MYMICHIGAN MEDICAL CENTER STANDISH: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MYMICHIGAN MEDICAL CENTER STANDISH (EIN 38-1671120)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201321359349302452
- 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 | 2013-05-15T09:47:45-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1 |
| City | Cincinnati | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381671120 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Standish Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAN | NameControl |
| Phone | 9898464521 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 W Cedar Street | AddressLine1 |
| City | Standish | City |
| State | MI | State |
| ZIP Code | 48658 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Anthony J Doud | Name |
| Title | Controller | Title |
| Phone | 9898464521 | Phone |
| Date Signed | 2013-05-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Matthew Montogomery | Name |
| PTIN | P00492843 | PTIN |
| Phone | 5137847100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's of MI Standish Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Sharon Leaman Case | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 W Cedar Street | AddressLine1 |
| City | Standish | City |
| State | MI | State |
| ZIP Code | 48658 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 23796996 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1960 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | Operation of a hospital, skilled nursing facility, emergency room and rural health clinic. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 313 | TotalNbrEmployees |
| Total Nbr Volunteers | 43 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 90685 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 263406 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 22560661 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 22452900 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1638658 | InvestmentIncomePriorYear |
| Investment Income Current Year | 884184 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 182181 | OtherRevenuePriorYear |
| Other Revenue Current Year | 138665 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24472185 | TotalRevenuePriorYear |
| Total Revenue Current Year | 23739155 | 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 | 13375033 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 13200684 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 40050 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9625079 | OtherExpensePriorYear |
| Other Expenses Current Year | 9682208 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 23000112 | TotalExpensesPriorYear |
| Total Expenses Current Year | 22882892 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1472073 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 856263 | RevenuesLessExpensesCY |
| Total Assets BOY | 28908250 | TotalAssetsBOY |
| Total Assets EOY | 28430082 | TotalAssetsEOY |
| Total Liabilities BOY | 7184300 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7118436 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 21723950 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 21311646 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Operation of a non-profit hospital, skilled nursing facility, emergency room and rural health clinic to provide health care services to the sick and poor. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 15654074 | Expense |
| Revenue | 22452900 | Revenue |
| Description | Standish Hospital is dedicated to spiritually centered, holistic care that sustains and improves the health of individuals and communities. It furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. A substantial portion of its services are provided to the elderly and poor. During the fiscal year ending June 30, 2012, approximately 51.0% of the value of services rendered was to elderly patients under the Medicare program, and approximately 18.5% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's of Michigan Standish Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2012, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $17,549,758. | Description |
| Total Program Service Expense | 15654074 | 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 | 0 | 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 | 24 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 313 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| 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 | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Anthony J Doud | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9898464521 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 W Cedar Street | AddressLine1 |
| City | Standish | City |
| State | MI | State |
| ZIP Code | 48658 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Curt Hillman | |||||||
| Chairman | 0.50 | X | X | 0 | 0 | 0 | |
| Bill Borushko | |||||||
| Vice-Chairman | 0.50 | X | X | 0 | 0 | 0 | |
| Keith Sivier | |||||||
| Treasurer | 0.50 | X | X | 0 | 0 | 0 | |
| Deb Morgan | |||||||
| Secretary | 0.50 | X | X | 0 | 0 | 0 | |
| Tom Birkett | |||||||
| Director | 0.50 | X | 0 | 0 | 0 | ||
| John Graham Sch O | |||||||
| President & CEO SMMMC | 0.50 | X | 0 | 887444 | 8437 | ||
| Rasheed Siddiqui MD | |||||||
| Chief of Staff | 84.00 | X | X | 588772 | 0 | 23676 | |
| Sharon Leaman-Case | |||||||
| Administrator | 45.00 | X | X | 0 | 243643 | 21996 | |
| Doraisamy Venkitapathy | |||||||
| Physician | 84.00 | 496521 | 0 | 25416 | X | ||
| Cesar Casten | |||||||
| Physician | 40.00 | 195658 | 0 | 11247 | X | ||
| Cathy Gifford | |||||||
| CRNA | 20.00 | 118038 | 0 | 14357 | X | ||
| Catherine McDonell | |||||||
| CRNA | 20.00 | 106212 | 0 | 21469 | X | ||
| Rose Goick | |||||||
| DON | 40.00 | 103458 | 0 | 36171 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1608659 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1131087 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 162769 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Alliance HNI LLC | |||||
| 7647 Collections Drive | Chicago | IL | 606930076 | Mobile MRI Services | 618440 |
| Dr Brian McColgan | |||||
| 8340 E Orange Blossom Ln | Scottsdale | AZ | 85250 | ER Physician | 174375 |
| Community Hospital Services | |||||
| 1321 Cumberland | Saginaw | MI | 48601 | Laundry Service | 145273 |
| Bri Car Roofing | |||||
| 4597 South Garfield Rd | Auburn | MI | 48611 | Roofing Contractor | 138770 |
| Trimedx | |||||
| PO Box 636129 | Cincinnati | OH | 45263 | Equipment Maintenance | 130714 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Fundraising Events | 9234 | FundraisingEvents |
| Government Grants | 20765 | GovernmentGrants |
| All Other Contributions | 233407 | AllOtherContributions |
| Total Contributions | 263406 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Revenue | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 22452900 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22452900 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 22452900 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 884184 | TotalRevenueColumn |
| Exclusion | $884,184 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 72044 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 38698 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 33346 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 33346 | TotalRevenueColumn |
| Exclusion | $33,346 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 53431 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 9234 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 19143 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34288 | TotalRevenueColumn |
| Exclusion | $34,288 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Cafeteria Revenue | 722320 | 41137 | $41,137 |
| Miscellaneous | 621990 | 29894 | $29,894 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 71031 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23739155 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22452900 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,022,849 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 800275 | Total |
| Program Services | 592805 | ProgramServices |
| Management And General | 207470 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9224758 | Total |
| Program Services | 6776978 | ProgramServices |
| Management And General | 2427643 | ManagementAndGeneral |
| Fundraising | 20137 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 451489 | Total |
| Program Services | 338921 | ProgramServices |
| Management And General | 112568 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2050276 | Total |
| Program Services | 1539158 | ProgramServices |
| Management And General | 511118 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 673886 | Total |
| Program Services | 486631 | ProgramServices |
| Management And General | 187255 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26 | Total |
| Management And General | 26 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65197 | Total |
| Management And General | 65197 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 615 | Total |
| Management And General | 615 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 395973 | Total |
| Program Services | 369739 | ProgramServices |
| Management And General | 26234 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85788 | Total |
| Program Services | 1963 | ProgramServices |
| Management And General | 83825 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1298839 | Total |
| Program Services | 1161270 | ProgramServices |
| Management And General | 137569 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 444133 | Total |
| Program Services | 259256 | ProgramServices |
| Management And General | 184877 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46978 | Total |
| Program Services | 24274 | ProgramServices |
| Management And General | 22704 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 144769 | Total |
| Program Services | 108674 | ProgramServices |
| Management And General | 36095 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 777831 | Total |
| Program Services | 594084 | ProgramServices |
| Management And General | 183747 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76343 | Total |
| Program Services | 45065 | ProgramServices |
| Management And General | 31278 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Purchased Services | 2218219 | 123211 | 2095008 | |
| Supplies | 2119630 | 1786209 | 313508 | 19913 |
| Bad Debt | 1169447 | 1169447 | ||
| Dues & Subscriptions | 17041 | 8592 | 8449 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 821379 | Total |
| Program Services | 267797 | ProgramServices |
| Management And General | 553582 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22882892 | Total |
| Program Services | 15654074 | ProgramServices |
| Management And General | 7188768 | ManagementAndGeneral |
| Fundraising | 40050 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1707131 | BOY |
| EOY | 1771236 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 466565 | BOY |
| EOY | 524959 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2865111 | BOY |
| EOY | 2542840 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6934 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 318401 | BOY |
| EOY | 234390 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32712 | BOY |
| EOY | 24666 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 17775717 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12315480 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4626417 | BOY |
| EOY | 5460237 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18884979 | BOY |
| EOY | 17871754 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28908250 | BOY |
| EOY | 28430082 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3184548 | BOY |
| EOY | 3147401 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3999752 | BOY |
| EOY | 3971035 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7184300 | BOY |
| EOY | 7118436 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21257385 | BOY |
| EOY | 21248013 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 466565 | BOY |
| EOY | 63633 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21723950 | BOY |
| EOY | 21311646 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28908250 | BOY |
| EOY | 28430082 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 856263 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1268567 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $615 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 615 | 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 | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Standish Community Hospital does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Balance | 0 | BeginningBalance |
| Ending Balance | 0 | EndingBalance |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 500 | OtherCostOrOtherBasis |
| Book Value | 500 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5163018 | OtherCostOrOtherBasis |
| Depreciation | 4084309 | Depreciation |
| Book Value | 1078709 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5193244 | OtherCostOrOtherBasis |
| Depreciation | 2085046 | Depreciation |
| Book Value | 3108198 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6073411 | OtherCostOrOtherBasis |
| Depreciation | 5233504 | Depreciation |
| Book Value | 839907 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1345544 | OtherCostOrOtherBasis |
| Depreciation | 912621 | Depreciation |
| Book Value | 432923 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5460237 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Interest in investments held with Ascension Health Alliance | 17367884 |
| Other Current Assets | 501735 |
| Patient Trusts-Checking | 2135 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 17871754 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Intercompany Debt to Ascension Health Alliance | $3,882,188 |
| IBNR Liability | $88,847 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3971035 | TotalOfAmounts |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Living Legends Ball | NameOfEvent1 |
| Gross Receipts Event1 | 26737 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 8051 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 18686 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 1000 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 15412 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Dev Fund Auction | NameOfEvent2 |
| Gross Receipts Event2 | 18628 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 1183 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 17445 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 350 | RentFacilityCostsEvent2 |
| Other Direct Expenses Event2 | 2381 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 2 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 17300 | GrossReceiptsOtherEvents |
| Gross Revenue Other Events | 17300 | GrossRevenueOtherEvents |
| Gross Receipts Total | 62665 | GrossReceiptsTotal |
| Charitable Contributions Total | 9234 | CharitableContributionsTotal |
| Gross Revenue Total Events | 53431 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 1350 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 17793 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 19143 | DirectExpenseSummaryEvents |
| Net Income Summary | 34288 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 993625 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 993625 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04580 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4735166 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4937767 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -202601 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5728791 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4937767 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 791024 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04580 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 71368 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22061 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 49307 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 71368 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22061 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 49307 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5800159 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4959828 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 840331 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04800 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,169,447 | BadDebtExpenseAmount |
| Amount Attributable To | 535539 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7076390 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 7006327 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 70063 | 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 | Standish Community Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 W Cedar Street | AddressLine1 |
| City | Standish | City |
| State | MI | State |
| ZIP Code | 48658 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | Skilled Nursing Facility | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Standish Community 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 | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| 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 |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. | ||
| Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services. | ||
| Part I, L7 Col(f): The amount of bad debt expense reported on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentages in Part I, Line 7, column (f) is $1,169,447. | ||
| Part II: St. Mary's of Michigan Standish Hospital provided the following community building activities in 2011: - Caring Bear Picnic: A health and safety day for children in the community that teaches proper hand washing, car seat safety, the importance of bicycle helmets, healthy nutrition, and the benefits of exercise.- Senior Olympics & Health Fair: An event focused on connecting Senior Citizens with health and wellness resources in the community.- Diabetes and Chronic Obstructive Pulmonary Disease (COPD) support group meetings were held on a bi-monthly basis, free of charge.- School education: St. Mary's of Michigan Standish Hospital nurses partner with the local school systems to provide education to both the teachers and students on flu prevention, proper nutrition and exercise. | ||
| Part III, Line 4: The organization is a part of the St. Mary's Health consolidated audit. The provision for bad debts is based upon management's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year management assesses the adequacy of allowance for uncollectible accounts based upon historical write off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, St. Mary's follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with St. Mary's policies. | ||
| Part III, Line 9b: Patients are encouraged to participate in their own care by working with the financial counselor and applying for Medicaid or other public assistance programs to qualify for charity or financial assistance. Any patient that may be eligible for public assistance must make an application for such. A documented response from public assistance must be on file prior to final determination of charity care funds. | ||
| Part VI, Line 2: St. Mary's of Michigan Standish Hospital (SMMSH) participates in Community Needs Assessments to gain information about the health care needs of the community. The Community Needs Assessments provides an assessment of Arenac County pertaining to demographics, health, safe and stable homes, and economic development. SMMSH uses this information to ensure that the organization is meeting the needs of the community. | ||
| Part VI, Line 3: St. Mary's of Michigan Standish Hospital informs the community about their Charity Care Program, as well as other state or local government programs, through the following ways:- A Patient Financial Consultant is available Monday through Friday to discuss and assist with signup for state and local government programs, and/or the hospital's charity care program.- The Patient Financial Consultant or Case Manager meet with self-pay patients who have been admitted to the hospital to discuss financial assistance programs that are available.- Self-pay outpatients receive the hospital's financial assistance application, as well as other state and federal assistance program information (MI Child, Central Health Plan, Medicaid, and others as applicable), through the mail. | ||
| Part VI, Line 4: St. Mary's of Michigan Standish Hospital is a critical access hospital which provides healthcare services to individuals in Arenac County and the surrounding communities (Pinconning, Rhodes, Bentley, Whittemore, Skidway, Alger). Arenac County is a rural community with a population of approximately 16,000. According to the U.S. Census Bureau, 18.2 percent of Arenac County residents were living under the poverty guidelines in 2008. | ||
| Part VI, Line 6: St. Mary's of Michigan Standish Hospital is a member of Ascension Health. Ascension Health is a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 20 of the United States and the District of Columbia. Ascension Health is sponsored by the Northeast, Southeast, East Central, and West Central Provinces of the Daughters of Charity of St. Vincent de Paul, the Congregation of St. Joseph, and the Sisters of St. Joseph of Carondelet.Standish Community Hospital's sole corporate member is St. Mary's Health. Standish Community Hospital, located in Standish, Michigan, is a nonprofit critical care access hospital. Admitting physicians are primarily practitioners in the local area. St. Mary's is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of St. Mary's are related to providing healthcare services.Mission:Ascension Health directs its governance and management activities toward strong, vibrant, Catholic health ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with Ascension Health's mission of service to those who are poor and vulnerable, each Health Ministry accepts patients regardless of their ability to pay. Ascension Health uses four categories to identify the resources utilized for the care of persons who are poor and community benefit programs:-Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.-Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the poor.-Cost of other programs for the poor includes unreimbursed costs of programs intentionally designed to serve the poor and vulnerable of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.-Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the poor, including health promotion and education, health clinics and screenings, and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons who are poor and community benefit programs. The cost of providing care of persons who are poor and community benefit programs is estimated using internal cost data. | ||
| MI | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John Graham Sch O | |||||||||||||
| 0 | 437672 | 0 | 426823 | 0 | 22949 | 0 | 7350 | 0 | 1087 | 0 | 895881 | 0 | 0 |
| Rasheed Siddiqui MD | |||||||||||||
| 587951 | 0 | 0 | 0 | 821 | 0 | 13550 | 0 | 10126 | 0 | 612448 | 0 | 0 | 0 |
| Sharon Leaman-Case | |||||||||||||
| 0 | 233980 | 0 | 0 | 0 | 9663 | 0 | 21996 | 0 | 0 | 0 | 265639 | 0 | 0 |
| Doraisamy Venkitapathy | |||||||||||||
| 494168 | 0 | 0 | 0 | 2353 | 0 | 18375 | 0 | 7041 | 0 | 521937 | 0 | 0 | 0 |
| Cesar Casten | |||||||||||||
| 193875 | 0 | 0 | 0 | 1783 | 0 | 8434 | 0 | 2813 | 0 | 206905 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | Part I, Line 3: St. Mary's of Michigan Medical Center, a related organization of Standish Community Hospital, uses the following to establish the compensation of the organization's CEO: -Independent Compensation Consultant -Written Employment Contract -Approval by the Board or Compensation Committe | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 1 | Two Voting Members are not independent. John Graham receives compensation from St. Mary's , Dr. Rasheed Siddiqui is employed and receives a W-2 from Standish Community Hospital. | |
| Form 990, Part VI, Section A, line 6 | Standish Community Hospital has a single corporate member, St. Mary's Health. | |
| Form 990, Part VI, Section A, line 7a | Standish Community Hospital has a single corporate member, St. Mary's Health, who has the ability to elect members to the governing body of the Standish Community Hospital. | |
| Form 990, Part VI, Section A, line 7b | All decisions that have a material impact to Standish Community Hospital financial information or corporation as a whole are subject to approval by its sole corporate member, St. Mary's Health. | |
| Form 990, Part VI, Section A, line 8b | There are not any separate committees that have the authority to act on behalf of the governing body for Standish Community Hospital. | |
| Form 990, Part VI, Section B, line 11 | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all committee members are provided the Form 990 and management team members are available to answer any committee member questions. | |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. | |
| Form 990, Part VI, Section B, line 15 | In determining the compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Ascension Health board reviewed and approved the compensation. In the review of the compensation, the CEO was compared to other organizations in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his or her compensation was decided. The Executive Committee of the Board of Directors in conjunction with the Intermediate Sanctions Compliance Policy of the hospital is responsible for determining the compensation of other officers or key employees of the organization. The process includes a market analysis of comparable healthcare positions from other organizations of comparable size, complexity, and business activity. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. | |
| Form 990, Part VI, Section C, line 19 | The organization will provide any documents open to public inspection upon request. | |
| Form 990, Part VII: | John Graham received payments from related organizations. The payments he received were for his role as the current CEO at St. Mary's of Michigan Medical Center, a related entity, and not for his role as a director of Standish Hospital. | Explanation of the Compensation of John Graham: |
| Form 990, Part XI, line 5: | Net unrealized losses on investments: -1,313,121. Transfer from Restricted Funds 44,554. Total to Form 990, Part XI, Line 5: -1,268,567. | Changes in Net Assets or Fund Balances: |
| Form 990, Part III, Line 4a: | This report illustrates the significant degree to which St. Mary's of Michigan Standish Hospital contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system, St. Mary's of Michigan Standish Hospital continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of St. Mary's of Michigan Standish Hospital is to serve all persons with special attention to those who are poor and vulnerable. St. Mary's of Michigan Standish Hospital is dedicated to spiritually centered, holistic care that sustains and improves the health of individuals and communities. St. Mary's of Michigan Standish Hospital furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. Our concern for all human life and dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. St. Mary's of Michigan Standish Hospital has engaged in the following activities to ensure that our mission is accomplished: Unreimbursed Services Provided to the Elderly and the Poor St. Mary's of Michigan Standish Hospital provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2012 approximately 51.0% of the value of services rendered was to elderly patients under the Medicare program, and approximately 18.5% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. In the spirit of principles adopted by Ascension Health, St. Mary's of Michigan Standish Hospital has taken proactive steps to address those issues that will affect accessibility, the financing, and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the underserved. During the fiscal year ending June 30, 2012, the estimated unreimbursed cost to charges provided to the elderly, uninsured, and underinsured totaled $17,549,758. Patient Services St. Mary's of Michigan Standish Hospital provides the following in-patient and out-patient medical services to the community: - Ambulatory Care Services - Rural Health Clinic Office - Emergency Care Services - Visiting Physician Services - Cardiac Rehab Services - Rehabilitation Services - Operating Room Surgeries - Skilled Nursing Facility Some of the services listed above operate at a loss in order to ensure that all services are available to meet community health care needs. These include our Rural Health Clinic and Speech Therapy. During the fiscal year ending June 30, 2012, our hospital treated adults and children in the community for a total of 14,499 patient days of service. The medical center also provided services to 43,476 outpatients, including 88 outpatient surgery patients and 9,622 emergency visits. Community Outreach activities St. Mary's of Michigan Standish Hospital seeks to improve the physical, mental, social and spiritual health status of its surrounding community. In addition to providing health care services to all individuals who require medical attention, St. Mary's of Michigan Standish Hospital has developed the following programs to help achieve its mission: - Diabetes Education - Chronic Obstructive Disease Education - Car Seat Safety Programs - Community Thanksgiving Dinner - MIChild and Healthy Kids Enrollment Summary St. Mary's of Michigan Standish Hospital furthers its charitable purposes by providing a broad array of services to meet the healthcare needs of patients and organizations in the community. We provide essential medical services to the community, train and recruit healthcare professionals to serve the needs of the broader community, provide appropriate charity services to those patients who are not able to pay for their own healthcare needs, provide services to other organizations that allow them to provide quality services to their patients or constituents, and present education information classes and activities to the community in order to improve its overall health status. | Community Benefit Report |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Ascension Health | ||||||||||
| PO BOX 45998 | St Louis | MO | 63145 | 311662309 | National Health System | MO | Section 501(c)(3) | Schedule A, Line 11a | Ascension Health Alliance | 0 |
| St Mary's Health | ||||||||||
| 800 S Washington | Saginaw | MI | 48601 | 383477071 | Hospital Parent | MI | Section 501(c)(3) | Schedule A, Line 11a | St Mary's of Michigan Medical Center | 0 |
| St Mary's of Michigan Medical Center | ||||||||||
| 800 S Washington | Saginaw | MI | 48601 | 380997730 | Hospital | MI | Section 501(c)(3) | Schedule A, Line 3 | Ascension Health | 0 |
| St Mary's Hospital Foundation | ||||||||||
| 800 S Washington | Saginaw | MI | 48601 | 382246366 | Fundraising | MI | Section 501(c)(3) | Schedule A, Line 11c | St Mary's of Michigan Medical Center | 1 |
| Field Neurosciences Institute | ||||||||||
| 800 S Washington | Saginaw | MI | 48601 | 382790703 | Medical Research Organization | MI | Section 501(c)(3) | Schedule A, Line 9 | St Mary's of Michigan Medical Center | 1 |
| Field Neurosciences Institute Foundation | ||||||||||
| 800 S Washington | Saginaw | MI | 48601 | 383638165 | Fundraising | MI | Section 501(c)(3) | Schedule A, Line 11c | St Mary's of Michigan Medical Center | 1 |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Towne Centre Surgery Center LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4599 Towne Centre | AddressLine1 |
| City | Saginaw | City |
| State | MI | State |
| ZIP Code | 48604 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204943843 | EIN |
| Primary Activity | Outpatient services | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's of Michigan Specialists | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 S Washington | AddressLine1 |
| City | Saginaw | City |
| State | MI | State |
| ZIP Code | 48601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205959777 | EIN |
| Primary Activity | Physician Practices | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | 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 (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| St Mary's of Michigan Medical Center | ||
| O | 1966378 | Actual Amount Paid |
| St Mary's of Michigan Medical Center | ||
| N | 329022 | Actual Amount Paid |
| Ascension Health | ||
| O | 1773396 | Actual Amount Paid |