MYMICHIGAN MEDICAL CENTER STANDISH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MYMICHIGAN MEDICAL CENTER STANDISH (EIN 38-1671120)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-15
- IRS object ID
- 201411359349300041
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-15T08:29:02-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1 |
| City | Cincinnati | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381671120 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Standish Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAN | NameControl |
| Phone | 9898464521 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 W Cedar Street | AddressLine1 |
| City | Standish | City |
| State | MI | State |
| ZIP Code | 48658 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Anthony J Doud | Name |
| Title | Controller | Title |
| Phone | 9898464521 | Phone |
| Date Signed | 2014-05-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Alicia M Janisch | Name |
| PTIN | P00741382 | PTIN |
| Phone | 5137847100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's of MI Standish Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Rose A Goick | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 W Cedar Street | AddressLine1 |
| City | Standish | City |
| State | MI | State |
| ZIP Code | 48658 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22668686 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1960 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | Operation of a hospital, skilled nursing facility, emergency room and rural health clinic. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 292 | TotalNbrEmployees |
| Total Nbr Volunteers | 41 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 263406 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 26146 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 22452900 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 21479497 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 884184 | InvestmentIncomePriorYear |
| Investment Income Current Year | 860713 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 138665 | OtherRevenuePriorYear |
| Other Revenue Current Year | 187366 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 23739155 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22553722 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13200684 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12361810 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 47814 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9682208 | OtherExpensePriorYear |
| Other Expenses Current Year | 9568885 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22882892 | TotalExpensesPriorYear |
| Total Expenses Current Year | 21930695 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 856263 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 623027 | RevenuesLessExpensesCY |
| Total Assets BOY | 28430082 | TotalAssetsBOY |
| Total Assets EOY | 31911365 | TotalAssetsEOY |
| Total Liabilities BOY | 7118436 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9302666 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 21311646 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 22608699 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Operation of a non-profit hospital, skilled nursing facility, emergency room and rural health clinic to provide health care services to the sick and poor. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 14685880 | Expense |
| Revenue | 21479497 | Revenue |
| Description | Standish Hospital is dedicated to spiritually centered, holistic care that sustains and improves the health of individuals and communities. It furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. A substantial portion of its services are provided to the elderly and poor. During the fiscal year ending June 30, 2013, approximately 53.6% of the value of services rendered was to elderly patients under the Medicare program, and approximately 15.9% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's of Michigan Standish Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2013, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $20,330,887. | Description |
| Total Program Service Expense | 14685880 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 17 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 292 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Anthony J Doud | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9898464521 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 W Cedar Street | AddressLine1 |
| City | Standish | City |
| State | MI | State |
| ZIP Code | 48658 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Curt Hillman | ||||||||
| Chairman | 1.00 | 0.00 | X | X | 0 | 0 | 0 | |
| Bill Borushko end 1112 | ||||||||
| Vice Chairman | 1.00 | 0.00 | X | X | 0 | 0 | 0 | |
| Deb Morgan | ||||||||
| Secretary | 1.00 | 0.00 | X | X | 0 | 0 | 0 | |
| Keith Sivier | ||||||||
| Treasurer | 1.00 | 0.00 | X | X | 0 | 0 | 0 | |
| Tom Birkett | ||||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| John Graham | ||||||||
| President/CEO-Health System | 1.00 | 44.00 | X | X | 0 | 1243097 | 8958 | |
| Rasheed Siddiqui MD | ||||||||
| Chief of Staff | 84.00 | 0.00 | X | X | 600982 | 0 | 38271 | |
| Sharon Leaman-Case end 1212 | ||||||||
| Administrator | 45.00 | 0.00 | X | X | 0 | 206811 | 22698 | |
| Gina Butcher | ||||||||
| CFO - Health System | 1.00 | 44.00 | X | 0 | 214870 | 5814 | ||
| Rose Goick start 113 | ||||||||
| Adm Dir of Operations | 45.00 | 0.00 | X | 101735 | 0 | 16916 | ||
| Doraisamy Venkitapathy | ||||||||
| Physician | 84.00 | 0.00 | 564707 | 0 | 51173 | X | ||
| Cesar Casten | ||||||||
| Physician | 40.00 | 0.00 | 200640 | 0 | 33491 | X | ||
| Cathy Gifford | ||||||||
| CRNA | 20.00 | 0.00 | 106209 | 0 | 35009 | X | ||
| Catherine McDonell | ||||||||
| CRNA | 20.00 | 0.00 | 115478 | 0 | 39295 | X | ||
| Renee Reetz | ||||||||
| HR Director | 45.00 | 0.00 | 105476 | 0 | 27906 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1795227 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1664778 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 279531 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Touchpoint Support Services | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Cafeteria & Housekeeping Services | 1127154 |
| Alliance HNI LLC | |||||
| 7647 Collections Drive | Chicago | IL | 606930076 | Mobile MRI Services | 594700 |
| JE Johnson Inc | |||||
| PO Box 1863 | Midland | MI | 48642 | Building Contractor | 354576 |
| RC Hendrick & Son Inc | |||||
| 2885 S Graham Rd | Saginaw | MI | 486088440 | Building Contractor | 337585 |
| TriMedx | |||||
| PO Box 636129 | Cincinnati | OH | 45263 | Equipment Maintenance | 295085 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Fundraising Events | 16900 | FundraisingEvents |
| Government Grants | 9246 | GovernmentGrants |
| Total Contributions | 26146 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Revenue | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 21479497 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21479497 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 21479497 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 860713 | TotalRevenueColumn |
| Exclusion | $860,713 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 65797 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 46832 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 18965 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18965 | TotalRevenueColumn |
| Exclusion | $18,965 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 71572 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 16900 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 24752 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 46820 | TotalRevenueColumn |
| Exclusion | $46,820 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 40258 | GrossSalesOfInventory |
| Cost Of Goods Sold | 43380 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -3122 | TotalRevenueColumn |
| Exclusion | -$3,122 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Miscellaneous | 621990 | 79482 | $79,482 |
| Cafeteria Revenue | 722320 | 45221 | $45,221 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 124703 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22553722 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21479497 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,048,079 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 674126 | Total |
| Program Services | 618303 | ProgramServices |
| Management And General | 55823 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8930935 | Total |
| Program Services | 6957749 | ProgramServices |
| Management And General | 1951866 | ManagementAndGeneral |
| Fundraising | 21320 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 492761 | Total |
| Program Services | 388668 | ProgramServices |
| Management And General | 104093 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1624515 | Total |
| Program Services | 1281363 | ProgramServices |
| Management And General | 343152 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 639473 | Total |
| Program Services | 484254 | ProgramServices |
| Management And General | 155219 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54254 | Total |
| Management And General | 54254 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 605 | Total |
| Management And General | 605 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 219390 | Total |
| Program Services | 215238 | ProgramServices |
| Management And General | 4152 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61801 | Total |
| Program Services | 3839 | ProgramServices |
| Management And General | 57962 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1317726 | Total |
| Program Services | 1038344 | ProgramServices |
| Management And General | 279382 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 488412 | Total |
| Program Services | 291132 | ProgramServices |
| Management And General | 197280 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47977 | Total |
| Program Services | 27385 | ProgramServices |
| Management And General | 20592 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 134747 | Total |
| Program Services | 106283 | ProgramServices |
| Management And General | 28464 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 903704 | Total |
| Program Services | 630563 | ProgramServices |
| Management And General | 273141 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127960 | Total |
| Program Services | 75535 | ProgramServices |
| Management And General | 52425 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Purchased Services | 3128217 | 151629 | 2976588 | |
| Medical Supplies | 2368594 | 1952488 | 389612 | 26494 |
| QAAP Fees | 455704 | 455704 | ||
| Dues & Subscriptions | 17242 | 7403 | 9839 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 242552 | Total |
| Management And General | 242552 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21930695 | Total |
| Program Services | 14685880 | ProgramServices |
| Management And General | 7197001 | ManagementAndGeneral |
| Fundraising | 47814 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1771236 | BOY |
| EOY | 709947 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 524959 | BOY |
| EOY | 543894 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2542840 | BOY |
| EOY | 4289061 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 234390 | BOY |
| EOY | 254225 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24666 | BOY |
| EOY | 131326 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18424109 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12581420 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5376231 | BOY |
| EOY | 5842689 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84006 | BOY |
| EOY | 139147 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17871754 | BOY |
| EOY | 20001076 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28430082 | BOY |
| EOY | 31911365 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3147401 | BOY |
| EOY | 5360785 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3971035 | BOY |
| EOY | 3941881 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7118436 | BOY |
| EOY | 9302666 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21248013 | BOY |
| EOY | 22523009 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63633 | BOY |
| EOY | 85690 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21311646 | BOY |
| EOY | 22608699 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28430082 | BOY |
| EOY | 31911365 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 623027 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 656201 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 17825 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $605 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 605 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Standish Community Hospital does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 500 | OtherCostOrOtherBasis |
| Book Value | 500 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5160142 | OtherCostOrOtherBasis |
| Depreciation | 4251355 | Depreciation |
| Book Value | 908787 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5458301 | OtherCostOrOtherBasis |
| Depreciation | 2426001 | Depreciation |
| Book Value | 3032300 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5990342 | OtherCostOrOtherBasis |
| Depreciation | 5369238 | Depreciation |
| Book Value | 621104 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1814824 | OtherCostOrOtherBasis |
| Depreciation | 534826 | Depreciation |
| Book Value | 1279998 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5842689 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Interest in Investments Held by Ascension Health Alliance | 19149187 |
| Third Party Receivables | 386920 |
| Other Current Receivables | 463339 |
| Due from Related Organization | 1630 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 20001076 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Intercompany Debt with Ascension Health Alliance | $3,886,413 |
| Current Portion of Long Term Debt | $55,468 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3941881 | TotalOfAmounts |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Living Legends Ball | NameOfEvent1 |
| Gross Receipts Event1 | 51844 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 13802 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 38042 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 1000 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 20055 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Auction | NameOfEvent2 |
| Gross Receipts Event2 | 18212 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 3098 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 15114 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 350 | RentFacilityCostsEvent2 |
| Other Direct Expenses Event2 | 3347 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 2 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 18416 | GrossReceiptsOtherEvents |
| Gross Revenue Other Events | 18416 | GrossRevenueOtherEvents |
| Gross Receipts Total | 88472 | GrossReceiptsTotal |
| Charitable Contributions Total | 16900 | CharitableContributionsTotal |
| Gross Revenue Total Events | 71572 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 1350 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 23402 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 24752 | DirectExpenseSummaryEvents |
| Net Income Summary | 46820 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 879389 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 879389 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04010 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3857662 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4195933 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -338271 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4737051 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4195933 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 541118 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38814 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19517 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19297 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38814 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19517 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19297 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4775865 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4215450 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 560415 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04100 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,100,722 | BadDebtExpenseAmount |
| Amount Attributable To | 673801 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6908223 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6839825 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 68398 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Standish Community Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 W Cedar Street | AddressLine1 |
| City | Standish | City |
| State | MI | State |
| ZIP Code | 48658 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.stmarysofmichigan.org/standish | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | Skilled Nursing Facility | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Standish Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Community Benefit Report: | Part I, Line 6: | This report illustrates the significant degree to which St. Mary's of Michigan Standish Hospital contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system, St. Mary's of Michigan Standish Hospital continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of St. Mary's of Michigan Standish Hospital is to serve all persons with special attention to those who are poor and vulnerable. St. Mary's of Michigan Standish Hospital is dedicated to spiritually centered, holistic care that sustains and improves the health of individuals and communities. St. Mary's of Michigan Standish Hospital furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. Our concern for all human life and dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. St. Mary's of Michigan Standish Hospital has engaged in the following activities to ensure that our mission is accomplished:Unreimbursed Services Provided to the Elderly and the Poor:St. Mary's of Michigan Standish Hospital provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2013 approximately 53.6% of the value of services rendered was to elderly patients under the Medicare program, and approximately 15.9% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's of Michigan Standish Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2013, the estimated unreimbursed charges of services provided to the elderly, uninsured, and underinsured totaled $20,330,887.Patient Services:St. Mary's of Michigan Standish Hospital provides the following in-patient and out-patient medical services to the community:- Ambulatory Care Services- Rural Health Clinic Office- Emergency Care Services- Visiting Physician Services- Cardiac Rehab Services- Rehabilitation Services - Operating Room Surgeries- Skilled Nursing FacilitySome of the services listed above operate at a loss in order to ensure that all services are available to meet community health care needs. These include our Rural Health Clinic and Speech Therapy.During the fiscal year ending June 30, 2013, our hospital treated adults and children in the community for a total of 13,670 patient days of service. The medical center also provided services to 44,698 outpatients, including 77 outpatient surgery patients and 9,172 emergency visits. Community Outreach activities:St. Mary's of Michigan Standish Hospital seeks to improve the physical, mental, social and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, St. Mary's of Michigan Standish Hospital has developed the following programs to help achieve its mission:- Diabetes Education- Chronic Obstructive Disease Education- Car Seat Safety Programs- Community Thanksgiving Dinner- MIChild and Healthy Kids Enrollment Summary:St. Mary's of Michigan Standish Hospital furthers its charitable purposes by providing a broad array of services to meet the healthcare needs of patients and organizations in the community. We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those patients who are not able to pay for their own healthcare needs, provide services to other organizations that allow them to provide quality services to their patients or constituents, and present education information classes and activities to the community in order to improve its overall health status. |
| Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. | ||
| Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services. | ||
| Part II: St. Mary's of Michigan Standish Hospital provided the following community building activities in 2012: - Caring Bear Picnic: A health and safety day for children in the community that teaches proper hand washing, car seat safety, the importance of bicycle helmets, healthy nutrition, and the benefits of exercise.- Senior Olympics & Health Fair: An event focused on connecting Senior Citizens with health and wellness resources in the community.- Diabetes and Chronic Obstructive Pulmonary Disease (COPD) support group meetings were held on a bi-monthly basis, free of charge.- School education: St. Mary's of Michigan Standish Hospital nurses partner with the local school systems to provide education to both the teachers and students on flu prevention, proper nutrition and exercise. | ||
| Part III, Line 4: From the consolidated audited financial statements of Ascension Health Alliance and subsidiaries (which include the activity of Standish Community Hospital):The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies. | ||
| Part III, Line 8: Ascension Health and related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. | ||
| Part III, Line 9b: Patients are encouraged to participate in their own care by working with the financial counselor and applying for Medicaid or other public assistance programs to qualify for charity or financial assistance. Any patient that may be eligible for public assistance must make an application for such. A documented response from public assistance must be on file prior to final determination of charity care funds. | ||
| Standish Community Hospital | Part V, Section B, Line 3: 2010 Public Health SummitOn March 10, 2010, the Central Michigan District Health Department organized a Public Health Summit for those who live and work in Arenac, Clare, Gladwin, Isabella, Osceola, and Roscommon counties. The day-long event served to inform participants about health issues within each county and to solicit the participants' perceptions of the key health issues within their communities and methods of addressing these issues.The attendees included residents of the central Michigan health district; state, county, and local government officials; tribal nation representatives; members of the academic community and public school systems; representatives from businesses in health care, transportation, restaurant, and other types of industries; and members of nongovernmentorganizations, including community organizations.The 2010 County Health Rankings provided by University of Wisconsin Population Health Institute served as the basis for discussion of the health related issues within the six counties. Participants broke out into county-specific groups and began brainstorming sessions on health issues, identifying factors associated with the issues, determining the three most crucial issues within their county, and summarizing potential approachesand methods to address the most crucial issues using nominal group process and affinity diagrams.For Arenac County, the primary issues identified are:1. Poverty, including socioeconomic and employment issues2. Nutrition, including availability of nutritious food, education, and physical activity3. Access to care particularly for the uninsured and underinsuredThe information from the Public Health Summit is used by the Arenac County Health Improvement Planning (HIP) work group to develop objectives, measures, strategies and actions that will strengthen current efforts and respond to gaps in servicing needs.2011 Public Health SummitOn April 14, 2011, the second annual Public Health Summit convened. It brought together 120 individuals from local and state organizations involved in health care, health and social services and health services delivery, as well as stakeholders in the Central Michigan District Health Department's six county region. The Summit served as a forum to review the 2011 County Health Rankings, celebrate successes, and share insight into health improvement plans and initiatives that are underway within the counties.In 2011, a Health Issues Survey was created by the Arenac County HIP work group with the help of Veronica Romanov, Public Health Consultant. Various health statistics were used to develop the survey. It was structured on the model developed by the University of Wisconsin's Population Health Institute and the County Health Rankings. The survey asked for perceptions of severity and importance of factors within the two primary areas measured in the County Health Rankings. The health factors which directly affect health outcomes and organized intothe major four topic areas of:- Health related behaviors- Health systems/clinical care- Preventative actions and wellness- Environmental factors and health outcomes (examples of poor health outcomes include premature death, disease, and ill health)Survey respondents provided their opinion on the importance of each issue (on a 5-point scale with 1 being of utmost importance to the community) and their perceptions as to the need for additional information regarding each item (using a 3-point scale with 1 indicating that additional information or research is definitely needed and 3 indicating that there is enough information available). Additionally, each respondent was given the opportunity to identify up to three direct health factors that he/she believed were of the utmost importance to the community. The survey included more than 80 direct health factor and 70 health outcome items.The Health Issues Survey was distributed via email in March 2011, with 10 returned. Of the surveys returned, the majority of the responses came from individuals that work in the public service arena or health care field. The following issues were identified as priority items for the county:- Health services- Nutrition, weight status, and physical activity- Substance abuse- Reproductive and sexual health Arenac County Resident SurveyDue to the limited amount of responses from the Health Issues Survey, the HIP work group decided to repeat the survey to a larger population, with special attention given to the poor and underserved. Paper copies of the survey were available at various locations throughout Arenac County including Michigan Works, St. Mary's of Michigan Standish Hospital, Department of Human Services, Central Michigan District Health Department, NEMSCA Early Head Start, and Sterling Area Health Center. Electronicsurveys were sent out via email to area businesses for distribution to their employees.The local newspaper, Arenac County Independent, published an article about the survey and informed the community on how to access it. It is unknown how many surveys were distributed county-wide since this was conducted via both paper and electronic formats; 222 surveys were returned.Following compilation of the results of the Arenac County Resident Survey, five general topic areas were identified. These results will be used by the HIP work group to help determine and prioritize health improvement goals and set priorities, steps and timelines for actions.- Access to Health Services- Family Life /Parenting- Nutrition & Physical Activity- Housing- Environmental IssuesThe survey results indicated that the issue of most concern to Arenac County residents was the lack of access to health services, particularly among uninsured and "underinsured' individuals, as well as the lack of access to affordable health services. Family life/parenting, as well as nutrition and lack of physical activity, were also identified as major issues of concern. | |
| Standish Community Hospital | Part V, Section B, Line 5c: The Community Health Needs Assessment ("CHNA") of the hospital facility can be located at the following web address:http://www.stmarysofmichigan.org/documents/SMOM_Standish_CHNA.pdf | |
| Standish Community Hospital | Part V, Section B, Line 7: St. Mary's of Michigan Standish Hospital will not be addressing the following needs that were identified in the 2012 Community Health Needs Assessment:Housing: The Arenac County Continuum of Care is tasked with addressing the issue of housing and homelessness. While St. Mary's of Michigan Standish Hospital supports their efforts by being an active partner on the collaborative body, it was determined that the hospital does not have the resources available to directly affect change in this category.Environmental Health: The Central Michigan District Health Department's Environmental Health Services oversees the quality of land, food and water for Arenac County. They work closely with the Michigan Department of Community Health to address the community's environmental health needs. | |
| Standish Community Hospital | Part V, Section B, Line 14g: A summary of financial assistance policy is posted on the hospital facility's emergency rooms or waiting rooms and admission offices. | |
| Standish Community Hospital | Part V, Section B, Line 18e: Question 18 is more appropriately answered as not applicable as the Billing and Collections Policy of Standish Community Hospital does not allow a hospital to engage in extraordinary collection actions before the organization made reasonable efforts to determine whether the individual is eligible for assistance under the financial assistance policy. Reasonable efforts taken include but are not limited to: - Notifying individuals of the financial assistance policy on admission- Notifying individuals of the financial assistance policy prior to discharge- Notifying individuals of the financial assistance policy in communications with the patients regarding the patients' bills- Documenting its determination of whether patients were eligible for financial assistance under the hospital facility's financial assistance policy. | |
| Part VI, Line 2: St. Mary's of Michigan Standish Hospital (SMMSH) participates in Community Needs Assessments to gain information about the health care needs of the community. The Community Needs Assessments provides an assessment of Arenac County pertaining to demographics, health, safe and stable homes, and economic development. SMMSH uses this information to ensure that the organization is meeting the needs of the community. | ||
| Part VI, Line 3: St. Mary's of Michigan Standish Hospital informs the community about their Charity Care Program, as well as other state or local government programs, through the following ways:- A Patient Financial Consultant is available Monday through Friday to discuss and assist with signup for state and local government programs, and/or the hospital's charity care program.- The Patient Financial Consultant or Case Manager meet with self-pay patients who have been admitted to the hospital to discuss financial assistance programs that are available.- Self-pay outpatients receive the hospital's financial assistance application, as well as other state and federal assistance program information (MI Child, Central Health Plan, Medicaid, and others as applicable), through the mail. | ||
| Part VI, Line 4: St. Mary's of Michigan Standish Hospital's primary service area is Arenac County. Over 70 percent of its patients reside in the county.Arenac County is located at the bottom of Saginaw Bay on Lake Huron on Michigan's eastern coast. It is a popular resort area, dubbed the "sunrise side" of Michigan. A rural, largely undeveloped county, with plenty of canoeing, hunting, and fishing attracts tourists year-round. In addition to tourism, the economic base of Arenac County consists of agriculture and manufacturing. Agriculture accounts for approximately 48% of the land use. Additionally, health services provide a great deal of local employment.Standish, the county seat, is known as a supply headquarters for those traveling to Northern Michigan. It is also the location of the county's only hospital, St. Mary's of Michigan Standish Hospital. Approximately 15,649 people reside in Arenac County. They live in widely varying economic circumstances, with 17.9% of individuals identified as living below the poverty level; somewhat higher than the state rate of 15.7%.The unemployment rate is 13.2% which is slightly higher than the state average of 10.3%.There are several medical services many of which are tied to St. Mary's of Michigan Standish Hospital, but it is considered to be a health professional shortage area according to the US Health Resources and Services Administration. Accessing health care services can often be a challenge for those living in rural settings. Additional strains and stresses on these services are presented by the transient nature of some of the population (e.g. seasonal residents, tourists, and summer visitors) and general economic and demographic changes (i.e. an increasing aged population) that are occurring more generally in all of Michigan and the United States (i.e. increasing numbers of unemployed, increasing numbers of the "working poor").PopulationWith a population of roughly 15,649 inhabitants (2011 estimate), Arenac County has seen a steady decline in population since 2000 which was 17,269. The following is the population information of Arenac County from the U.S. Census Bureau.Total population - 15,899Male - 8,056Female - 7,843Under 5 years - 7545 to 9 years - 83810 to 14 years - 92915 to19 years - 1,06420 to 24 years - 72225 to 34 years - 1,53735 to 44 years - 1,73145 to 54 years - 2,66155 to 59 years - 1,24160 to 64 years - 1,19565 to 74 years - 1,89275 to 84 years - 97985 years and over - 356Race & EthnicityThe following illustrates the race and ethnicity of Arenac County residents for the year 2010.White - 15,393Black or African American - 29American Indian or Alaska Native - 190Asian - 29Hispanic or Latino - 225Native Hawaiian or Other Pacific Islander - 9Other - 44Unemployment RateThe unemployment rate of Arenac County is 13.2% which is slightly higher than the state average of 10.3%.Arenac County2000 - 5.8%2010 - 16.1%2011 - 13.2%Michigan2000 - 3.7%2010 - 12.7%2011 - 10.3%PovertyAccording to the U.S. Census Bureau, the per capita and median household income is lower in Arenac County than in Michigan. The percentage of persons below poverty is higher than the Michigan average.Arenac CountyPer Capita Income in Past 12 Months - $19,386Median Household Income - $36,281Persons below poverty level, percent - 17.9%MichiganPer Capita Income in Past 12 Months - $25,482Median Household Income - $48,669Persons below poverty level, percent - 15.7%Education RateOf the population age 25 and over, 18.9% have less than a high school diploma which is higher than the state rate of 11.6%.Arenac CountyLess than 9th Grade - 6259th to 12th Grade, no diploma - 1,602High School Graduate - 4,834Some College, no degree - 2,553Associate's Degree - 900Bachelor's Degree - 840Graduate or Professional Degree - 429MichiganLess than 9th Grade - 229,0799th to 12th Grade, no diploma - 534,231High School Graduate - 2,041,868Some College, no degree - 1,561,637Associate's Degree - 540,517Bachelor's Degree - 1,021,486Graduate or Professional Degree - 638,046Physical EnvironmentA community's health is affected by the physical environment. A safe, clean environment that provides access to healthy food and recreational opportunities is important to maintaining and improving community health.Grocery Store AccessThe following reports the number of grocery stores per 100,000 population. This indicator provides a measure of healthy food access and environmental influences on dietary behaviors.Arenac CountyTotal Population, 2010 Census 15,899Number of Establishments - 5Establishment Rate (Per 100,000 Pop.) 31.45MichiganTotal Population, 2010 Census 9,883,640Number of Establishments - 2,154Establishment Rate (Per 100,000 Pop.) 21.79United StatesTotal Population, 2010 Census 312,471,327Number of Establishments - 67,342Establishment Rate (Per 100,000 Pop.) 21.55Recreation and Fitness Facility AccessThe following reports the number per 100,000 population of recreation and fitness facilities. This indicator is relevant because access to recreation and fitness facilities encourages physical activity and other healthy behaviors.Arenac CountyTotal Population, 2010 Census 15,899Number of Establishments - 1Establishment Rate (Per 100,000 Population) 6.29MichiganTotal Population, 2010 Census 9,883,640Number of Establishments - 894Establishment Rate (Per 100,000 Population) 9.05United StatesTotal Population, 2010 Census 308,745,538Number of Establishments 29,896Establishment Rate (Per 100,000 Population) 9.68Health BehaviorsHealth behaviors such as poor diet, a lack of exercise, and substance abuse contribute to poor health status.Physical Inactivity (Adult)The following reports the percentage of adults aged 18 and older who self-report no leisure time for activity, based on the question: "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?". Current behaviors are determinants of future health and this indicator may illustrate a cause of significant health issues, such as obesity and poor cardiovascular health.Arenac CountyTotal Population (Age 18) - 13,214Number Physically Inactive - 3,263.86Percent Physically Inactive 24.70%MichiganTotal Population (Age 18) - 7,531,713Number Physically Inactive - 1,709,699Percent Physically Inactive 22.70%United StatesTotal Population (Age 18) - 111,821,887Number Physically Inactive - 27,579,949Percent Physically Inactive 24.66%Heavy Alcohol ConsumptionThe following reports the percentage of adults aged 18 and older who self-report heavy alcohol consumption (defined as more than two drinks per day for men and one drink per day for women). Current behaviors are determinants of future health and this indicator may illustrate a cause of significant health issues, such as cirrhosis, cancers, and untreated mental and behavioral health needs.Arenac CountyTotal Population (Age 18) - 13,214Number Physically Inactive - 1,572.47Percent Physically Inactive 11.90%MichiganTotal Population (Age 18) - 7,531,713Number Physically Inactive - 1,408,430Percent Physically Inactive 18.70%United StatesTotal Population (Age 18) - 111,821,887Number Physically Inactive - 18,576,867Percent Physically Inactive 16.61%52 | ||
| Part VI, Line 5: St. Mary's of Michigan Standish Hospital offers the following activities to focus on improving the health of the community. - Health screenings and educational materials are provided free or at a reduced cost. - Diabetes support group meetings occur on a bi-monthly basis and are available, free of charge.- Grief support group meetings are offered twice a month, free of charge.- Speakers Bureau: Associates are available to provide educational programs to civic and non-profit groups, free of charge.- Free health and safety events are hosted by the hospital. | ||
| Part VI, Line 6: St. Mary's of Michigan Standish Hospital is a member of Ascension Health. Ascension Health Alliance became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension Health Alliance serves as the member or shareholder of various other subsidiaries. Ascension Health Alliance, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System. Ascension Health Alliance is sponsored by Ascension Health Ministries, a Public Juridic Person. The Participating Entities of Ascension Health Ministries are the Daughters of Charity of St. Vincent de Paul in the United States, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, the Congregation of Alexian Brothers of the Immaculate Conception Province-American Province, and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi-US/Caribbean Province.Standish Community Hospital's sole corporate member is St. Mary's Health. Standish Community Hospital, located in Standish, Michigan, is a nonprofit critical care access hospital. Admitting physicians are primarily practitioners in the local area. St. Mary's is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of St. Mary's are related to providing healthcare services.Mission:The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care that sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.- Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the poor.- Cost of other programs for the poor includes unreimbursed costs of programs intentionally designed to serve the poor and vulnerable of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the poor, including health promotion and education, health clinics and screenings, and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons who are poor and community benefit programs. The cost of providing care of persons living in poverty and community benefit programs is estimated using internal cost data and is calculated in compliance with guidelines established by both the Catholic Health Association (CHA) and the Internal Revenue Service (IRS). | ||
| Reports Filed With States | Part VI, Line 7 | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John Graham | ||||||||||||||
| President/CEO-Health System | 0 | 443146 | 0 | 774935 | 0 | 25016 | 0 | 7350 | 0 | 1608 | 0 | 1252055 | 0 | 0 |
| Rasheed Siddiqui MD | ||||||||||||||
| Chief of Staff | 600161 | 0 | 0 | 0 | 821 | 0 | 16184 | 0 | 22087 | 0 | 639253 | 0 | 0 | 0 |
| Sharon Leaman-Case end 1212 | ||||||||||||||
| Administrator | 0 | 145036 | 0 | 49275 | 0 | 12500 | 0 | 21996 | 0 | 702 | 0 | 229509 | 0 | 0 |
| Gina Butcher | ||||||||||||||
| CFO - Health System | 0 | 187615 | 0 | 18742 | 0 | 8513 | 0 | 3703 | 0 | 2111 | 0 | 220684 | 0 | 0 |
| Doraisamy Venkitapathy | ||||||||||||||
| Physician | 562354 | 0 | 0 | 0 | 2353 | 0 | 22497 | 0 | 28676 | 0 | 615880 | 0 | 0 | 0 |
| Cesar Casten | ||||||||||||||
| Physician | 198705 | 0 | 0 | 0 | 1935 | 0 | 20166 | 0 | 13325 | 0 | 234131 | 0 | 0 | 0 |
| Catherine McDonell | ||||||||||||||
| CRNA | 115264 | 0 | 0 | 0 | 214 | 0 | 15875 | 0 | 23420 | 0 | 154773 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 3 | St. Mary's of Michigan Medical Center, a related organization of Standish Community Hospital, uses the following to establish the compensation of the organization's CEO: - Independent Compensation Consultant, and - Approval by the Board or Compensation Committee. |
| Part I, Line 4b | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation as Form 990, Schedule J, Part II, Column B in the year paid. A related organization that paid the salaries of the individuals listed in Schedule J, Part II, contributed to the supplemental nonqualified retirement plan in the amount as noted: Gina Butcher - $8,329 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | Standish Community Hospital has a single corporate member, St. Mary's Health. | |
| Form 990, Part VI, Section A, line 7a | Standish Community Hospital has a single corporate member, St. Mary's Health, who has the ability to elect members to the governing body of the Standish Community Hospital. | |
| Form 990, Part VI, Section A, line 7b | All decisions that have a material impact to Standish Community Hospital financial information or corporation as a whole are subject to approval by its sole corporate member, St. Mary's Health. | |
| Form 990, Part VI, Section A, line 8b | There are not any separate committees that have the authority to act on behalf of the governing body for Standish Community Hospital. | |
| Form 990, Part VI, Section B, line 11 | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all committee members are provided the Form 990 and management team members are available to answer any committee member questions. | |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. | |
| Form 990, Part VI, Section B, line 15 | In determining the compensation of the organization's CEO, the process performed by St. Mary's of Michigan Medical Center (a related organization who paid the CEO), included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Ascension Health board reviewed and approved the compensation. In the review of the compensation, the CEO was compared to other organizations in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his or her compensation was decided. The Executive Committee of the Board of Directors in conjunction with the Intermediate Sanctions Compliance Policy of the hospital is responsible for determining the compensation of other officers of the organization. The process includes a market analysis of comparable healthcare positions from other organizations of comparable size, complexity, and business activity. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. | |
| Form 990, Part VI, Section C, line 19 | The organization will provide any documents open to public inspection upon request. | |
| Form 990, Part XI, line 9: | Other 78,422. Transfer from Restricted Funds -60,597. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Ascension Health | ||||||||||
| PO BOX 45998 | St Louis | MO | 63145 | 311662309 | National Health System | MO | Section 501(c)(3) | Schedule A, Line 11a | Ascension Health Alliance | 0 |
| St Mary's Health | ||||||||||
| 800 S Washington Avenue | Saginaw | MI | 48601 | 383477017 | Hospital Parent | MI | Section 501(c)(3) | Schedule A, Line 11a | St Mary's of Michigan Medical Center | 0 |
| St Mary's of Michigan Medical Center | ||||||||||
| 800 S Washington Avenue | Saginaw | MI | 48601 | 380997730 | Hospital | MI | Section 501(c)(3) | Schedule A, Line 3 | Ascension Health | 0 |
| St Mary's of Michigan Foundation | ||||||||||
| 800 S Washington Avenue | Saginaw | MI | 48601 | 382246366 | Fundraising | MI | Section 501(c)(3) | Schedule A, Line 11c | St Mary's of Michigan Medical Center | 0 |
| Field Neurosciences Institute | ||||||||||
| 800 S Washington Avenue | Saginaw | MI | 48601 | 382790703 | Medical Research Organization | MI | Section 501(c)(3) | Schedule A, Line 9 | St Mary's of Michigan Medical Center | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Towne Centre Surgery Center LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4599 Towne Centre | AddressLine1 |
| City | Saginaw | City |
| State | MI | State |
| ZIP Code | 48604 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204943843 | EIN |
| Primary Activity | Outpatient Services | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's of Michigan Specialists | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 S Washington Avenue | AddressLine1 |
| City | Saginaw | City |
| State | MI | State |
| ZIP Code | 48601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205959777 | EIN |
| Primary Activity | Physician Practices | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| St Mary's of Michigan Medical Center | ||
| O | 273202 | FMV |
| St Mary's of Michigan Medical Center | ||
| P | 3602534 | FMV |
| Ascension Health | ||
| P | 927220 | FMV |