PINE REST CHRISTIAN MENTAL HEALTH SERVICES: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PINE REST CHRISTIAN MENTAL HEALTH SERVICES (EIN 38-1368360)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-09
- IRS object ID
- 202241319349305589
- Schema version
- 2020v4.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-09T12:04:54-07:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381368360 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PINE REST CHRISTIAN MENTAL HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PINE | BusinessNameControlTxt |
| Phone | 6164555000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 68th Street SE PO Box 165 | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 495010165 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Paul Karsten | PersonNm |
| Person Title | Vice President & CFO | PersonTitleTxt |
| Phone | 6164555000 | PhoneNum |
| Signature | 2022-05-09 | SignatureDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 1 | TrustedCustomerCd |
| OOB Security Verification | 11 | OOBSecurityVerificationCd |
| Last Submission Rqr OOB | 1 | LastSubmissionRqrOOBCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Profile Password Change | Yes (X) | ProfilePasswordChangeInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mark Eastburg | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 68th Street SE | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49548 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $204,616,756 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | pinerest.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1908 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity, and compassion. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 2389 | TotalEmployeeCnt |
| Total Volunteers | 123 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,134,198 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,894,027 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $148,049,190 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $157,485,633 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,515,889 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,468,703 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,588,723 | PYOtherRevenueAmt |
| CY Other Revenue | $5,624,922 | CYOtherRevenueAmt |
| PY Total Revenue | $161,288,000 | PYTotalRevenueAmt |
| CY Total Revenue | $174,473,285 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $117,681,151 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $125,109,113 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $570,379 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $43,863,097 | PYOtherExpensesAmt |
| CY Other Expenses | $38,675,985 | CYOtherExpensesAmt |
| PY Total Expenses | $161,544,248 | PYTotalExpensesAmt |
| CY Total Expenses | $163,785,098 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$256,248 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,688,187 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $112,227,991 | TotalAssetsBOYAmt |
| Total Assets EOY | $128,907,137 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $51,161,968 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $56,535,608 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $61,066,023 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $72,371,529 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity, and compassion. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $65,195,514 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $86,334,168 | RevenueAmt |
| Desc | Hospital Based Services inpatient and partial hospitalization programs include dedicated psychiatric services for children, adolescents, adults and older adults. Clinical conditions addressed included the full array of psychiatric diagnoses, co-occurring substance abuse diagnoses, and psychiatric disorders where treatment is complicated by co-existing medical conditions. Patients experience professional assessment and individualized treatment including: diagnosis, medication management and education, individual and group therapies, individual and family consultations and therapy, case management, discharge planning and aftercare. The inpatient and partial hospitalization programs are accredited by the Joint Commission of Accreditation of Healthcare Organizations (JCAHO). Hospital Based Services, had 70,541 patient days of care in Fiscal year 2021. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $48,901,524 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $51,364,692 | RevenueAmt |
| Desc | Clinic Network through its 19 clinics, offers outpatient, ambulatory care at locations throughout West and Northern Michigan, and in Iowa. For people who do not require the structured environment of the inpatient or residential care settings, outpatient services are at the center of the behavioral health continuum. Nearly 75% of all persons who come to Pine Rest are served through outpatient care. Clinicians provide a broad spectrum of intervention across the age continuum in convenient, non-restrictive environments. In addition to traditional outpatient care, Pine Rest provides a variety of specialty services including assessment through the Psychological Consultation Center, intensive outpatient and residential substance abuse/addictions services, court-related services and assessments, and more. The Clinic Network had 338,919 patient visits in fiscal year 2021. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,404,636 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $8,752,386 | RevenueAmt |
| Desc | Pine Rest has operated a psychiatry residency program since July 2014, successfully beginning the sixth year of the program on July 1, 2019. There are currently 46 residents that spend 1 - 2 half days in lectures and individual supervision. The remaining time is spent on their rotations, working under the supervision of a psychiatrist to provide care to patients. Rotations include addictions, Network 180 (emergency psychiatry), child and adolescent, adult inpatient, older adult inpatient, primary care (OP family practice locations), neurology (Spectrum Health and Mercy Health) and outpatient clinic services. And, the Pine Rest OP Residency Clinic opened in October 2015 and is currently providing services to numerous community members. Applications for the next year's residency program are received in the fall. Pine Rest is pleased that our residents come from a variety of excellent medical schools located throughout the country. The candidates are ranked based on their past record in medical school, test scores and performance on their interviews with faculty. The Graduate Medical Education match system then assigns the residents to Pine Rest. The Pine Rest Psychiatry Residency Program is currently accredited by the ACGME through 2025. A fellowship to train Child and Adolescent psychiatrists began in July 2017. This two year training program involves rotations in the child and adolescent inpatient unit, residential program, partial hospital and outpatient services, as well as rotations at locations in the community such as community mental health and adolescent addiction programs. Research has shown that over 60% of psychiatry residents stay and work in the community where they train. Pine Rest's goal is to ensure over time that West Michigan has a sufficient amount of psychiatry to serve our community. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (4 entries)
| ExpenseExpenseAmt | GrantGrantAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|---|
| $5,021,823 | $0 | $5,577,263 | The Pine Rest Adult Residential Division offers longer term psychiatric services to adults with mental health needs in a residential setting. These programs include both locked and unlocked settings. These services and facilities are licensed and accredited by the State of Michigan as well as the Commission on Accreditation of Rehabilitation Facilities (CARF). The Caring Communities Program brings Pine Rest into invited partnerships with established community organizations to introduce behavioral health services to under-served populations. Clients typically have limited resources and limited access to behavioral healthcare. With partners like Baxter Community Center, Belknap Commons, Dwelling Place, Grand Rapids Public Schools, Heartside Ministries, Grand Rapids Housing Commission and many more, Pine Rest addresses behavioral health needs in a non-traditional model. Adult Residential services had 10,025 patient days of care in fiscal year 2021. |
| $3,422,967 | $0 | $3,273,289 | Homes for the Developmentally Disabled serves adults with developmental disabilities in exceptional residential settings with multiple opportunities for engaging in on-site and community activities that match abilities. Homes for the Developmentally Disabled services program had 22,454 patient days of care in fiscal year 2021. |
| $891,041 | $0 | $962,192 | Education and Prevention offers a range of education and prevention activities that help promote community wellness. Pine Rest is the recipient of several grants that promote education and prevention activities around mental health as well as perform research to further determine best practice models of care. An internship program for graduate students studying psychology is offered. |
| $1,312,247 | $0 | $1,221,642 | Pine Rest has a Grants Management Program designed to introduce new research and programs to the organization and provide better services to our patients and community. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $10,648,078 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $11,034,386 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $133,149,752 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 132 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2389 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Paul H Karsten | PersonNm |
| Phone | 6162816363 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 68th St SE | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 495010165 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Institutional TrusteeInstitutionalTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Amandeep S Saluja | ||||||||||
| Medical Staff | 55 | 0 | Yes (X) | $628,448 | $0 | $21,064 | ||||
| Bibhas Singla | ||||||||||
| Medical Staff | 55 | 0 | Yes (X) | $582,607 | $0 | $22,660 | ||||
| Marwan Tabbara | ||||||||||
| Medical Staff | 55 | 0 | Yes (X) | $464,600 | $0 | $22,267 | ||||
| James Eicher | ||||||||||
| Medical Professional | 55 | 0 | Yes (X) | $424,824 | $0 | $24,997 | ||||
| William Sanders | ||||||||||
| Chief Medical Officer | 60 | 0 | $416,302 | $0 | $25,467 | Yes (X) | ||||
| Mark C Eastburg PhD | ||||||||||
| President & CEO | 58 | 2 | $376,063 | $0 | $26,201 | Yes (X) | ||||
| Brian Hesler | ||||||||||
| Medical Professional | 55 | 0 | Yes (X) | $390,818 | $0 | $9,627 | ||||
| Jack Mahdasian | ||||||||||
| Medical Staff | 55 | 0 | $390,818 | $0 | $9,627 | Yes (X) | ||||
| Katherine Jawor | ||||||||||
| Medical Staff | 55 | 0 | $389,440 | $0 | $6,730 | Yes (X) | ||||
| Valerie MathisAllen | ||||||||||
| Medical Staff | 55 | 0 | $340,504 | $0 | $10,672 | Yes (X) | ||||
| Daniel Schellenberg | ||||||||||
| Medical Staff | 55 | 0 | $308,512 | $0 | $26,375 | Yes (X) | ||||
| Robert L Nykamp | ||||||||||
| VP & COO | 60 | 0 | $255,042 | $0 | $22,794 | Yes (X) | ||||
| Paul H Karsten | ||||||||||
| VP & CFO | 58 | 2 | $237,593 | $0 | $19,456 | Yes (X) | ||||
| Susan Langeland | ||||||||||
| Chief Information Officer | 60 | 0 | $184,589 | $0 | $25,267 | Yes (X) | ||||
| Verle Bell | ||||||||||
| Medical Staff | 55 | 0 | $184,369 | $0 | $11,816 | Yes (X) | ||||
| Scott A Wagner | ||||||||||
| VP BHS | 60 | 0 | $154,138 | $0 | $22,120 | Yes (X) | ||||
| Alan M Armstrong MD | ||||||||||
| Chief Medical Officer | 55 | 0 | $145,911 | $0 | $7,328 | Yes (X) | ||||
| Jody Vanderwel | ||||||||||
| Chairperson | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Scott Bolinger | ||||||||||
| Vice Chairperson and Secretary | 2.0 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Gil Segovia | ||||||||||
| Treasurer | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Mary Ann Cartwright | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| LaRissa Hollingsworth | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Art Jongsma PhD | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Doug Josephson | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Ron Kool | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Glenn Mitcham | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| David McKeague | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Laurie Murphy | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Susan Valcq | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Sylvia Daining | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Brett Holleman | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Kirk Lambers | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Marilyn Litka-Klein | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Abbey Slakick | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Stacia Ford-Spicer | ||||||||||
| Board Member | 1 | 0 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,874,578 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $314,468 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 144 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| Unidine Corporation | ||||||
| PO Box 360639 | Pittsburgh | PA | 152516639 | Patient Dietary and Cafeteria Services | $2,611,994 | |
| US Signal LLC | ||||||
| 201 Ionia Avenue SW | Grand Rapids | MI | 49503 | Cloud Data Hosting | $1,809,825 | |
| Institutional Pharmacy Solutions | ||||||
| 3480 EAstern Boulevard | Montgomery | AL | 36116 | Pharmacy | $1,583,212 | |
| SHI International Corp | ||||||
| 150 N Michigan Avenue | Chicago | IL | 60601 | Provider of Technology Products and Services | $1,574,827 | Suite 500 |
| Epic Systems Corporation | ||||||
| 1979 Milky Way | Verona | WI | 53593 | Electronic Medical Record | $1,458,025 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 70 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $1,933,908 | RelatedOrganizationsAmt |
| Government Grants | $2,960,119 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $4,894,027 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Inpatient Care | 622000 | $97,030,319 | $97,030,319 | $0 | $0 |
| Outpatient Care | 621400 | $50,750,203 | $50,750,203 | $0 | $0 |
| Residential Patient Care | 623000 | $9,705,111 | $9,705,111 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $157,485,633 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,718,841 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,718,841 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $21,628 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $20,008 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,620 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,620 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,620 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $31,873,325 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $30,123,463 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,749,862 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,749,862 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,749,862 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Network 180 BHH/StreetReach contracts | 624100 | $2,257,355 | $0 | $0 | $2,257,355 |
| ORS Contracts | 624100 | $871,779 | $0 | $0 | $871,779 |
| CARES Act Provider Relief Fund | 624230 | $118,256 | $0 | $0 | $118,256 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,375,912 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,375,912 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,623,302 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $174,473,285 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $157,485,633 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $12,093,625 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,918,271 | TotalAmt |
| Program Services | $595,008 | ProgramServicesAmt |
| Management And General | $1,323,263 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,600,787 | TotalAmt |
| Program Services | $92,266,671 | ProgramServicesAmt |
| Management And General | $10,946,135 | ManagementAndGeneralAmt |
| Fundraising | $387,981 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,476 | TotalAmt |
| Program Services | $659,089 | ProgramServicesAmt |
| Management And General | $96,424 | ManagementAndGeneralAmt |
| Fundraising | $3,963 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,830,579 | TotalAmt |
| Program Services | $16,571,785 | ProgramServicesAmt |
| Management And General | $2,189,556 | ManagementAndGeneralAmt |
| Fundraising | $69,238 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,059 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $5,059 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $553,609 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $553,609 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,476 | TotalAmt |
| Program Services | $128,157 | ProgramServicesAmt |
| Management And General | $194,319 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,250 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $187,250 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,939,425 | TotalAmt |
| Program Services | $6,577,236 | ProgramServicesAmt |
| Management And General | $3,327,917 | ManagementAndGeneralAmt |
| Fundraising | $34,272 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $672,690 | TotalAmt |
| Program Services | $51,002 | ProgramServicesAmt |
| Management And General | $605,135 | ManagementAndGeneralAmt |
| Fundraising | $16,553 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,009,282 | TotalAmt |
| Program Services | $596,409 | ProgramServicesAmt |
| Management And General | $396,878 | ManagementAndGeneralAmt |
| Fundraising | $15,995 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,926,513 | TotalAmt |
| Program Services | $119,496 | ProgramServicesAmt |
| Management And General | $3,807,017 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,120,875 | TotalAmt |
| Program Services | $2,186,160 | ProgramServicesAmt |
| Management And General | $934,715 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,423 | TotalAmt |
| Program Services | $52,258 | ProgramServicesAmt |
| Management And General | $32,165 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,309,673 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,309,673 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,056,643 | TotalAmt |
| Program Services | $3,423,799 | ProgramServicesAmt |
| Management And General | $3,606,938 | ManagementAndGeneralAmt |
| Fundraising | $25,906 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $540,052 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $540,052 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Food Costs | $2,742,623 | $2,737,333 | $5,290 | $0 |
| Pharmacy Costs | $1,406,430 | $1,406,430 | $0 | $0 |
| Medical Supplies | $1,381,903 | $1,380,531 | $1,372 | $0 |
| Patient Assistance | $1,654,971 | $1,654,971 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,762,088 | TotalAmt |
| Program Services | $2,743,417 | ProgramServicesAmt |
| Management And General | $2,200 | ManagementAndGeneralAmt |
| Fundraising | $16,471 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,785,098 | TotalAmt |
| Program Services | $133,149,752 | ProgramServicesAmt |
| Management And General | $30,064,967 | ManagementAndGeneralAmt |
| Fundraising | $570,379 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,583,548 | BOYAmt |
| EOY | $5,679,408 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,874 | BOYAmt |
| EOY | $269,601 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,183,703 | BOYAmt |
| EOY | $21,136,737 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,456 | BOYAmt |
| EOY | $40,969 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,755 | BOYAmt |
| EOY | $161,207 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,610,754 | BOYAmt |
| EOY | $2,926,576 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $144,218,446 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $84,036,915 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,425,237 | BOYAmt |
| EOY | $60,181,531 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,069,526 | BOYAmt |
| EOY | $36,140,043 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $823,355 | BOYAmt |
| EOY | $823,355 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,315,783 | BOYAmt |
| EOY | $1,547,710 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,227,991 | BOYAmt |
| EOY | $128,907,137 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,652,306 | BOYAmt |
| EOY | $19,280,403 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,008 | BOYAmt |
| EOY | $147,223 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,200,000 | BOYAmt |
| EOY | $30,200,000 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,256,959 | BOYAmt |
| EOY | $2,845,571 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,005,695 | BOYAmt |
| EOY | $4,062,411 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,161,968 | BOYAmt |
| EOY | $56,535,608 | 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 | $59,674,168 | BOYAmt |
| EOY | $70,362,356 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,391,855 | BOYAmt |
| EOY | $2,009,173 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,066,023 | BOYAmt |
| EOY | $72,371,529 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,227,991 | BOYAmt |
| EOY | $128,907,137 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $10,688,187 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $617,319 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $5,059 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $5,059 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 | FormAndLineReferenceDesc |
| Explanation | Verbal and written communication with public officials regarding legislation and proposals affecting the delivery of healthcare in Michigan and Nationally. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $26,104,515 | BeginningYearBalanceAmt |
| Contributions | $117,946 | ContributionsAmt |
| Investment Earnings Or Losses | $5,332,485 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,094,565 | GrantsOrScholarshipsAmt |
| Other Expenditures | $6,177 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $30,454,204 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $25,715,850 | BeginningYearBalanceAmt |
| Contributions | $127,880 | ContributionsAmt |
| Investment Earnings Or Losses | $1,481,591 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,219,787 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,019 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $26,104,515 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $24,572,355 | BeginningYearBalanceAmt |
| Contributions | $704,814 | ContributionsAmt |
| Investment Earnings Or Losses | $1,632,181 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,193,500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $25,715,850 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $24,177,318 | BeginningYearBalanceAmt |
| Contributions | $176,400 | ContributionsAmt |
| Investment Earnings Or Losses | $1,366,629 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,132,261 | GrantsOrScholarshipsAmt |
| Other Expenditures | $15,731 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $24,572,355 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $23,301,864 | BeginningYearBalanceAmt |
| Contributions | $790,005 | ContributionsAmt |
| Investment Earnings Or Losses | $1,954,474 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,534,202 | GrantsOrScholarshipsAmt |
| Other Expenditures | $334,823 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $24,177,318 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.85 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.15 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $102,148 | OtherCostOrOtherBasisAmt |
| Book Value | $102,148 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $80,489,237 | OtherCostOrOtherBasisAmt |
| Depreciation | $46,582,046 | DepreciationAmt |
| Book Value | $33,907,191 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $4,860,456 | OtherCostOrOtherBasisAmt |
| Depreciation | $993,310 | DepreciationAmt |
| Book Value | $3,867,146 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $49,788,872 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,922,500 | DepreciationAmt |
| Book Value | $16,866,372 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $8,977,733 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,539,059 | DepreciationAmt |
| Book Value | $5,438,674 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $60,181,531 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Capital Lease Obligation | Desc |
| Amt | $4,062,411 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,062,411 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $174,306,043 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $0 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $20,008 | DonatedServicesAndUseFcltsAmt |
| Recoveries Prior Year Grants | $0 | RecoveriesPriorYearGrantsAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $20,008 | RevenueNotReportedAmt |
| Revenue Subtotal | $174,286,035 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $187,250 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $187,250 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $174,473,285 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $163,617,856 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $20,008 | DonatedServicesUseFcltsAmt |
| Prior Year Adjustments | $0 | PriorYearAdjustmentsAmt |
| Losses Reported | $0 | LossesReportedAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $20,008 | ExpensesNotReportedAmt |
| Expenses Subtotal | $163,597,848 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $187,250 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $187,250 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $163,785,098 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 | The spending policy allows for annual spending of 5% of the average fair market value of the net assets for the prior three years. This amount is transferred from the Foundation to the operating funds of the Corporation to provide for the care of patients and other initiatives that benefit the organization. The spending policy allows for use of investment earnings on permanently restricted endowment funds in accordance with donor wishes. |
| Schedule D, Part X, Line 2 | The Corporation is not-for-profit corporation pursuant to section 501(C)(3) of the Internal Revenue Code and is exempt from income taxes on related income pursuant to section 501(A). The Corporation recognizes interest and penalties related to unrecognized tax positions and includes these in interest and income tax expense. The Corporation has no amounts accrued for interest and penalties as of June 30, 2021. The Corporation does not expect the total amount of unrecognized tax benefits to significantly change over the next twelve months. The Corporation is no longer subject to examination by tax authorities for years before 2018. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 2.5 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,659,749 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,659,749 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0103 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,622,691 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $39,534,690 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $35,282,440 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $39,534,690 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,659,749 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0103 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68,718 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $68,718 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $83,280,855 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $75,042,052 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,238,803 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $592,939 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $592,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0067 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $83,942,512 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $75,042,052 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,900,460 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0067 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $119,224,952 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $114,576,742 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,560,209 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0170 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $74,547 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $74,547 | NetCommunityBenefitExpnsAmt |
| Total Expense | 1 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $74,547 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $74,547 | NetCommunityBenefitExpnsAmt |
| Total Expense | 1 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,106,747 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,212,164 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,151,212 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,960,099 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$808,887 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | Pine Rest Christian Mental Health Services | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 68th Street SE | AddressLine1Txt |
| Address Line2 | PO Box 165 | AddressLine2Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 495010165 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.pinerest.org | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pine Rest Christian Mental Health Services | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.pinerest.org/about-us/#KCCNA | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | http://www.kentcountychna.org/workgroups.html | OtherWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.pinerest.org/media/pine-rest-strategy-for-community-needs-assessment-report.pdf | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | 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 (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.pinerest.org/about-us/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.pinerest.org/about-us/financial-assistance/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.pinerest.org/about-us/financial-assistance/ | 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 Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | 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 | 0 | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Emergency Care Limited | Yes (X) | EmergencyCareLimitedInd |
| Other Reason | Yes (X) | OtherReasonInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5-Pine Rest Christian Mental Health Services | The process of assessing community health needs is undertaken on a collaborative basis. This process (called the CHNA) involved over fifty community organizations in 2020. Through community engagement and participation, this process identifies and prioritizes health-related needs and analyzes a broad range of social, economic, environmental and behavioral factors that may contribute to health needs or influence health outcomes of residents. Pine Rest Christian Mental Health Services is a principal participant in the CHNA process, as it relates to behavioral health in all its aspects. See www.kentcountychna.org for details on methods employed, data collection, sources of input and key findings. Information from the CHNA is used to develop a Community Health Improvement Plan (CHIP) which aims to address the prioritized needs. Pine Rest Christian Mental Health Services uses the CHIP to establish strategic initiatives addressing the needs identified in the behavioral health field. see https://www.pinerest.org/about-us/#KCCNA |
| Schedule H, Part V, Section B, Line 6a-Pine Rest Christian Mental Health Services | Mercy Health St. Mary's, Spectrum Health, University of Michigan Health-West and Mary Free Bed |
| Schedule H, Part V, Section B, Line 6b-Pine Rest Christian Mental Health Services | see www.kentcountychna.org for a complete list of participants |
| Schedule H, Part V, Section B, Line 11-Pine Rest Christian Mental Health Services | Each year, Pine Rest CMHS assesses and updates a response to the most recent CHNA. Consequently, Pine Rest CMHS has selected issues from the CHNA that can and should be addressed by Pine Rest CMHS. |
| Schedule H, Part V, Section B, Line 13h-Pine Rest Christian Mental Health Services | In determining financial assistance eligibility, Pine Rest CMHS will evaluate the patient/guarantor's ability to reimburse Pine Rest CMHS for the services being requested or previously provided. Pine Rest CMHS will evaluate information such as the following: income level, net worth, employment status, other financial obligations and amount and frequency of healthcare costs. |
| Schedule H, Part V, Section B, Line 21c-Pine Rest Christian Mental Health Services | Pine Rest CMHS is a psychiatric facility. We do not provide emergency medical care and do not fall under EMTALA |
| Schedule H, Part V, Section B, Line 21d-Pine Rest Christian Mental Health Services | Pine Rest CMHS is a psychiatric facility. We do not provide emergency medical care and do not fall under EMTALA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 33 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (33 entries)
| Business Name Line2BusinessName/BusinessNameLine2Txt | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| Pine Rest -Center for Psychiatric Services | ||||||
| CPRS | 300 68th Street SE | Grand Rapids | MI | 49548 | Residential Child Caring Institution | |
| Pine Rest - Campus Clinic | ||||||
| 300 68th Street SE | Grand Rapids | MI | 495010165 | Outpatient clinic, residential detox, screening, assessment, referral | PO Box 165 | |
| Pine Rest - Southwest Clinic | ||||||
| 4211 Parkway Place | Grandville | MI | 49418 | Outpatient Clinic, screening, assessment, referral and follow up | ||
| Pine Rest - Traverse City Clinic | ||||||
| 1050 Silver Drive | Traverse City | MI | 49684 | Outpatient Clinic, mental health, addiction treatment and follow up | ||
| Pine Rest - Northeast Clinic | ||||||
| 3225 North Evergreen Drive NE | Grand Rapids | MI | 49525 | Outpatient Clinic, screening, assessment, referal and follow up | Suite 301 | |
| Pine Rest - Northwest Clinic | ||||||
| 2118 3 Mile Road | Grand Rapids | MI | 49544 | Outpatient Clinic, screening, assessment, referral and follow up | ||
| Pine Rest - Northshore Clinic | ||||||
| 17325 VanWagoner Road | Spring Lake | MI | 49456 | Outpatient Clinic, screening, assessment, referral and follow up | ||
| Pine Rest - ECT TMS Clinic | ||||||
| 300 68th Street SE | Grand Rapids | MI | 49508 | Outpatient and Inpatient, screening, assessment, referral and follow up | ||
| Pine Rest - Christian Counseling Center | ||||||
| 1870 Leonard NE | Grand Rapids | MI | 49505 | Outpatient Clinic, screening, assessment, referral and follow up | ||
| Pine Rest - PCC Psychological Consolation Center | ||||||
| 300 68th St | Grand Rapids | MI | 49548 | PCC Psychological Consolation Center | ||
| Pine Rest - InterActions Residential Treatment | ||||||
| 300 68th Street SE | Grand Rapids | MI | 49548 | Adult Foster Care | ||
| Pine Rest - Sub-Acute Detox | ||||||
| 300 68th Street SE | Grand Rapids | MI | 49548 | Residential mental health and addiction treatment and detox | ||
| Pine Rest - Holland Clinic | ||||||
| 926 S Washington Ave | Holland | MI | 49423 | Outpatient Clinic, screening, assessment, referral and follow up | Suite 210 | |
| Pine Rest - Kalamazoo Clinic | ||||||
| 1530 Nichols Road | Kalamazoo | MI | 49006 | Outpatient Clinic, screening, assessment, referral and follow up | ||
| Pine Rest - Addictions Medicine | ||||||
| 300 68th Street SE | Grand Rapids | MI | 49548 | Outpatient Clinic, screening, assessment, referral and follow up | ||
| Pine Rest - Community Case Management | ||||||
| 320 Commerce Avenue SW | Grand Rapids | MI | 49503 | Outpatient Clinic, comm change alternative informatin training, prevention and mental health | ||
| Pine Rest - Zeeland Clinic | ||||||
| 8333 Felch | Zeeland | MI | 49464 | Outpatient Clinic, screening, assessment, referral and follow up | Suite 210 | |
| Pine Rest - Caledonia Clinic | ||||||
| 6505 Cherry Meadow Dr | Caledonia | MI | 49316 | Outpatient Clinic, screening, assessment, referral and follow up | ||
| Pine Rest - CenterPointe Recovery Center | ||||||
| 1145 Oakland Drive | Kalamazoo | MI | 49008 | Adult Foster Care | ||
| Pine Rest - Cameron | ||||||
| 6680 Adrian SE | Grand Rapids | MI | 49548 | Adult Foster Care | ||
| Pine Rest - SEQUOIA Program | ||||||
| 300 68th Street SE | Grand Rapids | MI | 49548 | Education, awareness, access and non-traditional services to the community | ||
| Pine Rest - Westwood | ||||||
| 7047 Madison SE | Grand Rapids | MI | 49548 | Adult Foster Care | ||
| Pine Rest - Pine Grove | ||||||
| 7051 Madison SE | Grand Rapids | MI | 49548 | Adult Foster Care | ||
| Pine Rest - Portage Clinic | ||||||
| 1350 W Centre Avenue | Portage | MI | 49024 | Outpatient Clinic, screening, assessment, referral and follow up | ||
| Pine Rest - Adrian | ||||||
| 6700 Adrian SE | Grand Rapids | MI | 49548 | Adult Foster Care | ||
| Pine Rest - Eastwood | ||||||
| 7041 Madison SE | Grand Rapids | MI | 49548 | Adult Foster Care | ||
| Pine Rest - Supported Independent Living | ||||||
| 821 68th Street SE | Grand Rapids | MI | 49508 | Residential supervised independent living | ||
| Pine Rest - Forest Hills Clinic | ||||||
| 877 Forest Hill Ave SE | Grand Rapids | MI | 49546 | Outpatient clinic, residential detox, screening, assessment, referral | ||
| Pine Rest - Hastings Clinic | ||||||
| 450 Meadow Run | Hastings | MI | 49058 | Outpatient clinic, residential detox, screening, assessment, referral | ||
| Pine Rest - Lakeland Clinic | ||||||
| 3950 Hollywood Road | St Joseph | MI | 49085 | Outpatient clinic, residential detox, screening, assessment, referral | Ste 200 | |
| Pine Rest - Telehealth Clinic | ||||||
| 300 68th Street SE | Grand Rapids | MI | 49548 | Outpatient clinic, residential detox, screening, assessment, referral | ||
| Pine Rest - Transition Clinic | ||||||
| 300 68th Street SE | Grand Rapids | MI | 49548 | Assist youth in transitioning from Foster care | ||
| Pine Rest - Psychological Consultation Center | ||||||
| 300 68th Street SE | Grand Rapids | MI | 49548 | Providing Psychological Urgent Care to Adults | ||
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7 | Utilized prescribed worksheets 1 through 8 as defined by the IRS |
| Schedule H, Part II | Pine Rest CMHS provides patient transportation through bus passes or gift cards for gas to improve the ability for patients to receive their healthcare needs. |
| Schedule H, Part III, Section A, Line 4 | The provision for bad debts is based upon management's assessment of historical and expected collections of accounts receivable considering business and economic conditions, trends in healthcare coverage and other collection indicators. Accounts receivable are written off and charged to the provision for bad debts after collection efforts have been made in accordance with organizational policies. Recoveries are treated as a reduction to the provision for bad debts. Accounts receivable are reduced by an allowance for doubtful accounts. Periodically, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by major payer category. |
| Schedule H, Part III, Section B, Line 8 | The source is the Medicare cost report |
| Schedule H, Part III, Section C, Line 9b | If a patient is eligible for financial assistance for their care, Pine Rest CMHS will inform them of the amount that they will receive through financial assistance and what reduced amount they are responsible for, if any. The patient will be refunded any amounts he or she paid for their care up to the approved assistance amount, unless less than $10.00. |
| Schedule H, Part VI, Line 2 | Each year, Pine Rest CMHS assesses and updates a response to the CHNA. Pine Rest CMHS is a psychiatric hospital. Consequently, Pine Rest CMHS is selecting issues from the CHNA that can and should be addressed by Pine Rest CMHS |
| Schedule H, Part VI, Line 3 | At admission, the organization communicates to the patient or family as appropriate, the benefits, both public and private, that are available for the prescribed care. Once the patient responsibility is established, the patient status relative to charity care is reviewed and a decision is made regarding patient assistance application |
| Schedule H, Part VI, Line 4 | Pine Rest CMHS is a multi-service behavioral health organization serving a diverse group of people in multiple settings throughout West Michigan. Its network of inpatient, residential and outpatient services reaches people of all ages. The majority of people service by Pine Rest CMHS are identified as being from counties within the state of Michigan. |
| Schedule H, Part VI, Line 5 | To assure a strategic focus on the health needs of the community served, the majority of the governing body is composed of people who reside in the organization's primary service area and who are neither employees nor contractors of the organization. In addition the organization has an open medical staff allowing hospital staff membership to all physicians in the community who meet membership and clinical privilege requirements. This improves care to the community served through greater availability of medical staff within the service area. Since 1908, the organization has consistently applied surplus funds to the improvement of patient care and access, staff education and research designed to expand and improve the level of patient care provided to all patients. Pine Rest CMHS has board designated funds that fund outreach services improving access in the community. Pine Rest CMHS also provides educational opportunities to the community on various behavioral health topics. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Amandeep S Saluja | ||||||||||||||
| Medical Staff | $608,948 | $0 | $0 | $0 | $430 | $0 | $19,500 | $0 | $21,064 | $0 | $649,942 | $0 | $532,987 | $0 |
| Bibhas Singla | ||||||||||||||
| Medical Staff | $555,046 | $0 | $0 | $0 | $8,510 | $0 | $19,500 | $0 | $22,660 | $0 | $605,716 | $0 | $367,638 | $0 |
| Marwan Tabbara | ||||||||||||||
| Medical Staff | $441,228 | $0 | $0 | $0 | $450 | $0 | $23,372 | $0 | $22,267 | $0 | $487,317 | $0 | $357,594 | $0 |
| James Eicher | ||||||||||||||
| Medical Professional | $392,454 | $0 | $0 | $0 | $13,302 | $0 | $19,500 | $0 | $24,997 | $0 | $450,253 | $0 | $0 | $0 |
| William Sanders | ||||||||||||||
| Chief Medical Officer | $377,302 | $0 | $0 | $0 | $19,862 | $0 | $19,500 | $0 | $25,467 | $0 | $442,131 | $0 | $424,644 | $0 |
| Brian Hesler | ||||||||||||||
| Medical Professional | $371,317 | $0 | $0 | $0 | $450 | $0 | $19,500 | $0 | $9,627 | $0 | $400,894 | $0 | $0 | $0 |
| Katherine Jawor | ||||||||||||||
| Medical Staff | $343,940 | $0 | $0 | $0 | $19,950 | $0 | $26,000 | $0 | $6,730 | $0 | $396,620 | $0 | $388,480 | $0 |
| Jack Mahdasian | ||||||||||||||
| Medical Staff | $344,430 | $0 | $0 | $0 | $19,325 | $0 | $24,252 | $0 | $24,626 | $0 | $412,633 | $0 | $461,914 | $0 |
| Mark C Eastburg PhD | ||||||||||||||
| President & CEO | $330,563 | $0 | $0 | $0 | $19,950 | $0 | $26,000 | $0 | $26,201 | $0 | $402,714 | $0 | $404,965 | $0 |
| Valerie MathisAllen | ||||||||||||||
| Medical Staff | $311,466 | $0 | $0 | $0 | $19,950 | $0 | $9,539 | $0 | $10,672 | $0 | $351,627 | $0 | $376,208 | $0 |
| Daniel Schellenberg | ||||||||||||||
| Medical Staff | $289,012 | $0 | $0 | $0 | $19,916 | $0 | $26,000 | $0 | $26,375 | $0 | $361,303 | $0 | $361,969 | $0 |
| Robert L Nykamp | ||||||||||||||
| VP & COO | $228,367 | $0 | $0 | $0 | $5,216 | $0 | $21,675 | $0 | $22,794 | $0 | $278,052 | $0 | $278,460 | $0 |
| Paul H Karsten | ||||||||||||||
| VP & CFO | $221,016 | $0 | $0 | $0 | $352 | $0 | $16,578 | $0 | $19,456 | $0 | $257,402 | $0 | $263,638 | $0 |
| Susan Langeland | ||||||||||||||
| Chief Information Officer | $178,720 | $0 | $0 | $0 | $327 | $0 | $5,869 | $0 | $25,267 | $0 | $210,183 | $0 | $243,503 | $0 |
| Verle Bell | ||||||||||||||
| Medical Staff | $179,434 | $0 | $0 | $0 | $252 | $0 | $4,935 | $0 | $11,816 | $0 | $196,437 | $0 | $284,924 | $0 |
| Scott A Wagner | ||||||||||||||
| VP BHS | $130,229 | $0 | $0 | $0 | $261 | $0 | $23,909 | $0 | $22,120 | $0 | $176,519 | $0 | $162,219 | $0 |
| Alan M Armstrong MD | ||||||||||||||
| Chief Medical Officer | $125,228 | $0 | $0 | $0 | $9,214 | $0 | $11,683 | $0 | $7,328 | $0 | $153,453 | $0 | $302,799 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a | Taxable term life premiums added to taxable income were grossed up to compensate for taxes on these premiums. Grossed up amounts were taxed. |
| Schedule J, Part I, Line 3 | The Board of Directors has adopted a written executive compensation plan and has delegated to the Compensation Committee the responsibility for implementing and overseeing compensation issues with regular reporting to the board. In setting and reviewing executive compensation for the COO, CFO, CMO and Vice Presidents, the Compensation Committee relies on market data for similarly situated hospital executives in comparable organizations. The Compensation Committee also reviews salary market information for the CEO and makes recommendations to the Executive Committee. The Executive Committee relies on market data for similarly situated professionals serving comparable institutions. The organization regularly commissions studies by Integrated Healthcare Strategies to assure that the total compensation paid to physicians is reasonable, consistent with objective market data and in the best interest of the organization. The compensation model for physicians was adopted by the organization based upon those studies. Review and approval of all new physician employment contracts by both the CFO and Chairman of the Compensation Committee is required to insure that all compensation packages are within the approval limits. Documenation and supporting detail are maintained for all compensation decisions. |
| Schedule J, Part I, Line 7 | Employment contracts with officers of the organization allow for performance based incentives. Each year, the Board of Directors articulates and approves objective, measurable performance criteria. If performance criteria are met, then performance based incentives are paid. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Kent Hospital Finance Authority | ||||||||
| A | 381603110 | 490576AC9 | 2015-10-01 | $10,330,000 | Refinancing of original debt | 0 | 0 | 0 |
| Kent Hospital Finance Authority | ||||||||
| B | 381603110 | 2017-12-29 | $24,000,000 | Expansion of Hospital Facility | 0 | 0 | 0 | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | 2023 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | 2027 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| Macatawa Bank | |||||||||
| A | Yes (1) | Yes (1) | Yes (1) | 1.0 | 0 | 0 | 0 | 0 | Yes (1) |
| Macatawa Bank | |||||||||
| B | Yes (1) | Yes (1) | Yes (1) | 1.0 | 0 | 0 | 0 | 0 | Yes (1) |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | William Sanders | PersonNm |
| Relationship With Org | Medical Staff | RelationshipWithOrgTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $100,000 | OriginalPrincipalAmt |
| Balance Due | $100,000 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $100,000 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, Line 11b | The Board of Directors has authorized the Finance committee of the Board of Directors to review and approve the form 990 each year prior to submission to the IRS. Each year a copy of the Form 990 is given to the external auditors for review. Recommended changes are made to the IRS form 990 and supporting schedules. The Finance committee votes on a motion to approve the form as amended. The Final filed form 990 is made available to all Board members for their review and information. |
| Form 990, Part VI, Section B, Line 12c | Ongoing Board of Directors and Board Committee discussions in concert with annual audit and Corporate Integrity office activities monitor and maintain oversight of this activity. |
| Form 990, Part VI, Section B, Line 15 | The Board of Directors has adopted a written Executive compensation plan and has designated the Compensation Committee the responsibility for implementing and overseeing issues with regular reporting to the board. In setting and reviewing executive compensation for the COO, CFO, CMO and Vice Presidents, the Compensation Committee relies on market data for similarly situated hospital executives in comparable institutions. The Compensation Committee also reviews salary market information for the CEO and makes recommendations to the Executive Committee. The Executive Committee oversees CEO compensation. In setting and reviewing compensation of Physicians (both employed and independent contractors), the Compensation Committee relies on market data for similarly situated professionals serving in comparable institutions. The Corporation regularly commissions studies by Integrated Healthcare Strategies to assure that the total compensation paid to physicians is reasonable, consistent with objective market data and in the best interest of the Corporation. The compensation model for Physicians adopted by the Corporation is based on those studies. Review and approval of all new Physician employment contracts by both the CFO and Chairman of the Compensation Committee is required to insure that the compensation packages are within the approval limits. Documentation and supporting detail are maintained for all compensation decisions. |
| Form 990, Part VI, Section C, Line 19 | All documents are available upon request. |
| Form 990, Part XI, Line 9 | This is the change in Net assets with donor restrictions. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pine Rest Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 68th Street SE | AddressLine1Txt |
| Address Line2 | PO Box 165 | AddressLine2Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 495011065 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381676540 | EIN |
| Primary Activities | Fundraising | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Type 1 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pine Rest Christian Mental Health Services | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Pine Rest Foundation | ||
| c | $1,094,565 | Each year, following a specific formula, the Pine Rest Foundation awards grants to Pine Rest Christian Mental Health Services to fund various aspects of behavioral healthcare and counseling programs. |
| Pine Rest Foundation | ||
| m | $1,337,439 | The Pine Rest Foundation serves as the single-portal for all donations intended for the Pine Rest Foundation and Pine Rest Christian Mental Health Services. |
| Pine Rest Foundation | ||
| p | $26,095 | The Pine Rest Christian Mental Health Services Accounts Payable department processes all invoices for the Pine Rest Foundation. The Pine Rest Foundation then reimburses Pine Rest CMHS an amount equal to the invoices that have been paid on their behalf. |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Pine Rest Christian Mental Health Services filed and received approval of form 8868 extension which moved the due date of this report to May 15, 2022 | ExplanationTxt |