WA FOOTE MEMORIAL HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- WA FOOTE MEMORIAL HOSPITAL (EIN 38-2027689)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-08
- IRS object ID
- 201421289349301652
- 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 B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-08T12:22:00-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 346565596 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ernst & Young US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 South High Street | AddressLine1 |
| City | Columbus | City |
| State | OH | State |
| ZIP Code | 43215 | 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 | 382027689 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA Foote Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WAFO | NameControl |
| Phone | 5177884800 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 N East Avenue | AddressLine1 |
| City | Jackson | City |
| State | MI | State |
| ZIP Code | 49201 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Georgia Fojtasek | Name |
| Title | President & CEO | Title |
| Phone | 5177884800 | Phone |
| Date Signed | 2014-04-30 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Diane L Bean | Name |
| PTIN | P00104972 | PTIN |
| Phone | 6142245678 | 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 | Allegiance Health | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Georgia Fojtasek | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 N East Avenue | AddressLine1 |
| City | Jackson | City |
| State | MI | State |
| ZIP Code | 49201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 461998828 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.allegiancehealth.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1970 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | We lead our community to better health and well-being at every stage of life. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 4074 | TotalNbrEmployees |
| Total Nbr Volunteers | 843 | TotalNbrVolunteers |
| Total Gross UBI | 4742289 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -33106 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 6245493 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3873688 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 399476676 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 404465728 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 7629400 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9911659 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 8143786 | OtherRevenuePriorYear |
| Other Revenue Current Year | 8953035 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 421495355 | TotalRevenuePriorYear |
| Total Revenue Current Year | 427204110 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 581000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 643000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 216798486 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 230033028 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 199907478 | OtherExpensePriorYear |
| Other Expenses Current Year | 207310272 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 417286964 | TotalExpensesPriorYear |
| Total Expenses Current Year | 437986300 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4208391 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -10782190 | RevenuesLessExpensesCY |
| Total Assets BOY | 472377426 | TotalAssetsBOY |
| Total Assets EOY | 498210237 | TotalAssetsEOY |
| Total Liabilities BOY | 286171720 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 292252910 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 186205706 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 205957327 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | See Schedule OOur MissionWe lead our community to better health and well-being at every stage of life.Our ValuesCompetence: expertise in carrying out responsibilities and inspiring others to have confidence in you.Integrity: behavior that is honest, fair, trustworthy and sincere, strength of character and respect for others.Teamwork: working together in an environment of mutual respect.Diversity: respect for individual beliefs, uniqueness, and differences.Quality: committment to excellence in care.Compassion: acknowledging the feelings of others with empathy, support, encouragement, and sensitivity. Listening and responding to individual needs in a patient and caring manner.Customer Service: taking pride in providing service beyond expectations.Healing Environment: providing an environment that promotes an atmosphere of trust, comfort, healing and security. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 355639154 | Expense |
| Grants | 643000 | Grants |
| Revenue | 410256681 | Revenue |
| Description | See Schedule OThe Hospital devotes substantial efforts and resources to providing health services to people in its communities. The Hospital is engaged in the following activities to ensure that our mission is accomplished:Unreimbursed Services Provided to the Underserved:The Hospital provides a substantial portion of its services to the underserved (elderly and low income residents). During the fiscal year ended June 30, 2013, approximately 46% of the value of services rendered were to elderly patients under the Medicare program, and approximately 15% of the services were provided to patients who were deemed indigent under state, county, or Medicaid Center guidelines.In the spirit of our mission and values, the Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare services to all persons. During the fiscal year ended June 30, 2013, the Hospital provided charity care of $48.6 million and recorded a provision for bad debts of $42.7 million. Consistent with Schedule H reporting, charity care at cost for fiscal year 2013 was $14 million.Patient Services:The Hospital serves seven counties with a medical staff of more than 475 physicians. A complete listing of services is available at AllegianceHealth.org.The Hospital supports unprofitable/subsidized health services, including inpatient and outpatient behavioral health and substance abuse services, obstetrics, emergency and trauma services, general medicine, family/general practice, senior services, cardiac and pulmonary rehabilitation, palliative care, wound care, pain clinic and diabetes clinic.Community Benefit Activities:The Hospital is engaged in community programs and services that address identified community health needs regardless of source or availability of payment and provide measurable improvement in health access, health status, and the use of health care resources. These programs address one of the six criteria:Supports the Hospitals community-based missionTargets the problems of the poor or medically underservedImpacts the health status of the identified communityReduces community health costsIs accessible to the entire target community regardless of ability to payStimulates external community partnershipsThe Health Improvement Organization (HIO) was created by Allegiance Health in 2001 to promote a culture of continuous health improvement in our community and integrate wellness and prevention throughout our services. The Allegiance Department of Prevention and Community Health provides staff and infrastructure to facilitate the coordination of local health improvement activities. The HIO Coordinating Council (HIO CC) is a multi-disciplinary stakeholders group led by Allegiance Health with representation from local government, public health, health care, health and human service agencies, nonprofits, school districts, health plans, mental health, employers and the faith community. The HIO CC coordinates efforts across community leaders in health to create unprecedented alignment of goals and resources, as well as a strong community platform for advocacy. The work of the HIO CC has culminated in the completion of a Community Action Plan including goals, objectives and strategies to address physical activity, nutrition, tobacco use, and depression in Jackson County. The Plan is based on assessment and data-driven processes, as well as input from over 30 representatives from local health and human service agencies, and over 100 community stakeholders. The overarching tactics that the Community Action Plan relies upon include evidence-based activities to:Enhance media attention and public recognition of healthy lifestyle practices;Improve access to healthy foods and safe, attractive, affordable places for activity through supportive policies and physical environment changes;Provide social support and services that promote consistent screening, referral and supportive relationships for physical activity, nutrition, mental health and smoking behavior change.Health Improvement Organization: The HIO builds upon existing community strengths and infrastructure to support implementation of health initiatives that have been prioritized as part of a community wide plan with significant community engagement and an established infrastructure to support longevity. In addition to operational support for the HIO CC, the Allegiance Health Department of Prevention and Community Health provides subject matter expertise on wellness and prevention at the Board, Service Line and community level, and direct service delivery (including employer-based health management, tobacco treatment services, weight management, faith community nursing, etc.) to a broad base of community members to support the health improvement priorities identified by the HIO. The Department of Prevention and Community Health has an annual budget of around $1 million. Since 2001, the Hospital has committed over $21.4 million of funding to this program.Other Community Benefit Activities:Through Community Education and Outreach, the Hospital provided educational sessions and clinics that reached 108,751 individuals at a cost of $842,642 in fiscal year 2013. The sessions/clinics included education on asthma, AIDS/HIV, diabetes, family planning, fitness/exercise, overall health, cardiovascular health, nutrition and weight management, pulmonary, smoking cessation and womens health. These educational offerings were located at the Hospital, community fairs, parishes, schools, work sites and by phone. Free Medical Screenings for high blood pressure, diabetes, mental health/depression, vascular disease and womens health served 1,219 community members at a cost of $18,882 in fiscal year 2013.The Hospital funded a 24-hour nurse call center to provide health information to the community. The cost of the center in fiscal year 2013 was $388,790.Free and discounted prescription drug and medical supplies were provided to community members at a cost of $45,193 during fiscal year 2013. Through Meals on Wheels and other food donation programs, the Hospital served approximately 25,000 individuals at a cost of $42,978.Transportation Assistance, including wheelchair van, ambulance, transport to and from cancer centers and cab service served 6,947 community members in fiscal year 2013 at a cost of $174,072.Partnerships:The Hospital played a leadership role in the establishment of the Center for Family Health, a Federally Qualified Health Center, providing $600,000 in fiscal year 2013 support for the uninsured.The Hospital played a leadership role in the establishment of the Jackson County Health Plan, whose mission is to improve healthcare coverage in Jackson County for the underserved.The Hospital partnered with the medical staff and community to establish Project Access, a program which provides free physician and hospital care for 500 community members that do not qualify for federal or state financial assistance and are uninsured. The Hospital provides free care for medically necessary hospital based services. Hospital executive staff sit on a number of governance boards of non-profit organizations in our community, such as Center for Family Health, Ella Sharp Museum of Art and History, Jackson Community Foundation, Fitness Council of Jackson, Health Improvement Organization, Allegiance Hospice, Allegiance Health Foundation, CareLink, Healthlink, Jackson Community Ambulance, Huron Valley Ambulance, Jackson Community Medical Record, Michigan Health Information Network, United Way of Jackson, Jackson Health Network, and Junior Achievement of Michigan Edge.The Hospital is also represented on public and private organizations including The Enterprise Group of Jackson, Inc. (promotes economic development), Jackson Citizens for Economic Growth, and South Central Michigan Works. The Hospital donates office space to two area non-profit organizations. These organizations are the Enterprise Group of Jackson, Inc. and Birthline of Jackson. | Description |
| Total Program Service Expense | 355639154 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | 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 | 1 | ForeignOffice |
| Foreign Activities | 1 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 287 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 4074 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| 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 | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | 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 | 1 | 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jeanne Wickens | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5177884800 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 N East Avenue | AddressLine1 |
| City | Jackson | City |
| State | MI | State |
| ZIP Code | 49201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (34 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 | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Georgia Fojtasek | |||||||||
| President & CEO | 55.00 | 5.00 | X | X | 702224 | 0 | 75587 | ||
| Aaron Boatin | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| Neeta Delaney | |||||||||
| Trustee | 2.00 | 1.00 | X | 0 | 0 | 0 | |||
| Doug Finch | |||||||||
| Trustee | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| David Halsey | |||||||||
| Trustee | 4.00 | 1.00 | X | 41258 | 0 | 0 | |||
| Steven Hogwood | |||||||||
| Trustee | 2.00 | 1.00 | X | 0 | 0 | 0 | |||
| Nitin Ambani | |||||||||
| Chief of Staff thru 12/31/12 | 5.00 | 1.00 | X | 37201 | 0 | 0 | |||
| John Mogerman | |||||||||
| Chief of Staff as of 01/01/13 | 5.00 | 1.00 | X | 357948 | 0 | 45969 | |||
| Steven Rick | |||||||||
| Trustee | 2.00 | 1.00 | X | 0 | 0 | 0 | |||
| Tim Levy | |||||||||
| Vice Chairman | 3.00 | 1.00 | X | 0 | 0 | 0 | |||
| John Nally | |||||||||
| Secretary/Treasurer | 3.00 | 1.00 | X | X | 0 | 0 | 0 | ||
| Harish Rawal | |||||||||
| Trustee thru 04/01/13 | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Larry Schultz | |||||||||
| Chairman | 5.00 | 1.00 | X | 0 | 0 | 0 | |||
| Lynn VanWagnen | |||||||||
| Trustee thru 04/01/13 | 0.00 | 0.00 | X | 0 | 0 | 0 | |||
| Allan Tompkins | |||||||||
| Trustee | 3.00 | 1.00 | X | 9747 | 0 | 0 | |||
| Michael Shore | |||||||||
| Trustee | 3.00 | 1.00 | X | 0 | 0 | 0 | |||
| Mohan Kulkarni | |||||||||
| Trustee | 3.00 | 1.00 | X | 156452 | 0 | 0 | |||
| Karen Chaprnka | |||||||||
| SVP & COO | 55.00 | 5.00 | X | 421296 | 0 | 52700 | |||
| Jeanne Wickens | |||||||||
| SVP & CFO | 55.00 | 5.00 | X | 433569 | 0 | 65139 | |||
| Richard Warren | |||||||||
| VP & CIO | 55.00 | 5.00 | X | 281524 | 0 | 67769 | |||
| Jacalyn Liebowitz | |||||||||
| VP Patient Care | 55.00 | 5.00 | X | 290563 | 0 | 46533 | |||
| Kenneth Empey | |||||||||
| General Counsel | 55.00 | 5.00 | X | 248309 | 0 | 60381 | |||
| Cheryl Lamborn | |||||||||
| VP Human Resources | 55.00 | 5.00 | X | 243634 | 0 | 33533 | |||
| Anthony Gardner | |||||||||
| VP Marketing | 55.00 | 1.00 | X | 173097 | 0 | 31986 | |||
| Beth Smith | |||||||||
| VP Organizational Excellence | 55.00 | 1.00 | X | 158224 | 0 | 33131 | |||
| Gerald Grannan | |||||||||
| VP Physician Integrationg & Planning | 55.00 | 1.00 | X | 181095 | 0 | 28402 | |||
| John Hyden | |||||||||
| Chief Compliance Officer | 55.00 | 5.00 | X | 125882 | 0 | 17629 | |||
| Ray King | |||||||||
| Chief Medical Officer | 55.00 | 5.00 | X | 360955 | 0 | 56904 | |||
| Ryan Beekman | |||||||||
| Physician | 50.00 | 0.00 | 1322670 | 0 | 51295 | X | |||
| Vishal Gupta | |||||||||
| Physician | 50.00 | 0.00 | 832452 | 0 | 83098 | X | |||
| Tudor Tien | |||||||||
| Physician | 50.00 | 0.00 | 769645 | 0 | 37906 | X | |||
| Brian Daly | |||||||||
| Physician | 50.00 | 0.00 | 718436 | 0 | 51678 | X | |||
| Ivan Cubas | |||||||||
| Physician | 50.00 | 0.00 | 642543 | 0 | 73080 | X | |||
| William Kiel | |||||||||
| VP Development thru 04/10/12 | 0.00 | 0.00 | 247239 | 0 | 24226 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 8755963 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 936946 | TotalOtherCompensation |
| Number Individuals GT100 K | 207 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| Mckesson Technologies Inc | |||||
| PO Box 98347 | Chicago | IL | 60693 | Healthcare Consulting | 3578739 |
| Independent Emergency Physicians | |||||
| PO Box 100 | Royal Oak | MI | 48068 | Healthcare Services | 3555714 |
| GE Healthcare Services | |||||
| PO Box 96483 | Chicago | IL | 60693 | Healthcare Consulting | 2913195 |
| Cogent Healthcare Management Inc | |||||
| PO Box 645037 | Cinncinnati | OH | 45264 | Hospitalists | 2800371 |
| Pulmonary Clinics of southern MI | |||||
| 900 E Micigan Avenue | Jackson | IL | 49201 | Healthcare Services | 2707608 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 217 | NumberOfContractorsGT100K |
| Related Organizations | 368538 | RelatedOrganizations |
| Government Grants | 3505150 | GovernmentGrants |
| Total Contributions | 3873688 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Patient Services | 621990 | 403977981 | 400913919 | 3064062 |
| SubPart F Income | 524298 | 281055 | 281055 | |
| FHC, JCA, and JCMR | 621910 | 206692 | 206692 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 404465728 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5440596 | TotalRevenueColumn |
| Exclusion | $5,440,596 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 138404 | TotalRevenueColumn |
| Exclusion | $138,404 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1013829 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 935453 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 78376 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 78376 | TotalRevenueColumn |
| Exclusion | $78,376 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 38191144 | Securities |
| Other | 780 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 33753805 | Securities |
| Other | 105460 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4437339 | Securities |
| Other | -104680 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4332659 | TotalRevenueColumn |
| Exclusion | $4,332,659 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Services to Affiliates | 561000 | 4328931 | 3433473 | 895458 | |
| Cafeteria | 722210 | 1703867 | $1,703,867 | ||
| Vendor Rebates | 621990 | 715272 | 715272 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2126589 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1624875 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 501714 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 8874659 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 427204110 | TotalRevenueColumn |
| Related Or Exempt Function Income | 406894231 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 4742289 | UnrelatedBusinessRevenue |
| Exclusion | $11,693,902 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 643000 | Total |
| Program Services | 643000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4834416 | Total |
| Program Services | 491645 | ProgramServices |
| Management And General | 4342771 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 493170 | Total |
| Management And General | 493170 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 183268610 | Total |
| Program Services | 150967940 | ProgramServices |
| Management And General | 32300670 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10457488 | Total |
| Program Services | 8399397 | ProgramServices |
| Management And General | 2058091 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18047646 | Total |
| Program Services | 14495771 | ProgramServices |
| Management And General | 3551875 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12931698 | Total |
| Program Services | 10386669 | ProgramServices |
| Management And General | 2545029 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419000 | Total |
| Management And General | 419000 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1465911 | Total |
| Program Services | 1177412 | ProgramServices |
| Management And General | 288499 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 400136 | Total |
| Management And General | 400136 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 239057 | Total |
| Management And General | 239057 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 298750 | Total |
| Management And General | 298750 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46366103 | Total |
| Program Services | 37241001 | ProgramServices |
| Management And General | 9125102 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1741904 | Total |
| Program Services | 1399088 | ProgramServices |
| Management And General | 342816 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21668596 | Total |
| Program Services | 17404098 | ProgramServices |
| Management And General | 4264498 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11372560 | Total |
| Program Services | 9134378 | ProgramServices |
| Management And General | 2238182 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8539631 | Total |
| Program Services | 6858985 | ProgramServices |
| Management And General | 1680646 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 431763 | Total |
| Program Services | 346790 | ProgramServices |
| Management And General | 84973 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 431763 | Total |
| Program Services | 346790 | ProgramServices |
| Management And General | 84973 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7503237 | Total |
| Program Services | 6026559 | ProgramServices |
| Management And General | 1476678 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26363640 | Total |
| Program Services | 21175132 | ProgramServices |
| Management And General | 5188508 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1342834 | Total |
| Program Services | 1078557 | ProgramServices |
| Management And General | 264277 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 33398135 | 33398135 | |
| Drugs | 31462662 | 31462662 | |
| Swap Loss Transaction | 6038725 | 6038725 | |
| Food | 2191827 | 2191827 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5634038 | Total |
| Program Services | 1013318 | ProgramServices |
| Management And General | 4620720 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 437986300 | Total |
| Program Services | 355639154 | ProgramServices |
| Management And General | 82347146 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18448875 | BOY |
| EOY | 8560443 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3009859 | BOY |
| EOY | 1980897 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59121532 | BOY |
| EOY | 50532032 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4135 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90000 | BOY |
| EOY | 115000 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2420563 | BOY |
| EOY | 2594211 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6464600 | BOY |
| EOY | 6874186 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7323770 | BOY |
| EOY | 9480192 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 337931169 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 182959803 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155907043 | BOY |
| EOY | 154971366 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 211566539 | BOY |
| EOY | 249871604 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8020510 | BOY |
| EOY | 13230306 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 472377426 | BOY |
| EOY | 498210237 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44981101 | BOY |
| EOY | 53947584 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 169609993 | BOY |
| EOY | 169988808 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3367990 | BOY |
| EOY | 3367990 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 18000000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68212636 | BOY |
| EOY | 46948528 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 286171720 | BOY |
| EOY | 292252910 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 186205706 | BOY |
| EOY | 205957327 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 186205706 | BOY |
| EOY | 205957327 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 472377426 | BOY |
| EOY | 498210237 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -10782190 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 10220992 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 20312819 | 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 B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $286,916 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 286916 | 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 | Health care is a highly-regulated field, requiring frequent and high-level communication with regulators and elected officials. A small investment in lobbying enables us to remain in contact with legislators and government agencies, maximize the resources with which we are entrusted and assure that we provide the best care to our community. Allegiance enlists the services of several lobbying consultants, attorneys and healthcare trade associations. In addition, the hospital employs a corporate accounts specialist. The specialist spends a portion of his time contacting legislators, participating in grass roots advocacy, and other activities closely related to lobbying. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1250833 | BeginningOfYearBalance |
| Contributions | 671894 | Contributions |
| Grants Or Scholarships | 370538 | GrantsOrScholarships |
| End Of Year Balance | 1552189 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1124117 | BeginningOfYearBalance |
| Contributions | 2790346 | Contributions |
| Investment Earnings Or Losses | 5025 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2015249 | GrantsOrScholarships |
| Other Expenditures | 653406 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 1250833 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 642729 | BeginningOfYearBalance |
| Contributions | 2045207 | Contributions |
| Investment Earnings Or Losses | -5012 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 849502 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 709305 | AdministrativeExpenses |
| End Of Year Balance | 1124117 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 42176 | BeginningOfYearBalance |
| Contributions | 946077 | Contributions |
| Other Expenditures | 345524 | OtherExpenditures |
| End Of Year Balance | 642729 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9630527 | OtherCostOrOtherBasis |
| Book Value | 9630527 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 182365338 | OtherCostOrOtherBasis |
| Depreciation | 89229289 | Depreciation |
| Book Value | 93136049 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 129313606 | OtherCostOrOtherBasis |
| Depreciation | 90801549 | Depreciation |
| Book Value | 38512057 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16621698 | OtherCostOrOtherBasis |
| Depreciation | 2928965 | Depreciation |
| Book Value | 13692733 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 154971366 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Retirement Plan Liability | $35,084,177 |
| Note Payable | $252,057 |
| Physician Recruitment Loan | $283,854 |
| Tax Abatement Liability | $231,630 |
| Deferred Comp | $2,660,775 |
| Swap Market Value Adjustment | $8,436,035 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 46948528 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Intended Use of Endowment Funds: | Identifier |
| Return Reference | Part V, Line 4: | ReturnReference |
| Explanation | The organization's endowment funds are used for various charitable hospital programs including treatment of uninsured patients and community preventative health education. | Explanation |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Cayman Islands | Region |
| Number Of Offices | 0 | NumberOfOffices |
| Number Of Employees | 1 | NumberOfEmployees |
| Type Of Activities Conducted | Program Services | TypeOfActivitiesConducted |
| Specific Services Provided | Self & Malpractice Insurance | SpecificServicesProvided |
| Total Expenditures | 3435112 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 1 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 1 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 3435112 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 3435112 | TotalAmountSpent |
| Transfer To Foreign Corp | 1 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 1 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
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 |
| Pcent350 | X | Pcent350 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| 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 | 14063924 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 26803 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 14037121 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03200 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 62977078 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 51226140 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11750938 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02680 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 77041002 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 51252943 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 25788059 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05880 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 913532 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 913532 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1550172 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1550172 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2463704 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2463704 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00560 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 79504706 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 51252943 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 28251763 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06440 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 31703 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 31703 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 628505 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 628505 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 660208 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 660208 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $42,733,028 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 164820786 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 192889175 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -28068389 | 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 |
Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 Foote Health Center Associates | |||
| Entity leases medical office space. | 0.54430 | 0.00000 | 0.45570 |
| 2 Jackson Community Medical Records | |||
| Entity provides electronic medical records to hospital & community doctors. | 0.51000 | 0.00000 | 0.49000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | WA Foote Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 NEast Avenue | AddressLine1 |
| City | Jackson | City |
| State | MI | State |
| ZIP Code | 49201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.allegiancehealth.org | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WA Foote Memorial 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 | 1 | 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 | 1 | 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 | 350.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Medicaid Medicare | X | MedicaidMedicare |
| 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 |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 38 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (38 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Allegiance Hematology Oncology | ||||
| 1100 E Michigan Avenue | Jackson | MI | 49201 | Cancer Treatment |
| Allegiance Vascular Health | ||||
| 300 W Washington Avenue | Jackson | MI | 49201 | Vascular Health |
| Allegiance Orthopedics | ||||
| 1201 E Michgan Avenue | Jackson | MI | 49201 | Orthopedics |
| Allegiance Gastroenterology | ||||
| 1100 E Michigan Avenue Ste 310 | Jackson | MI | 49201 | Gastroenterology |
| Allegiance General Surgery | ||||
| 300 W Washington Avenue | Jackson | MI | 49201 | Surgery Center |
| Allegiance Hospitalist Service | ||||
| 205 N East Avenue | Jackson | MI | 49201 | Hospitalists Group |
| Allegiance Express Care | ||||
| 110 N Elm | Jackson | MI | 49202 | Emergency Care |
| Allegiance Family Medicine - Townsend | ||||
| 400 Hinckley Blvd | Jackson | MI | 49203 | Family Medicine |
| Allegiance Cardio Surgery | ||||
| 1125 E Michigan Avenue | Jackson | MI | 49201 | Surgery Center |
| Allegiance Family Medicine - Leslie | ||||
| 130 N Sherman | Leslie | MI | 49251 | Family Medicine |
| Allegiance Intensivist Services | ||||
| 205 N East Avenue | Jackson | MI | 49201 | Internal Medicine |
| Allegiance Behavioral Health | ||||
| 205 N East Avenue | Jackson | MI | 49201 | Behavioral Health |
| Allegiance Rheumatology | ||||
| 1201 E Michgan Avenue Ste 100 | Jackson | MI | 49201 | Rheumatology |
| Allegiance Family Medicine - Summit Wood | ||||
| 2585 Spring Arbor Road | Jackson | MI | 49203 | Family Medicine |
| Allegiance Family Medicine - Spring Arbo | ||||
| 7845 Spring Arbor Road | Spring Arbor | MI | 49283 | Family Medicine |
| Allegiance EKG | ||||
| 205 N East Avenue | Jackson | MI | 49201 | Pulmonary Medicine |
| Allegiance Family Medicine - Mason | ||||
| 810 Hogsback Road | Mason | MI | 48854 | Family Medicine |
| Allegiance Hearing Center | ||||
| 1111 Teneyck | Jackson | MI | 49201 | Hearing Loss Treatment |
| Allegiance Family Medicine - Albion | ||||
| 27931 C Drive North | Albion | MI | 49224 | Family Medicine |
| Express Care Kids | ||||
| 110 N Elm | Jackson | MI | 49202 | Emergency Care |
| Allegiance Neuropsychiatry | ||||
| 205 N East Avenue | Jackson | MI | 49201 | Neuropsychiatry |
| Allegiance Internal Medicine | ||||
| 900 E Michigan Avenue | Jackson | MI | 49201 | Internal Medicine |
| Allegiance Family Medicine - Brookyln | ||||
| 153 Wamplers Lake Road | Brooklyn | MI | 49230 | Family Medicine |
| Allegiance Family Medicine - Grass Lake | ||||
| 12369 E Michigan Avenue | Grass Lake | MI | 49240 | Family Medicine |
| Allegiance Family Medicine - Cascade Rid | ||||
| 3333 Spring Arbor Road Ste 100 | Jackson | MI | 49203 | Family Medicine |
| Allegiance Family Medicine - MI CTR | ||||
| 4304 Page Avenue | Michigan Center | MI | 49254 | Family Medicine |
| Allegiance Senior Health Center | ||||
| 205 N East Avenue | Jackson | MI | 49201 | Geriatric Services |
| Allegiance Palliative Care | ||||
| 205 N East Avenue | Jackson | MI | 49201 | Palliative Care |
| Allegiance Neurology | ||||
| 1201 E Michgan Avenue | Jackson | MI | 49201 | Neurology |
| Allegiance Diabetes Center | ||||
| 817 W High Street | Jackson | MI | 49203 | Diabetes |
| Allegiance EEG | ||||
| 205 N East Avenue | Jackson | MI | 49201 | Brain Diagnostics |
| Allegiance Occupational Health Urgent Ca | ||||
| One Jackson Square | Jackson | MI | 49201 | Urgent Care |
| Allegiance Family Medicine - North Stree | ||||
| 1401 W North Street | Jackson | MI | 49202 | Family Medicine |
| Allegiance Family Medicine - East Michig | ||||
| 3235 E Michigan Avenue | Jackson | MI | 49202 | Family Medicine |
| Allegiance Family Medicine - Onsted | ||||
| 8958 West M-50 | Onsted | MI | 49265 | Family Medicine |
| Allegiance Family Medicine - Springport | ||||
| 2282 Springport Road Ste B | Jackson | MI | 49202 | Family Medicine |
| Michigan Heart | ||||
| 309 Page Avenue | Jackson | MI | 49201 | Cardiovascular Care |
| Allegiance Digestive Health | ||||
| 4400 Ann Arbor Road | Jackson | MI | 49202 | Digestive Health |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part I, Line 6a: The Hospital prepares an annual community benefit report, which can be accessed at allegiancehealth.org/givingback. | |
| Part I, Line 7: The Hospital used a cost-to-charge ratio to calculate the cost of charity care and Medicaid shortfall. Community Health Improvement Services and Cash and In-Kind Contributions are actual amounts. | |
| Part I, L7 Col(f): Our total expense from Form 990, Part IX, line 25, column (A) was $437,986,300. This expense is used as the denominator for purposes of calculating Part I, Line 7, column(f). The denominator does not include bad debt expense. Bad debt expense is subtracted from net patient services revenue. | |
| Part II: The Hospital is involved in numerous community building activities. We believe these activities, such as supporting affordable housing, working in partnership with the local community college to develop skilled nurses and supporting economic development programs directly improve the general health and wellness of the community. Also, staff at every level of the organization are encouraged to serve community groups that promote education, health and economic advocacy for the less fortunate. | |
| Part III, Line 4: Accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its historical experience and identifies trends for each of its major payor sources to estimate the appropriate allowance for uncollectible accounts and the provision for bad debts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party health care coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and provision for bad debts. For receivables associated with self-pay accounts (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. The provision for bad debts has been reported as a deduction from net patient service revenue.The amount of bad debt reported in the fiscal year 2013 audited financial statements was $42,733,028. | |
| Part III, Line 8: The organization believes the entire Medicare shortfall reported on Line 7 should be treated as Community Benefit. Allegiance Health is nationally recognized by Healthgrades as being in the top five percent nationally for clinical excellence and patient safety. Allegiance Health also benchmarks favorably on overall cost per case and is deemed to be an efficient provider. The organization is subsidizing a government program and sustaining significant losses in providing health care to Medicare receipients. By continuing to treat patients eligible for Medicare, hospitals alleviate the federal government's burden for directly providing medical services. | |
| Part III, Line 9b: The Hospital does not collect from patients known to qualify for charity care or other financial assistance. Patients having difficulty paying their bills are directed to financial counselors. These counselors review the patients information in order to see if they qualify for assistance. In addition, bills sent to patients include a number to call for help in providing the required financial information to qualify for charity care. | |
| Part V, Section B, Line 3: The Health Improvement Organization Coordinating Council, founded by Allegiance Health, is a collaborative of community stakeholders committed to improving the health status of the community through an integrated health improvement infrastructure that addresses Jacksons priority health issues. The HIO Coordinating Council serves as the stakeholder planning committee for Allegiances Board HIO Committee, Jackson Countys Healthy Community initiative, the United Way of Jackson Countys Community Solutions Team on Health, and the Health Strand of the Jackson 2020 initiative. The scope of our responsibility includes monitoring community level indicators, identifying specific health priorities and developing community action plans to address common goals.In this model, community stakeholders work with public health experts to develop and complete a community health assessment for Jackson County. This assessment provides a data collection mechanism that better aligns efforts among community partners and creates a more strategic framework for local health improvement activities.Contributing PartnersAARP of MichiganAllegiance HealthAstraZenecaAWARE, Inc.Community Action AgencyCareLinkCatholic Charities of JacksonCenter for Family HealthCommunity MembersFitness Council of JacksonGreat Lakes IndustryJackson Community CollegeJackson Community FoundationJackson County AdministrationJackson County Youth CenterJackson Health NetworkJackson County Health DepartmentJackson County Intermediate School DistrictLifeWaysMarriage MattersMeridian Health PlanMichigan Purchasers Health AlliancePartnership Park Downtown Neighborhood AssociationUnited Way of Jackson CountyYMCA of Jackson CountyYMCA Storer Camps | W.A. Foote Memorial Hospital |
| Part V, Section B, Line 4: CareLink of Jackson, a Community Owned Specialty Hospital | W.A. Foote Memorial Hospital |
| Part V, Section B, Line 14g: Financial assistance policy brochures are placed in the ER waiting room. | W.A. Foote Memorial Hospital |
| Part VI, Line 2: Allegiance Health conducts a telephone survey every three years in order to gather information on the health status of Jackson County. Through a statistically valid survey, we collect responses from over 1,000 Jackson County residents age 18 and older to a 180 question survey about their health status, insurance coverage, personal health habits and health care experiences. The specific steps involve collecting and analyzing health information for our County (including subpopulations within our County); measuring our health status against other communities, the state and the nation; prioritizing health issues within the community; creating a system for sharing this data with community organizations and residents; initiating strategic planning to address these issues through collaborative activities; and monitoring impact of health initiatives on community health outcomes. | |
| Part VI, Line 3: Uninsured inpatients and observation patients are referred to a financial counselor (contracted agent/partner) for assistance with Medicaid, SSI, and Allegiance Health program applications. Many outpatients needing or having received hospital services are also referred to the agent/partner for assistance. ER patients are provided with a packet of information at discharge from the department. This packet includes information about how assistance may be obtained through the local Medicaid office and about how to apply for our income structured payment plan and uncompensated care programs. When patients are billed for balances they owe, we solicit them to call the Business Office with any questions or for assistance. Additionally, a series of letters are sent to patients to apprise them of payment and assistance options. Allegiance has a printed brochure that is available through Registration that includes information regarding Medicaid application assistance and our internal programs. The Allegiance Health website includes a series of web pages related to transparency, quality, pricing, and our financial policies, procedures, and programs. Uninsured patients needing mental health services are screened for eligibility through our partnership with the Jackson Community Mental Health Agency, which funds care for indigent, dual diagnosis, and Medicaid patients. Patients seeking substance abuse care are linked with the Mid-South Substance Abuse Commission. Registration and Business Office team members receive direct training on our programs and scripting for ensuring information is provided to the patients and families with whom our staff interact. Education is provided to organizational leaders to ensure that team members outside of Finance are aware of our programs and where to direct patients and families who may need or who are seeking assistance. | |
| Part VI, Line 4: Allegiance Health population is determined geographically by the boundaries of Jackson County. The hospital is a tax exempt Health System that serves the collective health needs of the more than 160,000 residents of Jackson County. The gender distribution of Jackson County residents is 49% female and 51% male. The age distribution of Jackson County is 26% of residents 19 years and under, 18% between 20 and 34 years, 29% between 35 and 54 years, 13% between 55 and 64 years, and 14% of residents are 65 years and older. Racial distribution of Jackson County residents according to the 2011 Census Data is 88.0% as white, 7.9% as African American, 0.7% as Asian, 0.4% as American Indian or Alaska Native, and 3.0% as some other race or two or more races. Of males aged 15 years and over, 33.0% have never married, 50.4% are married, 1.5% are separated, 2.9% are widowed, and 12.3% are divorced. Of females aged 15 and over, 25.0% have never married, 50.4% are married, 1.7% are separated, 9.8% are widowed, and 13.2% are divorced. According to the Bureau of Labor Statistics (2013), Jackson County also experiences a high unemployment rate of 8.8%. With 69,400 individuals in the civilian labor force, 6,100 residents are currently unemployed. Of those employed, major industries represented include educational services, health care, and social assistance (23.9%); manufacturing (18.7%); retail trade (12.1%); professional, scientific, management, administrative, and waste management services (7.7%); and arts, entertainment, recreation, accommodation, and food services (7.5%). Approximately 47% of Allegiance Hospital patients were covered by Medicare, while 15% were on Medicaid and 4% were uninsured. During the 2013 fiscal year, Allegiance Health had 9,399 Medicare discharges and 4,238 Medicaid discharges from inpatient services. Physician practice visits totaled 200,327 during FY 2013, with 126,337 primary care visits and 73,990 visits to specialists. Allegiance Health also provides financial and leadership support of primary care services for the underserved, regardless of their ability to pay, through the Center for Family Health (CFH), a federally qualified health center. In fiscal 2013, CFH saw 27,398 patients, which 54% were on Medicaid, 7% were on Medicare and 24% were uninsured. | |
| Part VI, Line 5: Allegiance Health is honored to have received national recognition in recent years, including the American Hospital Associations 2010 Foster G. McGaw Prize for excellence in community service, which is presented to only one hospital in the United States each year. This award is the ultimate recognition of Allegiance Health's commitment to community health improvement and partnership.Allegiance Health is a community owned and locally governed integrated health system located in Jackson, Michigan. As the sole community provider in Jackson County, Allegiance offers a comprehensive range of inpatient and outpatient medical services. Originally founded in 1918 as a community hospital, Allegiance has grown in response to community demand and over the last decade has made substantial investments modernizing its more than 40 healthcare facilities, increasing staff, expanding and renovating its oncology centers, emergency department, and surgery facilities, and installing next generation electronic medical records system. Allegiance's modern facilities, state of the art technologies, and innovative new services ensure that area residents receive a full range of medical services close to home.Allegiance's commitment to building a patient centered, physician led community health system has resulted in numerous industry awards and national recognition. Recent awards include the Thomson Reuters 100 Top Hospitals (awarded in 1995,1996,2008,2010,2011), HealthGrades Distinguished Hospital Award for Clinical Excellence(awarded in 2008,2010,2011,2012,2013), HealthGrades Patient Safety Excellence Award (awarded in 2009,2010,2011,2012,2013), HealthGrades Top 100 Hospital Award for 2013, and the CareChex Top 100 Hospital Award for 2013.The Health Improvement Organization (HIO) was created by Allegiance Health in 2001 to promote a culture of continuous health improvement in our community and integrate wellness and prevention throughout our services. The Allegiance Department of Prevention and Community Health provides staff and infrastructure to facilitate the coordination of local health improvement activities. The HIO Coordinating Council (HIO CC) is a multi-disciplinary stakeholders group led by Allegiance Health with representation from local government, public health, health care, health and human service agencies and nonprofits, school districts, health plans, mental health, employers and the faith community. The HIO CC coordinates efforts across community leaders in health to create unprecedented alignment of goals and resources, as well as a strong community platform for advocacy. The work of the HIO CC has culminated in the completion of a Community Action Plan including Goals, Objectives and Strategies to address physical activity, nutrition, tobacco, and depression in Jackson County based on assessment and data-driven processes, as well as input from over 30 representatives from local health and human service agencies, and over 100 community stakeholders. The overarching tactics that the Community Action Plan relies upon include evidence-based activities to:Enhance media attention and public recognition of healthy lifestyle practicesImprove access to healthy foods and safe, attractive, affordable places for activity through supportive policies and physical environment changes Provide social support and services that promote consistent screening, referral and supportive relationships for physical activity, nutrition, mental health and smoking behavior changeSee Form 990, Schedule O, Program Service Accomplishments for more detail. | |
| Part VI, Line 6: The Hospital's sole corporate member is Allegiance Health Services, a 501(c)(3) organization. Other affiliates include a Foundation, a Hospice, a Long Term Acute Care Hospital (LTACH), a Volunteer Organization and a Home Health Care company, all 501(c)(3) organizations. Additionally, the hospital recently formed a clinically integrated network.The Hospital, Hospice, LTACH and Home Health Care organization work together to provide necessary medical services to the Jackson Community. The Foundation and the Volunteer Organization work closely with the Parent and the Hospital in raising funds for projects and services that would benefit the overall well-being of the community. The most recent campaign is raising funds for a Graduate Medical Education program. Previous campaigns successfully raised funds to expand and improve our cancer care service line and provided free medical care to indigent patients. The clinically intergrated network works to improve patient clinical outcomes thru coordinated care and lowering overall health care costs. See Form 990, Schedule O, Program Service Accomplishments for more detail. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|---|
| Center for Family Health | |||||||||
| 2298 Springport Road | Jackson | MI | 49202 | 383251354 | 501(c)(3) | 600000 | 0 | N/A | The Center for Family Health grant provides operational support for medically underserved populations. |
| Healthlink | |||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382756425 | 501(c)(3) | 30000 | 0 | N/A | The Helping Hands Home Care grant supports respite care for families without the financial means to pay for needed assistance. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: The organization sends out an award letter to all grantee recipents. The letter outlines what the funding may be used for and requests a final report detailing the year's activities. Further funding is contingent upon satisfactory completion of this report. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | X | FirstClassOrCharterTravel |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | 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 | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Georgia Fojtasek | ||||||||||||||
| President & CEO | 624464 | 0 | 0 | 0 | 77760 | 0 | 47841 | 0 | 27746 | 0 | 777811 | 0 | 23480 | 0 |
| John Mogerman | ||||||||||||||
| Chief of Staff as of 01/01/13 | 45448 | 0 | 310902 | 0 | 1598 | 0 | 24863 | 0 | 21106 | 0 | 403917 | 0 | 0 | 0 |
| Mohan Kulkarni | ||||||||||||||
| Trustee | 156452 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 156452 | 0 | 0 | 0 |
| Karen Chaprnka | ||||||||||||||
| SVP & COO | 353739 | 0 | 0 | 0 | 67557 | 0 | 41394 | 0 | 11306 | 0 | 473996 | 0 | 45630 | 0 |
| Jeanne Wickens | ||||||||||||||
| SVP & CFO | 375578 | 0 | 0 | 0 | 57991 | 0 | 40831 | 0 | 24308 | 0 | 498708 | 0 | 39620 | 0 |
| Richard Warren | ||||||||||||||
| VP & CIO | 231822 | 0 | 0 | 0 | 49702 | 0 | 47691 | 0 | 20078 | 0 | 349293 | 0 | 27415 | 0 |
| Jacalyn Liebowitz | ||||||||||||||
| VP Patient Care | 243291 | 0 | 0 | 0 | 47272 | 0 | 21418 | 0 | 25115 | 0 | 337096 | 0 | 28482 | 0 |
| Kenneth Empey | ||||||||||||||
| General Counsel | 227750 | 0 | 0 | 0 | 20559 | 0 | 35161 | 0 | 25220 | 0 | 308690 | 0 | 17355 | 0 |
| Cheryl Lamborn | ||||||||||||||
| VP Human Resources | 171301 | 0 | 0 | 0 | 72333 | 0 | 17637 | 0 | 15896 | 0 | 277167 | 0 | 0 | 0 |
| Anthony Gardner | ||||||||||||||
| VP Marketing | 171777 | 0 | 0 | 0 | 1320 | 0 | 22398 | 0 | 9588 | 0 | 205083 | 0 | 0 | 0 |
| Beth Smith | ||||||||||||||
| VP Organizational Excellence | 154842 | 0 | 0 | 0 | 3382 | 0 | 22191 | 0 | 10940 | 0 | 191355 | 0 | 441 | 0 |
| Gerald Grannan | ||||||||||||||
| VP Physician Integrationg & Planning | 180216 | 0 | 0 | 0 | 879 | 0 | 24991 | 0 | 3411 | 0 | 209497 | 0 | 0 | 0 |
| Ray King | ||||||||||||||
| Chief Medical Officer | 341064 | 0 | 0 | 0 | 19891 | 0 | 33699 | 0 | 23205 | 0 | 417859 | 0 | 0 | 0 |
| Ryan Beekman | ||||||||||||||
| Physician | 67286 | 0 | 916203 | 0 | 339181 | 0 | 36448 | 0 | 14847 | 0 | 1373965 | 0 | 284081 | 0 |
| Vishal Gupta | ||||||||||||||
| Physician | 28070 | 0 | 776044 | 0 | 28338 | 0 | 61948 | 0 | 21150 | 0 | 915550 | 0 | 0 | 0 |
| Tudor Tien | ||||||||||||||
| Physician | 8438 | 0 | 495039 | 0 | 266168 | 0 | 16680 | 0 | 21226 | 0 | 807551 | 0 | 235752 | 0 |
| Brian Daly | ||||||||||||||
| Physician | 69365 | 0 | 428512 | 0 | 220559 | 0 | 31318 | 0 | 20360 | 0 | 770114 | 0 | 177494 | 0 |
| Ivan Cubas | ||||||||||||||
| Physician | 4000 | 0 | 599966 | 0 | 38577 | 0 | 51811 | 0 | 21269 | 0 | 715623 | 0 | 0 | 0 |
| William Kiel | ||||||||||||||
| VP Development thru 04/10/12 | 51959 | 0 | 0 | 0 | 195280 | 0 | 8739 | 0 | 15487 | 0 | 271465 | 0 | 41438 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Georgia Fojtasek flew on a charter plane with a delegation of Michigan hospital delegates to a Regional Policy Board meeting. The hospital paid Georgia's proportionate charter flight cost. Allegiance Health provides a country club membership to three executives. The executives are Georgia Fojtasek, Ray King and Karen Chaprnka. Executives reimburse the hospital for any personal use of the club. |
| Part I, Line 3 | The CEO is accountable for ensuring that Allegiance Health's mission is efficiently carried out with the highest levels of quality, safety and service, while at the same time ensuring that the organization is financially healthy. Executive compensation is reviewed annually by the Executive Compensation Committee of the Board of Trustees. This committee works with an independent compensation consultant to ensure that Allegiance Health compensation practices are consistent with industry standards and that compensation levels are fair compared to similar healthcare organizations nationally. The compensation consultant benchmarks Allegiance positions against data from multiple published surveys of health care executive compensation in the national health care labor market. Based upon the consultants recommendations, the Executive Compensation Committee makes a recommendation to the Board of Trustees for approval of the executive compensation program. Only independent Trustees vote on this recommendation. |
| Part I, Lines 4a-b | The following former executives received severance payments in calendar year 2012. Cheryl Lamborn $53,681 William Kiel $143,706 Allegiance Health's officers and highest compensated employees participated in a non-qualified deferred compensation plan. The plan which began in 2005 partially vested for some executives in 2012. Payout of vested amounts resulted in an increase of salary for several executives. The calendar year 2012 contribution and payout amounts are as follows: 457(f) Contributions reported in Schedule J, Part II, column (C): Georgia Fojtasek $24,480, Karen Chaprnka $20,849, Jeanne Wickens $21,897, Ray King $19,644, Richard Warren $14,250, Jacalyn Liebowitz $7,363, Kenneth Empey $13,111, Anthony Gardner $9,669, Cheryl Lamborn $5,077, Gerald Grannan $9,120, Beth Smith $8,889, John Hyden $6,433, Ryan Beekman $34,560, Vishal Gupta $60,698, Tudor Tien $16,680, Brian Daly $29,491, Ivan Cubas $49,938 457(f) Payouts reported in Schedule J, Part II, column B(iii): Georgia Fojtasek $46,990, Karen Chaprnka $45,630, Jeanne Wickens $39,620, Richard Warren $27,415, Jacalyn Liebowitz $28,482, Kenneth Empey $17,355, William Kiel $41,438, Ryan Beekman $321,436, Tudor Tien $264,482, Brian Daly $183,899, |
| Part I, Line 7 | Column B(ii) of Part II, Schedule J includes non-fixed payments to certain physicians based on their productivity and other performance metrics. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| County of Jackson Hospital Finance Authority | ||||||||
| A | 386004845 | 467148EH1 | 2011-04-21 | 65375000 | See Part VI - Supplemental Information | 0 | 0 | 0 |
| County of Jackson Hospital Finance Authority | ||||||||
| B | 386004845 | 467148DC3 | 2010-11-02 | 140238036 | See Part VI - Supplemental Information | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount RetiredAmountRetired | Amount In Reserve FundAmountInReserveFund | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 65375000 | 540128 | 18425 | 64816447 | 2011 | 1 | 0 | 1 | 1 | |||
| B | 144677411 | 840059 | 495263 | 136965114 | 2010 | 1 | 0 | 1 | 1 | 72416447 | 4868559 | 1508416 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Engage Bond Counsel ContractsEngageBondCounselContracts | Any Research AgreementsAnyResearchAgreements | Engage Bond Counsel ResearchEngageBondCounselResearch | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 1 | 1 | 1 | 1 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 1 |
| B | 0 | 0 | 1 | 1 | 1 | 1 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Business Name Line2NameOfHedgeProvider/BusinessNameLine2 | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Royal Bank of | ||||||||||||
| A | 0 | 1 | 0 | 0 | 1 | 1 | Canada | 25.000000000000 | 0 | 0 | 0 | 1 |
| (no name) | ||||||||||||
| B | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | ||||
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 0 |
| B | 0 |
Form990 Schedule K Part VI Form990ScheduleKPartVI (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part I, Line A, Column (f) | Description of Bond Purpose | Primarily to add marketability to underlying variable rates and refund Bonds. The Bonds refunded are as follows: $36,500,000 County of Jackson Hospital Finance Authority Variable Rate Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2011A were issued to refund the Series 2006A bonds. $28,875,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2011B were issued to refund the Series 2006B bonds. |
| Part I, Line B, column (f) | Description of Bond Purpose | Primarily to obtain traditional fixed interest on bond debt at a time of low prevailing rates and to reissue and refund bonds. The bonds reissued and refunded are as follows: $29,925,000 County of Jackson Hospital Finance Authority Hospital Variable Rate Demand Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan), Series 2006B-1, reissued for tax purposes on 11/02/2010 $8,940,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan) Series 2006B-2, reissued for tax purposes on 11/02/2010 $47,400,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (W.A. Foote Memorial Hospital, Jackson, Michigan) Series 2006C, reissued for tax purposes on 11/02/2010 $51,655,000 County of Jackson Hospital Finance Authority Hospital Revenue Refunding Bonds (Allegiance Health, Jackson, Michigan), Series 2010A were issued to refund the Series 2007A and Series 1997A bonds. |
| Part II, Line 3, Column B | The difference of $4,439,375 between Part I, column (e) and Part II, Line 3 is due to net investment losses and investment income. | |
| Part IV, Line 6 | No gross proceeds were invested beyond an available temporary period. The box is shown blank due to a software glitch that only allows the answer to be checked yes. | |
| Part V | Procedures to Undertake Corrective Action. | The organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program. These written procedures were established in fiscal year 2014. |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Patrick Nally | NamePerson |
| Relationship With Organization | Son of John Nally, Secretary/Treasurer of Allegiance Health | RelationshipWithOrganization |
| Purpose Of Loan | Employee Recruitment Loan | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $115,000 | OriginalPrincipalAmount |
| Balance Due | 115000 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 115000 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Amy Schultz | |||
| Daughter of Larry Schultz, Chairman of Allegiance Health | 184112 | Employee Wages | 0 |
| Patrick Nally | |||
| Son of John Nally, Secretary/Treasurer of Allegiance Health | 10922 | Employee Wages | 0 |
| Sona Ambani | |||
| Daughter of Nitin Ambani, Allegiance Health Chief of Staff/Director | 26406 | Employee Wages | 0 |
| Jackson Physicians Alliance | |||
| JCMR Partnership | 1809462 | Reported amount is for payments by Jackson Community Medical Record (JCMR) to Allegiance Health for rent, leased employees, accounting services, information support and other miscellaneous services provided by the hospital. Lynn VanWagnen, Director of Allegiance Health, is an officer of Jackson Physicians Alliance (JPA). (JPA) holds a 49% ownership stake in JCMR. Allegiance Health holds a 51% JCMR ownership stake. | 0 |
| VanWagnen Real Estate LLC | |||
| Leasing Services Provider | 11168 | Reported amount is for lease payments Allegiance Health makes to VanWagnen Real Estate LLC for medical diagnostic space. VanWagnen Real Estate LLC is owned by Trustee Lynn VanWagnen. | 0 |
| Clark & King Investments LLC | |||
| Leasing Services Provider | 404323 | Reported amount is for lease payments made by Allegiance Health to Clark & King Investments LLC for a medical office building. Ray King an Allegiance Health officer is a partner in Clark & King Investments LLC. | 0 |
| Jackson Physicians Alliance | |||
| JCMR Partnership | 1230252 | Reported amount is for payments by Allegiance Health to Jackson Community Medical Record(JCMR) to lease an electronic medical records license. Lynn VanWagnen, Director of Allegiance Health, is an officer of Jackson Physicians Alliance (JPA). (JPA) holds a 49% stake in JCMR. Allegiance Health holds a 51% ownership stake. | 0 |
| Great Lakes Brain & Spine Institute | |||
| Medical Services Provider | 315432 | Reported amount is for services provided to Allegiance Health patients by Great Lakes Brain & Spine Institute. Harish Rawal an Allegiance Health Trustee is an owner of Great Lakes Brain & Spine Institute. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | The Corporation is organized on a membership basis. The sole corporate member of the Corporation is Allegiance Health Services. | |
| Form 990, Part VI, Section A, line 7a | The sole Member of the organization may elect and remove, with or without cause, the Corporation's Trustees. | |
| Form 990, Part VI, Section A, line 7b | The following powers are reserved for the sole corporate Member of the hospital. Approve any change in the Articles of Incorporation, purposes or philosophy of the Corporation; Approve changes in those provisions of the Corporation's Bylaws which affect the size, composition, and method of selection of the Board of Trustees, or which affect this Article; Approve plans of merger, consolidation or dissolution of the Corporation; Elect and remove, with or without cause, the Corporation's Trustees, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present; Approve guarantees by the Corporation of the debt of others in excess of maximum limits established by the Member, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present; Authorize the sale, lease, mortgage or other disposition of all or substantially all of the assets owned, held or leased by or to the Corporation, approve any decision by the Corporation which would have the net effect of diminution of governance control of the Member, and any decision by the Corporation which would have the net effect of diminution in the Corporations governance control over its own subsidiary; and Ratify or reject operating and capital budgets developed by the Board and any non-budgetary expenditures or creations of debt in excess of an amount designated by the Member from time to time, upon a simple majority vote of the Directors then serving on the Board of the Member present at a meeting at which a quorum is present. Authorize the formation or acquisition of new subsidiaries of the Corporation or the sale or other disposition of existing subsidiaries. | |
| Form 990, Part VI, Section B, line 11 | Form 990 is reviewed by the organization's Director and VP of Finance, Chief Executive Officer, Chief Financial Officer, General Counsel, Compliance Officer and its public accounting firm. Final copies of the return are distributed to the hospital's Board of Trustees before the return is e-filed. | |
| Form 990, Part VI, Section B, line 12c | The Board Compliance Committee has ultimate responsibility over the enforcement of the Hospital's Conflict of Interest Policy. When a potential conflict of interest is identified, the Compliance Committee is responsible for review of the conflict of interest for compliance with the policy. Also, General Counsel routinely reviews upcoming Board and Committee meeting agendas to assess potential conflict situations. All employees are responsible to complete a conflict of interest statment. Trustees, directors, and key employees are required to fill out an annual conflict of interest questionnaire. Board Trustees identified as having a conflict of interest are permitted to discuss the potential transaction. They are not allowed to deliberate in the decision or vote on the matter. | |
| Form 990, Part VI, Section B, line 15 | The organization performs an annual review and assessment of the compensation of the Chief Executive Officer and each of the executives listed in Part VII of the Form 990. This review includes an independent compensation committee and the engagement of an independent compensation consultant. This process is usually undertaken during the Fall. The Compensation Committee, an independent committee of the Board of Trustees, is responsible for the executive compensation program. This committee performs an annual review of the competitiveness, reasonablenes and effectiveness of all executive cash compensation and benefit programs. The committee also leads the Board in evaluating the performance of the Chief Executive Officer and recommends all aspects of the Chief Executive Officer's compensation. The committee reviews the Chief Executive Officer's recommendations regarding the compensation of all other members of executive leadership. The Compensation Committee engages an independent compensation consulting firm to conduct a comprehensive market analysis of total compensation for executive leadership. This firm uses data representing compensation levels and practices from national not-for-profit healthcare markets as Allegiance typically competes in the the national healthcare marketplace for executive talent. National data also provides more comparable information for size and operational characteristics so that comparisons are made to organizations with similiar scope and complexity. | |
| Form 990, Part VI, Section C, line 19 | Forms 1023, 990 and 990-T are available upon request. Form 990 and the organization's conflict of interest policy are posted on the organization's website. | |
| Form 990, Part VII, Section A, Line 1a | Allegiance Health Trustees are not paid to serve on the Board. Compensation listed for Dr. David Halsey, Dr. Nitin Ambani, Dr. Allan Tompkins, Dr. Mohan Kulkarni, and Dr. John Mogerman in Part VII of the Form 990 is pay for on call medical service, medical director fees, employment compensation, and/or committee participation. | |
| Form 990, Part IX, line 11g | Professional Other: Program service expenses 37,241,001. Management and general expenses 9,125,102. Fundraising expenses 0. Total expenses 46,366,103. | Other Fees |
| Form 990, Part XI, line 9: | Transfer to Parent -532,717. Change in Accounting for Pensions SFAS 158 9,662,793. Change in fair value of interest rate swap 11,182,743. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | EINEIN |
|---|---|---|---|---|---|---|---|---|---|
| Physicians Choice Network LLC | |||||||||
| 205 N East Avenue | Jackson | MI | 49201 | Provider Network | MI | 7827 | 0 | WA Foote Memorial Hospital | |
| Jackson Health Network L3C | |||||||||
| 205 N East Avenue | Jackson | MI | 49201 | Clinically Integrated Network | MI | -1248905 | 538067 | WA Foote Memorial Hospital | 453253643 |
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Allegiance Health Services | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382756428 | Exempt Health System | MI | 501(c)(3) | Line 11b, II | N/A | 0 | |
| Allegiance Health Foundation | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 383607833 | Supports Allegiance Health | MI | 501(c)(3) | Line 11b, II | 1 | Allegiance Health Services | |
| Hospice of Jackson dba Allegiance Hospice | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382336367 | Hospice Care | MI | 501(c)(3) | Line 7 | 1 | Heathlink | |
| The Hospice of Jackson Endowment Fund | |||||||||||
| One Jackson Square | Jackson | MI | 49201 | 383422146 | Raise Funds for Allegiance Hospice | MI | 501(c)(3) | Line 11c, III-FI | 1 | Allegiance Hospice | |
| Healthlink | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382756425 | Home Health Care | MI | 501(c)(3) | Line 11a, I | 1 | Allegiance Health Services | |
| Michigan Imaging Services | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382895225 | Medical Imaging | MI | 501(c)(3) | Line 11a, I | 1 | Allegiance Health Services | |
| South Central Practice Association | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 383309805 | Idle Organization | MI | 501(c)(3) | Line 11a, I | 1 | Allegiance Health Services | |
| Allegiance Health Volunteers | |||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 386082835 | Exempt Association | MI | 501(c)(3) | Line 11d, III-O | 1 | Allegiance Health Services | |
| CareLink of Jackson | |||||||||||
| 110 North Elm Avenue | Jackson | MI | 49202 | 381218485 | Long Term Acute Care Hospital | MI | 501(c)(3) | Line 3 | 1 | Allegiance Health Services | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jackson Community Medical Records | |||||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 371502443 | Electronic Medical Records | MI | WA Foote Memorial Hospital | Related | -45301 | 1650036 | 0 | 0 | 0.51000 |
| Foote Health Center Associates | |||||||||||||
| 1100 E Michigan Avenue | Jackson | MI | 49201 | 383017711 | Lessor of Medical Condominiums | MI | WA Foote Memorial Hospital | Related | 105048 | 1062004 | 0 | 0 | 0.54430 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Viking Health System Inc | |||||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 382756161 | Idle Healthcare Administration Corporation | MI | WA Foote Memorial Hospital | C | 1.00000 | 1 | |||
| Cascades Insurance Company LTD | |||||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 981132982 | Hospital Malpractice Insurance Captive | WA Foote Memorial Hospital | C | 1.00000 | 1 | CJ | 2083792 | 16647999 | |
| Cascades Professional Staffing Corporation | |||||||||||||
| 205 N East Avenue | Jackson | MI | 49201 | 383370242 | Idle Staffing Corporation | MI | WA Foote Memorial Hospital | C | 1.00000 | 1 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (20 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Foote Health Center Associates | ||
| D | 1735000 | FMV |
| Foote Health Center Associates | ||
| A | 102000 | FMV |
| Allegiance Health Services | ||
| R | 532717 | FMV |
| Hospice of Jackson dba Allegiance Hospice | ||
| J | 310536 | COST |
| Hospice of Jackson dba Allegiance Hospice | ||
| L | 880662 | COST |
| Hospice of Jackson dba Allegiance Hospice | ||
| O | 578716 | FMV |
| Cascades Insurance Company LTD | ||
| P | 3117476 | FMV |
| Cascades Insurance Company LTD | ||
| L | 2410315 | FMV |
| Jackson Community Medical Records | ||
| A | 8822 | FMV |
| Jackson Community Medical Records | ||
| A | 57558 | FMV |
| Jackson Community Medical Records | ||
| L | 1751904 | FMV |
| Jackson Community Medical Records | ||
| M | 1230252 | FMV |
| Jackson Community Medical Records | ||
| D | 2412889 | FMV |
| Allegiance Health Foundation | ||
| C | 368538 | FMV |
| Healthlink | ||
| K | 630216 | COST |
| Healthlink | ||
| D | 531000 | FMV |
| CareLink of Jackson | ||
| L | 4966035 | COST |
| CareLink of Jackson | ||
| M | 804727 | FMV |
| CareLink of Jackson | ||
| K | 143863 | COST |
| CareLink of Jackson | ||
| D | 328486 | FMV |