2015-02-13T15:41:39-06:00 2014-03-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2013-04-01 208756459 MACKINAC STRAITS HEALTH SYSTEM INC MACK 9066438585 1140 N STATE STREET ST IGNACE MI 49781 JASON ANDERSON CFO 9066438585 2015-02-13 1 TERRI REXRODE CPA MST P00096513 9206620016 2015-02-13 2013 2016-02-25 16:41:14Z JASON ANDERSON 1140 N STATE STREET ST IGNACE MI 49781 31444957 0 X MACKINACSTRAITSHEALTH.ORG X 2008 MI WE WILL BE THE HOSPITAL OF CHOICE AND RECOGNIZED FOR OUR EXEMPLARY PATIENT CARE, PEOPLE AND PERFORMANCE. WE HAVE A PASSION FOR EXCELLENCE AND STRIVE TO SET AND DELIVER THE HIGHEST STANDARDS OF SERVICE, INTEGRITY AND MOST OF ALL QUALITY. WE VALUE THE DIVERSITY AND CULTURES IN OUR COMMUNITY. 9 11 190 7 0 0 498465 337133 30620978 29732071 45059 56339 -356380 1310469 30808122 31436012 0 0 0 0 15167097 17221739 12504 0 0 16728832 19135147 31908433 36356886 -1100311 -4920874 48107655 47557933 56783968 59282825 -8676313 -11724892 PROVIDING LOCAL ACCESS AND QUALITY HEALTHCARE TO THE FAMILIES AND COMMUNITIES WE SERVE. 0 0 33873727 30612643 MACKINAC STRAITS HEALTH SYSTEM, INC. OPERATES A 15-BED ACUTE CARE FACILITY, A 48-BED LONG-TERM CARE UNIT, AND SEVERAL PHYSICIAN CLINICS IN MACKINAC COUNTY, MICHIGAN. THE PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, AND PHYSICIAN SERVICES TO THE RESIDENTS OF MACKINAC COUNTY AND THE SURROUNDING AREAS. 33873727 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 190 1 1 1 0 0 0 0 0 0 0 0 0 X 9 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JASON ANDERSON 9066438585 1140 N STATE STREET ST IGNACE MI 49781 JAMES NORTH BOARD MEMBER 1.00 X 0 0 0 PRENTISS BROWN III BOARD MEMBER 1.00 X 0 0 0 CHRISTINE MCPHERSON BOARD MEMBER 1.00 X 0 0 0 DR CARL HAWKINS BOARD MEMBER/CHIEF OF STAFF 40.00 X 163781 0 23311 DR SUSAN HEPKER BOARD MEMBER/POST CHIEF OF STAF 40.00 X 422359 0 17539 PATRICK SHANNON BOARD CHAIRMAN 1.00 X X 0 0 0 RICHARD SMITH BOARD VICE CHAIR 1.00 X X 0 0 0 STEVE AUTORE BOARD TREASURER 1.00 X X 0 0 0 MARGARET DOUD BOARD SECRETARY 1.00 X X 0 0 0 DR MATTHEW BOWES BOARD MEMBER 40.00 X 386979 0 21994 MARY MAURER BOARD MEMBER 1.00 X 0 0 0 RODNEY NELSON CEO AND PRESIDENT 40.00 2.00 X 157992 0 22373 JASON ANDERSON CFO 40.00 2.00 X 130175 0 20355 DR EDWARD SMITH PHYSICIAN 40.00 X 391975 0 31991 DR JENNIFER SHOCKLEY PHYSICIAN 40.00 X 195000 0 0 DR DARRIN BENZING ER PHYSICIAN 48.00 X 232302 0 20748 2080563 0 158311 8 0 1 0 RALPH OLECHOWSKI PO BOX 833 SAULT STE MARIE MI 49783 PHYSICIAN SERVICES 233363 DONZA WORDEN 36040 S ALTON ROAD DRUMMOND ISL MI 49726 PHYSICIAN SERVICES 134692 2 12518 65676 258939 337133 PATIENT REVENUE 900099 28559000 28559000 QAAP REVENUE 900099 953639 953639 AFFILIATE RENTAL REVENUE 900099 217972 217972 OTHER REVENUE 900099 1460 1460 29732071 42910 42910 13429 0 13429 13429 13429 8945 12518 8945 0 TAX LEVY 900099 1100004 1100004 PHYSICIAN INCENTIVES 900099 210465 210465 1310469 31436012 30612643 0 486236 1366858 1035963 330895 11170357 10425337 745020 1013143 928880 84263 2800212 2600509 199703 871169 798714 72455 246154 245629 525 119051 119051 3401460 3149559 251901 120739 120739 4183668 4171234 12434 3153734 3095496 58238 108917 94568 14349 52816 35674 17142 2482677 2482677 2319011 2319011 162196 162196 BAD DEBT EXPENSE 1303906 1303906 QAAP TAXES PAID 681674 681674 MINOR EQUIPMENT 100353 100353 PENALTIES AND FINES 64473 64473 634318 619758 14560 36356886 33873727 2483159 0 213456 1964 317913 291456 199909 82971 4113300 4069010 44523 36392 159510 201122 448334 523422 52016 37671 50594250 12454299 38402920 38139951 4155774 4173974 48107655 47557933 5007211 5485764 280000 40000 420000 220000 42783217 42990761 8293540 10546300 56783968 59282825 X -8704258 -11753267 27945 28375 -8676313 -11724892 48107655 47557933 X -4920874 -36705 1909000 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2738 2738 0 PART II-B, LINE 1: THE ORGANIZATION BELONGS TO THE AHA AND MHA AND PAYS DUES. THE ORGANIZATION PAYS A TOTAL OF $3,109 IN DUES TO THE AHA. OF THAT AMOUNT, $735 OF THE DUES ARE SPENT ON LOBBYING ACTIVITIES. THE ORGANIZATION PAYS A TOTAL OF $10,643 IN DUES TO THE MHA. OF THAT AMOUNT $2,003 OF THE DUES ARE SPENT ON LOBBYING ACTIVITIES. 1213406 1213406 39122860 9955561 29167299 3223487 585504 2637983 6734905 1672176 5062729 299592 241058 58534 38139951 UNAMORTIZED DEBT ISSUE COSTS 1966901 OTHER ASSETS 52588 DEBT SERVICE RESERVE 1657372 CAPITALIZED INTEREST 347113 403B RECEIVABLE 150000 4173974 AMOUNTS PAYABLE TO THIRD PARTIES 1950000 PENSION LIABILITY 5421581 PATIENT TRUST SAVINGS 18823 LINE OF CREDIT 494378 CAPITAL LEASE OBLIGATION 161518 MID MICHIGAN LINE OF CREDIT 2500000 10546300 X 30521909 5313 5313 30516596 919416 919416 31436012 35639045 5313 5313 35633732 723154 723154 36356886 PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHINCAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF MARCH 31, 2014 OR 2013. THE ORGANIZATION'S TAX RETURNS FOR TAX YEARS 2011 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISIONS FOR BAD PLEDGES 5,313. PART XI, LINE 4B - OTHER ADJUSTMENTS: QAAP PAYMENTS 681,674. RESTRICTED CONTRIBUTIONS 196,262. MHA CHAP PAYMENTS 41,480. PART XII, LINE 2D - OTHER ADJUSTMENTS: PROVISIONS FOR BAD PLEDGES 5,313. PART XII, LINE 4B - OTHER ADJUSTMENTS: QAAP PAYMENTS 681,674. MHA CHAP PAYMENTS 41,480. HOOPING FOR A CURE 21463 12518 8945 8945 21463 12518 8945 8945 8945 0 1 1 1 X 1 X 150.000000000000 1 0 1 1 789753 939164 -149411 0.00000 6307672 4765541 1542131 0.04400 7097425 5704705 1392720 0.04400 9530 9530 0.00030 366464 366464 0.01050 1098 1098 0.00000 377092 377092 0.01080 7474517 5704705 1769812 0.05480 0 1309219 1114176 10018470 10102030 -83560 X 1 0 2 1 MACKINAC STRAITS HEALTH SYSTEM INC 1140 N STATE STREET ST IGNACE MI 49781 X X RHC 2 MACKINAC ISLAND MEDICAL CLINIC 7474 MARKET STREET MACKINAC ISLAND MI 49757 X MACKINAC STRAITS HEALTH SYSTEM INC 1 1 X X X X X X X X X 13 1 0 1 X SEE PART V, SECTION C FOR SECTION B, LINE X X X X X X 0 0 1 1 100.000000000000 1 150.000000000000 1 X X X 1 1 X X 1 0 X 1 X 0 0 MACKINAC STRAITS HEALTH SYSTEM, INC. PART V, SECTION B, LINE 3: KEY INFORMATIONAL INTERVIEWS WERE CONDUCTED WITH MEMBERS OF THE COMMUNITY SERVED BY MACKINAC STRAITS HEALTH SYSTEM. THESE INDIVIDUALS WERE IDENTIFIED BY THE COMMITTEE BASED ON THEIR QUALIFICATIONS TO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED. GENERALLY, THE INTERVIEWEES INCLUDED PERSOMS WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AND PERSONS WHO REPRESENT THE MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS. MACKINAC STRAITS HEALTH SYSTEM, INC. PART V, SECTION B, LINE 5D: THE CHNA CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT HTTP://MACKINACSTRAITSHEALTH.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT.HTML MACKINAC STRAITS HEALTH SYSTEM, INC. PART V, SECTION B, LINE 6I: IMPLEMENTATION PLANONCE THE HEALTH NEEDS WERE PRIORITIZED BY THE CHNA ADVISORY COMMITTEE, THE FINAL STEP IN THE CHNA PROCESS INVOLVED DEVELOPING AN IMPLEMENTATION STRATEGY. THE PURPOSE OF THE IMPLEMENTATION STRATEGY IS TO DEVELOP A CLEAR SET OF GOALS TO RESPOND TO THE PRIORITIES IDENTIFIED THROUGH THE CHNA. THE IMPLEMENTATION STRATEGY SHOULD INCLUDE A WRITTEN PLAN THAT ADDRESSES EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, DESCRIBE HOW THE HOSPITAL PLANS TO MEET THE HEALTH NEEDS, AND IDENTIFY HEALTH NEEDS THE HOSPITAL DOES NOT INTEND TO MEET AND WHY.WITH THE SUPPORT OF WIPFLI, THE CHNA ADVISORY COMMITTEE DEVELOPED THE IMPLEMENTATION STRATEGY. THE COMMITTEE ADDRESSED THE FOLLOWING IMPLEMENTATION STRATEGY COMPONENTS WITHIN EACH PRIORITY IDENTIFIED:1. OBJECTIVES/STRATEGY2. TACTICS (HOW)3. PROGRAMS/RESOURCES TO COMMIT4. IMPACT OF PROGRAMS/RESOURCES ON HEALTH NEED5. ACCOUNTABLE PARTIES6. PARTNERSHIPS/COLLABORATIONTHE DETAILED IMPLEMENTATION STRATEGY FOR EACH PRIORITY CAN BE FOUND IN APPENDIX 5. IN SUMMARY, THE FOLLOWING PRIORITIES WERE ADDRESSED THROUGH THE IMPLEMENTATION STRATEGY:1. AVAILABILITY OF HEALTH INSURANCE AND ACCESS TO LOW COST HEALTH CARE2. OBESITY/DIABETES3. WEEKEND ACCESS TO LOCAL PHARMACY4. EDUCATE THE COMMUNITY REGARDING WHAT PROGRAMS ARE AVAILABLETHE IMPLEMENTATION STRATEGY DETAIL FOR EACH PRIORITY LOCATED IN APPENDIX 5 PROVIDES SUPPORTING TACTICS, PROGRAMS/RESOURCES, ACCOUNTABLE PARTIES, AND POTENTIAL PARTNERSHIPS/COLLABORATION FOR EACH STRATEGY. MACKINAC STRAITS HEALTH SYSTEM, INC. PART V, SECTION B, LINE 7: UPDATE ON OUR IMPLEMENTATION STRATEGY:PRIORITY: AVAILABILITY OF HEALTH INSURANCE AND ACCESS TO LOW COST HEALTH CARE: WE HAVE COLLABORATED WITH CHAC AND HIRED A STAFF MEMBER WHO WAS TRAINED BY CHAC AND WORKS DIRECTLY WITH CHAC STAFF ALONG WITH MSHS STAFF TO WORK WITH PATIENTS TO FIND COVERAGE FOR THEIR HEALTHCARE.PRIORITY: LOCAL ACCESS TO MENTAL HEALTH SERVICES: WE ARE CURRENTLY OFFERING SPACE TO A MENTAL HEALTH PROVIDER TO SEE PATIENTS IN MACKINAC COUNTY ON A MONTHLY BASIS.PRIORITY: LOCAL ACCESS TO RADIATION THERAPY CANCER SERVICES: THERE HAS BEEN NO CHANGE IN THE AVAILABILITY OF RADIATION THERAPY SERVICES IN OUR AREA.PRIORITY: WEEKEND ACCESS TO LOCAL PHARMACY: CONTINUE TO WORK WITH LOCAL PHARMACY TO EXPLORE OPPORTUNITIES TO EXPAND HOURS. UNABLE TO OPEN PHARMACY IN MACKINAC CITY. PRIORITY: OBESITY/DIABETES: DIETICIAN CONTINUES EDUCATIONAL OUTREACH PROGRAMS AND EVENTS.PRIORITY: EDUCATE THE COMMUNITY REGARDING AVAILABLE PROGRAMS: HIRE ADDITIONAL STAFF MEMBER WHO IS A REGISTERED SOCIAL WORKER WHO FOLLOWS UP WITH UNINSURED PATIENTS TO MAKE SURE THEY ARE AWARE OF AVAILABLE OPTIONS FOR ASSISTANCE. MACKINAC STRAITS HEALTH SYSTEM, INC. PART V, SECTION B, LINE 20D: FAP ELIGIBLE PATIENTS RECEIVE A DISCOUNT WHICH IS A SLIDING FEE BASED ON POVERTY LEVEL. 5 ST IGNACE RHC 1140 N STATE STREET ST IGNACE MI 49781 PHYSICIAN OFFICE MACKINAW CITY MEDICAL CLINIC 580 SOUTH NICOLET ST MACKINAW CITY MI 49701 PHYSICIAN OFFICE RIVERTWON MEDICAL CLINIC 920 SOUTH HURON STREET CHEBOYGAN MI 49721 PHYSICIAN OFFICE PICKFORD MEDICAL CENTER 7742 N M-129 PICKFORD MI 49774 PHYSICIAN OFFICE NAUBINWAY FAMILY HEALTH CLINIC 11650 W HWY US-2 NAUBINWAY MI 49762 PHYSICIAN OFFICE PART I, LINE 7: THE ORGANIZATION UTILIZES A COST TO CHARGE RATIO WHEN CALCULATING THE PERCENTAGE OF CHARITY CARE AND COMMUNITY BENEFIT PERCENTAGES. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE IS CALCULATED UTILIZING ACTUAL WRITE-OFFS AND THE AMOUNTS THAT HAVE BEEN DETERMINED LIKELY TO BE WRITTEN OFF GIVEN PAST EXPERIENCE OF THE COLLECTION POSSIBILITIES. ALTHOUGH THERE ARE SOME AMOUNTS OF CHARITY CARE INCLUDED IN THIS AMOUNT, THERE IS NOT A CURRENT METHOD TO EASILY OBTAIN THE AMOUNT THAT SHOULD HAVE BEEN CHARITY CARE. BAD DEBT EXPENSE OF $1,303,906 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT OF TOTAL EXPENSES ON SCHEDULE H. PART II, COMMUNITY BUILDING ACTIVITIES: PROVIDED 24 HOUR EMERGENCY AND ESSENTIAL HEALTH CARE SERVICES TO RURAL COMMUNITY. PART III, LINE 4: THERE IS NOT ANY FIANANCIAL STATEMENT FOOTNOTE ON BAD DEBT EXPENSE. PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE FROM THE MEDICARE COST REPORT PART VI, LINE 2: FEEDBACK FROM COMMUNITY MEMBERS VIA SURVEY AND PRESENTATIONS AT LOCAL ORGANIZATIONS PART VI, LINE 3: PAMPLETS AND OTHER LITERATURE AND SIGNAGE PART VI, LINE 4: MACKINAC COUNTY - A RURAL COUNTY IN MICHIGAN'S UPPER PENNINSULA. SEASONAL ECONOMY WITH HIGHER THAN AVERAGE UNEMPLOYMENT. AGING POPULATION WITH LARGE NUMBER OF NATIVE AMERICANS. PART VI, LINE 5: A MAJORITY OF OUR ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND ALSO PROVIDES COURTESY PRIVILIGES TO AMNY VISITING SPECIALISTS WHO ARE ALSO PROVIDED SPACE IN OUR BUILDINGS IN ORDER TO SEE THEIR PATIENTS. X X X X 0 0 0 0 0 0 0 0 0 DR CARL HAWKINS BOARD MEMBER/CHIEF OF STAFF 163781 0 0 0 0 0 0 0 23311 0 187092 0 0 0 DR SUSAN HEPKER BOARD MEMBER/POST CHIEF OF STAF 399002 0 0 0 23357 0 0 0 17539 0 439898 0 0 0 DR MATTHEW BOWES BOARD MEMBER 386979 0 0 0 0 0 0 0 21994 0 408973 0 0 0 RODNEY NELSON CEO AND PRESIDENT 150000 0 0 0 7992 0 0 0 22373 0 180365 0 0 0 JASON ANDERSON CFO 100283 0 0 0 29892 0 0 0 20355 0 150530 0 0 0 DR EDWARD SMITH PHYSICIAN 391975 0 0 0 0 0 0 0 31991 0 423966 0 0 0 DR JENNIFER SHOCKLEY PHYSICIAN 195000 0 0 0 0 0 0 0 0 0 195000 0 0 0 DR DARRIN BENZING ER PHYSICIAN 232302 0 0 0 0 0 0 0 20748 0 253050 0 0 0 DR SUSAN HEPKER BOARD MEMBER/CHIEF OF STAFF RELOCATION/HOUSING X 90000 36392 0 1 1 36392 FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS HAS DELEGATED TO REVIEW AND APPROVAL OF THE FORM 990 TO THE CFO. THE 990 RETURN IS E-MAILED TO THE BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS MONITORS THE CONFLICT OF INTEREST POLICY. NEW CONFLICTS OF INTEREST ARE REVIEWED BY THE BOARD IN ACCORDANCE WITH THE POLICY AND DOCUMENTED. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING ALL COMPENSATION IS BASED ON THE MHA ANNUAL SURVEY. THE COMPENSATION IS THEN REVIEWED BY THE BOARD FOR THE CEO AND IS REVIEWED BY THE CEO FOR OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THEIR DOCUMENTATION AVAILABLE TO THE PUBLIC BY REQUEST ONLY. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 MAKING THEM AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART XI, LINE 9: CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE 1,909,000. FORM 990, PART XI, LINE 2C THE AUDITED FINANCIAL STATEMENTS ARE PRESENTED TO THE MACKINAC STRAITS HEALTH SYSTEM FINANCE COMMITTEE AND RECOMMENDATIONS ARE TAKEN TO THE MACKINAC STRAITS HEALTH SYSTEM BOARD OF DIRECTORS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSES DIALYSIS UNIT 1140 NORTH STATE STREET ST IGNACE MI 49781 320031170 RENAL DIALYSIS SERVICES MI 501(C)(3) LINE 3 MACKINAC STRAITS HEALTH SYSTEM INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 MOSES DIALYSIS UNIT O 267627 BOOK VALUE MOSES DIALYSIS UNIT Q 127972 BOOK VALUE