2014-05-14T14:14:36-05:00 2013-06-30 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2012-07-01 382124042 BELL MEDICAL CENTER BELL 9064864431 901 LAKESHORE DRIVE ISHPEMING MI 49849 TERESA MORRISON 9064852605 2014-05-14 1 TERRI REXRODE CPA MST P00096513 9206620016 2014-05-14 2012 2015-11-30 17:44:51Z TERESA MORRISON 901 LAKESHORE DRIVE ISHPEMING MI 49849 11885345 0 X WWW.BELLMEMORIAL.ORG X 1977 MI TO IMPROVE THE LIVES OF EVERYONE WE TOUCH. 11 4 143 7 0 0 2568191 2980757 9388443 8866597 22243 18791 14548 -2259 11993425 11863886 0 0 0 0 9365634 8215756 0 0 0 3429948 3534987 12795582 11750743 -802157 113143 1644386 1719299 722728 684498 921658 1034801 TO IMPROVE THE LIVES OF EVERYONE WE TOUCH. 0 0 9899148 8866597 BELL MEDICAL IS A NOT-FOR-PROFIT PHYSICIAN PRACTICE CORPORATION PRIMARILY DEDICATED TO PROVIDING MEDICAL SERVICES TO THE COMMUNITIES OFMARQUETTE COUNTY. OVER THE PAST SEVERAL YEARS, BELL MEDICAL HAS EVOLVED INTO A MEDICAL GROUP OF PHYSICIANS, PHYSICIAN ASSISTANTS, AND NURSEPRACTITIONERS. PROVIDING FAMILY MEDICINE, OBSTETRICS AND GYNECOLOGY, INTERNAL MEDICINE, GERIATRIC MEDICINE, OCCUPATIONAL MEDICINE. EXPENSES INCURRED BY THIS ORGANIZATION RELATE TO DELIVERING HEALTHCARESERVICES TO THE RESIDENTS OF ISHPEMING, MI AND THE SURROUNDING AREA AND RENTAL OF OFFICE SPACE TO PHYSICIANS PROVIDING HEALTHCARE. 9899148 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 26 0 143 1 0 0 0 0 0 0 0 0 0 0 X 11 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X TERESA MORRISON CFO 9064852605 901 LAKESHORE DRIVE ISHPEMING MI 49849 SHAHAR MADJAR MD 40.00 X 396054 0 28832 HOLLY RAY DO 40.00 X X 252542 0 28939 MICHAEL GROSSMAN MD 40.00 X X 295539 0 28775 MICHAEL PREVOST MD 40.00 X X 243170 0 27637 RICHARD GRAYBILL 2.00 X X 0 0 0 CB RAO MD 2.00 X 0 0 0 NICK JOSEPH 2.00 X 0 0 0 GERALD MESSANA 5.00 2.00 X X 0 118196 21983 JUDD JOHNSTON MD 2.00 0.00 X 0 297276 31844 ROBERT DELLANGELO MD 2.00 X 0 0 0 FLOYD BOUNDS 5.00 4.00 X X 0 64068 1264 JOEL JOHNSON MD 40.00 X 650832 0 27872 RONALD SNYDER MD 20.00 X 307947 0 26807 WENDY FRYE MD 40.00 X 454628 0 22424 KELLY MENGE 40.00 X 339631 0 23975 WAYNE CARLSON MD 40.00 X 266739 0 28147 RICK AMENT 0.00 0.00 X 0 249891 0 3207082 729431 298499 20 1 1 0 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 LOCUM PHYSICIANS 385747 BE SMITH INTERM SERVICES INC DEPARTMENT 300 PO BOX 219241 KANSAS CITY MO 64121 INTERIM VP OF PROVIDER SERVICES 132082 PHILIP PORTER 10356 SPOOK WOOD ROAD PORT BYRON NY 13140 INTERIM VP OF PROVIDER SERVICES 128028 3 2980757 2980757 PATIENT SERVICE REVENUE 621110 7681318 7681318 OTHER 900099 610206 610206 TRAINING AND TESTING 900099 298511 298511 OCCUPATIONAL MED 900099 250809 250809 UROLOGY 900099 25753 25753 8866597 19200 21459 -2259 -2259 -2259 18791 0 18791 18791 18791 11863886 8866597 0 16532 X 1290404 1290404 5960917 5060280 900637 581813 491484 90329 382622 334414 48208 1477744 903917 573827 753695 646224 107471 154185 150613 3572 17126 12796 4330 202558 202558 208865 208591 274 89827 89827 PROVISION FOR BAD DEBTS 463004 463004 DUES AND SUBSCRIPTIONS 122070 27306 94764 45913 17730 28183 11750743 9899148 1851595 0 213579 532599 854980 611072 297366 373927 46221 30752 2120731 1974782 226033 145949 6207 25000 1644386 1719299 722728 684498 722728 684498 X 921658 1034801 921658 1034801 1644386 1719299 113143 0 X X 0 1 X 1 0 X X X 0 0 0 BELL MEMORIAL HOSPITAL 381394903 501(C)(3) 1 1 1 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 52500 52500 945195 933769 11426 1123036 1041013 82023 145949 X 11422341 -463004 -463004 11885345 -21459 -21459 11863886 11309198 21459 21459 11287739 463004 463004 11750743 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS IN 2013 AND 2012. FEDERAL INCOME TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2010, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -463,004. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -21,459. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 21,459. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 463,004. 1 X X X X 1 0 0 0 0 0 0 0 0 SHAHAR MADJAR MD 299676 0 94356 0 2022 0 12638 0 16194 0 424886 0 0 0 HOLLY RAY DO 216551 0 34337 0 1654 0 12402 0 16537 0 281481 0 0 0 MICHAEL GROSSMAN MD 270113 0 21519 0 3907 0 12581 0 16194 0 324314 0 0 0 MICHAEL PREVOST MD 218551 0 22750 0 1869 0 11443 0 16194 0 270807 0 0 0 JUDD JOHNSTON MD 0 285880 0 6529 0 4867 0 15650 0 16194 0 329120 0 0 JOEL JOHNSON MD 459857 0 188521 0 2454 0 14917 0 12955 0 678704 0 0 0 RONALD SNYDER MD 276608 0 30269 0 1070 0 10613 0 16194 0 334754 0 0 0 WENDY FRYE MD 452915 0 0 0 1713 0 11279 0 11145 0 477052 0 0 0 KELLY MENGE 338087 0 0 0 1544 0 7781 0 16194 0 363606 0 0 0 WAYNE CARLSON MD 245957 0 17500 0 3282 0 11953 0 16194 0 294886 0 0 0 RICK AMENT 0 249891 0 0 0 0 0 0 0 0 0 249891 0 0 SUPPLEMENTAL INFORMATION PART III RICK AMENT, FORMER CEO, RECEIVED $249,891 FROM HIS SEVERANCE PACKAGE. FORM 990, PART VI, SECTION A, LINE 6 SUPERIOR HEALTHCARE SYSTEMS HAS CONTROL OVER THE JOINT OPERATING COUNCIL OF THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A SUPERIOR HEALTHCARE SYSTEMS HAS THE RIGHT TO ELECT BOARD MEMBERS OF BELL MEDICAL CENTER JOINT OPERATING COUNCIL AND CAN BE SAID TO HAVE CONTROL OF THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B SUPERIOR HEALTHCARE SYSTEMS HAS THE AUTHORITY TO APPROVE DECISIONS MADE BY THE JOINT OPERATING COUNCIL. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WAS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO BEING SUBMITTED TO THE IRS. QUESTIONS AND COMMENTS WERE SOLICITED FROM THE BOARD OF DIRECTORS TO ENSURE THE COMPLETENESS AND ACCURACY OF THE FORM. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS REVIEW AND SIGN THE CONFLICT OF INTEREST DISCLOSURES ANNUALLY. THESE STATEMENTS ARE REVIEWED BY THE ORGANIZATION'S LEGAL COUNCIL TO ENSURE COMPLIANCE WITH THE POLICY. IF A MEMBER IS FOUND TO HAVE A CONFLICT, THEY ARE REQUIRED TO REMOVE THEMSELVES FROM ANY DISCUSSIONS OF THE MATTER. IF THE CONFLICT COULD NOT BE DEALT WITH THE COUNCIL WOULD HAVE TO CONSIDER WHETHER THE MEMBER SHOULD STAY A MEMBER OF THE COUNCIL TO DATE, THE ORGANIZATION HAS NOT HAD ANY COUNCIL MEMBERS WITH CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES COMPENSATION SURVEYS AND MEDICAL GROUP MANAGEMENT ASSOCIATION DATA TO ENSURE COMPENSATION DATA IS COMPARABLE. DETERMINATION OF THE PHYSICIANS' COMPENSATION PACKAGES WERE LAST CONDUCTED IN 2010 USING THE AFOREMENTIONED DATA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 903,917. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 903,917. PURCHASED CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 573,827. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 573,827. FORM 990, PART XII, LINE 2C: THE PROCESS FOR THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM THE PRIOR YEAR. SUPERIOR HEALTHCARE SYSTEMS 901 LAKESHORE DR ISHPEMING MI 49849 383040126 HEALTHCARE SERVICES MI 501(C)(3) LINE 11B, II N/A 0 BELL MEMORIAL HOSPITAL 901 LAKESHORE DR ISHPEMING MI 49849 381394903 HEALTHCARE SERVICES MI 501(C)(3) LINE 3 SUPERIOR HEALTHCARE SYSTEMS 1 BELL FOUNDATION 97 S FOURTH ST ISHPEMING MI 49849 383040125 FUNDRAISING MI 501(C)(3) LINE 11B, II SUPERIOR HEALTHCARE SYSTEMS 1 SUPERIOR ENTERPRISES INC 97 S FOURTH ST ISHPEMING MI 49849 383112668 REHABILITATION SERVICES MI N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 BELL MEMORIAL HOSPITAL S 2980757 FMV