GOTTLIEB MEMORIAL HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- GOTTLIEB MEMORIAL HOSPITAL (EIN 36-2379649)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-09
- IRS object ID
- 201321299349300632
- 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 B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-09T14:08:51-05:00 | 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 | 362379649 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOTTLIEB MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GOTT | NameControl |
| Phone | 7084504966 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W NORTH AVE | AddressLine1 |
| City | MELROSE PARK | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AJAY SIAL | Name |
| Title | TREASURER | Title |
| Phone | 7084504966 | Phone |
| Date Signed | 2013-05-09 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LARRY GOLDBERG | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W NORTH AVE | AddressLine1 |
| City | MELROSE PARK | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 132856482 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GOTTLIEBHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1956 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | HEALTH CARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1308 | TotalNbrEmployees |
| Total Nbr Volunteers | 217 | TotalNbrVolunteers |
| Total Gross UBI | 2074173 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -118266 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 134971 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 462838 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 120971380 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 129880571 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4690 | InvestmentIncomePriorYear |
| Investment Income Current Year | 737218 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 8659161 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1599005 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 129770202 | TotalRevenuePriorYear |
| Total Revenue Current Year | 132679632 | 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 | 70514206 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 67365807 | 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 | 60416550 | OtherExpensePriorYear |
| Other Expenses Current Year | 65986470 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 130930756 | TotalExpensesPriorYear |
| Total Expenses Current Year | 133352277 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1160554 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -672645 | RevenuesLessExpensesCY |
| Total Assets BOY | 119134315 | TotalAssetsBOY |
| Total Assets EOY | 152695436 | TotalAssetsEOY |
| Total Liabilities BOY | 60244457 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 78193014 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 58889858 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 74502422 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HEALTH CARE SERVICES - SEE SCHEDULE H FOR MORE INFORMATION | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 115318744 | Expense |
| Revenue | 128551091 | Revenue |
| Description | GOTTLIEB MEMORIAL HOSPITAL (GOTTLIEB) IS AN ACUTE CARE NOT-FOR-PROFIT HOSPITAL WITH 255 LICENSED BEDS. OPERATING IN THE WESTERN SUBURBS OF ILLINOIS, GOTTLIEB PROVIDES VITAL HEALTH CARE SERVICES 24 HOURS A DAY, SEVEN DAYS A WEEK, TO PATIENTS IN VARIOUS SETTINGS, INCLUDING CARDIOVASCULAR/THORACIC, OBSTETRICS, ORTHOPAEDICS, MEDICAL IMAGING, GASTROENTEROLOGY, UROLOGY, HOME CARE AND HOSPICE SERVICES, TRANSITIONAL CARE, AND ADULT DAY CARE SERVICES.DURING FISCAL YEAR 2012 GOTTLIEB PROVIDED OVER 47,000 DAYS OF HEALTHCARE SERVICES AND OVER 77,000 OUTPATIENT VISITS TO THE COMMUNITY. GOTTLIEB MEMORIAL HOSPITAL IS DEDICATED TO PROVIDING SUPERIOR HEALTHCARE TO IMPROVE THE OVERALL HEALTH OF ALL WE SERVE. INDIVIDUALS WITHIN OUR COMMUNITY ARE PROVIDED ACCESS TO MEDICALLY NECESSARY CARE REGARDLESS OF THEIR ABILITY TO PAY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THE MISSION STATEMENT OF GOTTLIEB MEMORIAL HOSPITAL IS AS FOLLOWS:WE SERVE TOGETHER IN TRINITY HEALTHIN THE SPIRIT OF THE GOSPELTO HEAL BODY, MIND, AND SPIRITTO IMPROVE THE HEALTH OF OUR COMMUNITIESAND TO STEWARD THE RESOURCES ENTRUSTED TO US. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 115318744 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | 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 | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| 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 | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 88 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1308 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| 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 | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELLYN CHIN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7084504534 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W NORTH AVE | AddressLine1 |
| City | MELROSE PARK | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (34 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| DANIEL HALE | |||||||||
| INTERIM CHAIR AS OF 7/11 | 2.00 | X | X | 0 | 925954 | 106225 | |||
| PATRICIA CASSIDY | |||||||||
| INTERIM PRES FROM 7/11 THROUGH 3/12 | 20.00 | X | X | 0 | 1885874 | 173667 | |||
| LARRY GOLDBERG | |||||||||
| DIRECTOR AS OF 10/11;PRES AS OF 4/12 | 10.00 | X | X | 0 | 196650 | 12915 | |||
| ROBERT FLANIGAN MD | |||||||||
| DIRECTOR AS OF 8/11 | 2.00 | X | 0 | 408994 | 25796 | ||||
| RICHARD GAMELLI MD | |||||||||
| DIRECTOR AS OF 7/11 | 2.00 | X | 0 | 890026 | 29194 | ||||
| P TERRENCE O'ROURKE | |||||||||
| DIRECTOR AS OF 7/11 | 2.00 | X | 0 | 863581 | 50709 | ||||
| ROBERT SULO MD | |||||||||
| DIRECTOR | 2.00 | X | 0 | 333392 | 42076 | ||||
| DAVID WILBER | |||||||||
| DIRECTOR | 2.00 | X | 0 | 640268 | 26131 | ||||
| NANCY KNOWLES | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| HENRY LANG | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| WILLIAM REICHERT | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| MARC SCHWARTZ | |||||||||
| DIRECTOR AS OF 8/11 | 2.00 | X | 0 | 0 | 0 | ||||
| SR JOAN MARIE STEADMAN CSC | |||||||||
| DIRECTOR AS OF 7/11 | 2.00 | X | 0 | 0 | 0 | ||||
| JACK WEINBERG | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| AJAY SIAL | |||||||||
| TREASURER AS OF 4/12 | 2.00 | X | 0 | 0 | 0 | ||||
| BENJAMIN CARTER | |||||||||
| TREASURER THROUGH 4/12 | 2.00 | X | 0 | 755014 | 102689 | ||||
| ELLYN CHIN | |||||||||
| ASST TREASURER AS OF 7/11 | 30.00 | X | 282497 | 0 | 62935 | ||||
| CHARLES REITER III | |||||||||
| SECRETARY 7/1/11 - 7/8/11 | 2.00 | X | 0 | 1588987 | 113850 | ||||
| JILL RAPPIS | |||||||||
| SECRETARY AS OF 7/11 | 2.00 | X | 0 | 288502 | 58102 | ||||
| DONNA HALINSKI | |||||||||
| ASSISTANT SECRETARY AS OF 12/11 | 2.00 | X | 0 | 309741 | 48973 | ||||
| TOM HONAN NAVIGANT | |||||||||
| INTERIM CFO THROUGH 4/12 | 10.00 | X | 0 | 1556520 | 0 | ||||
| KENNETH FISHBAIN | |||||||||
| COO | 30.00 | 519217 | 0 | 69060 | X | ||||
| ALAN GOLDBERG | |||||||||
| VP OF ADMIN SERVICES | 40.00 | 253087 | 0 | 128045 | X | ||||
| JOSEPH SWEDISH | |||||||||
| TRINITY HEALTH PRES & CEO | 2.00 | 0 | 5186660 | 576202 | X | ||||
| KEDRICK ADKINS | |||||||||
| TRINITY HEALTH PRES, INTEGRATED SVCS | 2.00 | 0 | 1405226 | 117120 | X | ||||
| J RICHARD O'CONNELL | |||||||||
| TRINITY HEALTH COO-HOSPITAL NTWKS | 2.00 | 0 | 943237 | 118221 | X | ||||
| MICHAEL MURPHY | |||||||||
| TRIN HLTH EVP, HLTH NTWKS UNTIL 4/12 | 2.00 | 0 | 474370 | 75538 | X | ||||
| BRETT WAKEFIELD | |||||||||
| VP, HR/MARKETING | 40.00 | 233997 | 0 | 202173 | X | ||||
| SILIA MIGLIO | |||||||||
| CORPORATE CONTROLLER | 40.00 | 157638 | 0 | 17486 | X | ||||
| MAURITA ADLER | |||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 150806 | 0 | 55342 | X | ||||
| ELIZABETH MCLAIN | |||||||||
| RN WEEKENDER II | 40.00 | 145698 | 0 | 14675 | X | ||||
| JOHN ASTREIDES | |||||||||
| DIRECTOR OF INFORMATION SVCS | 40.00 | 141313 | 0 | 30796 | X | ||||
| PAUL WHELTON | |||||||||
| FORMER OFFICER | 0.00 | 0 | 3693100 | 1453069 | X | ||||
| CONSTANCE CLARK | |||||||||
| FORMER KEY EMPLOYEE | 0.00 | 182710 | 0 | 27851 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2066963 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 22346096 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 3738840 | TotalOtherCompensation |
| Number Individuals GT100 K | 54 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| GEORGE SOLLITT CONSTRUCTION COMPANY | |||||
| 790 N CENTRAL AVE | WOODDALE | IL | 60191 | CONSTRUCTION SERVICES | 1692286 |
| FRESENIUS MANAGEMENT SERVICES | |||||
| 16343 COLLECTION CTR DR | CHICAGO | IL | 60693 | HEALTHCARE SERVICES | 379908 |
| UBS GLOBAL ASSET MANAGEMENT | |||||
| 23387 NETWORK PLACE | CHICAGO | IL | 60673 | BANK SERVICES | 324501 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| PO BOX 636981 | CINCINNATI | OH | 45263 | CLINICAL SERVICES | 312090 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 12989 | CHICAGO | IL | 60693 | LABORATORY SERVICES | 287614 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 22 | NumberOfContractorsGT100K |
| Fundraising Events | 4938 | FundraisingEvents |
| All Other Contributions | 457900 | AllOtherContributions |
| Total Contributions | 462838 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SVC REV | 900099 | 123649581 | 123649581 | |
| LABORATORY REV | 621500 | 4348860 | 4156817 | 192043 |
| PHARMACY REV | 446110 | 1882130 | 1882130 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 129880571 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 426034 | TotalRevenueColumn |
| Exclusion | $426,034 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 342149 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 342149 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 342149 | TotalRevenueColumn |
| Exclusion | $342,149 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 309184 | Securities |
| Other | 2000 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 309184 | Securities |
| Other | 2000 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 311184 | TotalRevenueColumn |
| Exclusion | $311,184 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 197311 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 4938 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 104851 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 92460 | TotalRevenueColumn |
| Exclusion | $92,460 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 99846 | GrossSalesOfInventory |
| Cost Of Goods Sold | 71999 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27847 | TotalRevenueColumn |
| Exclusion | $27,847 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAFETERIA | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 391856 | TotalRevenueColumn |
| Exclusion | $391,856 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 744693 | TotalRevenueColumn |
| Related Or Exempt Function Income | 744693 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1136549 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 132679632 | TotalRevenueColumn |
| Related Or Exempt Function Income | 128551091 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2074173 | UnrelatedBusinessRevenue |
| Exclusion | $1,591,530 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2599571 | Total |
| Management And General | 2599571 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50509620 | Total |
| Program Services | 46241521 | ProgramServices |
| Management And General | 4268099 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2425802 | Total |
| Program Services | 2330034 | ProgramServices |
| Management And General | 95768 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7891455 | Total |
| Program Services | 6980158 | ProgramServices |
| Management And General | 911297 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3939359 | Total |
| Program Services | 3450266 | ProgramServices |
| Management And General | 489093 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10 | Total |
| Management And General | 10 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 149114 | Total |
| Management And General | 149114 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9056859 | Total |
| Program Services | 4711352 | ProgramServices |
| Management And General | 4345507 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 745504 | Total |
| Management And General | 745504 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3680541 | Total |
| Program Services | 2867465 | ProgramServices |
| Management And General | 813076 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 997100 | Total |
| Program Services | 234296 | ProgramServices |
| Management And General | 762804 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2932437 | Total |
| Program Services | 2793803 | ProgramServices |
| Management And General | 138634 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70069 | Total |
| Program Services | 54781 | ProgramServices |
| Management And General | 15288 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154362 | Total |
| Program Services | 71342 | ProgramServices |
| Management And General | 83020 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100024 | Total |
| Program Services | 100024 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6701022 | Total |
| Program Services | 6701022 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4093083 | Total |
| Program Services | 4093083 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 20217445 | 19572901 | 644544 |
| BAD DEBT | 9123546 | 9123546 | |
| HOSPITAL PROVIDER TAX | 3347110 | 3347110 | |
| UBI TAXES | 30 | 30 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4618214 | Total |
| Program Services | 2646040 | ProgramServices |
| Management And General | 1972174 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133352277 | Total |
| Program Services | 115318744 | ProgramServices |
| Management And General | 18033533 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37685910 | BOY |
| EOY | 10803190 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58316 | BOY |
| EOY | 63107 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12350498 | BOY |
| EOY | 16889292 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 315171 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2759414 | BOY |
| EOY | 2874627 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 625540 | BOY |
| EOY | 415505 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 89913932 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6998849 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52086098 | BOY |
| EOY | 82915083 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75000 | BOY |
| EOY | 5298857 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 447260 | BOY |
| EOY | 8645504 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13046279 | BOY |
| EOY | 24475100 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119134315 | BOY |
| EOY | 152695436 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42195592 | BOY |
| EOY | 61487039 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 5554180 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18048865 | BOY |
| EOY | 11151795 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60244457 | BOY |
| EOY | 78193014 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58814858 | BOY |
| EOY | 74502422 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75000 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58889858 | BOY |
| EOY | 74502422 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119134315 | BOY |
| EOY | 152695436 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -672645 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 16285209 | 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 | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
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 | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $11,882 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 11882 | 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 | GOTTLIEB MEMORIAL HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED GOTTLIEB MEMORIAL HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. GOTTLIEB MEMORIAL HOSPITAL MADE NO CONTRIBUTIONS TO ANY LEGISLATORS OR CANDIDATES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12500000 | OtherCostOrOtherBasis |
| Book Value | 12500000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 50613391 | OtherCostOrOtherBasis |
| Depreciation | 3262442 | Depreciation |
| Book Value | 47350949 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17465481 | OtherCostOrOtherBasis |
| Depreciation | 3629915 | Depreciation |
| Book Value | 13835566 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9335060 | OtherCostOrOtherBasis |
| Depreciation | 106492 | Depreciation |
| Book Value | 9228568 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 82915083 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES | 4880526 | F |
| EQUITY METHOD INVESTMENTS | 3764978 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 8645504 | TotalOfBookValueSecurities |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| NET DEFERRED TAX ASSET | 146000 |
| INTERCOMPANY RECEIVABLES | 21553049 |
| OTHER RECEIVABLES | 2644732 |
| INVESTMENT IN UNCONSOLIDATED AFFILIATES | 101500 |
| OTHER CURRENT ASSETS | 29819 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 24475100 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| INTERCOMPANY PAYABLES | $7,541,925 |
| LONG-TERM ASSET RETIREMENT OBLIGATION (FIN 47) | $441,204 |
| OTHER CURRENT LIABILITIES | $1,918,666 |
| OTHER LONG-TERM LIABILITIES | $1,250,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11151795 | TotalOfAmounts |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | EMERALD BALL | NameOfEvent1 |
| Gross Receipts Event1 | 202249 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 4938 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 197311 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 104851 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 202249 | GrossReceiptsTotal |
| Charitable Contributions Total | 4938 | CharitableContributionsTotal |
| Gross Revenue Total Events | 197311 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 104851 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 104851 | DirectExpenseSummaryEvents |
| Net Income Summary | 92460 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 600.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 3062985 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 490600 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2572385 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02070 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15659044 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13435359 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2223685 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01790 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 18722029 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13925959 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4796070 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03860 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 1666 | PersonsServed |
| Total Community Benefit Expense | 55012 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 55012 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 16 | PersonsServed |
| Total Community Benefit Expense | 66900 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 66900 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 3661 | PersonsServed |
| Total Community Benefit Expense | 4004 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4004 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 8745 | PersonsServed |
| Total Community Benefit Expense | 38514 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 38514 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 14088 | PersonsServed |
| Total Community Benefit Expense | 164430 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 164430 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Persons Served | 14088 | PersonsServed |
| Total Community Benefit Expense | 18886459 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13925959 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4960500 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03980 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 40837 | PersonsServed |
| Total Community Building Expense | 80729 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 80729 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 40837 | PersonsServed |
| Total Community Building Expense | 80729 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 80729 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,488,106 | BadDebtExpenseAmount |
| Amount Attributable To | 446432 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 47392004 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 51824622 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4432618 | MedicareSurplusOrShortfall |
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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | 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 | GOTTLIEB MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W NORTH AVE | AddressLine1 |
| City | MELROSE PARK | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | INCLUDING OUTPATIENT SERVICES | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOTTLIEB MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 600.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| GOTTLIEB HOME HEALTH & HOSPICE | ||||
| 905 W NORTH AVE | MELROSE PARK | IL | 60160 | HOME HEALTH AND HOSPICE PROGRAM |
| GOTTLIEB ADULT DAY CARE CENTER | ||||
| 555 W NORTH AVE | MELROSE PARK | IL | 60160 | ADULT DAY CARE CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 6A: GOTTLIEB MEMORIAL HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF ILLINOIS. AS OF JULY 1, 2011, GOTTLIEB MEMORIAL HOSPITAL ALSO REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, GOTTLIEB MEMORIAL HOSPITAL WILL INCLUDE A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. | ||
| PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. | ||
| PART I, L7 COL(F): THE FOLLOWING NUMBER, $9,123,546, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). | ||
| PART II: COMMUNITY BUILDING ACTIVITIES - GOTTLIEB MEMORIAL HOSPITAL (GMH) PROVIDED A NUMBER OF COMMUNITY BUILDING ACTIVITIES IN FISCAL YEAR 2012 TO SUPPORT AND PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. GMH AND ITS STAFF ALLERGIST PROVIDE GMH'S DAILY ALLERGY COUNT (FROM APRIL THROUGH OCTOBER) FOR THE ENTIRE CHICAGO AREA. THE COUNT IS PROVIDED, AT NO COST, TO NEWS OUTLETS AND ALL CHICAGO METEOROLOGISTS. THE COUNT ALSO IS AVAILABLE ON GMH'S WEB SITE, VIA TWITTER AND BY A TELEPHONE HOTLINE EACH WEEKDAY MORNING DURING ALLERGY SEASON. IT IS A RELIED-UPON RESOURCE BY PEOPLE IN THE CHICAGO AREA WHO NEED TO DETERMINE WHETHER TO TAKE ALLERGY MEDICATION BEFORE STEPPING OUT THE DOOR IN THE MORNING.IN ADDITION, GMH STAFF PILOTED A PEDIATRIC OBESITY PROGRAM TO HELP ADDRESS THE NEEDS OF OVERWEIGHT CHILDREN AND ADOLESCENTS, WHICH LATER DEVELOPED INTO A FULL PROGRAM. GMH STAFF ALSO PARTICIPATED ON A COMMITTEE OF AREA PROVIDERS AND AGENCIES TO HELP CONNECT SENIORS AND OTHERS WITH HEALTHCARE RESOURCES. FURTHERMORE, GMH PROVIDED LANGUAGE SUPPORT SERVICES FOR THOSE NEEDING ASSISTANCE AND HEALTH INFORMATION THROUGH A WIDELY-DISTRIBUTED COMMUNITY HEALTH NEWSLETTER. | ||
| PART III, LINE 4: AS OF JULY 1, 2011, GOTTLIEB MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM THOSE STATEMENTS: "SUBSTANTIALLY ALL OF THE CORPORATION'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO PATIENTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. THE CORPORATION'S ESTIMATE FOR ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS BY PAYOR."COSTING METHODOLOGY FOR LINES 2 AND 3: AMOUNTS ARE CALCULATED ON LINE 2 USING A COST TO CHARGE RATIO METHODOLOGY.ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.THE AMOUNT ON LINE 3 IS BASED ON THE ACCOUNTS WRITTEN OFF TO BAD DEBT AFTER THEY WENT TO COLLECTION AGENCY THAT HAD A CREDIT SCORE OF LESS THAN 500. BASED ON THE EXPERTISE OF THE COLLECTION AGENCY, THESE PATIENTS ARE UNABLE TO PAY AND MOST LIKELY WOULD HAVE QUALIFIED FOR CHARITY IF THEY HAD COMPLETED ALL PAPERWORK. | ||
| PART III, LINE 8: GOTTLIEB MEMORIAL HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. | ||
| PART III, LINE 9B: GOTTLIEB'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE FOR FINANCIAL ASSISTANCE. THERE ARE MANY INSTANCES WHEN A PATIENT DOES NOT FORMALLY COMPLETE A CHARITY/FINANCIAL APPLICATION, BUT WOULD QUALIFY FOR CHARITY OR FINANCIAL ASSISTANCE IF THE APPLICATION WERE COMPLETED. BEFORE AN ACCOUNT IS TURNED OVER TO A COLLECTION AGENCY, THE PATIENT ACCOUNTS STAFF FOLLOWS THE PROCESS OF EVALUATING WHETHER A PATIENT COULD MEET CHARITY OR FINANCIAL ASSISTANCE BY REVIEW OF THE FOLLOWING INFORMATION: PATIENT HISTORY, PATIENT DEMOGRAPHICS, EMPLOYMENT STATUS, FINANCIAL INFORMATION INCLUDING CREDIT CHECK, RETURNED MAIL, CITIZENSHIP, AND VALID IDENTIFICATION. | ||
| PART V, SECTION B, LINE 19D: IN DETERMINING THE AMOUNTS BILLED TO INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, GOTTLIEB MEMORIAL HOSPITAL USED MEDICARE RECEIVED PER THE ILLINOIS UNINSURED PATIENT ACT. | GOTTLIEB MEMORIAL HOSPITAL | |
| PART VI, LINE 2: NEEDS ASSESSMENT - GOTTLIEB MEMORIAL HOSPITAL PERFORMS COMMUNITY HEALTH NEEDS EVALUATIONS, WHICH ARE A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL-BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR GOTTLIEB MEMORIAL HOSPITAL'S STRATEGIC AND SUBSEQUENT ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.THE GOTTLIEB MEMORIAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED - IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGTHE GOTTLIEB MEMORIAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). THE DATA HELPS SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES. GOTTLIEB MEMORIAL HOSPITAL PLANS TO COMPLETE A MORE FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT BY JUNE 30, 2013. | ||
| PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE -GMH IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THOSE WHO ARE POOR AND UNDERSERVED IN OUR COMMUNITIES - CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE; AND - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYGMH HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSGMH PROVIDES EFFECTIVE COMMUNICATION WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO - OR AT THE TIME OF - ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.GMH OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH A NUMBER OF MEANS, INCLUDING THE HOSPITAL'S WEBSITE. GMH HAS ESTABLISHED A WRITTEN POLICY FOR BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. GMH MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. GMH EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, AND BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. | ||
| PART VI, LINE 4: COMMUNITY INFORMATION - OPERATING IN THE WESTERN SUBURBS OF CHICAGO, GMH IS AN ACUTE CARE, 255-LICENSED BED, NOT-FOR-PROFIT HOSPITAL; WITH A PROFESSIONAL OFFICE BUILDING, ADULT DAY CARE, GOTTLIEB CENTER FOR FITNESS, AND MARJORIE G. WEINBERG CANCER CARE CENTER ON ITS CAMPUS. GMH PROVIDES VITAL HEALTH CARE SERVICES TO PATIENTS IN VARIOUS CLINICAL AREAS, INCLUDING GENERAL MEDICINE, OBSTETRICS/GYNECOLOGY, CARDIOVASCULAR SERVICES, ORTHOPEDICS, NEUROSCIENCES, SPINE CARE, ONCOLOGY, AND ADULT CARE SERVICE. GMH'S AFFILIATION WITH LOYOLA UNIVERSITY HEALTH SYSTEM AND LOYOLA UNIVERSITY MEDICAL CENTER BRINGS A HIGH-QUALITY, FULL-SERVICE COMMUNITY-BASED INSTITUTION TOGETHER WITH A WORLD-CLASS TEACHING HOSPITAL AND MEDICAL SCHOOL. BOTH ORGANIZATIONS ARE NOT-FOR-PROFIT HEALTHCARE INSTITUTIONS AND BRING DIFFERENT STRENGTHS TO THIS RELATIONSHIP. THE COMMUNITIES SERVED BY THESE INSTITUTIONS BENEFIT FROM THE AFFILIATION BY ENHANCED HEALTHCARE PROVIDED LOCALLY AND THE IMPROVED FINANCIAL POSITIONS OF BOTH ORGANIZATIONS. GMH'S TOTAL SERVICE AREA, WHICH INCLUDES THE WESTERN SECTION OF CHICAGO, WESTERN COOK COUNTY AND THE EASTERN PART OF DUPAGE COUNTY, COVERS A POPULATION OF ABOUT ONE MILLION PEOPLE CHARACTERIZED BY A WIDE DEMOGRAPHIC MIX OF AGE, RACE AND ECONOMIC DIVERSITY. THE AREA HAS SUBSTANTIAL DISPARITIES IN SOCIOECONOMIC STATUS, UNEMPLOYMENT AND HEALTH STATUS. SPECIFICALLY, THE AREA HAS THE FOLLOWING CHARACTERISTICS: - 11 PERCENT OF THE POPULATION IS AGE 65 OR OLDER- AVERAGE HOUSEHOLD INCOME IS $65,266 WITH 17.2 PERCENT OF HOUSEHOLDS OVER $100,000 AND 22.8 PERCENT UNDER $25,000- HISPANICS ARE AMONG THE FASTEST-GROWING GROUP MAKING UP 33.7 PERCENT OF THE POPULATION | ||
| PART VI, LINE 5: OTHER INFORMATION - IN FURTHERANCE OF LUHS' TRADITION OF TEACHING, GMH SUPPORTS HOSPITAL-BASED EDUCATION AND TRAINING OF FUTURE PROFESSIONALS. GMH PROVIDED HOME AND HOSPICE CARE TRAINING FOR STUDENT NURSES, SUPPLIED PRECEPTORS FOR PHARMACY STUDENTS, PROVIDED CLINICAL SUPERVISION OF PHYSICAL AND SPEECH THERAPY STUDENTS AND TRAINED MEDICAL STUDENTS TO EVALUATE PATIENTS' NEEDS THROUGH OUTREACH IN THE COMMUNITY. GMH ALSO PROVIDES SUBSIDIZED HEALTH PROGRAMS IN RESPONSE TO COMMUNITY NEEDS; THESE PROGRAMS OPERATE AT A FINANCIAL LOSS. PROGRAMS INCLUDE CLINICAL SERVICES, AS WELL AS COMMUNITY HEALTH AND EDUCATION PROGRAMS. SPECIFICALLY, GMH PROVIDED SUBSIDIZED SUPPORT FOR ITS ADULT DAY CARE CENTER. GMH BEGAN RUNNING THE CENTER AFTER A LOCAL CHURCH COULD NO LONGER AFFORD TO PROVIDE THIS COMMUNITY SERVICE. THE CENTER PROVIDES CARE FOR PERSONS WITH DIABETES, DEMENTIA, DEPRESSION AND OTHER MENTAL AND MEDICAL DIAGNOSES. IN ADDITION, DURING FISCAL YEAR 2012, GMH PROVIDED PRE-SCHOOL HEARING AND SPEECH SCREENINGS, AND ADMINISTERED 150 FREE VACCINATIONS AT ITS FLU SHOT FAIR. GMH ALSO MAINTAINS AND STAFFS A HEALTH INFORMATION RESOURCE CENTER TO GIVE PATIENTS, FAMILIES, THE GENERAL PUBLIC, EMPLOYEES AND OTHERS EASY ACCESS TO HEALTH INFORMATION. FURTHERMORE, GMH OFFERS OLDER ADULTS AN AARP SAFE DRIVING PROGRAM AND ITS YESTERDAY'S YOUTH CLUB, A SOCIAL CLUB WITH HEALTH AND LIFESTYLE EDUCATION AND ACTIVITIES FOR AN AVERAGE OF 900 SENIORS.GMH SUPPORTS OTHER NOT-FOR-PROFIT COMMUNITY ORGANIZATIONS THROUGH CASH AND IN-KIND CHARITABLE CONTRIBUTIONS. THIS CONTRIBUTION INCLUDES A SPONSORSHIP TO HISPANOCARE, A NOT-FOR-PROFIT ORGANIZATION WITH A MISSION TO PROVIDE QUALITY, COST-EFFECTIVE HEALTHCARE TO CHICAGO'S LATINO COMMUNITY IN A CULTURALLY SENSITIVE MANNER. HISPANOCARE COORDINATES COMMUNITY HEALTH FAIRS WHERE PREVENTIVE SERVICES AND SCREENINGS ARE OFFERED FREE OF CHARGE. IT EDUCATES THE LATINO COMMUNITY ABOUT GENERAL HEALTH, ILLNESS PREVENTION AND OTHER RELATED TOPICS THROUGH SPANISH RADIO TALK SHOWS, NEWSPAPER COLUMNS AND A MEMBER NEWSLETTER. HISPANOCARE ALSO ANNUALLY PROVIDES SEVERAL COLLEGE-LEVEL SCHOLARSHIPS TO STUDENTS ENROLLED IN HEALTHCARE-RELATED STUDIES. IN ADDITION, GMH AWARDED A GRANT TO A LOCAL ELEMENTARY SCHOOL IN THE 2012 FISCAL YEAR IN CONJUNCTION WITH THE PROJECT FIT AMERICA PROGRAM. THE GRANT WILL PAY FOR A SEVEN-STATION EXERCISE CIRCUIT INSTALLED ON THE SCHOOL GROUNDS AND A HEALTH-AND-FITNESS CLASSROOM COMPONENT, ALL DESIGNED TO HELP IMPROVE STUDENTS' FITNESS LEVELS AND MOTIVATE THEM TO ADOPT HEALTHY LIFESTYLES. SINCE THE PROGRAM WAS INITIATED, GMH HAS PROVIDED SPONSORSHIP GRANTS TO 14 SCHOOLS IN THIS HIGHLY EFFECTIVE NATIONAL PROGRAM. | ||
| PART VI, LINE 6: GMH IS A MEMBER ORGANIZATION OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE SYSTEMS IN THE COUNTRY. BASED IN LIVONIA, MICHIGAN, TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEVELOP, AND ARE HELD ACCOUNTABLE FOR ACHIEVING, COMMUNITY BENEFIT GOALS THAT INCLUDE DEVELOPING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THOSE WHO ARE POOR AND UNINSURED, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND OUTREACH TO THE ELDERLY. IN FISCAL YEAR 2012, THIS INCLUDED OVER $615 MILLION IN SUCH COMMUNITY BENEFITS. THEREFORE, TRINITY HEALTH TAKES A SYSTEM APPROACH IN ITS COMMUNITY BENEFIT PLANNING AND IMPLEMENTATION, AND IS CONSEQUENTLY ABLE TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ARE HELPING PROMOTE AND ADDRESS THE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. | ||
| IL | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 1 | 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 (27 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL HALE | |||||||||||||
| 0 | 479340 | 0 | 186340 | 0 | 260274 | 0 | 87640 | 0 | 18585 | 0 | 1032179 | 0 | 155414 |
| PATRICIA CASSIDY | |||||||||||||
| 0 | 490629 | 0 | 217040 | 0 | 1178205 | 0 | 158843 | 0 | 14824 | 0 | 2059541 | 0 | 0 |
| LARRY GOLDBERG | |||||||||||||
| 0 | 126243 | 0 | 50000 | 0 | 20407 | 0 | 12003 | 0 | 912 | 0 | 209565 | 0 | 0 |
| ROBERT FLANIGAN MD | |||||||||||||
| 0 | 321449 | 0 | 40579 | 0 | 46966 | 0 | 20982 | 0 | 4814 | 0 | 434790 | 0 | 0 |
| RICHARD GAMELLI MD | |||||||||||||
| 0 | 308813 | 0 | 383422 | 0 | 197791 | 0 | 20982 | 0 | 8212 | 0 | 919220 | 0 | 0 |
| P TERRENCE O'ROURKE | |||||||||||||
| 0 | 500415 | 0 | 209835 | 0 | 153331 | 0 | 22851 | 0 | 27858 | 0 | 914290 | 0 | 0 |
| ROBERT SULO MD | |||||||||||||
| 0 | 331070 | 0 | 0 | 0 | 2322 | 0 | 20982 | 0 | 21094 | 0 | 375468 | 0 | 0 |
| DAVID WILBER | |||||||||||||
| 0 | 567184 | 0 | 67500 | 0 | 5584 | 0 | 20982 | 0 | 5149 | 0 | 666399 | 0 | 0 |
| BENJAMIN CARTER | |||||||||||||
| 0 | 509505 | 0 | 174420 | 0 | 71089 | 0 | 73824 | 0 | 28865 | 0 | 857703 | 0 | 0 |
| ELLYN CHIN | |||||||||||||
| 246641 | 0 | 10856 | 0 | 25000 | 0 | 36904 | 0 | 26031 | 0 | 345432 | 0 | 0 | 0 |
| CHARLES REITER III | |||||||||||||
| 0 | 262219 | 0 | 130098 | 0 | 1196670 | 0 | 98740 | 0 | 15110 | 0 | 1702837 | 0 | 0 |
| JILL RAPPIS | |||||||||||||
| 0 | 237141 | 0 | 50152 | 0 | 1209 | 0 | 49455 | 0 | 8647 | 0 | 346604 | 0 | 0 |
| DONNA HALINSKI | |||||||||||||
| 0 | 227291 | 0 | 72792 | 0 | 9658 | 0 | 33582 | 0 | 15391 | 0 | 358714 | 0 | 0 |
| TOM HONAN NAVIGANT | |||||||||||||
| 0 | 1556520 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1556520 | 0 | 0 |
| KENNETH FISHBAIN | |||||||||||||
| 317784 | 0 | 6433 | 0 | 195000 | 0 | 57770 | 0 | 11290 | 0 | 588277 | 0 | 0 | 0 |
| ALAN GOLDBERG | |||||||||||||
| 158266 | 0 | 3826 | 0 | 90995 | 0 | 102014 | 0 | 26031 | 0 | 381132 | 0 | 0 | 0 |
| JOSEPH SWEDISH | |||||||||||||
| 0 | 1279458 | 0 | 677642 | 0 | 3229560 | 0 | 548602 | 0 | 27600 | 0 | 5762862 | 0 | 2698342 |
| KEDRICK ADKINS | |||||||||||||
| 0 | 743978 | 0 | 316652 | 0 | 344596 | 0 | 103857 | 0 | 13263 | 0 | 1522346 | 0 | 143708 |
| J RICHARD O'CONNELL | |||||||||||||
| 0 | 571942 | 0 | 230946 | 0 | 140349 | 0 | 85919 | 0 | 32302 | 0 | 1061458 | 0 | 0 |
| MICHAEL MURPHY | |||||||||||||
| 0 | 402598 | 0 | 0 | 0 | 71772 | 0 | 48365 | 0 | 27173 | 0 | 549908 | 0 | 0 |
| BRETT WAKEFIELD | |||||||||||||
| 69841 | 0 | 3272 | 0 | 160884 | 0 | 178142 | 0 | 24031 | 0 | 436170 | 0 | 0 | 0 |
| SILIA MIGLIO | |||||||||||||
| 137314 | 0 | 4919 | 0 | 15405 | 0 | 14043 | 0 | 3443 | 0 | 175124 | 0 | 0 | 0 |
| MAURITA ADLER | |||||||||||||
| 147615 | 0 | 3191 | 0 | 0 | 0 | 29311 | 0 | 26031 | 0 | 206148 | 0 | 0 | 0 |
| ELIZABETH MCLAIN | |||||||||||||
| 145698 | 0 | 0 | 0 | 0 | 0 | 7520 | 0 | 7155 | 0 | 160373 | 0 | 0 | 0 |
| JOHN ASTREIDES | |||||||||||||
| 138424 | 0 | 2889 | 0 | 0 | 0 | 21474 | 0 | 9322 | 0 | 172109 | 0 | 0 | 0 |
| PAUL WHELTON | |||||||||||||
| 0 | 485635 | 0 | 251100 | 0 | 2956365 | 0 | 1438402 | 0 | 14667 | 0 | 5146169 | 0 | 0 |
| CONSTANCE CLARK | |||||||||||||
| 98316 | 0 | 3723 | 0 | 80671 | 0 | 21657 | 0 | 6194 | 0 | 210561 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 3 | AS OF JULY 1, 2011, GOTTLIEB MEMORIAL HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. GOTTLIEB MEMORIAL HOSPITAL'S PRESIDENT IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF GOTTLIEB MEMORIAL HOSPITAL'S PRESIDENT: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE | |
| PART I, LINES 4A-B | THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2011. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III): PATRICIA CASSIDY - $1,031,555 CHARLES REITER, III - $960,000 BRETT WAKEFIELD - $59,989 PAUL WHELTON - $432,802 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNTS WHICH WERE UNPAID AS OF 12/31/11: PATRICIA CASSIDY - $121,005 ($60,503 PAID IN 2012 AND $60,502 TO BE PAID IN 2013) CHARLES REITER, III - $49,021 ($24,511 PAID IN 2012 AND $24,510 TO BE PAID IN 2013) BRETT WAKEFIELD - $81,803 (PAID IN 2012) PAUL WHELTON - $1,427,198 ($930,012 PAID IN 2012 AND $497,186 TO BE PAID IN 2013) PART I, LINE 4A: THE FOLLOWING INDIVIDUALS RECEIVED A CHANGE-OF-CONTROL PAYMENT IN CALENDAR 2011. THESE AMOUNTS WERE INCLUDED IN COLUMN B(III): CONSTANCE CLARK - $80,671 KENNETH FISHBAIN - $162,500 ALAN GOLDBERG - $82,895 BRETT WAKEFIELD - $70,895 PART II, LINE 4B: THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2011). THE FOLLOWING ACCRUALS FOR 2011 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $91,607 BENJAMIN CARTER - $54,011 LARRY GOLDBERG - $5,686 DANIEL HALE - $42,034 MICHAEL MURPHY - $27,513 J. RICHARD O'CONNELL - $66,279 JOSEPH SWEDISH - $255,902 THE FOLLOWING ARE PARTICIPANTS IN THE LOYOLA UNIVERSITY MEDICAL CENTER RETIREMENT RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2011). THE FOLLOWING TAXABLE AMOUNTS FOR 2011 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: PATRICIA CASSIDY - $145,408 CHARLES RETIER, III - $152,173 THE FOLLOWING IS A PARTICIPANT IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUAL FOR 2011 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: JOSEPH SWEDISH - $265,000 PART II: THE FOLLOWING INDIVIDUALS BECAME VESTED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) DURING CALENDAR 2011. AS A RESULT, THE VESTED AMOUNTS WERE INCLUDED IN THEIR 2011 TAXABLE INCOMES. THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $220,648 CHARLES REITER, III - $42,488 JOSEPH SWEDISH - $2,740,000 PAUL WHELTON - $2,362,626 COLUMN F OF SCHEDULE J INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. | |
| PART III | PART II: TOM HONAN - THE AMOUNT LISTED IN COLUMN B(I) OF SCHEDULE J, PART II REPRESENTS THE AMOUNT PAID BY LOYOLA UNIVERSITY MEDICAL CENTER IN CALENDAR 2011 TO NAVIGANT FOR MR. HONAN'S SERVICES AS INTERIM CFO. GOTTLIEB MEMORIAL HOSPITAL DOES NOT KNOW HOW MUCH MR. HONAN RECEIVED AS WAGES FROM NAVIGANT IN CALENDAR 2011. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | LOYOLA UNIVERSITY MEDICAL CENTER AND GOTTLIEB MEMORIAL HOSPITAL HAVE CONTRACTED WITH NAVIGANT FOR THE PROVISION OF INTERIM CFO SERVICES. SEE SCHEDULE J, PART III FOR ADDITIONAL INFORMATION. | |
| FORM 990, PART VI, SECTION A, LINE 4 | EFFECTIVE JULY 1, 2011, GOTTLIEB MEMORIAL HOSPITAL AND ITS SOLE MEMBER, LOYOLA UNIVERSITY HEALTH SYSTEM, BECAME PART OF THE TRINITY HEALTH SYSTEM. GOTTLIEB MEMORIAL HOSPITAL'S ARTICLES AND BYLAWS WERE AMENDED TO REFLECT THIS OWNERSHIP CHANGE. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF GOTTLIEB MEMORIAL HOSPITAL IS LOYOLA UNIVERSITY HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | LOYOLA UNIVERSITY HEALTH SYSTEM IS THE SOLE MEMBER OF GOTTLIEB MEMORIAL HOSPITAL. LOYOLA UNIVERSITY HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF GOTTLIEB MEMORIAL HOSPITAL. | |
| FORM 990, PART VI, SECTION A, LINE 7B | AS SOLE MEMBER, LOYOLA UNIVERSITY HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. LOYOLA UNIVERSITY HEALTH SYSTEM MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY THE TRINITY HOME OFFICE TAX DEPARTMENT, BASED ON INFORMATION PROVIDED BY A MULTI-DISCIPLINARY TEAM OF LOYOLA AND GOTTLIEB STAFF. A DETAILED SUMMARY OF THE DRAFT FORM 990 IS PRESENTED TO THE ORGANIZATION'S BOARD FINANCE & PLANNING COMMITTEE AND THE ORGANIZATION'S OFFICERS ARE PROVIDED A COPY OF THE ORGANIZATION'S DRAFT FORM 990 (INCLUDING ALL KEY REQUIRED SCHEDULES). THE COMPLETE FORM 990 IS PROVIDED TO THE GOTTLIEB MEMORIAL HOSPITAL BOARD IN ELECTRONIC FORM, PRIOR TO FINALIZING AND FILING THE FORM. | |
| FORM 990, PART VI, SECTION B, LINE 12C | GOTTLIEB MEMORIAL HOSPITAL HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF GOTTLIEB MEMORIAL HOSPITAL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH GOTTLIEB MEMORIAL HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO GOTTLIEB MEMORIAL HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF GOTTLIEB MEMORIAL HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO GOTTLIEB MEMORIAL HOSPITAL. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF DIRECTORS OF GOTTLIEB MEMORIAL HOSPITAL ON AN ANNUAL BASIS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF GOTTLIEB MEMORIAL HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | EFFECTIVE JULY 1, 2011, GOTTLIEB MEMORIAL HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, GOTTLIEB MEMORIAL HOSPITAL WILL BE INCLUDING A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. | |
| FORM 990, PART VII, SECTION A, LINE 1, COLUMN B: | THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: KEDRICK ADKINS - 53 HOURS BENJAMIN CARTER - 48 HOURS PATRICIA CASSIDY - 20 HOURS ELLYN CHIN - 10 HOURS KENNETH FISHBAIN - 10 HOURS ROBERT FLANIGAN, MD - 43 HOURS RICHARD GAMELLI, MD - 43 HOURS LARRY GOLDBERG - 35 HOURS DANIEL HALE - 48 HOURS DONNA HALINSKI - 43 HOURS TOM HONAN - 32 HOURS MICHAEL MURPHY - 53 HOURS J. RICHARD O'CONNELL - 53 HOURS P. TERRENCE O'ROURKE - 48 HOURS JILL RAPPIS - 45 HOURS CHARLES REITER, III - 43 HOURS AJAY SIAL - 43 HOURS ROBERT SULO, MD - 43 HOURS JOSEPH SWEDISH - 53 HOURS DAVID WILBER - 43 HOURS | ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -961,074. EQUITY TRANSFERS FROM AFFILIATES: 84,286,626. CHANGE IN DEFERRED RETIREMENT COST: -8,341,483. OTHER TRANSACTIONS: 115,998. PURCHASE ACCOUNTING ADJUSTMENTS DUE TO ACQUISITION BY TRINITY HEALTH CORP. -58,814,858. TOTAL TO FORM 990, PART XI, LINE 5: 16,285,209. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2 | GOTTLIEB MEMORIAL HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY12 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (96 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 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP | |||||||||||
| 245 STATE ST SE | GRAND RAPIDS | MI | 49503 | 272491974 | HEALTHCARE SERVICES | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| AMICARE HOSPICE SERVICES INC | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 382949053 | PROVIDE HOSPICE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| AUXILIARY OF HOLY ROSARY HOSPITAL | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 943059469 | SUPPORTS SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 9 | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | 0 | |
| BAUM HARMON MERCY HOSPITAL | |||||||||||
| 255 NORTH WELCH AVENUE | PRIMGHAR | IA | 51245 | 421500277 | ACUTE/AMBULATORY HEALTHCARE SERVICES | IA | 501(C)(3) | 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION | |||||||||||
| 255 NORTH WELCH AVENUE | PRIMGHAR | IA | 51245 | 262973307 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 11, TYPE I | BAUM HARMON MERCY HOSPITAL | 0 | |
| CATHERINE MCAULEY HEALTH SERVICES CORP | |||||||||||
| PO BOX 995 | ANN ARBOR | MI | 48106 | 382507173 | FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES | MI | 501(C)(3) | 11, TYPE II | TRINITY HEALTH-MICHIGAN | 0 | |
| COMMUNITY HEALTH PARTNERS OF SOUTH BEND | |||||||||||
| PO BOX 3998 | SOUTH BEND | IN | 46619 | 263051440 | HEALTHCARE SERVICES | IN | 501(C)(3) | 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| CRANBROOK HOSPICE CARE | |||||||||||
| 281 ENTERPRISE COURT | BLOOMFIELD HILLS | MI | 48302 | 383320699 | PROVIDE HOSPICE HEALTH SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| DILEY RIDGE MEDICAL CENTER | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 342032340 | HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIO | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| DUBUQUE MERCY HEALTH FOUNDATION INC | |||||||||||
| 250 MERCY DRIVE | DUBUQUE | IA | 52001 | 262227941 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 11, TYPE I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| DYERSVILLE HEALTH FOUNDATION INC | |||||||||||
| 1111 3RD STREET SW | DYERSVILLE | IA | 52040 | 205383271 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 11, TYPE I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION | |||||||||||
| 701 W NORTH AVE | MELROSE PARK | IL | 60160 | 363332852 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IL | 501(C)(3) | 9 | GOTTLIEB MEMORIAL HOSPITAL | 1 | |
| GOTTLIEB MEMORIAL FOUNDATION | |||||||||||
| 701 W NORTH AVE | MELROSE PARK | IL | 60160 | 743260011 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IL | 501(C)(3) | 11, TYPE III-FI | 0 | N/A | |
| GOTTLIEB MEMORIAL HOSPITAL | |||||||||||
| 701 W NORTH AVE | MELROSE PARK | IL | 60160 | 362379649 | HEALTHCARE SERVICES | IL | 501(C)(3) | 3 | LOYOLA UNIVERSITY HEALTH SYSTEM | 1 | |
| HACKLEY HOSPITAL | |||||||||||
| 1700 CLINTON ST PO BOX 3302 | MUSKEGON | MI | 494433302 | 381358196 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST | |||||||||||
| PO BOX 3302 | MUSKEGON | MI | 494433302 | 382299878 | SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY | MI | 501(C)(3) | 11, TYPE III-FI | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY LIFE COUNSELING | |||||||||||
| 1352 TERRACE ST | MUSKEGON | MI | 494423545 | 381386362 | COUNSELING, EDUCATION, AND SUPPORT | MI | 501(C)(3) | 9 | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY VISITING NURSE SERVICES AND HOSPICE INC | |||||||||||
| 888 TERRACE ST | MUSKEGON | MI | 49440 | 381359598 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 7 | MERCY HEALTH PARTNERS | 0 | |
| HOLY CROSS CARENET INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 48333 | 521945054 | LONG-TERM CARE AND REHABILITATION FOR THE ELDERLY | MD | 501(C)(3) | 9 | TRINITY CONTINUING CARE SERVICES | 0 | |
| HOLY CROSS HOSPITAL FOUNDATION INC | |||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 208428450 | CHARITABLE FUNDRAISING | MD | 501(C)(3) | 11, TYPE I | HOLY CROSS HOSPITAL OF SILVER SPRING | 0 | |
| HOLY CROSS HOSPITAL OF SILVER SPRING INC | |||||||||||
| 1500 FOREST GLEN RD | SILVER SPRING | MD | 209101484 | 520738041 | HEALTHCARE SERVICES | MD | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| HOLY CROSS MEDICAL CENTER | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 951985442 | HEALTHCARE SERVICES (FORMERLY) | CA | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| HOSPICE OF NORTH IOWA | |||||||||||
| 232 SECOND STREET SE | MASON CITY | IA | 504016208 | 421173708 | HOSPICE HEALTH CARE SERVICES | IA | 501(C)(3) | 7 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| HOSPICE OF WASHTENAW II | |||||||||||
| 806 AIRPORT BLVD | ANN ARBOR | MI | 48108 | 383320707 | HOSPICE HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| HPCN | |||||||||||
| 1675 LEAHY STREET | MUSKEGON | MI | 49442 | 300207909 | HEALTHCARE SERVICES | MI | 501(C)(3) | 11, TYPE II | MERCY HEALTH PARTNERS | 0 | |
| IHA HEALTH SERVICES CORPORATION | |||||||||||
| 24 FRANK LLOYD WRIGHT DR LOBBY J | ANN ARBOR | MI | 48106 | 383316559 | PROVIDES OFFICE-BASED MEDICAL CARE | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| LAKESHORE COMMUNITY HOSPITAL INC | |||||||||||
| 72 S STATE STREET | SHELBY | MI | 494551228 | 382549295 | ACUTE HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | MERCY HEALTH PARTNERS | 0 | |
| LOYOLA UNIVERSITY HEALTH SYSTEM | |||||||||||
| 2160 SOUTH FIRST AVENUE | MAYWOOD | IL | 60153 | 363342448 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IL | 501(C)(3) | 11, TYPE II | TRINITY HEALTH CORPORATION | 0 | |
| LOYOLA UNIVERSITY MEDICAL CENTER | |||||||||||
| 2160 SOUTH FIRST AVENUE | MAYWOOD | IL | 60153 | 364015560 | HEALTHCARE SERVICES | IL | 501(C)(3) | 3 | LOYOLA UNIVERSITY HEALTH SYSTEM | 0 | |
| MARIAN HOME HEALTHCARE | |||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51101 | 383320705 | PROVIDE HOME HEALTH CARE SERVICES | IA | 501(C)(3) | 11, TYPE I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MCAULEY CLINIC CORPORATION | |||||||||||
| PO BOX 992 | ANN ARBOR | MI | 48106 | 382561013 | HEALTHCARE SERVICES (FORMERLY) | MI | 501(C)(3) | 3 | CATHERINE MCAULEY HEALTH SERVICES CORP | 0 | |
| MERCY AMICARE HOME HEALTHCARE OAKLAND | |||||||||||
| 281 ENTERPRISE COURT | BLOOMFIELD HILLS | MI | 483020312 | 383320698 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY AMICARE HOME HEALTHCARE PORT HURON | |||||||||||
| 505 HURON AVENUE | PORT HURON | MI | 48060 | 383320701 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 2525 SOUTH MICHIGAN AVENUE | CHICAGO | IL | 60616 | 363227350 | SUPPORTS THE SERVICES OF RELATED HEALTH CARE SYSTEM | IL | 501(C)(3) | 11, TYPE I | MERCY HEALTH SYSTEM OF CHICAGO | 0 | |
| MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE | |||||||||||
| 684 HARVEY STREET | MUSKEGON | MI | 49442 | 383321856 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY HEALTH PARTNERS | |||||||||||
| 1415 LEAHY STREET | MUSKEGON | MI | 49442 | 382589966 | HEALTHCARE SYSTEM SUPPORT | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HEALTH SERVICES - IOWA CORP | |||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 311373080 | HEALTHCARE SERVICES | DE | 501(C)(3) | 3 | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HEALTH SYSTEM OF CHICAGO | |||||||||||
| 2525 SOUTH MICHIGAN AVENUE | CHICAGO | IL | 60616 | 363163327 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IL | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| MERCY HEALTH SYSTEM OF CHICAGO LIABILITY SELF INSURANCE TRUST | |||||||||||
| BK OF AMERICA 231 S LASALLE | CHICAGO | IL | 60697 | 912092113 | SELF INSURANCE FOR PROFESSIONAL AND COMPREHENSIVE LIABILITY | IL | 501(C)(3) | 11, TYPE III-FI | MERCY HEALTH SYSTEM OF CHICAGO | 0 | |
| MERCY HEALTHCARE FOUNDATION | |||||||||||
| 1410 N 4TH ST | CLINTON | IA | 52732 | 421316126 | FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICES | IA | 501(C)(3) | 11, TYPE I | MERCY MEDICAL CENTER-CLINTON | 0 | |
| MERCY HOSPITAL AND MEDICAL CENTER | |||||||||||
| 2525 SOUTH MICHIGAN AVENUE | CHICAGO | IL | 60616 | 362170152 | HEALTHCARE SERVICES | IL | 501(C)(3) | 3 | MERCY HEALTH SYSTEM OF CHICAGO | 0 | |
| MERCY HOSPITAL CADILLAC FOUNDATION | |||||||||||
| 400 HOBART | CADILLAC | MI | 496012331 | 203357131 | SUPPORT THE SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HOSPITAL GIFT SHOP | |||||||||||
| 2601 ELECTRIC AVE | PORT HURON | MI | 48060 | 381630480 | VOLUNTEER SERVICE AUXILIARY | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY MEDICAL CENTER - CLINTON INC | |||||||||||
| 1410 NORTH 4TH ST | CLINTON | IA | 527322940 | 421336618 | TO PROVIDE QUALITY HEALTH CARE | DE | 501(C)(3) | 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION | |||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51102 | 141880022 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 7 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA | |||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 504012800 | 421229151 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 11, TYPE III-FI | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MERCY NORTH HOMECARE AND HOSPICE | |||||||||||
| 7985 MACKINAW TRAIL | CADILLAC | MI | 49601 | 383313897 | HOME HEALTH AND HOSPICE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY PHYSICIAN GROUP INC | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 208192593 | TO PROVIDE QUALITY HEALTH CARE | ID | 501(C)(3) | 9 | SAINT ALPHONSUS MEDICAL CENTER-NAMPA | 0 | |
| MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 382719605 | PROVIDES LONG-TERM CARE FOR THE ELDERLY | MI | 501(C)(3) | 11, TYPE II | TRINITY CONTINUING CARE SERVICES INC | 0 | |
| MIDWEST MEDFLIGHT | |||||||||||
| 1300 VICTORS WAY | ANN ARBOR | MI | 48108 | 382684671 | AEROMEDICAL TRANSPORT | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| MOUNT CARMEL CARE CONTINUUM SERVICES CORP | |||||||||||
| 793 WEST STATE STREET | COLUMBUS | OH | 43222 | 311126211 | COOPERATIVE HOSPITAL SERVICE ORGANIZATION | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL COLLEGE OF NURSING | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311308555 | COLLEGE OF NURSING | OH | 501(C)(3) | 2 | MOUNT CARMEL HEALTH | 0 | |
| MOUNT CARMEL HEALTH | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 314379602 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH INSURANCE COMPANY | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 251912781 | HEALTH INSURANCE | OH | 501(C)(4) | N/A | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH PLAN INC | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311471229 | MEDICARE HMO FOR SENIORS | OH | 501(C)(4) | N/A | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH SYSTEM | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311439334 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | OH | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| MOUNT CARMEL HEALTH SYSTEM FOUNDATION | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311113966 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OH | 501(C)(3) | 11, TYPE I | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HOME CARE LLC | |||||||||||
| 1144 DUBLIN ROAD SUITE B | COLUMBUS | OH | 43215 | 262729300 | PROVIDE HOME HEALTH CARE SERVICES | OH | 501(C)(3) | 9 | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL | |||||||||||
| 7333 SMITHS MILL RD | NEW ALBANY | OH | 43054 | 870790288 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MRI MOBILE SERVICES OF WEST MICHIGAN | |||||||||||
| 1820 - 44TH STREET | KENTWOOD | MI | 49508 | 383073745 | OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY) | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| MUSKEGON COMMUNITY HEALTH PROJECT | |||||||||||
| 565 W WESTERN AVENUE | MUSKEGON | MI | 49440 | 911932918 | FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES | MI | 501(C)(3) | 7 | MERCY HEALTH PARTNERS | 0 | |
| OAKLAND MERCY HOSPITAL | |||||||||||
| 601 EAST 2ND STREET | OAKLAND | NE | 68045 | 208072234 | HEALTHCARE SERVICES | NE | 501(C)(3) | 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| OAKLAND MERCY HOSPITAL FOUNDATION | |||||||||||
| 601 E 2ND STREET | OAKLAND | NE | 68045 | 311678345 | SUPPORTS SERVICES OF RELATED HOSPITAL | NE | 501(C)(3) | 11, TYPE III-FI | OAKLAND MERCY HOSPITAL | 0 | |
| PORT HURON MERCY FAMILY CARE INC | |||||||||||
| 2601 ELECTRIC AVE | PORT HURON | MI | 48060 | 201855647 | HEALTHCARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| PROFESSIONAL MED TEAM | |||||||||||
| 965 FORK STREET | MUSKEGON | MI | 494423257 | 382638284 | MEDICAL CARE, TRANSPORTATION AND EDUCATION | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| PROFESSIONAL OFFICE CORPORATION | |||||||||||
| 1303 EAST HERNDON AVE | FRESNO | CA | 93720 | 942839324 | HEALTHCARE SERVICES | CA | 501(C)(3) | 11, TYPE I | SAINT AGNES MEDICAL CENTER | 0 | |
| SAINT AGNES MEDICAL CENTER | |||||||||||
| 1303 EAST HERNDON AVE | FRESNO | CA | 93720 | 941437713 | HEALTHCARE SERVICES | CA | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| SAINT ALPHONSUS BUILDING COMPANY INC | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 820401011 | SUPPORTS SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | 11, TYPE I | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT ALPHONSUS DIVERSIFIED CARE INC | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 943028978 | SUPPORTS SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | 11, TYPE I | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT ALPHONSUS FOUNDATION-BAKER CITY INC | |||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 943164869 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 7 | SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY | 0 | |
| SAINT ALPHONSUS FOUNDATION-ONTARIO INC | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 202683560 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 11, TYPE I | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | 0 | |
| SAINT ALPHONSUS HEALTH SYSTEM INC | |||||||||||
| 1055 N CURTIS ROAD | BOISE | ID | 83706 | 271929502 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | ID | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY | |||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 271790052 | TO PROVIDE QUALITY HEALTH CARE | OR | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-NAMPA | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 820200896 | TO PROVIDE QUALITY HEALTH CARE | ID | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 261737256 | SUPPORT THE SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | 7 | SAINT ALPHONSUS MEDICAL CENTER-NAMPA | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 271789847 | TO PROVIDE QUALITY HEALTH CARE | OR | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 820200895 | HEALTHCARE SERVICES | ID | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC | |||||||||||
| 1915 LAKE AVENUE PO BOX 670 | PLYMOUTH | IN | 46563 | 351142669 | HEALTHCARE SERVICES | IN | 501(C)(3) | 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC | |||||||||||
| PO BOX 1935 | SOUTH BEND | IN | 466341935 | 350868157 | HEALTHCARE SERVICES | IN | 501(C)(3) | 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER MISHAWAKA AUXILIARY INC | |||||||||||
| 5215 HOLY CROSS PARKWAY | MISHAWAKA | IN | 46545 | 356033285 | HOSPITAL SERVICE AUXILIARY | IN | 501(C)(4) | N/A | SAINT JOSEPH REGIONAL MEDICAL CENTER-S BEND | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC | |||||||||||
| 1915 LAKE AVENUE | PLYMOUTH | IN | 46563 | 356043563 | HOSPITAL SERVICE AUXILIARY | IN | 501(C)(3) | 11, TYPE II | SAINT JOSEPH REGIONAL MEDICAL CENTER-PLYMOUTH | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER INC | |||||||||||
| 801 EAST LASALLE AVE | SOUTH BEND | IN | 46617 | 351568821 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IN | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| SAINT JOSEPH'S TOWER INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 311040468 | PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALS | IN | 501(C)(3) | 9 | TRINITY CONTINUING CARE SERVICES-INDIANA | 0 | |
| SAINT MARY'S AMICARE HOME HEALTHCARE | |||||||||||
| 1430 MONROE NW | GRAND RAPIDS | MI | 49505 | 383320700 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| SAINT MARY'S FOUNDATION (FKA SAINT MARY'S DORAN FOUNDATION) | |||||||||||
| 200 JEFFERSON ST SE | GRAND RAPIDS | MI | 49503 | 381779602 | SUPPORTS SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | 7 | TRINITY HEALTH-MICHIGAN | 0 | |
| ST JOSEPH MERCY OAKLAND FOUNDATION | |||||||||||
| 44405 WOODWARD AVE | PONTIAC | MI | 48341 | 352356789 | SUPPORTS SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| ST ANN'S HOSPITAL | |||||||||||
| 500 SOUTH CLEVELAND AVE | WESTERVILLE | OH | 43081 | 314412701 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER | |||||||||||
| 4215 EDISON LAKES PARKWAY | MISHAWAKA | IN | 46545 | 351654543 | SUPPORTS SERVICES OF RELATED HOSPITAL | IN | 501(C)(3) | 11, TYPE I | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| TRI-HOSPITAL MRI CENTER | |||||||||||
| 4190 24TH AVENUE | FORT GRATIOT | MI | 48054 | 382884297 | MRI SERVICES | MI | 501(C)(3) | 3 | TRINITY HEALTH-MICHIGAN | 0 | |
| TRINITY CONTINUING CARE SERVICES | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 382559656 | MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY CONTINUING CARE SERVICES - INDIANA INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 930907047 | PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSING | IN | 501(C)(3) | 9 | TRINITY CONTINUING CARE SERVICES | 0 | |
| TRINITY HEALTH - MICHIGAN | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 382113393 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HEALTH CORPORATION | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 351443425 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IN | 501(C)(3) | 11, TYPE I | 0 | N/A | |
| TRINITY HEALTH INTERNATIONAL | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 421253527 | HEALTHCARE TRAINING AND SUPPORT SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HEALTH WELFARE BENEFIT TRUST | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 208151733 | RETIREE MEDICAL AND RETIREE LIFE INSURANCE COVERAGE | MI | 501(C)(9) | N/A | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HOME HEALTH SERVICES INC | |||||||||||
| 17410 COLLEGE PARKWAY | LIVONIA | MI | 48152 | 382621935 | HOME HEALTH CARE SYSTEM MANAGEMENT SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (32 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| ADVENT REHABILITATION LLC | ||||||||||
| 607 DEWEY AVENUE SUITE 300 | GRAND RAPIDS | MI | 49504 | 383306673 | REHABILITATION THERAPY SERVICES | MI | N/A | N/A | 0 | 0 |
| BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311608125 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| CENTER FOR DIGESTIVE CARE LLC | ||||||||||
| 5300 ELLIOTT DRIVE | YPSILANTI | MI | 48197 | 030447062 | PROVIDE GASTROINTESTINAL SERVICES | MI | N/A | N/A | 0 | 0 |
| CENTRAL OHIO SLEEP MEDICINE LTD | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311701029 | SLEEP MEDICINE SERVICES | OH | N/A | N/A | 0 | 0 |
| CLINTON IMAGING SERVICES LLC | ||||||||||
| 615 VALLEY VIEW DR STE 202 | MOLINE | IL | 61265 | 412044739 | MRI DIAGNOSTIC SERVICES | IA | N/A | N/A | 0 | 0 |
| FOREST PARK IMAGING LLC | ||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 134365966 | X-RAY AND MAMMOGRAPHY SERVICES | IA | N/A | N/A | 0 | 0 |
| FRANCES WARDE MEDICAL LABORATORY | ||||||||||
| 300 WEST TEXTILE ROAD | ANN ARBOR | MI | 48104 | 382648446 | LABORATORY | MI | N/A | N/A | 0 | 0 |
| FRESNO IMAGING CENTER | ||||||||||
| 1303 E HERNDON AVE | FRESNO | CA | 93720 | 770363563 | DIAGNOSTIC IMAGING | CA | N/A | N/A | 0 | 0 |
| HAWARDEN REGIONAL HEALTH CLINICS LLC | ||||||||||
| 1122 AVENUE L | HAWARDEN | IA | 51023 | 201444339 | MEDICAL CLINIC | IA | N/A | N/A | 0 | 0 |
| IDAHO GYNONCOLOGY SERVICES LLC | ||||||||||
| 1055 N CURTIS RD | BOISE | ID | 83706 | 202975807 | PROVIDE GYN ONCOLOGY SERVICES | ID | N/A | N/A | 0 | 0 |
| INTERMOUNTAIN MEDICAL IMAGING LLC | ||||||||||
| 877 WEST MAIN ST STE 603 | BOISE | ID | 83702 | 820514422 | PROVIDE IMAGING SERVICES | ID | N/A | N/A | 0 | 0 |
| LOYOLA AMBULATORY SURGERY CENTER | ||||||||||
| 1S224 SUMMIT AVE STE 201 | OAKBROOK TERRACE | IL | 60181 | 364119522 | SURGICAL SERVICES | IL | N/A | N/A | 0 | 0 |
| MAGNETIC RESONANCE SERVICES PARTNERSHIP | ||||||||||
| 1416 SIXTH STREET SW | MASON CITY | IA | 50401 | 421328388 | MRI SERVICES | IA | N/A | N/A | 0 | 0 |
| MASON CITY AMBULATORY SURGERY CENTER LLC | ||||||||||
| 990 4TH STREET SW | MASON CITY | IA | 50401 | 201960348 | SURGERY-SAME DAY | IA | N/A | N/A | 0 | 0 |
| MCE MOB IV LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 421544707 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| MCMC POB III LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311392994 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| MEDILUCENT MOB I | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 204911370 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| MERCY ADVANCED MRI LLC | ||||||||||
| 2525 SOUTH MICHIGAN AVE | CHICAGO | IL | 60616 | 262116721 | SUBLEASE MRI EQUIPMENT | IL | N/A | N/A | 0 | 0 |
| MERCY HEART & VASCULAR LLC | ||||||||||
| 2525 SOUTH MICHIGAN AVE | CHICAGO | IL | 60616 | 205272726 | SUBLEASE CT EQUIPMENT | IL | N/A | N/A | 0 | 0 |
| MERCY HEART CTR OP SERVICES LLC | ||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 134237594 | CARDIOVASCULAR SERVICES | IA | N/A | N/A | 0 | 0 |
| MERCY OUTPATIENT SURGERY CENTER LLC | ||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 841380439 | OUTPATIENT SURGERY | ID | N/A | N/A | 0 | 0 |
| MICHIANA HEALTH INFORMATION NETWORK LLC | ||||||||||
| 215 WEST MADISON STREET | SOUTH BEND | IN | 46601 | 352050128 | COMMUNITY BASED CLINICAL INFO SYS & DATA DEPOSITORY | IN | N/A | N/A | 0 | 0 |
| MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311369473 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| NEWCO AMBULATORY SURGERY CTR LLP | ||||||||||
| 4190 24TH AVENUE | FORT GRATIOT | MI | 48059 | 300136708 | OUTPATIENT SURGERY CENTER | MI | N/A | N/A | 0 | 0 |
| RIVERVIEW MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311531135 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| SARMED OUTPATIENT PHARMACY LLC | ||||||||||
| 999 N CURTIS RD STE 102 | BOISE | ID | 83706 | 510483218 | PHARMACY | ID | N/A | N/A | 0 | 0 |
| SIXTY FOURTH STREET LLC | ||||||||||
| 2373 64TH ST STE 2200 | BYRON CENTER | MI | 49315 | 202443646 | PROVIDE OUTPATIENT SURGICAL CARE | MI | N/A | N/A | 0 | 0 |
| ST ALPHONSUS CALDWELL CANCER CTR LLC | ||||||||||
| 3123 MEDICAL DR | CALDWELL | ID | 83605 | 820526861 | RADIATION ONCOLOGY | ID | N/A | N/A | 0 | 0 |
| ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311603660 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| TAMARACK MEDICAL CLINIC LLC | ||||||||||
| 610 VILLAGE DRIVE | DONNELLY | ID | 83615 | 201637921 | OUTPATIENT MEDICAL SERVICES | ID | N/A | N/A | 0 | 0 |
| WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311784409 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| WOODLAND IMAGING CENTER LLC | ||||||||||
| 5301 E HURON RIVER DR | ANN ARBOR | MI | 48106 | 760820959 | RADIOLOGY/IMAGING | MI | N/A | N/A | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (30 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH VENTURES INC | ||||||||||||
| 565 W WESTERN AVE | MUSKEGON | MI | 49440 | 383522260 | SOFTWARE MARKETING | MI | N/A | C | ||||
| GOTTLIEB MANAGEMENT SERVICES INC | ||||||||||||
| 701 W NORTH AVE | MELROSE PARK | IL | 60160 | 363330529 | MANAGEMENT SERVICES | IL | N/A | C | ||||
| HACKLEY HEALTH MANAGEMENT CENTER | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382961814 | WEIGHT MANAGEMENT | MI | N/A | C | ||||
| HACKLEY HEALTH VENTURES INC | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382589959 | OTHER MEDICAL SERVICES | MI | N/A | C | ||||
| HACKLEY HEALTHCARE EQUIPMENT | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382578569 | HOME MEDICAL EQUIPMENT | MI | N/A | C | ||||
| HACKLEY PROFESSIONAL CENTER | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383024797 | REAL ESTATE RENTAL | MI | N/A | C | ||||
| HACKLEY PROFESSIONAL PHARMACY | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382447870 | PHARMACY | MI | N/A | C | ||||
| HEF INC | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383086401 | OFFICE STAFFING | MI | N/A | C | ||||
| HOLY CROSS PRIVATE HOME SERVICES CORP | ||||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 521986562 | HOME CARE SERVICES | MD | N/A | C | ||||
| HPC CO-OWNERS ASSOCIATION | ||||||||||||
| 1700 CLINTON | MUSKEGON | MI | 49442 | 270734448 | CONDOMINIUM ASSOCIATION | MI | N/A | C | ||||
| HURON ARBOR CORPORATION | ||||||||||||
| 5301 EAST HURON RIVER DR PO BOX 992 | ANN ARBOR | MI | 48106 | 382475644 | PROVIDES OFFICE RENTAL SPACE | MI | N/A | C | ||||
| IHA AFFILIATION CORPORATION | ||||||||||||
| 24 FRANK LLOYD WRIGHT DR LOBBY J | ANN ARBOR | MI | 48106 | 383188895 | MEDICAL MANAGEMENT | MI | N/A | C | ||||
| LOYOLA UNIVERSITY OF CHICAGO INSURANCE CO LTD | ||||||||||||
| PROVISION OF INSURANCE COVERAGE | N/A | C | 23 LIME TREE BAY AVENUE | GRAND CAYMAN | CJ | CJ | ||||||
| MARYLAND CARE GROUP INC | ||||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 521815313 | HEALTHCARE HOLDING | MD | N/A | C | ||||
| MEDNOW INC | ||||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 820389927 | OUTPATIENT PHARMACY | ID | N/A | C | ||||
| MERCY MEDICAL SERVICES | ||||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51101 | 421283849 | PRIMARY CARE PHYSICIANS | IA | N/A | C | ||||
| MERCY SERVICES CORPORATION | ||||||||||||
| 2525 SOUTH MICHIGAN AVENUE | CHICAGO | IL | 60616 | 363227348 | DORMANT | IL | N/A | C | ||||
| MICHIGAN ATHLETIC CLUB | ||||||||||||
| 2500 BURTON | GRAND RAPIDS | MI | 49546 | 382647304 | ATHLETIC CLUB | MI | N/A | C | ||||
| MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES INC | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 310971510 | BEHAVIORAL HEALTHCARE SERVICES | OH | N/A | C | ||||
| MOUNT CARMEL HEALTH PROVIDERS INC | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311382442 | MEDICAL SERVICES | OH | N/A | C | ||||
| NORTH IOWA MERCY MEDICAL SERVICES INC | ||||||||||||
| 1000 4TH ST SW | MASON CITY | IA | 50401 | 421382308 | MEDICAL SERVICES | IA | N/A | C | ||||
| PRIORITY PLUS OF CALIFORNIA | ||||||||||||
| PO BOX 27230 | FRESNO | CA | 93729 | 770395267 | FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS | CA | N/A | C | ||||
| SAINT ALPHONSUS PHYSICIANS PA | ||||||||||||
| 1055 NORTH CURTIS ROAD | BOISE | ID | 837061370 | 331078261 | PHYSICIANS | ID | N/A | C | ||||
| SAINT MARY'S HEALTH MANAGEMENT COMPANY | ||||||||||||
| 1640 EAST PARIS SE | GRAND RAPIDS | MI | 49546 | 383450733 | ATHLETIC CLUB | MI | N/A | C | ||||
| SURGERY CENTER FINANCING CORPORATION | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311531102 | FINANCE, INSURANCE AND REAL ESTATE | OH | N/A | C | ||||
| THRE SERVICES LLC | ||||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 452603654 | REAL ESTATE BROKERAGE SERVICES | MI | N/A | C | ||||
| TRINITY HEALTH EMPLOYEE BENEFIT TRUST | ||||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 383410377 | GRANTOR TRUST | MI | N/A | T | ||||
| VENZKE INSURANCE COMPANY LTD | ||||||||||||
| 980453602 | PROVISION OF INSURANCE COVERAGE | N/A | C | PO BOX 1051 GRAND CAYMAN | GRAND CAYMAN | CJ | CJ | |||||
| WESTSHORE HEALTH NETWORK | ||||||||||||
| 1820 44TH STREET | KENTWOOD | MI | 49508 | 383280200 | PHYSICIAN HOSPITAL ORGANIZATION | MI | N/A | C | ||||
| WORKPLACE HEALTH OF GRAND HAVEN | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383112035 | OCCUPATIONAL HEALTH | MI | N/A | C | ||||
| 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 | 1 | 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 | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| LOYOLA UNIVERSITY MEDICAL CENTER | ||
| L | 240297 | PER BOOKS |
| GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION | ||
| C | 8374927 | PER BOOKS |
| TRINITY HEALTH CORPORATION | ||
| C | 75892285 | PER BOOKS |
| TRINITY HEALTH CORPORATION | ||
| O | 5344980 | PER BOOKS |
| GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION | ||
| K | 82394 | PER BOOKS |