BRONSON LAKEVIEW HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- BRONSON LAKEVIEW HOSPITAL (EIN 38-1359218)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-09
- IRS object ID
- 201833139349302933
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-09T16:27:09-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 S RIVERSIDE PLAZA 9TH FLOOR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381359218 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRONSON LAKEVIEW HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BRON | BusinessNameControlTxt |
| Phone | 2693416000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 JOHN STREET | AddressLine1Txt |
| City | KALAMAZOO | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49007 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | REBECCA EAST | PersonNm |
| Person Title | SENIOR VP/CFO | PersonTitleTxt |
| Phone | 2693416000 | PhoneNum |
| Signature | 2018-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 3122071040 | PhoneNum |
| Preparation | 2018-11-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.59.56.31 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-07 | IPDt |
| IP Tm | 12:33:54 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D6D028B83EC7BAE48696A0FE418AC7215527A94E | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 75C7EC6AC54A61BA087900A4F9B91D17BA572CD0 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | FRANK SARDONE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 JOHN STREET | AddressLine1Txt |
| City | KALAMAZOO | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49007 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $56,128,197 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | BRONSONHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A GENERAL ACUTE CARE HOSPITAL | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 435 | TotalEmployeeCnt |
| Total Volunteers | 35 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,849 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $55,296,336 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $55,837,743 | CYProgramServiceRevenueAmt |
| PY Investment Income | $42,848 | PYInvestmentIncomeAmt |
| CY Investment Income | $36,558 | CYInvestmentIncomeAmt |
| PY Other Revenue | $244,789 | PYOtherRevenueAmt |
| CY Other Revenue | $248,047 | CYOtherRevenueAmt |
| PY Total Revenue | $55,583,973 | PYTotalRevenueAmt |
| CY Total Revenue | $56,128,197 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,000,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,250,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,133,011 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,523,046 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,324,252 | PYOtherExpensesAmt |
| CY Other Expenses | $18,746,223 | CYOtherExpensesAmt |
| PY Total Expenses | $57,457,263 | PYTotalExpensesAmt |
| CY Total Expenses | $51,519,269 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,873,290 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,608,928 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,931,861 | TotalAssetsBOYAmt |
| Total Assets EOY | $24,227,991 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,338,481 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,025,683 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,593,380 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,202,308 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TOGETHER, WE ADVANCE THE HEALTH OF OUR COMMUNITIES | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $29,818,348 | ExpenseAmt |
| Grant | $1,250,000 | GrantAmt |
| Revenue | $46,136,719 | RevenueAmt |
| Desc | BRONSON LAKEVIEW HOSPITAL (BLH)IS A 35-BED CRITICAL ACCESS HOSPITAL, INCLUDING 25 CRITICAL ACCESS AND 10-BED GERIATRIC PSYCHIATRIC UNIT. BLH OFFERS A FULL RANGE OF ACUTE CARE FOR INPATIENTS AND IS A WELL-ESTABLISHED DESTINATION FOR SURGERY, GERIATRIC PSYCHIATRY AND EMERGENCY CARE. BLH OPERATES A FULL-SERVICE, 24/7 EMERGENCY DEPARTMENT THAT TREATS ABOUT 18,656 PATIENT VISITS ANNUALLY, REGARDLESS OF THEIR ABILITY TO PAY. OUTPATIENT SERVICES ARE PROVIDED AT THE HOSPITAL, AS WELL AS AT RURAL HEALTH CLINICS IN PAW PAW, DECATUR, AND MATTAWAN. IN 2017, IN FURTHERANCE OF ITS MISSION, BLH INCURRED NET COMMUNITY BENEFIT EXPENSE OF $2,957,882 | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,228,183 | ExpenseAmt |
| Revenue | $9,949,071 | RevenueAmt |
| Desc | IN 2017, BLH'S MEDICAID COST WAS $12,228,183 AND MEDICAID NET REVENUE WAS $9,949,071 | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,710,047 | ExpenseAmt |
| Desc | IN 2017, IN FURTHERANCE OF ITS MISSION, BLH INCURRED $2,710,047 IN BAD DEBT TO PROVIDE CARE TO ITS PATIENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $44,756,578 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 435 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REBECCA EAST SENIOR VPCFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2693416000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 JOHN STREET | AddressLine1Txt |
| City | KALAMAZOO | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49007 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (39 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| PARFET DONALD | ||||||||||
| CHAIRPERSON | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $998 | $0 | |||
| EBERTS RANDALL | ||||||||||
| VICE CHAIRPERSON | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $2,283 | $0 | |||
| KARRE NELSON | ||||||||||
| VICE CHAIRPERSON | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JAMES BARBARA | ||||||||||
| TREASURER | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $1,830 | $0 | |||
| NYBERG NEIL | ||||||||||
| SECRETARY | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $987 | $0 | |||
| LAWLOR JOHN | ||||||||||
| CHIEF OF STAFF | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $436,671 | $30,155 | |||
| ALLEN RICHARD | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||||
| ATKINSON MARK B | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $2,196 | $0 | ||||
| FINK KATY | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||||
| GIBSON SCOTT | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $43,225 | $0 | ||||
| GONZALEZ JORGE G | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||||
| GREENE JAMES E | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $2,309 | $0 | ||||
| HUNT BRENDA | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHNSTON WILLIAM | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||||
| KARAMCHANDANI MAHESH C | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $723,489 | $30,724 | ||||
| LANE-DAVIES AARON | ||||||||||
| PAST CHIEF OF STAFF | 1.00 | 8.00 | Yes (X) | $0 | $262,868 | $35,412 | ||||
| LIGGINS JAMES L | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $2,557 | $0 | ||||
| LINS STEVEN J | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $1,176 | $0 | ||||
| MONTGOMERY TABRON LA JUNE | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||||
| ODAR MICHAEL | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $1,116 | $0 | ||||
| ZELLER CHARLES | ||||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $736 | $0 | ||||
| SARDONE FRANK J | ||||||||||
| PRESIDENT AND CEO | 3.00 | 37.00 | Yes (X) | Yes (X) | $0 | $1,455,276 | $414,238 | |||
| EAST REBECCA L | ||||||||||
| SR VP CFO BHG | 3.00 | 37.00 | Yes (X) | $0 | $627,307 | $167,915 | ||||
| FALAHEE JAMES | ||||||||||
| SR VP LEGAL & LEG. AFFAIRS | 3.00 | 37.00 | Yes (X) | $0 | $666,937 | $168,771 | ||||
| HARRELSON KATHLEEN M | ||||||||||
| SR VP, CLINICAL OPERATIONS | 3.00 | 37.00 | Yes (X) | $0 | $673,301 | $183,984 | ||||
| HAYDEN JOHN | ||||||||||
| VP & CHIEF HR OFFICER | 3.00 | 37.00 | Yes (X) | $0 | $537,234 | $143,416 | ||||
| JONES JR JOHN L | ||||||||||
| SR. VP, REG. & PHYS. SVS. | 3.00 | 37.00 | Yes (X) | $0 | $667,296 | $184,862 | ||||
| LARSON SCOTT | ||||||||||
| SR VP MEDICAL AFFAIRS/CMO | 3.00 | 37.00 | Yes (X) | $0 | $743,968 | $155,712 | ||||
| GOEL ASHUTOSH | ||||||||||
| CHIEF MED INFORMATICS OFFI | 3.00 | 37.00 | $0 | $453,912 | $95,562 | Yes (X) | ||||
| RICHARDSON KIRK | ||||||||||
| VP COO BLH | 32.00 | 8.00 | $0 | $272,513 | $74,802 | Yes (X) | ||||
| SANGALLI-DAVIS CHRISTINE | ||||||||||
| VP CHIEF COMPLIANCE OFFICER | 3.00 | 37.00 | $0 | $207,167 | $57,531 | Yes (X) | ||||
| TRELLA REBECCA | ||||||||||
| VP POST ACUTE CARE | 3.00 | 37.00 | $0 | $300,210 | $69,453 | Yes (X) | ||||
| WAY MICHAEL S | ||||||||||
| VP MAT. MGT. & FACILITY SV | 3.00 | 37.00 | $0 | $290,739 | $81,321 | Yes (X) | ||||
| DOMMER MATTHEW | ||||||||||
| PHYSICIAN | 40.00 | $320,960 | $0 | $62,438 | Yes (X) | |||||
| DUPUIS PEARCE | ||||||||||
| PHYSICIAN | 40.00 | $257,380 | $0 | $29,396 | Yes (X) | |||||
| KHAIRALLAH NAJI | ||||||||||
| PHYSICIAN | 40.00 | $247,918 | $0 | $27,777 | Yes (X) | |||||
| LEKOVIC MIRSEN | ||||||||||
| PHYSICIAN | 40.00 | $376,530 | $0 | $26,517 | Yes (X) | |||||
| MIRZA NADEEM M | ||||||||||
| PSYCHIATRIST | 40.00 | $364,075 | $0 | $32,836 | Yes (X) | |||||
| TAFT KENNETH L | ||||||||||
| FORMER EXECUTIVE VICE PRESIDENT | 0.00 | 0.00 | $0 | $190,311 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,566,863 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,568,612 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,072,822 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 28 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SW MI EMERGENCY SERVICES PC | |||||
| 125 S KALAMAZOO MALL SUITE 204 | KALAMAZOO | MI | 49007 | MEDICAL SERVICES | $505,347 |
| SODEXO INC & AFFILIATES | |||||
| PO BOX 360170 | PITTSBURGH | PA | 152516170 | FOOD SERVICE | $402,018 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,849 | RelatedOrganizationsAmt |
| Total Contributions | $5,849 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | $55,321,643 | $55,321,643 |
| PGIP REVENUE | 900099 | $623,922 | $623,922 |
| RENTAL REVENUE FROM AFFILIATED OR | 532000 | $5,252 | $5,252 |
| MEANINGFUL USE REVENUE | 900099 | -$113,074 | -$113,074 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $55,837,743 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,252 | TotalRevenueColumnAmt |
| Exclusion | $2,252 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $34,306 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $34,306 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,306 | TotalRevenueColumnAmt |
| Exclusion | $34,306 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA EMPLOYEE REVENUE | 722310 | $163,203 | $163,203 |
| OUTSIDE SERVICE REVENUE | 900099 | $67,312 | $67,312 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,532 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,532 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $248,047 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,128,197 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $56,085,790 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $36,558 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,250,000 | TotalAmt |
| Program Services | $1,250,000 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,585,517 | TotalAmt |
| Program Services | $21,204,428 | ProgramServicesAmt |
| Management And General | $4,381,089 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,498,643 | TotalAmt |
| Program Services | $4,318,697 | ProgramServicesAmt |
| Management And General | $179,946 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,438,886 | TotalAmt |
| Program Services | $1,390,866 | ProgramServicesAmt |
| Management And General | $48,020 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,287,199 | TotalAmt |
| Program Services | $2,283,304 | ProgramServicesAmt |
| Management And General | $3,895 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,191 | TotalAmt |
| Program Services | $7,191 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,748,077 | TotalAmt |
| Program Services | $1,720,474 | ProgramServicesAmt |
| Management And General | $27,603 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,948,214 | TotalAmt |
| Program Services | $2,732,361 | ProgramServicesAmt |
| Management And General | $215,853 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,815 | TotalAmt |
| Program Services | $57,662 | ProgramServicesAmt |
| Management And General | $1,153 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,849 | TotalAmt |
| Program Services | $68,800 | ProgramServicesAmt |
| Management And General | $1,049 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,391,382 | TotalAmt |
| Program Services | $2,363,598 | ProgramServicesAmt |
| Management And General | $27,784 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,996 | TotalAmt |
| Program Services | $208,327 | ProgramServicesAmt |
| Management And General | $56,669 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,814,474 | $3,814,474 | |
| BAD DEBT EXPENSE | $2,710,047 | $2,710,047 | |
| ALLOCATION EXPENSE | $1,894,684 | $76,960 | $1,817,724 |
| EQUIPMENT MAINT/REPAIR | $605,144 | $603,368 | $1,776 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$53,849 | TotalAmt |
| Program Services | -$53,979 | ProgramServicesAmt |
| Management And General | $130 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,519,269 | TotalAmt |
| Program Services | $44,756,578 | ProgramServicesAmt |
| Management And General | $6,762,691 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,419 | BOYAmt |
| EOY | $730,625 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,845,742 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,117,309 | BOYAmt |
| EOY | $7,256,147 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $564,233 | BOYAmt |
| EOY | $595,585 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,548 | BOYAmt |
| EOY | $140,868 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,392,130 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $41,733,106 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,882,352 | BOYAmt |
| EOY | $13,659,024 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,931,861 | BOYAmt |
| EOY | $24,227,991 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,636,340 | BOYAmt |
| EOY | $2,171,374 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,702,141 | BOYAmt |
| EOY | $1,854,309 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,338,481 | BOYAmt |
| EOY | $4,025,683 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,593,380 | BOYAmt |
| EOY | $20,202,308 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,593,380 | BOYAmt |
| EOY | $20,202,308 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,931,861 | BOYAmt |
| EOY | $24,227,991 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,608,928 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $818,892 | OtherCostOrOtherBasisAmt |
| Book Value | $818,892 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,031,548 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,417,516 | DepreciationAmt |
| Book Value | $7,614,032 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,141,399 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,582,386 | DepreciationAmt |
| Book Value | $3,559,013 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,400,291 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,733,204 | DepreciationAmt |
| Book Value | $1,667,087 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,659,024 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COST REPORT SETTLEMENTS | Desc |
| Amt | $1,854,309 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,854,309 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $516,004 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $516,004 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 18463 | PersonsServedCnt |
| Total Community Benefit Expns | $12,228,183 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,949,071 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,279,112 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04670 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 18463 | PersonsServedCnt |
| Total Community Benefit Expns | $12,744,187 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,949,071 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,795,116 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05730 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 47 | PersonsServedCnt |
| Total Community Benefit Expns | $105,469 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $105,469 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 15 | PersonsServedCnt |
| Total Community Benefit Expns | $36,355 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $36,355 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $20,942 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,942 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 21 | ActivitiesOrProgramsCnt |
| Persons Served | 62 | PersonsServedCnt |
| Total Community Benefit Expns | $162,766 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $162,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 21 | ActivitiesOrProgramsCnt |
| Persons Served | 18525 | PersonsServedCnt |
| Total Community Benefit Expns | $12,906,953 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,949,071 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,957,882 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06060 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 1 | PersonsServedCnt |
| Total Community Benefit Expns | $2,435 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,435 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $2,460 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,460 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 1 | PersonsServedCnt |
| Total Community Benefit Expns | $4,895 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,895 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,710,047 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $67,433 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,846,289 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,336,082 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$489,793 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRONSON LAKEVIEW HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 HAZEN STREET | AddressLine1Txt |
| City | PAW PAW | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49079 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | BRONSONHEALTH.COM | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRONSON LAKEVIEW HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | 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 |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | BRONSONHEALTH.COM/MEDICAL-FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | BRONSONHEALTH.COM/MEDICAL-FINANCIAL-ASSISTANCE/FINANCIAL-ASSIST | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | BRONSONHEALTH.COM/MEDICAL-FINANCIAL-ASSISTANCE/PLAIN-LANGUAGE-P | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BRONSON LAKEVIEW HOSPITAL | PART V, SECTION B, LINE 5: BRONSON LAKEVIEW TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENTED THE COMMUNITY USING THREE METHODS; RESIDENT SURVEYS, KEY INFORMANT SURVEYS AND KEY INFORMANT INTERVIEWS. A PAPER-BASED SURVEY SEEKING INPUT FROM COUNTY RESIDENTS PERTAINING TO HEALTH NEEDS AND BARRIERS WAS DISTRIBUTED AT COMMUNITY AGENCIES AND VAN BUREN COMMUNITY MENTAL HEALTH. 3190 COMPLETED SURVEYS WERE COLLECTED AND ANALYZED. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS BASED ON THEIR EXTENSIVE KNOWLEDGE AND EXPERTISE ON PUBLIC HEALTH ISSUES, EXPERIENCE WITH VULNERABLE POPULATIONS OR STAKEHOLDER PERCEPTIONS OF THE COUNTY'S HEALTH STATUS AND UNMET NEEDS. THESE KEY INFORMANTS INCLUDED PERSONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY AND KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH. KEY INFORMANTS INCLUDED:-DOUG CULTRA, ADMINISTRATOR VAN BUREN COUNTY-KIRK RICHARDSON, VICE PRESIDENT BRONSON LAKEVIEW HOSPITAL-JOESEPH GOEPFRICH, DIRECTOR CHILD & FAMILY SERVICES OF SOUTHWEST MICHIGAN INC.-VERA TANIER, CEO VAN BUREN COUNTY UNITED WAY-CHRISTINE VANLANDINGHAM, DIRECTOR AREA AGENCY ON AGING -DEBRA HESS, CEO VAN BUREN COMMUNITY MENTAL HEALTH -MARK POMPEY, LEADER POKAGON TRIBAL SOCIAL SERVICES-VELMA HENDERSHOTT, DIRECTOR INTERCAREFOCUS GROUPS WITH VULNERABLE POPULATIONS WERE ALSO CONDUCTED BY AN INDEPENDENT CONSULTANT, AND WERE HELD AT THE FOLLOWING LOCATIONS:-FIRST CONGREGATIONAL CHURCH-VAN BUREN COMMUNITY MENTAL HEALTH HOPE CENTER-BANGOR HEALTH CLINIC |
| BRONSON LAKEVIEW HOSPITAL | PART V, SECTION B, LINE 6A: BRONSON METHODIST HOSPITALBRONSON BATTLE CREEK HOSPITAL |
| BRONSON LAKEVIEW HOSPITAL | PART V, SECTION B, LINE 11: THE CHNA PROCESS INCLUDED A PRIORITIZATION OF HEALTH NEEDS BASED UPON CONSENSUS CRITERIA, INCLUDING: MAGNITUDE OF NEED, MEASURABLE OUTCOMES, BRONSON CAPABILITIES, EVIDENCE FOR EFFECTIVE INTERVENTIONS, COMMUNITY COMMITMENT, AND CONSISTENCY WITH BRONSON STRATEGY. AT THE CONCLUSION OF THIS PRIORITIZATION PROCESS, IMPROVING ACCESS TO CARE WAS SELECTED AS THE FOCUS FOR COMMUNITY HEALTH ACTIVITIES IN 2016-2019. THIS FOCUSED EFFORT WILL REQUIRE SUBSTANTIAL FINANCIAL AND STAFFING RESOURCES AS WELL AS SIGNIFICANT COLLABORATIONS WITH COMMUNITY ORGANIZATIONS. GIVEN THE EXTRAORDINARY CHALLENGE OF SUBSTANTIALLY AND MEASURABLY IMPROVING ACCESS TO CARE IN AN ENVIRONMENT OF LIMITED RESOURCES, BRONSON LEADERS AND COMMUNITY HEALTH BOARD COMMITTEE MEMBERS HAVE CHOSEN TO LIMIT OUR INITIAL FOCUS TO THIS TOP PRIORITY HEALTH NEED. OTHER NEEDS IDENTIFIED INCLUDE OBESITY, LACK OF MENTAL HEALTH SUPPORT, CHRONIC DISEASE MANAGEMENT, ADDICTION PREVENTION, SAFETY, SOCIAL HEALTH, AND SEXUAL HEALTH. WHILE THESE HEALTH NEEDS WERE NOT THE PRIORITY AREA, BRONSON CONTINUES TO COLLABORATE AND PARTNER WITH THOSE AGENCIES BETTER SUITED TO HAVE AN IMPACT IN THESE AREAS AND BRONSON ANTICIPATES THAT IMPROVING ACCESS TO QUALITY CARE WILL IMPACT AND IMPROVE OUTCOMES FOR MANY OF THE OTHER NEEDS IDENTIFIED IN THE CHNA. THE ACCESS OF CARE PLAN IS ATTACHED TO THE 990 FOR REFERENCE OF AREAS NOT BEING ADDRESSED AT THIS TIME. |
| BRONSON LAKEVIEW HOSPITAL | PART V, SECTION B, LINE 20E: THE HOSPITAL ACKNOWLEDGES THAT ALL INDIVIDUALS ARE NOT EQUALLY CAPABLE OF PAYING FOR HEALTHCARE SERVICES, EITHER BY THEMSELVES OR THROUGH A THIRD PARTY INSURANCE CARRIER. THE HOSPITAL RECOGNIZES ITS RESPONSIBILITY TO OFFER CARE FOR PERSONS IN NEED, AND THEREFORE PROVIDES AND PROMOTES ACCESS TO EMERGENCY OR MEDICALLY NECESSARY SERVICES WITHOUT REGARD TO ABILITY TO PAY.THE HOSPITAL HAS SIGNS AT ENTRANCES TO THE EMERGENCY DEPARTMENT THAT INFORM PATIENTS OF THE FINANCIAL ASSISTANCE POLICY AS WELL AS THE ADMITTING AND FINANCIAL COUNSELING DEPARTMENTS. THE POLICY IS ALSO ON THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). THE PLAIN LANGUAGE SUMMARY IS INCLUDED ON ALL PATIENT STATEMENTS.PATIENTS MAY REQUEST AN APPLICATION TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE BY CALLING A PATIENT FINANCIAL COUNSELOR OR BRONSON'S BILLING DEPARTMENT. THE APPLICATION IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). |
| PART V, SECTION B, LINE 7A | WWW.BRONSONHEALTH.COM/APP/FILES/PUBLIC/2304/BLH-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-REPORT.PDF |
| PART V, SECTION B, LINE 10A | WWW.BRONSONHEALTH.COM/APP/FILES/PUBLIC/5041/BLH-ACCESS-TO-CARE-IMPLEMENTATION-2017-.PDF |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ORGANIZATION USES THE FOLLOWING FPG TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS:250% OF FPL IS ENTITLED TO A 90% REDUCTION300% OF FPL IS ENTITLED TO A 75% REDUCTION350% OF FPL IS ENTITLED TO A 65% REDUCTION |
| PART I, LINE 7: | (A-C)-COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS INSTRUCTIONS FOR LINES A-C. (E-I)- COSTING METHODOLOGY IS ACTUAL COSTS PER THE HOSPITAL ACCOUNTING SYSTEM FOR LINES E-I.(F)- THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $2,710,047 |
| PART II, COMMUNITY BUILDING ACTIVITIES: | BRONSON LAKEVIEW HOSPITAL (BLH) IS LOCATED IN THE COUNTY SEAT AND GENERATES EMPLOYMENT FOR OVER 430 EMPLOYEES. THE EMPLOYEES ARE ENCOURAGED TO BE INVOLVED IN VOLUNTEERISM WITHIN THE COMMUNITIES AND MOST NON PROFIT AGENCIES HAVE A BLH REPRESENTATIVE WORKING WITH THEM IN SOME CAPACITY. BRONSON HAS A VOLUNTEER TIME OFF PROGRAM WHERE EACH EMPLOYEE CAN GET UP TO FOUR HOURS OF PAID VOLUNTEER TIME TO SUPPORT COMMUNITY NONPROFITS. LOCATED ON MAPLE LAKE, THE ORGANIZATION MAKES ALL DECISIONS WITH THE ENVIRONMENT IN MIND AND UTILIZES GREEN TECHNOLOGY WHENEVER POSSIBLE.COMMUNITY HEALTH STAFF ARE INVOLVED WITH SEVERAL KEY COUNCILS INCLUDING THE HEALTH AND HUMAN SERVICES COUNCIL, GREAT START COLLABORATIVE AND OFFENDER SUCCESS TASK FORCE.BRONSON LAKEVIEW HOSPITAL (AND THE OTHER HOSPITALS THAT ARE PART OF THE BRONSON HEALTHCARE GROUP) CONDUCTED AN EXTENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2016. PLEASE REFER TO SCHEDULE H, PART V, SECTION B, COMMUNITY HEALTH NEEDS ASSESSMENT, ALONG WITH SCHEDULE H, PART V, SECTION C SUPPLEMENTAL INFORMATION, FOR A FULL DESCRIPTION OF THE CHNA. THE CHNA PROCESS INCLUDED A PRIORITIZATION OF HEALTH NEEDS BASED UPON CONSENSUS CRITERIA, INCLUDING: MAGNITUDE OF NEED, MEASURABLE OUTCOMES, BRONSON CAPABILITIES, EVIDENCE FOR EFFECTIVE INTERVENTIONS, COMMUNITY COMMITMENT, AND CONSISTENCY WITH BRONSON STRATEGY. AT THE CONCLUSION OF THIS PRIORITIZATION PROCESS, IMPROVING ACCESS TO CARE WAS SELECTED AS THE FOCUS FOR COMMUNITY HEALTH ACTIVITIES IN 2016-2019. |
| PART III, LINE 2: | UNCOLLECTIBLE AMOUNTS ARE WRITEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. BAD DEBT EXPENSE IS DISCLOSED BASED ON GROSS CHARGES. |
| PART III, LINE 3: | BAD DEBT WRITEOFFS SUPPORT THE COMMUNITY BY PROVIDING A PORTION OF SERVICES WITHOUT PAYMENT. THE AMOUNT OF BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS ESTIMATED BY REVIEWING THE BAD DEBT DETAIL FOR A SPECIFIC WRITE-OFF CODE. |
| PART III, LINE 4: | AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENTS ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA RELATED TO THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. THIS CAN BE FOUND IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER NOTE 2 SIGNIFICANT ACCOUNTING POLICIES FOR ACCOUNTS RECEIVABLE. |
| PART III, LINE 8: | WE UTILIZED THE ALLOWABLE COST AMOUNT FROM THE MEDICARE COST REPORT SCHEDULE D-1, PART II FOR INPATIENT AND SCHEDULE E, PART B FOR OUTPATIENT AND SCHEDULE M-SERIES. ALLOWABLE COST REPORT COST IS DETERMINED BASED ON THE PROVIDER REIMBURSEMENT MANUAL (PUBLICATION 15-1) AS ESTABLISHED BY CENTER FOR MEDICARE AND MEDICAID SERVICES. BRONSON LAKEVIEW HOSPITAL IS A CRITICAL ACCESS HOSPITAL THAT HAS AN INPATIENT PSYCHIATRIC FACILITY AS WELL AS THREE RURAL HEALTH CLINICS. THE INPATIENT PSYCHIATRIC FACILITY HAD A MEDICARE SHORTFALL OF $123,385, AND THE RURAL HEALTH CLINICS HAD A MEDICARE SHORTFALL OF $347,687. THE REMAINING SHORTFALL OF $18,721 IS DUE TO SEQUESTRATION REDUCING INPATIENT AND OUTPATIENT PAYMENTS. THE SHORTFALL IS COUNTED TOWARDS THE COMMUNITY BENEFIT.PART III, LINE 7: BRONSON LAKEVIEW HOSPITAL EXPERIENCE ADDITIONAL COMMUNITY BENEFIT EXPENSE OF $6,699,084 AND DIRECT OFFSETTING REVENUE OF $5,485,879 FOR A NET COMMUNITY BENEFIT OF $1,213,205 RELATED TO SERVICES PROVIDED TO MEDICARE ADVANTAGE INSUREDS. |
| PART III, LINE 9B: | THE POLICY REQUIRES THE COLLECTION AGENCY BE NOTIFIED AND ACTIVITY SUSPENDED WHEN A REQUEST FOR FINANCIAL ASSISTANCE IS MADE AND A PATIENT SUBMITS AN APPLICATION ON PREVIOUSLY LISTED ACCOUNTS. IF A PATIENT QUALIFIES FOR FULL FINANCIAL ASSISTANCE, THE ACCOUNT IS RETURNED TO BRONSON FROM THE AGENCY AND ANY INITIATED ECA IS REVERSED. IF THE PATIENT QUALIFIES FOR PARTIAL FINANCIAL ASSISTANCE, A DETERMINATION IS SENT TO THE AGENCY INDICATING THE NEW BALANCE AND ANY INITIATED ECA IS REVERSED. IF THE PATIENT DOES NOT PROVIDE COMPLETE APPLICATION INFORMATION OR IS DETERMINED TO BE INELIGIBLE, A DENIAL LETTER IS ISSUED AND THE AGENCY RESUMES COLLECTION ACTIVITY. |
| PART VI, LINE 2: | BRONSON LAKEVIEW HOSPITAL (BLH) WORKS WITH VAN BUREN COUNTY HEALTH DEPARTMENT, THE MICHIGAN OFFICE OF RURAL HEALTH, AND MANY LOCAL SOCIAL SERVICE AGENCIES IN RESPONDING TO THE HEALTHCARE NEEDS OF ITS RESIDENTS. THE AREAS IDENTIFIED ARE INCORPORATED INTO STRATEGIC PLANNING. AS A PART OF THE ANNUAL BUDGETING PROCESS, TRENDS IN SERVICE UTILIZATION ARE UTILIZED FOR RESOURCE PLANNING. |
| PART VI, LINE 3: | THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE EMERGENCY ROOM, THE ADMITTING DEPARTMENT, THE PATIENT FINANCIAL COUNSELING OFFICE, AND THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). THE PLAIN LANGUAGE SUMMARY IS ALSO INCLUDED IN THE PATIENT'S DISCHARGE DOCUMENTS, ON PATIENT STATEMENTS AND THE HOSPITAL'S WEBSITE. BOTH THE POLICY AND THE PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST. |
| PART VI, LINE 4: | BRONSON LAKEVIEW HOSPITAL (BLH) SERVES VAN BUREN COUNTY WHICH IS APPROXIMATELY 75,000 RESIDENTS. THE COUNTY IS AGRICULTURAL AND HAS HIGHER THAN STATE AVERAGE UNEMPLOYMENT. FIVE PROVIDER BASED HEALTH CLINICS ARE STRATEGICALLY PLACED THROUGHOUT EASTERN VAN BUREN COUNTY TO PROVIDE ACCESS TO CARE. THE CLINICS ACCEPT PATIENTS REGARDLESS OF ABILITY TO PAY AND HAVE CHARITY CARE PROCESSES IN PLACE. |
| PART VI, LINE 5: | BRONSON LAKEVIEW HOSPITAL (BLH) HAS AN OPEN MEDICAL STAFF AND HAS MANY SPECIALISTS FROM NEIGHBORING KALAMAZOO THAT HAVE HOSPITAL BASED CLINICS TO PROVIDE EASY ACCESS TO RESIDENTS. THE EMPLOYEES HOLD FOOD DRIVES FOR THE LOCAL FOOD PANTRIES AND ADOPT SEVERAL IN NEED FAMILIES EACH HOLIDAY SEASON. EMPLOYEES ARE ABLE TO PROVIDE MEDICAL SUPPORT TO MANY COMMUNITY ACTIVITIES AS PART OF THEIR SCHEDULED WORK TIME. BRONSON LAKEVIEW HOSPITAL IS THE ONLY HOSPITAL IN THE BRONSON SYSTEM THAT HAS CRITICAL ACCESS HOSPITAL (CAH) DESIGNATION. BLH PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A HOST OF EDUCATIONAL PROGRAMS AND ACTIVITIES, INCLUDING CPR CLASSES, BLOOD PRESSURE SCREENINGS, MAMMOGRAPHY SCREENINGS AND SUPPORT GROUPS FOR THOSE WHO ARE ALZHEIMERS CAREGIVERS. BLH AND ITS EMPLOYEES ACTIVELY PARTICIPATE IN AND PROVIDE SUPPORT TO MANY COMMUNITY ORGANIZATIONS. THESE INCLUDE PARTICIPATION IN THE 5TH DISTRICT MEDICAL RESPONSE COALITION, VANBUREN COUNTY MEDICAL COUNTRY AUTHORITY, VANBUREN EMERGENCY OPERATIONS AND LOCAL EMERGENCY PLANNING COMMITTEES, HEALTH FAIRS AND EXPOS, VAN BUREN COUNTY UNITED WAY, GREAT START COLLABORATIVE, OFFENDER SUCCESS TASK FORCE, HEALTH AND HUMAN SERVICES COUNCIL AND PAW PAW KIWANIS. THE HOSPITAL ALSO WORKS WITH LOCAL SCHOOL SYSTEMS TO PROVIDE CAREER DAY PROGRAMS AND VOCATIONAL TECH SCHOOL-TO-WORK INITIATIVESS AND DOES AN INSURANCE ENROLLMENT OUTREACH. |
| PART VI, LINE 6: | BRONSON LAKEVIEW HOSPITAL (BLH) IS PART OF AN AFFILIATED SYSTEM THAT INCLUDES THREE OTHER HOSPITALS, BRONSON METHODIST HOSPITAL, BRONSON SOUTH HAVEN HOSPITAL AND BRONSON BATTLE CREEK HOSPITAL. THE HOSPITALS ARE CONTROLLED BY BRONSON HEALTHCARE GROUP, WHICH IS COMMUNITY-OWNED AND GOVERNED NOT-FOR-PROFIT HOLDING COMPANY. THE BRONSON HEALTHCARE GROUP (BHG) BOARD IS COMPRISED OF 22 MEMBERS OF THE COMMUNITY. THE FOUR HOSPITALS IN THE BRONSON SYSTEM COLLABORATE TO PROMOTE THE HEALTH OF THE COLLECTIVE COMMUNITIES WE SERVE.IN ADDITION TO THE FOUR HOSPITALS, THE BHG SYSTEM INCLUDES SEVERAL SMALLER ENTITIES WHOSE EFFECTS SUPPORT THE HOSPITALS AND THEIR MISSION OF PROVIDING EXCELLENT HEALTHCARE TO THEIR COMMUNITIES. THESE ENTITIES INCLUDE: BRONSON HEALTHCARE GROUP, BRONSON COMMONS, BRONSON LIFESTYLE IMPROVEMENT & RESEARCH CENTER, BRONSON HEALTH FOUNDATION, BRONSON AT HOME, VBEMS, & BRONSON PROPERTIES CORPORATION. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRONSON HEALTHCARE GROUP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 JOHN STREET | AddressLine1Txt |
| City | KALAMAZOO | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49007 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 382418383 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $1,250,000 | CashGrantAmt |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THERE IS NO FORMAL PROCEDURE. GENERALLY GRANTS ARE UNRESTRICTED. THE GRANTS ARE MADE BY THE ORGANIZATION ON A DISCRETIONARY BASIS FOR PURPOSES CONSISTENT WITH THE ORGANIZATIONS'S MISSION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAWLOR JOHN | ||||||||||||||
| CHIEF OF STAFF | $0 | $407,024 | $0 | $10,800 | $0 | $18,847 | $0 | $13,400 | $0 | $16,755 | $0 | $466,826 | $0 | $0 |
| KARAMCHANDANI MAHESH C | ||||||||||||||
| DIRECTOR | $0 | $635,400 | $0 | $64,929 | $0 | $23,160 | $0 | $13,400 | $0 | $17,324 | $0 | $754,213 | $0 | $0 |
| LANE-DAVIES AARON | ||||||||||||||
| PAST CHIEF OF STAFF | $0 | $249,404 | $0 | $13,013 | $0 | $451 | $0 | $16,809 | $0 | $18,603 | $0 | $298,280 | $0 | $0 |
| SARDONE FRANK J | ||||||||||||||
| PRESIDENT AND CEO | $0 | $852,504 | $0 | $361,576 | $0 | $241,196 | $0 | $401,226 | $0 | $13,012 | $0 | $1,869,514 | $0 | $361,576 |
| EAST REBECCA L | ||||||||||||||
| SR VP CFO BHG | $0 | $400,643 | $0 | $132,538 | $0 | $94,126 | $0 | $150,689 | $0 | $17,226 | $0 | $795,222 | $0 | $132,538 |
| FALAHEE JAMES | ||||||||||||||
| SR VP LEGAL & LEG. AFFAIRS | $0 | $392,730 | $0 | $128,146 | $0 | $146,061 | $0 | $149,687 | $0 | $19,084 | $0 | $835,708 | $0 | $198,273 |
| HARRELSON KATHLEEN M | ||||||||||||||
| SR VP, CLINICAL OPERATIONS | $0 | $427,654 | $0 | $145,934 | $0 | $99,713 | $0 | $166,766 | $0 | $17,218 | $0 | $857,285 | $0 | $145,934 |
| HAYDEN JOHN | ||||||||||||||
| VP & CHIEF HR OFFICER | $0 | $327,567 | $0 | $101,056 | $0 | $108,611 | $0 | $132,362 | $0 | $11,054 | $0 | $680,650 | $0 | $145,677 |
| JONES JR JOHN L | ||||||||||||||
| SR. VP, REG. & PHYS. SVS. | $0 | $358,124 | $0 | $131,397 | $0 | $177,775 | $0 | $165,757 | $0 | $19,105 | $0 | $852,158 | $0 | $179,412 |
| LARSON SCOTT | ||||||||||||||
| SR VP MEDICAL AFFAIRS/CMO | $0 | $445,889 | $0 | $124,504 | $0 | $173,575 | $0 | $143,262 | $0 | $12,450 | $0 | $899,680 | $0 | $210,211 |
| GOEL ASHUTOSH | ||||||||||||||
| CHIEF MED INFORMATICS OFFI | $0 | $369,079 | $0 | $65,497 | $0 | $19,336 | $0 | $94,541 | $0 | $1,021 | $0 | $549,474 | $0 | $63,054 |
| RICHARDSON KIRK | ||||||||||||||
| VP COO BLH | $0 | $212,429 | $0 | $41,371 | $0 | $18,713 | $0 | $55,850 | $0 | $18,952 | $0 | $347,315 | $0 | $33,371 |
| SANGALLI-DAVIS CHRISTINE | ||||||||||||||
| VP CHIEF COMPLIANCE OFFICER | $0 | $175,548 | $0 | $30,609 | $0 | $1,010 | $0 | $50,782 | $0 | $6,749 | $0 | $264,698 | $0 | $30,609 |
| TRELLA REBECCA | ||||||||||||||
| VP POST ACUTE CARE | $0 | $257,619 | $0 | $41,507 | $0 | $1,084 | $0 | $57,232 | $0 | $12,221 | $0 | $369,663 | $0 | $41,507 |
| WAY MICHAEL S | ||||||||||||||
| VP MAT. MGT. & FACILITY SV | $0 | $213,467 | $0 | $56,888 | $0 | $20,384 | $0 | $64,515 | $0 | $16,806 | $0 | $372,060 | $0 | $56,888 |
| DOMMER MATTHEW | ||||||||||||||
| PHYSICIAN | $290,265 | $0 | $12,413 | $0 | $18,282 | $0 | $56,496 | $0 | $5,942 | $0 | $383,398 | $0 | $0 | $0 |
| DUPUIS PEARCE | ||||||||||||||
| PHYSICIAN | $240,545 | $0 | $16,677 | $0 | $158 | $0 | $12,414 | $0 | $16,982 | $0 | $286,776 | $0 | $0 | $0 |
| KHAIRALLAH NAJI | ||||||||||||||
| PHYSICIAN | $240,809 | $0 | $5,677 | $0 | $1,432 | $0 | $15,651 | $0 | $12,126 | $0 | $275,695 | $0 | $0 | $0 |
| LEKOVIC MIRSEN | ||||||||||||||
| PHYSICIAN | $352,873 | $0 | $23,364 | $0 | $293 | $0 | $10,551 | $0 | $15,966 | $0 | $403,047 | $0 | $0 | $0 |
| MIRZA NADEEM M | ||||||||||||||
| PSYCHIATRIST | $339,716 | $0 | $13,159 | $0 | $11,200 | $0 | $13,401 | $0 | $19,435 | $0 | $396,911 | $0 | $2,632 | $0 |
| TAFT KENNETH L | ||||||||||||||
| FORMER EXECUTIVE VICE PRESIDENT | $0 | $2,500 | $0 | $116,681 | $0 | $71,130 | $0 | $0 | $0 | $0 | $0 | $190,311 | $0 | $116,681 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | THE BOARD OF DIRECTORS IS NOT DIRECTLY COMPENSATED. SPOUSAL TRAVEL AND HEALTH CLUB DUES ARE AVAILABLE FOR THE BOARD OF DIRECTORS. THOSE WHO PARTICIPATE RECEIVE A 1099 AND THE DUES ARE TREATED AS A TAXABLE FRINGE BENEFIT. |
| PART I, LINE 3 | EXPLANATION: BRONSON HEALTHCARE GROUP, A RELATED ORGANIZATION, USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY AND/OR STUDY AND APPROVAL BY BOARD AND/OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. |
| PART I, LINE 4B | HARRELSON, KATHLEEN $79,023 SERP CONTRIBUTION FALAHEE JR.,JAMES B $70,127 SERP DISTRIBUTION FALAHEE JR.,JAMES B $70,609 SERP CONTRIBUTION TAFT, KENNETH L $71,130 SERP DISTRIBUTION SARDONE,FRANK J $201,160 SERP CONTRIBUTION JONES JR, JOHN $48,015 SERP DISTRIBUTION JONES JR, JOHN $73,095 SERP CONTRIBUTION LARSON,SCOTT D $85,707 SERP DISTRIBUTION LARSON,SCOTT D $78,088 SERP CONTRIBUTION EAST, REBECCA $75,672 SERP CONTRIBUTION HAYDEN,JOHN T $44,621 SERP DISTRIBUTION HAYDEN,JOHN T $61,014 SERP CONTRIBUTION |
| PART II, COLUMN (B) (III) AND (F) | EXPLANATION: INCLUDED IN PART II, COLUMN (B) (III) AND (F) ARE AMOUNTS THAT WERE PAID TO THE EXECUTIVE UNDER THE BRONSON HEALTHCARE GROUP, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THESE AMOUNTS WERE CREDITED TO AN ACCOUNT FOR THE EXECUTIVE IN PRIOR YEARS AND WERE PREVIOUSLY REPORTED IN COLUMN C IN THE PRIOR YEAR, BUT THE EXECUTIVE WAS REQUIRED TO REMAIN EMPLOYED UNTIL THE YEAR FOR WHICH THIS FORM IS BEING FILED IN ORDER TO BECOME VESTED IN HIS OR HER ACCOUNT. AMOUNTS HAVE BEEN CREDITED TO THESE EXECUTIVES' ACCOUNTS EACH YEAR SINCE THE SERP WAS ADOPTED IN 1994, AND THE ACCOUNTS HAVE ALSO BEEN ADJUSTED FOR GAINS AND LOSSES SINCE THAT TIME. THEREFORE, THESE AMOUNTS SHOULD BE VIEWED AS HAVING BEEN EARNED OVER THE EXECUTIVE'S ENTIRE PERIOD OF EMPLOYMENT AS AN EXECUTIVE OF BRONSON. THE AMOUNT CREDITED TO EACH EXECUTIVE'S ACCOUNT IN THE SERP EACH YEAR AND EACH EXECUTIVES TOTAL COMPENSATION PACKAGE WAS APPROVED BY AN INDEPENDENT CONSULTANT TO ENSURE THAT THESE AMOUNTS ARE COMPARABLE TO OR LESS THAN THE AMOUNTS AWARDED TO EXECUTIVES OF COMPARABLE HEALTH CARE ORGANIZATIONS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| KIMBERLY JAMES | |||
| DAUGHTER OF BOARD MEMBER, BARBARA JAMES | $90,097 | TOTAL COMPENSATION FOR BEING AN EMPLOYEE OF BRONSON METHODIST HOSPITAL | 0 |
| MARLA ATKINSON | |||
| SPOUSE OF BOARD MEMBER MARK ATKINSON | $149,057 | TOTAL COMPENSATION FOR BEING AN EMPLOYEE OF BRONSON METHODIST HOSPITAL | 0 |
| JAIDEEP KARAMCHANDANI | |||
| SON OF BOARD MEMBER MAHESH KARAMCHANDANI | $68,929 | TOTAL COMPENSATION FOR BEING AN EMPLOYEE OF BRONSON METHODIST HOSPITAL | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | KENNETH TAFT, FRANK SARDONE, STEVEN J. LINS, M.D. AND SCOTT C. GIBSON, M.D. HAVE A BUSINESS RELATIONSHIP. ALL BOARD MEMBERS HAVE A BUSINESS RELATIONSHIP WITH ALL BRONSON SUBSIDIARIES DUE TO BEING ON BRONSON HEALTHCARE GROUP BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | BRONSON HEALTHCARE GROUP IS THE SOLE MEMBER OF BRONSON LAKEVIEW HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | BRONSON HEALTHCARE GROUP (BHG) IS THE SOLE MEMBER OF BRONSON METHODIST HOSPITAL (BMH) AND AS SUCH MEMBER IT ELECTS 10-15 OF THE TOTAL 20-24 MEMBERS OF THE BMH BOARD. COMMUNITY PARTNERS SHALL, AFTER CONSULTING WITH AND SEEKING INPUT FROM THE NOMINATING COMMITTEE OF BHG, APPOINT 6 MEMBERS TO THE BOARD. THE REMAINING 3 MEMBERS OF THE BOARD SHOULD BE EX OFFICIO, WITH VOTE, AND SHALL CONSIST OF THE PRESIDENT, THE CHIEF OF STAFF, AND IMMEDIATE PAST CHIEF OF THE MEDICAL STAFF OF THE HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7B | BRONSON HEALTHCARE GROUP (BHG) IS THE SOLE MEMBER OF BRONSON LAKEVIEW HOSPITAL (BLH) AND HAS CERTAIN RESERVED POWERS OVER THE ACTIONS OF BLH. THE BOARD OF DIRECTORS HAS THE POWER TO: - AMENDMENT, RESTATEMENT, OR REPEAL OF THE HOSPITALS ARTICLES OF INCORPORATION OR BYLAWS. - ADOPTION, EXECUTION, REVOCATION, OR ABANDONMENT OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION, REORGANIZATION, OR OTHER MAJOR CHANGE IN CORPORATE STRUCTURE INVOLVING THE HOSPITAL. - SALE, LEASE EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE HOSPITALS PROPERTY AND ASSETS. - ACQUISITION OF ANY OTHER ENTITY OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE. - ADOPTION OF ALL OPERATING AND CAPITAL EXPENDITURE BUDGETS. - INCUR OPERATING OR CAPITAL EXPENDITURES WHICH CAUSE AGGREGATE OPERATING OR CAPITAL EXPENDITURES TO EXCEED BUDGETED AGGREGATES AND/OR THE DOLLAR AMOUNT SPECIFIED BY BHG. - SECURE BORROWINGS, WITH THE EXCEPTION OF EQUIPMENT LEASES AND PURCHASE MONEY SECURITY INTERESTS APPROVED AS A PART OF A BUDGET. - CHANGE THE MISSION STATEMENT, PURPOSES, OR STRATEGIC GOALS OF THE HOSPITAL. - ANY SIGNIFICANT CHANGE IN THE SCOPE OF SERVICES OR PROGRAMS. - APPOINTMENT, REMOVAL OR COMPENSATION OF THE PRESIDENT OR ANY DIRECTOR OR OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE SR VP/CFO & CONTROLLER REVIEWS THE 990S. THE SR VP/CFO MET WITH THE FINANCE COMMITTEE CHAIRPERSON ON OCTOBER 9, 2018 TO REVIEW THE PREPARED FORM 990 AND SCHEDULES. THE FINANCE COMMITTEE OF THE BOARD REVIEWED THE PREPARED FORM 990S AT ITS REGULARLY SCHEDULED MEETING ON OCTOBER 22ND, 2018. THE REVIEW WAS LED BY THE SR VP/CFO AND PLANTE MORAN. THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY WERE PROVIDED THE PREPARED FORM 990 FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE CONFLICT OF INTEREST POLICY AND ITS ACCOMPANYING QUESTIONNAIRE ARE REVIEWED, AND REVISED, IF NECESSARY, ON AN ANNUAL BASIS BY THE ORGANIZATION'S GENERAL COUNSEL/CORPORATE COMPLIANCE OFFICER AND THE BOARD'S EXECUTIVE COMMITTEE. ALL BOARD MEMBERS AND ALL EMPLOYEES HOLDING THE TITLE OF VICE PRESIDENT AND ABOVE ARE COVERED BY THE CONFLICT OF INTEREST POLICY AND ANNUALLY COMPLETE THE CONFLICT OF INTEREST QUESTIONNAIRE. ALL COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE ORGANIZATION'S GENERAL COUNSEL/CORPORATE COMPLIANCE OFFICER AND THE EXECUTIVE COMMITTEE. DETERMINATIONS AS TO WHETHER A CONFLICT EXISTS ARE MADE BY THE GENERAL COUNSEL/CORPORATE COMPLIANCE OFFICER AND THE EXECUTIVE COMMITTEE. ACTUAL CONFLICTS ARE REVIEWED BY THE GENERAL COUNSEL/CORPORATE COMPLIANCE OFFICER AND THE EXECUTIVE COMMITTEE. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS ON THE TRANSACTION IN QUESTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR THE CEO, OFFICERS AND OTHER KEY EMPLOYEES, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH FUNCTIONS AS THE COMPENSATION COMMITTEE FOR BRONSON HEALTHCARE GROUP, RETAINS THE SERVICES OF AN EXTERNAL EXECUTIVE COMPENSATION CONSULTANT (SULLIVAN, COTTER AND ASSOCIATES) WHO CONDUCTS A THOROUGH COMPENSATION AND BENEFIT SURVEY PROCESS THAT IS USED TO DETERMINE THE APPROPRIATE ADJUSTMENT IN CASH COMPENSATION AND BENEFITS PROVIDED. THIS PROCESS IS DONE ANNUALLY AND WAS UNDER TAKEN IN 2017. THE CONSULTANT USES THREE TO FIVE NATIONAL HEALTHCARE-BASED SURVEYS FOR COMPARABILITY DATA, EACH ONE OF LIKE REVENUE SIZED HEALTHCARE SYSTEMS TO THE BRONSON HEALTHCARE GROUP. THE CONSULTANT PREPARES A DETAILED REPORT WITH RECOMMENDATIONS FOR PAY AND/OR BENEFIT ADJUSTMENTS, AND PRESENTS THE INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS (WHEN THE CEOS SURVEY DATA AND RECOMMENDATIONS ARE PRESENTED, THE CEO AND STAFF ARE EXCUSED FROM THE DELIBERATIONS). AFTER ALL QUESTIONS OF THE BOARD MEMBERS ARE ANSWERED, FORMAL MOTIONS ARE PROPOSED, SECONDED AND VOTED ON (FOR ANY PAY ADJUSTMENTS AND FOR RECEIPT OF THE CONSULTANT'S REPORT). AT THE SUBSEQUENT MEETING OF THE FULL BOARD OF DIRECTORS, THE CHAIR DISCLOSES THE RESULTS AND APPROVED MOTIONS OF THE EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC BY POSTING THEM ON THE ORGANIZATION'S WEBSITE AND PROVIDING COPIES ON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS, OTHER THAN THE FORM 990, ARE NOT AVAILABLE TO THE PUBLIC. |
| PART VII SECTION A, LINE 1A | THE BOARD OF DIRECTORS IS NOT DIRECTLY COMPENSATED. SPOUSAL TRAVEL AND HEALTH CLUB DUES ARE AVAILABLE FOR THE BOARD OF DIRECTORS. THOSE WHO PARTICIPATE RECEIVE A 1099 AND THE DUES ARE TREATED AS A TAXABLE FRINGE BENEFIT. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BRONSON HEALTHCARE GROUP | |||||||||||
| 601 JOHN STREET | KALAMAZOO | MI | 49007 | 382418383 | PROVIDE SUPPORT SERVICES | MI | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| BRONSON METHODIST HOSPITAL | |||||||||||
| 601 JOHN STREET | KALAMAZOO | MI | 49007 | 381359087 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | BRONSON HEALTHCARE GROUP | |
| BRONSON HEALTH FOUNDATION | |||||||||||
| 601 JOHN STREET | KALAMAZOO | MI | 49007 | 382415081 | SUPPORTS HEALTHCARE ORGANIZATION | MI | 501(C)(3) | LINE 11 | 0 | BRONSON HEALTHCARE GROUP | |
| BRONSON COMMONS | |||||||||||
| 23332 RED ARROW HWY | MATTAWAN | MI | 49071 | 382842451 | SKILLED NURSING | MI | 501(C)(3) | LINE 10 | 0 | BRONSON HEALTHCARE GROUP | |
| VBEMS | |||||||||||
| 39338 W RED ARROW HWY | PAW PAW | MI | 49079 | 382745910 | AMBULANCE SERVICES | MI | 501(C)(3) | LINE 10 | 0 | BRONSON HEALTHCARE GROUP | |
| BRONSON PROPERTIES CORPORATION | |||||||||||
| 601 JOHN STREET | KALAMAZOO | MI | 49007 | 386052573 | PROVIDE SUPPORT SERVICES | MI | 501(C)(3) | LINE 12B, II | 0 | BRONSON HEALTHCARE GROUP | |
| BRONSON BATTLE CREEK HOSPITAL | |||||||||||
| 300 NORTH AVE | BATTLE CREEK | MI | 49016 | 382776791 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | BRONSON HEALTHCARE GROUP | |
| BRONSON AT HOME | |||||||||||
| 165 N WASHINGTON AVE | BATTLE CREEK | MI | 49037 | 383298476 | NURSING, HOSPICE, & EQUIP SALES | MI | 501(C)(3) | LINE 10 | 0 | BRONSON HEALTHCARE GROUP | |
| BRONSON SOUTH HAVEN HOSPITAL | |||||||||||
| 955 S BAILEY AVE | SOUTH HAVEN | MI | 49090 | 381676780 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | BRONSON HEALTHCARE GROUP | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| HOSPITAL NETWORK INC LEASING | |||||||
| 6212 AMERICAN AVE | PORTAGE | MI | 49002 | 383638430 | SUPPORT SERVICES | MI | N/A |
| HOSPITAL NETWORK VENTURES LLC | |||||||
| 6212 AMERICAN AVE | PORTAGE | MI | 49002 | 383302979 | SUPPORT SERVICES | MI | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| BRONSON MANAGEMENT SERVICES CORPORATION | |||||||||
| 601 JOHN STREET | KALAMAZOO | MI | 49007 | 382415032 | OTHER MEDICAL SERVICES | MI | N/A | C | 0 |
| BRONSON LIFESTYLE AND IMPROVEMENT RESEARCH CENTER | |||||||||
| 601 JOHN STREET | KALAMAZOO | MI | 49007 | 383552556 | REHABILITATION SERVICES | MI | N/A | C | 0 |
| WESTLEY DEVELOPMENT COMPANY | |||||||||
| 301 JOHN STREET | KALAMAZOO | MI | 49007 | 383619232 | REAL ESTATE OWNERSHIP | MI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (10 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| BRONSON BATTLE CREEK HOSPITAL | ||
| O | $71,455 | METHOD BASED ON ACTUAL COST |
| BRONSON HEALTHCARE GROUP | ||
| L | $1,632,854 | METHOD BASED ON ACTUAL COST |
| BRONSON HEALTHCARE GROUP | ||
| M | $2,984,931 | METHOD BASED ON ACTUAL COST |
| BRONSON HEALTHCARE GROUP | ||
| O | $9,070,469 | METHOD BASED ON ACTUAL COST |
| BRONSON HEALTHCARE GROUP | ||
| B | $1,250,000 | CASH TRANSFER |
| BRONSON METHODIST HOSPITAL | ||
| L | $5,663,917 | METHOD BASED ON ACTUAL COST |
| BRONSON METHODIST HOSPITAL | ||
| O | $890,072 | METHOD BASED ON ACTUAL COST |
| BRONSON METHODIST HOSPITAL | ||
| M | $732,532 | METHOD BASED ON ACTUAL COST |
| BRONSON PROPERTIES CORP | ||
| M | $2,364,541 | METHOD BASED ON ACTUAL COST |
| BRONSON PROPERTIES CORP | ||
| L | $63,146 | METHOD BASED ON ACTUAL COST |