2015-05-12T09:48:24-05:00 2014-06-30 381357951 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2013-07-01 382934134 MONROE COMMUNITY HEALTH SERVICES MONR 7342404520 718 N MACOMB STREET MONROE MI 48162 THOMAS W SCHILLING CFO & SR VP OF FINANCE 7342404520 2015-05-07 1 CAROL LALONDE CPA P00181637 2483522500 2013 2016-03-07 17:11:31Z MERCY MEMORIAL NURSING CENTER THOMAS W SCHILLING 718 N MACOMB STREET MONROE MI 48162 7576757 0 X WWW.MERCYMEMORIAL.ORG X 1989 MI PROMOTE THE GENERAL HEALTH OF THE PUBLIC IN MONROE COUNTY, MICHIGAN AND SURROUNDING AREAS. 17 12 178 18 0 0 99 154511 7522538 7419424 8576 2822 0 0 7531213 7576757 0 2000000 0 0 3765080 4037775 0 0 0 3185873 3255130 6950953 9292905 580260 -1716148 7068252 4939481 2943614 2530991 4124638 2408490 PROMOTE THE GENERAL HEALTH OF THE PUBLIC IN MONROE COUNTY, MICHIGAN AND SURROUNDING AREAS. 0 0 8654985 2000000 7419424 OPERATED A 70-BED SKILLED NURSING FACILITY, DBA MERCY MEMORIAL NURSING CENTER. THIS FACILITY PROVIDED 22,932 RESIDENT DAYS OF CARE IN 2014 AS FOLLOWS:- MEDICAID 12,731- PRIVATE PAY 2,688- MEDICARE 7,513THIS REPRESENTS AN AVERAGE CENSUS OF 62.8 RESIDENT UNITS PER DAY. 8654985 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 18 0 1 178 1 0 0 0 0 0 0 0 0 0 0 X 17 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MI X THOMAS W SCHILLING 7342404520 718 N MACOMB STREET MONROE MI 48162 BHURGRI MD AAMER CHIEF OF STAFF - EX OFFICIO 2.00 4.00 X 22400 71341 0 CALENDAR KAREN TRUSTEE 1.00 1.00 X 0 0 0 CHARBONEAU DO MICHAEL TRUSTEE, SURGEON 1.00 40.00 X 0 563524 17005 COMPEAN MD JOSE R TRUSTEE 1.00 1.00 X 0 32192 0 DARROW KURT L VICE CHAIR 1.00 1.00 X X 0 0 0 FRANZEN VICKI L SECRETARY 1.00 1.00 X X 0 0 0 KABIR MD ABDUL TRUSTEE 1.00 1.30 X 0 42793 0 KUBISKE DAVID TRUSTEE 1.00 1.00 X 0 0 0 KULISH BARTON TREASURER 1.00 1.00 X X 0 0 0 MCNAMEE MD KENNETH J TRUSTEE 1.00 1.00 X 0 8362 0 PHILLIPS ANNETTE S PRESIDENT & CEO - EX OFFICO 1.00 40.00 X X 0 411794 77587 RYAN SISTER JANET TRUSTEE 1.00 1.00 X 0 0 0 SPENCER EDD DONALD A CHAIRPERSON 1.00 1.00 X X 0 0 0 WALSH ARLENE R TRUSTEE 1.00 1.00 X 0 0 0 WETZEL SUZANNE TRUSTEE 1.00 1.00 X 0 0 0 WILBURN WALTER TRUSTEE 1.00 1.00 X 0 0 0 ZWACK MATTHEW TRUSTEE 1.00 1.00 X 0 0 0 SCHILLING THOMAS W CFO SENIOR VP FINANCE 1.00 40.00 X 0 273225 43261 JAN MARTIN ADMINISTRATOR 40.00 0.00 X 117678 0 7825 140078 1403231 145678 1 0 1 0 CONCEPT REHAB INC 7150 GRANITE CIRCLE SUITE 200 TOLEDO OH 43617 PATIENT THERAPY 682564 1 154104 407 154511 SKILLED NURSING - MMNC 623000 7419424 7419424 7419424 2822 2822 7576757 7419424 0 2822 2000000 2000000 22400 22400 2830906 2564209 266697 969637 871393 98244 214832 193065 21767 67316 67316 35572 35572 84 84 926943 893523 33420 7271 7271 58562 18903 39659 297466 277985 19481 6523 3452 3071 3206 1324 1882 76899 76899 321515 300459 21056 44325 44325 MEDICAL SUPPLIES 662975 662975 QAAP FEES 357590 357590 BAD DEBT EXPENSE 218846 218846 DIETARY 170037 170037 9292905 8654985 637920 0 8556 6650 3246863 906473 1884677 2293651 11389 12602 10031140 8315992 1910496 1715148 6271 4957 7068252 4939481 1462605 1204692 1481009 1326299 2943614 2530991 X 4123792 2407257 846 1233 4124638 2408490 7068252 4939481 -1716148 0 X X 0 1 X 1 0 X 1664 189 44 99 154511 156507 10714465 9296773 7513194 7522538 7419424 42466394 10716129 9296962 7513238 7522637 7573935 42622901 0 15346 202777 151051 147305 516479 15346 202777 151051 147305 516479 42106422 198647 59779 8892 8076 2822 278216 198647 59779 8892 8076 2822 278216 10914776 9356741 7522130 7530713 7576757 42901117 0.98150 0.97710 0.00650 0.01380 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 84 84 0 PART II-B, LINE 1: A PERCENTAGE OF DUES PAID TO VARIOUS ORGANIZATIONS IS ALLOCATED BY THOSE ORGANIZATIONS AS LOBBYING COSTS. 846 387 1233 832 14 846 788 44 832 636 152 788 542 94 636 1.00000 0 1 1 375115 375115 6738886 5718204 1020682 29780 29193 587 2825986 2568595 257391 61373 61373 1715148 ALLOCATION OF BOND PROCEEDS 1326299 1326299 X PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS FOR RESIDENT ACTIVITIES. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2014, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. 0 MERCY MEMORIAL HOSPITAL CORPORATION 718 N MACOMB STREET MONROE MI 48162 381984289 501(C)(3) 2000000 N/A N/A TO AID IN FUNDING THE ASSETS AND SERVICES OF THE MERCY MEMORIAL OUTPATIENT SURGERY CENTER. 1 0 0 1 0 0 0 0 0 0 0 CHARBONEAU DO MICHAEL TRUSTEE, SURGEON 0 562549 0 75 0 900 0 0 0 17005 0 580529 0 0 PHILLIPS ANNETTE S PRESIDENT & CEO - EX OFFICO 0 406994 0 0 0 4800 0 61049 0 16538 0 489381 0 0 SCHILLING THOMAS W CFO SENIOR VP FINANCE 0 267225 0 0 0 6000 0 26723 0 16538 0 316486 0 0 PART I, LINE 3 THE CHIEF EXECUTIVE OFFICERS COMPENSATION WAS ESTABLISHED BY A RELATED ORGANIZATION USING THE FOLLOWING RESOURCES: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B A RELATED ORGANIZATION OFFERS SELECT MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES ANNUAL EMPLOYER-FUNDED CONTRIBUTIONS EQUAL TO A FIXED PERCENT OF BASE SALARY: 15% FOR CEO, 10% FOR SENIOR VICE PRESIDENTS AND 5% FOR VICE PRESIDENTS. BENEFITS ARE VESTED AFTER THREE YEARS OF SERVICE AND ARE PAID OUT IN A LUMP SUM BY MARCH 15 OF THE YEAR FOLLOWING THE YEAR IN WHICH THEY BECOME VESTED. THE FOLLOWING INDIVIDUALS REPORTED ON FORM 990, PART VII ARE PARTICIPANTS: ANNETTE PHILLIPS AND THOMAS SCHILLING. FORM 990, PART I, ITEM C DBA: MERCY MEMORIAL HEALTH CENTER DBA: MERCY MEMORIAL COMMUNITY HEALTH CENTER FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS DR. KENNETH MCNAMEE, DR. AAMER BHURGRI, DR. MICHAEL CHARBONEAU, AND DR. ABDUL KABIR HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MONROE COMMUNITY HEALTH SERVICES HAS MEMBERS. MERCY MEMORIAL HOSPITAL CORPORATION IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE POWERS AND VOTING RIGHTS TO: [A] APPOINT, ELECT, AND REMOVE TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE POWERS AND VOTING RIGHTS TO: [B] APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION; [C] ADOPT, AMEND, OR REPEAL THE BYLAWS; [D] APPROVE EACH BUDGET AND LONG-RANGE PLAN; [E] APPROVE CONTRACT OR LOAN OBLIGATING THE CORPORATION TO EXPEND/REPAY AN AMOUNT IN EXCESS OF $50,000 WHICH WAS NOT INCLUDED IN PREVIOUSLY APPROVED BUDGETS; [F] APPROVE CONTRACTS OUTSIDE THE ORDINARY COURSE OF THE BUSINESS OF THE CORPORATION; [G] APPROVE ALL PLANS OF MERGER OR CONSOLIDATION; [H] APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION; AND [I] APPROVE A VOLUNTARY DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 INPUT DATA IS REVIEWED AND ANALYZED BY THE CONTROLLER AND THEN SUBMITTED TO THE CERTIFIED PUBLIC ACCOUNTING FIRM FOR PREPARATION. THE COMPLETED FORM 990 IS THEN RETURNED TO THE CFO AND THE CEO FOR FINAL REVIEW AND APPROVAL BEFORE THE BOARD MEETING. BEFORE THE RETURN IS FILED, THE FORM 990 IS REVIEW BY THE BOARD. ALL MEMBERS RECEIVE A COPY OF THE FORM 990, EVEN THOSE THAT ARE UNABLE TO ATTEND THE SCHEDULED MEETING. THE REVIEW IS PERFORMED DURING ONE OF THE MONTHLY BOARD MEETINGS, WHERE EACH MEMBER HAS A CHANGE TO ASK QUESTIONS. THIS REVIEW IS DOCUMENTED VIA MINUTES TO THE MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS, OFFICERS AND EMPLOYEES OF THE ORGANIZATION. ON AN ANNUAL BASIS, THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS DISTRIBUTED TO OFFICERS, EMPLOYEES, AND TRUSTEES OF MONROE COMMUNITY HEALTH SERVICES. POTENTIAL CONFLICTS OF INTEREST ARE ANALYZED BY THE HOSPITAL'S LEGAL DEPARTMENT AND ARE GIVEN RANKINGS OF LOW, MODERATE, AND SEVERE RISK. THIS ANALYSIS IS GIVEN TO THE BOARD CHAIR AND THE HOSPITAL'S CHIEF EXECUTIVE OFFICER. ANY MEMBER WITH AN IDENTIFIED CONFLICT OF INTEREST IS EXCUSED FROM THE MEETING DURING DISCUSSIONS PERTAINING TO THE ISSUE OF CONFLICT, AND THE MEMBER IS NOT PERMITTED TO VOTE ON ANY ISSUE OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 OFFICERS ARE COMPENSATED BY MERCY MEMORIAL HOSPITAL CORPORATION, A RELATED ORGANIZATION. THE EXECUTIVE COMPENSATION COMMITTEE OF THE HOSPITAL'S BOARD OF TRUSTEES DETERMINES AND APPROVES ALL COMPENSATION FOR THOSE DESIGNATED IN SENIOR LEADERSHIP POSITIONS, SUCH AS THE CHIEF EXECUTIVE OFFICER & PRESIDENT AND THE CHIEF FINANCIAL OFFICER & SENIOR VICE PRESIDENT OF FINANCE. THE INDEPENDENT BOARD COMMITTEE RETAINS AN OUTSIDE CONSULTANT TO ANALYZE AND ASSIST IN MAKING THESE DETERMINATIONS THROUGH A VARIETY OF MARKET SURVEYS/STUDIES. THIS PROCESS IS UNDERTAKEN ANNUALLY AND WAS LAST PERFORMED IN 2014. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR. FORM 990, PART IV, LINE 24 & SCHEDULE K: TAX EXEMPT BONDS: MONROE COMMUNITY HEALTH SERVICES IS A MEMBER OF THE MERCY MEMORIAL HOSPITAL CORPORATION OBLIGATED GROUP OF WHICH MONROE COMMUNITY HEALTH SERVICES HAS BEEN ALLOCATED FUNDS FROM A 2006 BOND ISSUANCE. DUE TO THIS, ALL INFORMATION RELATING TO THE 2006 BOND ISSUANCE HAS BEEN REPORTED ON THE MERCY MEMORIAL HOSPITAL CORPORATION 2013 FORM 990 AND IS NOT INCLUDED ON THIS RETURN. MERCY MEMORIAL HOSPITAL CORPORATION 718 N MACOMB STREET MONROE MI 48162 381984289 HOSPITAL MI 501(C)(3) LINE 3 N/A 0 MONROE HEALTH VENTURES 718 N MACOMB STREET MONROE MI 48164 382704426 PHARMACY MI N/A C 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 MERCY MEMORIAL HOSPITAL CORPORATION L 222140 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION P 1540783 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION Q 82476 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION C 154104 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION M 153879 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION B 2000000 ACTUAL ALLOCATED COST