MONROE COMMUNITY HEALTH SERVICES: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MONROE COMMUNITY HEALTH SERVICES (EIN 38-2934134)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-04-24
- IRS object ID
- 201321149349300422
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-04-24T14:41:59-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 307 | AddressLine1 |
| City | SOUTHFIELD | City |
| State | MI | State |
| ZIP Code | 480370307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382934134 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONROE COMMUNITY HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MONR | NameControl |
| Phone | 7342404520 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS W SCHILLING | Name |
| Title | CFO & SR VP OF FINANCE | Title |
| Phone | 7342404520 | Phone |
| Date Signed | 2013-04-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN MIENCIER | Name |
| PTIN | P00842339 | PTIN |
| Phone | 2483522500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | THOMAS W SCHILLING | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7538030 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCYMEMORIAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1989 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | PROMOTE THE GENERAL HEALTH OF THE PUBLIC IN MONROE COUNTY, MICHIGAN AND SURROUNDING AREAS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 172 | TotalNbrEmployees |
| Total Nbr Volunteers | 24 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 189 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 44 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9296773 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 7513194 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 32718 | InvestmentIncomePriorYear |
| Investment Income Current Year | 24792 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -22063 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 9307617 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7538030 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4443800 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 3724246 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4270334 | OtherExpensePriorYear |
| Other Expenses Current Year | 3102401 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8714134 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6826647 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 593483 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 711383 | RevenuesLessExpensesCY |
| Total Assets BOY | 5731986 | TotalAssetsBOY |
| Total Assets EOY | 6930200 | TotalAssetsEOY |
| Total Liabilities BOY | 2898991 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3385822 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2832995 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3544378 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROMOTE THE GENERAL HEALTH OF THE PUBLIC IN MONROE COUNTY, MICHIGAN AND SURROUNDING AREAS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6298757 | Expense |
| Revenue | 7513194 | Revenue |
| Description | OPERATED A 70-BED SKILLED NURSING FACILITY, DBA MERCY MEMORIAL NURSING CENTER. THIS FACILITY PROVIDED 23,264 RESIDENT DAYS OF CARE IN 2012 AS FOLLOWS:- MEDICAID 10,848- PRIVATE PAY 4,408- MEDICARE 8,008THIS REPRESENTS AN AVERAGE CENSUS OF 63.6 RESIDENT UNITS PER DAY. | Description |
| Total Program Service Expense | 6298757 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 9 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 172 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | THOMAS W SCHILLING | NamePerson |
| Telephone Number | 7342404520 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| BELLINO KAREN M VUICH | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| BHURGRI MD AAMER | |||||||
| CHIEF OF STAFF - EX OFFICIO W/VOTING | 4.00 | X | 0 | 49278 | 45929 | ||
| BRAUNLICH PAUL E | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| CALENDAR KAREN | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| CALENDAR KENYON S | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| CARTER KURT W | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| CHARBONEAU DO MICHAEL | |||||||
| VICE CHIEF OF STAFF - EX OFFICIO W/VOTING | 1.00 | X | 0 | 363926 | 12543 | ||
| DARROW KURT L | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| FRANZEN VICKI L | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | |
| KABIR MD ABDUL | |||||||
| TRUSTEE | 1.00 | X | 0 | 35394 | 531 | ||
| MCNAMEE MD KENNETH J | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| PETERS RUTH ANN | |||||||
| GUILD PRESIDENT - EX OFFICIO W/VOTING | 1.00 | X | 0 | 0 | 0 | ||
| PHILLIPS ANNETTE S | |||||||
| PRESIDENT & CEO - EX OFFICIO W/VOTING | 4.00 | X | 0 | 434409 | 29668 | X | |
| ROBBINS BASIL D | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | |
| RYAN SISTER JANET | |||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | X | |
| SABO CPA DEBORAH A | |||||||
| SECRETARY (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | X | |
| SPENCER EDD DONALD A | |||||||
| VICE CHAIR (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | X | |
| WALSH ARLENE R | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| WILBURN WALTER | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| WORRELL MARK | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| KUBISKE DAVID | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| KULISH BARTON | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| AMIN JATIN | |||||||
| TRUSTEE - EX OFFICIO (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| JAVAID MUHAMMAD | |||||||
| TRUSTEE - EX OFFICIO (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| SCHILLING THOMAS W | |||||||
| CFO SENIOR VP FINANCE | 4.00 | 0 | 311655 | 30325 | X | ||
| JAN MARTIN | |||||||
| ADMINISTRATOR | 40.00 | 118869 | 0 | 30624 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 118869 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1194662 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 149620 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONCEPT REHAB INC | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7150 GRANITE CIRCLE SUITE 200 | AddressLine1 |
| City | TOLEDO | City |
| State | OH | State |
| ZIP Code | 43617 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | PATIENT THERAPY | DescriptionOfServices |
| Compensation | 905762 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 44 | AllOtherContributions |
| Total Contributions | 44 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SKILLED NURSING - MMNC | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 7513194 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7513194 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 7513194 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8892 | TotalRevenueColumn |
| Exclusion | $8,892 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 15900 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 15900 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15900 | TotalRevenueColumn |
| Exclusion | $15,900 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7538030 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7513194 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $24,792 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2797896 | Total |
| Program Services | 2549026 | ProgramServices |
| Management And General | 248870 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12846 | Total |
| Program Services | 11703 | ProgramServices |
| Management And General | 1143 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 701830 | Total |
| Program Services | 639403 | ProgramServices |
| Management And General | 62427 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 211674 | Total |
| Program Services | 192846 | ProgramServices |
| Management And General | 18828 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44916 | Total |
| Management And General | 44916 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18008 | Total |
| Management And General | 18008 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 137 | Total |
| Management And General | 137 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1138567 | Total |
| Program Services | 1088479 | ProgramServices |
| Management And General | 50088 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9734 | Total |
| Management And General | 9734 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53587 | Total |
| Program Services | 22650 | ProgramServices |
| Management And General | 30937 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 263920 | Total |
| Program Services | 246636 | ProgramServices |
| Management And General | 17284 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11090 | Total |
| Program Services | 7324 | ProgramServices |
| Management And General | 3766 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1489 | Total |
| Program Services | 75 | ProgramServices |
| Management And General | 1414 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90690 | Total |
| Program Services | 90690 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 253333 | Total |
| Program Services | 236743 | ProgramServices |
| Management And General | 16590 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45997 | Total |
| Program Services | 42249 | ProgramServices |
| Management And General | 3748 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| MEDICAL SUPPLIES | 472417 | 472417 |
| QUALITY ASSURANCE ASSES | 304349 | 304349 |
| BAD DEBT EXPENSE | 229021 | 229021 |
| DIETARY | 165146 | 165146 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6826647 | Total |
| Program Services | 6298757 | ProgramServices |
| Management And General | 527890 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2996612 | BOY |
| EOY | 7790 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 3292340 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1054182 | BOY |
| EOY | 1814462 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19803 | BOY |
| EOY | 8561 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9511084 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7711752 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1652104 | BOY |
| EOY | 1799332 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9285 | BOY |
| EOY | 7715 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5731986 | BOY |
| EOY | 6930200 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1123252 | BOY |
| EOY | 1755134 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1775739 | BOY |
| EOY | 1630688 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2898991 | BOY |
| EOY | 3385822 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2832207 | BOY |
| EOY | 3543546 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 788 | BOY |
| EOY | 832 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2832995 | BOY |
| EOY | 3544378 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5731986 | BOY |
| EOY | 6930200 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 711383 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1812 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2001 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1664 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 189 | CurrentTaxYearMinus1Year |
| Current Tax Year | 44 | CurrentTaxYear |
| Total | 5710 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10629556 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9875332 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10714465 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9296773 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7513194 | CurrentTaxYear |
| Total | 48029320 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10631368 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9877333 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10716129 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9296962 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7513238 | CurrentTaxYear |
| Total | 48035030 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 26311 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 45342 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 15346 | CurrentTaxYearMinus2Years |
| Current Tax Year | 202777 | CurrentTaxYear |
| Total | 289776 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 26311 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 45342 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 15346 | CurrentTaxYearMinus2Years |
| Current Tax Year | 202777 | CurrentTaxYear |
| Total | 289776 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 47745254 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 403763 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 355462 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 198647 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 59779 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8892 | CurrentTaxYear |
| Total | 1026543 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 403763 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 355462 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 198647 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 59779 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8892 | CurrentTaxYear |
| Total | 1026543 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11035131 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 10232795 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10914776 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9356741 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7522130 | CurrentTaxYear |
| Total | 49061573 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.97320 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.97180 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.02090 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.02590 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $137 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 137 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | A PERCENTAGE OF DUES PAID TO VARIOUS ORGANIZATIONS IS ALLOCATED BY THOSE ORGANIZATIONS AS LOBBYING COSTS. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 788 | BeginningOfYearBalance |
| Contributions | 44 | Contributions |
| End Of Year Balance | 832 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 636 | BeginningOfYearBalance |
| Contributions | 152 | Contributions |
| End Of Year Balance | 788 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 542 | BeginningOfYearBalance |
| Contributions | 94 | Contributions |
| End Of Year Balance | 636 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 464 | BeginningOfYearBalance |
| Contributions | 78 | Contributions |
| End Of Year Balance | 542 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 375115 | OtherCostOrOtherBasis |
| Book Value | 375115 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6017214 | OtherCostOrOtherBasis |
| Depreciation | 5231892 | Depreciation |
| Book Value | 785322 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 29780 | OtherCostOrOtherBasis |
| Depreciation | 28925 | Depreciation |
| Book Value | 855 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2696652 | OtherCostOrOtherBasis |
| Depreciation | 2450935 | Depreciation |
| Book Value | 245717 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 392323 | OtherCostOrOtherBasis |
| Book Value | 392323 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1799332 | TotalOfBookValueLandBuildings |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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: | 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, 2012, 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARBONEAU DO MICHAEL | |||||||||||||
| 0 | 276533 | 0 | 75 | 0 | 87318 | 0 | 4000 | 0 | 8543 | 0 | 376469 | 0 | 0 |
| PHILLIPS ANNETTE S | |||||||||||||
| 0 | 340138 | 0 | 89471 | 0 | 4800 | 0 | 10378 | 0 | 19290 | 0 | 464077 | 0 | 0 |
| SCHILLING THOMAS W | |||||||||||||
| 0 | 254155 | 0 | 51500 | 0 | 6000 | 0 | 10559 | 0 | 19766 | 0 | 341980 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| 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. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBERS DR. KENNETH MCNAMEE, DR. AAMER BHURGRI, DR. MICHAEL CHARBONEAU, JATIN AMIN AND DR. ABDUL KABIR HAVE A BUSINESS RELATIONSHIP. BOARD MEMBERS KAREN CALENDAR AND KENYON CALENDAR HAVE A FAMILY 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 2012. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| 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 2010 FORM 990 AND IS NOT INCLUDED ON THIS RETURN. |
| FORM 990, PART VII, SECTION A: | THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO, RELATED ORGANIZATION, MERCY MEMORIAL HOSPITAL CORPORATION: JATIN AMIN 1 HOUR KAREN M. VUICH BELLINO 1 HOUR AAMER BHURGRI, M.D. 4 HOURS PAUL E. BRAUNLICH 1 HOUR KAREN CALENDAR 1 HOUR KENYON S. CALENDAR 1 HOUR KURT W. CARTER 1 HOUR MICHAEL CHARBONEAU, D.O. 40 HOURS KURT L. DARROW 1 HOUR VICKI L. FRANZEN 1 HOUR MUHAMMAD JAVAID 1 HOUR ABDUL KABIR, M.D. 4 HOURS DAVID KUBISKE 1 HOUR BARTON KULISH 1 HOUR KENNETH J. MCNAMEE, M.D. 1 HOUR RUTH ANN PETERS 1 HOUR ANNETTE S. PHILLIPS 40 HOURS BASIL D. ROBBINS 1 HOUR SISTER JANET RYAN 1 HOUR DEBORAH A. SABO, C.P.A. 1 HOUR DONALD A. SPENCER, ED.D. 1 HOUR ARLENE R. WALSH 1 HOUR WALTER WILBURN 1 HOUR MARK WORRELL 1 HOUR THOMAS W. SCHILLING 40 HOURS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEMORIAL HOSPITAL CORPORATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381984289 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | MI | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 3 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONROE HEALTH VENTURES | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48164 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382704426 | EIN |
| Primary Activity | PHARMACY | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MERCY MEMORIAL HOSPITAL CORPORATION | ||
| L | 133397 | ACTUAL ALLOCATED COST |
| MERCY MEMORIAL HOSPITAL CORPORATION | ||
| K | 134415 | ACTUAL ALLOCATED COST |
| MERCY MEMORIAL HOSPITAL CORPORATION | ||
| O | 1263606 | ACTUAL ALLOCATED COST |
| MERCY MEMORIAL HOSPITAL CORPORATION | ||
| P | 81828 | ACTUAL ALLOCATED COST |
| MERCY MEMORIAL HOSPITAL CORPORATION | ||
| Q | 1028460 | ACTUAL ALLOCATED COST |