MCKENIZE MEMORIAL HOSPITAL: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- MCKENIZE MEMORIAL HOSPITAL (EIN 38-1738615)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-03-18
- IRS object ID
- 202440789349300504
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-03-18T09:03:33-05:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381738615 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | MCKENZIE HEALTH SYSTEM | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % AMY RUEDISUELI | InCareOfNm |
| Business Name Control | MCKE | BusinessNameControlTxt |
| Phone | 8106486162 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY RUEDISUELI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8106486162 | PhoneNum |
| Signature | 2024-03-18 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | AMY | PersonFirstNm |
| Person Last | RUEDISUELI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | false | IRSResponsiblePrtyInfoCurrInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 1 | TrustedCustomerCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVE BARNETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,156,135 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCKENZIEHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1961 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | FOUNDED AS A COMMUNITY HOSPITAL MCKENZIE MEMORIAL HOSPITAL EXISTS TO PROVIDE EXCELLENT COMPASSIONATE AND ESSENTIAL HEALTHCARE | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 341 | TotalEmployeeCnt |
| Total Volunteers | 61 | TotalVolunteersCnt |
| Total Gross UBI | $25,507 | TotalGrossUBIAmt |
| PY Contributions Grants | $139,791 | PYContributionsGrantsAmt |
| CY Contributions Grants | $117,116 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,611,793 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $29,678,473 | CYProgramServiceRevenueAmt |
| PY Investment Income | $31,562 | PYInvestmentIncomeAmt |
| CY Investment Income | $216,456 | CYInvestmentIncomeAmt |
| PY Other Revenue | $80,399 | PYOtherRevenueAmt |
| CY Other Revenue | $44,911 | CYOtherRevenueAmt |
| PY Total Revenue | $28,863,545 | PYTotalRevenueAmt |
| CY Total Revenue | $30,056,956 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,833,642 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,159,062 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $24,264 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,740,180 | PYOtherExpensesAmt |
| CY Other Expenses | $11,890,004 | CYOtherExpensesAmt |
| PY Total Expenses | $27,573,822 | PYTotalExpensesAmt |
| CY Total Expenses | $30,049,066 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,289,723 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,890 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,405,743 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,359,067 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,247,997 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,193,431 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,157,746 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,165,636 | NetAssetsOrFundBalancesEOYAmt |
| Mission | FOUNDED AS A COMMUNITY HOSPITAL, MCKENZIE MEMORIAL HOSPITAL EXISTS TO PROVIDE EXCELLANT, COMPASSIONATE AND ESSENTIAL HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $30,049,066 | ExpenseAmt |
| Revenue | $30,056,956 | RevenueAmt |
| Desc | PROVIDE INPATIENT, OUTPATIENT & EMERGENCY CARE SERVICES INPATIENT REGISTRATION=152 OUTPATIENT REGISTRATION=23,914 EMERGENCY ROOM=5,693 AMBULANCE RUNS=2,266 | Desc |
| Total Program Service Expenses | $30,049,066 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 341 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Excs Tax Sect4951 Or4952 Or4953 | false | ExcsTaxSect4951Or4952Or4953Ind |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY RUEDISUELI | PersonNm |
| Phone | 8106486162 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| MICHAEL DREYER | |||||||
| CHAIRPERSON | Yes (X) | $0 | $0 | $0 | |||
| LARRY MITCHELL | |||||||
| SECRETARYTREASURER | Yes (X) | $0 | $0 | $0 | |||
| STEVE BARNETT | |||||||
| CEOPRESIDENT | Yes (X) | $237,654 | $0 | $9,944 | 40.00 | Yes (X) | |
| JAMES SAMS | |||||||
| CHIEF OF STAFF | Yes (X) | $227,834 | $0 | $9,336 | 40.00 | ||
| MATTHEW GORMLEY | |||||||
| PHYSICIAN | $198,653 | $0 | $8,440 | 40.00 | Yes (X) | ||
| AMY RUEDISUELI | |||||||
| CFO | $165,948 | $0 | $6,565 | 40.00 | Yes (X) | ||
| BILLI JO HENNIKA | |||||||
| COO | $145,892 | $0 | $6,091 | 40.00 | Yes (X) | ||
| GINA PATTERSON | |||||||
| DIRECTOR PHARMACY | $154,761 | $23,276 | $7,218 | 40.00 | Yes (X) | ||
| JAMES KOSIUR | |||||||
| PHYSICIAN | $477,830 | $0 | $9,150 | 40.00 | Yes (X) | ||
| MARK ENGLISH | |||||||
| PHYSICIAN | $183,434 | $0 | $7,892 | 40.00 | Yes (X) | ||
| BRANDON GUIBORD | |||||||
| SECRETARYTREASURER | Yes (X) | $0 | $0 | $0 | |||
| JAY SMITH | |||||||
| DIAGNOSTIC DIRECTOR | $145,758 | $0 | $6,170 | 40.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,937,764 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $23,276 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $70,806 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MICHIGAN EMERGENCY PHYS L | |||||
| PO BOX 677979 | DALLAS | TX | 752677979 | ER PHYSICIANS | $1,970,037 |
| DAVID E JOHNSON ARCHITECT | |||||
| 4551 TROUSDALE DR | NASHVILLE | TN | 37204 | CAPITAL PROJECTFACILITY | $1,341,577 |
| MCKESSON | |||||
| 38220 PLYMOUTH RD | LIVONIA | MI | 48150 | DRUG PURCHASES | $656,234 |
| EVIDENT | |||||
| PO BOX 11407 | BIRMINGHAM | AL | 352466448 | SOFTWARE SERVICE | $351,319 |
| WPS GHA | |||||
| 1717 WEST BROADWAY | MADISON | WI | 53713 | MEDICARE | $257,005 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 21 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $117,116 | AllOtherContributionsAmt |
| Total Contributions | $117,116 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | BusinessBusinessCd |
|---|---|---|---|
| INPATIENT OUTPATIENT | $37,022,642 | $37,022,642 | |
| PROVIDER OFFICE REVENU | $3,442,179 | $3,442,179 | 621110 |
| RHC REVENUE | $2,322,849 | $2,322,849 | 621110 |
| CONTRACTUAL ADJUSTMENT | -$15,234,212 | -$15,234,212 | |
| BAD DEBT CHARITY | -$909,815 | -$909,815 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,034,830 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,034,830 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $29,678,473 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $213,056 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $213,056 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,507 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,507 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,507 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $25,507 | UnrelatedBusinessRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,400 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,400 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,400 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,400 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $118,583 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $99,179 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,404 | TotalRevenueColumnAmt |
| Exclusion | $19,404 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,056,956 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,894,929 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $25,507 | UnrelatedBusinessRevenueAmt |
| Exclusion | $19,404 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $693,970 | TotalAmt |
| Management And General | $693,970 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,999,368 | TotalAmt |
| Program Services | $10,881,234 | ProgramServicesAmt |
| Management And General | $3,102,157 | ManagementAndGeneralAmt |
| Fundraising | $15,977 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $454,625 | TotalAmt |
| Program Services | $107,142 | ProgramServicesAmt |
| Management And General | $347,483 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,014,152 | TotalAmt |
| Program Services | $353,797 | ProgramServicesAmt |
| Management And General | $1,660,355 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $996,947 | TotalAmt |
| Program Services | $758,969 | ProgramServicesAmt |
| Management And General | $236,924 | ManagementAndGeneralAmt |
| Fundraising | $1,054 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,548,730 | TotalAmt |
| Program Services | $3,072,391 | ProgramServicesAmt |
| Management And General | $1,476,339 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,526 | TotalAmt |
| Management And General | $104,526 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,875 | TotalAmt |
| Management And General | $60,875 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $824 | TotalAmt |
| Management And General | $824 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,483 | TotalAmt |
| Management And General | $124,483 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,235 | TotalAmt |
| Program Services | $57,756 | ProgramServicesAmt |
| Management And General | $110,599 | ManagementAndGeneralAmt |
| Fundraising | $4,880 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,982 | TotalAmt |
| Program Services | $123,471 | ProgramServicesAmt |
| Management And General | $259,384 | ManagementAndGeneralAmt |
| Fundraising | $1,127 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,953 | TotalAmt |
| Program Services | $92,233 | ProgramServicesAmt |
| Management And General | $275,720 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,888 | TotalAmt |
| Program Services | $329,130 | ProgramServicesAmt |
| Management And General | $7,758 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,183 | TotalAmt |
| Program Services | $11,337 | ProgramServicesAmt |
| Management And General | $20,203 | ManagementAndGeneralAmt |
| Fundraising | $643 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,246 | TotalAmt |
| Program Services | $57,771 | ProgramServicesAmt |
| Management And General | $31,475 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,340 | TotalAmt |
| Program Services | $5,340 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,422,672 | TotalAmt |
| Program Services | $1,234,106 | ProgramServicesAmt |
| Management And General | $188,566 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,925 | TotalAmt |
| Program Services | $219,260 | ProgramServicesAmt |
| Management And General | $70,665 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS | $780,660 | $780,660 | |
| REPAIRS MAINTENANCE | $782,639 | $610,038 | $172,601 |
| MEDICAL SUPPLIES | $1,366,081 | $1,366,081 | |
| FOOD & LAUNDRY | $155,703 | $97,034 | $58,669 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $864,059 | TotalAmt |
| Program Services | $161,361 | ProgramServicesAmt |
| Management And General | $702,115 | ManagementAndGeneralAmt |
| Fundraising | $583 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,049,066 | TotalAmt |
| Program Services | $20,319,111 | ProgramServicesAmt |
| Management And General | $9,705,691 | ManagementAndGeneralAmt |
| Fundraising | $24,264 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,552 | BOYAmt |
| EOY | $203,467 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,520,537 | BOYAmt |
| EOY | $5,501,473 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,502,001 | BOYAmt |
| EOY | $6,542,876 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $461,399 | BOYAmt |
| EOY | $518,271 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,620 | BOYAmt |
| EOY | $588,304 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,609,898 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,511,169 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,142,634 | BOYAmt |
| EOY | $7,098,729 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $905,947 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,405,743 | BOYAmt |
| EOY | $21,359,067 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,753,474 | BOYAmt |
| EOY | $3,197,561 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,890 | BOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,633 | BOYAmt |
| EOY | $89,923 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $905,947 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,247,997 | BOYAmt |
| EOY | $4,193,431 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,109,173 | BOYAmt |
| EOY | $17,116,739 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,573 | BOYAmt |
| EOY | $48,897 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,157,746 | BOYAmt |
| EOY | $17,165,636 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,405,743 | BOYAmt |
| EOY | $21,359,067 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $7,890 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Org Leg Ctrl | false | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | false | DisclosedForCharitablePrpsInd |
| Written Policy Monitoring | false | WrittenPolicyMonitoringInd |
| Section170h Rqr Stsfd | false | Section170hRqrStsfdInd |
| Solicited Assets Sale | false | SolicitedAssetsSaleInd |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $424,492 | OtherCostOrOtherBasisAmt |
| Book Value | $424,492 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,753,920 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,792,532 | DepreciationAmt |
| Book Value | $1,961,388 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $142,048 | OtherCostOrOtherBasisAmt |
| Depreciation | $136,991 | DepreciationAmt |
| Book Value | $5,057 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,444,164 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,581,646 | DepreciationAmt |
| Book Value | $1,862,518 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,845,274 | OtherCostOrOtherBasisAmt |
| Book Value | $2,845,274 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,098,729 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RIGHT TO USE ASSETSLEASES | Desc |
| Book Value | $905,947 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $905,947 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RIGHT TO USE LEASE LIABILITIES | Desc |
| Amt | $905,947 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $905,947 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $29,703,992 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $29,703,992 | RevenueSubtotalAmt |
| Other Revenues Not Included | $352,964 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $352,964 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $30,056,956 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $30,049,079 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $13 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $13 | ExpensesNotReportedAmt |
| Expenses Subtotal | $30,049,066 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $30,049,066 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| P11, Ln 4b | INTEREST; $211,632, SALE OF ASSETS; $3,400, CONTRIBUTIONS; $136,520 |
| P11, Ln 4b | INTEREST; $1,423, ROUNDING; $-11. |
| P12, Ln 2d | ROUNDING $13. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | HOSP AUXILL | Event1Nm |
| Gross Receipts Event1 | $63,963 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $63,963 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $60,455 | OtherDirectExpensesEvent1Amt |
| Event2 | AUTUMN BENE | Event2Nm |
| Gross Receipts Event2 | $54,620 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $54,620 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $38,724 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $118,583 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $118,583 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $99,179 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $99,179 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $19,404 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 12 | PersonsServedCnt |
| Total Community Benefit Expns | $8,478 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,479 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0003 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 5345 | PersonsServedCnt |
| Total Community Benefit Expns | $6,198,608 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,147,943 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,050,664 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1015 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 5357 | PersonsServedCnt |
| Total Community Benefit Expns | $6,207,086 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,147,943 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,059,143 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1018 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 96 | ActivitiesOrProgramsCnt |
| Persons Served | 16593 | PersonsServedCnt |
| Total Community Benefit Expns | $72,425 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $35,822 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $36,603 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0012 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 287 | PersonsServedCnt |
| Total Community Benefit Expns | $50,233 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $50,233 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0017 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 313 | PersonsServedCnt |
| Total Community Benefit Expns | $703 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $703 | NetCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 102 | ActivitiesOrProgramsCnt |
| Persons Served | 17193 | PersonsServedCnt |
| Total Community Benefit Expns | $123,361 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $35,822 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $87,539 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0029 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 104 | ActivitiesOrProgramsCnt |
| Persons Served | 22550 | PersonsServedCnt |
| Total Community Benefit Expns | $6,330,447 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,183,765 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,146,682 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1047 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $533 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $533 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $150 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $150 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 40 | PersonsServedCnt |
| Total Community Benefit Expns | $1,306 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,306 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 90 | PersonsServedCnt |
| Total Community Benefit Expns | $1,989 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,989 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $887,835 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,181,793 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,270,136 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$88,343 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE HEALTH SYSTEM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MCKENZIEHEALTH.ORG | WebsiteAddressTxt |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MCKENZIEHEALTH.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.MCKENZIEHEALTH.ORG/DOCUMENTS/46490_MKHS | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.MCKENZIEHEALTH.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.MCKENZIEHEALTH.O | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.MCKENZIEH | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (24 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 5 | STAKEHOLDERS WERE DEFINED AS AGENCY & COMMUNINTY LEADERS THAT HAVE A WIDE |
| 5 | KNOWLEDGE BASE OF THE REGION, INCLUDING HUMAN SERVICES AGENCIES, BEHAVIOR |
| 5 | HEALTH AGENCIES, GREAT START COLLAB., EDUCATION, GOV'T, LAW ENFORCEMENT, |
| 5 | AND MSU EXTENSION. 2,519 SURVEY PARTICIPANTS FROM 4 COUNTIES. |
| 6B | MICHIGAN THUMB PUBLIC HEALTH ALLIANCE. |
| 11 | COMMITTIES ADDRESS SIGNIFICANT NEEDS INDENTIFED BY THE CHNA, INCLUDING; |
| 11 | BEHAVIORAL HEALTH, CHRONIC DISEASE, SOCIAL HEALTH DETERMINATES, AWARENESS |
| 11 | OF SERVICES, ACCESS TO SPECIALISTS, TELE-HEALTH SERVICES, IN-HOME CARE, |
| 11 | TRANSPORTATION, FINANCIAL ASSISTENCE & HEALTH INSURANCE, PRENATAL CARE. |
| 11 | MHS IS EXPLORING INTEGRATING BEHAVIOR HEALTH WITH PRIMARY CARE, CONSULTING |
| 11 | ER PATIENTS WITH SOCIAL WORK & TELE-PSYCH PROVIDERS, AND IMPLEMENTING |
| 11 | THE COLLABORATIVE CARE MODEL. MHS WILL GROW CHRONIC CARE MGMT PROGRAM AND |
| 11 | INCREASE DIETITIAN SERVICES AND EDUCATION AT PRIMARY CARE OFFICES. |
| 11 | MHS WILL CONTINUE TO USE COMMUNITY PARAMEDICINE TO INCREASE ACCESS TO CARE. |
| 11 | MHS CONTINUES TO ASSIST INDIVIDUALS IN REDUCING COST BARRIERS TO ACCESSING |
| 11 | CARE, INCLUDING NAVIGATOR GRANT PROGRAM, AND WORK WITH COMMUNITY PARTNERS |
| 11 | TO IDENTIFY STRATEGIES TO IMPROVE ACCESS TO TIMELY PRENATAL CARE. |
| 11 | MHS WILL CONTINUE TO WORK WITH COMMUNITY PARTNERS TO EDUCATE THE PUBLIC |
| 11 | ABOUT HEALTH NEEDS & SERVICES AVAILABLE; INCLUDING TELE-HEALTH SERVICES & |
| 11 | SPECIALIST SERVICES. MHS WILL ALSO EVALUATE AND MAKE IMPROVEMENTS AS NEEDED |
| 11 | TO SCREENING & REFERRAL PRACTICES FOR SOCIAL DETERMINANTS OF HEALTH NEEDS, |
| 11 | INVESTIGATE HOW LOCAL WHEELCHAIR TRANSPORTATION IS ACCESSABLE IN & OUT OF |
| 11 | COUNTY, & UTILIZE BEST PRACTICE TO MEET PATIENTS WHERE THEY ARE. |
| 38-1738615 | 5 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| MCKENZIE HEALTH & WELLNESS | ||||
| 170 W ARGYLE STREET | SANDUSKY | MI | 48471 | PROVIDER OFFICE |
| MCKENZIE RURAL HEALTH CLIN | ||||
| 75 DAWSON STREET | SANDUSKY | MI | 48471 | PROVIDER OFFICE |
| MCKENZIE FAMILY HEALTHCARE | ||||
| 109 N DELAWARE STREET | SANDUSKY | MI | 48471 | PROVIDER OFFICE |
| LAKESHORE INTERNAL MEDICIN | ||||
| 7307 CHERRY STREET | PORT SANILAC | MI | 48469 | PROVIDER OFFICE |
| CROSWELL CLINIC | ||||
| 8 N HOWARD | CROSWELL | MI | 48422 | PROVIDER OFFICE |
| PECK MEDICAL CLINIC | ||||
| 251 E PECK ROAD | PECK | MI | 48466 | PROVIDER OFFICE |
| MCKENZIE AFTER HOURS CLINI | ||||
| 120 DELAWARE STREET | SANDUSKY | MI | 48471 | PROVIDER OFFICE |
| MCKENZIE ORTHOPEDICS | ||||
| 100 W ARGYLE STREET | SANDUSKY | MI | 48471 | PROVIDER OFFICE/RENTAL |
| MCKENZIE GI CLINIC | ||||
| 115 DELAWARE STREET | SANDUSKY | MI | 48471 | PROVIDER OFFICE |
Supplemental Information Detail SupplementalInformationDetail (23 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I LINE 7 | SCH H WORKSHEETS WERE USED TO PREPARE THE COST TO CHARGE RATIO. |
| PART II | MHS PROMOTED COMMUNITY HEALTH THROUGH SENIOR FAIR, SCHOOL TOURS, COUNTY 4-H |
| PART II | TOWN HALLS, VIRTUAL HEALTHY LIVING EVENTS, CAREER FAIRS, ETC. |
| PART III LINE 2 | BAD DEBTS ARE ESTIMATED BY ALLOWANCE METHOD & AUDITED INDEPENDENTLY ANNUALY |
| PART III LINE 2 | NET OF DISCOUNTS/PAYMENTS REC'D ON ACCT POST BAD DEBT DETERMINATION. |
| PART III LINE 4 | SEE ATTACHED AUDITED FINANCIAL STATEMENTS, PAGE 10' NOTE 1. |
| PART III LINE 8 | MHS IS A CRITICAL ACCESS HOSPITAL UNDER MEDICARE REG, COST BASED REIMBURSED |
| PART III LINE 8 | THE SHORTFALL OF $88,343 CONSISTS OF 2% SEQUESTRATION. |
| PART III LINE 8 | MEDICARE COST REPORT DATA WAS USED TO CALCULATE THESE FIGURES. |
| PART III LINE 9B | COLLECTION POLICY REFERENCES THE FAP FOR THOSE PATIENTS THAT ARE ELIGABLE |
| PART III LINE 9B | FOR ASSISTENCE AS A METHOD OF PAYMENT. |
| PART VI-2 | CNHA DESCRIBES HOW IDENTIFIED NEEDS WERE PRIORITIZED & STRATEGIES WERE IMP- |
| PART VI-2 | LEMENTED. MHS ALSO MONITORS QUALITY SCORES & PATIENT SURVEYS, LEADERSHIP |
| PART VI-2 | IS IN CONTACT IWTH COMMUNITY HEALTHCARE AGENCIES & ACCESSES FINDINGS |
| PART VI-2 | THROUGH COLLABORATION. |
| PART VI-3 | UNISURED PATIENTS RECEIVE A FINANCIAL POLICY BROCURE MHS DIR HUMAN SERVICES |
| PART VI-3 | FOLLOWS UP TO ASSIST IN APPLICATIONS FOR MEDICARE, MEDICAID, & FAP. |
| PART VI-3 | THIS INFO IS ALSO LOCATED IN BROCHURE, WEBSITE, PATIENT STATEMENT, HOSPITAL |
| PART VI-3 | LOBBY, ER, & PATIENT FINANCIAL SERVICES. |
| PART VI-4 | MHS IS A CAH IN SANILAC COUNTY, MI. POPULATION 40,747, OVER 1,600 SQ MILES |
| PART VI-4 | 90% RURAL, 11% OF ADULTS ARE UNINSURED, UNEMPLOYMENT RATE IS 6%, |
| PART VI-4 | AND 26% OF CHILDREN UNDER AGE 6 LIVE IN A HOME WITH INCOME BELOW POVERTY. |
| PART VI-5 | GOVERNED BY BOD, SERV., GERIATRICS, IMMUNIZATION, PHYSICALS, ECT. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|
| MICHAEL DREYER | ||||||
| CHAIRPERSON | ||||||
| LARRY MITCHELL | ||||||
| SECRETARYTREASURER | ||||||
| STEVE BARNETT | ||||||
| CEOPRESIDENT | $237,654 | $9,944 | $25,154 | $272,752 | ||
| JAMES SAMS | ||||||
| CHIEF OF STAFF | $227,834 | $9,336 | $10,469 | $247,639 | ||
| MATTHEW GORMLEY | ||||||
| PHYSICIAN | $198,653 | $8,440 | $27,774 | $234,867 | ||
| AMY RUEDISUELI | ||||||
| CFO | $165,948 | $6,565 | $172,513 | |||
| BILLI JO HENNIKA | ||||||
| COO | $145,892 | $6,091 | $24,491 | $176,474 | ||
| GINA PATTERSON | ||||||
| DIRECTOR PHARMACY | $154,761 | $7,218 | $21,418 | $183,397 | $23,276 | $23,276 |
| JAMES KOSIUR | ||||||
| PHYSICIAN | $477,830 | $9,150 | $13,947 | $500,927 | ||
| MARK ENGLISH | ||||||
| PHYSICIAN | $183,434 | $7,892 | $28,425 | $219,751 | ||
| BRANDON GUIBORD | ||||||
| SECRETARYTREASURER | ||||||
| JAY SMITH | ||||||
| DIAGNOSTIC DIRECTOR | $145,758 | $6,170 | $20,859 | $172,787 | ||
Schedule L IRS990ScheduleL
Disqualified Person Ex Bnft Tr DisqualifiedPersonExBnftTrGrp (6 entries)
| Transaction CorrectedTransactionCorrectedInd |
|---|
| false |
| false |
| false |
| false |
| false |
| false |
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (10 entries)
| DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (10 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| BARNETT ANESTHESIA | |||
| CEO'S SPOUSE | $175,788 | CRNA SERVICES | false |
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI Line 11b | BOD ARE PROVIDED A FULL COPY OF 990 AS WELL AS A RECONCILIATION TO |
| Part VI Line 11b | AUDITED FINANCIAL STATEMENTS. |
| Part VI Line 19 | ALL DOCUMENTS ARE AVAILABLE FOR REVIEW BY REQUEST AT THE REQUEST |
| Part VI Line 19 | AT THE CEO'S OFFICE. |
| PART VI LINE 6 | CLASSES OF MEMBERS MAKE UP THE BOARD OF DIRECTORS. |
| PART VI LINE 7A | BOARD MEMBERS MUST BE APPROVED BY THE BOARD OF MCKENZIE HEALTHCARE CORP. |
| PART VI LINE 7B | MCKENZIE HEALTHCARE CORP APPROVE FINANCIAL TRANSACTIONS OVER $1 MILLION |
| PART VI LINE 7B | PRIOR TO THOSE TRANSACTIONS BEING TAKEN TO MHS BOARD OF DIRECTORS. |
| PART VI LINE 12C | BOARD AND COMMITTEE MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT |
| PART VI LINE 12C | OF INTEREST POLICY & ABSTAIN FROM ANY CONFLICTING VOTE. |
| PART VI LINE 15 | COMPENSATION IS APPROVED BY THE FULL MHS BOARD, BASED ON RECOMMENDATIONS |
| PART VI LINE 15 | AND RECENT COMPENSATION SURVEYS. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MMH PROPERTY GROUP LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | LAND HOLDING | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE MEMORIAL HOSPITA | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEKENZIE HEALTHCARE CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382702946 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Exempt Code Section | 501 C | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ITSELF | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SANILAC SERVICES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 78 S ELK STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382774983 | EIN |
| Primary Activities | RENTAL BUILDING | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE HEALTHCARE CORP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Share Of Total Income | $17,732 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $383,917 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SANILAC SERVICES INC | ||
| A | $11,257 | COST BASIS |
| (no name) | ||
| L | $8,100 | COST BASIS |
| SANDUSKY | ||
| Q | $128 | COST BASIS |
Comments