COREWELL HEALTH: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- COREWELL HEALTH (EIN 38-2748035)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-07-30
- IRS object ID
- 202012129349300821
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-30T11:00:38-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135381590 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Ottawa Ave NW Suite 300 | AddressLine1Txt |
| City | Grand Rapids | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382748035 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Memorial Health Services Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 2699836501 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4368 Cleveland Avenue | AddressLine1Txt |
| City | Stevensville | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49127 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL KONOPACKI | PersonNm |
| Person Title | VP - Finance & CFO | PersonTitleTxt |
| Signature | 2020-07-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jacob Cook | PreparerPersonNm |
| PTIN | P01240455 | PTIN |
| Phone | 6167747000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-11-19 02:30:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pine Ridge A Rehabilitation & Nursing Center | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MELINDA GRUBER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1234 NAPIER AVENUE | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,914,093 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LAKELANDHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE HEALTH, INSPIRE HOPE AND SAVE LIVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 178 | TotalEmployeeCnt |
| Total Volunteers | 54 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,983,943 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,914,034 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2 | PYInvestmentIncomeAmt |
| CY Investment Income | $59 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $10,983,945 | PYTotalRevenueAmt |
| CY Total Revenue | $11,914,093 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,941,474 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,567,357 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,610,347 | PYOtherExpensesAmt |
| CY Other Expenses | $4,153,276 | CYOtherExpensesAmt |
| PY Total Expenses | $11,551,821 | PYTotalExpensesAmt |
| CY Total Expenses | $11,720,633 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$567,876 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $193,460 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,721,351 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,912,704 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,576,069 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,573,962 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,145,282 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,338,742 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE HEALTH, INSPIRE HOPE AND SAVE LIVES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,102,534 | ExpenseAmt |
| Revenue | $11,914,034 | RevenueAmt |
| Desc | REHABILITATION & NURSING HOME OPERATIONS WERE PROVIDED TO 104 PATIENTS DURING FISCAL YEAR 2019. | Desc |
| Total Program Service Expenses | $10,102,534 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 178 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Frank Samuel | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2694282416 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1234 Napier Avenue | AddressLine1Txt |
| City | St Joseph | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| MELINDA GRUBER | |||||||||
| CHAIR | 2.0 | 48.0 | Yes (X) | Yes (X) | $0 | $190,618 | $22,871 | ||
| MARY ANN PATER | |||||||||
| SECRETARY | 1.0 | 49.0 | Yes (X) | Yes (X) | $0 | $275,160 | $20,420 | ||
| TIMOTHY CALHOUN | |||||||||
| TREASURER | 4.0 | 46.0 | Yes (X) | Yes (X) | $0 | $442,328 | $24,142 | ||
| LOREN HAMEL MD | |||||||||
| PRESIDENT & CEO | 6.0 | 44.0 | Yes (X) | $0 | $3,169,131 | $25,007 | |||
| DEBBIE LULL | |||||||||
| CHIEF NURSING OFFICER POST ACUTE CARE | 50.0 | 0 | $111,714 | $41,810 | $19,198 | Yes (X) | |||
| PATRICK MCQUONE | |||||||||
| ADMINISTRATOR PINE RIDGE | 50.0 | 0 | $108,389 | $0 | $5,444 | Yes (X) | |||
| KENDALL TROYER | |||||||||
| FORMER TREASURER | 0.0 | 50.0 | $0 | $227,808 | $27,568 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $220,103 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,346,855 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $144,650 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REHABCARE GROUP | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7733 FORSYTH BLVD SUITE 1700 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | THERAPY SERVICES | ServicesDesc |
| Compensation | $878,517 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $11,908,556 | $11,908,556 |
| OTHER OPERATING REVENUE | 621400 | $5,478 | $5,478 |
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 | $11,914,034 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59 | TotalRevenueColumnAmt |
| Exclusion | $59 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| 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) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,914,093 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,914,034 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $59 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,010,780 | TotalAmt |
| Program Services | $5,109,163 | ProgramServicesAmt |
| Management And General | $901,617 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,418 | TotalAmt |
| Program Services | $155,055 | ProgramServicesAmt |
| Management And General | $27,363 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $941,538 | TotalAmt |
| Program Services | $800,307 | ProgramServicesAmt |
| Management And General | $141,231 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $432,621 | TotalAmt |
| Program Services | $367,728 | ProgramServicesAmt |
| Management And General | $64,893 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $325 | TotalAmt |
| Management And General | $325 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,900 | TotalAmt |
| Management And General | $3,900 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,103,950 | TotalAmt |
| Program Services | $938,358 | ProgramServicesAmt |
| Management And General | $165,592 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,550 | TotalAmt |
| Program Services | $1,318 | ProgramServicesAmt |
| Management And General | $232 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,566 | TotalAmt |
| Program Services | $8,131 | ProgramServicesAmt |
| Management And General | $1,435 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,885 | TotalAmt |
| Program Services | $118,902 | ProgramServicesAmt |
| Management And General | $20,983 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $896 | TotalAmt |
| Program Services | $762 | ProgramServicesAmt |
| Management And General | $134 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,771 | TotalAmt |
| Program Services | $197,855 | ProgramServicesAmt |
| Management And General | $34,916 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357,076 | TotalAmt |
| Program Services | $303,515 | ProgramServicesAmt |
| Management And General | $53,561 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,903 | TotalAmt |
| Program Services | $30,518 | ProgramServicesAmt |
| Management And General | $5,385 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES AND DRUGS | $1,026,460 | $872,491 | $153,969 |
| QAAP ASSESSMENTS | $805,021 | $805,021 | |
| PROVISION FOR BAD DEBTS | $152,222 | $152,222 | |
| REPAIRS AND MAINTENANCE | $111,127 | $94,458 | $16,669 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,624 | TotalAmt |
| Program Services | $146,730 | ProgramServicesAmt |
| Management And General | $25,894 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,720,633 | TotalAmt |
| Program Services | $10,102,534 | ProgramServicesAmt |
| Management And General | $1,618,099 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,482,291 | BOYAmt |
| EOY | $735,964 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,200,546 | BOYAmt |
| EOY | $2,181,580 | 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 |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,329 | BOYAmt |
| EOY | $15,046 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,843,413 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,203,768 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,993,233 | BOYAmt |
| EOY | $8,639,645 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,952 | BOYAmt |
| EOY | $340,469 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,721,351 | BOYAmt |
| EOY | $11,912,704 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $857,954 | BOYAmt |
| EOY | $971,978 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,266,445 | BOYAmt |
| EOY | $6,966,583 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $451,670 | BOYAmt |
| EOY | $635,401 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,576,069 | BOYAmt |
| EOY | $8,573,962 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,145,282 | BOYAmt |
| EOY | $3,338,742 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,145,282 | BOYAmt |
| EOY | $3,338,742 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,721,351 | BOYAmt |
| EOY | $11,912,704 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $193,460 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $0 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $0 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $0 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,262,005 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,871,177 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,979,236 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,983,943 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,914,034 | CurrentTaxYearAmt |
| Total | $54,010,395 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,262,005 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,871,177 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,979,236 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,983,943 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,914,034 | CurrentTaxYearAmt |
| Total | $54,010,395 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $54,010,395 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $59 | CurrentTaxYearAmt |
| Total | $61 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $59 | CurrentTaxYearAmt |
| Total | $61 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,262,005 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,871,177 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,979,236 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,983,945 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,914,093 | CurrentTaxYearAmt |
| Total | $54,010,456 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.0000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.0 | PublicSupportPY509Pct |
| Investment Income CY | 0.0000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.0 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Adj Net Income Distributable | $0 | CYAdjNetIncomeDistributableAmt |
| CY Pct85 Adjusted Net Income | $0 | CYPct85AdjustedNetIncomeAmt |
| CY Total Min Ast Distributable | $0 | CYTotalMinAstDistributableAmt |
| CY Greater Adjusted Minimum | $0 | CYGreaterAdjustedMinimumAmt |
| CY Income Tax Imposed PY | $0 | CYIncomeTaxImposedPYAmt |
| CY Distributable As Adjusted | $0 | CYDistributableAsAdjustedAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (true) | AgentTrusteeEtcInd |
| Beginning Balance | $13,380 | BeginningBalanceAmt |
| Additions During Year | $31,371 | AdditionsDuringYearAmt |
| Distributions During Year | $15,879 | DistributionsDuringYearAmt |
| Ending Balance | $28,872 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $610,891 | OtherCostOrOtherBasisAmt |
| Book Value | $610,891 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,358,317 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,204,075 | DepreciationAmt |
| Book Value | $7,154,242 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,874,205 | OtherCostOrOtherBasisAmt |
| Depreciation | $999,693 | DepreciationAmt |
| Book Value | $874,512 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,639,645 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED PARTIES | Desc |
| Amt | $635,401 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $635,401 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $11,761,871 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$152,222 | OtherRevenueAmt |
| Revenue Not Reported | -$152,222 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,914,093 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,914,093 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,568,411 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,568,411 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $152,222 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $152,222 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,720,633 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part IV, Line 1b Agent, trustee, custodian, or other intermediary arrangement | MERCY MEMORIAL HEALTH SERVICES (EIN 38-2748035) ACTS AS A CUSTODIAN OF RESIDENT TRUST BANK ACCOUNTS. THESE BANK ACCOUNTS ARE USED FOR THE RESIDENT'S SPENDING DURING THEIR STAY FOR ITEMS SUCH AS ROOM & BOARD AND BARBER & BEAUTY SERVICES. THE FUNDS IN THE BANK ACCOUNTS COME FROM THE SOCIAL SECURITY ADMINISTRATION OR OTHER PERSONAL SOURCES. |
| Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 | PROVISION FOR BAD DEBTS - -152222 |
| Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements | PROVISION FOR BAD DEBTS - 152222 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MELINDA GRUBER | ||||||||||||||
| CHAIR | $0 | $164,600 | $0 | $8,554 | $0 | $17,464 | $0 | $9,589 | $0 | $13,282 | $0 | $213,489 | $0 | $0 |
| MARY ANN PATER | ||||||||||||||
| SECRETARY | $0 | $233,929 | $0 | $11,738 | $0 | $29,493 | $0 | $13,319 | $0 | $7,101 | $0 | $295,580 | $0 | $0 |
| TIMOTHY CALHOUN | ||||||||||||||
| TREASURER | $0 | $364,832 | $0 | $36,478 | $0 | $41,018 | $0 | $16,628 | $0 | $7,514 | $0 | $466,470 | $0 | $0 |
| KENDALL TROYER | ||||||||||||||
| FORMER TREASURER | $0 | $208,208 | $0 | $10,406 | $0 | $9,194 | $0 | $12,266 | $0 | $15,302 | $0 | $255,376 | $0 | $0 |
| LOREN HAMEL MD | ||||||||||||||
| PRESIDENT & CEO | $0 | $508,000 | $0 | $0 | $0 | $2,661,131 | $0 | $20,053 | $0 | $4,954 | $0 | $3,194,138 | $0 | $0 |
| DEBBIE LULL | ||||||||||||||
| CHIEF NURSING OFFICER POST ACUTE CARE | $110,994 | $37,088 | $720 | $0 | $0 | $4,722 | $9,290 | $0 | $9,908 | $0 | $130,912 | $41,810 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | FormAndLineReferenceDesc |
| Explanation | LAKELAND MAINTAINS A 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. THE INDIVIDUALS LISTED IN PART VII WHO PARTICIPATED IN THE PLAN ARE: LOREN HAMEL, MD MELINDA GRUBER MARY ANN PATER KENDALL TROYER TIMOTHY CALHOUN | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL AUTHORITY OF THE CITY OF ST JOSEPH (MI) | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 383151499 | BondIssuerEIN |
| CUSIP | 000000000 | CUSIPNum |
| Bond Issued | 2012-09-06 | BondIssuedDt |
| Issue Price | $8,500,000 | IssuePriceAmt |
| Purpose | NEW FACILITY CONSTRUCTION | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,445,000 | RetiredAmt |
| Total Proceeds | $8,500,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $105,875 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $8,394,125 | CapitalExpendituresAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | false | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Total Private Business Use | 0.0 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | false | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | Yes (true) | Form8038TFiledInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule K, Part I BOND ISSUE A | THE $8.5 MILLION BOND ISSUE WAS A DIRECT PURCHASE BOND BY J.P. MORGAN CHASE. BOND PROCEEDS WERE DRAWN DURING CONSTRUCTION PERIOD TO BUILD A NEW FACILITY. |
| Schedule K, Part II BOND PROCEEDS RECONCILIATION | ISSUE PRICE OF BONDS: 8,500,000 SUBTRACT OUT ISSUE COSTS FROM PROCEEDS: 105,875 EQUALS EXPENDITURES FROM PROCEEDS: 8,394,125 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | THE CEO AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. AN INDEPENDENT FIRM IS HIRED BY THE BOARD TO DETERMINE COMPENSATION PACKAGES FOR THE CEO AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. THE FIRM PRESENTS COMPARATIVE PAY RANGES AND COMPENSATION RECOMMENDATIONS TO THE GOVERNANCE (COMPENSATION) COMMITTEE FOR THEIR APPROVAL. FOR SENIOR MANAGEMENT, THE CEO CAN PROVIDE INPUT AND RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. FOR THE CEO'S COMPENSATION, THE GOVERNANCE COMMITTEE PRESENTS THE COMPENSATION PACKAGE TO THE FULL BOARD FOR APPROVAL. WRITTEN CONTRACTS FOR THE CEO ARE APPROVED BY THE FULL BOARD OF DIRECTORS. THE GOVERNANCE COMMITTEE USED THE 2017 COMPENSATION SURVEY DATA TO DETERMINE 2018 COMPENSATION PACKAGES AND INCREASED IT BY 2% TO DETERMINE THE 2019 COMPENSATION PACKAGES. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A copy of the Form 990 is provided to the Board of Directors prior to filing. The review process for this Form 990 is as follows: 1. Preparation of the return is supervised and reviewed by the Organization's Corporate Tax Manager. 2. A second review is performed by an external CPA firm with expertise in tax-exempt return preparation. 3. The returns are posted to the board portal for review prior to filing (the board portal is available to all board members). 4. The Organization's Vice President, Finance reviews comments or questions received by members of the Board of Directors, if any, to address or to incorporate, as appropriate, into the return prior to filing. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT, THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES, AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE ASKED TO RESIGN. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| Form 990, Part XII, Line 2c OVERSIGHT OF THE AUDIT | THERE HAS BEEN NO CHANGE IN THE AUDIT OVERSIGHT PROCESS FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| LAKELAND REGIONAL HEALTH SYSTEM INC | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382609624 | PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY | MI | 501(c)(3) | Type III-FI | NA | false |
| LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382156872 | PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY | MI | 501(c)(3) | 3 | LAKELAND REGIONAL HEALTH SYSTEM INC | false |
| LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 383452303 | LONGTERM HEALTHCARE/HEALING SERVICES | MI | 501(c)(3) | 3 | LAKELAND REGIONAL HEALTH SYSTEM INC | false |
| LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382539929 | PROMOTE AND ASSIST IN PROVIDING HEALTH CARE | MI | 501(c)(3) | 7 | LAKELAND REGIONAL HEALTH SYSTEM INC | false |
| LAKELAND HEALTH FOUNDATION NILES | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 383130558 | PROMOTE/ASSIST IN PROVIDING HEALTH CARE SERVICES IN SOUTHWESTERN MICHIGAN | MI | 501(c)(3) | 7 | LAKELAND REGIONAL HEALTH SYSTEM INC | false |
| LAKELAND COMMUNITY HOSPITAL - WATERVLIET | ||||||||||
| 400 MEDICAL PARK DRIVE | WATERVLIET | MI | 49098 | 381368745 | TO PROVIDE GENERAL HEALTH OF THE COMMUNITY THROUGH EDUCATION AND HEALTHCARE | MI | 501(c)(3) | 3 | LAKELAND REGIONAL HEALTH SYSTEM INC | false |
| HOSPICE AT HOME INC | ||||||||||
| 4025 HEALTH PARK LANE | ST JOSEPH | MI | 49085 | 382416086 | TO PROVIDE HOSPICE AND PALLIATIVE CARE TO THE TERMINALLY ILL | MI | 501(c)(3) | 7 | LAKELAND REGIONAL HEALTH SYSTEM INC | false |
| SPECTRUM HEALTH SYSTEM | ||||||||||
| 100 MICHIGAN ST NE MC 498 | GRAND RAPIDS | MI | 49503 | 383382353 | MANAGEMENT | MI | 501(c)(3) | Type III-FI | na | false |
| SPECTRUM HEALTH HOSPITALS | ||||||||||
| 100 MICHIGAN ST NE | GRAND RAPIDS | MI | 49503 | 381360529 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION | ||||||||||
| 212 S SULLIVAN AVENUE | FREMONT | MI | 49412 | 381359517 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| MEMORIAL MEDICAL CENTER OF WEST MICHIGAN | ||||||||||
| ONE ATKINSON DRIVE | LUDINGTON | MI | 49431 | 381359266 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| MECOSTA COUNTY MEDICAL CENTER | ||||||||||
| 605 OAK STREET | BIG RAPIDS | MI | 49307 | 381368744 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| REED CITY HOSPITAL CORPORATION | ||||||||||
| 300 N PATTERSON RD | REED CITY | MI | 49677 | 382770076 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| PENNOCK HOSPITAL | ||||||||||
| 1009 WEST GREEN STREET | HASTINGS | MI | 49058 | 381360562 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH UNITED | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 381358412 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH KELSEY | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 381297435 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH UNITED | false |
| ZEELAND COMMUNITY HOSPITAL | ||||||||||
| 8333 FELCH STREET | ZEELAND | MI | 49464 | 381411184 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH CONTINUING CARE | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 383242232 | REHAB/CARE | MI | 501(c)(3) | 10 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH CONTINUING CARE CENTER | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 382415333 | REHAB/NRS | MI | 501(c)(3) | 10 | SPECTRUM HEALTH CONTINUING CARE | false |
| SPECTRUM HEALTH WORTH SERVICES | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 382786617 | HEALTHCARE | MI | 501(c)(3) | 10 | SPECTRUM HEALTH CONTINUING CARE | false |
| VISITING NURSE SERVICES OF WESTERN MICHIGAN | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 381359195 | HEALTHCARE | MI | 501(c)(3) | 10 | SPECTRUM HEALTH CONTINUING CARE | false |
| SPECTRUM HEALTH FOUNDATION | ||||||||||
| 100 MICHIGAN ST NE | GRAND RAPIDS | MI | 49503 | 382752328 | PHILANTHROPY | MI | 501(c)(3) | 7 | SPECTRUM HEALTH SYSTEM | false |
| SPECTRUM HEALTH PRIMARY CARE PARTNERS | ||||||||||
| 1840 WEALTHY ST SE | GRAND RAPIDS | MI | 49506 | 381358164 | HEALTHCARE | MI | 501(c)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
| PRIORITY HEALTH | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 382715520 | HMO | MI | 501(c)(4) | SPECTRUM HEALTH SYSTEM | false | |
| TRINITY HEALTH PLANS | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 382663747 | HMO MGMT | MI | 501(c)(4) | PRIORITY HEALTH | false | |
| PRIORITY HEALTH CHOICE INC | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 320016523 | HMO (MEDICAID) | MI | 501(c)(3) | 10 | PRIORITY HEALTH | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST MICHIGAN ACCOUNTABLE CARE ORGANIZATION LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 221 MICHIGAN ST NE STE 501 | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 833153113 | EIN |
| Primary Activities | ACCOUNTABLE CARE ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECTRUM HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | Related | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| UBI Code V | $0 | UBICodeVAmt |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| LAKELAND HEALTH ENTERPRISES INC | |||||||||
| 31 NORTH ST JOSEPH AVENUE | NILES | MI | 49120 | 382669798 | ACCOUNTING AND BILLING | MI | LAKELAND REGIONAL HEALTH SYSTEM INC | C Corporation | false |
| PHARMACY SHOPPE INC DBA LAKELAND PHARMACY SHOPPE INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382929090 | PHARMACEUTICALS | MI | LAKELAND HEALTH ENTERPRISES INC | C Corporation | false |
| LAKELAND MEDICAL PRACTICES | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 270381199 | MEDICAL ADMINISTRATIVE SERVICES | MI | LAKELAND HEALTH ENTERPRISES INC | C Corporation | false |
| SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272589359 | PHYSICIAN OFFICE | MI | LAKELAND HEALTH ENTERPRISES INC | C Corporation | false |
| FOUR FLAGS PROPERTIES INC | |||||||||
| 122 GRANT STREET | NILES | MI | 49120 | 364501639 | PROPERTY MANAGEMENT/RENTAL | MI | LAKELAND HEALTH ENTERPRISES INC | C Corporation | false |
| LAKELAND HEALTH VENTURES INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272313790 | HOLDING COMPANY | MI | LAKELAND HEALTH ENTERPRISES INC | C Corporation | false |
| LAKELAND PHYSICIAN CARE NETWORK | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 208513031 | MEDICAL SERVICES | MI | LAKELAND HEALTH ENTERPRISES INC | C Corporation | false |
| LAKELAND PERSONAL CARE SERVICES INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272990797 | HEALTH CARE SERVICES | MI | LAKELAND HEALTH ENTERPRISES INC | C Corporation | false |
| PRIORITY HEALTH INSURANCE COMPANY | |||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 201529553 | INSURANCE | MI | NA | C Corporation | false |
| PRIORITY HEALTH MANAGED BENEFITS | |||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 383085182 | THIRD PARTY ADMINISTRATOR | MI | NA | C Corporation | false |
| WEST MICHIGAN HEART | |||||||||
| 1840 WEALTHY STREET SE | GRAND RAPIDS | MI | 49506 | 382125186 | PHYSICIANS | MI | NA | C Corporation | false |
| SPECTRUM HEALTH PHYSICIAN ALLIANCE | |||||||||
| 100 MICHIGAN ST NE | GRAND RAPIDS | MI | 49503 | 371655728 | PHYSICIANS | MI | NA | C Corporation | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule R, Part II IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS | NAME OF RELATED ORGANIZATION: LAKELAND HEALTH FOUNDATION, NILES PRIMARY ACTIVITY: PROMOTE/ASSIST IN PROVIDING HEALTH CARE SERVICES IN SOUTHWESTERN MICHIGAN |
| Schedule R, Part IV IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS CORP OR TRUST | NAME OF RELATED ORGANIZATION: LAKELAND HEALTH ENTERPRISES, INC. DIRECT CONTROLLING ENTITY: LAKELAND REGIONAL HEALTH SYSTEM, INC. NAME OF RELATED ORGANIZATION: PHARMACY SHOPPE, INC. D/B/A LAKELAND PHARMACY SHOPPE, INC. DIRECT CONTROLLING ENTITY: LAKELAND HEALTH ENTERPRISES, INC. NAME OF RELATED ORGANIZATION: LAKELAND MEDICAL PRACTICES DIRECT CONTROLLING ENTITY: LAKELAND HEALTH ENTERPRISES NAME OF RELATED ORGANIZATION: SOUTHWESTERN MEDICAL CLINIC PHYSICIANS, INC. DIRECT CONTROLLING ENTITY: LAKELAND HEALTH ENTERPRISES, INC NAME OF RELATED ORGANIZATION: FOUR FLAGS PROPERTIES, INC. DIRECT CONTROLLING ENTITY: LAKELAND HEALTH ENTERPRISES, INC. NAME OF RELAED ORGANIZATION: LAKELAND HEALTH VENTURES, INC. DIRECT CONTROLLING ENTITY: LAKELAND HEALTH ENTERPRISES, INC. NAME OF RELATED ORGANIZATION: LAKELAND PHYSICIAN CARE NETWORK DIRECT CONTROLLING ENTITY: LAKELAND HEALTH ENTERPRISES, INC. NAME OF RELATED ORGANIZATION: LAKELAND PERSONAL CARE SERVICES, INC. DIRECT CONTROLLING ENTITY: LAKELAND HEALTH ENTERPRISES, INC. |
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