MYMICHIGAN MEDICAL CENTER CLARE: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MYMICHIGAN MEDICAL CENTER CLARE (EIN 38-1518643)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201511349349307091
- Schema version
- 2013v4.0
- 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 D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-14T16:48:42-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 383133790 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREWS HOOPER PAVLIK PLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5300 GRATIOT RD | AddressLine1 |
| City | SAGINAW | City |
| State | MI | State |
| ZIP Code | 486386035 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381518643 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMICHIGAN MEDICAL CENTER - CLARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MIDM | BusinessNameControlTxt |
| Phone | 9898393181 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 703 NORTH MCEWAN STREET | AddressLine1 |
| City | CLARE | City |
| State | MI | State |
| ZIP Code | 48617 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRANCINE M PADGETT | PersonNm |
| Person Title | SR. VP & TREASURER | PersonTitleTxt |
| Phone | 9898393181 | PhoneNum |
| Signature | 2015-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURA M EBEL | PreparerPersonNm |
| PTIN | P00184232 | PTIN |
| Phone | 9894975300 | PhoneNum |
| Preparation | 2015-05-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RAYMOND STOVER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 703 NORTH MCEWAN STREET | AddressLine1 |
| City | CLARE | City |
| State | MI | State |
| ZIP Code | 48617 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $45,896,457 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MIDMICHIGAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. FORM 990, PART I, LINE 1 & PART III, LINE 1 - ORGANIZATION'S VISION OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 360 | TotalEmployeeCnt |
| Total Volunteers | 68 | TotalVolunteersCnt |
| Total Gross UBI | $8,369 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$12,038 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $34,880 | PYContributionsGrantsAmt |
| CY Contributions Grants | $47,663 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $41,750,605 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $41,378,692 | CYProgramServiceRevenueAmt |
| PY Investment Income | $882,412 | PYInvestmentIncomeAmt |
| CY Investment Income | $602,422 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,495,359 | PYOtherRevenueAmt |
| CY Other Revenue | $2,395,520 | CYOtherRevenueAmt |
| PY Total Revenue | $45,163,256 | PYTotalRevenueAmt |
| CY Total Revenue | $44,424,297 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,591,039 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,981,884 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,100,571 | PYOtherExpensesAmt |
| CY Other Expenses | $25,607,648 | CYOtherExpensesAmt |
| PY Total Expenses | $43,691,610 | PYTotalExpensesAmt |
| CY Total Expenses | $43,589,532 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,471,646 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $834,765 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $41,863,244 | TotalAssetsBOYAmt |
| Total Assets EOY | $36,940,104 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,421,934 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,902,104 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,441,310 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,038,000 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. FORM 990, PART I, LINE 1 & PART III, LINE 1 - ORGANIZATION'S VISION OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $35,582,550 | ExpenseAmt |
| Revenue | $41,378,692 | RevenueAmt |
| Desc | MIDMICHIGAN MEDICAL CENTER - CLARE PROVIDES COMPASSIONATE PATIENT CARE SERVICES OF SUPERIOR QUALITY TO CLARE AND ITS SURROUNDING COUNTIES. 1,172 PATIENT ADMISSIONS AND 89,906 HOSPITAL OUTPATIENT VISITS WERE RECORDED IN FISCAL YEAR 2014. THE CATH LAB HAD 39 VISITS IN FISCAL YEAR 2014. CARE IS PROVIDED WITHOUT RESPECT TO PATIENTS ABILITY TO PAY. | Desc |
| Total Program Service Expenses | $35,582,550 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 360 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FM PADGETT SR VP TREASURER | PersonNm |
| Phone | 9898393181 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4000 WELLNESS DR | AddressLine1 |
| City | MIDLAND | City |
| State | MI | State |
| ZIP Code | 48670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| DIANE POSTLER-SLATTERY | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $684,458 | $51,167 | |||
| TOM CLARINGBOLD DO | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $323,019 | $36,434 | |||
| RAYMOND STOVER | |||||||||
| PRESIDENT | 2.00 | 50.00 | Yes (X) | $0 | $262,794 | $76,116 | Yes (X) | ||
| LEYDA SU HAM DO | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $214,335 | $6,411 | |||
| MICHAEL WERTHEIMER MD | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $162,237 | $35,293 | |||
| JEFFREY FOSSITT | |||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| MIKE JENKINS | |||||||||
| CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| TOM HOUSE | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| DON RICHARDS | |||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| KAREN KLEINHARDT | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| LISA BENIC | |||||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| AMY STARK | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| THERESA SLOCUM | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JJ KLAUS | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAN TIMMINS | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| FRANCINE PADGETT | |||||||||
| ASSISTANT TR | 2.00 | 50.00 | $0 | $521,192 | $141,589 | Yes (X) | |||
| DONNA RAPP | |||||||||
| ASSISTANT SE | 2.00 | 50.00 | $0 | $389,673 | $125,707 | Yes (X) | |||
| WILLIAM GROVES | |||||||||
| CRNA | 50.00 | $216,045 | $0 | $26,186 | Yes (X) | ||||
| RUSSELL RADER | |||||||||
| ANESTHESIOLO | 50.00 | $208,758 | $0 | $23,941 | Yes (X) | ||||
| KELLY MATHISON | |||||||||
| CRNA | 50.00 | $208,518 | $0 | $16,796 | Yes (X) | ||||
| RICHARD DEFLUITER | |||||||||
| CRNA | 50.00 | $208,151 | $0 | $24,037 | Yes (X) | ||||
| JOSHUA SCHEXNAILDRE | |||||||||
| CRNA | 50.00 | $185,374 | $0 | $8,444 | Yes (X) | ||||
| LAWRENCE BARCO | |||||||||
| FORMER PRESI | 0.00 | $138,348 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,165,194 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,557,708 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $572,121 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt | Business Name Line2ContractorName/BusinessName/BusinessNameLine2 |
|---|---|---|---|---|---|---|
| MICHIGAN EMERGENCY PHYS LLP | ||||||
| PO BOX 793 | TRAVERSE CITY | MI | 496850793 | ER ADMIN | $958,880 | |
| SIEMENS MED SOLUTIONS USA INC | ||||||
| DEPT 14195 | PALATINE | IL | 600554195 | EQUIP MAINT | $789,842 | C/O MELLON BANK |
| THREE RIVERS CONSTRUCTION | ||||||
| PO BOX 1467 | MIDLAND | MI | 48641 | CONSTRUCTION | $739,959 | |
| EMCARE INC | ||||||
| 7032 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SVCS | $721,442 | |
| KAWKAWLIN ROOFING COMPANY INC | ||||||
| PO BOX 538 | KAWKAWLIN | MI | 486310538 | CONSTRUCTION | $331,079 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $17,574 | FundraisingAmt |
| All Other Contributions | $30,089 | AllOtherContributionsAmt |
| Total Contributions | $47,663 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| MEDICARE/MEDICAID PAYMENTS | 621990 | $26,093,117 | $26,093,117 | |
| NET PATIENT REVENUE | 621990 | $15,062,120 | $15,062,120 | |
| CONTRACTED CLINICAL SERVICES | 621990 | $215,086 | $215,086 | |
| REFERENCE LABORATORY | 621500 | $8,369 | $8,369 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $41,378,692 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $171,074 | TotalRevenueColumnAmt |
| Exclusion | $171,074 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4 | TotalRevenueColumnAmt |
| Exclusion | $4 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,897,621 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,335,695 | SecuritiesAmt |
| Other | $130,582 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $561,926 | SecuritiesAmt |
| Other | -$130,582 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $431,344 | TotalRevenueColumnAmt |
| Exclusion | $431,344 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $17,574 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $5,883 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,883 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| AFFILIATE RELATED INCOME | 900099 | $695,271 | $695,271 | |
| OUTSIDE INCOME | 900099 | $224,689 | $224,689 | |
| CAFETERIA/FOOD SERVICE | 722514 | $98,989 | $98,989 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,382,454 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,382,454 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,401,403 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,424,297 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,672,737 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $8,369 | UnrelatedBusinessRevenueAmt |
| Exclusion | $701,411 | 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 | $47,072 | TotalAmt |
| Program Services | $47,072 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,232,416 | TotalAmt |
| Program Services | $13,582,074 | ProgramServicesAmt |
| Management And General | $650,342 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $560,911 | TotalAmt |
| Program Services | $536,654 | ProgramServicesAmt |
| Management And General | $24,257 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,120,462 | TotalAmt |
| Program Services | $2,022,347 | ProgramServicesAmt |
| Management And General | $98,115 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,021,023 | TotalAmt |
| Program Services | $975,146 | ProgramServicesAmt |
| Management And General | $45,877 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,800 | TotalAmt |
| Management And General | $28,800 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,641 | TotalAmt |
| Management And General | $35,641 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,196,844 | TotalAmt |
| Program Services | $3,796,121 | ProgramServicesAmt |
| Management And General | $5,400,723 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,390 | TotalAmt |
| Program Services | $47,883 | ProgramServicesAmt |
| Management And General | $17,507 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $793,158 | TotalAmt |
| Program Services | $528,322 | ProgramServicesAmt |
| Management And General | $264,836 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,212,092 | TotalAmt |
| Program Services | $711,918 | ProgramServicesAmt |
| Management And General | $500,174 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,509 | TotalAmt |
| Program Services | $31,094 | ProgramServicesAmt |
| Management And General | $1,415 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,537 | TotalAmt |
| Program Services | $295,537 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,682,485 | TotalAmt |
| Program Services | $989,420 | ProgramServicesAmt |
| Management And General | $693,065 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,517 | TotalAmt |
| Program Services | $554 | ProgramServicesAmt |
| Management And General | $215,963 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHYSICIAN SUBSIDY | $7,197,867 | $7,173,867 | $24,000 |
| MEDICAL SUPPLIES | $3,729,262 | $3,722,995 | $6,267 |
| QAAP FEES | $1,010,224 | $1,010,224 | |
| LOSS ON EARLY DEBT EXTIN | $111,322 | $111,322 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,589,532 | TotalAmt |
| Program Services | $35,582,550 | ProgramServicesAmt |
| Management And General | $8,006,982 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,470 | BOYAmt |
| EOY | $1,320 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $216,730 | BOYAmt |
| EOY | $715,182 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,357,628 | BOYAmt |
| EOY | $5,759,946 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,825 | BOYAmt |
| EOY | $3,069 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $401,157 | BOYAmt |
| EOY | $375,901 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,991,315 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $18,466,115 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,678,601 | BOYAmt |
| EOY | $13,525,200 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,489,701 | BOYAmt |
| EOY | $2,066,873 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,539,189 | BOYAmt |
| EOY | $14,466,858 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,943 | BOYAmt |
| EOY | $25,755 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,863,244 | BOYAmt |
| EOY | $36,940,104 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,568,640 | BOYAmt |
| EOY | $2,729,852 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,991,772 | BOYAmt |
| EOY | $4,390,748 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $316,458 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,861,522 | BOYAmt |
| EOY | $2,465,046 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,421,934 | BOYAmt |
| EOY | $9,902,104 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,433,400 | BOYAmt |
| EOY | $27,033,299 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,910 | BOYAmt |
| EOY | $4,701 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,441,310 | BOYAmt |
| EOY | $27,038,000 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,863,244 | BOYAmt |
| EOY | $36,940,104 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $834,765 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,315,823 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$553,898 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,826,668 | OtherCostOrOtherBasisAmt |
| Book Value | $1,826,668 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,917,510 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,813,160 | DepreciationAmt |
| Book Value | $7,104,350 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $828,922 | OtherCostOrOtherBasisAmt |
| Depreciation | $642,411 | DepreciationAmt |
| Book Value | $186,511 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,200,741 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,010,544 | DepreciationAmt |
| Book Value | $4,190,197 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $217,474 | OtherCostOrOtherBasisAmt |
| Book Value | $217,474 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,525,200 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER FINANCIAL INVESTMENTS | Desc |
| Book Value | $14,466,858 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $14,466,858 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| SELF INSURANCE, OTHER | $2,465,046 |
| INTERCOMPANY LOANS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,465,046 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $45,747,565 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,315,823 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$93,379 | OtherRevenueAmt |
| Revenue Not Reported | $1,222,444 | RevenueNotReportedAmt |
| Revenue Subtotal | $44,525,121 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $35,641 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | -$136,465 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$100,824 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $44,424,297 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $43,629,904 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $56,754 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $56,754 | ExpensesNotReportedAmt |
| Expenses Subtotal | $43,573,150 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $35,641 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | -$19,259 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $16,382 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $43,589,532 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | NET ASSETS RELEASED FROM RESTRICTIONS FOR CAP. PURCHASES 17,944 LOSS ON EARLY EXTINGUISHMENT OF DEBT -111,323 |
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | LOSS ON DISPOSAL OF ASSETS - RECLASSIFIED -130,582 DIRECT EXPENSES RELATED TO FUNDRAISING - RECLASSIFIED -5,883 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | NET ASSETS RELEASED FROM RESTRICTIONS 50,871 DIRECT EXPENSES RELATED TO FUNDRAISING - RECLASSIFIED 5,883 |
| SCHEDULE D, PAGE 4, PART XII, LINE 4B | LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -130,582 LOSS ON EARLY EXTINGUISHMENT OF DEBT 111,323 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | LOVE LIGHT TREE | NameOfEvent1Amt |
| Gross Receipts Event1 | $17,574 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $17,574 | CharitableContriEvent1Amt |
| Food And Beverage Event1 | $900 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $4,983 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $17,574 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $17,574 | CharitableContributionsTotAmt |
| Food And Beverage Total Events | $900 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,983 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $5,883 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$5,883 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $95,165 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $95,165 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $7,887,496 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,234,775 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,652,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06090 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $7,982,661 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,234,775 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,747,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06300 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 112 | ActivitiesOrProgramsCnt |
| Persons Served | 3923 | PersonsServedCnt |
| Total Community Benefit Expns | $182,036 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,204 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $178,832 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00410 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 75 | ActivitiesOrProgramsCnt |
| Persons Served | 118 | PersonsServedCnt |
| Total Community Benefit Expns | $104,349 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $104,349 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 350 | PersonsServedCnt |
| Total Community Benefit Expns | $2,542 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,542 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 201 | ActivitiesOrProgramsCnt |
| Persons Served | 4391 | PersonsServedCnt |
| Total Community Benefit Expns | $288,927 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,204 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $285,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 203 | ActivitiesOrProgramsCnt |
| Persons Served | 4391 | PersonsServedCnt |
| Total Community Benefit Expns | $8,271,588 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,237,979 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,033,609 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06960 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $4,133 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,133 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 53 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $5,053 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,053 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 23 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $551 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $551 | NetCommunityBenefitExpnsAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $18,798 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,798 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 90 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $28,535 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $28,535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,799,230 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $69,718 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,274,224 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,670,463 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$396,239 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMICHIGAN MEDICAL CENTER - CLARE | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 703 N MCEWAN ST | AddressLine1 |
| City | CLARE | City |
| State | MI | State |
| ZIP Code | 486171440 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMICHIGAN MEDICAL CENTER - CLARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MIDMICHIGAN.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (true) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lawsuit | Yes (X) | PermitLawsuitInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Lawsuit | Yes (X) | LawsuitInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | Yes (true) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, MIDMICHIGAN MEDICAL CENTER - CLARE - PART V, LINE 3 | MIDMICHIGAN MEDICAL CENTER-CLARES COMMUNITY EDUCATION COORDINATOR IS INVOLVED IN A COMMUNITY COLLABORATIVE THAT GATHERS AND REVIEWS DATA AND WORKS TOWARD COMMON GOALS FOR HEALTH IMPROVEMENT; CALLED THE TOGETHER WE CAN HEALTH IMPROVEMENT PLANNING WORKING GROUP (HIP) FOR CLARE AND GLADWIN COUNTY. THIS WORKING GROUP IS A SUBCOMMITTEE OF THE TOGETHER WE CAN HEALTH IMPROVEMENT COUNCIL, A COLLABORATIVE OF COMMUNITY MEMBERS AND AGENCIES FROM ACROSS THE REGION LED BY THE CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT IN AN EFFORT TO ADDRESS HEALTH NEEDS IN THE COMMUNITIES SERVED, INCLUSIVE OF THOSE SERVED BY MIDMICHIGAN MEDICAL CENTER-CLARE. OTHER MEMBERS INCLUDE THE CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT CHIEF HEALTH OFFICER; DIRECTOR OF PUBLIC HEALTH PROMOTION AND PREPAREDNESS AT CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT; HEALTH PROMOTION AND PREPAREDNESS SUPERVISOR AT CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT; AND DIRECTOR OF PERSONAL HEALTH SERVICES AT CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT. THE COMMITTEE IS RESPONSIBLE FOR DEVELOPING AND EVALUATING ASSESSMENTS OF COMMUNITY NEED AND DEVELOPING PLANS TO MEET THOSE NEEDS. ADDITIONALLY, MIDMICHIGAN MEDICAL CENTER-CLARE IS A PARTNER WITH MIHIA. THE MICHIGAN HEALTH INFORMATION ALLIANCE, INC., OR MIHIA, IS A FORMAL, MULTI-STAKEHOLDER, COMMUNITY COLLABORATION WORKING TO ACHIEVE A COMMUNITY OF HEALTH EXCELLENCE FOR THE 14-COUNTY REGION IT SERVES. WE WORK WITH THE MIHIA DATA DASHBOARD AND THE DIRECTOR OF MIHIA, WHO ADVISES WITH DATA COLLECTION AND INTERPRETATION. |
| FACILITY 1, MIDMICHIGAN MEDICAL CENTER - CLARE - PART V, LINE 12I | PATIENTS RELIGIOUS BELIEFS PREVENT HIM/HER FROM PARTICIPATING DIRECTLY WITH AN INSURANCE COMPANY. |
| FACILITY 1, MIDMICHIGAN MEDICAL CENTER - CLARE - PART V, LINE 14G | THE COMPLETE POLICY IS NOT PUBLISHED. HOWEVER NOTICES OF THE EXISTENCE OF A FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN REGISTRATION AREAS (INCLUDING EMERGENCY ROOM). PATIENT BILLING INVOICES AND THE HOSPITAL WEBSITE INDICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE. |
| FACILITY 1, MIDMICHIGAN MEDICAL CENTER - CLARE - PART V, LINE 22 | - PATIENTS WHO DID NOT FOLLOW THEIR INSURANCE POLICY RULES (SUCH AS ACCESSING PARTICIPATING PROVIDERS, OBTAINING REFERRALS, ETC.) - GUARANTORS REFUSING TO ASSIGN BENEFITS TO THE HOSPITAL IF THEY ARE AVAILABLE - PATIENTS WHO ARE UNCOOPERATIVE WITH THE MEDICAID APPLICATION PROCESS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| MIDMI MEDICAL CENTER-CLARE REHAB SV | ||||
| 231 SOUTH FIRST STREET | HARRISON | MI | 48625 | REHABILITATION SERVICES ONLY |
| MIDMICHIGAN HEALTH PARK-HOUGHTON LK | ||||
| 9249 W LAKE CITY ROAD | HOUGHTON LAKE | MI | 48629 | REHABILITATION, LAB, & MAMMOGRAPHY |
| MIDMICHIGAN URGENT CARE - CLARE | ||||
| 700 WEST FIFTH ST | CLARE | MI | 48617 | URGENT CARE, OCCUPATIONAL MEDICINE |
| CLARE MMO RHC | ||||
| 602 BEECH STREET | CLARE | MI | 48617 | RURAL HEALTH CLINIC |
| HARRISON RHC | ||||
| 815 NORTH CLARE AVENUE | HARRISON | MI | 48625 | RURAL HEALTH CLINIC |
| FARWELL RHC | ||||
| 2812 WEST CADILLAC DRIVE | FARWELL | MI | 48622 | RURAL HEALTH CLINIC |
| 6TH AND MAPLE STREET | ||||
| 212 W SIXTH STREET | CLARE | MI | 48617 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II - COMMUNITY BUILDING ACTIVITIES | MIDMICHIGAN MEDICAL CENTER-CLARE EMPLOYEES CONTRIBUTED MANY HOURS AS MEMBERS OF COMMUNITY BOARDS, CIVIC ORGANIZATIONS, ADVISORY COMMITTEES, COALITIONS, AND WORK GROUPS. MIDMICHIGAN MEDICAL CENTER-CLARE IS A KEY PARTNER WITH UNITED WAY OF CLARE AND GLADWIN COUNTY, WHICH SUPPORTS MANY NON-PROFIT AGENCIES IN THESE COUNTIES, INCLUDING 211 FIRST CALL FOR HELP. MIDMICHIGAN MEDICAL CENTER-CLARE EMPLOYEES SERVE ADVISORY AND OTHER KEY ROLES FOR NON-PROFIT BOARDS AND/OR COMMITTEES, IMPACTING COMMUNITY HEALTH THROUGH CONTRIBUTIONS TO ORGANIZATIONS AND COMMITTEES THAT GATHER TO IMPROVE HEALTH, SUCH AS THE COMMUNITY HEALTH IMPROVEMENT ADVOCACY COUNCIL AND THE MIDMICHIGAN COMMUNITY HEALTH SERVICES EXECUTIVE COMMITTEE. CLARE IS ALSO REPRESENTED ON THE CHAMBER OF COMMERCE, WHICH ASSISTS THE COMMUNITY WITH SMALL BUSINESS DEVELOPMENT AND PROVIDES FINANCIAL SUPPORT FOR YOUTH LEADERSHIP PROGRAMS AND A BUSINESS EXPO EACH YEAR THAT PROVIDES HEALTH CARE SCREENINGS. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | OTHER UNCOMPENSATED CARE REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH PAYMENT IS EXPECTED AT THE TIME SERVICE IS PROVIDED, BUT PAYMENT IS NOT RECEIVED OR IS LESS THAN THE COST INCURRED TO PROVIDE THE SERVICE. THE FOLLOWING IS INCLUDED AS PROGRAMS AND SERVICES RELATED TO OTHER UNCOMPENSATED CARE: UNCOMPENSATED SERVICES, AT COSTREPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH A FEE HAS BEEN ASSESSED BUT NOT COLLECTED OR ONLY A PORTION OF THE COST OF THE RENDERED SERVICE HAS BEEN RECOVERED. LINE 2 - COSTING METHODOLOGY: AN AVERAGE COST-TO-CHARGE RATIO IS APPLIED TO THE CHARGE WRITE-OFF. THE RATIO IS CALCULATED BY REMOVING FROM TOTAL EXPENSE THE OTHER OPERATING INCOME, UNCOMPENSATED CARE EXPENSE AND THE DIRECTLY ASSIGNED MEDICAID ASSESSMENT EXPENSE, THEN DIVIDING THIS NET EXPENSE BY TOTAL GROSS PATIENT REVENUES. THIS RATIO IS MULTIPLIED WITH THE CHARITY CARE CHARGES AND UNCOMPENSATED CARE CHARGES WRITTEN OFF FOR THE RELATED EXPENSE. LINE 3 - BAD DEBT ATTRIBUTABLE TO CHARITY CARE: HISTORICAL COLLECTION ACTIVITY OBTAINED FROM 3RD PARTY COLLECTION AGENCIES IS USED TO ESTIMATE THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE. |
| PART III, LINE 8 - MEDICARE EXPLANATION | THE SOCIAL SECURITY ACT AMENDMENT TO ESTABLISH MEDICARE STATES THAT MEDICARE WILL NOT PAY THE COST TO PROVIDE CARE TO NON-BENEFICIARIES AND NON-BENEFICIARIES WILL NOT PAY THE COST OF CARE FOR BENEFICIARIES. WHEN MEDICARE DOES NOT PAY RATES THAT COVER ALL THE COST OF CARE FOR BENEFICARIES, IT BECOMES A COMMUNITY BURDEN. THEREFORE, THE FULL AMOUNT OF SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THIS ORGANIZATION BELIEVES THE AUDITED FINANCIAL STATEMENT CALCULATION IS A MORE ACCURATE DETERMINATION OF COST THAN THE MEDICARE ALLOWABLE COSTS USED FOR COST REPORTS THAT ARE REQUIRED TO BE UTILIZED ON THIS SCHEDULE IN PART III, SECTION B. THE AUDITED FINANCIAL STATEMENTS INCLUDE ALL MEDICARE REVENUES AND COSTS AND ALSO USE A COST-TO-CHARGE RATIO METHOD. THE AUDIT CALCULATION REPORTS A MEDICARE SHORTFALL OF 3,760,201 FOR THIS ORGANIZATION FOR THE FISCAL YEAR ENDED JUNE 30, 2014. HOWEVER, WITHOUT MEANINGFUL USE PAYMENTS THIS ORGANIZATION WOULD HAVE SHOWN A MEDICARE SHORTFALL OF 4,422,152. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | MIDMICHIGAN HEALTH DOES NOT TRY TO COLLECT FROM THOSE WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. MIDMICHIGAN HEALTH'S COLLECTION POLICY STATES THAT THE PURPOSE OF THE POLICY "IS TO PROVIDE COST EFFECTIVE PAYMENT OPTIONS TO PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE (PER FINANCIAL AID/CHARITY CARE POLICY) AND EITHER HAVE NO INSURANCE OR HAVE A BALANCE AFTER INSURANCE WHICH IS THEIR RESPONSIBILITY TO PAY." MIDMICHIGAN HEALTH ALSO OFFERS PATIENTS A CREDIT CARD PAYMENT PROGRAM ALLOWING PATIENTS TO PAY THEIR BALANCE AT 0.00% INTEREST OVER 12-36 MONTHS DEPENDING ON THE PATIENT BALANCE. MIDMICHIGAN HEALTH ASSURES THE COST OF THE PROGRAM (INTEREST) AND GUARANTEES THE RECEIVABLES. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | MIDMICHIGAN MEDICAL CENTER CLARE OPERATES FROM A COMMUNITY HEALTH NEEDS ASSESSMENT PLAN, DEVELOPED FROM DATA OUTLINED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL HAS PROVIDED COMMUNITY BENEFITS TO THE AREAS SERVED THROUGH DIRECT FINANCIAL ASSISTANCE TO PATIENTS, SUBSIDIZED PROGRAMS, AND COMMUNITY OUTREACH PROGRAMS, INCLUDING LOW COST AND FREE HEALTH CARE SCREENINGS AND OTHER PREVENTION PROGRAMS. THE IMPLEMENTATION STRATEGY FOR FY 2013-2016 INCLUDES REGULAR MEASUREMENT OF SHORT-TERM IMPACT ON PRIORITY ACTION ITEMS AND LONG-TERM IMPACT ON COMMUNITY HEALTH STATUS. DATA WITHIN THE CHNA COMES FROM A VARIETY OF LOCAL AND NATIONAL SOURCES. THIS DATA IS UTILIZED TO DETERMINE CURRENT HEALTH CARE TRENDS AND HEALTH CARE ISSUES; AND TO PRIORITIZE AND EVALUATE HEALTH CARE PROGRAM PROGRESS. PARTIAL LIST OF SOURCES FOR GENERAL HEALTH DATA FOLLOW: CDC MICHIGAN BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS); COMBINED ADULT AND YOUTH. COUNTY HEALTH RANKINGS (UNIVERSITY OF WISCONSIN DATA) CDC DATA AND STATISTICS (USED FOR GENERAL AND AGE SPECIFIC AND HEALTH CONDITION DATA SUCH AS AGING, TOBACCO USE, VACCINES AND IMMUNIZATIONS) MICHIGAN DEPARTMENT OF COMMUNITY HEALTH (MDCH) VITAL STATISTICS DHHS COMMUNITY HEALTH STATUS INDICATORS DHHS MEDICARE COMPARE DHHS MATERNAL AND CHILD HEALTH RESOURCE CENTER US DEPARTMENT OF HEALTH AND HUMAN SERVICES STATISTICS LINKS AMERICAN CANCER SOCIETY AMERICAN DIABETES ASSOCIATION WHO COUNTRY AND REGIONAL DIABETES DATA AMERICAN HEART ASSOCIATION (HEART AND OBESITY PREVENTION INFORMATION) NATIONAL CANCER INSTITUTE CANCER STUDIES CDC FUNDED STATISTICS ON HIV/AIDS; LUNG CANCER; SEXUALLY TRANSMITTED DISEASES NATIONAL CENTER FOR HEALTH STATISTICS-MENTAL DISORDERS CENTERS FOR MEDICARE AND MEDICAID SERVICES - RESEARCH, STATISTICS AND DATA SYSTEMS NATIONAL CENTER FOR HEALTH STATISTICS U.S. CENSUS BUREAU KAISER FAMILY FOUNDATION. WE COLLABORATE WITH LOCAL AGENCIES TO HELP DETERMINE AND RESPOND TO LOCAL NEEDS. FOR EXAMPLE, THE MIDMICHIGAN COMMUNITY ACTION AGENCY COMMUNITY NEEDS ASSESSMENT IS COMPLETED EVERY THREE YEARS, AND INCLUDES CLARE, GLADWIN, AND MIDLAND COUNTIES (THIS SURVEY ADDRESSES HEALTH CARE COST, INCLUDING PRESCRIPTION MEDICATIONS, AFFORDABLE PREVENTATIVE HEALTH CARE, AND TRANSPORTATION TO SERVICES). CLARE PARTICIPATES IN A STRONG COLLABORATIVE PARTNERSHIP HEADED BY CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT CALLED TOGETHER WE CAN, AND A SMALLER SUBSET OF THAT GROUP THE CLARE-GLADWIN HEALTH IMPROVEMENT PLAN. THESE GROUPS HAVE DEVELOPED A HEALTH IMPROVEMENT PLAN THAT IS BEING ENACTED TO IMPROVE COUNTY HEALTH AND CONSEQUENTLY THEIR RANKINGS AS DETERMINED BY THE ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | WE COMMUNICATE TO PATIENTS AND THE PUBLIC OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE THROUGH INFORMATIONAL BROCHURES AT REGISTRATION AREAS AND THROUGH PATIENT ACCOUNTING COUNSELORS. PATIENT ACCOUNTING COUNSELORS ARE TRAINED TO HELP PATIENTS OBTAIN FREE OR LOW-COST HEALTH INSURANCE OR TO WORK WITH PATIENTS TO PROVIDE CHARITY CARE OR FINANCIAL AID BASED ON THEIR FINANCIAL STATUS. ADDITIONALLY, SOCIAL WORKERS PROVIDE INFORMATION, BOTH WRITTEN AND VERBAL, ABOUT PROGRAMS FOR ASSISTANCE. THEY ALSO COORDINATE WITH THE MEDICAID ELIGIBILITY REPRESENTATIVE FROM DHS FOR FOLLOW-UP OR EXPEDITED APPLICATIONS. THEY PROVIDE MEDICAID APPLICATIONS, PERSONAL FINANCIAL STATEMENTS FOR HOSPITAL CHARITY CARE AND REFER TO THE PATIENT ACCOUNTING COUNSELORS. ADDITIONALLY, CONTACT INFORMATION ABOUT FINANCIAL ASSISTANCE IS AVAILABLE ON OUR WEBSITE AT HTTP://WWW.MIDMICHIGAN.ORG/PATIENTSVISITORS/BILLING- INSURANCE/FAQ-BILLING/NOINSURANCE. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | MIDMICHIGAN MEDICAL CENTER-CLARE'S PRIMARY SERVICE AREA IS COMPRISED OF THE 4 ZIP CODES WHICH CAPTURE CLARE COUNTY. 79.9% OF THEIR DISCHARGES ORIGINATED IN THESE ZIP CODES AND THEIR INPATIENT MARKET SHARE IS 20.3%. MIDMICHIGAN MEDICAL CENTER-MIDLAND ALSO SERVES THIS COMMUNITY RECEIVING A 34.4% MARKET SHARE FOLLOWED BY MCLAREN - CENTRAL MICHIGAN WITH A 15.7% MARKET CAPTURE AND MIDMICHIGAN MEDICAL CENTER-GRATIOT AT A 5.6% CAPTURE. CLARE COUNTY IS A DESIGNATED LOW INCOME MEDICALLY UNDERSERVED POPULATION AS WELL AS A DESIGNATED GEOGRAPHIC SINGLE COUNTY HEALTH PROFESSIONAL SHORTAGE AREA. DEMOGRAPHICS --------------------------------------------------------------------------- 2014 % OVER AVERAGE MEDIAN NUMBER OF MEDIAN POPULATION 65 YEARS INCOME INCOME HOUSEHOLDS AGE --------------------------------------------------------------------------- 33,465 20.8% 42,600 34,210 13,989 45.1 RACE --------------------------------------------------------------------------- PERCENT WHITE/ PERCENT PERCENT PERCENT PERCENT CAUCASIAN ASIAN INDIAN HISPANIC BLACK --------------------------------------------------------------------------- 95.8% 0.3% 0.8% 2.0% 1.1% |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | MIDMICHIGAN HEALTHS FOCUS ON IMPROVING THE HEALTH OF OUR COMMUNITIES IS REFLECTED IN OUR MISSION, VALUES, AND VISION. WE PARTNER WITH SCHOOLS, BUSINESSES AND HEALTH CARE AGENCIES TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITIES SERVED. ACTIVE COMMUNITY MEMBER BOARDS OVERSEE COMMUNITY OUTREACH ENDEAVORS FOR EACH MIDMICHIGAN HEALTH AFFILIATE. ADDITIONALLY, STAFF PARTICIPATE IN COMMUNITY COLLABORATIVES FOR AREA NON-PROFITS WITH A FOCUS ON HEALTH LIKE THE MIDMICHIGAN COMMUNITY HEALTH SERVICES EXECUTIVE COMMITTEE AND THE MICHIGAN HEALTH INFORMATION ALLIANCE, INC., OR MIHIA, WHICH IS A DIVERSE GROUP OF STAKEHOLDERS COLLABORATING TOGETHER AS A NON-PROFIT ORGANIZATION TO IMPROVE HEALTH AND HEALTH DELIVERY IN CENTRAL MICHIGAN. THESE COMMUNITY COLLABORATIONS HELP TO BUILD A HEALTH CARE SYSTEM WHERE CONSUMERS, PROVIDERS AND PAYERS MAKE DECISIONS FOR BEST PRACTICE IN THE AREA SERVED. ADDITIONALLY, WE PARTNER ON NEEDED HEALTH INITIATIVES, WORKING WITH LOCAL PUBLIC HEALTH DEPARTMENTS, AND HEALTH AND HUMAN SERVICE AGENCIES TO UNDERSTAND THE UNIQUE HEALTH NEEDS OF EACH OF OUR COMMUNITIES. THE COMMUNITY EDUCATION COORDINATOR FOR MIDMICHIGAN MEDICAL CENTER-CLARE IS AN ACTIVE MEMBER OF THE TOGETHER WE CAN HEALTH IMPROVEMENT TEAM FOR CLARE AND GLADWIN COUNTIES. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | 5.4 MILLION IN COMMUNITY BENEFITS WAS PROVIDED BY MIDMICHIGAN HEALTH LAST YEAR THROUGH COMMUNITY EDUCATION PROGRAMS, SCREENINGS, SPECIAL EVENTS AND HEALTH EXPERTISE, INCLUDING INSURANCE UNDER-REIMBURSEMENTS AND SERVICES TO THOSE WHO COULD NOT PAY. AREAS OF FOCUS IN THE MIDMICHIGAN HEALTH COMMUNITY BENEFIT PLANS ARE: ACCESS TO CARE, INCLUDING INITIATION AND COORDINATION OF CARE, CONTINUITY OF SERVICES AND CARE FOR THE UNDERINSURED; HEALTH OUTCOMES INCLUDING HEART DISEASE, CANCER AND DIABETES; HEALTH CARE BEHAVIORS INCLUDING HEALTHY DIET, PHYSICAL ACTIVITY AND HEALTHY WEIGHT; AND MATERNAL AND INFANT HEALTH, INCLUDING IMPROVED BIRTH WEIGHTS AND BREASTFEEDING DURATION. MIDMICHIGAN MEDICAL CENTER-CLARE FOCUSED ON DIABETES PREVENTION THROUGH PREDIABETES CLASSES, ALONG WITH OFFERED SCREENINGS AND EDUCATION FOR PEOPLE WITH DIABETES. ADDITIONALLY, CLOSE TO 750 COMMUNITY MEMBERS ATTENDED HEALTH FAIRS WHERE EDUCATION AND HEALTH CARE SCREENINGS WERE PROVIDED. IN AN EFFORT TO IMPROVE BREASTFEEDING DURATION RATES, ADDITIONAL BREASTFEEDING SUPPORTS THROUGH BREASTFEEDING FACILITATORS WERE PROVIDED. JUST UNDER 750 INDIVIDUALS PARTICIPATED IN FREE OR LOW-COST HEART DISEASE AND STROKE SCREENING (TOTAL LIPID PROFILE, BLOOD GLUCOSE, BLOOD PRESSURE, WEIGHT, BODY MASS INDEX, WAIST CIRCUMFERENCE, EKG), BLOOD PRESSURE, AND OSTEOPOROSIS SCREENINGS PROVIDED CONVENIENT FREE OR LOW-COST MEANS FOR DETECTING POTENTIALLY SERIOUS HEALTH PROBLEMS IN THEIR EARLIEST STAGES, WHEN TREATMENT IS USUALLY MORE SUCCESSFUL, RESULTING IN LOWER MORBIDITY OR MORTALITY. MIDMICHIGAN HEALTH SCREENED 2,458 PEOPLE IN OUR SERVICE AREA THIS YEAR, AT A COST OF 48,310.25, IN AN EFFORT TO ADDRESS INCREASING OBESITY AND CHOLESTEROL LEVELS AND DECREASED PHYSICAL ACTIVITY AMONG ADULTS AND CHILDREN. ADDITIONALLY, EXERCISE AND FITNESS RELATED ACTIVITIES FOR A TOTAL OF 1,509 COMMUNITY MEMBERS WERE PROVIDED. HEALTH FAIRS REACHED OUT TO ENCOURAGE AND TEACH CHILDREN ABOUT REGULAR EXERCISE, GOOD NUTRITION AND MAINTAINING A HEALTHY WEIGHT. MIDMICHIGAN HEALTH COLLABORATED WITH SCHOOLS WITH MANY OF THESE PROGRAMS. TRAUMA PREVENTION ACTIVITIES IN LINE WITH OUR TRAUMA TWO CERTIFICATION WERE INITIATED; PROVIDING 1,157 BIKE HELMET FITTINGS FOR CHILDREN AND THINK FIRST AND FALL PREVENTION EDUCATION FOR MANY OTHERS. MIDMICHIGAN HEALTH COMMUNITY EDUCATION STAFF MADE A CONCENTRATED EFFORT THIS FISCAL YEAR TO CONNECT PEOPLE TO PHYSICIANS AND NEEDED HEALTH SERVICES. CONTACT INFORMATION FOR SERVICES WERE TAKEN TO EACH SCREENING AND COMMUNITY OUTREACH EVENT AND PROVIDED AT THE TIME OF PHYSICIAN APPOINTMENTS; WHEN SCHEDULING APPOINTMENTS OR INQUIRING ABOUT AN APPOINTMENT AT A COMMUNITY EVENT. THE MIDMICHIGAN HEALTH PHYSICIAN DIRECTORY HAS INFO ABOUT ACCESS LINE, AND PHYSICIAN LIAISONS TO PROVIDE INFORMATION TO OFFICES RE: MIDMICHIGAN ACCESS LINE, TO HELP THEM DETERMINE IF A PROGRAM OR SERVICE IS AVAILABLE LOCALLY, OR TO TRANSFER THEM TO A PHYSICIAN OFFICE OR DEPARTMENT FOR REFERRALS. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | MICHIGAN |
| ADDITIONAL INFORMATION | PART I, LINE 3A AND 3B AS WELL AS USING THE FEDERAL POVERTY GUIDELINES, THE PATIENT'S AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT ARE TAKEN INTO CONSIDERATION WHEN DETERMINING FREE OR DISCOUNTED CARE. PATIENTS WHOSE FAMILY INCOME EXCEEDS 200% OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DIANE POSTLER-SLATTERY | ||||||||||||
| DIRECTOR | $527,025 | $111,784 | $45,649 | $33,067 | $18,100 | $735,625 | ||||||
| TOM CLARINGBOLD DO | ||||||||||||
| DIRECTOR | $257,339 | $64,752 | $928 | $20,611 | $15,823 | $359,453 | ||||||
| RAYMOND STOVER | ||||||||||||
| PRESIDENT | $191,063 | $52,015 | $19,716 | $58,383 | $17,733 | $338,910 | ||||||
| LEYDA SU HAM DO | ||||||||||||
| DIRECTOR | $173,570 | $40,540 | $225 | $10 | $6,401 | $220,746 | ||||||
| MICHAEL WERTHEIMER MD | ||||||||||||
| DIRECTOR | $122,325 | $37,363 | $2,549 | $18,930 | $16,363 | $197,530 | ||||||
| FRANCINE PADGETT | ||||||||||||
| ASSISTANT TREASURER | $329,724 | $90,341 | $101,127 | $117,994 | $23,595 | $662,781 | ||||||
| DONNA RAPP | ||||||||||||
| ASSISTANT SECRETARY | $285,948 | $78,293 | $25,432 | $110,797 | $14,910 | $515,380 | ||||||
| WILLIAM GROVES | ||||||||||||
| CRNA | $212,513 | $400 | $3,132 | $10,935 | $15,251 | $242,231 | ||||||
| RUSSELL RADER | ||||||||||||
| ANESTHESIOLOGY MGR | $198,739 | $1,600 | $8,419 | $10,580 | $13,361 | $232,699 | ||||||
| KELLY MATHISON | ||||||||||||
| CRNA | $186,342 | $20,400 | $1,776 | $10,483 | $6,313 | $225,314 | ||||||
| RICHARD DEFLUITER | ||||||||||||
| CRNA | $207,122 | $200 | $829 | $10,483 | $13,554 | $232,188 | ||||||
| JOSHUA SCHEXNAILDRE | ||||||||||||
| CRNA | $174,844 | $10,300 | $230 | $8,444 | $193,818 | |||||||
| LAWRENCE BARCO | ||||||||||||
| FORMER PRESIDENT | $138,348 | $138,348 | ||||||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | LAWRENCE BARCO 138,348 0 0 |
| SCHEDULE J, PAGE 1, PART I, LINE 7 | MIDMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE INDEPENDENT COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES (60% OF MEDIAN). THE COMPENSATION COMMITTEE, WHO IS AUTHORIZED TO ACT ON BEHALF OF THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS, APPROVED COMPENSATION FOR THE MIDMICHIGAN HEALTH CEO, SENIOR EXECUTIVES AND PHYSICIANS. SULLIVAN COTTER ISSUED A COMPREHENSIVE ASSESSMENT IN 2009 AND AGAIN IN 2013. IN ADDITION, AS A PART OF THE PHYSICIAN ENTERPRISE ENGAGEMENT, KAUFMAN HALL ISSUED A SAFE HARBOR LETTER THAT WAS REVIEWED AT THE JUNE 2013 COMPENSATION COMMITTEE MEETING. |
| SCHEDULE J, PART III | ON MAY 8, 2009 MIDMICHIGAN HEALTH'S COMPENSATION COMMITTEE APPROVED ITS FIRST COMPENSATION COMMITTEE CHARTER AND EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH APPROVED BOTH THE CHARTER AND THE STRATEGY ON JUNE 8, 2009. MIDMICHIGAN HEALTH ALSO CONTINUES TO UTILIZE AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES, HOSPITAL LEVEL EXECUTIVES AND SELECTED OTHER EXECUTIVES. MIDMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MIDMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED NATIONALLY FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY. PART I, LINE 4B - POSTLER-SLATTERY, PADGETT, RAPP, AND STOVER ARE PARTICIPANTS IN A 457(F) PLAN. NO PAYMENTS TO THESE PARTICIPANTS WERE MADE IN 2013. THE SERP IS UNFUNDED AND BEGAN ON JANUARY 1, 2009. THE CURRENT PARTICIPANTS OF THE PLAN ARE THOSE WHO HOLD A CORPORATE OFFICE OF VICE PRESIDENT OR ABOVE. EACH PARTICIPANTS ANNUAL AWARD IS A BENEFIT RESTORATION AMOUNT THAT PROVIDES THE ADDITIONAL BENEFITS THAT THE PARTICIPANT DID NOT EARN UNDER THE PENSION PLAN AND 403(B) PLAN DURING A PLAN YEAR BECAUSE OF THE STATUTORY LIMITS. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MIDMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: ATTAINMENT OF NORMAL RETIREMENT AGE; DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; OR, PROVIDED THEY HAVE BEEN EMPLOYED AT LEAST FIVE YEARS AND THE PARTICIPANT EARNS 75 POINTS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 2006A MI STATE HOSPITAL FINANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 382889417 | BondIssuerEIN |
| CUSIP | 59465HEB8 | CUSIPNum |
| Bond Issued | 2006-11-07 | BondIssuedDt |
| Issue Price | $4,332,800 | IssuePriceAmt |
| Purpose | CAPITAL PROJECTS | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $4,332,800 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $25,050 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $4,394,794 | CapitalExpendituresAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Current Refunding | false | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Concerning UBI | 0.00020 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00020 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | Yes (true) | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K - DATE REBATE COMPUTATION PERFORMED | 2006A MI STATE HOSPITAL FINANCE 05/01/10 |
| SCHEDULE K - ADDITIONAL INFORMATION | 2006A MI STATE HOSPITAL FINANCE IT HAS BEEN DETERMINED THAT NO ARBITRAGE REBATE IS DUE FOR THIS BOND ISSUE. THEREFORE, FORM 8038-T IS NOT REQUIRED. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERRESA SLOCUM | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER | RelationshipDescriptionTxt |
| Transaction | $40,322 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. FORM 990, PART I, LINE 1 & PART III, LINE 1 - ORGANIZATION'S VISION OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE. |
| FORM 990 | ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. PART I, LINES 3 & 4 AND PART VI, SECTION A, LINE 1 - THOSE MEMBERS WHO ARE NOT INDEPENDENT ARE EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION LISTED IN SCHEDULE R AND ARE COMPENSATED AT MARKET VALUE FOR THE SERVICES PROVIDED TO THAT ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS MIDMICHIGAN HEALTH. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; AND G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 INFORMATION IS PREPARED BY THE FINANCE STAFF AT MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THIS ORGANIZATION. THE INFORMATION IS SUBMITTED FOR REVIEW BY A SENIOR FINANCE STAFF MEMBER AT MIDMICHIGAN HEALTH. THE STAFF MEMBER IN CONSULTATION WITH OUR TAX ACCOUNTANT (A CERTIFIED PUBLIC ACCOUNTING FIRM) REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. ONCE THE INITIAL REVIEW IS COMPLETE, THE INFORMATION IS SUBMITTED TO OUR TAX PROFESSIONALS AT ANDREWS HOOPER PAVLIK PLC. UPON REVIEW BY THEIR PROFESSIONALS,INCLUDING A PARTNER, INFORMATION IS RETURNED TO MIDMICHIGAN HEALTH FOR ITS FINAL REVIEW. THIS REVIEW INCLUDES A REVIEW BY THE SVP AND TREASURER. ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MIDMICHIGAN HEALTH CEO PRIOR TO FILING. PRIOR TO FILING: THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION IS REVIEWED BY THE COMPENSATION COMMITTEE PRIOR TO FILING. FORM 990, INCLUDING ALL SCHEDULES, IS MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS IN A SECURE ELECTRONIC FORMAT WITH A SUMMARY OF ALL THE MAJOR CHANGES FROM THE PRIOR YEAR RETURN. QUESTIONS OR CONCERNS ARE ADDRESSED BY THE SVP AND TREASURER. THE QUESTIONS OR CONCERNS OF THESE REVIEWS ARE PRESENTED TO THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS AND THIS ORGANIZATION'S BOARD OF DIRECTORS, IF ANY ARE IDENTIFIED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE, AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; AND 3) TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MIDMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES ARE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND ABSTAIN FROM VOTING ON ANY ISSUE IN WHICH THEY ARE NOT INDEPENDENT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ALL CEOS AND OPERATING OFFICERS COMPENSATION IS ANNUALLY APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF MIDMICHIGAN HEALTH. THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J. |
| FORM 990, PAGE 6, PART VI, LINE 15B | ALL OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J. |
| FORM 990, PAGE 6, PART VI, LINE 19 | ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PAGE 7, PART VII | NO DIRECTORS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD. THEY ARE CONSIDERED TO WORK AN AVERAGE OF 2 HOURS A WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK RELATED TO THEIR FULL-TIME POSITION. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MIDMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES IS NOT TRACKED BY AFFILIATE. THEREFORE THE FULL TIME SERVICE TO ALL AFFILIATES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS. |
| FORM 990, PART IX, LINE 11G | ASSOCIATION DUES & OTHER FEES 2,854,114 5,028,255 0 PURCHASED/CONTRACT SERVICES 942,007 372,468 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MIDMICHIGAN HEALTH | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 382459948 | SUPPORT | MI | 501C3 | 11A | NA | false |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 380833014 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | Yes (true) |
| MIDMICHIGAN MEDICAL CENTER-GRATIOT | ||||||||||
| 300 E WARWICK DR | ALMA | MI | 48801 | 381437919 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | Yes (true) |
| MIDMICHIGAN MEDICAL CENTER-GLADWIN | ||||||||||
| 515 QUARTER STREET | GLADWIN | MI | 48624 | 386020434 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | Yes (true) |
| MIDMICHIGAN STRATFORD VILLAGE | ||||||||||
| 2121 ROCKWELL DR | MIDLAND | MI | 48642 | 382623324 | LT CARE | MI | 501C3 | 9 | MIDMI HLTH | Yes (true) |
| MIDMICHIGAN GLADWIN PINES | ||||||||||
| 449 QUARTER STREET | GLADWIN | MI | 48624 | 382754875 | LT CARE | MI | 501C3 | 9 | MIDMI HLTH | Yes (true) |
| MIDMI VNA DBA MIDMICHIGAN HOME CARE | ||||||||||
| 3007 N SAGINAW RD | MIDLAND | MI | 48640 | 381459397 | HOME EQUIP | MI | 501C3 | 9 | MIDMI HLTH | Yes (true) |
| MIDMICHIGAN PHYSICIANS GROUP | ||||||||||
| 2620 W SUGNET ROAD | MIDLAND | MI | 48640 | 383317788 | MED OFFICE | MI | 501C3 | 11A | MIDMI HLTH | Yes (true) |
| MIDMICHIGAN REGIONAL IMAGING | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 352182295 | EQUIPMENT | MI | 501C3 | 11B | MIDMI HLTH | Yes (true) |
| MIDMICHIGAN URGENT CARE | ||||||||||
| 3009 N SAGINAW RD | MIDLAND | MI | 48640 | 205064848 | AMBULATORY | MI | 501C3 | 9 | MIDMI HLTH | Yes (true) |
| MIDMICHIGAN HEALTH DEV ASSOC | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 382459947 | OPERATIONS | MI | 501C2 | MIDMI HLTH | Yes (true) | |
| REGIONAL DIALYSIS SERVICES | ||||||||||
| PO BOX 608 | ALMA | MI | 48801 | 383120704 | DIALYSIS | MI | 501C3 | 11A | MIDMI HLTH | Yes (true) |
| MIDMI MED CENTER-CLARE VOLUNTEERS | ||||||||||
| 703 NORTH MCEWAN STREET | CLARE | MI | 48617 | 382944967 | SUPPORT | MI | 501C3 | 11A | NA | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMICHIGAN ASSURANCE GROUP LTD | BusinessNameLine1 |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1051 23 LIME TREE BAY AVENUE | AddressLine1 |
| Address Line2 | GOVERNORS SQUARE BLDG 4 2ND FLOOR | AddressLine2 |
| City | GEORGE TOWN | City |
| Province Or State | GRAND CAYMAN | ProvinceOrState |
| Country | CJ | Country |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 980585596 | EIN |
| Primary Activities | INSURANCE | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMI HLTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORP | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (12 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MIDMICHIGAN PHYSICIANS GROUP | ||
| B | $711,360 | BOOKS & RECORDS |
| MIDMICHIGAN REGIONAL IMAGING | ||
| C | $157,462 | BOOKS & RECORDS |
| MIDMICHIGAN REGIONAL IMAGING | ||
| E | $148,418 | BOOKS & RECORDS |
| MIDMICHIGAN REGIONAL IMAGING | ||
| K | $331,889 | BOOKS & RECORDS |
| MIDMICHIGAN HEALTH DEV ASSOC | ||
| K | $97,989 | BOOKS & RECORDS |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||
| P | $1,018,179 | BOOKS & RECORDS |
| MIDMICHIGAN MEDICAL CENTER-GRATIOT | ||
| P | $74,278 | BOOKS & RECORDS |
| MIDMICHIGAN HEALTH | ||
| P | $3,810,669 | BOOKS & RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| P | $7,415,522 | BOOKS & RECORDS |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||
| Q | $525,952 | BOOKS & RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| Q | $81,968 | BOOKS & RECORDS |
| MIDMICHIGAN MEDICAL CENTER-GLADWIN | ||
| Q | $53,728 | BOOKS & RECORDS |