LAKESHORE COMMUNITY HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- LAKESHORE COMMUNITY HOSPITAL INC (EIN 38-2549295)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-04
- IRS object ID
- 201201259349301010
- Schema version
- 2010v3.4
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-04T08:47:56-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382549295 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKESHORE COMMUNITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAKE | NameControl |
| Phone | 2318612156 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 72 S STATE STREET | AddressLine1 |
| City | SHELBY | City |
| State | MI | State |
| ZIP Code | 494551228 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GARY ALLORE | Name |
| Title | CFO | Title |
| Phone | 2318612156 | Phone |
| Date Signed | 2012-05-04 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHELBY FAMILY CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN BRYAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 CLINTON AVE | AddressLine1 |
| City | MUSKEGON | City |
| State | MI | State |
| ZIP Code | 49442 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 23312035 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCY-HEALTHPARTNERS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE ACUTE HEALTHCARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 221 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 129124 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 18455 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 18176491 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 22107267 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -130253 | InvestmentIncomePriorYear |
| Investment Income Current Year | 564071 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 273187 | OtherRevenuePriorYear |
| Other Revenue Current Year | 588927 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18448549 | TotalRevenuePriorYear |
| Total Revenue Current Year | 23278720 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10657567 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12693474 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6741011 | OtherExpensePriorYear |
| Other Expenses Current Year | 9075909 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 17398578 | TotalExpensesPriorYear |
| Total Expenses Current Year | 21769383 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1049971 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1509337 | RevenuesLessExpensesCY |
| Total Assets BOY | 12161021 | TotalAssetsBOY |
| Total Assets EOY | 21411299 | TotalAssetsEOY |
| Total Liabilities BOY | 5722425 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13126571 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6438596 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8284728 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE ACUTE HEALTHCARE SERVICES - SEE SCHEDULE H FOR MORE INFORMATION | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 18433730 | Expense |
| Grants | 0 | Grants |
| Revenue | 22681278 | Revenue |
| Description | LAKESHORE COMMUNITY HOSPITAL IS A 24 BED CRITICAL ACCESS HOSPITAL LOCATED IN SHELBY, MICHIGAN, A SMALL RURAL COMMUNITY. IT IS THE ONLY HOSPITAL IN THE COUNTY.LAKESHORE COMMUNITY HOSPITAL PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT OF SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF LAKESHORE COMMUNITY HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND, FURTHER, THAT OUR MISSION IS TO PROVIDE THE BEST POSSIBLE HEALTH CARE TO MEET THE NEEDS OF THE COMMUNITY WITH A DEDICATION TO EXCELLENCE. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY:1) FREE CARE AND/OR SUBSIDIZED CARE,2) CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, AND3) HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITYWILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUAL'S ABILITY TO PAY COEXISTS. SEE SCHEDULE H FOR MORE INFORMATION. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISSION:THE MISSION STATEMENT FOR THE HOSPITAL IS AS FOLLOWS:WE SERVE TOGETHER IN TRINITY HEALTHIN THE SPIRIT OF THE GOSPELTO HEAL BODY, MIND, AND SPIRITTO IMPROVE THE HEALTH OF OUR COMMUNITIESAND TO STEWARD THE RESOURCES ENTRUSTED TO US. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 18433730 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 21 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 221 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLENN PEULER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6166853574 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1820 44TH STREET SE | AddressLine1 |
| City | KENTWOOD | City |
| State | MI | State |
| ZIP Code | 49508 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| JOHN BRYAN | |||||||||
| PRESIDENT & CEO | 50.00 | X | X | 176350 | 0 | 31575 | |||
| GARY BAILEY | |||||||||
| BOARD PRESIDENT | 2.00 | X | X | 0 | 0 | 0 | |||
| RICHARD LOUND | |||||||||
| BOARD VICE PRESIDENT | 2.00 | X | X | 0 | 0 | 0 | |||
| STEVEN LESSENS MD | |||||||||
| SECRETARY/TREASURER; PHYSICIAN | 50.00 | X | X | 160766 | 0 | 17362 | |||
| TIMOTHY HORTON | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| GERALD MEYERS | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| PAUL WAGNER DO | |||||||||
| TRUSTEE; PHYSICIAN | 50.00 | X | 223547 | 0 | 30977 | ||||
| LORRAINE CHASE | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| NANCY MCCARTHY | |||||||||
| TRUSTEE UNTIL 09/10 | 1.00 | X | 0 | 0 | 0 | ||||
| ROGER SPOELMAN | |||||||||
| MERCY HLTH PARTNERS CEO | 5.00 | 0 | 675759 | 159117 | X | ||||
| GREGORY LOOMIS | |||||||||
| MERCY HLTH PARTNERS COO | 5.00 | 0 | 355381 | 51399 | X | ||||
| GARY ALLORE | |||||||||
| MERCY HLTH PARTNERS CFO | 5.00 | 0 | 308479 | 38128 | X | ||||
| F REMINGTON SPRAGUE | |||||||||
| MHP VP PRIMARY CARE SVCS | 5.00 | 0 | 410763 | 50934 | X | ||||
| MARY BOYD | |||||||||
| MHP CHIEF DEV OFFICER | 5.00 | 0 | 316467 | 35245 | X | ||||
| JEFFREY ALEXANDER | |||||||||
| MHP VP INTEGRATED SVCS | 5.00 | 0 | 291602 | 30121 | X | ||||
| KIMBERLY MAGUIRE | |||||||||
| MHP VP PATIENT CARE | 5.00 | 0 | 243121 | 46001 | X | ||||
| RUDY OCHS | |||||||||
| PHYSICIAN | 40.00 | 238621 | 0 | 17182 | X | ||||
| THOMAS GRAFF | |||||||||
| PHYSICIAN | 40.00 | 214558 | 0 | 43586 | X | ||||
| SUSAN BRYAN | |||||||||
| CRNA | 40.00 | 212629 | 0 | 26577 | X | ||||
| JOSEPH KERSCHEN | |||||||||
| PHYSICIAN | 40.00 | 204527 | 0 | 31076 | X | ||||
| LOREN REED | |||||||||
| PHYSICIAN | 40.00 | 197328 | 0 | 44929 | X | ||||
| DAVID GINGRAS | |||||||||
| FORMER KEY EMPLOYEE | 0.00 | 0 | 192696 | 1579 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1628326 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2794268 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 655788 | TotalOtherCompensation |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PHOENIX PHYSICIANS LLC | |||||
| 1501 NW 49TH ST STE 140 | FT LAUDERDALE | FL | 33309 | HEALTH CARE SERVICES | 214200 |
| SIEMENS MEDICAL SOLUTIONS USA | |||||
| 51 VALLEY STREAM PKWY | MALVERN | PA | 19355 | HEALTH CARE SERVICES | 132518 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| All Other Contributions | 18455 | AllOtherContributions |
| Total Contributions | 18455 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SVC REV. | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 22107267 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22107267 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 22107267 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 188338 | TotalRevenueColumn |
| Exclusion | $188,338 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 47946 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 33315 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 14631 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14631 | TotalRevenueColumn |
| Exclusion | $14,631 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 375733 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 375733 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 375733 | TotalRevenueColumn |
| Exclusion | $375,733 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| OTHER REVENUE | 900099 | 480257 | 480257 | |
| CAFETERIA REVENUE | 900099 | 285 | $285 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 93754 | TotalRevenueColumn |
| Related Or Exempt Function Income | 93754 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 574296 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23278720 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22681278 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $578,987 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 710910 | Total |
| Management And General | 710910 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 333121 | Total |
| Program Services | 333121 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9234235 | Total |
| Program Services | 9071448 | ProgramServices |
| Management And General | 162787 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 412285 | Total |
| Program Services | 412285 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1354445 | Total |
| Program Services | 1278995 | ProgramServices |
| Management And General | 75450 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 648478 | Total |
| Program Services | 616567 | ProgramServices |
| Management And General | 31911 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 872 | Total |
| Management And General | 872 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 792944 | Total |
| Program Services | 640943 | ProgramServices |
| Management And General | 152001 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84 | Total |
| Program Services | 84 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 289002 | Total |
| Program Services | 289002 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1093417 | Total |
| Program Services | 45874 | ProgramServices |
| Management And General | 1047543 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 943156 | Total |
| Program Services | 837553 | ProgramServices |
| Management And General | 105603 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55928 | Total |
| Program Services | 46146 | ProgramServices |
| Management And General | 9782 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63096 | Total |
| Program Services | 58505 | ProgramServices |
| Management And General | 4591 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57122 | Total |
| Program Services | 57122 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 691234 | Total |
| Program Services | 379566 | ProgramServices |
| Management And General | 311668 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 159008 | Total |
| Program Services | 159008 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 1652539 | 1611985 | 40554 |
| BAD DEBT | 1359402 | 1359402 | |
| I/C PURCHASED SERVICES | 884489 | 380619 | 503870 |
| HOSPITAL PROVIDER TAXES | 419120 | 419120 | |
| EQUIPMENT MAINTENANCE | 297549 | 294194 | 3355 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 316947 | Total |
| Program Services | 142191 | ProgramServices |
| Management And General | 174756 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21769383 | Total |
| Program Services | 18433730 | ProgramServices |
| Management And General | 3335653 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1278791 | BOY |
| EOY | 844644 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2928572 | BOY |
| EOY | 4548554 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17995 | BOY |
| EOY | 28521 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120449 | BOY |
| EOY | 107895 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47164 | BOY |
| EOY | 125054 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8186567 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6697941 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1148093 | BOY |
| EOY | 1488626 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4313849 | BOY |
| EOY | 6384299 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2103916 | BOY |
| EOY | 7260374 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165176 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37016 | BOY |
| EOY | 623332 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12161021 | BOY |
| EOY | 21411299 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1534838 | BOY |
| EOY | 1990543 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11248 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4176339 | BOY |
| EOY | 11136028 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5722425 | BOY |
| EOY | 13126571 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6436996 | BOY |
| EOY | 8278684 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1600 | BOY |
| EOY | 6044 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6438596 | BOY |
| EOY | 8284728 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12161021 | BOY |
| EOY | 21411299 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1509337 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 336795 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $593 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 593 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | LAKESHORE COMMUNITY HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO A NATIONAL HEALTH CARE ORGANIZATION, WHERE THE ORGANIZATION HAS PROVIDED LAKESHORE COMMUNITY HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 133700 | OtherCostOrOtherBasis |
| Book Value | 133700 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1884168 | OtherCostOrOtherBasis |
| Depreciation | 2041103 | Depreciation |
| Book Value | -156935 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6159925 | OtherCostOrOtherBasis |
| Depreciation | 4655156 | Depreciation |
| Book Value | 1504769 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8774 | OtherCostOrOtherBasis |
| Depreciation | 1682 | Depreciation |
| Book Value | 7092 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1488626 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES | 941160 | F |
| ABSOLUTE RETURN STRATEGY FUNDS | 3361284 | F |
| BOND FUND | 2957930 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 7260374 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| INTERCOMPANY ACCOUNTS PAYABLE | $9,410,075 |
| OTHER CURRENT LIABILITIES | $119,459 |
| ASSET RETIREMENT OBLIGATION | $124,140 |
| INTERCOMPANY NOTES PAYABLE | $1,482,354 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11136028 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 516 | PersonsServed |
| Total Community Benefit Expense | 445636 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 445636 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02180 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 8149 | PersonsServed |
| Total Community Benefit Expense | 3192555 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3394144 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -201589 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 663 | PersonsServed |
| Total Community Benefit Expense | 250259 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 45512 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 204747 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 9328 | PersonsServed |
| Total Community Benefit Expense | 3888450 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3439656 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 448794 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03180 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 498 | PersonsServed |
| Total Community Benefit Expense | 7197 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7197 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 498 | PersonsServed |
| Total Community Benefit Expense | 7197 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7197 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 9826 | PersonsServed |
| Total Community Benefit Expense | 3895647 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3439656 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 455991 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03220 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 537 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 537 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 537 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 537 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $829,719 | BadDebtExpenseAmount |
| Amount Attributable To | 82972 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5426715 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5442796 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -16081 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTH PARTNERS LAKESHORE CAMPUS | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 72 S STATE STREET | AddressLine1 |
| City | SHELBY | City |
| State | MI | State |
| ZIP Code | 49455 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | NOT REQUIRED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| HART FAMILY MEDICAL CENTER | ||||
| 611 E MAIN STREET | HART | MI | 49420 | PRIMARY CARE PHYSICIAN OFFICE |
| LAKESHORE MEDICAL CENTER - WHITEHALL | ||||
| 905 E COLBY STREET | WHITEHALL | MI | 49461 | PRIMARY CARE PHYSICIAN OFFICE |
| SHELBY FAMILY CARE | ||||
| 71 W BEVIER ROAD | SHELBY | MI | 49455 | PRIMARY CARE PHYSICIAN OFFICE |
| LAKESHORE MEDICAL CENTER - SHELBY | ||||
| 218 N MICHIGAN AVENUE | SHELBY | MI | 49455 | PRIMARY CARE PHYSICIAN OFFICE |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 6A: LAKESHORE COMMUNITY HOSPITAL, INC. REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG. IN ADDITION, LAKESHORE COMMUNITY HOSPITAL, INC. WILL BE INCLUDING A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH TRINITY HEALTH'S WEBSITE AS WELL AS MERCY HEALTH PARTNER'S WEBSITE (WWW.MERCY-HEALTHPARTNERS.ORG) |
| PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.UNREIMBURSED MEDICAID:LAKESHORE COMMUNITY HOSPITAL, INC. HAS REPORTED TOTAL COST OF MEDICAID OF $3,192,555 IN LINE 7B, COLUMN (C). ACTUAL DIRECT OFFSETTING REVENUE WAS $3,394,144, RESULTING IN A NET NEGATIVE COMMUNITY BENEFIT EXPENSE OF -$201,589. THIS NET EXPENSE IS -.99% OF TOTAL EXPENSE.THE TAX REPORTING SOFTWARE DOES NOT PERMIT A NEGATIVE PERCENTAGE TO BE REPORTED IN COLUMN (F). THEREFORE, THE UNREIMBURSED MEDICAID PERCENTAGE IN COLUMN (F) IS SHOWING ZERO PERCENT. |
| PART I, L7 COL(F): THE FOLLOWING NUMBER, $1,359,402, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). |
| PART II: COMMUNITY BUILDING ACTIVITIES - COMMUNITY BUILDING ACTIVITIES, SUCH AS COALITION AND COLLABORATIVE MEETINGS, WELLNESS FORUMS, COMMUNITY HEALTH AWARENESS MARKETING CAMPAIGNS, AND OTHER OUTREACH AND EDUCATION ACTIVITIES WERE NOT TRACKED AND REPORTED IN FY11. IN CONSULTATION WITH THE COMMUNITY BENEFIT STAFF OF MERCY HEALTH PARTNERS, LAKESHORE HOSPITAL IS DEVELOPING AN INTERNAL PROCESS TO TRACK COMMUNITY BUILDING ACTIVITIES AND CREATING AN APPROPRIATE PROCEDURE FOR REPORTING PROGRAM CONTENT, OUT-COMES AND EXPENSES IN FY12. |
| PART III, LINE 4: LAKESHORE COMMUNITY HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM THOSE STATEMENTS: "SUBSTANTIALLY ALL OF THE CORPORATION'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO PATIENTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. THE CORPORATION'S ESTIMATE FOR ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS BY PAYOR."COSTING METHODOLOGY FOR LINES 2 AND 3: AMOUNTS ARE CALCULATED ON LINE 2 USING A COST TO CHARGE RATIO METHODOLOGY.ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.WHILE CURRENT OPERATIONS ATTEMPT TO IDENTIFY THOSE CASES THAT WILL QUALIFY FOR CHARITY OR UNCOMPENSATED CARE, IT IS ASSUMED THAT APPROXIMATELY 10% OF THE REMAINING BAD DEBT AMOUNT MAY ALSO QUALIFY AS CHARITY. |
| PART III, LINE 8: LAKESHORE COMMUNITY HOSPITAL, INC. DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. |
| PART III, LINE 9B: THE ORGANIZATION'S COLLECTION POLICY CONTAINS THE CRITERIA FOR FINANCIAL ASSISTANCE, AND CONTAINS THE FOLLOWING VERBIAGE FOR ARRANGEMENTS WITH OUTSIDE COLLECTION AGENCIES: THE AGREEMENT MUST DEFINE THE STANDARDS AND SCOPE OF PRACTICES TO BE USED BY OUTSIDE COLLECTION AGENTS ACTING ON BEHALF OF THE MINISTRY ORGANIZATION, ALL OF WHICH MUST BE IN COMPLIANCE WITH THIS POLICY. |
| PART VI, LINE 2: NEEDS ASSESSMENT - LAKESHORE COMMUNITY HOSPITAL, INC. (MERCY HEALTH PARTNERS-LAKESHORE CAMPUS) ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY NEEDS ASSESSMENTS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR MERCY HEALTH PARTNERS' STRATEGIC AND SUBSEQUENT ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.THE MERCY HEALTH PARTNERS' CHNA PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED - IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGTHE MERCY HEALTH PARTNERS' COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). IN 2010, MERCY BEGAN USING GRAPHIC INFORMATION SYSTEM SOFTWARE TO GEO-MAP FINANCIAL ASSISTANCE RECORDS AND VARIOUS DISEASE CONDITIONS TO HELP IDENTIFY "HOT SPOTS" THAT NEED ATTENTION. THE USE OF GEO-MAPPING WILL BE EXPANDED IN THE 2012 CHNA TO INCLUDE SOCIAL DETERMINANTS OF HEALTH, HEALTH LITERACY AND ER UTILIZATION FOR PRIMARY CARE TO FURTHER IDENTIFY HEALTH DISPARITIES. THE DATA HELPS SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES. THE MERCY HEALTH PARTNERS-LAKESHORE CAMPUS' UP-COMING 2012 COMMUNITY NEEDS ASSESSMENT IS EXPECTED TO BE COMPLETED BY JUNE 30, 2012 AND WILL FOLLOW THE TRINITY HEALTH SYSTEM'S GUIDE FOR MISSION ORGANIZATIONS TO PREPARE THEIR INDIVIDUAL COMMUNITY HEALTH NEEDS ASSESSMENTS. THE GUIDE WAS PREPARED BY THE MUSKEGON COMMUNITY HEALTH PROJECT IN 2008 AND UPDATED IN 2010. THE STEERING COMMITTEE WILL INCLUDE KEY COMMUNITY HEALTH STAKEHOLDERS, INCLUDING MERCY HEALTH PARTNERS' MERCY, HACKLEY AND LAKESHORE CAMPUSES, LAKESHORE HEALTH NETWORK, MERCY PHARMACIES, VISITING NURSE SERVICES, HARBOR HOSPICE, MUSKEGON COUNTY PUBLIC HEALTH, DISTRICT 10 PUBLIC HEALTH, UNITED WAY OF THE LAKESHORE, MUSKEGON COUNTY AND OCEANA COUNTY COMMUNITY MENTAL HEALTH. AT LEAST 20 MUSKEGON AND OCEANA COUNTY HEALTH AND HUMAN SERVICE PROVIDERS WILL BE CONTRIBUTING TO THE CHNA PROCESS, PRINCIPALLY WITH THE COMMUNITY INPUT AND PRIORITIZATION ELEMENTS. AS IN 2009, CHNA WILL BE CONDUCTED BY THE COMMUNITY BENEFIT ARM OF MERCY HEALTH PARTNERS, THE MUSKEGON COMMUNITY HEALTH PROJECT. PETER J. SARTORIUS, MA, MS, DEVELOPMENT AND PLANNING MANAGER WILL LEAD AND MANAGE THE PROCESS AGAIN IN 2012. THE 2012 CHNA WILL AGAIN MAKE USE OF A PROFESSIONAL FACILITATOR FOR FORUMS AND FOCUS GROUPS, AND A PROJECT CONSULTANT TO ASSIST WITH THE ANALYSIS. A SECOND CONTRACTOR MAY BE USED FOR THE DATA GATHERING COMPONENT.THE HEALTH DISPARITIES REDUCTION COALITION, CONVENED IN JANUARY 2010, HAS CONTINUED EXAMINING HEALTH DISPARITY ISSUES IN MUSKEGON AND OCEANA COUNTIES. DATA INDICES PERTAINING TO HEALTH DISPARITIES BASED ON RACE, ETHNICITY AND LANGUAGE HAVE BEEN COMPILED TO TRACK PROGRESS TOWARD REDUCING DISPARITY IN THE TWO COUNTIES. MANY PATIENT INFORMATION BROCHURES HAVE BEEN TRANSLATED INTO SPANISH IN CONJUNCTION WITH MERCY HEALTH PARTNERS AND DISTRIBUTED TO ALL CAMPUSES. PATIENT SATISFACTION SURVEYS ARE BEING REVISED TO INCLUDE QUESTIONS PERTAINING TO HEALTH DISPARITY. COMMUNITY CARE COORDINATION PROGRAMS ARE BEING EXPLORED FOR BEST PRACTICE MODELS THAT CONNECT HIGH-RISK CHRONIC DISEASE PATIENTS TO THE HEALTH AND HUMAN SERVICES NEEDED TO SUPPORT THEIR MEDICAL TREATMENTS. THE COALITION IS LAUNCHING AN EDUCATIONAL WEB SITE AND A PUBLIC AWARENESS MEDICAL CAMPAIGN IN 2011 THAT WILL CONTINUE IN 2012. |
| PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY HEALTH PARTNERS-LAKESHORE CAMPUS IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, MERCY HEALTH PARTNERS- LAKESHORE CAMPUS HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMERCY HEALTH PARTNERS-LAKESHORE CAMPUS EFFECTIVELY COMMUNICATES WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS OFFERS IN-PERSON SUPPORT WITH FINANCIAL COUNSELORS, CASHIERS AND THE MUSKEGON COMMUNITY HEALTH PROJECT (A PART OF MERCY HEALTH). ANY REGISTRAR CAN MAKE A CONNECTION TO PATIENTS. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS PUBLISHES THE PHONE NUMBERS FOR OUR CALL-IN SUPPORT, AND SHARED SERVICES ALSO PROVIDES PHONE SUPPORT. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS HAS AN EXTERNAL VENDOR, MEDASSIST, AND WE ALSO WORK WITH DEPARTMENT OF HUMAN SERVICES STAFF.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS UTILIZES AN EXTERNAL VENDOR AS AN EXTENSION OF HOSPITAL SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.BEGINNING IN 2010, MERCY HEALTH PARTNERS ESTABLISHED A SINGLE ENROLLMENT FORM, APPLICABLE TO ALL CAMPUSES, FOR FINANCIAL ASSISTANCE THAT INCLUDES GATHERING ALL THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY AND ENROLLMENT FOR A VARIETY OF ASSISTANCE PROGRAMS, INCLUDING HEALTH COVERAGE, FOOD STAMPS, PHARMACEUTICAL ASSISTANCE PROGRAMS, VISION AND HEARING SERVICES, BEHAVIORAL AND MENTAL HEALTH SERVICES, CHRONIC DISEASE SELF MANAGEMENT EDUCATION, AND DRUG AND ALCOHOL ABUSE COUNSELING AND TOBACCO CESSATION EDUCATION. THE SINGLE ENROLLMENT FORM IS USED ON ALL MERCY HEALTH PARTNER CAMPUSES. MERCY HEALTH PARTNERS BEGAN DEPLOYING COMMUNITY HEALTH WORKERS FROM THE MUSKEGON COMMUNITY HEALTH PROJECT TO WORK WITH UNINSURED HOSPITAL DISCHARGE PATIENTS AND ENSURE THAT ALL ELIGIBLE PATIENTS ARE ENROLLED IN APPLICABLE ASSISTANCE PROGRAMS. THE HEALTH PROJECT ALSO SCREENS AND ENROLLS RESIDENTS FROM ALL PARTS OF THE SERVICE AREA, USING WIDE-REACHING OUTREACH STRATEGIES AND TECHNIQUES TO ENGAGE UNINSURED AND UNDERSERVED POPULATIONS.MERCY HEALTH PARTNERS-LAKESHORE CAMPUS OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH THE PUBLICATION OF PATIENT BROCHURES, NOTICES OR MESSAGING INCLUDED ON PATIENT BILLS; POSTING OF NOTICES IN PUBLIC REGISTRATION AREAS, INCLUDING EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS; HOSPITAL PATIENT ACCOUNTING DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON OUR CAMPUSES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO ACCESS HEALTH, INC., AMERICAN RED CROSS, BENSON DRUGS, CATHOLIC CHARITIES OF WEST MICHIGAN, CITY OF MUSKEGON, CITY OF MUSKEGON HEIGHTS, COMMUNITY ACCESS LINE OF THE LAKESHORE, COMMUNITY MENTAL HEALTH SERVICES OF MUSKEGON COUNTY, COOPERATING CHURCHES, DISABILITY CONNECTION OF WEST MICHIGAN, EVERY WOMAN'S PLACE, GOODWILL INDUSTRIES, HACKLEY COMMUNITY CARE CENTER, HACKLEY PHARMACIES, LIFE COUNSELING, LIONS CLUBS OF MUSKEGON COUNTY, MISSION FOR AREA PEOPLE, MUSKEGON COUNTY PUBLIC HEALTH, MUSKEGON COUNTY DEPT. OF HUMAN SERVICES/FAMILY RESOURCE CENTERS, MUSKEGON FAMILY CARE, MUSKEGON/OCEANA MICHIGAN WORKS!, THE SALVATION ARMY, SENIOR RESOURCES, URBAN LEAGUE, WESTSHORE PHARMACY, AND WEST MICHIGAN THERAPY. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON THE MERCY HEALTH PARTNERS WEBSITE, AS WELL AS IN THE ADMISSION PACKAGE. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH, REFLECTING THE OTHER PRIMARY LANGUAGE SPOKEN BY THE POPULATION SERVED BY OUR HOSPITAL. MERCY HEALTH PARTNERS HAS ESTABLISHED A WRITTEN POLICY, APPLICABLE TO ALL CAMPUSES, FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES, WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS' FRONTLINE REGISTRATION ASSOCIATES, CASHIERS AND THE MUSKEGON COMMUNITY HEALTH PROJECT RECEIVE TRAINING ON MAKING A CONNECTION TO A FINANCIAL COUNSELOR. |
| PART VI, LINE 4: COMMUNITY INFORMATION - MERCY HEALTH PARTNERS- LAKESHORE CAMPUS' SERVICE AREA INCLUDES NEWAYGO AND OCEANA COUNTIES, LOCATED IN CENTRAL WEST MICHIGAN, ON OR NEAR THE SHORELINE OF LAKE MICHIGAN. TOTAL POPULATION OF THE SERVICE AREA IS ABOUT 75,000 AND IS COMPRISED PRINCIPALLY OF RURAL AREAS. THE RURAL AREA IS CHARACTERIZED BY A CHIEFLY AGRICULTURAL, RECREATION AND TOURISM ECONOMY. THE MERCY HEALTH PARTNERS SYSTEM AS A WHOLE SERVES A TOTAL POPULATION OF ABOUT 250,000. DIAGNOSTIC TESTING, LABORATORY AND SPECIALTY MEDICAL SERVICES ARE GENERALLY PROVIDED TO LAKESHORE PATIENTS AT THE MERCY AND HACKLEY CAMPUSES, WHICH ARE LOCATED IN THE MUSKEGON METROPOLITAN AREA OF ABOUT 120,000 PEOPLE. IT IS COMPRISED OF FIVE CITIES, THE LARGEST OF WHICH IS THE CITY OF MUSKEGON, WITH 38,401 POPULATION. MUSKEGON'S ECONOMY IS LARGELY MANUFACTURING AND SERVICE INDUSTRIES. THE POPULATION IS GENERALLY DIVERSE WITH MANY ETHNIC AND RACIAL POPULATION SEGMENTS. THE METROPOLITAN AREA HAS A SIGNIFICANT AFRICAN-AMERICAN POPULATION, WHILE OCEANA COUNTY HAS A HIGHER CONCENTRATION OF HISPANIC RESIDENTS. MUSKEGON COUNTY IS HOME TO THE COUNTY'S MAJOR HOSPITAL SYSTEM, MERCY HEALTH PARTNERS, WHICH RECENTLY MERGED WITH HACKLEY HOSPITAL AND NOW INCLUDES FOUR CAMPUSES, INCLUDING LAKESHORE HOSPITAL IN OCEANA COUNTY. BASED ON THE 2010 CENSUS, THERE WERE 172,188 PEOPLE, 65,654 HOUSEHOLDS, AND 44,690 FAMILIES RESIDING IN COUNTY. THE RACIAL MAKEUP WAS APPROXIMATELY 80% CAUCASIAN, 14.5% BLACK AND 1.3% FOR NATIVE AMERICAN, ASIAN, AND PACIFIC ISLANDER. THE MEDIAN HOUSEHOLD INCOME WAS $38,916, AND THE MEDIAN INCOME FOR A FAMILY WAS $51,519. ABOUT 12.4% OF FAMILIES AND 18.6% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 22.4% OF THOSE UNDER AGE 18 AND 8.7% OF THOSE AGES 65 OR OVER.OCEANA COUNTY IS A RURAL COUNTY ROUGHLY 41 MILES NORTH OF MUSKEGON AND 75 MILES NORTHWEST OF GRAND RAPIDS. THE RACIAL MAKEUP ACCORDING TO THE 2000 CENSUS WAS 90.1 % CAUCASIAN, WITH AFRICAN-AMERICAN, ASIAN, AND PACIFIC ISLANDER EACH COMPRISING 1.7% OF THE TOTAL POPULATION. ROUGHLY 13.7% OF THE POPULATION WAS HISPANIC OR LATINO, THE HIGHEST PERCENTAGE OF LATINOS OF ANY COUNTY IN MICHIGAN. RECENT ESTIMATES SHOW THE PERCENTAGE OF LATINOS AND AFRICAN-AMERICANS TO BE INCREASING, WHILE THE PERCENTAGE OF NON-HISPANIC WHITES DECREASING. THE CENSUS BUREAU ESTIMATES THE 2010 COUNTY POPULATION AT 26,570. THE AVERAGE HOUSEHOLD SIZE WAS 2.65 AND THE AVERAGE FAMILY SIZE WAS 3.14 IN 2010. MEDIAN INCOME WAS $37,655.NEWAYGO COUNTY IS HOME TO GERBER INDUSTRIES AND THE GERBER MEMORIAL HOSPITAL, LOCATED IN FREMONT. THE GEOGRAPHIC PROXIMITY OF THE TWO URBAN CENTERS RESULTS IN SOME COUNTY RESIDENTS TRAVELING TO THE MUSKEGON AREA FOR HEALTHCARE SERVICES WHILE OTHERS USE THE SERVICES AVAILABLE IN GRAND RAPIDS. BASED ON THE 2010 CENSUS, THE RACIAL MAKEUP WAS APPROXIMATELY 94.1% CAUCASIAN, 1% BLACK, AND 1.2% FOR NATIVE AMERICAN, ASIAN, AND PACIFIC ISLANDER. THE CENSUS BUREAU ESTIMATES THE 2008 COUNTY POPULATION AT 48,460. THE MEDIAN HOUSEHOLD INCOME WAS $39,059 AND THE MEDIAN INCOME FOR A FAMILY WAS $49,819. ABOUT 12.1% OF FAMILIES AND 18.6% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING APPROXIMATELY 22.1% OF THOSE UNDER AGE 18 AND 8.2% OF THAT AGE 65 OR OVER. |
| PART VI, LINE 6: OTHER INFORMATION - THE MAJORITY OF THE GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE MERCY HEALTH PARTNERS' (LAKESHORE CAMPUS, HACKLEY CAMPUS AND MERCY CAMPUS) PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS. SINCE MERCY HEALTH PARTNERS IS THE ONLY HOSPITAL IN MUSKEGON COUNTY, STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE ALLOCATED TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. THE SERVICE AREA HAS VERY HIGH RATES OF UNINSURED (MUSKEGON CO. 23.5%; OCEANA CO 27.6%; NEWAYGO CO 12.7%), SO MERCY HEALTH PARTNERS-LAKESHORE CAMPUS' FOCUS HAS BEEN ON ACCESS TO CARE. MERCY HEALTH PARTNERS' HEALTH PROJECT HAS BEEN VERY PROACTIVE IN WORKING WITH MEDICAL CLINICS AND THE TWO FQHCS. THE DESIGN OF A SINGLE ENROLLMENT PROCESS HAS PROVEN TO MAKE APPLYING FOR ASSISTANCE LESS CUMBERSOME. THE NEW FORM INCLUDES ALL INFORMATION ESSENTIAL FOR DETERMINING ELIGIBILITY FOR MULTIPLE HEALTH AND HUMAN SERVICES, THUS STREAMLINING THE PROCESS OF ASSISTING PATIENTS TO RECEIVE SERVICES. THE WHEELS OF MERCY, A MOBILE UNIT, IS TAKEN TO VARIOUS AREAS THROUGH THE THREE COUNTIES, PROVIDING, AT THE LEAST, BLOOD PRESSURE, DIABETES, PULMONARY FUNCTION, VISION AND CHOLESTEROL CHECKS. ENROLLMENT ASSISTANCE INTO VARIOUS PROGRAMS IS ALSO PROVIDED. THE GOAL IS TO ALLEVIATE MANY EMERGENCY DEPARTMENT VISITS BY SCREENING AND ALERTING PATIENTS TO TREATABLE PROBLEMS THAT COULD ESCALATE INTO LIFE-THREATENING SITUATIONS. DEPARTMENTS ARE AGGRESSIVELY INVOLVED IN COMMUNITY PROGRAMS, FOR INSTANCE OUTREACH AND ENROLLMENT SPECIALISTS CONDUCT HEALTH AND HUMAN SERVICE ELIGIBILITY SCREENS ON ALL UNINSURED PATIENTS AT THE TIME OF DISCHARGE FROM THE HOSPITAL OR EMERGENCY DEPARTMENT. INCLUDED IN THE SCREENING IS ELIGIBILITY FOR MEDICAID, SCHIP OR OTHER AVAILABLE HEALTH COVERAGE, FOOD ASSISTANCE PROGRAM, MERCY HEALTH PARTNERS FINANCIAL ASSISTANCE, ET AL. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS PARTICIPATES IN THE UNITED WAY DAY OF CARING. ALSO, EVERY YEAR, THE HEALTHY-U EVENT IS CONDUCTED TO EDUCATE THE COMMUNITY ABOUT HEART HEALTH, AND PROVIDE WORKSHOPS AND PROGRAMS AT NO COST. SUPPORT FOR EVENTS, SUCH AS THE AFRICAN-AMERICAN DIABETES CONFERENCE, MEN'S HEALTH FAIR AND SCREENING, AND THE WALK FOR DIABETES ARE CONDUCTED TO RAISE FUNDS FOR PHARMACEUTICAL PRODUCTS FOR PEOPLE WHO CAN'T AFFORD THEM. MERCY HEALTH PARTNERS-LAKESHORE CAMPUS CONDUCTS EXTENSIVE COMMUNITY-BASED SCREENINGS AT CHURCHES AND OTHER VENUES AROUND THE COMMUNITY. PHYSICIANS VOLUNTEER THEIR TIME IN DOC TALKS FOR THE COMMUNITY; COMMUNITY SERVICES ARE PROVIDED TO BENEFIT EVERYONE IN THE COMMUNITY, SUCH AS BIRTHING CLASSES. ALL OF MERCY HEALTH PARTNERS' CAMPUSES SUPPORT THE USE OF FACILITIES BY NON-PROFIT ORGANIZATIONS FOR MEETINGS AND SUPPORT. A CERTAIN PERCENT OF EARNINGS FROM THE SISTER SIMONE FUND ARE REDIRECTED BACK TO COMMUNITY GROUPS FOR PROJECTS TO IMPROVE THE HEALTH OF THE COMMUNITY. MEDICAL AND ADMINISTRATIVE STAFFS SIT ON COMMUNITY COALITIONS THAT TARGET AREAS OF COMMUNITY NEED, INCLUDING HIV/AIDS; DIABETES; CHILDHOOD OBESITY; HEALTH DISPARITIES, ASTHMA; ALCOHOL, TOBACCO AND SUBSTANCE ABUSE; AND YOUTH RISK BEHAVIORS. MERCY HEALTH PARTNERS ALSO GIVES MONEY TO SUPPORT THE COMMUNITY ACCESS LINE OF THE LAKESHORE (CALL 2-1-1) INFORMATION AND REFERRAL PHONE LINE; ACCESS HEALTH, A "3-SHARE" MODEL COMMUNITY HEALTH COVERAGE PROGRAM; AS WELL AS VISION SERVICES. MERCY HEALTH PARTNERS (ALL CAMPUSES) IS INVOLVED WITH "ALIGNING FORCES FOR QUALITY: EQUITY AND LANGUAGE QUALITY" TO MEET THE TRINITY EQUITY IN CARE PROCESS OF DETERMINING WHETHER INEQUITIES EXIST IN CARE DUE TO RACE OR ETHNICITY. A MERCY HEALTH PARTNERS' COLLABORATIVE, THE OCEANA COUNTY HEALTHCARE NEEDS AND OUTREACH SERVICES CONTINUES TO MEET AT THE LAKESHORE HOSPITAL IN OCEANA COUNTY TO BUILD A COMMUNITY CONSENSUS AROUND EVALUATION, PLANNING AND DEPLOYMENT OF HEALTHCARE SERVICES TO MEET THE NEEDS OF UNDERSERVED RESIDENTS OF OCEANA COUNTY. THE COMMITTEE IS WORKING ON LIFE-LONG PREVENTION SERVICES/LIFESTYLE CHANGES. MERCY HEALTH PARTNERS' LAKESHORE HEALTH NETWORK CONTINUES TO LEAD A HEALTH LITERACY COMMITTEE, CALLED CLEAR COMMUNICATION FOR HEALTH COLLABORATIVE, TO FOCUS ON ISSUES THAT EMERGED OUT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. THIS COMMITTEE IS LOOKING AT HOW WE CAN IMPROVE GIVING PATIENTS INFORMATION THEY CAN UNDERSTAND IN ORDER TO IMPROVE THEIR HEALTH AND COMPLIANCE WITH MEDICAL PROTOCOLS.IN PARTNERSHIP WITH LAKESHORE HEALTH NETWORK, THE HEALTH PROJECT HAS BEEN OPERATING THE MUSKEGON AREA MEDICATION DISPOSAL PROJECT (MAMDP) SINCE LATE 2010. THE MEDICATION TAKE-BACK PROJECT REDUCES YOUTH ACCESS TO NON-PRESCRIBED MEDICATIONS, REDUCES THE NUMBER OF EXPIRED AND POTENTIALLY UNSAFE MEDICATIONS, ASSISTS LAW ENFORCEMENT WITH NEIGHBORHOOD SAFETY FOR THOSE SEEKING OUT DRUGS IN MEDICINE CABINETS AND REDUCES THE ENVIRONMENTAL IMPACT ON WATER QUALITY. THE MAMDP HELD FOUR EVENTS IN FY 2011 AND COLLECTED OVER 2,527 POUNDS OF MATERIALS FROM OVER 750 PARTICIPANTS. NEARLY 40% (282 POUNDS) OF THE MATERIALS WERE CLASSIFIED AS CONTROLLED SUBSTANCES. OVER 200 POUNDS OF SHARPS WERE COLLECTED AND 127 POUNDS OF NEW/UNUSED MEDICATIONS WERE DONATED TO A NON-PROFIT DISPENSARY. |
| PART VI, LINE 7: MERCY HEALTH PARTNERS-LAKESHORE CAMPUS IS A MEMBER ORGANIZATION OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE SYSTEMS IN THE COUNTRY. BASED IN NOVI, MICHIGAN, TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEVELOP, AND ARE HELD ACCOUNTABLE FOR ACHIEVING, COMMUNITY BENEFIT GOALS THAT INCLUDE DEVELOPING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THE POOR AND UNINSURED, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND OUTREACH FOR THE ELDERLY. IN FISCAL YEAR 2011, THIS INCLUDED NEARLY $453 MILLION IN SUCH COMMUNITY BENEFITS. THEREFORE, TRINITY HEALTH TAKES A SYSTEMS APPROACH IN ITS COMMUNITY BENEFIT PLANNING AND IMPLEMENTATION, AND IS CONSEQUENTLY ABLE TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ARE HELPING PROMOTE AND ADDRESS THE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN BRYAN | |||||||||||||
| 153416 | 0 | 0 | 0 | 22934 | 0 | 15332 | 0 | 16243 | 0 | 207925 | 0 | 0 | 0 |
| STEVEN LESSENS MD | |||||||||||||
| 158964 | 0 | 0 | 0 | 1802 | 0 | 15087 | 0 | 2275 | 0 | 178128 | 0 | 0 | 0 |
| PAUL WAGNER DO | |||||||||||||
| 223402 | 0 | 0 | 0 | 145 | 0 | 14015 | 0 | 16962 | 0 | 254524 | 0 | 0 | 0 |
| ROGER SPOELMAN | |||||||||||||
| 0 | 410821 | 0 | 163555 | 0 | 101383 | 0 | 137197 | 0 | 21920 | 0 | 834876 | 0 | 37116 |
| GREGORY LOOMIS | |||||||||||||
| 0 | 277822 | 0 | 74931 | 0 | 2628 | 0 | 37341 | 0 | 14058 | 0 | 406780 | 0 | 0 |
| GARY ALLORE | |||||||||||||
| 0 | 241748 | 0 | 65933 | 0 | 798 | 0 | 19444 | 0 | 18684 | 0 | 346607 | 0 | 0 |
| F REMINGTON SPRAGUE | |||||||||||||
| 0 | 320194 | 0 | 85880 | 0 | 4689 | 0 | 41004 | 0 | 9930 | 0 | 461697 | 0 | 0 |
| MARY BOYD | |||||||||||||
| 0 | 252954 | 0 | 61657 | 0 | 1856 | 0 | 32858 | 0 | 2387 | 0 | 351712 | 0 | 0 |
| JEFFREY ALEXANDER | |||||||||||||
| 0 | 228562 | 0 | 61904 | 0 | 1136 | 0 | 18936 | 0 | 11185 | 0 | 321723 | 0 | 0 |
| KIMBERLY MAGUIRE | |||||||||||||
| 0 | 191177 | 0 | 51342 | 0 | 602 | 0 | 31968 | 0 | 14033 | 0 | 289122 | 0 | 0 |
| RUDY OCHS | |||||||||||||
| 237398 | 0 | 0 | 0 | 1223 | 0 | 15970 | 0 | 1212 | 0 | 255803 | 0 | 0 | 0 |
| THOMAS GRAFF | |||||||||||||
| 200357 | 0 | 13864 | 0 | 337 | 0 | 20695 | 0 | 22891 | 0 | 258144 | 0 | 0 | 0 |
| SUSAN BRYAN | |||||||||||||
| 171563 | 0 | 0 | 0 | 41066 | 0 | 24512 | 0 | 2065 | 0 | 239206 | 0 | 0 | 0 |
| JOSEPH KERSCHEN | |||||||||||||
| 188909 | 0 | 13864 | 0 | 1754 | 0 | 23251 | 0 | 7825 | 0 | 235603 | 0 | 0 | 0 |
| LOREN REED | |||||||||||||
| 196384 | 0 | 0 | 0 | 944 | 0 | 23115 | 0 | 21814 | 0 | 242257 | 0 | 0 | 0 |
| DAVID GINGRAS | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 192696 | 0 | 0 | 0 | 1579 | 0 | 194275 | 0 | 151850 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINES 4A-B | ReturnReference |
| Explanation | THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2010. THIS AMOUNT IS INCLUDED IN COLUMN B(III): DAVID GINGRAS - $163,158 PART I, LINE 4B: THE FOLLOWING IS A PARTICIPANT IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2010). THE FOLLOWING ACCRUAL FOR 2010 FOR THIS PLAN IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: ROGER SPOELMAN - $101,579 | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN | |||
| F. REMINGTON SPRAGUE, KEY EMPLOYEE, IS TRUSTEE OF BLUE CROSS BLUE SHIELD-MI | 3889999 | NET REVENUE FROM PROVISION OF MEDICAL SERVICES | 0 |
| SUSAN BRYAN | |||
| SUSAN BRYAN IS A FAMILY MEMBER OF JOHN BRYAN, PRESIDENT & CEO | 207734 | EMPLOYMENT ARRANGEMENT | 0 |
| CONSTANCE STRBICH | |||
| CONSTANCE STRBICH IS A FAMILY MEMBER OF PAUL WAGNER, TRUSTEE | 125387 | EMPLOYMENT ARRANGEMENT | 0 |
| KIDDIE COLLEGE REALTY | |||
| PAUL WAGNER, D.O., TRUSTEE, IS A PARTIAL OWNER OF KIDDIE COLLEGE REALTY | 134889 | LAKESHORE COMMUNITY HOSPITAL LEASES SPACE FROM KIDDIE COLLEGE REALTY | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DOING BUSINESS AS | FORM 990, PART I, ITEM C | LAKESHORE MEDICAL CENTER-WHITEHALL LAKESHORE MEDICAL CENTER-SHELBY MERCY HEALTH PARTNERS, LAKESHORE CAMPUS HACKLEY LAKESHORE HOSPITAL HART FAMILY MEDICAL CENTER MERCY HEALTH LAKESHORE |
| FORM 990, PART VI, SECTION A, LINE 2 | JOHN BRYAN, PRESIDENT AND CEO, AND GARY BAILEY, BOARD PRESIDENT, HAVE A BUSINESS RELATIONSHIP. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF LAKESHORE COMMUNITY HOSPITAL, INC. IS MERCY HEALTH PARTNERS. SEE LINE 7 FOR ADDITIONAL INFORMATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | MERCY HEALTH PARTNERS IS THE SOLE MEMBER OF LAKESHORE COMMUNITY HOSPITAL, INC. MERCY HEALTH PARTNERS HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF LAKESHORE COMMUNITY HOSPITAL. | |
| FORM 990, PART VI, SECTION A, LINE 7B | AS SOLE MEMBER, MERCY HEALTH PARTNERS MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH PARTNERS MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | PRIOR TO FILING, THE FORM 990 FOR LAKESHORE COMMUNITY HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF TRUSTEES. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. | |
| FORM 990, PART VI, SECTION B, LINE 12C | LAKESHORE COMMUNITY HOSPITAL, INC. HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF LAKESHORE COMMUNITY HOSPITAL, WHICH INCLUDES TRUSTEES, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH LAKESHORE COMMUNITY HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO LAKESHORE COMMUNITY HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF TRUSTEES OF LAKESHORE COMMUNITY HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO LAKESHORE COMMUNITY HOSPITAL. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF TRUSTEES OF LAKESHORE COMMUNITY HOSPITAL ON AN ANNUAL BASIS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF LAKESHORE COMMUNITY HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | LAKESHORE COMMUNITY HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, LAKESHORE COMMUNITY HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MERCY HEALTH PARTNER'S WEBSITE (WWW.MERCY-HEALTHPARTNERS.ORG) | |
| ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: | FORM 990, PART VII, SECTION A, COLUMN B: | THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: JEFFREY ALEXANDER - 45 HOURS GARY ALLORE - 45 HOURS MARY BOYD - 45 HOURS GREGORY LOOMIS - 45 HOURS KIMBERLY MAGUIRE - 45 HOURS F. REMINGTON SPRAGUE - 45 HOURS ROGER SPOELMAN - 45 HOURS |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 489,505. EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE: -155,063. OTHER: 2,353. TOTAL TO FORM 990, PART XI, LINE 5: 336,795. |
| FORM 990, PART XII, LINE 2: | LAKESHORE COMMUNITY HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY11 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (93 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP | |||||||||||
| 245 STATE ST SE | GRAND RAPIDS | MI | 49503 | 272491974 | HEALTHCARE SERVICES | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| AMICARE HOSPICE SERVICES INC | |||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 382949053 | PROVIDE HOSPICE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| AUXILIARY OF HOLY ROSARY HOSPITAL | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 943059469 | SUPPORTS SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 9 | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | 0 | |
| BATTLE CREEK HEALTH SYSTEM | |||||||||||
| 300 NORTH AVENUE | BATTLE CREEK | MI | 49016 | 382776791 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | TRINITY HEALTH - MICHIGAN | 0 | |
| BATTLE CREEK HEALTH SYSTEM AUXILIARY | |||||||||||
| 300 NORTH AVENUE | BATTLE CREEK | MI | 49016 | 383355520 | SUPPORT OF TAX EXEMPT HEALTH ORGANIZATION | MI | 501(C)(3) | 11, TYPE I | BATTLE CREEK HEALTH SYSTEM | 0 | |
| BAUM HARMON MERCY HOSPITAL | |||||||||||
| 255 NORTH WELCH AVENUE | PRIMGHAR | IA | 51245 | 421500277 | ACUTE/AMBULATORY HEALTHCARE SERVICES | IA | 501(C)(3) | 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION | |||||||||||
| 255 NORTH WELCH AVENUE | PRIMGHAR | IA | 51245 | 262973307 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 11, TYPE I | BAUM HARMON MERCY HOSPITAL | 0 | |
| CAPITAL PARK FAMILY HEALTH CENTER INC | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311387838 | OPERATION OF A FEDERALLY QUALIFIED HEALTH CENTER (FORMERLY) | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| CATHERINE MCAULEY HEALTH SERVICES CORP | |||||||||||
| PO BOX 995 | ANN ARBOR | MI | 48106 | 382507173 | FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES | MI | 501(C)(3) | 11, TYPE II | TRINITY HEALTH-MICHIGAN | 0 | |
| COMMUNITY HEALTH PARTNERS OF SOUTH BEND | |||||||||||
| PO BOX 3998 | SOUTH BEND | IN | 46619 | 263051440 | HEALTHCARE SERVICES | IN | 501(C)(3) | 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| CRANBROOK HOSPICE CARE | |||||||||||
| 281 ENTERPRISE COURT | BLOOMFIELD HILLS | MI | 48302 | 383320699 | PROVIDE HOSPICE HEALTH SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| DILEY RIDGE MEDICAL CENTER | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 342032340 | HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIO | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| DUBUQUE MERCY HEALTH FOUNDATION INC | |||||||||||
| 250 MERCY DRIVE | DUBUQUE | IA | 52001 | 262227941 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 11, TYPE I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| DYERSVILLE HEALTH FOUNDATION INC | |||||||||||
| 1111 3RD STREET SW | DYERSVILLE | IA | 52040 | 205383271 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 11, TYPE I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| HACKLEY HOSPITAL | |||||||||||
| 1700 CLINTON ST PO BOX 3302 | MUSKEGON | MI | 494433302 | 381358196 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST | |||||||||||
| PO BOX 3302 | MUSKEGON | MI | 494433302 | 382299878 | SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY | MI | 501(C)(3) | 11, TYPE III-FI | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY LIFE COUNSELING | |||||||||||
| 1352 TERRACE ST | MUSKEGON | MI | 494423545 | 381386362 | COUNSELING, EDUCATION, AND SUPPORT | MI | 501(C)(3) | 9 | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY VISITING NURSE SERVICES AND HOSPICE INC | |||||||||||
| 888 TERRACE ST | MUSKEGON | MI | 49440 | 381359598 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 7 | MERCY HEALTH PARTNERS | 0 | |
| HOLY CROSS CARENET INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 48333 | 521945054 | LONG-TERM CARE AND REHABILITATION FOR THE ELDERLY | MD | 501(C)(3) | 9 | TRINITY CONTINUING CARE SERVICES | 0 | |
| HOLY CROSS HOSPITAL FOUNDATION INC | |||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 208428450 | CHARITABLE FUNDRAISING | MD | 501(C)(3) | 11, TYPE I | HOLY CROSS HOSPITAL OF SILVER SPRING INC | 0 | |
| HOLY CROSS HOSPITAL OF SILVER SPRING INC | |||||||||||
| 1500 FOREST GLEN RD | SILVER SPRING | MD | 209101484 | 520738041 | HEALTHCARE SERVICES | MD | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| HOLY CROSS MEDICAL CENTER | |||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 951985442 | HEALTHCARE SERVICES (FORMERLY) | CA | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| HOLY ROSARY MEDICAL CENTER FOUNDATION | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 202683560 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 11, TYPE I | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | 0 | |
| HOSPICE OF NORTH IOWA | |||||||||||
| 232 SECOND STREET SE | MASON CITY | IA | 504016208 | 421173708 | HOSPICE HEALTH CARE SERVICES | IA | 501(C)(3) | 7 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| HOSPICE OF WASHTENAW II | |||||||||||
| 806 AIRPORT BLVD | ANN ARBOR | MI | 48108 | 383320707 | HOSPICE HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| HPCN | |||||||||||
| 1675 LEAHY STREET | MUSKEGON | MI | 49442 | 300207909 | HEALTHCARE SERVICES | MI | 501(C)(3) | 11, TYPE II | MERCY HEALTH PARTNERS | 0 | |
| IHA HEALTH SERVICES CORPORATION | |||||||||||
| 24 FRANK LLOYD WRIGHT DR LOBBY J | ANN ARBOR | MI | 48106 | 383316559 | PROVIDES OFFICE-BASED MEDICAL CARE | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| LAKESHORE COMMUNITY HOSPITAL INC | |||||||||||
| 72 S STATE STREET | SHELBY | MI | 494551228 | 382549295 | ACUTE HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | MERCY HEALTH PARTNERS | 0 | |
| LIFESPAN INC | |||||||||||
| 166 EAST GOODALE AVE | BATTLE CREEK | MI | 490372728 | 383298476 | PROVIDE HOSPICE HEALTH SERVICES | MI | 501(C)(3) | 9 | BATTLE CREEK HEALTH SYSTEM | 0 | |
| MARIAN HOME HEALTHCARE | |||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51101 | 383320705 | PROVIDE HOME HEALTH CARE SERVICES | IA | 501(C)(3) | 11, TYPE I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MCAULEY CLINIC CORPORATION | |||||||||||
| PO BOX 992 | ANN ARBOR | MI | 48106 | 382561013 | HEALTHCARE SERVICES (FORMERLY) | MI | 501(C)(3) | 3 | CATHERINE MCAULEY HEALTH SERVICES CORP | 0 | |
| MERCY AMICARE HOME HEALTHCARE OAKLAND | |||||||||||
| 281 ENTERPRISE COURT | BLOOMFIELD HILLS | MI | 483020312 | 383320698 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY AMICARE HOME HEALTHCARE PORT HURON | |||||||||||
| 505 HURON AVENUE | PORT HURON | MI | 48060 | 383320701 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE | |||||||||||
| 684 HARVEY STREET | MUSKEGON | MI | 49442 | 383321856 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY HEALTH PARTNERS | |||||||||||
| 1415 LEAHY STREET | MUSKEGON | MI | 49442 | 382589966 | HEALTHCARE SYSTEM SUPPORT | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HEALTH SERVICES - IOWA CORP | |||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 311373080 | HEALTHCARE SERVICES | DE | 501(C)(3) | 3 | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HEALTHCARE FOUNDATION | |||||||||||
| 1410 N 4TH ST | CLINTON | IA | 52732 | 421316126 | FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICES | IA | 501(C)(3) | 11, TYPE I | MERCY MEDICAL CENTER-CLINTON | 0 | |
| MERCY HOSP & HEALTH SERVICES OF DETROITMARSHALL PARK HEALTH SERVICES INC | |||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 381562325 | SUPPORTS MALPRACTICE CONTINGENCIES OF CLOSED HOSPITAL | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HOSPITAL CADILLAC FOUNDATION | |||||||||||
| 400 HOBART | CADILLAC | MI | 496012331 | 203357131 | SUPPORT THE SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HOSPITAL GIFT SHOP | |||||||||||
| 2601 ELECTRIC AVE | PORT HURON | MI | 48060 | 381630480 | VOLUNTEER SERVICE AUXILIARY | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY MEDICAL CENTER - CLINTON INC | |||||||||||
| 1410 NORTH 4TH ST | CLINTON | IA | 527322940 | 421336618 | TO PROVIDE QUALITY HEALTH CARE | DE | 501(C)(3) | 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION | |||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51102 | 141880022 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 7 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA | |||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 504012800 | 421229151 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | 11, TYPE III-FI | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MERCY MEDICAL CENTER FOUNDATION INC | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 261737256 | SUPPORT THE SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | 7 | SAINT ALPHONSUS MEDICAL CENTER-NAMPA | 0 | |
| MERCY NORTH HOMECARE AND HOSPICE | |||||||||||
| 7985 MACKINAW TRAIL | CADILLAC | MI | 49601 | 383313897 | HOME HEALTH AND HOSPICE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY PAVILION OF BATTLE CREEK | |||||||||||
| 300 NORTH AVENUE | BATTLE CREEK | MI | 49016 | 382783350 | PROVIDES LONG-TERM CARE FOR THE ELDERLY | MI | 501(C)(3) | 9 | BATTLE CREEK HEALTH SYSTEM | 0 | |
| MERCY PHYSICIAN GROUP INC | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 208192593 | TO PROVIDE QUALITY HEALTH CARE | ID | 501(C)(3) | 9 | SAINT ALPHONSUS MEDICAL CENTER-NAMPA | 0 | |
| MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 382719605 | PROVIDES LONG-TERM CARE FOR THE ELDERLY | MI | 501(C)(3) | 11, TYPE II | TRINITY CONTINUING CARE SERVICES INC | 0 | |
| MIDWEST MEDFLIGHT | |||||||||||
| 1300 VICTORS WAY | ANN ARBOR | MI | 48108 | 382684671 | AEROMEDICAL TRANSPORT | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| MOUNT CARMEL CARE CONTINUUM SERVICES CORP | |||||||||||
| 793 WEST STATE STREET | COLUMBUS | OH | 43222 | 311126211 | COOPERATIVE HOSPITAL SERVICE ORGANIZATION | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL COLLEGE OF NURSING | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311308555 | COLLEGE OF NURSING | OH | 501(C)(3) | 2 | MOUNT CARMEL HEALTH | 0 | |
| MOUNT CARMEL HEALTH | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 314379602 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH INSURANCE COMPANY | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 251912781 | HEALTH INSURANCE | OH | 501(C)(4) | N/A | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH PLAN INC | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311471229 | MEDICARE HMO FOR SENIORS | OH | 501(C)(4) | N/A | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH SYSTEM | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311439334 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | OH | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| MOUNT CARMEL HEALTH SYSTEM FOUNDATION | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311113966 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OH | 501(C)(3) | 11, TYPE I | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HOME CARE LLC | |||||||||||
| 1144 DUBLIN ROAD SUITE B | COLUMBUS | OH | 43215 | 262729300 | PROVIDE HOME HEALTH CARE SERVICES | OH | 501(C)(3) | 9 | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL | |||||||||||
| 7333 SMITHS MILL RD | NEW ALBANY | OH | 43054 | 870790288 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MRI MOBILE SERVICES OF WEST MICHIGAN | |||||||||||
| 1820 - 44TH STREET | KENTWOOD | MI | 49508 | 383073745 | OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY) | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| MUSKEGON COMMUNITY HEALTH PROJECT | |||||||||||
| 565 W WESTERN AVENUE | MUSKEGON | MI | 49440 | 911932918 | FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES | MI | 501(C)(3) | 7 | MERCY HEALTH PARTNERS | 0 | |
| OAKLAND MERCY HOSPITAL | |||||||||||
| 601 EAST 2ND STREET | OAKLAND | NE | 68045 | 208072234 | HEALTHCARE SERVICES | NE | 501(C)(3) | 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| OAKLAND MERCY HOSPITAL FOUNDATION | |||||||||||
| 601 E 2ND STREET | OAKLAND | NE | 68045 | 311678345 | SUPPORTS SERVICES OF RELATED HOSPITAL | NE | 501(C)(3) | 11, TYPE III-FI | OAKLAND MERCY HOSPITAL | 0 | |
| PORT HURON MERCY FAMILY CARE INC | |||||||||||
| 2601 ELECTRIC AVE | PORT HURON | MI | 48060 | 201855647 | HEALTHCARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| PROFESSIONAL MED TEAM | |||||||||||
| 965 FORK STREET | MUSKEGON | MI | 494423257 | 382638284 | MEDICAL CARE, TRANSPORTATION AND EDUCATION | MI | 501(C)(3) | 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| PROFESSIONAL OFFICE CORPORATION | |||||||||||
| 1303 EAST HERNDON AVE | FRESNO | CA | 93720 | 942839324 | HEALTHCARE SERVICES | CA | 501(C)(3) | 11, TYPE I | SAINT AGNES MEDICAL CENTER | 0 | |
| SAINT AGNES MEDICAL CENTER | |||||||||||
| 1303 EAST HERNDON AVE | FRESNO | CA | 93720 | 941437713 | HEALTHCARE SERVICES | CA | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| SAINT ALPHONSUS BUILDING COMPANY INC | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 820401011 | SUPPORTS SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | 11, TYPE I | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT ALPHONSUS DIVERSIFIED CARE INC | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 943028978 | SUPPORTS SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | 11, TYPE I | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT ALPHONSUS HEALTH SYSTEM INC | |||||||||||
| 1055 N CURTIS ROAD | BOISE | ID | 83706 | 271929502 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | ID | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY | |||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 271790052 | TO PROVIDE QUALITY HEALTH CARE | OR | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-NAMPA | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 820200896 | TO PROVIDE QUALITY HEALTH CARE | ID | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 271789847 | TO PROVIDE QUALITY HEALTH CARE | OR | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 820200895 | HEALTHCARE SERVICES | ID | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC | |||||||||||
| 1915 LAKE AVENUE PO BOX 670 | PLYMOUTH | IN | 46563 | 351142669 | HEALTHCARE SERVICES | IN | 501(C)(3) | 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC | |||||||||||
| PO BOX 1935 | SOUTH BEND | IN | 466341935 | 350868157 | HEALTHCARE SERVICES | IN | 501(C)(3) | 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER INC | |||||||||||
| 801 EAST LASALLE AVE | SOUTH BEND | IN | 46617 | 351568821 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IN | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| SAINT JOSEPH'S AUXILIARY OF MARSHALL COUNTY | |||||||||||
| 1915 LAKE AVENUE | PLYMOUTH | IN | 46563 | 356043563 | HOSPITAL SERVICE AUXILIARY | IN | 501(C)(3) | 11, TYPE II | SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC | 0 | |
| SAINT JOSEPH'S TOWER INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 311040468 | PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALS | IN | 501(C)(3) | 9 | TRINITY CONTINUING CARE SERVICES-INDIANA | 0 | |
| SAINT MARY'S AMICARE HOME HEALTHCARE | |||||||||||
| 1430 MONROE NW | GRAND RAPIDS | MI | 49505 | 383320700 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| SAINT MARY'S DORAN FOUNDATION CO SAINT MARY'S HEALTH CARE | |||||||||||
| 200 JEFFERSON ST SE | GRAND RAPIDS | MI | 49503 | 381779602 | SUPPORTS SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | 7 | TRINITY HEALTH-MICHIGAN | 0 | |
| ST JOHN'S HEALTH SYSTEM | |||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 350877584 | HEALTHCARE SERVICES (FORMERLY) | IN | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| ST JOSEPH MERCY OAKLAND FOUNDATION | |||||||||||
| 44405 WOODWARD AVE | PONTIAC | MI | 48341 | 352356789 | SUPPORTS SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH-MICHIGAN | 0 | |
| ST ANN'S HOSPITAL | |||||||||||
| 500 SOUTH CLEVELAND AVE | WESTERVILLE | OH | 43081 | 314412701 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| ST ELIZABETH HEALTH CARE FOUNDATION | |||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 943164869 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 7 | SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY | 0 | |
| ST JOSEPH'S MEDICAL CENTER AUXILIARY | |||||||||||
| 801 E LASALLE AVE PO BOX 1935 | SOUTH BEND | IN | 466341935 | 356033285 | HOSPITAL SERVICE AUXILIARY | IN | 501(C)(4) | N/A | SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC | 0 | |
| THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER | |||||||||||
| 4215 EDISON LAKES PARKWAY | MISHAWAKA | IN | 46545 | 351654543 | SUPPORTS SERVICES OF RELATED HOSPITAL | IN | 501(C)(3) | 11, TYPE I | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| TRINITY CONTINUING CARE SERVICES | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 382559656 | MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY CONTINUING CARE SERVICES - INDIANA INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 930907047 | PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSING | IN | 501(C)(3) | 9 | TRINITY CONTINUING CARE SERVICES | 0 | |
| TRINITY HEALTH - MICHIGAN | |||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 382113393 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HEALTH CORPORATION | |||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 351443425 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IN | 501(C)(3) | 11, TYPE I | 0 | N/A | |
| TRINITY HEALTH INTERNATIONAL | |||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 421253527 | HEALTHCARE TRAINING AND SUPPORT SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HEALTH WELFARE BENEFIT TRUST | |||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 208151733 | RETIREE MEDICAL AND RETIREE LIFE INSURANCE COVERAGE | MI | 501(C)(9) | N/A | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HOME HEALTH SERVICES INC | |||||||||||
| 17410 COLLEGE PARKWAY | LIVONIA | MI | 48152 | 382621935 | HOME HEALTH CARE SYSTEM MANAGEMENT SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (31 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCED IMAGING SERVICES OF BATTLE CREEK | |||||||||||
| 5352 BECKLEY ROAD STE A | BATTLE CREEK | MI | 49015 | 204594297 | RADIOLOGY/IMAGING | MI | N/A | N/A | 0 | 0 | 0.00000 |
| ADVENT REHABILITATION LLC | |||||||||||
| 607 DEWEY AVENUE SUITE 300 | GRAND RAPIDS | MI | 49504 | 383306673 | REHABILITATION THERAPY SERVICES | MI | N/A | N/A | 0 | 0 | 0.00000 |
| BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | |||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311608125 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 | 0.00000 |
| CENTER FOR DIGESTIVE CARE LLC | |||||||||||
| 5300 ELLIOTT DRIVE | YPSILANTI | MI | 48197 | 030447062 | PROVIDE GASTROINTESTINAL SERVICES | MI | N/A | N/A | 0 | 0 | 0.00000 |
| CENTRAL OHIO SLEEP MEDICINE LTD | |||||||||||
| 5955 EAST BROAD ST | COLUMBUS | OH | 43213 | 311701029 | SLEEP MEDICINE SERVICES | OH | N/A | N/A | 0 | 0 | 0.00000 |
| CLINTON IMAGING SERVICES LLC | |||||||||||
| 615 VALLEY VIEW DR STE 202 | MOLINE | IL | 61265 | 412044739 | MRI DIAGNOSTIC SERVICES | IA | N/A | N/A | 0 | 0 | 0.00000 |
| FOREST PARK IMAGING LLC | |||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 134365966 | X-RAY AND MAMMOGRAPHY SERVICES | IA | N/A | N/A | 0 | 0 | 0.00000 |
| FRANCES WARDE MEDICAL LABORATORY | |||||||||||
| 300 WEST TEXTILE ROAD | ANN ARBOR | MI | 48104 | 382648446 | LABORATORY | MI | N/A | N/A | 0 | 0 | 0.00000 |
| FRESNO IMAGING CENTER | |||||||||||
| 1303 E HERNDON AVE | FRESNO | CA | 93720 | 770363563 | DIAGNOSTIC IMAGING | CA | N/A | N/A | 0 | 0 | 0.00000 |
| HAWARDEN COMMUNITY CLINIC LLC | |||||||||||
| 1122 AVENUE L | HAWARDEN | IA | 51023 | 201444339 | MEDICAL CLINIC | IA | N/A | N/A | 0 | 0 | 0.00000 |
| IDAHO GYNONCOLOGY SERVICES LLC | |||||||||||
| 1055 N CURTIS RD | BOISE | ID | 83706 | 202975807 | PROVIDE GYN ONCOLOGY SERVICES | ID | N/A | N/A | 0 | 0 | 0.00000 |
| INTERMOUNTAIN MEDICAL IMAGING LLC | |||||||||||
| 877 WEST MAIN ST STE 603 | BOISE | ID | 83702 | 820514422 | PROVIDE IMAGING SERVICES | ID | N/A | N/A | 0 | 0 | 0.00000 |
| MAGNETIC RESONANCE SERVICES PARTNERSHIP | |||||||||||
| 1416 SIXTH STREET SW | MASON CITY | IA | 50401 | 421328388 | MRI SERVICES | IA | N/A | N/A | 0 | 0 | 0.00000 |
| MASON CITY AMBULATORY SURGERY CENTER LLC | |||||||||||
| 990 4TH STREET SW | MASON CITY | IA | 50401 | 201960348 | SURGERY-SAME DAY | IA | N/A | N/A | 0 | 0 | 0.00000 |
| MCE MOB IV LIMITED PARTNERSHIP | |||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 421544707 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 | 0.00000 |
| MCMC POB III LIMITED PARTNERSHIP | |||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311392994 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 | 0.00000 |
| MEDILUCENT MOB I | |||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 204911370 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 | 0.00000 |
| MERCY HEART CTR OP SERVICES LLC | |||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 134237594 | CARDIOVASCULAR SERVICES | IA | N/A | N/A | 0 | 0 | 0.00000 |
| MERCY OUTPATIENT SURGERY CENTER LLC | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 841380439 | OUTPATIENT SURGERY | ID | N/A | N/A | 0 | 0 | 0.00000 |
| MICHIANA HEALTH INFORMATION NETWORK LLC | |||||||||||
| 215 WEST MADISON STREET | SOUTH BEND | IN | 46601 | 352050128 | COMMUNITY BASED CLINICAL INFORMATION SYSTEM AND DATA DEPOSITORY | IN | N/A | N/A | 0 | 0 | 0.00000 |
| MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP | |||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311369473 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 | 0.00000 |
| NEWCO AMBULATORY SURGERY CTR LLP | |||||||||||
| 4190 24TH AVENUE | FORT GRATIOT | MI | 48059 | 300136708 | OUTPATIENT SURGERY CENTER | MI | N/A | N/A | 0 | 0 | 0.00000 |
| RIVERVIEW MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | |||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311531135 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 | 0.00000 |
| ROSENBERG & BRUNO PROPERTIES LLC (FKA BSV MEDICAL OFFICE BUILDING II LLC) | |||||||||||
| 855 M STREET TENTH FLOOR | FRESNO | CA | 93721 | 202673839 | MEDICAL OFFICE BUILDING RENTAL | CA | N/A | N/A | 0 | 0 | 0.00000 |
| SARMED OUTPATIENT PHARMACY LLC | |||||||||||
| 999 N CURTIS RD STE 102 | BOISE | ID | 83706 | 510483218 | PHARMACY | ID | N/A | N/A | 0 | 0 | 0.00000 |
| SIXTY FOURTH STREET LLC | |||||||||||
| 2373 64TH ST STE 2200 | BYRON CENTER | MI | 49315 | 202443646 | PROVIDE OUTPATIENT SURGICAL CARE | MI | N/A | N/A | 0 | 0 | 0.00000 |
| ST ALPHONSUS CALDWELL CANCER CTR LLC | |||||||||||
| 3123 MEDICAL DR | CALDWELL | ID | 83605 | 820526861 | RADIATION ONCOLOGY | ID | N/A | N/A | 0 | 0 | 0.00000 |
| ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP | |||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311603660 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 | 0.00000 |
| TAMARACK MEDICAL CLINIC LLC | |||||||||||
| 610 VILLAGE DRIVE | DONNELLY | ID | 83615 | 201637921 | OUTPATIENT MEDICAL SERVICES | ID | N/A | N/A | 0 | 0 | 0.00000 |
| WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | |||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311784409 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 | 0.00000 |
| WOODLAND IMAGING CENTER LLC | |||||||||||
| 5301 E HURON RIVER DR | ANN ARBOR | MI | 48106 | 760820959 | RADIOLOGY/IMAGING | MI | N/A | N/A | 0 | 0 | 0.00000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (32 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH VENTURES INC | ||||||||||||
| 565 W WESTERN AVE | MUSKEGON | MI | 49440 | 383522260 | SOFTWARE MARKETING | MI | N/A | C | ||||
| HACKLEY HEALTH MANAGEMENT CENTER | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382961814 | WEIGHT MANAGEMENT | MI | N/A | C | ||||
| HACKLEY HEALTH VENTURES INC | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382589959 | OTHER MEDICAL SERVICES | MI | N/A | C | ||||
| HACKLEY HEALTHCARE EQUIPMENT | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382578569 | HOME MEDICAL EQUIPMENT | MI | N/A | C | ||||
| HACKLEY PROFESSIONAL CENTER | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383024797 | REAL ESTATE RENTAL | MI | N/A | C | ||||
| HACKLEY PROFESSIONAL PHARMACY | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382447870 | PHARMACY | MI | N/A | C | ||||
| HEF INC | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383086401 | OFFICE STAFFING | MI | N/A | C | ||||
| HOLY CROSS PRIVATE HOME SERVICES CORP | ||||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 521986562 | HOME CARE SERVICES | MD | N/A | C | ||||
| HPC CO-OWNERS ASSOCIATION | ||||||||||||
| 1700 CLINTON | MUSKEGON | MI | 49442 | 270734448 | CONDOMINIUM ASSOCIATION | MI | N/A | C | ||||
| HURON ARBOR CORPORATION | ||||||||||||
| 5301 EAST HURON RIVER DR PO BOX 992 | ANN ARBOR | MI | 48106 | 382475644 | PROVIDES OFFICE RENTAL SPACE | MI | N/A | C | ||||
| INTEGRATED HEALTH ASSOCIATES INC | ||||||||||||
| 24 FRANK LLOYD WRIGHT DR LOBBY J | ANN ARBOR | MI | 48106 | 383126920 | MEDICAL MANAGEMENT | MI | N/A | C | ||||
| IHA AFFILIATION CORPORATION | ||||||||||||
| 24 FRANK LLOYD WRIGHT DR LOBBY J | ANN ARBOR | MI | 48106 | 383188895 | MEDICAL MANAGEMENT | MI | N/A | C | ||||
| IHA HEALTH SERVICES CORPORATION | ||||||||||||
| 24 FRANK LLOYD WRIGHT DR LOBBY J | ANN ARBOR | MI | 48106 | 383316559 | MEDICAL SERVICES | MI | N/A | C | ||||
| MARYLAND CARE GROUP INC | ||||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 521815313 | HEALTHCARE HOLDING | MD | N/A | C | ||||
| MEDNOW INC | ||||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 820389927 | OUTPATIENT PHARMACY | ID | N/A | C | ||||
| MERCY COMMUNITY PHYSICIANS | ||||||||||||
| 363 FREMONT STREET | BATTLE CREEK | MI | 49017 | 264252468 | HEALTHCARE SERVICES | MI | N/A | C | ||||
| MERCY MEDICAL SERVICES | ||||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51101 | 421283849 | PRIMARY CARE PHYSICIANS | IA | N/A | C | ||||
| MICHIGAN PHYSICIAN SERVICES | ||||||||||||
| 44405 WOODWARD AVENUE H-5 | PONTIAC | MI | 48341 | 383293125 | PHYSICIAN SERVICES | MI | N/A | C | ||||
| MICHIGAN ATHLETIC CLUB | ||||||||||||
| 2500 BURTON | GRAND RAPIDS | MI | 49546 | 382647304 | ATHLETIC CLUB | MI | N/A | C | ||||
| MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES INC | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 310971510 | BEHAVIORAL HEALTHCARE SERVICES | OH | N/A | C | ||||
| MOUNT CARMEL HEALTH HORIZONS CORP | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311177652 | MEDICAL SERVICES/RENT | OH | N/A | C | ||||
| MOUNT CARMEL HEALTH PROVIDERS INC | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311382442 | MEDICAL SERVICES | OH | N/A | C | ||||
| NORTH IOWA MERCY MEDICAL SERVICES INC | ||||||||||||
| 1000 4TH ST SW | MASON CITY | IA | 50401 | 421382308 | MEDICAL SERVICES | IA | N/A | C | ||||
| PRIMARY CARE NETWORK OF OHIO INC | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311422486 | HEALTH MANAGEMENT SERVICES | OH | N/A | C | ||||
| PRIORITY PLUS OF CALIFORNIA | ||||||||||||
| PO BOX 27230 | FRESNO | CA | 93729 | 770395267 | FORMERLY HEALTH MANAGEMENT NOW DISCONTINUED SUBSTANTIALLY ALL OPERATIONS | CA | N/A | C | ||||
| SAINT ALPHONSUS PHYSICIANS PA | ||||||||||||
| 1055 NORTH CURTIS ROAD | BOISE | ID | 837061370 | 331078261 | PHYSICIANS | ID | N/A | C | ||||
| SAINT MARY'S HEALTH MANAGEMENT COMPANY | ||||||||||||
| 1640 EAST PARIS SE | GRAND RAPIDS | MI | 49546 | 383450733 | ATHLETIC CLUB | MI | N/A | C | ||||
| SURGERY CENTER FINANCING CORPORATION | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311531102 | FINANCE, INSURANCE AND REAL ESTATE | OH | N/A | C | ||||
| TRINITY HEALTH EMPLOYEE BENEFIT TRUST | ||||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 383410377 | GRANTOR TRUST | MI | N/A | T | ||||
| VENZKE INSURANCE COMPANY LTD | ||||||||||||
| 980453602 | PROVISION OF INSURANCE COVERAGE | N/A | C | PO BOX 1051 GRAND CAYMAN | GRAND CAYMAN | CJ | CJ | |||||
| WESTSHORE HEALTH NETWORK | ||||||||||||
| 1820 44TH STREET | KENTWOOD | MI | 49508 | 383280200 | PHYSICIAN HOSPITAL ORGANIZATION | MI | N/A | C | ||||
| WORKPLACE HEALTH OF GRAND HAVEN | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383112035 | OCCUPATIONAL HEALTH | MI | N/A | C | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MERCY HEALTH PARTNERS | ||
| J | 67939 | PER BOOKS |
| MERCY HEALTH PARTNERS | ||
| L | 1639215 | PER BOOKS |
| MERCY HEALTH PARTNERS | ||
| O | 981498 | PER BOOKS |
| TRINITY HEALTH CORPORATION | ||
| L | 156954 | PER BOOKS |
| TRINITY HEALTH - MICHIGAN | ||
| L | 70220 | PER BOOKS |
| TRINITY HEALTH - MICHIGAN | ||
| O | 296389 | PER BOOKS |
| HACKLEY HOSPITAL | ||
| K | 68781 | PER BOOKS |
| HACKLEY HOSPITAL | ||
| L | 249008 | PER BOOKS |
| HACKLEY HOSPITAL | ||
| Q | 66845 | PER BOOKS |