2014-03-28T15:12:52-05:00 2013-06-30 381357951 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2012-07-01 382934134 MONROE COMMUNITY HEALTH SERVICES MONR 7342404520 718 N MACOMB STREET MONROE MI 48162 THOMAS W SCHILLING 7342404520 2014-03-24 1 BETSY ARETZ P00996282 2483522500 2012 2015-11-30 17:44:51Z THOMAS W SCHILLING 718 N MACOMB STREET MONROE MI 48162 7531213 0 X WWW.MERCYMEMORIAL.ORG X 1989 MI PROMOTE THE GENERAL HEALTH OF THE PUBLIC IN MONROE COUNTY, MICHIGAN AND SURROUNDING AREAS. 17 10 171 21 0 0 44 99 7513194 7522538 24792 8576 0 0 7538030 7531213 0 0 0 0 3724246 3765080 0 0 0 3102401 3185873 6826647 6950953 711383 580260 6930200 7068252 3385822 2943614 3544378 4124638 PROMOTE THE GENERAL HEALTH OF THE PUBLIC IN MONROE COUNTY, MICHIGAN AND SURROUNDING AREAS. 0 0 6446266 0 7522538 OPERATED A 70-BED SKILLED NURSING FACILITY, DBA MERCY MEMORIAL NURSING CENTER. THIS FACILITY PROVIDED 22,982 RESIDENT DAYS OF CARE IN 2013 AS FOLLOWS:- MEDICAID 11,530- PRIVATE PAY 3,365- MEDICARE 8,087THIS REPRESENTS AN AVERAGE CENSUS OF 63.0 RESIDENT UNITS PER DAY. 6446266 1 0 0 1 0 0 0 0 0 1 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 0 0 0 1 23 0 1 171 1 0 0 0 0 0 0 0 0 0 0 X 17 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X THOMAS W SCHILLING 7342404520 718 N MACOMB STREET MONROE MI 48162 BHURGRI MD AAMER 2.00 4.00 X 9333 87870 0 BRAUNLICH PAUL E 1.00 1.00 X 0 0 0 CALENDAR KAREN 1.00 1.00 X 0 0 0 CARTER KURT W 1.00 1.00 X 0 0 0 CHARBONEAU DO MICHAEL 1.00 40.00 X 0 586356 17172 COMPEAN MD JOSE R 1.00 1.00 X 0 31292 0 DARROW KURT L 1.00 1.00 X X 0 0 0 FRANZEN VICKI L 1.00 1.00 X X 0 0 0 KABIR MD ABDUL 1.00 1.30 X X 0 31049 0 KUBISKE DAVID 1.00 1.00 X 0 0 0 KULISH BARTON 1.00 1.00 X X 0 0 0 MCNAMEE MD KENNETH J 1.00 1.00 X 0 19508 0 PHILLIPS ANNETTE S 1.00 40.00 X X 0 444279 30327 ROBBINS BASIL D 1.00 1.00 X X 0 0 0 RYAN SISTER JANET 1.00 1.00 X X 0 0 0 SPENCER EDD DONALD A 1.00 1.00 X X 0 0 0 WALSH ARLENE R 1.00 1.00 X 0 0 0 WETZEL SUZANNE 1.00 1.00 X 0 0 0 WILBURN WALTER 1.00 1.00 X 0 0 0 ZWACK MATTHEW 1.00 1.00 X 0 0 0 SCHILLING THOMAS W 1.00 40.00 X 0 296196 30202 JAN MARTIN 40.00 0.00 X 115205 0 6965 124538 1496550 84666 1 0 1 0 CONCEPT REHAB INC 7150 GRANITE CIRCLE SUITE 200 TOLEDO OH 43617 PATIENT THERAPY 902282 1 99 99 SKILLED NURSING - MMNC 623000 7522538 7522538 7522538 8076 8076 500 0 500 500 500 7531213 7522538 0 8576 X 20533 20533 2793044 2567070 225974 20093 18333 1760 719562 656519 63043 211848 193287 18561 48233 48233 1906 1906 20500 20500 86 86 1013643 987580 26063 2438 2438 27152 6017 21135 14386 7193 7193 305440 285437 20003 5234 3405 1829 4786 2919 1867 83915 83915 290641 271607 19034 43175 38646 4529 MEDICAL SUPPLIES 593937 593937 QUALITY ASSURANCE ASSES 335280 335280 BAD DEBT EXPENSE 220561 220561 DIETARY 174560 174560 6950953 6446266 504687 0 7790 8556 3292340 3246863 1814462 1884677 8561 11389 9904973 7994477 1799332 1910496 7715 6271 6930200 7068252 1755134 1462605 1630688 1481009 3385822 2943614 X 3543546 4123792 832 846 3544378 4124638 6930200 7068252 580260 0 X X 0 1 X 1 0 X 2001 1664 189 44 99 3997 9875332 10714465 9296773 7513194 7522538 44922302 9877333 10716129 9296962 7513238 7522637 44926299 0 45342 15346 202777 151051 414516 45342 15346 202777 151051 414516 44511783 355462 198647 59779 8892 8076 630856 355462 198647 59779 8892 8076 630856 10232795 10914776 9356741 7522130 7530713 45557155 0.97710 0.97320 0.01380 0.02090 X 0 0 0 0 0 0 0 0 1 86 86 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A PERCENTAGE OF DUES PAID TO VARIOUS ORGANIZATIONS IS ALLOCATED BY THOSE ORGANIZATIONS AS LOBBYING COSTS. 832 14 846 788 44 832 636 152 788 542 94 636 464 78 542 1.00000 0 1 1 375115 375115 6666682 5464700 1201982 29780 29068 712 2793631 2500709 292922 39765 39765 1910496 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS FOR RESIDENT ACTIVITIES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2013, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. 0 1 0 0 0 0 0 0 0 CHARBONEAU DO MICHAEL 0 585231 0 225 0 900 0 179 0 16993 0 603528 0 0 PHILLIPS ANNETTE S 0 388637 0 50842 0 4800 0 13321 0 17006 0 474606 0 0 SCHILLING THOMAS W 0 263473 0 26723 0 6000 0 13207 0 16995 0 326398 0 0 PART I, LINE 3 THE CHIEF EXECUTIVE OFFICERS COMPENSATION WAS ESTABLISHED BY A RELATED ORGANIZATION USING THE FOLLOWING RESOURCES: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B A RELATED ORGANIZATION OFFERS SELECT MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES ANNUAL EMPLOYER-FUNDED CONTRIBUTIONS EQUAL TO A FIXED PERCENT OF BASE SALARY: 15% FOR CEO, 10% FOR SENIOR VICE PRESIDENTS AND 5% FOR VICE PRESIDENTS. BENEFITS ARE VESTED AFTER THREE YEARS OF SERVICE AND ARE PAID OUT IN A LUMP SUM BY MARCH 15 OF THE YEAR FOLLOWING THE YEAR IN WHICH THEY BECOME VESTED. THE FOLLOWING INDIVIDUALS REPORTED ON FORM 990, PART VII ARE PARTICIPANTS: ANNETTE PHILLIPS AND THOMAS SCHILLING. FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS DR. KENNETH MCNAMEE, DR. AAMER BHURGRI, DR. MICHAEL CHARBONEAU, AND DR. ABDUL KABIR HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MONROE COMMUNITY HEALTH SERVICES HAS MEMBERS. MERCY MEMORIAL HOSPITAL CORPORATION IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE POWERS AND VOTING RIGHTS TO: [A] APPOINT, ELECT, AND REMOVE TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE POWERS AND VOTING RIGHTS TO: [B] APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION; [C] ADOPT, AMEND, OR REPEAL THE BYLAWS; [D] APPROVE EACH BUDGET AND LONG-RANGE PLAN; [E] APPROVE CONTRACT OR LOAN OBLIGATING THE CORPORATION TO EXPEND/REPAY AN AMOUNT IN EXCESS OF $50,000 WHICH WAS NOT INCLUDED IN PREVIOUSLY APPROVED BUDGETS; [F] APPROVE CONTRACTS OUTSIDE THE ORDINARY COURSE OF THE BUSINESS OF THE CORPORATION; [G] APPROVE ALL PLANS OF MERGER OR CONSOLIDATION; [H] APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION; AND [I] APPROVE A VOLUNTARY DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 INPUT DATA IS REVIEWED AND ANALYZED BY THE CONTROLLER AND THEN SUBMITTED TO THE CERTIFIED PUBLIC ACCOUNTING FIRM FOR PREPARATION. THE COMPLETED FORM 990 IS THEN RETURNED TO THE CFO AND THE CEO FOR FINAL REVIEW AND APPROVAL BEFORE THE BOARD MEETING. BEFORE THE RETURN IS FILED, THE FORM 990 IS REVIEW BY THE BOARD. ALL MEMBERS RECEIVE A COPY OF THE FORM 990, EVEN THOSE THAT ARE UNABLE TO ATTEND THE SCHEDULED MEETING. THE REVIEW IS PERFORMED DURING ONE OF THE MONTHLY BOARD MEETINGS, WHERE EACH MEMBER HAS A CHANGE TO ASK QUESTIONS. THIS REVIEW IS DOCUMENTED VIA MINUTES TO THE MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS, OFFICERS AND EMPLOYEES OF THE ORGANIZATION. ON AN ANNUAL BASIS, THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS DISTRIBUTED TO OFFICERS, EMPLOYEES, AND TRUSTEES OF MONROE COMMUNITY HEALTH SERVICES. POTENTIAL CONFLICTS OF INTEREST ARE ANALYZED BY THE HOSPITAL'S LEGAL DEPARTMENT AND ARE GIVEN RANKINGS OF LOW, MODERATE, AND SEVERE RISK. THIS ANALYSIS IS GIVEN TO THE BOARD CHAIR AND THE HOSPITAL'S CHIEF EXECUTIVE OFFICER. ANY MEMBER WITH AN IDENTIFIED CONFLICT OF INTEREST IS EXCUSED FROM THE MEETING DURING DISCUSSIONS PERTAINING TO THE ISSUE OF CONFLICT, AND THE MEMBER IS NOT PERMITTED TO VOTE ON ANY ISSUE OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 OFFICERS ARE COMPENSATED BY MERCY MEMORIAL HOSPITAL CORPORATION, A RELATED ORGANIZATION. THE EXECUTIVE COMPENSATION COMMITTEE OF THE HOSPITAL'S BOARD OF TRUSTEES DETERMINES AND APPROVES ALL COMPENSATION FOR THOSE DESIGNATED IN SENIOR LEADERSHIP POSITIONS, SUCH AS THE CHIEF EXECUTIVE OFFICER & PRESIDENT AND THE CHIEF FINANCIAL OFFICER & SENIOR VICE PRESIDENT OF FINANCE. THE INDEPENDENT BOARD COMMITTEE RETAINS AN OUTSIDE CONSULTANT TO ANALYZE AND ASSIST IN MAKING THESE DETERMINATIONS THROUGH A VARIETY OF MARKET SURVEYS/STUDIES. THIS PROCESS IS UNDERTAKEN ANNUALLY AND WAS LAST PERFORMED IN 2013. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G PHYSICAL, OCCUPATIONAL, SPEECH THERAPIES: PROGRAM SERVICE EXPENSES 987,580. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 987,580. MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 26,063. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,063. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR. FORM 990, PART IV, LINE 24 & SCHEDULE K: TAX EXEMPT BONDS: MONROE COMMUNITY HEALTH SERVICES IS A MEMBER OF THE MERCY MEMORIAL HOSPITAL CORPORATION OBLIGATED GROUP OF WHICH MONROE COMMUNITY HEALTH SERVICES HAS BEEN ALLOCATED FUNDS FROM A 2006 BOND ISSUANCE. DUE TO THIS, ALL INFORMATION RELATING TO THE 2006 BOND ISSUANCE HAS BEEN REPORTED ON THE MERCY MEMORIAL HOSPITAL CORPORATION 2012 FORM 990 AND IS NOT INCLUDED ON THIS RETURN. MERCY MEMORIAL HOSPITAL CORPORATION 718 N MACOMB STREET MONROE MI 48162 381984289 HOSPITAL MI 501(C)(3) LINE 3 N/A 0 MONROE HEALTH VENTURES 718 N MACOMB STREET MONROE MI 48164 382704426 PHARMACY MI N/A C 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 MERCY MEMORIAL HOSPITAL CORPORATION L 152284 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION P 1415661 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION Q 130598 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION R 473482 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION M 261496 ACTUAL ALLOCATED COST