HENRY FORD HEALTH ROCHESTER HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- HENRY FORD HEALTH ROCHESTER HOSPITAL (EIN 38-1359247)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201643209349315664
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule F
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-15T17:02:21-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 307 | AddressLine1Txt |
| City | SOUTHFIELD | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 480370307 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381359247 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENTON HOSPITAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CRIT | BusinessNameControlTxt |
| Phone | 2486525000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY DRIVE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48307 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET DIMOND | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2486525000 | PhoneNum |
| Signature | 2016-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CAROL A LALONDE CPA | PreparerPersonNm |
| PTIN | P00181637 | PTIN |
| Phone | 2483522500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARGARET DIMOND | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY DRIVE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48307 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $328,202,930 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CRITTENTON.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1900 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | CRITTENTON HOSPITAL MEDICAL CENTER IS DEDICATED TO ENHANCING THE HEALTH STATUS OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 1693 | TotalEmployeeCnt |
| Total Volunteers | 400 | TotalVolunteersCnt |
| Total Gross UBI | $2,797,794 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$1,143,807 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $325,202 | PYContributionsGrantsAmt |
| CY Contributions Grants | $101,727 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $223,919,269 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $197,961,381 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,109,875 | PYInvestmentIncomeAmt |
| CY Investment Income | $17,225,940 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,059,011 | PYOtherRevenueAmt |
| CY Other Revenue | $2,557,894 | CYOtherRevenueAmt |
| PY Total Revenue | $230,413,357 | PYTotalRevenueAmt |
| CY Total Revenue | $217,846,942 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $86,817,126 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $91,785,277 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $137,646,715 | PYOtherExpensesAmt |
| CY Other Expenses | $167,547,471 | CYOtherExpensesAmt |
| PY Total Expenses | $224,463,841 | PYTotalExpensesAmt |
| CY Total Expenses | $259,332,748 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,949,516 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$41,485,806 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $380,154,978 | TotalAssetsBOYAmt |
| Total Assets EOY | $361,124,723 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $214,063,057 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $259,940,082 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $166,091,921 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $101,184,641 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CRITTENTON HOSPITAL MEDICAL CENTER IS DEDICATED TO ENHANCING THE HEALTH STATUS OF THE INDIVIDUALS AND COMMUNITIES WE SERVE IN PARTNERSHIP WITH OUR PHYSICIANS, EMPLOYEES, AND COMMUNITY MEMBERS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $195,493,887 | ExpenseAmt |
| Revenue | $195,125,992 | RevenueAmt |
| Desc | THE HOSPITAL WAS INVOLVED IN A LARGE NUMBER OF COMMUNITY CARE PROJECTS, EITHER AS A PARTICIPANT OR A SPONSORING ORGANIZATION. THESE INCLUDE, BUT ARE NOT LIMITED TO: HEALTHY PREGNANCY, WOMEN'S HEALTHY HEART, NUTRITION, WEIGHT LOSS, HEALTHY AGING, CHILD SAFETY, HEALTH RISK APPRAISALS, SMOKING CESSATION, MANAGING STRESS, CPR, SLEEP DISORDER AND MEN'S HEALTH CLASSES FOR THE COMMUNITY. IN ADDITION, FREE BLOOD PRESSURE SCREENINGS ARE MADE AVAILABLE TO THE COMMUNITY. A BEREAVEMENT PROGRAM IS OFFERED THROUGH THE OBSTETRICS DEPARTMENT FOR GRIEVING PARENTS OF INFANTS. ANNUALLY, VOLUNTEERS FROM THE HOSPITAL PARTICIPATE AT THE ROCHESTER ARTS AND APPLES FESTIVAL, COLLECT GIFTS FOR THE ROCHESTER NEIGHBORHOOD HOUSE, COLLECT FOOD FOR THE MICHIGAN HARVEST GATHERING AND PARTICIPATE IN THE NORTH OAKLAND AMERICAN HEART WALK, THE BROOKSIE WAY AND COATS FOR COLD. A GEROPSYCHIATRIC PROGRAM WAS STARTED TO ASSIST OLDER ADULTS WITH HEALTH CARE CHANGES AND THE HOSPITAL ALSO HAS WOUND CARE SERVICES, INCLUDING HYPERBARIC TREATMENTS. | Desc |
| Total Program Service Expenses | $195,493,887 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 265 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1693 | 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KIM HAUSCHILD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2486525780 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY DRIVE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48307 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT LENIHAN II | ||||||||
| CHAIRMAN | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BEVERLY ALLEN | ||||||||
| VICE CHARIMAN & TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRYAN BARNETT | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LISA ASADOORIAN | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY DECLAIRE MD | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $104,211 | $0 | $0 | ||
| PETER DESTEIGER | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT GO MD | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $42,759 | $0 | $0 | ||
| KENNETH JOHNSON | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHRIN KUDNER | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| FREDERICK MAIBAUER MD | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| F SCOTT MILLER | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RUSSELL SHELTON | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRAD UPTON | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRADFORD MERRELLI MD | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT SKANDALARIS | ||||||||
| TRUSTEE - PART YEAR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROY POWELL | ||||||||
| PRESIDENT & CEO | 38.00 | 2.00 | Yes (X) | $527,563 | $0 | $35,778 | ||
| TERRY HAMILTON | ||||||||
| INTERIM CEO | 20.00 | 0.00 | Yes (X) | $12,000 | $0 | $0 | ||
| KENNETH SANGER | ||||||||
| CHIEF NURSING OFFICER | 40.00 | 0.00 | Yes (X) | $188,309 | $0 | $34,474 | ||
| AUDRIANNE MOCERI | ||||||||
| EXECUTIVE ASSISTANT | 40.00 | 0.00 | Yes (X) | $73,293 | $0 | $18,355 | ||
| PETER KORDA MD | ||||||||
| CHIEF OF STAFF | 40.00 | 0.00 | Yes (X) | $50,640 | $0 | $0 | ||
| MICHELLE HORNBERGER | ||||||||
| CHIEF STRATEGY OFFICER - PART YEAR | 39.00 | 1.00 | Yes (X) | $161,501 | $0 | $39,674 | ||
| DONNA KOPINSKI | ||||||||
| CHIEF FINANCIAL OFFICER | 38.00 | 2.00 | Yes (X) | $263,120 | $0 | $41,605 | ||
| SAMER KAZZIHA MD | ||||||||
| EXECUTIVE MEDICAL DIRECTOR | 31.20 | 0.00 | $339,800 | $0 | $0 | Yes (X) | ||
| DOUGLAS PUGMIRE DO | ||||||||
| MED. DIRECTOR ROBOTICS/GYN ONCOLOGY | 40.00 | 0.00 | $600,440 | $0 | $16,672 | Yes (X) | ||
| KEVIN FLOREK DO | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $263,776 | $0 | $39,705 | Yes (X) | ||
| ROBERT LACOSTE MD | ||||||||
| MEDICAL DIRECTOR BEHAVIORAL HEALTH | 40.00 | 0.00 | $263,496 | $0 | $21,674 | Yes (X) | ||
| MICHAEL LAKER MD | ||||||||
| ORTHOPEDIC SURGEON | 40.00 | 0.00 | $354,425 | $0 | $28,993 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,245,333 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $276,930 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 95 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WAYNE STATE UNIVERSITY | |||||
| 1420 STEVENSON HIGHWAY | TROY | MI | 48083 | PROFESSIONAL SERVICES | $8,588,679 |
| SODEXO INC AND AFFILIATES | |||||
| 4880 PAYSHERE CIRCLE | CHICAGO | IL | 60674 | PROFESSIONAL SERVICES | $5,356,799 |
| CARETECH SOLUTIONS INC | |||||
| PO BOX 674271 | DETROIT | MI | 48267 | IT SERVICES | $3,969,197 |
| CERNER HEALTHCARE SOLUTIONS | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64117 | IT SERVICES | $3,462,695 |
| SODEXO CTM | |||||
| PO BOX 415000 | NASHVILLE | TN | 37241 | PROFESSIONAL SERVICES | $2,270,169 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 69 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $101,727 | RelatedOrganizationsAmt |
| Total Contributions | $101,727 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $197,189,342 | $194,353,953 | $2,835,389 |
| AUC SCHOOL OF MEDICINE | 611600 | $274,144 | $274,144 | |
| DRS LAKER/PRINCE | 900099 | $175,180 | $175,180 | |
| MEDICAL RECORDS | 900099 | $115,434 | $115,434 | |
| COMMUNITY HEALTH | 900099 | $75,087 | $75,087 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $132,194 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $132,194 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $197,961,381 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,124,751 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$41,034 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,165,785 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $121,966,671 | SecuritiesAmt |
| Other | $3,490,506 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $107,078,177 | SecuritiesAmt |
| Other | $3,277,811 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,888,494 | SecuritiesAmt |
| Other | $212,695 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,101,189 | TotalRevenueColumnAmt |
| Exclusion | $15,101,189 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| JVHL | 621500 | $916,489 | $916,489 |
| MEDICAL STAFF FUNCTIONS | 900099 | $255,494 | $255,494 |
| TV RENTAL INCOME | 900099 | $202,902 | $202,902 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,183,009 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $3,439 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,179,570 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,557,894 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $217,846,942 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $195,125,992 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,797,794 | UnrelatedBusinessRevenueAmt |
| Exclusion | $19,821,429 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,581,282 | TotalAmt |
| Management And General | $1,581,282 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,181,644 | TotalAmt |
| Program Services | $66,487,807 | ProgramServicesAmt |
| Management And General | $7,693,837 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,450,972 | TotalAmt |
| Program Services | $2,312,457 | ProgramServicesAmt |
| Management And General | $138,515 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,436,173 | TotalAmt |
| Program Services | $6,894,756 | ProgramServicesAmt |
| Management And General | $541,417 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,135,206 | TotalAmt |
| Program Services | $5,616,781 | ProgramServicesAmt |
| Management And General | $518,425 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,751,912 | TotalAmt |
| Management And General | $3,751,912 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,998 | TotalAmt |
| Program Services | $17,407 | ProgramServicesAmt |
| Management And General | $280,591 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,977 | TotalAmt |
| Management And General | $78,977 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,254,045 | TotalAmt |
| Program Services | $34,818,336 | ProgramServicesAmt |
| Management And General | $1,435,709 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,356,280 | TotalAmt |
| Management And General | $1,356,280 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,696,770 | TotalAmt |
| Program Services | $2,522,091 | ProgramServicesAmt |
| Management And General | $174,679 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,802,212 | TotalAmt |
| Management And General | $8,802,212 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,934,274 | TotalAmt |
| Program Services | $2,281,760 | ProgramServicesAmt |
| Management And General | $2,652,514 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,324 | TotalAmt |
| Program Services | $25,715 | ProgramServicesAmt |
| Management And General | $24,609 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,538 | TotalAmt |
| Program Services | $12,529 | ProgramServicesAmt |
| Management And General | $4,009 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,242,801 | TotalAmt |
| Program Services | $4,242,801 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,105,182 | TotalAmt |
| Program Services | $10,754,835 | ProgramServicesAmt |
| Management And General | $5,350,347 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $758,970 | TotalAmt |
| Program Services | $1,333 | ProgramServicesAmt |
| Management And General | $757,637 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $40,841,581 | $40,577,801 | $263,780 |
| MALPRACTICE | $26,925,203 | $12,593 | $26,912,610 |
| BAD DEBT EXPENSE | $10,948,409 | $10,948,409 | $0 |
| QAAP EXPENSE | $5,270,165 | $5,270,165 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,215,830 | TotalAmt |
| Program Services | $2,696,311 | ProgramServicesAmt |
| Management And General | $1,519,519 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,332,748 | TotalAmt |
| Program Services | $195,493,887 | ProgramServicesAmt |
| Management And General | $63,838,861 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,814 | BOYAmt |
| EOY | $73,826 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,598,459 | BOYAmt |
| EOY | $25,762,837 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,237,915 | BOYAmt |
| EOY | $27,312,544 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,904,647 | BOYAmt |
| EOY | $3,968,195 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,075,262 | BOYAmt |
| EOY | $2,709,363 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $171,422,791 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,322,820 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,726,728 | BOYAmt |
| EOY | $168,099,971 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,332,899 | BOYAmt |
| EOY | $93,428,744 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,224 | BOYAmt |
| EOY | $40,925 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,807,256 | BOYAmt |
| EOY | $8,901,695 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,417,774 | BOYAmt |
| EOY | $30,826,623 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $380,154,978 | BOYAmt |
| EOY | $361,124,723 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,158,333 | BOYAmt |
| EOY | $23,849,387 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $153,965,478 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,861 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,786,385 | BOYAmt |
| EOY | $236,090,695 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $214,063,057 | BOYAmt |
| EOY | $259,940,082 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,034,360 | BOYAmt |
| EOY | $101,127,122 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,561 | BOYAmt |
| EOY | $57,519 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,091,921 | BOYAmt |
| EOY | $101,184,641 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $380,154,978 | BOYAmt |
| EOY | $361,124,723 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$41,485,806 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$15,339,066 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $5,058 | DonatedServicesAndUseFcltsAmt |
| Prior Period Adjustments | $57,563 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$8,145,029 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | 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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $164,215 | BeginningYearBalanceAmt |
| Other Expenditures | $22,761 | OtherExpendituresAmt |
| End Year Balance | $141,454 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $141,495 | BeginningYearBalanceAmt |
| Contributions | $91,800 | ContributionsAmt |
| Investment Earnings Or Losses | $2 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $62,852 | OtherExpendituresAmt |
| Administrative Expenses | $6,230 | AdministrativeExpensesAmt |
| End Year Balance | $164,215 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $138,145 | BeginningYearBalanceAmt |
| Contributions | $182,593 | ContributionsAmt |
| Investment Earnings Or Losses | $56 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $177,223 | OtherExpendituresAmt |
| Administrative Expenses | $2,076 | AdministrativeExpensesAmt |
| End Year Balance | $141,495 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $827,601 | BeginningYearBalanceAmt |
| Contributions | $193,472 | ContributionsAmt |
| Investment Earnings Or Losses | $7,886 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $885,577 | OtherExpendituresAmt |
| Administrative Expenses | $5,237 | AdministrativeExpensesAmt |
| End Year Balance | $138,145 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $843,841 | BeginningYearBalanceAmt |
| Contributions | $219,377 | ContributionsAmt |
| Investment Earnings Or Losses | $12,055 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $243,647 | OtherExpendituresAmt |
| Administrative Expenses | $4,025 | AdministrativeExpensesAmt |
| End Year Balance | $827,601 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 1.00000 | 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 | $3,950,000 | OtherCostOrOtherBasisAmt |
| Book Value | $3,950,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $139,463,464 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,156,215 | DepreciationAmt |
| Book Value | $138,307,249 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $863,850 | OtherCostOrOtherBasisAmt |
| Depreciation | -$901,527 | DepreciationAmt |
| Book Value | $1,765,377 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,063,868 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,016,094 | DepreciationAmt |
| Book Value | $24,047,774 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $81,609 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,038 | DepreciationAmt |
| Book Value | $29,571 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $168,099,971 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (9 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ACCOUNTS RECEIVABLE AFFILIATES | $21,205,808 |
| MISCELLANEOUS ACCOUNTS RECEIVABLE | $913,287 |
| PHYSICIAN LOAN FORGIVENESS | $123,500 |
| PHYSICIAN LOANS | $182,061 |
| LOAN RECEIVABLE DOCTORS HOSPITAL | $447,818 |
| ACCOUNTS RECEIVABLE RHREH | $400,465 |
| ACCOUNTS RECEIVABLE RREH | $1,752,617 |
| MALPRACTICE GROSS UP | $5,558,096 |
| ACCOUNTS RECEIVABLE MMPI | $242,971 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $30,826,623 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (9 entries)
| DescDesc | AmtAmt |
|---|---|
| SELF FUNDED MALPRACTICE INS CLAIMS LIABILITY | $8,587,692 |
| POST RETIREMENT HEALTH INS LIABILITY | $492,822 |
| PENSION LIABILITY | $24,422,680 |
| IBNR AETNA | $633,070 |
| CDMS NOTE PAYABLE RELATED PARTY | $161,224,398 |
| ACCOUNTS PAYABLE SAAC | $736,279 |
| DUE TO AFFILIIATES | $3,731,866 |
| W/C LIABILITY | $1,017,739 |
| GENERAL LIABILITIES | $35,244,149 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $236,090,695 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS ARE USED FOR THE GIFT SHOP, THE AUXILLIARY AND THE HOSPITAL FOR GRANTS, SCHOLARSHIPS AND OTHER EXPENSES. |
| PART X, LINE 2: | THE MEMBER HEALTHCARE ENTITIES OF THE SYSTEM ARE PRIMARILY TAX-EXEMPT ORGANIZATIONS UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) OR SECTION 501(C)(2), AND THEIR RELATED INCOME IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A). THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2016. THE SYSTEM HAD DEFERRED TAX ASSETS OF APPROXIMATELY $378,000 AND $354,000 FOR FEDERAL AND STATE INCOME TAX PURPOSES PRIMARILY RELATED TO NET OPERATING LOSS CARRYFORWARDS FOR THE YEARS ENDED JUNE 30, 2016 AND 2015, RESPECTIVELY. A VALUATION ALLOWANCE OF APPROXIMATELY $377,000 AND $344,000 WAS RECORDED DUE TO THE UNCERTAINTY REGARDING USE OF THE DEFERRED TAX ASSETS FOR THE YEARS ENDED JUNE 30, 2016 AND 2015, RESPECTIVELY. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)
| RegionRegionTxt | OfficesOfficesCnt | EmployeeEmployeeCnt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Specific Services ProvidedSpecificServicesProvidedTxt | Region Total ExpendituresRegionTotalExpendituresAmt |
|---|---|---|---|---|---|
| CENTRAL AMERICA/CARIBBEAN | 0 | 0 | PROGRAM SERVICES | INSURANCE | $560,282 |
| CENTRAL AMERICA/CARIBBEAN | 0 | 0 | INVESTMENT | $161,224 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $721,506 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $721,506 | TotalSpentAmt |
| Transfer To Foreign Corp | Yes (1) | 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 | 0 | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $179,619 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $179,619 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,307,045 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,673,558 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,633,487 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03070 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $94,814 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $103,707 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$8,893 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,581,478 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,777,265 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,804,213 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03140 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $126,067 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $126,067 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,101,943 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,779,772 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,322,171 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03350 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,229,310 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,779,772 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,449,538 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03400 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,810,788 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,557,037 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,253,751 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06540 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 1034 | PersonsServedCnt |
| Total Community Benefit Expns | $1,581 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,581 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 3 | PersonsServedCnt |
| Total Community Benefit Expns | $963 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $963 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 30 | ActivitiesOrProgramsCnt |
| Persons Served | 1675 | PersonsServedCnt |
| Total Community Benefit Expns | $5,924 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,924 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 60 | PersonsServedCnt |
| Total Community Benefit Expns | $372 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $372 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 48 | ActivitiesOrProgramsCnt |
| Persons Served | 2772 | PersonsServedCnt |
| Total Community Benefit Expns | $8,840 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,840 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,948,409 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $21,169 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $59,311,543 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $73,002,256 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,690,713 | 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 USC LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | SURGICAL CENTER | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.28640 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.71360 | 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 | CRITTENTON HOSPITAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48307 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENTON HOSPITAL MEDICAL CENTER | 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 |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CRITTENTON.COM | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HTTP://WWW.CRITTENTON.COM/PUBLIC/UPLOADS/2012/07/COMMUNITY-HEALTH-NEEDS- | 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 | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.CRITTENTON.COM/COMMUNITY-ASSESSMENT/ | 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 | 300.000000000000 | 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 |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.CRITTENTON.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.CRITTENTON.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-POLICY/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.CRITTENTON.COM/PATIENTS-VISITORS/BILLING-AND-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 Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| 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 |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CRITTENTON HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 5: THE METHODOLOGY FOR SURVEY ASSESSMENT INVOLVED THE DISTRIBUTION OF THE SURVEY ELECTRONICALLY, ONLINE, AND ON PAPER DURING THE MONTHS OF SEPTEMBER THROUGH NOVEMBER 2012. THE SURVEY TOOL WAS DEVELOPED TO ASSESS THE NEEDS OF THE COMMUNITY, THE INDIVIDUAL NEEDS AND HEALTH STATUS OF THE RESPONDERS, AND TO ASSESS THE SERVICES THAT CHMC PROVIDES TO THE COMMUNITY. THE INTENTION OF THE SURVEY TOPIC SELECTION WAS TO ASSESS A GENERAL OVERVIEW OF THE COMMUNITY NEEDS. THE SURVEY TAKERS WERE GIVEN MULTIPLE CHOICE OPTIONS WITH IMPORTANT ISSUES IDENTIFIED BY: HIGH NEED/CONCERN, LOW NEED/CONCERN, NO NEED/CONCERN, AND DO NOT KNOW.COMMUNITY STAKEHOLDERS OF DIFFERENT AGES, SOCIOECONOMIC STATUS, OCCUPATION, AND CULTURAL BACKGROUNDS WERE INVITED TO PARTICIPATE. FEATURE ARTICLE AND INVITATION TO TAKE SURVEY IN OUR WELLSPRING PUBLICATION WAS DISTRIBUTED TO 15,000 HOUSEHOLDS IN OUR PRIMARY SERVICE AREA. EMAIL INVITATIONS WITH SURVEY WEBSITE LINK WERE SENT TO ALL OF OUR COMMUNITY MEMBERS IN OUR PRIMARY SERVICE AREAS:1. PUBLIC/PRIVATE SCHOOLS2. PUBLIC HEALTH3. BUSINESS LEADERS4. PHYSICIANS5. RELIGIOUS ORGANIZATIONS6. UNIVERSITIES/COLLEGES7. HIGH SCHOOL LEADERSHIP GROUPS8. SENIOR CENTERSHARD COPY INVITATIONS AND PAPER SURVEYS WERE DISTRIBUTED AT ALL COMMUNITY EVENTS WITH INSTRUCTIONS TO TAKE THE SURVEY ONLINE OR PAPER SURVEYS COMPLETED ON-SITE OR MAILED IN. THESE EVENTS INCLUDED:1. COMMUNITY HEALTH FAIRS AND EXPOS2. BREAST CANCER WALK3. PHYSICIAN LECTURES4. HEALTH SCREENINGS |
| CRITTENTON HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 7D: DISTRIBUTION OF ANNUAL COMMUNITY BENEFIT REPORT TO 15,000 HOUSEHOLDS, IN HOSPITAL AND AT COMMUNITY EVENTS |
| CRITTENTON HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 2: CRITTENTON HOSPITAL WAS ACQUIRED BY ASCENSION HOSPTIAL ON 10/1/15. |
| CRITTENTON HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 11: CHMC WILL NOT ADDRESS THE INCREASED AVAILABILITY OF CHILDCARE PRIORITY BECAUSE THERE ARE SUFFICIENT RESOURCES IN THE COMMUNITY. THERE ARE A VARIETY OF CHILDCARE OPTIONS FROM IN-HOME, LEARNING CENTERS, DAYCARE CENTERS, AND DROP-IN CARE. CHMC HAS A CHILDCARE FACILITY, CHILDREN'S CHOICE, AVAILABLE TO EMPLOYEES AND THE COMMUNITY. CHMC WILL NOT ADDRESS THE IMMUNIZATIONS FOR CHILDREN AND ADULTS PRIORITY BECAUSE THERE ARE SUFFICIENT RESOURCES IN THE COMMUNITY. CHMC OFFERS FRIENDS AND FAMILY FLU SHOT EVENT IN THE FALL, CHMC TRAVEL MEDICINE AND THE CRITTENTON WELLNESS CENTER AT OLDER PERSON COMMISSION (OPC) OFFERS IMMUNIZATIONS TO THE PUBLIC, THE PUBLIC HEALTH DEPARTMENT PROVIDES FREE IMMUNIZATIONS, AND LOCAL NON-PROFIT OFFERS FREE IMMUNIZATIONS FOR CHILDREN IN AUGUST AT AN ANNUAL HEALTH BAZAAR.CHMC WILL NOT ADDRESS THE LOW AWARENESS OF POTENTIAL HEALTH THREATS PRIORITY BECAUSE CHMC CURRENTLY HAS AND EMERGENCY MANAGEMENT COMMITTEE COMPRISED OF HOSPITAL TEAM MEMBERS, LOCAL AGENCIES AND BUSINESSES, AND COMMUNITY MEMBERS. INFORMATION IS POSTED ON THE WEBSITE AND ARTICLES ARE PUBLISHED IN WELLSPRING ON THIS ISSUE. |
| CRITTENTON HOSPITAL MEDICAL CENTER | PART V, SECTION B, LINE 22D: THOSE PATIENTS THAT ARE ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ARE EITHER NOT CHARGED FOR THEIR SERVICES OR ARE CHARGED A 75% DISCOUNT RATE WHICH ON AVERAGE SHOULD NOT EXCEED THE GREATER OF OUR THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 2 - MICHIGAN RESONANCE IMAGING | ||||
| 355 BARCLAY CIRCLE STE A | ROCHESTER | MI | 48307 | IMAGING CENTER |
| 3 - MICHIGAN MOBILE PET | ||||
| 15500 LUNDY PARKWAY | DEARBORN | MI | 48126 | IMAGING CENTER |
| 4 - USC LLC | ||||
| 4800 INVESTMENT DRIVE STE 370 | TROY | MI | 48098 | SURGICAL CENTER |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | CRITTENTON HOSPITAL MEDICAL CENTER USED THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILTY FOR PROVIDING BOTH 'FREE' CARE AND 'DISCOUNTED' CARE TO LOW INCOME INDIVIDUALS. THE FAMILY INCOME LIMIT USED IS 200% FOR 'FREE' CARE AND UP TO 300% FOR 'DISCOUNTED' CARE. |
| PART I, LINE 7: | THE COSTING METHOD USED FOR FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMS WAS A COST TO CHARGE RATIO FROM WORKSHEET 2 AND OTHER COMMUNITY BENEFITS WAS CALCULATED BASED UPON ACTUAL COST. |
| PART I, LINE 7G: | CRITTENTON HOSPITAL MEDICAL CENTER DOES NOT HAVE ANY SUBSIDIZED HEALTH SERVICES TO REPORT. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE OF $10,948,409 WAS REMOVED FROM THE DENOMINATOR FOR THE CALCULATION OF THE PERCENT OF TOTAL EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY HEALTH LEADERSHIP AND OTHER SENIOR LEADERS ACTIVELY PARTICIPATE ON A BROAD RANGE OF COMMUNITY COALITIONS SUCH AS THE OLDER PERSON'S COMMISSION, ROCHESTER COMMUNITY SCHOOLS, ROCHESTER/AUBURN HILLS COMMUNITY COALITION, OAKLAND COUNTY OBESITY COALITION, REGION 2 NORTH, OAKLAND COUNTY MEDICAL CONTROL AUTHORITY, MICHIGAN DEPT OF COMMUNITY HEALTH, CROSSROADS PREGNANCY CENTER AND OTHERS. THIS PROVIDES ONGOING KNOWLEDGE OF VARYING COMMUNITY NEEDS AND ADJUSTS AS ECONOMIC, ENVIRONMENTAL, AND HEALTHCARE CHANGES OCCUR IN CRITTENTON'S KEY COMMUNITIES. THE VARIOUS PROGRAMS THAT CHMC OFFERS TO THE COMMUNITY HELP TO ENHANCE THE HEALTH STATUS BY EDUCATION, EARLY DETECTION, SCREENING, AND ACCESSIBILITY TO RESOURCES. WE RECEIVE MULTIPLE STORIES EVERY YEAR STATING THAT IF THEY HAD NOT ATTENDED ONE OF OUR SCREENINGS, THEN THEY MAY NOT HAVE PURSUED FURTHER MEDICAL CARE OR TREATMENT. THE SCREENING OR EDUCATION IS WHAT INCREASED THEIR AWARENESS AND ENCOURAGED THEM TO SEEK CARE AND THAT SCREENING OR ACTIVITY IS WHAT HELPED TO ENHANCE THEIR HEALTH. |
| PART III, LINE 2: | THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HOSPITAL FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES. THE BAD DEBT AMOUNT REPORTED ON PART III LINE 2 IS THE HOSPITAL'S PROVISION FOR BAD DEBT PER THE HOPSITAL'S FINANCIAL STATEMENTS AND PER FORM 990 PART IX. |
| PART III, LINE 4: | THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE, ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE ARE REASONABLE EFFORTS TO COLLECT FROM THE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE SYSTEM. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE SYSTEM'S POLICIES. THE METHODOLOGY FOR DETERMINING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED WRITE-OFFS ON UNINSURED PATIENT ACCOUNTS HAS REMAINED CONSISTENT WITH THE PRIOR YEAR. |
| PART III, LINE 8: | AS A NON-PROFIT HOSPITAL, CRITTENTON HOSPITAL MEDICAL CENTER IS REQUIRED TO PROVIDE MINIMAL LEVELS OF COMMUNITY BENEFIT IN EXCHANGE FOR OUR TAX EXEMPT STATUS. THESE COMMUNITY BENEFITS INCLUDE HEALTH EDUCATION OPPORTUNITIES, CHARITY AND BAD DEBT WRITEOFFS, AND OUR LOSSES ON MEDICARE. IN KEEPING WITH OUR MISSION TO PROMOTE HEALTH IN THE COMMUNITY, WE PROVIDE CARE TO MEDICARE BENEFICIARIES AT A LOSS, THUS HELPING TO RELIEVE THE GOVERNMENT BURDEN OF TREATING THESE PATIENTS WHO MAY OTHERWISE HAVE THEIR ACCESS TO CARE LIMITED. |
| PART III, LINE 9B: | IT IS THE POLICY OF CRITTENTON HOSPITAL MEDICAL CENTER TO REQUIRE PAYMENT IN FULL FOR ALL SERVICES RENDERED, WHICH ARE PATIENT PAY, UPON RECEIPT OF THEIR FIRST STATEMENT. THE PATIENT THEN HAS THIRTY DAYS TO REMIT PAYMENT IN FULL. THE BURDEN OF PROOF OF A PATIENT'S INABILITY TO PAY IN FULL IS THE RESPONSIBILITY OF THE PATIENT. IF THE PATIENT CAN PROVE AN INABILITY TO PAY THEIR DEBT IN FULL, PARTIAL PAYMENT ARRANGEMENTS CAN BE MADE. IT IS ALSO THE POLICY OF THE HOSPITAL TO PROVIDE THE PATIENT WITH INFORMATION REGARDING THE AVAILABILITY OF WHATEVER SOCIAL SERVICES MAY BE APPLICABLE FOR THE PATIENT. IN ADDITION, A CHARITY CARE APPLICATION MAY ALSO BE PROVIDED. |
| PART VI, LINE 2: | THE ALLOCATION OF CRITTENTON'S RESOURCES TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE OF COMMUNITY RESIDENTS ARE BASED ON COMMUNITY NEEDS THAT ARE IDENTIFIED BOTH THROUGH THE STRATEGIC PLANNING PROCESS AND THROUGH A YEARLY COMPREHENSIVE REVIEW OF COUNTY, STATE AND FEDERAL HEALTHCARE DATA BY CRITTENTON'S COMMUNITY HEALTH AND EDUCATION DEPARTMENT. WE HAVE GATHERED AND ALIGNED THE COMMUNITY HEALTH NEEDS FROM OUR COMMUNITY, THE COUNTIES IN WHICH WE SERVE, THE STATE OF MICHIGAN FOUR BY FOUR PLAN, AND HEALTHY PEOPLE 2020. ONE OF THE IDENTIFIED NEEDS THAT CONSISTENTLY REMAINS A PRIORITY IS THE MENTAL HEALTH OF OUR ADOLESCENT POPULATION; SPECIFICALLY FOUCUSED ON SUBSTANCE ABUSE AND SUICIDE. WE HAVE CREATED A PROGRAM FOR TEENS, TEEN NIGHT, IN COLLABORATION WITH OUR COMMUNITY PARTNERS: THE VILLAGE OF ROCHESTER HILLS, ROCHESTER/AUBURN HILLS COMMUNITY COALITION, COMMON GROUND, OAKLAND COUNTY SHERRIFF'S DEPARTMENT, OAKLAND UNIVERSITY, AMERICAN CANCER SOCIETY, AVONDALE YOUTH ASSISTANCE, AND ROCHESTER AREA COUNSELING SERVICES THAT INTEGRATES EDUCATION AND SUPPORT IN A FUN, INTERACTIVE EVENING. WE RECENTLY HELD OUR 4TH ANNUAL TEEN NIGHT AND HAVE REACHED OVER 1,500 TEENS AND THEIR FAMILIES. |
| PART VI, LINE 3: | CRITTENTON HOSPITAL MEDICAL CENTER DOES A NUMBER OF THINGS IN ORDER TO EDUCATE AND/OR ASSIST A PATIENT IN RECEIVING OUTSIDE ASSISTANCE, INCLUDING THE FOLLOWING:1. SIGNAGE IS POSTED AT REGISTRATION POINTS AROUND THE HOSPITAL REGARDING ASSISTANCE AVAILABLE TO PAY FOR SERVICES AS WELL AS OUR UNCOMPENSATED SERVICES PROGRAM, HANDOUTS ARE GIVEN TO THE PATIENTS AND THE PROGRAM IS OUTLINED ON THE BACK OF EVERY STATEMENT THAT IS SENT TO THE PATIENT.2. FINANCIAL COUNSELORS ARE ON SITE THAT ARE CONTACTED EVERY TIME A PATIENT WITHOUT INSURANCE COMES INTO THE EMERGENCY ROOM OR IS ADMITTED TO THE HOSPITAL. IN THE PAST 12 MONTHS THE FINANCIAL COUNSELORS HAVE ASSISTED OVER 600 PATIENTS IN QUALIFYING FOR COUNTY, STATE, FEDERAL, OR HOSPITAL ASSISTANCE PROGRAMS.3. TAKE PART AND ASSIST PATIENTS IN QUALIFYING FOR THE COUNTY INDIGENT HOSPITATLIZATION PROGRAM WHICH IS RUN DIRECTLY THROUGH THE HOSPITAL AND PLACES VIRTUALLY NO BURDEN OF ANY TYPE ON THE PATIENT IN ORDER TO BE QUALIFIED.4. ALL MANAGERS THAT DEAL WITH THE PUBLIC ARE DIRECTLY INFORMED OF OUR UNCOMPENSATED SERVICE PROGRAMS AND VERBALLY ASSIST PATIENTS WITH SUGGESTIONS AS WELL AS OUR CASHIERS HAVING ACCESS TO THE SAME INFORMATION AND TRAINING.5. OFFER ASSISTANCE TO NEWBORN MOTHERS WITHOUT INSURANCE IN THE FORM OF ASSISTANCE IN APPLYING FOR MEDICAID AND PROVIDING MINIMAL PAYMENT OPTIONS. |
| PART VI, LINE 4: | CRITTENTON HOSPITAL MEDICAL CENTER IS A 290 BED ACUTE CARE HEALTH FACILITY SERVING COMMUNITIES IN OAKLAND, MACOMB AND LAPEER COUNTIES. THE ENTIRE SERVICE AREA ENCOMPASSES 35 ZIP CODES IN THREE REGIONS AND IS FURTHER SUBDIVIDED INTO THREE SECTORS: OUR CORE SECTOR WHICH ENCOMPASSES THE THREE ROCHESTER ZIP CODES, AND THE PRIMARY AND SECONDARY SECTORS. THE DEMOGRAPHIC SKEW FOR THE AREA IS SLIGHTLY OLDER THAN THE NORM WITH HIGHER HOUSEHOLD INCOMES. |
| PART VI, LINE 5: | CRITTENTON HOSPITAL MEDICAL CENTER DOES NOT WANT TO FORGET THE IMPORTANT ROLE THE COMMUNITY PLAYS IN ITS SUCCESS. THE HOSPITAL IS ESPECIALLY GRATEFUL THAT THEY ARE ABLE TO GIVE BACK TO THE COMMUNITY THROUGH ESSENTIAL HEALTHCARE SERVICES AND EDUCATION TO CATER TO THE UNMET NEEDS OF SO MANY IN ITS COMMUNITY. OFFERING ADVANCED CARE AND SERVICES IS ONE OF THE MANY WAYS CRITTENTON SERVES ITS COMMUNITY. CRITTENTON HAS PARTNERED WITH PREMIER ORGANIZATIONS TO FULFILL ITS MISSION OF ENHANCING THE HEALTH STATUS OF THE COMMUNITY, I.E. WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE AND OAKLAND UNIVERSITY SCHOOL OF NURSING ARE JUST A FEW. |
| PART VI, LINE 6: | CRITTENTON HOSPITAL MEDICAL CENTER IS DEDICATED TO PROVIDING CARE TO ALL RESIDENTS OF THE COMMUNITY, REGARDLESS OF THEIR FINANCIAL STATUS. THROUGH UNCOMPENSATED CARE, GOVERNMENT SPONSORED HEALTH CARE, COMMUNITY HEALTH SERVICES AND DONATIONS THE HOSPITAL IS ABLE TO REACH OUT TO THE COMMUNITY. THE FOUNDATION IS THE FUNDRAISING ARM OF THE ORGANIZATION. THEY HAVE HOSTED EVENTS SUCH AS THE GOLF, TENNIS AND FUN WALK BENEFIT AND THE GOURMET GALA BENEFIT WHICH HAS RAISED MONEY FOR A VARIETY OF ENHANCEMENTS TO THE HOSPITAL. THE CRITTENTON VOLUNTEER AUXILLARY IS AN INTEGRAL PART OF THE HOSPITAL'S SUCCESS. THE GROUP CONTRIBUTES A GREAT DEAL OF TIME AND SERVICE TO FURTHER THE GOAL OF PROVIDING CLINICAL EXCELLENCE IN A COMFORTABLE, WELCOMING ENVIRONMENT. SOME OF THE SERVICES THAT THEY PROVIDE INCLUDE CLERICAL ASSISTANCE, ESCORTING PATIENTS AROUND THE FACILITY, AND GREETING FAMILIES AND VISITORS. THE CRITTENTON WELLNESS CENTER AND THE OLDER PERSONS COMMISSION HAVE COMBINED HEALTH, WELLNESS, EDUCATION AND ACTIVITIES ALL WITH THE OLDER PERSON IN MIND. MEMBERSHIP IS FREE TO RESIDENTS OF ROCHESTER, ROCHESTER HILLS, AND OAKLAND TOWNSHIP WHO ARE OLDER THAN AGE FIFTY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROY POWELL | ||||||||||||||
| PRESIDENT & CEO | $514,057 | $0 | $10,000 | $0 | $3,506 | $0 | $18,173 | $0 | $17,605 | $0 | $563,341 | $0 | $0 | $0 |
| KENNETH SANGER | ||||||||||||||
| CHIEF NURSING OFFICER | $187,790 | $0 | $0 | $0 | $519 | $0 | $12,800 | $0 | $21,674 | $0 | $222,783 | $0 | $0 | $0 |
| MICHELLE HORNBERGER | ||||||||||||||
| CHIEF STRATEGY OFFICER - PART YEAR | $161,316 | $0 | $0 | $0 | $185 | $0 | $18,000 | $0 | $21,674 | $0 | $201,175 | $0 | $0 | $0 |
| DONNA KOPINSKI | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $243,120 | $0 | $20,000 | $0 | $0 | $0 | $24,000 | $0 | $17,605 | $0 | $304,725 | $0 | $0 | $0 |
| SAMER KAZZIHA MD | ||||||||||||||
| EXECUTIVE MEDICAL DIRECTOR | $306,421 | $0 | $0 | $0 | $33,379 | $0 | $0 | $0 | $0 | $0 | $339,800 | $0 | $0 | $0 |
| DOUGLAS PUGMIRE DO | ||||||||||||||
| MED. DIRECTOR ROBOTICS/GYN ONCOLOGY | $515,825 | $0 | $0 | $0 | $84,615 | $0 | $0 | $0 | $16,672 | $0 | $617,112 | $0 | $0 | $0 |
| KEVIN FLOREK DO | ||||||||||||||
| PHYSICIAN | $263,776 | $0 | $0 | $0 | $0 | $0 | $22,100 | $0 | $17,605 | $0 | $303,481 | $0 | $0 | $0 |
| ROBERT LACOSTE MD | ||||||||||||||
| MEDICAL DIRECTOR BEHAVIORAL HEALTH | $171,392 | $0 | $0 | $0 | $92,104 | $0 | $0 | $0 | $21,674 | $0 | $285,170 | $0 | $0 | $0 |
| MICHAEL LAKER MD | ||||||||||||||
| ORTHOPEDIC SURGEON | $353,855 | $0 | $0 | $0 | $570 | $0 | $13,154 | $0 | $15,839 | $0 | $383,418 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | ROY POWELL RECEIVED A SEVERANCE PAYMENT OF $3,506 IN 2015. THERE IS A SEVERANCE AGREEMENT SIGNED BY BOTH THE EMPLOYER AND EACH EMPLOYEE DETAILING THE TERMS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE GOVERNING DOCUMENTS OF CRITTENTON HOSPITAL MEDICAL CENTER CHANGED WITH THE ACQUISITION BY ASCENSION MICHIGAN. ASCENSION MICHIGAN BECAME THE SOLE MEMBER OF CRITTENTON HOSPITAL MEDICAL CENTER ON 10/1/15. THE GOVERNING DOCUMENTS WERE AMENDED TO CONFORM WITH THIS ACQUISITION. THE PHILOSOPHY OF CHMC IS THAT OF ASCENSION SPONSOR IN THAT IT WILL BE IN ACCORDANCE WITH THE OFFICAL TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEAL CARE SERVICES. THERE ARE POWERS AND RESPONSIBILITIES RESERVED FOR ASCENSION. |
| FORM 990, PART VI, SECTION A, LINE 6 | ASCENSION MICHIGAN (MINISTRY MARKET CORPORATION) THE SOLE MEMBER OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | MINISTRY MARKET CORPORATION HAS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD. IT CAN ALSO APPOINT AND REMOVE THE CHAIR OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | MINISTRY MARKET CORPORATION HAS THE FOLLOWING DECISION MAKING RIGHTS: ANNUAL PERFORMANCE ASSESSMENT OF THE BOARD; MINISTRY MARKET STRATEGY; CHANGES TO MAJOR CLINICAL PROGRAMS OR SERVICES PROVIDED; STRATEGIES INVOLVING CHMC FOR PRATICIPATING IN CLINICALLY INTEGRATED SYSTEMS OF CARE; ARRANGEMENTS WITH PHYSICIANS PRACTICING AT CHMC'S HEALTH CARE FACILITIES; STRATEGIES INVOLVING CHMC FOR ESTABLISHING ARRANGEMENTS WITH LOCAL PAYORS, SELF-INSURED EMPLOYERS AND OTHER HEALTH CARE PURCHASES; STATEGIES NECESSARY TO MEET COMMUNITY NEEDS; AND MARKET-SPECIFIC CLINICALLY RELIABLE PROCESS DEVELOPMENT. ASCENSION HAS THE FOLLOWING DECISION MAKING RIGHTS: MAJOR TRANSACTIONS INVOLVING CHMC AND SUBSIDIARY THAT IS A CREDIT GROUP MEMBER; AND THE INCURRENCE OF DEBT BY CHMC OR ANY SUBSIDIARY. ASCENSION HEALTH HAS THE FOLLOWING DECISION MAKING RIGHTS: CHANGES TO ARTICLES OF INCORPORATION OR BYLAWS WHERE SUCH CHANGES ARE NOT CONSISTENT WITH SYSTEM POLICY; THE APPOINTMENT, REMOVAL AND PERFORMANCE EVALUATION OF CHMC'S PRESIDENT; THE FORMATION OF A SUBSIDIARY; AND MAJOR TRANSACTIONS INVOLVING ANY SUBSIDIARY THAT IS NOT A CREDIT GROUP MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE RETURN IS GIVEN TO THE BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW BEFORE FILING. AFTER THE REVIEW, THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL POLICY STATES THAT ALL EMPLOYEES HAVE A CONTINUOUS OBLIGATION TO DISCLOSE CONFLICTS OF INTEREST, AN ACTUAL IMPROPRIETY, AND/OR AN APPEARANCE OF IMPROPRIETY. EMPLOYEES AT THE MANAGER LEVEL AND ABOVE EACH SIGN A STATEMENT ON AN ANNUAL BASIS ACKNOWLEDGING THEIR UNDERSTANDING OF THE POLICY AND VERIFYING THEIR APPROPRIATE DISCLOSURE OF ANY CONFLICTS. ALL REPORTED CONFLICTS SHALL BE REVIEWED BY THE CEO IN CONJUCTION WITH THE COMPLIANCE OFFICER AND DEPARTMENT OF LEGAL AFFAIRS. IF IT IS DETERMINED THAT A CONFLICT EXISTS THE EMPLOYEEE SHALL DISCONTINUE ALL ACTIVITIES SURROUNDING THAT CONFLICT. THE EMPLOYEE MAY ALSO SEEK A WAIVER OF THE CONFLICT FROM THE CEO. CHMC ALSO HAS A QUESTIONNAIRE FOR INDIVIDUALS AND THEIR IMMEDIATE FAMILY MEMBERS, INCLUDING BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES REGARDING CONFICTS OF INTEREST AND THIS MUST BE SIGNED BY THE INDIVIDUALS. THE QUESTIONNAIRE INCLUDES THE FOLLOWING: 1. IDENTIFY YOUR SERVICE ON ANY BOARD OF DIRECTORS OR TRUSTEES OF ANY OF THE COMPANY'S WITH WHICH CHMC OR ANY OF ITS' AFFILIATES DOES BUSINESS. 2. IDENTIFY WHETHER YOU ARE ASSOCIATED DIRECTLY OR INDIRECTLY OR HOLD A POSITION OR FINANCIAL INTEREST IN ANY OUTSIDE ORGANIZATION OR CONCERN WITH WHICH CRITTENTON DOES BUSINESS. 3. IDENTIFY WHETHER YOU DIRECT, MANAGE,OR PROVIDE SERVICES OR CONSULTATION TO ANY OUTSIDE ORGANIZATION OR CONCERN THAT DOES BUSINESS WITH OR COMPETES WITH CRITTENTON. 4. IDENTIFY ANY ACTIVITIES IN WHICH YOU ARE ENGAGED THAT MIGHT BE REGARDED AS CONSTITUTING A POTENTIAL CONFLICT OF INTEREST WITH CRITTENTON. 5. DISCLOSE ANY DIRECT OR INDIRECT COMPENSATION THAT YOU RECEIVE, OR ANTICIPATE RECEIVING, FROM ANY PERSON, FIRM, CORPORATION, OR MARKET IN ANY WAY RELATED TO YOUR POSITION WITH CRITTENTON. IF AT ANY TIME THERE IS A MATTER UNDER CONSIDERATION WHICH MAY CREATE A DIRECT OR INDIRECT CONFLICT OF INTEREST, IT IS THE INDIVIDUAL'S OBLIGATION TO DISCLOSE THE FACTS SURROUNDING THE POSSIBLE CONFLICT TO THE CORPORATE COMPLIANCE OFFICER OR DEPARTMENT OF HUMAN RESOURCES AND THAT THE INDIVIDUAL AGREES TO PROMPTLY REPORT ANY NEW SITUATIONS THAT REQUIRE DISCLOSURE UNDER THIS QUESTIONNAIRE. THERE IS A SIGNED WRITTEN AGREEMENT/DOCUMENTATION FOR ANY BOARD MEMBER OR OFFICER IF A CONFLICT OF INTEREST ARISES. CURRENTLY THERE HAVE NOT BEEN ANY RESTRICTIONS PLACED ON ANY BOARD MEMBER OR OFFICER AS AN ISSUE HAS NOT ARISEN TO WARRANT THIS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE AUDIT COMMITTEE REVIEWS THE PERFORMANCE AGAINST THE GOALS SET FOR THE CEO. IN ADDITION THE AUDIT COMMITTEE PERFORMS A REVIEW OF THE TOTAL SALARY AGAINST MARKET STATISTICS. FROM THAT REVIEW, A RECOMMENDATION IS MADE TO THE EXECUTIVE COMMITTEE OF THE BOARD AND THE BOARD FOR APPROVAL. THE DETERMINATION AND DECISION ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE OF THE BOARD MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN 2012. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST OF THE INDIVIDUAL. |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES-PHYSICIANS, CLINICAL,CLERICAL: PROGRAM SERVICE EXPENSES 14,820,355. MANAGEMENT AND GENERAL EXPENSES 230,730. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,051,085. OP SURGICAL SERVICES: PROGRAM SERVICE EXPENSES 19,383. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,383. PURCHASED SERVICES-GENERAL: PROGRAM SERVICE EXPENSES 1,724,320. MANAGEMENT AND GENERAL EXPENSES 694,936. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,419,256. HOUSEKEEPING: PROGRAM SERVICE EXPENSES 2,588,732. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,588,732. FOOD AND NUTRITION: PROGRAM SERVICE EXPENSES 2,384,003. MANAGEMENT AND GENERAL EXPENSES 72,801. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,456,804. BIO-MED: PROGRAM SERVICE EXPENSES 1,870,726. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,870,726. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 1,139,873. MANAGEMENT AND GENERAL EXPENSES 155,560. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,295,433. PURCHASED SERVICES-MEDICAL: PROGRAM SERVICE EXPENSES 1,460,188. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,460,188. LAUNDRY: PROGRAM SERVICE EXPENSES 1,332,527. MANAGEMENT AND GENERAL EXPENSES 53. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,332,580. REHAB SERVICES: PROGRAM SERVICE EXPENSES 739,219. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 739,219. PHARMACY: PROGRAM SERVICE EXPENSES 542,419. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 542,419. RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 502,645. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 502,645. GROUNDS MAINTENANCE: PROGRAM SERVICE EXPENSES 22,397. MANAGEMENT AND GENERAL EXPENSES 182,124. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 204,521. REIMBURSEMENT CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 99,505. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,505. EHR INCENTIVE : PROGRAM SERVICE EXPENSES 5,671,549. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,671,549. |
| FORM 990, PART XI, LINE 9: | FMV ADJUSTMENTS -7,578,947. LOSS ON INVESTMENT IN JOINT VENTURE -566,082. |
| PART IV, LINE 20B: | CRITTENTON HOSPITAL MEDICAL CENTER (CHMC) WAS ACQUIRED BY ASCENSION MICHIGAN ON OCTOBER 1, 2016. THERE WAS NO AUDIT PERFORMED FOR THE TAX YEAR JANUARY 1, 2015 THROUGH DECEMBER 31, 2015. CHMC WAS INCLUDED IN ASCENSION'S JUNE 30, 2016 AUDITED FINANCIAL STATEMENTS THAT COVERED CHMC FOR THE PERIOD OF OCTOBER 1, 2015 THROUGH JUNE 30, 2016. ATTACHED ARE ASCENSION'S JUNE 30, 2016 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR WHICH CHMC WAS INCLUDED. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1101 W UNIVERSITY DR | ROCHESTER | MI | 48307 | 382627336 | SUPPORTING | MI | 501(C)(3) | LINE 11A, I | CRITTENTON HOSPITAL MEDICAL CENTER | Yes (1) | |
| CRITTENTON CANCER CENTER | |||||||||||
| 1101 W UNIVERSITY DR | ROCHESTER | MI | 48307 | 383239057 | CANCER TREATMENT | MI | 501(C)(3) | LINE 9 | CRITTENTON HOSPITAL MEDICAL CENTER | Yes (1) | |
| ASCENSION HEALTH ALLIANCE | |||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| ASCENSION HEALTH | |||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(C)(3) | LINE 11A, I | ASCENSION HEALTH ALLIANCE | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| CRITTENTON MEDICAL EQUIPMENT | |||||||
| 161 S LIVERNOIS RD | ROCHESTER HILLS | MI | 48307 | 383433794 | MEDICAL EQUIPMENT SALES | MI | N/A |
| BALD MOUNTAIN SURGICAL CENTER | |||||||
| 1375 S LAPEER RD STE 3109 | LAKE ORION | MI | 48360 | 030444972 | SURGICAL SERVICES | MI | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CRITTENTON DEVELOPMENT CORPORATION | ||||||||||
| 2251 N SQUIRREL RD STE 310 | AUBURN HILLS | MI | 48326 | 382594115 | REAL ESTATE | MI | CRITTENTON HOSPITAL MEDICAL CENTER | C | 1.00000 | 0 |
| CRITTENTON MEDICAL PHARMACY | ||||||||||
| 1101 W UNIVERSITY | ROCHESTER | MI | 48307 | 203773341 | PHARMACY SALES | MI | CRITTENTON DEVELOPMENT CORPORATION | C | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | 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 | 0 | 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 | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CHMC FOUNDATION | ||
| C | $101,727 | ACTUAL CASH TRANSFERRED |
| CHMC FOUNDATION | ||
| L | $72,700 | ACTUAL CASH TRANSFERRED |
| CHMC FOUNDATION | ||
| M | $249,149 | ACTUAL CASH TRANSFERRED |
| CHMC FOUNDATION | ||
| O | $56,925 | ACTUAL COST INCURRED |
| CRITTENTON CANCER CENTER | ||
| J | $153,000 | ACTUAL COST INCURRED |
| CRITTENTON CANCER CENTER | ||
| D | $933,533 | ACTUAL COST INCURRED |
| CRITTENTON CANCER CENTER | ||
| P | $61,023 | ACTUAL COST INCURRED |