MYMICHIGAN MEDICAL CENTER CLARE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MYMICHIGAN MEDICAL CENTER CLARE (EIN 38-1518643)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201341359349305549
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-15T14:04:49-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREWS HOOPER PAVLIK PLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5300 GRATIOT RD | AddressLine1 |
| City | SAGINAW | City |
| State | MI | State |
| ZIP Code | 486386035 | 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 | 381518643 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMICHIGAN MEDICAL CENTER - CLARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MIDM | NameControl |
| Phone | 9898393181 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 703 NORTH MCEWAN STREET | AddressLine1 |
| City | CLARE | City |
| State | MI | State |
| ZIP Code | 48617 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | FRANCINE M PADGETT | Name |
| Title | SR. VP & TREASURER | Title |
| Phone | 9898393181 | Phone |
| Date Signed | 2013-05-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LAURA M EBEL | Name |
| Phone | 9894975300 | Phone |
| Date Prepared | 2013-05-15 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RAYMOND STOVER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 703 NORTH MCEWAN STREET | AddressLine1 |
| City | CLARE | City |
| State | MI | State |
| ZIP Code | 48617 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 51356856 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MIDMICHIGAN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1951 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 391 | TotalNbrEmployees |
| Total Nbr Volunteers | 107 | TotalNbrVolunteers |
| Total Gross UBI | 13973 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -2000 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 33962 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 25948 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 44482419 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 46386134 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1589922 | InvestmentIncomePriorYear |
| Investment Income Current Year | 713734 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 573177 | OtherRevenuePriorYear |
| Other Revenue Current Year | 710407 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 46679480 | TotalRevenuePriorYear |
| Total Revenue Current Year | 47836223 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 18646194 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19063366 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 28259855 | OtherExpensePriorYear |
| Other Expenses Current Year | 31063839 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 46906049 | TotalExpensesPriorYear |
| Total Expenses Current Year | 50127205 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -226569 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2290982 | RevenuesLessExpensesCY |
| Total Assets BOY | 43087648 | TotalAssetsBOY |
| Total Assets EOY | 39348920 | TotalAssetsEOY |
| Total Liabilities BOY | 16969081 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16161421 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 26118567 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 23187499 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 43381635 | Expense |
| Revenue | 46386134 | Revenue |
| Description | MIDMICHIGAN MEDICAL CENTER - CLARE PROVIDES COMPASSIONATE PATIENT CARE SERVICES OF SUPERIOR QUALITY TO CLARE AND ITS SURROUNDING COUNTIES. 1,646 PATIENT ADMISSIONS AND 87,421 HOSPITAL OUTPATIENT VISITS WERE RECORDED IN FISCAL YEAR 2012. CARE IS PROVIDED WITHOUT RESPECT TO PATIENTS ABILITY TO PAY. | Description |
| Total Program Service Expense | 43381635 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 25 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 391 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | FM PADGETT SR VP TREASURER | NamePerson |
| Telephone Number | 9898393181 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4000 WELLNESS DR | AddressLine1 |
| City | MIDLAND | City |
| State | MI | State |
| ZIP Code | 48670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 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 |
|---|---|---|---|---|---|---|---|
| RICHARD REYNOLDS | |||||||
| DIRECTOR | 50.00 | X | 0 | 746845 | 317274 | ||
| JOHN NGUYGEN DO | |||||||
| DIRECTOR | 50.00 | X | 0 | 332288 | 7469 | ||
| TOM CLARINGBOLD DO | |||||||
| DIRECTOR | 50.00 | X | 0 | 297641 | 41832 | ||
| LAWRENCE BARCO | |||||||
| PRESIDENT | 50.00 | X | 263631 | 0 | 26665 | X | |
| DAVID BREMER MD | |||||||
| DIRECTOR | 50.00 | X | 0 | 247814 | 42631 | ||
| MICHAEL BEADLE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| MIKE JENKINS | |||||||
| VICE CHAIR | 2.00 | X | 0 | 0 | 0 | ||
| JEFF PUNCHES | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DAVID REECE | |||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | ||
| DON RICHARDS | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| KAREN KLEINHARDT | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DAN TIMMINS | |||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | ||
| RON VERCH | |||||||
| CHAIR | 2.00 | X | 0 | 0 | 0 | ||
| LISA BENIC | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| AMY STARK | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| JOSHUA WIGGINS | |||||||
| CONTROLLER | 50.00 | 0 | 109853 | 31568 | X | ||
| MARK DEAN | |||||||
| CRNA | 50.00 | 239843 | 0 | 25205 | X | ||
| EDWARDO MUNOZ | |||||||
| CRNA | 50.00 | 221031 | 0 | 18071 | X | ||
| WILLIAM GROVES | |||||||
| CRNA | 50.00 | 212935 | 0 | 27320 | X | ||
| RUSSELL RADER | |||||||
| ANESTHESIOLO | 50.00 | 199816 | 0 | 23479 | X | ||
| GLENN KING | |||||||
| VP | 50.00 | 145684 | 0 | 23694 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1282940 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1734441 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 585208 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EMCARE INC | |||||
| 7032 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SVCS | 676662 |
| THREE RIVERS CONSTRUCTION | |||||
| PO BOX 1467 | MIDLAND | MI | 48641 | CONSTRUCTION | 340354 |
| MICHIGAN EMERGENCY PHYS LLP | |||||
| PO BOX 793 | TRAVERSE CITY | MI | 496850793 | PHYSICIAN SVCS | 318067 |
| EMCARE PHYSICIANS SERVICES | |||||
| 1717 MAIN STREET SUITE 5200 | DALLAS | TX | 75201 | PHYSICIAN SVCS | 287218 |
| SIEMENS MED SOLUTIONS USA | |||||
| C/O MELLON BANK DEPT 14195 | PALATINE | IL | 600554195 | EQUIP MAINT | 278655 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Fundraising Events | 18655 | FundraisingEvents |
| All Other Contributions | 7293 | AllOtherContributions |
| Total Contributions | 25948 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| MEDICARE/MEDICAID PAYMENTS | 621990 | 28520299 | 28520299 | |
| NET PATIENT REVENUE | 621990 | 17528759 | 17528759 | |
| CONTRACTED CLINICAL SERVICES | 621990 | 323103 | 323103 | |
| REFERENCE LABORATORY | 621500 | 13973 | 13973 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 46386134 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 302158 | TotalRevenueColumn |
| Exclusion | $302,158 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3 | TotalRevenueColumn |
| Exclusion | $3 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3926195 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3488969 | Securities |
| Other | 25653 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 437226 | Securities |
| Other | -25653 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 411573 | TotalRevenueColumn |
| Exclusion | $411,573 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 18655 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 6011 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -6011 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| AFFILIATE RELATED INCOME | 900099 | 377808 | 377808 | |
| OUTSIDE INCOME | 900099 | 159580 | 159580 | |
| CAFETERIA/FOOD SERVICE | 722210 | 103378 | $103,378 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 75652 | TotalRevenueColumn |
| Related Or Exempt Function Income | 75652 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 716418 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 47836223 | TotalRevenueColumn |
| Related Or Exempt Function Income | 46985201 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 13973 | UnrelatedBusinessRevenue |
| Exclusion | $817,112 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 286898 | Total |
| Program Services | 143449 | ProgramServices |
| Management And General | 143449 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14950248 | Total |
| Program Services | 13835930 | ProgramServices |
| Management And General | 1114318 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 565125 | Total |
| Program Services | 535838 | ProgramServices |
| Management And General | 29287 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2185263 | Total |
| Program Services | 1933187 | ProgramServices |
| Management And General | 252076 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1075832 | Total |
| Program Services | 984562 | ProgramServices |
| Management And General | 91270 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6030 | Total |
| Management And General | 6030 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24714 | Total |
| Management And General | 24714 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45746 | Total |
| Management And General | 45746 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8022635 | Total |
| Program Services | 5348800 | ProgramServices |
| Management And General | 2673835 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72126 | Total |
| Program Services | 39662 | ProgramServices |
| Management And General | 32464 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 810178 | Total |
| Program Services | 588777 | ProgramServices |
| Management And General | 221401 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1247582 | Total |
| Program Services | 13674 | ProgramServices |
| Management And General | 1233908 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1650411 | Total |
| Program Services | 1143356 | ProgramServices |
| Management And General | 507055 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26578 | Total |
| Program Services | 25608 | ProgramServices |
| Management And General | 970 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 541481 | Total |
| Program Services | 541481 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1765500 | Total |
| Program Services | 1642525 | ProgramServices |
| Management And General | 122975 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30482 | Total |
| Management And General | 30482 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PHYSICIAN SUBSIDY | 6750940 | 6535350 | 215590 |
| UNCOMPENSATED SERVICES | 5197284 | 5197284 | |
| MEDICAL SUPPLIES | 3664603 | 3664603 | |
| QAAP FEES | 1207549 | 1207549 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50127205 | Total |
| Program Services | 43381635 | ProgramServices |
| Management And General | 6745570 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1545 | BOY |
| EOY | 1470 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 479757 | BOY |
| EOY | 1619342 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4345998 | BOY |
| EOY | 6206829 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8745 | BOY |
| EOY | 12576 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 398747 | BOY |
| EOY | 375646 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 31142723 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 18272374 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13990344 | BOY |
| EOY | 12870349 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3503665 | BOY |
| EOY | 2165542 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20166516 | BOY |
| EOY | 15915273 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 192331 | BOY |
| EOY | 181893 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43087648 | BOY |
| EOY | 39348920 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4576408 | BOY |
| EOY | 4339038 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10880784 | BOY |
| EOY | 10445191 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1511889 | BOY |
| EOY | 1377192 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16969081 | BOY |
| EOY | 16161421 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26112382 | BOY |
| EOY | 23174617 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6185 | BOY |
| EOY | 12882 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26118567 | BOY |
| EOY | 23187499 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43087648 | BOY |
| EOY | 39348920 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2290982 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -640086 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1826668 | OtherCostOrOtherBasis |
| Book Value | 1826668 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14711066 | OtherCostOrOtherBasis |
| Depreciation | 7945775 | Depreciation |
| Book Value | 6765291 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 830706 | OtherCostOrOtherBasis |
| Depreciation | 560393 | Depreciation |
| Book Value | 270313 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13606034 | OtherCostOrOtherBasis |
| Depreciation | 9766206 | Depreciation |
| Book Value | 3839828 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 168249 | OtherCostOrOtherBasis |
| Book Value | 168249 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 12870349 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER FINANCIAL INVESTMENTS | Description |
| Book Value | 15915273 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 15915273 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| SELF INSURANCE, OTHER | $1,156,418 |
| INTERCOMPANY LOANS | $220,774 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1377192 | TotalOfAmounts |
| Total Revenue | 47836223 | TotalRevenue |
| Total Expenses | 50127205 | TotalExpenses |
| Excess Or Deficit For Year | -2290982 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -421638 | NetUnrealizedGLOnInvestments |
| Other | -$218,448 | OtherAmount |
| Total Adjustments | -640086 | TotalAdjustments |
| Excess Or Deficit Per FS | -2931068 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 47400753 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -421638 | NetUnrealizedGainsInvestments |
| Other Revenues | 250 | OtherRevenues |
| Revenue Not Rptd F990 | -421388 | RevenueNotRptdF990 |
| Revenue Subtotal | 47822141 | RevenueSubtotal |
| Investment Expenses Not Included | 45746 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | -31664 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 14082 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 47836223 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 50132373 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 25261 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 25261 | ExpensesNotRptdF990 |
| Expenses Subtotal | 50107112 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 45746 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | -25653 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 20093 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 50127205 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RECONCILIATION OF CHANGES - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 8 | NET ASSETS RELEASED FROM RESTRICTIONS 250 LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED 25,653 DIRECT EXPENSES RELATED TO FUNDRAISING - RECLASSIFIED 6,011 NET ASSETS RELEASED FROM RESTRICTIONS -19,250 DIRECT EXPENSES RELATED TO FUNDRAISING - RECLASSIFIED -6,011 LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -25,653 |
| REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 2D | NET ASSETS RELEASED FROM RESTRICTIONS 250 |
| REVENUE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 4B | LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -25,653 DIRECT EXPENSES RELATED TO FUNDRAISING - RECLASSIFIED -6,011 |
| EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XIII, LINE 2D | NET ASSETS RELEASED FROM RESTRICTIONS 19,250 DIRECT EXPENSES RELATED TO FUNDRAISING - RECLASSIFIED 6,011 |
| EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XIII, LINE 4B | LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -25,653 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | LOVE LIGHT TREE | NameOfEvent1 |
| Gross Receipts Event1 | 18655 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 18655 | CharitableContributionsEvent1 |
| Food And Beverage Event1 | 991 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 5020 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 18655 | GrossReceiptsTotal |
| Charitable Contributions Total | 18655 | CharitableContributionsTotal |
| Food And Beverage Total Events | 991 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 5020 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 6011 | DirectExpenseSummaryEvents |
| Net Income Summary | -6011 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 473955 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 473955 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00950 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 8244261 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4678498 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3565763 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07110 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 8718216 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4678498 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4039718 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08060 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 150 | NumberOfActivitiesOrPrograms |
| Persons Served | 29454 | PersonsServed |
| Total Community Benefit Expense | 142591 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8770 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 133821 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 31 | NumberOfActivitiesOrPrograms |
| Persons Served | 119 | PersonsServed |
| Total Community Benefit Expense | 110894 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 110894 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 29 | NumberOfActivitiesOrPrograms |
| Persons Served | 835 | PersonsServed |
| Total Community Benefit Expense | 10139 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10139 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 210 | NumberOfActivitiesOrPrograms |
| Persons Served | 30408 | PersonsServed |
| Total Community Benefit Expense | 263624 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8770 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 254854 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00510 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 212 | NumberOfActivitiesOrPrograms |
| Persons Served | 30408 | PersonsServed |
| Total Community Benefit Expense | 8981840 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4687268 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4294572 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08570 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2480 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2480 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 21489 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 21489 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 9918 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 9918 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 54042 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 54042 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 87929 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 87929 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,181,435 | BadDebtExpenseAmount |
| Amount Attributable To | 218628 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 13307759 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 13659566 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -351807 | 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 | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | 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 | MIDMICHIGAN MEDICAL CENTER - CLARE | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 703 N MCEWAN ST | AddressLine1 |
| City | CLARE | City |
| State | MI | State |
| ZIP Code | 486171440 | 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 | MIDMICHIGAN MEDICAL CENTER - CLARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 150.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 6 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (6 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| MIDMI MEDICAL CENTER-CLARE REHAB SV | ||||
| 231 SOUTH FIRST STREET | HARRISON | MI | 48625 | REHABILITATION SERVICES ONLY |
| MIDMICHIGAN HEALTH PARK-HOUGHTON LK | ||||
| 9249 W LAKE CITY ROAD | HOUGHTON LAKE | MI | 48629 | REHABILITATION, LAB, & MAMMOGRAPHY |
| MIDMICHIGAN URGENT CARE - CLARE | ||||
| 700 WEST FIFTH ST | CLARE | MI | 48617 | URGENT CARE, OCCUPATIONAL MEDICINE |
| CLARE MMO RHC | ||||
| 602 BEECH STREET | CLARE | MI | 48617 | RURAL HEALTH CLINIC |
| HARRISON RHC | ||||
| 815 NORTH CLARE AVENUE | HARRISON | MI | 48625 | RURAL HEALTH CLINIC |
| FARWELL RHC | ||||
| 2812 WEST CADILLAC DRIVE | FARWELL | MI | 48622 | RURAL HEALTH CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| COMMUNITY BUILDING ACTIVITIES | PART II | MIDMICHIGAN MEDICAL CENTERCLARE EMPLOYEES CONTRIBUTED MANY HOURS AS MEMBERS OF COMMUNITY BOARDS CIVIC ORGANIZATIONS ADVISORY COMMITTEES COALITIONS AND WORK GROUPS CLARE EMPLOYEES SERVE ADVISORY AND OTHER KEY ROLES FOR NONPROFIT BOARDS ANDOR COMMITTEES PROVIDING OVERSIGHT OF COMMUNITY GRANT REQUESTS FOR HEALTH AND HUMAN SERVICES PROJECTS AND PARTICIPATING IN STRATEGIC INITIATIVES THROUGH THE TOGETHER WE CAN ADVISORY COMMITTEE WHICH INVOLVES CLARE ISABELLA AND GLADWIN COUNTY MIDMICHIGAN MEDICAL CENTERCLARE ADMINISTRATORS SIT ON VARIOUS COMMUNITY BOARDS OF DIRECTORS SUCH AS THE MID MICHIGAN COMMUNITY COLLEGE NURSING SAGINAW VALLEY STATE UNIVERSITY NURSING ADVISORY COMMITTEE CLARE INDUSTRIAL DEVELOPMENT CORPORATION MIDDLE MICHIGAN DEVELOPMENT CORPORATION MID MICHIGAN COMMUNITY HEALTH SERVICES AND THE CENTRAL HEALTH PLAN CLARE IS ALSO REPRESENTED ON THE CHAMBER OF COMMERCE WHICH ASSISTS THE COMMUNITY WITH SMALL BUSINESS DEVELOPMENT AND PROVIDES FINANCIAL SUPPORT FOR YOUTH LEADERSHIP PROGRAMS MIDMICHIGAN MEDICAL CENTERCLARE ALSO SPENT APPROXIMATELY 53400 IN PHYSICIAN RECRUITMENT FOR THE FISCAL YEAR OF 2012 |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | OTHER UNCOMPENSATED CARE REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH PAYMENT IS EXPECTED AT THE TIME SERVICE IS PROVIDED BUT PAYMENT IS NOT RECEIVED OR IS LESS THAN THE COST INCURRED TO PROVIDE THE SERVICE THE FOLLOWING IS INCLUDED AS PROGRAMS AND SERVICES RELATED TO OTHER UNCOMPENSATED CARE UNCOMPENSATED SERVICES AT COSTREPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH A FEE HAS BEEN ASSESSED BUT NOT COLLECTED OR ONLY A PORTION OF THE COST OF THE RENDERED SERVICE HAS BEEN RECOVERED LINE 2 COSTING METHODOLOGY AN AVERAGE COSTTOCHARGE RATIO IS APPLIED TO THE CHARGE WRITEOFF THE RATIO IS CALCULATED BY REMOVING FROM TOTAL EXPENSE THE OTHER OPERATING INCOME UNCOMPENSATED CARE EXPENSE AND THE DIRECTLY ASSIGNED MEDICAID ASSESSMENT EXPENSE THEN DIVIDING THIS NET EXPENSE BY TOTAL GROSS PATIENT REVENUES THIS RATIO IS MULTIPLIED WITH THE CHARITY CARE CHARGES AND UNCOMPENSATED CARE CHARGES WRITTEN OFF FOR THE RELATED EXPENSE LINE 3 HISTORICAL COLLECTION ACTIVITY OBTAINED FROM 3RD PARTY COLLECTION AGENCIES IS USED TO ESTIMATE THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE |
| MEDICARE EXPLANATION | PART III LINE 8 | THE SOCIAL SECURITY ACT AMENDMENT TO ESTABLISH MEDICARE STATES THAT MEDICARE WILL NOT PAY THE COST TO PROVIDE CARE TO NONBENEFICIARIES AND NONBENEFICIARIES WILL NOT PAY THE COST OF CARE FOR BENEFICIARIES WHEN MEDICARE DOES NOT PAY RATES THAT COVER ALL THE COST OF CARE FOR BENEFICARIES IT BECOMES A COMMUNITY BURDEN THEREFORE THE FULL AMOUNT OF SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT THIS ORGANIZATION BELIEVES THE AUDITED FINANCIAL STATEMENT CALCULATION IS A MORE ACCURATE DETERMINATION OF COST THAN THE MEDICARE ALLOWABLE COSTS USED FOR COST REPORTS THAT ARE REQUIRED TO BE UTILIZED ON THIS SCHEDULE IN PART III SECTION B THE AUDITED FINANCIAL STATEMENTS INCLUDE ALL MEDICARE REVENUES AND COSTS AND ALSO USE A COSTTOCHARGE RATIO METHOD THE AUDIT CALCULATION REPORTS A MEDICARE SHORTFALL OF 3094443 FOR THIS ORGANIZATION FOR THE FISCAL YEAR ENDED JUNE 30 2012 |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | MIDMICHIGAN HEALTH DOES NOT TRY TO COLLECT FROM THOSE WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE MIDMICHIGAN HEALTHS COLLECTION POLICY STATES THAT THE PURPOSE OF THE POLICY IS TO PROVIDE COST EFFECTIVE PAYMENT OPTIONS TO PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE PER FINANCIAL AIDCHARITY CARE POLICY AND EITHER HAVE NO INSURANCE OR HAVE A BALANCE AFTER INSURANCE WHICH IS THEIR RESPONSIBILITY TO PAY MIDMICHIGAN HEALTH ALSO OFFERS PATIENTS A CREDIT CARD PAYMENT PROGRAM ALLOWING PATIENTS TO PAY THEIR BALANCE AT 000 INTEREST OVER 1236 MONTHS DEPENDING ON THE PATIENT BALANCE |
| NEEDS ASSESSMENT | PART VI | MIDMICHIGAN MEDICAL CENTER CLARE HAS PROVIDED COMMUNITY BENEFITS TO THE AREAS WE SERVE THROUGH DIRECT FINANCIAL ASSISTANCE TO PATIENTS SUBSIDIZED PROGRAMS AND COMMUNITY OUTREACH PROGRAMS INCLUDING HEALTH CARE SCREENINGS AND OTHER PREVENTION PROGRAMS DATA FROM A VARIETY OF LOCAL AND NATIONAL SOURCES IS UTILIZED TO DETERMINE CURRENT HEALTH CARE TRENDS AND HEALTH CARE ISSUES AND TO PRIORITIZE AND EVALUATE HEALTH CARE PROGRAM PROGRESS SOURCES FOR GENERAL HEALTH DATA FOLLOW CDC MICHIGAN BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM BRFSS 20062008 COMBINED ADULT AND YOUTH COUNTY HEALTH RANKINGS UNIVERSITY OF WISCONSIN DATA CDC DATA AND STATISTICS USED FOR GENERAL AND AGE SPECIFIC AND HEALTH CONDITION DATA SUCH AS AGING TOBACCO USE VACCINES AND IMMUNIZATIONS MICHIGAN DEPARTMENT OF COMMUNITY HEALTH MDCH VITAL STATISTICS DHHS COMMUNITY HEALTH STATUS INDICATORS DHHS MEDICARE COMPARE DHHS MATERNAL AND CHILD HEALTH RESOURCE CENTER US DEPARTMENT OF HEALTH AND HUMAN SERVICES STATISTICS LINKS ADDITIONALLY WE USE DISEASE SPECIFIC DATA FROM NATIONAL ORGANIZATIONS LIKE THE AMERICAN CANCER SOCIETY THE AMERICAN DIABETES ASSOCIATION WHO COUNTRY AND REGIONAL DIABETES DATA AMERICAN HEART ASSOCIATION HEART AND OBESITY PREVENTION INFORMATION NATIONAL CANCER INSTITUTE CANCER STUDIES AND CDC FUNDED STATISTICS ON HIVAIDS LUNG CANCER SEXUALLY TRANSMITTED DISEASES NATIONAL CENTER FOR HEALTH STATISTICSMENTAL DISORDERS FOR HEALTH CARE COVERAGE AND FINANCE WE REFER TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES RESEARCH STATISTICS AND DATA SYSTEMS NATIONAL CENTER FOR HEALTH STATISTICS THE US CENSUS BUREAU AND THE KAISER FAMILY FOUNDATION |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | WE COMMUNICATE TO PATIENTS AND THE PUBLIC OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE THROUGH INFORMATIONAL BROCHURES AT REGISTRATION AREAS AND THROUGH PATIENT ACCOUNTING COUNSELORS PATIENT ACCOUNTING COUNSELORS ARE TRAINED TO HELP PATIENTS OBTAIN FREE OR LOWCOST HEALTH INSURANCE OR TO WORK WITH PATIENTS TO PROVIDE CHARITY CARE OR FINANCIAL AID BASED ON THEIR FINANCIAL STATUS ADDITIONALLY SOCIAL WORKERS PROVIDE INFORMATION BOTH WRITTEN AND VERBAL ABOUT PROGRAMS FOR ASSISTANCE THEY ALSO COORDINATE WITH THE MEDICAID ELIGIBILITY REPRESENTATIVE FROM DHS FOR FOLLOWUP OR EXPEDITED APPLICATIONS THEY PROVIDE MEDICAID APPLICATIONS PERSONAL FINANCIAL STATEMENTS FOR HOSPITAL CHARITY CARE AND REFER TO THE PATIENT ACCOUNTING COUNSELORS |
| COMMUNITY INFORMATION | PART VI | MIDMICHIGAN MEDICAL CENTERCLARES PRIMARY SERVICE AREA IS COMPRISED OF THE 4 ZIP CODES WHICH CAPTURE CLARE COUNTY 847 OF THEIR DISCHARGES ORIGINATED IN THESE ZIP CODES AND THEIR INPATIENT MARKET SHARE IS 298 MIDMICHIGAN MEDICAL CENTERMIDLAND ALSO SERVES THIS COMMUNITY RECEIVING A 260 MARKET SHARE FOLLOWED BY MCLAREN CENTRAL MICHIGAN WITH A 131 MARKET CAPTURE CLARE COUNTY IS A DESIGNATED MEDICALLY UNDERSERVED POPULATION AS WELL AS A DESIGNATED GEOGRAPHIC SINGLE COUNTY HEALTHCARE PROVIDER SHORTAGE AREA DEMOGRAPHICS 2012 OVER AVERAGE MEDIAN NUMBER OF MEDIAN POPULATION 65 YEARS INCOME INCOME HOUSEHOLDS AGE 33925 191 44216 33799 14121 443 RACE PERCENT WHITE PERCENT PERCENT PERCENT PERCENT CAUCASIAN ASIAN INDIAN HISPANIC BLACK 966 03 08 16 05 |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | MIDMICHIGAN HEALTHS FOCUS ON IMPROVING THE HEALTH OF OUR COMMUNITIES IS REFLECTED IN OUR MISSION VALUES AND VISION CLARE PARTNERS WITH SCHOOLS BUSINESSES AND HEALTH CARE AGENCIES TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITIES SERVED ACTIVE COMMUNITY MEMBER BOARDS OVERSEE OUR COMMUNITY OUTREACH ENDEAVORS WE PARTNER ON NEEDED HEALTH INITIATIVES WORKING WITH LOCAL PUBLIC HEALTH DEPARTMENTS AND HEALTH AND HUMAN SERVICE AGENCIES TO UNDERSTAND THE UNIQUE HEALTH NEEDS OF EACH OF OUR COMMUNITIES INCLUDING THE COLLABORATIVE PARTNERSHIP HEADED BY THE CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT CALLED TOGETHER WE CAN AND A SMALLER SUBSET OF THAT GROUP THE CLAREGLADWIN HEALTH IMPROVEMENT PLAN WHICH ADDRESSES WAYS COMMUNITY PARTNERS CAN COLLABORATE TO IMPROVE OVERALL COUNTY HEALTH AND THEIR RANKINGS AS DETERMINED BY THE ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS |
| AFFILIATED HEALTH CARE INFORMATION | PART VI | 59 MILLION IN COMMUNITY BENEFITS WAS PROVIDED BY MIDMICHIGAN HEALTH LAST YEAR THROUGH COMMUNITY EDUCATION PROGRAMS SCREENINGS SPECIAL EVENTS AND HEALTH EXPERTISE INCLUDING INSURANCE UNDERREIMBURSEMENTS AND SERVICES TO THOSE WHO COULD NOT PAY AREAS OF FOCUS IN THE MIDMICHIGAN HEALTH COMMUNITY BENEFIT PLANS ARE ACCESS TO CARE INCLUDING INITIATION AND COORDINATION OF CARE CONTINUITY OF SERVICES AND HEALTH CARE INSURANCE HEALTH OUTCOMES INCLUDING HEART DISEASE CANCER AND DIABETES HEALTH CARE BEHAVIORS INCLUDING SMOKING CESSATION HEALTHY DIET PHYSICAL ACTIVITY AND HEALTHY WEIGHT MATERNAL AND INFANT HEALTH INCLUDING BIRTH WEIGHTS AND BREASTFEEDING IN AN EFFORT TO IMPROVE BREASTFEEDING DURATION RATES ADDITIONAL BREASTFEEDING SUPPORT VIA BREASTFEEDING FACILITATORS AND SCHOLARSHIPS FOR THOSE WHO COULD NOT AFFORD BREASTFEEDING PREPARATION CLASS WERE PROVIDED HEALTH SCREENINGS PROVIDED A CONVENIENT FREE OR LOWCOST MEANS FOR DETECTING POTENTIALLY SERIOUS HEALTH PROBLEMS IN THEIR EARLIEST STAGES WHEN TREATMENT IS USUALLY MORE SUCCESSFUL RESULTING IN LOWER MORBIDITY OR MORTALITY EVENTS INCLUDED SCREENINGS FOR SKIN AND ORAL CANCER STROKE AND OSTEOPOROSIS AND KNOW YOUR NUMBERS TOTAL LIPID PROFILE BLOOD GLUCOSE BLOOD PRESSURE WEIGHT BODY MASS INDEX AND WAIST CIRCUMFERENCE MIDMICHIGAN SCREENED 13374 PEOPLE AT 428 EVENTS IN OUR SERVICE AREA THIS YEAR AT A COST OF 184588 IN AN EFFORT TO ADDRESS INCREASING OBESITY AND CHOLESTEROL LEVELS AND DECREASING PHYSICAL ACTIVITY AMONG CHILDREN MIDMICHIGAN HEALTH AND THE GREAT LAKES LOONS CREATED LOU ES FIT CLUB AND THE FITNESS WATCH PROJECT THE GOAL IS TO INCREASE KIDS MODERATE INTENSITY ACTIVITY FOR BETTER PHYSICAL FITNESS AND LESS CHILDHOOD OBESITY CHILDREN 6 TO 12 JOIN FREE TO ENJOY EVENTS AND RECEIVE A MONTHLY EMAIL NEWSLETTER ABOUT BEING HEALTHY AND ACTIVE AT THE DOW DIAMOND FITNESS POSTERS AT LOU ES LOOKOUT DEMONSTRATE EIGHT EXERCISES THAT KIDS CAN DO ANYWHERE FOR EVERY 60 MINUTES OF MODERATEINTENSITY ACTIVITY THE FITNESS WATCH PROVIDES A REWARD CODE STUDENTS CAN EXCHANGE FOR FUN PRIZES SIX HUNDRED STUDENTS FROM FOUR MIDLAND ELEMENTARY SCHOOLS USED LOU ES ACTIVITY WATCH FOR SIX MONTHS AND AT LEAST 50 PERCENT IMPROVED THEIR FITNESS LEVELS ADDITIONALLY HEALTH FAIRS REACHED OUT TO ENCOURAGE AND TEACH CHILDREN ABOUT REGULAR EXERCISE GOOD NUTRITION AND MAINTAINING A HEALTHY WEIGHT MIDMICHIGAN HEALTH COLLABORATED WITH SCHOOLS ON SOME OF THESE PROGRAMS MIDMICHIGAN MEDICAL CENTERGLADWIN LAUNCHED THE GLADWIN COUNTY ADOLESCENT HEALTH COUNCIL TO IMPROVE ADOLESCENT HEALTH BY PARTNERING WITH COMMUNITY STAKEHOLDERS ADOLESCENTS ARE MORE SUCCESSFUL IN MAKING HEALTHY CHOICES WHEN FAMILIES PARTICIPATE SO THIS YEARS PROGRAM EXPANDED THE HOSPITALS YOUTH HEALTH FAIRS TO INCLUDE FAMILY FITNESS FOLLOWUP NIGHTS FEATURING HEALTHY LIVING AND NUTRITION EDUCATION GOALSETTING AND PHYSICAL TRAINING CHALLENGES WITH PRIZES HEALTH PROFESSIONALS ALSO MET WITH PARENTS WHO HAD QUESTIONS ABOUT THEIR STUDENTS HEALTH FAIR SCREENING RESULTS |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | MICHIGAN |
| ADDITIONAL INFORMATION | PART VI | PART I LINE 3A AND 3B AS WELL AS USING THE FEDERAL POVERTY GUIDELINES THE PATIENTS AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT ARE TAKEN INTO CONSIDERATION WHEN DETERMINING FREE OR DISCOUNTED CARE PATIENTS WHOSE FAMILY INCOME EXCEEDS 200 OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASEBYCASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE |
| MIDMICHIGAN MEDICAL CENTER CLARE LINE NUMBER 1 PART V LINE 11H | PART V LINE 11H | PATIENT RELIGIOUS BELIEF PREVENT HIMHER FROM PARTICIPATING DIRECTLY WITH AN INSURANCE COMPANY |
| MIDMICHIGAN MEDICAL CENTER CLARE LINE NUMBER 1 PART V LINE 13G | PART V LINE 13G | THE COMPLETE POLICY IS NOT PUBLISHED HOWEVER NOTICES OF THE EXISTENCE OF A FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN REGISTRATION AREAS INCLUDING EMERGENCY ROOM PATIENT BILLING INVOICES AND THE HOSPITAL WEBSITE INDICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE |
| MIDMICHIGAN MEDICAL CENTER CLARE LINE NUMBER 1 PART V LINE 21 | PART V LINE 21 | PATIENTS WHO DID NOT FOLLOW THEIR INSURANCE POLICY RULES SUCH AS ACCESSING PARTICIPATING PROVIDERS OBTAINING REFERRALS ETC GUARANTORS REFUSING TO ASSIGN BENEFITS TO THE HOSPITAL IF THEY ARE AVAILABLE PATIENTS WHO ARE UNCOOPERATIVE WITH THE MEDICAID APPLICATION PROCESS |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD REYNOLDS | |||||||||||
| 526730 | 200000 | 20115 | 293201 | 24073 | 1064119 | ||||||
| JOHN NGUYGEN DO | |||||||||||
| 328726 | 3000 | 562 | 10 | 7459 | 339757 | ||||||
| TOM CLARINGBOLD DO | |||||||||||
| 245988 | 50770 | 883 | 25182 | 16650 | 339473 | ||||||
| LAWRENCE BARCO | |||||||||||
| 197330 | 40000 | 26301 | 9704 | 16961 | 290296 | ||||||
| DAVID BREMER MD | |||||||||||
| 160566 | 84524 | 2724 | 28815 | 13816 | 290445 | ||||||
| MARK DEAN | |||||||||||
| 195005 | 40275 | 4563 | 9572 | 15633 | 265048 | ||||||
| EDWARDO MUNOZ | |||||||||||
| 217670 | 275 | 3086 | 11019 | 7052 | 239102 | ||||||
| WILLIAM GROVES | |||||||||||
| 201784 | 275 | 10876 | 10782 | 16538 | 240255 | ||||||
| RUSSELL RADER | |||||||||||
| 188422 | 1100 | 10294 | 10144 | 13335 | 223295 | ||||||
| GLENN KING | |||||||||||
| 124106 | 13000 | 8578 | 7694 | 16000 | 169378 | ||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NON-FIXED PAYMENTS PROVIDED | SCHEDULE J, PAGE 1, PART I, LINE 7 | MIDMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES (60% OF MEDIAN). THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS APPROVED COMPENSATION FOR THE MIDMICHIGAN HEALTH CEO, ALL OPERATING OFFICERS AND COMPENSATION FOR THE AFFILIATE CEOS, OPERATING OFFICERS AND PHYSICIANS. THE AFFILIATE BOARDS OF DIRECTORS REVIEWED ALL FIXED AND NONFIXED PAYMENTS FOR THEIR CEO AND OPERATING OFFICERS PRIOR TO PAYMENT. |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | ON MAY 8, 2009 MIDMICHIGAN HEALTH'S COMPENSATION COMMITTEE APPROVED ITS FIRST COMPENSATION COMMITTEE CHARTER AND EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH APPROVED BOTH THE CHARTER AND THE STRATEGY ON JUNE 8, 2009. MIDMICHIGAN HEALTH ALSO UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES, HOSPITAL LEVEL AND EXECUTIVES AND SELECTED OTHER EXECUTIVES. MIDMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MIDMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE, PRIMARILY IN THE MIDWEST AND REGIONALLY, BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY. PART I, LINE 4B - REYNOLDS AND BARCO ARE PARTICIPANTS IN A 457(F) PLAN. THERE WERE NO PAYMENTS MADE IN 2011. THE SERP IS UNFUNDED AND BEGAN ON JANUARY 1, 2009. THE CURRENT PARTICIPANTS OF THE PLAN ARE THOSE WHO HOLD A CORPORATE OFFICE OF VICE PRESIDENT OR ABOVE. EACH PARTICIPANTS ANNUAL AWARD IS A BENEFIT RESTORATION AMOUNT THAT PROVIDES THE ADDITIONAL BENEFITS THAT THE PARTICIPANT DID NOT EARN UNDER THE PENSION PLAN AND 403(B) PLAN DURING A PLAN YEAR BECAUSE OF THE STATUTORY LIMITS. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MIDMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: ATTAINMENT OF NORMAL RETIREMENT AGE; DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; OR, PROVIDED THEY HAVE BEEN EMPLOYED AT LEAST FIVE YEARS AND THE PARTICIPANT EARNS 75 POINTS. |
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 |
|---|---|---|---|---|---|---|---|
| 2006A MI STATE HOSPITAL FINANCE | |||||||
| 382889417 | 59465HEB8 | 2006-11-07 | 4332800 | CAPITAL PROJECTS | false | false | false |
| MICHIGAN FINANCE AUTHORITY SER D | |||||||
| 800596186 | 2011-06-09 | 455850 | CAPITAL PROJECTS | false | false | true | |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Refunding EscrowRefundingEscrow |
|---|---|---|---|---|---|---|---|---|
| 4332800 | 25050 | 4394794 | 2009 | false | false | true | true | |
| 455850 | 1062 | 2011 | true | false | true | true | 454788 |
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 | Engage Bond Counsel ResearchEngageBondCounselResearch | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| false | false | false | false | false | false | 0.00380 | 0.00380 | true |
| false | false | false | false | false | false | true |
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 |
|---|---|---|---|---|---|
| false | false | false | false | false | false |
| false | true | false | false | false | false |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE K | ReturnReference |
| Explanation | 2006A MI STATE HOSPITAL FINANCE IT HAS BEEN DETERMINED THAT NO ARBITRAGE REBATE IS DUE FOR THIS BOND ISSUE THEREFORE FORM 8038T IS NOT REQUIRED MICHIGAN FINANCE AUTHORITY SER D THIS BOND ISSUE IS A TRANSACTION WITH NO INVESTMENT OF PROCEEDS THEREFORE NO ARBITRAGE REBATE CALCULTION IS REQUIRED | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE. |
| ADDITIONAL INFORMATION | FORM 990 | ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. PART I, LINES 3 & 4 AND PART VI, SECTION A, LINE 1 - THOSE MEMBERS WHO ARE NOT INDEPENDENT ARE EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION LISTED IN SCHEDULE R AND ARE COMPENSATED AT MARKET VALUE FOR THE SERVICES PROVIDED TO THAT ORGANIZATION. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS MIDMICHIGAN HEALTH. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; AND G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 INFORMATION IS PREPARED BY THE FINANCE STAFF AT MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THIS ORGANIZATION. THE INFORMATION IS SUBMITTED FOR REVIEW BY A SENIOR FINANCE STAFF MEMBER AT MIDMICHIGAN HEALTH. THE STAFF MEMBER IN CONSULTATION WITH OUR TAX ACCOUNTANT (A CERTIFIED PUBLIC ACCOUNTING FIRM) REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. ONCE THE INITIAL REVIEW IS COMPLETE, THE INFORMATION IS SUBMITTED TO OUR TAX PROFESSIONALS AT ANDREWS HOOPER PAVLIK PLC. UPON REVIEW BY THEIR PROFESSIONALS,INCLUDING A PARTNER, INFORMATION IS RETURNED TO MIDMICHIGAN HEALTH FOR ITS FINAL REVIEW. THIS REVIEW INCLUDES A REVIEW BY THE SVP AND TREASURER. ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MIDMICHIGAN HEALTH CEO PRIOR TO FILING. PRIOR TO FILING: THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION WILL BE REVIEWED BY THE COMPENSATION COMMITTEE. FORM 990, INCLUDING ALL SCHEDULES, WILL BE MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS IN A SECURE ELECTRONIC FORMAT WITH A SUMMARY OF ALL THE MAJOR CHANGES FROM THE PRIOR YEAR RETURN PRIOR TO FILING. QUESTIONS OR CONCERNS WILL BE ADDRESSED BY THE SVP AND TREASURER. THE RESULTS OF THESE REVIEWS WILL BE PRESENTED TO THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS AND THIS ORGANIZATION'S BOARD OF DIRECTORS. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE, AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; AND 3) TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MIDMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES ARE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND ABSTAIN FROM VOTING ON ANY ISSUE IN WHICH THEY ARE NOT IMPARTIAL. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | ALL CEOS AND OPERATING OFFICERS COMPENSATION IS ANNUALLY APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF MIDMICHIGAN HEALTH. THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | ALL OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| RELATED ORGANIZATIONS | FORM 990, PAGE 7, PART VII | NO DIRECTORS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD. THEY ARE CONSIDERED TO WORK AN AVERAGE OF 2 HOURS A WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK RELATED TO THEIR FULL-TIME POSITION. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MIDMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES IS NOT TRACKED BY AFFILIATE. THEREFORE THE FULL TIME SERVICE TO ALL AFFILIATES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | CHANGES IN NET ASSETS: UNREALIZED LOSS ON INVESTMENT (421,638) TRANSFER OF NET ASSETS TO A RELATED TAX EXEMPT ENTITY (218,448) ----------- TOTAL CHANGE IN NET ASSETS (640,086) |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| MIDMICHIGAN HEALTH | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 382459948 | SUPPORT | MI | 501C3 | 11A | NA | false |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 380833014 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | true |
| MIDMICHIGAN MEDICAL CENTER-GRATIOT | ||||||||||
| 300 E WARWICK DR | ALMA | MI | 48801 | 381437919 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | true |
| MIDMICHIGAN MEDICAL CENTER-GLADWIN | ||||||||||
| 515 QUARTER STREET | GLADWIN | MI | 48624 | 386020434 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | true |
| MIDMICHIGAN STRATFORD VILLAGE | ||||||||||
| 2121 ROCKWELL DR | MIDLAND | MI | 48642 | 382623324 | LT CARE | MI | 501C3 | 9 | MIDMI HLTH | true |
| MIDMICHIGAN GLADWIN PINES | ||||||||||
| 449 QUARTER STREET | GLADWIN | MI | 48624 | 382754875 | LT CARE | MI | 501C3 | 9 | MIDMI HLTH | true |
| MIDMI VNA DBA MIDMICHIGAN HOME CARE | ||||||||||
| 3007 N SAGINAW RD | MIDLAND | MI | 48640 | 381459397 | HOME EQUIP | MI | 501C3 | 9 | MIDMI HLTH | true |
| MIDMICHIGAN PHYSICIANS GROUP | ||||||||||
| 2620 W SUGNET ROAD | MIDLAND | MI | 48640 | 383317788 | MED OFFICE | MI | 501C3 | 11A | MIDMI HLTH | true |
| MIDMICHIGAN REGIONAL IMAGING | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 352182295 | EQUIPMENT | MI | 501C3 | 11B | MIDMI HLTH | true |
| MIDMICHIGAN URGENT CARE | ||||||||||
| 3009 N SAGINAW RD | MIDLAND | MI | 48640 | 205064848 | AMBULATORY | MI | 501C3 | 9 | MIDMI HLTH | true |
| MIDMICHIGAN HEALTH DEV ASSOC | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 382459947 | OPERATIONS | MI | 501C2 | MIDMI HLTH | true | |
| REGIONAL DIALYSIS SERVICES | ||||||||||
| PO BOX 608 | ALMA | MI | 48801 | 383120704 | DIALYSIS | MI | 501C3 | 11A | MIDMI HLTH | true |
| MIDMI MED CENTER-CLARE VOLUNTEERS | ||||||||||
| 703 NORTH MCEWAN STREET | CLARE | MI | 48617 | 382944967 | SUPPORT | MI | 501C3 | 11A | NA | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMICHIGAN ASSURANCE GROUP LTD | BusinessNameLine1 |
Address Foreign AddressForeign
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1051 23 LIME TREE BAY AVENUE | AddressLine1 |
| Address Line2 | GOVERNORS SQUARE BLDG 4 2ND FLOOR | AddressLine2 |
| Province Or State | GRAND CAYMAN | ProvinceOrState |
| Country | CJ | Country |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 980585596 | EIN |
| Primary Activity | INSURANCE | PrimaryActivity |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountry |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMI HLTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORP | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | true | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | true | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (18 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MIDMICHIGAN REGIONAL IMAGING | ||
| J | 792158 | BOOKS RECORDS |
| MIDMICHIGAN HEALTH DEV ASSOC | ||
| J | 59570 | BOOKS RECORDS |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||
| O | 3691041 | BOOKS RECORDS |
| MIDMICHIGAN MEDICAL CENTER-GRATIOT | ||
| O | 216385 | BOOKS RECORDS |
| MIDMICHIGAN HEALTH | ||
| O | 1069546 | BOOKS RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| O | 6782022 | BOOKS RECORDS |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||
| P | 228276 | BOOKS RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| P | 71396 | BOOKS RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| Q | 218448 | BOOKS RECORDS |
| MIDMICHIGAN REGIONAL IMAGING | ||
| J | 792158 | BOOKS RECORDS |
| MIDMICHIGAN HEALTH DEV ASSOC | ||
| J | 59570 | BOOKS RECORDS |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||
| O | 3691041 | BOOKS RECORDS |
| MIDMICHIGAN MEDICAL CENTER-GRATIOT | ||
| O | 216385 | BOOKS RECORDS |
| MIDMICHIGAN HEALTH | ||
| O | 1069546 | BOOKS RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| O | 6782022 | BOOKS RECORDS |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||
| P | 228276 | BOOKS RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| P | 71396 | BOOKS RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| Q | 218448 | BOOKS RECORDS |