MCLAREN NORTHERN MICHIGAN: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MCLAREN NORTHERN MICHIGAN (EIN 38-2146751)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201243209349306439
- 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 F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-15T14:32:34-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382146751 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 E FRONT ST SUITE 300 | AddressLine1 |
| City | TRAVERSE CITY | City |
| State | MI | State |
| ZIP Code | 49686 | 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 | 382146751 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN MICHIGAN HOSPITALS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 2314874094 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 416 CONNABLE AVENUE | AddressLine1 |
| City | PETOSKEY | City |
| State | MI | State |
| ZIP Code | 49770 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CATHERINE DEVET | Name |
| Title | PRESIDENT & CEO | Title |
| Phone | 2314874094 | Phone |
| Date Signed | 2012-11-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00053797 | PTIN |
| Phone | 2319477800 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | 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 | NORTHERN MICHIGAN REGIONAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CATHERINE DEVET | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 416 CONNABLE AVENUE | AddressLine1 |
| City | PETOSKEY | City |
| State | MI | State |
| ZIP Code | 49770 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 201227864 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.NORTHERNHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1977 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTHCARE AS WE EXPECT FOR OUR OWN FAMILY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1453 | TotalNbrEmployees |
| Total Nbr Volunteers | 279 | TotalNbrVolunteers |
| Total Gross UBI | 152452 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 59665 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 4058815 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4610007 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 179137908 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 180156775 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 759413 | InvestmentIncomePriorYear |
| Investment Income Current Year | 937888 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2383786 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4270991 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 186339922 | TotalRevenuePriorYear |
| Total Revenue Current Year | 189975661 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 692174 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 355652 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 81376953 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 72401719 | 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 | 97284195 | OtherExpensePriorYear |
| Other Expenses Current Year | 105047662 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 179353322 | TotalExpensesPriorYear |
| Total Expenses Current Year | 177805033 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 6986600 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 12170628 | RevenuesLessExpensesCY |
| Total Assets BOY | 115530108 | TotalAssetsBOY |
| Total Assets EOY | 120103584 | TotalAssetsEOY |
| Total Liabilities BOY | 50677661 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 47367081 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 64852447 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 72736503 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | ESTABLISH, MAINTAIN AND OPERATE HOSPITAL TO CARE FOR THE SICK, INJURED AND DISABLED. PREVENTION OF ILLNESS, INJURY AND DISABILITY AND MAINTENANCE OF HEALTH. MORE SPECIFICALLY, NORTHERN MICHIGAN REGIONAL HOSPITAL AND ITS 1,453 EMPLOYEES ARE DEDICATED TO PROVIDING QUALITY HEALTHCARE SERVICES TO THE PEOPLE OF NORTHERN MICHIGAN. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 25386701 | Expense |
| Grants | 0 | Grants |
| Revenue | 40644394 | Revenue |
| Description | THE TREATMENT AND DIAGNOSIS OF CARDIAC DISEASE (DISCHARGES 1,748). | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8826088 | Expense |
| Revenue | 16209281 | Revenue |
| Description | THE TREATMENT AND DIAGNOSIS OF ORTHOPAEDIC CARE (DISCHARGES 891). | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6871098 | Expense |
| Grants | 0 | Grants |
| Revenue | 13872593 | Revenue |
| Description | THE TREATMENT AND DIAGNOSIS OF ONCOLOGY CARE (DISCHARGES 493). | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 91913541 | Expense |
| Grants | 355652 | Grants |
| Revenue | 112774858 | Revenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 91913541 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 355652 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 112774858 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 132997428 | 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 | 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 | 1 | 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 | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 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 | 173 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1453 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| 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 | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | 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 | CATHERINE DEVET | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2314874094 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 416 CONNABLE AVENUE | AddressLine1 |
| City | PETOSKEY | City |
| State | MI | State |
| ZIP Code | 49770 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (25 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 |
|---|---|---|---|---|---|---|---|---|
| CATHERINE DEVET | ||||||||
| TRUSTEE & PRESIDENT/CEO | 22.00 | X | X | 0 | 486688 | 55223 | ||
| DAVID BUZZELLI | ||||||||
| CHAIRPERSON | 2.50 | X | X | 0 | 0 | 0 | ||
| ROBERT FOSTER | ||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | ||
| THOMAS IRWIN | ||||||||
| VICE CHAIRPERSON | 2.50 | X | X | 0 | 0 | 0 | ||
| THOMAS MORAN | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| STEPHEN EIBLING | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| JOSEPH HANCE MD | ||||||||
| TRUSTEE | 1.30 | X | 0 | 0 | 0 | |||
| ELISE HAYES | ||||||||
| TRUSTEE | 1.30 | X | 0 | 0 | 0 | |||
| WILLIAM KANE MD CHIEF OF STAFF | ||||||||
| TRUSTEE | 1.30 | X | 0 | 0 | 0 | |||
| JOHN KOHLER | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| DAVID RYNBRANDT MD | ||||||||
| TRUSTEE | 1.30 | X | 0 | 0 | 0 | |||
| ANN STALLKAMP | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| STEPHEN SCANNELL | ||||||||
| VP OF FINANCE/CFO | 22.00 | X | 0 | 263995 | 45274 | |||
| EUGENE KAMINSKI | ||||||||
| VP OF HUMAN RESOURCES | 22.00 | X | 0 | 186927 | 39211 | |||
| ROBERT DEAN JR | ||||||||
| VP CHIEF MEDICAL OFFICER | 22.00 | X | 0 | 284283 | 26642 | |||
| MARY-ANNE PONTI | ||||||||
| COO | 22.00 | X | 0 | 231732 | 34317 | |||
| CAROLINE SEAGREN | ||||||||
| CHIEF DEV OFF/EXE DIR FOUNDATION | 22.00 | X | 0 | 173405 | 37045 | |||
| HOWARD BECK | ||||||||
| INTERIM VP CMO | 5.50 | X | 0 | 34053 | 0 | |||
| HUGH DEERY | ||||||||
| INTERIM VP CMO | 3.00 | X | 0 | 312462 | 22955 | |||
| MARK GRAY | ||||||||
| CHIEF INFORMATION OFFICER | 2.50 | 0 | 174192 | 14153 | X | |||
| DANIEL DRYDEN | ||||||||
| MEDICAL PHYSICIST | 40.00 | 159056 | 0 | 26945 | X | |||
| KEVIN PENDLETON | ||||||||
| DIRECTOR OF PHARMACY | 40.00 | 141974 | 0 | 12519 | X | |||
| ROLAND BROCKWAY | ||||||||
| DRUG PROCUREMENT COORDINATOR | 40.00 | 138130 | 0 | 17707 | X | |||
| MICHAEL GRIEB | ||||||||
| SR DURGICAL FIRST ASSISTANT | 40.00 | 133797 | 0 | 9408 | X | |||
| LINDA SCHOFIELD | ||||||||
| RESEARCH COORDINATOR | 40.00 | 126444 | 0 | 11446 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 699401 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2147737 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 352845 | TotalOtherCompensation |
| Number Individuals GT100 K | 21 | 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 |
|---|---|---|---|---|---|
| NORTHERN ANESTHESIA PROVIDERS | |||||
| 602 JACKSON | PETOSKEY | MI | 49770 | PHYSICIAN SERVICES | 1494425 |
| MAYO COLLABORATIVE SERVICES | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 554809146 | LABORATORY SERVICES | 739290 |
| NORTHERN PATHOLOGY ASSOCIATES PC | |||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | PHYSICIAN SERVICES | 428480 |
| PETOSKEY SURGEONS PC | |||||
| 521 MONROE | PETOSKEY | MI | 49770 | PHYSICIAN SERVICES | 425719 |
| NORTHERN UNITED MANAGEMENT COMPANY LLC | |||||
| 404 BIRCHWOOD AVENUE | TRAVERSE CITY | MI | 49686 | MANAGEMENT SERVICES | 420417 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 11 | NumberOfContractorsGT100K |
| Related Organizations | 4610007 | RelatedOrganizations |
| Total Contributions | 4610007 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REV | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 180156775 | TotalRevenueColumn |
| Related Or Exempt Function Income | 180156775 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 180156775 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 947480 | TotalRevenueColumn |
| Exclusion | $947,480 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 437230 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 437230 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 437230 | TotalRevenueColumn |
| Related Or Exempt Function Income | 437230 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 11226799 | Securities |
| Other | 15812 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 11210349 | Securities |
| Other | 41854 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 16450 | Securities |
| Other | -26042 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -9592 | TotalRevenueColumn |
| Exclusion | -$9,592 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| OTHER RELATED REVENUE | 900099 | 1913469 | 1913469 | |
| CAFETERIA SALES | 722210 | 774188 | $774,188 | |
| PHARMACEUTICAL RESEARC | 900099 | 510686 | 510686 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 635418 | TotalRevenueColumn |
| Related Or Exempt Function Income | 482966 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 152452 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3833761 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 189975661 | TotalRevenueColumn |
| Related Or Exempt Function Income | 183501126 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 152452 | UnrelatedBusinessRevenue |
| Exclusion | $1,712,076 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 355652 | Total |
| Program Services | 355652 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58944775 | Total |
| Program Services | 50196911 | ProgramServices |
| Management And General | 8747864 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9315310 | Total |
| Program Services | 7476330 | ProgramServices |
| Management And General | 1838980 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4141634 | Total |
| Program Services | 3410736 | ProgramServices |
| Management And General | 730898 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 416667 | Total |
| Management And General | 416667 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3025 | Total |
| Management And General | 3025 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109631 | Total |
| Management And General | 109631 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17100228 | Total |
| Program Services | 13706429 | ProgramServices |
| Management And General | 3393799 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72654 | Total |
| Program Services | 72454 | ProgramServices |
| Management And General | 200 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5904646 | Total |
| Program Services | 2634482 | ProgramServices |
| Management And General | 3270164 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49928 | Total |
| Management And General | 49928 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5484800 | Total |
| Program Services | 3263842 | ProgramServices |
| Management And General | 2220958 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 222830 | Total |
| Program Services | 100293 | ProgramServices |
| Management And General | 122537 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127474 | Total |
| Program Services | 89772 | ProgramServices |
| Management And General | 37702 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1443028 | Total |
| Management And General | 1443028 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6084169 | Total |
| Program Services | 2634143 | ProgramServices |
| Management And General | 3450026 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| INCOME TAXES | 4575 | 4575 | |
| MEDICAL SUPPLIES/DRUGS | 35925927 | 35925927 | |
| HOME OFFICE EXPENSE | 18938076 | 18938076 | |
| PROVISION FOR BAD DEBT | 8388353 | 8388353 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4771651 | Total |
| Program Services | 4737529 | ProgramServices |
| Management And General | 34122 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 177805033 | Total |
| Program Services | 132997428 | ProgramServices |
| Management And General | 44807605 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1923 | BOY |
| EOY | 2046 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25844080 | BOY |
| EOY | 28804386 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11573066 | BOY |
| EOY | 12869874 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 602498 | BOY |
| EOY | 779607 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5557595 | BOY |
| EOY | 6182429 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1685058 | BOY |
| EOY | 1339525 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 175080101 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 119801620 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52010392 | BOY |
| EOY | 55278481 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 985240 | BOY |
| EOY | 11529330 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12197924 | BOY |
| EOY | 458627 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109312 | BOY |
| EOY | 109312 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4963020 | BOY |
| EOY | 2749967 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115530108 | BOY |
| EOY | 120103584 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13885080 | BOY |
| EOY | 10315013 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27204 | BOY |
| EOY | 4207 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33786346 | BOY |
| EOY | 31700960 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2979031 | BOY |
| EOY | 5346901 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50677661 | BOY |
| EOY | 47367081 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61056009 | BOY |
| EOY | 70899195 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3796438 | BOY |
| EOY | 1837308 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64852447 | BOY |
| EOY | 72736503 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115530108 | BOY |
| EOY | 120103584 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 12170628 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -4286572 | 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 | 496200 | OtherCostOrOtherBasis |
| Book Value | 496200 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 94387787 | OtherCostOrOtherBasis |
| Depreciation | 59798542 | Depreciation |
| Book Value | 34589245 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1216121 | OtherCostOrOtherBasis |
| Depreciation | 606220 | Depreciation |
| Book Value | 609901 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 78979993 | OtherCostOrOtherBasis |
| Depreciation | 59396858 | Depreciation |
| Book Value | 19583135 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 55278481 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | COST REPORT SETTLEMENT PAYABLE | Description |
| Amount | $5,346,901 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 5346901 | TotalOfAmounts |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTERAL AMERICA AND THE CARIBBEAN | Region |
| Number Of Offices | 0 | NumberOfOffices |
| Number Of Employees | 0 | NumberOfEmployees |
| Type Of Activities Conducted | INVESTMENT | TypeOfActivitiesConducted |
| Total Expenditures | 120000 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 120000 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 120000 | TotalAmountSpent |
| Transfer To Foreign Corp | 0 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 1 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
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 |
| Pcent200 | X | Pcent200 |
| 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 | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2286591 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2286591 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01350 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9566033 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9003577 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 562456 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1289542 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1289542 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00760 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13142166 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9003577 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4138589 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02440 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 239 | NumberOfActivitiesOrPrograms |
| Persons Served | 16410 | PersonsServed |
| Total Community Benefit Expense | 494823 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 494823 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 3 | PersonsServed |
| Total Community Benefit Expense | 73930 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 73930 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12936466 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9129064 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3807402 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02250 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 408760 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 408760 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 246 | NumberOfActivitiesOrPrograms |
| Persons Served | 1521 | PersonsServed |
| Total Community Benefit Expense | 60560 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 60560 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 488 | NumberOfActivitiesOrPrograms |
| Persons Served | 17934 | PersonsServed |
| Total Community Benefit Expense | 13974539 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9129064 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4845475 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02860 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 488 | NumberOfActivitiesOrPrograms |
| Persons Served | 17934 | PersonsServed |
| Total Community Benefit Expense | 27116705 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18132641 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8984064 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05300 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 1253 | PersonsServed |
| Total Community Building Expense | 27548 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 27548 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 233 | PersonsServed |
| Total Community Building Expense | 1055 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1055 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 680 | PersonsServed |
| Total Community Building Expense | 7137 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7137 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 52 | PersonsServed |
| Total Community Building Expense | 5392 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5392 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 22 | PersonsServed |
| Total Community Building Expense | 3035 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3035 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 27 | NumberOfActivitiesOrPrograms |
| Persons Served | 2240 | PersonsServed |
| Total Community Building Expense | 44167 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 44167 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $7,996,468 | BadDebtExpenseAmount |
| Amount Attributable To | 1404893 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 30237722 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 40818604 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -10580882 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | 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 | NORTHERN MICHIGAN HOSPITALS | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 416 CONNABLE AVENUE | AddressLine1 |
| City | PETOSKEY | City |
| State | MI | State |
| ZIP Code | 49770 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Research Facility | X | ResearchFacility |
| 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 | NORTHERN MICHIGAN HOSPITALS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Medicare Rate | X | MedicareRate |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: WE UTILIZE A STEP DOWN COSTING METHODOLOGY. FIRST DIRECT EXPENSES ARE REDUCED BY ANY NON PATIENT REVENUES RECEIVED. THEN INDIRECT DEPARTMENTS (THOSE WITHOUT PATIENT CHARGES) ARE ALLOCATED TO DIRECT DEPARTMENTS USING DEPARTMENT SPECIFIC STATISTICS. THE STEP DOWN PROCESS INCLUDES NINE ITERATIONS. WHEN THE COSTING PROCESS IS COMPLETE, COSTS ARE ASSIGNED TO EACH UNIQUE PATIENT. THIS ALLOWS US TO DETERMINE THE ACTUAL COST OF PROVIDING SERVICES TO EACH UNIQUE PATIENT. | ||
| PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE ACUTE REHAB, PSYCHIATRY, NEWBORNS, OB, WOMEN'S SERVICES, ACUTE INPATIENT, OUTPATIENT FIXED AND HEMODIALYSIS. | ||
| PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24D - BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE SCHEDULE H, PART I, COLUMN F PERCENTAGE EQUALS $8,388,353. | ||
| PART II: COMMUNITY BUILDING ACTIVITIES SUPPORT IDENTIFIED COMMUNITY NEEDS AND COMMUNITY COLLABORATIVES SUCH AS POVERTY REDUCTION, TRANSPORTATION, WORKFORCE DEVELOPMENT AND COMMUNITY HEALTH, BY PROVIDING IN-KIND SERVICES, FINANCIAL RESOURCES AND STAFF EXPERTISE FROM THE HOSPITAL. | ||
| PART III, LINE 4: ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE:ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKEY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.TO DETERMINE THE ESTIMATED AMOUNT OF THE ORGANIZATIONS'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY, ADMINISTRATION ESTIMATED A PERCENTAGE OF INDIVIDUALS WHO DID NOT COMPLETE THE CHARITY CARE APPLICATION PROCESS, OR DID NOT TAKE THE TIME TO APPLY - WHICH AMOUNTS TO $1,404,893.THE BAD DEBT EXPENSE OF $7,996,468 INCLUDES TOTAL BAD DEBT EXPENSE FROM FORM 990, PART IX, LINE 25 OF $8,388,353 LESS NON-PATIENT RELATED BAD DEBTS OF $391,885. | ||
| PART III, LINE 8: TO DETERMINE THE COST OF MEDICARE SHORTFALLS, WE ISOLATED ALL PATIENT ACCOUNTS WHERE MEDICARE WAS THE PRIMARY PAYOR, AND OFFSET THE COST OF SERVICES PROVIDED BY ANY PAYMENT RECEIVED, FROM EITHER THE PATIENT, PRIMARY, SECONDARY, OR TERTIARY PAYORS. WE THEN ROLLED THOSE ACCOUNTS UP BY SUB SERVICE LINE FOR BOTH IN- AND OUT-PATIENT ACCOUNTS, AND REPORTED THE NET SHORTFALL OF SERVICES PROVIDED AT A LOSS. ONE HUNDRED PERCENT OF THAT SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. | ||
| PART III, LINE 9B: THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY DOES NOT CONTAIN PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE BECAUSE IF POSSIBLE WE TRY TO IDENTIFY AND DETERMINE ELIGIBILITY FOR CHARITY CARE BEFORE SERVICES ARE PROVIDED. ALSO, IT IS STATED IN OUR CHARITY CARE POLICY THAT ONCE ELIGIBLE, NO COLLECTION AGENCIES OR OTHER COLLECTION PROCESSES WILL BE FOLLOWED UNLESS THE PATIENT'S FINANCIAL CIRCUMSTANCES MATERIALLY CHANGE. | ||
| PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USES THE MEDICARE RATES FOR SERVICES WHEN REQUESTED BY THE PATIENT. ALSO, THE FACILITY USES 50% ON UNINSURED CLAIMS FOR 2011. | NORTHERN MICHIGAN HOSPITALS | |
| PART V, SECTION B, LINE 21: FOR PATIENTS THAT HAVE NOT RESPONDED TO CHARITY CARE APPLICATIONS OR STATEMENTS RECEIVED GROSS CHARGES ARE LEFT ON THEIR ACCOUNT. ONCE THEY ARE ELIGIBLE UNDER OUR FAP, WE WOULD ADJUST THEIR ACCOUNT ACCORDING TO OUR POLICIES. | NORTHERN MICHIGAN HOSPITALS | |
| PART VI, LINE 2: NORTHERN MICHIGAN REGIONAL HOSPITAL ASSESSES THE NEEDS AND ASSETS OF THE COMMUNITY BY COLLABORATING WITH COMMUNITY AND STRATEGIC PARTNERS, REVIEWING DEMOGRAHICS, HEALTH INDICATORS, MORBIDITY AND MORTALITY DATA, ANALYZING COST DRIVERS, AND CONDUCTING FOCUS GROUPS, SURVEYS, AND COMMUNITY FORUMS. | ||
| PART VI, LINE 3: AS PATIENTS ARE REGISTERED EITHER IN PERSON OR OVER THE PHONE THEY ARE GIVEN CONTACT INFORMATION FOR PATIENT FINANCIAL SERVICES REPRESENTATIVES IF THEY HAVE NO INSURANCE, ARE UNDER INSURED OR HAVE HIGH CO-PAY'S. THERE ARE PATIENT FINANCIAL SERVICES BROCHURES DISPLAYED AT ALL REGISTRATION AREAS THAT DESCRIBE THE VARIOUS FINANCIAL ASSISTANCE PROGRAMS AVAILABLE. THROUGH OUR CARE COORDINATION PROGRAM ALL PATIENTS WITH NO INSURANCE ARE SEEN TO ASSIST WITH FINANCIAL ASSISTANCE PROGRAMS. | ||
| PART VI, LINE 4: NORTHERN MICHIGAN REGIONAL HOSPITAL IS A 202-BED REGIONAL REFERRAL CENTER SERVING A 22-COUNTY REGION SPANNING NORTHERN MICHIGAN AND THE EASTERN PART OF THE UPPER PENINSULA. WITH A TOTAL MARKET POPULATION OF OVER 440,000, US CENSUS BUREAU DATA (2006) ESTIMATES THAT NEARLY 30% ARE AGE 45-64, AND NEARLY 20% ARE OVER AGE 65. ACCORDING TO THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH, TOP ADULT HEALTH CONCERNS INCLUDE: OVERWEIGHT AND OBESE, HIGH CHOLESTEROL, HIGH BLOOD PRESSURE, SMOKING, DIABETES AND UNINSURED. PREDICATED ON A VISION TO PROVIDE PATIENT-CENTERED CARE, EXTENSIVE EFFORTS IN TARGETING REGIONAL HEALTH CONCERNS HAS LED TO COLLABORATIVE PROGRAMS AND SERVICES IN PRIMARY CARE, HEART, CANCER AND DIAGNOSTICS. THIS APPROACH TO HIGH QUALITY, COST EFFECTIVE HEALTHCARE DELIVERY IN THIS RURAL AND REMOTE AREA HAS BEEN STRENGTHENED BY A LONG STANDING PRACTICE OF SPECIALTY PHYSICIANS HOSTING ON-SITE CLINIC VISITS TO OUTLYING COMMUNITIES. NORTHERN MICHIGAN REGIONAL HOSPITAL IS WORKING TO INFLUENCE BEHAVIOR THROUGH EDUCATION, PREVENTION THROUGH SCREENING, AND PROVIDING ACCESSIBLE TREATMENT THROUGH PHYSICIAN CLINIS AND HEALTH CENTERS THROUGHOUT THE REGION. | ||
| PART VI, LINE 5: THE HOSPITAL HAS AN ESTABLISHED REGIONAL COMMUNITY ADVISORY BOARD WHICH MEETS TO ACTIVELY ADDRESS HEALTHCARE ISSUES IN THE REGION. THE HOSPITAL PROVIDES COMMUNITY BENEFIT ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT AND HEALTH EDUCATION PROGRAMS AND SERVICES TO IMPROVE ACCESS TO HEALTHCARE, PROMOTE HEALTH AND WELLNESS, AND MANAGE CHRONIC DISEASE. | ||
| PART VI, LINE 6: AFFILIATES OF NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM INCLUDE THE FOLLOWING ORGANIZATIONS, EACH OF WHICH CONTRIBUTE TO HEALTH PROMOTION IN THE MANNER INDICATED: * NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM FOUNDATION - RAISES, MANAGES, AND DISPENSES FUNDS TO SUPPORT THE MISSION OF NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM AND PROVIDE PROGRAMS THAT ENHANCE THE WELL-BEING OF THE COMMUNITY. * COMMUNITY FREE CLINIC - PROVIDES MEDICAL TREATMENT TO THE AREA'S UNINSURED. * BOULDER PARK TERRACE - PROVIDES SKILLED NURSING AND SUB-ACUTE REHABILITATION SERVICES. * VITAL CARE - PROVIDES HOME HEALTH SERVICES, HOME MEDICAL EQUIPMENT ADN SUPPLIES, HOSPICE SERVICES, PRIVATE DUTY SERVICES, AND ADULT DAY SERVICES. * PHYSICIAN PRACTICES - OFFER THE OPPORTUNITY FOR SEAMLESS PATIENT CARE WITHIN THE REGION THROUGH A SYSTEM OF WHOLLY-OWNED SPECIALTY MEDICINE PRACTICES: MICHIGAN HEART & VASCULAR SPECIALISTS, NORTHERN MICHIGAN INFECTIOUS DISEASES, NORTHERN MICHIGAN HEMATOLOGY/ONCOLOGY, ROGERS CITY MEDICAL GROUP (PRIMARY CARE), AND NORTHERN MICHIGAN REGIONAL HOSPITAL NEUROSURGERY SERVICES. * PRESCRIPTION SERVICES PHARMACY - OFFERS RETAIL PHARMACY SERVICES. | ||
| MI | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|---|
| NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM FOUNDATION | |||||||||
| 360 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 382445611 | 501 (C) (3) | 60684 | N/A | N/A | RENT |
| PETOSKEY COMMUNITY FREE CLINIC | |||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 202675817 | 501 (C) (3) | 224110 | N/A | N/A | GENERAL OPERATIONS |
| ALCONA HEALTH CENTER | |||||||||
| PO BOX 655 | ALPENA | MI | 49707 | 382170985 | 501 (C) (3) | 70317 | N/A | N/A | GENERAL OPERATIONS HEALTH CLINIC |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE I, PART I, LINE 2 | Identifier |
| Explanation | GRANTS MADE TO RELATED ORGANIZATIONS ARE MONITORED THROUGH THE MONTHLY ACCOUNTING PROCESSES. GRANTS MADE TO ALCONA HEALTH CENTER, A FQHC, ARE BASED ON A PERCENT OF THEIR OPERATING LOSSES AS PRESENTED ON THEIR FINANCIAL STATEMENTS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | 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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CATHERINE DEVET | |||||||||||||
| 0 | 327018 | 0 | 90050 | 0 | 69620 | 0 | 48852 | 0 | 6371 | 0 | 541911 | 0 | 0 |
| STEPHEN SCANNELL | |||||||||||||
| 0 | 241305 | 0 | 5000 | 0 | 17690 | 0 | 24663 | 0 | 20611 | 0 | 309269 | 0 | 0 |
| EUGENE KAMINSKI | |||||||||||||
| 0 | 167489 | 0 | 100 | 0 | 19338 | 0 | 25213 | 0 | 13998 | 0 | 226138 | 0 | 0 |
| ROBERT DEAN JR | |||||||||||||
| 0 | 266832 | 0 | 0 | 0 | 17451 | 0 | 9745 | 0 | 16897 | 0 | 310925 | 0 | 0 |
| MARY-ANNE PONTI | |||||||||||||
| 0 | 214236 | 0 | 0 | 0 | 17496 | 0 | 27233 | 0 | 7084 | 0 | 266049 | 0 | 0 |
| CAROLINE SEAGREN | |||||||||||||
| 0 | 155337 | 0 | 50 | 0 | 18018 | 0 | 15636 | 0 | 21409 | 0 | 210450 | 0 | 0 |
| HUGH DEERY | |||||||||||||
| 0 | 272602 | 0 | 36050 | 0 | 3810 | 0 | 9800 | 0 | 13155 | 0 | 335417 | 0 | 0 |
| MARK GRAY | |||||||||||||
| 0 | 171354 | 0 | 0 | 0 | 2838 | 0 | 6954 | 0 | 7199 | 0 | 188345 | 0 | 0 |
| DANIEL DRYDEN | |||||||||||||
| 158602 | 0 | 0 | 0 | 454 | 0 | 6148 | 0 | 20797 | 0 | 186001 | 0 | 0 | 0 |
| KEVIN PENDLETON | |||||||||||||
| 140782 | 0 | 0 | 0 | 1192 | 0 | 5713 | 0 | 6806 | 0 | 154493 | 0 | 0 | 0 |
| ROLAND BROCKWAY | |||||||||||||
| 132628 | 0 | 4506 | 0 | 996 | 0 | 4939 | 0 | 12768 | 0 | 155837 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 3 | THE CEO/EXECUTIVE DIRECTOR IS COMPENSATED BY NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM, A RELATED ORGANIZATION. THEY UTILIZE AN INDEPENDENT COMPENSATION CONSULTANT AND BOARD APPROVAL TO ESTABLISH COMPENSATION. |
| PART I, LINE 4B | SIX INDIVIDUALS PARTICIPATE IN A NONQUALIFIED 457(F) RETIREMENT PLAN, OF WHICH INCLUDE CATHERINE DEVET, EUGENE KAMINSKI, STEPHEN SCANNELL, ROBERT DEAN, JR., MARY-ANNE PONTI, AND CAROLINE SEAGREN. CATHERINE DEVET RECEIVED A PAYMENT OF $50,918 FROM THE NONQUALIFIED 457(F) RETIREMENT PLAN IN 2011. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETOSKEY HOSPITAL FINANCE AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 382834360 | IssuerEIN |
| CUSIP Number | NONEAVAIL | CUSIPNumber |
| Date Issued | 2003-10-15 | DateIssued |
| Issue Price | 10000000 | IssuePrice |
| Description Of Purpose | ER/HEART CTR ADDITION | 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) |
|---|---|---|
| Total Proceeds | 10000000 | TotalProceeds |
| Issuance Costs From Proceeds | 110249 | IssuanceCostsFromProceeds |
| Capital Expenditures | 9889751 | CapitalExpenditures |
| Year Of Subst Completion | 2004 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | 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 | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| 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 | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM IS THE SOLE MEMBER OF NORTHERN MICHIGAN REGIONAL HOSPITAL. | |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE MEMBER OF NORTHERN MICHIGAN REGIONAL HEALTH, NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM SHALL HOLD AN ANNUAL MEETING IN JANUARY OF EACH YEAR AT SUCH TIME AND PLACE AS MAY BE DESIGNATED BY THE BOARD OF TRUSTEES FOR THE PURPOSE OF ELECTING MEMBERS TO THE BOARD OF TRUSTEES AND TRANSACTING SUCH OTHER BUSINESS AS MAY COME BEFORE THE MEETING. | |
| FORM 990, PART VI, SECTION B, LINE 11 | ONCE THE FORM 990 HAS BEEN PREPARED, IT IS REVIEWED BY THE FINANCE MANAGER, THE CFO, AND THE CEO. THE COMPLETED FORM 990 IS THEN PROVIDED TO THE BOARD OF TRUSTEES BEFORE IT IS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF TRUSTEES, MEDICAL STAFF, OFFICERS AND KEY EMPLOYEES REVIEW AND SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. IF ANY SPECIFIC CONFLICTS OF INTEREST ARISE DURING A BOARD MEETING, THE TRUSTEE WILL LEAVE THE ROOM OR REFRAIN FROM VOTING. COLLEAGUES ARE REMINDED AT THEIR ANNUAL EVALUATION TO ABIDE BY THE CODE OF CONDUCT, WHICH INCLUDES A STATEMENT ON CONFLICT OF INTEREST. | |
| FORM 990, PART VI, SECTION B, LINE 15 | TO DETERMINE EXECUTIVE COMPENSATION FOR THE CEO, VICE PRESIDENTS, AND OFFICERS OF THE CORPORATION, NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM USES AN INDEPENDENT CONSULTANT TO CONDUCT SALARY SURVEYS OF THE HEALTH CARE MARKET. RECOMMENDATIONS ARE REVIEWED AT THE BOARD LEVEL AND APPROVED BEFORE IMPLEMENTATION. THIS WAS LAST REVIEWED JANUARY-APRIL OF 2011. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR THE FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. | |
| FORM 990 PART VII SECTION A: | THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO, RELATED ORGANIZATIONS, NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM, NORTHERN MICHIGAN MEDICAL MANAGEMENT, NORTHERN MICHIGAN HEMATOLOGY AND ONCOLOGY, CARDIAC INSTITUTE MICHIGAN HEART AND VASCULAR SPECIALISTS, PETOSKEY COMMUNITY FREE CLINIC, NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM FOUNDATION, HOSPICE OF LITTLE TRAVERSE BAY, CHARLEVOIX NURSING HOME CORPORATION, HEALTHSHARE REAL ESTATE, AND VITALCARE INC. CATHERINE DEVET: 35.0 HOURS STEPHEN SCANNELL: 35.0 HOURS EUGENE KAMINSKI: 31.5 HOURS ROBERT DEAN,JR: 27.5 HOURS MARY-ANNE PONTI: 35.0 HOURS CAROLINE SEAGREN: 44.8 HOURS HOWARD BECK: 27.5 HOURS HUGH DEERY: 51.5 HOURS MARK GRAY: 35.0 HOURS DAVID BUZZELLI: 2.5 HOURS ROBERT FOSTER: 2.0 HOURS THOMAS IRWIN: 2.5 HOURS THOMAS MORAN: 2.0 HOURS STEPHEN EILBING: 4.5 HOURS JOSEPH HANCE: 1.3 HOURS ELISE HAYES: 4.3 HOURS WILLIAM KANE: 1.3 HOURS JOHN KOHLER: 2.0 HOURS DAVID RYNBRANDT: 1.3 HOURS ANN STALLKAMP: 1.3 HOURS | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -927,442. DECREASE IN TEMPORARILY RESTRICTED NET ASSETS -1,959,130. TRANSFER TO AFFILIATE -1,400,000. TOTAL TO FORM 990, PART XI, LINE 5: -4,286,572. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | THE FINANCE COMMITTEE OF THE HEALTH SYSTEM ASSUMES RESPONSIBILITY FOR REVIEW OF FINANCIAL STATEMENTS AND OVERSIGHT OF THE CONSOLIDATED AUDIT. THIS PROCESS HAS NOT CHANGED FORM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTHERN MICHIGAN MEDICAL MANAGEMENT | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 208458840 | PHYSICIAN PRACTICE | MI | 501(C)(3) | LINE 3 | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | |
| THE CARDIAC INSTITUTE DBA MICHIGAN HEART & VASCULAR SPECIALISTS | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 262774689 | PHYSICIAN PRACTICE | MI | 501(C)(3) | LINE 3 | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | |
| HOSPICE OF LITTLE TRAVERSE BAY | |||||||||||
| 1 HILAND DRIVE | PETOSKEY | MI | 49770 | 382425019 | HOSPICE CARE | MI | 501(C)(3) | LINE 7 | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | |
| PETOSKEY COMMUNITY FREE CLINIC | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 203675817 | HEALTH SERVICES | MI | 501(C)(3) | LINE 3 | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | |
| NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 382445613 | HEALTH SERVICES | MI | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| CHARLEVOIX NURSING HOME CORPORATION DBA BOULDER PARK TERRACE | |||||||||||
| 14676 WEST UPRIGHT | CHARLEVOIX | MI | 49720 | 383038683 | SKILLED NURSING FACILITY | MI | 501(C)(3) | LINE 9 | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | |
| HEALTHSHARE REAL ESTATE | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 382492223 | REAL ESTATE HOLDINGS | MI | 501(C)(2) | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | ||
| NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM FOUNDATION | |||||||||||
| 360 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 382445611 | FUNDRAISING | MI | 501(C)(3) | LINE 11A, I | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | |
| VITALCARE INC | |||||||||||
| 761 LAFAYETTE AVENUE | CHEBOYGAN | MI | 49721 | 382527255 | HOSPICE CARE/HOME HEALTH SERVICES | MI | 501(C)(3) | LINE 9 | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | |
| NORTHERN MICHIGAN HEMATOLOGY AND ONCOLOGY | |||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 320020293 | PHYSICIAN PRACTICE | MI | 501(C)(3) | LINE 3 | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | 1 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VITALCARE HOME MEDICAL EQUIPMENT INC | |||||||||||||||
| 761 LAFAYETTE AVENUE | CHEBOYGAN | MI | 49721 | 382662954 | SALE AND RENTAL OF DURABLE MEDICAL EQUIPMENT | MI | VITALCARE INC | C | |||||||
| PETOSKEY ASSURANCE LTD | |||||||||||||||
| 980628316 | PROFESSIONAL AND GENERAL LIABILITY COVERAGE | NORTHERN MICHIGAN HOSPITALS | C | 68 WEST BAY ROADPO BOX 1109 | GRAND CAYMAN | CJ | KY1-1102 | CJ | 5150078 | 1.00000 | |||||
| RAPIN & RAPIN INC DBA PRESCRIPTION SERVICES PHARMACY | |||||||||||||||
| 416 CONNABLE AVENUE | PETOSKEY | MI | 49770 | 383465261 | RETAIL PHARMACY | MI | NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | C | |||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | 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 (13 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| PETOSKEY COMMUNITY FREE CLINIC | ||
| B | 224110 | COST |
| NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM FOUNDATION | ||
| B | 60684 | COST |
| NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM FOUNDATION | ||
| C | 4610007 | COST |
| NORTHERN MICHIGAN HEMATOLOGY AND ONCOLOGY | ||
| O | 363295 | COST |
| NORTHERN MICHIGAN MEDICAL MANAGEMENT | ||
| O | 2980326 | COST |
| PETOSKEY COMMUNITY FREE CLINIC | ||
| P | 100145 | COST |
| NORTHERN MICHIGAN HEMATOLOGY AND ONCOLOGY | ||
| P | 1168740 | COST |
| NORTHERN MICHIGAN MEDICAL MANAGEMENT | ||
| P | 370894 | COST |
| THE CARDIAC INSTITUTE | ||
| P | 1774243 | COST |
| RAPIN & RAPIN INC | ||
| P | 54006 | COST |
| NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM | ||
| Q | 1400000 | COST |
| NORTHERN MICHIGAN REGIOANL HEALTH SYSTEM | ||
| O | 74006037 | COST |
| CHARLEVOIX NURSING HOME CORPORATION | ||
| P | 213217 | COST |