WA FOOTE MEMORIAL HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- WA FOOTE MEMORIAL HOSPITAL (EIN 38-2027689)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201741359349306409
- Schema version
- 2015v3.0
- 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 F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T12:43:03-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382027689 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA Foote Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WAFO | BusinessNameControlTxt |
| Phone | 5177884800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 N East Avenue | AddressLine1Txt |
| City | Jackson | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Georgia Fojtasek | PersonNm |
| Person Title | President & CEO | PersonTitleTxt |
| Phone | 5177884800 | PhoneNum |
| Signature | 2017-05-13 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Henry Ford Allegiance Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Georgia Fojtasek | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 N East Avenue | AddressLine1Txt |
| City | Jackson | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $634,445,989 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.allegiancehealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | We lead our community to better health and well-being at every stage of life. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 4406 | TotalEmployeeCnt |
| Total Volunteers | 467 | TotalVolunteersCnt |
| Total Gross UBI | $2,285,658 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$316,698 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,255,729 | PYContributionsGrantsAmt |
| CY Contributions Grants | $884,449 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $463,448,660 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $477,747,441 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,112,271 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,060,009 | CYInvestmentIncomeAmt |
| PY Other Revenue | $14,755,644 | PYOtherRevenueAmt |
| CY Other Revenue | $18,250,986 | CYOtherRevenueAmt |
| PY Total Revenue | $487,572,304 | PYTotalRevenueAmt |
| CY Total Revenue | $502,942,885 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $449,800 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $426,600 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $251,934,324 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $276,719,571 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $216,729,719 | PYOtherExpensesAmt |
| CY Other Expenses | $230,574,214 | CYOtherExpensesAmt |
| PY Total Expenses | $469,113,843 | PYTotalExpensesAmt |
| CY Total Expenses | $507,720,385 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $18,458,461 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,777,500 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $500,875,035 | TotalAssetsBOYAmt |
| Total Assets EOY | $493,063,032 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $268,381,663 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $278,213,503 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $232,493,372 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $214,849,529 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | See Schedule OOur MissionWe lead our community to better health and well-being at every stage of life.Our ValuesCompetence: expertise in carrying out responsibilities and inspiring others to have confidence in you.Integrity: behavior that is honest, fair, trustworthy and sincere, strength of character and respect for others.Teamwork: working together in an environment of mutual respect.Diversity: respect for individual beliefs, uniqueness, and differences.Quality: committment to excellence in care.Compassion: acknowledging the feelings of others with empathy, support, encouragement, and sensitivity. Listening and responding to individual needs in a patient and caring manner.Customer Service: taking pride in providing service beyond expectations.Healing Environment: providing an environment that promotes an atmosphere of trust, comfort, healing and security | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $418,904,872 | ExpenseAmt |
| Grant | $426,600 | GrantAmt |
| Revenue | $493,878,850 | RevenueAmt |
| Desc | See Schedule OThe Hospital devotes substantial efforts and resources to providing health services to people in its communities. The Hospital is engaged in the following activities to ensure that our mission is accomplished:Unreimbursed Services Provided to the Underserved:The Hospital provides a substantial portion of its services to the underserved (elderly and low income residents). During the fiscal year ended June 30, 2016, approximately 51% of the value of services rendered were to elderly patients under the Medicare program, and approximately 18% of the services were provided to patients who were deemed indigent under state, county, or Medicaid Center guidelines.In the spirit of our mission and values, the Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare services to all persons. During the fiscal year ended June 30, 2016, the Hospital provided charity care of $16.4 million and recorded a provision for bad debts of $37.1 million. Consistent with Schedule H reporting, charity care at cost for fiscal year 2016 was $5.3 million.Patient Services:The Hospital serves seven counties with a medical staff of more than 400 physicians. A complete listing of services is available at AllegianceHealth.org.The Hospital provides unprofitable health services on behalf of the community including inpatient and outpatient behavioral health and substance abuse services, obstetrics, emergency and trauma services, general medicine, family/general practice, senior services, cardiac and pulmonary rehabilitation, palliative care, wound care, pain clinic and diabetes clinic.Community Benefit Activities:The Hospital is engaged in community programs and services that address identified community health needs regardless of source or availability of payment and provide measurable improvement in health access, health status, and the use of health care resources. These programs address one of the six criteria:Supports the Hospital's community-based missionTargets the problems of the poor or medically underservedImpacts the health status of the identified communityReduces community health costsIs accessible to the entire target community regardless of ability to payStimulates external community partnershipsHealth Improvement Organization:The Health Improvement Organization (HIO) was created by Henry Ford Allegiance Health (HFAH) in 2001 to promote a culture of continuous health improvement in our community and integrate wellness and prevention throughout our services. The HFAH Department of Prevention and Community Health provides staff and infrastructure to facilitate the coordination of local health improvement activities. The HIO Coordinating Council (HIO CC) is a multi-disciplinary stakeholders group led by HFAH with representation from local government, public health, health care, health and human service agencies, nonprofits, school districts, health plans, mental health, employers and the faith community. The HIO CC coordinates efforts across community leaders in health to create unprecedented alignment of goals and resources, as well as a strong community platform for advocacy. The work of the HIO CC has culminated in the completion of a Community Action Plan including goals, objectives and strategies to address physical activity, nutrition, tobacco use, and depression in Jackson County. The Plan is based on assessment and data-driven processes, as well as input from over 30 representatives from local health and human service agencies, and over 100 community stakeholders. The overarching tactics that the Community Action Plan relies upon include evidence-based activities to:Enhance media attention and public recognition of healthy lifestyle practices;Improve access to healthy foods and safe, attractive, affordable places for activity through supportive policies and physical environment changes;Provide social support and services that promote consistent screening, referral and supportive relationships for physical activity, nutrition, mental health and smoking behavior change.The HIO builds upon existing community strengths and infrastructure to support implementation of health initiatives that have been prioritized as part of a community wide plan with significant community engagement and an established infrastructure to support longevity. In addition to operational support for the HIO CC, the HFAH Department of Prevention and Community Health provides subject matter expertise on wellness and prevention at the Board, Service Line and community level, and direct service delivery (including employer-based health management, tobacco treatment services, weight management, faith community nursing, etc.) to a broad base of community members to support the health improvement priorities identified by the HIO. The Department of Prevention and Community Health has an annual budget of around $1 million. Since 2001, the Hospital has committed over $24.4 million of funding to this program.Other Community Benefit Activities:Through Community Education and Outreach, the Hospital provided educational sessions and clinics that reached 76,185 individuals at a cost of $301,997 in fiscal year 2016. The sessions/clinics included education on asthma, AIDS/HIV, diabetes, family planning, fitness/exercise, overall health, cardiovascular health, nutrition and weight management, pulmonary, smoking cessation and womens health. These educational offerings were located at the Hospital, community fairs, parishes, schools, work sites and by phone. Free Medical Screenings for high blood pressure, diabetes, mental health/depression, vascular disease and womens health served 583 community members at a cost of $10,273 in fiscal year 2016.The Hospital funded a 24-hour nurse call center to provide health information to community members. The cost of the center in fiscal year 2016 was $364,747.Free and discounted prescription drug and medical supplies were provided to community members at a cost of $25,987 during fiscal year 2016. HFAH clinics provided reduced fee medical services serving 28,715 patients at a cost of $505,680 in fiscal year 2016.Through Meals on Wheels and other food programs, the Hospital donated $49,350 in food.Patient transportation assistance was provided in fiscal year 2016, including wheelchair van, ambulance, transport to and from cancer centers and cab service at a cost of $133,218.Partnerships:The Hospital played a leadership role in the establishment of the Center for Family Health, a Federally Qualified Health Center, providing $400,000 in fiscal year 2016 support for the uninsured.The Hospital partnered with the medical staff and community to establish Project Access, a program which provides free physician and hospital care for over 500 community members that do not qualify for federal or state financial assistance and are uninsured. The Hospital provides free care for medically necessary hospital based services. Hospital executive staff sit on a number of governance boards of non-profit organizations in our community, such as Center for Family Health, Jackson Community Foundation, Fitness Council of Jackson, Health Improvement Organization, Henry Ford Allegiance Hospice, Henry Ford Allegiance Health Foundation, Henry Ford Allegiance CareLink, Healthlink, Jackson Community Ambulance, Huron Valley Ambulance, Jackson Community Medical Records, Jackson Health Network, Michigan Health Information Network, United Way of Jackson, and Junior Achievement of Michigan Edge.The Hospital is also represented on public and private organizations including The Enterprise Group of Jackson, Inc. (promotes economic development), Jackson Citizens for Economic Growth, South Central Michigan Works, and Jackson Area Manufacturers Association.The Hospital donates office space to two area non-profit organizations, the Enterprise Group of Jackson, Inc. and Birthline of Jackson. | Desc |
| Total Program Service Expenses | $418,904,872 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | Yes (1) | ForeignOfficeInd |
| Foreign Activities | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | 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 | 322 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 4406 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | Yes (1) | ForeignFinancialAccountInd |
| Foreign Country | CJ | ForeignCountryCd |
| 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 | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | 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 | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David W Spring | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5177884800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 N East Avenue | AddressLine1Txt |
| City | Jackson | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Georgia Fojtasek | ||||||||||
| President & CEO | 55.00 | 5.00 | Yes (X) | Yes (X) | $1,177,283 | $0 | $75,777 | |||
| Robert Riney | ||||||||||
| Trustee as of 04/01/16 | 10.00 | 1.00 | Yes (X) | $0 | $2,110,783 | $50,200 | ||||
| Adnan Munkarah | ||||||||||
| Trustee as of 04/01/16 | 10.00 | 1.00 | Yes (X) | $0 | $799,729 | $46,816 | ||||
| Aaron Boatin | ||||||||||
| Trustee | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| Neeta Delaney | ||||||||||
| Trustee | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Bradley Clark | ||||||||||
| Trustee | 4.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| David Halsey | ||||||||||
| Trustee | 4.00 | 1.00 | Yes (X) | $25,818 | $0 | $0 | ||||
| Steven Hogwood | ||||||||||
| Trustee | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Mark Smith | ||||||||||
| Chief of Staff | 5.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Steven Rick | ||||||||||
| Secretary/Treasurer | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Tim Levy | ||||||||||
| Vice Chairman | 3.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| John Nally | ||||||||||
| Chairman | 5.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Larry Schultz | ||||||||||
| Trustee | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Allan Tompkins | ||||||||||
| Trustee | 3.00 | 2.00 | Yes (X) | $9,149 | $0 | $0 | ||||
| Gregg Patten | ||||||||||
| Trustee | 3.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Michael Shore | ||||||||||
| Trustee | 3.00 | 2.00 | Yes (X) | $3,611 | $0 | $0 | ||||
| Mohan Kulkarni | ||||||||||
| Trustee | 3.00 | 1.00 | Yes (X) | $800,257 | $0 | $71,736 | ||||
| Karen Chaprnka | ||||||||||
| SVP & COO thru 1/31/16 | 55.00 | 5.00 | $362,843 | $0 | $54,245 | Yes (X) | ||||
| Jeanne' Wickens | ||||||||||
| SVP & CFO thru 5/7/16 | 55.00 | 5.00 | $648,533 | $0 | $53,096 | Yes (X) | ||||
| Aaron Wootton | ||||||||||
| VP & CIO | 55.00 | 5.00 | $239,644 | $0 | $59,858 | Yes (X) | ||||
| Kenneth Empey | ||||||||||
| General Counsel | 55.00 | 5.00 | $339,650 | $0 | $66,865 | Yes (X) | ||||
| Beth Smith | ||||||||||
| Chief Compliance Officer | 55.00 | 1.00 | $231,187 | $0 | $34,246 | Yes (X) | ||||
| Ondrea Bates | ||||||||||
| SVP Patient Care | 55.00 | 5.00 | $379,270 | $0 | $68,940 | Yes (X) | ||||
| Ray King | ||||||||||
| Chief Medical Officer | 55.00 | 5.00 | $615,484 | $0 | $76,355 | Yes (X) | ||||
| Patricia Seagram | ||||||||||
| VP Human Resources as of 03/27/16 | 55.00 | 5.00 | $179,559 | $0 | $27,089 | Yes (X) | ||||
| Kevin Leonard | ||||||||||
| VP Finance | 55.00 | 5.00 | $250,383 | $0 | $40,792 | Yes (X) | ||||
| Vishal Gupta | ||||||||||
| Physician | 50.00 | 0.00 | $1,007,658 | $0 | $92,721 | Yes (X) | ||||
| Ryan Beekman | ||||||||||
| Physician | 50.00 | 0.00 | $880,864 | $0 | $64,657 | Yes (X) | ||||
| Harish Rawal | ||||||||||
| Physician | 50.00 | 0.00 | $1,589,836 | $0 | $61,743 | Yes (X) | ||||
| Amritraj Loganathan | ||||||||||
| Physician | 50.00 | 0.00 | $848,772 | $0 | $64,827 | Yes (X) | ||||
| Stephen Lee Kirkner | ||||||||||
| Physician | 50.00 | 0.00 | $959,521 | $0 | $80,157 | Yes (X) | ||||
| Anthony Gardner | ||||||||||
| VP Marketing thru 07/10/15 | 55.00 | 1.00 | $126,029 | $0 | $7,661 | Yes (X) | ||||
| Gerald Grannan | ||||||||||
| VP Physician Integrationg thru 02/05/16 & | 55.00 | 1.00 | $263,643 | $0 | $20,045 | Yes (X) | ||||
| George Hunter | ||||||||||
| VP Human Resources thru 06/12/15 | 55.00 | 5.00 | $277,106 | $0 | $11,156 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $11,216,100 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,910,512 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,128,982 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 264 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Independent Hospitalist Physicians | |||||
| PO Box 100 | Royal Oak | MI | 48068 | Hospitalists | $8,420,876 |
| St Joseph Mercy Health System | |||||
| PO Box 992 | Ann Arbor | MI | 48106 | Healthcare Services | $7,716,577 |
| GE Healthcare Services | |||||
| PO Box 96483 | Chicago | IL | 60693 | Healthcare Consulting | $3,984,273 |
| Mckesson Technologies Inc | |||||
| PO Box 98347 | Chicago | IL | 60693 | Healthcare Services | $3,225,361 |
| Independent Emergency Physicians | |||||
| PO Box 100 | Royal Oak | MI | 48068 | Healthcare Services | $2,934,654 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 252 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $290,521 | RelatedOrganizationsAmt |
| All Other Contributions | $593,928 | AllOtherContributionsAmt |
| Total Contributions | $884,449 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Services | 621990 | $477,073,264 | $475,203,071 | $1,870,193 |
| FHC, JCA, JCMR and Premier | 621910 | $674,177 | $666,077 | $8,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $477,747,441 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,846,087 | TotalRevenueColumnAmt |
| Exclusion | $5,846,087 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $838,325 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $941,622 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$103,297 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$103,297 | TotalRevenueColumnAmt |
| Exclusion | -$103,297 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $128,844,949 | SecuritiesAmt |
| Other | $1,930,455 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $129,041,786 | SecuritiesAmt |
| Other | $1,519,696 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$196,837 | SecuritiesAmt |
| Other | $410,759 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $213,922 | TotalRevenueColumnAmt |
| Exclusion | $213,922 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Contracted Pharmacy Revenue | 621110 | $6,696,908 | $6,696,908 |
| Services to Affiliates | 561000 | $4,552,816 | $4,552,816 |
| JHN | 621990 | $1,912,645 | $1,912,645 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,191,914 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,969,040 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $407,365 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,815,509 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $18,354,283 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $502,942,885 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $492,000,557 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,285,658 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,772,221 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $426,600 | TotalAmt |
| Program Services | $426,600 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,401,654 | TotalAmt |
| Management And General | $7,401,654 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339,097 | TotalAmt |
| Management And General | $339,097 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,882,475 | TotalAmt |
| Program Services | $183,331,871 | ProgramServicesAmt |
| Management And General | $39,550,604 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,275,768 | TotalAmt |
| Program Services | $8,195,447 | ProgramServicesAmt |
| Management And General | $2,080,321 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,579,082 | TotalAmt |
| Program Services | $16,412,863 | ProgramServicesAmt |
| Management And General | $4,166,219 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,241,495 | TotalAmt |
| Program Services | $12,155,866 | ProgramServicesAmt |
| Management And General | $3,085,629 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,522,940 | TotalAmt |
| Management And General | $3,522,940 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,225,077 | TotalAmt |
| Program Services | $1,774,612 | ProgramServicesAmt |
| Management And General | $450,465 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,547 | TotalAmt |
| Management And General | $44,547 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,915 | TotalAmt |
| Management And General | $138,915 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,842 | TotalAmt |
| Management And General | $203,842 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,844,020 | TotalAmt |
| Program Services | $45,436,281 | ProgramServicesAmt |
| Management And General | $8,407,739 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,647,758 | TotalAmt |
| Program Services | $2,111,721 | ProgramServicesAmt |
| Management And General | $536,037 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,946,353 | TotalAmt |
| Program Services | $12,718,026 | ProgramServicesAmt |
| Management And General | $3,228,327 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,221,612 | TotalAmt |
| Program Services | $14,532,661 | ProgramServicesAmt |
| Management And General | $3,688,951 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,346,991 | TotalAmt |
| Program Services | $6,657,149 | ProgramServicesAmt |
| Management And General | $1,689,842 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357,156 | TotalAmt |
| Program Services | $284,850 | ProgramServicesAmt |
| Management And General | $72,306 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357,156 | TotalAmt |
| Program Services | $284,850 | ProgramServicesAmt |
| Management And General | $72,306 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,644,264 | TotalAmt |
| Program Services | $3,704,036 | ProgramServicesAmt |
| Management And General | $940,228 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,405,852 | TotalAmt |
| Program Services | $20,262,457 | ProgramServicesAmt |
| Management And General | $5,143,395 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,366,696 | TotalAmt |
| Program Services | $1,887,560 | ProgramServicesAmt |
| Management And General | $479,136 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $41,252,728 | $41,252,728 | |
| Drugs | $39,908,888 | $39,908,888 | |
| Purchase Accounting Exp | $3,573,013 | $3,573,013 | |
| Food | $2,322,705 | $2,322,705 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,243,701 | TotalAmt |
| Program Services | $5,243,701 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $507,720,385 | TotalAmt |
| Program Services | $418,904,872 | ProgramServicesAmt |
| Management And General | $88,815,513 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,867,161 | BOYAmt |
| EOY | $23,917,434 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,542,624 | BOYAmt |
| EOY | $3,827,198 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,384,260 | BOYAmt |
| EOY | $48,987,703 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $19,634 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,000 | BOYAmt |
| EOY | $115,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,741,607 | BOYAmt |
| EOY | $7,267,112 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,948,430 | BOYAmt |
| EOY | $8,893,591 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $165,781,145 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,712,647 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,096,569 | BOYAmt |
| EOY | $160,068,498 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $261,900,072 | BOYAmt |
| EOY | $228,597,076 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,279,312 | BOYAmt |
| EOY | $11,369,786 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,875,035 | BOYAmt |
| EOY | $493,063,032 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,233,093 | BOYAmt |
| EOY | $71,908,195 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,997,676 | BOYAmt |
| EOY | $153,032,674 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,112,889 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,038,005 | BOYAmt |
| EOY | $53,272,634 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $268,381,663 | BOYAmt |
| EOY | $278,213,503 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,493,372 | BOYAmt |
| EOY | $214,849,529 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,493,372 | BOYAmt |
| EOY | $214,849,529 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,875,035 | BOYAmt |
| EOY | $493,063,032 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,777,500 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$3,429,895 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$9,436,448 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $138,915 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $138,915 | 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 | Health care is a highly-regulated field, requiring frequent and high-level communication with regulators and elected officials. A small investment in lobbying enables us to remain in contact with legislators and government agencies, maximize the resources with which we are entrusted and assure that we provide the best care to our community. W.A. Foote Memorial Hospital dba Henry Ford Allegiance Health enlists the services of several lobbying consultants, attorneys and healthcare trade associations. In addition, the Hospital employs a corporate accounts specialist. The specialist spends a portion of his time contacting legislators, participating in grass roots advocacy, and other activities closely related to lobbying. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,451,944 | BeginningYearBalanceAmt |
| Contributions | $463,114 | ContributionsAmt |
| Investment Earnings Or Losses | $12,856 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $313,806 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,614,108 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,312,432 | BeginningYearBalanceAmt |
| Contributions | $558,781 | ContributionsAmt |
| Investment Earnings Or Losses | -$4,612 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $404,908 | GrantsOrScholarshipsAmt |
| Other Expenditures | $9,749 | OtherExpendituresAmt |
| End Year Balance | $1,451,944 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,552,189 | BeginningYearBalanceAmt |
| Contributions | $694,089 | ContributionsAmt |
| Investment Earnings Or Losses | $75,992 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,009,838 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,312,432 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,250,833 | BeginningYearBalanceAmt |
| Contributions | $671,894 | ContributionsAmt |
| Grants Or Scholarships | $370,538 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,552,189 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,124,117 | BeginningYearBalanceAmt |
| Contributions | $2,790,346 | ContributionsAmt |
| Investment Earnings Or Losses | $5,025 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,015,249 | GrantsOrScholarshipsAmt |
| Other Expenditures | $653,406 | OtherExpendituresAmt |
| End Year Balance | $1,250,833 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.45000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.55000 | TermEndowmentBalanceEOYPct |
| 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 | $3,728,000 | OtherCostOrOtherBasisAmt |
| Book Value | $3,728,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $95,482,476 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,422,539 | DepreciationAmt |
| Book Value | $93,059,937 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $56,238,721 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,290,108 | DepreciationAmt |
| Book Value | $52,948,613 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,331,948 | OtherCostOrOtherBasisAmt |
| Book Value | $10,331,948 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $160,068,498 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Retirement Plan Liability | $43,497,511 |
| Settlement Payable to Third Party Payor | $5,743,316 |
| Note Payable | $37,137 |
| Tax Abatement Liability | $98,838 |
| Other | $121,706 |
| Deferred Comp | $3,774,126 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $53,272,634 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The Organization's endowment funds are used for various charitable hospital programs including treatment of uninsured patients, community preventative health education, program development and capital improvements. |
| Part X, Line 2: | The System does not have any material uncertain tax positions as of December 31, 2016 and 2015. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Cayman Islands | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 1 | EmployeeCnt |
| Type Of Activities Conducted | Program Services | TypeOfActivitiesConductedTxt |
| Specific Services Provided | Self & Malpractice Insurance | SpecificServicesProvidedTxt |
| Region Total Expenditures | $3,178,476 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 1 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Subtotal Spent | $3,178,476 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $3,178,476 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | Yes (1) | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| 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 | $5,263,467 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,263,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01040 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,053,844 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,053,844 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02770 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,317,311 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,317,311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03810 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,486,001 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,486,001 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,688,959 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,688,959 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01320 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,465,109 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,465,109 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $722,565 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $722,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,362,634 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,362,634 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,679,945 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,679,945 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06050 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $50,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $53,348 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $53,348 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,009,199 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,009,199 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00400 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,112,547 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,112,547 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $37,056,964 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $158,497,935 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $175,449,851 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$16,951,916 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 Foote Health Center Associates | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Entity leases medical office space. | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.62000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.38000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA Foote Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 N East Avenue | AddressLine1Txt |
| City | Jackson | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.allegiancehealth.org | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Research Facility | Yes (X) | ResearchFacilityInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA Foote Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.allegiancehealth.org/services/prevention-community-health | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.myhio.org | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | allegiancehealth.org/services/prevention-community-health | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | 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 | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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 |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.allegiancehealth.org/patient-guide/billing-insurance/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| W.A. Foote Memorial Hospital | Part V, Section B, Line 5: The Health Improvement Organization Coordinating Council, founded by Henry Ford Allegiance Health (HFAH), is a collaborative of community stakeholders committed to improving the health status of the community through an integrated health improvement infrastructure that addresses Jackson's priority health issues. The HIO Coordinating Council serves as the stakeholder planning committee for HFAH's Board HIO Committee, Jackson County's Healthy Community initiative, the United Way of Jackson County's Community Solutions Team on Health, and the Health Strand of the Jackson 2020 initiative. The scope of our responsibility includes monitoring community level indicators, identifying specific health priorities and developing community action plans to address common goals.In this model, community stakeholders work with public health experts to develop and complete a community health assessment for Jackson County. This assessment provides a data collection mechanism that better aligns efforts among community partners and creates a more strategic framework for local health improvement activities.Individuals contributing input for HFAH's recent CHNA:Megan Albertson, HFAHKellie Baker, LifeWaysMarilyn Bell, Michigan Purchasers Health AllianceSara Benedetto, Center for Family Health Adam Brown, Jackson County AdministrationCindy Bruner, Meridian Health PlanShelly Bullinger, Jackson County Health DepartmentKathleen Clark, YMCA Storer CampsMark Fall, Henry Ford Allegiance CareLinkAndrew Farmer, AARP of MichiganKevin Ford, MSUTed Hilleary, Community MemberJennifer Johnson, Great Lakes IndustryDavid King, LifeWaysRay King, HFAHDavid Kirk, HFAHIrene LeCrone, United WayKatie Luke, Partnership Park Neighborhood Assoc.Katherine Martin, Community Action AgencyRebecca Mayer, AWAREPamela McCrum, Catholic Charities of Jackson Dani Meier, Jackson Public SchoolsMonica Moser, Jackson Community Foundation Wendy Murdock, United Way of Jackson CountyErin Norton, United WayAmy Pelletier, Marriage MattersRhonda Rudolph, Jackson County Health DepartmentScott Schmidt, United Way of Jackson County Amy Schultz, HFAHSteve Sukta, Intermediate School DistrictScott TenBrink, Fitness Council of Jackson Shaina Tinsey, HFAHJulie Weisbrod, Jackson County Health DepartmentTed Westmeier, Jackson County Health Department |
| W.A. Foote Memorial Hospital | Part V, Section B, Line 6a: CareLink of Jackson, a Community-Owned Specialty Hospital. CareLink is a related non-profit corporation. |
| W.A. Foote Memorial Hospital | Part V, Section B, Line 6b: AARPBig Brothers/Big SistersCenter for Family HealthCommunity Action AgencyCradle to CareerFitness Council of JacksonGreat Lakes IndustryGreat StartJackson Community FoundationJackson County Health DepartmentJackson County Intermediate School DistrictJackson County Parks and RecreationJackson Health NetworkJackson YMCALifeWaysMarriage Matters JacksonMichigan State UniversityPartnership Park Downtown Neighborhood AssociationUnited Way of Jackson CountyUniversity of MichiganYMCA Storer Camps |
| W.A. Foote Memorial Hospital | Part V, Section B, Line 7d: The CHNA is posted on the hospital website at the address below. In addition, the CHNA is postged on other community organization websites, presented at public forums, and hard copies of the assessment are available upon request. www.allegiancehealth.org/services/prevention-community-health |
| W.A. Foote Memorial Hospital | Part V, Section B, Line 2: Effective April 1, 2016, Henry Ford Health System became the sole member of Henry Ford Allegiance Health Group (formerly Allegiance Health Services). Henry Ford Allegiance Health Group is the sole member of W. A. Foote Memorial Hospital d/b/a Henry Ford Allegiance Health. Henry Ford Health System is a non-profit 501(c)(3) organization. This affiliation allows Henry Ford Allegiance Health Group to join forces with one of the largest healthcare providers in Michigan to continue to provide high-quality healthcare services to residents of the community it serves. It also ensures that Henry Ford Allegiance Health Group will have the commitment to capital to continue to pursue growth opportunities and to expand existing healthcare services, with the goal of providing the best care possible. |
| W.A. Foote Memorial Hospital | Part V, Section B, Line 11: Henry Ford Allegiance Health and its community partners have a comprehensive implementation strategy to meet needs identified in the Community Health Needs Assessment (CHNA). The CHNA implementation strategy is rolled out in stages. A need not yet addressed is implementing various strategies within the physician population as the community has recently developed a clinically integrated network and resource allocation is still being structured; these resources are currently being developed and will be rolled out in the next 3 years.The implementation plan can be accessed on the hospital's website atwww.allegiancehealth.org/services/prevention-community-health/programs-initiatives. |
| W.A. Foote Memorial Hospital | Part V, Section B, Line 15e: Invoice provides patient with a number to call if they believe they may qualify for financial assistance. Patients calling the number are guided through the financial assistance application process by hospital representatives. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 92 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (92 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Allegiance Occupational Health | ||||
| 100 E Michigan Ave Ste 101 | Jackson | MI | 49201 | Urgent care, employment screening |
| 2 - Allegiance Physical Rehabilitation - Jac | ||||
| 100 E Michigan Ave Ste 103 | Jackson | MI | 49201 | Rehab |
| 3 - Allegiance Substance Abuse Services | ||||
| 100 E Michigan Ave Ste 104 | Jackson | MI | 49201 | Outpatient Treatment |
| 4 - Allegiance Home Care | ||||
| 100 E Michigan Ave Ste 400 | Jackson | MI | 49201 | Visiting Nurses |
| 5 - Allegiance Personal Care | ||||
| 100 E Michigan Ave Ste 400 | Jackson | MI | 49201 | Private duty nursing |
| 6 - Allegiance tobacco Treatment Services | ||||
| 100 E Michigan Ave Ste 900 | Jackson | MI | 49201 | Outpatient Treatment |
| 7 - Gayle M Jacob Cancer Center | ||||
| 1100 E Michigan Ave Ste 307 | Jackson | MI | 49201 | Hematology Oncology practice and infusion center |
| 8 - Allegiance Wellness Center | ||||
| 1100 E Michigan Ave Ste 100 | Jackson | MI | 49201 | Exercise facility |
| 9 - Allegiance Cardiac Rehabilitation | ||||
| 1100 E Michigan Ave Ste 102 | Jackson | MI | 49201 | Post-surgical exercise facility |
| 10 - Allegiance Pulmonary Rehabilitation | ||||
| 1100 E Michigan Ave Ste 102 | Jackson | MI | 49201 | Post-surgical exercise facility |
| 11 - Allegiance Diagnostic Center - Professio | ||||
| 1100 E Michigan Ave Ste 104 | Jackson | MI | 49201 | Lab and imaging services |
| 12 - Allegiance Outpatient Trauma | ||||
| 1100 E Michigan Ave Ste 201 | Jackson | MI | 49201 | Physician specialty practice |
| 13 - Allegiance Thoracic Surgery | ||||
| 1100 E Michigan Ave Ste 201 | Jackson | MI | 49201 | Physician specialty practice |
| 14 - Allegiance Pediatric Cardiology | ||||
| 1100 E Michigan Ave Ste 201 | Jackson | MI | 49201 | Physician specialty practice |
| 15 - U of M - Allegiance Cardiac Surgery Serv | ||||
| 1100 E Michigan Ave Ste 201 | Jackson | MI | 49201 | Physician specialty practice |
| 16 - Allegiance Radiation Oncology - Tejada C | ||||
| 1102 E Michigan Ave | Jackson | MI | 49201 | Radiation therapy |
| 17 - Allegiance ENT | ||||
| 1111 Teneyck St Ste 100 | Jackson | MI | 49201 | Physician specialty practice |
| 18 - Allegiance Hearing Center | ||||
| 1111 Teneyck St Ste 200 | Jackson | MI | 49201 | Hearing loss treatment; hearing aid sales/service |
| 19 - Allegiance Surgery Center | ||||
| 1125 E Michigan Avenue | Jackson | MI | 49201 | Outpatient surgery center |
| 20 - Allegiance Rheumatology | ||||
| 1201 E Michgan Avenue Ste 100 | Jackson | MI | 49201 | Physician specialty practice |
| 21 - Allegiance Neurology | ||||
| 1201 E Michgan Avenue Ste 240 | Jackson | MI | 49201 | Physician practice |
| 22 - Allegiance Orthopedics | ||||
| 1201 E Michgan Avenue Ste 300 | Jackson | MI | 49201 | Physician specialty practice |
| 23 - Allegiance Home Medical Equipment - Spec | ||||
| 1201 E Michigan Ave Ste 110 | Jackson | MI | 49201 | Retail sales of durable medical equipment |
| 24 - Allegiance Osteoporosis Center | ||||
| 1201 E Michigan Ave Ste 120 | Jackson | MI | 49201 | Physician practice |
| 25 - Allegiance Balance Center | ||||
| 1201 E Michigan Ave Ste 120 | Jackson | MI | 49201 | Rehabilitation services |
| 26 - Allegiance Pain Management Center | ||||
| 1201 E Michigan Ave Ste 200 | Jackson | MI | 49201 | Physician practice |
| 27 - Allegiance Neurosurgery | ||||
| 1201 E Michigan Ave Ste 240 | Jackson | MI | 49201 | Physician specialty practice |
| 28 - Allegiance Physical Medicine and Rehabil | ||||
| 1201 E Michigan Ave Ste 300 | Jackson | MI | 49201 | Physician specialty practice |
| 29 - Allegiance Physical Rehabilitation - Spe | ||||
| 1201 E Michigan Ave Ste 300 | Jackson | MI | 49201 | Rehabilitation services |
| 30 - Allegiance Diagnostic Center - Specialty | ||||
| 1201 E Michigan Avenue | Jackson | MI | 49201 | Laboratory and imaging services |
| 31 - Allegiance Diagnostic Center - Greenwood | ||||
| 1310 Greenwood Ave | Jackson | MI | 49203 | Laboratory services |
| 32 - Allegiance Neuropsychology | ||||
| 1400 E Michigan Ave | Jackson | MI | 49202 | Physician specialty practice |
| 33 - Allegiance Diagnostic Center - North Str | ||||
| 1401 W North Street | Jackson | MI | 49202 | Lab and imaging services |
| 34 - Allegiance Family Medicine - North Stree | ||||
| 1401 W North Street | Jackson | MI | 49202 | Family medicine and Extended Hours Clinic |
| 35 - Allegiance CRNA | ||||
| 205 N East Ave | Jackson | MI | 49201 | Anesthesiology services |
| 36 - Allegiance EEG | ||||
| 205 N East Ave | Jackson | MI | 49201 | Patient testing |
| 37 - Allegiance EKG | ||||
| 205 N East Ave | Jackson | MI | 49201 | Patient testing |
| 38 - Allegiance Emergency Care | ||||
| 205 N East Ave | Jackson | MI | 49201 | Emergency room and urgent care |
| 39 - Allegiance Health Pharmacy | ||||
| 205 N East Ave | Jackson | MI | 49201 | Outpatient pharmacy |
| 40 - Allegiance Sleep Health Center | ||||
| 205 N East Ave | Jackson | MI | 49201 | Diagnostic and testing center |
| 41 - Allegiance Health Hospital | ||||
| 205 N East Ave | Jackson | MI | 49201 | Main hospital facility with multiple IP and OP services |
| 42 - Allegiance Behavioral Health | ||||
| 205 N East Ave | Jackson | MI | 49201 | Mental health IP and OP services |
| 43 - Allegiance Digestive Health - East Ave | ||||
| 205 S East Ave | Jackson | MI | 49201 | Outpatient GI procedures |
| 44 - Phlebotomy - Drs O'Neill Kak | ||||
| 214 N Elm Ave | Jackson | MI | 49202 | Phlebotomy office (independent physician practice) |
| 45 - Phlebotomy - Dr Rosenburg et al | ||||
| 214 N West Ave | Jackson | MI | 49202 | Phlebotomy office (independent physician practice) |
| 46 - Allegiance Health Pharmacy | ||||
| 2200 Springport Road Ste 100 | Jackson | MI | 49202 | Long-term care pharmacy services |
| 47 - Allegiance Behavioral Health Services - | ||||
| 2200 Springport Road Ste 200 | Jackson | MI | 49202 | Mental health OP services |
| 48 - Allegiance Senior Health Center | ||||
| 2200 Springport Road Ste 500 | Jackson | MI | 49202 | Geriatric services |
| 49 - Allegiance Wound Care Center - Springpor | ||||
| 2200 Springport Road Ste 500 | Jackson | MI | 49202 | Treatment and therapy |
| 50 - Allegiance Diagnostic Center - Springpor | ||||
| 2200 Springport Road Ste 800 | Jackson | MI | 49202 | Laboratory services |
| 51 - Medication Therapy Management Clinic | ||||
| 2200 Springport Road Ste 900 | Jackson | MI | 49202 | Pharmaceutical counseling services |
| 52 - Allegiance Addiction Recovery Center | ||||
| 2424 W Washington Ave | Jackson | MI | 49203 | Inpatient and outpatient treatment |
| 53 - Allegiance Family Medicine - Summit Wood | ||||
| 2585 Spring Arbor Road | Jackson | MI | 49203 | Family medicine |
| 54 - Allegiance Vascular Health | ||||
| 300 W Washington Avenue Ste 300 | Jackson | MI | 49201 | Physician specialty practice |
| 55 - Allegiance Vascular Laboratory | ||||
| 300 W Washington Avenue Ste 350 | Jackson | MI | 49201 | Vascular system testing (ultrasound) |
| 56 - Michigan Heart | ||||
| 309 Page Avenue | Jackson | MI | 49201 | Cardiovascular care, diagnostic testing |
| 57 - Allegiance Family Medicine - East Michig | ||||
| 3235 E Michigan Avenue Ste 100 | Jackson | MI | 49202 | Family medicine |
| 58 - Allegiance Internal Medicine - East Mich | ||||
| 3235 E Michigan Avenue Ste 150 | Jackson | MI | 49202 | Internal medicine |
| 59 - Allegiance Diagnostic Center - West | ||||
| 3305 Spring Arbor Rd Ste 100 | Jackson | MI | 49203 | Lab and imaging services |
| 60 - Allegiance Women's Health Center | ||||
| 3305 Spring Arbor Rd Ste 500 | Jackson | MI | 49203 | Clinical exams, mammograms, spa services |
| 61 - Allegiance Family Medicine - Cascades Ri | ||||
| 3333 Spring Arbor Rd Ste 100 | Jackson | MI | 49203 | Family medicine (pending, not currently open) |
| 62 - Allegiance Family Medicine - Townsend | ||||
| 400 Hinckley Blvd Ste 100 | Jackson | MI | 49203 | Family medicine |
| 63 - Allegiance Diagnostic Center - Vandercoo | ||||
| 400 Hinckley Blvd Ste 200 | Jackson | MI | 49203 | Lab and imaging services |
| 64 - Allegiance Family Medicine - Michigan Ce | ||||
| 4304 Page Ave | Michigan Center | MI | 49254 | Family medicine (pending, not currently open) |
| 65 - Allegiance Diagnostic Center - Michigan | ||||
| 4304 Page Ave | Michigan Center | MI | 49254 | Lab and imaging services |
| 66 - Allegiance Physical Rehabilitation - Mic | ||||
| 4304 Page Ave Ste 100 | Michigan Center | MI | 49254 | Rehabilitation services |
| 67 - Allegiance Digestive Health - Ann Arbor | ||||
| 4400 Ann Arbor Road | Jackson | MI | 49202 | Outpatient GI procedures |
| 68 - Phlebotomy - Drs Munro Munro | ||||
| 500 Lansing Ave | Jackson | MI | 49202 | Phlebotomy office (independent physician practice) |
| 69 - Allegiance Diagnostic Center - North Jac | ||||
| 505 N Jackson St Ste 178 | Jackson | MI | 49201 | Lab and imaging services |
| 70 - Allegiance Home Medical Equipment | ||||
| 700 E Michigan Ave | Jackson | MI | 49201 | Retail sales of durable medical equipment |
| 71 - Allegiance Wound Care and Hyperbaric Cen | ||||
| 704 E Michigan Ave | Jackson | MI | 49201 | Oxygen treatment center |
| 72 - Phlebotomy - Dr Lynd | ||||
| 724 W Franklin | Jackson | MI | 49203 | Phlebotomy office (independent physician practice) |
| 73 - Allegiance General Surgery | ||||
| 744 W Michigan Ave Ste 200 | Jackson | MI | 49201 | Physician specialty practice |
| 74 - Allegiance Gastroenterology | ||||
| 744 W Michigan Ave Ste 201 | Jackson | MI | 49201 | Physician specialty practice |
| 75 - Riverside Pediatrics | ||||
| 760 W Franklin | Jackson | MI | 49203 | Pediatric medicine (acquired 1/1/16) |
| 76 - Allegiance Endocrinology | ||||
| 813 W Michigan Ave | Jackson | MI | 49202 | Physician specialty practice |
| 77 - Allegiance Wound Care Center | ||||
| 813 W Michigan Ave | Jackson | MI | 49202 | Treatment and therapy |
| 78 - Allegiance Diabetes Education Center | ||||
| 817 W High Street | Jackson | MI | 49203 | Diabetes education services |
| 79 - Allegiance Diagnostic Center - East | ||||
| 900 E Michigan Ave Ste 102 | Jackson | MI | 49201 | Laboratory services |
| 80 - Allegiance Diagnostic Center - Grass Lak | ||||
| 12369 E Michigan Ave | Grass Lake | MI | 49240 | Lab and imaging services |
| 81 - Allegiance Family Medicine - Grass Lake | ||||
| 12369 E Michigan Ave | Grass Lake | MI | 49240 | Family medicine |
| 82 - Allegiance Family Medicine - Leslie | ||||
| 130 N Sherman St | Leslie | MI | 49251 | Family medicine |
| 83 - Allegiance Family Medicine - Mason | ||||
| 810 Hogsback Rd Ste A | Mason | MI | 48854 | Family medicine |
| 84 - Allegiance Health Diagnostic Center - Ma | ||||
| 810 Hogsback Rd Ste B | Mason | MI | 48854 | Lab and imaging services |
| 85 - Allegiance Physical Rehabilitation - Mas | ||||
| 810 Hogsback Rd Ste B | Mason | MI | 48854 | Rehabilitation services |
| 86 - Allegiance Diagnostic Center - Brooklyn | ||||
| 153 Wamplers Lake Rd | Brooklyn | MI | 49230 | Laboratory services (Jan 2016 adding imaging services) |
| 87 - Hillsdale Specialty Clinic | ||||
| 30 S Howell St | Hillsdale | MI | 49242 | Specialty practice timeshare - Vascular and Neurosurgery |
| 88 - Hillsdale Hand Clinic | ||||
| 61 W Carleton | Hillsdale | MI | 49242 | Rebalitation services |
| 89 - Allegiance Family Medicine - Onsted | ||||
| 8958 M-50 | Onsted | MI | 49265 | Family medicine |
| 90 - Oaklawn Specialty Clinic | ||||
| 215 E Mansion St Ste 1-D | Marshall | MI | 49068 | Specialty practice timeshare - Thoracic |
| 91 - Allegiance Family Medicine - Albion | ||||
| 27931 C Drive North | Albion | MI | 49224 | Family medicine |
| 92 - Allegiance Family Medicine - Spring Arbo | ||||
| 7845 Spring Arbor Road | Spring Arbor | MI | 49283 | Family medicine |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | The Hospital prepares an annual community benefit report, which can be accessed at allegiancehealth.org/givingback. |
| Part I, Line 7: | The Hospital used a cost-to-charge ratio to calculate the cost of charity care and Medicaid shortfall. Community Health Improvement Services, Health Professions Education, Research and Contributions are actual amounts. |
| Part I, Ln 7 Col(f): | Our total expense from Form 990, Part IX, line 25, column (A) was $507,720,385. This expense is used as the denominator for purposes of calculating Part I, Line 7, column(f). The denominator does not include bad debt expense. Bad debt expense is subtracted from net patient services revenue. |
| Part II, Community Building Activities: | The Hospital is involved in numerous community building activities. We believe these activities, such as supporting affordable housing, working in partnership with the local community college to develop skilled nurses and supporting economic development programs directly improve the general health and wellness of the community. Also, staff at every level of the organization are encouraged to serve community groups that promote education, health and economic advocacy for the less fortunate. |
| Part III, Line 2: | The $37,056,964 is made up of actual write offs incurred during FY 2016 less any payments made to accounts after they have been determined to be bad debt. In addition any accounts that are still in accounts receivable have a reserve established based on historical experience to estimate the amount of bad debt that will result from these outstanding accounts. |
| Part III, Line 4: | Accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its historical experience and identifies trends for each of its major payor sources to estimate the appropriate allowance for uncollectible accounts and the provision for bad debts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party health care coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and provision for bad debts. For receivables associated with self-pay accounts (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. The provision for bad debts has been reported as a deduction from net patient service revenue.The amount of bad debt reported in the fiscal year 2016 financial statements was $37,056,964. |
| Part III, Line 8: | The Organization believes the entire Medicare shortfall reported on Line 7 should be treated as Community Benefit. Henry Ford Allegiance Health is nationally recognized by Healthgrades as being in the top five percent nationally for patient safety (seven years in a row). Henry Ford Allegiance Health also benchmarks favorably on overall cost per case and is deemed to be an efficient provider. The Organization is subsidizing a government program and sustaining significant losses in providing health care to Medicare receipients. By continuing to treat patients eligible for Medicare, hospitals alleviate the federal government's burden for directly providing medical services. |
| Part III, Line 9b: | The Hospital does not collect from patients known to qualify for charity care or other financial assistance. Patients having difficulty paying their bills are directed to financial counselors. These counselors review the patient's information in order to see if they qualify for assistance. In addition, bills sent to patients include a number to call for help in providing the required financial information to qualify for charity care. |
| Part VI, Line 2: | The Health Improvement Organization (HIO) was founded on the understanding that long-term health improvement requires that we extend beyond acute medical care to affect the social and environmental determinants of health. Since its creation in 2000, the HIO has evolved to become a national best practice model for organizing population health improvement efforts in a region. The Health Improvement Organization Coordinating Council (HIO CC) is the community stakeholder collaborative, led by Henry Ford Allegiance Health, responsible for completing shared needs assessments, identifying high priority health issues, developing and coordinating implementation of collaborative action plans and monitoring progress over time. In FY16, the HIO CC completed an updated Community Health Assessment report and 2016-2017 Community Action Plan. The Community Health Assessment was posted on the Henry Ford Allegiance Health and HIO websites and adopted by the Henry Ford Allegiance Board of Trustees and HIO Coordinating Council in June 2016. This plan reflects significant work of many dedicated organizations and individuals: Over 1200 Jackson County residents responded to our third Community Health Assessment phone survey or participated in focus group discussions to provide insight about local health status, attitudes, beliefs, behaviors and opportunities. More than 30 HIO Coordinating Council representatives from local government, public health, health care, school districts, mental health, employers and other human service sectors spent months reviewing local data, best practice research and community input to revise our Goals and Objectives for 2016-2017. Three existing community initiatives were voted into the Health Improvement Organization, resulting in seven Health Action Teams leading change around priority health issues.Over 20 organizations and individuals stepped up to lead Health Action Teams and champion specific strategies.Our Community Health Assessment gives Jackson a powerful tool to measure health indicators within geographic and demographic subpopulations and to track changes over time. Based on the most recent data, the HIO continues to prioritize obesity, smoking and behavioral health as targets for improvement. Action Teams organized around goals in each of these areas are pursuing evidence-based community strategies such as increasing access to healthy food, enhanced mental health screening, and anti-tobacco policies. In addition to topic-specific teams around improving nutrition, physical activity, smoke-free lifestyles, behavioral health, teen pregnancy prevention, maternal and child health, and substance abuse prevention, the HIO is active in two cross-network initiatives. The Collaborative Council is a stakeholder group comprised of individuals from health, education, and financial stability. The Collaborative Council exists to coordinate the work of all strands and agencies to maximize efficiency across the community. The Community Engagement Committee is a partnership of the HIO and Cradle to Career, Jackson's education network. Leaders from both initiatives recognized parallel goals to engage populations served and made the decision to combine efforts in order to maximize resources.The Community Action Plan (CAP) report approved by the Board of Trustees during FY2016 clearly communicates Henry Ford Allegiance Health's role and responsibilities relative to implementation of action plans. |
| Part VI, Line 3: | Uninsured inpatients and observation patients are referred to a financial counselor (contracted agent/partner) for assistance with Medicaid, SSI, and Henry Ford Allegiance Health program applications. Many outpatients needing or having received hospital services are also referred to the agent/partner for assistance. ER patients are provided with a packet of information at discharge from the department. This packet includes information about how assistance may be obtained through the local Medicaid office and about how to apply for our income structured payment plan and uncompensated care programs. When patients are billed for balances they owe, we solicit them to call the Business Office with any questions or for assistance. Additionally, a series of letters are sent to patients to apprise them of payment and assistance options. Allegiance has a printed brochure that is available through Registration that includes information regarding Medicaid application assistance and our internal programs. The Henry FordAllegiance Health website includes a series of web pages related to transparency, quality, pricing, and our financial policies, procedures, and programs. Uninsured patients needing mental health services are screened for eligibility through our partnership with the Jackson Community Mental Health Agency, which funds care for indigent, dual diagnosis, and Medicaid patients. Patients seeking substance abuse care are linked with the Mid-South Substance Abuse Commission. Registration and Business Office team members receive direct training on our programs and scripting for ensuring information is provided to the patients and families with whom our staff interact. Education is provided to organizational leaders to ensure that team members outside of Finance are aware of our programs and where to direct patients and families who may need or who are seeking assistance. |
| Part VI, Line 4: | Henry Ford Allegiance Health's market is determined geographically by the boundaries of Jackson County. The hospital is a tax exempt Health System that serves the collective health needs of the more than 160,000 residents of Jackson County. The gender distribution of Jackson County residents is 49% female and 51% male. The age distribution of Jackson County is 26% of residents 19 years and under, 18% between 20 and 34 years, 29% between 35 and 54 years, 13% between 55 and 64 years, and 14% of residents are 65 years and older. Racial distribution of Jackson County residents according to the 2011 Census Data is 88.0% as white, 7.9% as African American, 0.7% as Asian, 0.4% as American Indian or Alaska Native, and 3.0% as some other race or two or more races. Of males aged 15 years and over, 33.0% have never married, 50.4% are married, 1.5% are separated, 2.9% are widowed, and 12.3% are divorced. Of females aged 15 and over, 25.0% have never married, 50.4% are married, 1.7% are separated, 9.8% are widowed, and 13.2% are divorced. According to the Bureau of Labor Statistics (2013), Jackson County also experiences a high unemployment rate of 8.8%. With 69,400 individuals in the civilian labor force, 6,100 residents are currently unemployed. Of those employed, major industries represented include educational services, health care, and social assistance (23.9%); manufacturing (18.7%); retail trade (12.1%); professional, scientific, management, administrative, and waste management services (7.7%); and arts, entertainment, recreation, accommodation, and food services (7.5%). Approximately 51% of Allegiance Hospital patients were covered by Medicare, while 27% were on Medicaid and 1% were uninsured. During the 2016 fiscal year, Henry Ford Allegiance Health had 8,952 Medicare discharges and 4,655 Medicaid discharges from inpatient services. Physician practice visits totaled 266,070 during FY 2016, with 148,071 primary care visits and 117,999 visits to specialists. Henry Ford Allegiance Health also provides financial and leadership support of primary care services for the underserved, regardless of their ability to pay, through the Center for Family Health (CFH), a federally qualified health center. In fiscal year 2016, CFH saw approximately 27,000 patients. |
| Part VI, Line 5: | The mission of Henry Ford Allegiance Health is to lead our community to better health and well-being at every stage of life.Soon to celebrate a century of providing care to our community, Henry Ford Allegiance Health's success in creating an environment for safe, clinically sound, patient-centered care has earned many accolades from across the health care industry. While these awards recognize our commitment to providing exceptional patient care, they also challenge us toward continuous improvement across the continuum.CMS Four-Star Rating - Henry Ford Allegiance Health has received a four-star rating from the Centers for Medicare & Medicaid Services (CMS), largely reflecting our significant commitment to quality and safety.Another "A" for Patient Safety from The Leapfrog Group - The Leapfrog Group, a national patient safety watchdog, ranked Henry Ford Allegiance Health among the 844 hospitals to receive an "A," ranking it among the safest hospitals in the United States. Overall, Henry Ford Allegiance Health has received an A with every ranking-a total of ten times--since the Hospital Safety Grade was first initiated in Spring of 2012. Henry Ford Allegiance Health is one of only three hospitals in Michigan to accomplish this, and among the 72 graded hospitals that have achieved this longstanding recognition nationwide.We Honor Veterans - Henry Ford Allegiance Health is proud to have been designated a Level 3 Hospice Partner of the We Honor Veterans program, a collaboration with the National Hospice Palliative Care Organization and the Veterans Administration.Looking Toward our Community's Future: In late 2016, construction began on a new three-story, 59,000 square-feet patient tower with 66 private rooms. Forty-four new physicians and Advanced Practice Providers were added to increase access to primary care, specialty care and new services, which include dermatology, cosmetic and reconstructive plastic surgery, and obstetrics/gynecology.Ground was broken for a two-story Center for Health Innovation & Education-a regional training center for health care professionals that will include leading-edge technology, such as a simulation lab designed to look and feel like real inpatient and outpatient settings.Initiatives are underway to provide our community with care that is secure, comprehensive and accessible to all who need us. The implementation of Epic-a new electronic health record that will allow a seamless care experience by providing one patient record, available at all times and all places to patients and their caregivers. The system's MyChart patient portal provides a simple, secure and convenient way for patients to manage their health care online as well as connect with their physicians.Jackson Health Network is collaborating with Henry Ford Physician Network (comprised of more than 1,800 physicians throughout southeast Michigan) on ways to improve patient care system-wide.Clinicians and administrators are working to identify opportunities to bring new services to the Jackson area, including those related to oncology, rheumatology, urology, cardiovascular health and the neurosciences, including neurosurgery.Promoting Continuous Health Improvement in Our CommunityThe Health Improvement Organization (HIO) was created by our health system in 2001 to promote a culture of continuous health improvement in our community and integrate wellness and prevention throughout our services. The Henry Ford Allegiance Department of Prevention and Community Health provides staff and infrastructure to facilitate the coordination of local health improvement activities. |
| Part VI, Line 6: | The Hospital's sole corporate member is Henry Ford Allegiance Health Group, a 501(c)(3) organization. Other affiliates include: Henry Ford Allegiance Health Foundation; Henry Ford Allegiance Hospice; Henry Ford Allegiance CareLink, a Long Term Acute Care Hospital (LTACH); Volunteers of Henry Ford Allegiance Health. These are all 501(c)(3) non-profit organizations working together to improve healthcare in and around Jackson, MI. Additionally, the Hospital recently formed Jackson Health Network (JHN), a clinically integrated network.The Foundation and the Volunteer organization work closely with Henry Ford Allegiance Health Group and the hospital to raise funds for projects and services that benefit the overall well-being of the community. Previous campaigns successfully raised funds to expand and improve our Graduate Medical Education program, cancer care service line and provided free medical care to indigent patients. Jackson Health Network works to improve patient clinical outcomes thru coordinated care and lowering overall health care costs. |
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 | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| Center for Family Health | ||||||||||
| 2298 Springport Road | Jackson | MI | 49202 | 383251354 | 501(c)(3) | $400,000 | $0 | N/A | Federally Qualified Health Center | The Center for Family Health grant provides operational support for medically underserved populations. |
| United Way of Jackson County | ||||||||||
| 536 North Jackson Street | Jackson | MI | 49201 | 381368341 | 501(c)(3) | $26,600 | $0 | N/A | Fresh Food Initiative | Funded teen pregnancy prevention, community projects, and the Fresh Food Initiative. |
| 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 | The Organization sends out an award letter to all grantee recipents. The letter outlines what the funding may be used for and requests a final report detailing the year's activities. Further funding is contingent upon satisfactory completion of this report. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 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 | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Georgia Fojtasek | ||||||||||||||
| President & CEO | $677,474 | $0 | $375,104 | $0 | $124,705 | $0 | $52,504 | $0 | $23,273 | $0 | $1,253,060 | $0 | $25,744 | $0 |
| Robert Riney | ||||||||||||||
| Trustee as of 04/01/16 | $0 | $978,251 | $0 | $899,267 | $0 | $233,265 | $0 | $25,805 | $0 | $24,395 | $0 | $2,160,983 | $0 | $0 |
| Adnan Munkarah | ||||||||||||||
| Trustee as of 04/01/16 | $0 | $688,364 | $0 | $90,395 | $0 | $20,970 | $0 | $23,155 | $0 | $23,661 | $0 | $846,545 | $0 | $0 |
| Mohan Kulkarni | ||||||||||||||
| Trustee | $221,673 | $0 | $527,220 | $0 | $51,364 | $0 | $43,498 | $0 | $28,238 | $0 | $871,993 | $0 | $0 | $0 |
| Karen Chaprnka | ||||||||||||||
| SVP & COO thru 1/31/16 | $186,067 | $0 | $112,034 | $0 | $64,742 | $0 | $41,670 | $0 | $12,575 | $0 | $417,088 | $0 | $8,625 | $0 |
| Jeanne' Wickens | ||||||||||||||
| SVP & CFO thru 5/7/16 | $405,620 | $0 | $186,864 | $0 | $56,049 | $0 | $22,613 | $0 | $30,483 | $0 | $701,629 | $0 | $36,242 | $0 |
| Aaron Wootton | ||||||||||||||
| VP & CIO | $194,284 | $0 | $44,080 | $0 | $1,280 | $0 | $31,278 | $0 | $28,580 | $0 | $299,502 | $0 | $0 | $0 |
| Kenneth Empey | ||||||||||||||
| General Counsel | $250,050 | $0 | $70,511 | $0 | $19,089 | $0 | $45,583 | $0 | $21,282 | $0 | $406,515 | $0 | $6,250 | $0 |
| Beth Smith | ||||||||||||||
| Chief Compliance Officer | $163,901 | $0 | $46,290 | $0 | $20,996 | $0 | $23,533 | $0 | $10,713 | $0 | $265,433 | $0 | $4,110 | $0 |
| Ondrea Bates | ||||||||||||||
| SVP Patient Care | $260,705 | $0 | $117,677 | $0 | $888 | $0 | $39,608 | $0 | $29,332 | $0 | $448,210 | $0 | $0 | $0 |
| Ray King | ||||||||||||||
| Chief Medical Officer | $385,041 | $0 | $174,114 | $0 | $56,329 | $0 | $53,206 | $0 | $23,149 | $0 | $691,839 | $0 | $9,275 | $0 |
| Patricia Seagram | ||||||||||||||
| VP Human Resources as of 03/27/16 | $164,123 | $0 | $13,733 | $0 | $1,703 | $0 | $17,162 | $0 | $9,927 | $0 | $206,648 | $0 | $0 | $0 |
| Kevin Leonard | ||||||||||||||
| VP Finance | $190,586 | $0 | $55,414 | $0 | $4,383 | $0 | $30,189 | $0 | $10,603 | $0 | $291,175 | $0 | $0 | $0 |
| Vishal Gupta | ||||||||||||||
| Physician | $41,560 | $0 | $946,933 | $0 | $19,165 | $0 | $62,590 | $0 | $30,131 | $0 | $1,100,379 | $0 | $0 | $0 |
| Ryan Beekman | ||||||||||||||
| Physician | $133,413 | $0 | $728,286 | $0 | $19,165 | $0 | $58,067 | $0 | $6,590 | $0 | $945,521 | $0 | $0 | $0 |
| Harish Rawal | ||||||||||||||
| Physician | $296,466 | $0 | $1,101,036 | $0 | $192,334 | $0 | $39,481 | $0 | $22,262 | $0 | $1,651,579 | $0 | $133,958 | $0 |
| Amritraj Loganathan | ||||||||||||||
| Physician | $170,250 | $0 | $658,445 | $0 | $20,077 | $0 | $58,282 | $0 | $6,545 | $0 | $913,599 | $0 | $0 | $0 |
| Stephen Lee Kirkner | ||||||||||||||
| Physician | $153,130 | $0 | $771,457 | $0 | $34,934 | $0 | $59,757 | $0 | $20,400 | $0 | $1,039,678 | $0 | $0 | $0 |
| Anthony Gardner | ||||||||||||||
| VP Marketing thru 07/10/15 | $96,157 | $0 | $0 | $0 | $29,872 | $0 | $709 | $0 | $6,952 | $0 | $133,690 | $0 | $19,654 | $0 |
| Gerald Grannan | ||||||||||||||
| VP Physician Integrationg thru 02/05 | $198,586 | $0 | $62,973 | $0 | $2,084 | $0 | $15,259 | $0 | $4,786 | $0 | $283,688 | $0 | $0 | $0 |
| George Hunter | ||||||||||||||
| VP Human Resources thru 06/12/15 | $112,265 | $0 | $0 | $0 | $164,841 | $0 | $0 | $0 | $11,156 | $0 | $288,262 | $0 | $11,781 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Henry Ford Allegiance Health provides a country club membership to three executives. The executives reimburse the hospital for any personal use of the club. These benefits did not result in taxable compensation during FY 16. |
| Part I, Line 3 | The CEO is accountable for ensuring that Allegiance Health's mission is efficiently carried out with the highest levels of quality, safety and service, while at the same time ensuring that the organization is financially healthy. Executive compensation is reviewed annually by the Executive Compensation Committee of the Board of Trustees. This committee works with an independent compensation consultant to ensure that Henry Ford Allegiance Health compensation practices are consistent with industry standards and that compensation levels are fair compared to similar healthcare organizations nationally. The compensation consultant benchmarks Henry Ford Allegiance Health's positions against data from multiple published surveys of health care executive compensation in the national health care labor market. Based upon the consultants recommendations, the Executive Compensation Committee makes a recommendation to the Board of Trustees for approval of the executive compensation program. Only independent Trustees vote on this recommendation. |
| Part I, Lines 4a-b | Henry Ford Allegiance Health's officers and certain employed physicians participate in a non-qualified deferred compensation plan. The plan, which began in 2005, partially vested for someofficers and highest compensated employees in Fiscal Year 2016. Payout of vested amounts resulted in an increase of salary. The calendar year 2015 contribution and payout amounts are as follows: 457(f) Contributions reported in Schedule J, Part II, column (C): Georgia Fojtasek $26,666, Karen Chaprnka $21,625. Ray King $35,318, Kenneth Empey $21,733, Beth Smith $4,173, Kevin Leonard $16,881, Ondrea Bates $24,370, Ryan Beekman $56,079, Vishal Gupta $62,590 Harish Rawal $39,481, Stephen Lee Kirkner $57,770, Amritraj Loganathan $56,294 457(f) Payouts reported in Schedule J, Part II, column B(iii): Georgia Fojtasek $94,250, Jeanne' Wickens $36,242, Karen Chaprnka $39,193, Ray King $33,402, Kenneth Empey $11,894, George Hunter $11,788 Beth Smith $14,180, Anthony Gardner $19,666, Harish Rawal $147,167 |
| Part I, Line 7 | Column B(ii) of Part II, Schedule J includes non-fixed payments to certain physicians based on their productivity and other performance metrics. |
| Schedule J, Part II, Lines 2-3 | Amounts reported for Mr. Riney and Dr. Munkarah represent compensation paid to them by Henry Ford Health System in calendar year 2015. This is prior to the affiliation in April, 2016 with Henry Ford Allegiance Health Group. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| County of Jackson Hospital Finance Authority | ||||||||
| A | 386004845 | 467148EH1 | 2011-04-21 | $65,375,000 | See Part VI | 0 | 0 | 0 |
| County of Jackson Hospital Finance Authority | ||||||||
| B | 386004845 | 467148DC3 | 2010-11-02 | $140,238,036 | See Part VI | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | RetiredRetiredAmt | In Reserve FundInReserveFundAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $65,375,000 | $540,128 | $18,425 | $64,816,447 | 2011 | Yes (1) | 0 | Yes (1) | Yes (1) | ||
| B | $145,077,818 | $840,059 | $495,263 | $138,946,800 | Yes (1) | 0 | Yes (1) | Yes (1) | $84,951,447 | $4,795,696 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00440 | 0.00440 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Business Name Line2HedgeProviderName/BusinessNameLine2Txt | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Royal Bank of | |||||||||||||
| A | 0 | Yes (1) | 0 | 0 | Yes (1) | Yes (1) | Canada | 25.000000000000 | 0 | 0 | 0 | 0 | Yes (1) |
| (no name) | |||||||||||||
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) | ||||
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line A, Column (f) | Primarily to add marketability to underlying variable rates and refund Bonds. The Bonds refunded are as follows: $36,500,000 County of Jackson Hospital Finance Authority Variable Rate Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2011A were issued to refund the Series 2006A bonds. $28,875,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2011B were issued to refund the Series 2010 bonds. |
| Part I, Line B, column (f) | Primarily to obtain traditional fixed interest on bond debt at a time of low prevailing rates and to reissue and refund bonds. The bonds reissued and refunded are as follows: $29,925,000 County of Jackson Hospital Finance Authority Hospital Variable Rate Demand Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan), Series 2006B-1, reissued for tax purposes on 11/02/2010 $8,940,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan) Series 2006B-2, reissued for tax purposes on 11/02/2010 $47,400,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan) Series 2006C, reissued for tax purposes on 11/02/2010 $51,655,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2010A were issued to refund the Series 2007A and Series 1997A bonds. |
| Part II, Line 3, Column B | The difference of $4,839,782 between Part I, column (e) and Part II, Line 3 is due to net investment losses and investment income. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (3 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| Patrick Nally | |||||||
| Son of John Nally, Chairman of Allegiance Health | Employee Recruitment Loan | Yes (X) | $115,000 | $115,000 | 0 | Yes (1) | Yes (1) |
| Stephen Lee Kirkner | |||||||
| Highest Compensated Employee | Physician Recruitment Loan | Yes (X) | $9,578 | $756 | 0 | Yes (1) | Yes (1) |
| Amritraj Loganathan | |||||||
| Highest Compensated Employee | Physician Recruitment Loan | Yes (X) | $25,000 | $18,878 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $134,634 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Amy Schultz | |||
| Daughter of Larry Schultz, Henry Ford Allegiance Health Trustee | $216,297 | Employee Wages | 0 |
| Patrick Nally | |||
| Son of John Nally, Henry Ford Allegiance Health Trustee, Board Chair | $122,800 | Employee Wages | 0 |
| Clark & King Investments LLC (Clark & King) | |||
| Ray King, Henry FordAllegiance Health officer, is a partner in Clark & King | $387,200 | Reported amount is for lease payments made by Allegiance Health to Clark & King for a medical office building. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part IV, Line 12 | The organization is an element of the external audit report obtained for the consolidated operations of Henry Ford Health System. |
| Form 990, Part VI, Section A, line 4 | During the year, the Articles of Incorporation were amended to reflect the change in ownership of the parent company of Henry Ford Allegiance Health, Henry Ford Allegiance Health Group (formerly Allegiance Health Services). Henry Ford Health System became the sole member of Henry Ford Allegiance Health Group on April 1, 2016. Allegiance Health Services had previously been organized on a directorship basis. |
| Form 990, Part VI, Section A, line 6 | The Corporation is organized on a membership basis. The sole corporate member of the Corporation is Henry Ford Allegiance Health Group (formerly Allegiance Health Services). |
| Form 990, Part VI, Section A, line 7a | The sole Member of the organization may elect and remove, with or without cause, the Corporation's Trustees. |
| Form 990, Part VI, Section A, line 7b | The following powers are reserved for the sole corporate Member of the hospital. Approve any change in the Articles of Incorporation, purposes or philosophy of the Corporation; Approve changes in those provisions of the Corporation's Bylaws which affect the size, composition, and method of selection of the Board of Trustees, or which affect this Article; Approve plans of merger, consolidation or dissolution of the Corporation; Elect and remove, with or without cause, the Corporation's Trustees, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present; Approve guarantees by the Corporation of the debt of others in excess of maximum limits established by the Member, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present; Authorize the sale, lease, mortgage or other disposition of all or substantially all of the assets owned, held or leased by or to the Corporation, approve any decision by the Corporation which would have the net effect of diminution of governance control of the Member, and any decision by the Corporation which would have the net effect of diminution in the Corporation's governance control over it's own subsidiary; Ratify or reject operating and capital budgets developed by the Board and any non-budgetary expenditures or creations of debt in excess of an amount designated by the Member from time to time, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present; and Authorize the formation or acquisition of new subsidiaries of the Corporation or the sale or other disposition of existing subsidiaries. |
| Form 990, Part VI, Section B, line 11 | Form 990 is reviewed by the Organization's Director and VP of Finance, Chief Executive Officer, General Counsel, and Compliance Officer. Final copies of the return are distributed to the Hospital's Board of Trustees before the return is filed. |
| Form 990, Part VI, Section B, line 12c | The Board Compliance Committee has ultimate responsibility over the enforcement of the Hospital's Conflict of Interest Policy. When a potential conflict of interest is identified, the Compliance Committee is responsible for review of the conflict of interest for compliance with the policy. Also, General Counsel routinely reviews upcoming Board and Committee meeting agendas to assess potential conflict situations. All employees are responsible to complete a conflict of interest statment. Trustees, directors, and key employees are required to fill out an annual conflict of interest questionnaire. Board Trustees identified as having a conflict of interest are permitted to discuss the potential transaction. They are not allowed to deliberate in the decision or vote on the matter. |
| Form 990, Part VI, Section B, line 15 | The Organization performs an annual review and assessment of the compensation of the Chief Executive Officer and each of the executives listed in Part VII of the Form 990. This review includes an independent compensation committee and the engagement of an independent compensation consultant. This process is usually undertaken during the Fall. The Compensation Committee, an independent committee of the Board of Trustees, is responsible for the executive compensation program. This committee performs an annual review of the competitiveness, reasonablenes and effectiveness of all executive cash compensation and benefit programs. The committee also leads the Board in evaluating the performance of the Chief Executive Officer and recommends all aspects of the Chief Executive Officer's compensation. The committee reviews the Chief Executive Officer's recommendations regarding the compensation of all other members of executive leadership. The Compensation Committee engages an independent compensation consulting firm to conduct a comprehensive market analysis of total compensation for executive leadership. This firm uses data representing compensation levels and practices from national not-for-profit healthcare markets as Henry Ford Allegiance Health typically competes to the the national healthcare marketplace for executive talent. National data also provides more comparable information for size and operational characteristics so that comparisons are made to organizations with similiar scope and complexity. |
| Form 990, Part VI, Section C, line 19 | Forms 1023 and 990-T are available upon request. Form 990 is posted on the Organization's website. The conflict of interest policy is not available to the public. |
| Form 990, Part VII, Section A, Line 1a | Henry Ford Allegiance Health Trustees are not paid to serve on the Board. Compensation listed for Dr. David Halsey, Dr. Allan Tompkins, Dr. Mohan Kulkarni and Michael Shore in Part VII of the Form 990 is pay for on call medical service, medical director fees, employment compensation, and/or committee participation. |
| Form 990, Part IX, line 11g | Professional Other: Program service expenses 33,122,371. Management and general expenses 8,407,739. Fundraising expenses 0. Total expenses 41,530,110. Non Employed Physician Services: Program service expenses 12,313,910. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,313,910. |
| Form 990, Part XI, line 9: | Transfer from Parent -167,936. Change in Accounting for Pensions SFAS 158 -8,816,354. Other Changes in Net Assets -452,158. |
| Form 990, Part XII, Line 2C | Henry Ford Allegiance Health is included in the consolidated financial statements of Henry Ford Health System. The governing body of Henry Ford Health System has delegated oversight of the financial statements, including the choice of independent auditors, to its audit committee. Form 5713 - International Boycott Activity: A Form 5713, International Boycott Report, has been filed on our behalf by Henry Ford Health System (sole member of Henry Ford Allegiance Health Group). Henry Ford Allegiance Health did not itself have any activities associated with an international boycott company. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | EINEIN |
|---|---|---|---|---|---|---|---|---|---|
| Physicians Choice Network LLC | |||||||||
| 205 N East Avenue | Jackson | MI | 49201 | Provider Network | MI | $22,569 | -$11,083 | Henry Ford Allegiance Health | |
| Jackson Health Network L3C | |||||||||
| 205 N East Avenue | Jackson | MI | 49201 | Clinically Integrated Network | MI | $51,712 | $2,229,227 | Henry Ford Allegiance Health | 453253643 |
| Jackson Community Medical Records LLC | |||||||||
| 205 N East Avenue | Jackson | MI | 49201 | Electronic Medical Records | MI | -$116,296 | $2,303,610 | Henry Ford Allegiance Health | 371502443 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Henry Ford Allegiance Health Group | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382756428 | Exempt Health System | MI | 501(c)(3) | Line 11b, II | Henry Ford Health System | Yes (1) | |
| Allegiance Health Foundation | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 383607833 | Supports Allegiance Health | MI | 501(c)(3) | Line 11b, II | Henry Ford Allegiance Health Group | Yes (1) | |
| Hospice of Jackson dba Allegiance Hospice | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382336367 | Hospice Care | MI | 501(c)(3) | Line 7 | Heathlink | Yes (1) | |
| The Hospice of Jackson Endowment Fund | |||||||||||
| One Jackson Square | Jackson | MI | 49201 | 383422146 | Raise Funds for Allegiance Hospice | MI | 501(c)(3) | Line 11b, II | Allegiance Hospice | Yes (1) | |
| Healthlink | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382756425 | Home Health Care | MI | 501(c)(3) | Line 11a, I | Henry Ford Allegiance Health Group | Yes (1) | |
| Volunteers of Henry Ford Allegiance Health | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 386082835 | Exempt Association | MI | 501(c)(3) | Line 7 | Henry Ford Allegiance Health Group | Yes (1) | |
| CareLink of Jackson | |||||||||||
| 110 North Elm Avenue | Jackson | MI | 49202 | 381218485 | Long Term Acute Care Hospital | MI | 501(c)(3) | Line 3 | Henry Ford Allegiance Health Group | Yes (1) | |
| Henry Ford Health System | |||||||||||
| One Ford Place | Detroit | MI | 48202 | 381357020 | Healthcare Service Provider | MI | 501(c)(3) | Line 3 | 0 | N/A | |
| Henry Ford Wyandotte Hospital | |||||||||||
| 2333 Biddle Ave | Wyandotte | MI | 48192 | 382791823 | Healthcare Service Provider | MI | 501(c)(3) | Line 3 | Henry Ford Health System | Yes (1) | |
| Henry Ford Health System Foundation | |||||||||||
| One Ford Place | Detroit | MI | 48202 | 237383042 | Supporting Organization | MI | 501(c)(3) | Line 11a, I | Henry Ford Health System | Yes (1) | |
| Health Alliance Plan | |||||||||||
| 2850 W Grand Blvd | Detroit | MI | 48202 | 382242827 | Health Maintenance Organization | MI | 501(c)(4) | Henry Ford Health System | Yes (1) | ||
| HFHS Self Funded Liability | |||||||||||
| One Ford Place | Detroit | MI | 48202 | 386553031 | Malpractice Insurance | MI | 501(c)(4) | Henry Ford Health System | Yes (1) | ||
| Henry Ford Continuing Care | |||||||||||
| One Ford Place | Detroit | MI | 48202 | 382433285 | Nursing Homes | MI | 501(c)(3) | Line 9 | Henry Ford Health System | Yes (1) | |
| HFii Corporation | |||||||||||
| One Ford Place | Detroit | MI | 48202 | 900840304 | Scientific Research | MI | 501(c)(3) | Line 7 | Henry Ford Health System | Yes (1) | |
| Henry Ford Health System Government Affairs Services | |||||||||||
| One Ford Place | Detroit | MI | 48202 | 464064067 | Advocacy Services for HFHS and affiliates | ME | 501(c)(4) | Henry Ford Health System | Yes (1) | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Foote Health Center Associates | |||||||||||||
| 1100 E Michigan Avenue | Jackson | MI | 49201 | 383017711 | Lessor of Medical Condominiums | MI | Henry Ford Allegiance Health | Related | -$1,148,030 | $202,625 | 0 | 0 | 0.54430 |
| Northwest Detroit Dialysis | |||||||||||||
| 30100 Telegraph | Bingham Farms | MI | 48025 | 383232668 | Operate Dialysis Clinic | MI | Henry Ford Health System | Related | 0 | 0 | |||
| Macomb Regional Dialysis Centers | |||||||||||||
| 16151 Nineteen Mile Rd | Clinton Township | MI | 48038 | 260423581 | Operate Dialysis Clinic | MI | Henry Ford Health System | related | 0 | 0 | |||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Share Of EOY AssetsShareOfEOYAssetsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Viking Health System Inc | ||||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382756161 | Idle Healthcare Administration Corporation | MI | Henry Ford Allegiance Health | C | 1.00000 | Yes (1) | ||
| Cascades Insurance Company LTD | ||||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 981132982 | Hospital Malpractice Insurance Captive | Henry Ford Allegiance Health | C | 1.00000 | Yes (1) | CJ | $14,475,300 | |
| Horizon Properties Inc | ||||||||||||
| One Ford Place | Detroit | MI | 48202 | 382679527 | Real Estate - Lessor Buildings | MI | Henry Ford Health System | C | 0 | |||
| Sha Realy Inc | ||||||||||||
| One Ford Place | Detroit | MI | 48202 | 381378121 | Real Estate Holding | MI | Henry Ford Health System | C | 0 | |||
| Fairlane Health Services | ||||||||||||
| 30100 Telegraph | Bingham Farms | MI | 48025 | 382565235 | Healthcare Management | MI | Henry Ford Health System | C | 0 | |||
| 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 | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (9 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Henry Ford Allegiance Health Group | ||
| R | $617,936 | FMV |
| Hospice of Jackson dba Henry Ford Allegiance Hospice | ||
| J | $288,418 | Cost |
| Hospice of Jackson dba Henry Ford Allegiance Hospice | ||
| L | $968,948 | Cost |
| Hospice of Jackson dba Henry Ford Allegiance Hospice | ||
| Q | $654,851 | FMV |
| Cascades Insurance Company LTD | ||
| P | $2,789,364 | FMV |
| Cascades Insurance Company LTD | ||
| L | $7,277,221 | FMV |
| Allegiance Health Foundation | ||
| C | $290,521 | FMV |
| CareLink of Jackson | ||
| Q | $4,286,297 | Cost |
| CareLink of Jackson | ||
| M | $955,702 | FMV |