MERCY-MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MERCY-MEMORIAL HOSPITAL CORPORATION (EIN 38-1984289)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-04-24
- IRS object ID
- 201331149349300233
- Schema version
- 2011v1.5
- Note
- A later return for the same period supersedes this one.
- 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 F
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-04-24T14:41:59-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 307 | AddressLine1 |
| City | SOUTHFIELD | City |
| State | MI | State |
| ZIP Code | 480370307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381984289 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEMORIAL HOSPITAL CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 7342404520 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS W SCHILLING | Name |
| Title | CFO & SR VP OF FINANCE | Title |
| Phone | 7342404520 | Phone |
| Date Signed | 2013-04-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN MIENCIER | Name |
| PTIN | P00842339 | PTIN |
| Phone | 2483522500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | THOMAS W SCHILLING | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 208029042 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCYMEMORIAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1971 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | AS AN INDEPENDENT HEALTH CARE SYSTEM, WE PROVIDE HIGH QUALITY, COMPREHENSIVE SERVICES TO THE PEOPLE AND COMMUNITIES WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1882 | TotalNbrEmployees |
| Total Nbr Volunteers | 789 | TotalNbrVolunteers |
| Total Gross UBI | 5307144 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -759971 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1177458 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1169957 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 169563395 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 171880471 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3027515 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3161149 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -14714 | OtherRevenuePriorYear |
| Other Revenue Current Year | -27991 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 173753654 | TotalRevenuePriorYear |
| Total Revenue Current Year | 176183586 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 4000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 41300 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 82143925 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 86927030 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 133777 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 81430798 | OtherExpensePriorYear |
| Other Expenses Current Year | 81826404 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 163578723 | TotalExpensesPriorYear |
| Total Expenses Current Year | 168794734 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 10174931 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 7388852 | RevenuesLessExpensesCY |
| Total Assets BOY | 188002099 | TotalAssetsBOY |
| Total Assets EOY | 205039704 | TotalAssetsEOY |
| Total Liabilities BOY | 84143995 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 113555727 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 103858104 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 91483977 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | AS AN INDEPENDENT HEALTH CARE SYSTEM, WE PROVIDE HIGH QUALITY, COMPREHENSIVE SERVICES TO THE PEOPLE AND COMMUNITIES WE SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 142435639 | Expense |
| Grants | 2500 | Grants |
| Revenue | 166557943 | Revenue |
| Description | HOSPITAL BASED HEALTHCARE SERVICES -A MULTITUDE OF HEALTH CARE SERVICES WERE PROVIDED BY THE HOSPITAL TO THE PEOPLE OF MONROE COUNTY AND SURROUNDING AREAS. THESE PROGRAM SERVICES INCLUDED VARIOUS ASPECTS OF INPATIENT, OUTPATIENT, AND EMERGENCY CARE. THIS CARE WAS PROVIDED IN A MANNER THAT RESPECTED THE VALUE, PRIVACY, AND DIGNITY OF INDIVIDUAL PATIENTS AND THEIR FAMILIES. FURTHER, CONTINUOUS EFFORTS WERE MADE TO IDENTIFY AND IMPLEMENT NEW AND BETTER WAYS TO MEET THE PHYSICAL, SPIRITUAL, EMOTIONAL, AND SOCIAL NEEDS OF PATIENTS. DURING THE YEAR THE HOSPITAL PROVIDED:[A] 40,427 DAYS OF ACUTE CARE FOR ADULT AND PEDIATRIC INPATIENTS,[B] 1,471 DAYS OF ACUTE CARE FOR NEWBORNS,[C] EMERGENCY CARE FOR 48,658 OUTPATIENTS, AND[D] 1,365,170 OUTPATIENT SERVICE REGISTRATIONS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 10566 | Expense |
| Grants | 6000 | Grants |
| Revenue | 109048 | Revenue |
| Description | HOSPITAL GUILD - 129 MEMBERS RENDERED SERVICES TO THE HOSPITAL AND ITS PATIENTS BY OPERATING A GIFT SHOP, KNITTING CAPS FOR NEWBORNS, MAKING CRADLE PICTURES AVAILABLE, ASSISTING IN THE INTERNAL TRANSPORTATION OF PATIENTS AND ASSISTING IN OTHER PATIENT RELATED ACTIVITIES THROUGHOUT THE HOSPITAL. THE GIFT SHOP AND CRADLE PICTURES ARE PRIMARILY FOR THE CONVENIENCE OF EMPLOYEES, PATIENTS AND VISITORS. THE GUILD ALSO OFFERS SOME NURSING SCHOLARSHIPS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 42611 | Expense |
| Description | HOSPITAL MEDICAL STAFF - 332 MEMBERS [A] DIRECTED AND REVIEWED HOSPITAL BASED HEALTHCARE SERVICES AND [B] PARTICIPATED IN PERIODIC MEETINGS CONCERNING THE DELIVERY OF HEALTHCARE SERVICES, INCLUDING MEDICAL EDUCATION. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 142488816 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 1 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | 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 | 221 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 1 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1882 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| 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 | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | THOMAS W SCHILLING | NamePerson |
| Telephone Number | 7342404520 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (30 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| BELLINO KAREN M VUICH | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| BHURGRI MD AAMER | |||||||
| CHIEF OF STAFF - EX OFFICIO W/VOTING | 4.00 | X | 49278 | 0 | 45929 | ||
| BRAUNLICH PAUL E | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| CALENDAR KAREN | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| CALENDAR KENYON S | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| CARTER KURT W | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| CHARBONEAU DO MICHAEL | |||||||
| VICE CHIEF OF STAFF - EX OFFICIO W/VOTING | 40.00 | X | 363926 | 0 | 12543 | ||
| DARROW KURT L | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| FRANZEN VICKI L | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | |
| KABIR MD ABDUL | |||||||
| TRUSTEE | 4.00 | X | 35394 | 0 | 531 | ||
| MCNAMEE MD KENNETH J | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| PETERS RUTH ANN | |||||||
| GUILD PRESIDENT - EX OFFICIO W/VOTING | 1.00 | X | 0 | 0 | 0 | ||
| PHILLIPS ANNETTE S | |||||||
| PRESIDENT & CEO - EX OFFICIO W/VOTING | 40.00 | X | 434409 | 0 | 29668 | X | |
| ROBBINS BASIL D | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | |
| RYAN SISTER JANET | |||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | X | |
| SABO CPA DEBORAH A | |||||||
| SECRETARY (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | X | |
| SPENCER EDD DONALD A | |||||||
| VICE CHAIR (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | X | |
| WALSH ARLENE R | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| WILBURN WALTER | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| WORRELL MARK | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| KUBISKE DAVID | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| KULISH BARTON | |||||||
| TRUSTEE (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| AMIN JATIN | |||||||
| TRUSTEE - EX OFFICIO (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| JAVAID MUHAMMAD | |||||||
| TRUSTEE - EX OFFICIO (PARTIAL YEAR) | 1.00 | X | 0 | 0 | 0 | ||
| SCHILLING THOMAS W | |||||||
| CFO SENIOR VP FINANCE | 40.00 | 311655 | 0 | 30325 | X | ||
| PROCHNOW TODD | |||||||
| PHYSICIAN | 40.00 | 493606 | 0 | 30829 | X | ||
| OLENCHAK DANIEL | |||||||
| PHYSICIAN | 40.00 | 412292 | 0 | 8863 | X | ||
| RAMASWAMI GANESH | |||||||
| PHYSICIAN | 40.00 | 273516 | 0 | 28551 | X | ||
| MOHAMED ABDULLAHI | |||||||
| PHYSICIAN | 40.00 | 218863 | 0 | 22611 | X | ||
| KIBBLE JOHN | |||||||
| VICE PRESIDENT OF BUSINESS DEVELOPMENT | 40.00 | 218834 | 0 | 14579 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2811773 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 224429 | TotalOtherCompensation |
| Number Individuals GT100 K | 60 | 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 |
|---|---|---|---|---|---|
| ECLIPSYS | |||||
| 3 RAVINA DRIVE | ATLANTA | GA | 30346 | SOFTWARE SERVICES | 2976623 |
| GE HEALTHCARE | |||||
| 101 CARNEGIE CENTER | PRINCETON | NJ | 08540 | EQUIPMENT SERVICES | 1169064 |
| MICHIGAN CO-TENANCY LABS | |||||
| DEPT CH 14271 | PALATINE | IL | 60055 | LABORATORY SERVICES | 1028551 |
| PHILIPS MEDICAL SYSTEM | |||||
| 5550 PRAIRIE STONE PKWY | HOFFMAN ESTATES | IL | 60192 | EQUIPMENT SERVICES | 798287 |
| AUCH GEORGE W CO | |||||
| 735 S PADDOCK | PONTIAC | MI | 48341 | CONSTRUCTION MGT. | 627891 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 53 | NumberOfContractorsGT100K |
| Membership Dues | 40402 | MembershipDues |
| Fundraising Events | 156340 | FundraisingEvents |
| Government Grants | 45012 | GovernmentGrants |
| All Other Contributions | 928203 | AllOtherContributions |
| Noncash Contributions | 91261 | NoncashContributions |
| Total Contributions | 1169957 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| HOSPITAL BASED HEALTHC | 621990 | 166557943 | 166557943 | |
| NON-PATIENT PHARMACY | 446110 | 3891646 | 3891646 | |
| NON-PATIENT REF. LAB | 621500 | 993895 | 993895 | |
| DME | 446110 | 421603 | 421603 | |
| HOSPITAL GUILD | 621990 | 15384 | 15384 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 171880471 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1483792 | TotalRevenueColumn |
| Exclusion | $1,483,792 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1109106 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1207855 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -98749 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -98749 | TotalRevenueColumn |
| Exclusion | -$98,749 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 31916164 | Securities |
| Other | 14935 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 30194762 | Securities |
| Other | 58980 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1721402 | Securities |
| Other | -44045 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1677357 | TotalRevenueColumn |
| Exclusion | $1,677,357 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 144367 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 156340 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 181482 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -37115 | TotalRevenueColumn |
| Exclusion | -$37,115 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 52467 | GrossIncomeGaming |
| Gaming Direct Expenses | 38258 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14209 | TotalRevenueColumn |
| Exclusion | $14,209 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 257783 | GrossSalesOfInventory |
| Cost Of Goods Sold | 164119 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 93664 | TotalRevenueColumn |
| Related Or Exempt Function Income | 93664 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 176183586 | TotalRevenueColumn |
| Related Or Exempt Function Income | 166666991 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 5307144 | UnrelatedBusinessRevenue |
| Exclusion | $3,039,494 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32800 | Total |
| Program Services | 32800 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8500 | Total |
| Program Services | 8500 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1528159 | Total |
| Program Services | 631737 | ProgramServices |
| Management And General | 896422 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68816807 | Total |
| Program Services | 58360506 | ProgramServices |
| Management And General | 10367606 | ManagementAndGeneral |
| Fundraising | 88695 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 244348 | Total |
| Program Services | 217383 | ProgramServices |
| Management And General | 26638 | ManagementAndGeneral |
| Fundraising | 327 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11237872 | Total |
| Program Services | 9456581 | ProgramServices |
| Management And General | 1767073 | ManagementAndGeneral |
| Fundraising | 14218 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5099844 | Total |
| Program Services | 4279592 | ProgramServices |
| Management And General | 813818 | ManagementAndGeneral |
| Fundraising | 6434 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1311780 | Total |
| Management And General | 1311780 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 306296 | Total |
| Management And General | 306296 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 227461 | Total |
| Management And General | 227461 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19811 | Total |
| Management And General | 19811 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 314444 | Total |
| Management And General | 314444 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17310367 | Total |
| Program Services | 11229047 | ProgramServices |
| Management And General | 6071792 | ManagementAndGeneral |
| Fundraising | 9528 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 353344 | Total |
| Program Services | 13251 | ProgramServices |
| Management And General | 340093 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1900662 | Total |
| Program Services | 1138167 | ProgramServices |
| Management And General | 753603 | ManagementAndGeneral |
| Fundraising | 8892 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 948030 | Total |
| Management And General | 948030 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2750481 | Total |
| Program Services | 2536427 | ProgramServices |
| Management And General | 214054 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 568408 | Total |
| Program Services | 428292 | ProgramServices |
| Management And General | 140116 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 238052 | Total |
| Program Services | 50293 | ProgramServices |
| Management And General | 187759 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2527082 | Total |
| Program Services | 2526592 | ProgramServices |
| Fundraising | 490 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9229545 | Total |
| Program Services | 8516397 | ProgramServices |
| Management And General | 713148 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2294375 | Total |
| Program Services | 1923272 | ProgramServices |
| Management And General | 371103 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| HOSPITAL SUPPLIES | 26859413 | 26859413 |
| PROVISION FOR BAD DEBTS | 8928499 | 8928499 |
| QUALITY ASSURANCE ASSES | 4568031 | 4568031 |
| DIETARY SUPPLIES | 779469 | 779469 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 390854 | Total |
| Program Services | 4567 | ProgramServices |
| Management And General | 381094 | ManagementAndGeneral |
| Fundraising | 5193 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168794734 | Total |
| Program Services | 142488816 | ProgramServices |
| Management And General | 26172141 | ManagementAndGeneral |
| Fundraising | 133777 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3036485 | BOY |
| EOY | 118553 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17543562 | BOY |
| EOY | 16822030 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21344529 | BOY |
| EOY | 35109790 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2728503 | BOY |
| EOY | 2598929 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1982485 | BOY |
| EOY | 2071720 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 191320805 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 109054355 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79573260 | BOY |
| EOY | 82266450 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58853299 | BOY |
| EOY | 62924175 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 226230 | BOY |
| EOY | 320601 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2713746 | BOY |
| EOY | 2807456 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 188002099 | BOY |
| EOY | 205039704 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36548154 | BOY |
| EOY | 63907268 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44695841 | BOY |
| EOY | 43813402 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2900000 | BOY |
| EOY | 5835057 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84143995 | BOY |
| EOY | 113555727 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100604017 | BOY |
| EOY | 88054229 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3198335 | BOY |
| EOY | 3374057 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55752 | BOY |
| EOY | 55691 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 103858104 | BOY |
| EOY | 91483977 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 188002099 | BOY |
| EOY | 205039704 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 7388852 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -19762979 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $19,811 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 19811 | 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 | THE ORGANIZATION PAID DUES TO ORGANIZATIONS WHICH PERFORMED LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3257087 | BeginningOfYearBalance |
| Contributions | 1265452 | Contributions |
| Investment Earnings Or Losses | 96131 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2500 | GrantsOrScholarships |
| Other Expenditures | 1183422 | OtherExpenditures |
| End Of Year Balance | 3432748 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3106926 | BeginningOfYearBalance |
| Contributions | 1263779 | Contributions |
| Investment Earnings Or Losses | 87576 | InvestmentEarningsOrLosses |
| Other Expenditures | 1204194 | OtherExpenditures |
| End Of Year Balance | 3254087 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4973922 | BeginningOfYearBalance |
| Contributions | 1132367 | Contributions |
| Investment Earnings Or Losses | 168896 | InvestmentEarningsOrLosses |
| Other Expenditures | 3168259 | OtherExpenditures |
| End Of Year Balance | 3106926 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5308021 | BeginningOfYearBalance |
| Contributions | 1121436 | Contributions |
| Investment Earnings Or Losses | -178473 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 3000 | GrantsOrScholarships |
| Other Expenditures | 1274062 | OtherExpenditures |
| End Of Year Balance | 4973922 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.98000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.02000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15227143 | OtherCostOrOtherBasis |
| Book Value | 15227143 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 62416562 | OtherCostOrOtherBasis |
| Depreciation | 35301484 | Depreciation |
| Book Value | 27115078 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 113150911 | OtherCostOrOtherBasis |
| Depreciation | 73752871 | Depreciation |
| Book Value | 39398040 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 526189 | OtherCostOrOtherBasis |
| Book Value | 526189 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 82266450 | TotalOfBookValueLandBuildings |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | TRUE ENDOWMENT FUNDS ARE INTENDED TO BE USED FOR NURSING SCHOLARSHIPS. QUASI-ENDOWMENT FUNDS HAVE BEEN DESIGNATED FOR VARIOUS USES TO FURTHER THE HOSPITAL'S MISSION TO PROVIDE QUALITY, COMPREHENSIVE HEALTH CARE SERVICES. SOME OF THESE DESIGNATIONS INCLUDE HOSPICE, CHAPLAINCY, CANCER TREATMENT ASSISTANCE, CAPITAL IMPROVEMENTS, AND PHARMACY ASSISTANCE. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2012, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)
| RegionRegion | Number Of OfficesNumberOfOffices | Number Of EmployeesNumberOfEmployees | Type Of Activities ConductedTypeOfActivitiesConducted | Specific Services ProvidedSpecificServicesProvided | Total ExpendituresTotalExpenditures |
|---|---|---|---|---|---|
| CENTRAL AMERICA AND THE CARIBBEAN | 0 | 0 | PROGRAM SERVICE | PAYMENTS TO FOREIGN INSURANCE COMPANY THAT PROVIDES INSURANCE TO THE HOSPITAL | 2934618 |
| CENTRAL AMERICA AND THE CARIBBEAN | 0 | 0 | INVESTMENT | 3685407 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 6620025 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 6620025 | TotalAmountSpent |
| Transfer To Foreign Corp | 1 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 1 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | FANTASY OF TREES 2011 | NameOfEvent1 |
| Gross Receipts Event1 | 141404 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 66473 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 74931 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 54561 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 4730 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 19745 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 1392 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 19874 | OtherDirectExpensesEvent1 |
| Name Of Event2 | BLACK TOP BASH 2012 | NameOfEvent2 |
| Gross Receipts Event2 | 43676 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 27292 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 16384 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 550 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 1000 | RentFacilityCostsEvent2 |
| Entertainment Event2 | 2250 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 2646 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 12 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 115627 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 62575 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 53052 | GrossRevenueOtherEvents |
| Non Cash Prizes Other Events | 16610 | NonCashPrizesOtherEvents |
| Food And Beverage Other Events | 36915 | FoodAndBeverageOtherEvents |
| Other Direct Expenses Other Events | 21209 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 300707 | GrossReceiptsTotal |
| Charitable Contributions Total | 156340 | CharitableContributionsTotal |
| Gross Revenue Total Events | 144367 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 71721 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 5730 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 56660 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 3642 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 43729 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 181482 | DirectExpenseSummaryEvents |
| Net Income Summary | -37115 | NetIncomeSummary |
Gaming Information GamingInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | 52467 | GrossRevenueOtherGaming |
| Cash Prizes Other Gaming | 8500 | CashPrizesOtherGaming |
| Non Cash Prizes Other Gaming | 29155 | NonCashPrizesOtherGaming |
| Rent Facility Costs Other Gaming | 603 | RentFacilityCostsOtherGaming |
| Volunteer Labor Other Gaming | 1 | VolunteerLaborOtherGaming |
| Volunteer Labor Prcnt Other Gaming | 1.00000 | VolunteerLaborPrcntOtherGaming |
| Gross Revenue Total Gaming | 52467 | GrossRevenueTotalGaming |
| Cash Prizes Total Gaming | 8500 | CashPrizesTotalGaming |
| Non Cash Prizes Total Gaming | 29155 | NonCashPrizesTotalGaming |
| Rent Facility Costs Total Gaming | 603 | RentFacilityCostsTotalGaming |
| Direct Expense Summary Gaming | 38258 | DirectExpenseSummaryGaming |
| Net Gaming Income Summary | 14209 | NetGamingIncomeSummary |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | MI | StatesWhereGamingConducted |
| Licensed | 1 | Licensed |
| License Suspended Etc | 0 | LicenseSuspendedEtc |
| Gaming With Nonmembers | 1 | GamingWithNonmembers |
| Member Of Other Entity | 0 | MemberOfOtherEntity |
| Percentage Of Gaming Own Facility | 0.10000 | PercentageOfGamingOwnFacility |
| Percentage Of Gaming Othr Facility | 0.90000 | PercentageOfGamingOthrFacility |
| Name Of Gaming Rec Keeper Person | MOLLY MOORE | NameOfGamingRecKeeperPerson |
Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contract With3rd Party For Gam Rev | 0 | ContractWith3rdPartyForGamRev |
| Gaming Manager Name Person | MOLLY MOORE | GamingManagerNamePerson |
| Gaming Manager Compensation | 725 | GamingManagerCompensation |
| Gaming Manager Services Provided | OVERSEES GAMING ACTIVITIES AND RECORDKEEPING | GamingManagerServicesProvided |
| Gaming Manager Is Employee | X | GamingManagerIsEmployee |
| Charitable Distrib Required | 0 | CharitableDistribRequired |
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 | 0 | FPGReferenceDiscountedCare |
| 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) |
|---|---|---|
| Total Community Benefit Expense | 3352964 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3352964 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02100 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 27604836 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19670928 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7933908 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04960 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 30957800 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19670928 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11286872 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07060 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 743936 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 743936 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00470 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 465577 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 465577 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 236801 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 234801 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 55560 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 55560 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1501874 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1499874 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00940 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 32459674 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19672928 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12786746 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 10289 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10289 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 20889 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 20889 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 18262 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 18262 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 11818 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 11818 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 859 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 859 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 62117 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 62117 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $8,928,499 | BadDebtExpenseAmount |
| Amount Attributable To | 892850 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 41915732 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 44296841 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2381109 | 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 | MERCY MEMORIAL HOSPITAL CORPORATION | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48162 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEMORIAL HOSPITAL CORPORATION | 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 | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 0 | IncludesPublicityMeasures |
| 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 | 30 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (30 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| DIAGNOSTIC CENTER | ||||
| 901 N MACOMB STREET | MONROE | MI | 48162 | DIAGNOSTIC, CARDIOPULMONARY, LAB |
| MMH REHAB | ||||
| 650 STEWART ROAD | MONROE | MI | 48162 | REHAB SERVICES |
| HOME CARE CONNECTION | ||||
| 721/725 N MONROE STREET | MONROE | MI | 48162 | HOME CARE SERVICES |
| MMH OUTPATIENT SURGERY CENTER | ||||
| 750 STEWART ROAD | MONROE | MI | 48162 | AMBULATORY SURGERY CENTER |
| MERCY MEMORIAL HOSPICE | ||||
| 721/725 N MONROE STREET | MONROE | MI | 48162 | HOSPICE SERVICES |
| MMH POB | ||||
| 730 N MACOMB STREET | MONROE | MI | 48162 | OUTPATIENT CLINIC |
| PHLEBOTOMY-DELISLE CENTER | ||||
| 1056 N MONROE STREET | MONROE | MI | 48162 | OUTREACH LAB |
| PHLEBOTOMYXRAY-DRKABIR | ||||
| 219 W FRONT STREET | MONROE | MI | 48162 | OUTREACH LAB |
| PHLEBOTOMY-DR MALOOD | ||||
| 3160 LEWIS ROAD | IDA | MI | 48140 | OUTREACH LAB |
| WESTSIDE MEDICAL | ||||
| 100 POWELL | DUNDEE | MI | 48131 | DIAGNOSTIC THERAPY, LAB |
| PHLEBOTOMY-DR STEWART | ||||
| 811 N MONROE STREET | MONROE | MI | 48162 | OUTREACH LAB |
| DR AHADI OFFICE COMPLEX | ||||
| 55 COLE ROAD | MONROE | MI | 48162 | OUTREACH LAB |
| SLEEP LAB MACOMB | ||||
| 717 N MACOMB STREET | MONROE | MI | 48162 | SLEEP LAB SERVICES |
| PHLEBOTOMY-DR DONA | ||||
| 7505 GRAFTON ROAD SUITE 5 | MONROE | MI | 48162 | OUTREACH LAB |
| NEWPORT MEDICAL | ||||
| 7825 NORTH DIXIE | NEWPORT | MI | 48166 | PATIENT ACCOUNTING, LAB |
| KARPENKO | ||||
| 323 STEWART ROAD | MONROE | MI | 48162 | OUTREACH LAB |
| DR DANIEL OLENCHAK | ||||
| 730 N MACOMB STREET SUITE 419 | MONROE | MI | 48162 | DOCTOR OFFICE |
| DR TODD PROCHNOW | ||||
| 730 N MACOMB STREET SUITE 419 | MONROE | MI | 48162 | DOCTOR OFFICE |
| PHLEBOTOMY-DR QURESHI | ||||
| 5290 W BROOKSHIRE ROAD | MONROE | MI | 48161 | OUTREACH LAB |
| PHLEBOTOMY-DR ROECKER | ||||
| 14430 LAPLAISANCE ROAD | MONROE | MI | 48162 | OUTREACH LAB |
| OUTPATIENT THERAPY | ||||
| 214 ELM STREET | MONROE | MI | 48162 | OCCUPATIONAL THERAPY SERVICES |
| TEMPERANCE | ||||
| 1715 W DEAN ROAD | TEMPERANCE | MI | 48182 | SLEEP LAB, LAB SERVICES |
| PHLEBOTOMY-CARLETON FAMILY MEDICAL | ||||
| 130 MEDICAL CENTER | CARLETON | MI | 48117 | OUTREACH LAB |
| DR GANESH RAMASWAMI | ||||
| 730 N MACOMB STREET SUITE 300 | MONROE | MI | 48162 | DOCTOR OFFICE |
| DR MICHAEL CHARBONEAU | ||||
| 730 N MACOMB STREET | MONROE | MI | 48162 | DOCTOR OFFICE |
| DR JAMES DOYLE | ||||
| 920 N MACOMB STREET | MONROE | MI | 48162 | DOCTOR OFFICE |
| DR BETTY RUMSCHLAG | ||||
| 7470 SECOR ROAD | LAMBERTVILLE | MI | 48144 | DOCTOR OFFICE |
| DR LAURA GRIMA | ||||
| 110 MAIN STREET | DUNDEE | MI | 48131 | DOCTOR OFFICE |
| DR MICHELLE CHARTIER | ||||
| 7825 N DIXIE HWY | NEWPORT | MI | 48166 | DOCTOR OFFICE |
| DR KURT ROEKER | ||||
| 14930 LAPLAISANCE ROAD SUITE 419 | MONROE | MI | 48161 | DOCTOR OFFICE |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: A COST TO CHARGE RATIO, DERIVED FROM WORKSHEET 2, IS USED FOR LINES 7A AND 7B. ACTUAL COSTS FROM THE COST ACCOUNTING SYSTEM AND ACCOUNTING RECORDS ARE USED FOR LINES 7E THROUGH 7I. | ||
| PART I, LINE 7G: N/A - THE HOSPITAL DID NOT LIST ANY SUBSIDIZED HEALTH SERVICES. | ||
| PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THIS SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $8,928,499. | ||
| PART II: PARTICIPATION IN TASK FORCES AND COMMITTEES ASSURES A MORE COORDINATED APPROACH TO SERVICES FOR AN AGING POPULATION. EMERGENCY PREPAREDNESS AND COORDINATION OF EFFORT AMONG AGENCIES PROVIDING HUMAN SERVICES. SPECIFIC AREAS OF IMPROVEMENT INCLUDE PRE-HOSPITAL AMBULANCE CARE, REFERRAL OF SENIORS TO SUPPORTIVE COMMUNITY SERVICES, SUICIDE PREVENTION, SUBSTANCE ABUSE, AND BREASTFEEDING FOR IMPROVED CHILD HEALTH. | ||
| PART III, LINE 4: ACCOUNT RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:THE PROVISION FOR BAD DEBTS IS BASED UP ON MANAGEMENT'S ASSESSMENT OF THE HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTABLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES.THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS ESTIMATED AT 10 PERCENT OF BAD DEBT EXPENSE. | ||
| PART III, LINE 8: THE SHORTFALL SHOULD BE CONSIDERED AND INCLUDED IN THE COMMUNITY BENEFIT AS THE REIMBURSEMENT DID NOT MEET THE "COST" OF THE EXPENSE BASED ON REASONABLE COSTING METHODOLOGIES. THIS IS BASED ON THE METHODOLOGY REQUIRED FOR COMPLETING THE MEDICARE COST REPORT. | ||
| PART V, SECTION B, LINE 10: THE FINANCIAL ASSISTANCE POLICY IS FOR FREE CARE AND THE ONLY OTHER DISCOUNTED CARE AVAILABLE IS FOR ANY PATIENT PAYING WITHIN 30 DAYS RECEIVES A 20% DISCOUNT. | MERCY MEMORIAL HOSPITAL CORPORATION | |
| PART V, SECTION B, LINE 13G: ANY INDIVIDUAL WHO SELF PAYS IS ROUTED TO THE FINANCIAL COUNSELING DEPARTMENT. | MERCY MEMORIAL HOSPITAL CORPORATION | |
| PART V, SECTION B, LINE 19D: FAP-ELIGIBLE INDIVIDUALS ARE NOT CHARGED AND DO NOT RECEIVE A BILL IF THEY QUALIFY UNDER THE HOSPITAL'S FAP. | MERCY MEMORIAL HOSPITAL CORPORATION | |
| PART VI, LINE 2: TO IDENTIFY COMMUNITY NEEDS TO BE ADDRESSED IN THE ORGANIZATION'S 2010-2013 STRATEGIC PLAN: INTERVIEWS WITH ELECTED COMMUNITY LEADERS, EMPLOYERS, PHYSICIANS AND THE PUBLIC; SUPPLEMENTED ANALYSIS OF DATA FROM SOURCES SUCH AS THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH BEHAVIORAL RISK FACTOR SURVEY, ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS, AND THE HHS COMMUNITY HEALTH STATUS REPORT FOR MONROE COUNTY. | ||
| PART VI, LINE 3: WHEN IT IS DETERMINED THAT A PATIENT IS UNABLE TO PAY FOR SERVICES (EITHER BEFORE OR AFTER SERVICES ARE RENDERED) A FINANCIAL COUNSELOR WILL SPEAK TO THE PATIENT TO EXPLAIN FINANCIAL ASSISTANCE. THE FIRST OPTION OFFERED IS STATE MEDICAID. THE PATIENT IS ASSESSED FOR MEDICAID QUALIFICATION AND IF IT IS DETERMINED THE PATIENT DOES NOT QUALIFY, THEY ARE OFFERED CHARITY CARE ASSISTANCE. THE PATIENT IS GIVEN A CHARITY CARE APPLICATION AND REQUESTED TO COMPLETE AND RETURN TO THE FINANCIAL COUNSELOR WITH THE APPROPRIATE DOCUMENTATION. ONCE THE APPLICATION IS RETURNED TO THE FINANCIAL COUNSELOR, IT IS ASSEMBLED AND SENT TO THE PATIENT ACCOUNTING OFFICE FOR APPROVAL. DEPENDING ON THE AMOUNT, VARYING LEVELS OF APPROVAL ARE REQUIRED. | ||
| PART VI, LINE 4: CONSISTENT WITH THE US CENTERS FOR MEDICARE AND MEDICAID SERVICES, THE PRIMARY SERVICE AREA INCLUDES CONTIGUOUS ZIP CODES FOR THE CITY OF MONROE AND NEWPORT THAT PROVIDE 75 % OF MERCY MEMORIAL HOSPITAL'S DISCHARGES. THE SECONDARY SERVICE AREA IS THE REMAINDER OF MONROE COUNTY. IN 2011 THE TOTAL COUNTY POPULATION WAS ESTIMATED AT 151,560 WITH A HISTORIC APPROXIMATION OF 45% RESIDING IN THE PRIMARY SERVICE AREA. UNEMPLOYMENT WITH OUTMIGRATION HAS RESULTED IN A SLIGHT DECLINE OVER THIS LAST DECADE. INDIVIDUALS OVER AGE 65 IS THE MOST RAPIDLY GROWING COHORT IN A POPULATION THAT'S APPROXIMATELY 95% WHITE AND 2.5% EACH BLACK AND HISPANIC. SOME NORTHERN AND SOUTHERN PORTIONS OF MONROE COUNTY ARE FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS. | ||
| PART VI, LINE 5: OPEN MEDICAL STAFF WITH ACTIVE RECRUITMENT OF PHYSICIANS IN SPECIALTY AREAS OF IDENTIFIED COMMUNITY NEED AND PLACEMENT OF PHYSICIANS IN THE COUNTY TO ENHANCE PATIENT ACCESS, PURSUIT OF GRANTS TO SUPPORT MAMMOGRAPHY SCREENING FOR INDIGENT WOMEN, SUPPORT OF EMPLOYEE VOLUNTARY EFFORTS TO SUPPLY FOOD BANKS FOR IMPROVED NUTRITION AND HEALTH PRODUCTS TO ENHANCE HYGIENE, PRO-ACTIVELY EDUCATING AND ENROLLING ELIGIBLE PEOPLE IN MEDICAID, AND SOLICITING DONATIONS TO SUBSIDIZE PRESCRIPTIONS AND TRANSPORTATION FOR PEOPLE IN NEED. THE ORGANIZATION'S EMPLOYEES SERVE ON VARIOUS HUMAN SERVICE AGENCY BOARDS THAT IMPACT SOCIAL OR MEDICAL ASPECTS OF HEALTH. | ||
| PART VI, LINE 6: N/A - NOT AFFILIATED. | ||
| MI | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| FAMILY MEDICAL CENTER | |||||||
| 28 S MACOMB ST | MONROE | MI | 48162 | 382236628 | 501(C)(3) | 19800 | RENT FOR FEDERALLY QUALIFIED CLINIC |
| COMMUNITY FOUNDATION | |||||||
| 905 N MACOMB ST | MONROE | MI | 48162 | 382308659 | 501(C)(3) | 13000 | SPONSORSHIP OF VARIOUS FOUNDATION EVENTS AND PROJECTS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | NURSING SCHOLARSHIPS TO MONROE COUNTY COMMUNITY COLLEGE | TypeOfGrant |
| Number Of Recipients | 3 | NumberOfRecipients |
| Amount Of Cash Grant | 8500 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: NURSING SCHOLARSHIPS ARE AWARDED BASED ON AN APPLICATION PROCESS. THE FUNDS ARE DISBURSED DIRECTLY TO THE EDUCATIONAL INSTITUTION. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARBONEAU DO MICHAEL | |||||||||||||
| 276533 | 0 | 75 | 0 | 87318 | 0 | 4000 | 0 | 8543 | 0 | 376469 | 0 | 0 | 0 |
| PHILLIPS ANNETTE S | |||||||||||||
| 340138 | 0 | 89471 | 0 | 4800 | 0 | 10378 | 0 | 19290 | 0 | 464077 | 0 | 0 | 0 |
| SCHILLING THOMAS W | |||||||||||||
| 254155 | 0 | 51500 | 0 | 6000 | 0 | 10559 | 0 | 19766 | 0 | 341980 | 0 | 0 | 0 |
| PROCHNOW TODD | |||||||||||||
| 493231 | 0 | 375 | 0 | 0 | 0 | 7350 | 0 | 23479 | 0 | 524435 | 0 | 0 | 0 |
| OLENCHAK DANIEL | |||||||||||||
| 412067 | 0 | 225 | 0 | 0 | 0 | 8750 | 0 | 113 | 0 | 421155 | 0 | 0 | 0 |
| RAMASWAMI GANESH | |||||||||||||
| 273141 | 0 | 375 | 0 | 0 | 0 | 7350 | 0 | 21201 | 0 | 302067 | 0 | 0 | 0 |
| MOHAMED ABDULLAHI | |||||||||||||
| 218675 | 0 | 188 | 0 | 0 | 0 | 4727 | 0 | 17884 | 0 | 241474 | 0 | 0 | 0 |
| KIBBLE JOHN | |||||||||||||
| 184434 | 0 | 29600 | 0 | 4800 | 0 | 7081 | 0 | 7498 | 0 | 233413 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | THE HOSPITAL MAINTAINS A MEMBERSHIP WITH A COMMUNITY GOLF / COUNTRY CLUB. THE MEMBERSHIP IS INTENDED FOR THE GENERAL USE OF THE HOSPITAL, AND IS MAINTAINED UNDER THE NAME OF THE CHIEF EXECUTIVE OFFICER (AS A REPRESENTATIVE MUST BE NAMED IN THIS INSTANCE). USE OF THE MEMBERSHIP IS MADE AVAILABLE FOR BUSINESS PURPOSES ONLY, AND PERSONAL USE IS PROHIBITED. FACILITIES AT THE COUNTRY CLUB ARE USED FOR HOSPITAL FUNCTIONS, BUSINESS MEETINGS, VOLUNTEER RECOGNITION, AND FUNDRAISING. THIS BENEFIT IS NOT TREATED AS TAXABLE COMPENSATION. |
| PART I, LINE 4B | THE ORGANIZATION OFFERS SELECT MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES ANNUAL EMPLOYER-FUNDED CONTRIBUTIONS EQUAL TO A FIXED PERCENT OF BASE SALARY: 15% FOR CEO, 10% FOR SENIOR VICE PRESIDENTS AND 5% FOR VICE PRESIDENTS. BENEFITS ARE VESTED AFTER THREE YEARS OF SERVICE AND ARE PAID OUT IN A LUMP SUM BY MARCH 15 OF THE YEAR FOLLOWING THE YEAR IN WHICH THEY BECOME VESTED. THE FOLLOWING INDIVIDUALS REPORTED ON FORM 990, PART VII ARE PARTICIPANTS: ANNETTE PHILLIPS, THOMAS SCHILLING AND JOHN KIBBLE. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| COUNTY OF MONROE HOSPITAL FINANCE AUTHORITY | |||||||
| 386004873 | 610648AR8 | 2006-06-15 | 50405076 | CONSTRUCTION PROJECT ADDING 58,995 SQ FT; RENOVATING 66,910 SQ FT | 0 | 0 | 0 |
| COUNTY OF MONROE HOSPITAL FINANCE AUTHORITY | |||||||
| 386004873 | 2012-03-30 | 3170830 | CATH LAB RENOVATION AND EQUIPMENT | 0 | 0 | 0 | |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 52639779 | 3812411 | 709013 | 36382719 | 2009 | 1 | 0 | 1 | 1 |
| 3170830 | 30000 | 3140830 | 2012 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Engage Bond Counsel ContractsEngageBondCounselContracts | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 1 | 1 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 1 | 1 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 1 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| SCHEDULE K, PART I, BOND ISSUES: | MONROE COMMUNITY HEALTH SERVICES IS A MEMBER OF THE MERCY MEMORIAL HOSPITAL CORPORATION OBLIGATED GROUP OF WHICH MONROE COMMUNITY HEALTH SERVICES HAS BEEN ALLOCATED FUNDS FROM THIS 2006 BOND ISSUANCE. |
| SCHEDULE K, PART I, BOND ISSUES: | A- THE BOND ISSUE PRICE WAS $50,405,076.58 WITH A REDEMPTION PRICE OF $49,550,000 AT MATURITY. PROCEEDS OF THE ISSUE WERE USED FOR BOND ISSUANCE COSTS, REQUIRED RESERVE FUND, REFUND PRIOR ISSUE BONDS AND INDEBTEDNESS (02/01/1994 BONDS) AND BUILDING EXPANSION AND EQUIPMENT. B - SIEMENS PUBLIC INC. PROGRAM REVENUE NOTE ISSUE PRICE WAS $3,170,830. PROCEEDS OF THE ISSUE WERE USED FOR NOTE ISSUANCE COSTS AND CATH LAB RENOVATION EQUIPMENT. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| MARY CARTER | |||
| FAMILY MEMBER OF BOARD MEMBER KURT CARTER. | 28113 | EMPLOYMENT | 0 |
| LARRY CSOKASY | |||
| FAMILY MEMBER OF BOARD MEMBER KURT CARTER. | 95208 | EMPLOYMENT | 0 |
| MONROE HEALTH CENTER | |||
| >35% OWNED BY BOARD MEMBER AAMER BHURGRI. | 180372 | LEASE OF PROPERTY | 0 |
| MONROE EQUIPMENT LEASING | |||
| BOARD MEMBERS KABIR, AMIN & BHURGRI ARE OFFICERS OF MONROE EQUIP. LEASING | 851875 | MRI LEASE | 0 |
Schedule M IRS990ScheduleM
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 28705 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | COMPARABLE SALES | MethodOfDeterminingRevenues |
Securities Publicly Traded SecuritiesPubliclyTraded
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 2 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 42272 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | COMPARABLE SALES | MethodOfDeterminingRevenues |
Food Inventory FoodInventory
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 12 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 2000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | COMPARABLE SALES | MethodOfDeterminingRevenues |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 17 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 3056 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | COMPARABLE SALES | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | AUCTION ITEMS | Description |
| Number Of Contributions | 150 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 15227 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | COMPARABLE SALES | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBERS DR. KENNETH MCNAMEE, DR. AAMER BHURGRI, DR. MICHAEL CHARBONEAU, JATIN AMIN AND DR. ABDUL KABIR HAVE A BUSINESS RELATIONSHIP. BOARD MEMBERS KAREN CALENDAR AND KENYON CALENDAR HAVE A FAMILY RELATIONSHIP. | |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 INPUT DATA IS REVIEWED AND ANALYZED BY THE CONTROLLER AND THEN SUBMITTED TO THE CERTIFIED PUBLIC ACCOUNTING FIRM FOR PREPARATION. THE COMPLETED FORM 990 IS THEN RETURNED TO THE CFO AND THE CEO FOR FINAL REVIEW AND APPROVAL BEFORE THE BOARD MEETING. BEFORE THE RETURN IS FILED, THE FORM 990 IS REVIEW BY THE BOARD. ALL MEMBERS RECEIVE A COPY OF THE FORM 990, EVEN THOSE THAT ARE UNABLE TO ATTEND THE SCHEDULED MEETING. THE REVIEW IS PERFORMED DURING ONE OF THE MONTHLY BOARD MEETINGS, WHERE EACH MEMBER HAS A CHANGE TO ASK QUESTIONS. THIS REVIEW IS DOCUMENTED VIA MINUTES TO THE MEETING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS, OFFICERS AND EMPLOYEES OF THE HOSPITAL. ON AN ANNUAL BASIS, THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS DISTRIBUTED TO OFFICERS, EMPLOYEES, AND TRUSTEES OF MERCY MEMORIAL HOSPITAL CORPORATION. POTENTIAL CONFLICTS OF INTEREST ARE ANALYZED BY THE HOSPITAL'S LEGAL DEPARTMENT AND ARE GIVEN RANKINGS OF LOW, MODERATE, AND SEVERE RISK. THIS ANALYSIS IS GIVEN TO THE BOARD CHAIR AND THE HOSPITAL'S CHIEF EXECUTIVE OFFICER. ANY MEMBER WITH AN IDENTIFIED CONFLICT OF INTEREST IS EXCUSED FROM THE MEETING DURING DISCUSSIONS PERTAINING TO THE ISSUE OF CONFLICT, AND THE MEMBER IS NOT PERMITTED TO VOTE ON ANY ISSUE OF CONFLICT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES DETERMINES AND APPROVES ALL COMPENSATION FOR THOSE DESIGNATED IN SENIOR LEADERSHIP POSITIONS SUCH AS THE CHIEF EXECUTIVE OFFICER & PRESIDENT, THE CHIEF MEDICAL OFFICER & VICE PRESIDENT OF MEDICAL AFFAIRS, THE CHIEF FINANCIAL OFFICER & SENIOR VICE PRESIDENT OF FINANCE, THE CHIEF NURSING OFFICER & SENIOR VICE PRESIDENT OF CLINICAL OPERATIONS, AND OTHER VICE PRESIDENTS. THE INDEPENDENT BOARD COMMITTEE RETAINS AN OUTSIDE CONSULTANT TO ANALYZE AND ASSIST IN MAKING THESE DETERMINATIONS THROUGH A VARIETY OF MARKET SURVEYS/STUDIES. THIS PROCESS IS UNDERTAKEN ANNUALLY AND WAS LAST PERFORMED IN 2012. | |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. | |
| FORM 990, PART VII: | THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO, RELATED ORGANIZATION, MONROE COMMUNITY HEALTH SERVICES: JATIN AMIN 1 HOUR KAREN M. VUICH BELLINO 1 HOUR AAMER BHURGRI, M.D. 4 HOURS PAUL E. BRAUNLICH 1 HOUR KAREN CALENDAR 1 HOUR KENYON S. CALENDAR 1 HOUR KURT W. CARTER 1 HOUR MICHAEL CHARBONEAU, D.O. 1 HOUR KURT L. DARROW 1 HOUR VICKI L. FRANZEN 1 HOUR MUHAMMAD JAVAID 1 HOUR ABDUL KABIR, M.D. 1 HOUR DAVID KUBISKE 1 HOUR BARTON KULISH 1 HOUR KENNETH J. MCNAMEE, M.D. 1 HOUR RUTH ANN PETERS 1 HOUR ANNETTE S. PHILLIPS 4 HOURS BASIL D. ROBBINS 1 HOUR SISTER JANET RYAN 1 HOUR DEBORAH A. SABO, C.P.A. 1 HOUR DONALD A. SPENCER, ED.D. 1 HOUR ARLENE R. WALSH 1 HOUR WALTER WILBURN 1 HOUR MARK WORRELL 1 HOUR THOMAS W. SCHILLING 4 HOURS | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -1,350,787. PENSION LIABILITY ADJUSTMENT -18,532,339. INCOME FROM PROCEEDS OF BOND ISSUE NOT UNDER THE CONTROL OF THE HOSPITAL 120,147. TOTAL TO FORM 990, PART XI, LINE 5: -19,762,979. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONROE COMMUNITY HEALTH SERVICES | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48164 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382934134 | EIN |
| Primary Activities | SKILLED NURSING AND OUTPATIENT SURGERY | PrimaryActivities |
| Legal Domicile State | MI | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 9 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEMORIAL HOSPITAL CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONROE HEALTH VENTURES | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 N MACOMB STREET | AddressLine1 |
| City | MONROE | City |
| State | MI | State |
| ZIP Code | 48164 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382704426 | EIN |
| Primary Activity | PHARMACY | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEMORIAL HOSPITAL CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MONROE COMMUNITY HEALTH SERVICES | ||
| K | 133397 | ACTUAL ALLOCATED COST |
| MONROE COMMUNITY HEALTH SERVICES | ||
| L | 134415 | ACTUAL ALLOCATED COST |
| MONROE COMMUNITY HEALTH SERVICES | ||
| P | 1263606 | ACTUAL ALLOCATED COST |
| MONROE COMMUNITY HEALTH SERVICES | ||
| O | 81828 | ACTUAL ALLOCATED COST |
| MONROE COMMUNITY HEALTH SERVICES | ||
| R | 1028460 | ACTUAL ALLOCATED COST |