50450 | |
| EAST-WEST HOLDINGS LTD | ||||||||||||||
| 715 SOUTH TAFT AVE | FREMONT | OH | 43420 | 204066818 | REAL ESTATE | OH | MEMORIAL HOSPITAL | RELATED | $9,186 | $304,990 | 0 | 0 | 0.50000 | |
| SURGICAL INSTITUTE OF MONROE LLC | ||||||||||||||
| 1051 S TELEGRAPH RD | MONROE | MI | 48161 | 270843485 | AMBULATORY SURGICAL CENTER | MI | PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | RELATED | $326,937 | $3,626,251 | 0 | 0 | 0.54000 | |
| PROMEDICA MASTER TENANT LLC | ||||||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 475288490 | REAL ESTATE | OH | PROMEDICA MANAGER MEMBER LLC | RELATED | -$38 | $108,128 | 0 | Yes (1) | 0.01000 | |
| PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC | ||||||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 473163945 | REAL ESTATE | OH | PROMEDICA MANAGER MEMBER LLC | RELATED | -$10,580 | $27,579,007 | 0 | Yes (1) | 0.90000 | |
| ROCKET VENTURE FUND II LLC | ||||||||||||||
| 2865 N REYNOLDS RD STE 220 | TOLEDO | OH | 43615 | 475603627 | INVESTMENT FUND | OH | PROMEDICA HEALTH SYSTEM INC | UNRELATED | -$4,100 | $295,900 | 0 | 0 | 0.66660 | |
| APM PLUS LLC | ||||||||||||||
| 1120 G ST NW STE 1000 | WASHINGTON | DC | 20005 | 813082229 | ALTERNATIVE PAYMENT MODEL DEVELOPMENT | DE | PROMEDICA HEALTH SYSTEM INC | UNRELATED | -$284,065 | $715,935 | 0 | Yes (1) | 0.50000 | |
| KAPION LLC | ||||||||||||||
| 2865 N REYNOLDS RD STE 220 | TOLEDO | OH | 43615 | 812624635 | SOFTWARE DEVELOPMENT | OH | PROMEDICA HEALTH SYSTEM INC | UNRELATED | -$1,641 | $247,636 | 0 | Yes (1) | 0.50000 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARE HOLDINGS | |||||||||||||
| 5901 MONCLOVA RD | MAUMEE | OH | 43537 | 341796790 | HOLDING COMPANY | OH | N/A | C | Yes (1) | ||||
| HERRICK MEMORIAL DEVELOPMENT CORP | |||||||||||||
| 500 E POTTAWATAMIE TR | ADRIAN | MI | 49221 | 383146907 | FACILITY LEASING | MI | C | Yes (1) | EMMA L BIXBY MEDICAL CENTER | $50,707 | $1,000,420 | 1.00000 | |
| LHA PHYSICIAN SERVICES CORPORATION | |||||||||||||
| 818 RIVERSIDE AVE | ADRIAN | MI | 49221 | 611451576 | PHYSICIAN BILLING | MI | C | Yes (1) | EMMA L BIXBY MEDICAL CENTER | 1.00000 | |||
| PHYSICIANS ADVANTAGE MSO | |||||||||||||
| 5901 MONCLOVA RD | MAUMEE | OH | 43537 | 061811760 | PHYSICIAN MANAGEMENT SERVICES | OH | N/A | C | Yes (1) | ||||
| PROMEDICA CENTRAL CORPORATION OF MICHIGAN | |||||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 383322278 | PHYSICIAN HEALTH CARE SERVICES | OH | C | Yes (1) | PROMEDICA PHYSICIAN GROUP | $1,197,691 | $4,584,064 | 1.00000 | |
| PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES | |||||||||||||
| 1901 INDIAN WOOD CIR | MAUMEE | OH | 43537 | 341570675 | HEALTH CARE INSURANCE | OH | C | Yes (1) | PROMEDICA HEALTH SYSTEM INC | $38,622,854 | $370,594,769 | 1.00000 | |
| PROMEDICA NORTH PHYSICIAN CORPORATION | |||||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 383482148 | PHYSICIAN HEALTH CARE SERVICES | OH | C | Yes (1) | PROMEDICA PHYSICIAN GROUP | $149,134 | 1.00000 | ||
| PROMEDICA RETAIL GROUP INC | |||||||||||||
| 3890 MONROE ST | TOLEDO | OH | 43606 | 341159928 | FLORIST | OH | C | Yes (1) | PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | $937 | $760,746 | 1.00000 | |
| HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION | |||||||||||||
| 818 RIVERSIDE AVE | ADRIAN | MI | 49221 | 383639616 | FACILITY MANAGEMENT | MI | C | Yes (1) | HERRICK MEMORIAL DEVELOPMENT CORP | $28 | $74,777 | 0.71800 | |
| PROMEDICA HEALTH NETWORK INC | |||||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 474006496 | PHYSICIAN MANAGEMENT SERVICES | OH | C | Yes (1) | PROMEDICA HEALTH SYSTEM INC | -$1,165,706 | 1.00000 | ||
| MONROE HEALTH VENTURES | |||||||||||||
| 718 N MACOMB | MONROE | MI | 48164 | 382704426 | PHARMACY | MI | C | Yes (1) | MERCY MEMORIAL HOSPITAL CORPORATION | 1.00000 | |||
| PROMEDICA MANAGER MEMBER LLC | |||||||||||||
| 100 MADISON AVE | TOLEDO | OH | 43604 | 475168737 | REAL ESTATE | OH | C | Yes (1) | PROMEDICA HEALTH SYSTEM INC | -$13,118 | $9,998,989 | 1.00000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (1) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROMEDICA FOUNDATION | ||
| B | $275,797 | FMV |
| PROMEDICA PHYSICIANS AND CONTINUUM SERVICES | ||
| B | $4,500,000 | FMV |
| PROMEDICA FOUNDATION | ||
| C | $323,154 | FMV |
| EMMA L BIXBY MEDICAL CENTER | ||
| G | $77,724 | FMV |
| EMMA L BIXBY MEDICAL CENTER | ||
| P | $1,647,064 | FMV |
| PROMEDICA HEALTH SYSTEM INC | ||
| P | $7,306,462 | FMV |
| THE TOLEDO HOSPITAL | ||
| P | $411,905 | FMV |
| EMMA L BIXBY MEDICAL CENTER | ||
| Q | $98,002 | FMV |