ASPIRUS IRON RIVER HOSPITAL & CLINICS INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ASPIRUS IRON RIVER HOSPITAL & CLINICS INC (EIN 38-3236977)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-09-11
- IRS object ID
- 201222559349300637
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-09-11T16:11:36-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390758449 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1 |
| City | GREEN BAY | City |
| State | WI | State |
| ZIP Code | 543072237 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383236977 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHSTAR HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 9062656121 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W ICE LAKE RD | AddressLine1 |
| City | IRON RIVER | City |
| State | MI | State |
| ZIP Code | 49935 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GLENN DOBSON | Name |
| Title | CFO | Title |
| Phone | 9062656121 | Phone |
| Date Signed | 2012-08-24 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TERRI REXRODE CPA MST | Name |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | Phone |
| Date Prepared | 2012-08-24 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GLENN DOBSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W ICE LAKE RD | AddressLine1 |
| City | IRON RIVER | City |
| State | MI | State |
| ZIP Code | 49935 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 37812000 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.NORTHSTARHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | OUR ORGANIZATION CONTINUES TO STRIVE TO MEET THE EVOLVING NEEDS OF OUR SERVICE AREA WITH THE CONTINUATION AND EXPANSION OF SERVICES TO A LARGER DEMOGRAPHIC AREA. WE PROVIDE AMBULANCE SERVICE ALONG WITH CONTINUING TO BRING IN ADDITIONAL PHYSICIANS AND SERVICES INCLUDING EXPANSION OF ORTHOPAEDICS IN 2010. OUR FOCUS IN 2011 HAS BEEN TO IDENTIFY THE NEEDS OF THE AREA AND INCREASE MARKET SHARE BY OFFERING THE SERVICES IDENTIFIED THROUGH SURVEYS TO BE NEEDED AND IN DEMAND BY THE POPULATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 332 | TotalNbrEmployees |
| Total Nbr Volunteers | 25 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 85125 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 101218 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 33543939 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 36919006 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 190800 | InvestmentIncomePriorYear |
| Investment Income Current Year | 117172 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 33819864 | TotalRevenuePriorYear |
| Total Revenue Current Year | 37137396 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1925 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 18363547 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 18927138 | 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 | 17864069 | OtherExpensePriorYear |
| Other Expenses Current Year | 18981270 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 36227616 | TotalExpensesPriorYear |
| Total Expenses Current Year | 37910333 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -2407752 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -772937 | RevenuesLessExpensesCY |
| Total Assets BOY | 35976625 | TotalAssetsBOY |
| Total Assets EOY | 34633921 | TotalAssetsEOY |
| Total Liabilities BOY | 26981293 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 26540480 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8995332 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8093441 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | NORTHSTAR HEALTH SYSTEM IS A COMMUNITY-OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR THE PHYSICAL AND EMOTIONAL HEALTH OF PEOPLE LIVING IN SOUTH CENTRAL UPPER PENINSULA OF MICHIGAN AND NORTHERN WISCONSIN. DIRECTION, AND IN GENERAL PARTNERSHIP WITH COMMUNITIES, EMPLOYERS, SCHOOLS, AND GOVERNMENT OFFICIALS, AS WELL AS SELECT PARTNERSHIPS WITH OTHER HEALTH CARE PROVIDERS, WE GUIDE INDIVIDUALS AND FAMILIES IN THEIR LIFELONG JOURNEY TOWARD OPTIMAL HEALTH. WE ARE COMMITTED TO PROVIDING HIGH QUALITY, RELIABLE, COST-EFFECTIVE, TOTAL HEALTH SOLUTIONS WITH RESPECT AND COMPASSION. OUR INNOVATIVE EFFORTS WILL POSITIVELY IMPACT HEALTH CARE DELIVERY IN OUR SERVICE AREA. NORTHSTAR HEALTH SYSTEM'S VISIONS IS THAT THE PEOPLE WE SERVE WILL BE AMONG THE HEALTHIEST IN THE NATION. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 33097368 | Expense |
| Revenue | 36824555 | Revenue |
| Description | NORTHSTAR HEALTH SYSTEM PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL, AND PHYSICIAN CLINIC SERVICES TO THE RESIDENTS OF IRON COUNTY, MICHIGAN AND SURROUNDING AREAS. THE ORGANIZATION IS DESIGNATED BY MEDICARE AS A CRITICAL ACCESS HOSPITAL. IT OPERATES SEVERAL CLINICS ALONG WITH THE HOSPITAL TO PROVIDE HEALTHCARE SERVICES ON A NON-PROFIT BASIS TO THE GENERAL PUBLIC. THE ORGANIZATION RECORDED APPROXIMATELY 3,360 INPATIENT DAYS; 63,500 OUTPATIENT VISITS; 400 SWING BED DAYS; AND 7,000 HOME HEALTH VISITS IN 2011. THE ORGANIZATION ALSO PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THIS POLICY FOR 2011 WAS APPROXIMATELY $172,000. | Description |
| Total Program Service Expense | 33097368 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 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 | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 1 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 80 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 332 | 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLENN DOBSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9062656121 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W ICE LAKE ROAD | AddressLine1 |
| City | IRON RIVER | City |
| State | MI | State |
| ZIP Code | 499359594 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| MARK TOUSIGNANT | |||||||
| CHAIRMAN | 1.00 | X | X | 4798 | 0 | 0 | |
| RICK KENT | |||||||
| BOARD MEMBER | 1.00 | X | 2838 | 0 | 0 | ||
| DIANNE ROSTAGNO | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RANDY JACOBS | |||||||
| BOARD MEMBER | 1.00 | X | 1200 | 0 | 0 | ||
| SANDRA BATTYE | |||||||
| SECRETARY | 1.00 | X | X | 3600 | 0 | 0 | |
| JIM GIBULA | |||||||
| VICE CHAIR/TREASURER | 1.00 | X | X | 3623 | 0 | 0 | |
| MARGARET SMITH | |||||||
| BOARD MEMBER | 1.00 | X | 600 | 0 | 0 | ||
| BRUCE RAMPAGE | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | X | X | 263636 | 0 | 26472 | |
| DANNY YARGER MD | |||||||
| EX-OFFICIO MEMBER | 40.00 | X | 273373 | 0 | 27419 | ||
| WILLIAM MAYER | |||||||
| BOARD MEMBER | 1.00 | X | 600 | 0 | 0 | ||
| GLENN DOBSON | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | X | 124971 | 0 | 25148 | ||
| CONNIE KOUTOUZOS | |||||||
| CHIEF OPERATING OFFICER | 40.00 | X | 130237 | 0 | 2606 | ||
| MARITES ANSAY MD | |||||||
| PHYSICIAN | 40.00 | 185354 | 0 | 14591 | X | ||
| KIM MAHLER MD | |||||||
| PHYSICIAN | 40.00 | 274480 | 0 | 28006 | X | ||
| HAROLD CLINE MD | |||||||
| PHYSICIAN | 40.00 | 604453 | 0 | 31534 | X | ||
| NASEEM RIZKALLA MD | |||||||
| PHYSICIAN | 40.00 | 307656 | 0 | 31331 | X | ||
| ALAN CAUDILL MD | |||||||
| PHYSICIAN | 40.00 | 289266 | 0 | 24918 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2470685 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 212025 | TotalOtherCompensation |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MARQUETTE GENERAL HEALTH SYSTEMS | |||||
| 580 W COLLEGE AVE | MARQUETTE | MI | 49855 | EMERGENCY ROOM DOCTORS | 1801775 |
| DR CUBE | |||||
| PO BOX 335 | IRON RIVER | MI | 49935 | RADIOLOGIST | 585250 |
| ARAMARK UNIFORM COMPANY | |||||
| 5330 INDUSTRIAL BLVD SUITE 616 | FRIDLEY | MN | 55412 | LAUNDRY SERVICES | 443314 |
| ANESTHESIA ASSOCIATES | |||||
| 788 PENTOGA TRAIL | CRYSTAL FALLS | MI | 49920 | ANESTHESIA | 273550 |
| UP HEALTH CARE NETWORK | |||||
| 228 W WASHINGTON AVE | MARQUETTE | MI | 49855 | COMPUTER SERVICES | 239994 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| All Other Contributions | 101218 | AllOtherContributions |
| Total Contributions | 101218 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| NET PATIENT SERVICE RE | 900099 | 36824555 | 36824555 | |
| CAFETERIA MEALS | 900099 | 94451 | $94,451 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 36919006 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 134678 | TotalRevenueColumn |
| Exclusion | $134,678 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 635998 | Securities |
| Other | 21100 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 636963 | Securities |
| Other | 37641 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -965 | Securities |
| Other | -16541 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -17506 | TotalRevenueColumn |
| Exclusion | -$17,506 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37137396 | TotalRevenueColumn |
| Related Or Exempt Function Income | 36824555 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $211,623 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1925 | Total |
| Program Services | 1925 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2665451 | Total |
| Program Services | 2092381 | ProgramServices |
| Management And General | 573070 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12006463 | Total |
| Program Services | 10733996 | ProgramServices |
| Management And General | 1272467 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 544252 | Total |
| Program Services | 483964 | ProgramServices |
| Management And General | 60288 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2766652 | Total |
| Program Services | 2444741 | ProgramServices |
| Management And General | 321911 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 944320 | Total |
| Program Services | 831366 | ProgramServices |
| Management And General | 112954 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17838 | Total |
| Management And General | 17838 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 199686 | Total |
| Management And General | 199686 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117099 | Total |
| Management And General | 117099 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3952546 | Total |
| Program Services | 3217184 | ProgramServices |
| Management And General | 735362 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114652 | Total |
| Management And General | 114652 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1050046 | Total |
| Program Services | 859816 | ProgramServices |
| Management And General | 190230 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46800 | Total |
| Management And General | 46800 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 632286 | Total |
| Program Services | 462968 | ProgramServices |
| Management And General | 169318 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 188772 | Total |
| Program Services | 164964 | ProgramServices |
| Management And General | 23808 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1480860 | Total |
| Program Services | 1084306 | ProgramServices |
| Management And General | 396554 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1760819 | Total |
| Program Services | 1760819 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186619 | Total |
| Program Services | 44242 | ProgramServices |
| Management And General | 142377 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 4793388 | 4793388 | |
| REPAIRS AND MAINTENANCE | 2256562 | 2087091 | 169471 |
| PROVISION FOR BAD DEBTS | 1947886 | 1947886 | |
| DUES & SUBSCRIPTION | 150006 | 86331 | 63675 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85405 | Total |
| Management And General | 85405 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37910333 | Total |
| Program Services | 33097368 | ProgramServices |
| Management And General | 4812965 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 902388 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122292 | BOY |
| EOY | 692222 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5768804 | BOY |
| EOY | 5402962 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39180 | BOY |
| EOY | 39188 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 457968 | BOY |
| EOY | 424616 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 228209 | BOY |
| EOY | 210853 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 39936293 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 18555033 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22782984 | BOY |
| EOY | 21381260 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5321478 | BOY |
| EOY | 5166776 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1255710 | BOY |
| EOY | 413656 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35976625 | BOY |
| EOY | 34633921 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3982685 | BOY |
| EOY | 4413068 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22551080 | BOY |
| EOY | 21992486 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 161697 | BOY |
| EOY | 134926 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 285831 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26981293 | BOY |
| EOY | 26540480 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8995332 | BOY |
| EOY | 8093441 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8995332 | BOY |
| EOY | 8093441 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35976625 | BOY |
| EOY | 34633921 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -772937 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -128954 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 235876 | OtherCostOrOtherBasis |
| Book Value | 235876 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26131135 | OtherCostOrOtherBasis |
| Depreciation | 7054108 | Depreciation |
| Book Value | 19077027 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 222569 | OtherCostOrOtherBasis |
| Depreciation | 212426 | Depreciation |
| Book Value | 10143 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12769324 | OtherCostOrOtherBasis |
| Depreciation | 10933452 | Depreciation |
| Book Value | 1835872 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 577389 | OtherCostOrOtherBasis |
| Depreciation | 355047 | Depreciation |
| Book Value | 222342 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 21381260 | TotalOfBookValueLandBuildings |
| Total Revenue | 37137396 | TotalRevenue |
| Total Expenses | 37910333 | TotalExpenses |
| Excess Or Deficit For Year | -772937 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -324302 | NetUnrealizedGLOnInvestments |
| Other | $195,348 | OtherAmount |
| Total Adjustments | -128954 | TotalAdjustments |
| Excess Or Deficit Per FS | -901891 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 35187585 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 35187585 | RevenueSubtotal |
| Other Revenues Not Included | 1949811 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 1949811 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 37137396 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 35960522 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 35960522 | ExpensesSubtotal |
| Other Expenses Not Included | 1949811 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1949811 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 37910333 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CORPORATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS IN 2011 OR 2010. FEDERAL INCOME TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2008, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE 256,912. NET ASSET TRANSFER TO FOUNDATION -61,564. TOTAL TO SCHEDULE D, PART XI, LINE 8: 195,348. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS 1,947,886. SCHOOL GRANT EXPENSES 1,925. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS 1,947,886. SCHOOL GRANT EXPENSES 1,925. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 100.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 0 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 97719 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 97719 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2556596 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 900000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1656596 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04610 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2654315 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 900000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1754315 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04880 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37200 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 200 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 37000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 15000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1424919 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1351800 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 73119 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10100 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10100 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1487219 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1352000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 135219 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00370 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4141534 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2252000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1889534 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05250 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,106,657 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 13959926 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 15315869 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1355943 | 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 | NORTHSTAR HEALTH SYSTEM | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W ICE LAKE ROAD | AddressLine1 |
| City | IRON RIVER | City |
| State | MI | State |
| ZIP Code | 49935 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHSTAR HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 100.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 7 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (7 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| NORTHSTAR HOME CARE AND HOSPICE | ||||
| 927 RIVERSIDE AVENUE | IRON RIVER | MI | 49935 | HOME HEALTH AGENCY |
| NORTHSTAR HEALTH SYSTEM - ERSD | ||||
| 1328 US HWY 2 | CRYSTAL FALLS | MI | 49920 | DIALYSIS/FAMILY PRACTICE |
| GENESEE CLINIC | ||||
| 229 W GENESEE ST | IRON RIVER | MI | 49935 | ORTHOPEDICS/REHAB |
| NORTHSTAR ICE LAKE | ||||
| 1300 WEST ICE LAKE | IRON RIVER | MI | 49935 | FAMILY PRACTICE |
| NORTHSTAR RIVERSIDE PLAZA | ||||
| 927 RIVERSIDE AVENUE | IRON RIVER | MI | 49935 | FAMILY PRACTICE |
| MARENISCO CLINIC | ||||
| 236 MAIN STREET | MARENISCO | MI | 49947 | FAMILY PRACTICE |
| NORTHSTAR SURGERY | ||||
| 1500 WEST ICE LAKE RD | IRON RIVER | MI | 49935 | SURGERY |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE COSTING METHODOLOGY USED WAS A COST-TO-CHARGE RATIO. | ||
| PART I, LINE 7G: THE ORGANIZATION DID NOT INCLUDE ANY PHYSICIAN CLINICS IN CALCULATING SUBSIDIZED HEALTH SERVICE COSTS. | ||
| PART I, L7 COL(F): IN CALCULATING THE PERCENTAGES IN PART 1, LINE 7 BAD DEBT EXPENSE OF $1,947,886 WAS EXCLUDED FROM THE DENOMINATOR. | ||
| PART II: COMMUNITY BUILDING ACTIVITIES CONSISTED OF MISCELLANEOUS COMMUNITY SUPPORT. | ||
| PART III, LINE 4: THE COSTING METHODOLOGY USED IN DETERMINING AMOUNTS REPORTED ABOVE IS THE COST TO CHARGE RATIO. | ||
| PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE ALLOWABLE COSTS REPORTED ABOVE IS THE COST TO CHARGE RATIO. | ||
| PART III, LINE 9B: IF THE PATIENT QUALIFIES FOR CHARITY CARE AND A 100% WRITE-OFF IS NOT QUALIFIED FOR, THE PATIENT MUST MAKE MONTHLY PAYMENT ACCORDING TO FACILITY PAYMENT POLICY. IF PATIENT DOES NOT MAKE MONTHLY PAYMENTS AND CANNOT BE REACHED BY TELEPHONE, THE FORMAL COLLECTION PROCESS WOULD BEGIN. | ||
| PART V, SECTION B, LINE 15E: SYSTEM GENERATED LETTERS REMINDING THE PATIENT OF HIS/HER RESPONSIBILITIES IN MAKING PAYMENT ARRANGEMENTS. | NORTHSTAR HEALTH SYSTEM | |
| PART V, SECTION B, LINE 19D: PER OUR POLICY ON HOW CHARGES ARE CALCULATED. APPLICATION FOR CHARITY CARE IS REQUIRED. IF INDIGENT - NO BALANCE IS DUE FROM THE PATIENT. OTHERWISE A SLIDING FEE SCALE IS USED AS DETERMINED UPON 100% OF THE CURRENT POVERTY LEVEL. | NORTHSTAR HEALTH SYSTEM | |
| PART VI, LINE 2: THE ORGANIZATION ASSESSES THE NEEDS OF THE COMMUNITY THROUGH A NEEDS ASSESSMENT SURVEY, THROUGH DOCUMENTATION OF REQUESTS FROM OUTLYING AGENCIES OR COMMUNITY GROUPS, AND FROM EVALUATION OF THE REPEAT DIAGNOSIS OF PATIENTS SERVED WITHIN THE SERVICE AREA. | ||
| PART VI, LINE 3: THE ORGANIZATION HAS A DEPARTMENT DEVOTED TO SELF PAY ACCOUNTS RECEIVABLE WITH THEIR MAIN FOCUS ON MAKING PATIENT CONTACT WITH THOSE PATIENTS THAT EITHER HAVE NO INSURANCE OR ARE UNDER INSURED BASED UPON INFORMATION COLLECTED AT THE TIME OF SERVICE. THIS STAFF IS EDUCATED ON WHAT PROGRAMS ARE AVAILABLE WITHIN THE COMMUNITY AND CAN ASSIST THE PATIENT IN MAKING CONTACT WITH THESE AGENCIES AND CAN ASSIST IN APPLICATION COMPLETION FOR OUTSIDE PROGRAMS. THE CHARITY CARE PROGRAM IS ALSO COMMUNICATED THE SAME WAY. | ||
| PART VI, LINE 4: THE COMMUNITY SERVED IS RELATIVELY OLDER IN AGE WITH A HIGH UTILIZATION OF MEDICARE. THERE IS LITTLE INDUSTRY, NO AIRPORT, AND THE NEAREST TRAUMA CENTER IS 90 MILES AWAY. THE NEXT CLOSEST HOSPITALS ARE 45 TO 55 MILES AWAY. THE GEOGRAPHIC AREA, BY COUNTY, IS VERY LARGE BUT VERY LITTLE POPULATED. THE AREA SUPPORTS SEVERAL RURAL HEALTH CLINICS AND THIS FACILITY SURVIVES BECAUSE OF THE CRITICAL ACCESS HOSPITAL DESIGNATION ONLY. | ||
| PART VI, LINE 5: OUR BOARD IS MADE UP OF VOLUNTEER INDIVIDUALS FROM WITHIN THE DIRECT COMMUNITY. MEDICAL STAFF PRIVILEGES TO ALL PROVIDERS WITHIN THE COMMUNITY AND SURROUDING AREA/COUNTIES AS THE TRAVEL TIME TO OTHER HOSPITALS IS OVER 1 HR TO THE NEAREST. SURPLUS FUNDS HAVE BEEN PUT INTO AN $18 MILLION EXPANSION COMPLETED IN 2009 INCLUDING THE EXPANSION OF ED SERVICES AND IP ROOMS/ETC. | ||
| MI | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRUCE RAMPAGE | |||||||||||||
| 249978 | 0 | 0 | 0 | 13658 | 0 | 8273 | 0 | 18199 | 0 | 290108 | 0 | 0 | 0 |
| DANNY YARGER MD | |||||||||||||
| 238478 | 0 | 0 | 0 | 34895 | 0 | 8939 | 0 | 18480 | 0 | 300792 | 0 | 0 | 0 |
| GLENN DOBSON | |||||||||||||
| 112098 | 0 | 0 | 0 | 12873 | 0 | 4208 | 0 | 20940 | 0 | 150119 | 0 | 0 | 0 |
| MARITES ANSAY MD | |||||||||||||
| 173997 | 0 | 0 | 0 | 11357 | 0 | 6087 | 0 | 8504 | 0 | 199945 | 0 | 0 | 0 |
| KIM MAHLER MD | |||||||||||||
| 241730 | 0 | 0 | 0 | 32750 | 0 | 7906 | 0 | 20100 | 0 | 302486 | 0 | 0 | 0 |
| HAROLD CLINE MD | |||||||||||||
| 584722 | 0 | 0 | 0 | 19731 | 0 | 8734 | 0 | 22800 | 0 | 635987 | 0 | 0 | 0 |
| NASEEM RIZKALLA MD | |||||||||||||
| 280626 | 0 | 0 | 0 | 27030 | 0 | 9341 | 0 | 21990 | 0 | 338987 | 0 | 0 | 0 |
| ALAN CAUDILL MD | |||||||||||||
| 235516 | 0 | 0 | 0 | 53750 | 0 | 8100 | 0 | 16818 | 0 | 314184 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF IRON RIVER HOSPITAL FINANCE AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 383527449 | IssuerEIN |
| CUSIP Number | 463003AA1 | CUSIPNumber |
| Date Issued | 2008-05-15 | DateIssued |
| Issue Price | 22721540 | IssuePrice |
| Description Of Purpose | HOSPITAL FACILITY IMPROVEMENTS | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 265000 | AmountRetired |
| Total Proceeds | 22721540 | TotalProceeds |
| Amount In Reserve Fund | 1713975 | AmountInReserveFund |
| Refunding Escrow | 5667697 | RefundingEscrow |
| Issuance Costs From Proceeds | 422278 | IssuanceCostsFromProceeds |
| Capital Expenditures | 14917591 | CapitalExpenditures |
| Other Spent Proceeds | 15339869 | OtherSpentProceeds |
| Year Of Subst Completion | 2010 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 1 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 1 | MngmentCntrctBondFinancdPrprty |
| Engage Bond Counsel Contracts | 1 | EngageBondCounselContracts |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 1 | ExceptionToRebate |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K SUPPLENTAL INFORMATION | Identifier |
| Explanation | THIS BOND ISSUE WAS COMPRISED OF THREE BONDS THAT WERE ALL ISSED ON 5/15/2008. THE CUSIP NUMBERS INCLUDED IN THIS ONE ISSUANCE WERE ARE FOLLOWS: 463003AA1 463003AL7 463003AT0 | Explanation |
Schedule L IRS990ScheduleL
Loan Table LoanTable (4 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|
| DANNY YARGER MD | ||||||
| SIGN ON BONUS FORGIVEN OVER LIFE OF CONTRACT | X | $12,500 | 6667 | 0 | 1 | 1 |
| KIM MAHLER DO | ||||||
| SIGN ON BONUS FORGIVEN OVER LIFE OF CONTRACT | X | $20,000 | 6688 | 0 | 1 | 1 |
| HAROLD CLINE MD | ||||||
| SIGN ON BONUS FORGIVEN OVER LIFE OF CONTRACT | X | $24,238 | 13333 | 0 | 1 | 1 |
| GREGORY PEYER MD | ||||||
| SIGN ON BONUS FORGIVEN OVER LIFE OF CONTRACT | X | $15,000 | 12500 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 39188 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 IS E-MAILED TO ALL BOARD MEMBERS PRIOR TO MAILING/SUBMITTING THE FORM. MEMBERS OF THE BOARD ARE ALLOWED TO SUBMIT FEEDBACK AND APPROPRIATE REQUESTED CHANGES ARE INCORPORATED, IF WARRANTED, INTO THE FORM 990. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE WRITTEN CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. THIS REQUIREMENT IS STATED IN THE ORGANIZATION'S BYLAWS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S KEY EMPLOYEES AND HIGHEST PAID EMPLOYEES HAVE EMPLOYMENT CONTRACTS THAT GOVERN THEIR COMPENSATION. COMPENSATION LEVELS ARE REVIEWED BY THE APPLICABLE LEVEL OF MANAGEMENT AND/OR THE BOARD OF DIRECTORS. FOR GUIDANCE RELATED TO COMPENSATION LEVELS, MANAGEMENT GATHERS MARKET DATA AND COMPENSATION STUDIES TO ARRIVE AT AMOUNTS THAT ARE COMPETITIVE WITHIN THEIR MARKET AREA. THE COMPENSATION IS APPROVED BY INDIVIDUALS WITHOUT A CONFLICT OF INTEREST AND THEN DOCUMENTED. | |
| FORM 990, PART VI, SECTION C, LINE 19 | A COPY OF THE FILED FORM 990 IS AVAILABLE TO THE PUBLIC THROUGH A REQUEST FROM ANY MEMBER OF THE PUBLIC. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -324,302. CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE 256,912. NET ASSET TRANSFER TO FOUNDATION -61,564. TOTAL TO FORM 990, PART XI, LINE 5: -128,954. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | AUDIT FIRM IS APPROVED BY THE FINANCE COMMITTEE. THE AUDIT FIRM PRESENTS THE AUDIT RESULTS TO THE FINANCE COMMITTEE. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| GREATER IRON COUNTY EMS INC | ||||||||||
| 1400 WEST ICE LAKE ROAD | IRON RIVER | MI | 49935 | 383491283 | EMERGENCY MEDICAL SERVICES | MI | 501(C)3 | 11 | NORTHSTAR HEALTH SYSTEM | 1 |
| NORTHSTAR HEALTH SYSTEM FOUNDATION | ||||||||||
| 1400 WEST ICE LAKE ROAD | IRON RIVER | MI | 49935 | 383762132 | RAISE FUNDS FOR NORTHSTAR HEALTH SYSTEM | MI | 501(C)3 | 11 I | NORTHSTAR HEALTH SYSTEM | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| GREATER IRON COUNTY EMS INC | |
| R | 585000 |
| GREATER IRON COUNTY EMS INC | |
| N | 350000 |
| GREATER IRON COUNTY EMS INC | |
| P | 82000 |