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MACKINAC STRAITS HEALTH SYSTEM INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MACKINAC STRAITS HEALTH SYSTEM INC (EIN 20-8756459)
Tax period
2012-04-01 to 2013-03-31
Filed
2014-02-15
IRS object ID
201440489349301559
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-02-15T16:21:02-06:00Timestamp
Tax Period End Date2013-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390758449EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 12237AddressLine1
CityGREEN BAYCity
StateWIState
ZIP Code543072237ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN208756459EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MACKINAC STRAITS HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMACKNameControl
Phone9066438585Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11140 N STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJASON ANDERSONName
TitleCFOTitle
Phone9066438585Phone
Date Signed2014-02-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTERRI REXRODE CPA MSTName
PTINP00096513PTIN
Phone9206620016Phone
Date Prepared2014-02-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJASON ANDERSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11140 N STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode
FieldValueIRS element (for citing)
Gross Receipts31535896GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteMACKINACSTRAITSHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2008YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionWE WILL BE THE HOSPITAL OF CHOICE AND RECOGNIZED FOR OUR EXEMPLARY PATIENT CARE, PEOPLE AND PERFORMANCE. WE HAVE A PASSION FOR EXCELLENCE AND STRIVE TO SET AND DELIVER THE HIGHEST STANDARDS OF SERVICE, INTEGRITY AND MOST OF ALL QUALITY. WE VALUE THE DIVERSITY AND CULTURES IN OUR COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees190TotalNbrEmployees
Total Nbr Volunteers7TotalNbrVolunteers
Total Gross UBI-479867TotalGrossUBI
Net Unrelated Business Txbl Income-479868NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year650867ContributionsGrantsPriorYear
Contributions Grants Current Year498465ContributionsGrantsCurrentYear
Program Service Revenue Prior Year28369336ProgramServiceRevenuePriorYear
Program Service Revenue CY30620978ProgramServiceRevenueCY
Investment Income Prior Year45944InvestmentIncomePriorYear
Investment Income Current Year45059InvestmentIncomeCurrentYear
Other Revenue Prior Year371110OtherRevenuePriorYear
Other Revenue Current Year-356380OtherRevenueCurrentYear
Total Revenue Prior Year29437257TotalRevenuePriorYear
Total Revenue Current Year30808122TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year14582996SalariesEtcPriorYear
Salaries Etc Current Year15167097SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY12504TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year12504TotalFundrsngExpCurrentYear
Other Expense Prior Year16394386OtherExpensePriorYear
Other Expenses Current Year16728832OtherExpensesCurrentYear
Total Expenses Prior Year30981382TotalExpensesPriorYear
Total Expenses Current Year31908433TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1544125RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1100311RevenuesLessExpensesCY
Total Assets BOY48421691TotalAssetsBOY
Total Assets EOY48107655TotalAssetsEOY
Total Liabilities BOY54875938TotalLiabilitiesBOY
Total Liabilities EOY56783968TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-6454247NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-8676313NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDING LOCAL ACCESS AND QUALITY HEALTHCARE TO THE FAMILIES AND COMMUNITIES WE SERVE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense29681340Expense
Revenue30444054Revenue
DescriptionMACKINAC STRAITS HEALTH SYSTEM, INC. OPERATES A 15-BED ACUTE CARE FACILITY, A 48-BED LONG-TERM CARE UNIT, AND SEVERAL PHYSICIAN CLINICS IN MACKINAC COUNTY, MICHIGAN. THE PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, AND PHYSICIAN SERVICES TO THE RESIDENTS OF MACKINAC COUNTY AND THE SURROUNDING AREAS.Description
Total Program Service Expense29681340TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109622NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees190NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JASON ANDERSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9066438585TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11140 N STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerAverage Hours Per Week RelatedAverageHoursPerWeekRelatedHighest Compensated EmployeeHighestCompensatedEmployee
JAMES NORTH
BOARD MEMBER1.00X000
PRENTISS BROWN
BOARD MEMBER1.00X000
CHRISTINE MCPHERSON
BOARD MEMBER1.00X000
DR SUSAN HEPKER
BOARD MEMBER/CHIEF OF STAFF40.00X412979020733
PATRICK SHANNON
BOARD CHAIRMAN1.00X000X
RICHARD SMITH
BOARD VICE CHAIR1.00X000X
STEVE AUTORE
BOARD TREASURER1.00X000X
MARGARET DOUD
BOARD SECRETARY1.00X000X
RODNEY NELSON
CEO40.00150278020899X2.00
JASON ANDERSON
CFO40.0081814020803X2.00
DR CARL HAWKINS
PHYSICIAN40.00146839021733X
DR EDWARD SMITH
PHYSICIAN40.00389816022733X
DR MATTHEW BOWES
PHYSICIAN40.00367639020733X
DR JENNIFER SHOCKLEY
PHYSICIAN40.0019500000X
DR DARRIN BENZING
ER PHYSICIAN48.00140350015571X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1884715TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation143205TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
RALPH OLECHOWSKI
1140 N STATE STST IGNACEMI49781PHYSICIAN SERVICES223610
DONZA WORDEN
1140 N STATE STST IGNACEMI49781PHYSICIAN SERVICES132000
CLAUDIO DUARTE
1140 N STATE STST IGNACEMI49781PHYSICIAN SERVICES108000
RUTH HOLTHUIS
1140 N STATE STST IGNACEMI49781PHYSICIAN SERVICES103982
RICHARD HODGEMAN
1140 N STATE STST IGNACEMI49781PHYSICIAN SERVICES100880
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Fundraising Events16874FundraisingEvents
Government Grants6785GovernmentGrants
All Other Contributions474806AllOtherContributions
Total Contributions498465TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
PATIENT REVENUE9000992874366828743668
TAX LEVY90009910742901074290
QAAP REVENUE900099478771478771
CHAP REVENUE900099147325147325
CAFETERIA/VENDING REVENUE900099105799$105,799

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column71125TotalRevenueColumn
Exclusion$71,125ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue30620978TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column44559TotalRevenueColumn
Exclusion$44,559ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real363487Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real719867Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-356380Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-356380TotalRevenueColumn
Unrelated Business Revenue-479867UnrelatedBusinessRevenue
Exclusion$123,487ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other500Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column500TotalRevenueColumn
Exclusion$500ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events7907GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events16874CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses7907FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column30808122TotalRevenueColumn
Related Or Exempt Function Income30444054RelatedOrExemptFunctionIncome
Unrelated Business Revenue-479867UnrelatedBusinessRevenue
Exclusion$345,470ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1871431Total
Program Services1597637ProgramServices
Management And General273794ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8886999Total
Program Services8331200ProgramServices
Management And General555799ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1097446Total
Program Services1012821ProgramServices
Management And General84625ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2539194Total
Program Services2343394ProgramServices
Management And General195800ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total772027Total
Program Services712495ProgramServices
Management And General59532ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total141978Total
Program Services141978ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total86736Total
Program Services86736ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total12504Total
Fundraising12504Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3212690Total
Program Services2983847ProgramServices
Management And General228843ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total144817Total
Program Services144817ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3968304Total
Program Services3955950ProgramServices
Management And General12354ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2671333Total
Program Services2647325ProgramServices
Management And General24008ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total109156Total
Program Services80493ProgramServices
Management And General28663ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total61753Total
Program Services44596ProgramServices
Management And General17157ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2214654Total
Program Services2214654ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1747468Total
Program Services1747468ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total155039Total
Program Services155039ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE12153551215355
QAAP TAXES PAID715327715327
MINOR EQUIPMENT110011110011
DUES AND SUBSCRIPTIONS5030249452850

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total123909Total
Program Services106072ProgramServices
Management And General17837ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total31908433Total
Program Services29681340ProgramServices
Management And General2214589ManagementAndGeneral
Fundraising12504Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY213456EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY572944BOY
EOY317913EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY359913BOY
EOY199909EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4660190BOY
EOY4113300EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY59892BOY
EOY44523EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY160329BOY
EOY159510EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY316727BOY
EOY448334EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY162999BOY
EOY52016EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis48621891LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10218971LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY37915579BOY
EOY38402920EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4213118BOY
EOY4155774EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY48421691BOY
EOY48107655EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5704697BOY
EOY5007211EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY520000BOY
EOY280000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY41947307BOY
EOY43203217EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6703934BOY
EOY8293540EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY54875938BOY
EOY56783968EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-6481662BOY
EOY-8704258EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY27415BOY
EOY27945EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-6454247BOY
EOY-8676313EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY48421691BOY
EOY48107655EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1100311ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-20677ReconciliationUnrealizedInvest
Reconcilation Other Changes-1101078ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$285DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$716OtherActivitiesAmount
Total Lobbying Expenditures IIB1001TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationTHE ORGANIZATION BELONGS TO THE AHA AND PAYS DUES. THE ORGANIZATION PAYS A TOTAL OF $3,048 IN DUES TO THE AHA. OF THAT AMOUNT, $716 OF THE DUES ARE SPENT ON LOBBYING ACTIVITIES. THE ORGANIZATION SPENT $285 IN EXPENSES AT THE GREATER DETROIT CHAMBER MEETING THAT WAS HELD ON MACKINAC ISLAND.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1213406OtherCostOrOtherBasis
Book Value1213406BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis39029531OtherCostOrOtherBasis
Depreciation8444331Depreciation
Book Value30585200BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2562161OtherCostOrOtherBasis
Depreciation443637Depreciation
Book Value2118524BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3501618OtherCostOrOtherBasis
Depreciation1331003Depreciation
Book Value2170615BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2315175OtherCostOrOtherBasis
Book Value2315175BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings38402920TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
UNAMORTIZED DEBT ISSUE COSTS2053194
OTHER ASSETS85391
DEBT SERVICE RESERVE1615168
CAPITALIZED INTEREST177021
EMR RECEIVABLE225000
FieldValueIRS element (for citing)
Total Book Value Other Assets4155774TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
AMOUNTS PAYABLE TO THIRD PARTIES$150,784
PENSION LIABILITY$7,330,581
PATIENT TRUST SAVINGS$12,249
LINE OF CREDIT$495,000
CAPITAL LEASE OBLIGATION$304,926
FieldValueIRS element (for citing)
Total Of Amounts8293540TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt30825939TotRevenueEtcAuditedFinclStmt
Other Revenues-709957OtherRevenues
Revenue Not Rptd F990-709957RevenueNotRptdF990
Revenue Subtotal31535896RevenueSubtotal
Other Revenues Not Included-727774OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-727774RevenueNotRptdOnFinStmt
Total Revenue Per Form99030808122TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt31926250TotExpensesEtcAuditedFinclStmt
Other Expenses Included727774OtherExpensesIncluded
Expenses Not Rptd F990727774ExpensesNotRptdF990
Expenses Subtotal31198476ExpensesSubtotal
Other Expenses Not Included709957OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt709957ExpensesNotRptdOnFinStmt
Total Expenses Per Form99031908433TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS 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. MANAGEMENT DOES NOT BELIEVE THE ORGANIZATION HAS ANY MATERIAL UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:QAAP PAYMENTS -715,327. PROVISION FOR BAD PLEDGES 5,370.
PART XI, LINE 4B - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES -7,907. RENTAL EXPENSES -719,867.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES 7,907. RENTAL EXPENSES 719,867.
PART XII, LINE 4B - OTHER ADJUSTMENTS:QAAP PAYMENTS 715,327. PROVISION FOR BAD PLEDGES -5,370.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1HOOPING FOR A CURENameOfEvent1
Gross Receipts Event124781GrossReceiptsEvent1
Charitable Contributions Event116874CharitableContributionsEvent1
Gross Revenue Event17907GrossRevenueEvent1
Other Direct Expenses Event17907OtherDirectExpensesEvent1
Gross Receipts Total24781GrossReceiptsTotal
Charitable Contributions Total16874CharitableContributionsTotal
Gross Revenue Total Events7907GrossRevenueTotalEvents
Other Direct Expenses Total Events7907OtherDirectExpensesTotalEvents
Direct Expense Summary Events7907DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage150.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense902291TotalCommunityBenefitExpense
Direct Offsetting Revenue771916DirectOffsettingRevenue
Net Community Benefit Expense130375NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5606591TotalCommunityBenefitExpense
Direct Offsetting Revenue5210398DirectOffsettingRevenue
Net Community Benefit Expense396193NetCommunityBenefitExpense
Percent Of Total Expense0.01290PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6508882TotalCommunityBenefitExpense
Direct Offsetting Revenue5982314DirectOffsettingRevenue
Net Community Benefit Expense526568NetCommunityBenefitExpense
Percent Of Total Expense0.01710PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served2270PersonsServed
Total Community Benefit Expense11953TotalCommunityBenefitExpense
Net Community Benefit Expense11953NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served93PersonsServed
Total Community Benefit Expense137507TotalCommunityBenefitExpense
Net Community Benefit Expense137507NetCommunityBenefitExpense
Percent Of Total Expense0.00450PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served2363PersonsServed
Total Community Benefit Expense149460TotalCommunityBenefitExpense
Net Community Benefit Expense149460NetCommunityBenefitExpense
Percent Of Total Expense0.00490PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served2363PersonsServed
Total Community Benefit Expense6658342TotalCommunityBenefitExpense
Direct Offsetting Revenue5982314DirectOffsettingRevenue
Net Community Benefit Expense676028NetCommunityBenefitExpense
Percent Of Total Expense0.02200PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,215,355BadDebtExpenseAmount
Amount Attributable To975730AmountAttributableTo
Amount Reimbursed By Medicare8892210AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare8854109CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall38101MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24HoursOtherOther
MACKINAC STRAITS HEALTH SYSTEM INC
11140 N STATE STREETST IGNACEMI49781XXRHC
MACKINAC ISLAND MEDICAL CLINIC
27474 MARKET STREETMACKINAC ISLANDMI49757X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MACKINAC STRAITS HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
Other Needs AddressedXOtherNeedsAddressed
All Needs Addressed1AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent150.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Notified All PatientsXNotifiedAllPatients
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
PICKFORD MEDICAL CENTER
7742 N M-129PICKFORDMI49774PHYSICIAN OFFICE
NAUBINWAY FAMILY HEALTH CLINIC
11650 W HWY US-2NAUBINWAYMI49762PHYSICIAN OFFICE
MACKINAW CITY MEDICAL CLINIC
580 SOUTH NICOLET STMACKINAW CITYMI49701PHYSICIAN OFFICE

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 7: THE ORGANIZATION UTILIZES A COST TO CHARGE RATIO WHEN CALCULATING THE PERCENTAGE OF CHARITY CARE AND COMMUNITY BENEFIT PERCENTAGES.
PART I, L7 COL(F): THE BAD DEBT EXPENSE IS CALCULATED UTILIZING ACTUAL WRITE-OFFS AND THE AMOUNTS THAT HAVE BEEN DETERMINED LIKELY TO BE WRITTEN OFF GIVEN PAST EXPERIENCE OF THE COLLECTION POSSIBILITIES. ALTHOUGH THERE ARE SOME AMOUNTS OF CHARITY CARE INCLUDED IN THIS AMOUNT, THERE IS NOT A CURRENT METHOD TO EASILY OBTAIN THE AMOUNT THAT SHOULD HAVE BEEN CHARITY CARE.
PART II: PROVIDED 24 HOUR EMERGENCY AND ESSENTIAL HEALTH CARE SERVICES TO RURAL COMMUNITY.
PART III, LINE 4: THERE IS NOT ANY FIANANCIAL STATEMENT FOOTNOTE ON BAD DEBT EXPENSE.
PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE FROM THE MEDICARE COST REPORT
PART V, SECTION B, LINE 3: KEY INFORMATIONAL INTERVIEWS WERE CONDUCTED WITH MEMBERS OF THE COMMUNITY SERVED BY MACKINAC STRAITS HEALTH SYSTEM. THESE INDIVIDUALS WERE IDENTIFIED BY THE COMMITTEE BASED ON THEIR QUALIFICATIONS TO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED. GENERALLY, THE INTERVIEWEES INCLUDED PERSOMS WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AND PERSONS WHO REPRESENT THE MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS.MACKINAC STRAITS HEALTH SYSTEM, INC.
PART V, SECTION B, LINE 5C: THE CHNA CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT HTTP://MACKINACSTRAITSHEALTH.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT.HTMLMACKINAC STRAITS HEALTH SYSTEM, INC.
PART V, SECTION B, LINE 6I: IMPLEMENTATION PLANONCE THE HEALTH NEEDS WERE PRIORITIZED BY THE CHNA ADVISORY COMMITTEE, THE FINAL STEP IN THE CHNA PROCESS INVOLVED DEVELOPING AN IMPLEMENTATION STRATEGY. THE PURPOSE OF THE IMPLEMENTATION STRATEGY IS TO DEVELOP A CLEAR SET OF GOALS TO RESPOND TO THE PRIORITIES IDENTIFIED THROUGH THE CHNA. THE IMPLEMENTATION STRATEGY SHOULD INCLUDE A WRITTEN PLAN THAT ADDRESSES EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, DESCRIBE HOW THE HOSPITAL PLANS TO MEET THE HEALTH NEEDS, AND IDENTIFY HEALTH NEEDS THE HOSPITAL DOES NOT INTEND TO MEET AND WHY.WITH THE SUPPORT OF WIPFLI, THE CHNA ADVISORY COMMITTEE DEVELOPED THE IMPLEMENTATION STRATEGY. THE COMMITTEE ADDRESSED THE FOLLOWING IMPLEMENTATION STRATEGY COMPONENTS WITHIN EACH PRIORITY IDENTIFIED:1. OBJECTIVES/STRATEGY2. TACTICS (HOW)3. PROGRAMS/RESOURCES TO COMMIT4. IMPACT OF PROGRAMS/RESOURCES ON HEALTH NEED5. ACCOUNTABLE PARTIES6. PARTNERSHIPS/COLLABORATIONTHE DETAILED IMPLEMENTATION STRATEGY FOR EACH PRIORITY CAN BE FOUND IN APPENDIX 5. IN SUMMARY, THE FOLLOWING PRIORITIES WERE ADDRESSED THROUGH THE IMPLEMENTATION STRATEGY:1. AVAILABILITY OF HEALTH INSURANCE AND ACCESS TO LOW COST HEALTH CARE2. OBESITY/DIABETES3. WEEKEND ACCESS TO LOCAL PHARMACY4. EDUCATE THE COMMUNITY REGARDING WHAT PROGRAMS ARE AVAILABLETHE IMPLEMENTATION STRATEGY DETAIL FOR EACH PRIORITY LOCATED IN APPENDIX 5 PROVIDES SUPPORTING TACTICS, PROGRAMS/RESOURCES, ACCOUNTABLE PARTIES, AND POTENTIAL PARTNERSHIPS/COLLABORATION FOR EACH STRATEGY.MACKINAC STRAITS HEALTH SYSTEM, INC.
PART V, SECTION B, LINE 20D: FAP ELIGIBLE PATIENTS RECEIVE A DISCOUNT WHICH IS A SLIDING FEE BASED ON POVERTY LEVEL.MACKINAC STRAITS HEALTH SYSTEM, INC.
PART VI, LINE 2: FEEDBACK FROM COMMUNITY MEMBERS VIA SURVEY AND PRESENTATIONS AT LOCAL ORGANIZATIONS
PART VI, LINE 3: PAMPLETS AND OTHER LITERATURE AND SIGNAGE
PART VI, LINE 4: MACKINAC COUNTY - A RURAL COUNTY IN MICHIGAN'S UPPER PENNINSULA. SEASONAL ECONOMY WITH HIGHER THAN AVERAGE UNEMPLOYMENT. AGING POPULATION WITH LARGE NUMBER OF NATIVE AMERICANS.
PART VI, LINE 5: A MAJORITY OF OUR ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND ALSO PROVIDES COURTESY PRIVILIGES TO AMNY VISITING SPECIALISTS WHO ARE ALSO PROVIDED SPACE IN OUR BUILDINGS IN ORDER TO SEE THEIR PATIENTS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DR SUSAN HEPKER
BOARD MEMBER/CHIEF OF STAFF39470000018279000207330433712000
RODNEY NELSON
CEO150000000278000208990171177000
DR CARL HAWKINS
PHYSICIAN1468390000000217330168572000
DR EDWARD SMITH
PHYSICIAN3295000600000316000227330412549000
DR MATTHEW BOWES
PHYSICIAN3676390000000207330388372000
DR JENNIFER SHOCKLEY
PHYSICIAN195000000000000195000000
DR DARRIN BENZING
ER PHYSICIAN1403500000000155710155921000

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonDR SUSAN HEPKERNamePerson
Relationship With OrganizationBOARD MEMBER/CHIEF OF STAFFRelationshipWithOrganization
Purpose Of LoanRELOCATION/HOUSINGPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$90,000OriginalPrincipalAmount
Balance Due44523BalanceDue
Default0Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due44523TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE BOARD OF DIRECTORS HAS DELEGATED TO REVIEW AND APPROVAL OF THE FORM 990 TO THE CFO. THE 990 RETURN IS E-MAILED TO THE BOARD MEMBERS PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF DIRECTORS MONITORS THE CONFLICT OF INTEREST POLICY. NEW CONFLICTS OF INTEREST ARE REVIEWED BY THE BOARD IN ACCORDANCE WITH THE POLICY AND DOCUMENTED.
FORM 990, PART VI, SECTION B, LINE 15THE PROCESS FOR DETERMINING ALL COMPENSATION IS BASED ON THE MHA ANNUAL SURVEY. THE COMPENSATION IS THEN REVIEWED BY THE BOARD FOR THE CEO AND IS REVIEWED BY THE CEO FOR OTHER OFFICERS AND KEY EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES THEIR DOCUMENTATION AVAILABLE TO THE PUBLIC BY REQUEST ONLY. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 MAKING THEM AVAILABLE FOR PUBLIC INSPECTION.
FORM 990, PART IX, LINE 11GPHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 1,016,312. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,016,312. THERAPIST: PROGRAM SERVICE EXPENSES 306,144. MANAGEMENT AND GENERAL EXPENSES 2,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 308,644. TRANSPORT: PROGRAM SERVICE EXPENSES 123,372. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 123,372. NURSING SERVICES: PROGRAM SERVICE EXPENSES 171,901. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 171,901. PATIENT MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 5,266. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,266. CODING: PROGRAM SERVICE EXPENSES 127,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 127,260. LAB: PROGRAM SERVICE EXPENSES 212,468. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 212,468. RADIOLOGY PACS: PROGRAM SERVICE EXPENSES 101,524. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 101,524. CARDIOLOGY MONITORING: PROGRAM SERVICE EXPENSES 3,362. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,362. PHARMACY SYSTEMS: PROGRAM SERVICE EXPENSES 37,742. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,742. BILLING: PROGRAM SERVICE EXPENSES 319,350. MANAGEMENT AND GENERAL EXPENSES 109,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 428,350. MAINTENANCE: PROGRAM SERVICE EXPENSES 69,547. MANAGEMENT AND GENERAL EXPENSES 1,678. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 71,225. MED REC SCANNING: PROGRAM SERVICE EXPENSES 7,608. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,608. BIOMED: PROGRAM SERVICE EXPENSES 81,550. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,550. WASTE REMOVAL: PROGRAM SERVICE EXPENSES 45,208. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,208. LAUNDRY: PROGRAM SERVICE EXPENSES 58,305. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,305. SUPPORT SERVICES: PROGRAM SERVICE EXPENSES 129,255. MANAGEMENT AND GENERAL EXPENSES 48,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 177,255. PURCHASING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 16,698. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,698. EDUCATION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 7,121. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,121. PAYROLL: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 43,846. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,846. TRANSPORT: PROGRAM SERVICE EXPENSES 131,673. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 131,673. LTC RESIDENT OUTING: PROGRAM SERVICE EXPENSES 36,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,000.OTHER FEES
FORM 990, PART XI, LINE 9:CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE -1,101,078.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2CTHE AUDITED FINANCIAL STATEMENTS ARE PRESENTED TO THE MACKINAC STRAITS HEALTH SYSTEM FINANCE COMMITTEE AND RECOMMENDATIONS ARE TAKEN TO THE MACKINAC STRAITS HEALTH SYSTEM BOARD OF DIRECTORS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.OVERSIGHT OF AUDIT

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1MOSES DIALYSIS UNITBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11140 NORTH STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode
FieldValueIRS element (for citing)
EIN320031170EIN
Primary ActivitiesRENAL DIALYSIS SERVICESPrimaryActivities
Legal Domicile StateMILegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 3PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MACKINAC STRAITS HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
MOSES DIALYSIS UNIT
O320627
MOSES DIALYSIS UNIT
Q168383