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COREWELL HEALTH: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COREWELL HEALTH (EIN 38-1359266)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-04-11
IRS object ID
201341019349300024
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-04-11T14:49:05-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN381357951EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1600 E FRONT ST SUITE 300AddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49686ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN381359266EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL MEDICAL CENTER OF WEST MICHIGANBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMEMONameControl
Phone2318432591Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE ATKINSON DRIVEAddressLine1
CityLUDINGTONCity
StateMIState
ZIP Code49431ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKERRI L NELSONName
TitleVICE PRESIDENT OF FINANCETitle
Phone2318432591Phone
Date Signed2013-03-22DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMICHAEL BAKER CPAName
PTINP00053797PTIN
Phone2319477800Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK VIPPERMANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE ATKINSON DRIVEAddressLine1
CityLUDINGTONCity
StateMIState
ZIP Code49431ZIPCode
FieldValueIRS element (for citing)
Gross Receipts65037983GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MMCWM.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO ENHANCE LIFE THROUGH EXCEPTIONAL HEALTHCARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees618TotalNbrEmployees
Total Nbr Volunteers120TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year238363ContributionsGrantsPriorYear
Contributions Grants Current Year456694ContributionsGrantsCurrentYear
Program Service Revenue Prior Year55345290ProgramServiceRevenuePriorYear
Program Service Revenue CY62631084ProgramServiceRevenueCY
Investment Income Prior Year395861InvestmentIncomePriorYear
Investment Income Current Year449549InvestmentIncomeCurrentYear
Other Revenue Prior Year926373OtherRevenuePriorYear
Other Revenue Current Year1202172OtherRevenueCurrentYear
Total Revenue Prior Year56905887TotalRevenuePriorYear
Total Revenue Current Year64739499TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year18950GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY23473GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year27478191SalariesEtcPriorYear
Salaries Etc Current Year29443214SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year252389TotalFundrsngExpCurrentYear
Other Expense Prior Year25805568OtherExpensePriorYear
Other Expenses Current Year31757471OtherExpensesCurrentYear
Total Expenses Prior Year53302709TotalExpensesPriorYear
Total Expenses Current Year61224158TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3603178RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3515341RevenuesLessExpensesCY
Total Assets BOY66646423TotalAssetsBOY
Total Assets EOY82326477TotalAssetsEOY
Total Liabilities BOY36234874TotalLiabilitiesBOY
Total Liabilities EOY50328084TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY30411549NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY31998393NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO ENHANCE LIFE THROUGH EXCEPTIONAL HEALTHCARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense12042851Expense
Grants23473Grants
Revenue15628212Revenue
DescriptionOPERATING ROOM (7,669 VISITS) - SEE LINE 4D "OTHER PROGRAM SERVICES" FOR ADDITIONAL DESCRIPTION.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense6683840Expense
Revenue8673732Revenue
DescriptionLAB (338,626 TESTS) - SEE LINE 4D "OTHER PROGRAM SERVICES" FOR ADDITIONAL DESCRIPTION.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4404349Expense
Revenue5715598Revenue
DescriptionPHARMACY (754,396 UNITS) - SEE LINE 4D "OTHER PROGRAM SERVICES" FOR ADDITIONAL DESCRIPTION.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense27639958Expense
Revenue33657921Revenue
DescriptionMEMORIAL MEDICAL CENTER (38-1359266) PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY.REALIZING THAT REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE ONGOING OPERATION AND STABILITY OF MEMORIAL MEDICAL, WE STILL RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER RECOGNIZE THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH OUR COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY: A. FREE CARE AND/OR SUBSIDIZED CARE, B. CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT BELOW COST, C. HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S ABILITY TO PAY CO-EXISTS. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.MEMORIAL MEDICAL CENTER SERVED 2,562 INPATIENTS WITH 10,520 DAYS OF CARE, AND PROVIDED NEARLY 95,000 OUTPATIENT SERVICES DURING FISCAL YEAR 2012.OUR HOSPITAL PROVIDES CARE TO PEOPLE COVERED BY GOVERNMENTAL PROGRAMS AT LESS THAN WHAT WE MUST GENERATE IN ORDER TO MAINTAIN STABILITY OF OPERATIONS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS IS $92,653,590. IN ADDITION, FOR PATIENTS NOT COVERED BY A GOVERNMENTAL PROGRAM AND ALSO UNABLE TO PAY FOR SERVICES, WE RECOGNIZED $1,523,882 IN CHARITY CARE.OUR SCOPE OF COMMUNITY CARE WENT BEYOND THE AFOREMENTIONED RESPONSIBILITIES. IN ADDITION TO COMMUNITY BENEFIT EXPENDITURES, MANY REDUCED PRICE SERVICES AND FREE PROGRAMS ARE OFFERED THROUGHOUT THE YEAR, BASED UPON ACTIVITIES AND SERVICES WHICH MEMORIAL MEDICAL BELIEVES WILL SERVE COMMUNITY HEALTH NEEDS. THESE ARE DETAILED AS FOLLOWS: SCREENING PROGRAMS:- MONTHLY BLOOD PRESSURE AND BLOOD SUGAR TESTING AT 3 COMMUNITY LOCATIONS- PARTICIPATION IN TISSUE/ORGAN DONATION PROGRAM IN CONJUNCTION WITH GIFT OF LIFE- WORKSITE WELLNESS SCREENING AT AREA MANUFACTURING ORGANIZATIONCOMMUNITY EDUCATION ONGOING PROGRAMS:- PRENATAL AND MATERNAL CLASSES- NUTRITION PROGRAMS, MONTHLY PROGRAMS TAUGHT BY REGISTERED DIETITIANS FOR VARIOUS ORGANIZATIONS IN LUDINGTON AND HART.- OUTPATIENT DIABETIC SELF MANAGEMENT PROGRAM- FAMILY FAIR (HEALTH FAIR) WITH AREA SCHOOLSCOMMUNITY EDUCATIONAL PROGRAMS ON VARIOUS DISEASES & HEALTH TOPICS:- DONE FOR VARIOUS SERVICE ORGANIZATIONS, SCHOOLS, COMMUNITY GROUPS TOPICS INCLUDE: STRESS MANAGEMENT, HEALTHY EATING, UNDERSTANDING CHOLESTEROL, DIABETES, EYE DISEASES, INFECTION CONTROL, BACK SAFETY.- ANNUAL HEALTH FAIR AT LONGFELLOW TOWERS, PROGRAMS DONE BY HOME CARE AND DIETITIANS.- TEDDY BEAR CLINICS FOR PRE-SCHOOL CLASSES- GRADE SCHOOL TOURS AND CAREER FOCUS DAY- HIGH SCHOOL HEALTH CLASS TOURS WITH WELLNESS FOCUSSUPPORT GROUPS & OTHER SPONSORSHIPS:- TYPE 1 DIABETES GROUP - TYPE 2 DIABETES GROUP CLINICAL EXPERIENCE FOR STUDENT PROGRAMS:- WEST SHORE COMMUNITY COLLEGE = LPN & RN PROGRAMS, PRE-PHYSICIAN THERAPY- WEST SHORE COMMUNITY COLLEGE/LIFE EMS = EMS PROGRAMS- MID MICHIGAN COLLEGE = RADIOLOGY TECHNICIAN STUDENTS- BAKER COLLEGE, MUSKEGON = SURGICAL SCRUB TECHNICIAN PROGRAM, MEDICAL RECORDS PROGRAM, EMS, PHLEBOTOMY PROGRAM, PHARMACY PROGRAM, STERILE PROCESSING PROGRAM, PHYSICAL AND OCCUPATIONAL THERAPY ASSISTANT- BAKER COLLEGE, CADILLAC = SURGICAL SCRUB TECHNICIAN PROGRAM, EKG/PULMONARY PROGRAMS, SOCIAL WORK, EMS- MUSKEGON COMMUNITY COLLEGE = PHLEBOTOMY PROGRAM, RESPIRATORY THERAPY- WESTERN UNIVERSITY OF HEALTH SCIENCE (CALIFORNIA) = NURSE PRACTITIONER- CENTRAL MICHIGAN UNIVERSITY = PHYSICAL THERAPY PROGRAM, FOOD SERVICES ADMINISTRATION, PHYSICIAN ASSISTANT PROGRAM- GRAND VALLEY STATE UNIVERSITY = PRE-PHYSICAL THERAPY/PHYSICAL THERAPY, OCCUPATIONAL THERAPY, LABORATORY TECHNICIAN, NURSING, SOCIAL WORK- LUDINGTON AND MASON COUNTY AREA SCHOOLS = CAREERS IN HEALTHCARE PROGRAM- ROSS MEDICAL STUDENT TRAINING PROGRAM = MEDICAL ASSISTANT PROGRAM- MASON-LAKE ISD = ALLIED HEALTH PROGRAMS- WESTERN MICHIGAN UNIVERSITY = PHYSICIAN ASSISTANT PROGRAM- WEST SHORE COMMUNITY COLLEGE = ACCOUNTING- MICHIGAN STATE UNIVERSITY = SOCIAL WORK, NURSE PRACTITIONER- FERRIS STATE UNIVERSITY = HEALTHCARE ADMINISTRATION, ALLIED HEALTH, MEDICAL TRANSCRIPTION, MEDICAL CODING, NURSING, NUCLEAR MEDICINE, ULTRASOUND, PHARMACY, PHLEBOTOMY, HEALTH INFORMATION- CHATHAM UNIVERSITY = PHYSICIANS ASSISTANT- DAVENPORT UNIVERSITY = ALLIED HEALTH/HEALTH INFORMATION MANAGEMENT- KETTERING COLLEGE = PHYSICIAN'S ASSISTANT- NUMEROUS JOB SHADOWING EXPERIENCES = FOR HIGH SCHOOL THROUGH COLLEGE LEVEL STUDENTS THROUGHOUT THE HOSPITAL- NORTHWESTERN MICHIGAN COLLEGE = ABNORMAL PSYCHOLOGY- WALDEN UNIVERSITY = MSNSPEAKERS BUREAU:- TOPICS AND SPEAKERS LISTING AVAILABLE UPON REQUEST- LECTURES FOR AREA AGENCIES DONE ON HEALTH RELATED SUBJECTS ON A REQUEST BASIS BY HOME CARE, EDUCATION, DIETITIAN, CARDIAC REHAB, MEDICAL/SURGICAL, AND E.R. STAFF.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp27639958TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev33657921TotalOfOtherProgramServiceRev
Total Program Service Expense50770998TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109639NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees618NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KERRI L NELSON VICE PRESIDENT OF FINANCEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2318452551TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE ATKINSON DRIVEAddressLine1
CityLUDINGTONCity
StateMIState
ZIP Code49431ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JEANNE OAKES
PAST CHAIRMAN0.50XX000
ALLEN DEERING
CHAIRMAN2.00XX000
CHARLES DILLON
VICE CHAIRMAN1.00XX000
KENNETH ROCCO
SECRETARY0.50XX000
CONNIE KRUSNIAK
DIRECTOR0.50X000
ANTHONY FABAZ DO
DIRECTOR0.50X000
JDEAN GUSTAFSON
DIRECTOR0.50X000
MARC LENZ
TREASURER0.50XX000
ANTHONY MONTON
DIRECTOR0.50X000
ALLAN NELSON MD
DIRECTOR0.50X634300
MARGARET GUSTAFSON MD
DIRECTOR0.50X000
JAMES SCATENA
DIRECTOR0.50X000
TIMOTHY O'CALLAGHAN DO
CHIEF OF STAFF0.50X251200
TIMOTHY HEINRICH
VICE PRESIDENT & COO40.00X234794050793
KERRI NELSON
VICE PRESIDENT OF FINANCE40.00X164126020578
MARK VIPPERMAN
PRESIDENT & CEO40.00X345447038903
HELEN JOHNSON
VP OF PATIENT SERVICES40.00173577016500X
JOHN P COONEY DO
PHYSICIAN40.00184807025460X
TAMARA BUCKLES MD
PHYSICIAN40.00172813012293X
EDDIE MAKOWICKI
DIRECTOR OF PHARMACY40.00174080021162X
AMANDA OVERMYER MD
PHYSICIAN40.00148791012293X
ROBERT JOHNSON
DIRECTOR OF DEVELOPMENT40.00148644041903X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1755934TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation239885TotalOtherCompensation
Number Individuals GT100 K21NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
QUEST DIAGNOSTICS
13138 COLLECTIONS CTR DRIVELUDINGTONMI49431LAB SERVICES806010
ANESTHESIOLOGY ASSOCIATES OF WEST MICHIG
ONE ATKINSON DRIVELUDINGTONMI49431ANESTHESIA SERVICES436358
C & A INDUSTRIES
PO BOX 3037OMAHANE68103NURSING143480
HOSPITAL SLEEP SERVICES
1375 DAGGET RDSAND LAKEMI49343SLEEP LAB125450
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Fundraising Events405388FundraisingEvents
All Other Contributions51306AllOtherContributions
Total Contributions456694TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM SERVICE REVENUDescription
Business Code622110BusinessCode
Total Revenue Column62631084TotalRevenueColumn
Related Or Exempt Function Income62631084RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue62631084TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column459873TotalRevenueColumn
Exclusion$459,873ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real274304Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real239143Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real35161Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column35161TotalRevenueColumn
Related Or Exempt Function Income35161RelatedOrExemptFunctionIncome

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other10324Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-10324Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-10324TotalRevenueColumn
Exclusion-$10,324ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events25763GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events405388CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses49017FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-23254TotalRevenueColumn
Exclusion-$23,254ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
MISCELLANEOUS90009910092181009218
CAFETERIA SALES722210181047$181,047
FieldValueIRS element (for citing)
Total Other Revenue1190265TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column64739499TotalRevenueColumn
Related Or Exempt Function Income63675463RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$607,342ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total23473Total
Program Services23473ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1067916Total
Program Services490756ProgramServices
Management And General577160ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total21470001Total
Program Services18392784ProgramServices
Management And General2899849ManagementAndGeneral
Fundraising177368Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2049644Total
Program Services1547478ProgramServices
Management And General502166ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3209426Total
Program Services2492369ProgramServices
Management And General717057ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1646227Total
Program Services1242899ProgramServices
Management And General403328ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total71480Total
Management And General71480ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total58461Total
Management And General58461ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5626438Total
Program Services4507840ProgramServices
Management And General1058467ManagementAndGeneral
Fundraising60131Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total500796Total
Program Services1852ProgramServices
Management And General498944ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1402134Total
Program Services528837ProgramServices
Management And General873091ManagementAndGeneral
Fundraising206Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total305287Total
Program Services229440ProgramServices
Management And General73403ManagementAndGeneral
Fundraising2444Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total172647Total
Program Services130348ProgramServices
Management And General42299ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2780043Total
Program Services2098929ProgramServices
Management And General681114ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total340408Total
Management And General340408ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
SUPPLIES129786201159309913800245497
PROVISION FOR BAD DEBTS41242464124246
DSH EXPENSES17037001703700
QUALITY ASSURANCE TAXES14242151424215

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total268996Total
Program Services238733ProgramServices
Management And General23520ManagementAndGeneral
Fundraising6743Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total61224158Total
Program Services50770998ProgramServices
Management And General10200771ManagementAndGeneral
Fundraising252389Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1150BOY
EOY13553862EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY20283659BOY
EOY12504879EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY603958BOY
EOY673797EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4876712BOY
EOY6558131EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1041317BOY
EOY1364616EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY937617BOY
EOY1020260EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis59217721LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec34795715LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY21552747BOY
EOY24422006EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY7921644BOY
EOY9541033EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9427619BOY
EOY12687893EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY66646423BOY
EOY82326477EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4194535BOY
EOY5771037EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY6001683BOY
EOY10000000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2031888BOY
EOY8505000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY24006768BOY
EOY26052047EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY36234874BOY
EOY50328084EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY30411549BOY
EOY31998393EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY30411549BOY
EOY31998393EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY66646423BOY
EOY82326477EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3515341ReconcilationRevenueExpenses
Reconcilation Other Changes-1928497ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review1AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$4,257OtherActivitiesAmount
Total Lobbying Expenditures IIB4257TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPORTION OF ANNUAL DUES TO MICHIGAN HEALTH & HOSPITAL ASSOCIATION THAT ARE USED TOWARD LOBBYING ACTIVITIESExplanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3340111OtherCostOrOtherBasis
Book Value3340111BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis18559478OtherCostOrOtherBasis
Depreciation10445469Depreciation
Book Value8114009BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1319826OtherCostOrOtherBasis
Depreciation807002Depreciation
Book Value512824BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis32790350OtherCostOrOtherBasis
Depreciation23543244Depreciation
Book Value9247106BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3207956OtherCostOrOtherBasis
Book Value3207956BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24422006TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
PREPAID PENSION10678523
COST REPORT SETTLEMENTS RECEIVABLE2009370
FieldValueIRS element (for citing)
Total Book Value Other Assets12687893TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
ACCRUED INSURANCE$738,985
ACCRUED POST-RETIREMENT BENEFIT$25,127,557
COST REPORT SETTLEMENTS PAYABLE$107,524
PENDING REFUNDS$32,002
OR EQUIPMENT PAYABLE$45,979
FieldValueIRS element (for citing)
Total Of Amounts26052047TotalOfAmounts
Total Revenue64739499TotalRevenue
Total Expenses61224158TotalExpenses
Excess Or Deficit For Year3515341ExcessOrDeficitForYear
Net Unrealized GL On Investments1215608NetUnrealizedGLOnInvestments
Other-$3,144,105OtherAmount
Total Adjustments-1928497TotalAdjustments
Excess Or Deficit Per FS1586844ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt66243267TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1215608NetUnrealizedGainsInvestments
Revenue Not Rptd F9901215608RevenueNotRptdF990
Revenue Subtotal65027659RevenueSubtotal
Other Revenues Not Included-288160OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-288160RevenueNotRptdOnFinStmt
Total Revenue Per Form99064739499TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt64656423TotExpensesEtcAuditedFinclStmt
Other Expenses Included3432265OtherExpensesIncluded
Expenses Not Rptd F9903432265ExpensesNotRptdF990
Expenses Subtotal61224158ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99061224158TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE CENTER IS A NOT-FOR-PROFIT, TAX-EXEMPT ORGANIZATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2008.
PART XI, LINE 8 - OTHER ADJUSTMENTS:PENSION LIABILITY ADJUSTMENT -3,144,105.
PART XII, LINE 4B - OTHER ADJUSTMENTS:SPECIAL EVENT EXPENSES NETTED WITH REVENUE -49,017. RENTAL INCOME EXPENSES NETTED WITH REVENUE -239,143.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:PENSION LIABILITY ADJUSTMENT REPORTED ON SCHEDULE D, PART XI 3,144,105. SPECIAL EVENT EXPENSES NETTED WITH REVENUE 49,017. RENTAL INCOME EXPENSES NETTED WITH REVENUE 239,143.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1BENEFIT BALL 2011NameOfEvent1
Gross Receipts Event1153045GrossReceiptsEvent1
Charitable Contributions Event1131190CharitableContributionsEvent1
Gross Revenue Event121855GrossRevenueEvent1
Non Cash Prizes Event11567NonCashPrizesEvent1
Other Direct Expenses Event141808OtherDirectExpensesEvent1
Name Of Event2TEAM SPIRIT WEEK 2011NameOfEvent2
Gross Receipts Event2266611GrossReceiptsEvent2
Charitable Contributions Event2266611CharitableContributionsEvent2
Non Cash Prizes Event2200NonCashPrizesEvent2
Other Direct Expenses Event21965OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events11495GrossReceiptsOtherEvents
Charitable Contrib Other Events7587CharitableContribOtherEvents
Gross Revenue Other Events3908GrossRevenueOtherEvents
Non Cash Prizes Other Events170NonCashPrizesOtherEvents
Other Direct Expenses Other Events3307OtherDirectExpensesOtherEvents
Gross Receipts Total431151GrossReceiptsTotal
Charitable Contributions Total405388CharitableContributionsTotal
Gross Revenue Total Events25763GrossRevenueTotalEvents
Non Cash Prizes Total Events1937NonCashPrizesTotalEvents
Other Direct Expenses Total Events47080OtherDirectExpensesTotalEvents
Direct Expense Summary Events49017DirectExpenseSummaryEvents
Net Income Summary-23254NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2169124TotalCommunityBenefitExpense
Direct Offsetting Revenue1969317DirectOffsettingRevenue
Net Community Benefit Expense199807NetCommunityBenefitExpense
Percent Of Total Expense0.00350PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense8310398TotalCommunityBenefitExpense
Direct Offsetting Revenue5919775DirectOffsettingRevenue
Net Community Benefit Expense2390623NetCommunityBenefitExpense
Percent Of Total Expense0.04190PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense10479522TotalCommunityBenefitExpense
Direct Offsetting Revenue7889092DirectOffsettingRevenue
Net Community Benefit Expense2590430NetCommunityBenefitExpense
Percent Of Total Expense0.04540PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense79000TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense79000NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Benefit Expense5033309TotalCommunityBenefitExpense
Direct Offsetting Revenue4336911DirectOffsettingRevenue
Net Community Benefit Expense696398NetCommunityBenefitExpense
Percent Of Total Expense0.01220PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense23473TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense23473NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Benefit Expense5135782TotalCommunityBenefitExpense
Direct Offsetting Revenue4336911DirectOffsettingRevenue
Net Community Benefit Expense798871NetCommunityBenefitExpense
Percent Of Total Expense0.01400PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Benefit Expense15615304TotalCommunityBenefitExpense
Direct Offsetting Revenue12226003DirectOffsettingRevenue
Net Community Benefit Expense3389301NetCommunityBenefitExpense
Percent Of Total Expense0.05940PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense212411TotalCommunityBuildingExpense
Net Community Building Expense212411NetCommunityBuildingExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense212411TotalCommunityBuildingExpense
Net Community Building Expense212411NetCommunityBuildingExpense
Percent Of Total Expense0.00370PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,124,246BadDebtExpenseAmount
Amount Attributable To412425AmountAttributableTo
Amount Reimbursed By Medicare16278536AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare15058091CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall1220445MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL MEDICAL CENTER OF WEST MICHIGANBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1ONE ATKINSON DRIVEAddressLine1
CityLUDINGTONCity
StateMIState
ZIP Code49431ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL MEDICAL CENTER OF WEST MICHIGANBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL FAMILY CARE CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12481 N 72 AVEAddressLine1
CityHARTCity
StateMIState
ZIP Code49420ZIPCode
FieldValueIRS element (for citing)
Facility TypePHYSICIAN OFFICEFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 6A: N/A
PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM WORKSHEET 2, IS USED FOR LINES 7A AND 7B. ACTUAL COSTS ARE USED FOR LINES 7E AND 7I. COST-TO-CHARGE RATIOS DERIVED FROM THE COST REPORT ARE USED FOR LINE 7G.
PART I, LINE 7G: A PORTION OF THE REPORTED SUBSIDIZED HEALTH SERVICES INCLUDES THE FAMILY CARE CLINIC AND TWO PHYSICAN PRACTICES. THE TOTAL COMMUNITY BENEFIT EXPENSE RELATED TO THESE PHYSICIAN CLINICS IS $1,085,631, AND THE NET COMMUNITY BENEFIT EXPENSE IS $244,886.
PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE IS $4,124,246.
PART II: MEMORIAL MEDICAL CENTER PARTICIPATES IN A MULTITUDE OF COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNNITY SUCH AS SEVERAL HEALTH FAIRS, BLOOD DRIVES, PRENATAL AND CHILDBIRTH EDUCATION, NUTRITION EDUCATION WITH LOCAL SCHOOLS AND SPORTS GROUPS, EDUCATIONAL PRESENTATIONS RELATED TO MEDICATIONS AND MEDICAL CONDITIONS, STRONG PART IN DEVELOPMENT AND ADMINISTRATION OF HEALTHY COMMUNITIES COMMITTEE, DISTRIBUTES COMMUNITY HEALTH NEWSLETTERS, PROVIDES DIABETES TESTING AND COMMUNITY EVENTS, AND ASSIST WITH MANY DIFFERENT SUPPORT GROUPS, ALONG WITH SUPPORT THE LOCAL WIN WITH WELLNESS INITIATIVE.
PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE CENTER'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS.THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES.THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $412,425. THIS WAS CALCULATED BASED ON AN ESTIMATE OF 10 PERCENT OF BAD DEBT EXPENSE DETERMINED BY THE DIRECTOR OF THE HOSPITAL'S BUSINESS OFFICE.
PART III, LINE 8: THE HOSPITAL IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELY 67% OF ITS PATIENT BASE QUALIFYING FOR ONE OF THESE TWO PROGRAMS. AT PRESENT, THE REIMBURSEMENT RATES FOR BOTH PROGRAMS DO NOT FULLY COVER THE COST OF PROVIDING CARE TO THESE PATIENTS. THIS REPRESENTS THE ESTIMATED "SHORTFALL" CREATED WHEN A FACILITY RECEIVES PAYMENTS BELOW THE COSTS OF TREATING MEDICARE AND MEDICAID BENEFICIARIES. THE COST TO CHARGE RATIO METHOD IS USED.THE MEDICARE COSTS NOT INCLUDED IN THE MEDICARE COST REPORTS (MEDICARE ADVANTAGE AND FEE-FOR-SERVICE PHYSICIANS) ARE SUMMARIZED BELOW: TOTAL COST $5,682,258 TOTAL REIMBURSEMENT $5,678,372 __________ COST IN EXCESS OF REIMBURSEMENT $ (3,887)
PART III, LINE 9B: ALL PATIENTS/GUARANTORS WITH A BALANCE FOR CARE PROVIDED ARE SENT A LETTER REGARDING THE BALANCE. A STATEMENT IS THEN SENT AFTER 30 DAYS. A SECOND STATEMENT IS SENT IF THERE IS A REMAINING BALANCE. IF NO PAYMENT IS RECEIVED AFTER THE THIRD NOTIFICATION THE ACCOUNT IS SENT TO PRE-COLLECTION STATUS. A FINAL LETTER IS SENT TO THE PATIENT/GUARANTOR IF NOTHING HAS BEEN RECEIVED. IF THERE IS NO RESPONSE THEN THE ACCOUNT IS SENT TO COLLECTIONS. IF A PAYMENT IS RECEIVED AT ANY TIME DURING THIS PROCESS THE PROCESS IS REPEATED UNTIL THE ACCOUNT IS PAID IN FULL OR IT IS SENT TO A COLLECTION AGENCY.
PART V, SECTION B, LINE 19D: WE FIRST ATTEMPT TO QUALIFY PATIENT FOR FAP OR OTHER COMMUNITY RESOURCES FOR COVERAGE. PATIENT IS THEN OFFERED A DISCOUNT UP TO 30% OF CHARGES.MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
PART V, SECTION B, LINE 21: THE HOSPITAL FACILITY MAKES EVERY REASONABLE ATTEMPT TO HELP ITS PATIENTS RECEIVE SOME SORT OF ASSISTANCE OR DISCOUNT. IF THE PATIENT DOES NOT REPLY OR CORRESPOND TO HOSPITAL'S ATTEMPTS THEN A BILL COULD BE GENERATED USING GROSS CHARGES.MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
PART VI, LINE 2: IN THE PAST THE MASON COUNTY HEALTH DEPARTMENT CONDUCTS A HEALTH NEEDS ASSESSMENT OF THE COMMUNITY. MEMORIAL MEDICAL CENTER THEN WORKS ALONG SIDE THE HEALTH DEPARTMENT TO ANALYZE THOSE NEEDS TO ENSURE THAT THOSE NEEDS ARE BEING MET.MEMORIAL MEDICAL CENTER IS CURRENTLY PERFORMING A NEEDS ASSESSMENT.
PART VI, LINE 3: MEMORIAL MEDICAL CENTER PATIENTS HAVE A HOSPITAL FINANCIAL COUNSELOR THAT THEY MEET WITH. DURING THAT MEETING THE PATIENTS ARE INTERVIEWED TO ASSESS THEIR FINANCIAL ABILITY OR ASSISTANCE NEEDS. THEY ARE INFORMED AT THAT TIME IF THEY MAY BE POSSIBLE CANDIDATES FOR FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR THE HOPITAL'S CHARITY CARE PROGRAM.
PART VI, LINE 4: MEMORIAL MEDICAL CENTER SERVES A RURAL COMMUNITY THAT IS LOCATED ON THE COAST OF LAKE MICHIGAN. BECAUSE THE LOCATION IS A SEASONAL TOURIST ATTRACTION THE POPULATION OF THE COMMUNITY SIGNIFICANTLY CHANGES WITH THE SEASONS. ALSO SEASONALLY DRIVEN, BECAUSE OF THE AGRICULTURAL EMPLOYMENT OPPORTUNITIES, IS A MIGRANT POPULATION. A LARGE PART OF THE HOSPITAL PATIENTS ARE COVERED BY EITHER MEDICARE OR MEDICAID.
PART VI, LINE 5: NONE
PART VI, LINE 6: N/A - NOT AFFILIATED.
MIREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1LUDINGTON AREA ARTS COUNCILBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1107 S HARRISON STREETAddressLine1
CityLUDINGTONCity
StateMIState
ZIP Code49431ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient421625326EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant5000AmountOfCashGrant
Purpose Of GrantASSISTANCE FOR THE SWEET SUMMER CELEBRATION SPONSORSHIPPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: WHEN GRANTS ARE GIVEN TO PUBLIC CHARITIES, THE HOSPITAL REVIEWS EACH ORGANIZATION TO ENSURE THAT THEY ARE EXEMPT.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TIMOTHY HEINRICH
23479400000385000122930285587000
KERRI NELSON
1641260000082850122930184704000
MARK VIPPERMAN
34544700000287500101530384350000
HELEN JOHNSON
1735770000016500000190077000
JOHN P COONEY DO
18480700000131670122930210267000
TAMARA BUCKLES MD
1728130000000122930185106000
EDDIE MAKOWICKI
1740800000088690122930195242000
AMANDA OVERMYER MD
1487910000000122930161084000
ROBERT JOHNSON
14864400000317500101530190547000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 1AReturnReference
ExplanationTRAVEL FOR COMPANIONS: MARK VIPPERMAN, ALLOWED FOR IN HIS EMPLOYEMENT CONTRACT. TREATED AS TAXABLE COMPENSATION. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: MARK VIPPERMAN, LINCOLN HILLS DUES. BOB JOHNSON, ROTARY CLUB DUES. SOCIAL CLUB DUES ARE NOT TREATED AS TAXABLE COMPENSATION. THE ONLY REASON THE STAFF MEMBERS OBTAIN A MEMBERSHIP TO THE LOCAL SOCIAL CLUBS, IS SO MEMORIAL MEDICAL CENTER CAN USE THE SOCIAL CLUB FACILITIES FOR HOSPITAL SPONSORED EVENTS SUCH AS THE BENEFIT HALL, EMPLOYEE SERVICE AWARDS DINNER, ETC. THE MEMBERSHIP WAS NOT UTILIZED FOR PERSONAL BENEFIT. MEMORIAL MEDICAL CENTER DOES NOT PAY FOR HEALTH CLUB DUES.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MASON COUNTY HOSPITAL FINANCE AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN386004870IssuerEIN
Date Issued2012-06-15DateIssued
Issue Price10000000IssuePrice
Description Of PurposeREFINANCING AND CONSTRUCTIONDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds10000000TotalProceeds
Issuance Costs From Proceeds193251IssuanceCostsFromProceeds
Capital Expenditures6355082CapitalExpenditures
Other Spent Proceeds3451667OtherSpentProceeds
Year Of Subst Completion2013YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

Sharing Of RevenuesSharingOfRevenuesRelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransaction
(no name)
0
TIMOTHY O'CALLAGHAN DO PC
0BOARD MEMBER TIMOTHY O'CALLAGHAN IS OWNER OF THIS PHYSICIAN PRACTICE.165606HOSPITAL PAID RENT AND OVERHEAD COSTS OF HOSPITAL-EMPLOYED PHYSICIAN LOCATED IN THE BOARD MEMBER'S PHYSICIAN PRACTICE.
MARY O'CALLAGHAN
0SPOUSE OF BOARD MEMBER TIMOTHY O'CALLAGHAN72148QUALITY DIRECTOR STIPEND AND EKG FEES.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS PLACED ON THE AGENDA FOR THE BOARD MEETING AND EACH BOARD MEMBER HAS A CHANCE TO REVIEW THE 990 AND THEN ASK QUESTIONS REGARDING DATA WITHIN THE FORM BEFORE IT IS FILED. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING.
FORM 990, PART VI, SECTION B, LINE 12CTHE HOSPITAL HAS THE OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS SIGN A DOCUMENT DISCLOSING THEIR CONFLICTS OF INTEREST. THE DOCUMENTS ARE REVIEWED ONCE A YEAR BY THE BOARD MEMBERS AND THEY WOULD DETERMINE WHETHER A CONFLICT EXISTS. ANY PERSON WHO IS DEEMED TO HAVE A CONFLICT OF INTEREST WOULD BE PROHIBITED FROM PARTICIPATING IN ANY DELIBERATION AND DECISIONS REGARDING THE RELATED TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15ONCE A YEAR THE BOARD OF DIRECTOR'S EXECUTIVE COMMITTEE REVIEWS THE CEO'S AND ALL THE VICE PRESIDENTS' PERFORMANCE AND RECOMMENDS TO THE FULL BOARD ANY COMPENSATION INCREASES OR CHANGES AND THE CEO'S CONTINUATION OF EMPLOYEMENT. MEMORIAL MEDICAL CENTER'S HUMAN RESOURCES MANAGER COMPILES COMPARABILITY DATA FROM A NUMBER OF DIFFERENT COMPENSATION SURVEYS, THE BOARD COMPLETES AN EVALUATION FORM ON THE CEO'S PERFORMANCE, HUMAN RESOURCES COMPILES ALL OF THE DATA FROM THE SURVEYS AND PROVIDES THAT DATA - ALONG WITH THE COMPENSATION COMPARABILITY DATA TO THE BOARD. THE REVIEW FOR THE 10/01/11 - 9/30/12 PERFORMANCE AND THE REVIEW OF COMPENSATION COMPARABILITY DATA TO DETERMINE THE NEXT FISCAL YEAR'S OFFICER COMPENSATION WAS PERFORMED AT THE 11/27/12 BOARD MEETING.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 1,215,608. PENSION LIABILITY ADJUSTMENT -3,144,105. TOTAL TO FORM 990, PART XI, LINE 5: -1,928,497.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:NO CHANGES FROM PRIOR YEAR
FORM 990, PART X:FOR TAX RETURN PURPOSES, PREPAID PENSION HAS BEEN CLASSIFIED AS AN ASSET VERSUS NETTING AGAINST THE PENSION LIABILITY. DUE TO THIS, BALANCE SHEET ASSETS AND LIABILITIES ON THE 990 ARE HIGHER THAN THE AUDITED FINANCIAL STATEMENTS BY $10,678,523 AND $9,273,035 AS OF SEPTEMBER 30, 2012 AND 2011, RESPECTIVELY.