STURGIS HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- STURGIS HOSPITAL INC (EIN 35-2362438)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-10
- IRS object ID
- 201512229349300701
- 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 | 2015-08-10T07:07:02-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E Main St Suite 700 | AddressLine1 |
| City | Fort Wayne | City |
| State | IN | State |
| ZIP Code | 46802 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352362438 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STURGIS HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % ROBERT J LABARGE | InCareOfNm |
| Business Name Control | STUR | BusinessNameControlTxt |
| Phone | 2696594400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 916 MYRTLE AVENUE | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | STURGIS | City |
| State | MI | State |
| ZIP Code | 49091 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT J LABARGE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2696594400 | PhoneNum |
| Signature | 2015-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joyce A Dulworth | PreparerPersonNm |
| PTIN | P00151125 | PTIN |
| Phone | 2696594400 | PhoneNum |
| 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 | ROBERT J LABARGE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 916 MYRTLE AVENUE | AddressLine1 |
| City | STURGIS | City |
| State | MI | State |
| ZIP Code | 49091 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $45,926,035 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STURGISHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | STURGIS HOSPITAL IS AN 84-BED LICENSED, ACUTE CARE FACILITY SERVING A POPULATION OF APPROXIMATELY 50,000. IT EXISTS TO ENSURE THAT THE COMMUNITY HAS ADEQUATE ACCESS TO HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 420 | TotalEmployeeCnt |
| Total Volunteers | 117 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $104,719 | PYContributionsGrantsAmt |
| CY Contributions Grants | $205,426 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $48,617,502 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $45,199,088 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,319 | PYInvestmentIncomeAmt |
| CY Investment Income | $154,178 | CYInvestmentIncomeAmt |
| PY Other Revenue | $34,947 | PYOtherRevenueAmt |
| CY Other Revenue | $71,742 | CYOtherRevenueAmt |
| PY Total Revenue | $48,759,487 | PYTotalRevenueAmt |
| CY Total Revenue | $45,630,434 | 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 | $25,615,237 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $25,753,212 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,306,575 | PYOtherExpensesAmt |
| CY Other Expenses | $23,320,373 | CYOtherExpensesAmt |
| PY Total Expenses | $48,921,812 | PYTotalExpensesAmt |
| CY Total Expenses | $49,073,585 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$162,325 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,443,151 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $33,176,195 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,768,931 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,677,412 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,114,678 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,498,783 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,654,253 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | STURGIS HOSPITAL INC. IS COMMITTED TO THE PROVISION OF THE HIGHEST QUALITY PRIMARY AND SECONDARY HEALTHCARE TO THE COMMUNITY WE SERVE. STURGIS HOSPITAL INC. STRIVES, IN ALL CIRCUMSTANCES TO PROVIDE ACUTE AND PREVENTATIVE CARE THAT IS CONSISTENT WITH THE VALUES AND NEEDS OF THE UNIQUE SEGMENTS OF OUR POPULATION. BY EXERCISING RESPONSIBLE STEWARDSHIP OF OUR RESOURCES, STURGIS HOSPITAL INC. WILL ALSO ENDEAVOR TO MAXIMIZE THE BREADTH AND DEPTH OF CARE PROVIDED TO OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $41,293,213 | ExpenseAmt |
| Revenue | $45,258,328 | RevenueAmt |
| Desc | STURGIS HOSPITAL IS A 84-BED LICENSED, ACUTE CARE FACILITY. NEARLY 40 ACTIVE MEDICAL STAFF MEMBERS, AVAILABLE WITHIN THE STURGIS AND SURROUNDING COMMUNITIES, REPRESENT A WIDE VARIETY OF SPECIALTIES INCLUDING ANESTHESIOLOGY, FAMILY PRACTICE, GENERAL SURGERY, GYNECOLOGY, INTERNAL MEDICINE, OBSTETRICS, OPHTHALMOLOGY, ORTHOPAEDICS, PATHOLOGY, PEDIATRICS, PODIATRY, RADIOLOGY, UROLOGY AND VASCULAR SURGERY. ADDITIONAL SPECIALTIES ARE OFFERED THROUGH THE HOSPITAL'S COURTESY, CONSULTING AND AFFILIATE MEDICAL STAFF MEMBERS. THESE SERVICES INCLUDE CARDIOLOGY, NEUROLOGY, NEUROSURGERY, ONCOLOGY, AND PULMONARY MEDICINE. MEDICAL/SURGICAL CARE IS OFFERED ON AN INPATIENT AND OUTPATIENT LEVEL. BOTH LASER AND LAPAROSCOPIC PROCEDURES ARE PERFORMED IN THE HOSPITAL'S THREE ROOM SURGICAL SUITE. A FOUR-BED CORONARY/INTENSIVE CARE UNIT IS ALSO AVAILABLE FOR CRITICAL PATIENTS. THE 12-BED OBSTETRICAL DEPARTMENT OFFERS LABOR/DELIVERY/RECOVERY/POSTPARTUM ROOMS FOR THE EXPECTANT MOM AND HER FAMILY. EMERGENCY SERVICES ARE AVAILABLE 24 HOURS A DAY, 365 DAYS A YEAR, WITH FULL-TIME MEDICAL STAFF COVERAGE. CARDIAC REHABILITATION AND PHYSICAL THERAPY PROGRAMS AS WELL AS COMMUNITY EDUCATION PROGRAMS DESIGNED TO HELP OUR COMMUNITY LEAD A HEALTHIER LIFESTYLE, ARE ALSO AVAILABLE. STURGIS HOSPITAL HAS A COMMITMENT TO MAINTAIN STATE-OF-THE-ART DIAGNOSTIC TECHNOLOGY, WHICH INCLUDES ANGIOGRAPHY, 64-SLICE CT SCANNING, MAMMOGRAPHY, MOBILE MRI, A SLEEP DISORDER LABORATORY AND SPECT IMAGING AND ULTRASOUND. STURGIS HOME HEALTH CARE--A TOP 500 AGENCY IN THE NATION--IS A DIVISION OF STURGIS HOSPITAL. IT WORKS CLOSELY WITH PHYSICIANS TO PROVIDE QUALITY HOME HEALTH CARE SERVICES FOLLOWING DISCHARGE FROM A HOSPITAL OR FOR THOSE WITH SPECIAL MEDICAL NEEDS THAT DO NOT REQUIRE HOSPITALIZATION. THESE SERVICES INCLUDE NURSING ASSISTANCE, AIDS, COMPANIONS, PHYSICAL, OCCUPATIONAL, SPEECH AND LANGUAGE THERAPIES, AS WELL AS A MEDICAL SOCIAL WORKER. HOSPICE OF STURGIS PROVIDES SUPPORT AND CARE FOR PERSONS IN THE LAST PHASES OF AN INCURABLE DISEASE. THESE SERVICES CAN BE PROVIDED IN A PATIENT'S HOME, NURSING HOME OR ADULT FOSTER CARE SETTING. THE HOSPICE TEAM INCLUDES PHYSICIANS, NURSES, THERAPISTS, AIDES, SOCIAL WORKERS, NUTRITIONISTS, VOLUNTEERS AND CLERGY, AS WELL AS BEREAVEMENT AND SUPPORT GROUPS. | Desc |
| Total Program Service Expenses | $41,293,213 | 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 | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | 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 | false | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 129 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 420 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT J LABARGE | PersonNm |
| Phone | 2696594400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 916 MYRTLE AVENUE | AddressLine1 |
| City | STURGIS | City |
| State | MI | State |
| ZIP Code | 49091 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| ASHISH VERMA | |||||||
| MEDICAL STAFF PRESIDENT | 40.0 | Yes (X) | Yes (X) | $486,582 | $0 | $30,744 | |
| JOHN MAYER | |||||||
| BOARD PRESIDENT | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| FLOYD KUNCE | |||||||
| BOARD DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| PHILIP WARD | |||||||
| BOARD DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| JOSE ALBARRAN | |||||||
| BOARD DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| JEANNIE GERCHOW | |||||||
| BOARD DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| P JOSEPH HAAS JR | |||||||
| BOARD VICE-PRESIDENT | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARK HEYDLAUFF | |||||||
| BOARD DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| ERIC JONES | |||||||
| BOARD DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS ROCK | |||||||
| BOARD SECRETARY/TREASURER | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BHARAT VAKHARIA | |||||||
| BOARD DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| VICKI WATSON | |||||||
| BOARD DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| SHARI RANSBERGER | |||||||
| VP OF QUALITY MANAGEMENT | 40.0 | Yes (X) | $103,275 | $0 | $25,081 | ||
| JOSEPHINE HAGOOD | |||||||
| VP OF PHYSICIAN SERVICES | 40.0 | Yes (X) | $82,078 | $0 | $21,749 | ||
| CHARLOTTE PAVILANIS | |||||||
| VP OF PATIENT SERVICES | 40.0 | Yes (X) | $129,354 | $0 | $5,312 | ||
| MARY KAY SCHULTZ | |||||||
| VP OF HUMAN RESOURCES | 40.0 | Yes (X) | $110,488 | $0 | $20,915 | ||
| KEYER PATEL | |||||||
| PHYSICIAN | 40.0 | $658,935 | $0 | $26,302 | Yes (X) | ||
| WILSON SAWA | |||||||
| PHYSICIAN | 40.0 | $390,287 | $0 | $30,744 | Yes (X) | ||
| JAMES GRANNELL | |||||||
| PHYSICIAN | 40.0 | $444,046 | $0 | $25,921 | Yes (X) | ||
| ELIEZER MELENDEZ | |||||||
| PHYSICIAN | 40.0 | $493,575 | $0 | $30,744 | Yes (X) | ||
| YAZDI AMARIA | |||||||
| PHYSICIAN | 40.0 | $644,836 | $0 | $26,302 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,543,456 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $243,814 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | 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 |
|---|---|---|---|---|---|
| ALLIANCE-HNI LLC | |||||
| 7647 COLLECTION CENTER DRIVE | CHICAGO | IL | 606930076 | MRI SERVICES | $558,531 |
| SODEXO OPERATIONS LLC | |||||
| 4880 PAYSHPERE CIRCLE | CHICAGO | IL | 60674 | DIETARY MAINT. MGMT | $426,154 |
| SOUTH BEND MEDICAL FOUNDATION INC | |||||
| 118 W EDISON ROAD | MISHAWAKA | IN | 465453143 | LAB SERVICES | $608,544 |
| QUORUM HEALTH RESOURCES | |||||
| PO BOX 305172 | NASHVILLE | TN | 37230 | MANAGEMENT | $869,512 |
| PT SERVICES REHABILITATION INC | |||||
| PO BOX 833 | TIFFIN | OH | 448830833 | REHAB SERVICES | $376,964 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $34,800 | FundraisingAmt |
| All Other Contributions | $170,626 | AllOtherContributionsAmt |
| Total Contributions | $205,426 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INPATIENT REVENUE | 900004 | $16,761,382 | $16,761,382 |
| OUTPATIENT REVENUE | 900099 | $12,295,539 | $12,295,539 |
| PHYSICIAN OFFICE REVENUE | 900099 | $14,435,740 | $14,435,740 |
| CAFETERIA REVENUE | 900099 | $100,334 | $100,334 |
| OTHER REVENUE | 900099 | $1,510,741 | $1,510,741 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,352 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $95,352 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $45,199,088 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $154,178 | TotalRevenueColumnAmt |
| Exclusion | $154,178 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $347,280 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $288,040 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $59,240 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,240 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $59,240 | RelatedOrExemptFuncIncomeAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $20,063 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $34,800 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,561 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,502 | TotalRevenueColumnAmt |
| Exclusion | $12,502 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,630,434 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,258,328 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $166,680 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $991,493 | TotalAmt |
| Program Services | $793,194 | ProgramServicesAmt |
| Management And General | $198,299 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,564,416 | TotalAmt |
| Program Services | $15,651,533 | ProgramServicesAmt |
| Management And General | $3,912,883 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $361,562 | TotalAmt |
| Program Services | $48,031 | ProgramServicesAmt |
| Management And General | $313,531 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,482,351 | TotalAmt |
| Program Services | $3,289,420 | ProgramServicesAmt |
| Management And General | $192,931 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,353,390 | TotalAmt |
| Program Services | $1,015,297 | ProgramServicesAmt |
| Management And General | $338,093 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310,787 | TotalAmt |
| Program Services | $248,630 | ProgramServicesAmt |
| Management And General | $62,157 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,143 | TotalAmt |
| Program Services | $116,914 | ProgramServicesAmt |
| Management And General | $29,229 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,375 | TotalAmt |
| Program Services | $42,700 | ProgramServicesAmt |
| Management And General | $10,675 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,223,406 | TotalAmt |
| Program Services | $5,170,164 | ProgramServicesAmt |
| Management And General | $1,053,242 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,552 | TotalAmt |
| Program Services | $134,842 | ProgramServicesAmt |
| Management And General | $33,710 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,427,985 | TotalAmt |
| Program Services | $2,742,388 | ProgramServicesAmt |
| Management And General | $685,597 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,585 | TotalAmt |
| Program Services | $275,668 | ProgramServicesAmt |
| Management And General | $68,917 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,339,191 | TotalAmt |
| Program Services | $1,071,353 | ProgramServicesAmt |
| Management And General | $267,838 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,703 | TotalAmt |
| Program Services | $46,703 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,511 | TotalAmt |
| Program Services | $71,722 | ProgramServicesAmt |
| Management And General | $14,789 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $888,493 | TotalAmt |
| Program Services | $710,794 | ProgramServicesAmt |
| Management And General | $177,699 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,486,203 | TotalAmt |
| Program Services | $1,188,962 | ProgramServicesAmt |
| Management And General | $297,241 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $612,835 | TotalAmt |
| Program Services | $490,268 | ProgramServicesAmt |
| Management And General | $122,567 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $3,232,561 | $3,232,561 | |
| MEDICAL SUPPLIES | $4,910,375 | $4,910,375 | |
| MISCELLANEOUS EXPENSE | $42,668 | $41,694 | $974 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,073,585 | TotalAmt |
| Program Services | $41,293,213 | ProgramServicesAmt |
| Management And General | $7,780,372 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $650 | BOYAmt |
| EOY | $650 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,061,283 | BOYAmt |
| EOY | $1,887,137 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,707,288 | BOYAmt |
| EOY | $6,087,301 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $887,559 | BOYAmt |
| EOY | $978,441 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $613,013 | BOYAmt |
| EOY | $858,720 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $49,630,608 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,353,369 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,738,132 | BOYAmt |
| EOY | $17,277,239 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,905,177 | BOYAmt |
| EOY | $2,463,552 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $263,093 | BOYAmt |
| EOY | $215,891 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,176,195 | BOYAmt |
| EOY | $29,768,931 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,583,577 | BOYAmt |
| EOY | $6,470,654 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,340,057 | BOYAmt |
| EOY | $11,430,031 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,270,237 | BOYAmt |
| EOY | $1,237,875 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $483,541 | BOYAmt |
| EOY | $1,976,118 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,677,412 | BOYAmt |
| EOY | $21,114,678 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,449,054 | BOYAmt |
| EOY | $8,589,520 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,729 | BOYAmt |
| EOY | $64,733 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,498,783 | BOYAmt |
| EOY | $8,654,253 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,176,195 | BOYAmt |
| EOY | $29,768,931 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,443,151 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $181,835 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,583,214 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $109,943 | OtherCostOrOtherBasisAmt |
| Book Value | $109,943 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,308,445 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,535,813 | DepreciationAmt |
| Book Value | $13,772,632 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,090,355 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,524,587 | DepreciationAmt |
| Book Value | $1,565,768 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,121,865 | OtherCostOrOtherBasisAmt |
| Depreciation | $292,969 | DepreciationAmt |
| Book Value | $1,828,896 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,277,239 | TotalBookValueLandBuildingsAmt |
| Total Book Value Program Rltd | $0 | TotalBookValueProgramRltdAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PENSION LIABILITY | Desc |
| Amt | $1,976,118 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,976,118 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $42,273,319 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $295,601 | OtherRevenueAmt |
| Revenue Not Reported | $295,601 | RevenueNotReportedAmt |
| Revenue Subtotal | $41,977,718 | RevenueSubtotalAmt |
| Other Revenues Not Included | $3,652,716 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $3,652,716 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $45,630,434 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $45,866,915 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $295,601 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $295,601 | ExpensesNotReportedAmt |
| Expenses Subtotal | $45,571,314 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,502,271 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,502,271 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $49,073,585 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ASC 740 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| RECONCILIATION | PART XI LINE 2D & PART XII LINE 2D RENT EXPENSE $288,040 SPECIAL EVENTS EXPENSE $ 7,561 TOTAL ($295,601) PART XI LINE 4B BAD DEBT EXPENSE $3,232,560 INVESTMENT EXPENSE $ 10,628 CONTRIBUTIONS RECEIVED $ 170,626 OTHER INCOME $ 238,902 TOTAL $3,652,716 PART XII LINE 4B BAD DEBT EXPENSE $3,232,560 OTHER EXPENSE $ 53,531 LOSS ON EXTINGUISHMENT OF DEBT $ 216,180 TOTAL $3,502,271 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | AUTUMN FEAST | NameOfEvent1Amt |
| Gross Receipts Event1 | $36,813 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $27,950 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $8,863 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $738 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $35 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $635 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | GOLF OUTING | NameOfEvent2Amt |
| Gross Receipts Event2 | $18,050 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $6,850 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $11,200 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $1,253 | NonCashPrizesEvent2Amt |
| Other Direct Expenses Event2 | $4,900 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $54,863 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $34,800 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $20,063 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $1,253 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $738 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $35 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $5,535 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $7,561 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $12,502 | 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 |
| Percent200 | Yes (X) | Percent200Ind |
| 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 | $919,141 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $919,141 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $8,501,797 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,867,880 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,633,917 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03570 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $9,420,938 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,867,880 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,553,058 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05580 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 42 | ActivitiesOrProgramsCnt |
| Persons Served | 4523 | PersonsServedCnt |
| Total Community Benefit Expns | $51,896 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,660 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $48,236 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 48 | PersonsServedCnt |
| Total Community Benefit Expns | $10,697 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,697 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 43 | ActivitiesOrProgramsCnt |
| Persons Served | 4571 | PersonsServedCnt |
| Total Community Benefit Expns | $62,593 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,660 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $58,933 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 45 | ActivitiesOrProgramsCnt |
| Persons Served | 4571 | PersonsServedCnt |
| Total Community Benefit Expns | $9,483,531 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,871,540 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,611,991 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05710 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 148 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $27,708 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,708 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $113 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $113 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 149 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $27,821 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,821 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,232,561 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,484,608 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,928,947 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,828,374 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $100,573 | 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 | STURGIS HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 916 MYRTLE AVENUE | AddressLine1 |
| City | STURGIS | City |
| State | MI | State |
| ZIP Code | 49091 | 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 | STURGIS HOSPITAL | 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 |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.sturgishospital.com/news/124.pdf | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| 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 |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | 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 | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | false | FPGUsedDetermEligDscntCareInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| 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 (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V | FormAndLineReferenceDesc |
| Explanation | LINE 3 STURGIS HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY BY SURVEYING THE PUBLIC, DISTRIBUTING THE SURVEY AT SEVERAL LOCATIONS, AND SHARING THE SURVEY RESULTS WITH A PANEL OF 25 LOCAL HEALTH EXPERTS FOR INPUT. LINE 4 THE HOSPITAL'S CHNA WAS CONDUCTED WITH STURGIS HOSPITAL, THREE RIVERS HEALTH, COMMUNITY MENTAL HEALTH, AND THE PUBLIC HEALTH DEPARTMENT. LINE 5 THE HOSPITAL MADE ITS CHNA REPORT AVAILABLE BY SHARING SUMMARY RESULTS WITH COMMUNITY GROUPS AND PUBLISHING SPECIAL CIRCULAR WITH SUMMARY RESULTS. LINE 7 SOME OF THE NEEDS IDENTIFIED ARE OUTSIDE OF OUR SCOPE. PART V LINE 20D: FLAT DISCOUNT OF 100% IS PROVIDED FOR ELIGIBLE PATIENTS UNDER THE FEDERAL POVERTY GUIDELINES POVERTY GUIDELINES | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I | STURGIS HOSPITAL ACKNOWLEDGES THAT ALL INDIVIDUALS ARE NOT EQUALLY CAPABLE OF WITHSTANDING THE BURDEN OF PAYMENT FOR HEALTHCARE SERVICES. THE HOSPITAL PROVIDES AND PROMOTES ACCESS TO EMERGENCY AND MEDICALLY NECESSARY SERVICES WITHOUT REGARD TO ABILITY TO PAY. LINE 3C ACCORDING TO THE HOSPITAL'S EXISTING PUBLIC POLICY, ALL PATIENTS RECEIVING MEDICALLY NECESSARY SERVICES ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE NEED OF THE PATIENTS, LACK OF EXISTING INSURANCE, AND OTHER RESOURCES REQUIRED FOR PAYMENT. ELIGIBILITY CRITERIA IS FURTHER BASED ON THE FEDERAL POVERTY GUIDELINES AT A LEVEL OF 200% OF THAT GUIDELINE. LINE 6A STURGIS HOSPITAL PUBLISHES ITS ANNUAL REPORT WHICH INCLUDES ALL RELATED ORGANIZATIONS' PROGRAMS AND SERVICES DESIGNED TO LEAD THE COMMUNITY TO IMPROVED HEALTH AND PROMOTE HEALTHY LIFESTYLES. THE REPORT IS AVAILABLE ON STURGIS'S WEBSITE. LINE 7 COLUMN F BAD DEBT EXPENSE IN THE AMOUNT OF $3,232,561 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. THE ORGANIZATION USES A COMBINATION OF THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H AND DIRECT COSTING METHOD OF CERTAIN PROGRAMS. |
| PART III | LINE 3 THE AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE IS ESTIAMTED BASED UPON PAST EXPERIENCE. LINE 4 THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENTS LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. CHARGES ARE REPORTED AT 100%, AND THE AMOUNT WRITTEN OFF TO BAD DEBT IS REDUCED TO COST BY APPLYING THE COST TO CHARGE RATIO. LINE 8 COSTING METHODOLOGY TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MCR IS A STATISTICAL STEP DOWN ALLOCATION METHOD. ANY SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE THE HOSPITAL PROVIDES THESE SERVICES AS A COMMUNITY BENEFIT DESPITE THE FACT THAT THEY ARE PROVIDED AT A FINANCIAL LOSS. LINE 9B ONCE A THE EVALUATION IS COMPLETED AND A DETERMINATION HAS BEEN MADE THAT PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, NO COLLECTION EFFORTS ARE MADE. CONSIDERATION FOR ASSISTANCE IS ALSO GIVEN TO OTHER TYPES OF PATIENTS IF THE NEED FOR ASSISTANCE IS REQUIRED. PATIENTS IF THE NEED FOR ASSISTANCE IS REQUIRED. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY AND AVAILABILITY OF FINANCIAL ASSISTANCE BY: POSTING THE ORGANIZATIONS CHARITY CARE POLICY IN ACCESS AND REGISTRATION AREAS WITHIN THE HOSPITAL INDIVIDUAL INTERVIEW OF PATIENTS BY FINANCIAL COUNSELORS AND PREADMISSION STAFF WITH DISCUSSIONS CONCERNING FINANCIAL ASSISTANCE, AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS AND ASSISTANCE WITH THE APPLICATION FOR ASSISTANCE. THE HOSPITAL HAS ENTERED A MEMORANDUM OF UNDERSTANDING WITH THE COUNTY WHEREAS THE HOSPITAL MAKES A COMMITMENT TO PROVIDE HEALTH CARE SERVICES TO LOW INCOME RESIDENTS OF THE COUNTY (PUBLIC RECORD) |
| COMMUNITY BENEFIT REPORT | THE HOSPITAL DEMONSTRATES ITS DESIRE TO FURTHER ITS EXEMPT PURPOSE AND MISSION BY: A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED BY PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA, WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY (OPEN MEDICAL STAFF). ALL SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO PROMOTE SERVICE ENHANCEMENT TO ITS COMMUNITY AS WELL AS CAPITAL REPLACEMENT AND SERVICE DEVELOPMENT. THE ORGANIZATION FURTHER PROMOTES ITS MISSION BY PARTICIPATION IN HEALTH CARE SCREENING, HEALTH CARE EDUCATION AND CERTAIN SERVICES MADE TO THE COMMUNITY AT NO COST TO THE COMMUNITY. ORGANIZATION HAS ENTERED INTO MEMORANDUM OF UNDERSTANDING WITH ST.JOSEPH COUNTY COMMITTING TO PROVIDE SERVICES TO THE COMMUNITY REGARDLESS OF THE ABILITY TO PAY FOR THOSE SERVICES. COMMUNITY BENEFIT REPORT WOULD BE FILED ONLY IN THE STATE OF MICHIGAN. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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 Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEYER PATEL | ||||||||||||||
| PHYSICIAN | $658,773 | $0 | $0 | $0 | $162 | $0 | $7,650 | $0 | $18,652 | $0 | $685,237 | $0 | $0 | $0 |
| ASHISH VERMA | ||||||||||||||
| MEDICAL STAFF PRESIDENT | $486,402 | $0 | $0 | $0 | $180 | $0 | $7,650 | $0 | $23,094 | $0 | $517,326 | $0 | $0 | $0 |
| WILSON SAWA | ||||||||||||||
| PHYSICIAN | $390,107 | $0 | $0 | $0 | $180 | $0 | $7,650 | $0 | $23,094 | $0 | $421,031 | $0 | $0 | $0 |
| JAMES GRANNELL | ||||||||||||||
| PHYSICIAN | $442,858 | $0 | $0 | $0 | $1,188 | $0 | $7,269 | $0 | $18,652 | $0 | $469,967 | $0 | $0 | $0 |
| ELIEZER MELENDEZ | ||||||||||||||
| PHYSICIAN | $493,161 | $0 | $0 | $0 | $414 | $0 | $7,650 | $0 | $23,094 | $0 | $524,319 | $0 | $0 | $0 |
| YAZDI AMARIA | ||||||||||||||
| PHYSICIAN | $642,550 | $0 | $0 | $0 | $2,286 | $0 | $7,650 | $0 | $18,652 | $0 | $671,138 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS ARE LEASED FROM A MANAGEMENT COMPANY. THEREFORE, THEIR COMPENSATION IS DETERMINED AND PAID BY THIS MANAGEMENT COMPANY. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| CITY OF STURGIS BUILDING AUTHORITY | ||||||||
| A | 386004653 | 864108BE4 | 2004-12-29 | $10,000,000 | HOSPITAL EXPANSION PROJECT | false | false | false |
| CITY OF STURGIS BUILDING AUTHORITY | ||||||||
| B | 386004653 | 864108CK9 | 2005-08-11 | $995,000 | HOSPITAL EXPANSION PROJECT | false | false | false |
| CITY OF STURGIS FACILITIES & HOSPITAL AUTHORITY | ||||||||
| C | 386004653 | 2010-04-28 | $2,334,795 | HOSPITAL EXPANSION PROJECT | false | false | false | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $195,000 | $0 | $10,044,029 | $0 | $0 | $0 | $279,030 | $0 | $9,646,199 | $0 | $0 | $0 | 2006 | false | false | Yes (true) | Yes (true) |
| B | $25,000 | $0 | $1,001,184 | $0 | $0 | $0 | $42,584 | $0 | $958,600 | $0 | $0 | $0 | 2007 | false | false | Yes (true) | Yes (true) |
| C | $85,599 | $0 | $2,334,795 | $0 | $0 | $0 | $43,541 | $0 | $2,291,254 | $0 | $0 | $0 | 2012 | false | false | false | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | 0 | Yes (true) | false | false | false |
| B | false | false | false | false | 0 | Yes (true) | false | false | false |
| C | false | false | false | false | 0 | Yes (true) | false | false | false |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Exception To RebateExceptionToRebateInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1 | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||
| A | false | false | false | false | false | 0 | false | false |
| 0 | ||||||||
| B | false | false | false | false | false | 0 | false | false |
| 0 | ||||||||
| C | false | false | Yes (true) | false | false | 0 | false | false |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICOLE RANSBERGER | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | DAUGHTER TO SHARI RANSBER | RelationshipDescriptionTxt |
| Transaction | $22,474 | TransactionAmt |
| Transaction | EMPLOYEE COMPENSATION | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GOVERNING BODY & MANAGEMENT | PART VI, SECTION A QUESTION 1B: ASHISH VERMA IS A PAID EMPLOYEE OF THE HOSPITAL AND IS THEREFORE CONSIDERED NON-INDEPENDENT. QUESTION 3: BOARD OF TRUSTEES HAS ENGAGED QUORUM HEALTH RESOURCES TO PROVIDE MANAGEMENT SERVICES UNDER THE STRICT POLICIES AND BY-LAWS ADOPTED BY THE BOARD OF TRUSTEES. |
| POLICIES | PART VI, SECTION B QUESTION 11: THE FORM 990 IS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM AND FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS. QUESTION 12: BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. DISCLOSURES ARE REVIEWED TO DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT EXISTS, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS RELATING TO THE CONFLICT. QUESTION 15: COMPENSATION LEVELS ARE DETERMINED AT THE BOARD LEVEL UTILIZING VARIOUS SALARY SURVEYS FROM STATE HOSPITAL ASSOCIATION AS WELL AS THE MANAGEMENT COMPANY'S DATA BASE OF SALARY SCALES AND PROFESSIONAL RECRUITMENT FIRMS. QUESTION 19: STURGIS HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| PART XI | LINE 9 CHANGE IN DEFINED BENEFIT PENSION PLAN GAINS ($1,598,218) TEMPORARILY RESTRICTED CONTRIBUTIONS $15,004 TOTAL: ($1,583,214) |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STURGIS HOSPITAL PAIN MANAGEMENT LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 916 MYRTLE STREET | AddressLine1 |
| City | STURGIS | City |
| State | MI | State |
| ZIP Code | 49091 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461734503 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STURGIS HOSPITA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$14,032 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $75,065 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| UBI Code V | $0 | UBICodeVAmt |
| General Or Managing Partner | Yes (true) | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | 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 | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |