PAUL OLIVER MEMORIAL HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- PAUL OLIVER MEMORIAL HOSPITAL (EIN 38-1415623)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201311349349302051
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T09:27:23-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381415623 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAUL OLIVER MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PAUL | NameControl |
| Phone | 2313529621 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224 PARK AVE | AddressLine1 |
| City | FRANKFORT | City |
| State | MI | State |
| ZIP Code | 496359658 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARK A HEPLER | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 2313529621 | Phone |
| Date Signed | 2013-05-13 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES D AUSTIN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224 PARK AVE | AddressLine1 |
| City | FRANKFORT | City |
| State | MI | State |
| ZIP Code | 49635 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17804173 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MUNSONHEALTHCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1944 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | PAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 39.9 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2011 TAX YEAR. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 195 | TotalNbrEmployees |
| Total Nbr Volunteers | 58 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 27515 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 64605 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 15775190 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17486866 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 169951 | InvestmentIncomePriorYear |
| Investment Income Current Year | 137683 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 78952 | OtherRevenuePriorYear |
| Other Revenue Current Year | 76678 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16051608 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17765832 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6538166 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6561317 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 55189 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8274372 | OtherExpensePriorYear |
| Other Expenses Current Year | 9439776 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14812538 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16001093 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1239070 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1764739 | RevenuesLessExpensesCY |
| Total Assets BOY | 15742268 | TotalAssetsBOY |
| Total Assets EOY | 21165084 | TotalAssetsEOY |
| Total Liabilities BOY | 1800732 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3279288 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 13941536 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 17885796 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 39.9 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2011 TAX YEAR. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 14423546 | Expense |
| Revenue | 17344856 | Revenue |
| Description | PROVIDING HOSPITAL AND LONG-TERM CARE SERVICES TO THE RESIDENTS OF THE BENZIE, MICHIGAN REGION. | Description |
| Total Program Service Expense | 14423546 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 39 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 195 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MUNSON HEALTHCARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2319357777 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4230 COPPER RIDGE DR | AddressLine1 |
| City | TRAVERSE CITY | City |
| State | MI | State |
| ZIP Code | 49684 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| PAUL M SHIRILLA | ||||||
| DIRECTOR | 2.00 | X | 0 | 293209 | 47142 | |
| JAMES D AUSTIN | ||||||
| PRESIDENT | 16.00 | X | 0 | 256356 | 40601 | X |
| GERARD MAHONEY DO | ||||||
| DIRECTOR | 2.00 | X | 8200 | 0 | 0 | |
| GEORGE RYCKMAN DO | ||||||
| DIRECTOR | 2.00 | X | 2650 | 0 | 0 | |
| BRENDA SUE WEBBER | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| CHARLES TULL | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| DAVID MICINSKI | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| HON PAUL J CLULO | ||||||
| CHAIR | 2.00 | X | 0 | 0 | 0 | X |
| IRENE A NUGENT | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | X |
| JOETTA RILEY PARRIS | ||||||
| SEC/TREASURE | 2.00 | X | 0 | 0 | 0 | X |
| PAUL PATTERSON | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| BETSY EVANS | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| MARK A HEPLER | ||||||
| CFO | 1.00 | 0 | 322835 | 48469 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 10850 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 872400 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 136212 | TotalOtherCompensation |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SPENCE BROTHERS | |||||
| 417 MCCORSKRY ST | SAGINAW | MI | 48605 | CONSTRUCTION | 1311164 |
| CRYSTAL LAKE EMERGE | |||||
| 6227 FRANKFORT HWY | BENZONIA | MI | 496169654 | EMERGENCY SERVI | 810891 |
| SODEXO INC AND AFFILIATES | |||||
| 4880 PAYSHERE CIRCLE | CHICAGO | IL | 60674 | FOOD SERVICE | 140682 |
| MICHIGAN NEUROLOGY ASSOCIATES | |||||
| 1500 WEST PARK DR STE 390 | WESTBOROUGH | MA | 01581 | MRI SERVICES | 131975 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Events | 40530 | FundraisingEvents |
| Government Grants | 22075 | GovernmentGrants |
| All Other Contributions | 2000 | AllOtherContributions |
| Total Contributions | 64605 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| MEDICARE AND MEDICAID PMTS | 621990 | 9192677 | 9192677 | |
| PATIENT SERVICE REVENUE | 621990 | 7946337 | 7946337 | |
| COMMUNITY FITNESS CENTER | 713940 | 187540 | 187540 | |
| IN HOUSE CHILD CARE | 624410 | 160312 | $160,312 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17486866 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 70324 | TotalRevenueColumn |
| Exclusion | $70,324 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 4058 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 4058 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4058 | TotalRevenueColumn |
| Exclusion | $4,058 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 76644 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9285 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 76644 | Securities |
| Other | -9285 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 67359 | TotalRevenueColumn |
| Exclusion | $67,359 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 55900 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 40530 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 29056 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26844 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA SALES | 722210 | 22723 | $22,723 | |
| MISCELLANEOUS | 621990 | 18302 | 18302 | |
| AUXILIARY GIFT SHOP | 446199 | 4751 | $4,751 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 45776 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17765832 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17344856 | RelatedOrExemptFunctionIncome |
| Exclusion | $329,527 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4889193 | Total |
| Program Services | 4628320 | ProgramServices |
| Management And General | 260873 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 451836 | Total |
| Program Services | 427708 | ProgramServices |
| Management And General | 24128 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 863767 | Total |
| Program Services | 817642 | ProgramServices |
| Management And General | 46125 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 356521 | Total |
| Program Services | 337483 | ProgramServices |
| Management And General | 19038 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30000 | Total |
| Management And General | 30000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4255441 | Total |
| Program Services | 3654102 | ProgramServices |
| Management And General | 547784 | ManagementAndGeneral |
| Fundraising | 53555 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38291 | Total |
| Program Services | 16502 | ProgramServices |
| Management And General | 21649 | ManagementAndGeneral |
| Fundraising | 140 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 505031 | Total |
| Program Services | 443426 | ProgramServices |
| Management And General | 60602 | ManagementAndGeneral |
| Fundraising | 1003 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158363 | Total |
| Program Services | 146862 | ProgramServices |
| Management And General | 11501 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 621897 | Total |
| Program Services | 621897 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100504 | Total |
| Program Services | 65118 | ProgramServices |
| Management And General | 35220 | ManagementAndGeneral |
| Fundraising | 166 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 985 | Total |
| Program Services | 985 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 978279 | Total |
| Program Services | 881821 | ProgramServices |
| Management And General | 96458 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93964 | Total |
| Program Services | 69260 | ProgramServices |
| Management And General | 24704 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| MEDICAL SUPPLIES | 1350880 | 1350880 | ||
| BAD DEBT | 876617 | 876617 | ||
| LICENSES AND TAXES | 315498 | 14712 | 300786 | |
| MISCELLANEOUS | 61156 | 36330 | 24501 | 325 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52870 | Total |
| Program Services | 33881 | ProgramServices |
| Management And General | 18989 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16001093 | Total |
| Program Services | 14423546 | ProgramServices |
| Management And General | 1522358 | ManagementAndGeneral |
| Fundraising | 55189 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1050 | BOY |
| EOY | 1050 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2436679 | BOY |
| EOY | 4711939 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2169618 | BOY |
| EOY | 2643673 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 146603 | BOY |
| EOY | 117397 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 19799618 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 13577861 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5529354 | BOY |
| EOY | 6221757 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3211077 | BOY |
| EOY | 3285702 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2042406 | BOY |
| EOY | 3862347 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 205481 | BOY |
| EOY | 321219 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15742268 | BOY |
| EOY | 21165084 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1262817 | BOY |
| EOY | 1011201 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 537915 | BOY |
| EOY | 2268087 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1800732 | BOY |
| EOY | 3279288 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11899130 | BOY |
| EOY | 14023449 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2042406 | BOY |
| EOY | 3862347 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13941536 | BOY |
| EOY | 17885796 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15742268 | BOY |
| EOY | 21165084 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1764739 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2179521 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed4955 Tax | false | Form4720Filed4955Tax |
| Correction Made | false | CorrectionMade |
| Form1120 Pol Filed | false | Form1120PolFiled |
| Form4720 Filed | false | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $1,537 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 1537 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
| Substantially All Dues Nondeduct | false | SubstantiallyAllDuesNondeduct |
| Only In House Lobbying | false | OnlyInHouseLobbying |
| Agree To Carryover Prior Year | false | AgreeToCarryoverPriorYear |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE C, PART II-B, LINE 1 | ReturnReference |
| Explanation | OTHER GRASSROOTS LOBBYING INCLUDES THE PORTION OF DUES ALLOCATED TO LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5253482 | BeginningOfYearBalance |
| Contributions | 1819941 | Contributions |
| Investment Earnings Or Losses | 91515 | InvestmentEarningsOrLosses |
| Administrative Expenses | 16889 | AdministrativeExpenses |
| End Of Year Balance | 7148049 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4052095 | BeginningOfYearBalance |
| Contributions | 757959 | Contributions |
| Investment Earnings Or Losses | 458819 | InvestmentEarningsOrLosses |
| Administrative Expenses | 15390 | AdministrativeExpenses |
| End Of Year Balance | 5253483 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3736794 | BeginningOfYearBalance |
| Contributions | 260254 | Contributions |
| Investment Earnings Or Losses | 288192 | InvestmentEarningsOrLosses |
| Other Expenditures | 224769 | OtherExpenditures |
| Administrative Expenses | 8376 | AdministrativeExpenses |
| End Of Year Balance | 4052095 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4099630 | BeginningOfYearBalance |
| Contributions | 332714 | Contributions |
| Investment Earnings Or Losses | -535126 | InvestmentEarningsOrLosses |
| Other Expenditures | 149924 | OtherExpenditures |
| Administrative Expenses | 10500 | AdministrativeExpenses |
| End Of Year Balance | 3736794 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.45970 | BoardDesignatedEOYBalance |
| Term Endowment EOY Balance | 0.54030 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 193750 | OtherCostOrOtherBasis |
| Book Value | 193750 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12520672 | OtherCostOrOtherBasis |
| Depreciation | 8502950 | Depreciation |
| Book Value | 4017722 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 120618 | OtherCostOrOtherBasis |
| Depreciation | 22616 | Depreciation |
| Book Value | 98002 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6851877 | OtherCostOrOtherBasis |
| Depreciation | 4952599 | Depreciation |
| Book Value | 1899278 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 112701 | OtherCostOrOtherBasis |
| Depreciation | 99696 | Depreciation |
| Book Value | 13005 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 6221757 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INVEST IN PAUL OLIVER MEM FOUNDATION | Description |
| Book Value | 3862347 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 3862347 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED THIRD PARTY PAYMENTS | $1,998,509 |
| CAREPAYMENT LIABILITY | $269,578 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2268087 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | INTENDED USES FOR ENDOWMENT FUNDS | Identifier |
| Return Reference | SCHEDULE D, PAGE 2, PART V, LINE 4 | ReturnReference |
| Explanation | THE FUNDS ARE INTENDED FOR THE OPERATIONS AND CAPITAL NEEDS OF THE PAUL OLIVER MEMORIAL HOSPITAL. A SIGNIFICANT PORTION OF THE TEMPORARILY RESTRICTED FUNDS ARE FOR THE CAPITAL NEEDS OF THE HOSPITAL. | Explanation |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed States | MI | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF BENEFIT | NameOfEvent1 |
| Gross Receipts Event1 | 23363 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 9175 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 14188 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 7347 | OtherDirectExpensesEvent1 |
| Name Of Event2 | APPRECIATION DA | NameOfEvent2 |
| Gross Receipts Event2 | 20495 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 7743 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 12752 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 2482 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 4 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 50772 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 23612 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 27160 | GrossRevenueOtherEvents |
| Other Direct Expenses Other Events | 17237 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 94630 | GrossReceiptsTotal |
| Charitable Contributions Total | 40530 | CharitableContributionsTotal |
| Gross Revenue Total Events | 54100 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 27066 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 27066 | DirectExpenseSummaryEvents |
| Net Income Summary | 27034 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 170241 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 170241 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01130 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4136895 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3252968 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 883927 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05840 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 71196 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21569 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 49627 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4378332 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3274537 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1103795 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07300 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 117693 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 403 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 117290 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00780 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7084 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7084 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 32140 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 32140 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 156917 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 403 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 156514 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01040 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4535249 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3274940 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1260309 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08340 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 286 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 286 | NetCommunityBuildingExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 3349 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3349 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 35143 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 35143 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 250 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 250 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1877 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1877 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1415 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1415 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 42320 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 42320 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $439,053 | BadDebtExpenseAmount |
| Amount Attributable To | 66034 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4920253 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4920253 | CostOfCareReimbursedByMedicare |
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 | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAUL OLIVER MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224 PARK AVE | AddressLine1 |
| City | FRANKFORT | City |
| State | MI | State |
| ZIP Code | 49635 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | PAUL OLIVER MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| PAUL OLIVER MEMORIAL HOSPITAL SNF | ||||
| 224 PARK AVE | FRANKFORT | MI | 49635 | LONG TERM CARE |
| PHYSICAL THERAPY | ||||
| 9975 W OTTAWA AVE | EMPIRE | MI | 49630 | PHYSICAL THERAPY |
| FITNESS CENTER | ||||
| 102 AIRPORT RD | FRANKFORT | MI | 49635 | PHYSICAL THERAPY, CARDIAC REHAB AND EDU |
| PHYSICAL THERAPY | ||||
| 6227 FRANKFORT HIGHWAY | BENZONIA | MI | 49616 | PHYSICAL THERAPY |
| PHYSICAL THERAPY | ||||
| 1975 STIRLING DR | INTERLOCHEN | MI | 49643 | PHYSICAL THERAPY |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE | PART I LINE 3C | INCOME UP TO 200 OF THE FPG 100 DISCOUNT ON CHARGES INCOME BETWEEN 201 AND 300 FPG 75 DISCOUNT ON CHARGES INCOME BETWEEN 301 AND 400 FPG 50 DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG INCLUDES EARNINGS UNEMPLOYMENT COMPENSATION WORKERS COMPENSATION SOCIAL SECURITY SUPPLEMENTAL SECURITY INCOME PUBLIC ASSISTANCE VETERANS PAYMENTS SURVIVOR BENEFITS PENSION OR RETIREMENT INCOME INTEREST DIVIDENDS RENTS ROYALTIES INCOME FROM ESTATES EDUCATIONAL ASSISTANCE ALIMONY CHILD SUPPORT ASSISTANCE FROM OUTSIDE THE HOUSEHOLD AND OTHER MISCELLANEOUS SOURCES CASH CHECKING AND SAVINGS BALANCES MONEY MARKET ACCOUNTS CERTIFICATES OF DEPOSIT IRAS TRUSTS INHERITANCES ANNUITIES SAVINGS BONDS STOCKS MUTUAL FUNDS ANDOR CASH VALUE OF LIFE INSURANCE |
| RELATED ORGANIZATION INFORMATION | PART I LINE 6A | MUNSON MEDICAL CENTER BROTHER CORPORATION |
| SUBSIDIZED HEALTH SERVICES EXPLANATION | PART I LINE 7G | THERE ARE NO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES |
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | TOTAL EXPENSES FROM FORM 990 PART IX LINE 25 ARE 16001093 THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS 876617 THE NET EXPENSE OF 15124476 WAS USED FOR PURPOSES OF CALCULATING LINE 7 COLUMN F |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION |
| COMMUNITY BUILDING ACTIVITIES | PART II | POMH PROVIDED 42320 TO COMMUNITYBUILDING ACTIVITIES DURING THE 2012 FISCAL YEAR WHILE WE BELIEVE THESE ACTIVITIES PROMOTE COMMUNITY HEALTH BY SUPPORTING THE UNDERLYING CAUSES OF COMMUNITY HEALTH THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON THE SCHEDULE H THESE ACTIVITIES INCLUDE ADMINISTRATIVE AND CASH SUPPORT FOR COALITION BUILDING ACTIVITIES IN BENZIE COUNTY MEETING THE BASIC NEEDS OF PEOPLE IN POVERTY ON A LOCAL LEVEL BY MULTIPLE COLLABORATIVE ACTIVITIES PARTICIPATION IN THE BENZIE COUNTY CHAMBER OF COMMERCE TO PROMOTE WORKFORCE DEVELOPMENT AND SEVERAL ENVIRONMENTAL IMPROVEMENTS RELATED TO COMMUNITY GARDENING AND HEALTHY SCHOOL LUNCHES ALSO BECAUSE BENZIE COUNTY IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA POMH INVESTS DOLLARS INTO THE RECRUITMENT OF CRITICALLY NEEDED PHYSICIANS TO THE AREA TO PROMOTE PATIENT ACCESS TO CARE |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | TO DETERMINE THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS WHO WOULD PROBABLY QUALIFY UNDER MUNSON MEDICAL CENTERS CHARITY CARE POLICY MUNSON DIRECTED AN INTERNAL STUDY FROM A 3MONTH SAMPLE OF CURRENT BAD DEBT ACCOUNTS FIRST THE STUDY IDENTIFIED THE SELFPAY PORTION OF THE BAD DEBT EXPENSE THEN THE SELFPAY ACCOUNTS WERE ANALYZED USING REVENUE CYCLE ANALYTIC SOFTWARE TO IDENTIFY POTENTIAL CHARITY CARE CANDIDATES USING THE SOFTWARE ESTIMATIONS A PORTION OF THE SELFPAY ACCOUNTS WERE DEEMED CHARITY CARE ELIGIBLE THAT ESTIMATED PORTION WAS APPLIED TO THE SELFPAY BAD DEBT DOLLAR AMOUNT TO DETERMINE THE AMOUNT OF BAD DEBT THAT WOULD BE CONSIDERED CHARITY IF THE PROPER APPLICATIONS AND DOCUMENTATION WERE AVAILABLE FROM THE PATIENTS THE ACCOUNTS RECEIVABLE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF MUNSON HEALTHCARE AND SUBSIDIARIES STATES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITION IN ITS SERVICE AREA TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS THROUGHOUT THE YEAR MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITEOFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THE ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PASTDUE PATIENT BALANCES WITH COLLECTION AGENCIES |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | MUNSON HEALTHCARES INTERNAL AND EXTERNAL COLLECTION PRACTICES INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NONPAYMENT INCLUDING COLLECTIONS ACTIONS AND REPORTING TO COLLECTION AGENCIES SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY A PATIENTS GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE AND A PATIENTS GOOD FAITH EFFORT TO COMPLY WITH HISHER PAYMENT AGREEMENTS WITH MUNSON HEALTHCARE FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS MUNSON HEALTHCARE MAY OFFER EXTENDED PAYMENT PLANS WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY |
| NEEDS ASSESSMENT | PART VI | THE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE TO SERVE THE MUNSON SYSTEM BY REVIEWING INFORMATION ON COMMUNITY HEALTH NEEDS PRIORITIZING PROGRAMS AND SERVICES TO BE FUNDED REVIEWING PERFORMANCE INFORMATION REGARDING THE IMPACT AND COST EFFECTIVENESS OF PROGRAMS TARGETED TO IMPROVE THE HEALTH OF THE COMMUNITY IN GENERAL OR A TARGETED POPULATION INCLUDING THE UNDERSERVED AND UNDERINSURED AND TAKING RESPONSIBILITY FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MUNSON HEALTHCARES COMMUNITY BENEFIT PROGRAMS AND EXPENDITURES THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT OF MUNSON MEDICAL CENTER BROTHER CORPORATION PAUL OLIVER MEMORIAL HOSPITAL POMH A MEMBER OF THE MUNSON HEALTHCARE SYSTEM IS A CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN MUNSON HEALTHCARES EXTENSIVE GEOGRAPHICAL AREA COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED AS WELL AS WHERE PROGRESS HAS BEEN MADE THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITYWIDE PAUL OLIVER MEMORIAL HOSPITAL POMH IN CONJUNCTION WITH MUNSON HEALTHCARE PARENT AND SOLE MEMBER IS PREPARING A COMMUNITY NEEDS ASSESSMENT TO MEET THE REQUIREMENTS OF IRC SEC 501R WHICH WILL BE CONDUCTED IN FISCAL 2013 IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD POMH ALSO WILL COMPLETE AN IMPLEMENTATION PLAN IN FISCAL 2013 POMH REGULARLY SEEKS INFORMATION FROM AND PARTICIPATES IN THE BENZIE COUNTY COLLABORATIVE THE LOCAL UNITED WAY AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY HEALTH NEEDS POMH IN CONJUNCTION WITH MUNSON HEALTHCARE SEEKS TO COLLABORATE WITH REGIONAL PARTNERS ASSESSING FOR EXISTING PROGRAMS AND STRATEGIES THAT ARE ALREADY WORKING WELL AND THEN PARTNERING NOT REINVENTING IF A NEW PROGRAMMING NEED IS IDENTIFIED POMH SEEKS TO POOL ASSETS WITH THE MULTICOUNTY HEALTH DEPARTMENTS OTHER NONPROFITS AND LOCAL GOVERNMENTAL SERVICES FOR THE MOST EFFECTIVE USAGE OF RESOURCES ADDITIONALLY MUNSON HEALTHCARE WORKS IN CONJUNCTION WITH EFFORTS BY THE FIVECOUNTY COLLABORATIVES OF ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA COUNTIES THE TRAVERSE CITY CHAMBER OF COMMERCE THE LOCAL UNITED WAY AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY NEED |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS STATEMENT ON BILLS STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL SIGNS IN THE ER REGISTRATION AREA ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY REFERRAL BY REGISTRATION STAFF AT THE TIME OF REGISTRATION SELFPAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF PAUL OLIVER MEMORIAL HOSPITAL FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS IF THE PATIENT WOULD LIKE HELP THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO MEDICAID AND ALL OF ITS SUBSETS SOCIAL SECURITY DISABILITY TRAVERSE HEALTH CLINIC CHARITY CARE CATASTROPHIC CARE COVERAGE AND CAREPAYMENT |
| COMMUNITY INFORMATION | PART VI | PAUL OLIVER MEMORIAL HOSPITAL POMH IS LOCATED IN FRANKFORT MICHIGAN ONE OF SEVEN HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM POMH OFFERS QUALITY PERSONALIZED CARE FOR PRIMARY AND URGENT MEDICAL NEEDS DUE TO ITS RURAL GEOGRAPHIC LOCATION POMH IS DESIGNATED AS A MICHIGAN CRITICAL ACCESS HOSPITAL LABORATORY RADIOLOGY AND REHABILITATION SERVICES AT POMH ARE NETWORKED WITH MUNSON MEDICAL CENTER MMC BROTHER ORGANIZATION ENSURING PROMPT AND CONVENIENT DIAGNOSIS AND TREATMENT POMH HAS 8 ACUTE CARE BEDS AS WELL AS A 39BED EXTENDED CARE UNIT WHERE RESIDENTS ENJOY A SAFE WARM AND COMFORTABLE HOMELIKE SETTING FOUNDED ON PRINCIPLES OF QUALITY AND PERSONAL CARE BECAUSE THE CARE CENTER IS HOSPITALBASED PHYSICIANS AND EMERGENCY MEDICAL CARE ARE AVAILABLE 24 HOURS A DAY HOSPITAL SERVICES POMH PROVIDES 24HOUR EMERGENCY CARE ACUTE CARE LONGTERM CARE OUTPATIENT SURGICAL SERVICES AND RESPITE CARE MMC SPECIALISTS REGULARLY HOLD CLINICS AT POMH MAKING IT EASY TO RECEIVE SPECIALIZED CARE POPULATION SERVED BY PAUL OLIVER MEMORIAL HOSPITAL IN THE POMH MAIN SERVICE AREA OF BENZIE COUNTY 195 OF THE POPULATION IS 65 YEARS OR OLDER THE CENSUS BUREAU CURRENT POPULATION ESTIMATES 2009 UNEMPLOYMENT IS 11 OR HIGHER 23 OF ADULTS AGED 1864 YEARS OF AGE LACK HEALTH INSURANCE PREVALENCE ESTIMATES FOR BENZIE COUNTY 20062010 MICHIGAN BRFS 103 LIVE BELOW THE FEDERAL POVERTY LEVEL THE CENSUS BUREAU SMALL AREA INCOME POVERTY ESTIMATES 2009 QUALITY PAUL OLIVER MEMORIAL HOSPITAL HAS RECEIVED THE FOLLOWING AWARDS 2009 2010 AND 2011 SUMMIT AWARD FOR EMERGENCY CARE FROM PRESS GANEY ASSOCIATES INC POMH ALSO WON A SUMMIT AWARD IN 2011 FOR ITS OUTPATIENT CARE THE SUMMIT AWARD WAS PRESENTED FOR RANKING IN THE TOP 5 PERCENT IN THE NATION FOR PATIENT SATISFACTION FOR 12 CONSECUTIVE QUARTERS IN 2011 PAUL OLIVER MEMORIAL HOSPITAL WAS THE ONLY HOSPITAL IN MICHIGAN TO RECEIVE TWO SUMMIT AWARDS FROM PRESS GANEY THE 2009 2010 AND 2011 MICHIGAN RURAL HEALTH QUALITY IMPROVEMENT AWARD OF EXCELLENCE FOR ITS COMMITMENT TO QUALITY CARE AND EVIDENCEBASED MEDICINE IN THE AREA OF EMERGENCY ROOM TRANSFERS 2010 AND 2011 MICHIGAN RURAL HEALTH QUALITY IMPROVEMENT EXCELLENCE FOR ITS COMMITMENT TO OUTPATIENT CARE THE GOVERNORS AWARD OF EXCELLENCE FOR IMPROVING PATIENT SAFETY AND QUALITY OF CARE IN THE CRITICAL ACCESS SETTING THE AWARD HONORS MICHIGAN HOSPITALS THAT PERFORM QUALITY INITIATIVES AIMED AT IMPROVING PATIENT CARE THE HOSPITAL HAS REPEATEDLY RECEIVED THIS AWARD |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | THE POMH BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS THE MAJORITY OF WHOM RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS IN FUNDRAISING AND IN GENERAL STEWARDSHIP MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS POMH UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA A DESCRIPTION OF SEVERAL SIGNIFICANT PROGRAMS INITIATED BY THE HOSPITAL FOLLOWS HEALTHY FUTURES A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS HEALTH DEPARTMENTS AND MUNSON HEALTHCARE MUNSON HEALTHCARE SYSTEM PARENT AND SOLE MEMBER CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UNDER AGE TWO THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMESBASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY ACCESS TO HEALTH CARE AND IMMUNIZATIONS BECAUSE OF THE RURAL NATURE OF THE COMMUNITY TRAVEL TIME TO THE NEAREST MATERNAL CHILD HEALTHCARE SPECIALIST MAY BE GREATER THAN 30 MINUTES COST AND AVAILABILITY OF TRANSPORTATION CAN BE A DIFFICULT BARRIER TO ACCESS HEALTHCARE FOR YOUNG FAMILIES POMH PARTNERS WITH MUNSON MEDICAL CENTER TO BRING MATERNAL CHILD HEALTHCARE SPECIALISTS TO PAUL OLIVER MAKING IT EASY AND CONVINENT TO RECEIVE THE SPECIALIZED CARE NEEDED TRANSPORTATION AS PART OF MUNSON HEALTHCARE POMH SUBSIDIZES FUNDING FOR COUNTY TRANSPORTATION AUTHORITIES WHICH PROVIDES ACCESS TO HEALTHCARE SERVICES FOR DISADVANTAGED PERSONS SUCH AS THE ELDERLY PERSONS WITH DISABILITIES AND PERSONS OF LOW INCOME WHO HAVE DIFFICULTY PROVIDING THEIR OWN TRANSPORTATION BETSIE HOSICK HEALTH AND FITNESS CENTER THE BETSIE HOSICK HEALTH AND FITNESS CENTER IS OPEN TO PEOPLE OF ALL AGES ABILITIES AND FITNESS LEVELS TO ACHIEVE BETTER HEALTH THE FITNESS CENTER OFFERS A FULL RANGE OF FITNESS EQUIPMENT AND CLASSES MEDICALLY CREDENTIALED FITNESS PROFESSIONALS ARE ON STAFF TO ASSIST MEMBERS THROUGH THE BETSIE HOSICK HEALTH AND FITNESS CENTER SENIOR MOVEMENT AND BALANCE CLASSES ARE HELD AT SENIOR SITES AROUND THE COUNTY FREE OF CHARGE TO PROMOTE WELLNESS PAUL OLIVER HOLDS NUTRITIONAL EDUCATION CLASSES FOR COMMUNITY MEMBERS AT THE HOSPITAL CAREGIVER LIBRARY A LIBRARY INCLUDING COMPUTERS TO ASSIST THE PUBLIC TO OBTAIN HEALTHCARE INFORMATION SUPPORT GROUPS AND ASSISTANT ACTIVITIES FOR CHRONIC DISEASES SUCH AS ALZHEIMERS DISEASE PARKINSONS AND CANCER SCREENING SERVICES SUCH AS BLOOD PRESSURE CHECKS MAMMOGRAMS AND LABORATORY TESTS TO THOSE IN NEED NORTHERN MICHIGAN DIABETES INITIATIVE NMDI NORTHERN MICHIGAN DIABETES INITIATIVE NMDI A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 11 COUNTY SERVICE AREA WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES NMDI IS COMMITTED TO PROVIDING LOCAL REGIONAL AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS THE GENERAL COMMUNITY THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION AND RURAL PRIMARY CARE PROVIDERS PCP CARING FOR DIABETIC PATIENTS COLLABORATION WITH THE TRAVERSE HEALTH CLINIC THE TRAVERSE HEALTH CLINIC THC PROVIDES ACCESS TO AFFORDABLE HEALTH SERVICES THROUGH COMMUNITY COLLABORATION TO PEOPLE IN NEED IN BENZIE LEELANAU AND GRAND TRAVERSE COUNTIES THC SERVES AS A PRIMARY CARE PROVIDER FOR THOSE ADULTS WITH MEDICAID AND RUNS THE COALITION HEALTH ACCESS PROGRAM CHAP FOR THOSE ADULTS WITH NO INSURANCE WHO QUALIFY INCOME 200 OF FPG POMH DONATES LABS XRAYS AND OTHER SERVICES TO THC PATIENTS LIVING IN THEIR RURAL SERVICE AREA |
| AFFILIATED HEALTH CARE INFORMATION | PART VI | PAUL OLIVER MEMORIAL HOSPITAL IS A MEMBER OF THE MUNSON HEALTHCARE SYSTEM A COMMUNITYOWNED HEALTH SYSTEM THAT INCLUDES SEVEN ACUTE CARE HOSPITALS AS WELL AS NUMEROUS OUTPATIENT SERVICES AND CLINICS ALL THE HOSPITALS IN THE SYSTEM ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR RESPECTIVE COMMUNITIES EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL INITIATIVES ANDOR PROMOTION ACTIVITIES AS WELL AS SHARED INITIATIVES PAUL OLIVERS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE A 501C3 CORPORATION AFFILIATES OTHER THAN THE HOSPITALS INCLUDE TWO FOUNDATIONS HOME HEALTH ORGANIZATIONS MOBILE IMAGING COMPANIES AND AN EMERGENCY TRANSPORTATION ORGANIZATION ALL 501C ENTITIES IN ADDITION TO DIRECTING COMMUNITY BENEFIT ACTIVITIES OF THE SYSTEM MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFITS PROGRAMS FOR THE SYSTEM THROUGH PLANNING DEVELOPING IMPLEMENTING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS POMH WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT A PALLIATIVE CARE PROGRAM AND A HOSPICE PROGRAM ON THE MUNSON MEDICAL CENTER CAMPUS CLOSE TO 300000 DOLLARS IN COMMUNITY BENEFIT IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR NORTH FLIGHT INC IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM WITH ITS FIXED WING AND HELICOPTER AIR SERVICES IN COMBINATION WITH GROUND TRANSPORT PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE NORTH FLIGHT INC PROVIDED 12 MILLION IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR MUNSON MEDICAL GROUP THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM PROVIDED OVER A HALF MILLION DOLLARS IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2011 PAUL OLIVER MEMORIAL HOSPITAL PARTICIPATES IN MUNSON HEALTHCARE SYSTEM NEEDS ASSESSMENT PROCESS UTILIZING THIS NEEDS ASSESSMENT MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING DEVELOPING IMPLEMENTING EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS IN TOTAL THE MUNSON HEALTHCARE SYSTEM PROVIDED 399 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS OUTREACH PROGRAMS BAD DEBT AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN |
| PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 11H | PART V LINE 11H | PATIENTS WHOSE FAMILY INCOME EXCEEDS 400 OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASEBYCASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES IE HIGH DEBTTOINCOME RATIO AT THE SOLE DISCRETION OF MUNSON HEALTHCARE |
| PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 13G | PART V LINE 13G | IT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS INFORMATION POSTED ON THE WEBSITE STATEMENT ON BILLS ANDOR SIGNS IN THE REGISTRATION AREAS |
| PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 19D | PART V LINE 19D | SELFPAYNO INSURANCE PATIENTS ARE GIVEN A DISCOUNT EQUAL TO 15 OFF THEIR TOTAL BILL FOR ALL MEDICALLY NECESSARY AND EMERGENCY SERVICES THIS RATE WAS DETERMINED BY TAKING THE AVERAGE OF COMMERCIAL RATES NOT INCLUDING BLUE CROSS |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|
| PAUL M SHIRILLA | ||||||
| 259620 | 29778 | 3811 | 31773 | 15369 | 340351 | |
| JAMES D AUSTIN | ||||||
| 176495 | 45865 | 33996 | 22596 | 18005 | 296957 | 3698 |
| MARK A HEPLER | ||||||
| 228393 | 25779 | 68663 | 27822 | 20647 | 371304 | 20253 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 3 | THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. |
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | PAUL M. SHIRILLA 0 16,196 0 JAMES D. AUSTIN 0 12,006 0 MARK A. HEPLER 0 14,118 0 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | EXECUTIVE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS OF MUNSON HEALTHCARE, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE RETIREMENT FUNDS ARE AVAILABLE TO THE PARTICIPANTS UPON THEIR RETIREMENT FROM MUNSON. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| CRYSTAL LAKE CLINIC | |||
| OWNER DIRECTOR | 50108 | MEDICAL SERVICES | false |
| CRYSTAL LAKE EMERGENCY SERVICES PC | |||
| OWNER DIRECTOR | 910408 | GROUP PHYSICIAN PRAC | false |
| NRTW LLC | |||
| OWNER DIRECTOR | 63068 | LEASE | false |
| INTERLOCHEN MEDICAL PROPERTIES LLC | |||
| OWNER DIRECTOR | 80040 | LEASE | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | PAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 39.9 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2011 TAX YEAR. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | PAUL OLIVER MEMORIAL HOSPITAL IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | DIRECTORS ARE ELECTED FROM AMONG THOSE PERSONS RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE AT THE MUNSON HEALTHCARE ANNUAL MEETING. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | CERTAIN DECISIONS OF THE PAUL OLIVER MEMORIAL HOSPITAL DIRECTORS ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING THE AMENDMENT OF THE ARTICLES OF INCORPORATION; AMENDMENT OF THE MISSION STATEMENT; ADOPTION OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION OR REORGANIZATION; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL TO THE PROPERTY AND ASSETS; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF PAUL OLIVER MEMORIAL HOSPITAL; ACCEPTANCE OF THE ANNUAL BUDGET AND ANNUAL FINANCIAL STATEMENTS; INCURRENCE OF EXPENDITURES EXCEEDING BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT; INCURRENCE OF CERTAIN DEBT; CHANGE IN SCOPE OF SERVICES OR PROGRAMS PROVIDED BY PAUL OLIVER MEMORIAL HOSPITAL; AND APPOINTMENT OF THE PRESIDENT. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE PAUL OLIVER MEMORIAL HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. PAUL OLIVER MEMORIAL HOSPITAL BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION OF OTHER OFFICERS IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES PAUL OLIVER MEMORIAL HOSPITAL AND MUNSON HEALTHCARE. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE PAUL OLIVER MEMORIAL HOSPITAL ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. PAUL OLIVER MEMORIAL HOSPITAL DOES NOT MAKE THE BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| GROUP RETURN METHOD | FORM 990, PAGE 7, PART VII | PARENT ORGANIZATION HAS FILED A SEPARATE RETURN |
| RELATED ORGANIZATIONS | FORM 990, PAGE 7, PART VII | JAMES D. AUSTIN ALLOCATES 16 HOURS TO PAUL OLIVER MEMORIAL HOSPITAL AND THE REMAINDER OF HIS TIME TO OTHER MUNSON HEALTHCARE SYSTEM RESPONSIBILITIES. MARK HEPLER, CFO, ALLOCATES 40% OF HIS TIME TO MUNSON HEALTHCARE, SYSTEM PARENT ORGANIZATION; 60% TO MUNSON MEDICAL CENTER; AND LESS THAN AN HOUR A WEEK TO THE REMAINING ORGANIZATIONS IN THE MUNSON HEALTHCARE SYSTEM IN HIS CAPACITY AS CFO FOR ALL MUNSON SYSTEM ORGANIZATIONS. PAUL M. SHIRILLA, VICE PRESIDENT OF GENERAL COUNSEL FOR THE MUNSON HEALTHCARE SYSTEM, ALLOCATES 85% OF HIS TIME TO SYSTEM MATTERS AND 15% TO MUNSON MEDICAL CENTER. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | INVESTMENT IN SUB - PAUL OLIVER HOSPITAL FND 2,963,458 TRANSFER TO AFFILIATE -641,311 UNREALIZED INVESTMENT LOSS -68,885 PRIOR PERIOD ADJUSTMENT -73,740 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MUNSON DIALYSIS CENTER | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 383097861 | DIALYSIS | MI | (C)(3) | 3 | MUNSON HC | MUNSON HEALTHCARE | false |
| MUNSON HEALTHCARE | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382640544 | PARENT | MI | (C)(3) | 11B | NA | false | |
| MUNSON HEALTHCARE REGIONAL FOUNDATI | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382642724 | RAISE FUND | MI | (C)(3) | 7 | MUNSON HC | MUNSON HEALTHCARE | false |
| MUNSON HOME CARE | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382191390 | HOME HEALT | MI | (C)(3) | 9 | MUN HOME H | MUNSON HOME HEALTH | false |
| MUNSON HOME HEALTH | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 383335362 | HOME HEALT | MI | (C)(3) | 11B | MUNSON HC | HEALTHCARE | false |
| MUNSON HOME SERVICES | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382543463 | HOME HEALT | MI | (C)(3) | 9 | MUN HOME H | MUNSON HOME HEALTH | false |
| MUNSON MEDICAL CENTER | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 381362830 | HOSPITAL | MI | (C)(3) | 3 | MUNSON HC | MUNSON HEALTHCARE | false |
| NORTH FLIGHT INC | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382657917 | MED TRANSP | MI | (C)(3) | 11B | MUNSON HC | MUNSON HEALTHCARE | false |
| PAUL OLIVER MEMORIAL HOSPITAL FOUND | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 237201619 | RAISE FUND | MI | (C)(3) | 3 | PAUL OLIVE | PAUL OLIVER MEMORIAL HOSPITAL | true |
| MUNSON MEDICAL GROUP | |||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 273600575 | HEALTHCARE | MI | (C)(3) | 9 | MUNSON MED | MUNSON MEDICAL CENTER | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| MUNSON MEDICAL BUILDING PARTNERS | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382830005 | REAL ESTAT | MI | N/A | false | false |
| NORTHERN MICHIGAN SUPPLY ALLIANCE | |||||||||
| 2651 AERO PARK DR | TRAVERSE CITY | MI | 49686 | 383453378 | PURCHASING | MI | N/A | false | false |
| MUNSON MEDICAL BUILDING PARTNERS | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382830005 | REAL ESTAT | MI | N/A | false | false |
| NORTHERN MICHIGAN SUPPLY ALLIANCE | |||||||||
| 2651 AERO PARK DR | TRAVERSE CITY | MI | 49686 | 383453378 | PURCHASING | MI | N/A | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (12 entries)
| Business Name Line2NameOfRelatedOrg/BusinessNameLine2 | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|
| MEDICAL OFFICE BUILDING CONDOMINIUM | ||||||||
| MEDICAL OFFICE BUILDING CONDOMINIUM | PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 383567278 | REAL ESTAT | MI | N/A |
| MUNSON SERVICES INC | ||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 383144382 | PHARMACY | MI | N/A | |
| MUNSON SUPPORT SERVICES | ||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382872821 | LAUNDRY | MI | N/A | |
| SIXTH STREET DRUGS INC | ||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382298290 | PHARMACY | MI | N/A | |
| MEDICAL OFFICE CONDOMINIUM | ||||||||
| MEDICAL OFFICE CONDOMINIUM | PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 201902620 | REAL ESTAT | MI | N/A |
| MUNSON MOBILE IMAGING | ||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382704069 | IMAGING | MI | N/A | |
| MEDICAL OFFICE BUILDING CONDOMINIUM | ||||||||
| MEDICAL OFFICE BUILDING CONDOMINIUM | PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 383567278 | REAL ESTAT | MI | N/A |
| MUNSON SERVICES INC | ||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 383144382 | PHARMACY | MI | N/A | |
| MUNSON SUPPORT SERVICES | ||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382872821 | LAUNDRY | MI | N/A | |
| SIXTH STREET DRUGS INC | ||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382298290 | PHARMACY | MI | N/A | |
| MEDICAL OFFICE CONDOMINIUM | ||||||||
| MEDICAL OFFICE CONDOMINIUM | PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 201902620 | REAL ESTAT | MI | N/A |
| MUNSON MOBILE IMAGING | ||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382704069 | IMAGING | MI | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (39 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MUNSON MEDICAL CENTER | ||
| O | 6375983 | FMV |
| MUNSON MEDICAL CENTER | ||
| N | 1024071 | FMV |
| MUNSON HEALTHCARE | ||
| B | 1000000 | FMV |
| MUNSON MEDICAL CENTER | ||
| L | 920273 | FMV |
| NORTHERN MICHIGAN SUPPLY ALLIANCE | ||
| O | 183922 | FMV |
| MUNSON HEALTHCARE | ||
| L | 135948 | FMV |
| MUNSON DIALYSIS CENTER | ||
| P | 125000 | FMV |
| MUNSON HEALTHCARE | ||
| N | 124936 | FMV |
| MUNSON HEALTHCARE | ||
| O | 120366 | FMV |
| MUNSON SUPPORT SERVICES | ||
| L | 86090 | FMV |
| PAUL OLIVER MEM HOS FOUNDATION | ||
| Q | 68000 | FMV |
| MUNSON SERVICES INC | ||
| L | 59018 | FMV |
| PAUL OLIVER MEM HOS FOUNDATION | ||
| L | 53088 | FMV |
| MUNSON MEDICAL CENTER | ||
| O | 6375983 | FMV |
| MUNSON MEDICAL CENTER | ||
| N | 1024071 | FMV |
| MUNSON HEALTHCARE | ||
| B | 1000000 | FMV |
| MUNSON MEDICAL CENTER | ||
| L | 920273 | FMV |
| NORTHERN MICHIGAN SUPPLY ALLIANCE | ||
| O | 183922 | FMV |
| MUNSON HEALTHCARE | ||
| L | 135948 | FMV |
| MUNSON DIALYSIS CENTER | ||
| P | 125000 | FMV |
| MUNSON HEALTHCARE | ||
| N | 124936 | FMV |
| MUNSON HEALTHCARE | ||
| O | 120366 | FMV |
| MUNSON SUPPORT SERVICES | ||
| L | 86090 | FMV |
| PAUL OLIVER MEM HOS FOUNDATION | ||
| Q | 68000 | FMV |
| MUNSON SERVICES INC | ||
| L | 59018 | FMV |
| PAUL OLIVER MEM HOS FOUNDATION | ||
| L | 53088 | FMV |
| MUNSON MEDICAL CENTER | ||
| O | 6375983 | FMV |
| MUNSON MEDICAL CENTER | ||
| N | 1024071 | FMV |
| MUNSON HEALTHCARE | ||
| B | 1000000 | FMV |
| MUNSON MEDICAL CENTER | ||
| L | 920273 | FMV |
| NORTHERN MICHIGAN SUPPLY ALLIANCE | ||
| O | 183922 | FMV |
| MUNSON HEALTHCARE | ||
| L | 135948 | FMV |
| MUNSON DIALYSIS CENTER | ||
| P | 125000 | FMV |
| MUNSON HEALTHCARE | ||
| N | 124936 | FMV |
| MUNSON HEALTHCARE | ||
| O | 120366 | FMV |
| MUNSON SUPPORT SERVICES | ||
| L | 86090 | FMV |
| PAUL OLIVER MEM HOS FOUNDATION | ||
| Q | 68000 | FMV |
| MUNSON SERVICES INC | ||
| L | 59018 | FMV |
| PAUL OLIVER MEM HOS FOUNDATION | ||
| L | 53088 | FMV |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE R | ReturnReference |
| Explanation | PAUL OLIVER MEMORIAL HOSPITAL USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED SUMMARIZED AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS | Explanation |