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HACKLEY HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
HACKLEY HOSPITAL (EIN 38-1358196)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-04
IRS object ID
201131249349300028
Schema version
2009v1.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-04T14:15:46-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN381358196EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HACKLEY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHACKNameControl
Phone2317284952Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11700 CLINTON STREET PO BOX 3302AddressLine1
CityMUSKEGONCity
StateMIState
ZIP Code494433302ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY ALLOREName
TitleCFOTitle
Phone2317284952Phone
Date Signed2011-05-04DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1HACKLEY CORNERSTONE FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonGARY ALLORENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11700 CLINTON STREET PO BOX 3302AddressLine1
CityMUSKEGONCity
StateMIState
ZIP Code494433302ZIPCode
FieldValueIRS element (for citing)
Gross Receipts154048317GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.MERCY-HEALTHPARTNERS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1932YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTHCARE SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees1498TotalNbrEmployees
Total Nbr Volunteers243TotalNbrVolunteers
Total Gross UBI2038605TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year350093ContributionsGrantsPriorYear
Contributions Grants Current Year398201ContributionsGrantsCurrentYear
Program Service Revenue Prior Year150329055ProgramServiceRevenuePriorYear
Program Service Revenue CY149865988ProgramServiceRevenueCY
Investment Income Prior Year-1479958InvestmentIncomePriorYear
Investment Income Current Year-119649InvestmentIncomeCurrentYear
Other Revenue Prior Year771987OtherRevenuePriorYear
Other Revenue Current Year886489OtherRevenueCurrentYear
Total Revenue Prior Year149971177TotalRevenuePriorYear
Total Revenue Current Year151031029TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4800GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY8865GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year80426032SalariesEtcPriorYear
Salaries Etc Current Year71847248SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year76891539OtherExpensePriorYear
Other Expenses Current Year121332348OtherExpensesCurrentYear
Total Expenses Prior Year157322371TotalExpensesPriorYear
Total Expenses Current Year193188461TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7351194RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-42157432RevenuesLessExpensesCY
Total Assets BOY77283624TotalAssetsBOY
Total Assets EOY111121536TotalAssetsEOY
Total Liabilities BOY127619259TotalLiabilitiesBOY
Total Liabilities EOY146643884TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-50335635NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-35522348NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTHCARE SERVICES - SEE SCHEDULE H FOR MORE INFORMATIONMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense175470965Expense
Grants8865Grants
Revenue148598548Revenue
DescriptionHACKLEY HOSPITAL IS A 181-BED, NOT-FOR-PROFIT HOSPITAL LOCATED IN THE CITY OF MUSKEGON, MICHIGAN, WITH A 100-YEAR TRADITION OF PROVIDING QUALITY MEDICAL SERVICES TO THE POPULATION OF WESTERN MICHIGAN.HACKLEY HOSPITAL PROVIDES HEALTH CARE SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR THE ABILITY TO PAY. ALTHOUGH REIMBURSEMENT OF SERVICES RENDERED IS CRITICAL TO THE OPERATION AND FINANCIAL STABILITY OF HACKLEY HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS HAVE THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THE HOSPITAL'S MISSION, THE COMMUNITY IS PROVIDED THE FOLLOWING:1) FREE OR SUBSIDIZED MEDICAL CARE TO INCOME-ELIGIBLE PATIENTS,2) SUBSIDIZED CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS,3) DONATED COMMUNITY HEALTH ACTIVITIES AND PROGRAMS.SEE SCHEDULE H FOR MORE INFORMATION.Description

Activity2 Activity2

FieldValueIRS element (for citing)
DescriptionMission:the mission statement for the hospital is as follows:we serve together in trinity healthin the spirit of the gospelto heal body, mind, and spiritto improve the health of our communitiesand to steward the resources entrusted to us.Description
FieldValueIRS element (for citing)
Total Program Service Expense175470965TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109698NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1498NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1GLENN PEULERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6166853574TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11820 44TH STREET SEAddressLine1
CityKENTWOODCity
StateMIState
ZIP Code49508ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
A SCOTT LACHNIET MD
TRUSTEE (THROUGH 9/09)2.00X000
MICHAEL K OLTHOFF
TRUSTEE2.00X000
DANA BRYANT
TRUSTEE2.00X000
GREGORY C PITTMAN JD
TRUSTEE2.00X000
SR MARY D PALASZEKRSM
TRUSTEE2.00X000
ROGER SPOELMAN
PRESIDENT AND CEO20.00X088511688965X
SR MYRA BERGMAN RSM
TRUSTEE2.00X000
FRANK BEDNAREK
TRUSTEE2.00X000
DAVID DORA DO
TRUSTEE2.00X018528046996
MARK FAZAKERLEY
CHAIR2.00X000X
T BRUCE FOX
TRUSTEE2.00X000
MICHAEL GLUHANICH
SECRETARY & TREASURER2.00X000X
YOUSIF HAMATI MD
TRUSTEE2.00X0144000
CAMILLE S JOURDEN-MARK
TRUSTEE2.00X000
PHILIP MCCORKLE
TRUSTEE2.00X0989470200681
GREGORY LOOMIS
MERCY HLTH PARTNERS COO20.00035908849144X
GARY ALLORE
MERCY HLTH PARTNERS CFO20.00030373030144X
JEFFREY ALEXANDER
MHP VP INTEG SERVICES20.00028589127803X
JOSEPH SWEDISH
TRINITY HEALTH PRES & CEO2.0003023292798303X
MICHAEL SLUBOWSKI
TRINITY PRES HLTH & HOSP NTWKS2.0001617841154389X
KEDRICK ADKINS
TRINITY PRES INTEG SVCS2.0001453695130171X
F REMINGTON SPRAGUE
VP PRIMARY CARE SVCS20.00041983751499X
MARY BOYD
MHP CHIEF DEV OFFICER20.00031705325378X
KIMBERLY MAGUIRE
MHP VP PATIENT CARE20.00023391633597X
J RICHARD OCONNELL
TRINITY PRES HOSP NETWORK2.00049514311123X
JOHN M RATCHFORD
PHYS., ADMINISTRATION50.00317532040702X
BRUCE OLSON MD
PHYSICIAN/V.CHF OF STAFF50.00310607039994X
CHARLES FELDT
PHYS., WORKPLACE HEALTH50.00206187031158X
JOSEPH RAFFERTY
DIRECTOR, DENTAL SVCS50.00177921028213X
RONI DEVLIN
PHYSICIAN50.00168166011333X
GORDON MUDLER
FORMER CEO0.004197760353096X
DAVID GINGRAS
FORMER VP SUBSIDIARIES0.002587890179327X
RON HAASE
FORMER VP HUMAN RESOURCES0.0015029604486X
MARY TOBIN
FORMER KEY EMPLOYEE0.00057195332X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2009274TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs10583752TotalReportableCompFrmRltdOrgs
Total Other Compensation2336502TotalOtherCompensation
Number Individuals GT100 K35NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MCKESSON INFORMATION SOLUTIONS
PO BOX 98347CHICAGOIL60693INFORMATION SYSTEMS SERVICES1476884
PINE REST CHRISTIAN MENTAL HEALTH SVCS
PO BOX 165GRAND RAPIDSMI49501HEALTH CARE SERVICES758695
TOWERS WATSON
1079 SOLUTIONS CTRCHICAGOIL60677PENSION SERVICES653087
SECURITAS SECURITY SERVICES INC
PO BOX 403412ATLANTAGA30384SECURITY SERVICES594855
WEST MI SHARED HOSPITAL LAUNDRY
PO BOX 1134GRAND RAPIDSMI49501LAUNDRY SERVICES461518
FieldValueIRS element (for citing)
Number Of Contractors GT100 K23NumberOfContractorsGT100K
Government Grants339943GovernmentGrants
All Other Contributions58258AllOtherContributions
Noncash Contributions12025NoncashContributions
Total Contributions398201TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SVC REV900099147827383147827383
REFERENCE LAB62150020386052038605
FieldValueIRS element (for citing)
Total Program Service Revenue149865988TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1308239TotalRevenueColumn
Exclusion$1,308,239ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1115966Real
Personal122800Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1366373Real
Personal76523Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-250407Real
Personal46277Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-204130TotalRevenueColumn
Exclusion-$204,130ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other146504Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities342028Securities
Other1232364Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-342028Securities
Other-1085860Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1427888TotalRevenueColumn
Exclusion-$1,427,888ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCAFETERIADescription
Business Code900099BusinessCode
Total Revenue Column319454TotalRevenueColumn
Exclusion$319,454ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column771165TotalRevenueColumn
Related Or Exempt Function Income771165RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1090619TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column151031029TotalRevenueColumn
Related Or Exempt Function Income148598548RelatedOrExemptFunctionIncome
Unrelated Business Revenue2038605UnrelatedBusinessRevenue
Exclusion-$4,325ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total8865Total
Program Services8865ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total61853Total
Program Services61853ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total52522701Total
Program Services48191336ProgramServices
Management And General4331365ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5304622Total
Program Services4867337ProgramServices
Management And General437285ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10017059Total
Program Services9191605ProgramServices
Management And General825454ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3941013Total
Program Services3517570ProgramServices
Management And General423443ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2438Total
Program Services375ProgramServices
Management And General2063ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total25444Total
Management And General25444ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6750Total
Management And General6750ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10247341Total
Program Services8411295ProgramServices
Management And General1836046ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3936Total
Program Services3936ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total23433393Total
Program Services22429050ProgramServices
Management And General1004343ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5058124Total
Program Services13617ProgramServices
Management And General5044507ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3801161Total
Program Services3257243ProgramServices
Management And General543918ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total63861Total
Program Services34255ProgramServices
Management And General29606ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total25166Total
Program Services5551ProgramServices
Management And General19615ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2364992Total
Program Services2364992ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6603465Total
Program Services4420107ProgramServices
Management And General2183358ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2383747Total
Program Services2382296ProgramServices
Management And General1451ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PENSION PLAN CURTAILMNT4629833546298335
BAD DEBT76786907678690
INTERCO PURCHASED SVCS51449444152096992848
HOSPITAL PROVIDER TAXES45399584539958
UBI TAXES17704770410000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3632899Total
Program Services3632899ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total193188461Total
Program Services175470965ProgramServices
Management And General17717496ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4818016BOY
EOY2051937EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY25721BOY
EOY25897EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY45000BOY
EOY45000EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14714559BOY
EOY14607369EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY71832BOY
EOY23309EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2055194BOY
EOY1911890EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1735614BOY
EOY856319EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis150331436LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec118808773LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY28113508BOY
EOY31522663EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY11610654BOY
EOY33879914EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4777325BOY
EOY13654792EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY169854BOY
EOY156127EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9146347BOY
EOY12386319EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY77283624BOY
EOY111121536EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY16975008BOY
EOY17054884EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY15014EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY110644251BOY
EOY129573986EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY127619259BOY
EOY146643884EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-52586567BOY
EOY-37856656EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY777623BOY
EOY698303EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1473309BOY
EOY1636005EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-50335635BOY
EOY-35522348EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY77283624BOY
EOY111121536EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$2,905GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB2905TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationHACKLEY HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO A NATIONAL HEALTH CARE ORGANIZATION, WHERE THE ORGANIZATION HAS PROVIDED HACKLEY HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1473309BeginningOfYearBalance
Contributions2600Contributions
Investment Earnings Or Losses160096InvestmentEarningsOrLosses
End Of Year Balance1636005EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1472499BeginningOfYearBalance
Contributions810Contributions
End Of Year Balance1473309EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5148000OtherCostOrOtherBasis
Book Value5148000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis75041404OtherCostOrOtherBasis
Depreciation59579365Depreciation
Book Value15462039BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis63338847OtherCostOrOtherBasis
Depreciation56552974Depreciation
Book Value6785873BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6803185OtherCostOrOtherBasis
Depreciation2676434Depreciation
Book Value4126751BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings31522663TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES7184384F
ABSOLUTE RETURN STRATEGY FUNDS6470408F
FieldValueIRS element (for citing)
Total Of Book Value Securities13654792TotalOfBookValueSecurities

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
OTHER ASSETS639119
INTERCOMPANY RECEIVABLES11544326
MISCELLANEOUS RECEIVABLES202874
FieldValueIRS element (for citing)
Total Book Value Other Assets12386319TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
OTHER LONG TERM LIABILITIES$722,189
INTERCOMPANY NOTES PAYABLE$98,916,195
INTERCOMPANY ACCOUNTS PAYABLE$29,027,652
OTHER CURRENT LIABILITIES$907,950
FieldValueIRS element (for citing)
Total Of Amounts129573986TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:SOME OF HACKLEY HOSPITAL'S ENDOWMENT FUNDS ARE FOR PATIENT RELATED PURPOSES. OTHER HACKLEY ENDOWMENT FUNDS ARE FOR NURSING EDUCATION AND TRAINING.
Part X:Description of Uncertain Tax Positions Under FIN 48:HACKLEY HOSPITAL is included in the consolidated financial statements of Trinity Health. Trinity Health's financial statements for the year ended June 30, 2010 did not include a FIN 48 footnote.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served8472PersonsServed
Total Community Benefit Expense4073468TotalCommunityBenefitExpense
Direct Offsetting Revenue25926DirectOffsettingRevenue
Net Community Benefit Expense4047542NetCommunityBenefitExpense
Percent Of Total Expense0.02180PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served57908PersonsServed
Total Community Benefit Expense27088007TotalCommunityBenefitExpense
Direct Offsetting Revenue20577873DirectOffsettingRevenue
Net Community Benefit Expense6510134NetCommunityBenefitExpense
Percent Of Total Expense0.03510PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served3962PersonsServed
Total Community Benefit Expense2407813TotalCommunityBenefitExpense
Direct Offsetting Revenue1718739DirectOffsettingRevenue
Net Community Benefit Expense689074NetCommunityBenefitExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served70342PersonsServed
Total Community Benefit Expense33569288TotalCommunityBenefitExpense
Direct Offsetting Revenue22322538DirectOffsettingRevenue
Net Community Benefit Expense11246750NetCommunityBenefitExpense
Percent Of Total Expense0.06060PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Persons Served7497PersonsServed
Total Community Benefit Expense126662TotalCommunityBenefitExpense
Net Community Benefit Expense126662NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served39PersonsServed
Total Community Benefit Expense8195TotalCommunityBenefitExpense
Net Community Benefit Expense8195NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense74TotalCommunityBenefitExpense
Net Community Benefit Expense74NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Total Community Benefit Expense14883TotalCommunityBenefitExpense
Net Community Benefit Expense14883NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs18NumberOfActivitiesOrPrograms
Persons Served7536PersonsServed
Total Community Benefit Expense149814TotalCommunityBenefitExpense
Net Community Benefit Expense149814NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs23NumberOfActivitiesOrPrograms
Persons Served77878PersonsServed
Total Community Benefit Expense33719102TotalCommunityBenefitExpense
Direct Offsetting Revenue22322538DirectOffsettingRevenue
Net Community Benefit Expense11396564NetCommunityBenefitExpense
Percent Of Total Expense0.06140PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense1052TotalCommunityBuildingExpense
Net Community Building Expense1052NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense1052TotalCommunityBuildingExpense
Net Community Building Expense1052NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$3,125,033BadDebtExpenseAmount
Amount Attributable To312503AmountAttributableTo
Amount Reimbursed By Medicare34575180AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare48836011CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-14260831MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
MERCY HEALTH PARTNERS HACKLEY CAMPUS
1700 CLINTON AVEMUSKEGONMI49442XXX
MERCY HEALTH PARTNERS LAKES CAMPUS
6401 PRAIRIE STNORTON SHORESMI49444OUTPATIENT SERVICES, LAB
MERCY HEALTH PARTNERS LAKES CAMPUS (CON
6401 PRAIRIE STNORTON SHORESMI49444URGENT CARE, REHAB, IMAGING

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Annual Community Benefit ExplnPart I, Line 6a: HACKLEY HOSPITAL reports its community benefit information as part of the consolidated community benefit information reported by Trinity Health in its annual report, available at www.trinity-health.org.In addition, HACKLEY HOSPITAL WILL BE INCLUDING a copy of its most recently filed schedule H on both trinity health's WEBSITE AS WELL AS MERCY HEALTH PARTNER'S WEBSITE (WWW.MERCY-HEALTHPARTNERS.ORG).AnnualCommunityBenefitExpln
Costing Method UsedPart I, Line 7: The best available data was used to calculate the cost amounts reported in item 7. For certain categories, primarily total charity care and means-tested government programs, specific cost-to-charge ratios were calculated and applied to those categories. The cost-to-charge ratio was derived from worksheet 2, ratio of patient care cost-to-charges. In other categories, the best available data was derived from the Hospital's cost accounting system.CostingMethodUsed
Percent Of Total Expense ExplnPart I, Line 7f: The following number, $7,678,690, represents the amount of bad debt expense included in total functional expenses in Form 990, Part IX, Line 25. Per IRS instructions, this amount was excluded from the denominator when calculating the percent of total expense for Schedule H, Part I, Line 7, column (f).PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: HACKLEY HOSPITAL is included in the consolidated financial statements of Trinity Health. The following is the text of the allowance for doubtful accounts footnote from those statements: "Substantially all of the corporation's receivables are related to providing healthcare services to patients. Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. The corporation's estimate for its allowance for doubtful accounts is based upon management's assessment of historical and expected net collections by payor."Costing methodology for lines 2 and 3: Amounts are calculated on line 2 using a cost to charge ratio methodology.Any discounts provided or payments made to a particular patient account are applied to that patient account prior to any bad debt write-off and are thus not included in bad debt expense. As a result of the payment and adjustment activity being posted to bad debt accounts, we are able to report bad debt expense net of these transactions.A BAD DEBT to Charity Reclass was conducted at two of the Western Michigan Region TRINITY HEALTH ORGANIZATIONS. Based on data returned from Collection Agencies, which was validated through electronic means (iSolutions), amounts that had been written off to Bad Debt were re-classed to Charity due to patient's inability to pay that would meet Presumptive Charity Criteria. Selected returned accounts were cases where there was no payment within 90 days of placement with the agency.As iSolutions data was not available for HACKLEY HOSPITAL, we assume approximately 10% of the amounts written-off to Bad Debt would have qualified for Charity based on similar findings within the region.WHILE CURRENT OPERATIONS ATTEMPT TO IDENTIFY THOSE CASES THAT WILL QUALIFY FOR CHARITY OR UNCOMPENSTATED CARE, IT IS ASSUMED THAT APPROXIMATELY 10% OF THE REMAINING BAD DEBT AMOUNT MAY ALSO QUALIFY AS CHARITY.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: Similar to CHA recommendations, which state that serving Medicare patients is not a differentiating feature of tax-exempt healthcare organizations and that the existing community benefit framework allows community benefit programs that serve the Medicare population to be counted in other community benefit categories, HACKLEY HOSPITAL does not believe any Medicare shortfall should be treated as community benefit.Part III, Line 8: Costing methodology for line 6 - Medicare costs were obtained from the filed Medicare cost report. The costs are based on Medicare allowable costs as reported on worksheet B, column 27, which exclude direct medical education costs. Inpatient Medicare costs are calculated based on a combination of allowable cost per day times Medicare days for routine services and cost to charge ratio times Medicare charges for ancillary services. Outpatient Medicare costs are calculated based on cost to charge ratio times Medicare charges by ancillary department.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: THE ORGANIZATION'S collection policy contains the criteria for financial assistance, and contains the following verbiage for arrangements with outside collection agencies: The agreement must define the standards and scope of practices to be used by outside collection agents acting on behalf of the MINISTRY ORGANIZATION, all of which must be in compliance with this policy.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: NEEDS ASSESSMENT - HACKLEY HOSPITAL (Mercy Health Partners-Hackley Campus) assesses the health needs of the community through community needs assessments every three years. A community needs assessment is a point-in-time effort to measure the health and well being of the community. It serves as the basis for Mercy Health Partners' strategic and subsequent action planning to develop health policy, allocate resources, improve or expand existing services, implement new programs and collaborate with other community healthcare providers. A community needs assessment also serves as a benchmark for future assessment of relative progress toward established community health objectives.The Mercy Health Partners community needs assessment provides the opportunity to:-Gain insights into the needs and assets of the communities served -Identify and address the needs of vulnerable populations within the community-Enhance hospital/community relationships and the opportunity for collaborative community action, including involvement with coalitions, partnerships, boards, committees, commissions, advisory groups and panels-Provide the information required for community outreach planningThe Mercy Health Partners community needs assessment process involves the gathering of two types of data: quantitative (demographics, health indicators, etc.) and qualitative (public surveys, forums, focus groups). The data helps support short-term and long-term decisions about allocation of community human and capital resources. The Mercy Health Partners community needs assessment is current as of June, 2009. The community needs assessment was conducted with the assistance of outside experts including Peter J. Sartorius, Development and Planning Manager, MCHP; Christine Robere, President, United Way of the Lakeshore; Kenneth Kraus, Health Officer, Muskegon County Public Health; Paula Kelson, Projects Coordinator, Community Mental Health Services of Muskegon County; Jennifer Bailey, Provider Network Manager, Lakeshore Health Network; Joan Vanover, Community Benefit Coordinator, Mercy Health Partners; Helen Sherman, Office Assistant, MCHP; and Gerald L. Adams, Focus Group and Forum Facilitator, Project Consultant.NeedsAssessment
Patient Education AssistancePart VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY HEALTH PARTNERS-HACKLEY CAMPUS IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE- BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AHA RECOMMENDATIONS, MERCY HEALTH PARTNERS-HACKLEY CAMPUS HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS:- PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMERCY HEALTH PARTNERS-HACKLEY CAMPUS EFFECTIVELY COMMUNICATES WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE.MERCY HEALTH PARTNERS-HACKLEY CAMPUS OFFERS IN-PERSON SUPPORT WITH FINANCIAL COUNSELORS, CASHIERS AND THE MUSKEGON COMMUNITY HEALTH PROJECT (A PART OF MERCY HEALTH PARTNERS). ANY REGISTRAR CAN MAKE A CONNECTION TO PATIENTS. MERCY HEALTH PARTNERS-HACKLEY CAMPUS PUBLISHES THE PHONE NUMBERS FOR OUR CALL-IN SUPPORT, AND SHARED SERVICES ALSO PROVIDES PHONE SUPPORT. MERCY HEALTH PARTNERS-HACKLEY CAMPUS HAS AN EXTERNAL VENDOR, MEDASSIST, AND WE ALSO WORK WITH DEPARTMENT OF HEALTH SERVICES STAFF.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. MERCY HEALTH PARTNERS-HACKLEY CAMPUS UTILIZES AN EXTERNAL VENDOR AS AN EXTENSION OF HOSPITAL SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.MERCY HEALTH PARTNERS-HACKLEY CAMPUS OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH THE PUBLICATION OF PATIENT BROCHURES, NOTICES OR MESSAGING INCLUDED ON PATIENT BILLS; POSTING OF NOTICES IN PUBLIC REGISTRATION AREAS, INCLUDING EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS; HOSPITAL PATIENT ACCOUNTING DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON OUR CAMPUSES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO ACCESS HEALTH, INC., AMERICAN RED CROSS, BENSON DRUGS, CATHOLIC CHARITIES OF WEST MICHIGAN, CITY OF MUSKEGON, CITY OF MUSKEGON HEIGHTS, COMMUNITY ACCESS LINE OF THE LAKESHORE, COMMUNITY MENTAL HEALTH SERVICES OF MUSKEGON COUNTY, COOPERATING CHURCHES, DISABILITY CONNECTION OF WEST MICHIGAN, EVERY WOMAN'S PLACE, GOODWILL INDUSTRIES, HACKLEY COMMUNITY CARE CENTER, HACKLEY PHARMACIES, LIFE COUNSELING, LIONS CLUBS OF MUSKEGON COUNTY, MISSION FOR AREA PEOPLE, MUSKEGON COUNTY PUBLIC HEALTH, MUSKEGON COUNTY DEPT. OF HUMAN SERVICES/FAMILY RESOURCE CENTERS, MUSKEGON FAMILY CARE, MUSKEGON/OCEANA MICHIGAN WORKS!, THE SALVATION ARMY, SENIOR RESOURCES, URBAN LEAGUE, WESTSHORE PHARMACY, AND WEST MICHIGAN THERAPY.INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON THE MERCY HEALTH PARTNERS-HACKLEY CAMPUS' WEBSITE, AS WELL AS IN THE ADMISSION PACKAGE. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH, REFLECTING THE OTHER PRIMARY LANGUAGE SPOKEN BY THE POPULATION SERVED BY OUR HOSPITAL.MERCY HEALTH PARTNERS-HACKLEY CAMPUS HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY HEALTH PARTNERS-HACKLEY CAMPUS MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. MERCY HEALTH PARTNERS-HACKLEY CAMPUS EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. MERCY HEALTH PARTNERS-HACKLEY CAMPUS' FRONTLINE REGISTRATION ASSOCIATES, CASHIERS AND THE MUSKEGON COMMUNITY HEALTH PROJECT RECEIVE TRAINING ON MAKING A CONNECTION TO A FINANCIAL COUNSELOR.PatientEducationAssistance
Community InformationPart VI, Line 4: COMMUNITY INFORMATION - MERCY HEALTH PARTNERS-HACKLEY CAMPUS' SERVICE AREA INCLUDES MUSKEGON, OCEANA AND NEWAYGO COUNTIES, LOCATED IN CENTRAL WEST MICHIGAN, ON OR NEAR THE SHORELINE OF LAKE MICHIGAN. TOTAL POPULATION OF THE SERVICE AREA IS ABOUT 250,000 AND IS COMPRISED OF BOTH SIGNIFICANT RURAL AND URBAN AREAS. THE RURAL AREA IS CHARACTERIZED BY A CHIEFLY AGRICULTURAL, RECREATION AND TOURISM ECONOMY. THE METROPOLITAN AREA OF ABOUT 120,000 IS CENTERED AROUND THE CITY OF MUSKEGON AND IS LARGELY COMPRISED OF MANUFACTURING AND SERVICE INDUSTRIES. THE POPULATION IS GENERALLY DIVERSE WITH MANY ETHNIC AND RACIAL POPULATION SEGMENTS. THE METROPOLITAN AREA HAS A SIGNIFICANT AFRICAN-AMERICAN POPULATION, WHILE OCEANA COUNTY HAS A HIGHER CONCENTRATION OF HISPANIC RESIDENTS.MUSKEGON COUNTY IS HOME TO THE COUNTY'S MAJOR HOSPITAL SYSTEM, MERCY HEALTH PARTNERS, WHICH RECENTLY MERGED WITH HACKLEY HOSPITAL AND NOW INCLUDES FOUR CAMPUSES, INCLUDING LAKESHORE HOSPITAL IN OCEANA COUNTY.BASED ON THE 2000 CENSUS, THERE WERE 170,200 PEOPLE, 63,330 HOUSEHOLDS, AND 44,267 FAMILIES RESIDING IN THE COUNTY. THE RACIAL MAKEUP WAS APPROXIMATELY 81% CAUCASIAN, 14% BLACK AND LESS THAN 1% EACH FOR NATIVE AMERICAN, ASIAN, AND PACIFIC ISLANDER. THE MEDIAN HOUSEHOLD INCOME WAS $38,008, AND THE MEDIAN INCOME FOR A FAMILY WAS $45,710. ABOUT 9% OF FAMILIES AND 11% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 16% OF THOSE UNDER AGE 18 AND 8% OF THOSE AGES 65 OR OVER.OCEANA COUNTY IS A RURAL COUNTY ROUGHLY 41 MILES NORTH OF MUSKEGON AND 75 MILES NORTHWEST OF GRAND RAPIDS. THE RACIAL MAKEUP ACCORDING TO THE 2000 CENSUS WAS 90% CAUCASIAN, WITH AFRICAN-AMERICAN, ASIAN, AND PACIFIC ISLANDER EACH COMPRISING LESS THAN 1% OF THE TOTAL POPULATION. ROUGHLY 12% OF THE POPULATION WAS HISPANIC OR LATINO, THE HIGHEST PERCENTAGE OF LATINOS OF ANY COUNTY IN MICHIGAN. RECENT ESTIMATES SHOW THE PERCENTAGE OF LATINOS AND AFRICAN-AMERICANS TO BE INCREASING, WHILE THE PERCENTAGE OF NON-HISPANIC WHITES IS DECREASING. THE CENSUS BUREAU ESTIMATES THE 2008 COUNTY POPULATION AT 27,598. THE AVERAGE HOUSEHOLD SIZE WAS 2.67 AND THE AVERAGE FAMILY SIZE WAS 3.09 IN 2000. MEDIAN INCOME WAS $35,307.NEWAYGO COUNTY IS HOME TO GERBER INDUSTRIES AND THE GERBER MEMORIAL HOSPITAL, LOCATED IN FREMONT. THE GEOGRAPHIC PROXIMITY OF THE TWO URBAN CENTERS RESULTS IN SOME COUNTY RESIDENTS TRAVELING TO THE MUSKEGON AREA FOR HEALTHCARE SERVICES WHILE OTHERS USE THE SERVICES AVAILABLE IN GRAND RAPIDS.BASED ON THE 2000 CENSUS, THE RACIAL MAKEUP WAS APPROXIMATELY 95% CAUCASIAN, 1% BLACK, AND LESS THAN 1% EACH FOR NATIVE AMERICAN, ASIAN, AND PACIFIC ISLANDER. THE CENSUS BUREAU ESTIMATES THE 2008 COUNTY POPULATION AT 48,897. THE MEDIAN HOUSEHOLD INCOME WAS $37,130 AND THE MEDIAN INCOME FOR A FAMILY WAS $42,498. ABOUT 9% OF FAMILIES AND 12% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING APPROXIMATELY 15% OF THOSE UNDER AGE 18 AND 9% OF THOSE AGE 65 OR OVER.CommunityInformation
Community Building ActivitiesPart VI, Line 5: COMMUNITY BUILDING ACTIVITIES - Mercy Health Partners-Hackley conducted the following community building program, Muskegon Area Medication Disposal (MAMDP). The program included planning meetings and going into the community to collect the actual medications for disposal.CommunityBuildingActivities
Other InformationPart VI, Line 6: OTHER INFORMATION - THE MAJORITY OF THE MERCY HEALTH PARTNERS-HACKLEY CAMPUS' GOVERNING BODY IS COMPRISED OF PEOPLE WHO RESIDE IN THE MERCY HEALTH PARTNERS (LAKESHORE CAMPUS, HACKLEY CAMPUS AND MERCY CAMPUS) PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS. SINCE MERCY HEALTH PARTNERS IS THE ONLY HEALTH SYSTEM IN MUSKEGON COUNTY, STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.Surplus funds are allocated to improvements in patient care, medical education and research. HOWEVER FY2010 has AGAIN not been A typical YEAR. The service area has very high rates of uninsured (Muskegon Co. 23.5%; Oceana Co. 27.6%; Newaygo Co. 12.7%), so Mercy Health Partners' focus has been on access to care. Mercy Health Partners' Health Project has been very proactive in working with medical clinics and the two FQHCs. The design of a single enrollment process has proven to make applying for assistance less cumbersome. The new form includes all information essential for determining eligibility for multiple health and human serviceS, thus streamlining the process of assisting patients to receive services. The Wheels of Mercy, a mobile unit, is taken to various areas through the three counties, providing, at the least, blood pressure, diabetes, pulmonary function, vision and cholesterol checks. Enrollment assistance into various programs is also provided. The goal is to alleviate many Emergency Department visits by screening and alerting patients to treatable problems that could escalate into life-threatening situations. Departments are aggressively involved in community programs. for instance, Outreach and Enrollment Specialists conduct health and human service eligibility screens on all uninsured patients at the time of discharge from the hospital or Emergency Department. Included in the screening is eligibility for Medicaid, SCHIP or other available health coverage, Food Assistance Program, Mercy Health Partners financial assistance, et al. Mercy Health Partners participates in the United Way Day of Caring. Also, every year, the Healthy-U event is conducted to educate the community about heart health, and provide workshops and programs at no cost. Support for events, such as the African-American Diabetes Conference, Men's Health Fair and Screening, and the Walk for Diabetes are conducted to raise funds for pharmaceutical products for people who can't afford them. Mercy Health Partners-Hackley Campus conducts extensive community-based screenings at churches and other venues around the community. Physicians volunteer their time in Doc Talks for the community; community services are provided to benefit everyone in the community, such as birthing classes. All of Mercy Health Partners supports the use of facilities by non-profit organizations for meetings and support. A certain percent of earnings from the Sister Simone Fund are redirected back to community groups for projects to improve the health of the community. Medical and administrative staffs sit on community coalitions that target areas of community need, including HIV/AIDS; diabetes; childhood obesity; health disparities, asthma; alcohol, tobacco and substance abuse; and youth risk behaviors. Mercy Health Partners' also gives money to support the Community Access Line of the Lakeshore (CALL 2-1-1) information and referral phone line; Access Health, a "3-share" model community health coverage program; as well as vision services. Mercy Health Partners (all campuses) is involved with "Aligning Forces for Quality: Equity and Language Quality" to meet the Trinity Equity in Care process of determining whether inequities exist in care due to race or ethnicity. A Mercy Health Partners' collaborative has been meeting at the Lakeshore Hospital in Oceana County to build a community consensus around evaluation, planning and deployment of healthcare services to meet the needs of underserved residents of Oceana County. The committee is working on life-long prevention services/lifestyle changes. Mercy Health Partners' Lakeshore Health Network developed a Health Literacy Committee to focus on issues that emerged out of the Community Needs Assessment process. This committee is looking at how we can improve giving patients information they can understand in order to improve their health and compliance with medical protocols.In partnership with Lakeshore Health Network, the Health Project has been in development of the Muskegon Area Medication Disposal Project. A medication take-back project reduces youth access to non-prescribed medications, reduces the number of expired and potentially unsafe medications, assists law enforcement with neighborhood safety for those seeking out drugs in medicine cabinets and reduces the environmental impact on water quality.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: HACKLEY HOSPITAL is a member organization of Trinity Health, the fourth-largest Catholic health care system in the country. Based in Novi, Michigan, Trinity Health annually requires that all member organizations develop, and are held accountable for achieving, community benefit goals that include developing needed services or expanding access to services for low-income individuals. As a not-for-profit health system, Trinity Health reinvests its profits back into the community through programs to serve the poor and uninsured, manage chronic conditions like diabetes, health education and promotion initiatives, and outreach for the elderly. In fiscal year 2010, this included nearly $456 million in such community benefits. Therefore, Trinity Health takes a systems approach in its community benefit planning and implementation, and is consequently able to ensure that its member hospitals and other entities/affiliates are helping promote and address the health needs of their respective communities.For more information about Trinity Health, visit www.trinity-health.org.AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: DONATIONS MADE BY HACKLEY HOSPITAL TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE AND ARE CONSIDERED UNRESTRICTED WITH REGARD TO THE USE OF THE FUNDS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (21 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROGER SPOELMAN
0406506036717101114390674310215340974081037936
DAVID DORA DO
01806490004631022323024673023227600
PHILIP MCCORKLE
041759804045050167367016991903076201190151075751
GREGORY LOOMIS
02743310549830297740317150174290408232016013
GARY ALLORE
0240389048380014961011339018805033387400
JEFFREY ALEXANDER
0227560045424012907014791013012031369400
JOSEPH SWEDISH
0121445801607837020099707698990284040382159500
MICHAEL SLUBOWSKI
069610806817250240008012592202846701772230094766
KEDRICK ADKINS
07124150611975012930501172500129210158386600
F REMINGTON SPRAGUE
03173380630170394820364880150110471336022076
MARY BOYD
024972205020301712802307302305034243106015
KIMBERLY MAGUIRE
01883600376740788201812601547102675130153
J RICHARD OCONNELL
04409250005421801112300050626600
JOHN M RATCHFORD
31071600068160242510164510358234000
BRUCE OLSON MD
24399706566009500235800164140350601000
CHARLES FELDT
2003190568601820109390202190237345000
JOSEPH RAFFERTY
1711280006793020116080970206134000
RONI DEVLIN
122086045962011805599057340179499000
GORDON MUDLER
0000419776034500708089077287204140080
DAVID GINGRAS
56197031170017142201668300124970438116000
RON HAASE
00001502960004486015478201453850

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4aReturnReference
ExplanationTHE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2009. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III): DAVID GINGRAS - $151,850 RON HAASE - $148,846 GORDON MUDLER - $414,008 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING AMOUNTS WHICH WERE UNPAID AS OF 12/31/09. THESE AMOUNTS WERE PAID AND INCLUDED IN THE INDIVIDUALS' TAXABLE INCOME IN 2010. DAVID GINGRAS - $151,850 GORDON MUDLER - $345,007 PART I, LINE 4B: THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2009). THE FOLLOWING ACCRUALS FOR 2009 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $59,584 PHILIP MCCORKLE - $125,372 MICHAEL SLUBOWSKI - $42,832 ROGER SPOELMAN - $37,116 JOSEPH SWEDISH - $249,263 PART I, LINE 4B: THE FOLLOWING ARE PARTICIPANTS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUALS FOR 2009 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $38,675 MICHAEL SLUBOWSKI - $55,733 JOSEPH SWEDISH - $493,225 PART I, LINE 4B: THE FOLLOWING INDIVIDUAL RECEIVED A TAXABLE DISTRIBUTION FROM A 457(F) PLAN DURING CALENDAR 2009. THIS AMOUNT IS INCLUDED IN COLUMN B(III): DAVID GINGRAS - $16,916 PART I, LINE 6: THE FOLLOWING BONUSES REPORTED IN COLUMN B(ii) WERE DETERMINED BASED ON THE NET EARNINGS OF THE PHYSICIAN PRACTICE DEPARTMENTS FOR WHICH EACH INDIVIDUAL WORKS, AS WELL AS THEIR PRODUCTIVITY. BRUCE OLSON - $65,660 RONI DEVLIN - $45,962 Part II, Column B (ii): The following individuals received amounts in 2009 from a long-term incentive plan (LTIP). Participants in the LTIP (CEOs and certain Trinity executives) were eligible to receive a payment under the plan only if certain patient loyalty improvement targets were achieved by the end of a three-year period (FY07 through FY09). The following LTIP amounts are included in Schedule J, Part II, Column B(ii): KEDRICK ADKINS - $337,826 PHILIP MCCORKLE - $275,409 MICHAEL SLUBOWSKI - $403,918 ROGER SPOELMAN - $248,854 JOSEPH SWEDISH - $1,042,563Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
NICHOLS
MICHAEL OLTHOFF, TRUSTEE, IS ALSO A BOARD MEMBER OF NICHOLS156746PURCHASE OF CLEANING EQUIPMENT AND SUPPLIES FROM NICHOLS0
BLUE CROSS BLUE SHIELD OF MICHIGAN
F. REMINGTON SPRAGUE, KEY EMPLOYEE, IS TRUSTEE OF BLUE CROSS BLUE SHIELD-MI30933131NET REVENUE FROM PROVISION OF MEDICAL SERVICES0
(no name)
0
(no name)
0
(no name)
0
PAMELA ALEXANDER
FAMILY MEMBER OF JEFFREY ALEXANDER, KEY EMPLOYEE61853EMPLOYMENT ARRANGEMENT0
(no name)
0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part I, Item CDoing Business AsMERCY HEALTH PARTNERS-WORK PLACE HEALTH MERCY HEALTH PARTNERS, HACKLEY CAMPUS
Form 990, Part VI, Section A, line 6THE SOLE MEMBER OF HACKLEY HOSPITAL IS MERCY HEALTH PARTNERS. SEE LINE 7 FOR ADDITIONAL INFORMATION.
Form 990, Part VI, Section A, line 7aMERCY HEALTH PARTNERS IS THE SOLE MEMBER OF HACKLEY HOSPITAL. MERCY HEALTH PARTNERS HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF HACKLEY HOSPITAL.
Form 990, Part VI, Section A, line 7bAS SOLE MEMBER, MERCY HEALTH PARTNERS MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH PARTNERS MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS.
Form 990, Part VI, Section B, line 11PRIOR TO FILING, THE FORM 990 FOR HACKLEY HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF TRUSTEES. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
Form 990, Part VI, Section B, line 12cHACKLEY HOSPITAL HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF HACKLEY HOSPITAL, WHICH INCLUDES trustees, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH HACKLEY HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO HACKLEY HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF trustees OF HACKLEY HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO HACKLEY HOSPITAL. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF trustees OF HACKLEY HOSPITAL ON AN ANNUAL BASIS.
Form 990, Part VI, Section B, line 15TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF HACKLEY HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.
Form 990, Part VI, Section C, line 19HACKLEY HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, HACKLEY HOSPITAL WILL BE INCLUDING A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE as well as Mercy Health Partner's website (www.meRCY-healthpartners.org).
FORM 990, PART VII, SECTION A:Trustees:Sr. MYRA BERGMAN, RSM is a member of the RELIGIOUS SISTERS OF MERCY. Having taken a vow of poverty, Sr. MYRA did not receive compensation for the services she provided AS VICE PRESIDENT, MISSION SERVICES FOR SAINT MARY'S HEALTH CARE (A DIVISION OF TRINITY HEALTH - MICHIGAN). Instead, a total of $185,761 was paid by TRINITY HEALTH - MICHIGAN directly to the SISTERS OF MERCY for Sr. MYRA's services.
CORE FORM, PART VII, SECTION A, COLUMN B:ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS:THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: KEDRICK ADKINS - 53 HOURS JEFFREY ALEXANDER - 30 HOURS GARY ALLORE - 30 HOURS MARY BOYD - 30 HOURS DAVID DORA, DO - 48 HOURS GREGORY LOOMIS - 30 HOURS KIMBERLY MAGUIRE - 30 HOURS PHILIP MCCORKLE - 48 HOURS J. RICHARD O'CONNELL - 53 HOURS MICHAEL SLUBOWSKI - 53 HOURS ROGER SPOELMAN - 30 HOURS F. REMINGTON SPRAGUE - 30 HOURS JOSEPH SWEDISH - 53 HOURS
CORE FORM, PART XI, LINE 2:HACKLEY HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY10 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CLR Investments LLC
120 W HARRIS STCADILLACMI49601320008631Real estate rental & developmentMI19827175469Trinity Health-Michigan
Saint Agnes Home Health and Hospice LLC
17410 COLLEGE PARKWAY STE 150LIVONIAMI48152382621935Provide home health servicesCA93676041116725Trinity Home Health Services Inc
Saint Mary's Pharmacy LLC
200 JEFFERSON AVE SEGRAND RAPIDSMI49503383404443PharmacyMI00Trinity Health-Michigan
Mount Carmel HealthProviders Two LLC
6150 E BROAD STREETCOLUMBUSOH43213201983271MEDICAL SERVICESOH00MOUNT CARMEL HEALTH PROVIDERS INC
PATHWAY HOSPICE LLC
1050 SW 3RD AVE SUITE 1600ONTARIOOR97914931310235HOSPICE CAREOR12735031512716SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
TRINITY HEALTH-WARDE LAB LLC
34605 W TWELVE MILE ROADFARMINGTON HILLSMI48331272681908REAL ESTATE RENTALDE00TRINITY HEALTH - MICHIGAN
MOUNT CARMEL HEALTH PROVIDERS III LLC
10 West Broad St Ste 2100COLUMBUSOH43215204145781MEDICAL SERVICESOH17410596043MOUNT CARMEL HEALTH PROVIDERS INC

Form990 Schedule R Part II Form990ScheduleRPartII (90 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling Entity NADirectControllingEntityNA
AMICARE HOSPICE SERVICES INC
27870 CABOT DRIVENOVIMI483772920382949053PROVIDE HOSPICE SERVICESMI501(C)(3)11, TYPE ITRINITY HOME HEALTH SERVICES INC
AUXILIARY OF HOLY ROSARY HOSPITAL
351 SW 9TH STREETONTARIOOR97914943059469SUPPORTS SERVICES OF RELATED HOSPITALOR501(C)(3)9SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
BATTLE CREEK HEALTH SYSTEM
300 NORTH AVENUEBATTLE CREEKMI49016382776791HEALTHCARE SERVICESMI501(C)(3)3TRINITY HEALTH - MICHIGAN
BATTLE CREEK HEALTH SYSTEM AUXILIARY
300 NORTH AVENUEBATTLE CREEKMI49016383355520SUPPORT OF TAX EXEMPT HEALTH ORGANIZATIONMI501(C)(3)11, TYPE IBATTLE CREEK HEALTH SYSTEM
BAUM HARMON MERCY HOSPITAL
255 NORTH WELCH AVENUEPRIMGHARIA51245421500277Acute/Ambulatory healthcare servicesIA501(C)(3)3Mercy Health Services-Iowa Corp
BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION
255 NORTH WELCH AVENUEPRIMGHARIA51245262973307Support the services of related hospitalIA501(C)(3)11, TYPE IBaum Harmon Mercy Hospital
CAPITAL PARK FAMILY HEALTH CENTER INC
6150 EAST BROAD STREETCOLUMBUSOH43213311387838Operation of a federally qualified health center (formerly)OH501(C)(3)3Mount Carmel Health System
CATHERINE MCAULEY HEALTH SERVICES CORP
PO BOX 995ANN ARBORMI48106382507173Further Trinity Health activities, organize and develop medical servicesMI501(C)(3)11, TYPE IITrinity Health-Michigan
Cranbrook Hospice Care
281 ENTERPRISE COURTBLOOMFIELD HILLSMI48302383320699Provide hospice health servicesMI501(C)(3)11, TYPE ITrinity Home Health Services Inc
Diley Ridge Medical Center
6150 EAST BROAD STREETCOLUMBUSOH43213342032340Hospital campus in Fairfield County OhioOH501(C)(3)3Mount Carmel Health System
Dubuque Mercy Health Foundation Inc
250 MERCY DRIVEDUBUQUEIA52001262227941Support the services of related hospitalIA501(C)(3)11, TYPE IMercy Health Services-Iowa Corp
Dyersville Health Foundation Inc
1111 3RD STREET SWDYERSVILLEIA52040205383271Support the services of related hospitalIA501(C)(3)11, TYPE IMercy Health Services-Iowa Corp
Hackley Hospital
1700 CLINTON ST PO BOX 3302MUSKEGONMI494433302381358196HEALTHCARE SERVICESMI501(C)(3)3Mercy Health Partners
Hackley Hospital Self Insurance Professional Liability Trust
PO BOX 3302MUSKEGONMI494433302382299878Self insurance for general and malpractice liabilityMI501(C)(3)11, TYPE III-FIMercy Health Partners
Hackley Life Counseling
1352 TERRACE STMUSKEGONMI494423545381386362Counseling, education, and supportMI501(C)(3)9Mercy Health Partners
Hackley Visiting Nurse Services and Hospice Inc
888 TERRACE STMUSKEGONMI49440381359598Provide home health care servicesMI501(C)(3)7Mercy Health Partners
Holy Cross Carenet Inc
PO BOX 9184FARMINGTON HILLSMI48333521945054Long-term care and rehabilitation for the elderlyMD501(C)(3)9Trinity Continuing Care Services
Holy Cross Hospital Foundation Inc
11801 TECH ROADSILVER SPRINGMD20904208428450Charitable fundraisingMD501(C)(3)11, TYPE IHoly Cross Hospital of Silver Spring Inc
Holy Cross Hospital of Silver Spring Inc
1500 FOREST GLEN RDSILVER SPRINGMD209101484520738041HEALTHCARE SERVICESMD501(C)(3)3Trinity Health Corporation
Holy Cross Medical Center
27870 CABOT DRIVENOVIMI483772920951985442HEALTHCARE SERVICES (FORMERLY)CA501(C)(3)3Trinity Health Corporation
HOLY ROSARY MEDICAL CENTER FOUNDATION
351 SW 9TH STREETONTARIOOR97914202683560SUPPORT THE SERVICES OF RELATED HOSPITALOR501(C)(3)11, TYPE ISAINT ALPHONSUS MEDICAL CENTER-ONTARIO
Hospice of North Iowa
232 SECOND STREET SEMASON CITYIA504016208421173708Hospice health care servicesIA501(C)(3)7Mercy Health Services-Iowa Corp
Hospice of Washtenaw II
806 AIRPORT BLVDANN ARBORMI48108383320707Hospice health care servicesMI501(C)(3)11, TYPE ITrinity Health-Michigan
HPCN
1675 LEAHY STREETMUSKEGONMI49442300207909HEALTHCARE SERVICESMI501(C)(3)11, TYPE IIMercy Health Partners
Lakeshore Community Hospital Inc
72 S STATE STREETSHELBYMI494551228382549295Acute healthcare servicesMI501(C)(3)3Mercy Health Partners
Lifespan Inc
166 EAST GOODALE AVEBATTLE CREEKMI490372728383298476Provide hospice health servicesMI501(C)(3)9Battle Creek Health System
Marian Home Healthcare
801 5TH STREETSIOUX CITYIA51101383320705Provide home health care servicesIA501(C)(3)11, TYPE IMercy Health Services-Iowa Corp
McAuley Clinic Corporation
PO BOX 992ANN ARBORMI48106382561013HEALTHCARE SERVICES (FORMERLY)MI501(C)(3)3Catherine McAuley Health Services Corp
Mercy Amicare Home Healthcare Oakland
281 ENTERPRISE COURTBLOOMFIELD HILLSMI483020312383320698Provide home health care servicesMI501(C)(3)11, TYPE ITrinity Home Health Services Inc
Mercy Amicare Home Healthcare Port Huron
2540 16TH STREETPORT HURONMI48060383320701Provide home health care servicesMI501(C)(3)11, TYPE ITrinity Home Health Services Inc
Mercy Community Physicians
363 FREMONT STBATTLE CREEKMI49017264252468HEALTHCARE SERVICESMI501(C)(3)3Battle Creek Health System
Mercy General Health Partners Amicare Homecare
684 HARVEY STREETMUSKEGONMI49442383321856Provide home health care servicesMI501(C)(3)11, TYPE ITrinity Home Health Services Inc
Mercy Health Partners
1415 LEAHY STREETMUSKEGONMI49442382589966Healthcare system supportMI501(C)(3)11, TYPE ITrinity Health-Michigan
Mercy Health Services - Iowa Corp
1000 4TH STREET SWMASON CITYIA50401311373080HEALTHCARE SERVICESDE501(C)(3)3Trinity Health-Michigan
Mercy Healthcare Foundation
1410 N 4TH STCLINTONIA52732421316126Fundraising and financial assistance for hospital charitable servicesIA501(C)(3)11, TYPE IMercy Medical Center-Clinton
Mercy Hosp & Health Services of DetroitMarshall Park Health Services Inc
27870 CABOT DRIVENOVIMI483772920381562325Supports malpractice contingencies of closed hospitalMI501(C)(3)11, TYPE ITrinity Health-Michigan
Mercy Hospital Cadillac Foundation
400 HOBARTCADILLACMI496012331203357131Support the services of related hospitalMI501(C)(3)11, TYPE ITrinity Health-Michigan
Mercy Hospital Gift Shop
2601 ELECTRIC AVEPORT HURONMI48060381630480Volunteer Service AuxiliaryMI501(C)(3)11, TYPE ITrinity Health-Michigan
Mercy Medical Center - Clinton Inc
1410 NORTH 4TH STCLINTONIA527322940421336618To provide quality health careDE501(C)(3)3Mercy Health Services-Iowa Corp
Mercy Medical Center - Sioux City Foundation
801 5TH STREETSIOUX CITYIA51102141880022Support the services of related hospitalIA501(C)(3)7Mercy Health Services-Iowa Corp
Mercy Medical Center Foundation - North Iowa
1000 4TH STREET SWMASON CITYIA504012800421229151Support the services of related hospitalIA501(C)(3)11, TYPE III-FIMercy Health Services-Iowa Corp
MERCY MEDICAL CENTER FOUNDATION INC
1512 12TH AVENUE ROADNAMPAID83686261737256SUPPORT THE SERVICES OF RELATED HOSPITALID501(C)(3)7SAINT ALPHONSUS MEDICAL CENTER-NAMPA
Mercy North Homecare and Hospice
7985 MACKINAW TRAILCADILLACMI49601383313897Home health and hospice servicesMI501(C)(3)11, TYPE ITrinity Home Health Services Inc
Mercy Pavilion of Battle Creek
300 NORTH AVENUEBATTLE CREEKMI49016382783350Provides long-term care for the elderlyMI501(C)(3)9Battle Creek Health System
MERCY PHYSICIAN GROUP INC
1512 12TH AVENUE ROADNAMPAID83686208192593TO PROVIDE QUALITY HEALTH CAREID501(C)(3)9SAINT ALPHONSUS MEDICAL CENTER-NAMPA
Mercy Services for Aging Non-profit Housing Corporation
PO BOX 9184FARMINGTON HILLSMI483339184382719605Provides long-term care for the elderlyMI501(C)(3)11, TYPE IITrinity Continuing Care Services Inc
Midwest Medflight
1300 VICTORS WAYANN ARBORMI48108382684671Aeromedical transportMI501(C)(3)9Trinity Health-Michigan
Mount Carmel Care Continuum Services Corp
793 WEST STATE STREETCOLUMBUSOH43222311126211Cooperative hospital service organizationOH501(C)(3)3Mount Carmel Health System
Mount Carmel College of Nursing
6150 EAST BROAD STREETCOLUMBUSOH43213311308555College of nursingOH501(C)(3)2Mount Carmel Health
Mount Carmel Health
6150 EAST BROAD STREETCOLUMBUSOH43213314379602HEALTHCARE SERVICESOH501(C)(3)3Mount Carmel Health System
Mount Carmel Health Insurance Company
6150 EAST BROAD STREETCOLUMBUSOH43213251912781Health InsuranceOH501(C)(4)N/AMount Carmel Health System
Mount Carmel Health Plan Inc
6150 EAST BROAD STREETCOLUMBUSOH43213311471229Medicare HMO for seniorsOH501(C)(4)N/AMount Carmel Health System
Mount Carmel Health System
6150 EAST BROAD STREETCOLUMBUSOH43213311439334Healthcare system management and supportOH501(C)(3)11, TYPE ITrinity Health Corporation
MOUNT CARMEL HEALTH SYSTEM FOUNDATION
6150 EAST BROAD STREETCOLUMBUSOH43213311113966SUPPORT THE SERVICES OF RELATED HOSPITALOH501(C)(3)11, TYPE IMOUNT CARMEL HEALTH SYSTEM
Mount Carmel Home Care LLC
1144 DUBLIN ROAD SUITE BCOLUMBUSOH43215262729300Provide home health care servicesOH501(C)(3)9Trinity Home Health Services Inc
Mount Carmel New Albany Surgical Hospital
7333 SMITHS MILL RDNEW ALBANYOH43054870790288HEALTHCARE SERVICESOH501(C)(3)3Mount Carmel Health System
MRI Mobile Services of West Michigan
1820 - 44TH STREETKENTWOODMI49508383073745OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY)MI501(C)(3)9Trinity Health-Michigan
MUSKEGON COMMUNITY HEALTH PROJECT
565 W WESTERN AVENUEMUSKEGONMI49440911932918FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICESMI501(C)(3)7MERCY HEALTH PARTNERS
Oakland Mercy Hospital
601 EAST 2ND STREETOAKLANDNE68045208072234HEALTHCARE SERVICESNE501(C)(3)3Mercy Health Services-Iowa Corp
Port Huron Mercy Family Care Inc
2601 ELECTRIC AVEPORT HURONMI48060201855647HEALTHCARE SERVICESMI501(C)(3)11, TYPE ITrinity Health-Michigan
Professional Med Team
965 FORK STREETMUSKEGONMI494423257382638284Medical care, transportation and educationMI501(C)(3)9Trinity Health-Michigan
Professional Office Corporation
1303 EAST HERNDON AVEFRESNOCA93720942839324HEALTHCARE SERVICESCA501(C)(3)11, TYPE ISaint Agnes Medical Center
Saint Agnes Medical Center
1303 EAST HERNDON AVEFRESNOCA93720941437713HEALTHCARE SERVICESCA501(C)(3)3Trinity Health Corporation
Saint Alphonsus Building Company Inc
1055 NORTH CURTIS RDBOISEID83706820401011Supports services of related hospitalID501(C)(3)11, TYPE ISaint Alphonsus Regional Medical Center Inc
Saint Alphonsus Diversified Care Inc
1055 NORTH CURTIS RDBOISEID83706943028978Supports services of related hospitalID501(C)(3)11, TYPE ISaint Alphonsus Regional Medical Center Inc
SAINT ALPHONSUS HEALTH SYSTEM INC
1055 N CURTIS ROADBOISEID83706271929502HEALTHCARE SYSTEM MANAGEMENT AND SUPPORTID501(C)(3)11, TYPE ITRINITY HEALTH CORPORATION
SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY
3325 POCAHONTAS ROADBAKER CITYOR97814271790052TO PROVIDE QUALITY HEALTH CAREOR501(C)(3)3SAINT ALPHONSUS HEALTH SYSTEM INC
SAINT ALPHONSUS MEDICAL CENTER-NAMPA
1512 12TH AVENUE ROADNAMPAID83686820200896TO PROVIDE QUALITY HEALTH CAREID501(C)(3)3SAINT ALPHONSUS HEALTH SYSTEM INC
SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
351 SW 9TH STREETONTARIOOR97914271789847TO PROVIDE QUALITY HEALTH CAREOR501(C)(3)3SAINT ALPHONSUS HEALTH SYSTEM INC
Saint Joseph Regional Medical Center - Plymouth Campus Inc
1915 LAKE AVENUE PO BOX 670PLYMOUTHIN46563351142669Healthcare servicesIN501(C)(3)3Saint Joseph Regional Medical Center Inc
Saint Joseph Regional Medical Center - South Bend Campus Inc
PO BOX 1935SOUTH BENDIN466341935350868157Healthcare servicesIN501(C)(3)3Saint Joseph Regional Medical Center Inc
Saint Joseph Regional Medical Center Inc
801 EAST LASALLE AVESOUTH BENDIN46617351568821Healthcare system management and supportIN501(C)(3)11, TYPE ITrinity Health Corporation
Saint Joseph's Auxiliary of Marshall County
1915 LAKE AVENUEPLYMOUTHIN46563356043563Hospital Service AuxiliaryIN501(C)(3)11, TYPE IISaint Joseph Regional Medical Center - Plymouth Campus Inc
Saint Joseph's Tower Inc
PO BOX 9184FARMINGTON HILLSMI483339184311040468Provides housing for low income elderly individualsIN501(C)(3)9Trinity Continuing Care Services-Indiana
Saint Mary's Amicare Home Healthcare
1430 MONROE NWGRAND RAPIDSMI48905383320700Provide home health care servicesMI501(C)(3)11, TYPE ITrinity Home Health Services Inc
Saint Mary's Doran Foundation CO Saint Mary's Health Care
200 JEFFERSON ST SEGRAND RAPIDSMI49503381779602Supports services of related hospitalMI501(C)(3)7Trinity Health-Michigan
St Alphonsus Regional Medical Center
1055 NORTH CURTIS RDBOISEID83706820200895Healthcare servicesID501(C)(3)3Trinity Health Corporation
St John's Health System
27870 CABOT DRIVENOVIMI483772920350877584HEALTHCARE SERVICES (FORMERLY)IN501(C)(3)3Trinity Health Corporation
St Joseph Mercy Oakland Foundation
44405 WOODWARD AVEPONTIACMI48341352356789Supports services of related hospitalMI501(C)(3)11, TYPE ITrinity Health-Michigan
St Ann's Hospital
500 SOUTH CLEVELAND AVEWESTERVILLEOH43081314412701HEALTHCARE SERVICESOH501(C)(3)3Mount Carmel Health System
ST ELIZABETH HEALTH CARE FOUNDATION
3325 POCAHONTAS ROADBAKER CITYOR97814943164869SUPPORT THE SERVICES OF RELATED HOSPITALOR501(C)(3)7SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
St Joseph's Medical Center Auxiliary
801 E LASALLE AVE PO BOX 1935SOUTH BENDIN466341935356033285Hospital Service AuxiliaryIN501(C)(4)N/ASaint Joseph Regional Medical Center - South Bend Campus Inc
The Foundation of Saint Joseph Regional Medical Center
4215 EDISON LAKES PARKWAYMISHAWAKAIN46545351654543Supports services of related hospitalIN501(C)(3)11, TYPE ISaint Joseph Regional Medical Center Inc
Trinity Continuing Care Services
PO BOX 9184FARMINGTON HILLSMI483339184382559656Management services for Long term care and senior living facilitiesMI501(C)(3)11, TYPE ITrinity Health Corporation
Trinity Continuing Care Services - Indiana Inc
PO BOX 9184FARMINGTON HILLSMI483339184930907047Provides long-term care and residential housingIN501(C)(3)9Trinity Continuing Care Services
Trinity Health - Michigan
27870 CABOT DRIVENOVIMI483772920382113393HEALTHCARE SERVICESMI501(C)(3)3Trinity Health Corporation
Trinity Health Corporation
27870 CABOT DRIVENOVIMI483772920351443425Healthcare system management and supportIN501(C)(3)11, TYPE IN/A
Trinity Health International
27870 CABOT DRIVENOVIMI483772920421253527Healthcare training and support servicesMI501(C)(3)11, TYPE ITrinity Health Corporation
Trinity Health Welfare Benefit Trust
27870 CABOT DRIVENOVIMI483772920208151733Retiree medical and retiree life insurance coverageMI501(C)(9)N/ATrinity Health Corporation
Trinity Home Health Services Inc
17410 COLLEGE PARKWAYLIVONIAMI48152382621935Home health care system management servicesMI501(C)(3)11, TYPE ITrinity Health Corporation

Form990 Schedule R Part III Form990ScheduleRPartIII (31 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
ADVANCED IMAGING SERVICES OF BATTLE CREEK
5352 BECKLEY ROAD STE ABATTLE CREEKMI49015204594297RADIOLOGY/IMAGINGMIN/AN/A00
ADVENT REHABILITATION LLC
560 FIFTH ST NW STE 404GRAND RAPIDSMI49504383306673REHABILITATION THERAPY SERVICESMIN/AN/A00
BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311608125MEDICAL OFFICE BUILDING RENTALOHN/AN/A00
BSV MEDICAL OFFICE BUILDING II LLC
855 M STREET TENTH FLOORFRESNOCA93721202673839MEDICAL OFFICE BUILDING RENTALCAN/AN/A00
CCH LABORATORY
775 SOUTH MAIN STREETCHELSEAMI48118382910400LABORATORYMIN/AN/A00
CENTRAL OHIO SLEEP MEDICINE LTD
5955 EAST BROAD STCOLUMBUSOH43213311701029SLEEP MEDICINE SERVICESOHN/AN/A00
CLINTON IMAGING SERVICES LLC
1410 NORTH 4TH STCLINTONIA52732412044739MRI DIAGNOSTIC SERVICESIAN/AN/A00
FOREST PARK IMAGING LLC
1000 4TH STREET SWMASON CITYIA50401134365966X-RAY AND MAMMOGRAPHY SERVICESIAN/AN/A00
FRANCES WARDE MEDICAL LABORATORY
300 WEST TEXTILE ROADANN ARBORMI48104382648446LABORATORYMIN/AN/A00
FRESNO IMAGING CENTER
1303 E HERNDON AVEFRESNOCA93720770363563DIAGNOSTIC IMAGINGCAN/AN/A00
HAWARDEN COMMUNITY CLINIC LLC
1122 AVENUE LHAWARDENIA51023201444339MEDICAL CLINICIAN/AN/A00
IDAHO GYNONCOLOGY SERVICES LLC
1055 N CURTIS RDBOISEID83706202975807PROVIDE GYN ONCOLOGY SERVICESIDN/AN/A00
MAGNETIC RESONANCE SERVICES PARTNERSHIP
1416 SIXTH STREET SWMASON CITYIA50401421328388MRI SERVICESIAN/AN/A00
MASON CITY AMBULATORY SURGERY CENTER LLC
990 4TH STREET SWMASON CITYIA50401201960348SURGERY-SAME DAYIAN/AN/A00
MCE MOB IV LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222421544707MEDICAL OFFICE BUILDING RENTALOHN/AN/A00
MCMC POB III LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311392994MEDICAL OFFICE BUILDING RENTALOHN/AN/A00
MEDILUCENT MOB I
793 W STATE STREETCOLUMBUSOH43222204911370MEDICAL OFFICE BUILDING RENTALOHN/AN/A00
MERCY HEART CTR OP SERVICES LLC
1000 4TH STREET SWMASON CITYIA50401134237594CARDIOVASCULAR SERVICESIAN/AN/A00
MERCY OUTPATIENT SURGERY CENTER LLC
1512 12TH AVENUE ROADNAMPAID83686841380439OUTPATIENT SURGERYIDN/AN/A00
MICHIANA HEALTH INFORMATION NETWORK LLC
215 WEST MADISON STREETSOUTH BENDIN46601352050128COMMUNITY BASED CLINICAL INFORMATION SYSTEM AND DATA DEPOSITORYINN/AN/A00
MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311369473MEDICAL OFFICE BUILDING RENTALOHN/AN/A00
NEWCO AMBULATORY SURGERY CTR LLP
4190 24TH AVENUEFORT GRATIOTMI48059300136708OUTPATIENT SURGERY CENTERMIN/AN/A00
PLAZA SURGICAL CENTER
PO BOX 27230FRESNOCA93729371463357AMBULATORY SURGERYCAN/AN/A00
RIVERVIEW MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311531135MEDICAL OFFICE BUILDING RENTALOHN/AN/A00
SARMED OUTPATIENT PHARMACY LLC
999 N CURTIS RD STE 102BOISEID83706510483218PHARMACYIDN/AN/A00
SIXTY FOURTH STREET LLC
2373 64TH ST STE 2200BYRON CENTERMI49315202443646PROVIDE OUTPATIENT SURGICAL CAREMIN/AN/A00
ST ALPHONSUS CALDWELL CANCER CTR LLC
3123 MEDICAL DRCALDWELLID83605820526861RADIATION ONCOLOGYIDN/AN/A00
ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311603660MEDICAL OFFICE BUILDING RENTALOHN/AN/A00
TAMARACK MEDICAL CLINIC LLC
610 VILLAGE DRIVEDONNELLYID83615201637921OUTPATIENT MEDICAL SERVICESIDN/AN/A00
WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311784409MEDICAL OFFICE BUILDING RENTALOHN/AN/A00
WOODLAND IMAGING CENTER LLC
5301 E HURON RIVER DRANN ARBORMI48106760820959RADIOLOGY/IMAGINGMIN/AN/A00

Form990 Schedule R Part IV Form990ScheduleRPartIV (32 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
COMMUNITY HEALTH VENTURES INC
565 W WESTERN AVEMUSKEGONMI49440383522260SOFTWARE MARKETINGMIN/AC
GENERAL HEALTHCORP VENTURES INC
1820-44TH STREETKENTWOODMI49508382533165MEDICAL SERVICESMIN/AC
HACKLEY HEALTH MANAGEMENT CENTER
1415 LEAHY STMUSKEGONMI49442382961814WEIGHT MANAGEMENTMIN/AC
HACKLEY HEALTH VENTURES INC
1415 LEAHY STMUSKEGONMI49442382589959OTHER MEDICAL SERVICESMIN/AC
HACKLEY HEALTHCARE EQUIPMENT
1415 LEAHY STMUSKEGONMI49442382578569HOME MEDICAL EQUIPMENTMIN/AC
HACKLEY ORTHOTICS & PROSTHETICS
1415 LEAHY STMUSKEGONMI49442382999815HEALTHCARE SERVICESMIN/AC
HACKLEY PROFESSIONAL CENTER
1415 LEAHY STMUSKEGONMI49442383024797REAL ESTATE RENTALMIN/AC
HACKLEY PROFESSIONAL PHARMACY
1415 LEAHY STMUSKEGONMI49442382447870PHARMACYMIN/AC
HEF INC
1415 LEAHY STMUSKEGONMI49442383086401OFFICE STAFFINGMIN/AC
HOLY CROSS PRIVATE HOME SERVICES CORP
11801 TECH ROADSILVER SPRINGMD20904521986562HOME CARE SERVICESMDN/AC
HURON ARBOR CORPORATION
5301 EAST HURON RIVER DR PO BOX 992ANN ARBORMI48106382475644PROVIDES OFFICE RENTAL SPACEMIN/AC
MARYLAND CARE GROUP INC
11801 TECH ROADSILVER SPRINGMD20904521815313HEALTHCARE HOLDINGMDN/AC
MEDNOW INC
1512 12TH AVENUE ROADNAMPAID83686820389927OUTPATIENT PHARMACYIDN/AC
MERCY MEDICAL SERVICES
801 5TH STREETSIOUX CITYIA51101421283849PRIMARY CARE PHYSICIANSIAN/AC
MICHIGAN PHYSICIAN SERVICES
44405 WOODWARD AVENUE H-5PONTIACMI48341383293125PHYSICIAN SERVICESMIN/AC
MICHIGAN ATHLETIC CLUB
2500 BURTONGRAND RAPIDSMI49546382647304ATHLETIC CLUBMIN/AC
MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES INC
6150 EAST BROAD STREETCOLUMBUSOH43213310971510BEHAVIORAL HEALTHCARE SERVICESOHN/AC
MOUNT CARMEL HEALTH HORIZONS CORP
6150 EAST BROAD STREETCOLUMBUSOH43213311177652MEDICAL SERVICES/RENTOHN/AC
MOUNT CARMEL HEALTH PROVIDERS INC
6150 EAST BROAD STREETCOLUMBUSOH43213311382442MEDICAL SERVICESOHN/AC
NORTH IOWA MERCY MEDICAL SERVICES INC
1000 4TH ST SWMASON CITYIA50401421382308MEDICAL SERVICESIAN/AC
PRIMARY CARE NETWORK OF OHIO INC
6150 EAST BROAD STREETCOLUMBUSOH43213311422486HEALTH MANAGEMENT SERVICESOHN/AC
PRIORITY PLUS OF CALIFORNIA
PO BOX 27230FRESNOCA93729770395267FORMERLY HEALTH MANAGEMENT NOW DISCONTINUED SUBSTANTIALLY ALL OPERATIONSCAN/AC
SAINT ALPHONSUS PHYSICIAN SERVICES INC
1055 NORTH CURTIS ROADBOISEID83706820477852PHYSICIAN CLINICSIDN/AC
SAINT ALPHONSUS PHYSICIANS PA
1055 NORTH CURTIS ROADBOISEID837061370331078261PHYSICIANSIDN/AC
SAINT MARY'S HEALTH MANAGEMENT COMPANY
1640 EAST PARIS SEGRAND RAPIDSMI49546383450733ATHLETIC CLUBMIN/AC
SURGERY CENTER FINANCING CORPORATION
6150 EAST BROAD STREETCOLUMBUSOH43213311531102FINANCE, INSURANCE AND REAL ESTATEOHN/AC
TRINITY HEALTH EMPLOYEE BENEFIT TRUST
27870 CABOT DRIVENOVIMI483772920383410377GRANTOR TRUSTMIN/AT
TRINITY HEALTH SELF-INSURANCE PLAN
27870 CABOT DRIVENOVIMI483772920386742154GRANTOR TRUSTMIN/AT
TRINITY HEALTH SELF-INSURED WORKERS' COMPENSATION FUND
27870 CABOT DRIVENOVIMI483772920386742157GRANTOR TRUSTMIN/AT
VENZKE INSURANCE COMPANY LTD
980453602PROVISION OF INSURANCE COVERAGEN/ACPO BOX 1051 GRAND CAYMANGRAND CAYMANCJCJ
WESTSHORE HEALTH NETWORK
1820 44TH STREETKENTWOODMI49508383280200PHYSICIAN HOSPITAL ORGANIZATIONMIN/AC
WORKPLACE HEALTH OF GRAND HAVEN
1415 LEAHY STMUSKEGONMI49442383112035OCCUPATIONAL HEALTHMIN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (15 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
TRINITY HEALTH - MICHIGAN
L1101537
TRINITY HEALTH CORPORATION
E61900000
TRINITY HEALTH CORPORATION
C18000000
TRINITY HEALTH CORPORATION
L2017584
TRINITY HEALTH CORPORATION
Q2126396
MERCY HEALTH PARTNERS
J142819
MERCY HEALTH PARTNERS
K214157
MERCY HEALTH PARTNERS
L7091729
MERCY HEALTH PARTNERS
O6641932
MERCY HEALTH PARTNERS
Q877359
LAKESHORE COMMUNITY HOSPITAL INC
K230151
LAKESHORE COMMUNITY HOSPITAL INC
P78106
HACKLEY VISITING NURSE SERVICES AND HOSPICE INC
C2713577
HACKLEY LIFE COUNSELING
R68861
HACKLEY PROFESSIONAL CENTER
J232898