HENRY FORD HEALTH ROCHESTER HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- HENRY FORD HEALTH ROCHESTER HOSPITAL (EIN 38-1359247)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201911349349310481
- Schema version
- 2017v2.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-14T19:31:23-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381359247 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (FKA CRITTENTON HOSPITAL MEDICAL C | BusinessNameLine1Txt |
| Business Name Line2 | ENTER) | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ASCE | BusinessNameControlTxt |
| Phone | 3147338000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 West University Drive | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48307 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tonya Mershon | PersonNm |
| Person Title | Tax Officer | PersonTitleTxt |
| Signature | 2019-05-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRISTOPHER J PALAZZOLO | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 West University Drive | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48307 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $205,836,912 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SEE SCHEDULE O | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1900 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | To improve the health and well-being of all people in the communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1707 | TotalEmployeeCnt |
| Total Volunteers | 400 | TotalVolunteersCnt |
| Total Gross UBI | $2,895,039 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$254,729 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $167,868 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $207,791,418 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $200,806,156 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$136,300 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,479,753 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,738,973 | PYOtherRevenueAmt |
| CY Other Revenue | $3,271,241 | CYOtherRevenueAmt |
| PY Total Revenue | $209,561,959 | PYTotalRevenueAmt |
| CY Total Revenue | $205,558,150 | 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 | $86,913,170 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $88,537,645 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $111,810,487 | PYOtherExpensesAmt |
| CY Other Expenses | $131,502,193 | CYOtherExpensesAmt |
| PY Total Expenses | $198,723,657 | PYTotalExpensesAmt |
| CY Total Expenses | $220,039,838 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $10,838,302 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$14,481,688 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $280,911,089 | TotalAssetsBOYAmt |
| Total Assets EOY | $269,366,648 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $226,541,566 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $225,661,580 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $54,369,523 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $43,705,068 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. | MissionDesc |
| Significant New Program Srvc | Yes (true) | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $154,779,093 | ExpenseAmt |
| Revenue | $198,001,139 | RevenueAmt |
| Desc | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) is a 226-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) treated 9,774 adults and children for a total of 44,696 patient days of service. The hospital also provided services for 190,384 outpatient visits, which included 4,684 outpatient surgeries and 28,790 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. | Desc |
| Total Program Service Expenses | $154,779,093 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | 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 | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 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 | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 206 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1707 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | Yes (true) | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SARA OBRIEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3147338070 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11775 BORMAN DRIVE | AddressLine1Txt |
| City | MARYLAND HEIGHTS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63146 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PETER DESTEIGER | ||||||||||
| CHAIR | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ROBERT DERY | ||||||||||
| VICE CHAIR | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JUDY DIDION PHD | ||||||||||
| SECRETARY/TREASURER | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| TIM CRAWFORD | ||||||||||
| TRUSTEE | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| JEFFREY DECLAIRE MD | ||||||||||
| TRUSTEE | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| BRADFORD MERRELLI MD | ||||||||||
| TRUSTEE | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| JULIE NICHOLSON | ||||||||||
| TRUSTEE | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| TOMASINE F MARX | ||||||||||
| CFO/COO | 48.0 | 2.0 | Yes (X) | $0 | $493,783 | $41,868 | ||||
| MARGARET A DIMOND | ||||||||||
| PRESIDENT & CEO (END 11/2017) | 48.0 | 2.0 | Yes (X) | $0 | $559,844 | $24,349 | ||||
| CHRISTOPHER J PALAZZOLO | ||||||||||
| PRESIDENT & CEO (START 11/2017) | 1.0 | 49.0 | Yes (X) | $0 | $997,987 | $42,988 | ||||
| SHERYL ANN WISSMAN MD | ||||||||||
| CMO | 50.0 | 0 | $264,221 | $0 | $8,094 | Yes (X) | ||||
| DEBORAH KING RN | ||||||||||
| CNO | 50.0 | 0 | $255,618 | $0 | $40,980 | Yes (X) | ||||
| DOUGLAS E PUGMIRE DO | ||||||||||
| MEDICAL DIRECTOR | 50.0 | 0 | $344,181 | $0 | $32,245 | Yes (X) | ||||
| SAMER KAZZIHA MD | ||||||||||
| MEDICAL DIRECTOR | 50.0 | 0 | $311,644 | $0 | $35,823 | Yes (X) | ||||
| MATTHEW R PRINCE DO | ||||||||||
| SURGEON | 50.0 | 0 | $275,836 | $0 | $25,498 | Yes (X) | ||||
| ROBERT LACOSTE MD | ||||||||||
| MEDICAL DIRECTOR | 50.0 | 0 | $255,399 | $0 | $33,637 | Yes (X) | ||||
| ANA M ROTAR MD | ||||||||||
| PHYSICIAN | 50.0 | 0 | $205,162 | $0 | $21,024 | Yes (X) | ||||
| MARY KAY LACHANCE | ||||||||||
| FORMER KEY EMPLOYEE (END 6/2017) | 0.0 | 50.0 | $0 | $452,422 | $23,163 | Yes (X) | ||||
| TERENCE HAMILTON | ||||||||||
| FORMER OFFICER (END 5/2016) | 0.0 | 50.0 | $0 | $440,369 | $40,976 | Yes (X) | ||||
| ROY A POWELL | ||||||||||
| FORMER OFFICER (END 10/2015) | 50.0 | 0.0 | $493,996 | $0 | $5,285 | Yes (X) | ||||
| DONNA M KOPINSKI | ||||||||||
| FORMER OFFICER (END 5/2017) | 0.0 | 0.0 | $236,827 | $0 | $18,484 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,642,884 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,944,405 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $394,413 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 52 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Client Financial Services of Michigan LLC | |||||
| PO Box 350 | Fenton | MI | 48430 | Collection Agency | $306,233 |
| REHABCARE GROUP SRS DIV | |||||
| PO BOX 503534 | SAINT LOUIS | MO | 63150 | REHABILITATION SERVICES | $239,297 |
| ARUP LABORATORIES | |||||
| 500 S CHIPETA WAY | SALT LAKE CITY | UT | 841081221 | LABORATORY SERVICES | $155,750 |
| ROCHESTER GENERAL SURGERY PLC | |||||
| 75 BARCLAY CIR STE 200 | ROCHESTER HILLS | MI | 483075821 | MEDICAL SERVICES | $146,867 |
| SYNTHES US SALES LLC | |||||
| 1101 SYNTHES AVE | MONUMENT | CO | 80132 | MEDICAL EQUIPMENT AND DEVICES | $113,447 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Government Grants | $1,000 | GovernmentGrantsAmt |
| Total Contributions | $1,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient Service Revenue | 621990 | $199,007,749 | $196,112,710 | $2,895,039 |
| Income from Joint Ventures | 900099 | $113,401 | $113,401 | |
| Management Fees | 541610 | $140 | $140 | |
| Program Related Rent | 531120 | $1,684,866 | $1,684,866 |
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 | $200,806,156 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $472,583 | TotalRevenueColumnAmt |
| Exclusion | $472,583 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $76,159 | SecuritiesAmt |
| Other | $1,145,408 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $214,396 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $76,159 | SecuritiesAmt |
| Other | $931,012 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,007,170 | TotalRevenueColumnAmt |
| Exclusion | $1,007,170 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $102,489 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $64,366 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,123 | TotalRevenueColumnAmt |
| Exclusion | $38,123 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Cafeteria/Vending Revenue | 722514 | $791,400 | $791,400 | |
| Community Services | 900099 | $90,022 | $90,022 | |
| RESIDENT EDUCATION | 611430 | $334,902 | $334,902 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,016,794 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,016,794 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,233,118 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $205,558,150 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $198,001,139 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,895,039 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,660,972 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $568,912 | TotalAmt |
| Program Services | $506,332 | ProgramServicesAmt |
| Management And General | $62,580 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,270,251 | TotalAmt |
| Program Services | $65,325,322 | ProgramServicesAmt |
| Management And General | $7,944,929 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,887,571 | TotalAmt |
| Program Services | $2,574,459 | ProgramServicesAmt |
| Management And General | $313,112 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,244,379 | TotalAmt |
| Program Services | $5,566,895 | ProgramServicesAmt |
| Management And General | $677,484 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,566,532 | TotalAmt |
| Program Services | $4,962,874 | ProgramServicesAmt |
| Management And General | $603,658 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,044 | TotalAmt |
| Management And General | $7,044 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$30,473 | TotalAmt |
| Management And General | -$30,473 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,122 | TotalAmt |
| Management And General | $52,122 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,382 | TotalAmt |
| Management And General | $14,382 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,422,137 | TotalAmt |
| Program Services | $13,724,747 | ProgramServicesAmt |
| Management And General | $697,390 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,410 | TotalAmt |
| Program Services | $37,160 | ProgramServicesAmt |
| Management And General | $126,250 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $747,782 | TotalAmt |
| Program Services | $267,359 | ProgramServicesAmt |
| Management And General | $480,423 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,032 | TotalAmt |
| Program Services | $301,504 | ProgramServicesAmt |
| Management And General | $96,528 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,747,953 | TotalAmt |
| Program Services | $2,410,035 | ProgramServicesAmt |
| Management And General | $3,337,918 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,164 | TotalAmt |
| Program Services | $51,214 | ProgramServicesAmt |
| Management And General | $12,950 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,680 | TotalAmt |
| Program Services | $144,443 | ProgramServicesAmt |
| Management And General | $48,237 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,725,299 | TotalAmt |
| Management And General | $5,725,299 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,891,742 | TotalAmt |
| Program Services | $5,936,649 | ProgramServicesAmt |
| Management And General | $7,955,093 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,760 | TotalAmt |
| Management And General | $604,760 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $36,916,846 | $38,616,278 | -$1,699,432 |
| Purchased Services | $24,057,802 | $9,556,318 | $14,501,484 |
| Management Fee to Affiliate | $21,089,595 | $21,089,595 | |
| Maintenance & Repairs | $1,511,745 | $1,149,021 | $362,724 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,925,171 | TotalAmt |
| Program Services | $3,645,119 | ProgramServicesAmt |
| Management And General | $2,280,052 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,039,838 | TotalAmt |
| Program Services | $154,775,729 | ProgramServicesAmt |
| Management And General | $65,264,109 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,358,048 | BOYAmt |
| EOY | $2,721 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,900,355 | BOYAmt |
| EOY | $31,235,581 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,644,049 | BOYAmt |
| EOY | $29,273,573 | 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 | $2,736,206 | BOYAmt |
| EOY | $2,746,432 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,013,869 | BOYAmt |
| EOY | $4,607,307 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,847,708 | BOYAmt |
| EOY | $414,641 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $215,378,216 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,500,507 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,102,166 | BOYAmt |
| EOY | $176,877,709 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,260,041 | BOYAmt |
| EOY | $0 | 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 | $8,713,637 | BOYAmt |
| EOY | $7,441,633 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,044,941 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,335,010 | BOYAmt |
| EOY | $14,722,110 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,911,089 | BOYAmt |
| EOY | $269,366,648 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,876,204 | BOYAmt |
| EOY | $15,666,639 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,201 | BOYAmt |
| EOY | $56,695 | 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 | $209,532,161 | BOYAmt |
| EOY | $209,938,246 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,541,566 | BOYAmt |
| EOY | $225,661,580 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,307,598 | BOYAmt |
| EOY | $43,705,068 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,925 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,369,523 | BOYAmt |
| EOY | $43,705,068 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,911,089 | BOYAmt |
| EOY | $269,366,648 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$14,481,688 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $934,381 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $2,886,216 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $14,382 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $14,382 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. |
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $61,925 | BeginningYearBalanceAmt |
| Grants Or Scholarships | $56,349 | GrantsOrScholarshipsAmt |
| Other Expenditures | $5,576 | OtherExpendituresAmt |
| End Year Balance | $0 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $141,454 | BeginningYearBalanceAmt |
| Other Expenditures | $79,529 | OtherExpendituresAmt |
| End Year Balance | $61,925 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $141,454 | BeginningYearBalanceAmt |
| End Year Balance | $141,454 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $164,215 | BeginningYearBalanceAmt |
| Other Expenditures | $22,761 | OtherExpendituresAmt |
| End Year Balance | $141,454 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $141,495 | BeginningYearBalanceAmt |
| Contributions | $91,800 | ContributionsAmt |
| Investment Earnings Or Losses | $2 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $62,852 | OtherExpendituresAmt |
| Administrative Expenses | $6,230 | AdministrativeExpensesAmt |
| End Year Balance | $164,215 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.0 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,780,000 | OtherCostOrOtherBasisAmt |
| Book Value | $3,780,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $156,039,935 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,052,836 | DepreciationAmt |
| Book Value | $142,987,099 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,398,936 | OtherCostOrOtherBasisAmt |
| Depreciation | $659,573 | DepreciationAmt |
| Book Value | $739,363 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,924,146 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,418,071 | DepreciationAmt |
| Book Value | $23,506,075 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,235,199 | OtherCostOrOtherBasisAmt |
| Depreciation | $370,027 | DepreciationAmt |
| Book Value | $5,865,172 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $176,877,709 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from Affiliates | $4,828,794 |
| Other Receivables | $244,566 |
| Physician Guarantee Asset | $462,500 |
| Security Deposit | $95,644 |
| Self Insurance Trust Funds | $4,647,275 |
| Estimated 3rd Party Payor Settlements | $4,443,331 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $14,722,110 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (10 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension & Other Post Retirement Liability | |
| Contingency Reserves | $9,016,871 |
| Professional Insurance Liability | |
| Long Term at Risk Liability | |
| Due to Affiliates | $36,850,574 |
| Deferred Compensation/Retirement/Pension Liability | $480,586 |
| Estimated 3rd Party Payor Settlement | $5,906,795 |
| Recovery Tail Liability | $535,192 |
| Debt with Ascension Health Alliance | $157,066,485 |
| PGL IBNR LIABILITY | $81,743 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $209,938,246 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 Intended uses of endowment funds | THE ENDOWMENT FUNDS ARE USED FOR THE GIFT SHOP, THE AUXILLIARY AND THE HOSPITAL FOR GRANTS, SCHOLARSHIPS AND OTHER EXPENSES. |
| Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $407,044 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $407,044 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0018 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,923,283 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,862,556 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,060,727 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0366 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | 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 | $16,330,327 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,862,556 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,467,771 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0385 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15000 | PersonsServedCnt |
| Total Community Benefit Expns | $202,738 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,345 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $198,393 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0009 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 303 | PersonsServedCnt |
| Total Community Benefit Expns | $1,567,508 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,567,508 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0071 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1289 | PersonsServedCnt |
| Total Community Benefit Expns | $20,595 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $696 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,899 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 16592 | PersonsServedCnt |
| Total Community Benefit Expns | $1,790,841 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,041 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,785,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0081 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 16592 | PersonsServedCnt |
| Total Community Benefit Expns | $18,121,168 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,867,597 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,253,571 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0466 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8404 | PersonsServedCnt |
| Total Community Benefit Expns | $20,413 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,413 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 547 | PersonsServedCnt |
| Total Community Benefit Expns | $2,485 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,485 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 520 | PersonsServedCnt |
| Total Community Benefit Expns | $2,078 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,078 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 394 | PersonsServedCnt |
| Total Community Benefit Expns | $10,439 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,439 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1506 | PersonsServedCnt |
| Total Community Benefit Expns | $38,580 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $38,580 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 11371 | PersonsServedCnt |
| Total Community Benefit Expns | $73,995 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $73,995 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0003 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $5,090,103 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $129,415 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $107,837,088 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $121,030,100 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,193,012 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | USC LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Surgery Center | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.2427 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.7573 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (FKA CRITTENTON HOSPITAL MEDICAL C | BusinessNameLine1Txt |
| Business Name Line2 | ENTER) | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W University | AddressLine1Txt |
| City | Rochester | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48307 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://healthcare.ascension.org/locations/michigan/miroc/rochester-ascension-providence-rochester-h | WebsiteAddressTxt |
| State License | M391415 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (FKA CRITTENTON HOSPITAL MEDICAL C | BusinessNameLine1Txt |
| Business Name Line2 | ENTER) | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://healthcare.ascension.org/locations/michigan/miroc/rochester-ascension-providence-rochester-h | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://healthcare.ascension.org/locations/michigan/miroc/rochester-ascension-providence-rochester-h | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://healthcare.ascension.org/Financial-Assistance/Michigan | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://healthcare.ascension.org/Financial-Assistance/Michigan | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://healthcare.ascension.org/Financial-Assistance/Michigan | 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 (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 3E | To better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed. |
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER). Community stakeholders of different ages, socioeconomic status, occupation, and cultural backgrounds were invited to participate in the community health needs assessment. The methodology for survey assessment involved the distribution of the survey electronically via email, website accessibility, display boards at community events, and hard copies during the months of September through November 2015. Email invitations with survey website link were sent to: public/private schools, public health, business leaders, physicians, religious organizations, universities/colleges, high school leadership groups, senior centers, and local government agencies. In an effort to specifically identify the needs of the underserved population in the community, surveys were also distributed at area mobile food bank locations. Some of the organizations/agencies that had individual representation on the advisory committee are as follows: * City of Rochester * La Familia * Macomb County Health Department * Oakland County Health Department * Older Persons' Commission * Rochester Area Neighborhood House * Rochester Auburn Hills Community Coalition * Rochester Community Schools * Rochester Hills Public Library * Wayne State University * St. Mary's of the Hills * Gleaners Food Bank of Southeastern Michigan |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER). ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTO HOSPITAL MEDICAL CENTER) has identified three (3) priority needs: #1: Obesity/Overweight. Respondents identified several needs related to obesity including concerns to improve nutrition and diabetes. In addressing the prioritized need of obesity/overweight, community-wide programs have been implemented in addressing healthier lifestyles that integrate education, physical activity, and nutrition. ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTO HOSPITAL MEDICAL CENTER) is committed to improving the health and wellness of the surrounding communities and fully supports local government initiatives and wellness coalitions in their efforts to impact the overall health of the surrounding community. #2: Mental Health: Respondents identified access to substance abuse treatment (alcohol, drugs, and tobacco), mental health, and suicide as areas of concern. ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) is working to address these factors through education classes and youth-led community improvement initiatives. #3: Access to Care: Respondents identified concerns over the inability to pay co-pays and deductibles and the ability to access primary care physicians and specialists. ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) does provide financial assistance available for those who are unable to pay full cost of care. It's part of ASCENSION PROVIDENCE ROCHESTER HOSPITAL'S (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) commitment to the patients and the community. ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) continues to grow its primary care and physician specialty network and now has the benefit of the Ascension Michigan physician resources. Community Needs not being Addressed Identified needs that will not be directly addressed were determined by availability of services in the community. Chronic diseases with substantial support in the community such as cancer, lung disease, and heart disease which are supported by the American Cancer Society, American Lung Association, and the American Heart Association. Injury prevention which scored moderately high will not be addressed by ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER). ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) is a Level 3 Trauma Center with very specific requirements for community education, prevention, strategies, and safety guidelines in place. Finally, senior services scored at a moderate level; however, ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) will not address this need due to the services provided by the Older Person's Commission in the community and the Crittenton Wellness Center located on-site. Crittenton will work collaboratively with these organizations as deemed appropriate to ensure optimal service coordination and utilization. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 22 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| USC LLC (dba Unasource Surgery Center) | ||||
| 4550 Investment Drive | Troy | MI | 48098 | Surgical Center |
| Michigan Resonance Imaging (dba North OaklandNorth Macomb Imaging) | ||||
| 355 Barclay Circle | Rochester | MI | 48307 | Imaging Center |
| Crittenton Outpatient Imaging Center | ||||
| 2251 N Squirrel Road Suite 201 | Auburn Hills | MI | 48326 | Imaging Services |
| Crittenton Outpatient Sports Rehabilitation Center | ||||
| 2251 N Squirrel Road Suite 101 | Auburn Hills | MI | 48326 | Rehabilitation Services |
| Crittenton Barclay Imaging Center | ||||
| 355 Barclay Circle Suite B | Rochester Hills | MI | 48307 | Imaging Services |
| Crittenton Wellpointe Imaging Center | ||||
| 1701 S Boulevard East Suite B50 | Rochester Hills | MI | 48307 | Imaging Services |
| Crittenton Washington Outpatient Therapy | ||||
| 57850 Van Dyke Rd Suite 200 | Washington Township | MI | 48094 | Rehabilitation Services |
| Crittenton Oxford Imaging Center | ||||
| 72 S Washington Street | Oxford | MI | 48371 | Imaging Services |
| Crittenton North Oakland Internist | ||||
| 3100 Cross Creek Parkway Suite 220 | Auburn Hills | MI | 48326 | Physician Practice |
| Crittenton Internal Medicine & Cardiology | ||||
| 42370 Van Dyke Rd Suite 100 | Sterling Heights | MI | 48314 | Physician Practice |
| Crittenton Rochester OBGYN | ||||
| 1135 W University Dr Suite 310 | Rochester | MI | 48307 | Physician Practice |
| Crittenton Physical Therapy at OPC (Older Person's Commission) | ||||
| 650 Letica Dr | Rochester | MI | 48307 | Rehabilitation Services |
| Crittenton Primary Care | ||||
| 1135 W University Dr Suite 225 | Rochester | MI | 48307 | Physician Practice |
| Crittenton Dr Pugmire | ||||
| 1901 Star Batt Dr Suite 200 | Rochester Hills | MI | 48309 | Physician Practice |
| Crittenton Diabetes Education and Nutrition Counseling Center | ||||
| 1000 W University Dr Suite 202 | Rochester | MI | 48307 | Educational Services |
| Crittenton Dr Cheema & Associates | ||||
| 1135 W University Dr Suite 355 | Rochester | MI | 48307 | Physician Practice |
| Crittenton Internal Medicine | ||||
| 2191 South Blvd Suite 101 | Auburn Hills | MI | 48326 | Physician Practice |
| CRITTENTON OUTREACH LABORATORY | ||||
| 72 S WASHINGTON STREET SUITE 101 | OXFORD | MI | 48371 | OUTREACH LABORATORY SERVICES |
| CRITTENTON OUTREACH LABORATORY | ||||
| 57850 VAN DYKE ROAD SUITE 200 | WASHINGTON TOWNSHIP | MI | 48094 | OUTREACH LABORATORY SERVICES |
| CRITTENTON OUTREACH LABORATORY | ||||
| 3100 CROSS CREEK PARKWAY SUITE 220 | AUBURN HILLS | MI | 48326 | OUTREACH LABORATORY SERVICES |
| CRITTENTON OUTREACH LABORATORY | ||||
| 75 BARCLAY SUITE 112 | ROCHESTER | MI | 48307 | OUTREACH LABORATORY SERVICES |
| CRITTENTON OUTREACH LABORATORY | ||||
| 135 BARCLAY CIRCLE SUITE 100B | ROCHESTER | MI | 48307 | OUTREACH LABORATORY SERVICES |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. |
| Schedule H, Part II Community Building Activities | RESEARCH SHOWS THAT SOCIAL DETERMINANTS AND QUALITY OF LIFE PLAY A MAJOR ROLE IN THE HEALTH STATUS OF INDIVIDUALS AND COMMUNITIES. COMMUNITY BUILDING ACTIVITIES, WHICH FOCUS ON IMPROVING THE QUALITY OF LIFE WITHIN A COMMUNITY, ULTIMATELY INFLUENCE AND IMPROVE HEALTH STATUS. THE COMMUNITY AND COALITION BUILDING ACTIVITIES ARE PERFORMED WITH GROUPS WITH WHICH CRITTENTON HAS PARTNERED TO ENHANCE THE HEALTH OF THE COMMUNITY. THESE ACTIVITIES INCLUDE EVENTS, MEETINGS, AND PROVIDING SUPPORT. THE GROUPS ASSOCIATED WITH COMMUNITY BUILDING INCLUDE: LAKE ORION AND ROCHESTER ROTARY, ROCHESTER COMMUNITY SCHOOLS, LEADER DOG FOR THE BLIND, OAKLAND COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, OLDER'S PERSON'S COMMISSION, AND OAKLAND UNIVERSITY. THE GROUPS FOR COALITION BUILDING ACTIVITIES INCLUDE: ALLIANCE OF COALITIONS FOR HEALTHY COMMUNITIES, ROCHESTER AUBURN HILLS COMMUNITY COALITION, AND THE MICHIGAN BREASTFEEDING NETWORK. THE WORKFORCE DEVELOPMENT PROGRAMS ARE PROVIDED TO STUDENTS IN ROCHESTER COMMUNITY SCHOOLS AND OAKLAND UNIVERSITY TO EXPLORE HEALTHCARE PROFESSIONS. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE IN FISCAL YEAR 2018 WAS $380,632 AT CHARGES, ($129,415 AT COST). |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE, ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | THE ORGANIZATION IS PART OF THE ASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSES THE BAD DEBT EXPENSE IS LOCATED ON PAGE 21. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED. |
| Schedule H, Part V, Section B, Line 16a FAP website | - ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER): Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/Michigan; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER): Line 16b URL: https://healthcare.ascension.org/Financial-Assistance/Michigan; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER): Line 16c URL: https://healthcare.ascension.org/Financial-Assistance/Michigan; |
| Schedule H, Part VI, Line 2 Needs assessment | PLEASE SEE PART V, SECTION B, LINE 3 DISCLOSURE. IN ADDITION, THE ALLOCATION OF ASCENSION PROVIDENCE ROCHESTER HOSPITAL'S (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) RESOURCES TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE OF COMMUNITY RESIDENTS, ARE BASED ON COMMUNITY NEEDS IDENTIFIED THROUGH BOTH THE STRATEGIC PLANNING PROCESS AND A YEARLY COMPREHENSIVE REVIEW OF COUNTY, STATE, AND FEDERAL HEALTHCARE DATA. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) DOES SEVERAL THINGS IN ORDER TO EDUCATE AND/OR ASSIST A PATIENT IN RECEIVING OUTSIDE ASSISTANCE, INCLUDING THE FOLLOWING: 1) SIGNANGE IS POSTED AT REGISTRATION POINTS THROUGHOUT THE HOSPITAL REGARDING ASSISTANCE TO PAY FOR SERVICES AS WELL AS CRITTTENTON'S UNCOMPENSATED SERVICES PROGRAM. HANDOUTS ARE GIVEN TO THE PATIENTS AND THE PROGRAM IS ALSO OUTLINED ON THE BACK OF EVERY STATEMENT THAT IS SENT TO PATIENTS. 2) FINANCIAL COUNSELORS ARE ON-SITE THAT ARE CONTACTED WHEN A PATIENT WITHOUT INSURANCE COMES INTO THE EMERGENCY ROOM OR IS ADMITTED TO THE HOSPITAL. FINANCIAL COUNSELORS ASSIST PATIENTS IN QUALIFYING FOR COUNTY, STATE, FEDERAL, OR HOSPITAL ASSISTANCE PROGRAMS. 3) TAKE PART AND ASSIST PATIENTS IN QUALIFYING FOR COUNTY INDIGENT HOSPITALIZATION PROGRAM. 4) ALL HOSPTAL MANAGERS THAT DEAL WITH THE PUBLIC ARE DIRECTLY INFORMED OF CRITTENTON'S UNCOMPENSATED SERVICE PROGRAMS AND ASSIST PATIENTS WITH SUGGESTIONS AS WELL AS CASHIERS HAVING ACCESS TO THE SAME INFORMATION AND TRAINING. 5) OFFER ASSISTANCE TO NEWBORN MOTHERS WITHOUT INSURANCE IN THE FORM OF ASSISTANCE IN APPLYING FOR MEDICAID OR OTHER POTENTIAL PAYMENT COVERAGE. |
| Schedule H, Part VI, Line 4 Community information | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) is a 290-bed all inclusive medical facility serving communities in Oakland, Macomb, and Lapeer counties; providing service to both urban and rural areas. In addition to downsizing, many employers are reducing benefits or cost shifting to employees as a means to save costs. This results in higher co-pays and deductibles for the patient. This increase in out-of-pocket expenditures is acting as a deterrent in seeking health care services as a result. Demographically, the population forecast projects minimal growth over the next three years, however, the age of the population continues to rise. The growth of individuals over the age of 55 is projected to grow 20-30%. Demographically, ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) serves a population with a median income of $77,000; well above Michigan's median income of $49,000 and the national median of $53,500. The percent of individuals below poverty level is 7.2%; half the state and national level at 16.2% and 14.8% respectfully. The average age of the population served by ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) is 40 years old and the educational attainment of the community served is 92% earning a high school diploma or higher. According to census.gov, Rochester has 4.6% uninsured individuals. ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) resides in a highly competitive market in Southeast Michigan. There are three other hospital systems within a six mile radius that provide competing primary, secondary, and tertiary health care services. ASCENSION PROVIDENCE ROCHESTER HOSPITAL'S (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) presence with only 290 beds is substantial in that it captures 34% of the market share in its core service area. |
| Schedule H, Part VI, Line 5 Promotion of community health | PLEASE SEE PART V, SECTION B, LINE 3 DISCLOSURE. IN ADDITION, ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) UNDERSTANDS THE IMPORTANT ROLE IN WHICH THE COMMUNITY PLAYS IN ITS SUCCESS. THE HOSPITAL IS ABLE TO GIVE BACK TO THE COMMUNITY THROUGH ESSENTIAL HEALTHCARE SERVICES AND COMMUNITY EDUCATION TO CATER TO THE UNMET NEEDS WITHIN ITS COMMUNITY. OFFERING ADVANCED CARE AND SERVICES IS ONE OF THE MANY WAYS ACH SERVES ITS COMMUNITY. ACH HAS ALSO PARTNERED WITH PREMIER ORGANIZATIONS (E.G. WAYNE STATE UNIVERSITY AND OAKLAND UNIVERSITY) TO FULLFILL ITS MISSION OF ENHANCING THE HEALTH STATUS OF THE COMMUNITY. |
| Schedule H, Part VI, Line 6 Affiliated health care system | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER), a 290 LICENSED BED HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES FOR THE RESIDENTS PRIMARILY OF OAKLAND, MACOMB, AND LAPEER COUNTIES IN MICHIGAN, IS A MEMBER OF ASCENSION MICHIGAN, WHICH IS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA.ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. APR IS RELATED TO ACENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF ASCENSION HEALTH ARE RELATED TO PROVIDING HEALTH CARE SERVICES. THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, EACH MINISTRY MARKET ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY OT PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILITZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: 1) TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. 2) UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS. 3) COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH AQUIRED IMMUNE DEFICIENCY SYNDROME. 4) COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED AND UNDERINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALITY FOR FINANCIAL ASSISTANCE ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TO THE ENTITY'S BILLED CHARGES FOR PATIENT CARE. CERTAIN COSTS SUCH AS GRADUATE MEDICAL EDUCATION AND CERTAIN OTHER ACTIVITIES ARE EXCLUDED FROM TOTAL OPERATING EXPENSES FOR PURPOSES OF THIS COMPUTATION. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | 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 (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TERENCE HAMILTON | ||||||||||||||
| FORMER OFFICER (END 5/2016) | $0 | $310,389 | $0 | $86,825 | $0 | $43,155 | $0 | $16,200 | $0 | $24,776 | $0 | $481,345 | $0 | $0 |
| ROY A POWELL | ||||||||||||||
| FORMER OFFICER (END 10/2015) | $93 | $0 | $0 | $0 | $493,903 | $0 | $0 | $0 | $5,285 | $0 | $499,281 | $0 | $0 | $0 |
| DONNA M KOPINSKI | ||||||||||||||
| FORMER OFFICER (END 5/2017) | $88,467 | $0 | $3,397 | $0 | $144,962 | $0 | $5,492 | $0 | $12,991 | $0 | $255,310 | $0 | $0 | $0 |
| TOMASINE F MARX | ||||||||||||||
| CFO/COO | $0 | $304,604 | $0 | $120,558 | $0 | $68,622 | $0 | $17,550 | $0 | $24,318 | $0 | $535,651 | $0 | $24,697 |
| MARGARET A DIMOND | ||||||||||||||
| PRESIDENT & CEO (END 11/2017) | $0 | $361,616 | $0 | $138,094 | $0 | $60,134 | $0 | $8,100 | $0 | $16,249 | $0 | $584,193 | $0 | $0 |
| CHRISTOPHER J PALAZZOLO | ||||||||||||||
| PRESIDENT & CEO (START 11/2017) | $0 | $544,785 | $0 | $324,134 | $0 | $129,068 | $0 | $16,200 | $0 | $26,788 | $0 | $1,040,975 | $0 | $0 |
| MARY KAY LACHANCE | ||||||||||||||
| FORMER KEY EMPLOYEE (END 6/2017) | $0 | $314,434 | $0 | $116,742 | $0 | $21,247 | $0 | $17,550 | $0 | $5,613 | $0 | $475,585 | $0 | $0 |
| SHERYL ANN WISSMAN MD | ||||||||||||||
| CMO | $215,759 | $0 | $27,504 | $0 | $20,958 | $0 | $5,002 | $0 | $3,091 | $0 | $272,315 | $0 | $0 | $0 |
| DEBORAH KING RN | ||||||||||||||
| CNO | $176,028 | $0 | $43,755 | $0 | $35,835 | $0 | $13,491 | $0 | $27,489 | $0 | $296,598 | $0 | $0 | $0 |
| DOUGLAS E PUGMIRE DO | ||||||||||||||
| MEDICAL DIRECTOR | $299,269 | $0 | $42,308 | $0 | $2,604 | $0 | $14,670 | $0 | $17,575 | $0 | $376,426 | $0 | $0 | $0 |
| SAMER KAZZIHA MD | ||||||||||||||
| MEDICAL DIRECTOR | $307,759 | $0 | $0 | $0 | $3,885 | $0 | $8,100 | $0 | $27,723 | $0 | $347,467 | $0 | $0 | $0 |
| MATTHEW R PRINCE DO | ||||||||||||||
| SURGEON | $268,513 | $0 | $7,000 | $0 | $323 | $0 | $7,315 | $0 | $18,183 | $0 | $301,334 | $0 | $0 | $0 |
| ROBERT LACOSTE MD | ||||||||||||||
| MEDICAL DIRECTOR | $215,888 | $0 | $38,055 | $0 | $1,456 | $0 | $8,103 | $0 | $25,535 | $0 | $289,036 | $0 | $0 | $0 |
| ANA M ROTAR MD | ||||||||||||||
| PHYSICIAN | $197,958 | $0 | $7,200 | $0 | $5 | $0 | $4,750 | $0 | $16,274 | $0 | $226,186 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | ASCENSION HEALTH, A RELATED ORGANIZATION OF ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | The following individual(s) received severance payments from the organization or a related organization during calendar year 2017: Donna M Kopinski - $130,038 Roy A Powell - $493,190 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received payment from the supplemental nonqualified retirement plan in the amount as noted during calendar year 2017: Tomasine F Marx - $24,697 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 2 New program services | The hospital assumed the responsibility for the services historically provided by the Crittenton Cancer Center (CCR - related 501(c)(3) due to the dissolution of the CCR as of 6/30/2017. Such services included providing rental property, both real and personal, utilized in the delivery of Cancer Care services. |
| Form 990, Part IV, Line 20b AUDITED FINANCIAL STATEMENTS | The activity of ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) is completed. Therefore, the audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER). |
| Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO, THE PROCESS PERFORMED BY ST. JOHN PROVIDENCE, A RELATED ORGANIZATION OF ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE PRESIDENT & CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. |
| Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES | IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE PROCESS PERFORMED BY ST. JOHN PROVIDENCE, A RELATED ORGANIZATION OF ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER), INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) HAS A SINGLE CORPORATE MEMBER, ASCENSION MICHIGAN. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) HAS A SINGLE CORPORATE MEMBER, ASCENSION MICHIGAN, WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF CRITTENTON HOSPITAL MEDICAL CENTER. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, ASCENSION MICHIGAN. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | Miscellaneous Revenue - Total Revenue: 2016794, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 2016794; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | FAS 158 PENSION ADJUSTMENT - 62207; TRANSFERS WITH ALPHA FUND - 2488186; TRANSFERS WITH AFFILIATE - 335823; |
| Form 990, Part XII, Line 2c AUDIT COMMITTEE | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (F/K/A CRITTENTON HOSPITAL MEDICAL CENTER) is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. |
| FORM 990, PAGE 1, ITEM J ENTITY WEBSITE | https://healthcare.ascension.org/Locations/Michigan/MIROC/Rochester-Ascension-Providence-Rochester-Hospital |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (37 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 | Business Name Line2DisregardedEntityName/BusinessNameLine2Txt | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | ||||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3) | Type I | NA | false | ||
| ASCENSION HEALTH | ||||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3) | Type I | ASCENSION HEALTH ALLIANCE | false | ||
| ASCENSION MICHIGAN | ||||||||||||
| 28000 DEQUINDRE ROAD | WARREN | MI | 48092 | 382631907 | HEALTH CARE | MI | 501(c)(3) | 10 | ASCENSION HEALTH | false | ||
| BORGESS HEALTH ALLIANCE INC | ||||||||||||
| 1521 GULL ROAD | KALAMAZOO | MI | 49048 | 382335286 | HEALTH SYSTEM PARENT | MI | 501(c)(3) | Type III-FI | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION BORGESS HOSPITAL FKA BORGESS MEDICAL CENTER | ||||||||||||
| 1521 GULL ROAD | KALAMAZOO | MI | 49048 | 381360526 | HEALTHCARE SERVICES | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION BRIGHTON CENTER FOR RECOVERY FKA BRIGHTON CENTER FOR RECOVERY | ||||||||||||
| 12851 GRAND RIVER | BRIGHTON | MI | 48116 | 381576680 | HOSPITAL | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| GENESYS HEALTH SYSTEM | ||||||||||||
| ONE GENESYS PARKWAY | GRAND BLANC | MI | 484398065 | 383339703 | HEALTH SYSTEM PARENT | MI | 501(c)(3) | Type II | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION GENESYS HOSPITAL FKA GENESYS REGIONAL MEDICAL CENTER | ||||||||||||
| ONE GENESYS PARKWAY | GRAND BLANC | MI | 484398065 | 382377821 | HOSPITAL | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION BORGESS-LEE HOSPITAL FKA LEE MEMORIAL HOSPITAL CORPORATION | ||||||||||||
| 420 WEST HIGH STREET | DOWAGIAC | MI | 49047 | 381490190 | HEALTHCARE SERVICES | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION PROVIDENCE HOSPITAL FKA PROVIDENCE - PROVIDENCE PARK HOSPITAL | ||||||||||||
| 16001 WEST NINE MILE ROAD | SOUTHFIELD | MI | 48037 | 381358212 | HOSPITAL | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION ST JOHN HOSPITAL FKA ST JOHN HOSPITAL & MEDICAL CENTER | ||||||||||||
| 28000 DEQUINDRE ROAD | WARREN | MI | 48092 | 381359063 | HEALTH CARE | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION MACOMB OAKLAND HOSPITAL FKA ST JOHN MACOMB-OAKLAND HOSPITAL | ||||||||||||
| 28000 DEQUINDRE ROAD | WARREN | MI | 48092 | 383322109 | HOSPITAL | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ST JOHN PROVIDENCE | ||||||||||||
| 28000 DEQUINDRE ROAD | WARREN | MI | 48092 | 382244034 | PARENT | MI | 501(c)(3) | Type III-FI | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION RIVER DISTRICT HOSPITAL FKA ST JOHN RIVER DISTRICT HOSPITAL | ||||||||||||
| 4100 RIVER ROAD | EAST CHINA | MI | 48054 | 383160564 | HOSPITAL | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION ST JOSEPH'S HOSPITAL (FKA ST JOSEPH HEALTH SYSTEM INC) | ||||||||||||
| 200 HEMLOCK ROAD | TAWAS CITY | MI | 48763 | 381443395 | HEALTH CARE | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ST MARY'S - ST JOSEPH HEALTH SYSTEM | ||||||||||||
| 800 S WASHINGTON AVENUE | SAGINAW | MI | 48601 | 461084363 | SUPPORTING ORGANIZATION | MI | 501(c)(3) | Type III-FI | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION ST MARY'S HOSPITAL FKA ST MARY'S OF MICHIGAN | ||||||||||||
| 800 S WASHINGTON AVENUE | SAGINAW | MI | 48601 | 380997730 | HOSPITAL | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| ASCENSION STANDISH HOSPITAL FKA STANDISH COMMUNITY HOSPITAL | ||||||||||||
| 805 WEST CEDEAR STREET | STANDISH | MI | 48658 | 381671120 | HOSPITAL | MI | 501(c)(3) | 3 | ASCENSION MICHIGAN | Yes (true) | ||
| BORGESS AMBULATORY CARE CORPORATION | ||||||||||||
| 1521 GULL ROAD | KALAMAZOO | MI | 49048 | 382468823 | HOLDING COMPANY | MI | 501(c)(3) | 3 | BORGESS HEALTH ALLIANCE INC | Yes (true) | ||
| ASCENSION BORGESS FOUNDATION FKA BORGESS FOUNDATION | ||||||||||||
| 1521 GULL ROAD | KALAMAZOO | MI | 49048 | 237222558 | FUNDRAISING | MI | 501(c)(3) | Type III-FI | BORGESS HEALTH ALLIANCE INC | Yes (true) | ||
| ASCENSION BORGESS LEE FOUNDATION FKA LEE MEMORIAL FOUNDATION | ||||||||||||
| 420 W HIGH STREET | DOWAGIAC | MI | 49047 | 382860459 | FUNDRAISING | MI | 501(c)(3) | Type III-FI | ASCENSION BORGESS-LEE HOSPITAL FKA LEE MEMORIAL HOSPITAL CORPORATION | Yes (true) | ||
| ASCENSION EASTWOOD BEHAVIORAL HEALTH FKA EASTWOOD COMMUNITY CLINICS | ||||||||||||
| 28000 DEQUINDRE ROAD | WARREN | MI | 48092 | 381958763 | HEALTH CARE | MI | 501(c)(3) | 10 | ST JOHN PROVIDENCE | Yes (true) | ||
| ASCENSION PROVIDENCE FOUNDATION | ||||||||||||
| 22101 MOROSS | DETROIT | MI | 48236 | 383526629 | FUNDRAISING | MI | 501(c)(3) | Type III-FI | ST JOHN PROVIDENCE | Yes (true) | ||
| SETON HEALTH CORPORATION OF SOUTHEAST MICHIGAN | ||||||||||||
| 28000 DEQUINDRE | WARREN | MI | 48092 | 382820107 | HEALTH CARE | MI | 501(c)(3) | 10 | ST JOHN PROVIDENCE | Yes (true) | ||
| ASCENSION SOUTHEAST MICHIGAN COMMUNITY HEALTH (FKA ST JOHN COMMUNITY HEALTH | ||||||||||||
| 28000 DEQUINDRE ROAD | WARREN | MI | 48092 | 382262856 | HEALTH CARE | MI | 501(c)(3) | 3 | ST JOHN PROVIDENCE | Yes (true) | INVESTMENT CORP) | |
| ASCENSION ST JOHN FOUNDATION FKA ST JOHN HOSPITAL FOUNDATION | ||||||||||||
| 22101 MOROSS | DETROIT | MI | 48236 | 202961579 | FUNDRAISING | MI | 501(c)(3) | 7 | ST JOHN PROVIDENCE | Yes (true) | ||
| ST JOHN PROVIDENCE PHYSICIANS CMG | ||||||||||||
| 28000 DEQUINDRE ROAD | WARREN | MI | 48092 | 382601348 | HEALTH CARE | MI | 501(c)(3) | 10 | ST JOHN PROVIDENCE | Yes (true) | ||
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||||||||||||
| 200 HEMLOCK ROAD | TAWAS CITY | MI | 48763 | 010790428 | FUNDRAISING | MI | 501(c)(3) | Type I | ASCENSION ST JOSEPH'S HOSPITAL (FKA ST JOSEPH HEALTH SYSTEM INC) | Yes (true) | ||
| FIELD NEUROSCIENCES INSTITUTE | ||||||||||||
| 800 S WASHINGTON AVENUE | SAGINAW | MI | 48601 | 382790703 | MEDICAL RESEARCH ORGANIZATION | MI | 501(c)(3) | 10 | ASCENSION ST MARY'S HOSPITAL FKA ST MARY'S OF MICHIGAN | Yes (true) | ||
| ASCENSION ST MARY'S FOUNDATION FKA ST MARY'S MEDICAL CENTER FOUNDATION SAGI | ||||||||||||
| 800 S WASHINGTON AVENUE | SAGINAW | MI | 48601 | 382246366 | FUNDRAISING | MI | 501(c)(3) | Type II | ASCENSION ST MARY'S HOSPITAL FKA ST MARY'S OF MICHIGAN | Yes (true) | NAW MICHIGAN | |
| CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION | ||||||||||||
| 1101 WEST UNIVERSITY DR | ROCHESTER | MI | 48307 | 382627336 | SUPPORTING | MI | 501(c)(3) | Type I | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (FKA CRITTENTON HOSPITAL MEDICAL CE | Yes (true) | NTER) | |
| CRITTENTON CANCER CENTER | ||||||||||||
| 1101 WEST UNIVERSITY DR | ROCHESTER | MI | 48307 | 383239057 | CANCER TREATMENT | MI | 501(c)(3) | 10 | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (FKA CRITTENTON HOSPITAL MEDICAL CE | Yes (true) | NTER) | |
| GENESYS AMBULATORY HEALTH SERVICES | ||||||||||||
| 5455 ALI DR DEPT 200 | GRAND BLANC | MI | 484395195 | 382371754 | HEALTH SRVCS/STAFFING/PROP MNGT | MI | 501(c)(3) | Type II | GENESYS HEALTH SYSTEM | Yes (true) | ||
| ASCENSION GENESYS FOUNDATION FKA GENESYS HEALTH FOUNDATION | ||||||||||||
| ONE GENESYS PARKWAY | GRAND BLANC | MI | 484398065 | 383591148 | FOUNDATION | MI | 501(c)(3) | Type I | GENESYS HEALTH SYSTEM | Yes (true) | ||
| THE HEALTH SOURCE GROUP | ||||||||||||
| 5455 ALI DR DEPT 200 | GRAND BLANC | MI | 484395195 | 382427678 | PRG RELATED INVESTMENTS | MI | 501(c)(3) | Type I | GENESYS HEALTH SYSTEM | Yes (true) | ||
| CENTER FOR GERONTOLOGY | ||||||||||||
| 5455 ALI DRIVE DEPT200 | GRAND BLANC | MI | 484395195 | 382514708 | ADULT DAY CARE | MI | 501(c)(3) | Type I | GENESYS AMBULATORY HEALTH SERVICES | Yes (true) | ||
| GENESYS CONVALESCENT CENTER | ||||||||||||
| 8481 HOLLY ROAD | GRAND BLANC | MI | 484391812 | 382317364 | CONVALESCENT CENTER | MI | 501(c)(3) | 3 | GENESYS AMBULATORY HEALTH SERVICES | Yes (true) | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|---|
| TOWNE CENTRE SURGERY CENTER LLC | |||||||||
| 4599 TOWNE CENTRE | SAGINAW | MI | 48604 | 204943843 | OUTPATIENT SERVICES | MI | NA | N/A | |
| Open MRI of Michigan | |||||||||
| 411 W 13 MILE ROAD | MADISON HEIGHTS | MI | 48071 | 383544539 | MRI Center | MI | NA | N/A | |
| The Michigan Institute for Advanced Surgery LLC | |||||||||
| 1375 S Lapeer Rd | Lake Orion | MI | 48360 | 030444972 | OUTPATIENT SERVICES | MI | NA | N/A | 109 |
| Hospital Consolidated Laboratories LLC | |||||||||
| 39595 W 10 Mile Rd | Novi | MI | 48375 | 383318428 | LAB SERVICES | MI | NA | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 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 | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOSEPH HEALTH ENTERPRISES | ||||||||||||
| 200 HEMLOCK ROAD | TAWAS CITY | MI | 48764 | 382686747 | OTHER MEDICAL | MI | NA | C Corporation | Yes (true) | |||
| GENESYS PRACTICE PARTNERS | ||||||||||||
| 5445 ALI DRIVE DEPT 200 | GRAND BLANC | MI | 48439 | 030516871 | EMPLOYED PHY PRACTICE | MI | NA | C Corporation | Yes (true) | |||
| BEECHER BALLENGER SERVICES | ||||||||||||
| ONE GENESYS PARKWAY | GRAND BLANC | MI | 484398065 | 382497922 | HOLDING COMPANY | MI | NA | C Corporation | Yes (true) | |||
| ADVENT INC | ||||||||||||
| 28000 DEQUINDRE | WARREN | MI | 48092 | 382971743 | RENTAL REAL ESTATE | MI | NA | C Corporation | Yes (true) | |||
| AFFILIATED HEALTH SERVICES INC | ||||||||||||
| 28000 DEQUINDRE | WARREN | MI | 48092 | 382292922 | MEDICAL SERVICES | MI | NA | C Corporation | Yes (true) | |||
| St Mary's Health | ||||||||||||
| 800 S Washington Avenue | Saginaw | MI | 48601 | 383477017 | Dormant | MI | NA | C Corporation | Yes (true) | |||
| TEXTILE SYSTEMS INC | ||||||||||||
| 817 WALBRIDGE | KALAMAZOO | MI | 49007 | 382705047 | LAUNDRY SERVICES | MI | NA | C Corporation | Yes (true) | |||
| CRITTENTON DEVELOPMENT CORPORATION | ||||||||||||
| 2251 N SQUIRREL RD STE 310 | AUBURN HILLS | MI | 48326 | 382594115 | REAL ESTATE | MI | ASCENSION PROVIDENCE ROCHESTER HOSPITAL (FKA CRITTENTON HOSPITAL MEDICAL CE | C Corporation | Yes (true) | NTER) | $3,788,544 | $13,154,349 |
| 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 | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | 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 | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION | ||
| O | $63,716 | FAIR MARKET VALUE |
| CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION | ||
| Q | $111,035 | FAIR MARKET VALUE |
| CRITTENTON DEVELOPMENT CORPORATION | ||
| S | $1,318,362 | FAIR MARKET VALUE |
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