2012-05-11T13:51:05-05:00 2011-06-30 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2010-07-01 382934134 MONROE COMMUNITY HEALTH SERVICES MONR 7342404520 718 N MACOMB STREET MONROE MI 48162 THOMAS W SCHILLING 7342404520 2012-05-09 1 2483522500 2010 2016-02-24 21:20:13Z THOMAS W SCHILLING 718 N MACOMB STREET MONROE MI 48162 12128571 0 X WWW.MERCYMEMORIAL.ORG X 1989 MI PROMOTE THE GENERAL HEALTH OF THE PUBLIC IN MONROE COUNTY, MICHIGAN AND SURROUNDING AREAS. 19 13 197 14 0 0 1664 189 10714466 9296773 -175348 32718 103713 -22063 10644495 9307617 0 0 0 0 4869017 4443800 0 0 0 5291971 4270334 10160988 8714134 483507 593483 14353284 5731986 8280091 2898991 6073193 2832995 X PROMOTE THE GENERAL HEALTH OF THE PUBLIC IN MONROE COUNTY, MICHIGAN AND SURROUNDING AREAS. 0 1 6062821 0 7221839 OPERATED A 70-BED SKILLED NURSING FACILITY, DBA MERCY MEMORIAL NURSING CENTER. THIS FACILITY PROVIDED 22,813 RESIDENT DAYS OF CARE IN 2011 AS FOLLOWS:- MEDICAID 10,888- PRIVATE PAY 3,873- MEDICARE 8,052THIS REPRESENTS AN AVERAGE CENSUS OF 62.8 RESIDENT UNITS PER DAY. 1375215 0 2074934 OPERATED AN OUTPATIENT (AMBULATORY) SURGERY CENTER FOR LESS INTENSE, PRIMARILY ENDOSCOPY AND OPHTHALMOLOGY, SURGICAL CASES. THE SURGERY CENTER HAD 2,887 SURGICAL CASES IN FISCAL YEAR 2011. 7438036 1 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 18 0 1 197 1 0 0 0 0 0 0 0 0 0 0 X 19 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X THOMAS W SCHILLING 7342404520 718 N MACOMB STREET MONROE MI 48162 BELLINO KAREN M VUICH 1.00 X 0 0 0 BHURGRI MD AAMER 1.00 X 0 47407 0 BRAUNLICH PAUL E 1.00 X 0 0 0 CALENDER KENYON S 1.00 X 0 0 0 CARTER KURT W 1.00 X 0 0 0 CHARBONEAU DO MICHAEL 1.00 X 0 0 0 DARROW KURT L 1.00 X 0 0 0 FRANZEN VICKI L 1.00 X 0 0 0 KABIR MD ABDUL 1.00 X 0 22596 0 MCNAMEE MD KENNETH J 1.00 X 0 2052 0 PETERS RUTH ANN 1.00 X 0 0 0 PHILLIPS ANNETTE S 4.00 X X 0 448314 14126 ROBBINS BASIL D 1.00 X X 0 0 0 RYAN SISTER JANET 1.00 X X 0 0 0 SABO CPA DEBORAH A 1.00 X X 0 0 0 SPENCER EDD DONALD A 1.00 X X 0 0 0 WALSH ARLENE R 1.00 X 0 0 0 WILBURN WALTER 1.00 X 0 0 0 WORRELL MARK G 1.00 X 0 0 0 HECK GERALD 1.00 X 0 0 0 MILLER JAMES 1.00 X 0 0 0 AMIN JATIN 1.00 X 0 0 0 JAVAID MUHAMMAD 1.00 X 0 0 0 SCHILLING THOMAS W 4.00 X 0 347872 23946 JAN MARTIN 40.00 X 106764 0 4402 106764 868241 42474 1 0 1 0 CONCEPT REHAB INC 7150 GRANITE CIRCLE SUITE 200 TOLEDO OH 43617 PATIENT THERAPY 716863 REHABCARE GROUP INC 7733 FORSYTH BLVD ST LOUIS MO 63105 PATIENT THERAPY 115967 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICES 104127 3 189 189 SKILLED NURSING - MMNC 623000 7221839 7221839 SURGERY CENTER - OPSC 621990 2074934 2074934 9296773 53478 53478 6301 28364 -22063 -22063 -22063 2771830 2792590 -20760 -20760 -20760 9307617 9296773 0 10655 3353470 3010388 343082 875 785 90 834332 748974 85358 255123 229022 26101 72204 1031 71173 7725 7725 126 126 4204 4204 1296334 1188871 107463 24 24 313948 196927 117021 5945 575 5370 215353 202783 12570 8612 1547 7065 2812 172 2640 97002 97002 362757 338995 23762 166322 166322 MEDICAL SUPPLIES 897605 897605 BAD DEBT EXPENSE 299502 299502 QUALITY ASSURANCE ASSES 296002 0 296002 DIETARY 223857 223857 8714134 7438036 1276098 0 2486127 2996612 234443 6454324 1054182 158687 99831 19803 9174189 7522085 2328413 1652104 2580486 10973 9285 14353284 5731986 6368537 1123252 1911554 1775739 8280091 2898991 X 6072557 2832207 636 788 6073193 2832995 14353284 5731986 X 593483 -3833681 X X 0 1 1 X 0 X 3104 1812 2001 1664 189 8770 10096669 10629556 9875332 10714465 9296773 50612795 10099773 10631368 9877333 10716129 9296962 50621565 0 32085 26311 45342 15346 119084 32085 26311 45342 15346 119084 50502481 328950 403763 355462 198647 59779 1346601 328950 403763 355462 198647 59779 1346601 10428723 11035131 10232795 10914776 9356741 51968166 0.97180 0.96790 0.02590 0.02940 X 0 0 0 0 0 0 0 0 1 126 126 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: A PERCENTAGE OF DUES PAID TO VARIOUS ORGANIZATIONS IS ALLOCATED BY THOSE ORGANIZATIONS AS LOBBYING COSTS. 636 152 788 542 94 636 464 78 542 1.00000 0.00000 0.00000 0 1 1 279283 279283 5956374 5034103 922271 29780 28144 1636 2716745 2459838 256907 192007 192007 1652104 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS FOR RESIDENT ACTIVITIES. 0 0 0 0 0 0 0 0 0 PHILLIPS ANNETTE S 0 301074 0 139979 0 7261 0 7350 0 6776 0 462440 0 0 SCHILLING THOMAS W 0 247094 0 92500 0 8278 0 7350 0 16596 0 371818 0 0 SUPPLEMENTAL INFORMATION PART III THE CHIEF EXECUTIVE OFFICERS COMPENSATION WAS ESTABLISHED BY A RELATED ORGANIZATION USING THE FOLLOWING RESOURCES: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PROPERTY, PLANT & EQUIPMENT 2010-12-31 815195 BOOK VALUE 381984289 MERCY MEMORIAL HOSPITAL 718 N MACOMB ST MONROE MI 48162 501(C)(3) NET ACCOUNTS RECEIVABLE 2010-12-31 79175 BOOK VALUE 381984289 MERCY MEMORIAL HOSPITAL 718 N MACOMB ST MONROE MI 48162 501(C)(3) INVESTMENTS 2010-12-31 2814525 INVESTMENT REPORT 381984289 MERCY MEMORIAL HOSPITAL 718 N MACOMB ST MONROE MI 48162 501(C)(3) INVENTORY/PREPAID/ACCRUED EXPENSES 2010-12-31 134808 BOOK VALUE 381984289 MERCY MEMORIAL HOSPITAL 718 N MACOMB ST MONROE MI 48162 501(C)(3) 1 1 0 0 PART II, LINE 2E: - KAREN M. VUICH BELLINO- AAMER BHURGRI, M.D.- PAUL E. BRAUNLICH- KENYON S. CALENDER- KURT W. CARTER- MICHAEL CHARBONEAU, D.O.- KURT L. DARROW- VICKI L. FRANZEN- ABDUL KABIR, M.D.- KENNETH J. MCNAMEE, M.D.- RUTH ANN PETERS- ANNETTE S. PHILLIPS- BASIL D. ROBBINS- SISTER JANET RYAN- DEBORAH A. SABO, C.P.A.- DONALD A. SPENCER, ED.D.- ARLENE R. WALSH- WALTER WILBURN- MARK G. WORRELL- JATIN AMIN- MUHAMMAD JAVAID- THOMAS W. SCHILLING PART II, LINE 2E: LINE 2A - THE DIRECTORS OF THIS ORGANIZATION ARE ALSO DIRECTORS OF THE TRANSFEREE ORGANIZATION. LINE 2B - THE OFFICERS OF THIS ORGANIZATION ARE ALSO EMPLOYEES OF THE TRANSFEREE ORGANIZATION. CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 IN JANUARY 2011, THE AMBULATORY SURGERY CENTER'S NET ASSETS AND EQUITY WERE TRANSFERRED FROM MONROE COMMUNITY HEALTH SERVICES TO RELATED PARTY MERCY MEMORIAL HOSPITAL CORPORATION. FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBER DR. KENNETH MCNAMEE AND BOARD MEMBER DR. JAMES MILLER HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MONROE COMMUNITY HEALTH SERVICES HAS MEMBERS. MERCY MEMORIAL HOSPITAL CORPORATION IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE POWERS AND VOTING RIGHTS TO: [A] APPOINT, ELECT, AND REMOVE TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE POWERS AND VOTING RIGHTS TO: [B] APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION; [C] ADOPT, AMEND, OR REPEAL THE BYLAWS; [D] APPROVE EACH BUDGET AND LONG-RANGE PLAN; [E] APPROVE CONTRACT OR LOAN OBLIGATING THE CORPORATION TO EXPEND/REPAY AN AMOUNT IN EXCESS OF $50,000 WHICH WAS NOT INCLUDED IN PREVIOUSLY APPROVED BUDGETS; [F] APPROVE CONTRACTS OUTSIDE THE ORDINARY COURSE OF THE BUSINESS OF THE CORPORATION; [G] APPROVE ALL PLANS OF MERGER OR CONSOLIDATION; [H] APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION; AND [I] APPROVE A VOLUNTARY DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 INPUT DATA IS REVIEWED AND ANALYZED BY THE CONTROLLER AND THEN SUBMITTED TO THE CERTIFIED PUBLIC ACCOUNTING FIRM FOR PREPARATION. THE COMPLETED FORM 990 IS THEN RETURNED TO THE CFO AND THE CEO FOR FINAL REVIEW AND APPROVAL BEFORE THE BOARD MEETING. BEFORE THE RETURN IS FILED, THE FORM 990 IS REVIEW BY THE BOARD. ALL MEMBERS RECEIVE A COPY OF THE FORM 990, EVEN THOSE THAT ARE UNABLE TO ATTEND THE SCHEDULED MEETING. THE REVIEW IS PERFORMED DURING ONE OF THE MONTHLY BOARD MEETINGS, WHERE EACH MEMBER HAS A CHANGE TO ASK QUESTIONS. THIS REVIEW IS DOCUMENTED VIA MINUTES TO THE MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS, OFFICERS AND EMPLOYEES OF THE ORGANIZATION. ON AN ANNUAL BASIS, THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS DISTRIBUTED TO OFFICERS, EMPLOYEES, AND TRUSTEES OF MONROE COMMUNITY HEALTH SERVICES. POTENTIAL CONFLICTS OF INTEREST ARE ANALYZED BY THE HOSPITAL'S LEGAL DEPARTMENT AND ARE GIVEN RANKINGS OF LOW, MODERATE, AND SEVERE RISK. THIS ANALYSIS IS GIVEN TO THE BOARD CHAIR AND THE HOSPITAL'S CHIEF EXECUTIVE OFFICER. ANY MEMBER WITH AN IDENTIFIED CONFLICT OF INTEREST IS EXCUSED FROM THE MEETING DURING DISCUSSIONS PERTAINING TO THE ISSUE OF CONFLICT, AND THE MEMBER IS NOT PERMITTED TO VOTE ON ANY ISSUE OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 OFFICERS ARE COMPENSATED BY MERCY MEMORIAL HOSPITAL CORPORATION, A RELATED ORGANIZATION. THE EXECUTIVE COMPENSATION COMMITTEE OF THE HOSPITAL'S BOARD OF TRUSTEES DETERMINES AND APPROVES ALL COMPENSATION FOR THOSE DESIGNATED IN SENIOR LEADERSHIP POSITIONS, SUCH AS THE CHIEF EXECUTIVE OFFICER & PRESIDENT AND THE CHIEF FINANCIAL OFFICER & SENIOR VICE PRESIDENT OF FINANCE. THE INDEPENDENT BOARD COMMITTEE RETAINS AN OUTSIDE CONSULTANT TO ANALYZE AND ASSIST IN MAKING THESE DETERMINATIONS THROUGH A VARIETY OF MARKET SURVEYS/STUDIES. THIS PROCESS IS UNDERTAKEN ANNUALLY AND WAS LAST PERFORMED IN 2011. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 9,834. SURGERY CENTER EQUITY TRANSFER -3,843,704. DONATIONS BOOKED TO EQUITY 189. TOTAL TO FORM 990, PART XI, LINE 5: -3,833,681. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR. FORM 990, PART IV, LINE 24 & SCHEDULE K: TAX EXEMPT BONDS: MONROE COMMUNITY HEALTH SERVICES IS A MEMBER OF THE MERCY MEMORIAL HOSPITAL CORPORATION OBLIGATED GROUP OF WHICH MONROE COMMUNITY HEALTH SERVICES HAS BEEN ALLOCATED FUNDS FROM A 2006 BOND ISSUANCE. DUE TO THIS, ALL INFORMATION RELATING TO THE 2006 BOND ISSUANCE HAS BEEN REPORTED ON THE MERCY MEMORIAL HOSPITAL CORPORATION 2010 FORM 990 AND IS NOT INCLUDED ON THIS RETURN. FORM 990, PART VII, SECTION A: THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO, RELATED ORGANIZATION, MERCY MEMORIAL HOSPITAL CORPORATION, FOR WHICH COMPENSATION IS REPORTED IN COLUMNS E & F: ANNETTE S. PHILLIPS 40 HOURS THOMAS W. SCHILLING 40 HOURS AAMER BHURGRI, M.D. 4 HOURS ABDUL KABIR, M.D. 4 HOURS MERCY MEMORIAL HOSPITAL CORPORATION 718 N MACOMB STREET MONROE MI 48162 381984289 HOSPITAL MI 501(C)(3) LINE 3 N/A 0 MONROE HEALTH VENTURES 718 N MACOMB STREET MONROE MI 48164 382704426 PHARMACY MI MERCY MEMORIAL HOSPITAL CORPORATION C 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 MERCY MEMORIAL HOSPITAL CORPORATION L 122733 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION K 150021 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION O 4163923 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION R 3628899 ACTUAL ALLOCATED COST MERCY MEMORIAL HOSPITAL CORPORATION Q 3843704 COST ON BOOKS